1. The document discusses the anatomy, physiology, and pharmacology of the autonomic nervous system as it relates to pupil function and abnormalities.
2. Key topics covered include the causes, features, and approaches to evaluating anisocoria, Horner's syndrome, Adie's tonic pupil, and other pupil abnormalities.
3. Tests involving pharmacological agents are described that can help localize lesions in various parts of the autonomic nervous system pathways controlling the pupil.
1. The document discusses the anatomy, physiology, and pharmacology of the autonomic nervous system as it relates to pupil function and abnormalities.
2. Key topics covered include the causes, features, and approaches to evaluating anisocoria, Horner's syndrome, Adie's tonic pupil, and other pupil abnormalities.
3. Tests involving pharmacological agents are described that can help localize lesions in various parts of the autonomic nervous system pathways controlling the pupil.
This document discusses visual field defects and how to determine the location of lesions based on perimetry results. In 3 sentences: It provides examples of visual field defects from various causes like glaucoma, anterior ischemic optic neuropathy (AION), drusen, retinal vein occlusions, and lesions in different areas of the visual pathway. Common visual field defects are described for different pathological conditions along with their likely anatomical locations. Examples of visual field defects from glaucoma include central or paracentral defects, nasal steps, temporal wedges, and arcuate scotomas.
This document discusses various types of primary and secondary glaucomas including:
- Primary open angle glaucoma (POAG) which presents with increased intraocular pressure (IOP) and optic nerve damage in older patients.
- Primary angle closure glaucoma (PACG) which occurs when the iris blocks the drainage angle, commonly in East Asian populations.
- Normal tension glaucoma (NTG) which has optic nerve damage and visual field loss with normal IOP, often associated with nocturnal hypotension.
- Secondary glaucomas caused by conditions like pseudoexfoliation syndrome, pigment dispersion syndrome, neovascular glaucoma, and lens-induced glaucomas
Classification Staging Grading in OphthalmologyMeng Hsien Yong
This document discusses various classification and staging systems used in ophthalmology. It covers classifications for corneal and external eye diseases, glaucoma, uveitis, vitreo-retinal diseases, and others. For each condition, it provides details on the classifications used to describe risk factors, pathogenesis, clinical features, severity, investigations, and management approaches. The classifications discussed include international standardized systems as well as other commonly used staging methods.
This document summarizes orbital anatomy and various orbital diseases. It describes the anatomy of orbital structures like bones, foramina and fissures. It then discusses symptoms, signs, investigations and treatment of various inflammatory orbital diseases including thyroid eye disease, idiopathic orbital inflammatory disease, orbital cellulitis, subperiosteal abscess and mucormycosis. It also briefly mentions other conditions like orbital myositis, dacryoadenitis and Tolosa-Hunt syndrome.
The document discusses various types of corneal diseases including congenital, traumatic, inflammatory, degenerative/dystrophic, and neoplastic conditions. It provides details on infectious keratitis caused by bacteria like Staphylococcus, Pseudomonas, and Neisseria as well as fungi and protozoa. Viral keratitis from herpes simplex virus, herpes zoster virus, and adenovirus are also examined. Signs, risk factors, investigations, and treatment approaches are described for each condition. Inflammatory keratitis can be infective or immune-related disorders like marginal keratitis and Mooren's ulcer are also reviewed.
The document discusses different patterns of visual field defects seen in various eye conditions, provides examples of defects associated with specific pathologies, and outlines laser and surgical treatment options for glaucoma including trabeculectomy, various shunt procedures, and laser trabeculoplasty. It also reviews medication classes used for glaucoma treatment and their mechanisms of action.
This document contains information about two interactive medical cases presented by Samhaa Mohammed Abd Elmoneim.
Case one involves an 8-month-old girl with right lid swelling and erythema for two days, with a recent history of fever and nasal discharge. Multiple choice questions are included to test the differentiation between preseptal and orbital cellulitis, common causes, and clinical findings and test results.
Case two involves a 2-year-old boy noted to have inward deviation of the left eye for two weeks. His cycloplegic refraction results and alternate prism cover test indicate a diagnosis of refractive accommodative esotropia. Multiple choice questions assess the most likely diagnosis, appropriate
1. The document describes the candidate's FRCS viva exam, which consisted of 4 stations testing different areas of ophthalmology.
2. Each station had 2 examiners and lasted 20 minutes, with cases involving emergency situations, neuroophthalmology, and posterior and anterior segment pathologies.
3. The clinical exam portion involved 4 stations testing the posterior segment, neuro-motility, oculoplasty, and anterior segment. Cases were presented and the candidate was examined on their diagnostic and management skills.
Uveitis is a general term for intraocular inflammation that does not indicate the specific site or cause of inflammation. It can be caused by autoimmune or infectious processes. Uveitis is a common cause of visual impairment and blindness worldwide. It is classified based on the site of inflammation - anterior, intermediate, posterior or panuveitis. Developing a differential diagnosis involves considering factors such as acuity of onset, laterality, associated symptoms and response to previous therapies. Common etiologies include idiopathic disease, infections like tuberculosis, and autoimmune diseases like sarcoidosis and Behcet's disease. Treatment involves corticosteroids and immunosuppressive therapies.
