OPTHA1 Flashcards by Abby David

What is the blood supply of the optic nerve?

A. Central retinal artery
B. Choriocapillaries
C. Long posterior ciliary artery
D. Short posterior ciliary artery

A. Central retinal artery

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Main drainage of the orbit is

A. retinal vein
B. superior orbital vein
C. inferior orbital vein
D. cavernous sinus

B. superior orbital vein

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A 34-year-old female sought consult and was diagnosed with Bell’s palsy. Where is the lesion?

A. Oculomotor nerve
B. Trochlear nerve
C. Abducens nerve
D. Facial nerve

D. Facial nerve

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A 64-year-old male was diagnosed with Pancoast tumor. He has difficulty breathing with mitosis, ptosis, and loss of ciliospinal reflex. Which of the following innervation was disrupted?

A. Oculomotor nerve
B. Facial nerve
C. Parasympathetic nerve
D. Sympathetic nerve

D. Sympathetic nerve

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Anterior boundary of the orbit that prevents contiguous spread of infection into the orbital tissue

A. Orbicularis oculi
B. Orbital septum
C. Medial orbital wall
D. Superior orbital fissure

B. Orbital septum

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True of Asian eyes:

A. The insertion of levator into the orbicularis of the upper eyelid crease is less developed
B. Thinner fat pads
C. Tarsal plate tends to be shorter
D. Thicker eyelid skin

A. The insertion of levator into the orbicularis of the upper eyelid crease is less developed

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A 70/M came in due to complaints of foreign body sensation. On examination, the ophthalmologist diagnosed him with distichiasis. This means that he has:

A. misdirected eyelashes
B. an accessory row of eyelashes
C. downward drooping of upper eyelid
D. outward protrusion of lower lid

B. an accessory row of eyelashes

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Young boy with a 3-month history of painless upper eyelid lesion. This chronic inflammatory granulomatous lesion is most likely from?

A. Meibomian gland
B. Zeiss gland
C. Sweat gland
D. Wolfing’s gland

A. Meibomian gland

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A 55-year-old hypertensive female consulted at the ER because of doubling vision. On examination she has grade 2 ptosis and mydriasis on the left eye. The patient has:

A. facial palsy
B. peripheral neuritis
C. oculomotor palsy
D. sympathetic palsy

C. oculomotor palsy

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A. trachoma
B. mucopurulent conjunctivitis
C. atopic conjunctivitis
D. vernal keratoconjunctivitis

D. vernal keratoconjunctivitis

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A. Trachoma
B. Staphylococcal conjunctivitis
C. Adenoviral conjunctivitis
D. Phlyctenular conjunctivitis

C. Adenoviral conjunctivitis

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A female patient, 18 years old, who has been a contact lens wearer for two years, is complaining of redness, lacrimation, and foreign body sensation on both eyes. On examination, visual acuity was 6/6 with negative fluorescent test. The expected diagnosis can be:

A. acute anterior uveitis
B. giant papillary conjunctivitis
C. bacterial keratitis
D. acute congestive glaucoma

B. giant papillary conjunctivitis

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It is the second most common ocular adnexal tumor and generally manifests as a salmon-pink patch on the fornix of the eye:

A. MALT lymphoma
B. HPV carcinoma
C. Melanoma
D. Papilloma

A. MALT lymphoma

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HPV strains that cause squamous cell carcinoma

A. HPV 6 & 11
B. HPV 16 & 18
C. HPV 6 & 18
D. HPV 11 & 16

B. HPV 16 & 18

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A 58-year-old female came in… It shows a pinkish, triangular tissue growth on the cornea of the eye.

A. Lymphoma
B. Pinguecula
C. Pterygium
D. Conjunctival cyst

C. Pterygium

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What is your advice for the patient above?

A. Observe
B. Topical steroids
C. Conjunctival excision with conjunctival autograft
D. Wide excision and topical chemotherapy

C. Conjunctival excision with conjunctival autograft

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A 55-year-old female on NSAIDs for years due to back pain sought consult for unilateral pain in the eye. Episcleral vessels were engorged and sclera was inflamed with a small bump. What laboratory test will you order to confirm the diagnosis?

