retina questions.txt

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rontongbai
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206567
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retina questions.txt
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2013-03-11 21:32:21
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  1. what test do you need to interpret ERG
    GVF
  2. what is the characteristic vascular change of DR
    loss of pericytes and basement membrane thickening -> capillary occlusion and subsequent nonperfusion
  3. summarize the finding of VISION (VEGF inhibition study in Ocular Neovasulirazation)
    less chance of moderate vision loss in 1 year for the pegaptanib (macugen) group compared to placebo
  4. findings of MARINA (minimally classic/occult trial of the anti-VEGF antibody ranizumab in the treatment of neovascular amd)
    less chance of 15 letter loss and more chance of letters gained in the ranibizumab group compared to placebo for minimally classic/occult lesions
  5. findings of CATT (complications of age related mac degen treatment trial)
    bevacizumab (avastin) monthly and prn was equivalent to ranibuzimab monthly and prn
  6. findings of View-1 and 2 studies
    aflibercept was noninferior to monthly ranibuzimab and had a similar safety profile
  7. what's in areds
    "vit C, vit E, beta carotene, zinc ozide, cupric oxide"
  8. what part of areds is CI for smokers and why
    beta carotene because of higher risk of lung cancer
  9. what retinal antigen causes CAR
    recoverin
  10. what vegf isoform is most pathologic in neovascular amd and what drug targets it
    "vegf 165, macugen"
  11. what are the exam and diagnostic findings of mewds
    "macular pigment stippling, macular wreath-like punctate hyperfluoresence on FA, mild disc edema"
  12. what is a prominent clinical finding of mewds
    photopsias
  13. what are findings of fabry's disease
    "cornea verticillata, abnormally dilated conjunctival vessels, retinal vessel tortuosity"
  14. what is the cause of fabry's disease
    mutation in alpha-galactosidase A gene -> accumulation of ceramide trihexoside
  15. which mitochondrial diseases are x-linked?
    "fabry's and hunter syndrome; think of a ""fabulous"" hunter aiming at target shaped like x"
  16. what is cause of tay-sachs disease
    deficiency of hexosaminidase A
  17. cause of gaucher's disease
    deficiency of glucocerebrosidase
  18. cause of neimann pick
    deficiency of sphingomyelinase
  19. what are classic manifestations of VKH syndrome
    "suguira sign (perilimbal vitiligo in the uveitic phase), dalen fuch nodules (punched out lesions, occur in 1/3), neck pain, tinnitus, dysacusis, flu-like illness"
  20. what is anterior persistent fetal vasculature
    "hylaoid artery remians -> white retrolental mass; associated signs are microphthalmos, shallow AC, long ciliary processes -> poor prognosis due to glaucoma, secondary cataract, deprivational ambylopia"
  21. disadvtnages of using a 25g vs 20g vitrectomy
    "risk of retinal tears, endolphthalmitis, hypotony -> this is due to not suturing the small incisions"
  22. patients with NON subfoveal geographic atrophy benefit from AREDS
    TRUE
  23. what 3 main questions did edtrs address
    1. is focal good for DME 2. is early scatter photocoagulation good for earlier stages of DR 3. can asa delay progression of DR
  24. "in erg, what cells does the b wave correspond to"
    bipolar and mueller cells
  25. what is found in von-hippel disease
    "capillary hemangiomas in the retina (or retinal hemangioblastoma), cerebellar hemangioblastomas, pheochromocytomas, renal cell carcinoma, spinal cord tumors and cysts"
  26. "what exam findings and features distinguish cone dystorphy from other congenital color deficiencies (deuteranopia, tritanopia, protanopia)"
    "symmetric bulls eye maculopathy, mild to severe temporal optic atrophy, signs of progressive disease, decreased VA, day blindness, photophobia"
  27. "according to bvos, when should you do scatter photocoagulation"
    "neovascularization; if >5 Das of non-perfusion present, you should do close observation in 4 month intervals to r/o NV"
  28. how do colobomas form
    incomplete closure of the embryonic fissure at week 5 (normal closure begins at inferior equator and proceeds anteriorly and posteriorly
  29. what drugs predispose to solar retinopathy
    psoralen and tetracycline
  30. what are newest guidliens for chloroquine toxocity
    10-2 and either ERG/OCT/FAF
  31. "according to CRUISE study, what is the initial treatment for CRVO"
    ranizumab injection qmonthly x 6 months
  32. what are the most common FA findings of csr
    expanding dot pattern > smokestack pattern > diffuse pattern
  33. "once hydrochloroquine is stopped, can further vision loss occur"
    yes
  34. what is stickler syndrome
    "autosomal dominant disease characterized by optically empty vitreous cavity due to premature vit breakdown -> high incidence of RD (lattice and retinal thinning), cataract, glaucoma, strabismus; associated with facial dysgenesis in Pierre Robin sequence with micrognathia, cleft palate, glossoptosis, hyperflexibility, arthritis"
  35. when do you start steriods in toxo
    3 days after abx tx
  36. what treatment can you give noncompliant toxo patients
    intravitreal clindamycin and dexamethasone
  37. what layer of retina are drusen
    extending between bruchs and rpe
  38. what hla associated with pars planitis? Birdshot? Behects?
