timed test #2 Flashcards
Which TWO of the following are TRUE in regards to frame adjustments on a patient’s face? (Select 2)
If the right lens is too close to the face, bring the right temple in
If the right lens is too low, bend the left temple down
If the right lens is too far from the face, bring the left temple out
If the right lens is too high, bend the right temple up
Which TWO of the following are TRUE in regards to frame adjustments on a patient’s face? (Select 2)
If the right lens is too close to the face, bring the right temple in
If the right lens is too high, bend the right temple up
Explanation
If the temple spread of a pair of spectacles is uneven, or one side of the patient’s head is somewhat wider than the other, it is possible that one lens will be closer to the face than the other. For example, if the right lens is too far from the patient’s face, this could be due to the fact that either the right temple is not spread far enough, making that side fit too tightly, or that the left temple is too loose. The opposite is true if the right lens were to be sitting too close to the face.
A simple rule of thumb for frame adjustment is:
-If the right lens is in -> move the right temple in (or left temple out)
-If the left lens is in -> move the left temple in (or right temple out)
-If the right lens is out -> move the right temple out (or left temple in)
-If the left lens is out -> move the left temple out (or right temple in)
If the frame is not straight on the face, it could be because of incomplete standard alignment, or because one ear of the patient is positioned slightly higher than the other. The solution is the same regardless of the cause of the misalignment:
- If the right lens is up -> bend the right temple up (or left temple down)
- If the left lens is up -> bend the left temple up (or right temple down)
- If the right lens is down -> bend the right temple down (or left temple up)
- If the left lens is down -> bend the left temple down (or right temple up)
Which 3 of the following blood tests are used in the analysis of kidney function? (Select 3)
Glomerular filtration rate (GFR) Bilirubin levels Alkaline phosphatase (ALP) Alanine and aspartate transaminase (ALT & AST) Blood urea nitrogen (BUN) Serum creatinine
Which 3 of the following blood tests are used in the analysis of kidney function? (Select 3)
Glomerular filtration rate (GFR)
Blood urea nitrogen (BUN)
Serum creatinine
Explanation
Healthy kidneys are responsible for removing wastes and excess fluids from the body. Several blood and urine tests can be utilized in order to assess proper kidney function. Three of the major blood tests include analysis of serum creatinine levels, blood urea nitrogen (BUN) and a measure of glomerular filtration rate (GFR).
Serum creatinine
- Creatinine is a waste product produced by muscles of the body
- A creatinine level greater than 1.2 for women and 1.4 for men may be an early indicator that the kidneys are not working properly
- As kidney disease progresses, levels of creatinine in the blood will rise
Blood urea nitrogen (BUN)
- Urea nitrogen originates from the breakdown of protein in food
- A normal BUN level is between 7 and 20
- As kidney function decreases, BUN levels will rise
Glomerular filtration rate (GFR)
- Measurement of how well the kidneys are removing waste and excess fluid from the blood
- It may be calculated from serum creatinine level using patient age, weight, gender, and body size
- Normal GFR values are 90 or above; a GFR below 60 indicates kidney disease; GFR below 15 indicates that treatment for kidney failure is necessary
What is the approximate cross reactivity between penicillins and cephalosporins in individuals who reported a penicillin allergy?
50% 30% 1% 10% 20%
What is the approximate cross reactivity between penicillins and cephalosporins in individuals who reported a penicillin allergy?
1%
Explanation
From a biochemistry perspective, first-generation cephalosporins and penicillin-based medications appear similar in that their physical pharmacological make-ups both possess a beta-lactam ring. Previous studies purport that roughly 10% of patients who are allergic to penicillin may also potentially exhibit an allergic response to the first-generation cephalosporins; however, recent studies have proved this data to be incorrect. It is now thought that there is approximately 1% or less cross-reactivity. The cross-reactivity between penicillins and cephalosporins is almost non-existent with the third-generation cephalosporins. Although the chances of a patient possessing a cross-reactivity between penicillin and cephalosporin drugs is very rare, it is still best to be cautious when a known allergy to penicillins exists.
