3 - opthalmology mcqs - 11 to 16

11) Mydriatic used in children

a. Atropine

b. Cyclopentolate

c. Homatropine

d. None of the above

Answer : a) Atropine

Reference: Khurana 3^rd Edition Page 68

12) Smoke Stack sign on fluorescein Angiogram is seen in

a. Central Serous Retinopathy

b. Retinitis pigmentosa

c. Retinal detachment

d. None of the above

Answer : central serous chorioretinopathy

Reference: Khurana 3^rd Edition Page 263

13) The modified Bailey Lovie chart is used to assess

a. Visual acuity

b. Dark adaptation

c. Contrast difference

d. Color vision

Answer : a) Visual Acuity

Reference: The lack of standardised visual acuity charts with established norms for preschool children has resulted in a diverse variety of visual acuity tests in use for the paediatric patient. All available tests appear to have some limitations, including inadequate norms, long test times, poor reliability, and frequent use test parameters and stimuli which are different from those used with adults. This study compares results for four visual acuity test charts. A Bailey-Lovie Illiterate E chart and an abbreviated Sheridan-Gardiner test were compared with two prototype acuity charts; a modified Bailey-Lovie letter chart and an Arrow chart. A novel symbol such as an arrow constructed as a Snellan optotype incorporated into a chart on the Bailey-Lovie principle, was the test of choice. This test was interesting to preschool children and results showed significant correlation with those obtained using charts based on adult standards.

14) 100 day Glaucoma / 40 day Glaucoma

a. Traumatic

b. Post operative

c. Central retinal vein obstruction

d. Steroid induced

Answer : C) Central Retinal Vein Obstruction

Reference: Khurana 3^rd Edition Page 254

15) Diopteric power of eye

a. 20

b. 30

c. 40

d. 60

Answer : d) 60 D

Reference: Khurana 3^rd Edition Page 50

16) The following is a component of visual perception

a. Color Vision

b. Texture Vision

c. Movement

d. All of these

Answer : d) All of these

Reference: Ganong 22^nd Ediotion page 168

2 - opthalmology mcqs - 1 to 10

1) concave lens is a

a. Diveging lens

b. Converging lens

c. Any of the above

d. None of the above

Answer (a) Diverging Lens

Reference: Khurana 3^rd Edition Page 47

2) Type of Surgery to Correct myopia

a. LASIK surgery

b. Dacrocystorhinostomy

c. Tarsorrpaphy

d. Enucleation

Answer (a) LASIK

Reference: Khurana 3^rd Edition Page 77

3) Strum's Conoid is associated with

a. Astigmatism

b. Glaucoma

c. Cataract

d. Retinal Detachment

Answer (a ) Astigmatism

Reference: Parson 18^th Edition Page 45

4) Retinitis pigmentosa is associated with all except

a. Goldenhar syndrome

b. Refsum’s Syndrome

c. Lawrence Moon Biedl

d. Usher’s Syndrome

Answer (a) Goldenhar Syndome

Reference: Khurana 3^rd Edition Page 261

5) Image in Direct opthalmoscopy is

a. Virtual Inverted magnified

b. Real Inverted Magnified

c. Real Erect and Magnified

d. Virtual, Erect and Magnified.

Answer (d) Erect, Virtual, Magnified

Reference: Khurana 3^rd Edition Page 34

6) To maintain the transperancy of cornea, the endothelial cell density should be at least

a. 3500 cells/sq.mm

b. 2500 cells/sq.mm

c. 1500 cells/sq.mm

d. 500 cells/sq.mm

Answer (d) 500 cells / sq. mm

Reference: Murphy C, et al. Prenatal and postnatal cellularity of the human corneal endothelium. A quantitative histologic study. Invest Ophthalmol Vis Sci 1984;25:312-22. and "Corneal endothelium." Wikipedia, The Free Encyclopedia. 22 Jul 2006, 05:15 UTC. Wikimedia Foundation, Inc. 9 Nov 2006 <http://en.wikipedia.org/w/index.php?title=Corneal_endothelium&oldid=65162345>.

The corneal endothelium is embryologically derived from the neural crest. The postnatal total endothelial cellularity of the cornea (approximately 300,000 cells per cornea) is achieved as early as the second trimester of gestation. Thereafter the endothelial cell density (but not the absolute number of cells) rapidly declines in direct proportion to the areal growth of the fetal cornea, achieving a final adult density of approximately 2400 - 3200 cells/mm². The normal corneal endothelium is a hexagonal monolayer of uniformly sized cells. This honeycomb tiling scheme yields the greatest efficiency, in terms of total perimeter, of packing the posterior corneal surface with cells of a given area.

To function properly, the endothelium must be intact. Transparency can be lost when endothelial cell density is reduced below a critical level, 500 cells/mm². Endothelial cell density in a normal human adult cornea is between 1,500 and 2,000 cells/mm². Infants have a higher density, even more than 3000 cells/mm²

Altered cell shape and the resulting decrease in cell-to-cell connections compromise the barrier function of corneal endothelium and can result in corneal edema and loss of visual acuity. (Right figure) Schematics of corneal endothelial cell density are shown (l to r) in young individuals, older individuals, and those with loss of monolayer integrity leading to gaps between cells (see arrow).

