Ophthalmology Board Exam Review Quiz

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Ophthalmology Board Exam Review Quiz - Quiz

Before you are completely allowed to practice as an optician, you have to take up the ophthalmology exam. The board exam review quiz below will help you revise and well prepare for your exam. Success in your forthcoming exam.


Questions and Answers
  • 1. 

    This nerve to an extraocular muscle does not pass through the muscle cone on entering the orbit

    • A.

      CN III

    • B.

      CN IV

    • C.

      CN V

    • D.

      CN VI

    • E.

      CN VIII

    Correct Answer
    B. CN IV
    Explanation
    CN IV, also known as the trochlear nerve, is the correct answer because it is the only nerve among the options that does not pass through the muscle cone on entering the orbit. The muscle cone, also called the annulus of Zinn, is a fibrous structure that surrounds the optic nerve and contains the other extraocular muscles and nerves. CN IV, however, exits the brainstem dorsally and passes through a small hole in the skull called the superior orbital fissure, bypassing the muscle cone.

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  • 2. 

    Which is true regarding orbital anatomy?

    • A.

      The lacrimal gland fossa is located within the lateral orbital wall.

    • B.

      The optic canal is located within the greater wing of the sphenoid bone

    • C.

      The medial wall of the optic canal is formed by the lateral wall of the spenoid sinus.

    • D.

      The nerve to the inferior rectus muscle travels anteriorly along the medial aspect of the muscle and innervates the muscle on its posterior surface

    Correct Answer
    C. The medial wall of the optic canal is formed by the lateral wall of the spenoid sinus.
    Explanation
    The correct answer is that the medial wall of the optic canal is formed by the lateral wall of the sphenoid sinus. This means that the space within the optic canal is bordered by the lateral wall of the sphenoid sinus, which is located in the skull. The optic canal is a passageway that allows the optic nerve to travel from the eye to the brain. Understanding the anatomy of the optic canal is important for understanding the pathway of the optic nerve and any potential issues that may arise in this area.

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  • 3. 

    The five major branches of the facial nerve include the temporal, buccal, marginal mandibular, cervical and

    • A.

      Temporal parietal

    • B.

      Zygomatic

    • C.

      Infraorbital

    • D.

      Zygomaticofacial

    Correct Answer
    B. Zygomatic
    Explanation
    The correct answer is "Zygomatic" because it is one of the five major branches of the facial nerve. The facial nerve is responsible for controlling the muscles of the face and is divided into several branches that innervate different regions. The zygomatic branch specifically innervates the muscles around the cheekbone area, including the zygomaticus major and minor muscles.

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  • 4. 

    What structure is deep to the plane of the facial nerve branches in the lower face?

    • A.

      Masseter muscle

    • B.

      Parotidomasseteric fascia

    • C.

      Deep temporal fascia

    • D.

      Parotid gland

    Correct Answer
    A. Masseter muscle
    Explanation
    The masseter muscle is deep to the plane of the facial nerve branches in the lower face. This means that the facial nerve branches are located beneath the masseter muscle when considering the anatomical layers of the lower face.

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  • 5. 

    The superior transverse ligament is also referred to as

    • A.

      Lockwood's ligament

    • B.

      Sommerring's ligament

    • C.

      The ROOF

    • D.

      Whitnall's ligament

    Correct Answer
    D. Whitnall's ligament
    Explanation
    The superior transverse ligament is commonly known as Whitnall's ligament. This ligament is located in the eye socket and helps to support the upper eyelid. It plays a crucial role in maintaining the proper position and function of the eyelid, ensuring that it opens and closes smoothly. Whitnall's ligament is named after the British ophthalmologist Charles Whitnall, who first described its anatomy and function.

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  • 6. 

    Compared to CT scanning, MRI scanning provides better

    • A.

      View of bone and calcium

    • B.

      View of the orbital apex and orbitocranial junction

    • C.

      Elimination of motion artificat

    • D.

      Comfort for claustrophobic patients

    • E.

      Safety to patients with prosthetic implants

    Correct Answer
    B. View of the orbital apex and orbitocranial junction
    Explanation
    MRI scanning provides a better view of the orbital apex and orbitocranial junction compared to CT scanning. This is because MRI uses magnetic fields and radio waves to create detailed images of soft tissues, while CT scanning uses X-rays to create images of bones and calcium. The ability of MRI to visualize soft tissues in high resolution makes it a preferred imaging modality for evaluating structures in the orbital apex and orbitocranial junction.

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  • 7. 

    In patients with a facial nerve paralysis, all of the following characteristics may be present except:

    • A.

      Eyebrow ptosis

    • B.

      Blepharoptosis

    • C.

      Lower eyelid ectropion

    • D.

      Epiphora

    • E.

      Ocular exposure symptoms

    Correct Answer
    B. Blepharoptosis
    Explanation
    Facial nerve paralysis can cause a variety of symptoms due to the loss of muscle control in the face. Eyebrow ptosis, lower eyelid ectropion, epiphora, and ocular exposure symptoms are all potential manifestations of facial nerve paralysis. However, blepharoptosis, which refers to drooping of the upper eyelid, is not typically associated with facial nerve paralysis. Therefore, the correct answer is "Blepharoptosis."

