1st le ophthalmology (2 files merged)

8/10/2019 1st LE Ophthalmology (2 Files Merged)

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Ophthalmology 1st

LE feedback (2015 A)

1.

The site of the detailed for central vision is:

a.

Optic nerve

b.

Pars plana

c.

Ora Serrata

d. Macula

2.

The aqueous humor is formed by secretion and diffusion of ciliary processes. Its

functions are:

a.

To maintain the intraocular pressure

b. Provides metabolism to the lens

c. Provide nutrition to the posterior cornea

d. all of the above

3.

the aqueous layer of the tear film is mainly derived from a. Lacrimal glands

b.

Meibomian glands

c.

Goblet cells

d.

All of the above

4. The anterior liquid layer of the tear film is mainly derived from

a. Accessory lacrimal gland of Krause and Wolfring

b.

Crypts of Henle

c.

Meibomian glands

d. All of the above

5. The thin mucin layer of the tear film:

a. Maintains stability of the tear film

b.

Contains glucose immunoglobulins

c.

Prevents evaporation

d.

Provides water tight seal

6.

The main source of nutrition of the sclera a.

Cornea

b. Aqueous Humor

c.

Choriocapillaries

d.

Episclera

7.

The process by which light absorbed by the photoreceptors is converted to electrical

energy:

a. Photosynthesis

b.

Accommodation

c.

Visual Transduction

d. None of the above

8.

The electrophysiologic test used to evaluate the optic nerve

a.

Electrooculography

b.

Electroretinography

c. Visual Evoked Response

d. All of the above

9.

The simultaneous movement of the eye directed to an object in the mid body plane

a. Version

b.

Duction

c. Vergence

d. Torsion

10. The muscle responsible for abduction:

a.

Medial rectusb.

Lateral rectus

c.

Superior rectus

d.

Inferior rectus

11. The muscle responsible for intorsion:

a. Superior rectus

b.

Superior oblique

c.

Inferior oblique

d.

Inferior rectus

12. In the elucidation of the patients chief complaint:

a.

It should be stated in the physicians words using concise medical terminology

b. The complaints of lesser importance should not be cited along with the chief

complaint

c.

It should document the patientspoint of view, which may be distinct from th

physician

d. It may include three or more complaints with their respective duration

13.

Which of the following are considered general categories for complaints?

a. Ocular pain and discomfort

b.

Abnormal appearances

c.

Abnormal ocular secretions

d.

All of the above

14.

In taking the history of present illness (HPI)

a. An ocular complaint which is bilateral can give the physician an idea that the

problem may have a systemic etiology or genetic predisposition

b. Clarifying complaints will uselessly lengthen the process

c.

The physicians medical terminology should be used for uniformity, to represen

what the patient said

d.

Negative symptomatology should always be ignored and not included in the

documentation of the HPI


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30. Myopia is likely present when:

a.

A person needs to hold his cellphone very close to his eyes to real his text

message

b.

A person needs to hold his cellphone at armslength to read his text message

c. A person needs to squint and make his palpebral fissure small to read his text

message

d. A person needs to turn his head to the right and look through the corner of his

eyes to read his text message

31.

Myopic correction is accomplished with

a.Convex lenses

b. Concave lenses

c.

Toric lenses

d.Cylinders

32. The focal point in an uncorrected myopia is located

a.

before the retina

b.

after the retina

c.

On the retina

d.

before and after the retina

33. A 41 year old insurance executive complains of temporal headaches noted usually in

the late afternoon after a day of heavy computer work relieved by sleep. She claims

to have had perfect vision all her life and never had to wear glasses. She was advised

by her boss to consult a neurologist but wanted to have her eye checked first. Your

primary consideration is:

a.

Glaucoma

b. Systemic hypertension

c.

Psoriasis

d. Presbyopia

34. A blowout fracture of the orbit occurs when an external force strikes the orbital

cavity. Which of the following walls is fractured the most?a.

Orbital roof

b. Orbital floor

c.

Medial wall

d.lateral wall

35. An ophthalmic surgery that involves removal of the whole globe is called?

a. evisceration

b. enucleation

c.

exenteration

d.

excision

36. A 62 year old female sought consult due to foreign body sensation and eye redness

on the left eye. On examination, the left lower eyelid margin was noted to turn

inward causing eyelashcorneal touch. The most probable diagnosis is?

a.

Ectropion

b.

Entropion

c.

Blepharoptosis

d.

Blepharitis

37. A small abscess caused by an acute staphylococcal infection of the meibomian gland

is called

a.

internal hordeolumMost commonly caused by staphylococcus

b. external hordeolum

c.

blephritisnot abscecss

d.

chalazion

38. A 6 year old male was noted to have a waxy and nodular lesion with central

umbilication at the eyelid margin. What is the moste likely diagnosis?

a.

Xanthelasma

b. Molluscum contagiosum

c.

Cutaneous horn

d.

Seborrheic keratosis

39.

A 60 year old farmer sought consult due to a pigmented lesion on the left lower

eyelid. It was described to like a rodentulcerwhat is the most likely diagnosis?

a. Basal cell carcinoma

b.

Squamous cell carcinoma

c.

