Midterm Exam Flashcards by Nacher Mohan

Presence of this cells is REQUIRED to classify inflammation I as Chronic Granulomatous Inflammation?

Epithelioid Histiocytes (Activated Macrophages)

Note: Multinucleated giant cells sometimes maybe present.

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What is the first step in WBC movement during a inflammatory reaction?

Rolling

Note: Loose, intermittent contact of WBC’s with endothelium, partially due to marination of WBC’s from stasis of blood

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Which type of necrosis is predominant in organs with high fat and lack of substantial protein matrix?

Liquefaction Necrosis

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Which of the following is suggestive of irreversible cellular injury?
A. Cellular swelling 
B. ER swelling
C. Loss of Enzymes (CK, LDH)
D. Loss of micro villi

C. Loss of Enzymes (CK, LDH)

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Hypoxia involves decrease in ATP. There are 3 major steps that occur during cellular injury, explain them.

1) Na/K pump fail: Na and water fill cell (cell swell)
2) Ca2+ pump fail: Ca+2 enter cells –> activates endonucleaes, protease so, phospholipases and DNAses.
3) Switch to anaerobic respiration Lactic Acid accumulates –> lower pH which disaggregates ribosomes and ER

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Activation of which enzymes is part of initiation of extra cellular and intracellular pathway of apoptosis?

Caspases

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What type of chemical injury involves either Direct toxicity or convert into toxic metabolites?

Chemical injury

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During cellular injury, there is increase mitochondrial cytotoxic calcium. What is released to activate apoptosis?

Cytochrome C

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There are 2 types of cellular injury types. Which of the following is not matching with Reversible cellular injury?
A. Light microscope - nuclear Karyolysis, Pyknosis, and Karyorrhexis
B. Electron Microscope - Cellular bless and small mitochondrial densities
C. ATP - once produced by the cell, the Na/K ratio and pH will be corrected

Not correct - A. Light microscope - nuclear Karyolysis, Pyknosis and Karyorrhexis.

Correct- Light microscope: Cellular swelling and fatty change.

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What three structures in the cell, if damaged, will cause irreversible cellular injury?
A. Golgi Apparatus, Plasma Membrane and Lysosome
B. Lysosome, Mitochondria and ER
C. Mitochondria, Golgi Apparatus and RNA
D. Cell membrane, Golgi Apparatus and Lysosome

B. Lysosome, Mitochondria and ER

Note: Loss of DNA, loss of mitochondria, loss of ER, damage to Lysosome and Plasma are all irreversible cellular injury

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What are the two types cell death?

Apoptosis- controlled breakdown of cells in response to damage to DNA or part of normal growth.

Necrosis - Uncontrolled breakdown of cells in response to injurious stimuli

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Apoptosis involves what breakdown enzyme? What is the name of the phase name when it is catalytically active? What is the name of the phase name when it causes the death of the cell?

Caspases - When active its is called INITIATION and when death of a cell occurs, it’s called EXECUTION.

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What type of cell in the liver, will show apoptosis?

Acidophil body

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In the initiation of extra cellular pathway, what ligand binds to a member of the tumor necrosis?

Fas receptor, this I turn activates Caspases.

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What type of tissue is Liquefactive necrosis commonly relative too?
A. High Protein
B. Low Protein
C. High Fat
D. Low fat

B. Low protein

It can also be apart of high concentration of proteolytic enzymes

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What does Nuclear Karyolysis mean?

Loss of basophilia

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What does Pyknosis mean?

Shrinkage of nucleus

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What does Karyorrhexis mean?

Fragmentation of nucleus

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What does Morphology of apoptosis involve?

Chromatin condensation and fragmentation

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What type of necrosis involves protein desaturation and is more prominent than enzymatic breakdown?
A. Coagulation necrosis
B. Liquefaction necrosis
C. Fat Necrosis
D. Caseous Necrosis

A. Coagulative necrosis

Note: Organs affected are any that involve high fat content (I.e. Brain)

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What type of organs are affect in Liquefactive necrosis?
A. Stomach and Pancreas
B. Small Intestine and Pancreas
C. Brain and Pancreas
D. Mycobacterium and Pancreas

C. Brain and Pancreas

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What type of necrosis involves the release of fatty acids, which combines with calcium to form chalky deposits?
A. Coagulation necrosis
B. Liquefaction necrosis
C. Fat Necrosis
D. Caseous Necrosis

C. Fat necrosis

Note: Fat necrosis occurs when change in adipose tissue due to trauma or the release of enzymes from adjacent organs

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What type of necrosis involves TB?
A. Coagulation necrosis
B. Liquefaction necrosis
C. Fat Necrosis
D. Caseous Necrosis

D. Caseous Necrosis - Cheesy looking necrosis associated with TB infections and other Granulomatous disease

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Before neutrophils enter the tissue of a dying heart, what type of necrosis generally occurs prior to the neutrophils entering the heart muscle?
A. Coagulative necrosis
B. Liquefaction necrosis
C. Fat Necrosis
D. Caseous Necrosis

A. Coagulative necrosis

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``` What is the function of Opsonins? A. Mark cells of Apoptosis B. Mark cells for Autolysis C. Mark cells for Pinocytosis D. Mark cells for Phagocytosis ```

D. Mark cells for Phagocytosis

``` What is the first step of Histamine? A. Vasodilation B. Increased Vascular permeability C. Rolling D. Pavementing E. Transmigration F. Chemotaxis ```

A.Vasodilation

``` What are the four possibilities that occur at Increased vascular permeability? A. Histamine B. Bradykinin C. IL-8 D. LFA -1 E. IgG F. TNF G. IL-1 ```

A. Histamine B. Bradykinin F. TNF G. IL-1

``` What is the name of the movement when WBC's cross through the endothelial layer? A. Rolling B. Pavmenting C. Transmigration D. Chemotaxis ```

C. Transmigration

``` What type of WBC movement involves WBC's to be drawn to the site of inflammation? A. Rolling B. Pavmenting C. Transmigration D. Chemotaxis ```

D. Chemotaxis

With acute inflammation, resolution outcome occurs when the inciting agent is removed, and all damage done by the inciting agent and inflammatory cells are repaired. However, for this to be true the epithelium needs to regenerate. What is helps the epithelium regenerate in this process?