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  • 8. 

    A one year old presents with a round, well-demarcated mass at the superotemporal rim.  The lesion has been present since birth.  The most likely diagnosis is

    • A.

      Rhabdomyosarcoma

    • B.

      Neurofibroma

    • C.

      Dermoid cyst

    • D.

      Capillary hemangioma

    • E.

      Metastatic Ewing sarcoma

    Correct Answer
    C. Dermoid cyst
    Explanation
    The most likely diagnosis in this case is a dermoid cyst. Dermoid cysts are typically present at birth and are well-demarcated masses. They can occur in various locations, including the superotemporal rim. Dermoid cysts are benign and are composed of tissue from the ectoderm, which can include hair follicles, sebaceous glands, and sweat glands. They are usually slow-growing and painless. Rhabdomyosarcoma, neurofibroma, capillary hemangioma, and metastatic Ewing sarcoma are less likely in this case because they do not typically present as well-demarcated masses present since birth.

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  • 9. 

    A 65 year old woman presents with a progressively enlarging mass in the right inferior orbit.  distraction of the lower eyelid reveals a "salmon patch" appearance to the fornix.  The most likely diagnosis is

    • A.

      Reactive lymphoid hyperplasia

    • B.

      Lymphoma

    • C.

      Sebaceous carcinoma

    • D.

      Melanoma

    • E.

      Apocrine hidrocystoma

    Correct Answer
    B. Lymphoma
    Explanation
    Based on the given information, a 65-year-old woman with a progressively enlarging mass in the right inferior orbit and a "salmon patch" appearance to the fornix, the most likely diagnosis is lymphoma. Lymphoma is a type of cancer that affects the lymphatic system and can present as a mass or swelling in various parts of the body, including the orbit. The "salmon patch" appearance refers to the reddish coloration often seen in lymphoma. Therefore, considering the symptoms and characteristics described, lymphoma is the most likely diagnosis.

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  • 10. 

    Which of the following signs is most likely to be prsent in a patient with Graves ophthalmopathy?

    • A.

      Exophthalmos

    • B.

      Exernal ophthalmoplegia

    • C.

      Eyelid Retraction

    • D.

      Optic neuropathy

    Correct Answer
    C. Eyelid Retraction
    Explanation
    Eyelid retraction is most likely to be present in a patient with Graves ophthalmopathy. Graves ophthalmopathy is an autoimmune condition that affects the eyes, commonly seen in patients with Graves' disease. It is characterized by inflammation and swelling of the tissues around the eyes, causing various eye symptoms. Eyelid retraction refers to the abnormal elevation of the upper eyelid, which is a classic sign of Graves ophthalmopathy. This condition is caused by the accumulation of glycosaminoglycans and inflammation in the tissues behind the eyes, leading to the protrusion of the eyeballs and retraction of the eyelids.

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  • 11. 

    In the US all of the following conditions could cause xerophthalmia except:

    • A.

      Chronic alcoholism

    • B.

      Cystic Fibrosis

    • C.

      Bowel resection

    • D.

      Glomerulonephritis

    Correct Answer
    D. Glomerulonephritis
    Explanation
    Xerophthalmia is a condition characterized by dryness of the eyes due to vitamin A deficiency. Chronic alcoholism, cystic fibrosis, and bowel resection are all conditions that can potentially lead to malabsorption of nutrients, including vitamin A, and therefore increase the risk of xerophthalmia. On the other hand, glomerulonephritis is a kidney disease that does not directly affect the absorption or utilization of vitamin A, making it the exception among the given conditions.

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  • 12. 

    Which of the following viruses is transmissible even after medical instrumentation is cleaned with alcohol?

    • A.

      Herpes simplex virus

    • B.

      Adenovirus

    • C.

      Human immunodeficiency virus

    • D.

      Epstein-Barr Virus

    Correct Answer
    B. Adenovirus
    Explanation
    Adenovirus is the correct answer because it is known to be resistant to alcohol-based disinfectants. This means that even after medical instruments are cleaned with alcohol, adenovirus can still remain viable and transmissible. Unlike other viruses listed, such as herpes simplex virus, human immunodeficiency virus (HIV), and Epstein-Barr virus, adenovirus has the ability to survive and persist on surfaces even after alcohol disinfection.

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  • 13. 

    Which of the following statements regarding Acanthamoeba is false?

    • A.

      Two potentially infectious forms of Acanthamoeba exist: the motile trophozoite and the dormant cyst

    • B.

      Acanthaamoeba keratitis can appear as a pseudodendrite early in its course

    • C.

      Acanthamoeba can be visualized with calcofluor white, acridine orange, or the Giemsa stain

    • D.

      Acantamoeba keratitis can appear as a pseudodendrite early in its course.

    Correct Answer
    D. Acantamoeba keratitis can appear as a pseudodendrite early in its course.
    Explanation
    Acanthamoeba keratitis does not typically appear as a pseudodendrite early in its course. Instead, it often presents with symptoms such as severe eye pain, redness, blurred vision, and light sensitivity.

