Sunday, October 20, 2013

OPHTHALMOLOGY 2013-14



Q.1  A 25 years old lady presents with sudden, serve bilateral loss of vision more so on right side with no perception of light. Rest of the examination including pupillary reflex, funds & optokinetic nystagmus are npormal.She was able to touch tips of her finger with right eye closed but not with left eye closed. Most likely diagnosis –
a) optic neuritis
b) anterior ischaemic optic neuropathy
c) cmv retinitis
d) functional visual loss
Q.2  A child presents bilateral white papillary reflex, on slit lamp examination there is zone of opacity around fetal nucleus with some spoke of wheel like arrangement towards centre. Probable diagnosis would be –
a) Cataracta purvulenta
b) Lamellar cataract
c) Posterior pole cataract
d) coronary cataract
Q.3  A 40 years old lady presents with bilateral papilloedema. CT scan shows normal ventricles. Diagnosis is:
a) Benign intracranial hypertension
b) Malignant hypertention
c) Papillitis
d) Raised intra – ocular pressure
Q.4  The total area of the retina seen in direct ophthalmoscopy is –
a)  1 DD         b) 2DD         c)  3DD            d) 4DD
Q.5  Which of the following is the most probable diagnosis in a patient with loss of central vision and normal ERG with no family history?
a) Best’s disease      b) Stargardt’s disease
c) Retinitis pigmentosa      d) Macular hole

