F. oral only one that undergoes first pass metabolism and passes through acidic stomach environment

C. Potassium is the main intracellular cation found. Sodium is the main cation found extracellularly

A. Iodine. Iodine was put into salt in 1924 to help prevent thyroid deficiency.

B. Hydrogen bonds are the most common chemical bond in the body. Covalent bonds are typically found in DNA. Van der Waals are found in organic liquids. Ionic bonds occur between metals.

C. Acyclovir is converted to its triphosphate form, acyclovir triphosphate (ACV-TP), which competitively inhibits viral DNA polymerase, incorporates into and terminates the growing viral DNA chain, and inactivates the viral DNA polymerase

What is an indirect-acting adrenergic agonist?

An indirect-acting adrenergic agonist does not bind to adrenergic receptors directly. Instead, it increases the amount of norepinephrine (NE) available at the synapse by one of the following mechanisms:

• Promoting the release of NE from presynaptic neurons (e.g., amphetamine)

• Inhibiting the reuptake of NE into the presynaptic neuron (e.g., cocaine)

• Inhibiting enzymes that break down NE, like monoamine oxidase (MAO)

Why does this matter in optometry?

Adrenergic agonists are relevant in several ocular contexts:

• Mydriasis (pupil dilation): Drugs like phenylephrine (a direct agonist) are used during eye exams.

• Indirect-acting agents like cocaine can dilate the pupil by preventing NE reuptake, which increases sympathetic tone.

• Cocaine is also used diagnostically in Horner’s syndrome to test sympathetic innervation to the pupil. If the pupil does not dilate, it suggests a sympathetic pathway disruption.

Key Point for Boards:

If the question asks what indirect-acting adrenergic agonists do, look for an option that says something like:
“Increase norepinephrine levels by promoting release or blocking reuptake.”

Avoid choices that focus on acetylcholine, muscarinic receptors, or direct receptor binding.

C. Pilocarpine 0.1% is better than 1%. Typically we use 0.125%. Cocaine is used in diagnosis of Horner’s syndrome

A. Cromolyn sodium. Montelukast is an antileukotriene drug. Albuterol is a short acting beta blocker. Zileuton is a Antileukotriene

A. Systemic absorption of a drug is decreased when the drug is applied to the specific location of need. In this case systemic absorption is low when the drug is presented in inhalation form.

B. bronchodilator. Bronchodilators are medications that usually come in inhalers — they relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier

D. Second generation antihistamine do not have drowsiness effects. First generation cross the Blood brain barrier and cause drowsiness because of this.

B. Plasma. The blood that runs through the veins, arteries, and capillaries is known as whole blood, a mixture of about 55 percent plasma and 45 percent blood cells

A. Internal jugular vein

B. External carotid artery

A. Artificially low. If the BP cuff is too tight you are already causing constriction of the blood flow before applying enough pressure for the cuff to read which would cause an artificially high reading. If the cuff is too loose the opposite happens

A. Middle temporal cortex. The inferotemporal cortex, also known as the ventral pathway, allows for identification of the object and recondition, visual attention, and constancy. The frontal eye field is partially responsible for saccades as well as the superior colliculus.

B. Conductivity and excitability. Like neurons, muscle is an excitable tissue, in that it can conduct or transmit electrical impulses (respond to stimuli)

A.B. Orbicularis oris presses the lips, mentalis depresses the lower lip as well as wrinkles the chin

A. Sternocleidomastoid muscle

B. Antigens are substances that cause the body to make an immune response against that substance. Antibody is a blood protein produced in response to and counteracting a specific antigen.

D. 2-5 days

B. H influenzae is the only gram negative coccobacilli on our outline. Staphylococcus is a gram positive cocci. Listeria is a gram positive bacilli.

B. Parkinson’s disease key symptom is resting tremors

D. Treponema pallidum is the organism responsible for causing syphilis and is detected using a venereal disease research laboratory testing. Toxoplasma gondii is tested using IgG immunological testing. Neisseria gonorrhoeae is found by a simple urine test and may be detected with a Thayer-Martin chocolate agar stain.

C. Broad spectrum.

A. Streptococcus Pyogenes. Remember this gram positive organism is beta-hemolytic meaning it has full hemolysis potential.It is classified as very opportunistic, breaking through the skin and secreing both endotoxins and exotoxins.

Staph aureus is the most common cause of blepharitis. Remember this organism is gram positive with features of being both catalase positive and coagulase positive. All other options are not microorganisms
Staphylococcus Epidermidis is the most common cause of postoperative endophthalmitis. Remember this organism is gram positive with features of being catalase positive but coagulase negative.

