Divine Intervention Episode 36 USMLE Ophthalmology. Some PGY1

Transcription

1 Divine Intervention Episode 36 USMLE Ophthalmology Some PGY1

2 1 71 yo M with central scotomas. Straight lines appear wavy and blurred when he tries to read. Diagnosis? Types of disease? Which is more rapid in progression? HY exam risk factors? Differentiating this disorder from glaucoma. Treatment strategies by type of disease? Most common cause of vision loss in the developed world?

3 2 35 yo M was punched in the eye 2 hrs ago. He is brought to the ED by a friend with complaints of visual difficulty in his left eye. He has a sensation of items floating in his visual fields along with bright streaks of light. Diagnosis? Classic presentation? HY exam risk factors? Treatment strategies.

4 3 Newborn with a white reflex in his right eye. An intraocular mass is suspected. Diagnosis? What is a potential future connective tissue malignancy?

5 4 Differentiating between amblyopia and strabismus. Other causes of amblyopia. Diagnostic testing in patients with strabismus. Treatment strategies.

6 5 A 45 yo Asian male has the sudden onset of severe pain in his right eye along with nausea and vomiting. He took a nasal decongestant an hour ago for some annoying nasal symptoms. Diagnosis? Treatment strategies? Other type of this disorder. Classic presentation/demographic/risk factors? Diagnostic testing? Findings on diagnostic testing? The pharmacology of this disorder.

7 6 23 yo M presents with a 2 day history of severe R eye pain and blurry vision. He has been taking Benadryl for a sinus problem that began 5 days ago. HEENT exam is notable for pain with R eye movement and 20/200 vision. Diagnosis? Diagnostic testing? Differentiating this disorder from its close cousin. Common bug causes. Treatment.

8 7 23 yo F presents with a 2 day history of severe left eye pain. She can barely see anything out of the left eye. The patient mentions that the visual difficulty gets worse after she takes a hot shower. Diagnosis? Diagnostic testing? Classic disease association? Pathophysiology? Unique treatment? Most likely sequel of disease?

9 8 76 yo F comes to her PCP for a routine annual exam. She complains of a 6 month history of difficulty driving at night and reading road signs. Diagnosis? Pathophysiology? Metabolic risk factor? Drug associated risk factor? Infectious risk factors? Newborn with a bilateral presentation? Most common cause of death in these newborns?

10 9A Most common cause of conjunctivitis in the first 24 hrs of life? 5 day old newborn with super purulent conjunctivitis (bug, tx, prophylaxis)? 12 day old newborn with watery discharge conjunctivitis and eyelid swelling (bug, tx, prophylactic relationship to presentation 2, pneumonia presentation, down the line nonbilious vomiting after tx)? Of the top 3 above, which is the most dangerous?

11 9B-What is the most likely cause of conjunctivitis? #1-Glued eyes in the morning (unilateral) + watery discharge + rhinorrhea (Dx, Tx, HY bug, HY bug associations, relevant epidemiology). #2-Glued eyes in the morning (unilateral) + purulent discharge + no rhinorrhea (Dx, MCC in adults, Tx, Tx in contact lens wearers). #3-Hx of asthma + bilateral itchy red eye

12 10 Eye pain + pain worsened with light in a 23 yo M with a history of chronic low back pain and morning stiffness. Diagnosis? Pulmonary disease association? Pediatric rheumatology association? Diagnostic testing? Treatment strategies (+ if caused by HSV, + if caused by an autoimmune phenomenon, + if caused by some kind of bacterium)?

13 11 70 yo F with difficulty reading books. She often has to move the book away from her eyes to make out words on the page. Diagnosis? Pathophysiology?

14 12 Differentiating a central retinal artery occlusion from a central retinal venous occlusion. Some Step 1 throwback with lysosomal storage diseases. Funduscopic findings in diabetic retinopathy (+ diagnostic testing, + diagnostic frequency, + tx strategies)

15 13 19 yo F presents with pain and a foreign body sensation in the eye. She wears contact lenses. Diagnosis? Diagnostic testing? Tx strategies?