A 19-year-old man presented with floaters and vision loss in his left eye over the past year. On examination, he had cells in his anterior chamber, vitreous hemorrhage, a swollen optic disc, cystoid macular edema, subretinal fibrosis, and chorioretinal scars in his left eye. Investigations did not reveal an infectious cause. He was treated with orbital floor triamcinolone injections which improved his cystoid macular edema but caused steroid-induced glaucoma, requiring glaucoma medication. His inflammation later flared up again requiring additional steroid treatment.
1. Proptosis refers to the forward displacement of the eye within the orbit. It can be caused by conditions affecting the orbit or endocrine system.
2. A thorough history and physical examination are important to determine the cause, characteristics, progression of proptosis, and assess for signs of inflammation, infection, or underlying systemic disease.
3. Imaging studies like CT and MRI help identify the location, size, and nature of any orbital lesions causing proptosis and guide management. Biopsy may be needed to confirm diagnosis in some cases.
The document summarizes a case presentation of a 43-year-old male with blurred vision who underwent LASIK surgery 9 years prior and now presents with worsening vision. Examination found stromal opacities and the patient underwent penetrating keratoplasty (PKP) in the right eye. One year later, vision decreased in both eyes and the patient underwent PKP in the left eye. The document discusses granular dystrophy, a genetic bilateral corneal dystrophy, and reviews the patient's clinical course and management.
This document summarizes several corneal disorders:
- Corneal abrasion is a scrape or scratch of the corneal epithelium, most commonly caused by objects hitting the eye. Symptoms include eye pain and blurred vision. Treatment involves removing any foreign objects and using analgesics and antibiotics.
- Corneal dystrophies are inherited disorders that affect the cornea's layers and transparency. Symptoms may include visual impairment and corneal erosion. Treatment addresses erosion and sometimes requires keratoplasty.
- Band keratopathy is a type of corneal degeneration causing a white, band-shaped calcification. It is often caused by hypercalcemia or eye inflammation. Treatment focuses on the underlying cause along with superficial debridement.
This document discusses common eye diseases and conditions, including:
1) Uveitis (inflammation of the uveal tract) which can be anterior, intermediate, or posterior. Anterior uveitis includes iritis which causes redness, pain, and blurred vision.
2) Cataracts which include senile, childhood, and traumatic cataracts. Cataract surgery techniques include ICCE, ECCE, and phacoemulsification.
3) Complications of cataract surgery can include infection, uveitis, glaucoma, vitreous prolapse, and retinal detachment.
History taking examination and diminution visionGayatree Mohanty
This document discusses the process of history taking and examination in ophthalmology. It covers collecting demographic data, chief complaints, history of present and past illness, family history, and performing an examination of visual acuity, external eye, and fundus. The examination section describes assessing the forehead, eyelids, conjunctiva, cornea, anterior chamber, iris, pupil, lens, vitreous, and retina. Common symptoms and clinical features of various eye conditions are also outlined.
This document discusses uveitis, including its classification, description, causes, and clinical presentation. It provides details on:
1) The anatomical, pathological, and clinical classifications of uveitis including anterior, intermediate, posterior, and panuveitis.
2) The description of uveitis including its course (acute, recurrent, relapse, remission), duration (limited, persistent), and onset (sudden, insidious).
3) The common causes of different types of uveitis including infectious (viral, bacterial, fungal, parasitic) and non-infectious etiologies with and without systemic associations. Specific causes of anterior, intermediate, and posterior uveitis are
OTHER RETINAL VASCULAR DISEASES by Iddi.pptxIddi Ndyabawe
This document provides an overview of various retinal vascular diseases including sickle cell retinopathy, vasculitis, cystoid macular edema, and other conditions. It discusses the pathophysiology, signs and symptoms, diagnosis, and treatment of sickle cell retinopathy in detail. It also describes other conditions like vasculitis, distinguishing between primary and secondary retinal vasculitis. Specific entities like Eales disease, Susac syndrome, and IRVAN are explained. Cystoid macular edema is discussed along with its causes and pathogenesis. Overall, the document comprehensively reviews other retinal vascular diseases beyond diabetic retinopathy.
This document discusses several common pediatric ophthalmic problems including congenital cataract, glaucoma, retinopathy of prematurity, squint, refractive error, allergic conjunctivitis, retinoblastoma, and ocular infections. It provides details on causes, presentations, investigations, and management of each condition. Congenital cataract surgery in children poses unique challenges due to the small eye and intense inflammation. Retinopathy of prematurity screening and timely laser treatment can help reduce vision loss in preterm infants.
This document discusses several tumors that commonly affect children, including:
1. Hemangiomas - benign tumors of blood vessels that often appear at birth and can involve the skin, mucosa, or viscera.
2. Neuroblastoma - a malignant tumor of the sympathetic nervous system that typically presents before 5 years of age and commonly involves the adrenal glands.
3. Retinoblastoma - a malignant tumor of the eye that is the most common eye cancer in children and may occur as a familial or sporadic condition associated with mutations in the RB gene.
This document discusses visual field defects and how to determine the location of lesions based on perimetry results. In 3 sentences: It provides examples of visual field defects from various causes like glaucoma, anterior ischemic optic neuropathy (AION), drusen, retinal vein occlusions, and lesions in different areas of the visual pathway. Common visual field defects are described for different pathological conditions along with their likely anatomical locations. Examples of visual field defects from glaucoma include central or paracentral defects, nasal steps, temporal wedges, and arcuate scotomas.
