Certified Retinal Angiographer (CRA) Practice Exam LATEST QUESTIONS AND
CORRECT ANSWERS GRADE A
**QUESTIONS:**
1. **What is the primary purpose of fluorescein angiography (FA)?**
A) To measure intraocular pressure
B) To visualize retinal and choroidal circulation using a fluorescent dye
C) To assess corneal thickness
D) To evaluate tear film quality
**ANSWER:** B
**EXPLANATION:** Fluorescein angiography is a diagnostic procedure that uses sodium
fluorescein dye and specialized photography to evaluate the blood flow in the retina and
choroid.
2. **Which vein is most commonly used for fluorescein dye injection?**
A) Jugular vein
B) Femoral vein
C) Antecubital vein
D) Dorsal hand vein
**ANSWER:** C
**EXPLANATION:** The antecubital vein in the arm is the most common and accessible
site for intravenous fluorescein injection.
3. **The excitation wavelength for sodium fluorescein is approximately:**
A) 365 nm (blue light)
B) 490 nm (blue-green light)
,C) 550 nm (green light)
D) 630 nm (red light)
**ANSWER:** B
**EXPLANATION:** Sodium fluorescein absorbs blue light with a peak excitation
wavelength of about 490 nm and emits green-yellow light at approximately 530 nm.
4. **What filter is placed in front of the camera lens to capture fluorescein emission?**
A) Blue exciter filter
B) Green barrier filter
C) Red-free filter
D) Ultraviolet filter
**ANSWER:** B
**EXPLANATION:** A barrier filter (usually yellow-green) blocks the reflected blue
excitation light and allows only the emitted green fluorescence (around 530 nm) to reach
the camera film or sensor.
5. **The normal arm-to-retina circulation time for fluorescein is approximately:**
A) 5-10 seconds
B) 10-15 seconds
C) 15-20 seconds
D) 20-25 seconds
**ANSWER:** B
**EXPLANATION:** In a normal patient, fluorescein dye typically reaches the retinal
circulation (choroid first, then retina) within 10 to 15 seconds after injection.
6. **Which phase of the FA comes first?**
A) Arteriovenous phase
,B) Choroidal flush
C) Recirculation phase
D) Late phase
**ANSWER:** B
**EXPLANATION:** The choroidal flush (or choroidal phase) occurs first, approximately 10-
15 seconds post-injection, showing patchy filling of the choriocapillaris.
7. **What does "window defect" or "transmission defect" indicate in FA?**
A) Dye leakage
B) Loss of retinal pigment epithelium (RPE)
C) Capillary non-perfusion
D) Neovascularization
**ANSWER:** B
**EXPLANATION:** A window defect appears as early hyperfluorescence that increases in
intensity but not in size. It occurs due to atrophy or thinning of the RPE, allowing normal
underlying choroidal fluorescence to be more visible.
8. **Which condition is a relative contraindication for fluorescein angiography?**
A) Hypertension
B) Pregnancy
C) Diabetes
D) Glaucoma
**ANSWER:** B
**EXPLANATION:** Pregnancy is considered a relative contraindication due to potential
(though minimal) risk to the fetus. The procedure is deferred unless the benefits
significantly outweigh the risks.
, 9. **The most common adverse reaction to fluorescein injection is:**
A) Anaphylactic shock
B) Nausea and vomiting
C) Cardiac arrest
D) Seizure
**ANSWER:** B
**EXPLANATION:** Transient nausea and sometimes vomiting are the most frequent side
effects, occurring in about 5-10% of patients. It is usually mild and self-limiting.
10. **What does "pooling" of dye indicate in FA?**
A) Leakage into anatomical spaces (e.g., subretinal space)
B) Blockage of fluorescence
C) Increased blood flow
D) Autofluorescence
**ANSWER:** A
**EXPLANATION:** Pooling refers to the accumulation of dye in an anatomical space, such
as the subretinal space (e.g., in central serous chorioretinopathy) or within retinal cysts. It
shows late staining that conforms to the space.