It needs to have a basement membrane that is intact.

``` Complications such as Pain, fever, rupture and swelling are associated with what type acute inflammation? A. Abscess B. Ulcer C. Fistula D. Chronic inflammation ```

A. Abscess Note: Can occur in any organ in the body. The process of repair and scarring is occurring more rapidly in the tissue around the site of the abscess

``` What type of acute inflammation will result in Erosion? A. Abscess B. Ulcer C. Fistula D. Chronic Inflammation ```

B. Ulcer - pain and hemorrhaging Erosion will occur due to the mucosa layer is lost. Deeper tissue loss can also occur.

``` What is the term called when the lumen or the GI tract has hemorrhaging occurring? A. Lumenitis B. Pancretitis C. Peritonitis D. Peripheralitis ```

C. Peritonitis Note: This type of inflammation has the following: fibrin, neutrophils, granulation tissue and fibrosis

What type of fistula involves skin to colon inflammation, such as colon cancer or inflammatory bowel disease? A. Extracutanous B. Enterocutaneous C. Intracutaneous

B. Enterocutaneous

True or False. When there is loss of tissue in an organ not capable of regeneration, this is referred to as loss of function?

True.

``` Which of the following do macrophages produce during a chronic inflammation? A. PDGF B. TNF C. IL-1 D. NO E. All of the above ```

E. All of the above Note: PDGF is produced by both activated Lymphocytes(Most commonly produced during chronic inflammation) and Macrophages

``` When does the timeline of scarring start? A. 2 hours B. 12 hours C. 24 hours D. 48 hours ```

C. 24 hours

``` When does granulation tissue become formed? A. 1 - 2 days B. 3 to 5 days C. 7 to 10 days D. 14 to 21 days ```

B. 3 to 5 days The term granulation tissue indicated a proliferation of fibroblasts, a new thinned walled vessels and loose extra cellular matrix

``` During scarring, when does edema and inflammatory cells are finally absent? A. 1 week B. 2 weeks C. 3 weeks D. 4 weeks ```

B. 2 weeks Note: At 1 month, the inflammatory infiltrate is absent and the scar consists of collagen. The collagen strengthens over the next few months.

What does regeneration mean? A. Regeneration of cells combined with scarring and fibrosis B. Reducing the wound by 5 to 10% due to contraction of myofibroblasts C. Complete replacement of damaged cells with no scar formation

C. Complete replacement of damaged cells with no scar formation

What is wound contraction? A. Regeneration of cells combined with scarring and fibrosis B. Reducing the wound by 5 to 10% due to contraction of myofibroblasts C. Complete replacement of damaged cells with no scar formation

B. Reducing the wound by 5 to 10% due to contraction of myofibroblasts.

What is healing? A. Regeneration of cells combined with scarring and fibrosis B. Reducing the wound by 5 to 10% due to contraction of myofibroblasts C. Complete replacement of damaged cells with no scar formation

Regeneration of cells combined with scarring and fibrosis

``` Dehiscence will cause which of the following? A. Collagen regeneration B. Regeneration Histiocytes C. Paralysis of organ D. Decrease in healing ```

D. Decrease in healing Dehiscence is unintentional reopening of the wound, often due to pressure or torsion.

Which of the two will cause excessive scar formation? A. Hypertrophic scars B. Dehiscence C. Keloid Scars

A. Hypertrophic scars | C. Keloid scars

``` What type Allergy mechanism involves Pollen, Dust, Mold and Animal dander? A. Skin Contact B. Inhalation C. Ingestion D. Injection ```

B. Inhalation

``` What type of Allergy mechanism involves Poisonous plants? A. Skin Contact B. Inhalation C. Ingestion D. Injection ```

A. Skin contact Note: Animal scratches, Pollen and Latex are also involved

``` What type of Allergy mechanism involves Bee stings and Medication? A. Skin Contact B. Inhalation C. Ingestion D. Injection ```

D. Injection

``` What type of Allergy mechanism involves Medication or Nuts and shellfish? A. Skin Contact B. Inhalation C. Ingestion D. Injection ```

C. Ingestion

``` What type of hypersensitivity involves immune complexes are deposited in tissues? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

C. Type 3 Note: Polymorphonuclear cells are attracted to the site. Also, they release lysosomal enzymes, causing tissue damage.

``` What type of hypersensitivity involves T-Lymphocytes? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

D. Type 4 Note: Lymphocytes are always involved in the memory based immune response

``` What type of hypersensitivity involves degranulation and release of mediators? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

A. Type 1 Note: IgE is the antigen induced antibody.

