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Information to know Flashcards

1
Q

Uses acetylcholine as main neuro-transmitter

A

Parasympathetic system

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2
Q

*Stimulates the parasympathetic nervous system

A

Parasympathomimetics

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3
Q

*Mimics effects of acetylcholine: Constricts pupils, slows down HR, Dilates blood vessels, Activates digestion

A

Parasympathomimetics

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4
Q

Pilocarpine is an example of….

A

Parasympathomimetics

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5
Q

Blocks action of parasympathetic systems

A

Parasympatholytics

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6
Q

Cyclopentolate is an example of…….

A

Parasympatholytics

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7
Q

Parasympathomimetics and parasympatholytics are used for what system?

A

Parasympatheic System

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8
Q

Calm system

A

Parasympathetic

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9
Q

Flight or flight system

A

Sympathetic System

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10
Q

Exerts effect on a- and B- adrenergenic receptors

A

Sympathetic System

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11
Q

This system’s main neurotransmitters are Epinehprine and Norepinephrine

A

Sympathetic System

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12
Q

*Stimulates the sympatheic nervous system

A

Sympathomimetics
* question are tricky-know the affects on pupils and what dilation drops do*

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13
Q

*Meds that stimulate the sympathetic nervous system, Dilate pupils, Increase HR, Inhibit digestion.

A

Sympathomimetics

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14
Q

*Atropine is an example of

A

Sympathomimetics

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15
Q

Inhibit sympathetic system, reduces BP

A

Sympatholytics

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16
Q

Sympathomimetics and Sympatholytics are under which system?

A

Sympathetic System

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17
Q

Peripheral nervous systems is under the

A

Central Nervous System

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18
Q

Somatic Nervous System and Autonomic Nervous System is under….

A

Peripheral Nervous System

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19
Q

Parasympathetic and Sympathetic systems is under….

A

Autonomic Nervous System

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20
Q

Beta Receptors and Alpha Receptors are part of what system?

A

Sympathetic System

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21
Q

This system controls Vegetative functions “Relax & Renew”

A

Parasympathetic

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22
Q

This system allows body to function under stress “Fight or Flight”

A

Sympathetic

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23
Q

What does R-O-Y-G-B-I-V stand for

A

Red, orange, yellow, green, blue, indigo, violet
Roygbiv (start with the longest and end with the shortest)

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24
Q

*What is the normal visible spectrum?

A

400nm-700nm

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25
Q

What color has the longest visible spectrum?

A

Red

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26
Q

What color has the shortest visible spectrum?

A

Violet

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27
Q

The distance between two similar points (peak to peak)

A

Wavelength

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28
Q

Number of peaks that pass a fixed point every second

A

Frequency

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29
Q

Maximum height of a peak measured from the midline

A

Amplitude

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30
Q

Speed at which light travels through space or a transparent medium

A

Velocity

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31
Q

Goldmann Visual Fields:
Error: Lid, lens rim artifacts
How do you remedy?

A

Tape lid, ensure lens near to eye, remove lens when testing beyond central 30 degrees.

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32
Q

Goldmann Visual Fields:
Error: Poor fixation
How do you remedy?

A

Monitor fixation, don’t tire patient with long test

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33
Q

Goldmann Visual Fields:
Error: Patient’s head tilted or moving off chin rest
How do you remedy?

A

Check positioning

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34
Q

Goldmann Visual Fields:
Error: Patient not understanding instructions
How do you remedy?

A

After explaining test, ask if pt has questions

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35
Q

Goldmann Visual Fields:
Error: Pt responding too slow
How do you remedy?

A

Common with older or senile pt
slow down test object

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36
Q

Goldmann Visual Fields:
Error: Moving target too slowly or too fast
How do you remedy?

A

Be aware of your pace

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37
Q

Goldmann Visual Fields:
Error: Marking chart inaccurately
How do you remedy?

A

Crucial

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38
Q

Goldmann Visual Fields:
Error: Poor adjustment of perimeter
How do you remedy?

