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BCSCSAP Review > Fundamentals and Principles > Flashcards

Fundamentals and Principles Flashcards

1
Q

Used preoperatively for prevention of PG-mediated pupillary miosis during ocular surgery

A

Topical NSAID drops such as flurbiprofen 0.03% and suprofen 1%

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2
Q

bilateral “snowflake” cataract

A

True diabetic cataract is a rapidly developing cataract that appears in the lens cortex of patients with poorly controlled type 1 DM.

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3
Q

Smooth muscle of the iris and ciliary body is derived from what germ layer?

A

neuroectoderm

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4
Q

A, B, C, D?

A

A - anterior TM

B- posterior TM

C - scleral spur

D - ciliary body band

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5
Q

Eyelid anatomy in asian versus other races?

A

non-Asian” orbital septum insterts onto the levator aponeurosis ABOVE the tarsus

Asian: orbital septum inserts into the levator aponeurosis between the eyelid margin and the superior border of the tarsus. Superior eyelid fold is minimal or absent.

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6
Q

Substance is combined with and activates fibrinogen to form athe sealant in a fibrin-based tissue adhesive

A

thrombin (used to control intraocular hemorrhage during vitrectomy)

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7
Q

What is the ratio of optic nerve axons that cross at the optic chiasm compared to those that do not cross?

A

53:47

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8
Q
A
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9
Q

Largest water-soluble lens protein

A

alpha-crystallins - function to keep other crystallins from denaturing

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10
Q

Krause and Wolfring are this type of gland?

A

exocrine

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11
Q

3 layers of trabecular meshwork

A

Uveal meshwork, corneoscleral meshwork, pericanalicular tissue

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12
Q

Mechanism of retrocorneal fibrous membrane (RCFM)

A

Infiltration of polymorphonuclear leukocytes in resonse to severe corneal injury induces endothelial cells to become fibroblastic and synthesize RCFM

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13
Q

Inner nuclear layer cell is nonneural and plasy a supportive role to the neural tissue extending from the inner segments of the photoreceptors to the ILM which is formed by their end-feet

A

glial cells (Muller cell)

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14
Q

In what ocular process does melanin participate?

A

retinal development and neuronal migration

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15
Q

Where is the germative zone of the lens epithelium located?

A

immediately anterior to the lens equator

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16
Q

Which cranial nerve also carries innervation to the pupillary sphincter muscle?

A

CN III

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17
Q

Most common collagen in descemet membrane

A

Type IV collagen

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18
Q

Cell population that increases with the use of topical cyclosporine 0.05%

A

goblet cells

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19
Q

Characteristic of Rb that suggests familial condition

A

FHx of Rb or stationary retinal tumors (retinomas) or enucleations.

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20
Q

Convert 1% solution to g/mL and mg/mL

A

1% solution = 1g/100mL or 1000mg/100mL

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21
Q

Stains devitalized epithelial cells

A

rose bengal

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22
Q

Most common collagen in vitreous

A

Type II collagen

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23
Q

Syndrome caused by loss of both alleles of a locus within human chromosome band 13q14

A

retinoblastoma

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24
Q

Location of the ciliary ganglion

A

1 cm in front of the annulus of Zinn on the lateral side of the ophthalmic artery between the ON and lateral rectus muscle

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25
Q

Darkening of the iris and periocular skin and hypertrichosis of the eyelashes

A

latanoprost - increases the number of malnosomes within melanocytes

prodrug of prostaglandin F2a

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26
Q

Component of aqueous that is always higher than concentration in aqueous than in plasma

A

lactate

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27
Q

PAX6

A

Aniridia

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28
Q

Ciliary ganglion receives thes 3 roots

A
  1. Long sensory root - from nasociliary branch of CN V1. 10-12 mm long and contains sensory fibers from cornea, iris, ciliary body
  2. Short motor root - (only one to synapse) from inferior division of CN III - inferior oblique, postganglionic fibers carry parasympathetic axons to supply the iris sphincter
  3. Sympathetic root - from plexus of internal carotid, innervates ocular blood vessels and dilator muscle of the pupil
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29
Q

What morphogen interacts with intracellular receptors to regulate gene expression during eye development

A

RETINOIC ACID

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30
Q

Examples of mutations of mtDNA-encoded tRNA

A

30% of cases of CPEO, mitochondrial encephalopathy, lactic acidosis, stroke like episodes (MELAS), myoclonic epilepsy with ragged red fibers (MERRF)

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31
Q

Components of aqeuous

A

Na+ 163 mmol/kg H20

Cl- 134 mmol/kg H20

HCO3-3 (20 mmol/kg H20)

Glucose (3 mmol/kg/H20) (70% plasma)

Ascorbate (1.06 mmol/kg H20)

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32
Q

Cranial nerves that directly innervate the eye?

A

6 of the 12 CN (CN II-VII)

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33
Q

Genetic disorder causes a pigmentary retinopathy and may be partially managed with a phytanic acid-restricted diet.