What is the name of the congenital retinal vascular anomaly in which a vessel that supplies perfusion to the macula and the papillomacular bundle can be observed emerging from the optic disc, separately from the central retinal artery?
Optociliary shunt vessel
Cilioretinal artery
Situs inversus
Arteriovenous anastomosis
What is the name of the congenital retinal vascular anomaly in which a vessel that supplies perfusion to the macula and the papillomacular bundle can be observed emerging from the optic disc, separately from the central retinal artery?
Cilioretinal artery
Explanation
Cilioretinal arteries are most frequently a result of an anomalous direct or indirect branch of the posterior ciliary arteries. In some cases, they can also arise from the peripapillary choroid. Cilioretinal arteries are typically observed as emerging from the temporal aspect of the optic disc, separately from the central retinal artery. The incidence of occurrence varies from 6-25% in the relevant literature. A cilioretinal artery has been said to be a possible protective feature that allows for a secondary route of blood flow to the macula in the event of a central retinal artery occlusion.
Optociliary shunt vessels are venous communications between the retinal and choroidal circulations; these vessels occur on the disc surface when there is impaired venous outflow through the retinal vein.
Situs inversus is a congenital vascular anomaly found at the optic disc, where the retinal vessels have followed an abnormal course. They enter the disc temporally and proceed towards the nasal retina before turning back and coursing out to the temporal retina.
An arteriovenous anastomosis of the retina is an abnormal communication between an artery and vein that occurs through collateral channels. It serves to shunt blood away from an artery to a vein in order to bypass a capillary bed.
Which of the following antimicrobial agents has a mechanism of action that results in interruption of protein synthesis via binding to the 30S ribosomal subunit of the infecting bacteria?
Cephalosporins Tetracyclines Fluoroquinolones Aminoglycosides Macrolides Penicillins Sulfonamides
Which of the following antimicrobial agents has a mechanism of action that results in interruption of protein synthesis via binding to the 30S ribosomal subunit of the infecting bacteria?
Tetracyclines
Explanation Erythromycin and azithromycin belong to a class of drugs called macrolides. Macrolides are effective antibiotics because they bind to the 50S subunit of bacterial ribosomes, thus interfering with bacterial protein synthesis. Tetracycline and doxycycline are classified as tetracyclines. This class of drugs also interferes with protein synthesis via binding to the 30S ribosomal subunit. Amoxicillin, cloxacillin, and dicloxacillin are common anti-bacterials belonging to a class of drugs termed penicillins. Penicillins disrupt cell wall synthesis, making them valuable and widely used antibiotics. Tobramycin, gentamicin and neomycin are categorized as aminoglycosides, which serve as antimicrobials via two mechanisms; aminoglycosides inhibit bacterial protein synthesis as well as create openings in bacterial cell membranes, allowing for increased antibiotic uptake.
Which of the following subnuclei of the third cranial nerve innervates its corresponding contralateral muscle?
Inferior oblique subnuclei
Inferior rectus subnuclei
Superior rectus subnuclei
Medial rectus subnuclei
Which of the following subnuclei of the third cranial nerve innervates its corresponding contralateral muscle?
Superior rectus subnuclei
Explanation
The nuclear complex of the oculomotor nerve resides in the midbrain at the level of the superior colliculus. It is composed of paired and unpaired subnuclei that innervate their corresponding muscles on either the ipsilateral or contralateral sides.
The medial rectus subnuclei, inferior rectus, and inferior oblique subnuclei are paired subnuclei (meaning that there is one on each side) and they innervate their corresponding muscles on the ipsilateral side. Lesions involving this area will result in ipsilateral medial rectus, inferior rectus, and inferior oblique weakness.