Q.6   The most common mode of spread of retinoblastoma is –
a) Haematogenous       b) Lymphatic     c) Optic nerve    d) Trans-scleral
Q.7 Damage to Superior oblique muscle causes diplopia in which direction
a)  Horizontal and downward 
b)  Vertical and downward
c)  Horizontal and upward
d)  Vertical and upward
Q.8  Which of the following is affected structure in PRP of retina?
a) Pigment Epithelium           b) Bipolar cell layer
c) Layers of rods & cones      d) Ganglion cell layer
Q.9  Dilator papillae is supplied by –
a) Post ganglionic parasympathetic fibers from Edinger Westphal nucleus
b) Post ganglionic sympathetic fibers from cervical sympathetic chain
c)  III nerve
d)  Sympathetic fibers from fronto orbital branch of V nerve
Q.10  A lesion in the left temporal lobe Is most likely to affect which visual field quadrant in the left eye :
a) Upper temporal
b) Lower temporal
c) Upper nasal
d) Lower nasal 
Q.11. A 5 yr old boy presented with leukocoria in right eye, while other eye had 2-3 small lesions in the periphery. What will be the ideal management for this patient?
a) Enucleation of both eyes
b) Enucleation of right eye & conservative management for the other eye
c) Enucleation for right eye and radiotherapy for the other eye
d) 6 cycles of chemotherapy
Q.12. A patient presents with diplopia in one eye. On examination with oblique illumination- golden crescent and on axial illumination black/dark crescent is seen. Likely diagnosis would be-
a) Ectopia lentis
b) Lenticonus
c) Coloboma
d) Microspherophakia
Q.13. Which of the following sign is most commonly seen in thyroid orbitopathy
a) Optic neuropathy
b) External ophthalmopledia
c) Eyelid retraction
d0 Exophthalmos
Q.14. The most important determinant in selecting a corrective procedure in any type of ptosis is:
a) Age of the patient
b) Amount of ptosis
c) Levator function
d) Position of the lid crease
Q.15. What is percentage of endothelial cell loss during Descemt’s membrance stripping in automated penetrating keratoplasty-
a) 1.0-5%
b) 2.10-15%
c) 3.30-40%
d) 4.50-60%
Q.16. Mizuo phenomenon is seen in-
a) Fundus albipunctatus
b) Fundus flavimiculatus
c) Oguchi’s disease
d) choroideremia
Q.17. Cherry-red spot is seen in all of the following conditions except
a) GM1 gangliosidosis
b) Nlemann-Pick disease
c) Krabbes disease
d) Sandoff’s disease
Q.18. Following 2 days of successful phacoemulsification and IOL placement, a diabetic patient presents with redness, pain & grey white papillary reflex. Patient also shows hypopyon, retrolental flare & posterior synechiae. Likely diagnosis is-
a) Post operative endophthalmitis
b) Post op Glaucoma
c) Post op Keratitis
d) Post op Cyclitis
Q.19. Commonest cause for bilateral proptosis in children?
a) Cavernous haemangioma
b) Rhabdomyosarcoma
c) ALL
d) AML
Q.20. Blepharophimosis is generally associated with all of the following except:
a) Ectropion
b) Distichiasis
c) Epicanthus
d) Telecanthus
Q.21. Three weeks following IOL implantation, a patient complains of diminished vision, on fundus florescent angiography flower petal hyperfluorescence of macula is noted. Most likely diagnosis is-
a) CME
b) Central serous retinopathy
c) Macular dystrophy
d) ARMD
Q.22. Fundoscopy of a patient shows chalky white optic dis,rest of the retina is absolutely normal.probable diagnosis is-
a) Primary optic atrophy
b) Post neuritic optic atrophy
c) Glaucomatous atrophy
d) Consecutive optic atrophy
Q.23. A35 year old male on slit lamp shows Keratic precipitates & aqueous flare in his right eye. No synechiae but a complicated cataract is seen. Probable diagnosis would be-
a) Intermediated uveitis
b) Heerfordt’s syndrome
c) Subacute iridocyclitis
d) Heterochromic iridocyclitis of Fuch’s
Q.24. An immunocompetent male presents with difficulty in vision. He gives history of vegetative material fallen in affected eye. On examination corneal ulcer with feathery margin & creamy exudates seen. Few satellite lesions were also noted. Likely diagnosis is-
a) Fusarium
b) Acanthameba
c) Pneumococci
d) Corynebacterium
Q.25. All of the following can cause optic neuritis except:
a) Rifampicin
b) Digoxin
c) Chloroquine
d) Ethambutol
Q.26. Retinitis pigmentosa is a triad of all except:
a) Bony spicules
b) Optic atrophy
c) vascular attenuation
d) Complicated cataract
Q.27. In the fetus, angiogenesis in the eye involve all except:
a) TNFa
b) IL-8
c) bFGF
d) VEGF
Q.28. Constantly changing refractory error is seen in
a) Traumatic cataract
b) Diabetic cataract
c) Morgagnian cataract
d) Intumescent cataract
Q.29. Treatment for threshold retinopathy is
a) Deoxygenation
b) Panretinal photocoagulation
c) Laser photocoagulation
d) Wait and watch
Q.30. 60 yr old man, both HTN and DM for 10 years, there is reduced vision in one eye, on fundus examination there is a central bleed and the fellow eye is normal, the diagnosis
a) Diabetic retinopathy
b) Retinal tear
c) Optic neuritis
d) Hypertensive retinopathy
Q.31. Which of the following is a corneal epithelial dystrophy
 a) Dot print
b) Macular
c) Granular
d) Lattice
Q.32. Posterior staphyloma can occur in:
a) Corneal ulcer
b) Pathological Myopia
c) Scleritis
d) Interestitial keratitis
Q.33. In patients with facial nerve paralysis all are present except:
a) Epiphora
b) Eye brow ptosis
c) Blepharoptosis
d) Interestitial keratitis
Q.34. Which of the following drug is currently used for the prophylaxis of non infections uveitis in LUMINATE programme-
a) Cyclosporine
b) Voclosporine
c) Methotrexate
d) Inflisimib
Q.35. On performing refraction using a plane mirror on a patient who has a refractive error of + 1 diopter sphere with -2 diopter cylinder at 900 from a distance of 1 meter under no cycloplegia, the reflex would be seen to move.
