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
what is the treatment for EBV related uveitis
what is the antibody test for EBV
"VCA IgM and EA titers (VCA= viral capsid antigen, EA=early antigen)"
what test should you get for HLA-b27 associated back pain
sacroiliac joint imaging
what should you avoid in uveitis CME
topical NSAIDS (not effective like in post-catat CME)
what test should you get if you see herpes zoster in a pt < 50yo
how can pacnes endolphthalmitis present
white plaque in the capsular bag
why do you have to treat toxo in AIDS patients sytemically
high risk of CNS invovlement
what ocular surgery has lowest rate of endolphthalmitis
why is toxocariasis with peripheral granulomas associated with poor vision
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 (dont 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"
whats the initial steroid sparing agent for JIA
methotrexate (well tolerated in kids)
what immunomodulatory agents can worsen MS
what form of JRA should be followed most closely
"pauciarticular, ANA positive, <7yo"
which organisms causing endolphthalmitis have best outcomes
"coagulase negative staph (s. epidermidis, s. saprophyticus)"
which organisms causing endolphthalmitis have worse outcomes
"what is the next line of treatment for pars planititis resistant to steroids (topical, oral, intravitreal)"
what are the screening and confirmoatry tests for HIV
ELISA; western blot
when is toxoplasmosis therapy with antibiotics ALWAYS indicated
"newborns with congenital infections, pregnant women with acquired disease, immunocomporomised patients "
what are the most common species of bleb-related endolphthalmitis
staph and strep (some people say strep and haemophilis)
what does congenital toxo present with
"toxo in retina, diffuse intracerebral calcifications, hydrocephalus"
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"
"for methotrextate patients, what testing do you do and why"
CBC and LFTs q4-6 weeks to monitor for myelosupression and liver damage
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"
what hla is posner schlossman associated
hla-b54 (posner schlossman is 54 yo) - also VKH
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
"positive titer for anti-toxocara ab, peripheral eosinophilia, lack of calcifications on CT scan"
how do you distinguish toxocariasis from RB
"RB usually in younger children, has calcifications, lacks inflammation "
when should you do cataract surgery on uveitic patients
after 3 months of quiet
what gl;aucoma surgery should you not do for uveitic glaucoma patients
"CPC, inflammation can induce pthysis"
what type of lens should you implant on JRA patietns with uveitis and cataract
acrilic type IOLs
what cytokines do Thelper 1 cells produce
"IL2, IL12, IFN-gamma, TGFbeta"
what cytokines do Thelper 2 cells produce
"IL4, IL5, IL10"
"what do you think of when you see old man with bloody nose, sinusitis, persistent cough (lower and upper airway involvement"
what is tx for wegeners and polyarteritis nodosa
sysetmic corticosteroids and cyclophosphamide
how do toxoplasmosis in AIDS patient different from immunocompetent patient
"in AIDS patient, toxo doesnt 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"
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"
"in VKH patients, treatment of a patient with chlorambucil who has what underlying blood disorder results in 14x risk of leukemia"
polycythemia rubra vera
what are findings of pars planitis
"CME, snowballs (white opacities in middle of vitreous), and snowbanks (white deposits along vitreous base)"
what is tx of pars planitis
sub tenons corticosteroids
what are 2 common complications of cyclophosphamide
"myelosuppresion and hemorrhagic cystitis (drink lots of water if microscopic, if grossly blood, then stop the med)"
why is CMV retinitis a perivascular pattern of infection
it affecst the endothelium of blood vessels -> frosted branch retinitis