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  • 14. 

    All of the following can be seen with ocular adenoviral infection except:

    • A.

      Preauricular lymphadenopathy

    • B.

      Large central geographic corneal erosions

    • C.

      Multifocal subepithelial infiltrates

    • D.

      Enlarged corneal nerves

    Correct Answer
    D. Enlarged corneal nerves
    Explanation
    Ocular adenoviral infection typically presents with symptoms such as preauricular lymphadenopathy, large central geographic corneal erosions, and multifocal subepithelial infiltrates. However, enlarged corneal nerves are not typically associated with ocular adenoviral infection.

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  • 15. 

    Which of the following statements regarding  Herpetic Eye Disease Study (HEDS) is false?

    • A.

      It demonstrated that topical corticosteroids given together with a prophylactic antiviral reduce persistence or progression of stromal inflammation and shorten the duration of herpes simplex stromal keratitis

    • B.

      It showed that long term suppressive oral acyclovir theraphy reduces the rate of recurrent HSV keratitis and helps to preserve vision

    • C.

      It showed some additional benefit of oral acyclovir in treating active HSV stromal keratitis in those patients also receiving concomitant topical cortiscosteroids and trifluridine

    • D.

      It deomstrated that oral acyclovir did not appear to prevent subsequent HSV stromal keratitis or iritis when it was given briefly along with trifluridine during an episode of epithelial keratitis

    Correct Answer
    C. It showed some additional benefit of oral acyclovir in treating active HSV stromal keratitis in those patients also receiving concomitant topical cortiscosteroids and trifluridine
    Explanation
    The Herpetic Eye Disease Study (HEDS) demonstrated that oral acyclovir has additional benefits in treating active HSV stromal keratitis when used in combination with topical corticosteroids and trifluridine. This suggests that the combination therapy is more effective in treating the condition compared to using oral acyclovir alone.

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  • 16. 

    A healthy 60 year old man presents with a 2 day history of a painful rash on the right side of his forehead extending down to the eyelids.  A vesicular skin lesion is also seen near the tip of his nose.  Which of the following therapies would be most appropriate?

    • A.

      Topical trifluridine 1% drops 8 times per day for 14 days

    • B.

      Oral famciclovir 500 mg two times per day for 10 days

    • C.

      Oral valacyclovir 1000mg three times per day for 10 days

    • D.

      Oral acyclovir 800mg three times per day for 10 days

    Correct Answer
    C. Oral valacyclovir 1000mg three times per day for 10 days
    Explanation
    The patient's presentation is consistent with herpes zoster ophthalmicus, which is caused by reactivation of the varicella-zoster virus. The most appropriate therapy for this condition is oral antiviral medication. Valacyclovir is a prodrug of acyclovir and has better bioavailability, allowing for less frequent dosing. The recommended duration of treatment for herpes zoster ophthalmicus is 7-10 days. Therefore, oral valacyclovir 1000mg three times per day for 10 days would be the most appropriate therapy for this patient.

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  • 17. 

    A 9 year old boy with a history of atopy presents with a seasonally recurrent bilateral conjunctivitis and complains of blurred vision for 1 week.  giant papillae are seen upon lid eversion.  All of the following could also be seen on the slit-lamp except:

    • A.

      Vascular pannus and pnctate epithelial erosions involving the superior cornea

    • B.

      An oval epithelial ulceration with underlying stromal opacification in the central cornea

    • C.

      Limbal follicles

    • D.

      Conjunctical symblephara

    Correct Answer
    D. Conjunctical symblephara
    Explanation
    The given answer is correct because conjunctival symblephara is not typically seen in patients with atopic conjunctivitis. Atopic conjunctivitis is characterized by inflammation of the conjunctiva, which can lead to the formation of giant papillae. Other findings that can be seen on slit-lamp examination in atopic conjunctivitis include limbal follicles, vascular pannus, and punctate epithelial erosions. However, symblephara, which refers to adhesions between the conjunctiva and the globe or eyelid, is not a common feature of atopic conjunctivitis.

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  • 18. 

    Which of the following statements regarding graft-versus-host disease (GVHD) is false?

    • A.

      It is a relatively common complication of allogeneic bone marrow transplantation in which the grafted cells can attack the patient's tissues.

    • B.

      Conjunctival inflammation and severe sicca are the main features

    • C.

      Cicatrical lagophthalmos can occur

    • D.

      Aggressive lubrication is adequate even in severe cases of GVHD

    Correct Answer
    D. Aggressive lubrication is adequate even in severe cases of GVHD
    Explanation
    Aggressive lubrication is not adequate in severe cases of GVHD. Severe cases of GVHD require more intensive treatment, such as systemic immunosuppressive therapy, to manage the inflammation and symptoms. Aggressive lubrication alone may not be enough to provide relief in severe cases.

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  • 19. 

    Which of the following infectious agents can be linked to interstital keratitis?

    • A.

      Herpes simplex virus

    • B.

      Herpes zoster virus

    • C.

