2. 1. In B-Scan, ‘B’ stands for
A. Brightness
B. Brilliance
C. Blue
D. Bold
3. 2. What is the frequency of sound waves used in B-Scan ultrasonography?
A. 8 – 10 MHz
B. 18 – 20 MHz
C. 20 – 30 MHz
D. 2 – 5 MHz
4. 3. Which of the following statement is false?
A. B scan is a non-invasive examination tool
B. B scan is cost effective
C. B scan is used to diagnose corneal disorders
D. B scan uses a piezo electric crystal
5. 4. The sound wave velocity is the fastest through which of the following medium?
A. Silicone oil
B. Vitreous
C. Crystalline lens
D. Air
6. Sound wave velocities
Medium Velocity (m/sec)
Water 1480
Aqueous/ vitreous 1532
Soft tissue 1550
Cornea/ Crystalline lens 1641
Air 330
Silicone oil (1000cst) 987
7. 5. B scan can be used to diagnose all of the following conditions except?
A. Retinal detachment
B. Retinoblastoma
C. Vitreous haemorrhage
D. Macular edema
8. 6. A 60 years old male gives a history of left eye injury while working with hammer
and chisel. What does the B scan image given below show?
A. Retinal detachment
B. Intra ocular foreign body
C. Dislocated lens
D. Choroidal detachment
9. 7. A 50 years old female presented with complaints of right eye defective vision for
10 days. She gives a history of undergoing cataract surgery 1 week back. B scan can
be used in this situation to evaluate which of the following?
A. Dislocated IOL
B. Retinal detachment
C. Endophthalmitis
D. All of the above
10. 8. What type of B scan is shown in the below picture?
A. Axial
B. Transverse
C. Longitudinal
D. None of the above
11. 9. What is the direction of marker on probe in horizontal transverse scan?
A. Superior
B. Nasal
C. Inferior
D. Temporal
12.
13. 10. What type of scan is shown in the below picture?
A. Vertical transverse
B. Longitudinal scan
C. Horizontal transverse
D. Vertical axial
14. 11. A 60 years old male patient presents with defective vision in his left eye for 2
months. There is no redness or pain. There is no history of trauma. His B scan
image is shown below. Which of these tests you do next? (select all that apply)
A. RBS
B. BP
C. Both A and B
D. Blood culture
15. 12. Which of the following is not an indication for B scan?
A. Corneal opacity
B. Vitritis
C. Hyphema
D. CNVM
16. 13. A 70 years old male patient presents with mature cataract in his right eye.
Which of the following investigation would you do?
A. OCT
B. B scan
C. HFA
D. Color vision
17. 14. Identify the ocular structure marked (yellow arrow) in the image given below?
A. Macula
B. Optic nerve
C. Lens
D. Vitreous cavity
18. 15. A 50 years old female patient recently underwent a complicated cataract
surgery in her left eye. What is shown in the image below?
A. Retinal detachment
B. Dislocated IOL
C. Lens cortex drop
D. Choroidal detachment
19. 16. A 60 years old male patient came with complaints of defective vision in his right
eye for 3 months. The image give below is his B scan. What is the diagnosis?
A. Retinal detachment
B. PVD
C. Choroidal detachment
D. None of the above
20. Differentiation of PVD, RD and CD
TECHNIQUE PVD RD CD
Topographic Smooth, open
funnel with or
without disc or
fundus
insertion.
Smooth or
folded, open or
closed funnel
with disc
insertion.
Smooth, dome
or flat ; no disc
insertion.
Quantitative Variable spike
height.
Steeply rising
100% high
spike.
Steeply rising,
thick, double
peaked 100%
high spike.
Kinetic Marked to
moderate
Moderate to
none
Mild to none
21. 17. A 20 years old female patient came with complaints of defective vision in her
right eye for 15 days. She also gave history of redness and pain in her right eye.
What is the diagnosis?
A. Anterior uveitis
B. Posterior scleritis
C. Vitritis
D. All of the above
22. 18. A 55 years old male patient came with complaints of defective vision in his left
eye for 3 months. The B scan shows a mass lesion. What is the most probable
diagnosis?
A. Retinoblastoma
B. Choroidal melanoma
C. Choroidal osteoma
D. Retinocytoma
24. 19. A 30 years old male patient came with complaints of defective vision in his left
eye for 3 days. He suffered an injury to his right eye with a cricket ball 3 days back.
What is the diagnosis?
A. Dislocated IOL
B. Dislocated lens
C. Vitreous hemorrhage
D. Intraocular foreign body
25. 20. All are true regarding the choroidal osteoma depicted in the picture except?
A. High internal reflectivity
B. Poor sound attenuation
C. Smooth/ flat apperance
D. High reflectivity on A-scan
26. • The image shows choroidal osteoma. It has
1. High internal reflectivity
2. Strong sound attenuation
3. Smooth/ flat apperance
4. High reflectivity on A-scan
Editor's Notes
In B scan, B stands for brightness and in A scan, A stands for amplitude
The test examines the brightness of the echoes
B scan ultrasound uses frequency of 8-10 MHz
B scan is used to diagnose posterior segment pathologies
Sound waves travel the fastest through crystalline lens and cornea, slowest through air.
Slow in oil
Indication for B Scan
Macular edema is best diagnosed with Optical Coherence Tomography (OCT)
Injury with hammer and chisel should raise the suspicion of a penetrating injury, and the presence of an intra ocular foreign body should be ruled out.
This B scan shows a inferior highly reflective lesion with after shadow (?picture). Minimal vitreous hemorrhage is also present. There is no retinal detachment.
All of the above conditions can be evaluated with B scan ultrasound
Use of B Scan in post-op cataract cases
The above image is an axial scan. The patient fixates in primary gaze and probe is placed on the center of the cornea. Lens and optic nerve are displayed in the center of the echogram. (? Add picture of probe position)
The marker is kept facing the nasal aspect in horizontal transverse scan.
This is a longitudinal scan of 12’0 clock
The B scan image shows vitreous hemorrhage. We must test for diabetes mellitus and hypertension as VH is most likely to be secondary to PDR or RVO
B scan is helpful in patients with media haze in the form of corneal opacity, vitritis, hyphema, etc.
B Scan does not play a role in diagnosing Choroidal neovascular membrane (CNVM). This is best evaluated with OCT.
Mature cataracts will obstruct view of the posterior segment. Hence we do a B Scan to rule out any posterior segment pathology.
Optic nerve is echographically considered as an anatomic reference for the posterior fundus
reference
B scans shows characteristic T sign due to fluid collection in the posterior episcleral space and extending around the optic nerve.
