Podcast
Questions and Answers
What is sildenafil citrate commonly known as?
What is sildenafil citrate commonly known as?
- Amiodarone
- Hydroxychloroquine
- Viagra (correct)
- Testosterone patch
Your patient says she is allergic to something common, but cannot remember the name. You suggest:
Your patient says she is allergic to something common, but cannot remember the name. You suggest:
- Penicillin, sulfa, or codeine (correct)
- Penicillin, sulfa, or caffeine
- Penicillin, sulfur, or codeine
- Niacin, sulfa, or codeine
Your patient says that beta-blockers make him nauseated. This is:
Your patient says that beta-blockers make him nauseated. This is:
- An unrelated occurrence
- A side effect (correct)
- An allergy
- Unimportant
Your patient says that erythromycin makes her break out in a rash. This is:
Your patient says that erythromycin makes her break out in a rash. This is:
Your patient is scheduled to have a chalazion excision. It is most important to know his previous reaction to:
Your patient is scheduled to have a chalazion excision. It is most important to know his previous reaction to:
Your patient is unsure if she has ever had any local anesthesia. You could ask if she:
Your patient is unsure if she has ever had any local anesthesia. You could ask if she:
Your patient reports an adverse reaction to dye injected for a kidney evaluation. This could affect:
Your patient reports an adverse reaction to dye injected for a kidney evaluation. This could affect:
Knowing a patient's occupation may be important in:
Knowing a patient's occupation may be important in:
A patient's social history would include all of the following except:
A patient's social history would include all of the following except:
Your patient has been referred to your practice for cataract surgery. You ask if there is anyone at home who can help the patient instill eye drops. This is part of the patient's:
Your patient has been referred to your practice for cataract surgery. You ask if there is anyone at home who can help the patient instill eye drops. This is part of the patient's:
The most common ocular disorders that run in families are:
The most common ocular disorders that run in families are:
A 25-year-old white woman comes in as a new patient because her mother has just been diagnosed with glaucoma. This information:
A 25-year-old white woman comes in as a new patient because her mother has just been diagnosed with glaucoma. This information:
A mother brings in a 2-year-old child with esotropia. Which of the following is significant for the history?
A mother brings in a 2-year-old child with esotropia. Which of the following is significant for the history?
Examples of hereditary systemic disease include:
Examples of hereditary systemic disease include:
Which of the following is not potentially a hereditary disorder?
Which of the following is not potentially a hereditary disorder?
Any pupil smaller than what size is considered miotic?
Any pupil smaller than what size is considered miotic?
Any pupil larger than what size is considered mydriatic?
Any pupil larger than what size is considered mydriatic?
Which of the following groups tend to have smaller pupils?
Which of the following groups tend to have smaller pupils?
Unequal pupil size is termed?
Unequal pupil size is termed?
The pupil evaluation includes:
The pupil evaluation includes:
An iris coloboma usually causes a pupillary shape defect:
An iris coloboma usually causes a pupillary shape defect:
Constriction of the pupil can be accomplished by any of the following except:
Constriction of the pupil can be accomplished by any of the following except:
Dilation of the pupil can be accomplished by any of the following except?
Dilation of the pupil can be accomplished by any of the following except?
Direct pupillary response refers to:
Direct pupillary response refers to:
Testing of the consensual light response in healthy eyes is possible because:
Testing of the consensual light response in healthy eyes is possible because:
When checking consensual pupil responses to light, all of the following should be done except:
When checking consensual pupil responses to light, all of the following should be done except:
To test pupillary response to accommodation:
To test pupillary response to accommodation:
To evaluate a patient for tonic pupil (or Adie's tonic pupil), one would use which method?
To evaluate a patient for tonic pupil (or Adie's tonic pupil), one would use which method?
Each pupil constricts to direct light. This indicates:
Each pupil constricts to direct light. This indicates:
Testing that reveals normal-appearing pupils that react appropriately is documented by the acronym:
Testing that reveals normal-appearing pupils that react appropriately is documented by the acronym:
The most common cause of a false-positive pupillary defect is:
The most common cause of a false-positive pupillary defect is:
Each of the following could cause abnormal pupil shape except:
Each of the following could cause abnormal pupil shape except:
Each of the following disorders can cause a change in pupil size except:
Each of the following disorders can cause a change in pupil size except:
Argyll Robertson pupils are often:
Argyll Robertson pupils are often:
You discover that your patient has an Argyll Robertson pupil. This pupillary defect is associated with:
You discover that your patient has an Argyll Robertson pupil. This pupillary defect is associated with:
Which of the following is associated with ptosis, miosis, and lack of perspiration (anhydrosis) on the affected side?
