Ocular Disease II > Uveitis: DDx & Diagnostic Testing > Flashcards

Uveitis: DDx & Diagnostic Testing Flashcards

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1
Q
  1. What would be considered an Acute disease? (onset)

2. Chronic onset?

A
  1. Sudden onset. Lasts up to 6 weeks

2. Insidious Onset. Usually Lasts MORE than 6 weeks

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2
Q

Causes of Acute Uveitis

  1. Most Cases of ANTERIOR UVEITIS? (4) (FAIR)
A
  1. a. Fuchs Heterchromic Iridocyclitis (FHI)
    b. Ankylosing Spondylitis (AS)
    c. Idiopathic
    d. Reiter Syndrome
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3
Q

Causes of Acute Uveitis

  1. What other causes are there? (5) (TAP VW)
A
  1. Trauma
  2. Acute Retinal Necrosis (ARN)
  3. Postsurgical Bacterial Infection
  4. Vogt-Koyanagi-Harada Syndrome (VKH)
  5. White-dot Syndromes: Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) & Multiple Evanescent White-dot Syndrome (MEWDS)
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4
Q

Granulomatous Uveitis

  1. What are ten causes of Granulomatous Uveitis? (SLITSS)
A
  1. a. Sarcoidosis
    b. Lens-induced Uveitis
    c. Intraocular Foreign Body
    d. Tuberculosis
    e. Sympathetic Ophthalmia
    f. Syphilis
    g. MS, Lyme Disease, Granulomatosis w/Polyangiitis (Wegener Granulomatosis), and VKH Syndrome
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5
Q

Causes of Unilateral Uveitis? (6) (ABS PIP)

A
  1. Acute Retinal Necrosis (ARN)
  2. Behcet Disease
  3. Sarcoidosis (may be bilateral)
  4. Parasitic Disease (Toxoplasmosis is typically Bilateral)
  5. Intraocular Foreign Body (IOFB)
  6. Postsurgical Uveitis
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6
Q

Causes of Anterior Uveitis (13)

A
  1. Ankylosing Spondylitits
  2. Behcet Disease
  3. FHI
  4. Glaucomatocyclitic Crisis
  5. HLA-B27 Associated Disease
  6. Idiopathic
  7. Inflammatory Bowel Disease
  8. JIA
  9. Masquerade Syndromes
  10. Psoriatic Arthritis
  11. Reiter Syndrome
  12. Sarcoidosis
  13. Syphilis
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7
Q

Causes of Intermediate Uveitis

  1. What is the WORSE PROGNOSIS?
  2. What other 4 did she have listed?
A
  1. PARS PLANITIS: Idiopathic; Worse Prognosis
  2. a. IBD
    b. Lyme Disease
    c. MS
    d. Sarcoidosis
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8
Q

Causes of Panuveitis

  1. What 5? (BIVSS)
A
  1. Behcet Disease
  2. Infectious Endophthalmitis
  3. VKH Syndrome
  4. Sarcoidosis
  5. Syphilis
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9
Q

Demographic Considerations

  1. Female? (2)
  2. Male? (2)
  3. American Black? (1)
  4. Native American? (1)
  5. Midwestern American (1)?
  6. Japanese (3)?
  7. Mediterranean Ancestry? (1)
  8. Central American? (2)
  9. South American? (2)
  10. West African? (1)
  11. IV Drug Use? (2)
A
  1. Chronic Anterior Uveitis, JIA
  2. AS, Sympathetic Ophthalmia
  3. Sarcoidosis
  4. VKH Syndrome
  5. Presumed Ocular Histoplasmosis (POHS)
  6. Behcet Disease, HTLV-1, VKH Syndrome
  7. Behcet Disease
  8. Cysticercosis, Onchocerciasis
  9. Cysticercosis, Toxoplasmosis
  10. Onchocerciasis
  11. AIDS, Fungal Endophthalmitis
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10
Q
  1. What is Sensitivity?