``` What type of hypersensitivity leads to antigens on a cell surface combine with IgG and leads to complement mediated lysis of the cell? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

B. Type 2

``` What type of hypersensitivity has the largest time of onset? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

C. Type 3 - 2 to 3 weeks Note: Shortest time would be Type 1, which is within minutes. Type 1 may resolve within 30 to 60 minutes

``` What is exaggerated IgE mediated immune response? A. Allergy B. Atrophy C. Atopy D. Autopsy ```

C. Atopy - Type 1 hypersensitivity Note: Allergy --Exaggerated immune response to antigen regardless of mechanism

``` A pt comes in complaining he has been sneezing and has nasal congestion in the past few days and it's occurring in the month of July. What could be the inhaled substance? A. Weed pollens B. Tree pollens C. Olive's pollens D. Grass Pollens ```

D. Grass pollens (Bermuda grass and Timothy grass)

``` A pt complains of allergies, but doesn't know what it is. She was recently on a hiking trip during her spring break, what could she be allergic too? A. Weed pollens B. Tree pollens C. Mango pollens D. Grass pollens ```

B. Tree pollens

``` Your pt complains of raking leaves just prior to Halloween night and has sneezing and mucous is everywhere. What could this individual be allergic too? A. Weed pollens B. Tree pollens C. Olive's pollens D. Grass Pollens ```

A. Weed pollens

``` A pt complains of wheezing and dyspnea, where in the respiratory tract are the symptoms occurring from? A. Upper respiratory tract B. Mouth C. Middle respiratory tract D. Lower respiratory tract ```

D. Lower respiratory tract Note: To differentiate from anaphylaxis is by noting wheezing and stridor

``` A pt comes in for an eye exam and complains of itching around the eyelids. After asking multiple questions, you find out there are rashes on the arms and behind their legs. A. Contact Dermatitis B. Dyshidrotic Dermatitis C. Nummular Dermatitis D. Atopic Dermatitis ```

D. Atopic dermatitis ``` Children - occurs around the cheeks Adults - behind grooves Swelling oozing and crusting Non contagious Fibrin platen is involved in its properties ```

``` What is celiac disease associated with? A. Allergies to Gluten B. Allergies to Pollen C. Allergies to Pollution D. Allergies to Kids ```

A. Allergies to Gluten Note: Celiac disease occurs when an individual has irritable bowel disorder with association of small intestine irritation

``` With atopic dermatitis, what is associated diagnostic marker of this allergy that shows multiple fold below the inferior eyelid? A.Urticaria B. Werner's spots C. Vossius sign D. Dennie Morgan lines ```

D. Dennie Morgan lines Note: This is usually caused by edema of the lower eye lid

``` What are the two contraindications of administering epinephrine? (Pick 2) A. Pt on A2 agonists B. Pt on Beta Blockers C. Pt of PG analogs D. Pt on Lisinopril ```

B. Beta Blockers D. Pt on Lisinopril Note: A cardiac pt should not be given an epi pen

``` Which of the following is involved in Bradycardia? A. 101 BPM B. 150/90 C. 120/80 D. 50 BPM ```

D. 50 BPM Note: This will most likely be associated with a vasovagal response.

Which of the two most likely is indicative of anaphylaxis? A. Tachycardia B. Bradycardia

A. Tachycardia

``` Which CN stimulates a vasovagal syncope due to the instillation of Fluress? A. CN 7 B. CN 8 C. CN 9 D. CN 10 ```

D. CN 10 Note: CN 10 will cause bradycardia

``` Which of the following is not a symptoms of syncope? A. Feeling dizzy B. Sudden sweating C. Vomitting D. Poor verbal response ```

C. Vomitting Note: That syncope is associated with bradycardia.

``` Which of the following is not associated with Cytotoxic hypersensitivity? A. Transfusion reactions B. Myasthenia Gravis C. Grave's disease D. Hyper acute graft reactions E. Pernicious Anemia F. None of the Above ```

F. None of the above. Note: Type 2 occurs when an antibody binds to antigen on a cell surface

``` What type of hypersensitivity responds to inflammation based on circulation of antigen-antibody complexes? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

Type 3 Note: 4 to 10 days after the exposure, can be chronic and is a complement system. Autoimmune diseases (SLE, RA) and Serum sickness are associated with Type 3

``` Which of the following is not associated with a Granuloma? A. Infiltrate B. B cell C. T cell D. Macrophage ```

B. B Cell Note: A chalazion is a Granulomatous based infection and a Granuloma is associated with Type 4 hypersensitivity.

Which, 2, are correct in regards to allergies? A. Latex is a Type 4 reaction and the chemicals from Latex are a Type 1 reaction. B. Latex and its chemicals are Type 1 reactions. C. Latex is a Type 1 reaction and the chemical from Latex are Type 4 reactions D. Latex and its chemicals are a type 4 reaction.

C. Latex is a type 1 reaction and the chemical from Latex are Type 4 reactions. Note: The chemicals are from the manufacturing process

``` Contact dermatitis is associated with surgery wear type of hypersensitivity? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

D. Type 4

``` What type of hypersensitivity is Steven Johnson syndrome? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

D. Type 4

``` When an pt comes in and complains of green mucous coming out of their nose, what kind of infection could this likely be? A. Fungal B. Parasitic C. Autoimmune D. Bacterial ```

Bacterial

``` Symptoms a pt displays are: Night sweats, weight loss, fever and hemoptysis. What could this problem be? A. Bronchitis B. Lung Cancer C. TB D. Pneumonia ```

C. TB Note: Hemoptysis means that blood is being coughed up.

A pt shows up with symptoms of a chronic cough for over 6 months and recently has started to find small amounts of blood in the cough. You as a doctor notice this to be the most common type of association between cough an blood. What is it? A. TB B. Bronchitis C. Lung Cancer

B. Bronchitis

True or False. Lung cancer will usually show less amount of blood in the cough than TB.