Which of the following is associated with ptosis, miosis, and lack of perspiration (anhydrosis) on the affected side?
Horner's syndrome is caused by:
Horner's syndrome is caused by:
Adie's tonic pupil (or tonic pupil) is caused by:
Adie's tonic pupil (or tonic pupil) is caused by:
You might first suspect that the patient has a tonic pupil when:
You might first suspect that the patient has a tonic pupil when:
A relative afferent pupillary defect (RAPD) is identified by using the:
A relative afferent pupillary defect (RAPD) is identified by using the:
The presence of a RAPD:
The presence of a RAPD:
An eye with a RAPD usually has:
An eye with a RAPD usually has:
Another name for a RAPD is:
Another name for a RAPD is:
You are performing a swinging flashlight test. The right pupil does not react at all when you shine the light in it. When you swing over to the left eye, the left pupil constricts rapidly. When you swing back to the right eye, there is again no reaction. This indicates:
You are performing a swinging flashlight test. The right pupil does not react at all when you shine the light in it. When you swing over to the left eye, the left pupil constricts rapidly. When you swing back to the right eye, there is again no reaction. This indicates:
In order to determine the base curve for a patient's contact lens, one must perform:
In order to determine the base curve for a patient's contact lens, one must perform:
Soft contact lens diameter can be selected by measuring the patient's:
Soft contact lens diameter can be selected by measuring the patient's:
For most contact lens fitting purposes, it is acceptable to measure corneal diameter:
For most contact lens fitting purposes, it is acceptable to measure corneal diameter:
Which of the following is not a factor in determining the appropriate power of a contact lens?
Which of the following is not a factor in determining the appropriate power of a contact lens?
Your patient, a 63-year-old woman, wants to try contact lenses. Which of the following should be done?
Your patient, a 63-year-old woman, wants to try contact lenses. Which of the following should be done?
A history is obtained by:
A history is obtained by:
The history should be recorded:
The history should be recorded:
When taking a history on a school-aged child, it is important to:
When taking a history on a school-aged child, it is important to:
Which of the following statements is false?
Which of the following statements is false?
Which of the following is not a part of a history?
Which of the following is not a part of a history?
The 'presenting complaint' is:
The 'presenting complaint' is:
An example of a question relating to onset would be:
An example of a question relating to onset would be:
The question 'Does your head hurt so badly that you have to leave school early?' relates to:
The question 'Does your head hurt so badly that you have to leave school early?' relates to:
To obtain the most important information about the presenting complaint, you should ask questions relating to:
To obtain the most important information about the presenting complaint, you should ask questions relating to:
A symptom is:
A symptom is:
An example of a sign is:
An example of a sign is:
A 56-year-old patient complains of a sudden onset of double vision. It is most important to ask:
A 56-year-old patient complains of a sudden onset of double vision. It is most important to ask:
An old photograph of the patient will be most useful to the physician if the patient complains of or exhibits:
An old photograph of the patient will be most useful to the physician if the patient complains of or exhibits:
Your patient has a cut eyelid. It is important to know what caused the injury because:
Your patient has a cut eyelid. It is important to know what caused the injury because:
A patient presents with a corneal foreign body, and your supervisor asks how the foreign body got into the eye. This is an important question because:
A patient presents with a corneal foreign body, and your supervisor asks how the foreign body got into the eye. This is an important question because:
The patient is not wearing contacts, but would like to be fit for them. The most relevant question is:
The patient is not wearing contacts, but would like to be fit for them. The most relevant question is:
A 52-year-old patient hands you his single-vision glasses, the only glasses he has. Which of the following is the most important question in determining the patient's refractive status?
A 52-year-old patient hands you his single-vision glasses, the only glasses he has. Which of the following is the most important question in determining the patient's refractive status?