2. What is Specificity?

A
  1. Ability of test to correctly identify affected individuals. (Persons test positive = TRUE POSITIVE) (Test negative = FALSE NEGATIVES)
  2. Persons testing positive = False positive; (ability of test to correctly identify non-affected individuals)
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11
Q

ACE (Angiotensin-Converting Enzyme)

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood Test
  2. 73% Sensitive; 83% Specific when alone. (increases almost to 100% w/whole Body Gallium Scanning)
  3. Blood sample ran thru Chemical process to ISOLATE ACE, then MEASURED by PHOTOMETRY
  4. Sarcoidosis: (Uveitis suspected to have sarcoidosis (elevated levels of ACE)

(Intermediate Uveitis)

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12
Q

ANA (Antinuclear Antibody)

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood Test (Titer: 1:160)
  2. In Lupus: Sensitivity more than 95%; Specificity: 90%
  3. Blood Test –> ELISA or Indirect Immunofluorescence
  4. Lupus, RA, Sjogrens, Scleroderma, JIA
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13
Q

cANCA (Anti-Neutrophil Cytoplasmic Antibody)

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood test then Autofluorescence
  2. More than 90% sensitivity. Variable Specificity depending on disease stage
  3. Blood test w/Titers for Antibodies PR3. then Staining for Pattern. cANCA (for Wegeners) will have staining throughout the Cytoplasm
  4. Wegener’s Granulomatosis (Granulomatosis w/Polyangitis)
    * SCLERITIS

Test ordered for Necrotizing Scleritis, Peripheral Ulcerative Keratitis, Retinal Vasculitis.

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14
Q

Antiphospholipid Ab (Lupus Anticoagulant; Anticardiolipin Ab)

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood Test: AI, Hypercoagulable State caused by ANTIPHOSPHOLIPID ANTIBODIES. (Blood clots (thrombosis) occurs in Arteries, Veins, CNS disease, and spontaneous abortions in patient)
  2. 67% Sensitivity; 91% Specificity
  3. In lab. Use Liquid Phase Coagulation Assays (Lupus Anticoagulant) and Solid Phase ELISA assays (Anti-cardiolipin Antibodies)
  4. SLE and Antiphospholipid Antibody Syndrome presented w/sudden onset of Pain, redness, photophobia, decreased vision.
    * Exam: Will see HYPOPYON UVEITIS and Vaso-occlusive Retinopathy.
    * Bilateral Iritis, Vitreitis, Retinal Vasculitis involving both veins and Arteries can lead to CRV occlusion
    * Know: SLE, Antiphospholipid Antibody Syndrome
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15
Q

Antitoxoplasma Ab

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood (usually ELISA)
  2. 88% Sensitivity; 96% Specificity
  3. ELISA test: Measures IgG and IgM Antibodies
  4. Toxoplasmosis which is a CAUSE of POSTERIOR UVEITIS!
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16
Q

B-Scan Ultrasonography

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Imaging
  2. None
  3. Anesthetize the eye. Gel put on the EYELID and a PROBE is placed on the EYELID to take SCANS. Patient may have to look in different directions depending on view needed. 15 minute test.
  4. Get Views of POSTERIOR EYE that can be DIRECTLY Blocked due to Uveitis.

Detects RETINAL DETACHMENTS, INFLAMMATION, VITREAL DEGENERATIONS, ETC.

