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PPO5 > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

How close should you be to the patient when doing DO?

A

1.5 to 3cm

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2
Q

How far off the visual axis should you be when doing DO?

A

15-20 degrees

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3
Q

Should patient have just one eye, or both eyes open for DO?

A

Both eyes

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4
Q

If you lose the red reflex when beginning DO, what should you do?

A

Pull back and start over

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5
Q

As you move closer to the patient with the DO, what lens power should you be adding?

A

Minus power

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6
Q

When you get the nerve or a vessel in view, what should you do with the power wheel?

A

Turn it until you get the clearest possible view

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7
Q

Why should you do DO with both eyes open?

A

To reduce your accommodation

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8
Q

Why should you have the patient keep both eyes open and look across the room?

A

To reduce their accommodation

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9
Q

Using your fingers as a spacer between your patient and yourself, you can also use that finger for what purpose?

A

A pivot point to move and follow blood vessels and such

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10
Q

What should you tell your patient for patient education?

A

Where to look, keep both eyes open, and that you will get very close

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11
Q

When doing DO, what correction should you be using?

A

Your habitual correction

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12
Q

If your patient is wearing contacts for DO, should they remove them?

A

No

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13
Q

If you patient is wearing glasses for DO, should they remove them?

A

Yes

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14
Q

What is the fixation aperture of the DO scope used for?

A

Observation of macula

Estimation of optic nerve size

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15
Q

What is the slit aperture of the DO used for?

A

To help determine elevations or depressions of the retina

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16
Q

What is the DO cobalt filter used for?

A

In combination with fluorescein, it is used to view small lesions, abrasions and foriegn objects on the cornea

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17
Q

What does the red-free filter exclude from the exam field?

A

Red rays

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18
Q

What does the red-free filter help you view in DO?

A

Veins, arteries, and nerve fibers

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19
Q

When using the cobalt filter and fluorescein with DO, you will most likely be using what lens?

A

+20

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20
Q

What are some things that the red-free filter helps to ID?

A 
Retinal hemorrhages
Choroidal nevus vs retinal pigmentation
Nerve fiber loss
ON rim tissue
Enhance NFL
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21
Q

When switching to the cobalt filter of the DO, a lesion you were viewing turns black. Where is it located?

A

In the retina

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22
Q

Red-free light only penetrates how far?

A

To the RPE

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23
Q

Where does white light from the DO scope penetrate?

A

To the choroid

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24
Q

How does the DO view the retina?

A

Upright

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25
Q

What are the two ways the retina can be viewed upright, rather than inverted?

A

DO

Goldmann Hruby lens

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26
Q

What fundus viewing techniques give an inverted, reversed, aerial image?

A

Fundus biomicroscopy

BIO

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27
Q

What is the mag of DO?

A

15x

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28
Q

The magnification of DO is dependent on what?

A

Examiner’s refractive error, and the patient’s refractive error

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29
Q

How big of a field of view is seen in DO?

A

2 disc diameters

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30
Q

What is the code for extended ophthalmoscopy?

A

92225

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31
Q

What is required for detailed ophthalmoscopy?

A

A detailed sketch with labeling
Interpretation
Plan of treatment

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32
Q

How many colors should be in an extended ophthalmoscopy drawing?

A

4-6

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33
Q

What artifact is colored in light red in retinal mapping?

A

Attached retina

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34
Q

What artifacts are colored in dark red in retinal mapping?

A

Retinal arteries

Preretinal or intraretinal hemorrhages

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35
Q

What artifact is colored light blue in retinal mapping?

A

Retinal detachment

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36
Q

What artifacts are colored dark blue in retinal mapping?

A

Retinal veins
Margins of retinal breaks
Lattice - outlined then crosslined

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37
Q

What artifacts are colored black in retinal mapping?

A

Chorioretinal pigmentation

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38
Q

What artifacts are colored yellow in retinal mapping?

A

Intraretinal or subretinal exudates

Cotton Wool Spots

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39
Q

What artifacts are colored green in retinal mapping?

A

Vitreous Opacities

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40
Q

For a diabetic patient that doesn’t dilate well, what should you do?

A

Instill another drop of tropicamide

41
Q

How far from the patient’s eye should the 20D lens be during BIO?

A

50mm or 5cm

42
Q

What is the Gulstrand principle for BIO?

A

That the BIO narrows the observer’s interpupillary distance, allowing both the illuminating and viewning beams within the patien’ts pupillary aperture

43
Q

When the patient is looking right, which way should you tilt your head to get a better view?

A

Right

44
Q

If you have an image on the 20D lens but it is blurry, what are your troubleshooting options?

A

Check trombone distance

Check working distance from the condensing lens

45
Q

If you see something at the edge of your field of view in a 20D lens, how do you bring it to the center of your view?

A

Scan toward it

46
Q

How do you get to the ora?

A

Fill the lens, then scan (tilt and lean) toward the far periphery

47
Q

Which retinal pathologies appear as “something dark”?

A 
Nevus
CHRPE
Optic nerve choroidal ring
Peripapillary atrophy
Choroidal pigment changes near ampullae (tigroid and brunette)
48
Q

What retinal pathologies appear as “something white”?

