MRCSI (Ophth) Written flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Relative afferent pupillary defect

Asymmetry in the pupillary constriction when light is swung between eyes, reflecting unilateral optic nerve or severe retinal dysfunction; tested with the swinging flashlight test.

Cherry-red fovea

Fundoscopic appearance in central retinal artery occlusion where the pale ischemic retina contrasts with the preserved choroidal circulation at the fovea, causing sudden painless vision loss.

Laser peripheral iridotomy

Definitive treatment for acute angle-closure glaucoma; a laser creates a small opening in the iris to relieve pupillary block and allow aqueous to flow into the anterior chamber.

Giant cell arteritis

Large-vessel vasculitis in older adults causing headache, jaw claudication and raised inflammatory markers, threatening irreversible blindness; high-dose corticosteroids must start before biopsy.

Endophthalmitis

Severe intraocular infection, typically after surgery or trauma, presenting with pain, hypopyon and profound vision loss; requires urgent sampling and intravitreal antibiotics.

Optic neuritis

Inflammation of the optic nerve causing painful monocular vision loss worsened by eye movement, color desaturation and an afferent pupillary defect; associated with multiple sclerosis.

Macula-on retinal detachment

Retinal detachment in which the macula remains attached; it is a surgical priority because repairing before macular involvement preserves central visual acuity.

Hypopyon

Layer of white blood cells settling in the anterior chamber, appearing as a fluid level; it indicates severe intraocular inflammation or infection and requires urgent evaluation.

Fluorescein staining

Test using fluorescein dye with cobalt-blue light to detect corneal epithelial defects and abrasions; it also helps identify dendrites of herpes simplex keratitis.

Proliferative diabetic retinopathy

Advanced diabetic eye disease with new vessel formation driven by retinal ischemia; these fragile vessels cause vitreous hemorrhage and tractional retinal detachment, treated with laser photocoagulation.

Papilledema

Bilateral optic disc swelling due to raised intracranial pressure; it typically preserves visual acuity initially but causes enlarged blind spots and transient visual obscurations.

Argyll Robertson pupil

Small, irregular pupils that accommodate but do not react to light, classically linked to neurosyphilis; the lesion lies in the midbrain, sparing the accommodation pathway.

Horner syndrome

Triad of ptosis, miosis and facial anhidrosis from sympathetic pathway disruption; painful acute onset warrants imaging to exclude carotid dissection.

Third nerve palsy

Deficiency causing ptosis, a down-and-out eye and a dilated pupil; pupil-involving acute presentations suggest compressive lesions such as posterior communicating artery aneurysm.

Open-angle glaucoma

Progressive optic neuropathy with characteristic disc cupping and field loss, usually with raised intraocular pressure; treatment lowers pressure with drops, laser or surgery.

Amaurosis fugax

Transient monocular visual loss described as a curtain descending, caused by retinal ischemia from emboli; it is a warning sign of carotid or cardiac disease.

Alvarado score

Clinical scoring system for suspected appendicitis combining migratory pain, anorexia, nausea, right iliac fossa tenderness, rebound, fever and leukocytosis to guide imaging or surgery.

Bowel obstruction features

Colicky abdominal pain, vomiting, distension and absolute constipation; imaging shows dilated loops and air-fluid levels, and strangulation signs such as fever and peritonism need urgent surgery.

Mesenteric ischemia

Insufficient intestinal blood flow causing pain out of proportion to examination findings; CT angiography and early revascularization are essential to prevent bowel infarction.

Strangulated hernia

Irreducible, tender groin or abdominal swelling with systemic upset from compromised blood supply; it is a surgical emergency requiring prompt operative repair.

FAST scan

Focused assessment with sonography for trauma, detecting free fluid in pericardial, perihepatic, perisplenic and pelvic regions during the primary survey of injured patients.

Triple assessment

Combined clinical examination, breast imaging and tissue sampling used to evaluate breast lumps; concordant benign results allow reassurance, discordance requires further biopsy.

Recurrent laryngeal nerve

Nerve running near the thyroid gland; injury during thyroid surgery causes hoarseness from vocal cord paralysis and is a key postoperative complication to recognize.

Post-thyroidectomy hypocalcemia

Low calcium from parathyroid injury or devascularization after thyroid surgery; presents with perioral tingling and carpopedal spasm, managed with calcium replacement.

Perianal abscess

Painful collection near the anus treated with prompt incision and drainage; a subsequent fistula-in-ano may require sphincter-preserving surgical management.

Postoperative fever

Common causes vary with timing: atelectasis and urinary infection early, wound infection later, and deep vein thrombosis; persistent fever requires systematic evaluation.

Wound dehiscence

Separation of a surgical wound, which may progress to evisceration of abdominal contents; it is a surgical emergency requiring theater and wound support.

ABCDE primary survey

Structured trauma assessment covering airway, breathing, circulation, disability and exposure; hemorrhage control and resuscitation occur before definitive imaging or operative management.

Volvulus

Twisting of a bowel segment, commonly sigmoid or cecal, causing closed-loop obstruction; imaging shows a coffee-bean sign and treatment involves decompression or surgery.

Cholecystitis

Inflammation of the gallbladder from cystic duct obstruction, causing right upper quadrant pain, fever and a positive Murphy sign; managed with antibiotics and cholecystectomy.

Small bowel obstruction causes

Adhesions from prior surgery are the commonest cause, followed by hernias and malignancy; initial management includes fluids, nasogastric decompression and monitoring for strangulation.

Appendicitis migration

Pain classically begins around the umbilicus and moves to the right iliac fossa as inflammation reaches the parietal peritoneum, accompanied by localized tenderness.