Podcast
Questions and Answers
What initial recommendation is made for patients with bleeding disorders?
What initial recommendation is made for patients with bleeding disorders?
- Administer NSAIDs for pain relief
- Perform emergency surgery immediately
- Start anticoagulant therapy
- Order CBC, PT, PTT for bleeding disorders (correct)
Which of the following is NOT suggested in the management of bleeding disorders?
Which of the following is NOT suggested in the management of bleeding disorders?
- Lubricants
- Use of NSAIDs (correct)
- Patient reassurance
- Referral to an internist if a blood disorder is suspected
Ocular Cicatricial Pemphygoid primarily affects which part of the body?
Ocular Cicatricial Pemphygoid primarily affects which part of the body?
- The brain
- The digestive tract
- The mucous membranes (correct)
- The skin
At what age is Ocular Cicatricial Pemphygoid most commonly diagnosed?
At what age is Ocular Cicatricial Pemphygoid most commonly diagnosed?
Which systemic treatment options are recommended for Ocular Cicatricial Pemphygoid?
Which systemic treatment options are recommended for Ocular Cicatricial Pemphygoid?
What is the primary cause of blister formation in Ocular Cicatricial Pemphygoid?
What is the primary cause of blister formation in Ocular Cicatricial Pemphygoid?
Which sign is commonly associated with Ocular Cicatricial Pemphygoid?
Which sign is commonly associated with Ocular Cicatricial Pemphygoid?
What stage of Ocular Cicatricial Pemphygoid involves conjunctival shrinkage and its associated complications?
What stage of Ocular Cicatricial Pemphygoid involves conjunctival shrinkage and its associated complications?
Which of the following drugs is NOT associated with drug-induced Ocular Cicatricial Pemphygoid?
Which of the following drugs is NOT associated with drug-induced Ocular Cicatricial Pemphygoid?
What is a potential complication of blisters in conjunctiva due to Ocular Cicatricial Pemphygoid?
What is a potential complication of blisters in conjunctiva due to Ocular Cicatricial Pemphygoid?
Which of the following antibiotics is NOT recommended for severe staphylococcal infections?
Which of the following antibiotics is NOT recommended for severe staphylococcal infections?
What is the age demographic most commonly affected by Superior Limbic Keratoconjunctivitis (SLK)?
What is the age demographic most commonly affected by Superior Limbic Keratoconjunctivitis (SLK)?
Which condition is associated with over 50% of patients suffering from Superior Limbic Keratoconjunctivitis?
Which condition is associated with over 50% of patients suffering from Superior Limbic Keratoconjunctivitis?
What is the primary characteristic of Superior Limbic Keratoconjunctivitis?
What is the primary characteristic of Superior Limbic Keratoconjunctivitis?
What is the suggested cause of the etiology of Superior Limbic Keratoconjunctivitis?
What is the suggested cause of the etiology of Superior Limbic Keratoconjunctivitis?
Which oral antibiotic class is noted as best for reducing collagenases in inflammation?
Which oral antibiotic class is noted as best for reducing collagenases in inflammation?
What is a common associated condition in patients with Superior Limbic Keratoconjunctivitis?
What is a common associated condition in patients with Superior Limbic Keratoconjunctivitis?
What treatment is NOT part of the regimen for severe staph infections?
What treatment is NOT part of the regimen for severe staph infections?
What is a treatment regimen for severe staphylococcal infections involving topical medication?
What is a treatment regimen for severe staphylococcal infections involving topical medication?
What is a typical follow-up interval for patients treated for severe staphylococcal infections?
What is a typical follow-up interval for patients treated for severe staphylococcal infections?
What is the primary treatment for inflamed conditions related to pingueculitis?
What is the primary treatment for inflamed conditions related to pingueculitis?
Which of the following symptoms is most commonly associated with corneal phlyctenules?
Which of the following symptoms is most commonly associated with corneal phlyctenules?
Which statement about the lesions associated with conjunctival phlyctenules is accurate?
Which statement about the lesions associated with conjunctival phlyctenules is accurate?
Which testing method is primarily used to check for tuberculosis in the context of phlyctenular conjunctivitis?
Which testing method is primarily used to check for tuberculosis in the context of phlyctenular conjunctivitis?
What is a potential complication of untreated corneal phlyctenules?
What is a potential complication of untreated corneal phlyctenules?
Which demographic is most frequently affected by conjunctival phlyctenules?
Which demographic is most frequently affected by conjunctival phlyctenules?
What underlying condition is commonly associated with the occurrence of phlyctenular conjunctivitis?
What underlying condition is commonly associated with the occurrence of phlyctenular conjunctivitis?
When can lubricants be used for treating non-inflamed conditions?
When can lubricants be used for treating non-inflamed conditions?
What does the systemic treatment typically involve for managing oral lesions?
What does the systemic treatment typically involve for managing oral lesions?
