Certified Retinal Angiographers

Front 1

If you noticed an exposure
drifting toward darkened images
overtime check what?

Back 1

Check the flash tube or
schedule a thorough cleaning
of camera

Front 2

What 2 types of dilation drops?

Back 2

Mydriatics and Cycloplegics

Front 3

What do mydriatics do?

Back 3

They cause the dilator muscle
to contract

Front 4

What is another term/name
for mydriatics?

Back 4

Sympathomimetics

Front 5

What do cycloplegics do?

Back 5

They relax iris sphincter muscle
and

Front 6

Name 5 reasons pupils may be small.

Back 6

Diabetic, glaucoma, dark iris, corneal scaring, old

Front 7

What are 4 things you can do to help get a photo of a retina with small pupils?

Back 7

Increase flash setting, choose smaller angle of view, insert small-pupil diaphragm. If none of those work place the "dark cloud" away from pathology you're photographing.

Front 8

If the pupil is significantly smaller than the outer diameter of the illuminating doughnut what artifact appears?

Back 8

Dark Cloud
A portion of the retina will receive inadequate illumination.

Front 9

What filter will help you
bring an image into focus?

Back 9

Red-free or Green filter
(540-570 nm)

Front 10

What layers of the retina
make up the inner retina? (3)

Back 10

ILM, NFL, GCL combine
to form the inner retina

Front 11

What blood vessels and
pathology are at the
inner retinal layers? (5)

Back 11

- Large retinal blood vessels
- Cotton-wool spots,
- NFL defects
- myelinated nerve fibers,
- flamed-shaped hemorrhages

Front 12

What layers of the
retina make up the central
retina? (4)

Back 12

IPL, INL, OPL, ONL

Front 13

What blood vessels and
pathology are at the
central retinal layers? (4)

Back 13

- Smaller blood vessels
branches
- Hard exudates
- DM microaneurysms
- FAZ

Front 14

What layers of the retina
make up the outter retina?(3)

Back 14

-Rods & Cones
-RPE
- Bruch's membrane

Front 15

ICG 8-12 min is what phase

Back 15

Isofluorescent

Front 16

Explain Inversion Phase
and how long into test it occurs.

Back 16

When the choroidal vessels have emptied and appear dark agains a bright background
about 20 min into test

Front 17

Describe recirculation phase.

Back 17

- When the arteries and veins are
equally faded
- Disc appears "HOT"
- Is in a F/A exam

Front 18

What 4 basic steps are required in processing black and white film?

Back 18

- Development
- Stop bath
- Fixation
- Washing

Front 19

Name two types of Luminescence

Back 19

Fluorescence
Phsophorescence

Front 20

What is differential focus?

Back 20

In stereo photos when focusing in
two different plains.

Front 21

When an image "floats" in the air
space both in front of and behind
the clear glass is termed...

Back 21

Aerial Image

Front 22

Developer's 2 most
important ingredients are?

Back 22

Metol and Hydroguinone

Front 23

The arm to retinal time is
usually how long?

Back 23

8 to 16 sec.

Front 24

If your patient is less than 100lbs
the 10% (F.S.) is how many mg's
per pound of body weight

Back 24

3.5 mg's per pound

Front 25

What times are images recorded
after initial phase in ICG?

Back 25

2-3min, 5-7min, 10-12min, 20min,
40min, 60min

NOTE: Late phases maybe more
informative depending on pathology

Front 26

What are contraindications for F/A's
(who wouldn't you perform this test on?)

Back 26

- Pregnant
- Recent history of chest pains
- Juvenile asthma

Front 27

What are contraindications for ICG?
(who wouldn't you perform this test on?)

Back 27

- Pregnant
- Caution if Iodine allergy
- Had allergic reaction before
- Uremia on hemodialysis are at
risk of reaction.

Front 28

What is Pseudofluorescence?

Back 28

Produced by poorly matched fliters
or worn out filters.

Front 29

What is Auto-fluorescence?

Back 29

Ocular tissue having appearance
of fluor. without fluor in system.
(Optic Nerve Drusen)

Front 30

How much fluorescein would you
give a child?

Back 30

35mg per pound of 10% fluoresceine

Front 31

Maximum light absorption and
fluorescent excitation of F.S. is ?
(In nm)

Back 31

Light Blue wavy length or
485nm to 530 nm

Front 32

When would the "inversion phase"
occur and what is it?

Back 32

About 20 min after ICG was injected.
When the choroidal vessels have emptied making them dark against a brighter background.

Front 33

What two terms are used to describe
when the choroidal vessels are
emptied against a brighter
background?

Back 33

Inversion Phase or Retrofluorescene

Front 34

Name mild adverse reactions to
F/A (3)

Back 34

- Nausa/vomiting
- Sneezing,hives,itchy
- Pain & swelling if site was
extravasated

Front 35

Plebitis

Back 35

Moderate adverse reaction to F/A
Inflammation to vein that was injected.

