Sunday, March 2, 2008
12 - 101 to 150 important mcqs in opthalmology
101- layers of retina from within outwards are : 1- stratum opticum
2- ganglionic layer
3- inner plexi form layer
4- inner nuclear layer ( layer of inner granules )
5- outer plexiform layer
6- outer nuclear layer ( layer of outer granules )
7- layer of rods and cones
102- a patient complains of pain both eyes with congestion , blurrng of vision , photophobia and mucopurulent discharge since one day , many cases
have been reported from the same community , causative agent is a- adeno virus b- entero virus 70 c- herpes simplex d- ECHO virus
----------- answer is entero virus 70 --- because in entero virus there is sudden onset and short duration , where as in adeno virus photophobia and epithelial keratitis
occurs 5 to 14 days after tearing and pain. ( pg- 313- ashish vol 2 )
103- a neonate 30 days old , presented with excessive lacrimatiion and photophobia , he has large and hazy cornea . his both lacrimal duct systems are normal , the diagnosis is ?
a- congenital glaucoma b- keratoconus ( keratoglobus ) c- megalocornea d- hunters syndrome
-----------answer is congenital glaucoma because the symptoms mentioned above are not seen in other three cases . when iop raises in children less than 3 years of age , the size of the globe
increases condition called buphthalmos .( pg 315 - ashish vol 2)
104- HAABS striae - corneal opacities due to rupture in descemets membrane - seen in buphthalmos - congenital glaucoma ( infantile glaucoma ).
105-a 12 year old boy presents with recurrent attacks of conjunctivitis for the last 2 years with intense itching and ropy discharge . the diagnosis is
---------------- VERNAL KERATOCONJUNCTIVITIS ( SPRING CATARRH - cobble stone ) ----- ropy discharge is the clue .
106- 60 year old male patient operated for cataract 6 months back now complains of floaters and sudden loss of vision , the diagnosis is ?
a - vitreous hemorrhage b- retinal detachment c- central retinal artery occlusion d- cystoid mcular edema
---------------answer is retinal detachment , because of all the options only a and b can cause floaters and out of the two vitreous hemorrhage is a acute complication
and the retinal complication is a long term complication .
107- causes of large cornea - keratoconus , megalocornea , bupthalomos ( congenital glaucoma )
108- late post operative complications of cataract surgery? after cataract ( Nd YAG laser ) , retinal detachment , cystoid macular edema , epithelial ingrowth , vitreous touch syndrome .
109- most common late postoperative complication of cataract surgery ? CYSTOID MACULAR EDEMA
110- causes of floaters ? retinal detachment , vitreous hemorrhage , coats disease , eales disease , HTN retinopathy , DM retinopathy , SABE , leukemia , pars planitis, retinal branch vein occlusion, ( LPR )
111- causes of sudden painless loss of vision? CRAO , CRVO , RD , VH , Macular edema due to any cause , anterior ischemic optic neuropathy .
112- a 25 year old lady presents with severe sudden onset of pain , corneal congestion , photophobia and deep anterior chamber in the right eye . the left eye is normal . x ray pelvis shows , sacroiliitis ?
-------------the diagnosis is anterior uveitis . the lady is suffering from ANKYLOSING SPONDYLITIS and the most common ocular manifestation in AS is anterior uveitis . 3 men AS= 1 WOMEN AS.
113- the most common complication of hypermature sclerotic cataract is ? lens dislocation .
114- a male patient with a history of hypermature cataract presents with a 2 day history of ciliary congestion , photophobia , blurring of vision and on examination has a deep
anterior chamber in the right eye , the left eye is normal. the diagnosis is - a - phakomorphic glaucoma b- phakolytic glaucoma c- phakotoxic glaucoma d- phakoanaphylactic uveitis
------------------ ans is phacoanaphylactic uveitis ... no symptoms of glaucoma like severe pain , hazy cornea , fixed dilated pupil. - complications caused by hypermature morgagnian type of
cataract are phacolytic glaucoma( leaked proteins blocking the outflow ) and phacoanaphylactic uveitis ( leaked proteins inducing antigen antibody reaction ) .
115- paralytic patient presents with ? diplopia , deviation, confusion
116-nystagmus which is not pathological ? OPTOKINETIC
117-in a child with retinoblastoma , on x ray we can see ? intra orbital calcification , multiple cranial deposits and widening of the optic foramen. intracerebral calcification is not present .