A patient reports that he sleeps in his contact lenses. An important question would be:
A patient reports that he sleeps in his contact lenses. An important question would be:
The patient gives a history of having a cataract removed with a laser. You should:
The patient gives a history of having a cataract removed with a laser. You should:
The patient gives a history of having a laser treatment, but is not sure what it was for. You might discover more by asking:
The patient gives a history of having a laser treatment, but is not sure what it was for. You might discover more by asking:
The patient states she used to wear contact lenses, but went back to her glasses. A pertinent question would be:
The patient states she used to wear contact lenses, but went back to her glasses. A pertinent question would be:
A 76-year old new patient tells you that he caught astigmatism from his brother when they were both children. You should:
A 76-year old new patient tells you that he caught astigmatism from his brother when they were both children. You should:
Knowledge of a past ocular injury is needed because:
Knowledge of a past ocular injury is needed because:
The patient states she has prism in her glasses. Which of the following is the most important question to ask?
The patient states she has prism in her glasses. Which of the following is the most important question to ask?
A mother brings in her 4-year old son. The mother says he has a lazy eye. What do you need to find out?
A mother brings in her 4-year old son. The mother says he has a lazy eye. What do you need to find out?
An example of a systemic illness is:
An example of a systemic illness is:
Questions asked of a hypertensive patient should include:
Questions asked of a hypertensive patient should include:
Questions asked of a diabetic patient should include:
Questions asked of a diabetic patient should include:
A patient with heart problems:
A patient with heart problems:
Knowledge of a patient's breathing or lung problems would be important if the patient also has:
Knowledge of a patient's breathing or lung problems would be important if the patient also has:
Your patient states that he has rheumatoid arthritis. You should now ask symptom-related question to find out if he has:
Your patient states that he has rheumatoid arthritis. You should now ask symptom-related question to find out if he has:
Sickle cell disease:
Sickle cell disease:
Sickle cell disease may affect the eye:
Sickle cell disease may affect the eye:
Knowing a patient's past history of surgical procedures is important because:
Knowing a patient's past history of surgical procedures is important because:
Major infections that can affect the eye include:
Major infections that can affect the eye include:
Your patient is a 4-month-old who was born prematurely. Which question will be most important in predicting the occurrence of eye disorders related to prematurity?
Your patient is a 4-month-old who was born prematurely. Which question will be most important in predicting the occurrence of eye disorders related to prematurity?
In which of the following ocular disorders would it be most important to know what eye drops a new patient is using?
In which of the following ocular disorders would it be most important to know what eye drops a new patient is using?
Which situation poses a potential problem in a patient taking aspirin-containing medications?
Which situation poses a potential problem in a patient taking aspirin-containing medications?
While taking the ocular history of a new patient, she mentions that her last ophthalmologist told her she has macular degeneration. This should trigger you to specifically ask about which of the following?
While taking the ocular history of a new patient, she mentions that her last ophthalmologist told her she has macular degeneration. This should trigger you to specifically ask about which of the following?
Patients taking a diuretic might have which special need during the exam?
Patients taking a diuretic might have which special need during the exam?
A patient taking a diuretic probably has which health problem?
A patient taking a diuretic probably has which health problem?
High blood pressure is frequently treated by:
High blood pressure is frequently treated by:
If a patient with glaucoma is to be treated using beta-blockers, it would be most important to know if the patient is currently being treated for:
If a patient with glaucoma is to be treated using beta-blockers, it would be most important to know if the patient is currently being treated for:
It is important to know if a patient is taking birth control pills because:
It is important to know if a patient is taking birth control pills because:
A patient who has been taking oral steroids for long periods should be evaluated for possible development of:
A patient who has been taking oral steroids for long periods should be evaluated for possible development of:
Conditions for which a person might take oral steroids include:
Conditions for which a person might take oral steroids include:
Patients often fail to report the use of over-the-counter medications because:
Patients often fail to report the use of over-the-counter medications because:
The patient has said he has no heart problems, but you notice that he is taking two heart medications. For the most complete history, you should:
The patient has said he has no heart problems, but you notice that he is taking two heart medications. For the most complete history, you should:
Diabetes medication includes:
Diabetes medication includes:
An example of an analgesic is:
An example of an analgesic is:
Which patient is most likely to be using hormone replacement therapy?
Which patient is most likely to be using hormone replacement therapy?
Study Notes
Patient History and Examination
- Obtaining a patient history involves asking organized and specific questions to gather relevant information about their symptoms and history.
- Accurate recording of patient history should condense the patient's narrative while emphasizing pertinent facts rather than transcribing it verbatim.
- For school-aged children, both the parent and the child should be interviewed to understand the full context of the child's health issue.
Presenting Complaints and Associated Symptoms
- The "presenting complaint" refers to the primary reason a patient visits the office, critical for guiding the examination.
- Symptoms are changes reported by the patient, while signs are observable conditions, such as elevated intraocular pressure.
