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Transcript
1
Expected questions
Basic fundamental
Pharmacology
All of the following about the mydriatic and cycloplegic agents are true EXCEPT:
(Pre test) P158, Q9-7
1. allergic reaction are most common with atropine
2. angle closure glaucoma may be precipitated in susceptible pt
3. topical phenylphrine 10% has been associated with adverse cardiovascular and
neurological sequelae
4. the cycloplegic effect is longer than the mydriatic effect
5. Physostigmine is effective for atropine intoxication
All of the following are potential side effect of systemic prednisone EXCEPT:
(Pre test) P158, Q9-17
1. Hyperosmolar coma
2. sodium retention
3. psychosis
4. hyperkalemia
hypokalemia
5. Peptic ulceration.
True statement regarding pt using Tamoxifen include all EXCEPT:
(Pretest) P215, Q12-49
1. Some pt develop retinopathy resemble that of canthaxanthin (Orobronze)
retinopathy
2. Macular edema is often present in pt with clinical retinopathy
3. Some pt develop whorl like corneal changes
4. Tamoxifen therapy places these pt at increased risk for retinal vascular occlusions
Medications that may cause a progressive retinopathy despite cessation of use of the drug
include two are true:
1. Digoxin
2. Thioridazine
3. Nicotinic acid
4. Chloroquine
What is the most characteristic side effect of oral cyclophosphamide?
1. Secondary infection
Kenneth P319, Q39
2. Secondary malignancy
3. Hemolytic anemia
4. Hemorrhagic cystitis
2
Anatomy:
How many mm medial to the medial canthus is the angular vein
Situated
(1064) P5, Q20
1. 1 mm
(pre Test) P124, Q15
2. 2 mm
3. 4 mm
4. 8 mm (*)
5. 10-12 mm
The superior orbital fissure is formed is an opening between the:
1. Frontal bone and ethmoidal bone
(1064) P2, Q6
2. Lesser wing of the sphenoid and frontal bone
3. Greater wing of the sphenoid and frontal bone
4. Lesser wing of sphenoid and palatine bone
5. Lesser wing and greater wing of sphenoid
The NLD open in to the:
(1064) P3, Q11
1. Superior meatus of the nose
DCR the opening will be
2. Middle meatus of the nose
to the middle meatus
3. Inferior meatus of the nose
4. 50% of the time in to the middle meatus and 50’% of the time to the inferior
meatus
5. 50% of the time in to the superior meatus and 50’% of the time to the middle
meatus
The average volume of the orbit is:
1. 6cc
2. 12cc
3. 18cc
4. 24cc
5. 30cc
(1064) P3, Q22
All of the following are true about bowman’s membrane EXCEPT:
Is approximately as thick as Descement membrane
(1064) P8, Q38
1. Can be considered the basement membrane of the epithelium
2. Fuses in to the corneal stroma with no well defined line of demarcation
3. Consists mainly of collagen fibrils
4. Dose not regenerates when destroyed
All of the following are true regarding orbital septum EXCEPT:
(1064) P15, Q67
The palpebral portion of the lacrimal gland is posterior to it
1. The lateral palpebral ligament is posterior to it.
2. The orbicularis oculi is anterior to it
3. The lacrimal sac is posterior to it
4. The septum pass in front of the trochlea of the superior oblique
3
Investigations:
An alternate linear area of hypofluorescence and hyperfluorescence on FFA is
characteristic of:
(1064)
1. retinal folds
2. multiple drusens
3. choroidal folds
4. Angioid streak
5. choroidal rupture
True statements concerning MRI of the orbits include:
(PreTest) P127, Q32
1. It the imaging study of choice for evaluating the osseous lesion
2. T-1 weighted images provide the best anatomic detail
3. In a T-2 weighted image the vitreous is dark (low signal intensity)
4. It is superior to CT for evaluating the orbital apex
Visual evoked response is an indication of the health of the:
1. Retina as a whole
(1064)P241, Q62
2. Optic nerve head
3. Foveal region
4. Rods and cones
5. Retinal pigment epithelium
4
Conjunctiva
All of the following is associated with trachoma EXCEPT:
1. Horner-Trantas’ dots
(1064) P63, Q16
2. Follicular hypertrophy
3. Papillary hypertrophy
4. Herbert’s pits
5. Corneal pannus
Viral conjunctivitis:
