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Quiz 2 Flashcards

1
Q

How close should you be to the patient when doing DO?

A

1.5 to 3cm

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2
Q

How far off the visual axis should you be when doing DO?

A

15-20 degrees

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3
Q

Should patient have just one eye, or both eyes open for DO?

A

Both eyes

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4
Q

If you lose the red reflex when beginning DO, what should you do?

A

Pull back and start over

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5
Q

As you move closer to the patient with the DO, what lens power should you be adding?

A

Minus power

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6
Q

When you get the nerve or a vessel in view, what should you do with the power wheel?

A

Turn it until you get the clearest possible view

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7
Q

Why should you do DO with both eyes open?

A

To reduce your accommodation

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8
Q

Why should you have the patient keep both eyes open and look across the room?

A

To reduce their accommodation

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9
Q

Using your fingers as a spacer between your patient and yourself, you can also use that finger for what purpose?

A

A pivot point to move and follow blood vessels and such

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10
Q

What should you tell your patient for patient education?

A

Where to look, keep both eyes open, and that you will get very close

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11
Q

When doing DO, what correction should you be using?

A

Your habitual correction

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12
Q

If your patient is wearing contacts for DO, should they remove them?

A

No

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13
Q

If you patient is wearing glasses for DO, should they remove them?

A

Yes

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14
Q

What is the fixation aperture of the DO scope used for?

A

Observation of macula

Estimation of optic nerve size

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15
Q

What is the slit aperture of the DO used for?

A

To help determine elevations or depressions of the retina

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16
Q

What is the DO cobalt filter used for?

A

In combination with fluorescein, it is used to view small lesions, abrasions and foriegn objects on the cornea

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17
Q

What does the red-free filter exclude from the exam field?

A

Red rays

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18
Q

What does the red-free filter help you view in DO?

A

Veins, arteries, and nerve fibers

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19
Q

When using the cobalt filter and fluorescein with DO, you will most likely be using what lens?

A

+20

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20
Q

What are some things that the red-free filter helps to ID?

A 
Retinal hemorrhages
Choroidal nevus vs retinal pigmentation
Nerve fiber loss
ON rim tissue
Enhance NFL
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21
Q

When switching to the cobalt filter of the DO, a lesion you were viewing turns black. Where is it located?

A

In the retina

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22
Q

Red-free light only penetrates how far?

A

To the RPE

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23
Q

Where does white light from the DO scope penetrate?

A

To the choroid

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24
Q

How does the DO view the retina?

