Dear students, in the previous lecture, I discussed about the interaction of heavy charge particles with matter and we found that the important properties of the heavy charge particles with regard to their interaction are the stopping power. The stopping power is nothing but the loss of energy in the unit thickness minus dE by dx and we also saw how that is related to the energy and charge of the ion. So, there is a term depending upon the property of the ion, it is another term depending upon property of the absorbed medium that is nz electron density number of atoms per cc into the atomic number of the material. So, it is essentially the electrons per cc. So, heavy charge particles are losing energy relatively much faster because they do not travel much because of the higher mass, higher charge. So, nz square by E as you recall the previous lecture, the energy as the energy decreases, the stopping power increases, but as the black curve signifies at the end of the journey, ion finally the velocity of the ion becomes less than velocity of little electrons and the heavy charge particle picks up electrons and then stops. At the end of this track or the range, the stopping will be purely by the nuclear, but in the beginning it is electronic stopping wherein the energy and excitation are the dominant mode of interaction. Now, we will discuss the interaction of fast electrons with the matter, which also includes the beta particles, beta plus and beta minus. Okay, so the fast electrons or beta particles, the interaction mechanisms are same, even positrons will be at the same way and the typical energies of this fast electrons or beta particles that we handle are in the range of q kv to q mv. Now, this in terms of the type of mechanism for interaction of these fast electrons with the matter, we can say that there are two types of processes that occur. First is the original energy loss, that means the electrons collide with the electrons of the medium through which they are passing and they can cause the ionization and excitation very much like in the case of heavy charge particles. But in addition to this, there is another mode of loss of energy, that is the true radiative energy loss, in which case the continuous radiation called Brin Stalin is limited when the fast electrons are passing through the medium. We will discuss more on this subsequently. The major differences between the interaction of heavy charge particles with fast electrons, let us discuss this first. So, firstly, the velocity of electrons is much, much higher than the velocity of heavy charge particles for the same energy that is q kv to q mv. So, because of that, these velocities are very high, the delta e by dx, the stopping power for fast electrons is much lower than that for the in charge particles. If you recall the stopping power from law, d e by dx is equal to m z square by e. In fact, it seems to not remain the same when it comes to electrons, but the velocity comes in the denominator and so velocity is high, that means the stopping power is low, grossly speaking. The second important point is that the energy transferred by electron to the electron in the medium in one point. So, considering the same equation in case of heavy charge particle, the maximum energy and electron can gain when it is struck by the incident particle maybe alpha or electron given by 4 mm capital M small n e 0 upon m plus m square cos theta. In fact, it is cos theta theta equal to 0, maximum energy is lost to n theta equal to 0. Now, if you substitute for capital M as mass of the electron, so both capital M and small m are same in the case of electron interaction. And so this would become e max equal to 4 m square e 0 upon m plus m is 2 m into square 4 m square. So, it will be e 0. That means the electron can lose all its energy in single collision when it is colliding with the electron. Because of these processes, you will find that the electron can get backscattered, backscattered in all angles in a single collision. So, this is a major difference when it comes to interaction of electrons better, we say which are the heavy charge particles. The third difference is that the electrons move in a tortuous path. The reason for that is the second point that is the electron can lose energy in a single collision. And so because of that, suppose you have an electron here, it is colliding with the electron. This electron can get scattered in different directions. And so because of that, the one the electron is going, it is scattered, it can further get scattered. Whenever it is interacting with an electron, it can go. So, this electron can go in a zigzag path. And so, you can say the different electrons will be moving in the tortuous path like a tortuous in a zigzag fashion. So, then you cannot define a well defined range for the electrons because their motion is tortuous. That is because of the large energy transferred in single collision in case of oscillators. The difference, another major difference is that when the electrons are interacting with the medium, particularly at energies which are of the relativistic order, then there is an emission of a continuous gamma radiation, beam Stalin. That beam Stalin is derived from the word breaking radiation. That means when the electron is accelerated or decelerated in the vicinity of a nucleus because of this electromagnetic interaction, the electron loses energy in the form of photons. That can be explained from electromagnetic theory. And this happens when the electron, the energy of the electron is of the tortuous, relativistic energy, that means beta equal to V by C, V is the velocity of the electron, C is the speed of light. And when it is close to 1, then the electron is relativistic. And so, that happens for the electron when the energy is of the 1 MeV. And therefore, the MeV order of energy electrons will undergo a large fraction of energy will be lost through beam Stalin emission. The same thing does not happen in case of protons of same energy because for 1 MeV proton, the beta value will be of, will be around 0.046, which is much, much less than 1. Therefore, proton is not relativistic at energy of 1 MeV. As a result of that, we do not see beam Stalin in the case of, which are the particles at these notes. I will, it will be possible, we will discuss that later on subsequently. So, let us first discuss the collision energy loss and radiative energy loss with regard to the stopping power. So, we will not go into details of the derivation of this formula because they are quite complicated. But hence, Bithé, in fact, derived this formulae. And the, so here instead of one type of collision, the stopping power, we have two types of losses. One is the loss in a collision with electrons. So, it is called a collision energy loss. And this collision energy loss again has the two terms, the electronic properties, the ion, single ion that is impinging 2 pi e to the power 4 upon m0 v square, where d is the velocity of electron. And mz is the electron density in the medium. And this is term again the velocity dependent is a relativistic term. In the case of beta particles and past electrons, relativistic term becomes important because beta is significant close to 1. But let us not go into too much details of the relativistic term. The, it simply is sufficient to say that the, in the collision energy losses again depend upon the velocity of the electron and the electron density of the medium. In this, in the fashion similar to that of the heavy charge particles. And the radiative energy loss, we have called radiative minus d by dxr is again given in terms of the electron, the atom density in the, so nz is the thing by electron density. E is the energy of the ion e to the power 4 upon 137 m0 square e to the power 4 and some term depending upon e n and 0 c square. So, electron is going to lose energy not only by collision with electrons which leads to emission and cetation, but also by loss in terms of emission of a electromagnetic radiation that is rhythm style. And so the total energy loss now by the electron is some of the collision energy loss plus the radiative energy loss. And for the higher energy electrons and particularly you know it is, if it is going to stop in a I z medium, then the radiative losses become very, very significant. Just to give you the feel of that from the dominant role of radiative loss, the ratio of radiative to collision energy loss. So, this upon this radiative upon collision, collision losses, if you see these two terms, in the simple way it can be written as e z upon 700. So, we will not bother about these terms how it has been arrived, but e is the energy in MeV, z is the atomic number of the absorber upon 700. So, it is a very simplified way of finding out the ratio of radiative to collision energy losses. So, what it tells is that higher is the energy of the ion, higher is the radiative energy loss, higher is the z of the absorbing material, hydrogen materials, higher is the radiative energy loss. So, if you are having a hydrogen material in the vicinity of a beta emitter, then you will have more of radiations. So, that is why you handle beta sources, you have to be very careful about nearby high energy material, high jet materials. So, for beta particles of the order of 1 to 2 MeV, in fact, radiative energy losses are not that high, but if it is a high absorber, high jet material, then the radiative losses become significant for beta particles of this energy domain. So, when you do beta counting, the absorber, the plate on which you make the source becomes significant. You should not make the source on a high jet backing material, you can make on aluminum, not on stainless steel or any other high jet. So, let us now discuss more the Brim Stalin. The Brim Stalin, as I mentioned, it derives on the name of breaking radiation. That means, suppose you apply a break, so when you apply a break on electrons, electron is losing energy. So, how does it lose energy? Say, if it is going in the vicinity of a nucleus, and nucleus has got charged particles like protons, so electron can be accelerated in the vicinity of the nucleus or it can be decelerated, then any accelerating or decelerating particle, charged particle, loses energy by means of emission of electromagnetic radius. So, essentially the electric field of the nucleus, if the electron is accelerating or decelerating, then it will emit a electromagnetic radiation. And this electromagnetic radiation is in fact, in the case of electrons, it is 10 power 6 times more for electrons than that for protons. So, why it is so that we did not have the Brim Stalin type of radiation in the case of protons and alpha particles. So, the explanation lies here, that is the force, the coulombic force between the electron and the nucleus, you can say mass into acceleration, mass m into a. So, the acceleration is f upon m, and the Brim Stalin intensity is proportional to square of acceleration. So, acceleration square, so if you assume that other things are constant, then it is 1 by m square. So, the Brim Stalin intensity is proportional to 1 by m square, where m is the mass of the accelerating ion. So, now based on this you can say the intensity of Brim Stalin for electron divided by electric intensity Brim Stalin for protons can be in terms of inverse ratio of their masses, that is the mass of the proton square upon mass of electron square. And you know the mass of proton to mass of electron is sum of 2000 and square of that is of the drop million times. So, that explains the Brim Stalin intensity for past electrons a million times more than that for the proton. So, as a result of that you will find we do not have Brim Stalin for protons and other particles of energies of few MEVs. But you can see that when the proton becomes relativistic, when the proton energy becomes GeV, Giga electron volt, in fact there are now actually machines