Test 3 Flashcards
Condition that is defined as a productive cough that occurs for 3 consecutive months
Chronic Bronchitis
Hypertrophy of the mucus secreting glands in the bronchioles.
Pts present with cyanosis of the fingers/gies and wheezing of the lungs.
How to minimize the amount of diplopia if you have a RLR palsy
Turn head towards the affected muscle (To the right) and look away (look to the left)
Infants can achieve 20/20 vision by ___ age with VEP. With normal testing, they achieve 20/20 by what age
6 months
3-4 years
Using TAC, acuity is 20/800 at 1 month and 20/50 at 1 year
Cerulean cataract
Lamellar cataract
Cerulean cataract- Tiny dot/flake-like white or blue green congenital opacity. Rarely affects vision.
Lamellar cataract- Located between nuclear and cortical layers of the lens.
Autorefractors are prone to overestimate
Myopia- mores in children and teens. Could be due to proximal accommodation.
The AR tries to stimulate a distant target, but the brain thinks it needs to accommodate because the target is in close proximity.
4 purkinje images
- Front of the cornea.
- Back of the cornea.
- Front of the lens
- Back of the lens- real inverted image. Only surface that is concave. The first 3 are convex (act as minus and will cause small upright image)
Crystallines in the lens
Mature lens fibers contain a high concentration of crystalline proteins that minimize light scattering via destructive interference. Alpha act as chaperones to reverse degradation of other crystalins.
What causes an increase in IOP in steroid responders?
Decreased outflow. Due to increase in deposition of glycosaminoglycans in the TM, resulting in reduced outflow.
What dye is used to stain the lacrimal sac prior to dacryochystorhinostomy ?
Methylene blue
What happens if warm water is poured in left ear
COWS
Direction of fast phase.
Fast phase- to the left
Slow phase- to the right
If your patient has an aneurysm of the internal carotid artery as it passes through the cavernous sinus, what EOM would be affected first?
LR
CN 6 palsy
CN 6 is located adjacent to the ICA within the cavernous sinus and would be affected first.
Role of glutathione in the lens
Protects against oxidative damage
SJS is what type of hypersensitivity reaction
Type 3
Erythema, arthritis, nephritis, CNS abnormalities, myocarditis
Also associated with penicillin, thiouracil, anticonvulsants and iodine.
What is present in the vitreous 40x higher than plasma?
Ascorbate, vitamin C
What happens when a photoreceptor is hyperpolarized by light. How does an on bipolar cell respond?
It decreases glutamate release, causing an on bipolar cell to release more glutamate.
PR are constantly depolarized in the absence of light, meaning they continually release glutamate in the dark.
An on-center bipolar cell is inhibited by glutamate and will hyperpolarize in the dark. In the light, the PR will hyper polarize and release less glutamate. Less glutamate will depolarize the on-center bipolar cell and it will release more glutamate to act on the ganglion cell.
An embolus originating as a thrombus in the ICA will most likely occlude a blood vessel where
In the retina
If the frame PD is smaller or larger than the pt pd, what direction do you decenter it?
Frame PD > Pt PD: Decenter in
Frame PD < Pt PD: Decenter out
Primary source of oxygen for the K
Team film that contains dissolved oxygen from the ATM
Pt with lax criteria have many ____ and not many ____
Click happy
Many false positives
Few false negatives
manifest hyperopia
Facultative hyperopia
Manifest- The amount of hyperopia that is present in a subjective refraction. Maximum plus that will allow the patient to obtain BCVA.
Facultative- Amount of hyperopia masked by accommodation and will not present on manifest. Can be determined by comparing the amount of hyperopia present on manifest and cyclo. It will be the difference.
High plus lenses have a reduced field of view for 2 reasons
Cause an increase in relative spec mag and induce BI prism, causing the image to move further out of view.
Which layer of the cornea is the first to become edematous under hypoxic conditions?
Epithelium
Ocular albinism is associated with
Foveal hypoplasia –> nystagmus
Strabismus
Hypopigmentation
TIDS
Under photopic conditions, CFF occurs at ____
Any light above this frequency will be perceived as
70Hz
Single stimulus rather than multiple separate lights
What eye movement is the slowest to initiate but move the fastest once they are started?
Saccades
Gradient AC/A
Determining AC/A at same distance while looking through 2 different lenses.
Catabolism of each of these yields how many calories/gram: lipids, protein, carb
Lipid- 9
Protein- 4
Carb- 4
Normal tear film Ph
7.4, which is why eye drops that are slightly basic would cause the least amount of discomfort.