    "HLA-dr2, hla-a28, hla-b51"
  39. "what disease causes corneal and conjunctival crystals, patchy retinopathy, and renal failure"
    cystinosis
  40. what is meridonal fold
    "redundant peripheral retina that project into vitreous, mostly in superonasal quadrant, increased risk of rd"
  41. what is parinaud's ocularglandular syndrome
    "granulomatous nodules in the palpebral conj, ipsilateral preauricular or submandibular adenopathy, occurs in 10% of cat scratch"
  42. what causes irvine gass syndrome
    inflammation induced blood-retina barrier breakdown since postaglandins disrupt blood vessel integrity resulting in leakage of fluid in macula
  43. how can you differentiate POHS and MCP?
    MCP has vitritis while POHS doesnÂ’t
  44. what FB material is most toxic to the eye
    copper
  45. what is chalcosis and what are signs of it
    "copper toxicity; deposits in Descemet's, sunflower cataract, greenish color iris, brown vitreous opacities, metallic flecks on retinal vessels"
  46. what type of bacteria is bartonella henselae
    GNR
  47. what makes up internal limiting membrane
    footplate of Muller cells (nucleus located in inner nuclear layer)
  48. what cell nuclei making up inner nuclear layer
    "Muller cells, bipolar cells, horizontal cells, amacrine cells"
  49. what are risk factors for aMD
    "age, cigarette smoking, light iris color, hyperopia, hypertension, high chol, female, fam history"
  50. what are erg findings of iron toxicity (siderosis)
    loss of amplitude of b-waves on erg eventually can be extinguished
  51. what are fundus characteristics of stargardt's disease
    "yellow parafoveal ""pisciform"" flecks and a ""beaten bronze"" macula"
  52. what is the FA finding of stargardts
    dark choroid due to blocking since lipofuscin like material accumulates in RPE
  53. what is stargardts
    inherited juvenile onset rod-cone dystrophy that causes progressive vision loss to 20/50-20/200
  54. what disease do you see fluorescein quenching
    birdshot; idiopathic rapid fluorescein clearing
  55. what disease do you see patchy delayed choroidal filling
    "choroidal ischemia in GCA, hypertensive choroidopathies, wegener associated choroidopathy"
  56. what mutation in stargartdts
    abca4
  57. what is tx for RMA
    photocoagulate if macular edema; observatino otherwise
  58. what are erg/eog findings of best
    "normal erg, abnormal EOG ALWAYS no matter the time period"
  59. what are ocular and systemic findings of bardet-biedl syndrome
    "macular pigment mottling, pigmentary retinopathy like RP, polydactyl, poor night vision, obese, mental retardation, hypogonadism, renal failure"
  60. what's the difference between bardet-biedl and lawrence moon syndrome
    along the same spectrum; lawrence moon has spastic paraplegia and NOT polydactyll
  61. what are findings of alstrom syndrome
    "AR d/o, tapetoretinal degeneration, obesity, DM, hearing loss, renal failure, dilated cardiomyopathy; CENTRAL VISION LOSS EARLY "
  62. what visual acuity findings separate alstrom syndrome and other pigmentary retinopathy
    central losss of vision early while others you lose peripheral vision first
  63. what allergic reactino do you have to ask for to get ICG
    iodide and shellfish allergies
  64. why should you not repair small extremely posterior scleral lacerations?
    extreme duction can cause vitreous prolapse through the wound
  65. what are indications for repair of RRD with pneumatic retinopexy
    "tear is at superior 8 clock hours, clear media, confidence that all breaks found, absence of PVR grade C and D"
  66. "what is ddx of disruption of normal inner segment, outer segment, and RPE layers?"
