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2. Dx Stains > stains > Flashcards

stains Flashcards

1
Q

what are the 5 diagnostic stains?

A 
fluorescein
rose bengal
indocyanine green*
lissamine green
fluramene**
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2
Q

Which diagnostic stain is NOT used by optometrists, but is used often by ophthalmologists?

A

indocyanine green (IGGY)

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3
Q

Which diagnostic stain is a COMBINATION stain; it contains 2 products.

A

fluramene

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4
Q

which is NOT a property of diagnostic stains?

a. serve to enhance contrast
b. has special affinity for ocular tissues and cells.
c. acidic, basic, or neutral
d. chromatic differentiation depends on distinct absorption and emission spectrums.

A

acidic, basic, or neutral.

this is wrong! stains are only acidic or basic. they are NOT neutral!!!

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5
Q

T/F: Diagnostic stains are not neutral, therefore they can irritate the patient’s eye. light which is not absorbed is reflected, and we see what is reflected.

A

true!!!!

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6
Q

T/F: fluorescein absorbs 465nm (cobalt blue) and 493 nm in blood.

A

false!! 493 = cobalt blue and 465 in blood.

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7
Q

T/F: fluorescein is ionized in tears, is not lipophilic, therefore it does not readily enter the cornea.

A

true

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8
Q

fluorescein is a natural pigment found in organisms, such as _________. we are worried about this because it can drill a hole through CL’s.

A

pseudomonas

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9
Q

in what case can fluorescein enter the cornea?

A

when the cornea is NOT completely intact, ie. when the cornea is dry. Tight junctions are broken and fluroscein can leak between the gaps, staining the cornea.

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10
Q

T/F: Aqueous humor has basic pH.

A

true

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11
Q

When fluorescein on the surface of the eye appears as a different color over a lesion (ie. when aqueous humor leaks out) this is a “positive ______ sign”.

A

positive seidel sign

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12
Q

What is the order of least quenching to most quenching anesthetic?

a. Benzoalkonium chloride (BAC), benoxinate < proparacaine < tetracaine.
b. tetracaine < proparacaine < BAC/benoxinate.

A

benzoalkonium chloride (BAC) benoxinate < proparacaine < tetracaine

BB<p><T

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13
Q

T/F: quenching refers to any process that increases the fluorescence intensity of a substance.

A

false. any process that DECREASES fluorescence intensity.

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14
Q

what kind if filter should you use to filter out 520nm light? and where do you put it?

A

Wratten filter. You should put the filter in front of the receiving lens, so that it allows you to see fluorescein in great contrast. DO NOT PUT FILTER IN FRONT OF THE COBALT BLUE FILTER!!!!!!!!

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15
Q

T/F: quenching can be problematic because it affects how well we’re able to see contrast. if anesthetic is on the eye, it can cause excited fluorescein to go back to ground state without emitting 493 nm.

A

true

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16
Q

T/F: due to quenching, fluorescence intensity is diminished and false positives may result

A

false!!

false negatives may result.

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17
Q

what is punctate keratitis?

A

dry eye!

18
Q

RGP lenses may block UV from a burton lamp, thus a wratten 47 filter is required over the light source.

A

true

19
Q

if you see fluroscein, that means it is trapped under the lens, and that the lens is NOT in contact with the eye. the lens has great EDGE LIFT

A

true

20
Q

what is methyl violet?

A

aniline dye used in indelible pencils. it is toxic!

21
Q

what does a sodium fluorescein stain evaluate??

A

can distinguish herpes simplex virus (HSV) vs. herpes zoster virus.

22
Q

if you see bulb-like ends on a fern-like filament, what kind of viral keratitis is this?

A

herpes simplex virus (not zoster)

23
Q

Quenching causes an ___________ of intraocular pressure evaluation with applanation tonometry.

a. overestimation
b. underestimation

A

underestimation

24
Q

stargardt’s disease is a genetically inherited juvenile macular degeneration that develops between what ages?

A

6-12 years old

leads to buildup of lipofuscin

25
Q

high molecular weight (HMW) formulas of fluorescein, such as fluoresoft and softglo, are safe for Soft CL wearers.

A

true

26
Q

what are some common adverse reactions of fluorescein?

a. sting
b. irritation
c. redness
d. dermatitis
e. all of the above

A

all of the above

27
Q

what diagnostic stains (x2) stain mucus or devitalized (dead) tissue?

A

rose bengal and lissamine green

28
Q

rose bengal is viewed under white light OR red-free filter (will appear dark/black).

A

true

29
Q

Because rose bengal is photoreactive, it causes RBCs to lyse, and has been used to treat cancer.

A

true

30
Q

rose bengal and lissamine green provide longer staining and higher contrast compared to fluorescein.

A

true

31
Q

rose bengal is an ______-based deriv. of fluorescein

A

iodine based

32
Q

Rose bengal stains edges while fluorescein stains centers.

A

true

33
Q

keratoconjunctivitis sicca (KCS), superior limbic keratoconjunctivitis (SLK) and herpes simplex/zoster viruses can all be stained with which diagnostic stain?

a. fluorescein
b. rose bengal
c. lissamine green
d. rose bengal and lissamine green
e. rose bengal only

A

rose bengal and lissamine green!

34
Q

what is the adverse effect of rose bengal? and how to alleviate it?

A

rose bengal is a pronounced irritant! put an anesthetic before administering rose bengal to prevent the burning sensation.

35
Q

T/F: lissamine green offers better contrast than rose bengal in red inflammed eyes, and it is longer lasting than rose bengal and does not cause irritation.

A

true!!!!

36
Q

which is viewed under white light or red filter?

a. rose bengal
b. lissamine green
c. fluorescein

A

lissamine green

recall that rose bengal is viewed under white light or red-free (green) filter.

37
Q

Why do doctors prefer lissamine green over rose bengal?

A

because lissamine green burns less (not as irritating)

38
Q

how does lissamine green come as?

A

pretreated sterile strip 1.5mg

39
Q

what is unique about fluramene?

A

it is a combination stain: lissamine green + fluorescein. (it is expensive, it is not available at the ECC. ) it does simultaneous corneal and conjunctival staining.

40
Q

which of the following is not true about indocyanine green?

a. commonly used for IV administration.
b. peak absorption is for long wavelengths (790nm)
c. can measure how quickly the heart is contracting.
d. not water soluble
e. stains the anterior surface of lens in capsulorrhexis

A

d. it IS water soluble

41
Q

what are the contraindications for indocyanine green?

A
  1. iodine/shellfish allergy
  2. uremia/hepatology (urea in the blood)
  3. pregnancy/lactation
42
Q

T/F: indocyanine green contains sodium iodide.

A

true, just like rose bengal!

So do not use these 2 diagnostic stains if patient is allergic to shellfish.

2. Dx Stains (1 decks)

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