Thursday, August 30, 2012

RMC Solved SEND-UP EXAMINATION OF OPHTHALMOLOGY2010 (MCQs+SEQs)

RAWALPINDI MEDICAL COLLEGE, RAWALPINDI
SEND-UP EXAMINATION OF OPHTHALMOLOGY2010

MCQs: 30
Single best                                    Marks: 30    Time: 30Mins

Optic disk oedema is seen in all except 
Papilloedema
CRVO
Open angle glaucoma
Hypertensive retinopathy
Papilitis 

The first line of treatment in chemical injury is
admission if severe
topical antibiotics
topical cycloplegia
neutralization of pH by irrigation
oral analgesia

The most common cause of proptosis is
orbital infection
orbital hemorrhage
orbital tumor
orbital pseudo-tumor
thyroid ophthalmopathy

Calculation of IOL power is called
Biometry
Pachymetry
Tonometry
Keratometry
Ophthalmoscopy

Aphakia can be corrected by following
Specticles
Contact lenses
Anterior chamber IOL
Posterior chamber IOL
All of above

A patient with sudden painless loss of vision and no fundal view was possible. Which of the investigation is helpful to see the retina.
Keratometry
Pachymetry
B-Scan
A-Scan
Indirect ophthmoscopy

Direct Ophthalmology is done for 
Examination  peripheral retina
Examination of central retina
Refractive power of eye
Axial length of eye
To find out the power of IOL

A patient presented with gross painful decrease of vision. On torch examination there was conjunctival congestion and pupil irregular miosed. Which is the probable diagnosis
Anterior uveitis
Acute congestive glaucoma
Conjunctivitis 
Scleritis
Foreign body
    

Regarding Myopia 
It is also called Far sightedness 
Correction is with concave lens
Correction is with convex lens
Image formed behind the retina
Eye ball is small

A patient who was operated for cataract four years back comes to you with foggy vision. On examination there was posterior capsular thickening, which mode of treatment is most useful.
Excimer laser
YAG-Laser
Argon laser
Krypton laser
Diode laser

Esotropia is 
Divergent squint
Latent convergent squint 
Associated with accommodation reflex
Associated with accommodation and hypermetropia
None of above

Which of the following regarding atropine is true
Increases IOP
Used in neovasular glaucoma
Miosis
Atropine is weak cycloplegic
All of above

Pathognomic clinical signs of proliferative diabetic retinopathy is
Micro aneurysms
Hard exudates
Deep retinal hemorrhages 
Neovascularization of retina
Vitreous hemorrhage 

A child of one year old presented with watering in left eye and sticky discharge. On examination regurgitation test was positive. What is the     diagnosis? 
Nasolacrimal duct block
Common canaliculus block
Punctal atresia
Buphthalmos
None of above


In Hypermetropia all are true except
Axial length of eye ball is small
Correction with convex lens
Image formed behind the retina
Refractive error can be diagnosed by retinoscopy
Rays of light converged behind the retina when accommodation reflex is active

Exophthalmos associated with thyroid ophthalmopathy have following clinical signs except
Proptosis
Ptosis
Lid retraction
Conjunctival chemosis
Extraocular muscle thickening 

Nasolacrimal duct opens in 
Superior meatus
Inferior meatus
Middle meatus
Nasopharynx
None of above

Trachoma is associated with except
Tranatas dots
Follicles
Papillae
Herbit pits
Corneal pannus

A patient presented with diplopia in primary position along with ptosis in left eye. The eye was deviated infrolaterally. The diagnosis will be 
Fourth nerve palsy
Third nerve palsy
Sixth nerve palsy
Seventh nerve palsy
All above

A young boy presented in emergency with watering and photophobia in right eye. Which test is appropriate?
a.    Schirmer test
b.    Tear breakup time
c.    Rose Bengal staining
d.    Applanation tonometry 
e.    Flouroscine staining

According to WHO a person is blind when
vision in better eye is less than 2/60 and/or visual field is less than 30 degrees in better eye
vision in better eye is less than 3/60 and/or visual field is less than 30 degrees in better  eye
vision in better eye is less than 3/60 and/or visual field is less than 20 degrees in better eye
vision in better eye is less than 3/60 and/or visual field is less than 60 degrees in better eye
vision in better eye is less than 5/60 and/or visual field is less than 30 degrees in better eye

Complications of contact lenses include all of the following except
Allergy
Corneal infiltrates
Corneal ulcer
Permanent loss of vision
Corneal pigmentation

WHO grading of trachoma includes all except
TF follicles
TI inflammation 
TS scarring
TT trichiasis
TP pannus

Least common cause of sudden loss of vision is 
Vitreous hemorrhage
Optic neuritis
Central retinal venous occlusion
Central retina artery occlusion
Retinal detachment

Symptoms of cataract include all of the following except
Halos
Decreased vision in low illumination
Decreased vision in bright light
Glare
Sudden loss of vision