(Ivor) P73, Q18
1. EKC dose not associate with conjunctival scaring
2. cause a purulent conjunctival discharge
3. Subconjunctival haemorrhages indicate Coxsackie infection
 Herpetic conjunctivitis is often associate with canalicular
disease
 herpetic conjunctivitis is often associated with a blepharitis
Bacterial conjunctivitis: two are false
(Ivor) P74, Q21
1. Gonococcal infection is the most common cause of conjunctivitis in neonate.
2. In children in UK is the most common cause is H.Inf
3. Pneumococcus is the most common cause in alcoholics.
4. H.aegyptii is a common cause in elder pt
5. Moraxilla lacunata is a common cause in immunodeficient
The classic cause of EKC is typically caused by"
1. Enterovirus type 70
2. Adenovirus type 3 & 7
3. new castle virus
4. adenovirus type 8 & 19
5. coxsackievirus
(Jeffrey)
Phlyctenular keratoconjunctivitis is associated with all of the following EXCEPT:
(1064) P65, Q25
1. TB
2. Staphylococcal blepharitis
3. Pneumococcal conjunctivitis
4. AKC
5. Koch-weeks conjunctivitis
All of the following is associated with oculoglandular syndrome (Parinaud’s) are
associated with conjunctival ulceration EXCEPT:
1. Cat scratch disease
(1064) P63, Q18
2. Tularemia
3. Sporotrichosis
4. TB
5. Primary syphilis
5
All of the following are true about VKC EXCEPT:
1. It is seasonally recurrent disease
(1064) P65, Q28
2. It is seen in association with keratoconus
3. It is seen in association with atopic eczema
4. The most common presenting complaint is FB sensation
5. It is more common in male
CORNEA
Keratoconus
All of the following are associated with keratoconus EXCEPT:
1. VKC
(1064) P72, Q61
2. Retinitis pigmentosa
3. Marfan’s syndrome
4. Mongolism
5. Phlyctenular conjunctivitis
Painless superior peripheral corneal thinning marked by lipid deposition at the advancing
edge and superficial vascularization is
most characteristic of:
(1064) P69, Q45
1. Terrien’s degeneration
2. Mooren’s ulcer
3. Pellucid marginal degeneration
4. Furrow degeneration
5. Keratoconus
All the following are true of Mooren’s ulcer EXCEPT:
1. ABOUR 25% of the cases are bilateral (1064) P69, Q46
2. It is associated with much pain
3. Satisfactory results have been obtained occasionally by resection of the limbal
conjunctiva adjacent to the lesion
4. The most rapid movement of the ulcer is ventrally with the leading edge
deepithelialzed and undermined
5. The most rapid movement of the ulcer is toward the sclera with marked
involvement of the limbal sclera and episclera in the necrotizing process
In Keratoconus one of the following are right: (Ivor) P74, Q22
1. it is associated with Down's syndrome
2. cause Hypermetropic astigmatism
3. is commonly inherited
4. corneal rupture is a feature of acute hydrops
5. is commonly managed by corneal grafting
6
Acanthamoeba infection: two are right:
Ivor) P76, Q31
1. Most commonly occur in contact lens wearer
2. Infection usually occur at the limbus
3. cause sever pain and photophobia
4. untreated may lead to endophthalmitis
5. respond to trimethoprim
Marginal keratitis can be caused by all of the following EXCEPT:
1. Terrine's disease
(Ivor) P74, Q23
2. Pellucid marginal degeneration
3. SLE
4. Wegener's granulomatosis
5. HSV keratitis
Band keratopathy can be seen in all of the following condition EXCEPT:
(1064) P69, Q44
1. Sarcoidosis
2. Adult RA
3. Juvenile RA
4. Vitamin D toxicity
5. Ichthyosis
All of the following are associated with corneal edema EXCEPT:
1. Anterior segment necrosis
(1064) P56, Q59
2. Posterior polymorphous dystrophy
3. FB in the anterior chamber angle
4. Fuchs dystrophy
5. Congenital hereditary corneal dystrophy
Posterior polymorphous dystrophy
It is non progressive lesions in the Descemet’s
membrane.
Following penetrating keratoplasty all the following dystrophies have been shown to
recur EXCEPT:
Pretest P216, Q8-24
1. Macular
2. Reis-Bucklers’
3. Granular
4. Posterior polymorphous
5. Lattice
Reis-Buckler’s corneal dystrophy is characterized by all of the following EXCET:
1. It is inherited as Autosomal dominant
(1064) P56, Q57
2. It is usually not associated with recurrent erosions
3. Destruction of bowman’s membrane is the primary disturbance
4. Multiple minute discrete opacities are seen just beneath the epithelium
7
All of the following entities are usually associated with prominent corneal nerves on slit
lamp examination EXCEPT:
1. TB keratitis
(1064) P72, Q62
2. Mycobacterium leprae infection
3. Keratoconus
4. NF
5. Amyloidosis
The systemic Mucopolysaccharidoses that cause both corneal clouding and Pigmentary
retinal degenerations include two are right:
1. Hurler syndrome
Pretest P216, Q12-63
2. Sanfilippo syndrome
3. Scheie syndrome
4. Morquio syndrome
Mucopolysaccharidoses
All the syndromes are associated with corneal clouding
EXCEPT -Hunter syndrome
- Sanfilippo
All the syndromes are associated with Pigmentary
retinopathy EXCEPT “Morquio syndrome”
8
Lens
Cataract formation is its complete cycle is associated with all of the following EXCEPT
1. Increase deposition of calcium in the lens
1064 P302, Q40
2. Loss of lens potassium
3. Increase of lens total protein
4. Decrease of the lens total water content
5. Increase of the lens total water content
Cataract formation
Protein decrease due to enzymes effects
Water increase in the beginning but it well decrease with time
when the protein decrease because of decrease osmotic pressure
Properties of crystalline lens include all EXCEPT:
Pretest P188, Q11-22
1. It has the highest protein content in the body
2. It is a potassium rich tissue
3. It is 65% water content by weight
4. The absorption of yellow rays increase through life
Metabolic conditions associated with cataract in infants and children include:
Pretest P188, Q11-21
1. Hyper phosphatemia
2. Hypoglycemia
3. Hypoxia
4. Hypocalcaemia
Cataracts all are true EXCEPT:
(Ivor)
1. Sunflower cataract occur in Wilson's disease
2. Presenile cataract occur in pt with NF2
3. Congenital cataracts occur in galactokinas deficiency. (Juvenile)
4. Propeller cataracts occur in fabry's disease
5. Christmas tree cataract occurs in Myotonic dystrophy.
Rubella cataracts all true EXCEPT:
1064, P307, Q62
1. Usually include the anterior capsule components
2. live virus may be present up to 3years after birth
3. usually occur when the mother is infected during the 1st trimester of pregnancy
4. the associated chorioretinitis rarely associated with visual loss
5. associated with iris hyperplasia
9
The morphology of typical rubella cataract is a:
1. Dense mature cataract
1046, P296, Q5
2. Dense posterior sub capsular cataract
3. Diffuse cataract with a "snowflake" like appearance
4. Dense white central lens area with the surrounding cortex and lens periphery less
opaque
5. Dense pearly white cortical cataract with a less opaque nuclear cataract
Which is the most common form of congenital cataract?