False. Lung cancer will display higher amount of blood loss

``` What are two facts correct about wheezing? Pick 2 A. Noticeable breathing IN B. Noticeable breathing OUT C. Could be life threatening D. Associated with allergies and asthma ```

B. Noticeable breathing OUT D. Associated with allergies and asthma Note: Stridor could be LIFE THREATENING and is noticeable on breathing INWARDS

Where would you find the defect if a pt shows signs of clubbing of fingers and toes due to the affects of hypoexemia? A. Reduced arterial resistance B. Increase venous pressure

A. Reduced arterial resistance This is due to respiratory insufficiency, which causes increased cardiac output, increased blood volume, hematocrit and viscosity. Note: Increased venous pressure will lead to RIGHT HEART FAILURE

``` What are the ocular manifestations of hypoexemia, which is associated with COPD and Cystic fibrosis? A. Dusk ones of conjunctival vessels B. Dilation of conjunctival vessels C. Dilation of retinal arteries D. Dilation of retinal veins E. All of the above ```

E. All of the above.

What are the ocular manifestations related to hypoexemia, in regards to Congenital Cyanotic Heart Disease? A. Dilated Conjunctival vessels B. Conjunctival And Optic Disc edema C. Dilation of retinal veins and arteries D. Retinal hemorrhages E. All of the above

E. All of the Above

``` What is the hallmark ocular finding associated with CO poisoning? A. Cotton wool spots B. Cortical blindness C. Swollen discs D. Flame shaped hemes ```

D. Flame shaped hemes Note: Purtcher's retinopathy is a disease of acute hypoxia.

``` What are the hallmark findings in Purtcher's retinopathy? Pick 2 A. Retinal Heme's B. Vitreous Heme's C. Multiple CWS D. NFL Infarcts ```

C. Multiple CWS D. NFL Infarcts Note: The other two findings are from Terson syndrome

``` What are the hallmark findings in Terson's syndrome? Pick 2 A. Multiple CWS B. NFL Infarcts C. Retinal Heme's D. Vitreal heme's ```

C. Retinal Heme's | D. Vitreal Heme's

``` What drug is give to someone who is suffering from Altitude sickness? A. Brinzolamide B. Apraclonidine C. Acetaminophen D. Acetazolamide ```

D. Acetazolamide - Diuretic which helps treat glaucoma, epilepsy, mountain sickness and fluid retention (edema) Note: High altitude retinopathy will display retinal Heme's, dilated venues and engorged arterioles.

``` What pulmonary problem causes inflammation and obstruction of the airway, and the pt experiences coughing and wheezing? A. CPOD B. BTI C. Asthma D. Neuropathy ```

C. Asthma

True of False. Flucatisone is a steroid that controls and cures Asthma.

False.

``` What is the most common ocular complication from Asthma? A. Dry eye B. Glaucoma C. Allergic Conjunctivitis D. Posterior Sub capsular cataract ```

C. Allergic conjunctivitis

``` If a pt is on anticholinergic, what do you expect the ocular compilation to be? A. Sub capsular cataract B. Uveitis C. Hordeoulum D. Dry eye ```

D. Dry eye Note: Treatment for this type of pt would be to provide Artificial Tears

``` A pt explains that he has smoked 15 cigarettes a day for 15 years, how many "pack years" would that amount up to? A. 82, 125 B. 5,475 C. 11.25 D. 20 ```

C. 11.25 --> (15/20) x 15 Note: To calculate use the formula. (Cigarettes per day)/(20, which is the amount a pack can hold) x years the pt has reported smoking for.

``` What type of ocular drugs are contraindicated for COPD, Asthma and cardiovascular disease? A. Adrenergic Agonist B. Beta Blockers C. CAI's D. Prostaglandin Analogs ```

B. Beta Blockers`

What is the hallmark lung finding in emphysema? A. Temporary enlargement of the airspace proximal to the terminal bronchioles B. Permanent enlargement of the airspace distal to the terminal bronchioles C. Temporary enlargement of the airspace distal to the terminal bronchioles D. Permanent enlargement of the airspace proximal to the terminal bronchioles

B. Permanent enlargement of the airspace distal to the terminal bronchioles

``` What type of cataract may form when a pt has complications of emphysema and uses inhaled steroids? A. NSC B. Cortical C. Cerulean D. PSC ```

D. PSC Note: Glaucoma may occur as well due to steroid responder. Papilledema and Optic neuritis may occur as well, due to the fact COPD leads to tissue hypoxia followed by polycythemia and cyanosis with CO poisoning

``` Pneumonia is an acute inflammation of the lungs due to an infection. What would be the type of bacteria related to hospital or nursing home acquired pneumonia? A. Staph Epidermis B. Staph Aureus C. Staph Pneumonia D. Strep Pneumonia ```

B. Staph Aureus

``` What is the term when there are large amounts of dust or particulate matter in the lungs? A. Byssinosis B. Asbestosis C. Black Lung disease D. Pneumoconiosis ```

D. Pneumoconiosis Note: Causes tissue reaction and fibrosis

``` What is associated with Mesothelioma A. Byssinosis B. Asbestosis C. Black Lung disease D. Leber's Optic Neuritis ```

B. Asbestosis

``` What is associated with coal worker Pneumoniosis? A. Byssinosis B. Asbestosis C. Black Lung disease D. Beryllium disease ```

C. Black lung disease

What is the hallmark finding in cystic fibrosis? A. Insufficient excretion of mucous B. Excessive secretion C. Overactive pulmonary function D. Increased fibrotic material in the dermis of the skin

B. Excessive excretion

``` Which is the following are not ocular findings of cystic fibrosis? A. Dry eye B. Vitamin A deficiency C. Reduced dark adaption D. Reduced contrast sensitivity E. Reduced VA F. None of the above G. All of the above ```

F. None of the above Note: Vitamin A deficiency is also called XEROPHTHALMIA

``` What is the gold standard test for diagnosing sleep apnea? A. Sleep PAP B. Stress test C. EKG D. Polysomnography ```

D. Polysomnography

``` Which is the following is NOT associated Ocular findings with Sleep Apnea? A. Glaucoma B. Papilledema C. AION D. NAION E. Floppy Eyelid syndrome ```

C. AION Note: Most of these conditions are related to obesity.