A

Follow set protocols, prepare instrument carefully

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39
Q

What are the types of automated visual field tests?

A

Threshold, Suprathreshold, Short wave Automated (SWOP), SITA (SITA fast, SITA Standard)-Screening test

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40
Q

Which Automated Visual Field test does this describe?
*Relative term, mathematical approximation
*Requires multiple tests of the same points of varying intensities of stimuli
*Represents the level a stimulus can be seen 50% of the time
*Both Static and Kinetic used
*VF’s from kinetic and static perimetry cannot be directly or consistently compared

A

Threshold

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41
Q

Which Automated Visual Field test does this describe?
*Stimuli presented at intensities statistically calculated to be above the patients’
*If the stimuli are seen, we assume that no significant defect exists
* Goldmann, Humphrey & Octopus use

A

Suprathreshold

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42
Q

Which Automated Visual Field test does this describe?
*Bright yellow background
*Isolates and measures blue cone function (thought to be damaged first in glaucoma)
*Fast
*Good for suspects

A

Short Wave Automated (SWOP)

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43
Q

Which Automated Visual Field test does this describe?
*Faster-50%-70% less test time
*Incorporated & analyzes pt’s responses to decrease test time
*No trials for false positives
*Monitor decibel graph to catch high readings for false positives

A

SITA

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44
Q

What could cause Central K edema with CL use?

A

Insufficient O2

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45
Q

How do you correct Insufficient O2 with CL use?

A

Blend junctions of CL curve better, flatten peripheral curve, reduce diameter, reduce diameter of OZ, fenestrating lens

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46
Q

CL: Cause of K abrasion

A

Insufficient O2 or lens too flat or too loose

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47
Q

Cure for K Abrasion with CL use

A

Increase CL diameter, OZ, reduece edge thickenss, steepen OZ or peripheral curve, increase BC

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48
Q

CL: Cause of 3 o’clock & 9 o’clock staining

A

Dryness, Improper Removal

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49
Q

Cure for dryness with CL use

A

Smaller, thinner CL, tears, blinking exercises

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50
Q

Cure for Improper Removal of CL

A

Reinstruct pt

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51
Q

CL: Cause of Zig Zag/Irregular Staining

A

FB bodies under lens

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52
Q

CL: Cause of Arc staining

A

Poor insertion technique, Sharp juncture lines between central posterior curve and intermediate or peripheral curve

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53
Q

CL:
Cure for Poor insertion technique

A

Reinstruct pt

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54
Q

CL: Cure for Sharp juncture lines between central posterior curve and intermediate or peripheral curve

A

Better blended lens

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55
Q

CL: Cause of Bubbles

A

Too steep

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56
Q

CL: Cure for CL being to steep

A

flatter lens

57
Q

CL: Cause of flare/streaming lights at night

A

optic zone too small

58
Q

CL: cure for optical zone being too small

A

Larger CL or OZ

59
Q

CL: Cause of Blurring of VA in daylight

A

Lens Rides too high
-High minus
-Small lens/tight lids

60
Q

CL: Cause of Gravitating too low after blink

A

Too heavy/high plus
Too thin at edge

61
Q

CL: how to remedy too thin at edge on CL

A

Redesign lens

62
Q

CL: Cause of Lens displaces nasally or temporally

A

Abnormally centered K

63
Q

Preparing for Fluorescein Angiogram:
What size syringe of dye is used?

A

10ml

64
Q

Preparing for Fluorescein Angiogram: Setup-
If container must be broken up you will need….

A

Filter Needle

65
Q

Preparing for Fluorescein Angiogram: Setup-
Butterfly infusion set with tubing and ____G, __” needle

A

21, 3/4

66
Q

Preparing for Fluorescein Angiogram: Setup-
What items are needed for set up for Fluorescein Angiogram?