1. Anterior axial embryonic
Pretest P188, Q11-7
2. Posterior polar
1064 313, Q91 similar Q
3. Zonular
4. Anterior polar cataract
5. Infectious
The differential l diagnosis of lenticular dislocation in the young child includes all of the
following EXCEPT:
(1064) P304, Q46
1. Marfan’s syndrome
2. Weill Marchesani syndrome
3. Homocyctinuria
4. Sulfite oxidase deficiency
5. All of the above
Lens subluxation occurs in all of the following EXCEPT: (Ivor)
1. Homocyctinuria
2. well-Marchesani syndrome
3. Ehlers Danlos syndrome
4. congenital syphilis
5. Marfan's syndrome
Spontaneous absorption of the lens is associated with:
1. Myotonic dystrophy
Pretest P188, Q11-12
2. Hallermann-Streiff syndrome
3. PHPV
4. Aniridia
5. Refsum’s disease
10
Cataract surgery
Which of the following has been associated with corneal meelting following cataract
extraction?
Pretest P188, Q11-10
1. Keratoconus
2. Temporal arteritis
3. Keratoconjunctivitis sicca
4. Fuchs’ dystrophy
5. Posterior polymorphous dystrophy
The incidence of cataract RD in surgical aphakia is approximately:
1. 1 in 10,000
(1064) P304, Q48
2. 1 in 1,000
3. 2 in 1,000
4. 1 in 100
5. 2 in 100
The retinal detachment after cataract extraction is seen in approximately:
1. 2%
(1064) P343, Q71
2. 5%
3. 7%
4. 9%
5. 10%
One half of all RD following the cataract surgery occur within:
1. 3month after the surgery
(1064) P304, Q49
2. 6month after the surgery
3. One year after surgery
4. Two year after surgery
5. Three year after surgery
Of the aphakic RD those that presented within the 1st year following cataract extraction
approximately:
(1064) P248, Q97
1. 10%
2. 20%
3. 30%
4. 40%
5. 50%
Approximately what percentage of aphakic RD is associated with retinal break:
(1064) P304, Q50
1. 10%
2. 30%
3. 50%
4. 70%
5. 90%
11
All of the following medication well flattens the AC EXCEPT:
1. Phospholine iodide administration
(1064) P308, Q69
2. Accommodation
3. Pilocarpine administration
4. Atropine administration
Cataract extraction with vitreous loss may be due to all of the following EXCEPT:
(1064) P310, Q78
1. Incomplete anesthesia of the 3rd CN
2. Incomplete anesthesia of the 7th CN
3. Subluxated lens
4. Failure to use the alphachmotrypsin
5. Retro bulbar hemorrhage
All of the following are true about the post cataract extraction choroidal detachments
EXCEPT:
(1064) P311, Q79
1. It is associated with wound leak
2. It is usually found anterior to the equator
3. An overlying retinal detachment is seen in 20% of the cases
4. It is most common in the inferior quadrants
5. Its clinical course is usually benign
Expulsive hemorrhage associated with cataract extraction surgery is usually due to
rupture of which of blood vessels:
1. A vortex vein
(1064) P312, Q87
2. A long ciliary artery
3. A short ciliary artery
4. A retinal blood vessel
5. The choriocapillaries
12
Glaucoma
POAG:
1. It affects 1%ofthe British population.
2. It is more common in diabetic pt.
3. It is more common in myopic pt than Hypermetropic pt.
4. It occurs more frequent in black than in white.
5. Produce a persistently high IOP.
Intermittently
(Ivor)
ALT all are true EXCEPT:
(Ivor)
1. The burns are placed at the junction between the pigmented and non pigmented
portion of the trabecular meshwork
2. is more effective with greater angle pigmentation
3. it is usually performed with a 50um spot size
4. it is not effective in pt with PXF glaucoma
5. can be performed with Abrahams lens this lens for PI
Congenital glaucoma:
1. It is more commonly due to trabecular dysgenesis
2. Is usually managed initially by trabeculectomy
3. Rarely cause Amblyopia
4. Inheritance is usually autosomal dominant
5. It is associated with rupture of the bowman's layer
Parasympathetic agent for glaucoma all are true EXCEPT:
1. The maximum useful concentration for Pilocarpine is 8%
2. Are poorly tolerated in pt under the age of 40years
3. It is contraindicated in pt with uveitis
4. Are not effective in pt with aphakia
5. May precipitate the angle closure glaucoma
Schwartz’s syndrome is caused by:
Kenneth P121, Q50
1. RPE blocking the trabecular meshwork
2. Forward rotation of the lens iris diaphragm
3. Ciliary body and choroidal edema
4. Photoreceptor outer segments blocking the trabecular meshwork
13
Neurophthalmology
Pursuit eye movement two are true:
(Ivor) P24, Q61
1. The visual threshold increase during the pursuit eye movement
2. Are generated from the frontal eye movement
3. Have a maximum velocity of 1000/sec
4. Are slowed by consumption of alcohol
5. Are generated from the ipsilateral cerebral hemisphere
Pursuit eye movement it is incited from the ipsilateral
visual cortex in the occipital lobe
Saccade eye movement it is incited from the
contralateral frontal lobe
Saccadic eye movement two are false
(Ivor) P24, Q61
1. The maximum eye movement is 7000/sec
2. Do not occur during sleep
(it occur during Rapid eye movement)
3. Only occur in the horizontal and vertical eye movement (also torsion)
4. Are generated by frontal eye fields
5. Can be hypermetric in cerebellar disease
All of the following are true of optic nerve drusen EXCEPT:
1. They are not familial
(1064) P244, Q76
2. They may be berried
3. VF defect may be present
4. VA may be affected
5. Optic nerve atrophy may be seen
In pseudotumor cerebri all of the following would be expected EXCEPT:
1. Bilateral six nerve palsy
(Pre test) P84, Q5-28
2. Papilledema
3. Headache
4. Tinnitus
5. Elevated cerebrospinal protein
Which one of the following is not an example of aberrant regeneration?
1. Duane’s retraction syndrome
Kenneth P107, Q42
2. Crocodile tears
3. Superior oblique myokymia
4. Marcus Gunn jaw wink
Aberrant regenerations dose not occur after injury to the oculomotor nerve with which
one of the following conditions
1. Trauma
Kenneth P107, Q43
nd
2. Ischemia 2 ry to diabetes
3. Tumor compression
4. Aneurysm
14
Which CN is traumatized most commonly after closed head injury?