Most common finding with orbital cellulitis
Proptosis
The obstruction to aqueous outflow in primary open angle glaucoma is most likely
In the TM- prob the JXT that causes the greatest resistance.
Difference between Keplerian and terrestrial telescope
Both have positive objective and ocular lenses.
Keplerian will have an inverted image
Terrestrial has an inverting prism in the middle and makes the image upright.
Parkinsons
Due to a degeneration of neurons within the substantial nigra, resulting in a deficiency of dopamine in the striatum and musculoskeletal issues.
Tremor, rigidity, akinesia, and postural instability. TRAP!!
Perfusion pressure of the retina
Indicator of how easily blood is able to pass through a given tissue.
Since it asked about the retina, it is the difference between blood entering and leaving the retina- retinal arteries and veins.
manifest is +2
Cyclo is +5
What is the facultative, absolute, and total?
Facultative + absolute = total hyperopia.
Absolute is the amount left over after accommodating.
Facultative is what they hide on manifest.
3 conditions that are characterized by abnormal collagen synthesis
Scurvy
Ehler’s Danlos
Osteogenesis Imperfecta
Scurvy- Secondary to vitamin C deficiency that leads to poor collagen synthesis with resulting deterioration.
Ehler’s Danlos- Abnormal synthesis of type 1 and 2 collagen.
Osteogenesis Imperfecta- Abnormal synthesis of type 1 collagen.
Type 1: Bowmans, bones, stroma, sclera.
Broca-Sulzer effect
Light flashes of a fixed luminance above a threshold will appear brightest if they last 50-100 msec. Longer or shorter flashes of the light will appear dimmer.
What type of tissue effect does each have?
Nd: YAG Excimer Tunable CO laser Argon
Nd: YAG- Photodisruption. Laser energy strips electrons off molecules of the target tissue. The ionized molecules and cloud of electrons together constitute a plasma that expands quickly, creating a shock wave that destroys the target tissue.
Excimer- Photoablation. Energy of the laser breaks chemical bonds in polymers, creating smaller fragments that rapidly expand due to the energy released by the breaking of bonds.
Tunable- Photoradiation.
CO laser- photovaporization. Energy absorbed by the tissue vaporizes the intracellular and extracellular water present.
Argon-photocoagulation. Energy of the laser is absorbed by the tissue and converted to heat, causing the denaturation of proteins.
3 corneal TGFB1 dystrophies
Granular
lattice
Avellino
How to reduce chromatic aberrations
Decrease vertex distance, induce sufficient pantoscopic tilt, switching to another lens material with a higher abbe value
Primary GAG in the K
Keratan Sulfate
Chondroitin sulfate is the most common GAG in the CT, bone, cartilage, tendon, and heart values.
Hyaluronic acid is the most common in the vitreous.
2nd Heart sound
Closure of the aortic and pulmonary valves
Exocrine gland definition
Endocrine gland
Releases its products into ducts.
Endocrine releases into the bloodstream.
The lens develops from
Surface ectoderm
Visual cycle starting with light absorption
Light absorption converts 11 cis retinal to all trans retinal within the disc lumen of PR.
The all trans retinal is taken to the cytoplasm and reduced to all trans retinol.
All trans retinol is transported to RPE cells and is converted into 11 cis retinol, which is then oxidized to 11-cis retinal.
11- cis retinal is moved back into the RP disc, ready to be activated by light.
IRMA
Intraretinal microvascular abnormalities
Association between therapeutic index and drug safety
Higher TI = safer drug.
TI measures the toxicity of a drug. Expressed as the dose than kills 50% of animals or people in the experimental group.
Before, during, and after a saccade, vision is suppressed by what pathway
Magnocellular system is suppressed in order to prevent blurring
MG
Autoimmune disease caused by antibodies directed against ACH receptors at the NMJ junction.
Coloboma locations
Embryonic fetal fissure is located inferior within the optic stalk and is composed of neural ectoderm.
if the fissure fails to close, a coloboma may develop of the eyelids, iris, ciliary body, retina, choroid, or ON.
Emmetropization of astigmatism
50-65% of infants are born with astigmatism that gradually shifts from ATR to WTR. Magnitude of astig begins to decrease around 18 months until reaching adult levels at age 4.
Oblique is the most rare, but most stable. Less likely to change.
3 most common conditions that lead to preseptal
Insect bite or breach of epidermis-
Internal hordeolum
Abrasion of eyelid skin
