Mcqs for Ophthal pgs 1

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Mcqs for Ophthal pgs 1

  1. 1. Dr A Rajendraprasad MS DO Professor of OphthalmologyCoimbatore Medical College, Coimbatore
  2. 2. 1. Gorlins syndrome: a. Is an inherited condition b. Is associated with multiple basal cell carcinoma c. Increases the incidence of cataract d. Is associated with liver carcinoma e. Increases the risk of retinal detachment
  3. 3. 1. a.T b.T c.F d.F e.FGORLINS SYNDROME (BASAL CELL NAEVUS SYNDROME)•Rare, autosomal dominant and multisystem disorder•Characterised by multiple basal cell carcinoma, jaw cysts,b skeletal anomalies, ectopic calcification of the falx cerebri and pitting of the hand and feet•ocular features also include hypertelorism, lateral displacement of the medial canthi and prominent supraorbital ridges
  4. 4. 2. Posterior polymorphous dystrophy : a. Is present at birth b. Causes corectopia c. Is inherited in an autosomal recessive fashion d. Causes blindness in over 90% of sufferers e. Can be treated with lamellar corneal grafts
  5. 5. 2. a.T b.T c.F d.F e.F Posterior polymorphous dystrophy:•A bilateral dominantly inherited dystrophy•Vesicular polymorphous deposits with clear halos in Descemets membrane•Usually asymptomatic, rarely endothelium decompensation requiring penetrating corneal graft• The abnormal endothelium may extend into the trabecular meshwork and iris• Glaucoma can occur as a result of trabecular meshwork involvement iris involvement can lead to corectopia and ectopia simulating iridocorneal endothelial syndrome except that the later is unilateral
  6. 6. 3. Crystalline deposits in the conjunctiva may be found in: a. Amyloidosis b. Cystinosis c. Gold treatment d. Contact lens wear e. Uraemia
  7. 7. 3. a.T b.T c.T d.F e.T Crystalline deposits occurs with:•Myloidosis as in multiple myeloma•Cystinosis•Treatment with gold•Uric acid from uraemia
  8. 8. 4. The histology of pterygium includes: a. Myxoid degeneration b. Epithelial inclusion bodies c. Precancerous changes d. Squamous metaplasia of the epithleium e. Elastotic degeneration
  9. 9. 4. a.T b.F c.F d.F e.T Pterygium:•Fibrovascular overgrowth of the bulbar conjunctiva•The stroma shows basophilic degeneration (elastotic) of collagen•The epithelium is often thin but may show hyperplasia or dysplasia
  10. 10. 5. The following may be found in conjunctiva in keratoconjunctivitis sicca a. Dysplasia of the epithelium b. Keratinisation c. Eosinophils d. Numerous goblet cells e. Lymphocytic infiltrates
  11. 11. 5. a.T b.T c.F d.T e.T Keratoconjunctivitis sicca (dry eyes):•Causes dysplasia of the epithelium which may eventually become keratinize•The goblet cells may increase due to chronic irritation from dry eyes•In Sjogrens syndrome, there is lymphocytic infiltration of the lacrimal and accessory glands
  12. 12. 6. Merkel cell carcinoma: a. Is most common in the bulbar conjunctiva b. Is associated with good prognosis c. Is an APUD cell tumour d. Is associated with ultraviolet exposure e. Produces corneal pigmentation
  13. 13. 6. a.F b.F c.T d.F e.F Merkel cell carcinoma:•An aggressive primary tumour of the skin, arising from papillary dermis•Usually presents as a firm non-tender solitary skin nodule on the face and neck•Early metastasis through the lymphatic channels•Contains APUD (amine precursor and uptake decarboxylation) cells
  14. 14. 7. Histological changes in lens induced uveitis include: a. Ghost cells b. Giant cell reaction c. Amyloid in the cornea d. Vasculitis e. Non-caseating granuloma
  15. 15. 7. a.F b.T c.F d.F e.T Lens-induce uveitis: - three types•Phacoanalphylactic endophthalmitis •Severe granulomatous inflammation when the lens protein is exposed • Zonal granulomatous reaction surrounding the exposed lens material. The inflammation include neutrophils, epihtelioid cells, macrophages and giant cells•Phacotoxic uveitis •Nongranulomatous inflammation when the lens protein is exposed. •Non-specific inflammation with lymphocytes, macrophages and occasional giant cells•Phacolytic glaucoma •Occurs when the hypermature cataract leaks out protein • Macrophages laden with eosinophilic lens materials are seen in the anterior chamber and the trabecular meshwork