1. CN3
Kenneth P107, Q44
2. CN2
3. CN4
4. CN6
What is the mechanism of action of edrophonium (Tensilon?)
1. Inhibits ACH esterase
Kenneth P107, Q69
2. It release the ACh from the presynaptic terminal
3. Directly binds to ACh sites on the receptor
4. Prevent the reuptake of ACh
What is the antidote for the crisis caused by over dose of Tensilon
1. Atropine
Kenneth P107, Q70
2. Dantrolene
3. Epinephrine
4. Verapaimil
All of the following is conditions can present with isolated optic neuropathy without
other ocular problems EXCEPT:
1. MS
Kenneth P137, answer 74
2. Sarcoidosis
3. Hyperthyroidism
4. Anterior ischemic optic neuropathy
Uhthoff’s symptom describes:
Kenneth P116, Q 89
1. Decrease in vision with increase in the body temperature
2. An electric shock sensation with neck flexion
Uhthoff’s symptom
3. The inability to distinguish facts
Usually comes with pt with MS
4. The ability to see moving objects but
It is usually triggered by
not stationary one
- Exercise
-
Hot shower
Uhthoff’s symptom is associated with:
(1064) P261, Q6
1. MS
2. Hyperthyroidism
3. MG
4. Panhypopituitarism
5. Behcet’s disease
6.
All of the following are commonly seen in multiple sclerosis EXCEPT:
1. Retro bulbar neuritis
(1064) P261, Q7
2. Nystagmus
MLF syndrome
3. Diplopia
Unilateral comes with ischemic lesion
4. Central scotoma
Bilateral comes with MS
5. Unilateral MLF syndrome
15
Pulfrich phenomenon is most helpful in diagnosis which of the following conditions
(1064) P267, Q31
1. Tobacco alcohol Amblyopia
2. Device’s disease
3. Aneurysm of the posterior communicating artery
4. Non communicating hydrocephalus
5. Early unilateral optic neuritis
MG pts are at high risk for all of the following EXCEPT:
1. Thymoma
10%
Kenneth P118, Q95
2. Gravis disease
5%
MG pts
3. SLE
They
are
at
high
risk
to develop an
4. MS
autoimmune disease like
Gravis disease, Rheumatoid arthritis, SLE
All of the following are about nasopharyngeal carcinoma EXCEPT:
1. Proptosis may be seen
(1064) P262, Q12
2. Decrease lacrimation may occur
3. Horner’s syndrome can be associated
4. Papilledema is frequently associated
5. 6th CN palsy is frequently seen
22years old male presented with history of limitation of movements in all gaze with
bilateral ptosis the most likely diagnosis is:
1) Eaton Lambert syndrome
(Pre test) P77, Q5-2
2) Kearns Sayre Daroff syndrome
3) Eales disease
4) Intrenuclear ophthalmopelgia
5) Non of the above
Kearns Sayre Daroff syndrome
(Chronic progressive external ophthalmopelgia)
It is mitochondrial defective function
Characterized by:
1. Absence of eye movement
2. Bilateral ptosis
3. Pigmentary retinopathy
The most common cause of pseudo-Foster Kennedy syndrome is:
1. Glaucoma
(Pre test) P80, Q5-11
2. Leber’s hereditary optic atrophy
3. Optic neuritis
4. Ischemic optic neuropathy Foster Kennedy syndrome
It is unilateral papilledema with contralateral optic disc atrophy
5. Non of the above
Pseudo-Foster Kennedy syndrome:
It is the same like true FK syndrome but there is no high ICP and the
vision loss of vision not like the papilledema that has no loss of vision
16
Pt whose only neurophthalmologic deficit is a homonymous hemianopia of occipital
origin could exhibit all of the following EXCEPT:
1. A congruous homonymous hemianopia (Pre test) P82, Q5-21
2. A scotomatous homonymous hemianopia
3. The riddoch phenomenon
4. Macular sparing
5. A RAPD Ipsilateral to the lesion
An RAPD associated with normal VF is most likely seen when which
of the following structures is damaged:
(Pretest) P82, Q5-22
1. Edinger-Westphal nucleus
2. Brachium of the superior colliculus
3. Recurrent nerve of Arnold
4. Anterior knee of von Eillebrand
5. Posterior pole of the occipital lobe
An 8 years old child has an isolated 3rd nerve palsy which of the following cause would
be LEAST likely:
(Pretest) P84, Q5-33
1. Tumor
2. Migraine
3. Infection
4. Aneurysm
5. Congenital origin
Conditions imitating a bitemporal hemianopia due to chiasmal compression include all of
the following EXCEPT:
1. Bilateral nasal sector retinitis
(Pretest) P94, Q5-61
2. Bilateral cecocentral scotoma
Glaucoma
3. Refractive scotomas
Preserves the temporal VF for long time
4. Tilted discs
It is giving binasal VF defect
5. Glaucoma
Findings in Parinaud’s syndrome include:
1. Accommodative spasms
2. Upward gaze palsy
3. Convergence retraction nystagmus
4. Light near dissociation
5. skew deviation
6. All of the above
(Pretest) P94, Q5-59
Parinaud’s syndrome
It is a dorsal midbrain disorder
It can be associated with
1. Neoplasm
2. Trauma
3. Demyelination
4. Vascular disease
17
VF defect
1) Lesion in the extreme anterior tip of the Calcarine fissure will give
contralateral loss of the temporal crescent with otherwise normal
fields
2) Lesion in the extreme posterior tip of the occipital lope will give
contralateral congruous homonymous hemianopic scotoma VF defect
3) Lesion in the temporal lobe ( Meyer’s loop) will give Pie in the sky
VF defect
18
Uveitis
A histological feature of granulomatous uveitis inflammation is:
1. Epithelioid cells
(Pre test) P159, Q9-21
2. Granulation tissue
3. B-lymphocyte infiltration
4. PMN cell infiltrate
5. Plasma cell infiltrate
Anterior granulomatous uveitis can present with all of the following EXCEPT:
1. Sarcoidosis
2. Lyme disease
3. TB
4. ankylosing spondylitis
5. syphilis
Which one of the following conditions is not typically associated with diffusely
distributed KPs:
Kenneth P312, Q11
1. Fuch’s heterochromic iridocyclitis
2. Sarcoidosis
3. VKH
4. Syphilis
All of the following can cause heterochromic iridis EXCEPT:
1. Sympathetic paralysis
(1064) P334, Q23
2. long standing hyphema
Other causes:
3. Sidrosis bulbi
1. latanoprost
4. glaucomatouscyclitis crisis
2. diffuse iris melanoma
5. Hypopyon
3. unilateral iris atrophy
Toxoplasmosis retinochoroditis all are true EXCEP:
1. is the most commonly congenital
(Ivor) P82, Q55
2. reactivation mostly occur adjacent to an area of previously affected retina
3. usually affect all children of an infected mother
4. is associated with intracerebral calcification
5. in AIDS pt the retinitis is diffused and it may CMV
35year old women with macular toxoplasmosis retinochoroditis acquired during her 1st
trimester of pregnancy all are true
EXCEPT two:
(Pre test) P161, Q9-31
1. Should be treated with sulfamethoxazole / trimethoprim rather than clindamycin
to minimize the teratogenic effects.