A. CBC
B. ESR
C. Rheumatic factor
D. CXR

C. Rheumatic factor

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Constitutes the posterior lamella of the lid

A. Skin and orbicularis
B. Tarsal plate and conjunctiva
C. Fat and skin
D. Fat and orbicularis

B. Tarsal plate and conjunctiva

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An imaginary ring around the limbus where rectus muscle insert

A. Scleral ring
B. Spiral of Tillaux
C. Orbital apex
D. Orbital rim

B. Spiral of Tillaux

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A condition in which the eyelid is inverted

A. Ectropion
B. Entropion
C. Epiblepharon
D. Blepharon

B. Entropion

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A 5-year-old child was brought to you because of marked lid edema, and erythema of the right upper lid. On palpation, you noted tenderness and fluctuance. The child has low-grade fever. CBC results show a mild leukocytosis. VA and ocular motility were normal. The patient probably has

A. orbital cellulitis
B. preseptal cellulitis
C. external hordeolum
D. cavernous sinus thrombosis

B. preseptal cellulitis

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A fibrous membrane that envelopes the globe from the limbus to the optic nerve

A. Episclera
B. Conjunctiva
C. Tenon’s capsule
D. Sclera

C. Tenon’s capsule

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Layer of the cornea that usually sheds off in a patient with recurrent corneal erosion

A. Epithelium
B. Endothelium
C. Descemet’s membrane
D. Stroma

A. Epithelium

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A 25 yo male went for consult due to red painful left eye. Dye tests shows branching of epithelial dendrites. What is the etiology?

A. Adenovirus 18, 29
B. Fungi
C. Herpes simplex
D. Gonococcal

C. Herpes simplex

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An 80 yo man has a painful lesion on the side of his nose. This raises the suspicion of involvement with a nerve that supplies the cornea is A. maxillary branch of the trigeminal nerve B. lacrimal nerve C. frontal nerve D. nasociliary branch of the trigeminal nerve

D. nasociliary branch of the trigeminal nerve

The external stye is due to A. granulomatous inflammation of the Meibomian glands B. suppurating glands of Zeiss at the base of the eyelashes C. viral infection of the lacrimal glands D. corneal abscess

B. suppurating glands of Zeiss at the base of the eyelashes

The primary retractor of the upper eyelid is the A. orbicularis oculi B. superior rectus C. levator muscle D. procerus

C. levator muscle

A patient presents in your office with a painless, slowly enlarging bump on the eyelid. What is the treatment? A. Topical antibiotic B. Oral antibiotic C. Send to ophthalmologist ASAP D. Warm compress

D. Warm compress

A young man was brought at the ER after a brawling spree. He has multiple facial hematomas and complained of blurring of vision after he was punched in the face. What is the most common site of perforation after a blunt trauma? A. Near the… B. Corneal limbus C. Corneal apex D. Near the insertion of the rectus muscle

D. Near the insertion of the rectus muscle

Part of the uveal tract of the eye A. Cornea B. Sclera C. Choroid D. Retina

C. Choroid

A 21 yo female shows up in your clinic with profuse purulent discharge from both eyes. Cytology reveals the presence of gram-negative cocci in pairs. The treatment of choice is A. Fortified vancomycin eye drops B. Tobramycin 80 mg IV C. Ceftriaxone 1000 mg IM injection D. Amphotericin B ointment ring

C. Ceftriaxone 1000 mg IM injection

This law says innervation to the yoke muscles are all equal A. Hering’s law B. Listing’s law C. Sherrington’s law

A. Hering’s law

An 82-year-old underwent removal of brunescent cataract on the right eye. After 1 week, he developed severe eye pain, redness, tearing, and loss of vision. He was diagnosed with bullous keratopathy leading to corneal decompensation. What is the most likely explanation for this complication? A. The epithelium of cornea is eroded due to lack of hemidesmosomes B. The Bowman’s layer is transected during cataract surgery C. There is a significant water retention in the corneal stroma D. The endothelial layer is depleted and aggravated during surgery

