uveitis questions.txt

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rontongbai
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208347
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uveitis questions.txt
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2013-03-19 18:00:52
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uveitis
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uveitis
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  1. what glaucoma meds should be avoided in inflammation
    xalatan and pilocarpine
  2. what type of JRA has the least likelihood of getting uveitis
    systemic onset and ANA negative (still's disease)
  3. what is sitlls disease
    "fever, swollen lymph nodes, hepatoslenomegaly, minimal joint involvement (variant of JRA)"
  4. what uveitis doesn’t have vitritis
    "POHS, PIC, serpiginious"
  5. what chemical causes oxyxgen radical production by granulocytes
    leukotriene B4
  6. whats the minimum size of cmv retinitis
    750 microns
  7. how long is retisert effective
    30 months
  8. what are side effects of retisert
    "cataracts (100%), glaucoma (30% require filter after 2 years)"
  9. what are posterior findings of sarcoidosis
    "periphlebitis with whitish exudates (candle wax drippings), ON swellign, mild vitritis (also mutton fat KPs)"
  10. what is ddx of intermediate uveitis
    "pars planitis (no associated sysetmic finding or infection), lyme, sjogren's syndrome, toxocariasis, syphillis, TB"
  11. what are associated with seronegative spondyloarthropathies and HLA-b27
    "ankylosing spondilitis, psoriatic arthritis, inflammatory bowel disease, reiter's syndrome, reactive (post infectious) arthritis"
  12. which of the lens induced glaucomas will have KPs
    phacoantigenic glaucoma
  13. what uveitis is associated with band K
    JIA
  14. what are assocaited ocular problems of pars planitis
    "RDs (rhegmatogenous and tractional, not exudative), CME, vit heme, glaucoma"
  15. what uveitides may benefit from early corticosteroid sparing agents
    "behcets, VKH, SO, necrotizing sclerouveitis"
  16. what are findings of whipple disease
    "bilateral panuveitis, retinal vascuilitis, migratory polyarthritis, GI symptoms"
  17. what organism causes whipple disease
    actinomycetes bacterium
  18. what is diagnosis of whipple disease
    duodenal biopsy- PAS positive organism in macrophages within intestinal villi
  19. what is the least helpful test in diagnosing CMV
    CMV serology (high rate of seropositivity in general population
  20. "in endolphathmmitis, what visual acuity would you do PPV"
    LP or worse
  21. how is PORN different from ARN and CMV
    "no vitritis, can involve macula, no retinal hemorrhages, no vasculitis"
  22. what is tx of PORN
    intravitreal and systemic gancyclovir or foscarnet
  23. what are systemic findings of relapsing polychondritis
    "external ear inflammation (auricular chondritis), nose inflammation (nasal chondritis), generalized arthralgias"
  24. what are eye manifestations of relapsing polychondritis
    "scleritis, episcleritis, uveitis, conjunctivitis, retinal vasculitis"
  25. what lab findings of relapsing polychondritis
    "p-anca, ANA, RF"
  26. what 2 noninfectious uveitis can present with hypopoin
    behcets and hla-b27 uveitis
  27. what are systemic findings of congenitl rubella syndrome
    "deafness, cardiac malformations (patent ductus arteritosis)"
  28. what are ocular findings of congenital rubella syndrome
    "cataract, pigmentary retinopathy (not cause of poor vision), microphthalmos; cataract and gluacoma do not occur simultaneously "
  29. "old man presents with sinisitus, bloody nasal discharge, persistent cough, and proptosis"
    wegeners
  30. what are systemic findings of wegeners
    "sinusitis, bloody nasal discharge (upper resiptiratory involvement), cough (lower respiratory involvement), arthritis, lower extremity purpura, CNS involvement, glomerulonephritis"
  31. what is immune recovery uveitis and what treatment should you avoid
    presents with anterior or intermediate uveitis with CME after treatment for CMV; don't tx with intravitreal steroids
  32. what is the treatment for EBV related uveitis
    supportive treatment
  33. what is the antibody test for EBV
    "VCA IgM and EA titers (VCA= viral capsid antigen, EA=early antigen)"
  34. what test should you get for HLA-b27 associated back pain
    sacroiliac joint imaging
  35. what should you avoid in uveitis CME
    topical NSAIDS (not effective like in post-catat CME)
  36. what test should you get if you see herpes zoster in a pt < 50yo
    HIV
  37. how can pacnes endolphthalmitis present
    white plaque in the capsular bag
  38. why do you have to treat toxo in AIDS patients sytemically
    high risk of CNS invovlement