The best choice for a ten year child with unilateral traumatic cataract is:
Extra capsular surgery with contact lens
Intra/extra capsular surgery with spectacles
Extra capsular surgery with intraocular lens.
Intra capsular surgery with contact lens
Phacoemulsification with foldable IOL

Iridodonesis is seen in:
Intumescent cataract
Closed angle glaucoma
Subluxation  of lens
Acute anterior Uveitis
High Myopia 

Main cause of Dendritic corneal ulcer is:
Fungal
Bacterial
Parasitic
Viral.
Toxic

Dry eye is usually seen in:
Lowe’s syndrome
Sjogren’s syndrome.
Refsum’s syndrome
Marfan’s syndrome
Perinaud syndrome

Regarding probing and syringing test, which statement is true
Recommended for acute dacryocystitis
Regurgitation is positive
Congental nasolacrimal duct block
Chronic dacryocystitis in old age
None of above



RAWALPINDI MEDICAL COLLEGE, RAWALPINDI
SEND-UP EXAMINATION OF OPHTHALMOLOGY 2010


SEQs:
Marks: 40,                                Time: 1Hour, 30Mins


A middle aged female presented with right painful red eye and gross decrease of vision for last one day. She had complaint of seeing halos in both eyes off and on since two months. On examination visual acuity was hand movement and circumciliary congestion with dialated vertically oval pupil and shallow anterior chamber.
What are the causes of painful red eye? (02)
acute conjunctivitis
acute anterior uveitis
acute congestive glaucoma
acute bacterial keratitis/ ulcer
What is the diagnosis in this case? (02)
Acute congestive glaucoma

Briefly write the treatment? (04)
reduction of IOP first medically then surgically by iridotomy 
I/v mannitol
oral glycerol
Pilocarpine ed
timolol ed
tab actazolamide
Anti inflammatory drops eg Steroids
analgesia
antiemetics
put fellow eye on pilocarpine or do prophylactic laser iridotomy

Write short notes on.
Trachoma (04)
Pterygium (04)


18 years old boy received tennis ball injury to the eye while playing cricket and presented in emergency with severe pain and loss of vision.
What are the effects of blunt trauma on the eye? (02)
lid laceration, tear, echymossis
conjunctival tear , sub conjunctival haemorrhage
corneal abrasion, tear, odema
hyphema
iridodialysis, traumatic mydriasis, sphincter tear
lens luxation, subluxation, cataract
vitreous haemorrhage
retinal haemorhages, commotio retinae
disc odema, avulsion of optic disc
muscle trauma
orbital floor fracture, medial wall fracture
orbital haemorrhage
etc
What special investigations will you perform? (02)
complete eye examination
plus visual fields,Bscan, Xray orbit, CT and MRI

What is the treatment of Hyphema? (04)
absolute bed rest for atleat 72 hours
analgesics (no asprin)
sedatives
Atropine ed
mild steriod ed
aminocaproic acid orally
Must take IOP regularly if raised then medically control IOP
If IOP more than 55mmhg  for 5 days or 35 for 7 days or corneal staining then surgical drainage (paracentesis)


70 years old male presented with drooping of left eye lid and diplopia. On examination the eye was deviated to downward and outward with normal papillary reaction. 
What are the causes of binocular diplopia? (02)
III nerve palsy
IV nerve palsy
Vi nerve palsy
nerve palsies are due to 
   idiopatic causes
   vsacular causes DM HT
   tumours
   Trauma
   Infections
myositis
myopathy (Myasthenia gravis)
muscle trauma
orbital floor fracture
thyropd ophthalmopathy
orbital cellulits
orbital pseudo tumor
raised ICP
etc

What is the diagnosis in this case? (02)
 III nerve palsy
What is the significance of papillary reaction in this case? (02)
 pupil sparing third nerve palsy signifies medical caused ie idiopathic, DM HT and CT scan is not indicated
What are the treatment options? (02)
consevative management
Treat the cause
treat diplopia with prisms
spontaneous recovery will occur in most cases
surgery after six months for any residual defect  ie causing diplopia in primary position of gaze and for severe ptosis

5.     Regarding Cataract

What are the causes? (02)
Senile
traumatic
endocrine
Secondary
Congenital
Hereditary
metabolic

What  are the indications of Cataract Extraction? (02)
Visual
medical
diagnostic/therapeutic
cosmetic

Name the operations? (02)
Lensectomy 
ICCE
ECCE
Phacoemulsification

What are the complications of Phacoemulsification? (02)
in addition to routine complication of cataract sugery
wound leakage, corneal burn, descmets membrane stripping, endothelial decompensation
Iris trauma, rhexis extending beyond equator,  small rhexis leading to phimosis,
PC rent and all its sequlae
Dropping of nucleus or pieces
Increased chanc3e of endophthalmitis as compared to ECCE

2 comments:

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