D. The endothelial layer is depleted and aggravated during surgery

A 2-year-old male diagnosed with retinoblastoma. He was advised to undergo enucleation. This surgical procedure means A. Removal of intraocular contents of the eye B. Removal of the retina C. Removal of the entire globe of the eye D. Removal of the orbital contents of the eye

C. Removal of the entire globe of the eye

This allows the examiner to estimate the intraocular pressure of the patient’s eye A. Confrontation test B. Digital tonometry C. Corneal reflex test D. Swinging flashlight test

B. Digital tonometry

A condition wherein the pupils constrict when an object is brought closer to the eye but don’t react to bright light A. Light-near dissociation B. Marcus Gunn pupil C. RAPD

A. Light-near dissociation

The term used for pupils that are either abnormally small or abnormally large A. Aniseikonia B. Anisocytosis C. Anisocoria D. Anisometropia

C. Anisocoria

What would be your advice for this patient? A. Observe B. Put topical antiglaucoma medications C. Evisceration D. Penetrating keratoplasty

D. Penetrating keratoplasty

A 50-year-old female was diagnosed with lung cancer stage IV and has been on chemotherapy for 6 months and was admitted at the ICU for monitoring. She was then referred to you for right eye redness and pain. What is the likely diagnosis? A. Bacterial keratitis B. Endogenous endophthalmitis C. Exogenous endophthalmitis

B. Endogenous endophthalmitis

This finding gives you an idea that the patient has an error of refraction A. Visual acuity is 20/20 in both eyes B. Visual acuity is better when the patient wears his glasses than without it C. Visual acuity is the same after pinhole test D. Visual acuity is better after controlling blood sugar

B. Visual acuity is better when the patient wears his glasses than without it

This unique instrument permits 3D visualization and measurements of the fine anatomy of the adnex and anterior segment of the eye A. Ophthalmoscope B. Retinoscope C. Slit-lamp biomicroscope D. Telescope

C. Slit-lamp biomicroscope

This term visualizes the posterior segment (vitreous cavity, choroid, optic nerve, blood vessels, retina) wherein a head gear is used along with the condensing lens directed at the patient’s eye A. Direct ophthalmoscopy B. Indirect ophthalmoscopy C. Retinoscopy D. Slit-lamp biomicroscopy

B. Indirect ophthalmoscopy

What replicative phenomenon that is seen when light passes through the pupil from anterior to posterior is replicated back off with a glow? A. Corneal light reflex B. Entropic phenomenon C. Pupillary light reflex D. Red-orange reflex

D. Red-orange reflex

Mr. Grey complained of blurring of vision. He went to an ophthalmologist to have a check-up and result was 20/70 right eye, 20/200 left eye. What is the diagnosis? A. Legal blindness B. Low vision C. Error of refraction D. Presbyopia

B. Low vision

Primary gaze A. Confrontation B. Cover-uncover test C. Hirschberg test D. Swinging flashlight test

C. Hirschberg test

The range of normal eye pressure A. 7-19 mmHg B. 10-21 mmHg C. 13-24 mmHg D. 15-26 mmHg

B. 10-21 mmHg

A routine eye exam can detect a brain tumor. A. True B. False

A. True

Distichiasis is: A. Outward protrusion of lower lid B. Misdirected eyelashes R C. Downward drooping of upper lid D. Accessory row of eyelashes

D. Accessory row of eyelashes

In most cases of eye trauma, not all eye exams are performed. Which of the following tests indicate a surgical emergency? A. Ruptured globe with no light perception B. Blunt eye trauma with vitreous hemorrhage C. Hyphemia with increased intraocular pressure D. Cranial nerve III palsy with pupil dilation

D. Cranial nerve III palsy with pupil dilation

The cranial nerve being tested in visual acuity and confrontational testing A. CN I B. CN II C. CN III D. CN IV