Sebaceous adenocarcinoma

d. Kaposis sarcoma

40. The eyelid malignancy may arise spontaneously or from areas of solar injury and

actinic keratosis. It is usually metastasize through the lymphatics, blood or direct

extension

a.

Sebaceous adenocarcinoma

b.

Basal cell carcinoma

c. Squamous cell carcinoma

d. Kaposis sarcoma

41.

A 35 y/o patient previously diagnosed with AIDS presented with a reddish dermal

mass in the left lower eyelid. The most likely diagnosis is:

a.

Basal cell carcinoma

b.

Kaposissarcomac.

Malignant Melanoma

d. Sebaceous adenocarcinoma

42.

In congenital nasolacrimal duct obstruction, there is usually a membranous block at

a.

Common canaliculus

b.

Inferior puncta

c.

Valve of Rosenmuller

d.

Valve of Hasner most common site (70 80% resolve in 6 months)

43.

What is the most common pathogen seen in patients with Canaliculitis?

a.

Staphylococcus aureus

b.

Streptococcus sp.

c.

Actinomyces israelii

d. Pseudomonas Aeroginosa


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59. Which of the ff chemistry of the normal crystalline lens is not true?

a.

Adult lens contains approximately 66% water and 33% protein

b.

Lens cortex is less hydrated than the lens nucleus

c.

Lens dehydration is maintained by an active Na, K ion water pump

d. Lens contains most K ion and less Na ions

60. One of the ff is not associated with ectopia lentis:

a. Marfan Syndrome

b. WellMarhesam Syndrome

c.

Rubella Syndrome

d. Homocystonuria

61. This layer of the crystalline lens is responsible for changing the shape of the lens

during accommodation?

a.

Cortexb. Nucleus

c.

Lens Capsule where zonular fibers are attached

d. Lens epithelium

62. Which of the ff symptoms is/are associated w/ posterior subcapsular cataract?

a. Good near vision but blurred far vision

b.

Good distance vision but typically have blurred near vision because it is

near the macula

c.

Good far and near vision

d.

Good near vision cycle

63.

Which type of cataract surgery is ideal for most senile (age related) cataract?

a.

Intracapsular cataract extraction

b. Extracapsular cataract extraction

c.

Aspiration lensectomy done in soft lens (senile and babies)

d. Phacoemulsification

64.

A 65 y/o female complained of painful blurring of vision in her right eye of 5 days

duration. Right eye examination revealed a hazy cornea, shallow AC, middilatedpupil

and intermittent lens. What is the most likely diagnosis?

a.

Phacolytic glaucoma

b.

Phacomorphic glaucomamorphologically block aqueous outflow

c. Phacoanaphylactic glaucoma

d.

Neovascular glaucoma

65. Type of cataract that results from the development of vacuoles and water clefts in the

lens. Fibers giving rise to a pearl like appearance:

a. Nuclear Cataract

b. Polar Cataract

c.

Cortical Cataract earliest sign is the formation of water vacuoles

d. Posterior Subcapsular Cataract

66. The changing of the crystalline lens shape during accommodation is controlled by?

a.

Zonular fiber

b.

Ciliary body

c.

Ciliary muscle

d. Vitreous body

67. The uveal layer of the human eye is composed of the:

a. Cornea and sclera

b. Iris, ciliary body, and choroid

c.

Sclera and uvea

d. Retina and Choroid

68. Features of the sclera include w/c of the ff?

a. It covers the of the total eyeball

b.

It serves as the insertion of the extracapsular muscles c.

It is opaque, white, fibrous tissue. Composed of different types of collag

and is almost acellular

d.

The optic nerve runs through its equator

69. Which of the ff is false regarding episcleritis?

a.

It is more common in males in their 20s and 30s

b. It is characterized by engorgement of episcleral vessels which run in rad

direction

c.

It may be localized and benign or does not signify and underlying system

disease

d.

Tenderness, discomfort and sometimes neuralgia are sometimes present

70.

A patient presented with a circumscribed mass as large as a lentil about 23 mm a

from limbus in the temporal area of the eye. It was hard, tender and immovable w

the conjunctiva moving freely over it. It is traversed by deeper episcleral ves

hence purple in color and is not bright red. There is mild tenderness and discomf

This patient most likely has:

a.

Nodular scleritisb. Nodular episcleritis

c.

Diffuse scleritis

d.

Diffuse episcleritis

71. A 36 y/o woman came in with a red eye with profound pain and some photopho

The eye is violecious red which does not blanch with the application of epinephr

This patient most likely has:

a. Episcleritis

b.

Uveitis

c.

Scleritis

d. Staphyloma


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72. The patient came in with sclera necrosis characterized by severe thinning and melting

of sclera. His eye is red painful and has worsening of symptoms as days progress.

There is associated anterior uveitis and was diagnosed by her dermatologist to have

Wegeners Granulomatosis. The condition is best managed by?

a.

Oral NSAIDs and topical ?????

b.

Oral NSAIDs, topical Prednisolone and abundant lubrication

c.

Oral prednisone at 1mg/kg/day, topical Prednisolone, and oral

immunosuppressants

d. Surgical management with sclera patch graft

73. Which of the ff is NOT an accepted treatment for posterior scleritis

a. IV methylprednisolone

b. Subconjunctival triameionolone injections

c. Antibiotics for infectious sclera disorders

d.