This document discusses various types of primary and secondary glaucomas including:
- Primary open angle glaucoma (POAG) which presents with increased intraocular pressure (IOP) and optic nerve damage in older patients.
- Primary angle closure glaucoma (PACG) which occurs when the iris blocks the drainage angle, commonly in East Asian populations.
- Normal tension glaucoma (NTG) which has optic nerve damage and visual field loss with normal IOP, often associated with nocturnal hypotension.
- Secondary glaucomas caused by conditions like pseudoexfoliation syndrome, pigment dispersion syndrome, neovascular glaucoma, and lens-induced glaucomas
Classification Staging Grading in OphthalmologyMeng Hsien Yong
This document discusses various classification and staging systems used in ophthalmology. It covers classifications for corneal and external eye diseases, glaucoma, uveitis, vitreo-retinal diseases, and others. For each condition, it provides details on the classifications used to describe risk factors, pathogenesis, clinical features, severity, investigations, and management approaches. The classifications discussed include international standardized systems as well as other commonly used staging methods.
This document summarizes orbital anatomy and various orbital diseases. It describes the anatomy of orbital structures like bones, foramina and fissures. It then discusses symptoms, signs, investigations and treatment of various inflammatory orbital diseases including thyroid eye disease, idiopathic orbital inflammatory disease, orbital cellulitis, subperiosteal abscess and mucormycosis. It also briefly mentions other conditions like orbital myositis, dacryoadenitis and Tolosa-Hunt syndrome.
The document discusses various types of corneal diseases including congenital, traumatic, inflammatory, degenerative/dystrophic, and neoplastic conditions. It provides details on infectious keratitis caused by bacteria like Staphylococcus, Pseudomonas, and Neisseria as well as fungi and protozoa. Viral keratitis from herpes simplex virus, herpes zoster virus, and adenovirus are also examined. Signs, risk factors, investigations, and treatment approaches are described for each condition. Inflammatory keratitis can be infective or immune-related disorders like marginal keratitis and Mooren's ulcer are also reviewed.
The document discusses different patterns of visual field defects seen in various eye conditions, provides examples of defects associated with specific pathologies, and outlines laser and surgical treatment options for glaucoma including trabeculectomy, various shunt procedures, and laser trabeculoplasty. It also reviews medication classes used for glaucoma treatment and their mechanisms of action.
This document contains information about two interactive medical cases presented by Samhaa Mohammed Abd Elmoneim.
Case one involves an 8-month-old girl with right lid swelling and erythema for two days, with a recent history of fever and nasal discharge. Multiple choice questions are included to test the differentiation between preseptal and orbital cellulitis, common causes, and clinical findings and test results.
Case two involves a 2-year-old boy noted to have inward deviation of the left eye for two weeks. His cycloplegic refraction results and alternate prism cover test indicate a diagnosis of refractive accommodative esotropia. Multiple choice questions assess the most likely diagnosis, appropriate
1. The document describes the candidate's FRCS viva exam, which consisted of 4 stations testing different areas of ophthalmology.
2. Each station had 2 examiners and lasted 20 minutes, with cases involving emergency situations, neuroophthalmology, and posterior and anterior segment pathologies.
3. The clinical exam portion involved 4 stations testing the posterior segment, neuro-motility, oculoplasty, and anterior segment. Cases were presented and the candidate was examined on their diagnostic and management skills.
Uveitis is a general term for intraocular inflammation that does not indicate the specific site or cause of inflammation. It can be caused by autoimmune or infectious processes. Uveitis is a common cause of visual impairment and blindness worldwide. It is classified based on the site of inflammation - anterior, intermediate, posterior or panuveitis. Developing a differential diagnosis involves considering factors such as acuity of onset, laterality, associated symptoms and response to previous therapies. Common etiologies include idiopathic disease, infections like tuberculosis, and autoimmune diseases like sarcoidosis and Behcet's disease. Treatment involves corticosteroids and immunosuppressive therapies.
A 19-year-old man presented with floaters and vision loss in his left eye over the past year. On examination, he had cells in his anterior chamber, vitreous hemorrhage, a swollen optic disc, cystoid macular edema, subretinal fibrosis, and chorioretinal scars in his left eye. Investigations did not reveal an infectious cause. He was treated with orbital floor triamcinolone injections which improved his cystoid macular edema but caused steroid-induced glaucoma, requiring glaucoma medication. His inflammation later flared up again requiring additional steroid treatment.
1. Proptosis refers to the forward displacement of the eye within the orbit. It can be caused by conditions affecting the orbit or endocrine system.
2. A thorough history and physical examination are important to determine the cause, characteristics, progression of proptosis, and assess for signs of inflammation, infection, or underlying systemic disease.
3. Imaging studies like CT and MRI help identify the location, size, and nature of any orbital lesions causing proptosis and guide management. Biopsy may be needed to confirm diagnosis in some cases.
The document summarizes a case presentation of a 43-year-old male with blurred vision who underwent LASIK surgery 9 years prior and now presents with worsening vision. Examination found stromal opacities and the patient underwent penetrating keratoplasty (PKP) in the right eye. One year later, vision decreased in both eyes and the patient underwent PKP in the left eye. The document discusses granular dystrophy, a genetic bilateral corneal dystrophy, and reviews the patient's clinical course and management.
This document summarizes several corneal disorders:
- Corneal abrasion is a scrape or scratch of the corneal epithelium, most commonly caused by objects hitting the eye. Symptoms include eye pain and blurred vision. Treatment involves removing any foreign objects and using analgesics and antibiotics.
