Ocular Disease II Mt 2

Approved & Edited by ProProfs Editorial Team
The editorial team at ProProfs Quizzes consists of a select group of subject experts, trivia writers, and quiz masters who have authored over 10,000 quizzes taken by more than 100 million users. This team includes our in-house seasoned quiz moderators and subject matter experts. Our editorial experts, spread across the world, are rigorously trained using our comprehensive guidelines to ensure that you receive the highest quality quizzes.
Learn about Our Editorial Process
| By Tseemore
T
Tseemore
Community Contributor
Quizzes Created: 24 | Total Attempts: 14,239
Questions: 36 | Attempts: 369

SettingsSettingsSettings
Glaucoma Quizzes & Trivia

Glaucoma


Questions and Answers
  • 1. 

    Describe why pts may be mis-diagnosed with ocular HTN & LTG based on their corneas.

  • 2. 

    What is the equatio for ocular perfusion (OP)?

  • 3. 

    Small scleral canals tend to be related to what type of refractive error?

    • A.

      Myopes

    • B.

      Hyperopes

    • C.

      Emmetropes

    • D.

      There is no relation of refractive error & scleral canal size

    Correct Answer
    B. Hyperopes
    Explanation
    Scleral canal size directly related to ONH & cup size

    Rate this question:

  • 4. 

    Indicate which areas of the lamina cribosa tend to have larger pore size.

    • A.

      Superior

    • B.

      Nasal

    • C.

      Temporal

    • D.

      Inferior

    Correct Answer(s)
    A. Superior
    D. Inferior
    Explanation
    Superior & inferior LC coorespond to the arcuate bundles. Larger diameter fibers (M cells) pass through superior & inferior poles (theory that M cells are affected 1st in GLC, which is the basis of FDT technology)

    Rate this question:

  • 5. 

    Where is there the greatest overlap of receptive fields?

    • A.

      Arcuate bundles

    • B.

      PM bundles

    • C.

      NR bundles

    • D.

      Equal overlap in all RNFL bundles

    Correct Answer
    B. PM bundles
    Explanation
    The greatest overlap of receptive fields is found in the PM bundles. Receptive fields refer to the area in the visual field that a single neuron responds to. When receptive fields overlap, it means that multiple neurons are responding to the same area, providing a more detailed and accurate representation of that particular region. In the case of PM bundles, the overlap of receptive fields is the highest, indicating a higher level of visual acuity and sensitivity in that area.

    Rate this question:

  • 6. 

    Most early VF loss in GLC occurs in the periphery and progresses centrally, eventually leading to blindness if left untreated.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Most early GLC VF loss occurs centrally, and later in the periphery

    Rate this question:

  • 7. 

    Indicate all the signs/symptoms associated with DIFFUSE axon loss.

    • A.

      Vertical elongation of cup

    • B.

      Tritan (B/Y) CV defect

    • C.

      Slit/wedge defect

    • D.

      Younger pts

    • E.

      Normal/slightly elevated IOPs

    • F.

      Nasal step

    Correct Answer(s)
    B. Tritan (B/Y) CV defect
    D. Younger pts
    Explanation
    Diffuse Axon Loss:
    - generalized cup increase (ROUND)
    - generalized RNFL drop out
    - general depression of VF
    - Tritan CV defect
    - increased latency & amp on ERG
    - often in younger pts & higher IOPs

    Focal Axon Loss:
    - ONH damage in localized regions (notching, vertical cup enlargement, occasionally temporal rim)
    - RNFL loss localize to arcuate bundles (slit defects, wedge defects)
    - Focal VF loss; arcuates damaged most often (nasal step, paracentral scotomas)
    - often in elderly, normal/slightly elevated IOPs

    Rate this question:

  • 8. 

    You do not need an increase an IOP or VF loss to diagnose GLC.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    GLC dx may be made of a basis of: structural damage OR functional loss OR high risk

    Rate this question:

  • 9. 

    GLC functional changes can precede structural damage by years

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Opposite! Structural damage can precede functional changes by years (pre-perimetric GLC)

    Rate this question:

  • 10. 

    1 tonometry reading has low sensitivity and relatively high specificiy

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    50% sensitivity due to 1) substantial IOP variation in GLC pts, 2) varing susceptiblty of different pts to IOP-related damage

    70-90% specificity --> most normals (non-GLC) show IOP < 21

    Rate this question:

  • 11. 

    Which of the following GLC meds does not work at night?

    • A.

      Latanoprost

    • B.

      Timolol

    • C.

      Brinzolamide

    • D.

      Pilocarpine

    Correct Answer
    B. Timolol
    Explanation
    Beta blockers do not work at night

    Rate this question:

  • 12. 

    Which ethnicity is the strongest risk factor for developing 'normal tension' GLC?

    • A.