Oral prednisone at 1 mg/kg BW

74.

A patient presents with an ocular staphyloma. Examination reveals iris incarceration.

This patient has:

a. Anterior staphyloma

b. Ciliary staphyloma

c. Interciliary staphyloma

d. Posterior staphyloma

75. A congenital development anomaly in the development of the iris, resulting to an

absence of the inferior portion of the iris revealing a keyholepupil called:

a. Iris coloboma

b. Aniridia

c. Rubeosis iridis

d.

Heterochromia iridis

76. Exudation of proteinaceous material in the anterior chamber of the eye produces

which clinical age of anterior uveal inflammation?

a.

Anterior chamber cellsb. Anterior chamber flare

c. Nodules

d.

77.

The currently used classification used in uveitis disease is:

a. International Uveitis Study Group (IUSG) Classification

b.

??? Classification

c. MEEI Harvard School Classification

d. Standardization of Uveitis Nomenclature (SUN) Working Group

Classification

78.

Which of the ff is not a primary determinant of IOP?

a. Rate of aqueous humor incretion

b.

Pupil dilation in myopia

c. Aqueous humor outflow faculty

d.

Episcleral venous pressure

79. The mean value for outflow faculty in normal eyes is?

a.

0.05 uL/min/mmHg

b.

0.15 uL/min/mmHg

c.

0.28 uL/min/mmHg

d. 0.48 uL/min/mmHg

80. Conjunctival hyperemia, growth of eyelashes, ocular pruritus, ocular dryness, vi

disturbance, ocular burning, foreign body sensation, eye pain, pigmentation of

periocular area, blepharitis, cataract, eyelid erythema, eyelash darkening,

ADVERSE REACTIONS associated with this antiglaucoma medication:

a.

Betaxolol

b.

Bimatoprost

c.

Brinzolamide

d.

Pilocarpine

81. Which of the ff best characterizes primary open angle glaucoma (POAG)?

a.

POAG usually presents with higher pressures compared to normal tensiglaucoma

b. POAG is a gradually progressive irreversible blinding disease

c.

POAG presents with higher eye pressures compared to congenital glaucom

d.

POAG is usually seen in hyperopia

82. One of the following is a risk factor for development for glaucoma

a. Prolonged use of computers

b.

Intake of oral steroids even topical steriods

c.

Prolonged exercise

d.

Intake of antihypertensive medications

83.

A 60 y/o Asian female complains of difficulty in driving characterized as inability

see the sidewalk for the past 6 months. Past health history is significant for diabe

of 5 years. She claims to have a sister who is blind. Eye examinations showed a vis

acuity of 20/20 on both eyes, eye pressure


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86. In the treatment of glaucoma, timolol maleate should not be given to patients with

a.

Hemorrhoids

b.

Psoriasis

c. Systemic HPNprecaution but not contraindicated

d. Bronchial Asthmamore common

87. Aqueous fluid exits the eye through?

a. Lacrimal duct

b. Vitreous collagenous channels

c.

Na K pump of the corneal endothelial cells

d. Trabecular meshwork

88. The most common mechanism identified in patients with primary angle closure

glaucoma is?

a.

Pupillary blockb.

c.

Angle recession

d.

Retinal detachment

89. A patient complaining of poor vision in one eye is subjected to a pinhole test. What is

true in the ff statements?

a. Error of refraction if vision is improved

b.

Patient is not looking thru pinhole if vision is not improved

c.

You need corrective glasses to look thru pinhole

d.

Pathological if vision is improved

90.

What is the importance of doing a cover and uncover test in a patient that has

intermittent double vision?

a. To break the fusion of vision

b.

To check for any blurring of vision

c.

Look for nystagmus not cause double vision

d.

Check how straight the eyes are

91. What is the single most important feature of a visual field defect that tells you central

vision vs. optic nerve lesion?

a.

If visual field defect respects the horizontal meridian raphe

b.

If field defect respects the vertical meridian hemianopsia present

c. If the visual fields look the same on both eyes

d.

If visual fields are congruous

92. Where is the lesion in a patient with temporal wedge shaped scotoma in one eye?

a. Temporal arcuate nerve fiber bundle

b. Optic Chiasmbitemporal hemianopsia

c.

Nasal radiating nerve fiber bundle

d. Papilioma nerve fiber bundle

93. A scotoma located 5 degrees from fixation is a lesion in?

a.

Papilomacular nerve fiber bundle

b.

Temporal arcuate nerve fiber bundle

c. Nasal radiating nerve fiber bundle

d.

Horizontal raphe

94. What is the most common chart used to check color vision?

a. Farnsworth color testmore sensitive

b.

c.

Ishihara test chartmost common

d.

95. What is the importance of swinging flashlight test?

a. Shows how pupil constricts with light stimulus

b.

Show equality of pupillary light reactionc. Will distinguish between Horners syndrome and Tonic pupil

d.

Will distinguish between optic nerve lesion and retinal problem

96.

A lesion affecting the nerve fibers of optic radiation will give what kind of visual fi

defect?

a. Homonymous hemianopsia

b. Heteronymous hemianopsia

c.