Corneal endothelial cells are post-mitotic and divide rarely, if at all, in the post-natal human cornea. Wounding of the corneal endothelium, as from trauma or other insults, prompts healing of the endothelial monolayer by sliding and enlargement of adjacent endothelial cells, rather than mitosis. Endothelial cell loss, if sufficiently severe, can cause endothelial cell density to fall below the threshold level needed to maintain corneal deturgescence. This threshold endothelial cell density varies considerably amongst individuals, but is typically in the range of 500 - 1000 cells/mm². Corneal edema can also occur as the result of compromised endothelial function due to intraocular inflammation or other causes. Excess hydration of the corneal stroma disrupts the normally uniform periodic spacing of Type I collagen fibrils, creating light scatter. In addition, excessive corneal hydration can result in edema of the corneal epithelial layer, which creates irregularity at the optically critical tear film-air interface. Both stromal light scatter and surface epithelial irregularity contribute to degraded optical performance of the cornea and can compromise visual acuity.

7) Long ciliary nerve supplies

a. Dilator Pupillae

b. Sphincter pupillae

c. Levator Palpabrae superioris.

d. None of the above

Answer ( a) Dilator Pupillae

Reference: Gray 38^th Edition Page 1234

8) Presbyopia is

a. insufficiency of accomodation,

b. decrease in elasticity and plasticity of the crystalline lens

c. Age related decrease in the power of ciliary muscles

d. all of the above

Answer (d) All of the above

Reference: Khurana 3^rd Edition Page

9) Shield ulcers are often seen in

a. Spring Catarrh

b. Exposure keratopathy

c. Neuroparalytic keratopathy

d. None of the above

Answer : a) Spring Catarrh

Reference: Khurana 3^rd Edition page 100

10) Dalen Fuch’s nodule is seen in

a. Corneal Ulcer

b. Retinitis Pigmentosa

c. Sympathetic ophthalmitis

d. None of the above

Answer : C) Syphathetic Ophthalmitis

Reference: Khurana 3^rd Edition Page

1 - glaucoma mcqs

Question 1
Essential feature of glaucoma is:
Optic neuropathy-----------
Raised intraocular pressure
Reduced vision
Painful eye

Question 2
Which of these is not a feature of ocular hypertension?
Elevated intraocular pressure
Closed angle-------------
Normal visual fields
Normal optic discs

Question 3
Risk factors for glaucoma include:
Cardiovascular diseases
Family history of glaucoma
Hypothyroidism
All of the above------------

Question 4
Which of these is not a likely cause of painful red eye in a patient?
Open angle glaucoma------------
Closed angle glaucoma
Conjunctivitis
Herpes simplex

Question 5
Drugs that facilitate aqueous humor outflow include:
Timolol
Pilocarpine
Epinephrine
B and C only-----------

Question 6
Which one of the following agents lowers intraocular pressure by reducing aqueous production?
Latanoprost
Dorzolamide--------------( carbonic anhydrase inhibitor )
Epinephrine
Pilocarpine

Question 7
Which class of drug is the first line of therapy for open angle glaucoma when no contraindication exists?
ß blockers----------------
a agonist
Carbonic anhydrase inhibitors
Prostaglandins

Question 8
Side effects of oral carbonic anhydrase inhibitors include:
Tingling sensation in the extremities
Nausea and vomiting
Fatigue
All of the above---------------

Question 9
Dorzolamide is a:
Oral carbonic anhydrase inhibitor
Topical carbonic anhydrase inhibitor-----------
Prostaglandin
None of the above

Question 10
Which one of the following statements regarding pilocarpine is true?
It is a sympathomimetic drug
It is the mainstay of glaucoma treatment
It can be employed in the treatment of both open angle and closed angle glaucoma--------------
It reduces production of aqueous humor

Question 11
Uveo-scleral outflow of aqueous humor is increased by:
Prostaglandins------------
ß blockers
Alpha agonist
Carbonic anhydrase inhibitors

Question 12
Which of the following are not suitable adjuncts?
Timolol and latanoprost
Pilocarpine and betaxolol
Dorzolamide and timolol
Brimonidine and betaxolol-------------?????

Question 13
In treatment of glaucoma, to achieve better effect blockers can be combined well with:
Miotics
Topical carbonic anhydrase inhibitors
Prostaglandins
Any of the above-----------

Question 14
A 75 year old lady with a long standing history of asthma treated with steroids presents to the clinic because of decreased vision. She is found to have posterior capsular opacities as well as an intraocular pressure of 28 mmHg. Which of the following medication should be prescribed?
Timolol
Pilocarpine
Latanoprost----------------
None of the above

Question 15
Neuroprotection is well established with:
Timolol
Brimonidine-----------
Latanoprost
None of the above

Question 16
The only US FDA approved drug for control of post-operative intraocular pressure spikes is:
Brimonidine 0.2%
Apraclonidine 1%-----------------
Latanoprost 0.005%
None of the above

Question 17
Which of these is not true with regard to laser trabeculoplasty?
It is done as an outpatient procedure
A new opening is created in the white of the eye to facilitate drainage of aqueous humor------------
Its effects may wear off over time
Is generally done after trying treatment with medications