1.
This is an example of ______.
Explanation
Ecchymosis refers to the discoloration of the skin caused by bleeding underneath, typically due to broken blood vessels. It appears as a purplish or bluish bruise-like mark on the skin. Therefore, the correct answer is ecchymosis.
2.
Lymphandeopathy (lymph node disease or swollen/enlarged lymph nodes) is indicative of _____ disease.
Explanation
Lymphadenopathy, or swollen lymph nodes, is commonly associated with viral infections. When the body is infected with a virus, the immune system responds by activating the lymph nodes, causing them to swell. This is because lymph nodes contain immune cells that help fight off infections. Therefore, the presence of lymphadenopathy suggests that the underlying cause is likely a viral disease.
3.
KKC has systemic involvement and will present with cough, fever etc.
Correct Answer
B. False
Explanation
EKC --> no systemic involvement
PCF --> systemic involvement
4.
Which diseases are associated with palpable, NON-TENDER lymph nodes? choose all that apply.
Correct Answer(s)
B. PFC
E. Inclusion conjunctivitis
Explanation
Palpable, non-tender lymph nodes are commonly associated with infections, inflammation, or malignancies. PFC (preauricular follicles) and inclusion conjunctivitis are both viral infections that can cause swollen lymph nodes. PFC is caused by the Epstein-Barr virus, while inclusion conjunctivitis is caused by the Chlamydia trachomatis bacteria. On the other hand, EKC (epidemic keratoconjunctivitis), hyperacute conjunctivitis, and preseptal cellulitis are not typically associated with palpable, non-tender lymph nodes.
5.
What is the only disease discussed in lecture that will result in VISIBLE lymph nodes?
Correct Answer
D. Ocular glandular syndrome
Explanation
Ocular glandular syndrome is the only disease discussed in the lecture that will result in visible lymph nodes. This suggests that the disease affects the lymphatic system, causing the lymph nodes to become enlarged and noticeable. The other options, PFC, HSV, and orbital cellulitis, do not specifically mention any involvement of the lymph nodes, making ocular glandular syndrome the correct answer.
6.
Which of the following disease will most likely produce the most pus?
Correct Answer
B. Hyperacute conjunctivitis
Explanation
Hyperacute conjunctivitis is the most likely disease to produce the most pus. Conjunctivitis is an inflammation of the conjunctiva, the thin clear tissue that lines the inside of the eyelid and covers the white part of the eye. Hyperacute conjunctivitis refers to a severe and rapidly progressing form of conjunctivitis. In this condition, there is a significant amount of discharge from the eye, which may contain pus. The presence of pus indicates a bacterial infection, which is more common in hyperacute conjunctivitis compared to other types of conjunctivitis.
7.
A pt comes into the office with a red eye and miotic pupils. What is the likely ddx?
Correct Answer
iritis
Explanation
iritis: inflammation of the uveal tract
8.
A pt comes into the office with a red eye and fixed, mid-dilated pupils. What is the likely ddx?
Correct Answer
angle closure
Explanation
The likely diagnosis for a patient presenting with a red eye and fixed, mid-dilated pupils is angle closure. Angle closure refers to a condition where the drainage angle of the eye becomes blocked, leading to increased intraocular pressure. This can result in symptoms such as redness of the eye and fixed, mid-dilated pupils. Prompt medical attention is necessary to prevent further complications.
9.
A pt comes into the office with a red eye and irregular, fixed pupils. What is the likely ddx?
Correct Answer
posterior synechiae
Explanation
The likely ddx (differential diagnosis) for a patient presenting with a red eye and irregular, fixed pupils is posterior synechiae. Posterior synechiae refers to the adhesion between the iris and the lens, which can cause the pupil to become irregular and fixed. This condition is often associated with inflammation or infection in the eye, such as uveitis or iritis. It is important to further evaluate the patient to determine the underlying cause and provide appropriate treatment.
10.
A pt comes into the office with a red eye and upon pupil testing you note an APD. What is the likely ddx?