Which of the following ocular conditions is characterized by the presence of a membrane on the conjunctiva?
Which of the following ocular conditions is characterized by the presence of a membrane on the conjunctiva?
How should abrasions typically be treated?
How should abrasions typically be treated?
What is an appropriate initial management step for ocular dry eye conditions?
What is an appropriate initial management step for ocular dry eye conditions?
Which treatment is indicated for lacerations that are greater than 1-1.5 cm?
Which treatment is indicated for lacerations that are greater than 1-1.5 cm?
What is the primary treatment approach for hemolytic anemia?
What is the primary treatment approach for hemolytic anemia?
Which of the following factors can precipitate Steven’s-Johnson Syndrome?
Which of the following factors can precipitate Steven’s-Johnson Syndrome?
Which feature is characteristic of the primary lesions in Steven’s-Johnson Syndrome?
Which feature is characteristic of the primary lesions in Steven’s-Johnson Syndrome?
What is the recommended follow-up interval for ocular treatments in patients with hemolytic anemia?
What is the recommended follow-up interval for ocular treatments in patients with hemolytic anemia?
Which treatment is suggested for patients experiencing lid margin disease?
Which treatment is suggested for patients experiencing lid margin disease?
In which demographic is Steven’s-Johnson Syndrome most commonly observed?
In which demographic is Steven’s-Johnson Syndrome most commonly observed?
What type of ocular treatment is used for trichiasis or entropion/ectropion?
What type of ocular treatment is used for trichiasis or entropion/ectropion?
What are the common early symptoms of Steven’s-Johnson Syndrome?
What are the common early symptoms of Steven’s-Johnson Syndrome?
What type of lubricant is recommended for ocular care in patients with specific conditions?
What type of lubricant is recommended for ocular care in patients with specific conditions?
What skin condition is characterized by erosive mucocutaneous lesions?
What skin condition is characterized by erosive mucocutaneous lesions?
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Study Notes
Treatment Overview
- Non-inflamed conditions treated with lubricants every 3 hours (QID) with follow-ups as needed.
- Inflamed conditions require lubricants every 3 hours (QID) and FML (fluorometholone) drops QID for 5-7 days with follow-ups every 3-7 days.
Pingueculitis
- Degeneration of the conjunctiva often presenting as redness and irritation.
- Associated with phlyctenular conjunctivitis, an immune reaction linked to staphylococcal proteins and tuberculosis, common in autoimmune diseases like Behcet’s and HIV.
- Distinguishes between conjunctival and corneal phlyctenules.
- Symptoms include foreign body sensation and burning, more prominent with limbal/corneal phlyctenules.
Diagnostic Tests for Phlyctenular Conjunctivitis
- Tuberculosis assessed via PPD and Chest X-ray.
- HLA-B51 testing for Behcet’s.
- HIV screening as needed.
Treatment for Phlyctenular Conjunctivitis
- Topical steroids to be tapered after initial treatment.
- If staphylococcal involvement is found, combination treatments including antibiotics may be necessary.
- Severe cases may require oral doxycycline, tetracycline, or erythromycin.
Superior Limbic Keratoconjunctivitis (SLK)
- Chronic inflammatory condition affecting the superior bulbar conjunctiva.
- Primarily affects middle-aged women (aged 20-55), often associated with thyroid disease.
- Common signs include irritation and inflammation; symptoms can resolve with time.
Management of SLK
- Treatment focuses on reassurance and lubricants.
- Avoid NSAIDs and aspirin; regular follow-ups are recommended.
- Advanced cases may require referrals for underlying conditions.
Mucous Membrane Disorders
- Includes diseases like ocular cicatricial pemphigoid (OCP) and erythema multiforme.
- Immune-mediated reactions affecting the mucosal basement membrane.
Ocular Cicatrical Pemphygoid (OCP)
- Rare disease (incidence of 1 in 15,000-40,000).
- Typically presents in older adults (after age 55).
- Blister formation and scarring in the eye can lead to vision loss, with stages of progression noted.
Systemic and Ocular Treatment for OCP
- Requires a multidisciplinary approach involving internists and dermatologists.
- Treatment typically includes systemic steroids and immunosuppressants.
- Ocular management includes lubricants, punctal occlusion, and potential surgery for eyelid deformities.
Stevens-Johnson Syndrome
- Severe inflammatory condition causing erosive lesions in skin and mucous membranes, typically triggered by medications or infections.
- Symptoms include fever, malaise, and distinctive target lesions.
- Requires hospitalization and elimination of potential causes with extensive ocular treatment for complications.
Abrasions and Lacerations
- Abrasions show localized staining with NaFl; treatment includes topical antibiotics without the need for patching.
- Lacerations can reveal a loose conjunctival flap; management involves evaluation and possible suturing for larger lacerations.
- Follow-up for both conditions occurs in a range of 3-7 days depending on severity.
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