Junctional scotoma

d.

Piein the skyphenomenon

97. What specific visual field defect would point specifically to an occipital lobe lesion?

a.

Homonymous hemianopsia

b. Central homonymous hemianopsia

c.

Inferior altitudinal defect

d.

Temporal island of vision in area of visual field defect

98.

What is a redglass test?for patients with diplopia

a.

Test for fusion of visionb.

Part of color vision test

c. Test for red desaturation

d.

Test for retina function

99.

A junctional scotoma is a sign of?

a.

Optic nerve compression

b. Optic chiasmatic cord compression

c. Temporal lobe lesion

d. Parietal lobe lesion

100.

What is the importance of congruity in a Visual Field Defect (VFD)?

a.

The more congruous the VFD the closer it is to the temporal lobe

b. The more congruous the VFD the closer it is to the visual cortex

c. It implies that the mass lesion is in the optic tract.

d. It measures the angle of field defect in a patient with optic


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1.The study that treats light as rays

a.

Quantum optics interaction of light and matter;

absorption and generation of light source

b.

Physical optics physical properties of light

c. Geometric optics

d.Refractive optics

1.

When light travels from a medium of higher

refractive index to a medium of lower refractive

index:a.It bends away from the normal.

b.

It bends towards the mirrorized surface.

c.

It bends away from the mirrorized surface.

d. It bends towards the normal. light travels from

the medium of lower refractive index to a medium of

higher refractive index

2.

Prisms bend light

a.

Towards the base

b.

Away from the base

c.Towards the apex

d.

Away from the mirrorized surface

3.

The focal length of a convex lens with a refractive

power of 2.00 D

a.

0.25 meter

b. 0.50 meter

c.

0.75 meter

d.

1.0 meter

4.Most common types of myopia

a.

Corneal

b. Axial

c.

Lenticular

d.Peripheral

6.

Myopic non-invasive correction that provides the

best quality of vision

a.

Contact lens Better optically because it moves

with your eye and is better cosmetically.

b.

LASIK

c.

Glasses

d.

Clear lens extraction with intraocular lens

implantation

7.Myopic correction is accomplished with

a.

Convex lenses for hyperopic correction

b.

Concave lenses this should be the answer???

c. Toric lenses for astigmatism

d. Cylinders

8.

The focal point in an uncorrected myope is located

a.before the retina

b.

after the retina - hyperopia

c.

On the retina

d.

before and after the retina

9.

Flat corneal curvatures are associated with

a.hyperopia

b.

myopia cornea is steep

c.

presbyopia

d.

metamorphopsia

10.

Correction for hyperopia is accomplished witha. minus lens - myopia

b. plus lens

c.

combination of concave and cylindrical lenses

d.

flat lenses

11.

One of the following cannot be used to correct

astigmatism

a. Presbyopic reading glasses for presbyopia

b.

Toric contact lenses

c.

Cylinder spectacle lenses

d.

Cataract extraction with toric intraocular lens

implantation

12.Far-sighted individuals

a.have long eyeballs near-sighted individuals

b.

have to bring objects closer to see them clearly -

near-sighted individuals

c.have narrow slit-like palpebral fissures

d. have short eyeballs

FIRST LONG EXAM FEEDBACK

Dr. Imperial July 24, 2013

Formula = 1/dioptre(meters) = 1 / 2 = 0.50 meter


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13.

individuals with astigmatism

a.see better with convex lenses - hyperopia

b.

see better with concave lenses - myopia

c. see better through pinholes

d. see better at night

14.

Astigmatism

a. is characterized by having multiple focal points

b.

cannot be corrected with contact lenses

c.can result from conjunctival redness

d.

treated best with clear lens extraction with

accommodative intraocular lens implantation

15.

A condition characterized by difficulty in reading

fine print resulting from loss of crystalline lens:

a.

cataract clouding of the lens of the eye or of its

surrounding transparent membrane that obstructs the

passage of light

b.presbyopia

c.

myopia cornea is too steep, eyeball is to long, light

focus in front of the retina

d.astigmatism having multiple focal points

16.

Which of the following is FALSE about the

Human crystalline lens?

a.Located behind the iris and pupil

b.

Avacular

c. Biconcave structure Lens is clear, transparent and

biconvex

d.Held in place by the zonular fibers

17.

which of the following is NOT TRUE about the

adult lens?

a.

Approximately 9.5 10mm in diameter

b.

Dehydrated structure

c.

Slow growth

d. The lens capsule becomes more elastic

18.

Which of the following chemical changes occur in

MATURE CATARACT?

a.Decreases in Na+ ion + water, increases in K+ and

soluble proteins

b.Increases in Na+ ion + water, losses of K+ ions +

soluble proteins

c.

Increases in Na+ ion + water, decreases in K+ ions +

soluble proteins

d.

No disruption of lens chemistry

19.

Responsible for changing the shape of the lens

during accommodation

a. Lens epithelium responsible for continuous

growth of the lens

b.

Lens capsule

c.Cortical fibers

d.

Nucleus

20.

Phacolytic glaucoma is associated with?

a. Intumescent lens

b. Hypermature cataract

c.

Incipient lens

d.Ectopia lentis

21.

Which of the following is a disadvantage of

phacoemulsification?a.