      Chlamydia trachomatis

    • D.

      All of the Above

    Correct Answer
    D. All of the Above
    Explanation
    All of the above infectious agents can be linked to interstitial keratitis. Interstitial keratitis is an inflammation of the cornea that can be caused by various infectious agents. Herpes simplex virus and herpes zoster virus are both known to cause interstitial keratitis, while Chlamydia trachomatis, a bacterium, can also lead to this condition. Therefore, all three options listed in the question are correct.

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  • 20. 

    The Joint Statement of the American Academy of Pediatrics, Section on Ophthalmology; the American Association for Pediatric Ophthalmology and Strabismus; and the American Academy of Ophthalmology recommends at least 2 dilated funduscopic examinations using binocular indirect ophthalmoscopy for all infants with:

    • A.

      A birth weight less than 1500 grams

    • B.

      A gestational age of 28 weeks or less

    • C.

      A birth weight between 1500 and 2000 grams and an unstable clinical course

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    The Joint Statement of the American Academy of Pediatrics, Section on Ophthalmology; the American Association for Pediatric Ophthalmology and Strabismus; and the American Academy of Ophthalmology recommends at least 2 dilated funduscopic examinations using binocular indirect ophthalmoscopy for all infants with a birth weight less than 1500 grams, a gestational age of 28 weeks or less, or a birth weight between 1500 and 2000 grams and an unstable clinical course. This means that all infants who meet any of these criteria should undergo the recommended examinations to assess their eye health.

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  • 21. 

    Which of the following statements about cataract surgery in patients with diabetes is correct?

    • A.

      Patients with diabetes enrolled in the ETDRS who underwent cataract surgery did not show an immediate imporvement in visual acuity.

    • B.

      Patiens with diabetes with CSME should have cataract surgery performed prior to focal laser

    • C.

      Patients with diabetes and high risk proliferative changes visible through their cataract should ideally have scatter laser immediately before cataract extraction

    • D.

      Patients with diabetes and high risk proliferative changes visible through their cataract should have scatter laser 1 to 2 months prior to cataract extraction

    • E.

      Preoperative phenylephrine drops for dilation are contraindicated in patients with diabetes undergoing cataract surgery

    Correct Answer
    D. Patients with diabetes and high risk proliferative changes visible through their cataract should have scatter laser 1 to 2 months prior to cataract extraction
    Explanation
    Patients with diabetes and high risk proliferative changes visible through their cataract should have scatter laser 1 to 2 months prior to cataract extraction. This statement suggests that patients with diabetes and high risk proliferative changes should undergo scatter laser treatment before cataract surgery. This is done to reduce the risk of complications and improve the outcome of the surgery. The scatter laser treatment helps to stabilize the proliferative changes and reduce the risk of bleeding during the cataract surgery. By performing the scatter laser treatment prior to cataract extraction, the surgeon can ensure a safer and more successful surgery for these patients.

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  • 22. 

    Which of the following statements about punctate inner choroidopathy (PIC) is correct?

    • A.

      The condition affects males and females with equal frequency

    • B.

      Punctate inner choroidopathy is more commonly seen in patients with the ocular histoplasmosis syndrome

    • C.

      Disease involvement is associated with HLA-DR2 antigen

    • D.

      The condition is differentiated from MEWDS in that choroidal neovascularization is rarely seen in PIC

    • E.

      The condition is usually bilateral

    Correct Answer
    E. The condition is usually bilateral
    Explanation
    Punctate inner choroidopathy (PIC) is usually bilateral, meaning that it typically affects both eyes. This is in contrast to other conditions such as MEWDS (Multiple Evanescent White Dot Syndrome) where the involvement is usually unilateral. Bilateral involvement in PIC is a characteristic feature of the condition.

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  • 23. 

    The following statement about diffuse unilateral subacute neuroretinitis (dusn) is correct:

    • A.

      The disease never occurs bilaterally

    • B.

      DUSN is a common casue of incorrectly diagnosed "unilateral retinitis pigmentosa"

    • C.

      Eradication of the subretinal nematode often results in an intense inflammatory reaction

    • D.

      Visual loss typically continues after successful eardication of the subretinal nematode

    • E.

      The condition is seen only in individuals with a history of travel to endemic areas

    Correct Answer
    C. Eradication of the subretinal nematode often results in an intense inflammatory reaction
    Explanation
    After eradicating the subretinal nematode in diffuse unilateral subacute neuroretinitis (DUSN), an intense inflammatory reaction often occurs due to the release of toxins from the dying parasite. This inflammation can exacerbate vision issues and may require additional treatment to manage complications and preserve visual function.

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  • 24. 

    The following statement is correct about pneumatic retinopexy:

    • A.

      Pneumatic retinopexy works by mechanically reattaching the detached retina.

    • B.

      Pneumatic retinopexy is contraindicated in patients with total retinal detachments

    • C.

      Pseudophakia is an absolute contraindication to pneumatic retinopexy

    • D.

      Chronic detaments are a relative contraindication for Pneumatic retinopexy

    • E.