``` Carcinoma of the lung is highly related too? A. Smoking B. Chewing Tobacco C. Excessive drinking of alcohol D. Breast cancer ```

A. Smoking

True or False. Symptoms arise away from the primary cancer site?

True

``` Pearly border skin lesions are usually associated with? A. Basal cell carcinoma B. Squamous cell carcinoma C. Progenitor Granuloma D. Melanoma ```

A. Basal cell carcinoma Note: Irregular shaped/pigmented = Melanoma Note: Erythematous and firm = squamous cell carcinoma

``` Your pt shows you a lesions that looks inflamed, red, scaly and itchy on the epidermis on the hand. What type of hypersensitivity would this be? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

A. Type 1 Note: This condition is called Eczema

``` What type of vitamin deficiency is associated with Seborrheic dermatitis? A. B1 B. B2 C. B6 D. B12 ```

B. Vitamin B a.k.a Riboflavin Note: Seborrheic dermatitis is common in HIV and Neurlogical disorder pts.

``` Impetigo displays a skin infection with crusting and Bullae, what is the most common type of bacteria involved? A. Staph Epi B. Staph Aureus C. Strep Pneumonia D. Strep Pyrognase ```

B. Staph Aureus -- 20% of the time

``` Which symptom in Erysiplas is common to it but not common in lupus, Rosacea or dermatitis? A. Dry eye B. Mucopurlent discharge C. Actinic Keratitis D. Fever ```

D. Fever

``` What type of rash is seen in Fifth disease? A. Finger print rash B. Nodular rash C. Slapped cheek rash D. No rash involvement ```

C. Slapped cheek rash

``` Which is the following is involved in a pre malignant skin change? A. Seborrheic Keratosis B. Actinic Keratosis C. Impetigo D. Eczema ```

B. Actinic Keratosis Note: Pink, red, scaly poorly marginated lesion on the non-sun exposed areas.

``` A malignant tumor of Keratinocytes is considered what type of carcinoma? Pick 2 A. Basal cell B. Squamous cell C. Seberrhoic cell D. Actinic cell ```

A. Basal cell B. Squamous cell Note: Bulk of tumor may be below the skin

``` What type of Sarcoma is associated with Herpes Virus 8? A. Squamous cell B. Basal C Seborrheic D. Karposi ```

D. Karposi Note: It looks like a red nodule and can surface on the conjunctiva

What is not true regarding JXA? A. Iris mass is the most common with heterochromia B. Most common etiology of hyphema in children C. Uveitis D. Most common extra-cutaneous involvement

C. Uveitis

``` What is a strawberry Nevus associated with? A. Choroidal Nevus B. Hemangioma C. Optic Neuritis D. Acne Rosecea ```

B. Hemangioma Note: With the Strawberry Nevus around the eyelids, a ptosis and amblyopia maybe accompanied with this condition.

``` What is the most common childhood orbital tumor? A. Capillary hemangioma B. Cavernous hemangioma C. Arterial hemangioma D. Choristoma ```

A. Capillary hemangioma 2 phases: Proliferation stage: Explosive growth within 3 to 6 months of diagnosis Involutional stage: 1-5 years with fibrosis fatty deposits around the blood vessels with ATROPHY and COLLAPSE of vascular spaces

``` What type is associated with Ehler's Danlos Syndrome, which is associated with ocular structures? A. Type 2 B. Type 4 C. Type 5 D. Type 6 ```

D. Type 6 (Kyphosis-scoliosis) Note: EDS is associated with a defect in COLLAGEN production and creates an extra elastic skin.

``` Which corneal layer is absent in EDS patients? A. Epithelium B. Bowman's C Stroma D. Descmet's E. Endothelium ```

B. Bowman's Note: LASIK surgery is contraindicated in these patients. Descemet's easily broken in these pt's therefore you will see Keratoconus occur.

``` Which type is only associated with Gronblad Stranberg syndrome? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

A. Type 1

``` What is the term when pinpoint bleeding occurs when scales are removed, which is associated with psoriasis? A. Auspitz Sign B. Chemosis C. CIN D. Onycholysis ```

A. Auspitz Sign Note: Onycholysis is the separation from the nail bed, painless and gradual. This finding is also associated with psoriasis

``` Keratoconjunctivitis sicca is associated with of the following conditions? A. Psoriasis B. Optic neuritis C. Dacryocystitis D. Dacryoadenitik ```

A. Psoriasis

``` Which of the following problems is associated with sausage shaped deformities of the fingers? A. Actinic Keratosis B. Otitis Media C. Psoriatic arthritis D. Rosacea ```

C. Psoriatic Arthritis Note: Also associated with Uveitis

``` What is common in Rosacea than in Lupus? A. Rhinophyma B. Hyphema C. Hypopyon D. Allergies ```

A. Rhinophyma which is tissue hypertrophy of the nose.

``` Which of the following would you consider to be safe for a pregnant woman, who is suffering from Rosacea? A. Tetracycline B. Doxycycline C. Erthromycin D. Fluoroquinoline ```

C. Erythromycin

``` In most pigment are disorder of the skin, which of the following enzyme is missing? A. Tyrosine B. Tyrosinase C. Adenine D. Glycine ```

B. Tyrosinase

``` Which condition is associated with dysphasia of the skin, found in males and dentition? A. Albinism B.Incontinentia pigmenti C. Reiter's syndrome D. Hutchinson's ```

B. Incontinentia Pigmenti Note: Most IP findings are found in the retina. There will be abnormal blood vessels, RPE mottling, Foveal hypoplasia and retinal detachment

What is the major difference between Nevus of OTA vs. Nevus of ITO? A. Pigmentation in OTA occurs on the back, whereas ITO does not. B. Pigmentation in ITO occurs on the back, whereas OTA does not. C. Nothing they are the same thing.

B. Pigmentation of ITO occurs on the back, whereas OTA does not.

