The most important factor for developing diabetic retinopathy is: MPL = 0

a. Duration of the diabetes

b. Poor metabolic control of diabetes c. Concomitant renal disease

d. Concomitant systemic hypertension 4. In hyperopia, the axial length is: MPL = 1.0

a. Too short

b. Too long c. Just right

d. Of no significance

5. The leading cause of avoidable and reversible blindness worldwide is/are … MPL = 0.5

a. …Cataracts.

b. …Corneal leukomas c. …Trauma.

d. …Glaucoma

6. The most useful chart attractive to preschool illiterate children: MPL = 0.5 a. Snellen Chart

b. Illiterate ‘E’ Chart

c. Allen Chart

d. ETDRS Chart

7. One advantage of Direct Ophthalmoscopy over Indirect Ophthalmoscopy is: MPL = 1.0 a. Stereoscopy

b. Magnification

c. Light Intensity

d. Wider Field of Vision

8. Flouresecin dye when viewed using a cobalt blue light will appear as: MPL = 0.5 a. Luminous orange

b. Luminous red c. Luminous blue

d. Luminous green

9. Blind spot on a normal visual field is also known as: MPL = 1.0

a. Scotoma

b. Epiphora c. Diplopia d. Asthenopia

10. Most accidental eye injuries can be prevented by… MPL = 0.5

a. …a good pair of protective goggles

b. … a good surgical mask c. ... common sense

d. all of the above

11. The most important consideration in Testing Near Acuity: MPL = 0.25

a. Age

b. Testing Distance c. Literacy

d. Stereoscopic Vision

12. Determination of Visual Field Extent is best demonstrated by: MPL = 0.25

a. Octopus Perimetry

b. Automated Keratometry c. Amsler Grid Testing d. Confrontation Fields Test

13. In performing Direct Ophthalmoscopy, the first element that must be observed: MPL = 0.5

a. Media Clarity

b. Red reflex

c. Macular changes d. Cup / Disc features

14. In the three-part step-wise sequence in external eye examination, one procedure that is not usually included: MPL = 1.0

a. Inspection b. Auscultation c. Palpation

d. Percussion

15. The patient was not able to see hand movement. What is the next step to check his visual acuity?MPL= 0.5

a. Check light perception*

b. Have the patient walk closer to the Snellen chart and ask if he can see the biggest letter

c. Do counting fingers

d. Check color perception test

16. A patient is only able to read the first line of the Jaeger chart. His near visual acuity is recorded as…MPL=0.3

a. J16

b. J16 -2 lines*

c. J16 +2 lines d. J16 +2

17. In assessing facial sensation, the three branches of the cranial nerve V that is being tested are…MPL=0.3

a. Supraorbital n., infraorbital n., intraorbital n. b. Facial n., abducens n., trochlear n.

c. Frontal n., zygomatic n., lacrimal n.

d. Ophthalmic n., maxillary n., mandibular n.*

18. Which of the following is/are true of the corneal blink reflex? MPL=0.3 a. Test is done by touching the eyelashes lightly with a wisp of cotton

b. The afferent arm of the reflex is the trigeminal nerve*

c. The efferent arm of the reflex is the optic nerve d. Visual startle reflex should be stimulated

19. Which of the following is a term used to describe normal binocular eye movement in the same direction? MPL=0.5

a. Ductions

b. Versions*

c. Vergence d. Convergence

20. Giant papillary reaction is common in… MPL = 1.0

a. Contact lens overuse

b. Preseptal cellulitis c. Orbital cellulitis d. Chalazion

21. Ophthalmia Neonatorum is usually a bacterial cause of conjunctivitis: MPL =0.3

a. True

c. Only rarely of bacterial cause

d. Real causative organism is unknown

22. The spread of epidemic viral conjunctivitis is best curtailed by: MPL =0.25 a. Putting prophylactic medication on the eyes

b. Avoiding crowded places c. Avoid touching one’s own eyes

d. Frequent hand washing

23. Which is not an anatomic locale description of the conjunctiva? MPL =0.5 a. Tarsal

b. Fornix

c. Limbal

d. Bulbar

24. Adenoviral conjunctivitis may cause: MPL =0.3

a. a true membrane on the tarsal conjunctiva

b. a pseudomembrane

c. never forms any membrane

d. may develop keratinized conjunctiva

25. Which of the following statements regarding the use of steroid eye drops for red eyes is correct? MPL =0.3

a. Patients may self medicate with steroids when they have red eyes. b. Steroids may be used so long as the dosage is less than 4 times a day.