which are running at 1000 GeV. So, at 1000 GeV proton becomes relativistic and you will find that the you will have the high energy relativity radiation emitted by protons. So, only we are talking about the low energy at MEV range protons and other particles we do not talk about Brim Stalin. But if you have relativistic protons and other particles they will also emit Brim Stalin. Now, this Brim Stalin I will see the spectrum the energy Brim Stalin is a continuous energy spectrum. So, if you have a electron of energy this much, then maximum energy of Brim Stalin can be energy of the electron, other it is a continuous spectrum and the average energy will be somewhere one third of the maximum energy. So, Brim Stalin gives you a continuous spectrum with average energy one third of the maximum energy of the positive electron. This is in fact a mechanism to produce gamma rays from electrons. These days you can easily have high electron high energy electron accelerators. So, if you want to have a intense source of photons you can use high energy electron sources and bombard them on high jet material like tantalum and you can get or tungsten you can get electrons and the photons of all energy spectrum. So, now, I like to discuss the range of heavy charge particles and what we saw that the heavy charge particles they in the transmission graph what I was showing here is the intensity of the initial electron is i 0 is passing through a thin slice of material and the transmitted intensity is i this is delta x then i upon i 0 that is called the transmitted intensity for fast electrons. If it is a mono energetic electrons like we have one energy electron then it will be just monotonically decreasing the intensity of this because the electrons get lost from the path in the beginning itself unlike in the case of alpha particles for alpha particles so we have like this this is for alpha or protons. For electrons you will find electrons start getting lost from the path from the beginning itself and that is why we cannot define you do not have a well defined range for fast electrons. So, normally you there is no point doing an experiment to determine the range of electrons for mono energetic electrons but for beta particles what happens the beta particles it has been found experimentally that the transmitted transmitted intensity follows an exponential decay that is given by this expression i equal to i 0 raised to minus nx where n is called the beta absorption coefficient and this n the coefficient correlates well with the beta and the point energy what means the end point energy the maximum energy of beta particle. Now, you know that the beta spectrum is a continuous spectrum why it is continuous spectrum we discussed in the beta decay that because of the emission of three part three body interaction. So, you have a electron you have a neutrino and you have the dotted nucleus so the energy the q beta q beta is shared in a different infinite number of ways between among the electron neutrino and heavy residue and therefore this continuous spectrum of beta is responsible for the exponential decay. So, it does not have any phenomenological explanation why beta decay attenuation transmission graph shows an exponential decay. So, what essentially happens is that the low energy part of the beta spectrum gives rise to the initial part of the exponential decay and the later part the high energy component of beta spectrum gives you the later part. So, it is a fictitious type of correlation it does not have a any particular basis based on a particular concept. But it became very handy in the earlier times you know when we did not have the advanced detector systems then you people are determining what you do you take a you take a source of beta and you put coils of different thickness different coils and you are measuring the loss in the intensity as a function of you put keep on putting different coils and what fraction is going out. So, this is experiment you know this is the so many coils you put and you generate this graph. So, i and i0 and what they found this is an experimental finding that the beta decay attenuation intensity is attenuated in a exponential fashion and this attenuation factor absorption coefficient n it has got excellent correlation and so from the n value one could identify the n point energy at that time the the radiochemistry people particularly know we did not have no access to high equipments. So, you like a mass spectrometer now you can determine this with respect to by mass spectrometers but do you want to find out n point energy of beta you just do a simple attenuation experiment like this one and you can find out what is the energy of this beta. So, beta counting in fact is requires that you need to really take care of this attenuation. So, if you have a thick absorber for example you are doing beta counting how do you do beta counting you have a sample you on a plate you put this precipitate and you put it in a you have a detector. So, beta will go from here to here you detect the beta. Now, if this absorber material is having high Z material like lead or stainless steel or tantalum then there will be back scattering that is one back scattering and second is the self absorption. So, this precipitate will be absorbing it will absorb and third may be the radiative losses. So, if it is a high Z material brimstalline also can take place. So, when you do beta counting one has to be very careful not to use high Z backing material for beta. I did not discuss this part in the beginning one of the dominant mode of interaction of harsh electrons because the energy lost by this mode is very small fraction. So, it does not really matter when it comes to loss of energy by electron, but it is a very fascinating topic to discuss and in fact, it is also used in the detection of electrons and this is called the Cherenkov radiation. Some people call it Cherenkov I will say you can use the term Cherenkov. So, what is Cherenkov radiation? So, blue the blue light that is emitted in a react swimming pool type of reactor. So, that is a particular manifestation of the Cherenkov radiation that is imitated and the beta particle is passing through a dielectric. So, what is Cherenkov radiation? When a charged particle passes through a transparent dielectric medium with velocity more than the phase velocity of light in the medium then this charged particle emits electromagnetic radiation which is in the UV visible range. So, the energy of the photons that are coming out is very small. So, a tiny fraction of the electron energy is utilized in Cherenkov radiation, but it is very interesting to see even this one if you put appropriate proton multiplier tube you can detect the electrons energy electron intensity by means of this Cherenkov detector. So, what exactly happens? Why, what is the mechanism of this? So, what happens that first of all the condition for this Cherenkov radiation is that the velocity of electron has to be more than c by n. What is c? c the speed of light which is reversal constant n is the refractive index of the material through which the particle is passing through. Now, if you see the v by c velocity of the electron upon c velocity of light called beta then it becomes beta n has to be more than 1. So, the condition for Cherenkov radiation is beta n is more than 1. How can the beta n be more than 1? The velocity of the ion can be close to c at the most. So, it cannot be more than c. The relativistic ion we just now saw 1 MeV electron has the beta value 0.94, but it is not more than c. So, if you have a medium of high refractive index like glass 1.5 there are certain materials dielectric materials which are transparent and have the refractive index close to 1.5 then c upon 1.5. So, the phase velocity of that light in that medium becomes much less than c and therefore, velocity of that electron becomes higher than that velocity of phase velocity of light in that medium. And as the electron is moving sincerely the concept behind that that electromagnetic field associated with the electron, electron is moving in the direction it has got electromagnetic field associated with that field moves with velocity c by n. And so, the electron is moving much at much higher speed than these velocity of the field associated with it in that medium. And it is like you know the field is left behind there are the electrons. And so, that field is appears because of the field leaving behind the ion it is within a core and this condition is met for a very small time because the ion electron will only lose energy in the medium and that condition will be not met. So, till that condition it met which happens generally in the high energy part of the beta then you will find for that particular time in the initial phase of this which is a journey it will emit that light and that light happens to be in the blue region that is why the Cerenkov radiation is having blue in blue, blue range. So, this is a typical swimming pool reactor U in Trombay and you can see the beautiful blue, blue color in the swimming pool. So, any swimming pool type of reactor if there is a fission has taken place then the fission products are limiting beta particles of high energy and you will see blue light. So, Cerenkov radiation the in terms of energy loss is not much, but it is important in terms of the duty of the radiation and the detection of the beta bisectron. Lastly, I will discuss the interaction of positrons. Positrons are also anti electrons to the in terms of collisional energy loss and radiation energy loss they are similar to electrons they are no difference, but there is several different electrons in positrons that this positrons when they thermalize in the medium the positron comes close to an electron and annihilates with an electron the electron positron annihilate and you do you get two so the rest of the energy of electron positron is 1.022 Nv that energy is now emitted in the form of photons and since the electron and positron as you thermalize the pair momentum is 0 the two 511 kV photons are limited at 180 degrees. So, this is the positron annihilation gives you two 511 kV gamma rays which are limited at 180 degree why at 180 degree because the momentum is 0 when the positron is thermalized its momentum is 0 electron is assumed to be already stationary or very low energy. So, at that time when there a system is annihilating mass is converted into energy in that of two photons the two photons have to have zero momentum and that is possible when it is emitted at 180 degrees. In fact, there is another mechanism of three gamma emission and when the three gamma emission happens then they have to be of at 180 degree 120 degrees each. So, but the three gamma probability is much smaller than that two gamma and in fact very rarely you see three gamma. So, the reason for the two photons emitted 180 degree because of the zero momentum and another very interesting aspect is the positronium atom formation. In fact, the positron and electron can form an atom like hydrogen atom, proton and electron hydrogen atom, positron and electron for positronium atom and the positronium atom has a beautiful chemistry. So, there is a subject of positronium chemistry itself and lastly the positron emission tomography. The fact that the two photons are emitted at 180 degree is utilized in detecting the tumors in the human body by injecting a positron emitter like chlorine 18, carbon 11, oxygen 15 and so on. So, many positron emitters when they are put into the body and they emit positron the positron in a relay give two filaments giving gamma ray and they can be used to detect the position of the tumors in the human body. So, we have lot of applications of this positron I thought I will touch upon this aspect in this particular. So, I will stop here. Thank you very much. Next time I will discuss the gamma ray interaction. Thank you.