``` What health issue does Iris mamillation occur in? A. Choroidal Nevus B. Stromal Nevus C. LPI D. Nevus of OTA ```

D. Nevus of OTA

``` What Autosomal Dominant condition destroys melanocytes and pts generally will have thyroid, gastric parietal cells and adrenal tissue damage? A. Nevus of OTA B. Nevus of ITA C. Vitiligo D. Myasthenia Gravis ```

C. Vitiligo

``` What is the type of hypersensitivity is Cicatricial pemphigoid associated with? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

B. Type 2

Out of the three tear layers, which of the following is not affected by Cicatricial pemphigoid? A. Lipid B. Aqueous C. Mucin

A. Lipid Note: Symblepheron and ankyloblepheron are both associated with this condition.

``` Which systemic condition is associated with skin and mucosal blisters in response to minor trauma with scarring? A. Epidermolysis bullosa B. Cicatricial pemphigoid C. Vitiligo D. Nevus of OTA ```

A. Epidermolysis bullosa Note: Mitten deformity is also a tell-tale sign of this condition

``` Which of the following systemic problem is associated with no itch and slight rubbing of skin causing exfoliation? A. Sjrogren's syndrome B. Symblepheron C. Steven Johnson D. Grave's disease ```

C. Stevens Johnson syndrome Note: Nicholsky's sign --> slight rubbing of skin causes exfoliation

``` Which of the following types of drugs that cause SJ/TEN? A. PCN and SULFA B. NSAIDS C. Anticonvulsants D. All of the above E. None of the above ```

D. All of the above

True or False. TEN survivors have a 40% chance of creating a debilitating lesion that could cause blindness.

True

``` What type of hypersensitivity is Pemphigus Vulgaris associated with? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

B. Type 2 Note: PV is a blistering disease that affects both skin and mucosa

``` What type of Encephalitis is the most common from the following list? A. Bacterial B. Fungal C. Parasitic D. Viral ```

D. Viral Note: HIV, CMV, Polio, HSV, Varicella and Mumps

``` Which type of Mosquito borne virus is involved in encephalitis? A. Zika virus B. Dengu virus C. West Nile virus D. Rabies ```

C. West Nile

``` Which of the following is not part of the triad for Meningitis? A. Stiff neck B. Agitation C. Fever D. Headache ```

B. Agitation is not part of the triad

``` What is the pneumonic for intracranial events leading to Papilledema? A. DICTATE B. UCRAP C. CANADA D. VINDICATE ```

``` D. VINDICATE V: Vascular I: Infection N: Neoplasticism D: Degenerative diseases I: Intoxication C: Congenital A: Auto immune T: Trauma E: Endocrine ```

True or False. The best way to differentiate between disc druses vs. Papilledema is to look at the vessel changes that occur by the border.

True

``` Which of the following are not ocular symptoms a pt may encounter with Papilledema? A. Central scotoma B. No decease in VA C. Normal pupils D. Enlarged blind spot ```

A. Central scotoma Note: The symptoms that are correct are associated with acute Papilledema

``` Which of the following is not associated with Pseudotumor Cerebri? A. Obesity B. Female C. Fertile D. Abnormal CSF composition ```

D. Abnormal CSF compostion Note: There are medications that cause PC as well. Know the pneumonic A-TON (Vitamin A, Tetracyclines, Oral Contraceptives and Nalidixic acid)

``` What is a common side effect of Pseudotumor Cerebri when using Acetazolamide? A. Peri-oral paresthesias B. Limbo-peritoneal shunt C. Ventriculitis D. Low risk of meningitis ```

A. Peri-oral paresthesias

Which cells are associated with central myelination of the nervous system? A. Astrocytes B. Oligiodendroglia C. Schwann cells

B. Oligiodendroglia Note: MS is a common demyelination disease

Myelination of the peripheral nervous system is conducted by? A. Astrocytes B. Oligiodendroglia C. Schwann cells

C. Schwann cells Note: Guillain Barre is a common demyelination of the peripheral system

``` What is Uhtoff's sign? A. Electric shock-like pain when neck is flexed B. Excess heat increases symptoms C. Decrease in water retention D. Increase in migraine headaches ```

B. Excess heat increases symptoms Note: Uhtoff's sign is associated with MS

``` What is L'hermitte sign? A. Electric shock-like pain when neck is flexed B. Excess heat increases symptoms C. Decrease in water retention D. Increase in migraine headaches ```

A. Electric shock-like pain when neck is flexed Note: This is associated with MS

``` Which condition only affects the eyes and spinal cord? A. Devic's Disease B. MS C. Charcot-Marie-Tooth D. Pseudotumor Cerebri ```

A. Devic's disease - Neuromyelitis Optica Tx: Corticosteroids, Immuno-modulators

``` A clinical manifestation of MS is Optic Neuritis. Which region of the optic nerve is impacted? A. Intraorbital B. Intracranial C. Retrobulbar D. Intracanilicular ```

C. Retrobulbar Note: Pendular nystagmus is also associated with MS as well

What is Charcot-Marie-Tooth disease? A. Build up of CT in the nerve axon/myelin B. Build up of lysosomes in the nerve axon/myelin C. Decrease in axon and myelin in the nerve D. Buildup of proteins in nerve axon/myelin