Less astigmatism

b.

Less risk of expulsive hemorrhages

c.

Small incision

d. Machine dependent

Questions 22-23

22.

A 90 year old male was diagnosed to have

Bilateral mature nuclear cataract. Visual acuity are

light perception. Which of the following pre-operative

test is not recommended?

a.

A-scan Biometry

b.

Ultra sonography (B-scan)c.

Specular microscopy

d. Ocular coherent tomography (OCT)

23.

In the above mentioned case, what type of cataract

operation is recommended?

a. ICCE (Intracapsular cataract extraction) with

ACIOL implantation

b. ECCE (Extracapsular cataract extraction) w/

PCIOL implantation.

c.Phacoemulsification with PCIOLimplantation

d.

Lensectomy + pars plana vitrectomy

24.

Which of the following is not associated with

anterior subcapsular cataract?

a.Chronic anterior uveitis

b.

Acute congestive angle closure glaucoma

c.

Blunt eye trauma

Anterior capsule, nucleus and cortex is removed, leaving

behind the posterior capsule to support the intraocular lens

that will be placed in the empty capsular bag.

In phacolytic glaucoma, there is hypermaturity of the

lens that would lead to shrinkage of the lens.

Lens are very elastic in young age.


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d. Prolong used of corticosteroid associated with

posterior subcapsular cataract; other associations are

DM, trauma, inflammation and irradiation

25.

A 75 year old male comes in complaining of

difficulty in driving caused by decreased distance

vision. He claims that his near vision improved. This

is more consistent with?

a.

Anterior subcapsular cataract near vision is

affected, good far vision

b.

Posterior subcapsular cataract near vision is

affected, good far vision

c. Nuclear sclerotic cataract - far vision is affected,

good near vision

d. Cortical cataract late blurring of vision

26.

Which of the following is not associated with

ectopia lentis?

a. Marfanssyndrome

b. Homocystinuria

c. Lowessyndrome

d. Weill-Marchesani syndrome

27. The following are ocular features of Marfans

syndrome, except:

a. Retinal detachment

b.Lenticular Myopia

c. Lens subluxation which is typically downwards

d. Hypoplasia of the dilator papillae

In Marfans syndrome it should be vertical

displacement/ upward subluxation of lens

b. Apply topical vasoconstrictors

c. Consider systemic work-up for infectious or

autoimmune diseases

d. Prescribe topical NSAIDS

letter (b) apply topical vasoconstrictors is given if

symptomatic ; letter (a) give topical lubricating eyedropsand fluoromethalone eye drops being weak topical steroids

are given to mild to moderate cases. For severe form give

stronger steroids as Prenisolone Acetate eye drops

30.

Complications of necrotizing scleritis with

inflammation include(s):

a.

Glaucoma

b.

Cataract

c.

Sclerosing keratitis

d. All of these

31.

A patient presents with decreased vision and

proptosis with minimal to no pain. Review of systems

does not point to any systemic disease. On

examination, there are restricted ocular movements.

Fundoscopy reveals posterior vitritis, optic disc

edema and exudative retinal detachment. B-scan

ultrasound shows a thickened sclera. One should

suspect:

a.

Posterior uveitis

b.

Anterior staphyloma

c.

Thyroid orbitopathy

d. Posterior scleritis

28.

The most common systemic disease associated

with episcleritis is:

a. Rheumatoid arthritisb.

Inflammatory bowel disease

c.

Lupus

d.

Herpes zoster virus

29.

For a patient with recurrent episcleritis, one

should:

a. Give topical lubricating eyedrops

32.

Which of the following is NOT an accepted

treatment for posterior scleritis

a. Intravenous methylprednisolone

b. Subconjunctival triameinolone injections

c.

Antibiotics for infectious sclera disorders

d.Oral Prednisone (steroids)

Complication also includes sclera melting. In necrotizing

scleritis, there is sclera necrosis with thinning and melting of

the sclera. With inflammation indicates red, painful eye,

with whitish patch of necrotizing area of sclera (thin and

imperforate), associated with anterior uveitis, autoimmune

disorder.

Causes of ectopia lentis can be either 1. Familial

Marfans and Homocystinuria or 2. Eye disease and

trauma(blunt or surgical - Iridodonesis

Anterior subcapsular cataract is associated with

increased IOP.

Findings are consistent with Posterior scleritis, which

is the inflammation with thickening of the posterior

sclera. Restricted ocular movements, proptosis,

posterior vitritis , optic disc edema, macular edema.

Fundoscopy visualizes edema and hemorrhage.


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33. Which of the following is NOT TRUE regarding

treatment outcomes in cases of scleritis?

a.

Rapid response to therapy is expected

b.Visual loss may happen in 10-85% of cases

c.

Glaucoma and cataracts may occur as complications

in up to 20% of cases

d. Corneal melting is common in these cases

34.

A patient presents with an ocular staphyloma.

Examination reveals iris incarceration. This

patient has:

a. Anterior staphyloma

35.

Of the following congenital and developmental

anomalies involving the iris, which is commonly

associated with anterior uveitis?

a.

Aniridia this is the incomplete formation of the

iris

b.

Congenital ectropion uvea linked withy

appearance of progressive open-angle

glaucoma due to angle dysgenesis

c.

