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Green Book > Paper 2 > Flashcards

Paper 2 Flashcards

1
Q

Which nerve supplies the maxillary sinus

A

Infraorbital nerve- branch of maxillary division of trigeminal nerve

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2
Q

Which nerve involvement can result in cheek numbness after orbital blowout fracture

A

Infraorbital nerve- branch of maxillary division of trigeminal nerve

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3
Q

Where does the inferior orbital fissure lie

A

lies in the lateral orbit floor between greater wing of sphenoid and maxilla

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4
Q

What is the inferior orbital fissure an opening from

A

from infratemporal and pterygopalatine fossae

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5
Q

Structures passing through inferior orbital fissure

A

Inferior ophthalmic vein which passes out of the orbit and drains into the pterygoid venous plexus
The infraorbital artery and vein
Two branches of V2 (Maxillary nerve which becomes infraorbital nerve, Zygomatic nerve)
Branches of the pterygopalatine ganglion

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6
Q

What is the action of the corrugator supercilli

A

Draws the eyebrows medially toward the nose- innervated by CNVII

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7
Q

How many eyelashes are found in the upper lid

A

150

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8
Q

How many eyelashes are found in the lower lid

A

75

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9
Q

Where does the inferior oblique muscle originate from

A

Only muscle not arising from the orbital apex. Arises from the orbital plate of the maxilla on the medial side of the orbital floor posterior to the orbital margin

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10
Q

What is the height of the tarsal plate in the upper and lower lids

A

Upper: 10mm
Lower 5mm

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11
Q

Which bone does the superior oblique originate from

A

Sphenoid

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12
Q

What is the ratio of EOM to skeletal muscles

A

1:2 to 1:7

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13
Q

Where is the lesion caused by a superior bitemporal hemianopia

A

Inferior to chiasm: Pituitary adenoma

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14
Q

Where is the lesion caused by an inferior bitemporal hemianopia

A

Superior to chiasm: Craniopharyngoma; suprasellar or olfactory groove meningioma

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15
Q

Where is the lesion caused by a junctional scotoma

A

Anterior to chiasm at junction of optic nerve: sphenoid meningioma

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16
Q

Where is the lesion caused by a binasal field defect

A

Lateral to chiasm: Dilation of 3rd ventricle in hydrocephalus

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17
Q

Where are the accessory glands of Krause located

A

Conjunctival fornix

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18
Q

Where are the accessory glands of Wolfring (Ciaccio glands) located

A

Border of tarsal plate

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19
Q

Branches of the External Carotid Artery

A

Some Anatomists Like Freaking Out Poor Medical Students:
S – superior thyroid artery
A – ascending pharyngeal artery
L – lingual artery
F – facial artery
O – occipital artery
P – posterior auricular artery
M – maxillary artery
S – superficial temporal artery

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20
Q

What are the terminal branches of the ECA

A

M – maxillary artery
S – superficial temporal artery

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21
Q

How many anterior ciliary arteries are there

A

7
lateral rectus has only a single anterior ciliary artery,

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22
Q

Where is the watershed area of retinal blood supply?

A

inner nuclear layer.

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23
Q

Choroidal vs Retinal blood flow rate

A

Choroidal high flow rate, retinal low flow rate more O2 exchange

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24
Q

Where is Wieger’s ligament found?

A

connects the anterior hyaloid face to the posterior lens capsule. 8–9 mm in diameter.
Its adherence to the posterior capsule becomes weaker with age. Intracapsular cataract surgery in young patients almost invariably leads to vitreous loss because of the adherence of Wieger’s ligament.

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25
Q

Length of cannaliculi tear ducts

A

2mm vertical segment followed by an 8 mm horizontal segment

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26
Q

Where is the lamina fusca found in relation to the scleral stroma

A

deep to the scleral stroma

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27
Q

Where is the sclera thinnest and thickest

A

thinnest behind the insertions of the extraocular muscles (0.3–0.4 mm) and thickest posteriorly near the optic nerve

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28
Q

What makes up the anterior boundary of the pterygopalatine fossa

A

Posterior surface of maxilla

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29
Q

What makes up the posterior boundary of the pterygopalatine fossa

A

Sphenoid including pterygoid process and greater wing

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30
Q

What makes up the superior boundary of the pterygopalatine fossa

A

Sphenoid at the junction of the body and greater wing

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31
Q

what makes up the inferior boundary of the pterygopalatine fossa

A

Pyramidal process of the palatine bone, open to palatine canals

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32
Q

what makes up the medial boundary of the pterygopalatine fossa

A

Vertical plate of the palatine bone

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33
Q

what makes up the lateral boundary of the pterygopalatine fossa

A

Open to the infratemporal fossa via the pterygomaxillary fissure

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34
Q

Where do the right and left common carotid arteries originate from

A

left- directly from the aortic arch,
right- brachiocephalic trunk divides into the right common carotid and right subclavian arteries.