- Corneal dystrophies are inherited disorders that affect the cornea's layers and transparency. Symptoms may include visual impairment and corneal erosion. Treatment addresses erosion and sometimes requires keratoplasty.
- Band keratopathy is a type of corneal degeneration causing a white, band-shaped calcification. It is often caused by hypercalcemia or eye inflammation. Treatment focuses on the underlying cause along with superficial debridement.
This document discusses common eye diseases and conditions, including:
1) Uveitis (inflammation of the uveal tract) which can be anterior, intermediate, or posterior. Anterior uveitis includes iritis which causes redness, pain, and blurred vision.
2) Cataracts which include senile, childhood, and traumatic cataracts. Cataract surgery techniques include ICCE, ECCE, and phacoemulsification.
3) Complications of cataract surgery can include infection, uveitis, glaucoma, vitreous prolapse, and retinal detachment.
History taking examination and diminution visionGayatree Mohanty
This document discusses the process of history taking and examination in ophthalmology. It covers collecting demographic data, chief complaints, history of present and past illness, family history, and performing an examination of visual acuity, external eye, and fundus. The examination section describes assessing the forehead, eyelids, conjunctiva, cornea, anterior chamber, iris, pupil, lens, vitreous, and retina. Common symptoms and clinical features of various eye conditions are also outlined.
This document discusses uveitis, including its classification, description, causes, and clinical presentation. It provides details on:
1) The anatomical, pathological, and clinical classifications of uveitis including anterior, intermediate, posterior, and panuveitis.
2) The description of uveitis including its course (acute, recurrent, relapse, remission), duration (limited, persistent), and onset (sudden, insidious).
3) The common causes of different types of uveitis including infectious (viral, bacterial, fungal, parasitic) and non-infectious etiologies with and without systemic associations. Specific causes of anterior, intermediate, and posterior uveitis are
OTHER RETINAL VASCULAR DISEASES by Iddi.pptxIddi Ndyabawe
This document provides an overview of various retinal vascular diseases including sickle cell retinopathy, vasculitis, cystoid macular edema, and other conditions. It discusses the pathophysiology, signs and symptoms, diagnosis, and treatment of sickle cell retinopathy in detail. It also describes other conditions like vasculitis, distinguishing between primary and secondary retinal vasculitis. Specific entities like Eales disease, Susac syndrome, and IRVAN are explained. Cystoid macular edema is discussed along with its causes and pathogenesis. Overall, the document comprehensively reviews other retinal vascular diseases beyond diabetic retinopathy.
This document discusses several common pediatric ophthalmic problems including congenital cataract, glaucoma, retinopathy of prematurity, squint, refractive error, allergic conjunctivitis, retinoblastoma, and ocular infections. It provides details on causes, presentations, investigations, and management of each condition. Congenital cataract surgery in children poses unique challenges due to the small eye and intense inflammation. Retinopathy of prematurity screening and timely laser treatment can help reduce vision loss in preterm infants.
This document discusses several tumors that commonly affect children, including:
1. Hemangiomas - benign tumors of blood vessels that often appear at birth and can involve the skin, mucosa, or viscera.
2. Neuroblastoma - a malignant tumor of the sympathetic nervous system that typically presents before 5 years of age and commonly involves the adrenal glands.
3. Retinoblastoma - a malignant tumor of the eye that is the most common eye cancer in children and may occur as a familial or sporadic condition associated with mutations in the RB gene.
Final collection rivision oral pathologyTAKEITSIMPLE
The document discusses various lesions, tumors, and syndromes that can occur in the oral cavity. It provides information on lesions that occur in the first year of life, syndromes associated with oral lesions, radiographic characteristics of lesions, histological patterns seen in different lesions, immunohistochemical markers for different lesion types, and differences in lesion occurrence between males and females. It also discusses self-healing lesions, lesions associated with different races or ethnicities, and premalignant oral lesions.
This document provides a dermatology revision guide for medical students at the University of Birmingham. It summarizes the dermatology curriculum to help students prepare for exams and their work as junior doctors. The guide covers topics like history taking, dermatology terminology, common inflammatory skin conditions like eczema and acne, benign and malignant skin tumors, skin infections, blistering diseases, and dermatological emergencies. It includes descriptions, diagrams, treatment options, and tips for exams. The overall purpose is to equip students with the essential dermatology knowledge needed for their studies and clinical practice.
This PPT is mainly oriented towards Bailey & Love - Topic on Skin & Sub-cutaneous tissue. Few common diseases has been added. Very useful to Final yr. MBBS Students
This document provides information on malignant skin lesions and skin cancers. It discusses the anatomy and function of skin, pre-malignant lesions like actinic keratosis, Bowen's disease and conditions that increase risk of skin cancers like neurofibromatosis. It then describes the most common skin cancers - basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma. For each cancer, it discusses epidemiology, etiology, clinical features, histopathology, prognosis and treatment options.