      Pneumatic retinopexy is contraindicated in failed scleral buckles

    Correct Answer
    D. Chronic detaments are a relative contraindication for Pneumatic retinopexy
    Explanation
    The statement "chronic detaments are a relative contraindication for Pneumatic retinopexy" is correct because while pneumatic retinopexy can be used to treat retinal detachments, it may not be as effective in cases of chronic detachments where the retina has been detached for a longer period of time. In these cases, other surgical interventions such as scleral buckles or vitrectomy may be more appropriate.

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  • 25. 

    Features that may help distinguish CRVO from carotid artery occlusive disease include all of the following except:

    • A.

      Dilated retinal veins

    • B.

      Tortuosity of retinal veins

    • C.

      Ophthalmodynamometry

    • D.

      Retinal artery pressure

    Correct Answer
    A. Dilated retinal veins
    Explanation
    The features listed in the question are all potential distinguishing factors between central retinal vein occlusion (CRVO) and carotid artery occlusive disease, except for dilated retinal veins. CRVO is characterized by dilated retinal veins, tortuosity of retinal veins, and increased retinal artery pressure. Ophthalmodynamometry is a diagnostic test that measures the pressure in the central retinal artery, which can help differentiate between the two conditions. Therefore, the absence of dilated retinal veins is the exception among the listed features.

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  • 26. 

    Multiple evanescent white dot syndrome (MEWDS) is characterized by each of the following clinical features except:

    • A.

      Enlargement of the physiologic blind spot on visual field testing

    • B.

      Individual hyperfluorescent spots on fluorescein angiogrpahy arranged in a wreathlike patter around the fovea

    • C.

      Typically presents with unilateral photopsias and loss of vision in young females with myopia

    • D.

      Absence of cell in the anterior chamber

    • E.

      Granular appearance of the fovea

    Correct Answer
    B. Individual hyperfluorescent spots on fluorescein angiogrpahy arranged in a wreathlike patter around the fovea
  • 27. 

    In a randomized, controlled clinical trial, pneumatic retinopexy

    • A.

      Was superior to scleral buckle in the anatomic success rate of repairing macula-sparing rhegmatogenous retinal detachments in pseudophakic patients

    • B.

      Provided slightly better visual outcome than scleral buckle in patients with macula involving rhegmatogenous retinal detachments of less than 14 day duration

    • C.

      Included patients with causative breaks in the inferior 90 degree of the retina

    • D.

      Led to a worse outcome in patients who required an additional scleral buckle procedure for persistent or recurrent retinal detachment than if a scleral buckle procedure had been performed primarilyi

    Correct Answer
    B. Provided slightly better visual outcome than scleral buckle in patients with macula involving rhegmatogenous retinal detachments of less than 14 day duration
    Explanation
    The explanation for the given correct answer is that in a randomized, controlled clinical trial, pneumatic retinopexy showed slightly better visual outcomes compared to scleral buckle in patients with macula involving rhegmatogenous retinal detachments of less than 14 day duration. This suggests that pneumatic retinopexy may be a more effective treatment option for this specific group of patients.

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  • 28. 

    Patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) may have all of the following clinical features except:

    • A.

      Unilateral or asymmetric fundus involvement

    • B.

      Recurrent or relentless progression of fundus lesions leading to permanent loss of central vision

    • C.

      Associated cerebral vasculitis

    • D.

      Prompt response to oral steroids

    Correct Answer
    D. Prompt response to oral steroids
    Explanation
    Patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) typically present with unilateral or asymmetric fundus involvement, recurrent or relentless progression of fundus lesions leading to permanent loss of central vision, and associated cerebral vasculitis. However, they do not show a prompt response to oral steroids. This means that while oral steroids may be used as a treatment option, they do not result in an immediate improvement in symptoms or resolution of the condition.

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  • 29. 

    All of these diagnostic tests are useful in evaluating a patient with a retained magnetic intraocular foreign body except:

    • A.

      Indirect ophthalmoscopy

    • B.

      Computed tomography

    • C.

      Electrophysiology

    • D.

      Magnetic resonance imaging (MRI)

    • E.

      Echography

    Correct Answer
    D. Magnetic resonance imaging (MRI)
    Explanation
    Magnetic resonance imaging (MRI) is not useful in evaluating a patient with a retained magnetic intraocular foreign body because it uses a strong magnetic field, which can cause movement or displacement of the foreign body and potentially lead to further complications. The other diagnostic tests mentioned, such as indirect ophthalmoscopy, computed tomography, electrophysiology, and echography, are all useful in evaluating a patient with a retained magnetic intraocular foreign body as they provide valuable information about the location, size, and potential damage caused by the foreign body.

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  • 30. 

    The most common cause of binocular transient visual loss lasting 30 minutes a 29 year old woman is

    • A.

      Migrane

    • B.

      Thromboembolism

    • C.

      Pseudotumor cerebri

    • D.

