Intro/Wound Repair/Specimen Handling/Special Procedures

Question 1

Hamartoma

Answer 1

proliferation of mature tissue at normal location

Question 2

Choristoma

Answer 2

normal, mature tissue at abnormal location

Question 3

What are Russell Bodies? What do they represent

Answer 3

eosinophilic inclusions in plasma cells. immunoglobulin

Question 4

Time for abrasion to be covered by epithelium? Time for full recovery of all layers?

Answer 4

24-48h. 4-6 weeks

Question 5

How is corneal stromal healing different than other tissues? How do neutrophils arrive at wound?

Answer 5

avascular healing. tear film

Question 6

What layer does not regenerate after a corneal ulcer?

Answer 6

Bowman’s (because it is acellular)

Question 7

Two matrix GAGs in cornea? Matrix GAG for sclera?

Answer 7

keratan sulfate and chondroitin sulfate

dermatan sulfate

Question 8

Wounds at the limbus cause ___ in the cornea and ___ in the sclera

Answer 8

swelling. shrinking

Question 9

2 differences between clear cornea and limbal incisions?

Answer 9

1. vascular ingrowth from episcleral vessels into a limbal wound v avascular corneal wound
2. surface remodeling of epithelium over a clear cornea wound that does not occur over a limbal wound

Question 10

Anatomic definition of limbus?

Answer 10

Anterior border: Line connecting Scwalbe’s line (termination of Descemet’s) to termination of Bowman’s

Posterior border: parallel line starting at slceral spur

Question 11

Ingrowth’s in Descemet’s that are normal in periphery and increase with age

Answer 11

Hassall-Henle warts

Question 12

What is a Lang’s fold?

Answer 12

Redundant fold of retina in young eye near ora serrata

Question 13

What lines the anterior segment of the iris?

Answer 13

Stroma

Question 14

What muscle lines the anterior border of the IPE?

Answer 14

Iris dilator (it is a derivative of IPE)

Question 15

Clinical correlate: pupillary abnormality in Rubella?

Answer 15

Miosis (hypoplasia of iris dilator m.)

Question 16

Clinical correlate: iron is deposited in the lens ____ and copper in the lens ___

Answer 16

epithelium

capsule

Question 17

First sign of diabetic ophthalmopathy?

Answer 17

thickened basement membrane of pars plicata

Question 18

How to diagnose optic atrophy on histology?

Answer 18

Widening of subdural space

Question 19

Where do lens epithelial cells normally terminate? Name of swollen lens epithelial cell found posterior to this? What does this cause clinically?

Answer 19

Lens equator. Wedl cell. Posterior subcapsular cataract

Question 20

Incomplete cortical removal during cataract extraction can lead to ____.

Answer 20

Soemmering ring cataract

Question 21

Where do zonules originate?

Answer 21

ciliary processes of pars plicata

Question 22

Depth of AC in choroidal effusion?

Answer 22

shallow

Question 23

Inferior oblique inserts ___ to the optic nerve

Answer 23

lateral, near the macula

Question 24

Calcium in Bowman’s layer?

Answer 24

Calcific band keratopathy

Question 25

Pathology of demarcation line?

Answer 25

RPE hyperplasia and fibrous metaplasia

Question 26

Histological definition of macula?

Answer 26

>/= 2 ganglion cells per cross section

Question 27

True v artifactual RD

Answer 27

True: subretinal fluid, outer segment retinal atrophy

Question 28

Acute optic nerve appearance in AION v papilledema?

Answer 28

pale in AION (no blood flow), hyperemic in papilledema (venous outflow compromised before arterial flow is)

Question 29

Cavernous spaces in retrolaminar portion of proximal optic nerve due to focal loss of myelin and axons and accumulation of hyaluronic acid

Answer 29

Schnabel's cavernous degeneration of optic nerve

Question 30

What is phthisis bulbi?

Answer 30

Atrophy, shrinkage, and disorganization of the eye and intraocular contents

Question 31

Types of immune reaction: I, II, III, IV

Answer 31

I: Immediate, IgE , mast cells (ex. allergic conjunctivitis) II: Antibody-antigen III: Immune complex (ex Lupus) IV: Delayed hypersensitivity (sympathetic ophthalmia)

Question 32

acanthosis

Answer 32

thickening of epithelium (stratum basale and stratum spinosum)

Question 33

3 places where uvea attaches to sclera?