A

10 ml Syringe of dye
Filter needle if container must be broken open
Butterfly infusion set with tubing and 21 G, 3/4” needle
Alcohol wipes
Tourniquet
Band Aids
Tape (for taping butterfly in place)
2x2’s
Emergency kit

67
Q

These are possible side effect of what?
Yellow-Orange urine x 24-48 hrs (common)
Yellow staining of mucous membranes x 24-48 hrs(common)
Sneezing
Uticaria (hives)-usually within 1st hr
Tongue and lip paresthesia
Nausea (15%) (common), vomiting 92%)
Dizziness, fainting-have smelling salts available
Allergic respiratory reaction
Anaphlactic Shock
Cardiac arrest
Local tissue necrosis (very rare)

A

Fluorescein Angiography

68
Q

Fluorescein Angiography:
What should you have available in case of Allergic respiratory reaction?

A

Have emergency airway resuscitation supplies available

69
Q

Fluorescein Angiography:
What should be on hand for dizziness, fainting?

A

have smelling salts available

70
Q

Fluorescein Angiography:
What should you have on hand in case reaction is anaphylactic shock?

A

IV epi, anti histimines, airway maintenance, transfer to emergency medical facility

71
Q

Fluorescein Angiography:
What are some contraindications with Fluorescein Angiography?

A

Previous hx of fluorescein reaction
If pt reports multiple allergies and has never had FA before, be on alert
Pregnancy
Important to document reaction, no matter how minor

72
Q

Fluorescein Angiography: If pt has Previous hx of fluorescein reaction……..

A

Ophthalmologist decide whether to proceed depending on severity
If diagnosis and treatment are obvious (Risks vs Benefits)-Ophthalmologists’

73
Q

What are the steps to take for Fluorescein Angiogram?

A
  1. Explain Procedure to Pt, Answer questions 2. Obtain Informed consent (most important) 3. name plate (if not digital) 4. Control Photos Green filter (red free) a. documents autofluorescence 5. Setting vary, typically lowest flash 6. Increase power for FA, Align 7. Setting vary, definitely higher than red-free 8. Recheck focus and alignment with the green filter 9. Set timer to zero and remove green filter 10. Put exciter and barrier filters in place 11. injection 12. Have everything aligned and in focus before injection begins 13. Position patient on chin rest 14. Let injector know when you’re ready. If you’re injecting, confirm needle is in vein by drawing back blood. Inject just a small amount of dye first. 15. Begin timing device when you tell injector ‘go’ or you begin injecting 16. inject Fluorescein at rate of 1 cc per sec. 17. injector should say ‘in’ when injection is complete 18. Take photo to record time of injection 19. Begin photographing approx 1 photo per sec for first minute ( you can’t take too many photos) 20. After re-circulation photos remove butterfly and compress injection site. Pt can relax 21. Take late phase photos 10 min post injection.
74
Q

FA Imaging Artifacts:
Illumincaiton artifacts, blurring of image

A

Media opacities

75
Q

FA Imaging Artifacts:
Reduces light causing uneven illumination

A

Poor pupillary dilation

76
Q

FA Imaging Artifacts:
Degrades retinal fluorescence

A

Excess topical fluorescein

77
Q

FA Imaging Artifacts:
Loss of field definition

A

Poor patient cooperation

78
Q

FA Imaging Artifacts:
Reduces amount of dye in retinal vessels and causes patient discomfort

A

Leakage of dye out of vein

79
Q

FA Imaging Artifacts:
Adjust what setting to compensate for high refractive errors?

A

Resolution, Image Brightness, and Myopic lens settings

80
Q

*With Retinoscopy do you seek with or against motion?

A

With motion

81
Q

Retinoscopy:
Follow __________ to neutrality

A

With motion

82
Q

Retinoscopy:
Maintain you working______

A

distance

83
Q

Retinoscopy:
Stay aligned with patient’s __________

A

visual axis

84
Q

Retinoscopy:
Watch center of________

A

pupil

85
Q

Retinoscopy:
Sweep side to side perpendicular to _______________

A

orientation of streak

86
Q

Retinoscopy:
If you are in doubt whether you’re at neutrality or not you should……..

