NBEO Part 1 – Questions With Correct Solutions
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Terms in this set (255)
A 32-year old female is seen at your Isotretinoin, birth control pills, and diuretics, among
office complaining of a recent onset many other drugs, can cause myopia in some
of blurred vision, only at a distance. A patients. Myopia mostly likely results from corneal
thorough case history reveals that she swelling, which steepens the curvature of the cornea.
recently began taking a new Drugs that cause swelling of the lens,
medication which you correctly accommodative spasm, or edema of the ciliary body
assume has induced myopia. Which of will also result in myopia. A reduction in the dose of
the following medications is MOST the medication or cessation of the offending drug
likely to be the culprit? will usually result in reversal of nearsightedness. Fish
oil, Tylenol, and Tums have not been shown to have a
correlation with transient myopia development.
An increased rate of molecular Facilitated diffusion is described as the net
movement down its respective movement of molecules down its concentration
concentration gradient via help from gradient whose rate of diffusion is increased via the
carrier proteins refers to which type of use of carrier proteins. Passive diffusion refers to the
transportation? movement of molecules through a plasma membrane
from an area of high concentration to an area of low
concentration without the use of carrier molecules.
Active transport implies the movement of material
against its respective concentration gradient. This
type of transport requires energy and enlists the use
of specific carrier proteins. Lastly, group
translocation is defined as the chemical modification
of a molecule while it is being transported into a cell;
for example, sugars are often phosphorylated during
transportation.
,A 24-year old female patient presents Topical antihistamines and mast cell stabilizers such
at your office complaining of side as Patanol (olopatadine) are commonly prescribed to
effects that began when she started relieve the symptoms associated with ocular
using Patanol to treat her ocular allergies. They are a very effective class of
allergies. She reports complete medication due to their dual action mechanisms.
compliance with her eye drop Topical antihistamines that possess this dual action
administration. Which of the following are olopatadine (Patanol), ketotifen fumarate
symptoms is MOST likely associated (Zaditor), azelastine (Optivar), and epinastine
with olopatadine (Patanol) use? (Elestat). The aforementioned drops serve to alleviate
itching and redness by blocking H1 receptors as well
as inhibiting mast cell and basophil degranulation.
Side effects of topical antihistamine/mast cell
stabilizers include stinging upon instillation,
headaches, and adverse taste (don't forget to inform
your patients about punctual occlusion!).
Tachycardia, depression, gastrointestinal discomfort,
and visual hallucinations have not been reported
with Patanol use.
A 63-year old female is seen at your Sodium chloride is a topical hyperosmotic agent
office with a chief concern of blurry used to relieve stromal edema caused by endothelial
vision in the morning that takes about decompensation. Topical steroids work well to
an hour to resolve before she can see decrease swelling caused by inflammation. In the
clearly again. Biomicroscopy reveals above case, the corneal edema is not mitigated by
endothelial guttata. You correctly an inflammatory response. Tobramycin and Vigamox
diagnose her with moderate Fuch's would be of no benefit since there is no active
dystrophy. Which ophthalmic drop infection, and prescribing either of these would only
would be of MOST benefit to her? lead to corneal toxicity or increased pathogen
resistance over time.
A deficiency of which vitamin leads to A deficiency of vitamin A causes prolonged dark
prolonged dark adaptation? adaptation. Vitamin A is classified as a retinoid, and its
active form is retinol. Retinol is necessary for the
formation of rhodopsin, a pigment used by rods.
Rods are most active in situations with dim
illumination. Less rhodopsin results in fewer rods
being able to respond in low levels of light, causing
prolonged dark adaption.
,+1.50-1.50 x 090 is required to A working distance of 50 cm creates a divergent
neutralize a reflex in retinoscopy with wave of 2.00 D that is neutralized by retinoscopy in
a working distance of 50 cm. What is addition to the patient's refractive error. Therefore, +
the resulting NET retinoscopy finding? 2.00 D must be subtracted from the spherical portion
of the findings. To determine how much to subtract
from the gross findings, one must first calculate the
reciprocal of the working distance in meters. In our
case, 1/0.5 = 2. Therefore +1.50 (the spherical gross
findings) -2 = -0.50-1.50 x 090. Remember NET is the
final result, this is found after the working distance
has been accounted for by subtracting the working
distance from the spherical portion of the findings.
A ray of light traveling in water (n=1.33) Snell's law of refraction states that when light travels
strikes a flat, transparent surface (n= through a material that possesses an index of
1.59) at an angle of 32 degrees from refraction greater than 1.0, the light rays change
the normal. What is the angle of direction and become bent (or refracted). Snell's law
refraction? is depicted as the following: n sin i= n' sin i' where n=
the index of refraction of the first medium, i= the
angle of incidence, n'= the index of the second
medium, and i' = the angle of the refracted ray. All
angles are measured with respect to the normal,
which lies perpendicular to the interface between
the different media. For the above example, 1.33(sin
32)=1.59 sin i', solving for i'= 26.31 degrees. It is
important to commit the index of refraction of water
to memory; it is 1.33.
