ACE Review - Optho Flashcards

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1
Q

questions

A

anwers

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2
Q

what is the purpose of the gas bubble in the eye

A

to help with retinal adhesion and fibrosis

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3
Q

what is avoided when gas bubbles are used

A

nitrous oxide

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4
Q

why is nitrousoxide bad? moa

A

it expands and will cause compressive ischemia on the retina

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5
Q

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

A

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

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6
Q

where is a retrobulbar block placed

A

muscular cone behind the globe

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7
Q

complications of retrobulbar block

A

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

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8
Q

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

A

peribulbar block

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9
Q

how is a peribulbar block done

A

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

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10
Q

what is a subTenon block

A

anes is injected under the sclera

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11
Q

does KTP;Nd-YAG laser cause damage to cornea

A

no it passes cornea and then goes to retina

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12
Q

what does KTP;Nd-YAG laser burn retina

A

bc it is absorbed by pigmented tissue

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13
Q

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

A

operators need red filter glasses

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14
Q

what do all lasers besides CO2 lasers have in common,

A

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

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15
Q

what color of filter is needed on glasses for krypton laser

A

amber colored filters

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16
Q

what laser has the highest infrared wavelength

A

co2 laser

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17
Q

what color is co2 laser

A

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

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18
Q

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

A

because it is also absorbed by clear tissue and water.

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19
Q

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

A

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

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20
Q

xxxxxxxxxxxxxxxxxxxxxxxxxx

A

xxxxxxxxxxxxxxxxxxxxxxxxxx

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21
Q

what is the most common cause for perioperative vision loss

A

ischemic optic neuropathy

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22
Q

what are 2 general categories for periopterative visino loss

A

anterior and posterior ischemic optic neuropathy

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23
Q

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

A

both are painless

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24
Q

what does anterior ischemic optic neuropathy mean

A

when the ischemic involves the optic disk

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25
Q

what does posterior ischemic optic neuropathy mean

A

when the retrobulbar portion of the optic nerve

26
Q

what vessel is affected in anterior optic neuropathy

A

the watershed areas of the short posterior ciliary arteries

27
Q

is anterior optic neuropathy unilateral or bilateral

A

45% unilateral, 55% bilateral

28
Q

what kind of surgery is anterior optic neuropathy usually associated with

A

cardiac surgery

29
Q

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

A

pale optic disk edema

30
Q

when does anterior optic neuropathy happen

A

24 - 48 hrs after surgery

31
Q

what nerve is affected by the posterior ischemic optic neuropathy

A

intraorbital optic nerve

32
Q

is posterior ischemic optic neuropathy unilateral or bilateral

A

bilateral 60-75% of cases

33
Q

what surgery is posterior ischemic optic neuropathy associated with

A

spine surgery

34
Q

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

A

normal exam

35
Q

when does posterior ischemic optic neuropathy manifest

A

right after surgery

36
Q

what are subdivisions of both ant and post ischemic optic neuropathy

A

arteric vs non-arteric

37
Q

what is temporal arteritis

A

is is a form of anterior ischemic optic neuropathy

38
Q

what symptom does temporal arteritis have.

A

it is painful

39
Q

what lab work is pathonomonic for temporal arteritis

A

temporal aa biopsy shows giant cells

40
Q

what do you do to treat temporal arteritis

A

steriods

41
Q

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

A

cortical blindness vs posterior ischemic optic neuropathy

42
Q

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

A

cortical blindness has normal pupillary reflexes

43
Q

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

A

beta blockers and parasympathomimetics

44
Q

what is assoc with beta blockers used for open angle glaucoma

A

they can cause severe hypotension

45
Q

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

A

not reliabily

46
Q

is the use of atropine strictly contraindicated in open angle glaucoma

A

no

47
Q

what is the pathophys behind glaucoma

A

the increase in iop causes decrease blood to optic nerve

48
Q

what is open angle glaucoma

A

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

49
Q

how do beta blockers prevent glaucoma

A

it decrease aqueous humor production

50
Q

what is apraclonidine and brimonidine for glaucoma

A

they are alpha 2 Agonist drugs used to decrease aqueous humor

51
Q

what is acetazolamide and dichlorphenamide used in glaucoma

A

these are carbonic anhydrase inhibitors

52
Q

what is prilocarpine and carbachol of glaucoma treatment

A

these constrict pupils and increase aqueous outflow

53
Q

what is latanoprost and xalantan of glaucoma treatment

A

they are prostoglandins that increase aqueous outflow

54
Q

what is physiostigmine and echothiophate and isofluorophate of glaucoma treatment

A

they are anticholinesterase inhibitors that decrease intraocular pressure

55
Q

would the use of atropine be contraindicated in glaucoma

A

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

56
Q

can you give scopolamine to a glaucoma patient

A

scopolamine causes significant pupil dilation…it is contraindicated

57
Q

iop. what is normal intraocular pressure

A

10 to 22 mmHg

58
Q

iop. 3 determinants of iop

A

sclera compliance, extraocular pressure, and intraocular volume

59
Q

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

A

ketamine

60
Q

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

A

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