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17
Q

Bx (Biopsy)

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Remove portion of Lesion and Test it. (Aq. Humor, Choroid, Conj, Lacrimal Gland, Retina, Skin, Vitreous Humor)
  2. ??
  3. Biopsy Lung: DEFINITIVE Dx: We See Noncaseating Granulomatous, Non-infectious Inflammatory Process on Biopsy
  4. Sarcoidosis; Can test Anterior Chamber for Herpesvirus.
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18
Q

CMV

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood
  2. N/A
  3. Blood test. Looks at IgG and IgM Levels. + IgG = PREVIOUS EXPOSURE. + IgM = Active Infection
  4. POSTERIOR UVEITIS (PIZZA and SAUCE): Test for CMV
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19
Q

Calcium

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Urine or Blood
  2. Sensitivity: 70-80%
    Specificity: 55-65%
  3. 24 hr Urine Collection. Urinary Analysis to test levels (or blood drawn for Serum Level Testing)
  4. SARCOIDOSIS (sarcoid granules secrete Vit D and this leads to Increased Absorption of Calcium in the GI Tract; Causes Increased Calcium in Urine (and Blood)
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20
Q

CBC w/Diff (Complete Blood Cell count w/platelet Differential)

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood Test
  2. ??
  3. Draw blood. Prepare sample to look at under a microscope. Count the different blood cells and Amt of each.
  4. Retinal Vasculitis w/Systemic Disease

Know: Anemia, Cancers (Leukemia, Lymphoma)

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21
Q

CD4+ T-cells

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood
  2. ??
  3. *Small retinal blot hemorrhages on retina usually associated w/decreasing CD4+ counts
  4. Low CD4+ Count predisposes pt to opportunistic infections (CMV)…basically, this should be done on Pts w/HIV (AIDs will have a major Diminished inflammatory response, especially when CD4+ counts are SEVERELY DIMINISHED)

High CD4+ Count in TUBERCULOID LESIONS

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22
Q

CMP (Complete Metabolic Panel)

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood Test
  3. Measures Health of Liver and Kidney
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23
Q

Coccidiodomycosis (IgG, IgM)

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood test
  2. ?
  3. Blood test for IgM and IgG Antibodies. IgG = CHRONIC INFECTION; IgM = ACTIVE/ACUTE Infection
  4. Fungal Infection Test (Starts in lungs and can spread to eyes)
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24
Q

CRP (C-reactive Protein)