2. may infect her fetus with toxoplasmosis
3. May infect subsequent offspring with toxoplasmosis
4. may exhibit rising IgM toxoplasmosis titer
19
Reiter's syndrome all are true EXCEPT:
(Ivor) P83, Q57
1. is more common in male than female
2. cause recurrence follicular conjunctivitis ----- papillary
3. occur more frequently in pt with AIDS
4. HAL-B27 is +ve in more the 70% of the pt
5. is associated with oral ulceration
Which one of the following findings would not be expected in pt with Reiter's syndrome?
Kenneth P313, Q13
1. Balanitis
2. Prostatitis
3. A recent history of diarrhea
4. Positive rheumatoid factor
The classic skin lesion associated with Reiter’s syndrome:
1. Erythema nodosum
Kenneth P313, Q15
2. Pustular psoriasis
3. Keratoderma blennorragicum
4. Eczema
Sympathetic ophthalmia:
(Ivor) P83, Q58
1. dose not occur after blunt trauma
2. Dahlen fuchs' nodules are lymphcytic aggregation within the choroid
3. the visual outcome frequently is better in the exciting then the sympathizing eye
4. dose not cause an anterior uveitis
5. dose not occur after cataract surgery
Sympathetic ophthalmia all are true EXCEPT:
(1064) P332, Q16
1. The uveitis may start as early as 5days or as late as 50years after the injury
2. 90% of the cases occur after 2weeks but within 1year following injury.
3. 80% of the cases occur after 2weeks and 3months post injury
4. Phacoanaphylactic endophthalmitis and SO are mutually exclusive due to the fact
that they are both presumed autosensitivity disease.
5. VKH is similar
Sympathatic Ophthalmia:
Pretest Q4-8, P62
1. Focal accumulations of the epithelioid cells in the subretinal space
2. Diffuse non granulomatous inflammatory infiltration of the choroid
3. Zonal granulomatous inflammation of the sclera
4. Inflammation that spares the choriocapillaries
5. Proliferation of histiocytes in the iris stroma with Touton giant cells
20
The major pathologic difference between the SO & VKH is:
(1064) P333, Q18
1. involvement of the anterior choroid versus posterior choroid
2. presence of the epitheloid cells
3. involvement of the choriochapillaris
4. position of the Dalen– fuchs nodules
5. non of the above
Uveitis associated with JRA:
(Ivor) P83, Q59
1. Occur more frequently in girls than boys.
2. Is rarely complicated by glaucoma
3. systemic steroid is the initial treatment of choice
4. usually unilateral
5. dose not occur until after age of 5years
JRA associated iridocyclitis is most common in: Kenneth P321, Q21
1. Early onset pauciarticular disease
2. Late onset pauciarticular disease
3. Still’s disease
4. Late onset polyarticular disease
All of the following may be useful in confirming a presumption of granulomatous
panuveitis due to Sarcoidosis EXCEPT:
1. Serum ACEI
(Pre test) P159, Q9-18
2. Biopsy of suspicions skin lesion
3. Salivary gland biopsy
4. HLA testing
5. Gallium scan
Associated systemic finding in a pt with sarcoid uveitis include all the following
EXCEPT:
(Pre test) P159, Q9-20
1. Elevated serum gamma globulin
2. Elevated urine calcium excretion
3. Erythema nodosum
4. Decrease pulmonary diffusing capacity
5. Adrenalin granuloma
Sarcoidosis: two are false
(Ivor) P84, Q61
1. koeppe nodules occurs in the pupillary margin
2. ocular involvement occurs in up to 30% of the pt
3. mantousx test is usually +ve
4. The diagnosis may be confirmed by conjunctival biopsy for caseating
granulomas.
5. 80% of the pt with ocular Sarcoidosis will have an abnormal chest X- ray.
21
Sarcoidosis ocular manifestations include all of the following EXCEPT:
1. Papillitis
Kenneth P310, Q6
2. Scleritis
3. Follicular conjunctivitis
4. Granulomatous keratic precipitate
Which form of uveitis is most common in ocular Sarcoidosis?
1. Panuveitis
Kenneth P318, Q33
2. Intermediate uveitis
3. Anterior uveitis
4. Choroiditis
Ocular complication of steroid treatment includes all of the following EXCEPT:
Kenneth P311, Q7
1. Cataract
2. Retinal NV
3. Glaucoma
4. Scleromalacia
Which one of the following regarding ARN is not true?
