Ophthamology & Toxicology Conference Review Questions

1. Acidic substances tend to cause more harm to the eyes than alkaline substances.

True

False

False. Alkaline substances are much more detrimental because of a process known as saponification which causes thrombosis of vessels, denaturation of collagen, and damage to cell membranes. It is important to irrigate the eyes as soon as possible with normal saline or LR using a Morgan lens if possible. There’s no such thing as over irrigation

Explanation

False. Alkaline substances are much more detrimental because of a process known as saponification which causes thrombosis of vessels, denaturation of collagen, and damage to cell membranes. It is important to irrigate the eyes as soon as possible with normal saline or LR using a Morgan lens if possible. There’s no such thing as over irrigation

2. It is safe to discharge patients with prescriptions for topical anesthetics for their eyes.

True

False

False! Topical anesthetics delay wound healing by preventing re-epithelialization so never discharge patients with them.

Explanation

False! Topical anesthetics delay wound healing by preventing re-epithelialization so never discharge patients with them.

3. What additional antidote should be considered in patients presenting with intractable seizures?

Vitamin A

Vitamin B6

Vitamin C

Vitamin D

Vitamin E

Think of INH ingestion in the case of intractable seizures unresponsive to benzodiazepines. It is possible that there is a relative vitamin B6 deficiency and it should be given, especially because it rarely causes harm when given.

Explanation

Think of INH ingestion in the case of intractable seizures unresponsive to benzodiazepines. It is possible that there is a relative vitamin B6 deficiency and it should be given, especially because it rarely causes harm when given.

4.

All of the following are reasons to consult ophthalmology when presented with an eyelid laceration EXCEPT:

Full-thickness eyelid perforation

Disruption of the lacrimal duct

Ptosis

Disruption of the inner aspect of the eyelid

Vertical laceration just below the eyelid

The correct answer is E. A-D are all indications to call Ophthalmology to come repair the laceration.

Explanation

The correct answer is E. A-D are all indications to call Ophthalmology to come repair the laceration.

5. All of the following foreign bodies should be removed when found in the eye EXCEPT:

Plant material

Copper

BBs

Protruding objects

Insects

The correct answer is C. Believe it or not, it is okay to leave a BB in the eye if it doesn’t disrupt vision and is made of metal other than copper. Crazy, I know!

Explanation

The correct answer is C. Believe it or not, it is okay to leave a BB in the eye if it doesn’t disrupt vision and is made of metal other than copper. Crazy, I know!

6. All of the following are indications for a lateral canthotomy in the case of a retrobulbar hematoma/hemorrhage EXCEPT:

Acute loss of visual acuity

Globe rupture

Proptosis

Increased intraocular pressure

Unconscious patient with intraocular pressure above 40

The correct answer is B. Globe rupture is an absolute contraindication to lateral canthotomy.

Explanation

The correct answer is B. Globe rupture is an absolute contraindication to lateral canthotomy.

7. Honey may be used to remove hard contact lenses if all other techniques fail.

True

False

True! Really?!?! If all other techniques including lateral pressure on the palpebral surface, pushing eyelids on the globe, using suction devices and cotton-tipped applicators are unsuccessful, the textbook by Fleisher and Ludwig recommend using honey on a gloved finger tip to aid in the removal of hard contact lenses.

Explanation

True! Really?!?! If all other techniques including lateral pressure on the palpebral surface, pushing eyelids on the globe, using suction devices and cotton-tipped applicators are unsuccessful, the textbook by Fleisher and Ludwig recommend using honey on a gloved finger tip to aid in the removal of hard contact lenses.

8. Which of the following etiologies of corneal ulcers can be seen without the use of fluorescein?

A. Streptococcal species

B. Staphylococcal species

C. Pseudomonas species

D. Fungi

The correct answer is C. Pseudomonas may fluoresce in UV light without fluorescein. This property is unique with Pseudomonas species and therefore should make you think of it when you see a patient present with the following eye findings:

Explanation

The correct answer is C. Pseudomonas may fluoresce in UV light without fluorescein. This property is unique with Pseudomonas species and therefore should make you think of it when you see a patient present with the following eye findings:

9. Maki Mini Mouse blocks can disrupt coagulation. If you have a patient who accidentally ingested a little bit of one, you should order coags stat!

Note on product: Active Ingredient: Bromadiolone. Kills Norway rats, Roof rats, house mice and warfarin resistant Norway rats. Packaged in one pound package that easily breaks up into eight blocks. Each block is formed to encourage rodents to consume more bait in a single feeding.

True

False

False! While the first part is true, Maki Mini Mouse Blocks disrupt coagulation, but their effects tend to be days later, not immediately. Also, large quantities must be ingested to cause significant harm.

Explanation

False! While the first part is true, Maki Mini Mouse Blocks disrupt coagulation, but their effects tend to be days later, not immediately. Also, large quantities must be ingested to cause significant harm.