Rubeosisiridis abnormal redness of iris,

d. Heterochromia iridis

37.

In observing anterior chamber cells, one can note

that the cells closer to the iris and the lens moves

upward and those close to the corneal endothelium

move downward. This is due to:

a. The aqueous humor drainage mechanism

b. Convection currents, since it is warmer at the

back of the eye

c. The relatively lighter weight of the white blood

cells as opposed to the red blood cells

d.

The inflammatory process in the choroid of the eye

38.

A condition that may appear as or masquerade as

uveitis is:

a.

Lymphoma

b.

Pigmentary dipersion

c.

Hyphema

d.

Vitreous hemorrhage

39.

Which of the following is NOT TRUE of Pediatric

Uveitis?

a.

A cause is found in almost 50-65% of cases of

pediatric uveitis

b.

According to anatomic location, the incidence of

pediatric uveitis is highest in the posterior

uvea of childrenc. Juvenile Rheumatoid Arthritis (JRA) is the most

common identified cause, accounting for almost

12% of all uveitis cases in children

d. Toxoplasmosis is the most commonly identified

infectious cause of uveitis in children

40. The most common intraocular malignancy in

adults is:

36. The most common type of uveitis is:

a. Iritis or iridocyclitis

b.

Intermediate uveitis

c.

Posterior uveitis back of the eye

d.Panuveitis - uveitis affecting all three layers of retina

a.

Retinoblastoma

b.

Melanoma

c.Lymphoma

d. Metastatic Carcinoma

41.

The simultaneous movement of the eyes is called:

a. version

b.vergence

Staphyloma is characterized by an ectasia of the outer coats

(cornea, sclera or both) with an incarceration of uveal tissue.

Caused by weakening of outer wall and raised IOP.

Equatorial staphyloma, is located at the equator behind the

limbus. Posterior Staphyloma is commonly seen near optic

nerve and produces choroidal atrophy and subretinal

neovascularizaton.

Iritis or iridocyclitis is under anterior uveitis and is the most

common type of uveitis.

Subconjunctival injections are CONTRAINDICATED for

posterior scleritis, these are only effective for anterior

scleritis

JRA is the most common identified cause, but accounts for

40% of total uveitis in children.Heterochromia iridis refers to difference in coloration of the

eye due to excess or lack of melanin. Patient would complain

of redness, pain and photophobia with blurring of vision.

Remember that uveitis would include symptoms of eye pain,

photophobia, decreased/blurred vision and seeing floaters in

field of vision


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c.

abduction movement of eye temporally

d.

adduction- movement of eye nasally

42.

The simultaneous movement of the eyes directed

to an object in the mid body plane:

a. versionb. vergence

c.abduction

d. adduction

43.

Electro-oculography or EOG:

a.

used to evaluate the condition of the retinal

pigment epithelium and photoreceptors

b.

used to evaluate the condition of the outer layers of

the retina

c.

Used to evaluate the response of the macula and the

optic nerve

d.

all of the above

44.

Electroretinography or ERG

a.



b. used to evaluate the condition of the outer layers

of the retina

c.

Used to evaluate the response of the macula and the

optic nerve

d.all of the above

45.

Visual Evoked Response or VER

a.



b.used to evaluate the condition of the outer layers of

the retina

c. Used to evaluate the response of the macula and

the optic nerve

d. all of the above

46.

Electromagnetic radiation consisting of massless

particles absorbed by the rods and cones:

a.

neutronsb.

electrons

c. photons

d. atoms

47.

Photopic vision is mainly due to

a. rods

b. cones

c.

both rods and cones

d.

none of the above

48.

Scotopic vision is mainly due to:

a. rods

b.

cones

c.

both rods and cones

d.

none of the above

49.

The process by which light absorbed by the

photoreceptors is converted to electrical

energy:

a. Photography

b. Visual transduction

c.

propagation of energy

d.

bleaching

50.

The main source of nutrition of the sclera:

a.

tears

b.

cornea

c. episclerad. conjunctiva

51.

The cornea is transparent because of its:

a.avascularity

b.

deturgescence

c. both of the above

d. none of the above

52.

Functions of the aqueous humor:a.

maintains intraocular pressure

b.provides metabolism to the lens

c.

keeps the posterior cornea healthy

d. all of the above

53.

The primary function of the lens is to focus light

rays upon the retina. Its transparency is due to:

a.

acellularity

b.

same refractive index

Sclera, is the fibrous outer layer of the eye made up of

collagen, dead tissue and serves as protective shell for

intraocular contents. Episclera covers sclera and protect

structures of the eyes, it is made of a thin layer of fine elastic

tissue which contains blood vessels.

This potential is amplified and modulated in the retina and

propagated to the brain via optic nerve.

photons with energy corresponding to wavelength of

400-700nm pass through cornea, lens and vitreous

until absorbed by rods and cones. Red light (570nm)

green light (535nm) Blue light (440nm)


13/16

c. all of the above

d. none of the above

54. Vitreous humor makes up the largest volume of

the eye. It consists of:

a.

99% water and 1% collagen and

hyaluronic acid

b.


hyaluronic acid

c.


hyaluronic acid

d.


hyaluronic acid

55.