      Giant cell arteritis

    Correct Answer
    A. Migrane
    Explanation
    Migraine is the most common cause of binocular transient visual loss lasting 30 minutes in a 29-year-old woman. Migraine is a neurological condition characterized by recurring headaches, often accompanied by visual disturbances such as flashing lights or blind spots. These visual disturbances, known as auras, can last for a short period of time and affect both eyes. Migraine-related visual loss is typically temporary and resolves on its own. Other potential causes such as thromboembolism, pseudotumor cerebri, and giant cell arteritis are less likely in this age group and presentation.

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  • 31. 

    Which of the follow is most useful in distinguishing the cause of anisocoria that is greater in dark than in light?

    • A.

      Cocaine 10 %

    • B.

      Pilocarpine 0.1%

    • C.

      Pilocarpine 1%

    • D.

      Pilocarpine 2.5%

    Correct Answer
    A. Cocaine 10 %
    Explanation
    Cocaine 10% is most useful in distinguishing the cause of anisocoria that is greater in dark than in light. Cocaine is a potent sympathomimetic drug that blocks the reuptake of norepinephrine, leading to dilation of the pupil. In cases where anisocoria is greater in the dark, it suggests a sympathetic denervation of the dilator muscle in the affected eye. By instilling cocaine 10% into the eye, if the anisocoria resolves or decreases, it confirms that the cause of anisocoria is related to sympathetic dysfunction.

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  • 32. 

    Parasympathetic fibers destined for the pupil reside in the

    • A.

      Medulla

    • B.

      Medial portion of CN III

    • C.

      Posterior communicating artery

    • D.

      Pons

    Correct Answer
    B. Medial portion of CN III
    Explanation
    The correct answer is the medial portion of CN III. Parasympathetic fibers that control the pupil are located in the medial portion of the third cranial nerve (CN III). CN III, also known as the oculomotor nerve, is responsible for controlling the movement of the eye muscles and also carries parasympathetic fibers that regulate the size of the pupil. Therefore, the parasympathetic fibers destined for the pupil reside in the medial portion of CN III.

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  • 33. 

    Which of the following is not considered to be an illusion?

    • A.

      Pulfrich phenomenon

    • B.

      Metamorphopsia

    • C.

      Micropsia

    • D.

      Palinopsia

    Correct Answer
    D. Palinopsia
    Explanation
    Palinopsia is a visual disturbance characterized by the persistence or recurrence of visual images after the stimulus has been removed. It is often associated with certain medical conditions or drug use. In contrast, the Pulfrich phenomenon, metamorphopsia, and micropsia are all considered to be illusions. The Pulfrich phenomenon refers to a perceived 3D effect caused by a slight delay in the processing of visual information between the two eyes. Metamorphopsia is the distortion or alteration of visual perception, while micropsia is the perception of objects as being smaller than they actually are.

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  • 34. 

    Which of the following is most likely to prompt additional evaluation in a patient with facial palsy

    • A.

      Simultaneous bilateral facial palsy

    • B.

      Recovery of facial nerve function that occurs 3 weeks after the facial palsy

    • C.

      Facial palsy occuring in a patient older than 50 years of age

    • D.

      Upper and lower facial musculature equally affected

    Correct Answer
    A. Simultaneous bilateral facial palsy
    Explanation
    Simultaneous bilateral facial palsy, where both sides of the face are affected, is most likely to prompt additional evaluation in a patient with facial palsy. This is because bilateral facial palsy is a rare condition and can be associated with more serious underlying causes such as Lyme disease, Guillain-Barré syndrome, or certain viral infections. Therefore, it is important to further investigate and determine the underlying cause of simultaneous bilateral facial palsy in order to provide appropriate treatment and management.

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  • 35. 

    An underlying condition is most likely to be determined in a patient with isolated eye pain and

    • A.

      Pain for greater than 2 years

    • B.

      Ipsilateral facial numbness

    • C.

      Normal neuroimaging of the brain and orbits

    • D.

      Poor reponse to tricyclic antidepressants

    Correct Answer
    B. Ipsilateral facial numbness
    Explanation
    The presence of ipsilateral facial numbness along with isolated eye pain suggests that there may be an underlying condition causing these symptoms. This combination of symptoms could be indicative of a neurological issue, such as trigeminal neuralgia or a tumor affecting the trigeminal nerve. The normal neuroimaging of the brain and orbits rules out any structural abnormalities, while the poor response to tricyclic antidepressants suggests that the pain is not related to a psychiatric condition. Therefore, the most likely explanation for the given symptoms is an underlying condition that is causing both the eye pain and facial numbness.

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  • 36. 

    A 1 year old child presents with monocular vertical nystagmus.  What is the best course of action?

    • A.

      Follow the case to see whether head nodding develops

    • B.

      Follow the case to see whether abnormal head position develops

    • C.

      Undertake drug toxicology screening

    • D.

      Undertake neuroimaging (perferably MRI)

    Correct Answer
    D. Undertake neuroimaging (perferably MRI)
    Explanation
    In this scenario, the best course of action is to undertake neuroimaging, preferably an MRI. Monocular vertical nystagmus in a 1-year-old child is a concerning symptom that may indicate an underlying neurological problem. Neuroimaging can help identify any structural abnormalities or lesions in the brain that may be causing the nystagmus. This can aid in making an accurate diagnosis and determining the appropriate treatment plan for the child.