B. A neural circuit is a group of neurons in which impulse is affected at the same time usually in the same direction. Convergent means many neurons send a signal to one nerve. Divergent means one nerve sends a signal to several nerves.

C. Koniocellular layers are located between each of the 6 layers throughout the LGN. The magnocellular layers are layers 1 and 2 on the ventral side of the LGN. Parvocellular layers are 3,4,5,6 on the dorsal side of the LGN.

B. Midbrain. local circuit neurons located in the midbrain near the oculomotor nucleus. These neurons generate a burst of action potentials. The onset of the burst is the command to generate a vergence movement, and the frequency of the burst determines its velocity

E. Anterior cerebral and middle cerebral supplies the frontal lobe of the brain. Middle cerebral supplies blood to every part of the brain. The posterior cerebral supplies blood to the temporal and occipital lobes of the brain .

C. stroma is highly hydrophilic. Epithelium is hydrophobic but lipophilic

D. lacrimal. Proteins are present in the lacrimal gland in addition to immunoglobulins, electrolytes, and water. Goblet cells secrete mucus. Zeis and meibomian secrete sebum or cholesterol

C. the Embryonic nucleus has the highest index of refraction. The lowest index of refraction is the outer cortex layer. The further deep you get into the lens the higher the index of refraction

C. 0.02mm per year

C. posterior knees loop into the ipsilateral optic tract before crossing

D. LGN. They originate from the LGN. The Parietal lobe contains the optic radiations that control the inferior section of the optic nerve or the superior portion of vision. The temporal lobe contains the optic radiations that control the superior ection of the optic nerve or the inferior portion of vision. PITS

E. Posterior communicating artery is the most commonly artery in the Circle of Willis that is subjected to aneurysm.

C. SPCN’s

D. Iris collarette. The anterior vascular is formed before the membrane. The membrane contributes to the minor circle not the major circle. The pupillary rugg is epithelial tissue

D. Mesenchyme. This layer only does bones and muscles of the orbital region

B. Sherrington’s law of innervation is concerned with the contraction and relaxation of the muscles in the same eye. Hering’s law is the muscle innervation between 2 eyes. Remember sherring the same eye.

B. Mesenchyme.

C. corrugator. Corrugators think concentration. Frontalis is the primary elevator of the eyebrows. Orbicularis is the primary depressor of the eyelids. Procerus elevates the nose

A. Left superior rectus. Superior rectus primary action is elevation secondary action of INcyclo and tertiary action of ADDuction. When the patient is looking towards their left (abduction) you are solely isolating the elevator muscle to cause elevation with no help from secondary action muscles. Thus Left superior rectus is the correct answer. For a visualization draw a Parks 3 step diagram and look at what muscle is isolated for elevation

C. immediately posterior to the vortex veins

B. cGMP keeps Na+ channels open to promote depolarization when glutamate is released to bipolar cells. An increase in light decreases levels of cGMP resulting in closure of the sodium channels, hence the negative charge of the cell membrane increases to -65mV.

B. B waves measure the activity of bipolar and muller cells. A wave measures photoreceptor activity. C wave measures RPE activity. Remember that an EOG can also be used to measure function of the RPE.

D. The ciliary body is the main producer and minor drainer of the human eye in addition to helping with the accommodation.

A,B. Risk factors for PVD include age, myopia, diabetes, intraocular surgery and inflammation, as well as trauma

D. The vitreous makes up 80% of the total volume of the eye. The total amount is 4mL

D. Autosomal dominant skin condition. Corneal verticillata can be caused by chloroquine, hydroxychloroquine, amiodarone ( RA drug), Indomethacin, Tamoxifen, Rho kinase inhibitors, and fabry’s disease.

D. 40. The eye total has 60 Diopters of power. Cornea contributes 40D, and the lens contributes 20D.

B. Purkinje image 1 is a direct result of reflection from the anterior corneal surface. When we do keratometry we are measuring the shape of the anterior cornea to see how to fit a RGP properly on that surface.

C. Scleromalacia perforans is a rare, severe eye disorder developing an autoimmune damage of episcleral and scleral performing vessels.

D. Rapid neovascularization is present. Staphyloma of sclera present with no neovascularization. The sclera is avascular.

A. Toxoplasmosis is more commonly found systematically than sarcoidosis. All options do cause posterior uveitis. Syphilis rarely causes posterior uveitis.