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35
Q

What are the locations of the pigmented and non pigmented layers of the ciliary epithelium

A

inner non-pigmented layer and an outer pigmented layer arranged apex to apex

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36
Q

Sites on globe vulnerable to rupture

A
  • Where the sclera is thinnest: at or just posterior to the insertion of the rectus muscles;
  • At the corneoscleral junction (limbus);
  • At the site of previous surgical incisions.
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37
Q

Anterior and Posterior chamber aqueous volume (Anterior segment)

A

250 microlitres
60 microlitres

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38
Q

Are choriocapillaris fenestrated

A

consists of relatively wide-bore capillaries. Unlike the larger vessels in Haller’s and Sattler’s layer, the endothelium is fenestrated rendering it permeable to large molecules including fluorescein.

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39
Q

What percentage of glucose is made in the lens by anaerobic glycolysis

A

Only lens epithelial cells possess mitochondria and so this is the only place in the lens where the citric acid (Krebs) cycle can occur. Anaerobic glycolysis accounts for approximately 80% of glucose consumption in the lens. The end products of this are lactic acid, which diffuses out into the aqueous, and adenosine triphosphate (ATP).

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40
Q

Function of matrix metalloproteinases

A

degrade extracellular matrix, are involved in both the maintenance of normal framework (principally MMP-2) and remodelling following injury.

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41
Q

How are RPE cells joined to each other

A

tight junctions

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42
Q

Where are fibrillins found

A

crucial component of the lens zonules and are also found in the lens capsule, the vitreous, and the stroma of most ocular tissues.

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43
Q

What condition results in mutation to fibrillin 1 gene

A

Marfan’s syndrome

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44
Q

Does ELISA use radioisotopes

A

No

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45
Q

Can ELISA be both quantitative and qualitative

A

Yes

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46
Q

What happens during photoisomerization to 11 cis retinal

A

Converted to all trans retinal

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47
Q

Where is All-trans retinal is converted to all-trans retinol

A

in the photoreceptor outer segment before being transported to the retinal pigment epithelial cells, where it is reconstituted into the 11-cis retinal isoform (an isoform of vitamin A derived from carotenoids).

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48
Q

At which synaptic junction is glutamate used

A

synapses between the photoreceptors and bipolar and horizontal cells. This occurs in the outer plexiform layer following phototransduction.

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49
Q

What is the diameter of actin

A

7mm

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50
Q

Function of actin in cells

A

important component of the cytoskeleton, cell motility, cell division, cell–cell interactions, contractility and the interaction of transmembrane and cytoplasmic proteins.

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51
Q

Which neural layer derives the EOM and Schlemm canal

A

Mesoderm

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52
Q

When does the sphenoid sinus develop

A

2-3 years after birth

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53
Q

Which sinuses are the first to appear

A

Maxillary sinus

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54
Q

When does the hyaloid vasculature develop in the baby

A

between the 3rd and 8th week along with the primary vitreous.

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55
Q

When does hyaloid vessels, the tunica vasculosa lentis and the primary vitreous begin to atrophy

A

From 18 weeks

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56
Q

What is the remnant structure once hyaloid vessels, the tunica vasculosa lentis and the primary vitreous begin to atrophy

A

Cloquet’s canal is formed.

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57
Q

When does blood flow in the hyaloid artery stop

A

30 weeks

58
Q

Which mutation causes Aniridia

A

PAX-6 mutations on chromosome 11.
Autosomal dominance inheritance

59
Q

What is Gillespie syndrome

A

A rare form of aniridia is Gillespie syndrome, which is usually autosomal recessive and associated with cerebellar ataxia.

60
Q

What is the order of size of chromosomes from 1 to 22

A

Chromosomes are numbered in decreasing order of size, and so chromosome 6 is bigger than 13.

61
Q

What are p and q arms of the chromosome

A

p short
q long

62
Q

What is inversion in genetics

A

involve two breaks in one chromosome, with 180° inversion of the segment. This interferes with chromosome pairing at meiosis and results in unbalanced gametes.

63
Q

What is the Hardy Weinburg equilibrium

A

describes the constancy of gene frequencies in a population from one generation to the next. For a gene with two alleles, it is expressed as:
p2 + 2pq + q2 = 1

The Hardy–Weinberg equilibrium can apply regardless of whether a condition is X-linked or autosomal.

64
Q

Ocular associations of Down’s syndrome

A

keratoconus, myopia (and its associated risks including retinal detachment), cataract and Brushfield’s spots on the iris.

