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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