  1. Type of Test
  2. Sensitivity/Specificity
  3. How is the Test Performed?
  4. Relationship to Uveitis?
A
  1. Blood Test
  3. Test to tell us if there is INFLAMMATION in the BODY! (Acute phase reactants)
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25
Brain CT 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Imaging 2. None 3. A Brain CT is a specialized type of X­ray. Instead of a beam shooting straight through you and hitting X­ray film, you are placed in a donut shaped machine that sends X­rays through the organ it is imaging in a 360 degree fashion. This information is transmitted to a computer, where it is processed and spits out 2­D transverse images that are about 1 micrometer in thickness. The test can be done w/dye or contrast, or it can be done without any dye or contrast. It just depends. 4. This test is excellent when a patient has Posterior Uveitis, and you suspect that the CNS is involved. The reason for this is that the CNS and the Posterior Section of the eye come from the same Embryology. I also saw that this test is done when you suspect Posterior Scleritis, Ocular Lymphoma, or Ocular Trauma and suspect a foreign body may still be in the orbit.
26
CXR (Chest X-ray) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Imaging 3. hmm... 4. TB, Sarcoidosis (Hylar Lymph Adenopathy: Indicative of Sarcoidosis)
27
DXA (Dual-Energy X-ray Absorptiometry) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Imaging (2 x-rays beams w/different energy levels) 3. Measures Bone Density 4. Inflammatory Bowel Disease, Osteoporosis, RA, Kidney and Liver function * Take when on LONG TERM ORAL CORTICOSTEROID Tx.
28
Diagnostic Vitrectomy (Vx) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Surgical. Obtain sample for Lab Tests/Culture 2. None 3. Remove Vitreous Humor so it can be analyzed thru lab tests to rule out malignancy or infection 4. Atypical Uveitis, or Uveitis that doesn't respond to treatment. Used to RULE OUT MALIGNANCY OR INFECTION!
29
ERG (Electroretinogram) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Electrical. Used to detect different Retinal Diseases 2. NONE 3. Electrodes placed on Cornea or Skin near the Eyes. Pt is Exposed to Stimuli and Signals are Recorded. Takes about an HOUR. 4. Used when: SEVERE POSTERIOR UVEITIS, Cataract is present, WHITE-DOT SYNDROME Associated w/Vitreitis. * NOT GOOD FOR ANTERIOR UVEITIS!
30
ESR (Erythrocyte Sedimentation Rate) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood Test 3. Centrifuge test 4. Arthritis/inflammation diseases. increased sedimentation rate = active inflammation
31
FA (Fluorescein Angiography) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Imaging Test 2. None 3. Fundus Photography. Evaluates BF w/in Retina and Choroid. Inject Fluorescein into forearm, dye travels to the eye. If inflammation or bleeding is PRESENT, dye will LEAK OUT of RETINAL BVs. 4. Visualize POSTERIOR UVEITIS, Vasculitis, Cystoid Macular Edema, Choroidal Neovascular Membrane. * Good for Presumed Ocular Histoplasmosis Syndrome (POHS), Bechet's, Birdshot Chorioretinopathy, and White Dot Syndromes * Dr. Tina: OCT more commonly used. But this test is still good for Several Posterior Uveitis Processes (Listed above)
32
FTA-ABs (Fluorescent Treponemal Antibody Absorption) Note: Pts w/Syphilis should also be tested for HIV and vice versa 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood test. 3. Tests antibodies for Treponema Pallidium (Syphilus) 4. Tests for Treponema Pallidium. Syphilus
33
Fundus Autofluorescence 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Imaging 2. None 3. Confocal Scan (Laser Technology). Several Images are captured by cSLO then aligned to reduce noise and INCREASE EXPOSURE. Fundus Camera high energy white flash and a wideband exciter filter to excite any existing lipofuscin. Creates a SINGLE IMAGE CAPTURED IN TIME Both Result in MONOCHROMATIC IMAGE. REVEALS Presence or Absence of LIPOFUSCIN 4. Posterior Uveitis, Panuveitis. * Test evaluated health of RPE. * Lipofuscin = Autofluorescent pigment that accumulates in RPE as a BYPRODUCT of PHAGOCYTOSIS of Photoreceptor Outer Segments.
34
Gallium Scan 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Nuclear Imaging 2. None. When used in Combo w/Elevated ACE, Specificity increases. 3. Gallium injected into Blood. Collects in BONE, some organs, and AREAS of INFLAMMATION or ACCUMULATION of WBCs. Camera then scans and detects where Gallium has gathered (about an hour) 4. Swelling, inflammation, infection, or cancer. Helps CONFIRM Dx of SARCOIDOSIS. *NOTE: ACE and Serum Lysozyme are done first. if STRONG suspicion for Sarcoidosis, then you do this.