Correct Answer
F. A and c
Explanation
The likely ddx (differential diagnosis) for a patient with a red eye and an afferent pupillary defect (APD) includes orbital cellulitis and endophthalmitis. Orbital cellulitis is an infection of the tissues surrounding the eye, while endophthalmitis is an infection within the eye. Both conditions can cause redness of the eye and an APD. Angle closure, which refers to a blockage of the drainage angle in the eye, is not likely to cause an APD. Therefore, the correct answer is "a and c" (orbital cellulitis and endophthalmitis).
11.
Mark all the possible causes of a blown pupil.
Correct Answer(s)
A. Trauma
C. Anti-histamine drops
D. CN 3 palsy
Explanation
Blown pupil refers to a dilated and non-reactive pupil, which can be caused by various factors. Trauma can lead to a blown pupil due to damage to the nerves controlling the pupil's constriction. Anti-histamine drops can cause pupil dilation as a side effect. CN 3 palsy, which is the dysfunction of the third cranial nerve, can result in a blown pupil as it controls the muscles responsible for pupil constriction. However, there is no direct link between orbital cellulitis or anti-hypertensive medications and blown pupil, so they are not considered as possible causes.
12.
Upon further eval of your red eye pt, you notice diffuse, beefy engorged vessels that are most prominent in the fornices of the conj. What is the possible cause?
Correct Answer
C. Bacterial
Explanation
The presence of diffuse, beefy engorged vessels in the fornices of the conjunctiva suggests a bacterial infection as the possible cause. Bacterial conjunctivitis is characterized by the inflammation of the conjunctiva, resulting in redness and swelling of the blood vessels. This type of infection is commonly caused by bacteria such as Staphylococcus aureus or Streptococcus pneumoniae. Viral conjunctivitis, on the other hand, typically presents with watery discharge and is often associated with a viral respiratory infection. Trauma and herpes may also cause redness in the eye, but the presence of engorged vessels points towards a bacterial infection.
13.
Indicate what conditions can lead to EOM restriction.
Correct Answer(s)
A. Grave's Disease
C. Orbital cellulitis
E. Trauma
Explanation
Conditions such as Grave's Disease, Orbital cellulitis, and trauma can lead to EOM (Extraocular Muscle) restriction. Grave's Disease is an autoimmune disorder that affects the thyroid gland and can cause inflammation and swelling of the eye muscles, leading to limited eye movements. Orbital cellulitis is a bacterial infection of the tissues surrounding the eye, which can result in inflammation and scarring of the eye muscles, causing restriction of eye movements. Trauma, such as fractures or injuries to the eye socket or surrounding structures, can also lead to EOM restriction due to damage or displacement of the eye muscles.
14.
Viral, scleritis, corneal ulcer, blepharoconjunctivitis, HSK, HZK, and toxic conjunctivitis will most likely present as:
Correct Answer
C. Diffuse injection of the entire conj
Explanation
The correct answer is "diffuse injection of the entire conj." Viral, scleritis, corneal ulcer, blepharoconjunctivitis, HSK, HZK, and toxic conjunctivitis are all conditions that can cause inflammation of the conjunctiva, the clear membrane that covers the white part of the eye. This inflammation typically leads to redness and injection of blood vessels in the conjunctiva. The term "diffuse injection" refers to widespread redness throughout the entire conjunctiva. Therefore, diffuse injection of the entire conjunctiva is the most likely presentation for these conditions.
15.
Explain the pattern of injection for a pt suffering from allergic conjunctivitis.
16.
Which diseases most likely result in circumlimal injection?
Correct Answer(s)
C. Uveitis
D. Angle closure
Explanation
Circumlimbal injection refers to the dilation of blood vessels around the limbus of the eye. Uveitis, which is the inflammation of the uvea (middle layer of the eye), can cause circumlimbal injection due to the increased blood flow to the affected area. Angle closure, on the other hand, refers to the narrowing or closure of the drainage angle in the eye, leading to increased intraocular pressure. This increased pressure can also result in circumlimbal injection. Therefore, both uveitis and angle closure are likely to cause circumlimbal injection.
17.
Episcleritis, pingueculitis, inflamed ptyergium, phylectenulosis, and FBs will have what type of pattern of injection?
Correct Answer
A. Sectoral
Explanation
sectoral: redness confined to one area of the conj
18.
Which diseaes can result in a sub-conj heme? Choose all that apply.