c. The possible complications of steroid use include Glaucoma AND Cataract formation

d. Ocular complications of steroid eye drops are independent of dosage and duration of use

26. The medication specifically used against adenovirus conjunctivitis currently is: MPL =0.3

a. Steroid antibiotic combination eye drops.

b. 4th generation flouroquinolone eye drops (moxifloxacin) c. Interferon eye drops

d. There is no specific medication against adenovirus

27. The definitive management of gonococcal conjunctivitis is: MPL =0.3 a. Tobramycin eye drops every hour to affected eye for 10 days.

b. Ceftriaxone 1gram intramuscular injection once only.

c. Gentamycin intravenous, 200mg q 6hrs for one week. d. Oral amoxicillin, 500mg t.i.d. for one week

28. Which of the following conjunctivitides is almost always bilateral? MPL =0.5 a. Viral

b. Bacterial c. Toxic

d. Allergic

29. Fusion of the bulbar and tarsal conjunctiva as a result of prolonged inflammation and scarring is termed: MPL =0.3

a. Ankyloblepharon.

b. Symblepharon

c. Eryblepharon d. Blepharitis

30. Painful blurring of vision can be due to: MPL = 1.0 a. Hypertensive Retinopathy

b. Acute angle closure glaucoma

c. Vitreous hemorrhage d. Mature Cataract

31. Glaucoma is characterized by: MPL = 0.25 a. Blurred disc margin

b. Exudates

c. Conjunctival discharge

d. Damage to optic nerve head

32. Secondary glaucoma may occur in: MPL = 0.25

a. Hyphema

b. Acute Bacterial conjunctivitis c. Central retinal vein occlusion d. Retinal detachment

33. The hallmark of Grade IV hypertensive retinopathy associated with malignant hypertension is: MPL = 0.25

a. silver-wiring of arterioles b. macular ‘star’ (hard exudates)

c. optic disc edema

d. cotton-wool spots

34. The systemic condition that presents with the most complications in the posterior pole of the eye: MPL = 0.25

a. Tuberculosis

b. Diabetes Mellitus

c. Allergy

d. Blood dyscrasias

35. In testing for strabismus, the corneal light reflex did not fall at the same relative position on each eye instead it was located at the temporal borders of the pupils, the patient has: MPL = 0.5

a. Orthophoria

b. Esotropia

c. Exotropia d. Hypertropia

36. In cover testing, the uncovered eye moves inward to fixate, the patient has: MPL = 0.5 a. Orthophoria

b. Esotropia c. Exotropia d. Hypertropia

37. A 5 year old child was brought to an ophthalmologist because his family had noticed a strange, white reflection that appeared in one of his eyes in photographs while the rest have red eyes due to the flash. Further examination disclosed Retinoblastoma. This white pupil is known as: MPL=0.5

a. pseudohypopyon

b. leucocoria

c. Hyphema d. Red eye e. Strabismus

38. Computed Tomogram of the above child showed a unilateral tumor filling the left eye. Nasal third of the tumor is calcified. Impression of Retinoblastoma is confirmed with the following histologic features: MPL=0.5

a. Islands of blue cells in a sea of pink necrosis

b. Cuboidal cells circled around a central luman: Flexner-Wintersteiner rosettes c. Flower like grouping of tumor cells which look like photoreceptors: Fleurettes

d. All of the above

e. B and c only

39. A 23/M consulted the OPD because anterior eyelid crusting of 3 days duration. The resident requested for a gram-stain which revealed Gram-positive cocci in clusters. Which statement is consistent with the impression of Staphylococcal blepharitis? MPL = 0.5

a. Coagulase production specifies etiologic agent to be Staphylococcus aureus

b. Catalase negative reaction identifies normal flora Staphylococcus epidermidis c. All staphylococcus species are catalase negative

d. B-lactamase production increases susceptibility to penicillins

40. Which of the following viruses is transmissible even after medical instrumentation is cleaned with alcohol? MPL = 0.5

a. Herpes simplex virus

b. Adenovirus

c. Human immunodeficiency virus d. Epstein-Barr virus

41. A newborn was admitted to the NICU because of mucopurulent eye discharge at birth. The mother had a documented chlamydial genito-urinary tract infection. What bacterial features are consistent with the neonatal ocular finding? MPL = 0.5

a. Elementary bodies stain blue with Giemsa in contrast to the purple of the host cell cytoplasm

b. Chlamydia trachomatis strains synthesize folates thus are resistant to sulfonamides

c. The outer cell wall resembles the cell-wall of gram-negative bacteria

d. Chlamydiae are obligate intracellular parasites that need to exist within host cells to synthesize ATP