  16. 16. 8. Xeroderma pigmentosa is associated with: a. Intraouclar tumours b. Metabolic disorders c. Photosensitivity d. Autosomal recessive inheritance e. Squamous cell carcinoma
  17. 17. 8 a.F b.F c.T d.T e.T Xeroderma pigmentosa:•Inheritance is autosomal recessive•Marked sensitive of skin to sunlight•Malignant skin tumours including squamous cell tumour, basal cell carcinoma and fibrosacorma•Main defect is due to the inability of the cells to repair damaged DNA following ultraviolet exposure
  18. 18. 9. Pathological changes in thyroid ophthalmopathy includes: a. Lymphocytic infiltrates b. Giant cell reaction c. Mucopolysaccharides d. Fat cells e. Fibroblast proliferation
  19. 19. 9. a.T b.F c.T d.T e.T Pathology of thyroid ophthalmopathy:•There is enlargement and inflammation of orbital tissue especially the extraocular muscles•Histologically there is interstitial oedema and inflammatory cell infiltration (mainly lymphocytes, plasma cells and sometimes mast cells)•Thecondition tend to involve the nontendinous part of extraocular muscle• The endomysial fibroblasts produces mucopolysaccharide especially hyaluronic acid• The muscles are initially inflammed and at later stage undergoes fibrosis and shows fatty infiltrate
  20. 20. 10. In histological stains: a. Chlamydia inclusion bodies stain with Giemsa b. Osmium tetroxide is the stain used in electron microscopy c. Fungi stain with Fuelgins stain d. Eosin stains the nuclei blue e. Haematoxylin stains the nuclei pink
  21. 21. 10. a.T b.T c.T d.F e.F Histological staining:•Giemsa stain can demonstrate inclusion body such as Chlamydia• Osmium tetroxide is used to fix and stain myelin for electron microscopy•Yeast and fungi can be stained with Fuelgins stain, PAS, Luxol blue fast and Gomori methenamine silver• Eosin stains the cytoplasm pink whereas haematoxylin stains the nuclei blue
  22. 22. 11. Sympathetic ophthalmitis a. Is characterized by Dalen-Fuchs nodule b. Prevented by removal of the exciting eye within 6 weeks of injury c. Pigment laden macrophages are diagnostic d. Is associated with poliosis and vitiligo e. Is a common cause of visual loss in traumatic eye injury
  23. 23. 11. a.T b.F c.F d.T e.F Sympathetic ophthalmitis•A uncommon bilateral granulomatous panuveitis which occurs after penetrating ocular injury or intraocular surgery•The inflammation usually begins 4 to 8 weeks after the injury•Dellen-Fuchs nodules are seen at the level of Bruchs membrane and represent aggregates of epitheloid•Cells, it is not diagnostic as the nodules also occur in VKH syndrome•May have systemic manifestation identical to Vogt-Koyanagi-Harada syndrome with cerebrospinal fluid•Pleocytosis, miningismus, alopecia, vitiligo and poliosis•Prevention is only useful if the injured eye were removed within the first 2 weeks after injury
  24. 24. 12. Abnormal material which may be present in the vitreous include: a. Exfoliation b. Lipofuscin c. Haemosiderin d. Amyloidosis e. Calcium
  25. 25. 12. a.T b.F c.T d.T e.T Abnormal material in the vitreous include:•Pseudoexfoliation in pseudoexfoliation syndrome•Haemosiderin from vitreous haemorrhage•Amyloidosis in familial amyloidosis•Calcium in asteroid hyalosis
  26. 26. 13. In giant cell arteritis: a. Histological diagnosis is based on fragmentation of the internal intimal b. C-reactive protein is always raised c. Giant cell is needed for diagnosis d. Anterior cerebral artery is often involved e. Anaemia is a feature
  27. 27. 13. a.T b .T c.F d.F e.T Giant cell arteritis:•Disease of the elderly•Sudden, painless and profound visual loss•Female more susceptible than male•Head ache, low grade fever, anorexia, weight loss, tenderness upon brushing hair and jaw claudication•ESR and C-reactive proteins are always raised but not diagnostic of the condition•Diagnosis is base on biopsy which reveal fragmentation of the internal elastic lamina and giant cell infiltration of the tunica media of the artery. However, giant cells are not essential for diagnosis.