The superior rectus subnuclei are also paired; however, they innervate their respective contralateral superior rectus muscle. Therefore, a lesion affecting the third nerve nuclear complex will spare the ipsilateral superior rectus and will involve the contralateral superior rectus.
The levator subnucleus is the only subnucleus that is unpaired. It lies in the caudal midline and innervates both levator muscles. Lesions in this area will result in bilateral ptosis.
A polycarbonate lens requires the addition of an anti-reflective coating. Which of the following equations would be used to find the MOST appropriate index of refraction for the coating?
√1.52
√1.586
1.586²
1.52²
A polycarbonate lens requires the addition of an anti-reflective coating. Which of the following equations would be used to find the MOST appropriate index of refraction for the coating?
√1.586
Explanation
Antireflective coatings are applied to ophthalmic lenses to increase the amount of light that is transmitted through the lens thereby minimizing the overall amount of light that is reflected off the surface of the lens. The higher the index of refraction of the lens, the greater the amount of reflection experienced. Antireflective coatings minimize reflections by creating destructive interference. The coating causes the reflected light from the surface of the lens to be 180 degrees out of phase with the light that is reflected from the coating. To optimize the antireflective property of the coating, the coating’s index of refraction should be equal to the square root of the index of refraction of the lens. For the above question, the index of refraction of polycarbonate lenses is 1.586 and the square root of 1.586 is 1.259.
Your 33 year-old patient with a manifest refraction of OD: -0.50 -2.75 x 172 and OS: -0.75 -1.75 x 010 wishes to try soft contact lenses. After discussion, you decide to PureVision2 monthly lenses. Which of the following prescriptions would you try first for his right eye?
- 0.50 -2.75 x 170
- 0.50 -2.25 x 170
- 0.50 -2.50 x 170
- 0.75 -2.75 x 170
- 0.75 -2.50 x 170
- 0.75 -2.25 x 170
Your 33 year-old patient with a manifest refraction of OD: -0.50 -2.75 x 172 and OS: -0.75 -1.75 x 010 wishes to try soft contact lenses. After discussion, you decide to PureVision2 monthly lenses. Which of the following prescriptions would you try first for his right eye?
-0.75 -2.25 x 170
Explanation
When determining the initial toric contact lens prescription to try on a patient, it is first important to know the contact lens parameters that are available for the specific brand of lenses that you would like to use. Most soft toric contact lenses all have very similar parameters; 0.25D steps in the spherical component (0.50 steps with higher Rxs), cylinder component is in 0.50 steps (starting with 0.75, up to 2.25 or 2.75 depending on brand), and cylinder axis is typically in 10-degree steps.
For the above patient, the cylinder component is -2.75D, but this is not available in PureVision2 toric lenses, as these lenses only go up to a cylinder value of -2.25. Therefore, for this patient, we would use -2.25D cyl. Because the cylinder component is being adjusted by 0.50D, in order to keep the same spherical equivalent, it is appropriate to add an additional -0.25 to the spherical component, making this -0.75D. When it comes to axis determination, this patient is between 170 and 180 but is closer to 170 degrees, so we would begin with a 170-degree axis lens.
Calculate the amount of image jump for the bifocal Rx below:
+3.00 -2.00 x 180 OU, +2.00 add
Flat top 28 bifocal
Distance PD 64 mm, Near PD 60 mm
1 prism diopter base down
1.5 prism diopter base up
1.5 prism diopter base down
1 prism diopter base up
Calculate the amount of image jump for the bifocal Rx below:
+3.00 -2.00 x 180 OU, +2.00 add
Flat top 28 bifocal
Distance PD 64 mm, Near PD 60 mm
1 prism diopter base down
Explanation
Image jump is based on the add power and the near optical center location and does not involve the distance Rx. As the person looks down into the segment to read, their eyes pass from the distance Rx into the bifocal segment. At that point they experience “jump”, since the eyes are not looking through the near optical center. Vertical prism is thus induced, causing the “jump” effect. Using Prentice’s rule, Prism = F x d(cm) where the power (F) is the add power and the distance (d) is determined by how far away the near optical center is from the top of the segment; i.e., prism = 2.00 x 0.5 or 1 prism diopter. Remember, for a flat top 28 bifocal, the optical center is located 5 mm below the segment line.