A central retinal artery occlusion A central retinal artery occlusion will cause a loss of
(CRAO) causes tremendous damage the b-wave which is formed by responses from the
to the retina. How will the bipolar and Muller cells, both of which are nourished
electroretinogram (ERG) of a person by the central retinal artery. The a-wave results from
who has suffered a CRAO be excitation of the photoreceptors. The a-wave will not
affected? be lost in the event of a CRAO due to the fact that
photoreceptors receive their oxygen supply via the
choroid.
, Free radicals can cause severe The aqueous humor contains many electrolytes
damage to tissue. Which of the including Na+, K+ , Cl-, HCO3-, glucose, lactate,
following electrolytes can function as amino acids, and ascorbate. Ascorbate is found in
an antioxidant in the aqueous? high concentrations in the aqueous (20x greater
when compared to the concentration found in
plasma). Ascorbate can serve as an antioxidant to
eradicate free radicals reducing potential damage
from ultraviolet light. Interesting note: the aqueous
humor and tears of uncontrolled diabetics display
higher levels of glucose than those of non-diabetics.
A 12-year old male is sitting in your Anaphylactic shock is defined as a severe, multi-
waiting room while his mother system, type I hypersensitive, acute allergic reaction
undergoes her annual eye exam. that may be life-threatening. Signs of an allergic
While waiting, he eats a candy bar reaction include tingling, itching, hives, swelling of
containing peanuts, and, as luck would lips and tongue, constriction of the airway,
have it, he is deathly allergic to nuts. vasodilation, myocardial depression, and a decrease
To counter anaphylactic shock, what in blood pressure. The EpiPen is injected
would be the BEST course of action? intramuscularly to the upper lateral thigh to ensure
rapid delivery. Epinephrine (Adrenaline) activates
both alpha and beta adrenergic receptors causing an
increase in peripheral vascular resistance and
allowing for an increase in blood pressure and
coronary artery perfusion. Adrenaline also serves to
reverse vasodilation and decrease urticaria and
angioedema. For severe, life-threatening reactions,
Benadryl (diphenhydramine) will not work quickly
enough. Topical antihistamines have little if any
systemic absorption and therefore will not be
effective in counteracting the anaphylaxis. While oral
steroids may be useful in the post-management of
anaphylactic shock, they will not yield the desired
immediate response.
Save Groups
Terms in this set (255)
A 32-year old female is seen at your Isotretinoin, birth control pills, and diuretics, among
office complaining of a recent onset many other drugs, can cause myopia in some
of blurred vision, only at a distance. A patients. Myopia mostly likely results from corneal
thorough case history reveals that she swelling, which steepens the curvature of the cornea.
recently began taking a new Drugs that cause swelling of the lens,
medication which you correctly accommodative spasm, or edema of the ciliary body
assume has induced myopia. Which of will also result in myopia. A reduction in the dose of
the following medications is MOST the medication or cessation of the offending drug
likely to be the culprit? will usually result in reversal of nearsightedness. Fish
oil, Tylenol, and Tums have not been shown to have a
correlation with transient myopia development.
An increased rate of molecular Facilitated diffusion is described as the net
movement down its respective movement of molecules down its concentration
concentration gradient via help from gradient whose rate of diffusion is increased via the
carrier proteins refers to which type of use of carrier proteins. Passive diffusion refers to the
transportation? movement of molecules through a plasma membrane
from an area of high concentration to an area of low
concentration without the use of carrier molecules.
Active transport implies the movement of material
against its respective concentration gradient. This
type of transport requires energy and enlists the use
of specific carrier proteins. Lastly, group
translocation is defined as the chemical modification
of a molecule while it is being transported into a cell;
for example, sugars are often phosphorylated during
transportation.
,A 24-year old female patient presents Topical antihistamines and mast cell stabilizers such
at your office complaining of side as Patanol (olopatadine) are commonly prescribed to
effects that began when she started relieve the symptoms associated with ocular
using Patanol to treat her ocular allergies. They are a very effective class of
allergies. She reports complete medication due to their dual action mechanisms.
compliance with her eye drop Topical antihistamines that possess this dual action
administration. Which of the following are olopatadine (Patanol), ketotifen fumarate
symptoms is MOST likely associated (Zaditor), azelastine (Optivar), and epinastine
with olopatadine (Patanol) use? (Elestat). The aforementioned drops serve to alleviate
itching and redness by blocking H1 receptors as well
as inhibiting mast cell and basophil degranulation.
Side effects of topical antihistamine/mast cell
stabilizers include stinging upon instillation,
headaches, and adverse taste (don't forget to inform
your patients about punctual occlusion!).
Tachycardia, depression, gastrointestinal discomfort,
and visual hallucinations have not been reported
with Patanol use.