Yeah. So kind of staying on topic about the nuclear power thing. Yep. For the last five years, I read my local newspaper every week on the weekend issue, Sunday issue. They have 10 local economists.  And they ask them some question. And it's a yes or no question.  And I can't remember ever hearing in five years a single thing Good said about nuclear power. And then today in the most recent one, the question was, is California, it's a grid, too reliant on renewable energy? And there are four out of 10 had a positive mention of how nuclear power, new nuclear, should be part of the discussions of if you're serious about greenhouse gases. And these are all just like either from, in standard political jargon, just either to the left or progressive or moderate maybe some of them. So I don't know if there's some memo that got out that said, OK, it's approved now. We're allowed to start talking about nuclear or we can say some good things about it. But we've gone from five years of only bad to in the same day, four out of 10 economists are giving some sort of thumbs up on it. I definitely think there's been a movement over the last few years that's become more positive about nuclear partially because anybody who is honest and who thinks climate change is an issue. And I know some people think that's impossible to be honest and to think climate change is an issue. But I think there are a lot of honest people who think climate change is an issue. Also realize that the only solution, if you're worried about fossil fuels, is nuclear power. There is no other solution, period. And I think that has become more and more and more obvious to the better people, to the more honest people. I was just listening to John Cochran today who was one of my favorite economists. I talk about it a lot. And he thinks climate change is real. He doesn't think it's imminent or catastrophic imminently or anything. It's just imminently existential. Yeah, he doesn't believe that. But he said the only way to deal with climate change is through nuclear power. I mean, it was obvious to him, it wasn't even a question. So I think that is dawning on people. I think there's been a lot more press about nuclear power that's positive. I seen just in the science engineering kind of press, there's been a lot more discussion about new nuclear power plants being built, about new technologies, new startups being started. And then I do think there's the Bill Gates effect, right? Bill Gates is the last two, three years it's been commonly known that he's heavily invested in this one nuclear power startup. There was about to build a sample nuclear power plant in China and the Trump administration banned him from doing it because of technology transfer or something. They didn't want China to be beneficiary of this. And now it looks like the Biden administration is approving their ability to build a sample nuclear power plant in Montana, I think, that they're transforming an old coal plant into a nuclear power plant. And it looks like they're going to start construction this year with the idea that it'll be finished by 2025, which is really fast for nuclear power plant. But it's a smaller plant produces less energy but also no, it recycles everything. So no waste and relatively cheap. And so I think the fact that he has talked about it, the fact that there's real venture capital money flowing into it, I think all of that has come together to make it more acceptable. It's still true that on the left, particularly among the environmentalists, maybe it's in Wyoming, not Montana, one of those states. And among the environmentalists, it's still not acceptable at all. But yeah, I think that's one area where there's probably movement towards the positive in accepting it among, certainly among the rational people out there. Yeah, I think I saw the tide turned today. I think the writing's on the wall now for it to pick up positive momentum. Yeah, I mean, the Scandinavians, I think it's Finland. Finland is building these massive, it's just built this massive nuclear power plant. I mean, so Finland and France, I guess, Finland's other European country, they're not, they're going full throttle ahead with nuclear. They're not waiting for the rest of the world. They don't wanna be dependent on natural gas from Russia. They don't wanna be dependent on oil from the North Sea from Norway because there's some reason to believe that the Norwegians are not really investing in new fields up there because they, partially because it's state run, so they're not that forward thinking and partially because they're fundamentally anti-fossile fuels and then they're drilling for fossil fuels. So the Norwegians are kind of torn. So Finland is gonna be energy independent, basically a nuclear, and I think Sweden is as well. Somebody says, Wanda Friedman says Sweden is as well. Because they don't want these dependencies and they realize that this is the rational, technologically sound, this is the future. And one of the sad things is that the US is so behind on nuclear. And nuclear is a fascinating field because I think we went into nuclear too quickly because government subsidized it. Because of that, we built nuclear power plants that weren't that good. They were marginally less safe than otherwise and they just didn't run very efficiently and were very expensive and so on. So they became very unpopular because they were expensive and then we had three mile island. So then the environmentalist had a pseudo excuse to promote banning them. But that's because we went in too early because of government. So we never allowed the market in nuclear to evolve properly. Whereas other countries waited and they invested in nuclear only after the technology was much better. And that's why in Western Europe and in Japan, nuclear power plants are much better than they are in the US because they came on board much later. And then they had less of a crazy backlash against it. It's funny how in some ways, in some areas, Europe is saner than the US where they have less regulations. They don't quite believe in the regulatory state quite as much as we do. Debbie. So a couple of comments on that. First of all, on behalf of Alex Epstein, I have to point out solar and wind are not renewables. They are unreliables. Yes. And they are. I just an interview with Alex like an hour ago, we did a whole hour on Puerto Rico. So hopefully he'll, and we talked about nuclear and we talked about unreliables. Yeah, I was just thinking of Alex, here's this. He has to be redeemed with this. No, no, they're not renewable. Did I say anything? No, it wasn't you. Okay. Yeah, no, it was Matt. And I think that was- That was the title of the question in the newspaper. Yeah. Yeah. Yeah, no worries, Matt. Yeah. And then also there's a really good book about this, about nuclear power. And it was written by, I can't remember the name because it's been many years since I've read it, but really good comprehensive book about nuclear power. And it was written by an environmentalist who learned about nuclear and about how unreliable the unreliables are. It's called Power to Save the World. So they talk a lot about the history of nuclear power and why people are so afraid of it. And then also why the wind and solar are absolutely not any kind of a path towards an industrial civilization. So it's really great. I don't know why it didn't get more exposure. Well, no, I do actually, probably because it was written by an environmentalist who kind of saw the light on that and realized that it's not. Solar and wind aren't gonna get us anywhere good. What we need today, what I call the new intellectual would be any man or woman who is willing to think. Meaning any man or woman who knows that man's life must be guided by reason, by the intellect, not by feelings, wishes, whims or mystic revelations. Any man or woman who values his life and who does not want to give in to today's cult of despair, cynicism and impotence and does not intend to give up the world to the dark ages and to the role of the collectivist brought. All right, before we go on, reminder, please like the show. We've got 163 live listeners right now. 30 likes. That should be at least a hundred. I figure at least a hundred of you actually like the show.  But at least the people who are liking it, I want to see a thumbs up. There you go. Start liking it. I want to see that go to a hundred. It all it takes is a click of a thing whether you're looking at this. And you know the likes matter. It's not an issue of my ego. It's an issue of the algorithm. The more you like something, the more the algorithm likes it. So, you know, and if you don't like the show, give it a thumbs down. Let's see your actual views being reflected in the likes. But if you like it, don't just sit there. Help get the show promoted. Of course, you should also share. And you can support the show at yourunbrookshow.com slash support on Patreon or subscribe star or locals and show your support for the work, for the value, hopefully you're receiving from this.  You'll know what shows are on, when they're on. You'll get notified, right? So, yes, like, share, subscribe, support. Like, share, subscribe, support. There you go. Easy. Do one or all of those please.


Yeah, I think we should get started. All right guys, so this review will have some pictures that I'll like you to basically diagnose and tell me what it is. Morning Rachel. You know, I really thought about how to present a review material as high yield as I can for you guys this morning. You know, I know an hour of your time is very, very precious. So I went over all my kind of old old cap notes and kind of really the high yield material, all the questions. So yeah, I'll ask you questions of kind of what the high yield material is kind of to focus you on. Okay, kind of what you need to know, but it'll be kind of random, all right? Okay, so first question, just keep track. So group one, what's the diagnosis? Some of the pictures are not the best, but that's not an excuse. Okay, all right, what is it? Nope, what's? Nope, so this is a PVD, okay? Not very good. That's a weissering that you're seeing right there, floating around, okay? That's okay, that's okay. Just to give you guys a sense of some of the pictures not good, this is one of the worst ones, so it's okay. So okay, so no points for that. So let's talk about kind of a PVD, okay? How it happens, PVD. So when there's a partial PVD, so there's liquefaction and then there's a cineresis of the vitreous. Fluid can get underneath the macula, okay? The periphobia, and that's a partial detachment. What's the area around anatomically, what's the area around the vitreous adhesion to the optic nerve, what is it called? Area of martigiani, okay? No points there again, okay? And then you have the vitreous connected anteriorly. Where is it connected to? What is it called? To the lens capsule, what is it called? Ligament of weird, or something, we something, okay? No points again. And then what's the space between anterior vitreous and the lens capsule, burger space, okay? These are, you know, you'll see these all in the OCAPs. These are like the minute questions that the OCAPs ask. And these are the questions I'll be asking you today, like the weird associations that they love. So once the PVD or the vitreous detaches from area of martigiani, then that's complete PVD, and that's what you see kind of the y-string, okay? PVD, and I'm not gonna belabor the clinical findings of PVD and the differential diagnosis, but some of the high yield