The add is a plus lens. Draw a plus lens in the segment so that the bases of the plus lens are coincident with the near optical center. If the patient’s eyes are just passing through the top of the segment, base down prism is induced.
A mother reports that her 2-year-old child’s right eye does not appear straight. You decide to perform the Hirschberg test to evaluate for strabismus. The corneal reflex of the right eye is displaced 0.5 mm temporally while the left reflex is centered. Angle Kappa (Lambda) is zero for each eye. What is the correct deviation and magnitude of the observed strabismus?
Right esotropia of 11 prism diopters
Right esotropia of 22 prism diopters
Right exotropia of 11 prism diopters
Right exotropia of 22 prism diopters
A mother reports that her 2-year-old child’s right eye does not appear straight. You decide to perform the Hirschberg test to evaluate for strabismus. The corneal reflex of the right eye is displaced 0.5 mm temporally while the left reflex is centered. Angle Kappa (Lambda) is zero for each eye. What is the correct deviation and magnitude of the observed strabismus?
Right esotropia of 11 prism diopters
Explanation
The Hirshberg test is performed at a distance of 50 cm. A penlight or transilluminator is held just below the doctor’s preferred eye and the doctor then sits in front of the patient and directs the beam towards the patient’s nose while the patient is instructed to fixate on the light. The position of the corneal reflexes relative to the center of the pupil is assessed in each eye. Temporal displacement of the corneal reflex suggests esotropia, while nasal displacement infers exotropia. Each millimeter of displacement of the reflex from the center of the pupil equates to roughly 22 prism diopters of deviation.
The magnitude of normal breathing is controlled by which structure in the brain stem?
The medulla oblongata
The pineal gland
The midbrain
The pons
The magnitude of normal breathing is controlled by which structure in the brain stem?
The medulla oblongata
Explanation
The medulla is surrounded by cerebrospinal fluid. Should the levels of carbon dioxide in the body become too elevated, the partial pressure of increased carbon dioxide causes a decrease in the pH of the cerebrospinal fluid. This stimulates the respiratory center in the brain to increase the breathing rate and depth to diminish carbon dioxide levels.
The pons is involved in regulating information between the cerebellum and the integration centers of the forebrain.
The pineal gland serves to regulate circadian rhythms
The midbrain mainly serves to coordinate visual, auditory, and tactile input.
Two spots of light are flashed simultaneously and are detected by the scotopic system, which transmits the information and signals as if there were one spot of light. This observation can be explained, in part, by which of the following?
The photopic system possesses greater temporal summation than the scotopic system
The receptive field of ganglion cells that receive information from rod cells is on-center surrounded by on-surround
The information from the second flash of light is not transmitted because the available rhodopsin has been bleached and therefore cannot signal the presence of the second light
The information from many rods cells is summated indirectly onto one ganglion cell
Two spots of light are flashed simultaneously and are detected by the scotopic system, which transmits the information and signals as if there were one spot of light. This observation can be explained, in part, by which of the following?
The information from many rods cells is summated indirectly onto one ganglion cell
Explanation
Spatial summation is utilized by the scotopic system and allows for greater sensitivity at the cost of resolution. Information from several rods across space is funneled indirectly onto one ganglion cell (rods do not directly synapse onto ganglion cells). Because the information is received from several rods, this combines to increase the chances of detecting an object (i.e., increased sensitivity). However, because the area over which the information is gathered is large and the information is sent to one ganglion cell, the resolution is poor. This is in opposition to the photopic system, which displays a much smaller degree of spatial summation, leading to decreased sensitivity but greater resolution. For example, two lights that are flashed close together in both time and space will be coded as one flash by the scotopic system because the information is sent to one ganglion cell. However, the same stimuli will be perceived as two lights by the photopic system due to the stimulation of two adjacent ganglion cells, thereby enabling this system to code for two different stimuli, resulting in greater resolution.
