Slan Opthalmology

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SLAN OPTHALMOLOGY 4.

1. The following are causes of ophthalrnia neonotorüm:


a) Silver nitrate prophylaxis.
b) Staph aureus.
c) N. Gonococcus.
d) Herpes simplex type II
e) All the above.

2. Blindness in trachoma is a result of: -


a) Cataract.
b) Ectropion.
c) Corneal scar.
d) Largophthalmos.
e) Endophthalmitis

3. Which is true of onchocerchiasis: -


a) It is speared by fleas.
b) Ii is a bacterial diseased.
c) Ii is highly contagious. It is a parasitic disease.
d) It affects only the eyes.

4. Which of the following is true?


a) Bacterial organism can only invade the cornea when the corneal epithelium has been
broken.
b) The common corneal infections are due to protozoa and fungi.
c) The most important diagnostic stain for corneal ulcers in .fluordquinolone.
d) Bacterial corneal infectious are usually treated using steroid — antibiotics.
e) Staph aureus is among the commonest bacterial causes of comeal ulcer.

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5. The cornea:-
a) Scarring can be distinguished from ulceration by using methlcellulose.
b) Can melt in cases of’ nutrition deficiency.
c) Can only be repaired by grafting.
d) Does not get repaired at all due to its avascularity.
e) All of the above.
6. What instrument can be used when measuring intraocular pressure?
a) Microscope.
b) Ultrasound machine.
c) Slit lamp.
d) Retinoscope.
e) Ophthalmoscope.
7. The following drugs can be used in treatment of glaucoma except:
a) Adrenaline 1%.
b) Timolol 0.5%
c) Acetazolamide.
d) Pilocarpine 2-4%
e) Atropine.
8. Pseudophakia is - -
a) Absence of crystalline lens.
b) Absence of an eyeball.
c) (j) Presence of an intraocular lens.
d) Presence of a crystalline lens.
e) None of the above.

9. Aphakia can be corrected by using:


a) Contact lenses.
b) Intraocular lenses.
c) Glasses.
d) Allof the above.
e) None of the above.

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10. In extra capsular cataract extraction: -
a) Only part of the posterior capsule is removed.
b) Only part of the anterior capsular is removed.
c) Both anterior and posterior capsules are removed.
d) Zonules are broken.
e) None of the above.
11. The following are used to make diagnosis of open angle glaucoma:-
a) Visual fields defects.
b) Cupping of discs.
c) Increased intraocular pressure.
d) All the above.
e) None of the above.
12. The lacrimal duct opens into the:
a) Lacrimal gland.
b) Maxillary sinus.
c) Nasal cavity.
d) Mouth.
e) Frontal sinus:

13. The refractive errors of a person is determined using:


a) Retinoscope.
b) Slit lamp.
c) Perimeter.
d) Ophthalmoscope.
e) Tonorneter.

14. In myopia:
a) The light rays focus posterior to the retina.
b) The eye has insufficient convergent power to focus light rays on the retina.
c) There is progressive loss of accommodation of the crystalline
d) There is excessive convergent power such that the light rays focus anterior to the retina.
e) Children commonly out grow the problem.
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15. Which of the following is true?
a) Aphakia is found in the elderly only.
b) All people are born with ametropia.
c) Myopia is corrected using convergent lenses.
d) The other name for hypermetropia is shortsightedness.
e) Astigmatism is corrected using cylindrical lenses.

16. The following are true except?


a) Myopia is commoner in infants than adolescents.
b) Cornea! scarring can lead to astigmatism.
c) Convergent squints can be present in high hypermetropia:
d) Uncorrected refractive errors can lead to amblyopia.
e) Astigmatism can occur after ocular surgery.

17. The structures responsible for refraction in the eye ball include the following 7-ccpt: -
a) The vitreous.
b) The cornea.
c) The lens.
d) The pupil.
e) The aqueous.

18. Which of the following is not used specifically in assessment ofa patient with refractive
errors:
a) Snellen’s chart. -
b) Retinoscope.
c) c Pinhole.
d) d Slit lamp microscope.
e) Reading chart.

