Ophthalmology Quiz: Retinal Disorders
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Questions and Answers

A patient presents with sudden, painless vision loss in one eye. Fundoscopy reveals a cloudy retina with a 'cherry-red' spot at the fovea. Which condition is most consistent with these findings?

  • Retinal Vein Occlusion
  • Retinal Artery Occlusion (correct)
  • Age-Related Macular Degeneration
  • Retinal Detachment

A patient with a history of chronic hypertension presents with visual changes. Fundoscopic exam reveals retinal vessel changes including sclerosis and fibrinoid necrosis. What is the most likely diagnosis?

  • Retinal Vein Occlusion
  • Retinal Artery Occlusion
  • Diabetic Retinopathy
  • Hypertensive Retinopathy (correct)

Which of the following conditions is most associated with 'blood and thunder' appearance during a fundoscopic exam?

  • Retinal Vein Occlusion (correct)
  • Retinitis Pigmentosa
  • Retinal Artery Occlusion
  • Retinal Detachment

A patient reports experiencing night blindness and progressive peripheral vision loss. Which retinal disorder is most consistent with these symptoms?

<p>Retinitis Pigmentosa (C)</p> Signup and view all the answers

An infant presents with an abnormal white reflection in one eye. Which of the following conditions should be highest in the differential diagnosis?

<p>Retinoblastoma (D)</p> Signup and view all the answers

A patient describes a 'dark curtain' moving across their vision, along with floaters and light flashes. Fundoscopy reveals wrinkling of the retina. What is the most likely cause of these symptoms?

<p>Retinal Detachment (C)</p> Signup and view all the answers

Which condition is characterized by optic disc swelling due to increased intracranial pressure?

<p>Papilledema (A)</p> Signup and view all the answers

Which finding is most suggestive of proliferative diabetic retinopathy?

<p>Retinal neovascularization (D)</p> Signup and view all the answers

A patient presents with conjunctival redness and pus accumulation in the anterior chamber of the eye. Which condition is most consistent with these findings?

<p>Uveitis (C)</p> Signup and view all the answers

Distortion of straight lines (metamorphopsia) and rapid decrease in vision are most commonly associated with which form of Age-Related Macular Degeneration?

<p>Wet (A)</p> Signup and view all the answers

What is the primary cause of visual loss in wet age-related macular degeneration?

<p>Bleeding following choroidal neovascularization (D)</p> Signup and view all the answers

A patient with acute and painless monocular vision loss most likely has which condition?

<p>Retinal Artery Occlusion (B)</p> Signup and view all the answers

What is the direct pathology behind a branch retinal vein occlusion?

<p>Sclerotic arteriole compressing an adjacent venule (D)</p> Signup and view all the answers

Which of the following is a likely consequence of a chronic hypertensive retinopathy?

<p>Fibrinoid necrosis of retinal vessels (B)</p> Signup and view all the answers

Which type of retinal detachment is most often caused by a tear in the retina?

<p>Rhegmatogenous (C)</p> Signup and view all the answers

What specific visual field defect is most commonly associated with retinitis pigmentosa?

<p>Peripheral vision loss (C)</p> Signup and view all the answers

What is the underlying cause of papilledema?

<p>Increased intracranial pressure (C)</p> Signup and view all the answers

Which of the following is NOT a cause of leukocoria?

<p>Retinal Detachment (D)</p> Signup and view all the answers

Why does proliferative diabetic retinopathy lead to neovascularization?

<p>Chronic retinal hypoxia (A)</p> Signup and view all the answers

Which gene mutation is directly implicated in the development of retinoblastoma?

<p>RB1 (C)</p> Signup and view all the answers

Which of the following best describes the pathophysiology of retinal artery occlusion?

<p>Blockage of the retinal artery due to an embolus or giant cell arteritis (A)</p> Signup and view all the answers

A patient with retinitis pigmentosa would most likely exhibit which finding on fundoscopic examination?

<p>Retinal pigmentation with bone spicule-shaped deposits (D)</p> Signup and view all the answers

Which of the following is a key feature of nonproliferative diabetic retinopathy?

<p>Macular edema (D)</p> Signup and view all the answers

A patient presenting with a painless monocular vision loss ('dark curtain'), floaters, and light flashes is most likely experiencing which condition?