- Important questions around symptoms include onset, duration, severity, and triggers to accurately assess the situation.
Understanding Patient Conditions
- Conditions such as diabetes and hypertension require specific inquiries regarding their management and how they might affect ocular health.
- A thorough history of past ocular injuries is essential for understanding current symptoms or conditions.
Medications and Their Implications
- The use of medications, including over-the-counter drugs, can significantly affect eye health, yet patients often neglect to disclose this information.
- Knowledge of any medications, particularly those impacting vision or eye conditions (like beta-blockers for glaucoma), is crucial during history-taking.
- Allergies to medications, and understanding their implications, is vital before prescribing new treatments or conducting procedures.
Special Considerations in Pediatric and Elderly Patients
- Information about a child’s ‘lazy eye’ or parents’ concerns should be clarified, as interpretations may vary within the family context.
- In elderly patients, especially those with multiple illnesses, it's important to correlate medication use with specific health issues to prevent adverse effects.
Surgical History and Reactions
- Past surgical procedures may necessitate special precautions for future eye surgeries, and patient reactions to anesthesia should be carefully documented.
- The significance of knowing previous reactions, such as to local anesthesia, is paramount for informing surgical risk assessments.
Systemic Diseases and their Ocular Effects
- Systemic conditions like rheumatoid arthritis and sickle cell disease can lead to specific ocular issues, such as dry eyes or vascular blockages.
- Eye examinations must consider how conditions like hypertension might complicate procedures, particularly in patients with glaucoma.
Additional Patient Querying
- Questions related to lifestyle (like occupation) can provide insight into potential risks for ocular injuries or the need for specific visual aids, like glasses.
- Comprehensive understanding of patients’ history regarding systemic illnesses, treatments, and lifestyle factors ensures a more thorough approach to eye care.
Communication and Clarity
- Clear communication around patients’ understanding of their conditions or treatments, such as what they mean by terms like "lazy eye," is crucial for accurate assessment.
- Patients may misinterpret medical terminology, highlighting the need for sensitivity and clarity in interviews.
Conclusion
- Overall, an eye care assistant should be diligent in collecting a comprehensive and clear medical history, understanding the relevance of symptoms, medications, and past medical interventions to provide optimal patient care.### Social History in Patients
- Social history includes tobacco use, living arrangements, and hobbies.
- Therapeutic drug use is not typically considered part of social history.
Patient Care and Eye Drops
- Assessing if someone at home can help with eye drops is part of a patient’s social history, especially for pre-operative assessments like cataract surgery.
Family Relation to Ocular Disorders
- Common hereditary ocular disorders include strabismus, myopia, and glaucoma.
- A family history of glaucoma is significant, warranting a full eye exam even in younger patients.
Pediatric Vision Concerns
- In a child with esotropia, assessing family history of crossed eyes is crucial for a comprehensive medical history.
Hereditary Systemic Diseases
- Hereditary systemic diseases include diabetes, hypertension, arthritis, and cancer.
Pupil Size Classifications
- A pupil smaller than 2 mm is classified as miotic; larger than 6 mm is mydriatic.
- Older individuals tend to have smaller pupils compared to other groups.
Pupil Evaluation
- Pupil evaluation includes assessing size, shape, and reaction to light.
- Unequal pupil size is known as anisocoria.
Pupil Reaction to Light
- Direct pupillary response is the reaction of one pupil to light.
- The consensual light response tests how both pupils react simultaneously to a light stimulus.
Testing for Pupil Response
- To test accommodation response, observe pupils transitioning between distant and near objects.
- The swinging flashlight test is used to identify a relative afferent pupillary defect (RAPD).
Common Pupillary Defects
- Argyll Robertson pupils are unreactive to light but may react to accommodation and are often associated with syphilis.
- Horner's syndrome features ptosis, miosis, and anhidrosis caused by nerve damage.
Contact Lens Fitting
- Determining contact lens base curve requires keratometry.
- Soft contact lens diameter is selected based on visible iris diameter.
Factors in Contact Lens Power
- Key factors for appropriate contact lens power include refractive error, vertex distance, and astigmatism, excluding pupil diameter.
- Tear evaluation is important for older patients seeking contact lenses.
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Prepare for the Certified Ophthalmic Assistant exam with these flashcards. The questions focus on key practices and procedures related to gathering patient history and conducting examinations. Test your knowledge and readiness for the exam with this targeted study aid.