      African Americans

    • B.

      Hispanic

    • C.

      Japanese

    • D.

      Chinese, Vietnamese, Eskimo

    Correct Answer
    C. Japanese
    Explanation
    Af. Am. + Hispanics --> POAG
    Chiese + Viet + Eskimo --> lower risk for POAG, but higher risk for ACG

    Rate this question:

  • 13. 

    Which of the following systemic disease results in slower recycling of mucopolysaccharides in the TM endothelium and subsequent increase in IOP?

    • A.

      Hyperthyroidism

    • B.

      High blood pressure

    • C.

      High cholesterol

    • D.

      Hypothyroidism

    Correct Answer
    D. Hypothyroidism
    Explanation
    - Hypothyroidism --> not a vascular issue, messes with the TM
    - High BP --> aggressively lowering BP is probably worse than high BP bc then you risk compromising the ON perfusion; however, long term high BP increases risk of GLC due to increased risk of arteriosclerosis & other vascular diseases
    - Diabetes --> vascular compromise

    Rate this question:

  • 14. 

    Corneal edema will result in false ____ IOP

    • A.

      Low

    • B.

      High

    • C.

      Could be high or low depending on etiology

    Correct Answer
    A. Low
    Explanation
    corneal edema --> false low
    corneal scarring --> false high

    Rate this question:

  • 15. 

    I-Care tonometry has many advantages including: no anesthetic needed, portable, less affected by biomechanical factors compared to NCT

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    I-Care is portable & does not require anesthetic, however it is still applanates and therefore is susceptible to IOP inaccuracies due to corneal biomech factors

    Rate this question:

  • 16. 

    Thicker corneas will have a false high IOP reading on GAT.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Thin Ks --> false low
    Think Ks --> false high (LASIK pts will have a false low reading due to thinner corneas)

    Rate this question:

  • 17. 

    1 mmHg increase in IOP results in ___% increased risk for GLC damage

    • A.

      1%

    • B.

      10%

    • C.

      20%

    • D.

      65%

    Correct Answer
    B. 10%
    Explanation
    A 1 mmHg increase in intraocular pressure (IOP) results in a 10% increased risk for glaucoma (GLC) damage. Glaucoma is a disease that damages the optic nerve, often caused by increased pressure in the eye. Studies have shown that even a small increase in IOP can significantly increase the risk of developing glaucoma and experiencing damage to the optic nerve. Therefore, a 1 mmHg increase in IOP corresponds to a 10% increased risk for glaucoma damage.

    Rate this question:

  • 18. 

    For every ____ microns thinner CCT than normal, there is a ____% increased risk for GLC damage.

    Correct Answer
    40
    70
    Explanation
    For every 40 microns thinner central corneal thickness (CCT) than normal, there is a 70% increased risk for glaucoma (GLC) damage. This means that as the CCT decreases by 40 microns, the risk of GLC damage increases by 70%. This relationship suggests that thinner CCT may be a risk factor for developing glaucoma.

    Rate this question:

  • 19. 

    What is the standard of care in GLC detection & management?

    • A.

      Tonometry

    • B.

      Fourier OCT Imaging

    • C.

      W/W Automated Threshold Perimetry

    • D.

      Pachymetry

    Correct Answer
    C. W/W Automated Threshold Perimetry
    Explanation
    Dr. Comer indicated that pachymetry will most likely become the standard of care, but at this point (as least legally) it is W/W perimetry

    Rate this question:

  • 20. 

    One advantage of FDT/Matrix perimeters is that they are better at detecting change in VFs since GLC VF loss gets 'deeper' (less sensitive) as it progresses.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    This is actually a disadvantage of FDT/Matrix since these perimeters bottom-out at 0dB, whereas W/W perimeters can go into the negative numbers to show the relative change between the pt's different VF tests.

    Rate this question:

  • 21. 

    What is the minimum number of VFs that should within the 1st 2 years of GLC diagnosis?

    • A.

      2

    • B.

      3

    • C.

      6

    • D.

      8

    Correct Answer
    C. 6
    Explanation
    At least 3 the 1st year & 3 the 2nd year to determine rate of progression and RO rapid progression

    Rate this question:

  • 22. 

    What is the most common mode of GLC progression?

    • A.

      VF defect gets denser

    • B.

      VF defect gets larger

    • C.

      A new VF defect occurs in same hemifield as previous VF defect

    • D.

      Improvement in VF

    Correct Answer
    A. VF defect gets denser
    Explanation
    Denser 79%
    Increased size 53%
    New VF in same hemifeld 50%
    Improvement 2% (temporary)

    Rate this question:

  • 23. 

    Where are paracentral scotomas most likely to appear in early GLC VF loss (in terms of VF, not retina)?

    • A.

      Superior

    • B.

      Inferior

    • C.