A

Refsum disease

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34
Q

Clinical effect do of direct-acting muscarinic agents

A

Increases range of accommodation

constrict the pupillary sphincter and ciliary muscle - results in increased myopia and decreased central anterior chamber

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35
Q

another name for retinoblastoma

A

Long arm 13 deletion (13q14) syndrome

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36
Q

outline corneal and conjunctival epithelial defects

A

Fluorescein and lissamine green

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37
Q

What kind of mitochonrial DNA disorder produces CPEO of the Kearns-Sayre variant?

A

a large rearrangement of mtDNA (deletions and insertions)

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38
Q

Difference between brimonidine and apraclonidine

A

Brimonidine is more lipophilic than apraclonidine. Penetrates cornea and blood-brain barrier better.

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39
Q

Age-related degeneration of the connective tissue of the Tenon capsule can lead to what condition?

A

Acquired strabismus

40
Q

Volume of the vitreous cavity

A

5.0 - 6.0 mL

Largest compartment within the globe; more than 2/3 volume of the eye

41
Q

caused by mutations of mtDNA-encoded ribosomal RNA

A

Maternally inhertied sensorineural deafness and aminoglycoside-induced deafness

42
Q

What medication may cause increased pigmentation of the iris and periocular skin?

A

bimatoprost

43
Q

How many extraocular muscles are innervated by cranial nerve III?

A

5: Superior division of CN III supplies the SR and levator muscles. The inferior division supplies the IR, IO, MR muscles

44
Q

These cells seal off the subretinal space by forming the external limiting membrane (ELM)

A

Muller cells (glial cells)

45
Q

What is the smallest water-soluble lens protein?

A

gamma-crystallins

46
Q

Collagen type of the corneal stroma responsible fro forming the anchoring fibril of the epithelium

A

type VII collagen

47
Q

Uveal tract is firmly attached to the sclera at only 3 sites:

A

Scleral spur

Exit point of the vortex veins

Optic nerve

48
Q

What portion of DNA coding sequence is removed as part of synthesis of messenger RNA?

A

intron

49
Q

Pigment within RPE responsible for signal generated in fudnus autofluorescence imaging

A

lipofuscin - granules arise from the discs of photoreceptor outer segments and represent residual bodies arising from phagosomal activity

50
Q

Genetic inheritance pattern for blepharophimosis?

A

Autosomal dominant

51
Q

Best option to reduce intraocular pressure for patient with severe ocular surface disease and intolerance to multiple previously prescribed eye drops

A

Tafluprost

available in preservative-free single-use containers

52
Q

Name of the PAS-positive lamina resulting from the fusion of the basal laminae of the RPE and choriocapillaris of the choroid?

A

Bruch membrane

53
Q

What is the uveal tract?

A

Main vascular compartment of the eye - iris, ciliary body, choroid

54
Q

Achromatopisa (complete color blindness) with myopia is seen commonly here

A

South Pacific island of Pingelap

55
Q

The en grappe innervation of what specific type of muscle fibers unique to the extraocular muscles is useful for smooth pursuit movements of the eyes?

A

tonic-type muscle fibers

multiple grapelike nerve endings that are useful for smooth purusit

56
Q

What bone makes up part of the orbital roof and the medial wall of the orbit?

A

lesser wing of the sphenoid bone

57
Q

What systemic side effect might result from treatment with oral carbonic anhydrase inhibitors?

A

Metabolic acidosis

Imbalance

Somnolence

Hypokalemia

Aplastic anemia

Anorexia

Paresthesias

weight loss

kidney stones

‘MISHAP WK’

58
Q

Approximate distance from the Schwalbe line to the ora serrata

A

6 millimeters

59
Q

Patient with very light hair and skin color, mild chronic photosensitivity and blurring OU. Recent dental procedure with excessive bleeding. Sister with similar history. Diagnosis?

A

Hermansky-Pudlak syndrome

Common puerto Rican but also india, japan UK, western europe

AR

Normal platelet counts but abnormal platelet aggregation

60
Q

Structures that run through the cavernous sinus

A
  • Internal carotid artery (ICA) and sympathetic carotid plexus
  • CN III, IV, VI
  • Ophthalmic and maxillary divisions of CN V
61
Q

Muscles that originate from the annulus of Zinn

A

lateral rectus

Superior, inferior, medial, lateral rectus

62
Q

Medication implicated in outbreaks of contamination-related infectious endophthalmitis?

A

bevacizumab

63
Q

Embryonic cell line that the iris sphincter muscles dervied from?

A

mesodermal cells

Others: dilator muscles, extraocular muscles

64
Q

Embryologic origin of the pigmented pupillary ruff?

A

neural ectoderm

pupillary pigmented ruff is brief anterior extension of the posterior pigmented layer of the iris onto the anterior border of the iris stroma

65
Q

3 affected males connected through an unaffected female suggest this mode of inheritance.