35
Histoplasmin Skin Test (test may cause an old, inactive histoplasmosis lesion and should be avoided in pts w/macular lesions) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Skin test 3. 4. Histoplasmosis (that causes Posterior Uveitis): POHS. Test can REACTIVATE old lesions. (CNMV)
36
HIV ELISA Pts w/HIV should be tested for syphilis and vice versa 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. ELISA (Blood Test...or Culture test depending on where you are getting the virus from) (Confirmed by Western Blot) 3. Usually positive after 2-8 weeks from initial infection. 4. HIV/AIDs infection. Test for syphilus at the same time
37
HLA-B5 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood Test 2. None 3. Blood to lab. Ab added and look for formation of Antigen-Ab complexes 4. Associated with BEHCET's DISEASE. (Can cause ANTERIOR and POSTERIOR UVEITIS)
38
HLA-B27 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood test 3. Antibody test...maybe ELISA?? 4. Ankylosing Spondylitis, Reactive Arthritis, others. and this is the other big one! IBD (Ulcerative Cholitis and Crohns)
39
HLA-B29 (or A29) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood Test 3. Ab binding...maybe ELISA 4. BIRDSHOT CHORIORETINITIS
40
HSV Abs IgG 1&2 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood Test 2. High for Both 3. 4. HSV
41
HTLV-1 (Human T-lymphotropic Virus-1) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood Test 2. Sensitivity: 95-99% Specificity: 97-99% 3. 4. Testing for HTLV-1 virus
42
ICG (Indocyanine Green Angiography) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Diagnostic test 3. Cyanine Green is injected and you can see it flow thru arteries and BVs 4. Serpiginous Choroiditis, Birdshot Chorioiditis
43
LFT (liver function test) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood Test 2. None 3. Take Blood sample 4. Medications taken for Uveitis (Methotrexate specifically) cause liver toxicity. Helps ensure liver is at baseline normal levels.
44
LP (Lumbar Puncture) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. CSF test 2. CSF-VDRL: High specificity, low sensitivity 3. CSF: FTA-ABS: High specificity; High Sensitivity 4. Dx for SYPHILiS (seen with PANUVEITIS), ocular signs w/syphilis, latent syphilis, tertiary syphilis
45
Lyme Titer 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood test 3. Test for Borellia Burgdorferi 4. Lyme Disease
46
Lysozyme 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood 2. Sensitivity: 80% Specificity: 70% 3. Centrifuge blood sample and measure lysozyme levels. 4. Helps rule out SARCOIDOSIS as possible cause of UVEITIS
47
MHA-TP (MicroHemagglutination-Treponema Pallidum): Syphilis 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood test for SYPHILIS 2. High for BOTH, over 90% 3. Confirmation test. Blood is drawn and mixed w/Antigen Treponema Pallidum. If Agglutination occurs, antibodies to the Antigen were present in pt's blood, indicating previous or ongoing infection. * FTA-ABS and MHA-TP will both be + if a Pt has ever had SYPHILIS. INFECTION that NEED Tx in TITER of 1:8 or GREATER. Once treated, Titer should be NEGATIVE or at MINIMUM of 1:4 or Less. FTA-ABs is preferred test. 4. UVEITIS most common ocular presentation of SYPHiLIS.
48
Brain MRI 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Imaging 2. None 3. Imaging takes 20-40 minutes 4. MS, Behcet's Disease, Sarcoidosis, VKH
49
OCT 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Imaging 2. None 3. Uses Laser to scan the Eye and Create an image. Takes about 10-15 minutes. 4. Monitor Malformations Associated w/CYSTOID MACULAR EDEMA EPIRETINAL MEMBRANE FORMATION, DIFFUSE MACULAR EDEMA, RETINITIS, SEROUS RETINAL DETACHMENTS or OPTIC NEURITIS
50
PCR 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood or Saliva Test 2. 88.9% Sensitivity; 100% Specificity 3. Detects pathogenic GENETIC material in infectious Uveitis from Bacteria, Fungi, and Viruses. Also used in Non-Infectious Uveitis for HLA Typing and to determine Immune Processes causing Ocular Inflammation 4. Infectious Uveitis (Bacteria, Fungi, Viruses); Non-Infectious Uveitis for HLA-Typing. And to Determine Immune Process causing Ocular Inflammation (AI)
51
PPD (Purified Protein Derivative) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Skin Test 2. 80% to 50% Sensitivity as size of the Wheal increases from 5-15 mm. 60% to 87% Specificity as size of wheal increases from 5 to 15mm 3. Inject under top layer of skin on inner forearm. Fluid makes a little bump (Wheal). Have read in 48-72 hrs. No bump or smaller than 5mm is normal or a negative result. 4. M. Tuberculosis that causes Uveitis. Hits lungs and Choroid tissue since it has the HIGHEST BLOOD FLOW RATE in the body.