1. Sever arteritis is common
Kenneth P312, Q10
2. HZV implicated as etiologic agent
3. Posterior pole involved initially with centrifugal spread
4. Retinal detachments common
HLA B-27 all are true EXCEPT:
1. is more common in male than female
2. is associated with oral ulceration
3. Unilateral
4. it is granulomatous uveitis
5. associated with hypopyon
The strongest HLA association to ocular disease is between
1. HLA-B27 and psoriatic arthritis
Kenneth P322, Q60
2. HLA-B27 and ocular histoplasmosis
3. HLA-B5 and Behcet’s disease
4. HLA-A29 and birdshot retinochoroidopathy
HLA
Birdshot retinochoroidopathy
Ankylosing spondylitis
Reiter's syndrome
Behcet’s disease
HLA-A29
HLA-B27
HLA-B27
HLA-B5
%
96%
89%
80%
68%
22
What is the most common cause of acute non infectious hypopyon?
1. Behcet’s disease
Kenneth P318, Q31
2. Idiopathic anterior uveitis
3. HLA B-27
4. Sarcoidosis iridocyclitis
A significant vitreous reaction is typically related to:
1. Presumed ocular histoplasmosis
(Pre test)P158, Q9-7
2. Serpiginous choroidopathy
3. ARN syndrome
4. CMV retinitis
5. Pneumocystic choroidopathy
A true statement regarding toxocariasis is:
(Pre test) P157, Q9-4
1. it is often associated with visceral larva migrans
2. it may present as a bilateral endophthalmitis
3. it typically will exhibit calcium in the region of a granulomas
4. it may be diagnosed in human by examining the stool
5. it is not responsive to thiabendazole
Toxocariasis
It is unilateral, in children
It may present as:
1. Endophthalmitis
2. Peripheral granuloma
3. Macular granuloma
Ocular inflammation is related to the dead worm so:
Anti helminthics is not indicated
And treatment is steroid
Cytotoxic therapy is indicated in all of the following conditions EXCEPT: (Pre test)
1. VKH
2. SO
Note:
3. Behcet's disease
All the infectious disease has no indication to
4. PP
use the cytotoxic therapy
5. ARN syndrome
6. Eales disease retinal vasculitis
7. Serpiginous choroidopathy
8. Retinal vasculitis
All of the following diseases are associated with uveitis show a hyper reactive skin test
EXCEPT:
(1064) P330, Q5
1. Behcet's disease.
2. Histoplasmosis.
3. Peripheral uveitis
4. Toxoplasmosis
23
The most common complication in PP is:
1. glaucoma
2. cataract
3. band keratopathy
4. RD
5. Macular degenerations
(1064) P336, Q31
Accepted treatment for chronic PP include all of the following EXCEPT:
1. Periocular corticosteroid
(Pre test) P157, Q9-2
2. Oral corticosteroid
3. Topical cycloplegics
4. Cryotheraby
5. Vitrectomy
The most likely cause of permanent decrease of vision in pt with PP is:
1. Maculopathy
(Pre test) P157, Q9-10
2. Glaucoma
3. Keratopathy
4. Amblyopia
5. Vitreous haze
Complication of PP includes all of the following EXCEPT:
1. Calcific band keratopathy
Kenneth P322, Q57
2. Choroidal neovascularization
3. Vitreous hemorrhage
4. Tractional RD
All of the following features are consistent with a diagnosis of the ocular histoplasmosis
syndrome EXCEPT:
(Pre test) P209, Q12-16
1. Peripheral curvilinear retinal lesions
2. Punched out Chorioretinal lesions in posterior pole
3. Peripheral atrophy
No vitritis in ocular
4. Mild vitritis
histoplasmosis
5. Diskform CNVM of the macula
All of the following statements a bout the presumed ocular histoplasmosis syndrome are
true EXCEPT:
1. Pts have usually resided in the Ohio Mississippi Valleys or Middle Atlantic state
2. Peripheral atrophic choroidal spots are seen
3. Preipapillary Pigmentary changes are seen
4. The chance of development of hemorrhagic maculopathy in the second eye is
dependant on whether scars are present
5. Prophylactic photocoagulation of inactive macular scars has proved beneficial
24
The most common cause of acute-onset, exogenous endophthalmitis:
1. Staph epidermidis
(Pre test) P157, Q9-14
2. Propionibacterium acnes
3. Aspergillus
4. Pneumococcus
5. Proteus mirabilis
What is the most characteristic side effect of oral cyclophosphamide?
5. Secondary infection
Kenneth P319, Q39
6. Secondary malignancy
7. Hemolytic anemia
8. Hemorrhagic cystitis
Which one of the following is the most common retinal finding in AIDS?
1. Cotton wool spot
Kenneth P320, Q46
2. CMV retinitis
CMV is the most common
3. Pneumocystic Choroiditis
opportunistic infection
4. Acute retinal necrosis
AIDS two are false:
(Ivor) P83, Q56
1. CMV retinitis usually start at the periphery of the retina
2. CWS are a sign of opportunistic infection of the retina
3. optic nerve involvement in CMV associated with sever visual loss
4. Falling of the CD-8 T cell account is an indicator of the increase
immunodeficiency.
5. Predispose to herpetic retinitis.
Pt with AIDS and CMV retinitis:
Kenneth P329, Q83
1.
Have CD4 lymphocytes count of 100-500Cells/mm3
2. Have mean survival rate of 6months
3. Have CD4 lymphocytes counts of less than 50cells/mm3
4. Have ocular pain and photophobia
Hyper sensitivity reaction
1. Type1:it is antibody mediated
E.g: - Hay fever
- Allergic reaction
2. Type2:it is mediated by Cytotoxic antibodies
E.g: - Ocular pemphigoid
- Mooren’s ulcer
3. Type 3: immune complex mediated
E.g: - phycoanaphylactic
- Weesley wring
- Scleritis
- Steven-Johnson Syndrom
4. Type 4: T cell mediated
E.g: - Sarcoidosis
- TB
- Corneal allograft
- Phlyctenulosis
25
All of the following major immunoglobulin classes are found in the human tears
EXCEPT:
KENETH P 304, Q20
1. IgD
In the tear film: all the classes of the Ig are available except IgD
2. IgE
IgA is most abundant in the tear
3. IgG
But:
4. IgM
In the subepithelial tissue: all the classes of the Ig are available.
