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Ophthalmology
UWORLD Round 2 2021 Part 1
| Question | Answer |
|---|---|
| Common 1st generation antihistamines: | Chlorpheniramine and Diphenhydramine |
| What are some of the added effects of first generation antihistamines? | 1. Anite-muscarinic, 2. Anit-alpha adrenergic 3. Anti-serotonergic |
| Which generation of antihistamines has anti-muscarinic, anti-a adrenergic, and anti-serotonergic properties, added to its anhitsinc effets? | First generation antihistamines |
| What ocular muscles are affected by antihistamine's anticholinergic properties? | Ocular Ciliary muscles |
| How do chlorpheniramine affect vision? | Anticholinergic effects on ocular ciliary muscles impair accomodation and cause blurring of vision for close objects |
| What is Open-angle Glaucoma? | Progressive loss of peripheral vision from elevated intraocular pressure |
| What is the diagnosis a patient with progressive loss of peripheral vision due to increased intraocular pressure? | Open-angle Glaucoma |
| What are the two forms two which treatment of glaucoma is directed? | 1. Decrease the secretion of Aqueous Humor by the ciliary epithelium 2. Increase the outflow of Aqueous humor |
| Which common diuretic is often used in treatment glaucoma? | Acetazolamide |
| How does Acetazolamide works in treatment of glaucoma? | It is a Carbonic anhydrase inhibitor, that decrease the aqueous humor secretion by the ciliary epithelium |
| Which are the blockers that are used to treat glaucoma? | Timolol and non-selective B-blockers |
| How do Prostaglandins and cholinomimetics are intended to treat glaucoma? | Decrease intraocular pressure by increasing the OUTFLOW of Aqueous humor |
| What are common Prostaglandins F2a used to treat glaucoma? | Latanoprost and Travoprost |
| Which cholinomimetics are used to increase outflow of aqueous humor and tx of glaucoma? | Pilocarpine and carbachol |
| What is another way to refer to Idiopathic Intracranial Hypertension? | Pseudotumor cerebri |
| Idiopathic Intracranial HTN often presents in: | Young, obese women with daily headaches, bilateral papilledema,and transient visual disturbances |
| 23 year old woman, BMI 36, presents with physician due to episodic loss of vision and daily headaches. Dx? | Idiopathic Intracranial Hypertension |
| How does Pseudotumor cerebri cause ocular symptoms? | The elevated ICP compresses the Optic nerves, resulting in impaired axoplasmic flow and optic edema |
| Fundoscopic finding of Idiopathic Intracranial Hypertension | Optic disc edema |
| Form of optic neuropathy characterized by elevated intraocular pressure and due to increase aqueous humor production or decreased outflow of aqueous humor. | Glaucoma |
| What is the prefered treatment option for Open-angle glaucoma? | Topical prostaglandins |
| Which pathway is used by prostaglandin to increase outflow of aqueous humor? | Uveoescleral pathway |
| What maneuver increases pain of headache in Idiopathic Intracranial hypertension? | Valsalva maneuver |
| Which type of Glaucoma, open- or closed-angle, is more severe? | Closed-angle glaucoma |
| Which structures of the eye form the reference angle in glaucoma? | Iris and cornea |
| Vision loss + wide angle between iris and cornea. Dx? | Open-angle Glaucoma |
| Which type of glaucoma develops slowly and commonly goes undetected thought life? | Open-angle Glaucoma |
| Which type of glaucoma, open or closed-angle, require immediate medical attention? | Closed-angle glaucoma |
| Iris is in the right position, and the uveoscleral drainage canals are clear. But the trabecular meshwork isn't draining properly. Dx? | Open-angle Glaucoma |
| The iris is squeezed against the cornea, blocking the uveoscleral drains and the trabecular meshwork. Dx? | Closed-angle glaucoma |
| What is a common ocular adverse effect of the use of Atropine? | Increased intraocular pressure leading to Glaucoma |
| Which type of glaucoma is more commonly precipitated by the use of Atropine? | Closed-angle glaucoma |
| A patient treated for bradycardia is counseled to periodically visit the opthamologist. Why is the patient given such indication? | A common drug for tx of bradycardia is atropine, which can precipitate closed-angle glaucoma |
| What is Retinitis Pigmentosa? | Genetic condition results in progressive dystrophy of Retinal pigmented epithelium and photoreceptors |
| What structures of the eye anatomy are affected in Retinitis Pigmentosa? | 1. Dystrophy of the Retinal pigmented epithelium 2. Photoreceptors |
| What is a key symptom or feature of Retinitis pigmentosa? | Night blindness |
| How is Retinitis Pigmentosa commonly presented clinically? | Progressive night blindness and loss of peripheral vision due to early loss of rods |
| What leads to the ocular(vision) symptoms seen in Retinitis pigmentosa? | Early loss of rods |
| What are the fundoscopic findings of Retinitis pigmentosa? | 1. Bone-spicule pattern, 2. Retinal vessel attenuation, and, 3. Optic disc pallor |
| What are areas of the body that are immune privileged? | CNS and brain, eyes, and testes |
| What important immune feature is present in the eyes, that is not seen in most of the body, except for few exceptions? | Immune privilege |
| What is immune privilege mode of action? | Upon injury, the tissue releases previous sequestered antigens that T-cells recognize as foreign |
| What does immune privilege provides? | Areas of body that are immune privilege, allow for a tolerance to introduction of antigen without eliciting an inflammatory immune response |
| Another way to refer to myopia | Nearsightedness |
| What is Myopia? | Refractive error in which the focal point of an image falls anterior to the retina |
| Why does the focal point of an image falls anterior to the retina in Myopia? | Due to increased anterior-posterior diameter of the eyes |
| What type of glasses fix myopia? | Concave (diverging) lenses |
| A person with glasses that have a concave form, suffer of myopia or hyperopia? | Myopia |
| How is the vision of a patient with Myopia? | Normal near vision, but difficulty seeing far away objects |
| If the student required to move closer to the board to see the writing, is the student has myopia or hyperopia? | Myopia |
| Focal point fall behind retina. Which is the refractive error, Myopia or Hyperopia? | Hyperopia |
| Focal point in front (anterior) to retina. Dx? | Myopia |
| Which refractive error condition requires convex lenses? | Hyperopia |
| If the patient is unable to visualize objects near or close, is the patient more likely to have myopia or hyperopia? | Hyperopia |
| How is the vision in Hyperopia? | Visualize normal objects far away, but difficulty focusing in objects near |
| What is Astigmatism? | Condition in which the curve of the cornea is abnormal |
| Which condition is known to cause blurry vision to objects at all distance, close and distant? | Astigmatism |
Created by:
rakomi
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