65
Q

Where is the VHL gene found

A

chromosome 3. Autosomal dominant

66
Q

Features of VHL

A

Retinal angiomata (also known as capillary haemangiomata) are the cardinal ocular feature. Cerebellar haemangioblastoma is also a cardinal feature of VHL but not an ocular one. Other non-ocular features include renal cell carcinomas and phaeochromocytomas.

67
Q

Difference between metacentric and acrocentric chromosomes

A

Metacentric- centromeres located centrally on the chromosome, giving rise to two arms of roughly equal length
Acrocentric- centromere near one terminal end, giving rise to a short arm that
is difficult to observe.

68
Q

Where is majority of complement produced

A

in the liver

69
Q

How is the complement classic pathway activated

A

by antibody–antigen binding, and by acute phase proteins such as CRP

70
Q

How is the alternative complement pathway triggered

A

binding of C3b to factor B on the surface of an organism or foreign material.

71
Q

Which complement make up MAC

A

C5b-6-7-8 complex binds to C9, causing cell death by osmolytic lysis

72
Q

Function of perforins and granzymes produced by cytotoxic T cells

A

perforins- create a channel in the membrane,
granzymes- induce apoptosis.

73
Q

Which interferon can stimulate cells to express MHC class 2 molecules

A

interferon-γ can induce certain endothelial and epithelial cells

74
Q

The peptides expressed by MHC 2 molecules are they intra or extracellular

A

principally from the extracellular environment, having been taken up by the cell and degraded in endosomes.

75
Q

What is the VEP a test of

A

the electrical response of the visual cortex to a changing visual stimulus and thus is an objective test of the visual pathways.

76
Q

Examples of single stranded RNA virus

A

Influenza A,
coxsackie
measles

77
Q

Examples of Double stranded DNA virus

A

Adenovirus

78
Q

What are Owl’s eye inclusion bodies are a specific histopathological sign of

A

CMV. detected on light microscopy in haematoxylin and eosin (H&E) stained preparations
Cytoplasmic- RNA viruses
Nuclear- DNA viruses

79
Q

What are Cowdry type A inclusion bodies a sign of

A

nuclear and can be seen in herpes simplex, varicella zoster and sometimes cytomegalovirus infection.

80
Q

What complement pathway do endotoxins activate

A

Alternative pathway- derived from the cell wall of Gram-negative bacteria

81
Q

What genus is Acanthamoeba

A

single-celled eukaryotic micro-organisms
They are also often described as protozoa

82
Q

Which acanthamoeba causes keratitis

A

Acanthamoeba polyphaga

83
Q

Which forms do Acanthamoeba exist in

A
  • Active trophozoites, which produce destructive enzymes to penetrate the cornea; and
  • Metabolically inactive cysts, which are very hardy and survive unfavourable conditions including chlorination of water.
84
Q

Which IgE does Toxocara stimulate

A

IgE

85
Q

What does a Porro prism do to the image

A

Image deviated 180
Image inverted but not transposed left to right

86
Q

What does a Dove prism do to the image

A

– Image not deviated
– Image inverted but not transposed left to right

87
Q

What does a Wollaston prism do to the image

A

Incident beam of light split into two polarised emergent beams at a fixed angle without dispersion

88
Q

SRK Formula

A

A-2.5(AL)-0.9(K)

89
Q

Magnifying factor of a 60D lens

A

1.15

90
Q

Magnifying factor of a 66D lens

A

1.00

91
Q

Magnifying factor of a 78D lens

A

0.93

92
Q

Magnifying factor of a 90D lens

A

0.76

93
Q

Radii of curvature of the anterior and posterior lens surfaces

A

anterior 7.7mm
posterior 6.8mm

94
Q

Where is the Argon Blue laser beam absorbed in the eye

A

absorbed by xanthophyll in the inner and outer plexiform layers of the macula and therefore should not be used to treat lesions in this area.

95
Q

Wavelength of Nd YAG laser

A

1064nm

96
Q

Properties of Image 1,2,3 Purkinje images

A

erect virtual images as they arise from convex reflecting surfaces

97
Q

Properties of Image 4 Purkinje image

A

inverted real image as it is the reflection from a concave reflecting surface

98
Q

Is the anterior corneal curvature steeper centrally than peripherally

A

Yes- reduces spherical aberration

99
Q

Does the lens nucleus have a higher refracting power than the periphery

A

Yes- reduces spherical aberration

100
Q

What type of lens is a Hruby lens

A

Planoconcave lens

101
Q

Power of a Hruby lens

A

-58.6 dioptres

102
Q

What cylinder is needed to correct WTR astigmatism

A

Positive at 90 degrees. or negative cylinder at 180°

103
Q

What cylinder is needed to correct ATR astigmatism

A

Positive at 180 degrees or negative cylinder at 90 degrees

104
Q

What factors determine angle of deviation of a prism

A

angle of incidence of the light ray,
the refracting angle of the prism
the refractive index of the prism material.