topics are earlier onset, is in myopia, diabetes, trauma, uveitis, and cataract surgery, okay? And then the clinical points, that's usually not tested, but clinically you should know that, okay? All right, this group, what is this? Great, coital rupture, okay? So for those of you not sure where the coital rupture is, is that crescent right there around the optic nerve for trauma that's usually where it's located, constructed to the optic nerve, okay? Things that you need to know, anteriorly they're parallel to the auricirata, okay? And then the complication for coital ruptures are coital neobascularization that can happen, okay? What is this? This group, okay? Is this one, I think that's my answer would be, for this one this is commotion, okay? Question for commotion is where's the damage? What's the mechanism? Photosubter, so outer retinal, okay? So that's the OCAP question for commotion is that it's in the outer retina, okay? Very good. Next one, this group, what did you say? Tersens, okay, that's one. It's not tersens. Perture, okay, very good. So some of the things that you need to know about OCAPs for perture syndrome, so what's the mechanism for pertures? Least of cytokines and crush injury. Yeah, compliment, that's the buzz word for perture's compliment. So what are the things that can cause pertures? Pancatitis is the big thing that they always kind of ask questions, but trauma to long bones, fat embolism, amniotic embolism, those are the ones that we cause for pertures, okay? So lots of cotton wool spots, those whiteing that you can see some pre-retinal hemorrhage, okay? Fat or amniotic fluid embolization, crush injury to the chest, long bone fractures and pancreatitis, this is the case scenario that you'll be given, okay? This one, this one's a little bit hard, but let's say this is kind of a baby, this group. Perfect, non-accidental trauma, okay? So you have those blood with a white center. This doesn't typically come out of OCAPS and AT, so. Okay, this one, this one has history of trauma. What is this group? All you guys are looking at, for those of you that just came in right now. So I went through all my notes last night and kind of looked at kind of the high yield questions that I've seen over the years for OCAPS. And just going through it. Okay, what is this? History of trauma, okay? Let's say a gunshot wound. Like a scleral rupture. So this is called sclopateria, okay? So the typical board's question is sclopateria. What's the mechanism of sclopateria? Shock waves, okay? So it's not direct impact. It's kind of the shock waves from something, okay? So that's sclopateria. High velocity, it's not really contusion, but it's shock waves, okay? Very good. This one, what is this? Perfect, that's what it is, intracular foreign body. You try to rule out a globe. And we've all, I have some questions here that I thought. So sometimes when intracular foreign bodies are inside the eye, sometimes it's never detected, right? And there's chronic findings. If it's iron, you can have heterochromia, cataracts, optic atrophy, if it's copper, chalcosis. One of the, so one of the questions for OCAPs is, where is copper located in the eye? And what does it look like? Copper. Where is it? Yeah, yeah, what's a typical, like, where is copper? Desimace. Desimace, okay? So that's a typical question in OCAPs. Copper is in a decimace. And then iron, remember there's heterochromia, okay? The initial findings are, you know, sometimes ERGs. That's another typical question for ERGs. For iron, ERGs are normal. And then you get, I think, lowering of B waves, okay? So iron, copper, copper, what's the finding for copper? And cataracts, what is it called? Yeah, perfect, good, yeah, so those are the questions. All right, what is this? Perfect retinal detachment. What are the predisposing things for retinal detachment or what are the lesions not predisposing to retinal detachment? Okay, hi, Mayopia, who? Lattice is predisposing to retinal detachment. What else predisposes to retinal detachment? Sure, I'm thinking of anatomic things inside the eye that you would see that we say, you know, this is how your risk. How about vitro retinal tuft? Is that predisposing to RD or not? Yes, good. How about like enclosed aura base, meridional folds? Yes, very good. How about cobblestone degeneration? No, perfect. How about reticular degeneration? Perforal cystoid degeneration? No, okay, so those do come out, okay? Anything else about retinal detachments? Retinal detachments versus retinoschesis, do you get an absolute scatoma or a relative scatoma in retinal detachment? Relative scatoma, okay. So I think about it in retinoschesis, the layers are split, okay, and you don't have a connection between kind of the retina and that's why they have an absolute scatoma. In retinal detachments, does lasers burn it or is there a whitening when you laser it versus retinoschesis? Yes, for retinoschesis, correct. There's a whitening when you add retinoschesis, okay. Very good, retinal detachment. We've all known kind of the three different parts, retomatogenous, exudative, and tractional, okay. Not gonna go through that. And they typically don't ask about kind of surgical approaches for retinal detachments. Okay, speaking of which, what is this? Schesis. Schesis, okay. Where is the schesis? Outer plexiform, so is this degenerative retinoschesis or juvenile retinoschesis? Degenerative, okay, because it's in the kind of the outer nuclear layer. Where is a juvenile retinoschesis split? Okay, yeah, I just think about it like RNFL for some reason. So retinoschesis and their fibro layer for the juvenile retinoschesis, very good. And it's usually located in for temporarily. Let me just think. Oh, for retinal, going back to retinal detachments, the other question is where breaks can usually happen for trauma when you get a trauma and you get a break? Where do you usually see it? Infer temporal is number one. Super nasal is the other one, okay? So I've always kind of remember, it's not the best kind of remembrance, but so once you have trauma, the globe expands equatorially and it's just kind of a little bit not equator, but infer temporal, I don't know if that makes sense. Probably not. All right, retinoschesis split occurs between the inner nuclear and outer plexiform layer, okay? So that's important. And oh, the other thing that comes out for OCAPS is its association with hyperopia, okay? So that's the important one. Like these small things really does matter. So I remember because a retinal detachment it's associated with myopia and retinoschesis it's associated with hyperopia and it's always confusing with these associations of hyperopia and myopia. So just remember hyperopia and retinoschesis, okay? All right, next thing is another high yield one. Which group is next, okay? That group, if I would describe this, I mean the buzzwords are kind of retinal folds or spoke like things in the macula, okay? This group. Come on guys, spoke like. Yeah, this is juvenile retinoschesis, okay? This is another high yield one, okay? Juvenile retinoschesis, and let's see. This is one of the differential diagnosis for vitreous hemorrhage in a kid, okay? Juvenile retinoschesis. What are the other differential diagnosis for vitreous hemorrhage in a kid? What do you think about? Trauma. Trauma, good. Sure. The classic ones. ROP. Not really. What do you guys think about for vitreous hemorrhage for a kid? Trauma. RV is one. Juvenile xanthogranuloma is another one. Intermediate uveitis is another one, okay?  How about this is another one? Juvenile retinoschesis, okay? Very good, very good. All right, what is this? Who is next? That's Lattice, okay, very good Lattice. So for Lattice, when you see Lattice, even kind of clinically, you have these like the RPE hyperpigmented and you have a trophic vessels to white when crossing it. That's characteristic of Lattice's generation, okay? So Lattice, you guys talked about it already. This is a risk for retinal detachment, but the risk is low. That's why we don't prophylactically laser these, okay? Very good. Good. All right, this one. Cole, you said it? Very good, CRA. So cherry red spots, other cherry red spots are Tay-Sachs, Neiman, Pig, commotion can look like this, okay? Typically, you have acyclineal retinal artery. That's why you get the macula sparing. Speaking of, let's talk about the anatomy first, okay? Some high yield things. What's the, how big is the macula dimensions? 5.5 millimeters, okay? So 5.5 is the whole macula. So how about the fovea? Less than that, right? 1.5 millimeter. So the fovea is the same as the optic nerve, basically area. So optic nerve is about 1.5. So fovea is 1.5. How about the para fovea? 0.5 outside of the 1.5, okay? It's a ring of kind of a 0.5 millimeter in that kind of radius. And then outside of that, the periphovia. Yeah, periphovia, then periphovia. Yeah, around one, yeah, good. I think it's two, actually, okay? So, so, it doesn't equal 5.5. That's what I remember when you, when you, so, so, but that, but you know, but those dimensions are, or sometimes you get asked those and kind of where that is. And then the foveola is kind of 0.35, okay? And was there a question? Okay, so C-R-A-O, a lot of things to think about with, you know, for O-CAPs, they don't actually ask a lot of the C-R-A-Os, B-R-A-Os, B-R-B-Os, you know? This is one of the most common things we see in clinic, but they don't ask a lot of that. They, you know, if it's a kid, you think about metabolic storage diseases. As I've said, Tay-Sach, Sniemenpik, Sandhoff, and Hurlers. Let's see, very good. Yeah, the cellular retinal arteries, sometimes they ask about that. Okay, this one, what is this? What's next? This could be a lot of things, right? So, but what is this? Well, salvo retinopathy, yeah, this is a classic one. So, you know, for those of you who haven't seen this, this is kind of just a hyaloid, kind of circling, and then you have it. So it's a pre-retinal hemorrhage trapped by hyaloid. So history of sneezing, coughing, and you know, lifting heavy stuff. Very good. Good, nothing else gets asked about that. This one, what is this? Not very good. Anybody? Yeah, great, yeah. So this is a B-R-A-O, okay? B-R-A-O, very similar to C-R-A-O in terms of how they ask, you know, how they would ask questions for basically a stroke workup. Just remember, emboli from carotids, hard valves, it could be calcium or arteriosclerosis, okay? Very good. And this one, blood and thunder, C-R-V-O, very good. Very good, C-R-V-O.  