This document provides information about tumors of the eye. It discusses various types of benign and malignant tumors that can occur in different parts of the eye, including the orbit, lacrimal gland, eyelids, conjunctiva, uveal tract, and retina. For each tumor type, it describes the classification (benign vs malignant), common sites of occurrence, signs and symptoms, diagnostic evaluation, and treatment approaches. For example, it explains that choroidal melanoma is the most common primary malignant tumor of the uveal tract, often appearing initially as an asymptomatic elevated pigmented mass, and treatment may involve plaque radiotherapy, enucleation, or charged particle radiation depending on tumor characteristics and prognosis. The document aims to
The document summarizes various tumors that can occur on the eyelid. It divides tumors into benign, pre-malignant, and malignant categories and lists examples of tumors that fall into each category. Some of the more common tumor types discussed include squamous cell papilloma, basal cell carcinoma, sebaceous gland adenoma and carcinoma, capillary hemangioma, and non-Hodgkin lymphoma. For each tumor, the summary provides details on clinical presentation and recommended treatment approaches.
Ocular tumors can arise in the eyelids, eye, and orbit. Early diagnosis is important to preserve vision and life. There are several types of benign and malignant tumors, including tumors of the orbit, eyelids, conjunctiva, uveal tract, and retina. Common orbital tumors are dermoid cysts, rhabdomyosarcoma, and orbital metastases. Eyelid tumors include basal cell carcinoma, squamous cell carcinoma, and sebaceous carcinoma. Conjunctival tumors include naevi, papilloma, primary acquired melanosis, and melanoma. Intraocular tumors involve the iris, ciliary body, and choroid, such as melanomas.
The document reviews ocular malignancies of the eyelids, cornea, conjunctiva, and iris. It discusses the most common eyelid tumors including basal cell carcinomas, squamous cell carcinomas, sebaceous cell carcinomas, and melanomas. It also reviews conjunctival intraepithelial neoplasia, invasive squamous cell carcinoma of the conjunctiva, and less common conjunctival neoplasms. Finally, it discusses tumors of the iris including nevi, melanomas, and other benign and malignant lesions.
The document discusses various lid pathologies and conditions. It describes the anatomy of the eyelid layers including the epidermis and dermis. It then covers various benign and malignant lid tumors as well as inflammatory conditions like blepharitis, chalazion, stye, entropion, and ectropion. It provides details on symptoms, signs, and management of these various lid diseases. Ptosis is also discussed, covering its various causes and approaches to surgical correction like levator resection or frontalis sling procedures.
This document summarizes the key characteristics of pre-malignant and malignant skin cancers. It describes the epidemiology, risk factors, pathogenesis, diagnostic criteria, treatment, and prognosis for the main types of skin cancer: actinic keratosis, Bowen's disease, basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. The summary focuses on the distinguishing clinical features and management considerations for each cancer type.
Basics of wounds, lumps, bumps, and rashes for gwep 2018SDGWEP
This document discusses the management of various skin lesions and defects. It provides information on diagnosing and treating common benign and malignant skin lesions such as basal cell carcinoma, squamous cell carcinoma, and melanoma. It also reviews options for reconstructing skin defects created by wide excision of malignant lesions, including the use of skin grafts versus flaps. Flaps are preferred when there is poor vascularity or reconstruction of facial structures is needed. Examples of specific flap techniques used for defects of the forehead and lower lip are described.
20181110 wound healing richard bodor_basics of wounds, lumps, bumps, and rash...SDGWEP
This document discusses the management of various skin lesions and defects. It provides information on diagnosing and treating common benign and malignant skin lesions such as basal cell carcinoma, squamous cell carcinoma, and melanoma. It also reviews options for reconstructing skin defects created by wide excision of malignant lesions, including the use of skin grafts versus flaps. Flaps are preferred when there is poor vascularity or reconstruction of facial structures is needed. The document concludes by discussing a case of excising a squamous cell carcinoma of the lower lip and reconstructing the defect using a free anterolateral thigh-tensor fasciae latae flap.
Slides prepared and compiled by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal , for teaching undergraduate and postgraduate ENT students in the field of otorhinolaryngology.
A clear and concise explanation of the basic concepts in the subject matter concerned.
He is the Head of department with a sound knowledge in the field of ENT to teach both undergraduate and postgraduate ENT students.
This presentation gives a lucid idea about different neoplasms of nose like inverted papilloma, ca maxilla, ethmoid and so on.
Slides prepared and compiled by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal , for teaching undergraduate and postgraduate ENT students in the field of otorhinolaryngology.
A clear and concise explanation of the basic concepts in the subject matter concerned. He is the Head of department with a sound knowledge in the field of ENT to teach both undergraduate and postgraduate ENT students
This document provides an overview of pathology of the uvea. It begins by describing the layers of the iris and ciliary body. It then discusses common pathological disorders including congenital anomalies, inflammation, neoplasms, degenerative diseases, vascular diseases, and trauma. Specific conditions affecting the iris, ciliary body, and choroid are described such as iris cysts, nodules, melanoma, ciliary body tumors, and choroidal dystrophies. Inflammatory diseases including uveitis and granulomatous inflammation are also summarized.
tumorsofjawbones-2.ppt describing details of all jaw tumoursSrinivas Marrapu
This document discusses various tumors of the jaw bones, including benign and malignant tumors as well as odontogenic and non-odontogenic tumors. It provides classifications of odontogenic tumors and non-odontogenic tumors. Specific tumors discussed in more detail include ameloblastoma, calcifying epithelial odontogenic tumor (CEOT), adenomatoid odontogenic tumor (AOT), odontoma, and cementoblastoma. Treatment approaches such as enucleation, resection, and reconstruction are also summarized.