Correct Answer(s)
A. Trauma
B. Valsalva maneuver
D. Blood that is too thin
F. Hypertension
Explanation
A sub-conj heme refers to a subconjunctival hemorrhage, which is bleeding underneath the conjunctiva, the clear membrane that covers the white part of the eye. Trauma can cause a sub-conj heme by directly injuring the blood vessels in the eye. The Valsalva maneuver, which involves forcefully exhaling against a closed airway, can increase pressure in the blood vessels and potentially cause them to rupture. Blood that is too thin, often due to certain medications or medical conditions, can make the blood vessels more prone to bleeding. Hypertension, or high blood pressure, can also increase the risk of blood vessel rupture and subsequent sub-conj heme.
19.
You notice in your red eye pt that their vessels appear like corkscrews...what is this most likely associated with?
Correct Answer
C. Carotid cavernous sinus fistula
Explanation
The presence of corkscrew-like vessels in the eye is most likely associated with a carotid cavernous sinus fistula. This condition occurs when there is an abnormal connection between the carotid artery and the cavernous sinus, a vein-filled cavity at the base of the skull. This connection causes an increased blood flow to the eye, leading to the appearance of twisted vessels. Other options like severe allergic reaction, toxic conjunctivitis, and episcleritis do not typically cause this specific vascular abnormality.
20.
Upon examining your pt, you notice that the conj appears to have a faint blue tint and the vessels are criss crossing. What do you think is the most likely dx?
Correct Answer
A. Scleritis
Explanation
The presence of a faint blue tint and criss-crossing vessels in the conjunctiva suggests scleritis. Scleritis is an inflammation of the sclera, the white part of the eye, which can cause a bluish discoloration and engorgement of blood vessels. Uveitis refers to inflammation of the uvea, the middle layer of the eye, and typically presents with other symptoms such as eye pain and sensitivity to light. Episcleritis is a milder form of eye inflammation that does not typically cause a blue tint or vessel criss-crossing. HZK refers to herpes zoster keratitis, which is a viral infection of the cornea and would not present with the described symptoms.
21.
Follicles that a central vessel running to the surface
Correct Answer
B. False
Explanation
Papillae have central vessels --> red bumps
Follicles have no central vesslels, but still may have vessels on surface --> yellow/white bumps
22.
What are you likely to see on the palpebral conj with bacterial, allergic, toxic, VKC, SLK or any chronic irritation?
Correct Answer
A. Papillae
Explanation
In cases of bacterial, allergic, toxic, VKC (vernal keratoconjunctivitis), SLK (superior limbic keratoconjunctivitis), or any chronic irritation of the palpebral conjunctiva, one is likely to observe the presence of papillae. Papillae are small, raised bumps or nodules that can develop on the conjunctiva as a result of inflammation and irritation. They are commonly seen in these conditions and can vary in size and appearance.
23.
Follicles are larger than papillae
Correct Answer
A. True
Explanation
Papillae: 0.1-0.2 mm
Follicles: 0.5-1.0 mm
Follicles are 5x as large as papillae
24.
Viral, chlaymidial and toxic offenses will result in what type of elevation on the conj?
Correct Answer
B. Follicles
Explanation
Viral, chlamydial, and toxic offenses can cause an elevation on the conjunctiva, specifically on the follicles. Follicles are small, raised bumps that can develop on the conjunctiva in response to inflammation or infection. This elevation is a common sign of these types of offenses and can help in their diagnosis.
25.
An infant with viral infection will have ____.
Correct Answer
A. Papillae
Explanation
viral infections usually cause follicles, but infants are not old enough to form follicles
26.
Pseudomembranes are caused by _____ infection
Correct Answer
adenoviral
adenovirus
Explanation
Pseudomembranes are caused by adenoviral infection, specifically by the adenovirus. Adenoviruses are a group of viruses that can cause a wide range of respiratory, gastrointestinal, and eye infections in humans. When adenoviral infection occurs, it can lead to the formation of pseudomembranes, which are thick, grayish-white membranes that develop on the affected tissues. These pseudomembranes can cause symptoms such as difficulty breathing, swallowing, or seeing, depending on the location of the infection. Therefore, adenoviral infection is the correct explanation for the presence of pseudomembranes.