B. CN II

A condition where one or both eyes are displaced anterior to the orbital rim due to thyroid eye disease A. Buphthalmos B. Enophthalmos C. Exophthalmos D. Proptosis

C. Exophthalmos

Injury to the facial nerve can result in ipsilateral: A. Lower lid ectropion B. Drooping of the cheek C. Eyebrow ptosis D. Exposure keratitis

B. Drooping of the cheek

Structures that pass through the optic canal except: A. Ophthalmic artery B. Ophthalmic vein C. Optic nerve D. Sympathetic nerves

B. Ophthalmic vein

The following are characteristics of the Direct Ophthalmoscope EXCEPT: A. Provides a larger image than the indirect ophthalmoscope B. Provides an upright image of the retina C. It gives the examiner a better view of the peripheral retinal structures. D. None of the above

C. It gives the examiner a better view of the peripheral retinal structures.

In visual acuity determination, a patient can only detect light projection. How do you record a finding if he/she is able to identify light source from 2-3 quadrants? A. Poor LPj B. Fair LPj C. Good LPj D. NLP

B. Fair LPj

An imaginary ring around the limbus where rectus muscle insert. A. Scleral ring B. Spiral of tillaux C. Orbital apex D. Orbital rim

B. Spiral of tillaux

Which nerve is affected in a patient who presents with miosis, ptosis and loss of ciliospinal reflex? A. Oculomotor nerve B. Facial nerve C. Parasympathetic nerves D. Sympathetic nerves

D. Sympathetic nerves

True of Asian eyes. A. The skin tends to be thinner than Caucasians. B. The insertion of the levator into the orbicularis of the upper lid crease is less developed. C. Thinner fat pads D. Tarsal plate tends to be larger

B. The insertion of the levator into the orbicularis of the upper lid crease is less developed.

A 22 y/o male encountered a vehicular accident and sustained multiple injuries. He came to the ER with a red painful frozen right eye. What is the first step to do as a medical student? A. Check for vision. B. Check for pupillary reaction. C. Do an orbital X-ray. D. Patch the eye.

B. Check for pupillary reaction.

Anterior boundary of the orbit that prevents contiguous spread of infection into the orbital tissue. A. Orbicularis oculi B. Orbital septum C. Medial orbital wall D. Superior orbital fissure

B. Orbital septum

Layer of the cornea that usually sheds off in a patient with recurrent corneal erosion. A. Epithelium B. Endothelium C. Descemet’s membrane D. Stroma

A. Epithelium

A 65 female came in with a 3-month history of headache and diplopia of the left eye. On physical examination there seems to be limitation on all gazes in the left eye, decreased corneal sensation, ptosis, proptosis and chemosis. CT scan was done and revealed a cranial mass on the left side of the brain. The patient probably has defect in the: A. Inferior orbital fissure B. Superior orbital fissure C. Orbital apex D. Cavernous sinus

B. Superior orbital fissure

Management of the pterygium except: A. Topical steroid B. Bare sclera excision C. Conjunctival excision with conjunctival autograft D. Conjunctival excision with Mitomycin C

A. Topical steroid

Blood supply of the optic nerve. A. Orbital artery B. Central retinal artery C. Short ciliary artery D. Long ciliary artery

B. Central retinal artery

The eye of the same patient seemed to have a loss of volume. There's no X-ray available in hand, which orbital bone is most likely fractured? A. Ethmoid bone B. Maxillary bone C. Lacrimal bone D. Frontal bone

B. Maxillary bone

A 55-year-old female sought consult for unilateral painful red eye. On examination, the episcleral vessels were engorged and the sclera was inflamed with a small bump. What laboratory test will you order to confirm the diagnosis? A. CBC B. ESR C. Rheumatoid Factor D. CXR

C. Rheumatoid Factor

All extraocular muscles originate from the orbital apex except: A. Inferior rectus B. Superior rectus C. Inferior oblique D. Superior oblique