Immunoglobulins in the human body
IgG is the most abundant class in the blood
IgA is the most abundant class in the tear
IgM is large Immunoglobulin so it can not bass the placenta
26
Retina
Retinal microaneurisms occur most often:
1. On the venous side of the capillary bed
2. On the arterial side of the capillary bed
3. In nonhypoxic stat
4. In congenital stat
5. Non of these
(1064) P232, Q17
Angioid streak can be associated with all EXCEPT: (1064)
1. Paget's disease
(1064)P238.Q49
2. lead poisoning ------------ in the other question IN diabetes
3. SCD
4. Pseudo exanthema elasticum
5. Ehlars - Danlos syndrome
Angioid streak:
(1064) P231, Q13
1. Are abnormal vessels in the retina
2. Represent changes in the choroidal circulations
3. Are break in the choroidal capillary layer
4. Represent break in the Burch’s membrane
5. Non of these
Conditions that may result in the biomicroscopic appearance of CME but lack FFA
evidence of late dye accumulation in the cyst like spaces include all of the following
EXCEPT:
Pre test P207, Q12-3
1. Juvenile Retinoschisis
2. Nicotinic acid maculopathy
3. Retinitis pigmentosa
4. Goldman - favre late FFA syndrome
5. Solar retinopathy
Choroidal neovascularization is LEAST likely to occur in which of
The following:
Pretest Q8-19, P143
1. Harada disease
Other causes
2. Pathologic myopia
1.
ocular
histoplasmosis
3. Cone dystrophy
2. optic disc drusen
4. Fundus flavimaculatus (Best’s disease)
3. choroidal rupture
5. Retinal photocoagulation
Which of the following peripheral retinal lesion has the largest association with RRD?
Pretest P211, Q12-29
- Paving stone degenerations
1. Paving stone degenerations
- Pars plana cyst
2. Cystic retinal tuft
Both are not a risk for RD
3. Meridional fold
- Meridional fold
4. Enclosed ora bay
- Enclosed ora bay
5. Pars plana cyst
Both are r associate with RD but rare
27
The systemic Mucopolysaccharidoses that cause both corneal clouding and Pigmentary
retinal degenerations include two are right:
5. Hurler syndrome
Pretest P216, Q12-63
6. Sanfilippo syndrome
7. Scheie syndrome
8. Morquio syndrome
Mucopolysaccharidoses
It is 6 syndromes:
2 H (Hunter, hurler)
2 S (scheie, sanfilippo)
2 M (Morquio, -----)
2- M syndromes: are the only syndromes that area not associated with retinopathy.
1H & 1S (Hurler, Scheie) are the most sever forms syndromes
All the syndromes are associated with corneal clouding EXCEPT “Hunter syndrome”
All the syndromes are associated with Pigmentary retinopathy EXCEPT “Morquio syndrome”
Systemic sphingolipidosis that may be associated macular cherry red spot include, two
are right:
Pretest P216, Q12-64
1. Tay-Sachs disease
Systemic sphingolipidosis
2. Fabry’s disease
All the diseases are associated with macular
3. Gaucher’s disease
cherry red spot EXCEPT
4. Krabbe’s disease
1. Fabry’s disease
2. Krabbe’s disease
Cherry red macula is seen in all the following EXCEPT:
1. Tay-Sachs disease
(1064) P233, Q20
2. Niemann-Pick disease
3. Metachromatic leucodystrophy
4. Generalized gangiosidosis
5. Fabry’s disease
Conditions that typically result in progressive loss of VF include two are true:
1. Sector retinitis pigmentosa
Pretest P216, Q12-56
2. Retinitis pigmentosa sine pigmento
3. Retinitis paravenous retinochoroidal atrophy
4. Retinitis punctate albescens
All of the following are true about the asteroid hyalosis EXCEPT:
1. It is most commonly bilateral
(1064) P233, Q22
2. Average age of diagnosis is 60years
3. The eye is other wise is normal
4. It is composed of calcium soaps
5. It is attached to vitreous fibrils
28
All of the following are true of Eales’ disease EXCEPT:
1. There is no sex predisposition
(1064) P236, Q36
2. Retinal prevasculitis picture
3. It may result in vascular proliferations
Eales’ is more
4. Age of onset is between 20-30years
common in males
5. Bilaterality is common in the majority of the cases
In acute multifocal placoid epitheliopathy the pathology is located in:
1. The vitreous
(1064) P238, Q45
2. Bruch’s membrane
3. The ganglion cell layer
4. The retinal pigmented epithelium
5. The rods and cones
All of the following are commonly associated with retinal neovascularization EXCEPT:
(1064) P243, Q73
1. Diabetic retinopathy
2. CRVO
3. CRAO
4. Macroglobulinemia
5. Coat’s disease
The prevalence of cilioretinal artery is:
1. 5-10%
2. 15-20%
3. 25-30%
4. 35-40%
5. Non of these
(1064) P245, Q83
Retinal changes in malignant HTN include:
1. Cotton wool patches
2. Linear hemorrhages
3. Papilledema
4. Exudative retinal detachment
5. all of these
(1064) P246, Q89
Which of the following is true regarding the synchysis scintillans?