a)  With the movement in the horizontal axis and in the vertical axis.
b) With the movement in vertical axis and no movement in the horizontal axis.
c) Against the movement in both the axis.
d) With the movement in horizontal axis, and no movement in the vertical axis.
Q.36. A regular contact lens user presents with complains of redness, photophobia & blurring of vision in one eye for more than 2 weeks, which was not responding to normal treatment. On examination cornea shows ring shaped lesion along with some overlying epithelial defect. probable diagnosis would be-
a) Fungal keratitis
b) Viral keratitis
c) Acanthameba keratitis
d) Bacterial ulcer
Q.37. According to the pump-leak theory
a) Sodium ions are actively pumped into the lens
b) Only active transport is involved in ion movement into the lens
c) Sodium flows into the back of the lens along a concentration gradient
d) Oubain can stimulate the pump
Q.38. The eye of new born is
a) Hypermetropic with regular astigmatism
b) Hypermetropic
c) Hypermetropic with irregular astigmatism
d) Myopic
Q.39. Tear are produced in a newborn after…
a) 1 wk
b) 2 wk
c) 3 wk
d) 4 wk
Q.40. Corneal reflex afferent is mediated by:
a) Sensory nucleus of trigeminal nerve
b) Facial nerve
c) Mesencephalic nucleus of the trigeminal nerve
d) Trochlear nerve
Q.41. Enothalmos is due to palsy of
a) LPS
b) Superior tarsal plate
c) orbitalis
d) tenon’s capsule
Q.42. Thinnest part of sclera:
a) limbus
b) anterior to attachment of superior rectus
c) posterior to attachment of superior retus
d) equator
Q.43. Diplopia with limitation of adduction of rt eye with abduction saccades of lt eye and normal convergence is due to
a) duane’s retraction syndrome
b) partial 3rd nerve palsy
c) internuclear ophthalmoplegia
d) absence of medial rectus
Q.44. Palsy of left abducens nerve causes:
a) Diplopia on left gaze
b) Inability to accommodate on all sides
c) Abduction difficulty in right eye
d) Adduction difficulty in left eye
Q.45. Raised NSE levels in aqueous is seen in:
a) Galactosemia
b) Glaucoma
c) Hemangioblastoma
d) Retinoblastoma
Q.46. Mass treatment with azithromycin is indicated if prevalence of trachoma follicles(TF) in 1-9 years populations is more than-
a) 1.10%
b) 2.8%
c) 3.6%
d) 4.4%
Q.47. All of following occur in herpes zoster ophthalmicus except
a) pseudodendritic keratitis
b) anterior stromal invasion
c) sclera keratitis
d) endothelitis
Q.48. WHO grading (X3a) for Xerophthalmia Indicates:
a) Corneal xerosis
b) Keratomalacia
c) Corneal ulcer
d) Conjunctival xerosis and Bitots spot
Q.49. A20 yr old Male present with night blindness and tubular vision. His IOP was 18mm of hg. Fundoscopy shows attenution of arterioles & waxy pallor of optic disc.Ring scotoma seen on perimetry. ERG is subnormal.-
a) Pigmentary retinal dystrophy
b) POAG
c) Lattice Degeneration of retina
d) Diabetic retinopathy
Q.50. ICG angiography is primarily indicated in:
a) Minimal classical CNV
b) Occult CNV
c) Angioid streak with CNV
d) Polypoidal choroidal vasculopathy
Q.51. CRAO may be seen in-
a) Diabetes mellitus
b) CMV retinitis
c) Panophthalmitis
d) Orbital mucormycosis
Q.52. Stereopsis is which grade of binocular vision
a) grade2
b) grade3
c) grade4
d) grade1
Q.53. Cystoid macular edema occurs due to a break in:
a) Outer blood-retinal barrier
b) Inner blood-retinal barrier
c) Both of the above
d) None of the above
Q.54. Mittendorf’s dots are present on the
a) Anterior corneal surface
b) Posterior corneal surface
c) Anterior lens surface
d) Posterior lens surface
Q.55. A malnourished child from poor socioeconomic status, residing in overcrowded & dirty areas present with a nodule around limbus with hyperemia of conjunctiva. Other significant findings were axillary & cervical lymph adenopathy-
a) Phylectenular conjunctivitis
b) foreign body granuloma
c) Scleritis
d) Episcleritis
Q.56. How much angle should each letter substend at the nodal point of the eye at the given distance in the Snellen’s chart?
a) 3 minutes
b) 5 minutes
c) 7 minutes
d) 9 minutes
Q.57. Reticular retinoschisis is splitting of retina between:
a) Outer plexiform and inner nuclear layer
b) Nerve fiber layer and ganglion cell layer
c) Ganglion cell layer and inner plexiform layer
d) Inner plexiform layer and outer nuclear layer
Q.58. Projection of light is interfered in
a) Morgagnian cataract
b) Acute congestive glaucoma
c) Macular degeneration
d) Retinitis pigmentosa
Q.59. Blood vessels in a trechomatous pannus lie:
a) Beneath the Descemet’s membrane
b) In the substantia propria
c) Between Bowman’s membrane and substantia propria
d) Between Bowman’s membrane and epithelium
Q.60. Amsler’s sign is seen in:
a) Posner- Schlossman syndrome
b) Pars Planitis
c) Macular degeneration
d) Fuch’s uveitis
Q.61. Naffziger test is a clinical test for measuring
a) Ptosis
b) Proptosis
c) Miosis
d) Mydriasis
Q.62. Corneal endothelium ion exchange pump are inhibited by:
a) Anaerobic glycolysis inhibition
b) Anaerobic glycolysis activation
c) CGMP Phosphodiesterase inhibition
d) Interference with electronic chaon transport.
Q.63. An elderly male on eye examination shows Limbal scar, deep ant chamber, iridodonesis, dark papillary reflex, visual acuity 6/6 with 11D LENS. Diag?
a) Aphakia
b) Pseudophakia
c) Hypermetropia
d) Posterior dislocation of lens
Q.64. In contrast to surgical third nerve palsy, all are true with medical third nerve palsy except:
a) Does not affect papillary response to light
b) Does not affect accommodation
c) Causes a decreased in intraocular press
d) Causes upper lid elevation on attempted downgaze
Q.65. Mucin layer tear film deficiency occurs in:
a) Keratoconjunctivits sicca
b) Lacrimal gland removal
c) Canalicular block
d) Herpetic keratitis.
   

              

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