So you can find that through FA. That doesn't get asked anymore as well, okay? But if there's a neovascularization, you do PRP. Very good. This one, B-R-V-O, good. Blood and thunder, kind of, sectorally. Very similar, okay, very good. Very good. Oh, one of the questions that get asked for B-R-V-O is kind of what quadrants the most common, you know? So it's super temporally, okay? A lot of things to remember right now. Okay, what is this? So cotton wool spots, not much hemorrhage. What do you think about? HIV's a good differential, for sure. This is hypertensive retinopathy, okay? So when you see more cotton wool spots than blood, think about hypertensive retinopathy. So just check for blood pressure. You can have copper or silver wiring. Good. Macular star, let's talk about macular star. Why is it a macular scar when there's exudation? Why is it that pattern? Where's the swelling? What part of the retina? Henlease rate layer, okay? And that's why it's kind of a, in a petaloid configuration. Other things that you can see in pictures are, I don't have pictures for this, sometimes in hypertensive retinopathy, are l-schnick spots or secret streaks. So sometimes they'll show you kind of a peripheral picture with these kind of dots. And, you know, that could be hypertensive. And then you'll just check for blood pressure. What is this? Perfect, okay, perfect, perfect. So nonproliferative diabetic retinopathy, a lot to know about here clinically. So the most important things to talk about here are, they have it here, is a kind of definition of a severe nonproliferative diabetic retinopathy. And that's the 4-2-1 rule. Four quadrants of dog blood hemorrhages or two quadrants of a venous beating or one quadrants of Irma. That's the definition for a severe nonproliferative diabetic retinopathy. Very good. Sometimes they ask questions about the trials, about, you know, insulin levels for type one or type two diabetics. So intensive control decreases the risk for even the prop and organ damage as well. Okay, what is this? Okay, so this is NVD from Diabetes. Would you do PRP on this person? Would you do PRP on this person? Yes, why? Because what? Partly, because I think, you know, the disc diameter of the new vascular may be about one half disc diameter. Okay, so if it's greater than that, you can, you know, that's the definition of high-risk PDR is important to know. If it's, you know, any NVD with vitrious hemorrhage, you do PRP. If it's a small NVD, you don't necessarily need to do PRP. If it's, you know, about half disc diameter. So even without vitrious hemorrhage, you can do PRP. NVE with vitrious hemorrhage, you do PRP as well. So those are the three definitions of high-risk PDR. There's also another set of definitions of PRP having, you know, three over the four. Do you guys remember all that? Okay, perfect. Very good. And then that's just what I said. New vascularation is greater than one third you do PRP, okay? If it's less than that, it has to have vitrious hemorrhage, okay? What is this? What is it? It's macular. Yeah, with macular. So this is a clinically significant macular edema. These definitions, you don't get, you know, fortunately I haven't seen a question like this in OCAPS or in the boards anymore asking for definitions of CSME. This is the old definition of when to do focal or grid laser, okay? But, you know, in here you can see that, well, it's hard to see, but this is, there's thickening of the retina within 500 microns of the fovea, okay? With associated exudation and that's the definition of clinically significant macular edema. So this person, back in the days, definitely would require to do focal. Nowadays, if we see DME, we would probably treat with anti-vegF, okay? So, but the definition of clinically significant macular edema are those three, okay? And just think about it as, you know, it focuses on thickening and not exudation. Thickening within 500 micrometers, 500 microns of the fovea. Retinal exudates within 500 microns of the fovea associated with adjacent thickening. And then retinal thickening, more than one disk area in size within what's the diameter of the center of the fovea. So if they have that, then they would qualify for focal laser, okay? All right, now it gets more fun. What is this? Sickle cell. So what do you see up there? Salmon patches. What is it? Salmon patch. Yes, salmon patch. Why do you get a salmon patch? What's the mechanism? What is it? For pro-fral vascular obliteration. So this is a kind of, we think that the sickle, there's sickling and then there's arterial occlusion and that's why you get salmon patch that gets asked as well. It's not new vascularization. That's kind of what they trick you on. And then below here, what do you see in FAA, buzzword C-fan. What's the other thing that can cause C-fan or the part of the differential that they like to trick you as well? No, not coats. Coats that's mostly telangiectasis, okay? That's the buzzword. Eels could be, but there's one that, you know, they're thinking sarcoid. Okay, sarcoid can cause like a C-fan in vascularization. So they'll show you kind of weird stuff. You see C-fan, it's not really sickle cell. Other things about sickle that's kind of tested. So, you know, so SS, you know, is the one that gets more systemic manifestations, but who actually gets more eye problems? Or Estal, okay, SC more than Estal, that's the other thing. Avoid carbonic and hydrogen inhibitors, especially for the ones with high FEMA. You guys know that. Other things, you see these, I've seen pictures of these as well, shown like kind of the, what is it called? Oh yeah, the sunburst spots, okay? Kind of that black thing. That's also highly testable and for OCAPs. Very good, good, good. All right, this one, what is this? Whose group is it? Okay. RAM, perfect, okay. So, those of you not sure where the RAM is, it's in this area right here, somewhere here, usually it's kind of in a vessel, you see kind of hemorrhage around it. You don't really sometimes see the aneurysm and then they'll show you some exudates. For RAM, they like to test this because it can have hemorrhages. It's one of the things that can cause hemorrhages in all layers of the retina, pre-retinal, intra-retinal, sub-retinal, et cetera, okay. And then what is it associated? What do you need to check on a patient if you see somebody like this? Hypertension, okay, so that's the answer. Hypertension, very good. And this one, this one's not easy. Anybody? History. Of radiation? Yeah. This is radiation retinopathy, okay? So, radiation retinopathy, so brachytherapy, et cetera. We just have a lot of pictures to go, right? Let's just go forward. So, you know, radiation retinopathy can mimic a lot of different things. You treat it just like a diabetic retinopathy, basically. Okay. Doses, never asked the question, I've never seen a question asking kind of a, you know, how much radiation it causes before your information, 30, 35, grace. But actually, when you start getting to 50 grace, okay, that's when, you know, 50% of the patients get radiation retinopathy. Okay, so that's really the threshold that I think about. Let's think, there was one more thing about, it's not really six months in one year, that's what I was thinking. It's more like a little bit longer than that, about 18 months before it presents. This one, so the other eye is normal, the other eye is not. Oh, excuse me. Very good, yeah. Usually mid-purple hemorrhages. You've seen a lot of this, hopefully, in call by now. O-I-A, O-I-S. So, carotid evaluation, five-year mortality is 40 to 50%, so pretty high. This one, he gets, you know, the next couple of sites are a bit difficult. Looks like it could be, like, hypertensive retinopathy. Yeah, it could be, right, yeah. So, this is leukemic retinopathy, okay? Leukemic retinopathy. What they test in leukemic retinopathy is somebody with kind of decreased vision, you see this and you have an APD, what do you need to do? Well, they have an APD. Well, like, for a leukemia. You get imaging, you know, and then what do you do with that? They need, like, yeah, emergent radiation. That's the answer. Yeah, that's usually, that's the answer. You get a CBC and if there's anything, you give two, radiation. All right, this one? Perfect, yeah, R-O-P. And what stage is this? Yeah, three. Yeah, I think it's a different patient, but so, you know, I ask a lot about R-O-P questions, you know, it's important to know the stages of R-O-P stage one, you have the line stage two, it's kind of a little bit more volume of the ridge. Stage three has a vascular proliferation to the vitreous. Stage four has a peripheral retinal detachment. Stage five is a total retinal detachment. You know, there's four A and four B. They don't ask about threshold disease, you know, you should know that, you know, things always change every year, but I've never seen any questions of when to treat just because it's always, I think it's always just kind of a moving target, you know, it's hard to test. But the things I do see is, you know, when to screen for R-O-P. So the gestation, what, how many weeks? Less than 30, yeah, sometimes it put 32, but it's less than 30, and then in terms of weight, less than 1500, and then, or, or if they have, if they've been in the ICU, if they've been septic, kind of just been sick, you know, maybe a little bit earlier. So those are the questions for R-O-P. We don't typically do cryo, typically just laser right now, and anti, you know, possible anti-vegetary, if it's really posterior, that's what you need to know for R-O-P. There's a lot in the BCSC about kind of the follow-up plan two weeks, one week. I've never seen any questions of that over the several years. This one, this one looks like RAM as well, right? So, but anything else that causes a lot of exudation? Coats, perfect, coats. All right, coats disease. So coats disease is one of the telangitages. So think about that for telangitage. Mac-Tel is kind of another telangitatic disease. This is the male unilateral disease. There's no genetic mutation for coats, so this is spontaneous. Another testable thing is the bimodal age distribution. So, you know, this is the disease that has two age distribution. I've seen that in questions. And I think that's it, you know, can cause a lot of a kind of a serious detachment. Okay, this one. This one, they love to test. What is this? Rachel's team. So there's stuff temporal to the fovea. What is it? Group two, Mac-Tel, perfect. So this is Mac-Tel, okay? It can still be called juxtaphoial telangitasia. And the BCSC, you know, even this year, they still kind of group it into three. Type one, type two, type three. Type two is Mac-Tel, you know, bird scenes research. But usually when you see, if you look at a fovea and you just see pigment changes, temporal to the fovea, okay? And nothing else around it, then it's a Mac-Tel. Other things that, you know, they ask for Mac-Tel is, you know, there's temporal leakage. There's like these atrophic looking cysts, temporal to the fovea. Anti-vegif does not respond very well to these patients. Those are the questions that get asked. Okay. Oh, and it's association with diabetes. So it's associated with diabetes. I think that still gets asked. Okay, this one, what is this? CSER, okay. So this is the classic smoke stack pattern of leakage, which doesn't really show very often. The other one is the expansile dots. Associations with stress, steroid use, type A personality, are, you know, sometimes anti-psychotic medications is another one that is associated with. And you just observe this, okay? They may ask questions about kind of treatment and the treatment is PDT, okay? Or laser. Okay, what is this? Optic pit, okay. Optic pit. What associations do you think about for optic pit? Rental detachment, so fluid can get in the optic pit and can detach the macula. So that's the important thing for optic pit. What else? Can't think of anything else. Oh, bear knows, we have another one, but yeah, papillorino syndrome, okay? That's sometimes they get asked as well with a PAX2 mutation. That's another thing for optic pit. Okay, this one, it's a good one. Okay, myelinated retinal fiber layer. What are the associations of myelinated retinal fiber? Hyperopia, myopia? Myopia, what else? I think about amblyopia as well. Okay, that's the other thing that they like to ask is amblyopia. Usually unilateral, usually is not visually significant, but again, you would see that in amblyopia. Very good. Okay, so myelination anterior to the lamina crevosa. Okay, this one, what is this? Yep, drusen, so this is macular degeneration. Okay, good, good. You know, for macular degeneration, they like to ask kind of the associations, what are the risk factors for, so smoking, hyper tetra family history, how about male or female? Female, okay, good. Trying to think, oh, the arids vitamins, that's kind of another high yield topic of what they ask, so just knowing it's vitamin C, vitamin E, luteins, e-sandine and zinc are in the arids two formulation. They don't ask about, you know, the arids one had beta carotene increases lung cancer, that's why we don't use it anymore. They don't ask about the old laser questions anymore for macular degeneration, mostly the anti-veg F now. And then the CNV, the three different types of CNV, classic or type one, type two and type three, okay. So, good. This one is a bit hard, but what is this? Toxo or OHS? Yeah, this is my optic degeneration, okay. So, that's why I said it's hard, I gave it to you guys. But yeah, that's what I thought actually when I first saw it, is probably kind of Toxo. You see peripapillary atrophy, you see kind of a thinned retina overall, so high myopia. So, I looked back in the BCSC and the definition of pathologic myopia is greater than minus six diopters or greater than 26.5 millimeters of axial length. That's, I think, typically lower than what I think most people kind of think about pathologic myopia. Since we're talking about optics, okay. Just throwing a couple of optics questions as well.  