A. Redness of the conjunctiva is the most commonly reported side effect of netarsudil AKA Rhopressa. This is due to the fact that there are rho kinase receptors found on blood vessels. Rhopressa is an inhibitor of rho kinase which causes vasodilation of the blood vessels.

D. Near visual acuity. Standard of care for glaucoma testing is goldmann tonometry for IOP, Humphrey visual field for any nerve damage analysis, Pachymetry in order to accurately adjust the IOP readings, Gonioscopy for determining if its closed angle or open angle glaucoma.

A. Dry eye disease is directly linked to the lack of aqueous produced by the tear glands.

A. The cotton swab test is used to evaluate corneal sensitivity, specifically cranial nerve V1, the nasociliary branch off of the ophthalmic nerve.

E. Together, the zygomatic bone makes up the lateral wall of the orbit with the greater wing of the sphenoid bone. Remember SMEL my medial wall → sphenoid, maxillary, ethmoid, lacrimal.

B. Ovaries are where female gametes are stored (eggs).

A. range of accommodative vergence. Blur is the first indication that accommodation has reached its max. When break occurs then accommodative vergence is broken thus indicating the end of accommodation.

C. 30% According to the Amblyopia treatment studies 30% of anisometropic amblyopes can be corrected by just Best rx only.
Chen AM, Cotter SA. The Amblyopia Treatment Studies: Implications for Clinical Practice. Adv Ophthalmol Optom. 2016 Aug;1(1):287-305. doi: 10.1016/j.yaoo.2016.03.007. PMID: 28435934; PMCID: PMC5396957.

D.

C.

B. second order

B. 1.2 M ; 3’=M/0.4

A. 3.28X ; 3in(0.0254/1in)=0.0762 m; (1/0.0762m)= (13.12/4) = 3.28X

C. 16 deg. We can solve this without any sin inverse or calculator. When light hits an object with a higher index of refraction the light is going to bend more creating less of a degree. 16 is the only number that is smaller than 25. Keeping this theory in mind will help you solve any problem like this.

A. Eso deviation. Eso deviation has a nasal eccentric fixation point thus creating a crossing of the lines closer than normal

E. All of the above.

A. Cornea absorbs 80% of drugs in the eye. 20% or more is usually lost to the lacrimal system.

D. Adrenergic antagonists are considered beta blockers. The MOA of beta blockers are to decrease the production of Aqueous Humor in the ciliary body

A. Atropine is contraindicated in Down Syndrome patients. The MOA effect on down syndrome patients is unknown. Phenylephrine is contraindicated in anyone with blood pressure issues, betaxolol is contraindicated in patients with asthma. Pilocarpine is contraindicated in anyone with a retinal detachment or high hyperopes.

B. pilocarpine causes contraction of the iris sphincter which opens up the aqueous outflow.

B. Carteolol is a weak non-selective beta blocker. Carteolol does not cross the Blood brain barrier and thus has the lowest chance of causing anything to go on with the chemical balance of the brain.

a. 17mm. Seg height= 0.5(A)- seg drop

C. Need low wavelength and fast pulse = strong power and fast pulse

C. 16/0.5 = 32

E. Only one that is a class one laser and is USED in surgical procedures. He-ne is also class one but is not USED in surgical procedures.

C. Decreasing edge lift will cause a decrease in oxygen not increase oxygen.

B. creates a positive tear lens.

A. Toposcope

A. -10X ; Fobj=440mm Feye=44mm ; M=-440/44=-10X

A. Type 1.

C. Behcet’s disease has no connection with the HLA b27 gene. Remember the UCRAP acronym to describe the HLA B27

B. CD4 counts below 50 indicates a diagnosis of AIDS and those with a weakened immune system have a higher likelihood to contract cytomegalovirus.

B. Parinaud oculoglandular syndrome has no particular environment in which it thrives. Parinaud Oculoglandular Syndrome is a conjunctival disease characterized by a unilateral granulomatous follicular conjunctivitis associated with ipsilateral regional lymphadenopathy. There are many vectors that transmit organisms that cause oculoglandular syndrome, of which, Cat Scratch Disease is the most common cause.

B. FTAB-ABS and VDRL are test specifically for syphilis

A. Pericytes. NVI is directly caused by diabetes which attacks pericytes on the short posterior ciliary arteries located in the inner nuclear layer which stops the autoregulation of the arteries and leads to retinal ischemia. Due to the newfound retinal ischemia, the RPE releases VEGF to create new blood vessel formation, otherwise known as neovascularization.

C. T4. T4 also known as triiodothyronine is found to be in decreased numbers when testing in patients with hypothyroidism. Elevated TSH are found also in hypothyroidism patients