  28. 28. 14. The following conditions are pre- malignant: a. Oncocytoma of the caruncle b. Actinic keratosis c. Bowens disease d. Squamous papilloma e. Syringoma
  29. 29. 14. a.F b.T c.T d.F e.T The following conditions are pre-malignant:• Actinic keratosis is the result of metaplasia due to ultraviolet light•Bowens disease•Oncocytoma of the caruncle results from metaplasia of the accessory gland and is not thought to be pre- malignant•Squamous papilloma is benign hyperplasia of the skin•Syringoma is benign tumour of the sweat glands
  30. 30. 15. Hypoxic damage in diabetic mellitus is suggested by: a. Nerve fibre layers haemorrhage b. Iris neovascularisation c. Anterior uveitis d. Vascular loop e. Decreased hard exudate
  31. 31. 15. a.T b.T c.T d.T e.F Hypoxic damage in diabetic mellitus is suggested by:•Cotton-wool spots•Extensive IRMA•Vascular beading•Extensive retinal haemorrhages•Iris neovascularization
  32. 32. 16. The following biopsy report may be found with rheumatoid arthritis: a. Posterior scleritis b. Loss of goblet cells in the conjunctiva c. Episcleral necrotic tissue d. Giant cell reaction e. Vasculitis
  33. 33. 16. a.T b .F c.T d.F e.T Biopsy report in rheumatoid arthritis include•Posterior scleritis•Episcleral necrotic tissue•Vasculitis-The dry eye in rheumatoid arthritis is caused by aqueousdeficiency and not goblet cell dysfunction
  34. 34. 17. The following report is associated with increased mortality in an enucleated eye with retinoblastoma: a. Involvement of the optic nerve b. Presence of calcification within the tumours c. Necrosis within the tumours d. Exophytic retinoblastoma e. Presence of retinal detachment
  35. 35. 17. a.T b.F c.F d.F e.F The prognosis of retinoblastma is detemined by:•Evidence of external spread such as optic nerve involvement•Size of the tumours•Cell differentiation•Calcification and necrosis are common in retinoblastoma.
  36. 36. 18. Diabetic microangiopathy include: a. Endothelial vascular proliferation b. Proliferation of pericytes associated with microaneurysms c. Deposition of calcium in the intima d. Thickening of the basement membrane e. Necrosis of the endothelium
  37. 37. 18. a.F b.F c.F d.T e.F Microangiopathy in diabetes mellitus is characterised by:•Microvascular obstruction and non-perfusion of capillaries• Retinal capillary microaneurysms• Absent membrane thickening• Loss of pericytes• Intraretinal microvascular abnormality
  38. 38. 19. Optic nerve glioma: a. Is associated with neurofibromatosis type I b. Increased incidence after 30 years old c. Majority is of pilocytic astrocytoma d. Rarely infiltrate the perineural tissue e. Mortality of 40%
  39. 39. 19. a.T b.F c.T d.T e.F Optic nerve glioma:•Associated with type I neurofibromatosis•Most common type is pilocytic (hair-like) astrocytoma•The age of onset is usually before the age of 10•Low-grade and rarely infiltrate the perineural tissue•Reactive meningeal hyperplasia•Good long-term survival
  40. 40. 20. Mutton fat keratic precipitates are seen in: a. Uveal effusion syndrome b. Tuberculosis c. Fuchs heterochromia cyclitis d. Sarcoidosis e. Fungal infection
  41. 41. 20 a.F b.T c.F d.T e.T Mutton fat keratic precipitates:- occurs in chronic granulomatous uveitis and seen in•Tuberculosis•Fungal•Leprosy•Syphilis•Sarcoidosis•Juvenile xanthogranuloma•Histiocytosis X•Sympathetic ophthalmia•Vogt-Koyanagi-Harada syndrome•Toxoplasmosis
  42. 42. Thank you

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