Answer 33

Optic nerve, vortex veins, and scleral spur

Question 34

What is iris color determined by?

Answer 34

number and size of melanosomes within a fixed amount of anterior stromal melanocytes

Question 35

Hallmarks of Coats' disease?

Answer 35

Exudative RD with peripheral telangiectasias

Question 36

Where is the disruption in traumatic angle recession? In iridodialysis?

Answer 36

Tear in ciliary body between longitudinal and circular muscles At the iris base

Question 37

Compression and rupture of IPE against anterior lens capsule?

Answer 37

Vossius ring

Question 38

Where is the lens capsule thinnest?

Answer 38

posterior pole

Question 39

Difference between lens subluxation and luxation?

Answer 39

subluxation incomplete, luxation complete

Question 40

Pathophysiology of commotio?

Answer 40

Traumatic disruption of photoreceptor architecture leading to retinal opacification

Question 41

Where is retinal dialysis most likely to occur?

Answer 41

Inferotemporal (least protected, think sucker punch to face) and superonasal (counter-coup)

Question 42

What layer is ruptured in a choroidal rupture?

Answer 42

Bruch's membrane

Question 43

What is sclopetaria?

Answer 43

chorioretinal rupture and necrosis

Question 44

In atrophia bulbi without shrinkage, which three structures are most sensitive to loss of nutrition, and what pathology do you see as a result?

Answer 44

lens (cataract), retina (serous detachment), and aqueous outflow tract (posterior synechiae)

Question 45

What are the three stages of the development of phthisis?

Answer 45

1. atrophia bulbi w/o shrinkage. 2. atrophia bulbi w/ shrinkage: aqueous production decreases, hypotony develops, globe becomes squared off in shape becuase of rectus muscle tension. Corneal endothelial damage leads to corneal edema, opacification, and vascularization 3. phthisis bulbi: disorganization of intraocular contents, RPE of preserved uvea undergoes proliferation or even osseous metaplasia, extensive calcification of Bowman, lens, retina (drusen), sclera becomes massively thickened.

Question 46

Routine fixation media for all tissues? | For cytology?

Answer 46

formalin | ethyl alcohol

Question 47

Fixative for electron microscopy? | For immunofluoresence?

Answer 47

gluteraldehyde | Michel media

Question 48

Approximate volume of formalin and fixation time for whole globe?

Answer 48

10:1, 24 hours (at least 12 hours)

Question 49

Stain for: 1. basement membrane 2. mucopolysaccharides 3. amyloid 4. bacteria 5. collagen 6. fungi 7. lipid 8. acid fast orgnisms 9. iron 10. calcium phosphate salts

Answer 49

1. PAS 2. Alcian blue or colloidal iron 3. Congo red 4. Gram 5. Masson trichome 6. Gomori methamine silver 7. Oil red O 8. Ziehl-Neelsen 9. Prussian blue 10. von Kossa

Question 50

Embryologic origin of the following: 1. corneal stroma and endothelium, TM, iris stroma, sclera (except temporal portion) 2. corneal epithelium and lacrimal drainage system 3. IPE, iris sphincter and dilator, RPE, neurosensory retina 4. temporal sclera, fibers of EOMs, Schlemm's canal

Answer 50

1. neural crest 2. surface ectoderm 3. neuroectoderm 4. mesoderm

Question 51

Antibodies in immunohistochemistry for the following: 1. epithelial cells (adenoma, carcinoma) 2. smooth or skeletal muscle (leiomyoma, rhabdomyosarcoma) 3. neuroectodermal origin (schwannoma, neurofibroma, melanoma) 4. melanocytic (nevus, melanoma) 5. neuroendocrine lesions (metastatic carcinoid, small cell carcinoma) 6. lesions of hematopoietic origin (leukemia, lymphoma)

Answer 51

1. cytokeratin 2. desmin, actin, myoglobin 3. S-100 4. HMB-45, Melan A 5. chromogranin and synaptophysin 6. leukocyte common antigen

Question 52

Immunophenotyping of leukocytes is accomplished by what type of diagnostic procedure?

Answer 52

flow cytometry

Question 53

What lesion should general ophthalmologists probably not perform FNAB on to prevent risk of seeding?

Answer 53

retinoblastoma

Question 54

What diagnostic procedure neciessitates fresh tissue?

Answer 54

flow cytometry

Question 55

Most common immunohistochemical markers for: B cells T cells

Answer 55

CD20 | CD10