118- one year old male child with cats eye reflex and increased intraocular tension , diagnosis ? RETINOBLASTOMA
119-what is amblyopia ? partial loss of sight in one or both eyes in the absence of opthalmoscopic or other marked objective signs . congenital or acquired . acquired can be organic ( toxic )
or functional. functional amblyopia results from the psychical suppression of the retinal image . it may be anisometric , strabismic or due to stimulus deprivation.
120- what is amblyopia ex anopsia ? amblyopia due to stimulus deprivation .
121- tests done for visual malingering ( one eye blind ) ? 1-convex lens test 2- prism base down test 3- prism base out test 4- snellens coloured types test ( a good eye can read
only red letters thru a red glass .)
122- what is amourosis ? complete loss of sight in one or both eyes in the absence of opthalmoscopic or other marked objective signs . types a- amaurosis fugax - sudden , temporary
and painless monocular visual loss occuring due to a transient failure of retinal circulation . common causes are carotid transient ischaemic attacks , embolization of retinal
circulation , papilledema , giant cell arteritis , raynaud's disease , migraine , as a prodromal symptom of CRAO or carotid artery occlusion , hypertensive retinopathy and venous
stasis retinopathy . b- uraemic amaurosis - sudden , bilateral ,complete loss of sight occuring probably due to the effect of certain toxic materials upon the cells of the visual centre
in patients suffering from acute nephritis , eclampsia of pregnancy and renal failure .visual loss is associated with dilated pupils which generally react to light , the fundi are usually
normal except for the coincidental findings of the hypertensive retinopathy , when associated . usuallly the vision recovers in 12 to 48 hours .
123- saccade - abrupt involuntary rapid eye movements .
124- field defect seen in pituitary adenomas and craniopharyngiomas - BITEMPORAL HEMIANOPIA ( temporal halfs of both sides lost ) . lesion or compression at the optic chiasma .
125- amblyopia shud be corrected within how many years? 5 years
126- visual defect in optic chiasmal lesion ? bitemporal hemianopia .
127- what is homonymous hemianopia ? visual field defect in which in one eye nasal field is visible and in the other eye temporal field is visible .
128- paralysis of the 3rd , 4th and 6 th nerve with the paralysis of the opthalmic division of the 5 th nerve , localises the lesion to ? CAVERNOUS SINUS .
129- A 25 year old male gives a history of sudden painless loss of vision in one eye for the past 2 weeks .no history of trauma . on examination the anterior segment is normal but there is no
fundal glow . what is the diagnosis ? a- vitreous hemorrhage b- developmental cataract c- optic atrophy d- acute attack of angle closure glaucoma-----
--------- answer is vitreous hemorrhage ... development cataract - there is gradual loss , optic atrophy also gradual loss , angle closure glaucoma acute attack is associated with pain.
130- levator palpebrae superioris is supplied by which nerve ? oculomotor nerve
131- UVEITIS associated with VITILIGO and AUDITORY DEFECTS occurs in ? VOGT - KOYANAGI SYNDROME .
132- sympathetic opthalmia is ? BILATERAL NON SUPPURATIVE UVEITIS .
133- most common cause of anterior uveitis associated with arthritis ? ANKYLOSING SPONDYLITIS.
134- the type of synechiae in iris bombe is ? RING TYPE .
135- SALT AND PEPPER FUNDUS IS SEEN IN ? CONGENITAL SYPHILIS .
136- visible retinal artery pulsations are seen in? increased intraocular tension
137-sudden increase in blood sugar in diabetics causes ? myopia
138- black floaters in a biabetic patient indicate ? vitreous hemorrhage .
139- an young adult male presents with sudden painless loss of vision , he recovered spontaneously within 3 months . diagnosis? central serous retinopathy.
140- berlin's edema is due to ? blunt injury .
141- vitreous hemorrhage in young adults indicates ? EALES DISEASE .
142- degree or development of diabetic retinopathy depends on ? duration of disease.
143- lens contains the oldest cells in ? the nucleus
144- the prominent ocular manifestation seen with the marfans syndrome? ectopia lentis .
145- typical glucocorticoids cause ? cataract and glaucoma .
146- commmonest cause of cataract ? age related .
147- retinal detachment is preceded by ? high myopia , trauma, floaters and flashes
148- laser used in the management of after cataracts ? Nd YAG laser .
149- atopic cataract is that which follows skin diseases like eczema .
150- CHRISTMAS TREE CATARACT IS SEEN IN ? MYOTONIC DYSTROPHY.
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