Midterm 1 Flashcards

1
Q

What makes up the APGAR score and what is a normal score

A

Appearance, Reflex, Respiratory, Pulse, Muscle Tone

7+ is normal

0-2 in each category

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2
Q

What is the recommended eye exam frequency?

A

Birth to 2 years: at 6 months

2-6: at 3 years old

6-18: Before 1st grade and then every 2 years if no risks

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3
Q

What is the age of infant

A

birth to 1 year

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4
Q

what is the age of toddler

A

1-3 years old

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5
Q

What is the age of preschooler

A

3-6

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6
Q

what is school age

A

6-18 years old

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7
Q

What are the components of a case history

A
Chief Complaint with at least 4 HPI (FLORIA) 
- routine, first eye exam, or annual 
Ocular History 
Family History 
Medical History -- ADHD, Asthma, Allergies
Allergies 
Medications
Academic History 
Developmental History
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8
Q

What are the FDA pregnancy categories

A

A: well controlled studies failed to demonstrate risk to fetus
B: Animal studies only
C: no animal or human studies show effect on fetus
D: evidence of human fetal risk
X: human or animal study have demonstrated risk to fetus

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9
Q

What are the new FDA categories (2015)

A

Pregnancy Category
Lactation Category
Female and Male Reproductive Potential

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10
Q

What are the types of acuity?

A
Resolution Acuity (spatial frequencies) 
Detection Acuity (something is there) 
Vernier Acuity (misalignment) 
Recognition Acuity (SNELLEN)
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11
Q

What are the immaturies in visual system?

A

cortical immaturity: incomplete myelination throughout visual pathway and foveal cone immaturities (adult by 4 years old) and foveal pit morphologies (varies by adult like by 17 months)

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12
Q

How do you interpret CSM results

A

Central
Steady – if not, nystagmus
Maintained – if not, poor acuity

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13
Q

What are the different types of FPL tests?

A

Forced Preferential Looking (must choose 1)

Resolution VA (spatial frequencies) 
TAC, Lea Paddles -- not snellen equivalent
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14
Q

What are the expected results of OKN and limits?

A

OKN: involuntary eye movement induced by the speed of motion of visual field

Holds images stable on retina

Start T to N first and then N to T and record if response

Not truly foveal; not affected by RE

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15
Q

What happens if there is no OKN response in a non-blind child

A

lesion in cortex, cerebellum or brainstem

cortical dysplasia or blindness

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16
Q

what can OKN be used for

A

determine if child has abnormal binocularity based on asymmetric responses

17
Q

Why do you use cycloplegia for infants

A

infants have small pupils and high accommodative response

18
Q

What is the avg RE of a full term newborn

A

+2D avg with a standard deviation of 2.75D

Range: -0.75 - 4.75

19
Q

What is emmetropization

A

tendency for eyes to go to plano

+0.50D to 1.00D with SD of 1D

20
Q

What is the active evidence for emmetropization

A

The eye is regulated by retinal blurs and adjusts accordingly

Increase axial length of eye = eye is growing

Lots of reading = increase myopia

Media opacities and retinopathy prematurity leads to more myopic patients

21
Q

What is the passive evidence for emmetropization

A

occurs as a result of physical or genetic changes

change in corneal lens power

parents who are myopic increases the chance of child being myopic

22
Q

What was significant about the BIBS study

A

Berk Infant Biometric Study
(2009)
262 infants defined emmetropization around less than 2D by 9 months

  • bidirectional: both M and H did it (the more magnitude of RE, the less likely to become emmetropic)

cycloplegic refraction was best predictor

23
Q

What is the streak for

A

neutrality and finding cyl axis

24
Q

what is the spot for

A

looking at more than 1 axis, brighter, better color, better for peds

25
How do you measure accommodation ability
NRA/PRA and Facility
26
How do you measure accommodation amplitude
Push up, Push away, minus lens method
27
how do you measure accommodation response
FCC + MEM (objective)
28
What are the reasons for a high lag?
normal, accommodative dysfunction (infacility, insufficiency), uncorrected M/H, overminused, eso with poor ranges or malingering
29
what are the reasons for low lag?
normal, accommodative dysfunction (spasm), overplussed, exo with poor ranges
30
What is the timeline for color vision development
infant: red from white 1 mos: blue and green from gray 3 mos: yellow, blue, green from gray
31
What are the anesthetics used for peds
Proparacaine, Tetracaine, or Benoxinate AE: irregular HR, SOB, nausea, swelling (SUPER RARE)