This document provides information on various surgical short cases including lipoma, sebaceous cyst, dermoid cyst, keloid, and basal cell carcinoma (BCC). It describes the presentation, diagnosis, and treatment of each condition. Lipomas are benign fatty tumors that can occur in different parts of the body. Sebaceous cysts and dermoid cysts are cysts lined by keratinizing squamous epithelium that may contain skin appendages. Keloids are fibroproliferative scars that can form after skin injuries. BCC is the most common type of skin cancer, arising from basal cells, with various clinical subtypes and risk factors described. Surgical excision is a common treatment approach for many
Ocular motility disorders: the Approach
Supra- vs infra- nuclear disorders and its related basic science
Other: synkinesis/aberrant regeneration, nystagmus
This document summarizes ocular motility and eye movements. It discusses the anatomy and physiology of the supranuclear and infranuclear control of eye movements, including the cranial nerves, brainstem structures, and eye muscle actions involved in different types of eye movements like saccades, smooth pursuit, vestibulo-ocular reflex, and vergence. It also outlines various eye movement systems and laws of ocular motility.
Vascular events in the eye can be ischemic or hemorrhagic in nature and can occur suddenly or gradually. Ischemic events include central retinal artery occlusion, branch retinal artery occlusion, central retinal vein occlusion, and anterior ischemic optic neuropathy. Hemorrhagic events include subconjunctival, vitreous, retinal, subretinal, and retroorbital hemorrhages. Risk factors include atherosclerosis, hypercoagulability, inflammation, vasculitis, and underlying medical conditions. Presenting symptoms often involve changes in vision. Management depends on the specific condition and may involve observation, medical therapy, laser treatment, or surgery.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Ophthalmic Tumours
1. Ophthalmic Tumours
Dr Yong Meng Hsien
Lecturer & Ophthalmologist, UKM & HCTM
yongmenghsien@ppukm.ukm.edu.my
Last edited: Feb 2022
2. Ophthalmic Tumours
• Primary VS Secondary
• Orbital VS Ocular
• Benign VS Malignant
• Childhood VS Adult
• Congenital VS Acquired
• Hamartoma VS Choristoma
• Infiltrative (leukemia lymphoma)
• Association
– Systemic/syndrome/phacomatoses
3. Ophthalmic Tumours
Orbital
• Eyelid
• Lacrimal gland
• ON/vascular/lymphoid
• Orbital soft tissue
• Orbital bone
Ocular
• Ocular surface/ conjunctival
• Uveal
• Retinal (nerve/vascular/cell)
• Choroid (vascular/cell)
• ON
4. Benign Lesion- Key
• stable size/shape/colour/border
• lack of induration/ulceration/hrge/change
• preservation of normal structures
• Histo: no hyperchromatism, pleomorphism,
mitotic figures, high nucleus-cytoplasm ratio
5. Pathology/Biopsy- Principles
• Tissue
– Incisional vs excisional (shave/simple/Mohs)
• Permanent section (formalin 10%- reduce autolysis)
• Frozen section (wet gauze): intraop complete
excision/margin free, correct sample for permanent section
• Fresh section (wet gauze): lymphoproliferative d/o for
flow cytometry/cell marker study
• Others fixative: glutaraldehyde (rapid stabilize protein-
good for ECM/cytoplasm), ethyl alcohol (good for
cytology/nuclear details)
• Cells
– FNAC
18. Keratoacanthoma
• Neoplasia/premalignant or variant of SCC
(SCC transformation 5%)
• VS SCC = same histopath (sq CIS) & risk, but
different genomic profile
• >middle age/elder,
• Classical: rapid growth (wk-mth) and
stabilization or regress, solitary flesh with
elevated edge and center keratin core
• Surgical excision include the deep
margin/base for HPE
20. Dermoid Cyst
1. Choristoma/developmental d/o
2. skin sequestered/displaced ectoderm to subcutaneous
along embryo closure line (>temporal frontal zygomatic)
3. round/film @lateral end of brow (65%), sup nasal (30%)
4. Subcutaneous with mobile under skin/tethered to deep
periosteum
5. Superficial vs deep (septum)
– Deep: >adult >gradual proptosis/dystopia
6. Ix CT: calcification/fluid/fat + bone erosion, wall enhanced
with contrast but not lumen
7. Cx: ruptured/inflam (+- trauma), +- bony defect
8. Mx: excision in toto (encapsule), steroid only if inflam
9. VS epidermoid/inclusion cyst: epidermis → dermis @line
of closure (round/slow/superficial +- rupture/inflam)
31. Cavernous VS Capillary Hemangioma: Similarity
• Most common benign orbital tumour in paeds/adult
• Benign vascular hamartoma/hemangioma
• F>M
• > Sporadic
• Unilateral discolouration lesion/mass
• Proptosis
• ON compression
• No pain/bruit/pulse
• B scan/doppler/CT/MRI
• No calcification/erosion
32. Cavernous VS Capillary Hemangioma:
Difference
Capillary
• Small vessels
• Small age (paeds)
• Fast flow
• Fast growth 3-6m then resolved by 7yo
• Superficial/deep, eatra/intra-conal
• +-axial/non proptosis
• > red (+- h’rge)
• Cry/compress → change
• No change
• > visceral assoc (skin/laryngeal/cns)
• a/w Kasabach Merritt/Maffucci
• Strawberry nevus
• No capsule/septum, poor margin
• endothelial only
• FFA: multiple feeder A&V (rapid flow)
• Rx steroid > excision
Cavernous
• Large vessels
• Large age (adult)
• Slow flow
• Slow growth then hypertrophy
• Deep intraconal
• Axial proptosis
• > pink (no h’rge)
• No change
• Pregnant/hypoxia → change
• No visceral assoc
• a/w SWS
• Yes capsule/septum, good margin
• endothelial + muscle wall + stroma
• Port wine stain
• FFA: no feeder, late stain (low flow)
• Rx observe > excision (capsule)
33. Infantile hemangioma
• Five indications for early treatment of problematic infantile hemangiomas (IHs) include the following:
• Life-threatening lesions, such as those that obstruct the airway, are associated with high-output congestive heart failure or
ulcerative IHs that profusely bleed.