      Temporal

    • D.

      Nasal

    Correct Answer
    D. Nasal
    Explanation
    Occur in nasal VF because arcuates are affected which are in the temporal retina. Can also occur beyond 20 deg superior.

    Rate this question:

  • 24. 

    Nasal steps do NOT cross horizontal midline

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Temporal wedge defects (nasal radial fibers) DO/CAN cross horizontal midline

    Rate this question:

  • 25. 

    Which area of the ON is focal damage most likely to occur?

    • A.

      Superior

    • B.

      Inferior

    • C.

      Temporal

    • D.

      Nasal

    Correct Answer
    B. Inferior
    Explanation
    Focal damage is most likely to occur in the inferior area of the ON.

    Rate this question:

  • 26. 

    Cupping precedes pallor in GLC

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Cupping w/o pallor inside cup until later is highly specific for GLC.
    Pallor of the rim tissue outside cup is non-GLC optic atrophy

    Rate this question:

  • 27. 

    What % of normal pts have C:D > 0.7?

    • A.

      < 0.5%

    • B.

      1%

    • C.

      2%

    • D.

      5%

    Correct Answer
    C. 2%
    Explanation
    The correct answer is 2% because it is the percentage of normal patients who have a C:D (Cup-to-Disc) ratio greater than 0.7. This means that out of all the normal patients, only 2% of them have an optic cup size that is more than 70% of the optic disc size.

    Rate this question:

  • 28. 

    Zone Alpha is more peripheral than Zone Beta

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Zone Beta is closer to ONH & has large chorodial vessles
    Zone Alpha is more peripheral & is the irregular pigmented outer edge of Beta

    Rate this question:

  • 29. 

    Parapapillary atrophy represents extensive damage to the ONH.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Parapapillary atrophy can precede GLC ONH damage by years. It is most commonly associated with age and is not a very strong sign for GLC. It is more common in DIFFUSE ONH damage & LTG. DDx RPE crescent

    Rate this question:

  • 30. 

    Like many signs of GLC, drance hemes are not highly specific to GLC

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Drance hemes are common, but transient. Precedes ONH damage / VF loss by years. Indicates chronic vascular insufficiency...future damage is coming

    Rate this question:

  • 31. 

    ____% of eyes w/ drance hemes will develop VF loss progression over the next 16 mo

    • A.

      10%

    • B.

      25%

    • C.

      40%

    • D.

      60%

    Correct Answer
    D. 60%
    Explanation
    Many eyes w/ drance hemes develop a focal notch at the location of drance heme & cooresponding VF defect

    Rate this question:

  • 32. 

    Indicate ALL of the DDx's for drance hemes

    • A.

      DM

    • B.

      Anti-coagulant

    • C.

      CRVO

    • D.

      Migraine

    • E.

      Cardiovascular Disease

    • F.

      Renal Disease

    • G.

      PVD

    • H.

      AION

    Correct Answer(s)
    A. DM
    B. Anti-coagulant
    D. Migraine
    G. PVD
    H. AION
    Explanation
    Drance hemes, also known as flame-shaped hemorrhages, are typically seen in the retina and can be indicative of various underlying conditions. The given answer options include DM (diabetes mellitus), anti-coagulant use, migraine, PVD (peripheral vascular disease), and AION (anterior ischemic optic neuropathy). These conditions are known to be associated with the development of drance hemes. However, it is important to note that this list is not exhaustive, and other conditions such as CRVO (central retinal vein occlusion) and cardiovascular disease can also cause drance hemes.

    Rate this question:

  • 33. 

    It is best to look for RNFL drop out with the slit lamp under high mag so you can determine whether or not the fine striations are present or absent,

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    For RNFL eval, want LOW MAG or else you will likely think there is a defect when there is not. For ONH eval, you want HIGH MAG so you can see details

    Rate this question:

  • 34. 

    Which of the following does NOT require treatment (assume the signs below are the only evidence you are basing you decision from).

    • A.

      1st RNFL defect in GLC suspect that you found no RNFL loss previously

    • B.

      Slit defect in pt having their 1st comprehensive eye exam

    • C.

      A GLC suspect with 1st drance heme

    • D.

      Pt with repeated GAT readings of 32/32

    Correct Answer
    B. Slit defect in pt having their 1st comprehensive eye exam
    Explanation
    If you are providing care for a pt for the first time and you notice a slit defect, it would be best to monitor at this point. Since you have no idea about the change/progression of the condition, it would be too soon to treat, and it could be a pseudo-defect. If they have cooresponding ONH damage, then it would be a good idea to treat.

    Rate this question:

Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 16, 2012
    Quiz Created by
    Tseemore
Back to Top Back to top
Advertisement
×

Wait!
Here's an interesting quiz for you.

We have other quizzes matching your interest.