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  • 37. 

    Optic disc drusen typically demonstrate all of the following features except

    • A.

      Arcuate visual field defects

    • B.

      High reflective signal on b-scan ultrasonography

    • C.

      Visual acuity loss

    • D.

      Optic disc elevation and blurred margins

    Correct Answer
    C. Visual acuity loss
    Explanation
    Optic disc drusen is a condition characterized by the presence of small calcium deposits in the optic disc. These deposits can cause various symptoms and features, such as optic disc elevation and blurred margins, high reflective signal on b-scan ultrasonography, and arcuate visual field defects. However, visual acuity loss is not typically associated with optic disc drusen. Therefore, the correct answer is visual acuity loss.

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  • 38. 

    All of the following are common causes of transient visual loss except

    • A.

      Nonarteretic ischemic optic neuropathy

    • B.

      Migraine

    • C.

      Giant cell arteritis

    • D.

      Pseudotumor cerebri

    Correct Answer
    A. Nonarteretic ischemic optic neuropathy
    Explanation
    Transient visual loss refers to a temporary loss of vision that lasts for a short duration. Nonarteritic ischemic optic neuropathy (NAION) is a condition characterized by sudden, painless vision loss due to ischemia (lack of blood flow) to the optic nerve. It is a common cause of transient visual loss and is often associated with risk factors such as hypertension, diabetes, and smoking. Migraine, giant cell arteritis (a condition that causes inflammation of blood vessels), and pseudotumor cerebri (increased pressure inside the skull) are also common causes of transient visual loss. Therefore, the correct answer is nonarteritic ischemic optic neuropathy, as it is not a common cause of transient visual loss.

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  • 39. 

    Which eye movement disorder is most commonly seen in patients with paraneoplastic syndromes?

    • A.

      Downbeat nystagmus

    • B.

      Upbeat nystagmus

    • C.

      Superior oblique myokymia

    • D.

      Opsoclonus

    Correct Answer
    D. Opsoclonus
    Explanation
    Opsoclonus is a type of eye movement disorder that is commonly seen in patients with paraneoplastic syndromes. Paraneoplastic syndromes are a group of rare disorders that occur due to an abnormal immune response to a cancerous tumor. Opsoclonus is characterized by rapid, involuntary, and unpredictable eye movements in multiple directions. It is often accompanied by other neurological symptoms such as ataxia, myoclonus, and behavioral changes. Opsoclonus is believed to result from an autoimmune response against the tumor, leading to inflammation in the brain and affecting the control of eye movements.

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  • 40. 

    In adults, the most common intraocular malignant tumor and most common site of involvement are

    • A.

      Melanoma, choroid

    • B.

      Metastasis, iris

    • C.

      Melanoma, iris

    • D.

      Metastasis, choroid

    Correct Answer
    D. Metastasis, choroid
  • 41. 

    Two tumors commonly associated with so-called masquerade syndrome are

    • A.

      Conjunctival lymphoma, choroidal melanoma

    • B.

      Conjunctival lymphoma, intraocular lymphoma

    • C.

      Eyelid sebaceous carcinoma, intraocular lymphoma

    • D.

      Basal cell carcinoma, retinoblastoma

    Correct Answer
    C. Eyelid sebaceous carcinoma, intraocular lymphoma
    Explanation
    The correct answer is eyelid sebaceous carcinoma, intraocular lymphoma. Masquerade syndrome refers to the situation where a malignant tumor mimics a benign condition, leading to delayed diagnosis and treatment. In this case, both eyelid sebaceous carcinoma and intraocular lymphoma can present with symptoms similar to benign conditions, such as chronic inflammation or infection. Therefore, they can be mistaken for less serious conditions, causing a delay in proper diagnosis and treatment.

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  • 42. 

    The most common secondary tumors in retinoblastoma patients within and outside of the field of ocular radiation are

    • A.

      Within, fibrosarcoma; outside, osteosarcoma

    • B.

      Within, osteosarcoma; outside, melanoma

    • C.

      Within, osteosarcoma; outside, pinealoblastoma

    • D.

      Within, osteosarcoma; outside, osteosarcoma

    Correct Answer
    D. Within, osteosarcoma; outside, osteosarcoma
    Explanation
    The correct answer is within, osteosarcoma; outside, osteosarcoma. Retinoblastoma patients are more likely to develop secondary tumors within the field of ocular radiation, and osteosarcoma is the most common secondary tumor in this area. Outside of the field of ocular radiation, retinoblastoma patients are also at an increased risk of developing osteosarcoma. Therefore, the most common secondary tumors in retinoblastoma patients are osteosarcoma both within and outside the field of ocular radiation.

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  • 43. 

    A family history of retinoblastoma is present in what percent of newly diagnosed retinoblastoma patients

    • A.

      1%

    • B.

      6%

    • C.

      18%

    • D.

