Advanced Optometry - Midterm 1
Have you just started your journey on becoming an ophthalmologist? The first topics we covered were on the basics and introduction. Now that the midterms are near, there is a need to revise to ensure you pass. The quiz below is designed to help you do just that. Give it a try!
- 1.
Which of the following is not a characteristic of anesthetic abuse keratopathy?
- A.
Stromal infiltrate
- B.
An increase number of white blood cells in the anterior chamber
- C.
A ring (half or full) shaped opacity
- D.
All are characteristics
Correct Answer
D. All are characteristicsExplanation
He stressed these...probably going to ask this in one form or anotherRate this question:
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- 2.
In which situation would you avoid administering a topical anesthetic?
- A.
Bacterial infection
- B.
Patient complains of cluster headaches
- C.
Welding patient gets debris in his eye
- D.
Patient has a corneal epithelial abrasion
Correct Answer
C. Welding patient gets debris in his eyeExplanation
Anything that risks damaging the endothelial cell layer should be avoided. Epithelium is fine though.Rate this question:
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- 3.
You want to stain your patients eye with NaFl. Which anesthetic would you use with the NaFl and why?
- A.
Proparacaine because it has minimal quenching
- B.
Benoxinate because it has maximal enching
- C.
Proparacaine because it has maximal quenching
- D.
Benoxinate because it has minimal quenching
Correct Answer
D. Benoxinate because it has minimal quenchingExplanation
The correct answer is Benoxinate because it has minimal quenching. Quenching refers to the reduction in the fluorescence intensity of a fluorescent dye. In this case, NaFl is a fluorescent dye used to stain the patient's eye. By using an anesthetic with minimal quenching, such as Benoxinate, the fluorescence intensity of NaFl will not be significantly reduced, allowing for better visualization and examination of the eye.Rate this question:
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- 4.
Which of the following is not true regarding NaFl?
- A.
It is the dye of choice for evaluating corneal surface integrity
- B.
Its brightness increases with increasing pH (until around pH 8)
- C.
Its brightness increases with increasing concentration (to a certain point)
- D.
Fluoroscein binds to intra and extra cellular structures
Correct Answer
D. Fluoroscein binds to intra and extra cellular structuresExplanation
Slide 41Rate this question:
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- 5.
Rose bengal is a vital dye
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Rose bengal is not a vital dye. It is actually a stain that is commonly used in ophthalmology to diagnose certain eye conditions, such as dry eye syndrome and corneal abrasions. It works by staining damaged or dead cells on the surface of the eye, making them more visible for examination. Therefore, the correct answer is false.Rate this question:
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- 6.
If you were to administer pilocarpine, what effect would you expect in your patient? (Select 2)
- A.
Pupillary miosis
- B.
Pupillary mydriasis
- C.
Decreased ability to accommodate
- D.
Ciliary body contraction
Correct Answer(s)
A. Pupillary miosis
D. Ciliary body contractionExplanation
Administering pilocarpine, a cholinergic agonist, would result in pupillary miosis (constriction of the pupil) and ciliary body contraction. Pilocarpine acts on muscarinic receptors in the eye, causing these effects. Pupillary miosis occurs due to the contraction of the pupillary sphincter muscle, while ciliary body contraction leads to increased tension on the zonular fibers, resulting in accommodation for near vision.Rate this question:
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- 7.
You need to do a complete cycloplegic exam on a 4 year old in order to better assess his esotropia. You want him to have 0 diopters of residual accommodation. Which drug will you give the patient?
- A.
Pilocarpine
- B.
Cyclopentolate
- C.
Tropicamide
- D.
Atropine
Correct Answer
D. AtropineExplanation
Atropine is the correct drug to give the patient in order to achieve 0 diopters of residual accommodation. Atropine is a potent cycloplegic agent that paralyzes the ciliary muscle, thereby preventing accommodation. This allows for a more accurate assessment of the patient's esotropia without the interference of accommodation. Pilocarpine, Cyclopentolate, and Tropicamide are not as effective as Atropine in achieving complete cycloplegia.Rate this question:
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- 8.
You suspect horners syndrome and give a patient cocaine drops, only the right eye dilates. Which is true? (Select 2)
- A.
Right eye is affected
- B.
Left eye is affected
- C.
The lesion is localized to the 2nd order neuron
- D.
Not enough info to localize the lesion
Correct Answer(s)
B. Left eye is affected
D. Not enough info to localize the lesionExplanation
The correct answer is "Left eye is affected" because if only the right eye dilates after giving cocaine drops, it suggests that the left eye is affected by Horner's syndrome. The sympathetic pathway responsible for pupillary dilation is disrupted on the affected side, leading to a smaller or no dilation of the pupil in the affected eye.
The correct answer is also "Not enough info to localize the lesion" because the information provided does not specify the exact location of the lesion causing Horner's syndrome. Further diagnostic tests or evaluation would be needed to determine the specific location of the lesion along the sympathetic pathway.Rate this question:
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- 9.
You suspect a patient has horners due to no response in the left eye with cocaine test. You then administer hydroxyamphetamine in the left eye. It then dilates. Which is true? (Select 2)
- A.
The left eye is the affected eye
- B.
The right eye is the affected eye
- C.
The problem is with the 3rd order neuron
- D.
The problem is with either the 1st or second order neuron
Correct Answer(s)
A. The left eye is the affected eye
D. The problem is with either the 1st or second order neuronExplanation
Dilation with hydroxyamphetamine rules out a problem with the 3rd order neuron.Rate this question:
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- 10.
Which patient should you further evaluate for possible glaucoma? (Select 2)
- A.
A patient with a lower hysteresis
- B.
A patient with increased cornea thickness
- C.
A patient with an IOP of 18 mmHg OD and 17 mmHg OS using the I Care tonometer
- D.
A patient with a diaton IOP reading of 21 mmHg
Correct Answer(s)
A. A patient with a lower hysteresis
D. A patient with a diaton IOP reading of 21 mmHgExplanation
Diaton tends to underestimate IOP at higher IOP's leading to an increased risk of false negatives. The 21 mmHg reading is probably higher than that. Lower corneal hysteresis and decreased cornea thickness are risk factors for glaucoma.Rate this question:
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- 11.
If this is what the mires look like, what should you do next?
- A.
Decrease applination pressure to bring the mires closer together
- B.
Take the IOP reading
- C.
Increase applination pressure to bring the mires closer together
- D.
Rotate axis 43 degrees
Correct Answer
C. Increase applination pressure to bring the mires closer togetherExplanation
Increasing applination pressure will bring the mires closer together. Applination pressure refers to the force applied to the cornea during tonometry, which is a method used to measure intraocular pressure (IOP). By increasing the pressure, the mires, which are the patterns observed on the cornea, will move closer together. This can help in obtaining a more accurate IOP reading.Rate this question:
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- 12.
DCT readings are independent of corneal thickness
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
He stressed this in class. It is less affected. But it is still affectedRate this question:
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- 13.
Your patient has a soft contact lens that cannot be removed at the moment. Which tonometer should you avoid using?
- A.
Goldman
- B.
Tono Pen
- C.
I Care
- D.
DCT
Correct Answer
A. GoldmanExplanation
The Goldman tonometer should be avoided when a patient has a soft contact lens that cannot be removed at the moment. This is because the Goldman tonometer requires the application of a topical anesthetic and the use of a prism, which can potentially dislodge or damage the contact lens. Therefore, it is safer to avoid using the Goldman tonometer in this situation.Rate this question:
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