Goes away within day. DO NOT use that vein again!!!!

Front 36

If you have a color slide that has
image that seems 1/2 cut off,
What would be the cause?

Back 36

Shutter not synchronized with
flash.

Front 37

For an 8-bit monitor what is the
number of bits it goes up to?

Back 37

0 to 255 pixels

Front 38

What does the "BIT" do in
digital photos?

Back 38

The bit determines how much
light will hit a pixel

Front 39

Resolution = number of _______
Sensitivity = number of _______
Contrast is ___________

Back 39

Pixels
Bits
Difference between light and dark

Front 40

Height and width or "Aspect" of
Digital photo
Film photo

Back 40

Digital 1x1
Film 2 x 3 for 35mm

Front 41

What is Irvin-Glass
syndrome?

Back 41

When post cat pt has CME
(centeral macular edema)
after uneventful cat sx.

Front 42

Small pupils can be
photographed better with
what angle of view?

Back 42

35 or 20 degrees
also set camera to "S"
if less than 5mm

Front 43

What do the arteries do?

Back 43

Carry oxygen rich blood
from lungs and heart to the
tissue.

Front 44

What do veins do?

Back 44

Carry blood containing
carbon dioxide and waste
away from the cells.

Front 45

What does the "Illumination
diaphragm lever" control?

Back 45

The amount of light from
the camera to the eye.

Front 46

Discribe leakage in a F/A.

Back 46

- Early hyperfluorescence
- increases in intensity in
lates
- Diffusion and enlargment of
dye

Front 47

Name ICG phases and
times (4)

Back 47

- Early 10-20 sec
(increases in brightness)
- Isofluorsent 8-12 min
- Inversion/Retrofluorescence
about 20min
- Lates 30 - 60 min

Front 48

If a hypoglycemic pt is
unconscious what injections
can be used to help them
regain consciousness?

Back 48

- Glucagon
- D-50

Front 49

What is Glucagon? Where
is it injected?

Back 49

It is a hormone that causes
sudden increase in sugar.

(1/2 cc & goes into muscular)

Front 50

What is D-50? Where is it
injected?

Back 50

- An injection that goes into
the veins.
- Amount determined by
sugar level & weight of pt
(Dr., RN, & paramatic ONLY)

Front 51

How soon after received the
sugar sould the Hypoglycemic
episode end?

Back 51

5 to 15 minutes

Front 52

Fluorscein Sodium (F.S.)
maximum emission is ? nm

Back 52

520 nm to 530 nm

Front 53

What filters would be used
for color f/a's?

Back 53

Wratten 12, 31 or 34
(Absorbsion filters)

Front 54

What does the hemoglobin
do during F/A's?

Back 54

Absorbs the F.S. along with
the Albumins.

Front 55

What does the term
"extinction" mean regarding
F.S.?

Back 55

Refers to the suppresion
of fluorescein.

Front 56

What is the apeture?

Back 56

It controls the size of the
hole that allows the light to
hit the film.
( It is the cameras pupil)

Front 57

Explain Isofuorescent and
what test is this phase in?

Back 57

- 8 to 12 min in to an ICG test
- Equal distribution between
choroidaal vessels and
the surroundings

Front 58

Name the phase 20 min
into and ICG.

Back 58

- Inversion phase or
Retrofluorscent

Front 59

In film developing if the slide
film has overlapping images.
What may have occured?

Back 59

The film did not advance
properly.

Front 60

Color slide has some frames
only part of the image is clear
& some looks like it didn't
develope properly.

What may have occured?

Back 60

Cameras back opened before
re-wound.

Front 61

What is extinction by
contamination?

Back 61

When F.S. is absorbed by
albumins.

Front 62

What is extinction by
concentration?

Back 62

When to much F.S. is
administered.

Front 63

What are Albumins?

Back 63

It is the plasma proteins that
absorbs f.s. in the choroid.

Front 64

What is fenastration?

Back 64

Choroidal area, little breaks
in blood vessels that f.s.
leaks out of.

Front 65

After taking your photo the periphery of the image is dark.

What is the problems and how would you correct it?

Back 65

You are to far away from the
pt or the pupil is to small.

-Go back and forth
-Change diaphragm level to S
-Take photo w/35 - 20 deg

Front 66

What is retrofluorescence?

Back 66

In ICG when choroid
vessels are dark against
bright background.

Front 67

What is window defect? (3)

Back 67

- Hyperfluorescent at 1st
- No change in shape or size
- Slowly decreases in intensity

Front 68

What is staining? (2)

Back 68

- Hyperfluorescent at end
- No change in shape or size

Front 69

What is pooling? (3)

Back 69

- Hyperfluorescent
- Slowly developes
- Sharp, demarcated boarders

Front 70

Congenital early cyanosis

Back 70

Tetralogy of Fallot

Front 71

Name four different terms that can
be used to describe
hyperfluorescence.

