systemic health -optoprep

Question 1

lower TSH = ____ thyroid

Answer 1

lower TSH = hyperactive thyroid

Question 2

higher TSH = ____thyroid

Answer 2

higher TSH = underactive thyroid

Question 3

thyrotoxicosis

Answer 3

elevated circulating thyroid hormone. due to: hyperthyroidism, thyroid cancer, pituitary adenoma, drugs, presence of iodide

Question 4

all hyperthyroidism is caused by _____ disease

Answer 4

all hyperthyroidism is caused by Graves disease

Question 5

graves disease is characterized by presence of ______

Answer 5

graves disease is characterized by presence of antibodies (thyroid stimulating immunoglobulins TSI)

Question 6

how does TSI work in Graves disease

Answer 6

TSI bind to and activate TSH receptors on the thyroid gland. Mimicks TSH

Question 7

resulting cause of TSI
(anatomical changes)

Answer 7

enlarged thyroid gland (goiter) and increased amount of T3/T4

Question 8

what findings confirms Graves disease?

Answer 8

presence of Thyroid stimulating immunoglobulins

Question 9

hashimoto disease is another autoimmune condition where ____ occurs

Answer 9

hashimoto disease is another autoimmune condition where hypothyroidism occurs

Question 10

what happens to thyroid cells in hashimoto

Answer 10

thyroid cells are destroyed

Question 11

when thyroid cells are destroyed in Hashimoto/hypothyroidoism, what is the thyroid’s response

Answer 11

releases stored supplied of thyroid hormones triggering transient periods of hyperthyroidism

Question 12

what is detected in bloodwork to confirm Hashimoto

Answer 12

elevated anti-thyroid peroxidase (anti TPO) antibodies in the blood

Question 13

Hershel, what is upper limit of normal for Caucasions/Black?

Answer 13

22mm/24 mm

Question 14

TYPE __
if a test fails to detect the disease that it was designed to detect in a patient that actually has the disease.

Answer 14

type 1 error

Question 15

people living in _____ would have greater chance of developing MS

Answer 15

northern hemisphere

Question 16

most commonly encountered VF defect for optic neuritis

Answer 16

altitudinal defect

Question 17

which systemic diseases most often correlate with BRVO

Answer 17

DB, HTN

Question 18

which area of the retina is most commonly affected by brvo?

Answer 18

superior nasal

Question 19

interferon & ribavirin are treatments for

Answer 19

Hepatitis C

Question 20

retinopathy associated with use of interferon therapy for trx of systemic conditions like hepatitis c

Answer 20

hemorrhages/CWS in area surrounding nerve

– unilat/bilat.

Question 21

if a pt starts interferon therapy for hepatitis c, what is important to note if there are retinal findings?

Answer 21

– retinal screening before initiating therapy
– other systemic health conditions like HTN & DM
- check BP and A1c to confirm if retinopathy if from therapy or sys conditions

Question 22

cotton wool spots : layer and why

Answer 22

NFL infarct
B/C of capillary non-perfusion

Question 23

if a pt undergoing interferon therapy for hep. C has CWS but is asymptomatic, what would you do?

Answer 23

– management is tailored to pt symptoms
– if asymptomatic, prescribing DR will continue w. interferon therapy
– symptomatic: stop therapy or reduce dosage of treatment
–either way: – MONITOR closely

Question 24

primary route of hepatitis C infection

Answer 24

IV drug use

Question 25

primary route of hepatitis A infection

Answer 25

object is taken in by mouth by objects contaminated with infected fecal matter -- also improper food handling (not washing hands)

Question 26

primary route of hepatitis B infection

Answer 26

blood, semen, bodily fluids of infected person enter body of another person : needle stick, direct contact w. blood or open sores, sexual contact, needle sharing

Question 27

what is this an image of

Answer 27

palisades of vogt

Question 28

describe palisades of vogt

Answer 28

white, radial structures around the cornea inferior>superior corneal epithelial stem cells

Question 29

limbal girdle of vogt

Answer 29

white crescent shaped corneal opacities (benign findings)

Question 30

schwabe's line is the anatomical line that indicated termination of _____ ____

Answer 30

schwabe's line is the anatomical line that indicated termination of Descemet's membrane

Question 31

sampaoeli line shows abundance of pigments at ______ ___. seen in conditions: ______ & ________

Answer 31

sampaoeli line shows abundance of pigments at Schwabe's line. seen in conditions: pseudoexfoliation syndrome and pigment dispersion glaucoma

Question 32

palisades are important anatomy for

Answer 32

housing blood vessels, nerves, connective tissue, lymphatics , stem cells found there

Question 33

proliferative retinopathy for sickle cell: stage1 : stage 2:

Answer 33

proliferative retinopathy for sickle cell: stage1 : occluded periph. arterioles stage 2: periph Arteriovenous anastomoses

Question 34

proliferative retinopathy for sickle cell: stage 3: stage 4:

Answer 34

stage 3: neovascularization of the AV anastomoses stage 4: vitreous hemorrhage -- (+) neovasc. refer for laser or observe until vitreous heme

Question 35

proliferative retinopathy for sickle cell: stage 5:

Answer 35

proliferation of fibrovascular tissue & rhegmatogenous or tractional RD

Question 36

ocular signs of sickle cell disease

Answer 36

-- tortuous retinal veins -- sea fan neovascularization -- sclerosis/hardening od peripheral retinal veins -- black sunburst -- salmon patch -- vitreous hemorrhage -- RD

Question 37

black sunburst appearance

Answer 37

oval/round retinal lesion made of RPE cells

Question 38

salmon patches

Answer 38

subretinal or intraretinal hemorrhages