The site of detailed vision in the retina:

a.ora serrata

b. macula

c.retinal pigment epithelium

d.none of the above

56.

The entrance height of the orbit is:

a.30 mm

b. 35 mm

c.

40 mm

d.

45 mm

57.

The strongest orbital wall is:

a.

roof

b.

medial

c.floor

d. lateral

58.

A 38 year old male sought consult due to gradual,

non-tender, proptosis of the right eye. You suspect a

mass behind the eye. What is the most valuable

imaging procedure to request for in this case?

a.

orbital x-rayb. orbital CT scan

c.

orbital ultrasound

d.orbital MRI

59.

A 7 y/o female was brought for consult due to

swelling of the left upper eyelid. The mother claims

that it started out as a pimple in the left upper lid.

Upon examination, a soft, diffuse, erythematous,

tender swelling was noted on the left upper lid.

Vision was not affected, extraocular movements were

intact. What is your most probable diagnosis?

a.

chelazion

b.

blepharitis

c. pre-septal cellulitisd. orbital cellulitis

60.

The most common clinical sign in Thyroid

Orbitopathy is

a.

proptosis

b. lid retraction

c.exposure keratopathy

d.

compressive optic neuropathy

61.

A 52 year old male sought consult due to bilateral

swelling of both upper eyelids. On CT scan,

enlargement of both lacrimal glands were present.

What is the most likely diagnosis?

a.

dermoid cyst

b. dacryoadenitis

c.dacrocystitis

d.

pre septal cellulitis

62.

What is the most common benign neoplasm of the

orbit in adults

a.capillary hemangioma

b. cavernous hemangioma

c.

optic nerve glioma

d.optic nerve meningioma

63.

A blow-out fracture of the orbit occurs when an

external force like a fist or a hard object hits the

orbital rim. Which of the following walls of the orbit

is most likely to be fractured first?

a.

roof

b.medial

c. floor

d. lateral

64.

Anophthalmos or absence of the globe is usually

due to surgical removal of the eye due to trauma,

tumors of a blind painful eye. This procedure entails

removal of the whole eye only.

a.excision

b.evisceration

c. enucleation

d. exenteration

65.

A 66 year old male complained of FB (foreign

body) sensation on the left eye. Upon examination,

the left lower eyelid margin was noted to turn inward

causing irritation to the cornea. What is the most

likely diagnosis?

a.

entropion

b.

ectropion

c.ptosis

d.

dermatochalasis

66.A small abscess caused by an acute staphylococcal

infection of the meibomian gland is called

a.

anterior blephritis

b.chalazion

c.external hordeolum

d. internal hordeolum

A is inward motion, outward motion is ectropoin

C would be inflammation of the lacrimal sac, not the glands

A is the most common clinical sign of Graves

If the extraocular movements and vision were affected, the

answer would be D.

eibomian gland = internal


14/16

67.

What is the most common eyelid malignancy

a.

basal cell carcinoma

b.

squamous cell carcinoma

c.

sebaceous gland carcinoma

d.

malignant melanoma

68.

A 48 year old male sought consult due to multiple

yellowish plaques in the medial canthal areas of both

eyelids. Patient disclosed that he has high cholesterol

levels. What is the most likely diagnosis

a.seborrheic keratosis

b.

molluscum contagiosum

c.dermal nevus

d. xanthelesma

69.

What is the average length of the canaliculi

a.1-2 mm

b.

3-6 mm

c. 8-12 mm

d. 12-15 mm

70.

A 34 year old male sought consult due to purulent

discharge on the left eye. On examination, the

punctum appears erythematous and pouting.

Purulent discharge is also noted. The most common

pathogen involved

a.

Staphylococcus aureus

b.

Sreptococcus sp

c. Actinomyces israelii found in the

canaliculi

d. Neisseria gonorrhoea

71.All of the following are components of the ocular

history, except

a.

Chief complaint

b.History of present illness

c.Family history

d. None

72.

If the patient for interview is a child, the examiner

a.should interview the child alone

b. may talk to the guardian or parent for

history taking

c. should not continue with the history

74.

The first step in history taking is

a.

getting the chief complaint

b.

getting the identifying data of the patient

c. establishing rapport

d. getting the details of the problem

75.

The mnemonic C-O-L-D-E-R in history taking

includes:

a.

limitation

b. onset

c.complications

d.

reason for visit

76.

The mnemoic C-O-L-D-E-R in history taking

includes:

a. Limitation

c. Complications

b. Onset

d.

Reason for visit

77.

Importance of the Review of Systems include:

a.

To be able to review other symptoms

b.Enables the physician to catch more clues

c.

To be able to get details that the physician may

have missed during the HPI

d. all of the above

78.

Intake of which medication may cause optic

neuropathies?

a.

Diamicron

b.

Prednisone

c. Ethambutol

d. Metoprolol

taking

73.

The chief complaint includes:

a.

main problem of the patient, laterality,

and duration of symptoms

b.

3 symptoms of the patient, duration and

minimal history

c.

only the main problem of the patient

d.

complete details of the problem

79.

Instillation of which medication may cause lens

opacities?

a. Atropine

b. Steroids

c.Anti-glaucoma medications

d.