A 63-year old female is seen at your Sodium chloride is a topical hyperosmotic agent
office with a chief concern of blurry used to relieve stromal edema caused by endothelial
vision in the morning that takes about decompensation. Topical steroids work well to
an hour to resolve before she can see decrease swelling caused by inflammation. In the
clearly again. Biomicroscopy reveals above case, the corneal edema is not mitigated by
endothelial guttata. You correctly an inflammatory response. Tobramycin and Vigamox
diagnose her with moderate Fuch's would be of no benefit since there is no active
dystrophy. Which ophthalmic drop infection, and prescribing either of these would only
would be of MOST benefit to her? lead to corneal toxicity or increased pathogen
resistance over time.
A deficiency of which vitamin leads to A deficiency of vitamin A causes prolonged dark
prolonged dark adaptation? adaptation. Vitamin A is classified as a retinoid, and its
active form is retinol. Retinol is necessary for the
formation of rhodopsin, a pigment used by rods.
Rods are most active in situations with dim
illumination. Less rhodopsin results in fewer rods
being able to respond in low levels of light, causing
prolonged dark adaption.
,+1.50-1.50 x 090 is required to A working distance of 50 cm creates a divergent
neutralize a reflex in retinoscopy with wave of 2.00 D that is neutralized by retinoscopy in
a working distance of 50 cm. What is addition to the patient's refractive error. Therefore, +
the resulting NET retinoscopy finding? 2.00 D must be subtracted from the spherical portion
of the findings. To determine how much to subtract
from the gross findings, one must first calculate the
reciprocal of the working distance in meters. In our
case, 1/0.5 = 2. Therefore +1.50 (the spherical gross
findings) -2 = -0.50-1.50 x 090. Remember NET is the
final result, this is found after the working distance
has been accounted for by subtracting the working
distance from the spherical portion of the findings.
A ray of light traveling in water (n=1.33) Snell's law of refraction states that when light travels
strikes a flat, transparent surface (n= through a material that possesses an index of
1.59) at an angle of 32 degrees from refraction greater than 1.0, the light rays change
the normal. What is the angle of direction and become bent (or refracted). Snell's law
refraction? is depicted as the following: n sin i= n' sin i' where n=
the index of refraction of the first medium, i= the
angle of incidence, n'= the index of the second
medium, and i' = the angle of the refracted ray. All
angles are measured with respect to the normal,
which lies perpendicular to the interface between
the different media. For the above example, 1.33(sin
32)=1.59 sin i', solving for i'= 26.31 degrees. It is
important to commit the index of refraction of water
to memory; it is 1.33.
A central retinal artery occlusion A central retinal artery occlusion will cause a loss of
(CRAO) causes tremendous damage the b-wave which is formed by responses from the
to the retina. How will the bipolar and Muller cells, both of which are nourished
electroretinogram (ERG) of a person by the central retinal artery. The a-wave results from
who has suffered a CRAO be excitation of the photoreceptors. The a-wave will not
affected? be lost in the event of a CRAO due to the fact that
photoreceptors receive their oxygen supply via the
choroid.
, Free radicals can cause severe The aqueous humor contains many electrolytes
damage to tissue. Which of the including Na+, K+ , Cl-, HCO3-, glucose, lactate,
following electrolytes can function as amino acids, and ascorbate. Ascorbate is found in
an antioxidant in the aqueous? high concentrations in the aqueous (20x greater
when compared to the concentration found in
plasma). Ascorbate can serve as an antioxidant to
eradicate free radicals reducing potential damage
from ultraviolet light. Interesting note: the aqueous
humor and tears of uncontrolled diabetics display
higher levels of glucose than those of non-diabetics.
A 12-year old male is sitting in your Anaphylactic shock is defined as a severe, multi-
waiting room while his mother system, type I hypersensitive, acute allergic reaction
undergoes her annual eye exam. that may be life-threatening. Signs of an allergic
While waiting, he eats a candy bar reaction include tingling, itching, hives, swelling of
containing peanuts, and, as luck would lips and tongue, constriction of the airway,
have it, he is deathly allergic to nuts. vasodilation, myocardial depression, and a decrease
To counter anaphylactic shock, what in blood pressure. The EpiPen is injected
would be the BEST course of action? intramuscularly to the upper lateral thigh to ensure
rapid delivery. Epinephrine (Adrenaline) activates
both alpha and beta adrenergic receptors causing an
increase in peripheral vascular resistance and
allowing for an increase in blood pressure and
coronary artery perfusion. Adrenaline also serves to
reverse vasodilation and decrease urticaria and
angioedema. For severe, life-threatening reactions,
Benadryl (diphenhydramine) will not work quickly
enough. Topical antihistamines have little if any
systemic absorption and therefore will not be
effective in counteracting the anaphylaxis. While oral
steroids may be useful in the post-management of
anaphylactic shock, they will not yield the desired
immediate response.