So, high plus lens or minus lens or like a high plus plane of concave or minus, yeah, okay. Very good. So, that's the question they ask, it's a plus lens. So, how do I remember it? You have a 90 diopter lens, right? It's plus 90, okay. It's inverted, okay. And when you go to do a PRP, it's also inverted. So, I think about a high plus lens. Okay, you get a wider view of things. Okay. It makes the figure, right? It's magnified as well. Since you asked that, how magnified is the main star wide field? Yeah, two. How about, no, not the wide field, but the PRP is two. How about the main star wide field? It's 1.5, but it's not tested in the O-caps. But it's a plus lens, okay. So, this is important because when do you do a minus lens? When do you need a... Like focal, right? You need a direct, highly magnified view. We don't do that as much anymore, even in residency, okay. But that's how I think about it. You use a 90 diopter, it's a high plus lens. You use that for PRP as well, okay. So, that's kind of an optics thing. Good. All right, this one. Good, what's your mnemonic? Good, what are they? Paget disease of what? The bone, sometimes they put breast, okay. So, Paget disease of the bone, okay. What else? Taylor Statenose, what else? Good, what else? Very good, what else? There's one in that mnemonic that gets tested as well. Beta thalassemia, okay. That's not in the mnemonic, so, but that gets tested as well. So, adjoined streaks. These are breaks in wear, brooks, okay. Very good, brooks. And you worry about crudal neurovascularization. Very good, good guys. One thing for pseudo-exanthoma elasticum, you know, that sometimes the case gets presented with a GI bleed, okay. So, think about a pseudo-exanthoma when a GI bleed. You have definitely seen that a lot. The other thing for like GI stuff that you think about is Von Hippolendau. Okay, when I think about that. Okay, that's it. Very good. Keep going. What is this? Macular hole, very good. And that white thing is all ERM, okay. So, macular hole. So, the stages of macular hole are important. You don't do surgery for stage one because they do a spontaneous resolution. Stage two is already a full thickness hole. So, through the RPE basically, but it's still small. Stage three is a little bit bigger. And stage four has, you know, larger already. Okay, this one. One guys, we still have a lot to go. ERM, very good. ERM, they don't ask a lot of questions for this, for ERM. But clinically, when it becomes 24 years or so, metamorphopsia that you can consider surgery. Okay, this one. What is this? Okay, or just a choroidal detachment. Okay, choroidal detachment. So, you can see kind of a, you know, it looks like the retinas detached, but it just looks like, you know, it doesn't have those corrugations. It looks thicker, you know, so that's kind of a choroid detachment. And ultrasound, you can see it as well. There's kind of a space. So, choroids detached. So, cord detachment, you know, the important point to think about is treatment. So, you kind of do a cycloplegic for choroidal detachment, okay. The other thing is choroidal detachment. If it's a choroidal effusion versus a super choroidal hemorrhage, what's the IOP, which is which, very high. Okay, so it's painful, it's high. And a choroidal effusion is gonna be low, okay. But the treatment is cycloplegics. When they become kissing, then you do surgery. But if not, then you just kind of watch it. You can, you know, you can drain as well if it's the really large. Good, I guess it's written there already. Yeah, many of these are important clinically, but, you know, for the old caps, it doesn't get asked. That's why I just skip over. Okay, what is this? Yeah, vitreous hemorrhage, very good. So, this is, you know, for vitreous hemorrhage we've talked about this for kids already. Very good, this one. RP, very good. What are the differential diagnosis for RP? The ones that they can trick, what do you think about right away when you have? Sure, coderod. What? You can, yeah, that's very good. Ducent for unilateral RP, you think about that. Syphilis is another mimicar. Azor is another mimicar, okay. These are the ones that get asked, you know, kind of trick you in the old caps of what it is. But RP, and which one is RP is the worst? X-linked, autosomal recessive, autosomal dominant. X-linked is the worst, okay. And then autosomal recessive is also bad. Autosomal dominant is the, you know, kind of easier. Oh, so associations for RP is very important, okay. So what are the associations, clinical findings in RP? Some of it listed here already. PSC. PSC, very good, that's one. What else? CME, very good. Optic disc, what? Druzen, very good, yeah, that's great. You do see that with optic disc, good. What else? That's for Usher syndrome, okay. You can have that for Usher syndrome. Anything else? Vitrucell, okay, so you can get mistaken for UVitis. So vitrucell. There's one obscure other association for RP. Vasoproliferative tumors, okay, is associated with RP. That gets tested as well, okay. You know, besides the waxy powder disc, attenuated vessels, okay. But vasoproliferative tumor, optic disc, Druzen, very good, those are the ones. Vasoproliferative tumor, yeah. When I think about vasoproliferative tumor, okay, I think about RP, I also think about R-O-P, R-O-P. Is there another association with it? Good. We don't do vitamin A palmitate, okay, and that will never get asked. High yield topics as well are the syndromic forms of RP, okay, the hearing loss Brad already talked about for Usher disease, I'm just thinking, what else? Kernsayer syndrome kind of has a salt and pepper retinopathy, heart block is what you think about for Kernsayer syndrome and CPEO, those are the things that get tested.  So this is, it looks very, very similar to vitamin A deficiency, okay. Other associations of RP is the one with a polydactyly. What do you guys think about that? Gets tested as well. Bardae beetle, very good. So Bardae beetle, they'll have a syndromic surgery. You have polydactyly, they get hypogonadism as well, intellectual disability. Okay, what is this? Croid oremia, this is, I think in every OCAPS, I always see a picture of a Croid oremia, okay. So just remember this. So Croid oremia, what's the genetic transmission? Excellent, good. So mostly males, okay. Croid oremia, what's the mutation? C.H.M., or what is it other called? What is it? Or, that's true. There's always one that they like to put. It's like geranol, geranol, something, something, so, but you remember the geranol, geranol esterase, it's a rabescopory, so they love putting that in, okay, for a Croid oremia, C.H.M. mutation. They put a chromosome in there, I can't remember what chromosome C.H.M. is. X. Oh yeah, it's X again, that's right, okay, nevermind. This is another one that they love to put, okay. So you see this a lot as well. And I gave this, what? Adgyrate atrophy, so gyrate atrophy. Very confusing, right? So, you know, ordnithine levels are elevated. And, oh, and then the treatment, the treatment. B6, and retric arginine, so very, very confusing, okay. I have a way to remember this, I forgot already, autosomal recessive, okay. Gyrate atrophy, okay. And it's ordnithine aminotransferase, okay. So that's the defect. This one, bullseye mycolopathy, this is combedestrophy, okay, combedestrophy. What are the mutations for, it's really annoying, but sometimes you just need to know a couple of the mutations, because the more that you know, what are the mutations for high, you know, that, it's never the answer, but you always see it in the answer choices. For con, goosey 2D, or like the goosey genes, okay. Goosey, yeah, yeah, goosey 2D, okay, for con dystrophy. Okay, this one, I know there's a lot of like, really my new points that I've seen a lot, so. So this is, what is this, come on guys. Irvine gets. No. Yeah. No, so pisiform flex, stargards, right, stargards. So is it leaking or staining? That's why it's stargards and not, or you know, not like CME, okay. Okay, what's the mutation? ABCA4, okay. What's the other mutations? Excuse me? PRPH2, very good. And ELOVL4, okay, PRPH2. Okay, what else do you think about PRPH2? These are tested. See these, PRPH2. Nope, pattern dystrophy, which is a bigger term and it's really adult viteleiform macular dystrophy. Okay, PRPH2, okay. Stargards and C's. So an FA, dark coroid, that's the buzzword for FA. This is autosomal dominant, okay. Don't worry about this, it's not tested anymore. Very good. Okay, this one? Best disease, what's the mutation? Best of it. Or VMD1, yes. So that's, you never see best one in the test, unfortunately, VMD1. So, and you know, what's abnormal in the test or what do you take it? EOG, and what's the ardent ratio? Less than what is abnormal? 