A

Add minus so see ‘with’ motion and gradually add one click of plus at a time til the with motion is no longer visible and center of pupil fills with light.

87
Q

Retinoscopy:
When you think you are at neutrality… if you move in a little you should see…..

A

with motion

88
Q

Retinoscopy:
When you think think you’re at neutrality if you move back a little you should see

A

against motion

89
Q

*Retinoscopy:
If you see with motion the focal point is ________ you.

A

Behind

90
Q

*Retinoscopy:
If you see against motion the focal point is ___________of you

A

In front

91
Q

Retinoscopy:
If you see neutrality ___________________________

A

You are at the focal point

92
Q

What are some common aseptic technique errors with masks?

A

Not covering mouth and nose
tied too loosely
hair loose from cap

93
Q

What are some common aseptic technique errors with scrubs?

A

Fingernails longer than 1 mm beyond nail bed
Runoff dripping down arms /hands
Too short scrub time
Not developing systemic scrub/missing area
Splashing clothes (strikethrough on sterile gown)

94
Q

What are some common aseptic technique errors with Drying

A

Using wet section of towel to dry hand
Allowing towel to touch non sterile clothing

95
Q

What are some common aseptic technique errors with Gowning

A

Allowing gown to come in contact with nonsterile items or hands

96
Q

What are some common aseptic technique errors with gloves

A

Touching outer portion of glove with bare hand
Undetected perforations in gown
Holding hands against body while waiting

97
Q

What are some common aseptic technique errors with skin prep

A

Going back and forth rather than in circular fashion
Not prepping lashes, lid margin or brows
Allowing even traces of soap to come in contact with quarternary ammonium compounds (ie Zephiran) thus neutralizing it.

98
Q

The surgical scrub:
Always scrub from…

A

the finders UP

99
Q

What should you begin with when doing a surgical scrub?

A

with nails

100
Q

When doing surgical scrub you should use what to clean nails

A

nail cleaner and brush

101
Q

When doing surgical scrub, scrub each side of the finger and treat each finger as a ____

A

four sided object

102
Q

After scrubbing fingers with surgical scrub you should then….

A

Scrub each side of the hands treating it as a four-sided object

103
Q

After scrubbing hands doing a surgical scrub you should then…..

A

Scrub the wrists, the arms and 2” past the elbows

104
Q

When doing a surgical scrub, keep hands tilted ______at all times

A

upwards

105
Q

Surgical scrub:
Rinse from _______to_____

A

fingertips to elbows

106
Q

Surgical scrub:
never allow water to __________

A

Drip back down to hands

107
Q

Surgical scrub:
Rinse all_____from under fingernails, in folds of knuckles

A

subds

108
Q

If you accidentally touch anything during or after you’ve done a surgical scrub you must______

A

start over

109
Q

What are the 3 main types of slit lamp illumination?

A

Direct
Indirect
Diffuse

110
Q

What are 4 types of Tonometry?

A

Shiotz
Goldmann
NonContact
Tonopen

111
Q

What principle is used with Schiotz

A

Indentation

112
Q

What principle is used in Goldmann tonometry?

A

Applanation Principle

113
Q

What principle does Non Contact tonometry use?

A

Indentation Principle

114
Q

What principle does Tonopen use?

A

Combination of applanation and indentation principles

115
Q

Tonometry: True or False
A force or weight will indent or sink into a soft eye further than into a hard eye.

A

True

116
Q

Tonometry:
Which tonometry method must you refer to a scale on the tonometer and then a conversion table to determine IOP?