A

X-linked recessive

66
Q

The anterior layer of the tear film is secreted primarily by the meibomian glands but secondarily by what other glands?

A

Glands of Zeis (sebaceous) located at eyelid margin close to eyelash roots secrete lipid

67
Q

Rb gene

A

long arm of chromosome 13

Of people who inherit the gene mutation, 90% will develop Rb (90% penentrance)

68
Q

Mechanism of skin darkening

A

increased number of melanosomes (increased melanin content, or melanogenesis) within melanocytes.

69
Q

Expected serum electrolyte effects of acetazolamide?

A

Hypokalemia and metabolic acidosis

70
Q

Mechanism of action of moxifloxacin?

A

inhibits bacterial DNA replication (topoisomerase, enzyme needed to separate bacterial DNA)

active against both gram-positive and gram negative bacteria

71
Q

NSAIDs block prostaglandin biosynthesis by inhibition of what enzyme?

A

cyclo-oxygenase

72
Q

What mechanism results in the random oxidation of lipids?

A

auto-oxidation

Inhibited by free-radical scavengers such as vitamin E

73
Q

Receptor that mediates medication naphazoline and tetrahydrozoline?

A

alpha-1

(oxymetazoline, phenylephrine hydrochloride topical drops to cause temporary vasoconstriction)

74
Q

Fibers from which of the 3 roots recevied by the ciliary ganglion actually synapse in the ganglion?

A

Short motor root

75
Q

Fungal-derived peptide emulsion approved by the FDA for treating the inflammatory component of dry eye syndrome

A

cyclosporine A

76
Q

What condition can cause tear film dysfunction as a result of alteration of the tear mucin component?

A

Giant papillary conjunctivitis - (excessive in number)

77
Q

inactivation of 1 X chromosome in every somatic cell in females

A

lyonization

78
Q

Type of mutation in Leber hereditary optic neuropathy (LHON) and neuropathy, ataxia, and retinitis pigmentosa (NARP)

A

missense and nonsense mutations

79
Q

How to convert a % solution. For example a 0.01% solution is

A

0.01g/100mL or 10mg/100mL

80
Q

First developmental site of malanogenesis in the body?

A

Retinal pigment epithelium

81
Q

The disruption of what corneal layer in laser subepithelial keratomileusis (LASEK/PRK) is thought to be the cause of increased risk for visual complications postoperatviely due to central cornea haze?

A

Bowman layer (prevents exposure of stromal corneal keratocytes to growth factors secreted by corneal epithelial cells and take on fibroblastic behaviors)

82
Q

Process by which oxygen is activated electronicaly by light to form singlet oxygen

A

photo-oxidation

83
Q

What part of the ocular outflow apparatus is in closest proximity to the anterior chamber?

A

Uveal meshwork - internal most portion of the TM and is closest proximity to the AC.

84
Q

Class of medications that may decrease the facility of aqueous outflow through the TM in some patients.

A

Corticosteroids

(sulfa derivatives do not affect aqeuous outflow)

85
Q

Exam finding that would help distinguish a lesion isolated to the cavernous sinus from one extending to the orbital apex

A

relative afferent pupillary defect (RAPD) - optic nerve (CN II) does not travel through the cavernous sinus

86
Q

What are the first cells that differenitate in the embryonic retina?

A

ganglion cells

87
Q

The arterial blood supply to the whole uveal tract, the sclera, the margin of the cornea, and adjacent conjunctiva is provided by what arteries?

A

posterior ciliary arteries

88
Q

Role of glycoproteins and glycolipids of cornea epithelium?

A

protoming stability of tear film and wettability of cornea surface

aid in pathogenesis of infection by acting as attachment sites for microbes

89
Q

1 mL of a 1:10,000 dilution

A

1 g of drug in 10,000 mL

90
Q
A

Corneal clouding and prominent Descemet folds

91
Q

Retrocorneal fibrous membrane (RCFM) forms at what location in the cornea

A

between Descemet membrane and the endothelium

92
Q

Mechanism of vitreous liquefaction

A

loss of shielding of type II collagen by type IX collagen

Syneresis or vitreous liquefaction is the breakdown of thin (12015 nm) collagen fibrils into smaller fragments

93
Q

What creates the force that holds the flap in place after LASIK?

A

endothelial pump

94
Q

In what area are the nerve fibers of the optic nerve first noted to be myelinated?

A

retrolaminar area

95
Q

Topically administered interferon speeds the recovery of what viral disease?

A

herpes simplex keratitis - interferon + acyclovir or trifluridine

96
Q

This layer of the tear film contributes to the optical properties of the tear film because of its postiion at the air-tear film interface

A

lipid layer

97
Q

Function of the aqueous layer of the tear film

A

maintain a constant electrolyte composition over the ocular surface epithelium

supply oxygen

antibacterial/antiviral defense

wash away dibris

smooth irregularities

BCSCSAP Review (13 decks)

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