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19. Which of the following is not true about orbital cellulitis:
a) It can follow a tooth extraction.
b) It can follow an upper respiratory tract infections.
c) It can present as a complication of a stye.
d) It can lead to cavernous sinus thrombosis.
e) It always follows systemic infection.

20. Panophthalmitis:
a) Is a results of severe glaucoma.
b) Is treated with steroids antibiotics.
c) Is treated by evisceration.
d) It can be an absolute indication of exenteration.
e) Is not associated with pain.

21. Enuleation is indicated in the following conditions except:


a) Glaucoma.
b) Badly ruptured eyeball.
c) Uveai melanoma.
d) Anterior staphyloma.
e) Painful blind eye.

22. The differential diagnosis of a leucocora includes the following expect:


a) Corneal ulcer,
b) Cataract.
c) Retinoblastorna
d) Retrolental fibroplasias.
e) Persistent Hyperplastic primary vitreous.

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23. Cavernous sinus thrombosis:-
a) Is inflammation with thrombosis in the paranasal sinuses.
b) Is a fatal condition resulting from infection spreading from the orbit to the cavernous
sinus.
c) Is usually treated using anticoagulants.
d) Is best associated with leukocoria.
e) The effected patient is managed as an outpatient.

24. Onchocerciasis may cause blindness by:


a) Patchy depigmentation of the retina.
b) Severe conjunctivitis.
c) Corneal perforation.
d) Conjunctival hypertrophy
e) Optic neuritis

25. Trachorna is: -


a) Usually unilateral.
b) Only spread by flies.
c) An acute Suppurative conjunctivitis.
c) Only found in Eastern Uganda.
e) A chronic follicular conjunctivitis

26. Astigmatism is caused by:-


a) Ciliary spasm.
b) Optic nerve disease.
c) Raised intra-ocular pressure.
d) Difference in degrees of refraction in the various meridians of the cornea.
e) Chroidal folds.

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27. The direct ophthalmosope is used to examine the following, except:-
a) Optic nerve head.
b) Macular
C) Vitreous
d) d Lens
e) .Ciliary process.

28. Which statement is NOT correct?


a) Perilimba) redness is a characteristic of iritis
b) The pinhole test is used for assessing the possible presence of a refractive error.
c) Conjunctivitis is associated with profound loss of vision.
d) River blindness is caused by a filarial worm.
e) Macular disease is associated with loss of central vision.

29. Hyphaema may be treated with the following drugs, except: -


a) Acétazolamide.
b) Atropine
c) Dexamethasonc.
d) Dorzolamidc.
e) Acyclovir

30. Primary open angle glaucoma is treated with:


a) Steroids.
b) Prostaglandin analogues.
c) Antihistamines.
d) Diuretics.
e) None of the above.

31. Damage to the macula may result in:


a) Loss of central vision.
b) ) Loss of colour vision.
c) Secondary glaucoma.
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d) Retinitis pigmentosa.
32. Presbyopia: -
a) Results from increased accommodative power of the lens and ciliary body.
b) Can be corrected with concave lenses.
c) Commonly sets in after 40years of age.
d) Increases with age in shortsighted people.
e) Can be corrected with lasers.

33. Surgical removal of an eye may be by: -


a) Exophthalmornetry.
b) Cyclophotocoagulation.
c) Exenteration.
d) Trabeculectorny.
e) Orbitotorny

34. Control of Vitamin A deficiency in a community includes the following strategies except: -
a) Immunization against measles.
b) Vitamin A supplementation.
c) c Encouraging consumption of fruits and vegetables
d) Screening for hepatitis B.
e) Food fortification.

35. Which statement is correct: -


a) Cataract cannot occur below 40 years of age.
b) Corneal ulcers should routinely be treated with steroids.
c) Prolonged use of topical steroid can result in retinal detachment.
d) Lasers arc not used to treat glaucoma.
e) Diabetic retinopathy results into bleeding from retinal micro aneurysms.

