Quiz for Ocular Disease III - Orbital dz

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Question 1
Multiple-choice

MRIs are useful for what types of structures?

Select the best answer

Capillary hemangiomas (strawberry nevus)

Vascular structures e.g. vascular tumors

you push on the eye and it doesn't give

Yes, but only after pt responds to IV Tx

Question 2
Multiple-choice

Your pt presents with a flesh colored bump on the brow ridge. On palpation you feel a small round "ball" that moves freely inside. There is no inflammation. You suspect...

Select the best answer

dermoid/epidermoid (cystic tumor)

high flow arteriovenous fistula

kids = assoc w/ polyps, allergies

Seidel test to make sure no leakage

Question 3
Multiple-choice

Enlarged lymph nodes at the neck/underarms, bruised eyelids (that won't go away) with a Hx of nosebleeds in a child makes you think...

Select the best answer

Can metastasize

ecto/mesodermal

Rabdomyosarcoma

Orbital X-ray

Question 4
Multiple-choice

ON Giloma Tx?

Select the best answer

Steroid (prednisone), anti-ulcer med (rantidine), low dose radiation if steroids fail, or as adj Tx; immunosupp Tx if above fail

Sudden onset of "pushing on back of my eye" = orbital cellulitis

Gradual = orbital tumor

Steroid IV (betamethasone and triamcinolone), but can depigment eye and incr IOP.

can also just monitor b/c can resolve over time on its own

If VA good, NOT surgery. Surgery only if VA loss or severe proptosis

Under 5 yo = chemo
Over 5 yo = radiation of ONH

Question 5
Multiple-choice

What EOM is usually affected in orbital blowout fractures?

Select the best answer

Yes, but only after pt responds to IV Tx

Idiopathic Orbital Inflammatory Syndrome

the vibration felt due to a hardened artery

IR (orbital floor break so IR gets trapped)

Question 6
Multiple-choice

Corkscrew vessels is a sign of ___ in orbital dz

Select the best answer

arteriovenous fistula

Decr sensation of CN V

Lacrimal gland tumor

lacrimal gland lesion

Question 7
Multiple-choice

What is a "thrill"?

Select the best answer

False - there is incr IOP, in high flow

the vibration felt due to a hardened artery

Yes, but only after pt responds to IV Tx

Capillary hemangiomas (strawberry nevus)

Question 8
Multiple-choice

High flow fistula demographic and cause?

Select the best answer

High = surgery
Low flow = most resolve on own (60%)

Young male, trauma; ICA fistula in cavernous sinus

no orbit; Tx = socket expansion and prosthesis

Side effect of vancomycin, a Tx for orbital cellulitis

Question 9
Multiple-choice

Afrin is indicated for orbital trauma because...

Select the best answer

(nasal decongestant) so pt won't blow nose (valsalva can push sinus contents into orbit)

False - enophthalmos (orbital floor drops so globe pulls back)

Thus also can see ptosis

Sudden onset of "pushing on back of my eye" = orbital cellulitis

Gradual = orbital tumor

False - not a solid mass (diffuse) therefore not diagnostic

Question 10
Multiple-choice

Difference b/w T1 and T2 MRIs?

Select the best answer

False - not a solid mass (diffuse) therefore not diagnostic

High = surgery
Low flow = most resolve on own (60%)

T1 = water (i.e. vitreous) is dark T2 = water is white

Pleomorphic adenoma, pleomorphic adenocarcinoma, cylindroma

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