CMN 568 UPDATED FINAL EXAM QUESTIONS AND
ANSWERS SURE A+
✔✔acute angle closure glaucoma - ✔✔- occurs in older age group
- usually farsighted ppl
- s/s: rapid onset pain, visual loss, halos around light, hard eye ball (inc IOP >50 mm
Hg), eye red, dilated and non-rx pupil, cloudy cornea
- primary - crisis - d/t closure of pre-existing narrow chamber; precipitated by pupillary
dilation
- tx: decrease IOP, may need sx, emergent referral
- if no tx then blind after 2-5 days
✔✔chronic glaucoma - ✔✔- gradual, progressive excavation (cupping) of optic disk
- vision loss starting in periphery (tunnel vision)
- sometimes inc IOP depending on type
- need 2/3 s/s for dx
- tx: meds (prostaglandins, beta blockers), laser or sx, decrease IOP even if normal
✔✔uveitis - ✔✔- inflammation of the uvea causing swelling and irritation
- usually d/t immunologic, systemic disorder
- acute anterior: sudden, blurry vision, trauma, ciliary flush (redness at border of cornea
and sclera)
- posterior: gradual, floaters
- most pedi cases are idiopathic
- tx: corticosteroids and refer urgently
✔✔Cataracts - ✔✔- leading cause of blindness worldwide
- opacities of lens, gradual, progressive blurred vision, glare
- usually BL
- usually age-related
- other causes: congenital (IU unfections), traumatic, 2nd/to sys dz, corticosteroid use,
uveitis, radiation
- need sx if impact ADLs
✔✔retinal detachment - ✔✔- patho: usually d/t retinal tears or holes
- may p/w abnormal or absent red reflex
- predispo: nearsightedness, cataracts extraction, trauma, ROP
- emergent referral, *transport with bad eye down
- s/s: painless curtain (starts at bottom and spreads up), no pain or redness, floaters,
flashing ligh
✔✔vitreous hemorrhage - ✔✔- Sudden loss of vision with floaters, usually secondary to
diabetic retinopathy
- "bleeding in eye"
- no pain or redness
, *refer
✔✔Age-related macular degeneration (AMD) - ✔✔- a loss of central vision caused by
yellow deposits (drusen) and neovascularity in the macula
- leading cause of perm vision loss in older population
- associating factors: female, fam hx, light eyes, smoking, HTN, inc cholesterol,
farsightedness, CV dz
- dry (atrophic, geogrpahic) - more common, gradual loss
- wet (neovascular, exudative) - more rapid onset, more serious, less common
✔✔retinal artery occlusion - ✔✔- sudden unilateral vision loss that is painless
- pale retinal swelling, HA, scalp tenderness, jaw claudication, thick or absent temporal
pulse
- medical emergency - stroke
✔✔Transient monocular vision loss - ✔✔- Amaurosis fugax (fleeting blindness)
- TIA, emboli
- curtain passing vertically
- last minutes and resolves
- tx: PO ASA and refer to ED
✔✔diabetic retinopathy - ✔✔- disease of the retina in diabetics characterized by
capillary leakage, bleeding, and new vessel formation (neovascularization) leading to
scarring and loss of vision
- proliferative less common but more severe
- need regular fundus screening
✔✔hypertensive retinochoroidpathy - ✔✔- most obvious changes in young people with
rapid increase in BP
- pre-eclempsia, eclampsia
✔✔optic neuritis - ✔✔- usually UL vision loss
- pain increase with eye movement
- a/w MS, viral infection, autoimmune disorders, color vision loss
✔✔conductive hearing loss - ✔✔- mechanical disruption of EAC or middle ear
- obstruction (cerumen) most common cause
- other: mass loading (MEE, ETD from URI); stiffness (osteosclerosis); discontinuity
(ossicular disruption)
✔✔sensorineural hearing loss - ✔✔- d/t deficits of inner ear or central (brain) auditory
oathways
- age-related most common
- gradual, progressive, high-frequency
- other causes: excessive noise, head trauma, ototoxic meds, sys dz