The receptive field of a ganglion cell is antagonistic and is either on-center surrounded by off-surround or off-center surrounded by on-surround.
You are verifying a spectacle lens prescription that has returned from your lab. You ordered an Rx for the right eye of +1.00 -2.50 x 100. Which of the following values should be used for determining the ANSI standard for the sphere power?
\+3.50 -1.50 \+1.00 -3.50 -2.50
You are verifying a spectacle lens prescription that has returned from your lab. You ordered an Rx for the right eye of +1.00 -2.50 x 100. Which of the following values should be used for determining the ANSI standard for the sphere power?
-1.50
Explanation
When determining the error tolerance for the sphere power of spectacle lenses, one must first find the meridian of highest absolute power. The easiest way to find this number is to put the ordered prescription on an optical cross. In this case, the highest absolute power is -1.50.
Which of the following tissue cells are insulin-independent?
Cells that line the walls of blood vessels Skeletal muscle cells Heart muscle cells Red blood cells Adipose cells
Which of the following tissue cells are insulin-independent?
Red blood cells
Explanation
Insulin is a hormone secreted by the beta cells of the pancreas in response to elevated blood glucose. The target sites for insulin are the liver, adipose tissue, and muscle cells where the hormone stimulates anabolic pathways. In muscle cells, there is an increase in the uptake of glucose.
In the liver, glucokinase and glycogen synthase are activated; this results in an increase in the uptake of glucose and an increase in the synthesis of glycogen respectively. The enzyme acetyl-CoA carboxylase is also activated, causing a rise in fatty acid synthesis. Conversely, glycogen phosphorylase is inhibited, producing a decrease in the breakdown of glycogen.
Lipoprotein lipase enzymes are activated in adipose tissue triggering an increase in the synthesis of triglycerides.
Red blood cells, brain cells, lens fiber cells, and kidney cells do not require insulin for proper functioning and therefore do not possess insulin receptors. Glucose entry into these cells is not regulated by insulin but rather the concentration difference of glucose levels on the inside versus the outside of the cell. Muscle cells and adipose cells require insulin receptors which mediate the transportation of glucose into the cells. Insulin-independent cells are therefore more susceptible to damage in diabetes cases as the glucose intake into these tissues is not as regulated as those that possess insulin receptors.
Which of the following oral antihistamines will most likely cause mydriasis and dry mouth?
Loratadine (Claritin®)
Cetirizine (Zyrtec®)
Fexofenadine (Allegra®)
Diphenhydramine (Benadryl®)
Which of the following oral antihistamines will most likely cause mydriasis and dry mouth?
Diphenhydramine (Benadryl®)
Explanation
Diphenhydramine is a first-generation antihistamine that also possesses significant anti-cholinergic activity; as such, it can induce dry mouth, urinary retention, constipation, delirium, and mydriasis. Furthermore, first-generation antihistamines freely cross the blood-brain barrier and by antagonizing histamine receptors in the CNS also cause significant somnolence.
Which of the following lipids is involved in inflammation?
Isoprenes
Eicosanoids
Cholesterol
Triglycerides
Which of the following lipids is involved in inflammation?
Eicosanoids
Explanation
Eicosanoids are derivatives of arachidonic acid. Examples of eicosanoids include leukotrienes, prostaglandins, and thromboxanes.
Progesterone, aldosterone, testosterone, estradiol and cortisol are all derived from cholesterol. Cholesterol has a unique configuration comprised of four joined cycloalkane rings. Because these hormones are fat-soluble, they readily pass through cell membranes. They diffuse into the blood and are generally bound to carrier proteins that transport the hormones to their designated target site, where they may further undergo further processing or transformation.
