RMC CLASS TEST FOURTH YEAR OPHTHALMOLOGY-2010 ~ Flash Medical

RAWALPINDI MEDICAL COLLEGE, RAWALPINDI

CLASS TEST FOURTH YEAR OPHTHALMOLOGY 8^th SEPTEMBER 2011

Total marks: 30Marks Time allowed: 45 Minutes

Instructions: All questions carry equal marks, Attempt all questions

No 1 A child presents with esotropia at 2 years of age;

a. What clinical (not laboratory) tests will you perform?

Ocular examination especially

Ocular movements

Cover -uncover test

Hirshberg, krimsky test

Cycloplegic refraction

b. What is the treatment?

Prescription of glasses

If no improvement then surgery

No 2. A young man was struck by ball while playing cricket, complains of double vision

a. What are the causes of diplopia?

Muscle trauma

Muscle entrapment

Hematoma

Nerve trauma

Orbital cellulitis

b. Which other clinical signs may be positive in such a case?

Infra orbital nerve anaesthesia

Subcutraneous emphysema

Double diplopia

Echymossis

Proptosis/ enophthalmos

Nasal bleed

Subconjunctival hemorrhage

No 3. A middle aged lady complains of sudden decrease of vision in one eye after a history of flashes and floaters for 3 days

a. What is the likely cause?

Retinal detachment

b. What is the treatment?

Retinal detachment surgery

No 4. Answer the following questions briefly

a. What is the definition of Myopia?

It is refractive error in which parallel light rays coming from infinity come to focus in front of the retina when the accommodation is at rest

b. What are the treatment options of Myopia?

Glasses

Contact lense

Refractive surgery

No 5. An elderly person presents with redness, severe pain and gross decrease in vision in the eye, 2 days after routine Phacoemulsification;

a. What is the D/D and most likely cause?

Acute post operative endophthalmitis

b. Which other clinical signs may be positive in such a case?

Lid odema

Conjunctival chemosis and congestion

Subconj haemorrhage

Corneal haze/ odema

Hypopyon

Piosterior synechae

Loss of fundal glow

MCQS

RAWALPINDI MEDICAL COLLEGE, RAWALPINDI

CLASS TEST FOURTH YEAR OPHTHALMOLOGY 8^th SEPTEMBER 2011

Time allowed: 30 Minutes ROLL NO: _____________

Total marks: 30Marks

MCQs single best, please tick or encircle the correct option.

1. Sjogren syndrome is keratoconjunctivitis sicca associated with many systemic diseases like

A. Systemic hypertension

B. Acid peptic disease

C. Rhematoid arthritis

D. Ischemic heart disease

2. A mother presented her 8 year old baby with rapidly progressive lid swelling and proptosis for the last one week. She tried treatment at a nearby general practitioner’s centre but there was absolutely no improvement. On examination by ophthalmologist lids were swollen and red but not hot. First line of diagnosis should be

A. Retinoblastoma

B. Rhabdomyosarcoma

C. Orbital cellulitis

D. Ruptured dermoid cyst

3. A 65yr old lady complaining of burning and watering eyes for the last many months was being evaluated for dry eye syndrome. Her Schirmer 1 test will be declared as positive if the length of wet filter paper at the end of five minutes is

A. Less than 6mm

B. Less than 5 cm

C. Less than 15mm

D. Less than 15cm

4. A 45 year old lady known thyrotoxic for the last many years and having dysthyroid orbitopathy started feeling impaired central vision and defective red green color appreciation for the last few days. Her problem is the result of

A. Severe proptosis

B. Dry eye

C. Restrictive thyroid myopathy

D. Dysthyroid optic neuropathy

5. A 15 year old boy presented with frequent change of glasses number, increasing irregular astigmatism and a state of visual dissatisfaction. He is suffering from

A. Blepharitis

B. Trachoma

C. Wilson,s disease

D. Keratoconus

6. Of the drugs known for their optic nerve toxicity include

A. Atropine

B. Steroids

C. Erythrocin

D. Ethambutol

7. Photorefractive keratectomy is a modern way of treating myopia. It works by

A. Reducing the length of globe

B. Thickening the central part of cornea

C. By modulating the crystalline lens

D. By decreasing the thickness of central part of cornea.

8. Bacterial conjunctivitis and keratitis are frequently treated by the quinoilone group of drugs like moxifloxacin, etc. they help to eliminate infection by

A. Destroying the cell wall of microbes

B. Inhibiting the protein synthesis

C. By inhibiting the cell wall synthesis

D. By inhibiting DNA-gyrase and cell proliferation.

9. Eye is an organ capable of focusing the images of distant objects upon the retina. The refractive power is maximally contributed by