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36. The oculornotor nerve innervates the following muscles except:
a) Medial rectus.
b) Lateral rectus.
c) Superior rectus.
d) Inferior rectus.
e) Inferior oblique.

37. The following is not part of the ocular media:-


a) The tear film.
b) The cornea.
c) The aqueous humours.
d) The pupils.
e) The vitreous.

38. After cataract extraction, the resulting refractive error is best evaluated by doing: -
a) Keratometry.
b) Biornetry.
c) Retinoscopy
d) Direct Ophthalmology.
e) Indirect Ophthalmology.

39. One of the following is not used in treatment of Glaucoma:


a) Acetazolamide.
b) Atropine.
c) Surgery.
d) Tirnolol.
e) Pilocarpine.

40. Fluoresceine stain can be used:


a) To treat cornea) ulcer.
b) To treat conjunctivitis. While taking intraocular pressure.
c) To lubricate the eye.
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d) To diagnose cataract.

41. In open angle glaucoma:-


a) The angle is closed by the root of the iris.
b) Medical treatment is never helpful.
c) Visual fields are not defective.
d) Patients usually present with acute pain.
e) B- adrenergic blockers can he used.
42. Secondary glaucoma can result from:,
a) Cataract surgery.
b) Anaemia.
c) Puru lent conjunctivitis.
d) Asthma.
e) Repeated intraocular pressure measurements.

43. One of the following is not true: -


a) Glaucoma is never familial.
b) Glaucoma can be congenital.
c) The normal intra-ocular pressure is 10- 21 mrnHg
d) Acute angle closure glaucoma can cause sudden loss of vision.
e) Timolol is contra indicated in asthmatic patients.

44. Retinoblastoma:
a) Is a secondary malignant tumour to the retina.
b) Never presents, with leukocoria.
c) Never presents with squint in the affected eye.
d) Can be treated by enucleation.
e) Can be treated by evisceration.

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45. The following conditions may be associated with proptosis except:
a) Myaesthenia gravis.
b) Grave’s disease.
c) Burkitts ymphoma:
d) Advanced orbital squamous cell carcinoma.
e) Pseudo tumour.

46. Exenteration is the absolute indication in the following conditions:-


a) Burkitts lymphoma.
b) Advance orbital squamous cell carcinoma.
c) Intraocular Retinoblastorna.
d) Glaucoma.
e) Trachorna.

47. The cornea:


a) Is highly vascularised.
b) Is semitransparent in darkness.
c) Is made up of 5 layers.
d) a, b and c.
e) a and c

48. The following structures of the eyeball are highly vascularised except:
a) The cornea:
b) The iris.
c) The choroids.
d) The ciliary body.
e) The conjunctiva.

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49. The following are components of the visual pathway except:
a) Visual cortex.
b) Optic chiasm.
c) Optic fissure.
d) Optic tract.
e) Optic radiations.

50. Simulium damnosun best breeds in:


a) Slow flowing water.
b) Stagnant water.
c) Well oxygenated water.
d) Large lakes.
e) Small pools.

1) The orbit-

a) Consists of four walls in a square shape.


b) Is made up of seven (7) bones
c) is bordered immediately by the mandible.
d) Is medial to the nose
e) houses the lacrimal gland and the lacrimal sac

2. The following is true about the cornea:-

a) Is highly vascularised.
b) Is made up of 5 layers
c) Is semi-transparent in darkness
d) is the least innervated tissue in the human body
e) derives its blood supply from the cavernous sinus

3. The following structures of the eye ball are highly vascularised except:-

a) The iris
b) The ciliary body.
c) The cornea
d) The conjunctiva
e) The choroid.

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4. The following is true about the crystalline lens (eye lens)

a) It is highly innervated.
b) It is highly avascular
c) It has five layers.
d) it is made up of cortex, nucleus and stroma
e) It is concave in shape

5. The aqueous humor is formed by the

1) Vitreous.
2) ciliary process.
3) Aqueous duct.
4) Lens.
5) choroid plexus

15. Primary Open angle glaucoma:-

a) Is common in women;
b) B) Sets in during early childhood.
c) Presents with severe pain of acute onset.
d) Is one cause of reversible blindness.
e) Has no clear structural cause of impaired drainage at the anterior chamber angle.