1.6, okay. 1.6 is abnormal, okay, for the ardent ratio, okay. And this is autosomal dominant, okay. All right, very good. This one, I know, very good. Thanks for remembering that, yeah. I put this in. I said it was. This is tested as well. I'll be punctatus, okay. So, flavium aculatus is an old term for stargarts. We know it's stargarts anymore. So if you forget that term, that's probably kosher. So, this is a fundus albipunctatus, okay. What's the mutation? You see that? Yeah, awesome, RDH5, or, what is it called? I know there's a lot, right? I actually forgot, so there's another, there's a name for RDH5. Good, very good guys. Is it ready? So, this is one of the congenital night blindness that has an abnormal fundus, okay. That's what you need to know about this. CSMB, so it's non-progressive. This one, this one I haven't seen this, you know, this is highly testable, but I haven't actually seen this on the test. Oh, shame. Huh? Oguchi disease, very good. So, which one is dark adapted and which one's light and has light? That one's light. That one's dark, okay. So, when you dark adapt these patients, their fundus becomes normal. What do you point to that? To the left, left and right. All right, I'm sorry, right. This one is dark adapted, okay. So, when you look at a patient, they have kind of a darker-ish picture and when you dark adapt it for like several hours, like 10 hours or something, they become normal. So, that's Oguchi disease that's, and I've seen this, you know, term like even in the test, the mitzvul nakamura, something phenomenon, okay. You know, sometimes they'll put those things to trick you. So, Oguchi disease. Very good. This one, very good. So, this is albinism, okay. Albinism, a lot of things that they like to test on albinism. So, foveal hypoplasia is one. You see foveal hypoplasia, that's albinism. The tyrosinase positive, tyrosinase negative, that's kind of the older term for it. And it's really the oculocutaneous versus oculo, just the ocular forms of albinism. But the biggest thing for albinism is you need to think about Chediak-Higashi syndrome and Hermansky pudlock. So, Chediak-Higashi has neutropenia. They get a lot of infections and Hermansky pudlock. The peas, you know, platelets are problematic, Puerto Ricans and the other peas. Okay, I'm not gonna go over this. Autosomal, yeah, platelets, bleeding. Both of them bleed, but the other one gets neutropenic, so. Okay, what is this? This is hard. So, these are the kind of the differential diagnosis for pigmentary retinopathies. This is phenothiazine toxicity, okay. What are the phenothiazines? Chloropromazine and? Thyroidazine, okay, the old anti-psychotic medications. Let's see if they get bipolarous. And this one, bullseye maculopathy. These are medication toxicities. What is it? Plaquino, or chloroquine, okay. Chloroquine or hydroxychloroquine. I don't, you know, they never look at the numbers. I've never seen a question of, you know, how much, but that's highly testable. Okay, this one. This is hard. This is a differential diagnosis for crystalline retinopathy. So, what are the crystalline retinopathies? Tamoxifen, talc, biedi, so this is biedi, okay. What else? Catazantine, right, like in sunblocks or tanning agents. Methoxyfluorine, the old kind of medication. So, crystalline, you know, you can have crystals for Mac-Tel.  Cystinosis is another one. So, for crystalline retinopathy, okay, good. Bernstein has never seen this as well, so. This one. End of a dot. Let's, eight o'clock. I think we should stop. What is that? Solar retinopathy, okay. Let me just see if there's any good ones. Oh, I was gonna go over this one. So, what is this? Hemangioblastoma from von Hippolandau Disease, chromosome three, right? You get a lot of cysts in the GI, pancreas, kidneys, epididymis. Hemangioblastomas in the brain. I can go over maybe this one. This one. Port Weinstein, Sturge Weber syndrome. The important thing is glaucoma. When it's below 10, it's, you know, angle dysgenesis. This is the mechanism for glaucoma. After 10 years old, the one older, it's Episcleros fetus pressure. That's one that gets tested. Remember, when there's double use, they are spontaneous, okay? So, the wilds, this one. Good, racemos angiomatosis. Racemos something angiomatosis. There's no cap, intervening capillaries. It doesn't leak this one. Good, retinal astrocytoma from tuberous sclerosis. The genes are TSC1, TSC2, chromosome nine, and chromosome 16. Subongal, you know, the subongal adjuv fibromas. Calcification through CT. And then you get proidol hemangioma. So, this one is important, just proidol hemangioma. So, just remember, you have it with ultrasound. So, this is high reflectivity, okay? So, kind of close in here. The high reflectivity, you think about proidol hemangioma. Lower is melanoma, okay? Low to mid is melanoma. That's the biggest thing. Terpy, this one. Melanocytoma, proidol melanoma. These are METs, neural retinitis. Oh, for neural retinitis. What are the, you know, there's two bugs, right? Bacillostoma, something, and acilostoma. Those get tested. I think that's it, okay? I'll talk about the retinol necrosis in FAA next week. What do you guys want to review for FAA next week? For, I just want to have it more high yield. I'll think of something. Okay, thanks guys.


The following message contains distressing scenes based on hate crimes prosecuted in Wales. Actors have been used and details changed to protect the victims. Because of who I am and the job I do, prejudice is something I live with every day. You don't belong here.  An attack hurts, not just in the moment. It's something that stays with you and affects you afterwards. It makes you question your place in society. Am I safe here? Can this ever feel like home? When am I going to be attacked again? The fact that my offender was taken to court and prosecuted gives me hope. Reporting this hate crime will help the wider community and not just me. I want to show offenders that they won't get away with their hate. This is my home too. Hate hurts Wales. If you see it happen report it and get support by calling the police or visiting gov.wales slash hate hurts Wales. Let's stand up to hate crime together.


A troupe of young dancers show members of the Scottish Parliament some well-practiced moves at the Tramway in Glasgow. They are just back from a series of shows in Belgium, one of the many overseas performances this group has staged in the 19 years it's been in existence. Independence I think represents the best in Scotland. We do it and we do it really really well, so independence are a great example of inclusive dance and we should be proud of it. If you are the European Committee in the Scottish Parliament and what we are looking at is Scotland's place in the world and how we influence that and this strand of the enquiry is all about Scotland's international relationships. Is there anywhere else outside of Europe you think you would like to go and dance? Yes. Would you like to go Adam? New York. I really enjoyed myself today and I'm really impressed with what you've done and we can congratulate you. Thank you. Thank you for coming to see us. It was a pleasure to be here with you today. Thanks for coming to see us. My pleasure. This is the type of thing that this enquiry is looking at how Scotland connects internationally. The things that we do in the world and we take to the world and we learn from the world so that's what we want to learn from you whether it's a professional group, whether it's a college or a university or even a local group if you're involved in something that takes Scotland's culture and whatever manner that is to the rest of the world we want to hear from you, we want to know how you do that, why you do it and the benefit from it. What international activities are happening in your sector or organisation now? What gets in the way when it comes to engaging internationally? What would help make you more effective in participating in overseas activities? What do you think organisations in Scotland should do to make an impact internationally? We can get in touch with us by email, by post or through social media. We need to have your views by Friday, April the 17th. You can get further information about the committee, our work and how to submit evidence on our webpage, we're looking forward to hearing from you.


Making changes in bulk can save you a lot of time since you won't have to do it one by one. So for example, right now we're in the drafts page. Keep in mind that bulk change options are different for the products, orders and drafts page. So let's take five items for example and make some bulk changes. So let's take this one, this one, this one. Just take two more, this one and this guy over here. So we got five items, five items selected. The first option is to edit all of them. So if we click on that and the plus over here, you'll have all of the options, all of the changes that you can make in bulk. So for example, you can change the break-even percentage, the additional profit by a fixed dollar amount or by a certain percentage, the items quantities, the stock monitoring, price monitoring, auto ordering and so forth. Those are the changes that you can make in bulk. Next you can import all of the products that we selected. So since we're in the drafts page, we can import them to the products. Once it gets imported to the products, all of the products that we selected will show up in our store. Next you can also remove the items from the list. This will remove them from the drafts. If you want to re-upload the items, you can do so using add products. So obviously you won't have removed from list or import all in products or in orders because these only apply to the drafts page. So those are mainly the changes that we can make in bulk. It saves you a lot of time instead of having to do it one by one. So be sure to take advantage of that. If you would like to create bulk changes to all of the items, instead of having to click each checkbox one by one, you can just click on the upper box up here. And it'll select all of the items for you. If you have any questions, please let us know in the comments below. We'll be happy to answer. We also have a chat support live 24 seven to help you with anything that you may need. And don't forget to subscribe to our YouTube channel to stay up to date with all of the stuff that we have going on and to learn more about the Autodea system itself.


Hi, I'm Tom Hicks, Deputy Assistant Secretary of the Navy for Energy, and this is our brand new Chevy Volt. This vehicle, the first one that we're taking delivery from our partner with GSA, it will save 280 gallons of fuel per year. This is really important and builds to our goals that the Secretary of the Navy has laid out for us to reduce our petroleum consumption by 50% by 2015, and that's on top of what we've already done of reducing our petroleum consumption by 30% over the last six years. So it's vehicles like these that are really going to power us in the future.


So today in the world, what are we seeing? I mean, I remember when the biggest current or amperage draw in your home was the stove, a 40 amp breaker. Then we started introducing hot tubs up to a 50-60 amp breaker, right? Now we're having electric cars. And what do we have up to when it comes to amperage? Could be 90-100 amp breaker for that electric car. Right. It's a very low percentage of people out there that are getting a permit for their electric car. That's against the rules. It's against the laws here when it comes to electrical work in your home. Why this is so important is that is so much power. You hear the hum behind me? That hum is electricity.  And that is actually picking up the power, giving more power to the building because the building needs a lot of electricity. Transforms power. When you hear that hum, that's a lot of power. You're not going to hear an 80 amp breaker to a 100 amp breaker humming, but that much power can do an awful lot of damage to your home and your family. You can burn the house down. You can be if you ever touch that amount of power. You're not, you know, we've all touched electricals. We've all had those little shocks. Oh, don't do that again. But you don't want to be touching anything that is that high. You have an electric car, hire a license, electrical contractor, confirm they work or their numbers on the ESA website. Then you know you're dealing with someone that's done everything right. They have all, they have all their tickets. They have all of their WSIB, the insurance. They have everything necessary to come into your home. Correct. Right, Mike. We always say there's no such thing as a safe shock, right? Every shock is a dangerous shock. So you want to avoid them at all costs. That's what I said. And those are the important things when you're looking at your home is, is there safety features I can put in here that would make it safer, not just the minimum?