<p>Retinal Detachment (A)</p> Signup and view all the answers

A 6-year-old child presents with strabismus and an abnormal white reflection in the left eye. This is most suggestive of which underlying condition?

<p>Retinoblastoma (C)</p> Signup and view all the answers

Which of the following describes the primary pathophysiology of papilledema?

<p>Impaired axoplasmic outflow in the optic nerve due to increased intracranial pressure (D)</p> Signup and view all the answers

What is the primary cause of the retinal neovascularization seen in proliferative diabetic retinopathy?

<p>Chronic hypoxia (D)</p> Signup and view all the answers

A patient with conjunctival redness and hypopyon in the anterior chamber is most likely experiencing:

<p>Uveitis (D)</p> Signup and view all the answers

Which of the following best characterizes the 'blood and thunder' appearance seen on fundoscopy?

<p>Venous engorgement and retinal hemorrhages (B)</p> Signup and view all the answers

Which of the following genetic patterns is most closely associated with retinitis pigmentosa?

<p>Autosomal Recessive (C)</p> Signup and view all the answers

Flashcards

Retinal Artery Occlusion

A condition where the central or branch retinal artery is blocked, usually due to an embolism from atherosclerotic plaques in the carotid artery or from a cardiac source.

Retinitis Pigmentosa

A group of inherited retinal dystrophies where photoreceptor cells and the retinal pigment epithelium degenerate, leading to progressive vision loss.

Papilledema

Swelling of the optic disc, usually caused by increased intracranial pressure, leading to impaired axoplasmic outflow in the optic nerve.

Retinal Detachment

A condition where the retina detaches from the underlying choroid, often due to tears or holes in the retina.

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Diabetic Retinopathy

A chronic condition where the retina's blood vessels are damaged due to high blood sugar levels, leading to vision loss.

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Age-Related Macular Degeneration

A common eye disorder that affects central vision. It occurs in two forms: Dry and Wet.

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Leukocoria

A term used to describe an abnormal white reflection in the eye, often seen in children. It is a sign, not a diagnosis, and can be caused by several conditions like cataracts or retinoblastoma.

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Retinal Vein Occlusion

A condition that occurs when there is a blockage in a retinal vein. There are two types: Central Retinal Vein Occlusion (CRVO) and Branch Retinal Vein Occlusion (BRVO).

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Uveitis

Inflammation of the uvea, the middle layer of the eye. There are three main types: anterior uveitis (iritis), posterior uveitis (choroiditis, retinitis), and panuveitis.

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Retinoblastoma

The most common intraocular malignancy in children, caused by mutations in both RB1 tumor suppressor genes on chromosome 13.

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Rhegmatogenous Retinal Detachment

The most common cause of retinal detachment, where tears or holes in the retina allow fluid to leak in and detach the retina from the choroid.

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Wet AMD

A condition characterized by a rapid decrease in vision due to bleeding from new blood vessels in the choroid that leak into the retina.

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Age-Related Macular Degeneration (AMD)

A chronic condition that affects central vision, most commonly caused by the gradual breakdown of the macula.

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Non-Rhegmatogenous Retinal Detachment

A condition that occurs when the retina detaches from the back of the eye, often caused by fluid accumulation.

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What is Retinal Artery Occlusion?

A blockage of either the central or branch retinal artery, often caused by an embolism from the carotid artery or heart.

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What is Retinitis Pigmentosa?

A group of inherited eye disorders leading to progressive degeneration of photoreceptor cells and the retinal pigment epithelium, causing vision loss.

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What is Papilledema?

Swelling of the optic disc, usually caused by increased pressure in the skull, affecting the flow of fluids in the optic nerve.

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What is Retinal Detachment?

A condition where the retina detaches from the choroid layer, often due to tears or holes in the retina.

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What is Diabetic Retinopathy?

A chronic condition where high blood sugar levels damage the retina's blood vessels, leading to vision loss.

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What is Age-Related Macular Degeneration (AMD)?

A common eye condition affecting central vision, usually developing gradually and often categorized as 'dry' or 'wet'.

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What is Leukocoria?

An abnormal white reflection in the eye, often seen in children, indicating a potential underlying issue, like cataracts or retinoblastoma.

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What is Retinal Vein Occlusion?