A

Cotton wool spots
Infarction/retina edema
Myelination

49
Q

What retinal pathologies appear as “something yellow”?

A

Drusen
Exudates
Emboli

50
Q

What retinal pathologies appear as “something red”?

A

Hemorrhages
Holes
Tears

51
Q

What “dark pathologies” are benign?

A

Pigment crescents
CHRPE, bear tracks
Choroidal pigment changes near ampullae
PPA when mild and associated with myopia

52
Q

When is peripapillary atrophy pathological?

A

When associated with glaucoma and histoplasmosis

53
Q

What is the typical presentation of peripapillary atrophy?

A

Irregular, hyper and hypopigmentation zone around the ONH

54
Q

Where is peripapillary most common?

A

On the temporal side of the ONH

55
Q

What is the typical presentation of a choroidal nevus?

A

A flat, or slightly elevated grayish-green lesion

56
Q

T or F: Choroidal nevi may grow with age.

A

True

57
Q

Choroidal nevi may have overlying ___.

A

Drusen

58
Q

What is the anatomical location of the macula in relation to the ONH?

A

Temporal and slightly inferior

59
Q

What does CHRPE stand for?

A

Congenital hypertrophy of the RPE

60
Q

What is the typical presentation of a CHRPE?

A

Isolated (distinct edges), dark gray/black areas

61
Q

Where would a CHRPE be located?

A

Anywhere

62
Q

Are CHRPEs elevated, or flat?

A

Flat

63
Q

What is a halo nevus?

A

A CHRPE with a depigmented area surrounding it

64
Q

Which would appear to be darker in color, a CHRPE or a choroidal nevus?

A

CHRPE (more superficial)

65
Q

What is the typical presentation of toxoplasmosis?

A

Black lesion, with a mixture of white

66
Q

What causes cotton wool spots?

A

Ischemia of NFL bundles

67
Q

Why are cotton wool spots commonly within 3-5DD of the disc?

A

That is where the NFL is thickest

68
Q

What is the most common cause of NFL ischemia, leading to cotton wool spots?

A

Acute obstruction of an arteriole, causing blockage of axoplasmic flow, and buildup of debris in the NFL

69
Q

In which diseases are cotton wool spots common?

A

Hypertension
Diabetes
Lupus
HIV/AIDs

70
Q

What (non disease) else can cause cotton wool spots?

A 
Vein occlusions
Interferon therapy (for hep C, melanoma, MS)
71
Q

Cotton wool spots are also called ___?

A

Soft exudates

72
Q

What are hard exudates formed out of?

A

Deposition of lipid and lipoproteins

73
Q

Hard exudates are a sign of what?

A

Abnormal vascular permeability

74
Q

In which diseases are hard exudates commonly found?

A

Diabetic retinopathy
Late stage HTN retinopathy
Ven occlusions

75
Q

Drusen are most commonly related to what?

A

Age

76
Q

Drusen are deposited where?

A

Between RPE and Bruch’s membrane

77
Q

Which appears brigher and more yellow, exudates or drusen?

A

Exudates

78
Q

Which deposit can obscure blood vessels, cotton wool spots or hard exudates?

A

Cotton wool spots

79
Q

What is the typical presentation of myelinated NFL?

A

White, feathery-edged configuration of the nerve fiber layer - may obscure blood vessels

80
Q

Where is myelinated NFL most commonly found?

A

Around the optic nerve and peripapillary NFL

81
Q

Under normal conditions, only the ___ optic nerve is myelinated.

A

Retrobulbar

82
Q

What is the blood supply to the retina?

A

Central Retinal Artery

Choroidal blood vessels

83
Q

What nourishes the inner retinal layers?

A

Central retinal artery

84
Q

What maintains the outer retina, particularly the photoreceptors?

A

Choroidal blood vessels

85
Q

Something white on the ONH is probably what?

A

Remnant of the hyaloid artery

86
Q

If there is a mound of glial tissue, it is called what?

A

Bergmmister papillae

87
Q

What is the normal, extra vessel called?

A

Cilioretinal artery

88
Q

What is the origin of the ciloretinal artery?

A

Choroid

89
Q

If a patient has CRA occlusion, but still has an islet of vision, they probably have what?

A

Cilioretinal artery, that redundantly supplies blood to a portion of the retina

90
Q

What is the typical presentation of a branch retinal artery occlusion?

A

An opaque area, signifying retinal edema due to retinal infarction

91
Q

What is the typical presentation of central retinal artery occlusion?

A

Cherry red spot

White fundus

92
Q

Why does a cherry red spot persist in CRA occlusion?

A

Macula has choroidal blood supply

93
Q

What causes the retina to turn white in CRA occlusion?

A

No blood

NFL has turned opaque

94
Q

A D-hemorrhage is found where?

A

Pre-retinal

95
Q

Flame hemes are in what part of the retina?

A

NFL

96
Q

What is the most common place for a BRVO?

A

Superior temporal arcade

97
Q

An intraretinal hemorrhage has what appearance?

A

Dot and blot

98
Q

Proliferative diabetic retinopathy typically includes what two things?

A

Neo of the disc

Neo of the retina (neo elsewhere)

PPO5 (3 decks)

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