16. Primary Open angle glaucoma can be treated with:-

a) Steroids,
b) Prostaglandin analogues.
c) Anti histamines.
d) Anti-hypertensive.
e) None of the above.

17. One of the following is not used in treatment of glaucoma:-

1) Acetaolamide.
2) Surgery.
3) Timolol.
4) Atropine.
5) Pilocarpine.

18. In angle closure glaucoma:-

a) The root of the iris is closing the anterior chamber angle.


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b) The patient is usually asymptomatic.
c) Medical treatment is never helpful.
d) (a) and (b).
e) (a) and (c)

19. Secondary glaucoma can result from the following:-

a) Trachoma.
b) Cataract surgery.
c) Steroid therapy.
d) (b) and (c)
e) Anaemia

20. The following are true about glaucoma except:-

a) Can be congenital.
b) Has a genetic/familial tendency.
c) Is treatable and reversible.
d) Timolol is contra-indicated in asthmatics.
e) The commonest type is angle closure glaucoma

28. Aphakia is corrected by

a) Concave glasses (- 10 DS)


b) Convex glasses of +3 DS
c) Intraocular lens implantation
d) Bifocal lenses of minus power
e) None of the above.

29. One of the symptoms of refractive errors is

a) Anaesthesia.
b) Seeing floaters,
c) Squint
d) Itching.
e) Photophobia

30. The following conditions can present with a squint in a child except.-

a) Retinopathy of prematurity.
b) Ciliary muscle trauma.
c) Brain tumour.
d) Cataract.
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e) Retinoblastoma.

31. Sympathetic ophthalmitis:-

a) Is a non blinding condition.


b) Occurs in the injured eye.
c) Usually occurs within five days after injury.
d) Occurs in the uninjured eye.
e) Is self-limiting.

32. Panophthalmitis:-

a) Is a common complication of vernal catarrh.


b) Is treated with steroid-antibiotics.
c) Is an absolute indication for exenteration.
d) Is a common indication for evisceration.
e) Is also known as sympathetic ophthalmitis.

33. Enucleation is indicated in the following condition except;-

a) Trachoma.
b) Anterior staphyloma
c) Retinoblastoma.
d) Painful blind eye.
e) Badly ruptured eyeball.

Hyphema:-

a) Is blood in the vitreous.


b) Can result in secondary glaucoma.
c) Always follows trauma.
d) Treatment of choice is Pilocarpine.
e) Will always resolve on its own.

35. Uveitis can lead to the following complications except:

a) Retinal detachment
b) Cataracts.
c) Glaucoma
d) Keratoconus
e) phthisis bulbi

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36. The differential diagnosis of a leucocoria includes the following excepti-

a) Retinopathy of prematurity.
b) Persistent hyporolastic primary vitreous
c) Corneal scar.
d) Retinoblastoma
e) Cataract.

37. Proptosis:-

a) Can be puisatile in case of a purely venous orbital lesion.


b) Is the backward protrusion of orbital fat.
c) Is when the eyeball is displaced forward.
d) Is the drooping of the eyelid.
e) None of the above.

38. The following are causes of proptosis except-

a) Sinus mucocele.
b) Orbital cellulitis.
c) Megalo-cornea.
d) Cavenous sinus thrombosis.
e) Thyroid disease.

39. Epiphora:-

a) Is another name for excessive tearing.


b) Is a common symptom of a painful red eye.
c) Is usually as a result of blockage in the tear drainage system.
d) Can be treated using fluorescein eye drops.
e) Surgery is contraindicated.

40. Which of the following is false about Ophthalmia neonatorum:-

a) Is a potentially blinding disease.


b) Can result from numerous vaginal examinations during labour.
c) Is commonly viral in origin.
d) Can result into orbital cellulitis.
e) Tetracycline eye ointment is one of the treatments.