Antibiotic ointments

Character (quality, severity, associated s/sx)

Onset (sudden, gradual, morning or nighttime)

Location/Laterality

Duration (approximation of existence of symptoms)

Exacerbation

Relief

Ethambutol has the following side effects:allergic reactions

(difficulty breathing; closing of the throat; swelling of the lips,

tongue, or face; or hives); vision changes (e.g., blurring, red-

green color blindness); a rash; numbness or tingling in your

fingers, toes, hands, or feet; confusion, disorientation, or

hallucinations; or fever.


15/16

80.

Instillation of which medication may cause

increase in intraocular pressure?

a. Atropine

b. Steroids

c.

Anti-glaucoma medications

d.

Antibiotic ointments

81.

The 8 elements of HPI include all, except:

a. Diagnosis

b.Quality

c.

Severity

d.

Location

82.

In taking the Past Ocular History, it is important

to note the:a.

Previous refraction/use of glasses

b.

Previous eye trauma

c.Previous eye surgery

d. All of the above

83.

Your patient complains of proptosis of both eyes.

One of the things you should be asking about our

patient is:

a.

Family history of cataract

b.

Family history of glaucoma

c. History of thyroid problem

d. History of hypertension

84.

Which of the following eye conditions may be

hereditary?

a.

Myopic eye of refraction

b.

Glaucoma

c.

Optic Neuropathy

d. All of the above

85.

Amiodarone causes which of the following ocular

complications?

a.

Corneal opacity

b.

Lens opacity

c.

Optic Neuropathy

d. All of the above

86.

The main purpose of the most anterior tear film

layer is to:

a. Product of antibodies

b. Prevent the evaporation of the aqueous layer of

the tear film

c.

Act as the primary refractive media of the eye

d.Promote adhesion of the tear film to the microvilli

in the surface of the cornea

87.

The mucin secretion of the goblet cells by the

conjunctiva forms the:

a.

Anterior layer of the tears

b.

Middle layer of the tearsc. Inner layer of tears

d. Sub-epithelial layer of the tears

88.The tear film composition, from the anterior to the

posterior layer, is arranged anatomically and

functionally as follows:

a. Hydrophobic hydrophilic hydrophobic

b.

Hydrophilic hydrophobic hydrophilic

c.

Hydrophilic hydrophilic hydrophobic

d.

Hydrophobic hydrophobic hydrophilic

89.

The average volume of tears produced per minute

in a normal individual is:a.

1 microliter

b.

1.5 milliliters

c. 2 microliters

d. 2.5 milliliters

90.

The most anterior portion of the human visual axis

is/are the:

a.Eyelashes

b.

Eyelids

c.

Cornea

d. Tear film

91.

The aqueous layer of the tear film is produced by

the lacrimal gland and the accessory glands of Krause

and:

a. Wolvering

b. Wolfring

c.Wolling

d.

Wolning

Most common cause of unilateral/bilateral proptosis

inadults, so when you see proptosis, think of the thyroid

first!

Location, Quality, Severity, Duration, Timing, Context,

Modifying Factors, Associated signs & symptoms

Side effects of Amiodarone: The most commonly affected

ocular structure is the cornea with punctuate opacities

occurring in 69% to 100% of patients. Lenticular changes

may include anterior, subcapsular, small, yellow-white

punctuate opacities.


16/16

92.

The lipid layer of the tears is produced by the

meibomian glands and the accessory glands of Zeiss

and:

a.

Mole

b.

Mohr

c. Moll

d. Avascularity

94. In the human visual axis, the highest refractive

power is seen in the:

a. Tear film

b. Cornea

c.Aqueous humor

d.

Lens

c.

Chemosis

d.

Chalazion

98.

Which of the following is a secretion of globlet

cells seen as a sticky clear material seen on the ocular

surface?

a. Tearsb. Mucus

c.

Mucopus

d.Purulent discharge

99.

An amaurotic pupil is a patient with RAPD is

recorded as having a:

a.1+defect

b.

2+defect

c.

3+defect

d. 4+defect

95.

The strongest layer of the cornea is its:a. Epithelium

b. Bowmanslayer

c. Descementsmembrane

d. Corneal stroma

96.

Types of inflammation of the eyelids include:

a.

Meibomianitis

b.Seborrheic blepharitis

c.

Demodactic blepharitis

d. All of these

97.

Diffuse redness from blood vessels that is usually

more prominent peripherally, tending to fade as the

limbus is approached is called:

a. Conjunctival injection

b. Ciliary injection

100. If macular disease is suspected, visual fields are

tested using:

a. Snellens chartfor visual acuity (far vision)

b. Jaegar chart for visual acuity (near vision)

c. Amsler grid - a grid of horizontal and vertical lines

used to monitor a person's central visual field d. Allen chart pediatric chart for measuring visual

acuity

The cornea is the principal refractive tissue (2/3 of the total

refractive power of the eye)

Grading Scale: RAPD

Grade 1+: A weak initial pupillary constriction followed by

greater redilation

Grade 2+: An initial pupillary stall followed by greater

redilation

Grade 3+: An immediate pupillary dilation

Grade 4+: No reaction to lightAmaurotic pupil

1st le ophthalmology (2 files merged)

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