Triglycerides are comprised of three fatty acid chains attached to a glycerol backbone. Triglycerides are important in long-term energy storage for use by cells.
Coenzyme Q, all steroids, cholesterol, and vitamins A, D, E, and K are derived from isoprenes or terpenes. These agents contain or at some point originated from precursors that were comprised of isoprene units. Isoprene units have the chemical formula C5H8.
Free radicals can cause severe damage to tissue. Which of the following electrolytes can function as an antioxidant in the aqueous?
Chloride ions Sodium ions Albumin Ascorbate IgG
Free radicals can cause severe damage to tissue. Which of the following electrolytes can function as an antioxidant in the aqueous?
Ascorbate
Explanation
The aqueous humor contains many electrolytes including Na+, K+ , Cl-, HCO3-, glucose, lactate, amino acids, and ascorbate. Ascorbate is found in high concentrations in the aqueous (20x greater when compared to the concentration found in plasma). Ascorbate can serve as an antioxidant to eradicate free radicals reducing potential damage from ultraviolet light. Interesting note: the aqueous humor and tears of uncontrolled diabetics display higher levels of glucose than those of non-diabetics.
Approximately how many axons comprise the normal adult human optic nerve?
4,000,000 2,200,000 700,000 1,200,000 3,500,000
Approximately how many axons comprise the normal adult human optic nerve?
1,200,000
Explanation
The normal adult human optic nerve is comprised of approximately 1.2 million retinal ganglion cell axons (using manual measuring techniques). These numbers have been shown to vary from about 700,000 to 1,400,000, utilizing automated counting algorithms. Factors that may affect the number of axons within the optic nerve include inherited differences, damage to the fibers from disease processes (such as optic neuropathy), and gradual loss due to the normal aging process.
Which of the following colors possesses the greatest wavelength?
Violet Green Blue Red Yellow
Which of the following colors possesses the greatest wavelength?
Red
Explanation
As one moves to the right in the electromagnetic spectrum, the wavelengths progressively decrease while the frequency of the emitted radiation increases. At the right end of the spectrum are radio waves; moving to the left we find microwaves, and infrared light (IR). We then see visible light and further to the left is ultraviolet light, X-ray and gamma ray. Sandwiched between IR and ultraviolet light is the visible portion of the spectrum; it is truly a very small slice of the entire spectrum. X-rays and gamma rays are very high in frequency but possess a small wavelength. Radiation emitted by rays at the far left of the spectrum can be quite dangerous. Remember the mnemonic ROY G BIV. This will help you to remember color wavelengths in the visible range as red possesses the longest wavelength while violet has the smallest wavelength. Red is roughly 650 nm, orange 600 nm, yellow 570 nm, green 520 nm, blue 470 nm and violet 400 nm.
The finding of subretinal epithelial deposits between the basement membrane of the retinal pigment epithelium (RPE) and Bruch’s membrane in the macular area of a 64-year old white female with a slight loss of visual acuity (20/30) and pseudophakia is the clinical hallmark of what disease?
Retinal pigment epithelium (RPE) dropout or window defect
Dry or age-related macular degeneration (AMD)
Macular pucker or epiretinal membrane (ERM)
Soft exudates or clinically significant macular edema (CSME)
The finding of subretinal epithelial deposits between the basement membrane of the retinal pigment epithelium (RPE) and Bruch’s membrane in the macular area of a 64-year old white female with a slight loss of visual acuity (20/30) and pseudophakia is the clinical hallmark of what disease?
Dry or age-related macular degeneration (AMD)
Explanation
Drusen are the hallmark of AMD. Multiple types of drusen have been described, including large (>64 microns) and small (<63 microns), calcified, and basal laminar. Drusen are required to make the diagnosis of AMD as they are the destructive force behind RPE loss. Drusen become more apparent on fluorescein angiography.