41. The following conditions lead to blindness in HIVIAIDS except:-

a) CMV retinitis.
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b) Herpes Zoster Ophthalmicus
c) Ocular TB
d) Toxoplasmic retinitis.
e) Cotton wool spots.

The following are treatment options for refractive efforts except

a) Telescopes
b) Spectacles with concave or convex lenses.
c) Contact lenses
d) Iridectomy
e) Refractive surgery.

21. The cornea

a) Scarring is distinguish from ulceration by methyl cellulose stain


b) Can melt in nutritional deficiency
c) Can only be repaired by grafting
d) Does not repair at all due to its avascularity
e) Is supplied by the nerve fibers derived from the optic nerve

22. Recommended treatment for herpetic corneal ulcer include

a) Topical antibiotic with steroid


b) Topical antibiotic with an antiviral
c) Topical antibiotic only
d) Topical antiviral with steroid always
e) All of the above

23. Corneal ulcers can be caused by:

a) Syphilis.
b) Trachoma.
c) Onchocerciasis
d) Gonorrhoes.
e) Helicobacter pylori.

24. Hypopyon is:-

a) Low tension in the eyeball,


b) Blood in the anterior chamber
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c) Pus in the cornea.
d) Pus in the vitreous.
e) Pus in the anterior chamber.

25. Which of the following is true?

a) Bacterial organisms can only invade the cornea when the epithelium has been broken.
b) The commonest diagnostic stain for corneal ulcers is fluoro-metholone,
c) Bacterial corneal infections are usually treated using steroid-antibioties,
d) Staph aureus is the commonest bacterial cause of corneal ulcers.
e) All the above.

26. The commonest type of cataract in Uganda is:

a) Congenital cataract.
b) Diabetic cataract,
c) Age related (Senile) cataract.
d) Traumatic cataract.
e) Inflammatory cataract,

The following are ways of cataract extraction except;-

a) Intracapsular cataract extraction (ICCE)


b) Extracapsular cataract extraction (ECCE),
c) Endocapsular cataract extraction (ECCE).
d) Phacoemulsification.
e) Lens wash out.

42. Squamous cell carcinoma of the conjunctiva:-

a) Is a disease of the elderly only.


b) Is usually treated by chemotherapy.
c) Is highly associated with HIV seropositivity in the young
d) Treatment of choice is nucleation.
e) Commonly presents with subcorjunctival haemorrhage.

43. The following are differentials of a painful red eye except.-

a) Corneal ulcer.
b) Subconjunctival haemorrhage
c) Acute angle closure glaucoma.
d) Anterior uveitis.
e) Allergic conjunctivitis.
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44. The following eye drops are commonly used in ocular examination except:-

a) Phenylephrine eye drops.


b) Amethocaine eye drops.
c) Cyclophosphamide eye drops.
d) Fluorescein eye drops
e) Homatropine eye drops.

45. Exenteration is the absolute indication in the following conditions:-

a) Burkitt's lymphoma.
b) Glaucoma
c) Intracular retinoblastoma.
d) Orbital dermoid cyst.
e) Orbital squamous cell carcinoma.

46. Onchocerciasis

a) Is caused by a filarial worm spread by a Simulium fly.


b) Is highly contagious.
c) Is a cause of avoidable blindness
d) (a) and(c).
e) All the above.

47. Trachoma:-

a) One of the signs is pannus in the lower quadrant.


b) Is as a result of chlamydial infection spread by flies.
c) Can be prevented by hand washing.
d) (b) and c) .
e) All the above.

48. The following are true about ocular leprosy except:-

a) Usually causes lagophthalmos.


b) Results in corneal ulceration.
c) Causes sclerosing Keratitis.
d) Can result in loss of eyelashes.
e) Can be treated with tarsorrhaphy.

49. Corneal scarring in children is commonly due to the following

a) Trauma
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b) Traditional eye medication.
c) Trachoma
d) Measles.
e) Glaucoma

50. The following organisms can grow inside eyeball except.-

a) Toxoplasma gondi.
b) Treponema pallidum.
c) Chlamydia trachomatis.
d) Onchercerca volvulus
e) Loa Loa.