C. Inferior oblique

A 6-month-old girl has a rapidly enlarging medial upper lid mass. The mass is strawberry like in appearance. The mass enlarges when the baby cries. It does not obscure the visual axis. The most probably diagnosis is: A. Capillary hemangioma B. Dermoid C. Lymphangioma D. Nevus flammeus

A. Capillary hemangioma

Complication of doing a DCR. A. Hemorrhage B. Fractured orbital wall C. CSF leak D. Infection

A. Hemorrhage

A 60-year-old female came in with an anterior neck mass and bulging eyes. On examination, the vision was 20/40, no RAPD, lid is retracted, the conjunctiva is hyperemic, cork-screwing of the vessels was present. The most likely etiology is: A. Thyroid eye disease B. Lacrimal gland tumor C. Carotid-cavernous fistula D. Cavernous sinus thrombosis

C. Carotid-cavernous fistula

It is the second most common ocular adnexal tumor and generally manifests as a salmon-pink patch on the fornix of the eye. A. MALT Lymphoma B. HPV carcinoma C. Melanoma D. Papilloma

A. MALT Lymphoma

A 21y.o, female shows up in your clinic with profuse purulent discharge from both eyes. Cytology reveals the presence of gram-negative cocci in pairs. The treatment of choice is: A. Fortified vancomycin eyedrops B. Tobramycin 80 mg IV 78 C. Ceftriaxone 1000mg IM injection D. Amphotericin B ointment

C. Ceftriaxone 1000mg IM injection

What muscles are responsible for right gaze? A. Right superior rectus and left inferior rectus B. Right inferior rectus and left superior oblique C. Left lateral rectus and right medial rectus D. Right lateral rectus and left medial rectus

D. Right lateral rectus and left medial rectus

A tumor in the lacrimal gland is best removed through which bony wall? A. Frontal bone B. Lacrimal bone C. Ethmoid bone D. Maxillary bone

A. Frontal bone

Viral etiology of epidemic keratoconjunctivitis. A. Adenovirus 18, 29 B. Adenovirus 8, 19 C. Herpes virus D. Enterovirus

B. Adenovirus 8, 19

A 5-year-old child was brought to you because of marked lid edema, erythema of the right upper lid. On palpation, you noted tenderness and fluctuance. The child has low grade fever. CBC results show a mild leukocytosis. VA and ocular motility were normal. This patient probably has: A. Orbital cellulitis B. Preseptal cellulitis C. External hordeolum D. Cavernous sinus thrombosis

B. Preseptal cellulitis

Main drainage of the orbit is: A. Retinal vein B. Superior orbital vein C. Inferior orbital vein D. Cavernous sinus

B. Superior orbital vein

Chalazion is a chronic inflammatory granuloma of: A. Meibomian gland B. Zeiss gland C. Sweat gland D. Wolfring's gland

A. Meibomian gland

Bell's palsy is a lesion in the: A. Oculomotor nerve B. Trochlear nerve C. Abducens nerve D. Facial nerve

D. Facial nerve

Distichiasis is: A. Misdirected eyelashes B. Accessory row of eyelashes C. Downward drooping of upper lid D. Outward protrusion of lower lid

B. Accessory row of eyelashes

If a patient's visual acuity is 6/30, this would mean that the person can read: A. At 6 feet what a normal person sees at 30 feet B. At 20 meters what a normal person sees at 6 meters C. At 30 feet what a normal person sees at 6 feet D. At 6 meters what a normal person sees at 30 meters

D. At 6 meters what a normal person sees at 30 meters

The patient in this picture is looking to her left. She has a problem of the: A. Right medial rectus B. Left medial rectus C. Right lateral rectus D. Left lateral rectus

D. Left lateral rectus

What is the ophthalmologic term for anterior protrusion/ displacement of the eye? A. Strabismus B. Exotropia C. Proptosis D. Esotropia

C. Proptosis

When the extraocular movement is tested with both eyes open, this is referred as: A. Duction test B. Version test C. Visual acuity examination D. IOP determination