42. A 50/M farmer consulted the OPD because of right corneal opacity of 3 weeks duration. He claimed his right eye was hit by a palay strand while harvesting. Clinical history alone leads to a strong suspicion of fungal keratitis. Which of the following statements is a recommended diagnostic management of fungal keratitis? MPL = 0.5

a. Fungi can easily be visualized using the routine hematoxylin and eosin (H&E) preparation

b. The cell wall polysaccharides are uniquely stained by periodic acid-Schiff (PAS)

c. The gold standard for morphologic classification is blood agar at room temperature

d. Corneal scrapings are best collected at the center of the main lesion rather than the small satellite lesions

43. A 43/F consulted because of a sessile mass at the limbus. The excision biopsy revealed squamous papilloma. Which of the following is true about the association of the Human Papilloma Virus (HPV) with squamous papilloma? MPL = 0.5

a. HPV DNA induces cellular necrosis leading to a secondary papilloma growth b. HPV subtypes 6 and 11 have been identified in hypertrophic papillomas

c. HPV DNA induces cellular proliferation and can lead to malignancy

44. A 30/M consulted the OPD because of foreign body sensation with mucopurulent discharge of 6 days duration. A detailed slit-lamp biomicroscopic examination

demonstrated clinical features of trachoma. Which are features of an adult trachoma compared to a neonatal chlamydial conjunctivitis is TRUE? MPL = 0.5

a. The amount of mucopurulent discharge is greater b. Membranes develop almost immediately

c. The percentage of intracytoplasmic inclusions is greater

d. Follicular response is greater

45. Condition in which there is discoloration of the eyelashes MPL = 0.5 a. Madarosis

b. Proptosis c. Trichiasis

d. Poliosis

46. The condition in which an extra row of lashes exists is MPL =0.5 a. Trichiasis

b. Distichiasis

c. Entropion d. Ectropion

47. A white pupillary reflex is called: MPL = 1.0 a. leukoma

b. glaucoma

c. leukocoria

d. anisocoria

48. An infant born less than 31 weeks, weighing less than 1500g (3 lb 5 oz) plus exposure to supplemental oxygen, one should screen the eyes for: MPL = 1.0

a. Persistent Hyperplastic Primary Vitreous (PHPV) b. congenital cataract

c. a retinal astrocytoma

d. Retinopathy of Prematurity (ROP)

49. This is the second most common mode of presentation in Retinoblastoma which account for about 20 % of cases: MPL =0.5

a. leukocoria

b. secondary glaucoma c. proptosis

d. strabismus

50. The following are treatment options for Retinoblastoma except MPL = 1.0 a. Cryotherapy

b. Radio Therapy c. Enucleation

d. Evisceration

51. The following are correct in visual acuity testing in a child EXCEPT MPL=0.5 a. At 6 months, test for ocular fixation and ocular movement

b. At 4 years old, test with tumbling “E” chart picture chart

c. At 8 years old, test with an Amsler grid chart

52. Leukocoria caused by the presence of red cells in the vitreous secondary to birth trauma MPL=0.5

a. Retinopathy of prematurity

b. Persistent Hyperplastic Primary Vitreous

c. Vitreous Hemorrhage

d. Posterior Uveitis

53. A biconves, avascular, colorless structure that focuses light rays to the retina, an opacity of which will cause leukocoria MPL=0.5

a. Lens

b. Vitreous c. Retina d. Optic Nerve

54. Ophthalmological examination that would identify presence of an intraocular mass MPL=0.5

a. Visual acuity testing

b. Indirect Ophthalmoscopy

c. Pupillary examination d. Sit lamp examination

55. The most common presenting sign of retinoblastoma is MPL=1.0 a. Red eye

b. Visual loss

c. White pupil

d. Strabismus

56. Due to the inheritance pattern of retinoblastoma, a vital part of treatment would incude: MPL=0.5

a. Psychological counseling

b. Genetic counseling

c. Psychotherapy

d. Rehabilitation counseling

57. A surgical procedure involving removal of intraocular contents: MPL=0.5 a. enucleation

b. evisceration

c. exenteration

a. retrobulbar alcohol

58. Management of CRAO includes MPL =0.5 a. “Brown bagging”

b. Alternate compression and decompression of the globe c. Oxygen inhalation

d. A and B only

e. B and C only

59. Characteristic findings in Central Retinal Artery Occlusion MPL = 0.25 a. Cotton wool spots

b. Cherry red spot in the macula

c. Vitreous floaters d. Papilledema

60. The TRUE statement regarding chemical burns MPL = 1.0

b. The first thing to do in cases of chemical burns is to check the visual acuity c. Neutralization should be achieved, so that an alkali burn can be treated by

instilling an acidic substance and vice versa

d. In copious irrigation of the eye, the fluid used need not be sterile, provided the chemical is diluted properly