11. **Indocyanine green angiography (ICGA) is particularly useful for imaging which
vascular layer?**
A) Retinal arterioles
B) Retinal capillaries
C) Choroidal vasculature
D) Iris vessels
**ANSWER:** C
CORRECT ANSWERS GRADE A
**QUESTIONS:**
1. **What is the primary purpose of fluorescein angiography (FA)?**
A) To measure intraocular pressure
B) To visualize retinal and choroidal circulation using a fluorescent dye
C) To assess corneal thickness
D) To evaluate tear film quality
**ANSWER:** B
**EXPLANATION:** Fluorescein angiography is a diagnostic procedure that uses sodium
fluorescein dye and specialized photography to evaluate the blood flow in the retina and
choroid.
2. **Which vein is most commonly used for fluorescein dye injection?**
A) Jugular vein
B) Femoral vein
C) Antecubital vein
D) Dorsal hand vein
**ANSWER:** C
**EXPLANATION:** The antecubital vein in the arm is the most common and accessible
site for intravenous fluorescein injection.
3. **The excitation wavelength for sodium fluorescein is approximately:**
A) 365 nm (blue light)
B) 490 nm (blue-green light)
,C) 550 nm (green light)
D) 630 nm (red light)
**ANSWER:** B
**EXPLANATION:** Sodium fluorescein absorbs blue light with a peak excitation
wavelength of about 490 nm and emits green-yellow light at approximately 530 nm.
4. **What filter is placed in front of the camera lens to capture fluorescein emission?**
A) Blue exciter filter
B) Green barrier filter
C) Red-free filter
D) Ultraviolet filter
**ANSWER:** B
**EXPLANATION:** A barrier filter (usually yellow-green) blocks the reflected blue
excitation light and allows only the emitted green fluorescence (around 530 nm) to reach
the camera film or sensor.
5. **The normal arm-to-retina circulation time for fluorescein is approximately:**
A) 5-10 seconds
B) 10-15 seconds
C) 15-20 seconds
D) 20-25 seconds
**ANSWER:** B
**EXPLANATION:** In a normal patient, fluorescein dye typically reaches the retinal
circulation (choroid first, then retina) within 10 to 15 seconds after injection.
6. **Which phase of the FA comes first?**
A) Arteriovenous phase
,B) Choroidal flush
C) Recirculation phase
D) Late phase
**ANSWER:** B
**EXPLANATION:** The choroidal flush (or choroidal phase) occurs first, approximately 10-
15 seconds post-injection, showing patchy filling of the choriocapillaris.
7. **What does "window defect" or "transmission defect" indicate in FA?**
A) Dye leakage
B) Loss of retinal pigment epithelium (RPE)
C) Capillary non-perfusion
D) Neovascularization
**ANSWER:** B
**EXPLANATION:** A window defect appears as early hyperfluorescence that increases in
intensity but not in size. It occurs due to atrophy or thinning of the RPE, allowing normal
underlying choroidal fluorescence to be more visible.
8. **Which condition is a relative contraindication for fluorescein angiography?**
A) Hypertension
B) Pregnancy
C) Diabetes
D) Glaucoma
**ANSWER:** B
**EXPLANATION:** Pregnancy is considered a relative contraindication due to potential
(though minimal) risk to the fetus. The procedure is deferred unless the benefits
significantly outweigh the risks.
, 9. **The most common adverse reaction to fluorescein injection is:**
A) Anaphylactic shock
B) Nausea and vomiting
C) Cardiac arrest
D) Seizure
**ANSWER:** B
**EXPLANATION:** Transient nausea and sometimes vomiting are the most frequent side
effects, occurring in about 5-10% of patients. It is usually mild and self-limiting.
10. **What does "pooling" of dye indicate in FA?**
A) Leakage into anatomical spaces (e.g., subretinal space)
B) Blockage of fluorescence
C) Increased blood flow
D) Autofluorescence
**ANSWER:** A
**EXPLANATION:** Pooling refers to the accumulation of dye in an anatomical space, such
as the subretinal space (e.g., in central serous chorioretinopathy) or within retinal cysts. It
shows late staining that conforms to the space.
11. **Indocyanine green angiography (ICGA) is particularly useful for imaging which
vascular layer?**
A) Retinal arterioles
B) Retinal capillaries
C) Choroidal vasculature
D) Iris vessels
**ANSWER:** C