  39. what ocular surgery has lowest rate of endolphthalmitis
    ppv
  40. why is toxocariasis with peripheral granulomas associated with poor vision
    macular traction
  41. where lens should you use and where should you use it in a patient with history of chronic uveitis
    "best choice would be hydrophobic acrylic 1-piece lens in the capsular bag (don’t ever put AC iol or sulcus IOL since it can cause inflammation), silicone iol associated with increased inflammation and bad if silicone oil needs to be used in the future"
  42. whats the initial steroid sparing agent for JIA
    methotrexate (well tolerated in kids)
  43. what immunomodulatory agents can worsen MS
    infliximab
  44. what form of JRA should be followed most closely
    "pauciarticular, ANA positive, <7yo"
  45. which organisms causing endolphthalmitis have best outcomes
    "coagulase negative staph (s. epidermidis, s. saprophyticus)"
  46. which organisms causing endolphthalmitis have worse outcomes
    enterococcus
  47. "what is the next line of treatment for pars planititis resistant to steroids (topical, oral, intravitreal)"
    PRP
  48. what are the screening and confirmoatry tests for HIV
    ELISA; western blot
  49. when is toxoplasmosis therapy with antibiotics ALWAYS indicated
    "newborns with congenital infections, pregnant women with acquired disease, immunocomporomised patients "
  50. what are the most common species of bleb-related endolphthalmitis
    staph and strep (some people say strep and haemophilis)
  51. what does congenital toxo present with
    "toxo in retina, diffuse intracerebral calcifications, hydrocephalus"
  52. why cant you diagnose congenital toxo with igG
    "iGG can be passively transmitted by mother through the placenta, and many mothers are already IgG positive to toxo"
  53. "for methotrextate patients, what testing do you do and why"
    CBC and LFTs q4-6 weeks to monitor for myelosupression and liver damage
  54. how do you distinguish PORN and ARN
    "PORN: typically no vitritis, can involve the posterior pole, usually immunocompromised (CD4 < 50 in AIDS), retinal vasculature minimally involved; in ARN, typically spares the posterior pole"
  55. what hla is posner schlossman associated
    hla-b54 (posner schlossman is 54 yo) - also VKH
  56. how should you treat someone with ocular lymphoma and no systemic involvement
    systemic chemo and radiation because >50% will develop primary CNS lymphoma in their lifetime
  57. how does ocular toxocariasis present
    1. peripheral granuloma (50%) 2. macular granuloma (25%) 3. leukocoria (25%)
  58. how do you diagnose ocular toxocariasis
    "positive titer for anti-toxocara ab, peripheral eosinophilia, lack of calcifications on CT scan"
  59. how do you distinguish toxocariasis from RB
    "RB usually in younger children, has calcifications, lacks inflammation "
  60. when should you do cataract surgery on uveitic patients
    after 3 months of quiet
  61. what gl;aucoma surgery should you not do for uveitic glaucoma patients
    "CPC, inflammation can induce pthysis"
  62. what type of lens should you implant on JRA patietns with uveitis and cataract
    acrilic type IOLs
  63. what cytokines do Thelper 1 cells produce
    "IL2, IL12, IFN-gamma, TGFbeta"
  64. what cytokines do Thelper 2 cells produce
    "IL4, IL5, IL10"
  65. "what do you think of when you see old man with bloody nose, sinusitis, persistent cough (lower and upper airway involvement"
    wegeners
  66. what is tx for wegeners and polyarteritis nodosa
    sysetmic corticosteroids and cyclophosphamide
  67. how do toxoplasmosis in AIDS patient different from immunocompetent patient
    "in AIDS patient, toxo doesn’t recur at site of old scar it arises de novo without associated scar; usulaly less inflammation, multifocal retinochoroiditis more common, size of lesion is larger"
  68. how do you distniugish SO from VKH
    "VKH is more likely to have systemic involvement, serous RD, choriocapillaris inflammation, with racial predilection (asian, hisptanic, native american, middle eastern) and no racial predilection in SO"
  69. "in VKH patients, treatment of a patient with chlorambucil who has what underlying blood disorder results in 14x risk of leukemia"
    polycythemia rubra vera
  70. what are findings of pars planitis
    "CME, snowballs (white opacities in middle of vitreous), and snowbanks (white deposits along vitreous base)"
  71. what is tx of pars planitis
    sub tenons corticosteroids
  72. what are 2 common complications of cyclophosphamide
    "myelosuppresion and hemorrhagic cystitis (drink lots of water if microscopic, if grossly blood, then stop the med)"
  73. why is CMV retinitis a perivascular pattern of infection
    it affecst the endothelium of blood vessels -> frosted branch retinitis

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