Good morning guys, welcome to today's video. Today we're doing some fun activities so my friend is traveling a little bit to ride with me at Cyclebar Winter Park so it's gonna be really fun. I don't know how many clips I'm gonna get in there because like I don't really take my phone into the studio anymore just because there's not really like a huge purpose to but like I'll show you guys and like walk in probably and then we are probably gonna go to Starbucks she has to like mail something so um I don't know I'm just gonna take you on today's adventures and we'll see how it goes anyway I just wanted to welcome you to the vlog and wearing my scuba half zip it is like in the 50s here and it's so cold so we've come to this location the Cyclebar class is so much fun it was probably like the best class but we got some pictures in front of this plant so cute I didn't like this text max being in the photo so we changed the like angles and stuff so we're on to our next location and I'll show you guys and you'll have to follow me on Instagram to see the photos I was nervous the hair was not gonna look good after class but it looks pretty good okay so sorry for the blurry lens it's kind of raining out here but this is our second location it was like not too far away and we just like the plants around here so we are on to the next location I think just having fun chilling out we've come here and I got a picture with this arch and like this tree thing I don't know we're just finding like cute little areas around town to take pictures in we're going into Trader Joe's now we're into Trader Joe's I just saw and we got some pictures like here I didn't get any there but like my friend did these cute plants I'm hoping to get one of these um like for my room sometime because I just really want one I don't know but they are really cute and definitely when I do eventually get one I'm gonna name it also guys I've been meaning to ask you how long do you like vlogs because there's so many people I don't know how they can do 15 to 20 minute vlogs they're just really hard oh I don't know I'm trying not to do as many cuts either because I want like longer watch time so I don't know let me know so we didn't really like get anything obviously but we got some almonds my friend got some almonds this is actually my first time in Trader Joe's and it's very interesting I thought it would be bigger to be honest I don't know I guess I'm just used to like publics and like big shopping trips I don't know biggie shopping markets we're in nectar it is an ethical place their menu is super cute you should check them out so I'll show you guys what we end up getting once we've ordered all right so we got our acai bowls I got the peanut butter one with like green apple on top just because I don't like a lot of topping she got the first choice I think it's banana okay so now we're at this little place called Avalon and it's like a thrift shop so let's go in and see what they have all right so this is kind of what it looks like they have a bit of everything and like a lot of different styles yeah I'm just gonna see what they have brows around I love this mirror I already see it here look how fun that this going on what is this look at the arms like army with like flowers I just I don't know guys it's very interesting here it is cool how they have everything like organized and like size pretty well it's organized so it's not horrible to like shop in here you know and like some other places okay so I ended up wanting to try a couple things on this is a Disney cruise line little spirit jersey and I saw this one at Avalon the cruise actually but never got it it says Disney cruise on the back I really like it it's $15 so I think I'm gonna go with it I like the lot if it's really well this is the next top I think I'm gonna get it because it looks really cute on and I can wear this to work and I've always made like cute clothes to wear to work it is also $15 I think and I just really like it it's pretty comfortable and this is the last thing I'm trying on yes no I'm not gonna put that thing on my crotch just because I don't know maybe I'll put it um I'll try it on like with my pants with my leggings on but this fits really well but I don't think I'm gonna get this one because like I want like puffy sleeves I see this like all over Pinterest and like the puffy sleeve ones they're like more my vision so yeah this is probably like a pass okay so I just found this when I went back out there and I just saw it in the extra large category but look at how freaking cute this is I know you can kind of see my raw hair but I would wear like a like blue lemon aline tank this is like perfect just to brawl on it's like an extra large I freaking love it I wish there was like some tears down here but it's fine definitely gonna get this so I've landed on getting this top and then this for work I think it's pretty successful a couple cute new items okay so I picked up one more thing that I just want to show you guys real quick before I forget and hopefully this vlog is like longer I'm gonna try to like not edit as much because like I'm trying to get my videos to 15 minutes it's so hard anyway but I also picked up this like I hope this fits which I'm gonna try it on now so I guess it's gonna be too late but it's like a size medium I'm definitely gonna not put this in the dryer but it has the turtleneck looking thing and then just this gray shirt um I can wear this like with jeans and then my sneakers to work and it's still like semi professional so yeah I got this and then I got the this white thing that you guys have already seen and then the red top that you guys already saw so yeah you know when you're gonna start driving the girls they're gonna go flying okay so my friend and I are getting starbucks and she loves the green tea iced graham matcha latte and kwa also from kk and baby j also gets this and they really like it and like I really want to like this drink so I'm hoping it's good okay um she ordered a grande but then she changed it to a venti and they gave her a grande still so yeah anyway she got her big one yes and um anyway I want to like this drink so bad because like so many people like it so I'm gonna try it on camera so you guys can see okay here we go I don't know how I feel about it oh no it's like not bad but I like the aftertaste it does taste like a tea okay it does taste like a tea it tastes like sushi tea that's the best way I can describe it a sushi tea because if you had sushi there's just a specific sushi taste and it's not bad it would be my first choice probably not just because I've like gotten into coffee and I would would I pick a chai tea over this yes but it's not bad like I'll probably end up finishing it because it's pretty good but I just have to get used to it I think out of 10 stars like right now it's like five it's very like average I always get a backup when I'm trying like new drinks so I got a sugar cookie almond latte because I love that I also love the blonde vanilla lattes because it tastes like pretty similar but we're just gonna have her after this I always have to add that backup you know all right so I'm almost done with this drink and it has grown on me I think it's a six out of five now a six out of ten it's gotten a little bit better so yeah I mean a lot better it does grow on you we've come to this cute little garden area full of plants the vibes in here are just so good it's so cute anyway we're gonna go explore holy cow look this is so cool I wonder if we're allowed back here oh sorry my hands are really really shaky because I'm freezing and I'm drinking my backup drink but luckily I do like the matcha so that's good to know I do like it man this place is pretty big so we've come to the winter park library because we didn't really know where to go and we saw this place on tik tok my friend actually tagged me and I was like oh what about like we just look on tik tok because there's so many like winter park stuff like ideas so we decided to come here and explore maybe get some eggs maybe on but I'll show you guys what I see and I want to say it's gotten a little more I don't know but we'll see this is what it looks like on the outside it's a really gray day out okay so this is what it looks like when you first enter sorry I'm trying to be really quiet because it is a library look in here this is a cool grand staircase okay so we're in the next thrift shop and this is called out of the closet and it supports like gay people and like people in the lgbt2 plus group I guess I don't know my parents are part of it I don't even know like the right terminology so anyway we're just going to explore here and see what we find okay guys so I found this really cute Kate speed dress that I'm gonna get it's like perfect for interviews and as you can see sorry I'm like doing a bad job it is Kate fade to size six it's really cute and it's only $25 we are now heading into Nordstrom rack we're in the purse section and everything here is like so cute like there's some good seals you can get at this place this is cute oh it's a guest there's so much stuff and like when I went out with my friends from like high school my friend Jaylin was carrying this bag and she was like it can fit so much stuff it's like the long-champ brand so she's carrying a black one I like this color it's cute I don't know where we're carrying it though so I don't have like a Nordstrom rack kind of anywhere close to us so it'll be fun to explore especially the purses guys look at the Dyson we have come into the floor now just to like look around I'm gonna get this $34 lipstick in pillow talk it's by it's not focusing but it's Charlotte Tilbury pillow talk because I have the lip liner and I really want the lipstick this is like so expensive like for this tiny little thing but whatever anyway we're just coming here to browse around and I did not get anything at Nordstrom rack but I just browsed around and it was fun as Sherry say hi to the vlog hi Sherry just got home from work Valerie hello the weather canceled our plants for dinner she's thrilled about that so I'm gonna show you guys you kind of already saw a lot of it but I'll just do a little haul so we went to Sephora and as you guys know I got this lip gloss that was like really overly priced but it's the same thing as my lip liner and I just decided to get it because why not um and then I got a new interview dress oh but I think perhaps you should clarify that you're not looking for a job put the blog no I'm not looking for a job I I'm no I'm just saying for like in the future if anything whatever like it's just to describe it okay I got this for $25 okay and is that dress you could also wear it like dress up too okay so that's that I got that piece and it was 25 and then this is the fabletics piece I modeled today to post for Instagram bra okay so these are your fabletics yeah that's how I just had it in this bag then I got this oversized sweater is this also from the thrift shop yeah this is from a different one though it's called Avalon park or whatever I don't know but it's like an oversized um sweater and then I could wear like uh my aline tank and have it like off the shoulder just like really cute and then I got a couple new work tops so like when we do go back in the office so I have this high neck gray blouse and this is like 15 bucks okay I could wear with like black jeans and flats you guys look so weird and then this is like good office shirt too where I could wear this with black leggings it's a button down okay very nice yeah very nice good haul so that's the stuff I got today all right I hope you guys enjoyed this video make sure to give it a thumbs up don't forget to subscribe and comment down below if you like thrifting videos and I'll see you guys in my next video bye