Which of the following acquired color vision deficiencies would you MOST expect to see in optic nerve disease and macular disease, respectively?
Blue-yellow, red-green
Red-green, blue-yellow
Red-green, rod monochromacy
Blue-yellow, rod monochromacy
Which of the following acquired color vision deficiencies would you MOST expect to see in optic nerve disease and macular disease, respectively?
Red-green, blue-yellow
Explanation
Dr. Kollner, an ophthalmologist, reviewed an extensive amount of literature on the nature of color vision impairment in patients with acquired ocular diseases. He concluded that most patients with diseases of the optic nerve tended to have difficultly discriminating red from green hues, while most patients with retinal disease (primarily macular) possessed a greater loss of discrimination between blue and yellow hues. This general dichotomy of red/green defects in optic nerve disease, and blue/yellow defects in macular disease has since come to be known as Kollner’s rule. It is important to note that not all cases of acquired color vision deficiencies conform to this rule, however this theory holds true for the majority of patients.
You prescribe a patient 4 base down prism in the right eye. The patient wishes to order bifocal lenses. How should the segment height be adjusted to compensate for the prism?
The segment height of the left eye should be raised
The segment height of the right eye should be lowered
The segment height does not need to be altered
The segment height of the right eye should be raised
You prescribe a patient 4 base down prism in the right eye. The patient wishes to order bifocal lenses. How should the segment height be adjusted to compensate for the prism?
The segment height of the right eye should be raised
Explanation
Because the prism will shift the image towards the apex, the patient’s eye will be looking slightly up at the image. In order to ensure that the pupils view through the segments at the same time, one must raise the bifocal height of the right eye. Make sure that you inform the patient that their seg heights will be unequal so there are no surprises when they pick up their glasses! A good rule of thumb to follow is that the segment height must be altered by 0.3 mm for every diopter of vertical prism added to one eye only (if the prism is distributed fairly equally between the eyes, then there is no need to adjust the bifocal height). Remember that for base down prism you must raise the seg height and for base up prism you must lower the seg height.
Which of the following glaucoma medications is considered a cholinergic?
Dipevefrin (Propine®)
Dichlorphenamide (Daranide®)
Pilocarpine
Epinephrine (Glaucon®)
Which of the following glaucoma medications is considered a cholinergic?
Pilocarpine
Explanation
Cholinergics decrease intraocular pressure by stimulation of the ciliary muscles, causing an increase in aqueous outflow. Side effects of cholinergics include accommodative myopia, band keratopathy, cataract formation, retinal detachment, miosis of pupils, and decreased night vision, among other side effects. Cholinergics are generally not the first line of choice for the management of glaucoma.
Which 2 of the following are the most common etiologies associated with non-granulomatous intraocular inflammation? (Select 2)
Idiopathic Syphilis HLA B27 autoimmune disease Tuberculosis Drug-induced Herpetic viral infections
Which 2 of the following are the most common etiologies associated with non-granulomatous intraocular inflammation? (Select 2)
Idiopathic
HLA B27 autoimmune disease
Explanation
Non-granulomatous intraocular inflammation most commonly involves the anterior segment of the eye, has an acute onset, and is accompanied by a cellular reaction that represents an accumulation of cells due to a breakdown of the blood-ocular barrier. These are primarily white blood cells and protein that present as cells and flare. If these cells form a cluster on the corneal endothelium they are called keratic precipitates. In granulomatous uveitis these precipitates are much larger and are referred to as mutton-fat keratic precipitates. These are thought to be an inflammatory or auto-immune response to an infectious organism. Non- granulomatous presentations are typically idiopathic in nature, or are due to HLA B27 involvement. Non-granulomatous inflammation also occurs more frequently than does granulomatous uveitis (especially in patients with anterior uveitis).