ANSWERS SURE A+
✔✔acute angle closure glaucoma - ✔✔- occurs in older age group
- usually farsighted ppl
- s/s: rapid onset pain, visual loss, halos around light, hard eye ball (inc IOP >50 mm
Hg), eye red, dilated and non-rx pupil, cloudy cornea
- primary - crisis - d/t closure of pre-existing narrow chamber; precipitated by pupillary
dilation
- tx: decrease IOP, may need sx, emergent referral
- if no tx then blind after 2-5 days
✔✔chronic glaucoma - ✔✔- gradual, progressive excavation (cupping) of optic disk
- vision loss starting in periphery (tunnel vision)
- sometimes inc IOP depending on type
- need 2/3 s/s for dx
- tx: meds (prostaglandins, beta blockers), laser or sx, decrease IOP even if normal
✔✔uveitis - ✔✔- inflammation of the uvea causing swelling and irritation
- usually d/t immunologic, systemic disorder
- acute anterior: sudden, blurry vision, trauma, ciliary flush (redness at border of cornea
and sclera)
- posterior: gradual, floaters
- most pedi cases are idiopathic
- tx: corticosteroids and refer urgently
✔✔Cataracts - ✔✔- leading cause of blindness worldwide
- opacities of lens, gradual, progressive blurred vision, glare
- usually BL
- usually age-related
- other causes: congenital (IU unfections), traumatic, 2nd/to sys dz, corticosteroid use,
uveitis, radiation
- need sx if impact ADLs
✔✔retinal detachment - ✔✔- patho: usually d/t retinal tears or holes
- may p/w abnormal or absent red reflex
- predispo: nearsightedness, cataracts extraction, trauma, ROP
- emergent referral, *transport with bad eye down
- s/s: painless curtain (starts at bottom and spreads up), no pain or redness, floaters,
flashing ligh
✔✔vitreous hemorrhage - ✔✔- Sudden loss of vision with floaters, usually secondary to
diabetic retinopathy
- "bleeding in eye"
- no pain or redness
, *refer
✔✔Age-related macular degeneration (AMD) - ✔✔- a loss of central vision caused by
yellow deposits (drusen) and neovascularity in the macula
- leading cause of perm vision loss in older population
- associating factors: female, fam hx, light eyes, smoking, HTN, inc cholesterol,
farsightedness, CV dz
- dry (atrophic, geogrpahic) - more common, gradual loss
- wet (neovascular, exudative) - more rapid onset, more serious, less common
✔✔retinal artery occlusion - ✔✔- sudden unilateral vision loss that is painless
- pale retinal swelling, HA, scalp tenderness, jaw claudication, thick or absent temporal
pulse
- medical emergency - stroke
✔✔Transient monocular vision loss - ✔✔- Amaurosis fugax (fleeting blindness)
- TIA, emboli
- curtain passing vertically
- last minutes and resolves
- tx: PO ASA and refer to ED
✔✔diabetic retinopathy - ✔✔- disease of the retina in diabetics characterized by
capillary leakage, bleeding, and new vessel formation (neovascularization) leading to
scarring and loss of vision
- proliferative less common but more severe
- need regular fundus screening
✔✔hypertensive retinochoroidpathy - ✔✔- most obvious changes in young people with
rapid increase in BP
- pre-eclempsia, eclampsia
✔✔optic neuritis - ✔✔- usually UL vision loss
- pain increase with eye movement
- a/w MS, viral infection, autoimmune disorders, color vision loss
✔✔conductive hearing loss - ✔✔- mechanical disruption of EAC or middle ear
- obstruction (cerumen) most common cause
- other: mass loading (MEE, ETD from URI); stiffness (osteosclerosis); discontinuity
(ossicular disruption)
✔✔sensorineural hearing loss - ✔✔- d/t deficits of inner ear or central (brain) auditory
oathways
- age-related most common
- gradual, progressive, high-frequency
- other causes: excessive noise, head trauma, ototoxic meds, sys dz
