fundamentals questions.txt

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rontongbai
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fundamentals questions.txt
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2013-03-27 18:27:29
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fundamentals
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  1. what medication can you give for accomodative esotropia
    phosphodine iodide
  2. what are side effects of chronic use of phospholine iodide and how can you prevent it?>
    iris cyst formation; prevent by co administration of phenylephrine
  3. what cells span from ILM to ELM
    muller cells
  4. what do muller cells do
    provide nutritional and structural support
  5. where are nuclei of muller cells located
    inner nuclear layer
  6. what problems does rubella in first trimest give? Second trimester?
    "1st trimester: cataracts, glaucoma (if you get cataracts, you never get glaucoma), deafness, cardiac problems; 2nd trimester: salt and pepper fundus"
  7. what drugs can prevent prostaglandin mediated pupillary meiosis
    topical NSAIDS
  8. what's the Na and K composition of the lens
    "Na low, K high; adenoside triphosphatase pumps Na out and K in (current comes in at ant and posterior capsule and out through equatorial region)"
  9. what is the blood supply to the nerve fiber layer portion of ON? Prelaminar and laminar portion? Retrolaminar portion? Proximal portion of intraorbital ON? Distal portion? Intracanalicular portion?
    central retinal artery; short posterior ciliary arteries; pial vessels and short posterior ciliary arteries; central retinal artery; ophthalmic artery
  10. what is avg depth of aC
    3mm
  11. what is nevus of ota
    ipsilateral dermal melanocytosis in patients with ocular melanocytosis
  12. what type collagen is stroma? What percent of cornea dry weight is it?
    type 1; 70% (think I storm)
  13. what are the layers of bruchs membrane
    "inner basal lamina of RPE, inner collagenous zone, elastic fibers, outer collagenous zone, basal lamina of choriocapillaris (BCECB)"
  14. is lipid solubility or water solubility more important for drug penetration of cornea
    lipid solubility to penetrate lipophilic epithelium
  15. what is the smallest overall muscle
    IO
  16. what light is most harmful to retina; what chemicals act as blue filters
    "blue light leads to formation of phototoxic compound A2E which damages cytochrome oxidase and leads to RPE and photoreceptor death (mechanism of dry amd), carotenoids lutein and zeazanthin act as blue filters"
  17. what chemicals stimluate accomodation?
    acetylcholine
  18. what CN has the longest course
    IV (4 goes 4ever)
  19. what subnuclei of CN III is fused and supplies axons to muscles of both eyes
    levator subnuclei
  20. what drugs are indirect cholinergics? Direct cholinergics?
    pyridostigmine and phospholine iodide; pilocarpine
  21. what part of ciliary body makes aqueous
    nonpigmented epithelium
  22. what layer is responsbile for outer retinal blood barrier
    RPE
  23. mutations in pax6 are responsble for what diseases
    "peter's anomaly, axenfelds anomaly, aniridia, posterior embryotoxon, congenital cataracts"
  24. what muscle only has one anterior ciliary artery
    lateral rectus
  25. what nerves synapses on ciliary ganglion
    parasympathetics
  26. what are the 3 orders of sympathetic chain
    1. hypothalamus to ciliospinal center of Budge-Waller 2. ciliospinal center to superior cervical ganglion 3. superior cervical ganglion to iris dilator muscle
  27. what type of collagen is lens capsule
    4 (lens capsule is basement membrane of the lens epithelium)
  28. what pathway produces most energy from glucose metabolism in cornea? Most glucose?
