Free COA Ophthalmic Pharmacology Questions and Answers — Questions and Answers
Question 1: A patient is prescribed a prostaglandin analog for glaucoma. Which of the following is a common, and often permanent, side effect the ophthalmic assistant should mention?
- Corneal thinning
- Increased iris pigmentation (Correct answer)
- Decreased night vision
- Frequent headaches
Correct answer: Increased iris pigmentation
Prostaglandin analogs, such as latanoprost, are known to cause several side effects, including increased pigmentation (darkening) of the iris. This change is often permanent. Other common side effects include eyelash growth and conjunctival hyperemia (redness). Corneal thinning, decreased night vision, and frequent headaches are not primary, common side effects of this class of medication.
Question 2: An ophthalmologist asks you to instill a cycloplegic drop for a pediatric refraction. Which of the following drops would be the MOST appropriate choice?
- Phenylephrine 2.5%
- Proparacaine 0.5%
- Cyclopentolate 1% (Correct answer)
- Ketorolac 0.5%
Correct answer: Cyclopentolate 1%
Cyclopentolate is a cycloplegic agent, meaning it paralyzes the ciliary muscle to inhibit accommodation, which is crucial for obtaining an accurate refraction in children. Phenylephrine is a mydriatic that dilates the pupil but does not significantly affect accommodation. Proparacaine is a topical anesthetic, and Ketorolac is a non-steroidal anti-inflammatory drug (NSAID).
Question 3: A patient with a history of severe asthma and bradycardia is being evaluated for glaucoma. Which class of topical medication is generally contraindicated for this patient?
- Prostaglandin analogs
- Alpha-adrenergic agonists
- Carbonic anhydrase inhibitors
- Beta-blockers (Correct answer)
Correct answer: Beta-blockers
Topical beta-blockers, such as timolol, can be absorbed systemically and may cause bronchospasm and a slowed heart rate (bradycardia). Therefore, they are contraindicated in patients with conditions like asthma, COPD, or significant cardiac issues like bradycardia.
Question 4: The primary purpose of using lissamine green dye during an ocular surface evaluation is to stain what?
- Areas of epithelial defects on the cornea
- The tear film to measure breakup time
- Dead and devitalized cells on the conjunctiva and cornea (Correct answer)
- The endothelial cell layer of the cornea
Correct answer: Dead and devitalized cells on the conjunctiva and cornea
Lissamine green is a vital dye that selectively stains dead or devitalized cells and mucus on the ocular surface, particularly the conjunctiva. It is especially useful for evaluating dry eye disease and other ocular surface disorders. Fluorescein sodium is used to highlight corneal epithelial defects and measure tear breakup time.
Question 5: A patient is being treated for postoperative inflammation following cataract surgery. The surgeon has prescribed both prednisolone acetate and ketorolac. What is the primary functional difference between these two drops?
- Prednisolone is an antibiotic, while ketorolac is an anti-inflammatory.
- Prednisolone is a steroid, while ketorolac is a non-steroidal anti-inflammatory drug (NSAID). (Correct answer)
- Both are steroids, but prednisolone is stronger.
- Prednisolone treats pain, while ketorolac treats inflammation.
Correct answer: Prednisolone is a steroid, while ketorolac is a non-steroidal anti-inflammatory drug (NSAID).
Prednisolone acetate is a potent corticosteroid, while ketorolac is a non-steroidal anti-inflammatory drug (NSAID). Both are used to control inflammation, but they work through different mechanisms. Steroids broadly suppress the inflammatory cascade, while NSAIDs primarily inhibit prostaglandin synthesis. Using them together can provide a more comprehensive anti-inflammatory effect.
Question 6: Which of the following drops works primarily as a mydriatic by stimulating the iris dilator muscle, resulting in pupil dilation without significant cycloplegia?
- Tropicamide
- Atropine
- Phenylephrine (Correct answer)
- Homatropine
Correct answer: Phenylephrine
Phenylephrine is a sympathomimetic agent that stimulates the alpha-1 adrenergic receptors of the iris dilator muscle, causing pupil dilation (mydriasis) with little to no effect on the ciliary muscle (cycloplegia). Tropicamide, atropine, and homatropine are anticholinergic agents that block the iris sphincter muscle and the ciliary body, causing both mydriasis and cycloplegia.
Free COA Ophthalmic Pharmacology Questions and Answers
A patient is prescribed a prostaglandin analog for glaucoma.
Which of the following is a common, and often permanent, side effect the ophthalmic assistant should mention?