D. Buildup of proteins in nerve axon/myelin Note: Pt will display impaired accommodation, tonic pupils, reduced ERG, unit or bi lateral ON involvement and significant pigmentary retinopathy

``` What type of hypersensitivity is MG? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

B. Type 2 Note: Episodic muscle weakness and easy fatigability. AcH receptors are malfunctioning

``` What are Phacomatoses most comprised of? A. Divitalized tissue B. Vessel Attenuation C. Hamartomas D. Skin cancer ```

C. Hamartomas Note: Abnormal proliferation of mature cells normally found in an involved organ

``` Ocular toot Apraxia is associated with what condition? A. MS B. MG C. TB D. Ataxia telangiectasia ```

D. Ataxia telegiectasia

``` Which condition is associated with Port wine stains? A. Tay-Sach's syndrome B. Leber's OHN C. Sturge Weber syndrome D. Down syndrome ```

C. Sturge Weber syndrome Note: For it to be called SYNDROME, you need 2 out of the 3: Dacial Angiomas (port wine stain, insulate real choroid all hemangioma and congenital glaucoma). To treat glaucoma pts with Sturge Weber syndrome, you must give them aqueous suppressants.

``` Which chromosome is associated with NF1? A. Chromosome 5 B. Chromosome 7 C. Chromosome 17 D. Chromosome 21 ```

C. Chromosome 17

``` Which of the following is not a brain tumor common in NF1? A. Optic pathway glioma B. Brain stem glioma C. Schwanoma D. Plexiform neuroma ```

D. Plexiform neuroma

``` Which orbital bone is associated with NF1? A. Lesser wing of sphenoid B. Palatine C. Greater wing of sphenoid D. Lacrimal ```

C. Greater wing of sphenoid

Which type of NF may cause an s-sign? A. NF 1 B. NF 2 C. NF 3

A. NF 1

``` At what age does an individual with ON glioma can be diagnosed by? A. 3 years old B. 4 years old C. 5 years old D. 6 years old ```

D. 6 years old

``` Which of the following are associated with NF1 - Juvenile pilocystic astrocytomas? A. Enlarged optic foremen B. Proptosis C. Visual loss D. Optic Atrophy E. Disc Edema F. All of the above ```

F. All of the above

``` Which of the following is a significant NF1 finding in the retina? A. Optic never hypoplasia B. RPE atrophy C. Myelinated nerve fibers D. Unmyelinated nerve fibers ```

C. Myelinated nerve fibers

``` What is neuroma is NF2? A. Acoustic Neuroma B. Retinal Neuroma C. Cerebral Neuroma D. Peri-dontalar Neuroma ```

A. Acoustic Neuroma

``` What of the following are pathognomonic for Tuberous Sclerosis? A. Cafe Au lait spots B. Ash leaf macules C. Cranberry lesions D. Mulberry lesions ```

B. Ash leaf macules | D. Mulberry lesions

``` Which type of syndrome is associated with Arterio-Venous Malformation of the midbrain? A. Sturge Weber syndrome B. Tay Sach's syndrome C. Wyburn Mason syndrome D. Hamartoma syndrome ```

Wyburn Mason syndrome

``` Which type of cataract is associated with Myotonic dystrophy? A. Cerulean B. PSC C. Christmas tree D. NSC ```

C. Christmas tree

Which of the following dystrophies is the most common and most severe muscular dystrophy? A. Myotonic B. Ducehnne C. Becker Musclar

B. Ducehnne - shows reduced ERG

Unsanitary administration of drugs can lead to with ocular condition. A. Internuclear Ophthalmoplegia B. HSV C. HSK

A. Inter nuclear Ophthalmoplegia

``` What type of bacteria can cause endocarditis due to drug abuse? A. Strep Pneumonia B. Strep Pyrognase C. Staph Epi D. Staph Aureus ```

D. Staph Aureus

True or False. During acute Heroin overdose the pupils will dilate.

False. Pupils will become miotic, flushing and itching are also associated symptoms. Note: During withdrawal you will see a dilated pupil

True or False. Vertical gaze nystagmus will occur with progressive addiction to anxiolytics.

False. Horizontal nystagmus will occur, with miosis as a secondary condition.

``` Which drug will exacerbate MG? A. Cocaine B. Heroin C. Marijuana D. Crystal Meth ```

A. Cocaine Note: Blurred vision, intraretinal Heme's and CRAO occur due to increased blood pressure caused by Cocaine

``` With hallucinogen's, which CN palsy is common? A. CN 3 B. CN 4 C. CN 7 D. CN 6 ```

D. CN 6 - usually bilateral

``` Which type of cells are lost in T1DM in the islets of langerhans? A. Alpha cells B. Beta cells C. Sigma cells D. Delta cells ```

B. Beta cells

What is the name for the condition associated with DM but displays velvet structures on an obese individual? A. Acantheomeba B. Acanthosis myelitis C. Acanthosis nigricans

C. Acanthus is nigricans

``` What is the largest factor in diagnosing T2DM? A. Height B. Gender C. Race D. Weight ```

D. Weight --> Obesity is a good indicator if the individual may have these issues.

``` What should be the fasting blood glucose equal to or higher than ? A. 3 mmol/l B. 4 mmol/l C. 6 mmol/l D. 7 mmol/l ```

D. 7 mmol/l Note: Random blood glucose equal to or greater than 11.1 mmol/l

What is the goal you want for diabetic pts, percentage wise? | A.

``` Which type of glaucoma drug can mask the signs of hypoglycemia? A. CAI's B. PG's C. Beta Blockers D. Pilocarpine ```

C. Beta blockers

What type of inflammation will occur with Ankylosing Spondylitis? A. Granulomatous B. Non Granulomatous

B. Non-Granulomatous Note: Uveitis is associated with AS.