52
Quantiferon-Gold 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Diagnostic Test (Blood Test) 3. ELISA 4. Test for Latent Tuberculosis Infection (Mycobacterium Tuberculosis), NOT for ACTIVE TB Infection diagnosing.
53
RF (Rheumatoid Factor) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood Test 2. 3. 4. Usually Associated with Anterior Uveitis. Uveitis that can be caused by AI disorders like RF or Ankylosing Spondylitis * Adults: Rheumatoid Arthritis; Children: Juvenile Idiopathic Arthritis (most likely it'll be negative, but 30% are positive)
54
RPR (Rapid Plasma Reagin) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood 2. Sensitivity: 85-93% Specificity: 72-99% 3. Measures non-specific Abs. Not directly linked to Treponema Pallidum but cells damaged by it. Doesn't Confirm syphilis but need another test to diagnose it 4. Rule out Syphilis. seen in PANUVEITIS ***ACTIVE SYPHILLIS!!!
55
Serum C3 & C4 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood Test 3. Measures Activity of C3 and C4 4. Lupus, AI Disorders
56
SPEP (Serum Protein Electrophoresis) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood test 2. Sensitivity: 96% Specificity: 71% 3. Electrophoresis. Separates size of serum proteins. Concentration of these proteins compared to a normal scale. Abnormal Value subjected to additional Testing. 4. Multiple Myeloma (Masquerading Disease)
57
Stool Sample 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Fecal Test 2. Reiter's Test: Sensitivity: 48-85%; Specificity: 98% gFOBT: 92% sensitive. *False positive due to eating meat, veges, Vit C. 3. Stool Guaiac Test: 3 stool smears on guaiac test paper. Drops of H2O2 turn it Blue. Blue = POSITIVE for BLOOD IN STOOL. Green-Blue = POSITIVE for BLOOD. Green = Negative CULTURE fecal sample 4. IBD and Parasites
58
TFT (Thyroid Function Tests) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood test or Radioactive iodine reuptake 2. Free T4 levels 94% Free T3 88% 3. Thyroid absorbs iodine to produce T4, so pt swallows it and doctor can track to see where it goes in the body. 4. Thyroid Dysfunction NOT associated w/uveitis but many Uveitis Pts suffer from AI disorders in Conjunction w/Thyroid Dysfunction
59
UPEP (Urine Protein Electrophoresis) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Urine Test 2. 3. 4. Detects ACUTE INFLAMMATION. Often used for AMYLOIDOSIS and any Kidney Problems
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UA (Urinalysis) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Urine Test 2. None 3. Gross Analysis (Color, Clarity, concentration), Urine test strips, Light microscopy, 24 hr sampling and/or culturing 4. Retinal Vasculitis or Sinusitis. Look for protein in Urine. CMV can be found in Urine in pts immunocompromised. Hematuria: Polyarteritis Nodosum, SLE, Wegener's, TINU. Calcium = Sarcoidosis Glucose = Diabetes Reactive Arthritis, Syphilis, or Chlamydia = possible urethral discharge
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VDRL (Venereal Disease Research Lab) 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood test 2. depends on stage of syphilis infection 3. 2 Part test: Part 1: Add Prepared antigen to Serum Sample. Look for Clotting (POSITIVE)...Indicated bacteria present Part 2: Perform Dilution of Serum and Add Antigen: Determines AMT of Bacteria Present. 4. 2 part test for SYPHILIS
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VZV Ab IgG 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood Test 2. ??? 3. 2 types of the Test 1. 1 Step Version: See if Antibodies to VZV are there. (Doesn't tell us if there's an active infection, just if there has ever been exposure to it) 2 Step Version: Take test twice (21 days apart) and compare if IgG number goes up/down/stays the same. A 4x change up/down = Active Infection 4. VZV: Chronic Anterior Uveitis
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X-Ray Sacroiliac Joint 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Imaging | 4. Ankylosing Spondylitis, Psoriatic Arthritis
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WNV Ab IgG & IgM 1. Type of Test 2. Sensitivity/Specificity 3. How is the Test Performed? 4. Relationship to Uveitis?
1. Blood test | 4. West nile Virus (rarely causes uveitis)
Ocular Disease II
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