B. Version test

The roof of the orbit is composed of the following: A. Greater wing of the sphenoid and frontal bone B. Lesser wing of the sphenoid and zygomatic bone C. Lesser wing of the sphenoid and frontal bone D. Greater wing of the sphenoid and zygomatic bone

C. Lesser wing of the sphenoid and frontal bone

It is a pinkish, triangular tissue growth on the cornea of the eye. A. Lymphoma B. Pinguecula C. Pterygium D. Conjunctival cyst

C. Pterygium

Shortest wall of the orbit. A. Roof B. Lateral wall C. Medial wall D. Floor

D. Floor

Proptosis is present in the following condition except: A. Horner's syndrome B. Orbital cellulitis C. Thyroid ophthalmopathy D. Cavernous sinus thrombosis

A. Horner's syndrome

A recurrent bilateral conjunctivitis occurring with the onset of hot weather in young boys with symptoms of blurring, itching, and lacrimation with large flat topped cobble stone papillae raised areas in the palpebral conjunctiva is: A. Trachoma B. Mucopurulent conjunctivitis C. Atopic conjunctivitis D. Vernal keratoconjunctivitis

D. Vernal keratoconjunctivitis

A patient's left eye constricts upon shining your penlight directly on it. However, when you swing the penlight to the right eye, the right eye dilates. These findings indicates that the patient has: A. Functioning left and right optic nerves B. Intact right oculomotor nerve C. Presence of Relative Afferent Pupillary Defect (RAPD) of the right eye D. None of the above

C. Presence of Relative Afferent Pupillary Defect (RAPD) of the right eye

When the extraocular movement is tested one eye at a time, this referred as: A. Duction test B. Version test C. Visual acuity examination D. IOP determination

A. Duction test

A fibrous membrane that envelopes the globe from the limbus to the optic nerve is: A. Episclera B. Conjunctiva C. Tenon's capsule D. Sclera

C. Tenon's capsule

A young child suffering from fever and sore throat began to complain of lacrimation. On examination, follicles were found in the palpebral conjunctiva with tender preauricular lymph nodes. The most probable diagnosis is: A. Trachoma B. Staphylococcal conjunctivitis C. Adenoviral conjunctivitis D. Phlyctenular conjunctivitis

C. Adenoviral conjunctivitis

80% of the tears drain into the: A. Upper punctum B. Lower punctum C. Upper canaliculus D. Lower canaliculus

B. Lower punctum

A 2-month-old infant was brought to you with a small patch of strawberry growth in upper eye lid. The mass doesn't obstruct the visual axis of the patient. What is appropriate management? A. Observe B. Start topical corticosteroid C. Start propranolol D. Start systemic corticosteroid

A. Observe

A female patient 18 years old, who is a contact lens wearer since two years, is complaining of redness, lacrimation, and foreign body sensation on both eyes. On examination, visual acuity was 6/6 with negative fluorescein test. The expected diagnosis can be: A. Acute anterior uveitis B. Giant papillary conjunctivitis C. Bacterial keratitis D. Acute congestive glaucoma

B. Giant papillary conjunctivitis

Which artery supplies the choroidal layer of the eye? A. Central retinal artery B. Choriocapillaris C. Long posterior ciliary artery D. Short posterior ciliary artery

D. Short posterior ciliary artery

Ptosis and mydriasis are seen in: A. Facial palsy B. Peripheral neuritis C. Oculomotor palsy D. Sympathetic palsy

C. Oculomotor palsy

A form of an anterior decompensation of the orbit is: A. Enophthalmos B. Proptosis C. Cellulitis D. Endophthalmitis

B. Proptosis

HPV strains that cause squamous cell carcinoma. A. HPV 6 &11 B. HPV 16 & 18 C. HPV 6 & 18 D. HPV 11 & 16

B. HPV 16 & 18

On fundoscopy, these were the disc findings. What is the estimated CD ratio of the right eye? A. 0.9 B. 0.5 C. 0.3 D. 1.0

B. 0.5

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OPTHA1 Flashcards

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