``` What is the best way of know that a pt has Ankylosing Spondilitis? A. Blood work B. Genetic work up C. X-Ray D. CT scan ```

C. X-Ray Note: "Bamboo Spine" will be seen

``` What type blood vessels are impacted in GCA? A. Small Veins B. Large Veins C. Small Arteries D. Large Arteries ```

D. Large Arteries Note: Medium sized arteries is generally Polyarteritis Nodosa

``` Which of the following layers is affected during GCA of Large Arteries? A. Basement Membrane B. Intima C. Media D. Externa ```

C. Media

``` Which is the following is the most common symptom in GCA pts? A. Jaw claudication B. Headache C. Anorexia D. Fatigue ```

B. Headache Note: Fever is also associated with GCA

``` Which type of GCA occurs in 21% pts with ocular manifestations but no systemic symptoms? A. Acute GCA B. Chronic GCA C. Degranulation GCA D. Occult GCA ```

D. Occult GCA

Which Ocular arteries are "Almost always" involved in GCA? A. Conjunctival arteries B. MACI C. Posterior Ciliary Arteries

C. Posterior Ciliary Arteries

``` Which of the following is not an important finding of Polyarteritis Nodosa? A. Peri-Arteritis B. BRVO C. CRAO D. CWS ```

D. CWS Note: These are all symptoms and signs of Polyarteritis but CWS is not as pertinent.

``` What type of collagen is associated with Relapsing Polychondritis? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

B. Type 2 Note: It is associated with sclera and cartilage and affects SMALL VESSELS. Floppy ears and saddle like nose are associated with this condition.

``` What is not part of the Susac Syndrome Triad? A. BRAO B. CRAO C. Encephalopathy D. Hearing loss ```

B. CRAO

``` Which lab test are you looking for when trying to find out if they have RA? A. CBC B. ABC C. RF D. EF ```

C. RF (Rhuematoid Factor)

``` A young girl, 6 year old, is brought into your clinic. She has a fever and complains of pain in the eye and is worse when light is shown into her eye. She also complains of hip and lower back pain. These symptoms have occurred since she has been born? A. Type 1 RA B. Type 1 JRA C. Type 2 RA D. Type 2 JRA ```

D. Type 2 JRA Note: The pain in her eye she is complaining of is IRITIS and the lower back pain is due to SACROILLIACITIS

``` Which of the following is not part of Still's Triad? A. Cataract B. BRAO C. Uveitis D. Band Keratopathy ```

B. BRAO Note: Pneumonica is CUB gets JRA Type 1.

``` Which type of immune cell will be more prominent with pts with Sjögren's syndrome? A. Neutrophils B. Basophils C. Eosinophils D. Lymphocytes ```

D. Lymphocytes

``` What is the hallmark of Lupus (SLE)? A. Dry eye B. Uveitis C. Scleritis D. Keratoconjunctivitis sicca ```

A. Dry eye Note: Lupus Retinopathy are the two major hallmark findings of SLE

1) Necrotizing Granulomatous lesion of the respiratory tract 2) Focal necrotizing Vaculitis 3) Glomerulonephritis With this triad in mind, what disease am I describing? A. SLE B. Purcher's C. RA D. Wegener's

D. Wegener's Granulomatosis

``` What is scleroderma? A. Loosening of the skin B. Hardening of the skin C. Pulmonary hypotension D. Wernicke's syndrome ```

B. Hardening of the skin Note: When thinking of Scleroderma, RA or JRA, always think of Raynaud's phenomenon as well.

``` Which of the following is are "more" frequent ocular findings in fetal alcohol syndrome? A. Optic Nerve hypoplasia B. Retinal vessel tortuosity C. Anterior segment anomalies D. Microophthalmos ```

A. Optic Nerve hypoplasia B. Retinal vessel tortuosity Note: These are all findings of FAS but the two listed above are the most common.

``` Which of the following signs of Anaphylatic reaction requires the most aggressive treatment? A. Respiratory signs B. Cardiovascular signs C. Dermatological signs D. Ocular signs ```

A. Respiratory signs Quiz 2 question

``` If a person has been smoking for 10 cigarettes per day for the last 20 years, how many pack years has he smoked? A. 5 B. 10 C. 20 D. 25 ```

B. 10 (Number of cigarettes per day/20) x years as a smoker = pack years 10/20 x 20 = 10 years Quiz 2 question

``` Which of the following is not the ocular manifestation of Hypoexemia? A. Constriction of conjunctival vessels B. Cotton wool spots C. Optic Disc Edema D. Striate Retinal Hemorrhages ```

A. Constriction of conjunctival vessels Quiz 2 question

``` Which of the following immune reaction predominantly involved in hyperACUTE graft rejection? A. Type 1 B. Type 2 C. Type 3 D. Type 4 ```

B. Type 2 Note: The question is involving ACUTE, which is usually Type 2. If it was chronic then it would Type 4. Blood transfusion is also a Type 2 reaction. Quiz question 2

80 YO male presents with sudden onset of new headache with jaw claudication and his PCP ordered ESR before referring pt to you and ESR is 60mm/her, what is the next step in management? A. Order C-reactive proteins B. Refer for temporal Biopsy C. Start high dose steroids and refer for temporal artery biopsy D. Observe pt for change in symptoms over next 24 hours

C. Start high dose steroids and refer for temporal artery biopsy Quiz 2 question

Midterm Exam Flashcards

(200 cards)