A. Cornea

B. Lens

C. Vitreous

D. Retina

10. The eyes prone to angle closure have

A. Small cornea, deep chamber, hypermetropia

B. Myopic eye, deep chamber, large corneas

C. Shallow chambers, thicker corneas, anteriorly placed lens, hypermetropes

D. Shallow chambers, thin cornea, posteriorly placed iris lens diaphragm

11. A 35 year old farmer sustained some eye injury by plant life which he felt trivial and a routine matter. However watering, irritation, etc started soon in the following days and he urged a medical advice for his worsening problem. His corneal perforation was impending because

A. There had developed a visible corneal opacity

B. Hypopyon formation had occured

C. Keratoconus and surface irregularities devoloped

D. there is descematocoele

12. While preparing for cataract surgery and doing his biometric calculations, the Keratometer gives

A. Horizontal and verticle diameters of cornea

B. Diaptoric power of the front of cornea

C. Power of back surface of cornea

D. Diaptoric power of the crystalline lens

13. The presence of Kayser-Fleischer ring is a sure feature of

A. Alkaptonuria

B. Keratoconus

C. Wilson’s disease

D. Albinism

Fossa for lacrimal sac is formed by lacrimal bone and

A. lodges in the medial orbital wall.

B. is present in the superotemporal wall of orbit anteriorly

C. is present in the inferotemporal part of the orbit posteriorly

D. in part by zygomatic bone

15. Regarding soft and hard exudates of retina

A. Soft exudates are reversible while hards exudates are not.

B. Soft exudates show lipid deposition while hards are calcium deposits

C. Soft exudates donot disturb vision while hard ones always disturb it

D. Soft exudates show retinal ischemia while hard exudates show leakage

A patient of retinal detachment usually comes with the complaints of

A. Sudden painful blindness

B. A veil or curtain falling in front with a shower of black spots

C. Pain, redness, watering

D. Colored haloes with severe headache.

17. A retinal detachment is a separation of

A. Retina from choroid

B. Retina and choroid from sclera

C. Neurosensory retina from retinal pigment epithelium

D. Separation of retina at inner plexiform layer

A young tennis player sustained injury on his right eye and there was a severe visual concern. The sign most consistent with a ruptured globe is

A. Cataract formation

B. Raised intraocular presurre

C. Hypotony and irregular anterior chamber

D. Subconjunctival haemorrhage

19. A young adult having complaints of backache and stiff joits presented to eye specialist for his ocular complaints. On examination he was found to have Iris bombe which is

A. A Nodule on iris surface

B. 360 degrees posterior synechiae

C. Effect of prolonged use of steroids

D. Effect of prolonged use of topical atropine

20. The following describes best the sympathetic ophthalmia

A. It is a condition when cancer from one eye spreads to the fellow eye

B. when a progressive corneal ulcer leads to perforation

C. An ocular wound with incarcination of uveal tissue in one eye leads to a granulomatous panuveitis in the fellow eye after a few weeks.

D. When an eye becomes sensless i.e doesnot see , doesnot pain, etc.

21. The drug of choice for the treatment of uveitis is:

A. Moxifloxacin

B. Beta-methasone

C. Atropine

D. Tropicamide

22. Commonest cause of cicatricial entropion in Pakistan is

A. Pemphigus

B. SLE

C. Trachoma.

D. Acid/Alkali burns

23. A young auto-electrician was on follow up visits after sustaining a chemical eye burn from burst wet motor battery some two months ago. His lids were found to be adherent with the globe. the condition is called as

A. Blepharoptosis

B. Symblepharon

C. Ankyloblepharon

D. Blepharophimosis

24. An orbital surgeon working at the orbital apex will not find

A. Superior oblique

B. Inferior oblique

C. Superior rectus

D. Inferior rectus

Synaptophore is a device used for

A. Measuring angle of deviation

B. Measuring degree and range of fusion

C. Determination of retinal correspondence

D. All of the above

Secondary angle of deviation is larger than primary in

A. Concomitant esotropia

B. Concomitant exotropia

C. Paralytic heterotropia

D. A and V pattern deviations

A known diabetic and hypertensive 55 years male sustained ischemic extraocular paralysis of his right lateral rectuts muscle. To avoid diplopia he is advised to keep his face turned

A. To the right

B. To the left

C. To the right and chin down

D. To the left and ipsilateral head tilt.

28. Open angle glaucoma can occur in the following situations

A. Taking analgesics for a prolonged period

B. Habitual use of preparations containing vitamins and minerals

C. Raised intracranial pressure

D. Finding pigment dispersion in anterior chamber

29. A 50 year old man on polytherapy for glaucoma presented following drugs to his ophthalmologist. The one capable of lowering IOP by increasing out flow facility includes

A. Latanoprost

B. Timolol

C. Acetazolamide

D. Infusion mannitol

30. The most favorite drug of ophthalmologists for quick lowering of IOP in emergency room/ operation room is

A. A.Pilocarpine eye drops

B. Timolol maleate eye drops

C. Oral glycerine

D. Mannitol infusion 20%

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