ACE Review - Optho

Question 1

questions

Answer 1

anwers

Question 2

what is the purpose of the gas bubble in the eye

Answer 2

to help with retinal adhesion and fibrosis

Question 3

what is avoided when gas bubbles are used

Answer 3

nitrous oxide

Question 4

why is nitrousoxide bad? moa

Answer 4

it expands and will cause compressive ischemia on the retina

Question 5

when can nitrous oxide be used in patients who had gas bubble

Answer 5

after 3 months to allow all of gas bubbles to be absorbed

Question 6

where is a retrobulbar block placed

Answer 6

muscular cone behind the globe

Question 7

complications of retrobulbar block

Answer 7

intravasc injection..sz’s, subarach injection, retrobulbar bleeding, optic nerve injury

Question 8

which block does not require a seperate facial block to prevent blinking

Answer 8

peribulbar block

Question 9

how is a peribulbar block done

Answer 9

it is placed outside the muscular cone, thus anes to the orbicularis oculi

Question 10

what is a subTenon block

Answer 10

anes is injected under the sclera

Question 11

does KTP;Nd-YAG laser cause damage to cornea

Answer 11

no it passes cornea and then goes to retina

Question 12

what does KTP;Nd-YAG laser burn retina

Answer 12

bc it is absorbed by pigmented tissue

Question 13

what kind of filter does protective eye wear for KPT;Nd-YAG need

Answer 13

operators need red filter glasses

Question 14

what do all lasers besides CO2 lasers have in common,

Answer 14

they conduct through glass very well, thus requiring special filters on glasswear

Question 15

what color of filter is needed on glasses for krypton laser

Answer 15

amber colored filters

Question 16

what laser has the highest infrared wavelength

Answer 16

co2 laser

Question 17

what color is co2 laser

Answer 17

it is colorless, so a helping light is used to guide the operator

Question 18

why does co2 laser cause corneal damage versus all the other lasers

Answer 18

because it is also absorbed by clear tissue and water.

Question 19

what kind of filter is needed on eyewear when using co2 laser

Answer 19

since it is absorbed by clear tissue and water, all eyewear that is clear is protective enough

Question 20

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Answer 20

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Question 21

what is the most common cause for perioperative vision loss

Answer 21

ischemic optic neuropathy

Question 22

what are 2 general categories for periopterative visino loss

Answer 22

anterior and posterior ischemic optic neuropathy

Question 23

what is a common associated symptom of both types of ischemic optic neuropathy

Answer 23

both are painless

Question 24

what does anterior ischemic optic neuropathy mean

Answer 24

when the ischemic involves the optic disk

Question 25

what does posterior ischemic optic neuropathy mean

Answer 25

when the retrobulbar portion of the optic nerve

Question 26

what vessel is affected in anterior optic neuropathy

Answer 26

the watershed areas of the short posterior ciliary arteries

Question 27

is anterior optic neuropathy unilateral or bilateral

Answer 27

45% unilateral, 55% bilateral

Question 28

what kind of surgery is anterior optic neuropathy usually associated with

Answer 28

cardiac surgery

Question 29

what do you see on fundoscopic exam of anterior ischemic optic neuropathy

Answer 29

pale optic disk edema

Question 30

when does anterior optic neuropathy happen

Answer 30

24 - 48 hrs after surgery

Question 31

what nerve is affected by the posterior ischemic optic neuropathy

Answer 31

intraorbital optic nerve

Question 32

is posterior ischemic optic neuropathy unilateral or bilateral

Answer 32

bilateral 60-75% of cases

Question 33

what surgery is posterior ischemic optic neuropathy associated with

Answer 33

spine surgery

Question 34

what do you see on fundoscopic exam of posterior ischemic optic neuropathy

Answer 34

normal exam

Question 35

when does posterior ischemic optic neuropathy manifest

Answer 35

right after surgery

Question 36

what are subdivisions of both ant and post ischemic optic neuropathy

Answer 36

arteric vs non-arteric

Question 37

what is temporal arteritis

Answer 37

is is a form of anterior ischemic optic neuropathy

Question 38

what symptom does temporal arteritis have.

Answer 38

it is painful

Question 39

what lab work is pathonomonic for temporal arteritis

Answer 39

temporal aa biopsy shows giant cells

Question 40

what do you do to treat temporal arteritis

Answer 40

steriods

Question 41

what is this…bilateral blindness, painless, normal fundoscopic exam

Answer 41

cortical blindness vs posterior ischemic optic neuropathy

Question 42

how can you tell difference between posterior ischemic optic neuropathy and cortical blindness

Answer 42

cortical blindness has normal pupillary reflexes

Question 43

what are 2 types of drug moa that is used for open angle glaucoma

Answer 43

beta blockers and parasympathomimetics

Question 44

what is assoc with beta blockers used for open angle glaucoma

Answer 44

they can cause severe hypotension

Question 45

does defasiculating dose of nmd help prevent increase intraoc pressure associated with succ

Answer 45

not reliabily

Question 46

is the use of atropine strictly contraindicated in open angle glaucoma

Answer 46

no

Question 47

what is the pathophys behind glaucoma

Answer 47

the increase in iop causes decrease blood to optic nerve

Question 48

what is open angle glaucoma

Answer 48

it is the decrease filtration and drainage of aqueous fluid through the trabeculae tissue

Question 49

how do beta blockers prevent glaucoma

Answer 49

it decrease aqueous humor production

Question 50

what is apraclonidine and brimonidine for glaucoma

Answer 50

they are alpha 2 Agonist drugs used to decrease aqueous humor

Question 51

what is acetazolamide and dichlorphenamide used in glaucoma

Answer 51

these are carbonic anhydrase inhibitors

Question 52

what is prilocarpine and carbachol of glaucoma treatment

Answer 52

these constrict pupils and increase aqueous outflow

Question 53

what is latanoprost and xalantan of glaucoma treatment

Answer 53

they are prostoglandins that increase aqueous outflow

Question 54

what is physiostigmine and echothiophate and isofluorophate of glaucoma treatment

Answer 54

they are anticholinesterase inhibitors that decrease intraocular pressure

Question 55

would the use of atropine be contraindicated in glaucoma

Answer 55

atropine is an anticholinergic....supposedly it causes pupil dilation....but the amount given is minimal and would not cause pupil dilation

Question 56

can you give scopolamine to a glaucoma patient

Answer 56

scopolamine causes significant pupil dilation...it is contraindicated

Question 57

iop. what is normal intraocular pressure

Answer 57

10 to 22 mmHg

Question 58

iop. 3 determinants of iop

Answer 58

sclera compliance, extraocular pressure, and intraocular volume

Question 59

iop. what is the intraveous agent that can cause increase in iop

Answer 59

ketamine

Question 60

iop. of the introcular volume...what is the most important factor that increases iop

Answer 60

venous blood volume...anything that prevents venous return back to the heart may increase iop...like c collar or trendelenburg position