A blockage in a retinal vein, either involving the central vein (CRVO) or a branch (BRVO), affecting blood flow.

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What is Uveitis?

Inflammation of the uvea, the middle layer of the eye, affecting the iris, choroid, or retina.

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What is Retinoblastoma?

The most common intraocular malignancy in children, caused by mutations in the RB1 gene, affecting cell growth and development.

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Study Notes

  • Dry (most common): Gradual decrease in vision, subretinal deposits
  • Wet: Rapid decrease in vision due to bleeding following choroidal neovascularization, distortion of straight lines (metamorphopsia)

Retinal Artery Occlusion

  • Blockage of central or branch retinal artery, due to emboli (carotid artery atherosclerosis), or giant cell arteritis
  • Clinical feature: acute and painless monocular vision loss

Retinal Vein Occlusion

  • Central retinal vein occlusion due to primary thrombosis
  • Branch retinal vein occlusion due to secondary thrombosis at arteriovenous crossings
  • Pathophysiology: sclerotic arteriole compresses adjacent venule causing turbulent blood flow
  • Fundoscopy: venous engorgement ("blood and thunder" appearance), retinal edema in affected areas, retinal hemorrhage

Retinitis Pigmentosa

  • Group of inherited dystrophies causing progressive degeneration of photoreceptors and retinal pigment epithelium
  • Due to blood supply loss (hypoxia)
  • Associations: abetalipoproteinemia, autosomal recessive, MTTP gene mutation, defective reabsorption of fats
  • Clinical features: night blindness (nyctalopia), peripheral vision loss
  • Fundoscopy: retinal pigmentation with bone spicule–shaped deposits, retinal vessel attenuation, optic disc pallor

Papilledema

  • Optic disc swelling, usually bilateral
  • Cause: Increased intracranial pressure (ICP) (e.g., due to mass effect), leading to impaired axoplasmic outflow in the optic nerve
  • Fundoscopy: elevated optic disc with blurred margins

Leukocoria

  • Abnormal white reflection of light on the eye.
  • Signs, not a diagnosis.
  • Causes: Congenital cataracts and retinoblastoma.

Diabetic Retinopathy

  • Chronic hyperglycemia leading to increased permeability and occlusion of retinal vessels.
  • Nonproliferative (most common): retinal hemorrhages, microaneurysms, cotton-wool spots, hard exudates
  • Proliferative: chronic hypoxia → retinal neovascularization, abnormal new vessels can cause vitreous hemorrhage and tractional retinal detachment
  • Fundoscopy: hard exudates, cotton-wool spots, retinal hemorrhages, microaneurysms

Hypertensive Retinopathy

  • Chronic hypertension: spasm → sclerosis → fibrinoid necrosis of retinal vessels
  • Clinical features: indicative of hypertensive emergency, warrants immediate lowering of blood pressure
  • Fundoscopy: arteriovenous nicking

Retinal Detachment

  • Monocular vision loss ("dark curtain")
  • Rhegmatogenous (most common): due to traumatic tears of retina.
  • Non-Rhegmatogenous: not due to tears: tractional (fluid accumulation) or exudative (fluid accumulation).
  • Fundoscopy: wrinkling of detached retina, change in vessel direction, and opacification

Retinoblastoma

  • Most common intraocular malignancy in children
  • Arises from immature retinal cells.
  • Mutation in both RB1 tumor suppressor gene on chromosome 13 (impedes G1 to S phase of cell cycle) appears sporadic (random) or familial (inherited)
  • Presentation: leukocoria, strabismus, nystagmus, eye redness
  • Fundoscopy: elevated optic disc with blurred margins

Uveitis

  • Inflammation of uvea (hypopyon - accumulation of pus in anterior chamber), conjunctiva redness
  • Associations with systemic inflammatory disorders (e.g., Crohn's disease), HLA-B27-associated conditions (e.g., juvenile idiopathic arthritis), Behçet syndrome, and sarcoidosis
  • Fundoscopy: inflammation of the uveal tract

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Description

Test your knowledge on various retinal disorders including Age-Related Macular Degeneration, Retinal Artery and Vein Occlusion, and Retinitis Pigmentosa. This quiz covers clinical features, pathophysiology, and genetic associations related to these conditions.

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