Back 71

- Window Defect/transmission
- Staining
- Leaking
- Pooling

Front 72

Name two different terms that
can be used to describe
hypofluorescence

Back 72

- Filling defect
- Blockage

Front 73

What 2 filters are needed to
perform F/A's? For ICG's?

Back 73

Exciter Barrier
F/A blue 490nm Green 530nm

ICG red 640nm Green 530nm

Front 74

Explain interference filters.

Back 74

Filters that will reflects light waves
Sharper images

Front 75

Explain absorption filters.

Back 75

Filters that absorb or block light
waves. Muddy image

Front 76

Emulsion of black and white film is
made up of ____ ____ ____ which
is suspended in gelatin layer.

Back 76

Silver Hyloid Crystals

Front 77

What does hyperfluorescence mean?

Back 77

Greater fluorescence in an area
than normal.

Front 78

What does background fluorescence?

Back 78

Uniform fluorescence of choroicapillaries during early phase
of F/A. "Choroid flush"

Front 79

What are major adverse reactions
in F/A? (4)

Back 79

- Bronchospasm
- Laryngeal Edema
- Cardiac Arrest
- Anaphylactic Shock

Front 80

What are moderate adverse
reactions in F/A? (3)

Back 80

- Fainting
- Plebitis
- Seizure

Front 81

Explain how to take photos of the
7 standard positions of gaze.

Back 81

1=optic nerve head, 2= macula,
3=temp to macula, 4=superior temporal 5=Iinferior temporal,
6= superior nasal, 7=inferior nasal

Front 82

How does drusen appear on f/a?

Back 82

Late Hyperfluorescence
There will be late staining

Front 83

Defective pixels are always
what color?

Back 83

BLACK

Front 84

Name filters are used for ICG tests
and the locations of these filters.

Back 84

Exciter: in front of the light: Red 640

Barrier: in front of the film: Green 530

Front 85

What are albumins?

Back 85

Plasma proteins in the choroid that
absorb the f.s.

Front 86

Name filters are used for F/A tests
and the locations of these filters.

Back 86

Exciter: in front of light: Blue 490nm

Barrier: in front of film: Green 530

Front 87

When taking a photo and the image
appears like a white curtain came
down over it, what is the problems?

Back 87

Patient blinked

Front 88

If the photo image has a crescent at
the edge of the frame, what is
occurring and how do you correct it?

Back 88

Camera is off center, getting a
shadow from the pupil.
Move camera toward shadow.

Front 89

Name all the phases of a F/A and
in their order.

Back 89

- Early/Pre-arterial/Background fluo.
- Arterial
- Arterial venous
- Venous
- Recirculation/Late

Front 90

What conditions are best noted in
"late" phase of a F/A?

Back 90

- Cystoid macular edema
- Significant macular edema
- Central Serious Maculopathy

Front 91

Name the nm for
- blue
- green
- red

Back 91

- Blue: 490nm (485nm-530nm)
- Green: 540nm-575nm
- Red: 640nm

Front 92

The _________ filter enhances
the choroidal detail and the borders
of pigmented lesions (nevi)

Back 92

- Red 640nm

Front 93

The _________ filter enhances
retinal vasculature and hemorrhages
on black and white film.

Back 93

- Green 540nm-575nm

Front 94

The _________ filter enhances
the nerve fiber layer on black and
white film.

Back 94

- Blue 485nm-530nm

Front 95

How does ICG come, how long is
it good for, and how does it work?

Back 95

- Powder form
- Good for 10 hours after being mixed
- Does NOT leak out of veins &
albumins.

Front 96

When ICG is injected within
_____ sec the image becomes
_____ and the light needs to be
turned ________.

Back 96

- 10 sec
- very bright
- turned down quickly

Front 97

Extinction by concentration
means what?

Back 97

This is when the f/a becomes
absorbed into the system.

Front 98

What 3 muscles control
the pupil size?

Back 98

- Cilliary muscle
- Iris sphincter muscle
- Dilator muscle

Front 99

What 2 people did the 1st
F/A and what year?

Back 99

- H.R. Novtny
- D.L. Alvis
- 1961

Front 100

When injected into the bloodstream
F.S. is absorbed by _______ and
_______ ______ particularly the
__________.

Back 100

- Hemoglobin
- Plasma proteins
- Albumins

Front 101

When taking a photo there are white
spots on the retinal image. What is
occurring?

Back 101

Dust on the lens

Front 102

What has happened when the
color slide comes back black
after developing?

Back 102

Either flash not working or film
did not advance.

Front 103

1. From 2-6 hours f.s. stains ___ ___,
___, ___.

2. From ___ to ____ hours f.s. stains the urine

Back 103

1. Mucous membranes, sclera, skin

2. 24 to 36 hours

Front 104

Prochlorperazine (compazine)
and Promethazine (phenergan)
can be given ____ min orally prior to
f/a to help provent what?

Back 104

Given 45 min prior

To provent nausea and vometting.

Front 105

What degree is considered the
"normal" angle of view?

Back 105

30 degrees