1. It is much rarer than asteroid hyalosis
(1064) P247, Q93
2. It is usually bilateral
3. It has freely floating opacities
4. Crystals are composed of cholesterol
5. All of these
29
All 3 types of retinal hemorrhage (preretinal, intraretinal, and subretinal) may occur
simultaneously in all of the following conditions except
1. Macroaneurysm
(Friedman), Q7
2. ARMD
3. Diabetes
4. Capillary hemangioma
All the following may present with preretinal, intraretinal, and subretinal hemorrhage
except:
1. CNVM
(KENETH)P514, Q44
2. Sickle cell retinopathy
3. Trauma
4. Macroaneurysm
30
Oculplasty
Intraorbital abscess formation most commonly in the Superio-temporal quadrant of the
orbit
(1064) P96, Q5
1. Inferio temporal quadrant of the orbit
2. Inferio temporal quadrant of the orbit
This is explained by orbital cellulites
3. Inferio nasal quadrant of the orbit
(Para nasal sinuses)
4. Axial area bordering on the globe
Conditions causing Enophthalmos include all EXCEPT:
1. Horne’s syndrome
(1064) P97, Q13
2. NF
3. Blow out fracture
4. Metastatic Brest cancer
5. Cavernous hemangioma
Enophthalmos occur with:
1. Metastatic breast carcinoma
2. Metastatic colonic carcinoma
3. NF
4. Crouzon’s disease
5. Scleroderma
(Ivor) P71, Q11
Gravies disease is the most common cause of lid retraction, other causes include all
EXCEPT:
(Pre test) P127, Q31
1. Cirrhosis of the liver
2. Marcus Gunn phenomenon
(1064) P100, Q29
3. Infantile hydrocephalus
Other causes:
4. Myotonic dystrophy
1. contralateral ptosis
2. hpokalemic periodic paralysis
Ocular pulsation may be seen in all of the following EXCEPT:
1. NF
Kenneth P116, Q87
2. Carotid cavernous sinus fistula
3. Orbitoencephaloceles
4. Capillary hemangioma
31
Ocular tumors
All of the following are true regarding the squamous cell carcinoma of the conjunctiva
EXCEPT:
Pretest Q41, P68
1. It is most commonly found in the limbus
2. It has strong tendency to infiltrate cornea either as a neoplastic process or as a
degenerative process (pannus formation)
3. Tumors are highly radiosensitive
4. 1/3 of these tumors will invade intraocular content
Tumors associated with Von Hippel Lindau disease include all of the
Following EXCEPT:
Pretest Q4-7, P62
1. Renal cell carcinoma
2. Pheochromocytoma
3. Retinal hemangioblastoma
4. Cerebellar hemangioblastoma
5. Hepatocellular carcinoma
Chocolate cysts are associated with:
1. Teratoma
2. Dermoid
3. Lymphangioma
4. Cavernous hemangioma
5. Neurofibroma
The most common site for metastases to the eye is:
1. iris
2. CB
3. Orbit
4. Choroid at the periphery
5. choroid at the posterior pole
(1064) P101, Q32
URTI
Usually aggravate proptosis in
- Lymphangioma in children
- Mucocele in adult
(1064) P340, Q53
Hemangioma of the choroid is most commonly seen as associated with:
1. Von-Hippel's disease
(1064) P344, Q81
2. tuberous sclerosis
3. ataxia telangectasia
4. wyburn mason syndrome
5. sturge weber syndrome
Bilateral ocular metastases seen in how many percentage of the cases:
1. 10%
(1064) P340, Q56
2. 20%
3. 40%
4. 50%
5. 75%
32
The true statement about cavernous hemangioma includes all of the following EXCEPT:
(Pre test) P125, Q19
1. It may cause retinal striae
(1064) P103, Q46
nd
th
2. It is usually present in the 2 to 4 decade.
3. It is a well encapsulated tumor
4. It is usually resolve spontaneously
5. It is the most common benign orbital tumor in adult
All of the following are true of retinoblastoma EXCEPT:
(1064) P234, Q27
1. It is the most common cause of intraocular malignancy in children
2. 30-35% of cases are bilateral
Retinoblastoma
3. Average age at diagnosis is 8years
Average age is 18montth
4. Race and sex do not influence incidence
It is inherited: AD in 6%
5. It is inherited as Autosomal dominant
Sporadic in 94%
The most common condition producing leukocoria of pseudoretinoblastoma type is:
(1064) P235, Q30
1. PHPV
2. Coat’s disease
3. Cataract
4. Chorioretinal coloboma
5. Uveitis
33
Systemic disease:
All of the following are true about Marfan's syndrome EXCEPT:
1. Aortic aneurysms are commonly seen
(1064) P298, Q18
2. The lens is usually dislocated in the downward direction
3. Blue sclera may be associated with it
4. A normal urinary cyanide nitroprusside reaction is important in diagnosing these
pts
5. It is inherited as autosomal dominant
The iris manifestations of DM include which of the following:
1. NVI
(1064) P348, Q99
2. Poor dilation with mydriatic
3. Transillumination of the iris
4. Increase pigment dispersion of the seen in anterior segment surgery
5. All of the following
The most common presentation of the familial Amyloidosis in the eye is the presence of:
(1064) P348, Q98
1. Lid ecchymosis
2. Proptosis
3. External ophthalmopelgia
4. Vitreous opacity
5. Glaucoma
Peters’ anomaly can be associated with all of the following EXCEPT:
1. Corectopia
1064 P76, Q80
2. iris hypoplasia
3. anterior polar cataract
4. Iridocorneal adhesions
5. all of the above
Peters’ anomaly
1064 P76, Q81
All of the following can be associated with peters’ anomaly EXCEPT:
1. Bilateral central corneal opacity
2. Absence of endothelium, Descemet’s membrane & bowman’s membrane
centrally.
3. histologically the same picture as the posterior corneal crater of posterior
keratoconus
4. The central crater is often called synonymously the internal ulcer of con
Hippel.
34
Goldenhar’s syndrome is associated with what prominent ocular feature:
1064 P77, Q84
1. Microcornea
2. Sclerocornea
3. Megalocornea
4. Epibulbar dermoid
5. Nystagmus
Mucopolysaccharidoses
Corneal clouding is significant in the following Mucopolysaccharidoses EXCEPT
1. Hurler syndrome
2. hunter syndrome
3. Morquio syndrome
4. Scheie syndrome
5. marateaux-Lamy syndrome
Ocular feature associated with Down's syndrome include all of the following EXCEPT:
PreTest Q18, 15
1. Lisch nodules
2. Brusheield spots
3. Myopia
4. Strabismus
5. Keratoconus
Pt presented with proptosis sclerouveitis, trcheitis, lung cavitations & glomerulonephritis
was also present, the most likely diagnosis is:
1. Polyarteritis nodosa
1064, P104, Q49
2. SLE
3. Wegener’s granulomatosis
4. Henoch Schonlein purpura
5. TB