    TCA cycle (less glucose but more efficient); HMP shunt
  29. what is the uveosclearl drainage pathway of aqueous
    across ciliary body and into supraciliary space
  30. where do anterior ciliary arteries arise
    ophthalmic artery
  31. what synthesizes descement's membrane
    endothelium
  32. when does tear production first occur
    3-6 weeks after birth
  33. what do goblet cells make
    mucin
  34. what syndrome do you think of with b/l CHRPE and what do you worry about
    "gardner's syndrome: (aka FAP), colon cancer"
  35. what molecule is regenerated in visual cycle
    "light sensitive molecule of ""phototransduction"" 11-cis retinal (derivative of vit A) is regenerated for use by photoreceptors"
  36. what is the process of phototransduction
    converts light energy into electrical signals by the following steps 1. photon strikes 11-cis retinal causing it to isomerize into all-trans retinal 2. activation of covalently attached opsin molecule which then activates multiple G-protein mediated signaling pathways 3. closing of ion channels that prevent influx of Na and Ca 4. photoreceptor outer segment membrane becomes polarized
  37. when does the dorsal ophthalmic artery become ophthalmic artery
    6 week of gestation
  38. where is the ora serrata closest to the limbus
    nasally
  39. wahts the most common site of rupture in the sclera from blunt trauma
    "superonasal (other sites are the arc parallel to the limbus in the quadrant opposite site of impact, insertion of rectus muscles, and equator)"
  40. what is the areds formualation
    "vit C 500mg, vit E 400 IU, cupric acid 2 mg, beta-carotene 15mg, zinc ozide 80mg (think 2,15,80,400,500)"
  41. what tissue is keratocytes derived from embryoloigcally
    neural crest cells
  42. what is inheritance of Lowe's syndrome
    x-linked recessive (rob Low is an seX deviant)
  43. what do patietns with lowe syndrome present with
    "glaucoma, cataracts, renal tubular dysfunction, mental retardation"
  44. what do you not give AACG and why
    pilo 4% because it can shift iris lens diaphragm forward
  45. what is the most common nucleotide deletion position of lebers
    "11778, which leads to abnormatliy in NADH dehydrogenase in mitochonrdia"
  46. what are 3 classic findings of lebers
    "elevation of the disc, peripapillary telangiectasia, retinal arteriolar tortuosity"
  47. what anesthetic should you avoid for ruptured globe repair and why
    "succinylcholine, which can lead to depoloarization of EOMs"
  48. what layer of the retina is watershed between choriocapillaris and blood supply from retinal vessels
    inner nuclear layer
  49. what is the largest number of axons in optic nerve and what week do you get it? What does it stay at and what week do you get it?
    "3.7 million at week 16, pruned to 1.1 million at week 33 and stays at that number"
  50. what are unique se's of epinephinre for glaucoma patients
    "adenochrome deposits (black deposits in conj), which represent oxidation reactions of epinephrine; cystoid maculoopathy in aphakic patients"
  51. what are axenfeld loops
    ciliary nerves visible in the sclera near the limbus
  52. what are cloquet's canals
    remnant of the hyaloid vasculature between the lens and the optic nerve head
  53. what is mittendorf's dots
    "small focal opacity in the nasal aspect of the posterior pole of the lens, associated with regression of the hyaloid vasculature"
  54. what lymph nodes drain lateral eyelid? Medial eyelid
    superficial preauricular lymph nodes; submandibular nodes
  55. "what are signs of parasympathetic hyperactivity (from pesticide poisoning, edrophonium overdosing)"
    "DUMBELLS: diarrhea, urination, miosis, bradycardia, bronchoconstriction, emesis, lacrimation, salivation, sweating, secretion"
  56. "what is antidote for parasympathetic hyperactivity (from pestide poisoning, edrophonium overdosing))"
    atropine or pralidoxime
  57. what layer of the iris does the nonpigmented layer of the ciliary body (which makes aqueous) corresopnd? What embryonic layer of optic nerve?
    pigmented posterior layer of iris; inner nonpigmented layer of optic nerve
  58. what are 3 GAGS found in cornea stroma
    "keratan sulfate, chondroitin sulfate, dermatan sulfate"
  59. what type of drug is cyclogyl
    antichonlinergic (accomdoation and mydriasis)
  60. fibers from which CN III subnuclei cross to innervate contralateral muscle
    superior rectus
  61. what are the 3 roots that supply the ciliary ganglion
    "sensory root from nasociliary branch of CN V(1), motor root from inferior division of CNIII (which innervates IO), sympathetic root"
  62. what is the longest to shortest duration of action of cycloplegics
    atropine > scopolamine > homatropine > cycloplentolate > tropicamide > phenylephrine
  63. what does the white zone overly in the surgical limbus (which consists of anterior blue zone and posterior white zone)
    trabecular meshwork
  64. how many diopters of power does K provide
    43.25D of the 60D refracting power of the eye
  65. what is the avg volume of vit cavity? Just the vit? AC? Posterior chamber?
    "5-6 mL, 4 mL, 200 uL, 60 uL"
  66. what layers of the lateral geniculate body receive fibers from the ipsilateral optic nerve?
    "2,3,5"
  67. what patients would hate pilocarpine 1% and why
    young plano or myopic patients because pilocarpine induces accomodation and young people have ample accodomative reserve and thus become more myopic
  68. how are cells of the nonpigmented and pigmented epithilum of ciliary body arranged?
    apex to apex
  69. where is the germinative zone of the lens epithelium
    "pre-equatorial region, cells divide here and migrate to equator where they become lens fiber"
  70. where is the defect in peter's anomaly?