A

Schiotz

117
Q

These are advantages of which tonometry method?
Reliable, simple mechanics
Inexpensive to buy and maintain
Calibration easy to check
Use on restricted pts
Can sterize for use in OR

A

Schiotz

118
Q

These are disadvantages of which tonometry method?
Pt apprehension
Anesthesia required
Need good pt cooperation
Risk of corneal abrasion
Rarely delegated
Must disassemble and clean after each use
Displaces significant aqueous

A

Schiotz

119
Q

What principle is decribed?
The pressure inside a thin-walled sphere=the force necessary to flatten its surface divided by the area of flattening

A

Imbert-Fink Principle

120
Q

These are advantages of which tonometry method?
Reference standard for accuracy
Rarely needs recalibrated
Displaces little aqueous, repeated readings accurate
Relatively inexpensive to buy and maintain
Compact
Hand held models available
No electronics, reliable

A

Goldmann

121
Q

The following are disadvantages of which tonometry method:
Requires topical anesthetic
Poor results with edematous cornea
Patient must be able to be positioned at slit lamp
Must send to factory for calibration
Influenced by external pressure
Risk of corneal abrasion
Subjective

A

Goldmann

122
Q

These are advantages of which tonometry method:
Accurate compared with Golmann (if <30mm)
No anesthetic required
Displaces little aqueous
Easily delegated by Dr.
No risk of K abrasion
Quick
Can measure through contact lenses

A

Non Contact tonometry

123
Q

The following are disadvantages of what tonometry method:
Some patients apprehensive
Expensive
Large, bulky
Must send to factory for calibration
Multiple readings required

A

Non Contact Tonometry

124
Q

These are advantages of which tonometry method:
Most accurate method for scarred or edematous corneas
Quick
Minimal corneal disruption
Easy to use with patients who can’t sit upright or hold steady
Portable, light weight

A

Tonopen

125
Q

These are disadvantages of which tonometry method:
Accuracy questionable
Factory calibration
Expensive to buy, operate and maintain
Displaces significant aqueuous
Influenced by external pressure

A

Tonopen

126
Q

How do you clean and disinfect Goldmann Tonometer?

A

Remove measuring prisms carefully from holder
Wipe prisms clean before rinsing for 30-60 seconds in running cold water
Disinfect with Hydrogen Peroxide for 10 minutes (3% aqueous solution) or Sodium Hypochlorite (household bleach) for 10 minutes (10% aqueous solution)
Rinse thoroughly with running cold water (Note:rinsing time in water not to exceed 60 minutes)
Dry with one way tissue clean and soft
Store in container clean and dry

127
Q

What cleaner is used to clean Goldmann tonometry prism tip?

A

Hydrogen peroxide or Sodium Hypochlorite

128
Q

What is the break down of phakic axial length measurements using immersion technique? (PCAPRS)

A

Probe, Cornea, Anterior lens, posterior lens, retina, sclera, then the space past this is orbital fat

129
Q

*EOM innervation Mnemonic

A

SO4, LR6, III

130
Q

What fluorescein angiography phase is present when fluorescein dye is indicated in the arteries and choroid only?

A

Arterial

131
Q

What fluorescein angiography phase is present when there is a full filling of larger veins?

A

Late venous

132
Q

What is the term for mid-phase fluorescein angiography?

A

Venous phase

133
Q

What fluorescein angiography phase is present when there are no white areas of leakage seen and diminution of fluorescein in all retinal blood vessels is indicated?

A

Late

134
Q

What is the earliest phase of retinal circulation in fluorescein angiography?

A

Arterial phase

135
Q

What is the primary purpose of using epinephrine for glaucoma?

A

Increase aqueous outflow

136
Q

What fluorescein angiography phase is present when capillaries fluoresce?

A

Early venous

137
Q

**What does PCAPRS stand for in A scan

(**Know what effect old RD and tumors have on the spikes and what and what it looks like when hits retina)

A

Probe/cornea/anterior lens/posterior lens/retina/sclera

138
Q

Goldman tonometry
** if mires are oval in OD and round in OS this means….

A

I answered OD has higher astigmatism ** I do not know if I was right.

COT (28 decks)

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