TQ Course | Swollen Optic Nerve Head: Now What? (Scottsdale 2022) by Optometric Education Consultants | Feb 24, 2022 | 2022 Scottsdale, TQ Courses | 0 comments HiddenSwollen Optic Nerve Head: Now What?HiddenDate (Hidden) MM slash DD slash YYYY 1. Which of the following signs could be a potential sign of truly swollen optic nerve heads?* a. Lack of spontaneous venous pulsation (SVP) b. Obscuration/blurring of blood vessels as they cross the disc margin c. Significant thickening of the retinal nerve fiber layer (rNFL) on OCT d. All of the above 2. If a patient with potential swollen optic nerve heads has obvious spontaneous venous pulsation on optic nerve head examination, which of the following must be true?* a. The patient must have papilledema b. The patient cannot have papilledema c. The patient likely has drusen of the optic nerve head d. The patient likely is having a stroke 3. Which of the following statement is false regarding Pseudotumor Cerebri?* a. It is also known as Idiopathic Intracranial Hypertension (IIH) b. Is is more likely seen in overweight females c. Headaches are the most common patient symptom d. It is most often seen in 60-80 year olds 4. In regards to Idiopathic Intracranial Hypertension (IIH), which test should be done first in the diagnostic process?* a. Lumbar puncture b. CT c. MRI/MRI d. B-scan ultrasound 5. Which of the following is a potential treatment option for Idiopathic Intracranial Hypertension (IIH)?* a. Weight loss b. Acetazolamide (Diamox) c. Surgical options such as optic nerve sheath decompression if headaches are severe or vision loss is progressive d. All of the above 6. Patients who suffer from non-arteritic anterior ischemic optic neuropathy (NAION) often report vision loss when?* a. First thing when they wake up in the morning b. Early afternoon c. Evening d. When laying down going to sleep 7. Which of the following statement regarding NAION is most correct?* a. Patients often report severe loss of vision (LP or worse) when they occur b. They are most often bilateral c. Treatment usually includes high dose oral or IV steroids d. They most often have a normal ESR and CRP 8. Which of the following are potential symptoms of patients with giant cell arteritis (GCA)?* a. Temporal headaches b. Jaw claudication c. Flu-like symptoms/weight loss d. All of the above 9. Which of the following patients is least likely to be diagnosed with arteritic anterior ischemic optic neuropathy (AAION) from giant cell arteritis?* a. 68 year old male with diabetes b. 82 year old female with rheumatoid arthritis c. 46 year old male with hypertension d. 92 year old female with high cholesterol 10. Regarding the treatment of patients with optic neuritis, the Optic Neuritis Treatment Trial (ONTT) specifically stated that which treated should be avoided when used by itself?* a. Oral steroids b. IV steroids c. Aspirin d. Ibuprofen 11. Which of the following is not one of the potential causes of swollen optic nerves that we talked about?* a. Inflammatory b. Ischemia c. Infiltrative d. Ocular Hypertension 12. A 28 year old female that has a loss of vision for 4 days with pain on eye movements has count fingers vision in that eye, and 20/20 vision in the other eye. An APD is present with a normal appearing anterior and posterior segment in both eyes. Which of the following is the most likely condition present?* a. NAION b. AAION c. Optic neuritis d. Infiltrative optic neuropathy 13. Which of the following rNFL readings on the OCTS would make you most suspicious for a truly swollen optic nerve?* a. 75 microns overall thickness b. 95 microns overall thickness c. 115 microns overall thickness d. 175 microns overall thickness 14. Which of the following signs should you look for on the OCT to see if there are truly swollen optic nerves?* a. V-sign b. S- sign c. T- sign d. A-sign 15. The definition of papilledema is:* a. Bilateral disc swelling due to any cause b. Bilateral disc swelling secondary to raised intracranial pressure c. Bilateral disc swelling that presents with one eye first and then the other d. Any swelling of either optic nerve from any cause 16. The #1 cause of swollen optic nerves in someone over the age of 50 is?* a. NAION b. AAION c. Optic Neuritis d. Traumatic optic neuropathy 17. Following a normal MRI and MRV, a lumbar puncture is often done to confirm IIH. Which of the following results would indicate elevated CSF pressure in a non-obese patients?* a. 125 mm H20 b. 150 mmH20 c. 200 mm H20 d. 275 mm H20 18. Studies show that weight loss can be one of the best treatments for IIH. Weight loss of as little as what % has been show to have a positive benefit for the patients signs and symptoms?* a. 6% b. 20% c. 40% d. 50% 19. Which of the following statements is true regarding treatment for NAION?* a. Oral long term steroids are an acceptable treatment option b. There is no proven effective long term treatment c. Hospitalization with IV steroids is the first line treatment option d. Oral Diamox should be considered for treatment 20. Which of the following swollen optic nerves is least likely to have an APD?* a. Papilledema from IIH b. NAION c. AAION d. 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