    descemet's membrane and endothelium
  71. how does lidocaine work
    blocks nerve conduction by blocking axonal sodium channels
  72. what do the 3 waves of ingrowth of neural crest cells form in the anterior chamber
    1st wave: double layered endothelium 2nd wave: iris and pupillary membrane 3rd wave: corneal stroma
  73. what cells do TM come from
    neural crest cells
  74. what gives rise to schlemms canal
    small plexus of venous canaliculi from the mesoderm
  75. what is weil-marchenasi syndrome
    "ectopia lentis, joint stiffness, heart defects, branchycephaly (broad head), microspherakia"
  76. what is the primary metabolic substrate of cornea and where does it come from
    "glucose, 90% aqeous, 10% from tears"
  77. what CN not affected by retrobulbar lidocaine
    CN IV (outside muscle cone) and VII
  78. how many vortex veins are there
    7-Apr
  79. describe the cycle of rhodopsin
    11-cis-retinaldehyde is photolyzed in photoreceptors to 11-trans-retinaldehyde. The 11-trans-retinaldehyde is transported to the RPE that then recycles 11-cis -retinaldehyde
  80. what light is filtered out by cornea and abscorbic acid in the aqueous
    UVB (<320 nm)
  81. what light is not filtered out by cornea and penetrates deeper into lens
    "UVA (320-400nm), generates oxygen free radicals and insoluble protein formation"
  82. what chemical is found in young people that is a major oxygen scavenger in the lens and diminishes with age
    glutathion (GSH)
  83. what layer forms temporal portion of sclera? Rest of sclera?
    mesoderm; neural crest
  84. what nerve innerves cornea and describe its cours
    "V1 -> nasociliary nerve > posterior long ciliary nerve -> iris, cornea, ciliary muscle"
  85. name a muscarinic agonist and how does it lower IOP
    "pilocarpine; lowers IOP by causing contracture of the longitudinal ciliary muscles which causes tension on scleral spur (where it is attached), which opens TM"
  86. what embryological tissue forms lacrimal drainage system
    surface ectoderm
  87. how many short posterior ciliary nerves and short posterior ciliary arteries enter the globe around the nerve? How many long posterior ciliary nerves and arteries?
    10;20;2;2
  88. describe the y sutures
    there is a anterior Y and a posterior inverted Y
  89. what is the volume of adult eye
    6.5-7ml
  90. what is willbrand's knee
    "inferonasal retinal ganglion cell axons serving the superotemporal field decussate in the optic chiasm as they track posteriorly; before entering the contrallateral optic tract, they loop anteriorly for a short segment in willbrand's knee into the contralateral optic nerve "
  91. where do older lens fibers go as new fibers are formed
    pushed to the center like a tree
  92. what is the bow region of the lens
    "at the equator, near lens fibers elongate and their nuclei line up in the bow region, lens at this time express major intrinsic protein (MIP) which is presumably correlated with elongation of the cell"
  93. what molecule is found in aqueous humor at concentrations 10-50x higerh than plasma
    ascorbic acid (vit C)
  94. the 3rd order neuron of sympathetic chain travels with what CN in the cavernous sinus
    VI (for a few mm)
  95. what percent have cilioretinal artery
    15
  96. which lens crystallins have largest size? Smallest size?
    "alpha, gamma"
  97. whats the most common ocular abnormality of FAS
    optic nerve hypoplasia
  98. rubella infection in 1st trimester causes what abnormalities? Second trimester?
    "1st: cataracts, also deafness and cardiac 2nd: salt and pepper fundus"
  99. describe cataracts seen with rubella
    pearly white nuclear opacifications
  100. what are 3 layers of TM
    "uveal, sclerocorneal, juxtacanalicular"
  101. "what mutation is associated with aniridia, posterior embryotoxon, peters anomaly, axenfeld anomaly, congenital cataract "
    pax6
  102. what glands do aprocrine hidrocystomas arise from
    glands of moll (molly is a sweaty ape)
  103. what glands produces reflex tears
    lacrimal gland
  104. what are the 3 stages of embryologic development of vitreous
    "primary vitreous: hyaloid artery, vasa hyaloidea propia, some mesenchymal cells, tunica vasculosa lentis; secondary vitreous at 9th week replaces primary vitreous (remnants of primary vitreous are cloquet's canal, mittendorf's dot, bermeister's papillae), tertiary vitreous consists of zonular fibers which hold the lens in place"
  105. what is cloquet's canal
    s-shaped channel through the vitreous associated with regerssion of hyaloid vasculature
  106. what syndrome is microspherophakia associated with?
    weill-marchesani syndrome
  107. what layer of TM is most responsible for aqueous resistance
    juxtacanalicular
  108. what is average volume of posterior chamber
    60 uL
  109. what serves as basis of EOG
    trans-RPE potential
  110. what is best disease
    "autosomal dominant disease caused by mutations in the VMD2 gene which encodes betrophin , a transmembrane chloride channel located in basolateral membrane of RPE"
  111. how many decussations are there in pupillary light reflex and where are they
    2; optic chiasm and pretectal nuclei
  112. what blood vessel supplies distal portion of intraorbital optic nerve? Proximal portion?
    central retinal artery; pial vessels and branches of ophthalmic artery supply proximal

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