6839170
Description
Flashcards by Andrew Street, updated more than 1 year ago
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Created by Andrew Street
about 8 years ago
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| Question | Answer |
| Conjunctivitis | |
| Bacterial conjunctivitis in a child with associated discharge | |
| 2405 S & Sx of conjunctivitis. | * Soreness * Redness * Discharge * Acuity is generally good K & C p1057. |
| Causes & Rx of conjunctivitis. | * Bacterial - usually bilateral + purulent discharge. Rx - empirical ABx Rx with chloramphenicol drops QDS for 5-7/7. If ineffective take swab. * Chlamydial - chlamydia trachomatis is sexually transmitted (seen in developed countries), trachoma isn't sexually transmitted (seen in tropics & middle east). Onset is slow with little discharge. Rx - topical erythromycin. * Viral: > Adenoviral - highly contagious. May have been cold/flu like Sx. Associated with chemosis, lid oedema, palpable preauricular lymph node. May cause loss of acuity. Rx - usually self-limiting. Lubricants & cold compresses for Sx. Good hygiene. > Herpes simplex - usually unilateral. Causes palpable preauricular lymph node & cutaneous vesicles on eyelids & periorbitally. May cause corneal ulcer. Rx - usually self-limiting though topical aciclovir is often used. K & C p1059. |
| Severe keratitis due to a fungal infxn | |
| What is keratitis? S & Sx & causes? | Inflammation of the cornea. Initially produces a localised oedema of the cornea, rapidly followed by infiltration of inflammatory cells, hence the invariable sign of localised corneal opacity. S & Sx: * Usually unilateral * Red - especially near infxn * Sticky (bacterial) * Watery (viral) * +++ P * Photophobic * Acuity may be affected * Hypopyon (bacterial) * Corneal opacity Causative organisms include: * Staphylococci & Streptococci * Herpes Simplex * Trachoma * Adenovirus * Herpes Zoster From P-Year opthamology notes on moodle. |
| Rx for keratitis. | * Bacterial - fluoroquinolone g. (eg ciprofloxacin)/hourly for 48/24 then QDS for 5/7. * Viral - aciclovir oc. or ganciclovir 5x/daily for 1-2/52 From P-Year lecture notes. |
| What is uveitis (aka iritis)? S & Sx & causes? | Inflammation of the uveal tract, which includes the iris, ciliary body & choroid. May be classed as anterior, intermediate (affecting the ciliary body), or posterior (choroid). S & Sx typically: * Blurred vision * P * Redness * Photophobia * Floaters (posterior) * Dots on rear of cornea (keratic precipitates) * Adhesions from iris to lens (posterior synechiae) Causes: * Ankylosing spondylitis & positive HLA-B27 * Arthritis * Inflammatory bowel DS * Sarcoid * TB * Syphilis * Toxoplasmosis * Behçet’s syndrome * Lymphoma * Viruses - herpes, CMV, HIV K & C p1062 & P-Year lecture notes. |
| Rx for uveitis. | * Topical steroid eg dexamethasone g.) * Dilating g. eg cyclopentolate g. * Ix for systemic conditions From P-Year lecture notes. |
| Acute angle-closure glaucoma. Hazy cornea & fixed mid-dilated pupil. | |
| Besides an ocular emergency what is acute angle-closure glaucoma? S & Sx? | There is a sudden rise in intraocular pressure to levels greater than 50 mmHg. This occurs due to reduced aqueous drainage as a result of the ageing lens (middle-older age pt's) pushing the iris forward against the trabecular meshwork. S & Sx: * Sudden onset of painful (may be severe) red eye * Blurred vision * N & V * Headache K & C p1062. |
| Rx of acute angle-closure glaucoma. | * Systemic acetazolamide (PO or IV) - turns off fluid production in ciliary body * Pilocarpine g. - pulls iris away from trabecular meshwork * Topical ocular antihypertensives & topical steroids * Definitive Rx = bilateral laser iridotomy (makes a hole in iris to allow fluid passage) From P-Year lecture notes. |
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