      40%

    Correct Answer
    B. 6%
    Explanation
    The correct answer is 6% because a family history of retinoblastoma is present in a small percentage of newly diagnosed retinoblastoma patients. This suggests that genetics play a role in the development of the disease, but it is not a common occurrence.

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  • 44. 

    Which of the following statements about pleomorphic adenoma of the lacrimal gland is false?

    • A.

      It can recur in a diffuse manner

    • B.

      It can transform to a malignant tumor if present long enough.

    • C.

      Recurrences can transform to malignancy

    • D.

      It can resolve spontaneously

    Correct Answer
    D. It can resolve spontaneously
    Explanation
    Pleomorphic adenoma of the lacrimal gland is a benign tumor that arises from the epithelial cells of the gland. It is known to have a tendency to recur, and in some cases, these recurrences can transform into malignancy. However, it is not known to resolve spontaneously. Therefore, the statement that it can resolve spontaneously is false.

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  • 45. 

    The modified Callender classification of ocular melanoma applies to melanomas of the

    • A.

      Eyelid

    • B.

      Conjunctiva

    • C.

      Iris

    • D.

      Choroid

    Correct Answer
    D. Choroid
    Explanation
    The modified Callender classification of ocular melanoma applies to melanomas of the choroid. This classification system is used to categorize and stage melanomas based on their size, location, and extent of invasion. The choroid is a layer of tissue in the eye that contains blood vessels and provides nourishment to the retina. Melanomas that develop in the choroid can be particularly dangerous as they can grow and spread to other parts of the eye and body. Therefore, it is important to accurately classify and stage these melanomas to determine the appropriate treatment and prognosis.

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  • 46. 

    Which of the following ocular histologic changes is not considered to be associated with diabetes mellitus?

    • A.

      Lacy vacuoliztiaon of the iris

    • B.

      Retinal hemorrhages

    • C.

      Iris hemorrhages

    • D.

      Thickened basement membranes

    Correct Answer
    C. Iris hemorrhages
    Explanation
    Iris hemorrhages are not considered to be associated with diabetes mellitus. Diabetes mellitus is known to cause various ocular histologic changes such as lacy vacuolization of the iris, retinal hemorrhages, and thickened basement membranes. However, iris hemorrhages are typically associated with other conditions such as trauma, inflammation, or certain systemic diseases like hypertension, rather than diabetes mellitus.

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  • 47. 

    Histologic differentiation between primary and recurrent pterygia can be based on

    • A.

      The degree of vascularity in the lesion

    • B.

      The presence of more fibrous tissue in the recurrent lesion

    • C.

      The absence of elastotic degeneration in recurrent pterygia

    • D.

      The presence of Bowman's layer in recurrent buy not primary pterygia

    Correct Answer
    C. The absence of elastotic degeneration in recurrent pterygia
    Explanation
    The correct answer is the absence of elastotic degeneration in recurrent pterygia. Elastotic degeneration is a characteristic feature of primary pterygia, but it is not present in recurrent pterygia. This difference in elastotic degeneration can be used to differentiate between primary and recurrent pterygia histologically.

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  • 48. 

    Which of the following is not a point of firm attachment between the sclera and uvea?

    • A.

      Ora serrata

    • B.

      Scleral spur

    • C.

      Internal ostia of vortex veins

    • D.

      Peripapillary tissue

    Correct Answer
    A. Ora serrata
    Explanation
    The ora serrata is the boundary between the retina and the ciliary body. It is not a point of firm attachment between the sclera and uvea. The scleral spur is a thickening of the sclera where the ciliary muscle attaches. The internal ostia of vortex veins are openings in the sclera through which blood drains from the choroid. The peripapillary tissue refers to the area surrounding the optic nerve head.

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  • 49. 

    Which of the following extraocular muscles inserts farthest from the limbus?

    • A.

      Superior rectus

    • B.

      Inferior rectus

    • C.

      Inferior oblique

    • D.

      Superior oblique

    Correct Answer
    C. Inferior oblique
    Explanation
    The inferior oblique muscle inserts farthest from the limbus. The limbus is the border between the cornea and the sclera of the eye. Among the given options, the inferior oblique muscle is the only one that inserts farthest from this border. The superior rectus, inferior rectus, and superior oblique muscles all insert closer to the limbus compared to the inferior oblique muscle.

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  • 50. 

    The ability of a light wave from a laser to form interference fringes with another wave from the same beam, separated in time, is a measure of its

    • A.

      Temporal coherence

    • B.

      Spatial coherence

    • C.

      Polarization

    • D.

      Directionality

    Correct Answer
    A. Temporal coherence
    Explanation
    Temporal coherence refers to the ability of a light wave to maintain a constant phase relationship over time. In the context of the question, when a light wave from a laser forms interference fringes with another wave from the same beam, it indicates that the waves are in phase and have a consistent phase relationship. This demonstrates the temporal coherence of the light wave. Spatial coherence refers to the ability of a wave to maintain a constant phase relationship at different points in space. Polarization refers to the orientation of the electric field vector of a light wave, and directionality refers to the ability of a wave to propagate in a specific direction.

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Apr 05, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Mar 17, 2009
    Quiz Created by
    Nazrox

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