61. EOM movement of one eye is called MPL =0.5

a. Ductions

b. Versions c. Nystagmus d. Diplopia

62. Absence of venous pulsations on funduscopy MPL =0.3 a. May indicate increase intracranial pressure

b. May be normal

c. Is a sign of glaucoma

d. A and b

63. To examine the optic nerve binocularly, use MPL = 0.3 a. Indirect ophthalmoscope

b. Non contact fundus lens c. Intraocular lens

d. A and B

64. What ancillary procedures should you do if suspecting optic nerve toxicity? MPL = 0.25 a. Visual field exam

b. Visual evoked potential c. Color test

d. All of the above

65. One of the most common reasons for Neuroophtha referral … MPL = 1.0

a. …unexplained vision loss

b. …cataracts

c. …retinal disorders d. none of the above

66. Which of the following is true regarding viewing the fundus… MPL = 1.0 a. Indirect ophthalmoscopes provides a monocular view of the fundus b. Direct ophthalmoscopes provides a Binocular view of the fundus

c. Direct ophthalmoscopy provides greater detail of the fundus

d. none of the above

67. What is the most important adverse effect of local anesthetic overdosage? MPL = 0.25 a. bronchoconstriction

b. renal failure

c. convulsion

d. skin rashes

68. Cortocosteroid stops the inflammatory process by inhibiting prostaglandin synthesis through the following mechanism: MPL = 1.0

a. blockage of the enzyme cyclooxygenase

b. blockage of the enzyme phospholipase A

c. blockage of GABA pain receptors

69. Which of the following statements regarding papilledema is not true? MPL =0.3

a. Loss of venous pulsation is always present

b. Symptoms accompanying papilledema may include visual loss and diplopia c. Nerve fiber layer hemorrhages around the disc are often present

d. Blurring of the peripapillary vessels

70. Most common visual field finding in papilledema MPL = 0.3 a. Central scotoma

b. Cecocentral scotoma c. Altitudinal defect

d. Enlargement of the blind spot

71. Typically the onset of visual loss in demyelinating optic neuritis is noted MPL = 0.25

a. Upon arising in the morning

b. Mid-day

c. At the end of the day

d. There is no temporal pattern for visual loss

72. One of the following findings is not a characteristic of true disc edema MPL = 0.25 a. capillary dilation

b. abnormal branching of vessels around the disc

c. disc hemorrhages

d. blurring of disc vessels along the margin

73. Most common cause of optic disc swelling in children MPL = 0.3

a. Infectious optic neuritis

b. Demyelinating optic neuritis c. Leber optic neuropathy

d. Non arteritic anterior ischemic optic neuropathy

74. One of the following is not a characteristic finding of optic neuritis in children MPL = 0.25

a. Often present simultaneously as a bilateral condition

b. More often anterior in location with optic disc edema seen on exam c. Occurs 1-2weeks after a known or presumed viral infection

d. Always resistant to steroids

75. Most common condition associated with nonarteritic anterior ischemic optic neuropathy MPL = 0.5

a. Diabetes mellitus b. Carotid artery disease c. Coagulopathies

d. Hypertension

76. Which of the following is the most common optic neuropathy in patients over the age of 50? MPL = 0.3

a. Compressive b. Demyelinating c. Traumatic

d. Nonarteritic anterior ischemic optic neuropathy

77. 10. An obese 26 year old woman presents with headaches and transient visual obscurations. Bilateral papilledema is documented. The next step should be which of the following MPL = 0.3

b. do lumbar tap

c. Start on acetazolamide

d. Do CT or MRI of the brain

78. Exophthalmos is a term used specifically in which of the following conditions? MPL = 1.0

a. Thyroid disease

b. Anemia c. Keratoconus d. Myopia

1. The most commonly observed Cumulative Trauma disorder is A. De Quervains

B. Trigger finger

C. Carpal tunnel syndrome

In document Surgery FinalA (Page 67-77)