27.
Pseudomembrane removal theoretically should not bleed
Correct Answer
A. True
Explanation
Pseudomembrane removal theoretically should not bleed because pseudomembranes are not composed of blood vessels. They are a layer of dead cells and fibrin that forms on the surface of tissues, typically as a result of infection or inflammation. Therefore, removing pseudomembranes should not cause any bleeding.
28.
Describe the main differences between pseudomembrane and true membranes.
29.
Indicate the possible causes of true membranes.
Correct Answer(s)
A. Gonnorhea
B. Stevens johnson syndrome
C. Chemical/thermal burns
Explanation
True membranes can be caused by various factors such as infections, autoimmune reactions, or physical trauma. In the case of gonorrhea, the infection can lead to the formation of true membranes as the body's immune response attempts to contain and eliminate the bacteria. Stevens-Johnson syndrome, a severe allergic reaction, can also cause the development of true membranes as a result of the body's immune system attacking its own tissues. Chemical or thermal burns can damage the skin or mucous membranes, leading to the formation of true membranes as part of the healing process.
30.
Chemosis is most often seen in _____ conjunctivitis.
Correct Answer(s)
allergic
Explanation
Chemosis can also occur in endophthalmitis, orbital cellulitis, retrobulbar mass
31.
Follicles are most marked in the upper tarsal conj
Correct Answer
B. False
Explanation
Follicles --> LOWER tarsal conj
32.
What is the most common type of corneal dystrophy?
Correct Answer
EBMD
Epithelial basement membrane dystrophy
Explanation
Epithelial basement membrane dystrophy (EBMD) is the most common type of corneal dystrophy. This condition affects the outermost layer of the cornea, called the epithelium, and the basement membrane that supports it. EBMD is characterized by the formation of abnormal deposits and irregularities on the cornea, leading to symptoms such as blurred vision, dryness, and discomfort. It is typically a non-progressive condition that can be managed with lubricating eye drops and other supportive measures.
33.
What are keratitic percipitates due to?
Correct Answer
B. Iritis
Explanation
Keratic precipitates are tiny deposits that form on the cornea of the eye. They are typically caused by inflammation in the eye, known as uveitis. Iritis specifically refers to inflammation of the iris, which is a part of the uvea. Therefore, iritis is a likely cause of keratic precipitates. Pannus refers to abnormal tissue growth on the cornea, and HZK stands for herpes zoster keratitis, which is a viral infection of the cornea. While these conditions can also cause inflammation in the eye, they are not commonly associated with the formation of keratic precipitates.
34.
Ghost vessels are associated with what corneal symptom?
Correct Answer
interstitial keratitis
Explanation
due to syphillis
35.
Ring ulcers are caused by:
Correct Answer
C. Acanthomeba
Explanation
Central + Peripheral ulcers due to bacteria + fungi
Keratitis ulcers due to herpes
36.
It is much worse to get an acid in the eye than an alkali
Correct Answer
B. False
Explanation
Alkalis lead to rapid penetration due to the high pH causing break down of FA in cell membranes. Acids lead to LOCALIZED areas of contact
37.
If you suspect a bacterial etiology for a staining pattern, you might want to take a culture of the eye before you instill any diagnostic or therapeutic agents.
Correct Answer
A. True
Explanation
If there is a suspicion of a bacterial infection causing the staining pattern in the eye, it is important to take a culture before applying any diagnostic or therapeutic agents. This is because the culture will help identify the specific bacteria causing the infection, which can then guide the appropriate choice of treatment. Applying agents before taking a culture may interfere with the growth of bacteria, making it difficult to obtain accurate results. Therefore, it is necessary to take a culture first to ensure proper diagnosis and treatment.
38.
What would be the best option if you needed to remove a lot of lashes due to trichiasis?
Correct Answer
C. Cryotherapy
Explanation
Cryotherapy would be the best option for removing a lot of lashes due to trichiasis. Cryotherapy involves the use of extreme cold temperatures to freeze and destroy abnormal tissues, including the lashes in this case. It is a non-invasive procedure that can effectively remove the lashes without causing significant damage to the surrounding area. Epilation, electrolysis, and radio frequency ablation are not suitable options for removing lashes in this scenario.