• IHs associated with functional impairment such as disturbance in vision or feeding interference.
• IH ulceration.
• IH-associated congenital anomalies such as PHACE syndrome (large IHs that can cause defects in the eyes, heart, major
arteries, and brain).
• Risk of permanent scarring.
• IH growth most rapidly occurs between 1 and 3 months of age.
• Imaging is not necessary unless the diagnosis is uncertain, there are five or more cutaneous IHs, or there is suspicion of
anatomic abnormalities.
• Oral propranolol (between 2 and 3 mg/kg per dose) is the recommended first-line treatment for cases requiring systemic
therapy.
• Counsel about the adverse events of propranolol such as sleep disturbances, bronchial irritation, and clinically symptomatic
bradycardia and hypotension.
• Use oral prednisolone or prednisone if there are contraindications or if the propranolol response is inadequate.
• Intralesional injection of triamcinolone and/or betamethasone can be recommended to treat focal or bulky IHs in certain
critical locations (eg, the lip) or during proliferation.
• Topical timolol maleate may be prescribed for thin or superficial IHs.
• Surgery and laser therapy may be recommended for certain situations such as ulcerated lesions or lesions that obstruct vital
structures
43. Limbal Dermoid
• Choristoma (peribulbar mass @ paeds 1/3 is choristoma)
• Variety of aberrant tissues, mesoblast metaplasia or pluripotent cells
sequestration
• Common features: inf temporal corneo-limbal area, superficial,
paeds/<16yo
• Complication: affecting visual axis, astig, lipid infiltration
• Potential risk: deeper extension till AC, malignant transformation- rare
• Systemic association: 30% e.g. Golderhar (eyelid coloboma), Duane
retraction syndrome, SCALP syndrome, NF, nevus flammeus
• Clinical diagnosis MRI only if unsure extension (EOM, orbital fat)
44. Limbal Dermoid- Treatment
• Superficial sclero-keratectomy (cutting flush with the
surface of the globe) + HPE
• Complete removal unnecessary (+- deep extension
perforation)
• +- lamellar keratoplasty/patch graft (if deep excision)
• +- AMT (if large bare sclera)
46. Pyogenic Granuloma
• benign vascular proliferation of immature capillaries that is neither
purulent nor granulomatous
• is also called lobular capillary hemangioma
• Misnomer: no inflammatory (purulent) exudate nor the typical epitheloid
giant cell reaction/granulomatous inflammation.
• Microscopically, aggregations of immature blood vessels and fibroblastic
stroma (granulation tissue), with accompanying lymphomcytes, plasma cells, and
scattered neutrophils.
• Early PG: have numerous capillaries and venules with prominent
endothelial cells arrayed radially toward the epithelial surface.
• Mature PG: exhibits a fibromyxoid stroma separating the lesion into
lobules. The epithelial surface exhibits inward growth at the base of the lesion.
• Regressing PG: has extensive fibrosis
• Classical: well circumscribed, smooth surfaced, pink, sessile/pedunculated,
and highly vascularized mass, underlying stalk of feeder blood vessels and
connective tissue
• Eyelids, conjunctival, rarely limbus/cornea
• Traumatic wound site or near a suture line rapid growth <few wks)
51. Choroidal Melanoma
• most common primary intraocular malignancy @adult, 75% of uveal melanoma
• EpiD: 50-60s, >light skin (15x)/blue eye/blonde hair
• Risk: ocular/oculodermal- melanocytosis (Ota), dysplastic nevus syndrome/AMS, NF1, smoking, UV,
genetic p53 (chr 7)
• SSx
– pigmented/elevated/dome shaped → collar stud/mushroom (break Bruch) +- amelanotic
– orange pigment (lipofuscin@RPE), feeder vessel, SRD, SRH/VH
– ant segment: uveitis/cataract/glaucoma
– systemic: liver > lung > breast mets, locally to ON/brain
– VS Nevus = PED/drusen/CNV/VF/orange pigment
– VS Nevus ≠ lipofuscin/orange pigment (but no drusen), near OD, size >2mm thick, Cx e.g. RD/SRF, hot spot in FFA,
histo +epithelioid cell
• B scan
– high reflective border
– low internal reflectivity/acoustic hollowness → DDX choroidal hemangioma (high) & choroidal mets (variable)
– Choroidal excavation (high spike d2 Bruch break)
– Orbital shadowing
– Extraocular extension
• FFA- double circulation (choroid/retina vessels), hyper (RPE destruction), hypo (lipofuscin mask)
• Other: CT/MRI/Bx & Callender classification - spindle A (nevus) → +spindle B (melanoma) → + epithelioid
(worst, morta 75%), usually mixed (86% cases/morta 50%)
• Mx: depends VA/size/location/extend-mets, COMS, laser photocoag → brachyT → enucleation (+-radioT)
52. Risk factor for malignant transformation
• “To Find Small Ocular Melanoma Using
Helpful Hints Daily” (TFSOM-UHHD)
– thickness > 2 mm (most important!)