51. In extra capsular cataract extraction

a) Only part of the posterior capsule is removed.


b) Only part of the anterior capsular is removed.
c) Both anterior and posterior capsules are removed.
d) Zonules are broken.
e) None of the above.

52. Retinoblastoma:-

a) Can present with a squint.


b) Typically presents with a cat's eye reflex.
c) May present with a nystagmus
d) (a) and (b)
e) (a),(b),and (c).

53. Corneal damage can be caused by the following except:-

a) Orbital tumour.
b) Glaucoma
c) Hyphema.
d) Vernal catarrh.
e) Ptosis.

54. Papilloedema occurs:-

a) In conditions with raised intra ocular pressure.


b) Usually in one eye.
c) In some patients with meningitis.
d) In cerebral malaria.
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e) None of the above.

5. Vitamin A deficiency may occur among the following except:-

a) Boarding School children.


b) Pregnant mothers.
c) Prisoners.
d) Communities on islands.
e) People in refugee camps.

56) The following treatment is suitable in managing trachoma.

a) Ectropion correction...........
b) Excision of the trachoma swellings. ........
c) Azithromycin treatment of community
d) Steroid antibiotics
e) Lid rotation.

57) Diabetes mellitus and the eye

a) Can cause myopia of adult onset.


b) Is associated with cataracts ......... ......
c) Can cause spontaneous sub-conjunctiva hemorrhage
d) Can complicate in retinopathy within one year of onset.
e) Treatment includes laser photocoagulation

58) Control of Vitamin A deficiency in a community includes:-

a) Vitamin A supplementation........
b) Fortification of food with iron and iodine..........
c) Encouraging consumption of fruits and vegetables ......
d) Encouraging mass consumption of multivitamin tablets.
e) Measles immunisation.

59) In Hypertension:-

a) Visual loss is a rare complication in young adults.


b) The severe form is associated with papilloedema ....
c) Is always associated with raised intraocular pressure
d) Is always associated with short sightedness
e) Is rarely associated with retinal hemorrhage ......

60) In HIV:-

a) a Kaposi's sarcoma presents with conjunctival or lid nodular lesions


b) Optic nerve atrophy may follow optic neuritis due to HIV
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c) CMV retinitis can occur at any level of CD4 count ......
d) Herpes simplex can lead to necrotizing blinding retinitis
e) Anti-retroviral drugs can result in immune reconstitution uveitis

61. Ophthalmic equipment:-

a) Corneal ulcers are best visualized with a keratometer


b) Classification of a cataract is better done using an ophthalmoscope
c) Retinal examination is best done using a retinometer
d) The slit lamp microscope is used in examining the anterior segment.
e) The indirect ophthalmoscope is the best instrument used to explore the whole retina

62. Treatment for

a) Pterygium is by radiotherapy
b) Chalazion is by incision and drainage
c) Stye is by incision and drainage..
d) Conjunctival Kaposi's sarcoma is by excision and radiotherapy.
e) Molluscum contangiosum is by excision

63. Drugs:-

a) Prolonged chloroguine use can lead to optic nerve damage.


b) Prolonged quinine use can lead to maculopathy
c) Prolonged steroid use can lead to glaucoma
d) Prolonged steroid use can lead to cataracts
e) Prolonged topical antibiotic use can lead to corneal damage.

64) Orbital cellulitis-

a) can follow a pricked pimple in the nose


b) Is usually treated with oral antibiotics.
c) The affected patient is usually managed as an outpatient
d) Dental extraction can be a predisposing factor .
e) Can be fatal once infection spreading from the orbit to the cavernous sinus.

END

SECTION B.
Choose two questions out of the three.
1. Define and give World Health Organisaton classification of Xerophthalmia.
2. Write short notes on :-
a) Astigmatism
b) Myopia.
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c) Hypermetropia.
d) Pterygium
e) Cornea
3. What is Onchocerciasis ?
a) Give its life cycle and how to manage it.
4. Define an ideal room for visual acuity examination and the steps taken.

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