    "mewds, AZOOR, solar retinopathy, commotio retinae"
  67. what is the most important prognostic factor for BRVO
    retinal ischemia
  68. what sickle cell traits are worst for the eye
    SC and Sthal
  69. what are the risk factors for brvo and crvo and which ones are different for them?
    "HTN, glaucoma, cardiovascular disease; BRVO also morbid obesity; CRVO also DM"
  70. what are indications for lasering lattice degeneration
    "aphakic, presence of RD in other eye, presence of flap tears, high myopia"
  71. how do you differentiate senile retinoschises from RD
    "smooth domed, reacts to photocoagulation, no shifting subretinal fluid, no vit pigment/heme, absolute scotoma"
  72. what are 2 types of retinoschises and where does split occur in each type
    "1. typigcal degenerative- split occurs in outer plexiform layer; 2. reticular degenerative- split occurs in nerve fiber layer, higher chance of posterior extension"
  73. is retinoschises assocaited with myopia or hyperopia
    hyperopia
  74. whats the most common cause of failure of rheg retinal detachment reppair
    PVR
  75. what is the prognosis of severe and very severe NPDR in progression to PDR
    15% and 45%
  76. what layer of the retina are exudates in the macular star of neuroretinitis
    outer plexiform layer
  77. what is ddx for bone spicules
    "RP (bilateral), DUSN (unilateral), old trauma, syphilis"
  78. what is DUSN
    "subretinal spread of nematode causing poor va, multifocal choroiditis, vitritis, ON edema, bone spicules; if worm is found, treatment is laser; raccoons are carriers of nematode"
  79. what genetic disease causes cherry red spot
    tay -sachs disease
  80. what is tay sachs disease
    defect in hexosamindase A enzyme causing accumulation of ganglioside GM2 which can be deposited in brain and retina -> cherry red spot due to accumulation of abnormal protein
  81. what is the tx for cme assocaited with RP
    "diamox first, then can try subtenons or intravitreal triamcinolone"
  82. what is ddx for dalen fuchs spots
    VKH and SO
  83. what are forster-fuchs spots
    spots found in myopic degeneration; dark spots due to RPE hyperplasia in response to small CNV lesion that does not progress
  84. what are characteristics of coat's disease
    "male predominant, non-hereditary, gene found on chromosome 4, no systemic manifestations, unilateral"
  85. fwhat are causes of angioid streaks
    "PEPSI: pseudoxanthoma elasticum, ehlos danlos, sickle cell anemia, pagets disease of bone, idiopathic (and beta thalassemia)"
  86. what are the prominent cell types involved in vitreomacular traction
    glial cells
  87. what is treatment of vitreomacular traction
    surgery improves VA > 2 lines in 75% of eyes; intravitreal ocriplasmin can result in resolution of traction
  88. what test can you get to see if theres an intraocular FB in severe trauma
    ct scan
  89. what are choroidal melanocytoma and how do you manage
    "benign rare neoplasm immediately adjacent to ON, extremely darkly pigmented -> can very rarely undergo malignant transofrmation so you should follow with photos"
  90. can you have birdshot without vitritis
    "normal erg, abnormal EOG ALWAYS no matter the time period"
  91. what is foveal granularity pathomneumonic for?
    "mewds, "
  92. what week do nasal and temporal retina completely vascularize
    36 and 40
  93. what are the most common locations for scleral rupture
    limbus and under insertion of rectus muscles
  94. what abx to tx b cereus
    vanc and clinda
  95. how do you distringuish birdshot and pohs
    pohs never had vitritis; birdshot always has vitritis
  96. what is vitiliginous chorioretinitis
    birdshot

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