– subretinal fluid
– Symptoms
– orange pigment present
– margin within 3 mm of the optic disc
– ultrasonographic hollowness (versus solid/flat),
– absence of halo (pigmented choroidal nevus
surrounded by a circular band of depigmentation.)
– absence of drusen
53. Collaborative Ocular melanoma Study (COMS)
• Small (1-3mm thick, <5mm long) @1989
–natural history/observe: 30% +growth in 5yr
–mortality: 6% 5yr, 15% 8yr → photoCoag
• Medium (3-8mm thick, <16mm long) @1998
–enucleation VS brachyT (iodine 125 gold
plaque/85Gy)
–survival: same (82% @5yr) → brachyT
• Large (8mm thick, >16mm long) @1994
–enucleation alone VS pre-radiation (ext
beam/20Gy)
–survival: same (60% @5yr) → enucleation
77. Other Associations with Systemic Malignancy
• Ophthalmic Metastasis
• Intracranial tumour (pituitary/optic
pathway)
• Paraneoplastic syndrome
• MEN 2B
78. Eye problem @systemic cancer
• Ocular metastasis
• Paraneoplastic syndrome
• Compression by tumour
• Infection secondary to chemoT
• Radiation complication (retinopathy)
79. Ophthalmic Metastasis
• Ocular > Orbit (& lids & conjunctival)
• Ocular: uvea > others
• Uvea: choroid > others
• Choroid: macular/peri-macular area > others
• Classical red flag: creamy yellow, elevated mass deep to the retina in the choroid +- symptoms
• Breast > lung > others
• Eye presentation before cancer: Lung > breast
• Lung vs Breast eye mets: breast >multiple > bilateral, lung +-pain
• Theory of “shower of mets to brain” – a/w brain mets (40%)
• Vs primary amelanotic melanoma: mets <thick (2-3mm vs 5-5mm), >yellow >homogeneous, <RPE
changes, >echogenic
• Others: ERD, OD swelling, hypopyon/panU
• Rx only for tumour threatening vision
– Multifocal/bilateral- ext beam radiation (OD for 4wk)
– Multifocal/bilateral/solid single- plaque radioT (2days)
• Important of ophthal assessment: first presentation before tumour, ocular Rx for vision
threatening, monitor response of systemic Rx
80. Breast Ca
• Metastatic foci of the disease in the lungs,
central nervous system, or bones are usually
detected prior to diagnosis of ocular
metastases
• risk of fellow eye involvement is
estimated to be 5% in a period of ten months
after diagnosis
81. Choroidal Mets
• Can be 1st sign of systemic malignancy in
1/3 cases
• Up to 10% of cancer +uvea mets (breast &
lung)
• Fundoscopy, ultrasonography (US), and
fluorescein angiography, indocyanine green
angiography (ICGA), optical coherence
tomography (OCT), Histopathological by
choroidal tumor biopsy
83. Visual paraneoplastic syndromes
• Circulating antibody affecting retinal protein
(cross reaction with tumour antigen)
• carcinoma-associated retinopathy
• melanoma-associated retinopathy
• bilateral diffuse melanocytic uveal
proliferation
• paraneoplastic optic neuropathy (PON)
• The first affects photoreceptors, the second
is thought to affect bipolar cell function, and the
third targets the uveal tract
84. Multiple endocrine neoplasia (MEN) type 2B
• AD (chr 10q11)
• medullary carcinoma of the thyroid gland,
pheochromocytoma, and mucosal neuromas
• marfanoid habitus, thickened corneal
nerves, conjunctival and eyelid neuromas and
keratoconjunctivitis sicca
85. Paraneoplastic Syndrome (PNS)
• Def: cancer-related SSx
– not related to mass effect but due to
– humoral (hormone/cytokine) from tumour, or
– immune reaction to tumour
• Common sources: lung, breast, ovaries, lymphoma
• Types:
– Neurological: Lambert Eaton/MG (small cell lung ca), myositis,
spinal cord, CNS
– Hematological: low/high RBC/Hb/hypercoagulopathy
– Endocrine: high Ca/ACTH-Cushing/ADH-SIADH/insulin-hypoG/
aldosterone/carcinoid (serotonin)
– Muco-cutaneous
– Ocular: retinopathy (CAR/MAR)
• Ix: autoimmune Ab (anti-Hu/Ri/Yo/Ma/Amphiphysin/CVS)
from IMR, whole body CT scan/PET
86. Paraneoplastic retinopathy
CAR (cancer-associated retinopathy)
– Ab against recoverin/retinal protein
– Peripheral + central visual loss (rapid/progress)
– Arterial narrowing with only min/no pigment
– ERG- Extinguished
MAR (melanoma-associated retinopathy)
– ERG- negative waveform
Others
– Autoimmnue retinopathy
– BDUMP (BL diffuse uveal melanocytic proliferation)-
choroidal lesion + ERD + PSCC + iris/CB cyst
– acute exudative polymorphous vitelliform maculopathy