105
Q

What are Flexner–Wintersteiner rosettes

A

tumour cells arranged around a central lumen. The cells resemble primitive photoreceptor cells on electron microscopy. They are characteristically seen in retinoblastoma

106
Q

What are Homer–Wright rosettes

A

represent neuroblastic differentiation and are relatively non-specific- can be seen in Retinoblastoma

107
Q

What are fleurettes

A

represent photoreceptor differentiation in Retinoblastoma

108
Q

Which other conditions can Flexner–Wintersteiner rosettes be seen in

A

pineoblastomas and medulloepitheliomas

109
Q

Which age does keratoconus stabilise by

A

early to mid-thirties

110
Q

What are Fleishcher rings in keratoconus

A

result of iron deposition in the basal epithelial layers at the base of the cone

111
Q

Does Behcets disease cause a granulomatous inflammation

A

NO

112
Q

Features of worst prognosis in choroidal melanoma

A

epithelioid cells
The most important cytogenetic predictors of mortality and metastasis in choroidal melanoma are:
monosomy of chromosome 3 and partial duplication of 8q.
Older age, large tumour size and extrascleral extension are further poor prognostic factors

113
Q

What type of rejection is a corneal graft rejection

A

Type 4

114
Q

Risk factors for corneal graft rejection

A
  • Young age
  • Repeat grafts
  • Large grafts
  • Preoperative stromal vascularisation
  • Loose or broken sutures
  • Active inflammation
115
Q

What type of receptor is the nicotinic acetylcholine receptor

A

Ligand gated ion channel

116
Q

What is The main barrier to intraocular penetration of topical drugs

A

Corneal epithelium. Tight junctions between the superficial cells form a hydrophobic barrier

117
Q

What does a higher pH cause in terms of corneal permeability

A

increases its intraocular penetration as well as its systemic absorption

118
Q

How do corticosteroids reduce the chronic inflammatory response

A

decrease fibroblast function but that they also impair wound healing.

119
Q

How does Edrophonium work in the tensilon test

A

inhibits acetylcholinesterase, therefore reducing the breakdown of acetylcholine
in the synaptic cleft.

120
Q

How does 5-FU Work

A

Fluorinated pyrimidine analogue which impedes DNA synthesis

121
Q

How does Mitomycin C work

A

Alkylation agent which crosslinks DNA

122
Q

Where in the cell cycle does 5-FU work

A

S phase
G2

123
Q

Where in the cell cycle does Mitomycin C work

A

Non cell cycle specific

124
Q

Is 5FU more toxic than Mitomycin to the corneal epithelium

A

YES

125
Q

How do amphetamines work

A

Increased noradrenaline release

126
Q

How does Cocaine work

A

Decreased Noradrenaline uptake

127
Q

How does MDMA work

A

Increased release of monoamine neurotransmitters (including noradrenaline), inhibition of serotonin reuptake

128
Q

Wavelengths of peak spectral sensitivity for Blue, green and red cones (SML)

A

Blue (S)- 445
Green (M)- 545
Red (L)- 570

129
Q

Commonest congenital colour defect

A

deuteranomaly, which occurs in 5% of men and 0.3% women.

130
Q

Which chromosome is the gene for red and green cones located on

A

X chromosome

131
Q

Which chromosome is the gene for blue cones located on

A

7

132
Q

What does somatostatin do to growth hormone

A

Prevents release

133
Q

Osmolarity units

A

Per litre of solution

134
Q

Osmolality units

A

Per kg of solvent

135
Q

Normal osmolality of plasma

A

280–305 mosmol/kg.

136
Q

4 principal proteins in lacrimal gland secretions

A

lysozyme,
lactoferrin,
lipocalcin
secretory IgA

137
Q

Which glycosaminoglycan is found in vitreous

A

Hyaluronan

138
Q

Where does aqueous drain into via the uveoscleral route

A

passes via the suprachoroidal spaces into the choroidal circulation

139
Q

Where are the cell bodies of the nerves of the optic radiations are located

A

LGN

140
Q

What is CSF highly constituent in

A

Higher concentrations of chloride, magnesium and hydrogen ions

141
Q

Examples of parametric tests

A

Student’s t test, the z test and analysis of variance (ANOVA)

142
Q

Examples of non parametric tests

A

χ2 test, Fisher’s exact test, and the Mann–Whitney (Wilcoxon rank sum) test.

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