A

Upright

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25
What are the two ways the retina can be viewed upright, rather than inverted?
DO | Goldmann Hruby lens
26
What fundus viewing techniques give an inverted, reversed, aerial image?
Fundus biomicroscopy | BIO
27
What is the mag of DO?
15x
28
The magnification of DO is dependent on what?
Examiner's refractive error, and the patient's refractive error
29
How big of a field of view is seen in DO?
2 disc diameters
30
What is the code for extended ophthalmoscopy?
92225
31
What is required for detailed ophthalmoscopy?
A detailed sketch with labeling Interpretation Plan of treatment
32
How many colors should be in an extended ophthalmoscopy drawing?
4-6
33
What artifact is colored in light red in retinal mapping?
Attached retina
34
What artifacts are colored in dark red in retinal mapping?
Retinal arteries | Preretinal or intraretinal hemorrhages
35
What artifact is colored light blue in retinal mapping?
Retinal detachment
36
What artifacts are colored dark blue in retinal mapping?
Retinal veins Margins of retinal breaks Lattice - outlined then crosslined
37
What artifacts are colored black in retinal mapping?
Chorioretinal pigmentation
38
What artifacts are colored yellow in retinal mapping?
Intraretinal or subretinal exudates | Cotton Wool Spots
39
What artifacts are colored green in retinal mapping?
Vitreous Opacities
40
For a diabetic patient that doesn't dilate well, what should you do?
Instill another drop of tropicamide
41
How far from the patient's eye should the 20D lens be during BIO?
50mm or 5cm
42
What is the Gulstrand principle for BIO?
That the BIO narrows the observer's interpupillary distance, allowing both the illuminating and viewning beams within the patien'ts pupillary aperture
43
When the patient is looking right, which way should you tilt your head to get a better view?
Right
44
If you have an image on the 20D lens but it is blurry, what are your troubleshooting options?
Check trombone distance | Check working distance from the condensing lens
45
If you see something at the edge of your field of view in a 20D lens, how do you bring it to the center of your view?
Scan toward it
46
How do you get to the ora?
Fill the lens, then scan (tilt and lean) toward the far periphery
47
Which retinal pathologies appear as "something dark"?
``` Nevus CHRPE Optic nerve choroidal ring Peripapillary atrophy Choroidal pigment changes near ampullae (tigroid and brunette) ```
48
What retinal pathologies appear as "something white"?
Cotton wool spots Infarction/retina edema Myelination
49
What retinal pathologies appear as "something yellow"?
Drusen Exudates Emboli
50
What retinal pathologies appear as "something red"?
Hemorrhages Holes Tears
51
What "dark pathologies" are benign?
Pigment crescents CHRPE, bear tracks Choroidal pigment changes near ampullae PPA when mild and associated with myopia
52
When is peripapillary atrophy pathological?
When associated with glaucoma and histoplasmosis
53
What is the typical presentation of peripapillary atrophy?
Irregular, hyper and hypopigmentation zone around the ONH
54
Where is peripapillary most common?
On the temporal side of the ONH
55
What is the typical presentation of a choroidal nevus?
A flat, or slightly elevated grayish-green lesion
56
T or F: Choroidal nevi may grow with age.
True
57
Choroidal nevi may have overlying ___.
Drusen
58
What is the anatomical location of the macula in relation to the ONH?
Temporal and slightly inferior
59
What does CHRPE stand for?
Congenital hypertrophy of the RPE
60
What is the typical presentation of a CHRPE?
Isolated (distinct edges), dark gray/black areas
61
Where would a CHRPE be located?
Anywhere
62
Are CHRPEs elevated, or flat?
Flat
63
What is a halo nevus?
A CHRPE with a depigmented area surrounding it
64
Which would appear to be darker in color, a CHRPE or a choroidal nevus?
CHRPE (more superficial)
65
What is the typical presentation of toxoplasmosis?
Black lesion, with a mixture of white
66
What causes cotton wool spots?
Ischemia of NFL bundles
67
Why are cotton wool spots commonly within 3-5DD of the disc?
That is where the NFL is thickest
68
What is the most common cause of NFL ischemia, leading to cotton wool spots?
Acute obstruction of an arteriole, causing blockage of axoplasmic flow, and buildup of debris in the NFL
69
In which diseases are cotton wool spots common?
Hypertension Diabetes Lupus HIV/AIDs
70
What (non disease) else can cause cotton wool spots?
``` Vein occlusions Interferon therapy (for hep C, melanoma, MS) ```
71
Cotton wool spots are also called ___?
Soft exudates
72
What are hard exudates formed out of?
Deposition of lipid and lipoproteins
73
Hard exudates are a sign of what?
Abnormal vascular permeability
74
In which diseases are hard exudates commonly found?
Diabetic retinopathy Late stage HTN retinopathy Ven occlusions
75
Drusen are most commonly related to what?
Age
76
Drusen are deposited where?
Between RPE and Bruch's membrane
77
Which appears brigher and more yellow, exudates or drusen?
Exudates
78
Which deposit can obscure blood vessels, cotton wool spots or hard exudates?
Cotton wool spots
79
What is the typical presentation of myelinated NFL?
White, feathery-edged configuration of the nerve fiber layer - may obscure blood vessels
80
Where is myelinated NFL most commonly found?
Around the optic nerve and peripapillary NFL
81
Under normal conditions, only the ___ optic nerve is myelinated.
Retrobulbar
82
What is the blood supply to the retina?
Central Retinal Artery | Choroidal blood vessels
83
What nourishes the inner retinal layers?
Central retinal artery
84
What maintains the outer retina, particularly the photoreceptors?
Choroidal blood vessels
85
Something white on the ONH is probably what?
Remnant of the hyaloid artery
86
If there is a mound of glial tissue, it is called what?
Bergmmister papillae
87
What is the normal, extra vessel called?
Cilioretinal artery
88
What is the origin of the ciloretinal artery?
Choroid
89
If a patient has CRA occlusion, but still has an islet of vision, they probably have what?
Cilioretinal artery, that redundantly supplies blood to a portion of the retina
90
What is the typical presentation of a branch retinal artery occlusion?
An opaque area, signifying retinal edema due to retinal infarction
91
What is the typical presentation of central retinal artery occlusion?
Cherry red spot | White fundus
92
Why does a cherry red spot persist in CRA occlusion?
Macula has choroidal blood supply
93
What causes the retina to turn white in CRA occlusion?
No blood | NFL has turned opaque
94
A D-hemorrhage is found where?
Pre-retinal
95
Flame hemes are in what part of the retina?
NFL
96
What is the most common place for a BRVO?
Superior temporal arcade
97
An intraretinal hemorrhage has what appearance?
Dot and blot
98
Proliferative diabetic retinopathy typically includes what two things?
Neo of the disc | Neo of the retina (neo elsewhere)

PPO5 (3 decks)

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