39.
What oral antibiotic can be give for chemical burns to reduce inflammation and help the epithelium heal quicker?
Correct Answer
D. Doxycycline 100 mg BID
Explanation
Doxycycline is a broad-spectrum antibiotic that has anti-inflammatory properties. It can help reduce inflammation caused by chemical burns and promote faster healing of the epithelium. The recommended dose of doxycycline for this purpose is 100 mg twice a day. Tetracycline and erythromycin are also antibiotics, but they may not be as effective in reducing inflammation and promoting healing in chemical burns as doxycycline.
40.
Phenylephrine or other vasoconstrictors are appropriate to manage chemical burns because they will prevent the spread of the chemical do deeper ocular structures
Correct Answer
B. False
Explanation
Phenyl should NEVER be administered in chemical burn situations because you want blood to be able to reach the injured area
41.
Chronic herpes simplex keratitis will result in reduced corneal sensitivity
Correct Answer
A. True
Explanation
**However, the first episode or acute HSK will NOT RESULT IN REDUCED CORNEAL SENSITIVITY
42.
What is a QUANTITATIVE MEASURE of corneal sensitivity?
Correct Answer
C. Cochet & Bonnet's aesthesiometer
Explanation
Cochet & Bonnet's aesthesiometer is a quantitative measure of corneal sensitivity. It is a device that measures the minimum amount of pressure required to elicit a response from the cornea. This measurement provides an objective and numerical value of corneal sensitivity, allowing for more accurate assessment and monitoring of corneal health. The other options, cotton wisp and poking the eye with a finger, are subjective measures and do not provide a quantitative value.
43.
What part of the nervous systems are you testing during the cotton wisp test?
Correct Answer
A. OpHthalmic branch of trigeminal
Explanation
The cotton wisp test is used to assess the sensitivity of the cornea and the ophthalmic branch of the trigeminal nerve. The ophthalmic branch of the trigeminal nerve is responsible for providing sensory innervation to the forehead, scalp, and the front part of the head. By gently touching the cornea with a cotton wisp, the test evaluates the integrity of the ophthalmic branch of the trigeminal nerve and its ability to transmit sensory information from the cornea to the brain.
44.
In Cochet & Bonnet's, a shorter thread is correlated with lower sensitivity.
Correct Answer
A. True
Explanation
shorter thread = more pressure = less sensitive cornea
45.
Gonio should be performed before IOPs because checking IOPs can affect the visibility of angle structures
Correct Answer
B. False
Explanation
Gonio should be performed AFTER IOP measurement bc gonio can affect IOP
46.
The average force measured with Cochet and Bonnet's aesthesiometer is ____ grams/mm2
Correct Answer
11.8
Explanation
The average force measured with Cochet and Bonnet's aesthesiometer is 11.8 grams/mm2.
47.
The RPS Adeno Detector is used to determine if a red eye is secondary to ______
Correct Answer
B. Virus
Explanation
The RPS Adeno Detector is used to determine if a red eye is secondary to a virus. This suggests that the device is specifically designed to detect the presence of viral infections in the eye, helping healthcare professionals diagnose and treat the condition accurately.
48.
Staph, strep and pseudomonas are the most common types of microbes associated with bacterial keratitis
Correct Answer
A. True
Explanation
Staph, strep, and pseudomonas are indeed the most common types of microbes associated with bacterial keratitis. Bacterial keratitis is an infection of the cornea caused by bacteria, and these three types of bacteria are frequently found to be the causative agents. Staphylococcus aureus and Streptococcus pneumoniae are the most common types of staph and strep bacteria associated with this condition, while Pseudomonas aeruginosa is the most common type of pseudomonas bacteria. Therefore, the statement that Staph, strep, and pseudomonas are the most common types of microbes associated with bacterial keratitis is true.
49.
Describe the diagnostic difference between an infiltrate and an ulcer
50.
Your pt comes in with an ulcer that appears whitish-grey with feathery borders. You also notice sateline infiltrates as well. What is the likely cause of their condition?
Correct Answer
C. Candida
Explanation
This is describing a FUNGAL ULCER (candida, fusarium, aspergillus)