QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: Sunflower cataract is associated with: September 2011
Options:
A. Chalcosis
B. Juvenile diabetes mellitus
C. Down syndrome
D. Trauma

Rationale: Ans. A: Chalcosis Sunflower cataract is associated with deposition of copper Chalcosis lentis/ Copper cataract/ Sunflower cataract A cataract caused by excessive intraocular copper. May be due to intraocular, copper containing foreign bodies Copper deposits in Descemet membrane, vitreous, internal limiting membrane of the retina, and fibrous capsule around the foreign bodies could be demonstrated by rhodanine, rubeanic acid, and alizarin blue stains Eyes with foreign bodies containing more than 85% copper tended to show more disseminated copper deposits. Eyes with alloy containing less than 85% copper showed more localized deposits of copper.

Answer: OPTION A IS CORRECT.
Question: Maximum refractive power is due to the
Options:
A. Anterior surface of lens
B. Posterior surface of lens
C. Anterior surface of cornea
D. Posterior surface of cornea

Rationale: Ans. Anterior surface of cornea

Answer: OPTION C IS CORRECT.
Question: A lady wants LASIK surgery for her daughter. She asks for your opinion. All the following things are suitable for performing LASIK surgery except:
Options:
A. Myopia of 4 Diopters
B. Age of 15 years
C. Stable refraction for 1 year
D. Corneal thickness of 600 microns

Rationale: B i.e. Age of 15 years LASIK is done in non progressive myopia i.e. the patient > 18 years and refraction stable for 18 months.Q It can correct 4 D of hypermetropia, 5 D of astigmatism and 12 D of myopia.

Answer: OPTION B IS CORRECT.
Question: Oval cells are seen in the stem cells of
Options:
A. Skin
B. Cornea
C. Liver
D. Bone

Answer: OPTION C IS CORRECT.
Question: Which of the following is wrong regarding ophthalmic aery
Options:
A. Present in dura along with optic nerve
B. Supplies anterior ethmoidal sinus
C. Aery to retina is end aery
D. Leaves orbit through inferior orbital fissure

Rationale: Ans. is 'd' i.e., Leaves orbit through inferior orbital fissure Ophthalmic aery does not leave the orbit. It terminates near the medial angle of eye by dividing into supratrochlear and dorsal nasal branches.It lies along with optic nerve in a common dural sheath.It supplies anterior ethmoidal sinus by its anterior ethmoidal branch.Central aery to retina (branch of ophthalmic aery) is an end aery.

Answer: OPTION D IS CORRECT.
Question: All of the following statements are true about Juxtafoveal Retinal Telangiectasias, Except -
Options:
A. Variant of Coat's disease
B. Associated with telangiectasias in the macula
C. Associated with structurally abnormal Retinal Vessels
D. Associated with peripheral telangiectasias

Rationale: Idiopathic juxtafoveal telangiectasia type II (aka macular telangiectasia) is a rare idiopathic condition that is characterized by telangiectatic vessels in the juxtafoveolar region, most commonly temporal to the fovea, of both eyes. ... OCT will show subfoveal cystoid spaces without cystoid macular edema. Ref AK khurana 6/e

Answer: OPTION D IS CORRECT.
Question: An infant present with bilateral white pupillary reflex. On slit lamp examination a zone of opacity is observed arround the fetal nucleus with spoke like radial opacities. The most likely diagnosis is-
Options:
A. Cataracta Centralis Pulverulenta
B. Lamellar cataract
C. Coronary cataract
D. Posterior polar cataract

Rationale: lamellar cataract - opacities in the foetal nucleus and which are small linear like spokes of a wheel towards the equator. Cataracta centralis pulverulenta - small rounded opacity lying exactly in the centre of the lens. Coronary cataract - opacities are often many hundreds in number and have a regular radial distribution in the periphery of lens encircling the central axis. posterior polar cataract - small circular circumscribed opacity involving the posterior pole.

Answer: OPTION B IS CORRECT.
Question: The following is not a feature of pierre - Robin syndrome -
Options:
A. Hearing defect
B. Coloboma Iris
C. Respiratory distress
D. Mandibular hypoplasia

Rationale: Ans. is 'b' i.e., Cloboma iris Pierre Robin syndrome consists of - Micrognatnia Fore shoened floor of mouth CHDs Cleft palate or high arched palate Mandibular hypoplasia (Micrognathia) Respiratory obstruction Normal size tongue

Answer: OPTION B IS CORRECT.
Question: Cat eye syndrome is:
Options:
A. Trisomy 13
B. Trisomy 18
C. Trisomy 21
D. Trisomy 22

Rationale: Cat eye syndrome Defect in chromosome number 22 sho arm (p) and a small section of the long arm (q) of chromosome 22 is present 3-4 times instead of the usual 2 times. C/F: Unilateral/bilateral iris coloboma Anal atresia Cleft palate Sho stature Hernias Renal abnormalities

Answer: OPTION D IS CORRECT.
Question: Radiographic studies of a 2 year old child brought to an emergency room reveal a new fracture of the humerus and evidence of multiple old fractures in ribs and long bones of the extremities. A social worker wants to initiate prosecution of the parents for child abuse, but an ale emergency room physician notices that, despite the broken arm, the toddler shows minimal bruising. A very careful, directed, physical examination reveals that the toddler has "peculiar teeth," a blue tinge to the sclera, and unusually mobile joints. The disease that the physician suspects the child has is characterized by an abnormality of which of the following biochemical functions?
Options:
A. Collagen type I synthesis
B. Collagen type II synthesis
C. Collagen type III synthesis
D. Collagen type IV synthesis

Rationale: The child has the most common variant (type I) of osteogenesis imperfecta, which is an autosomal dominant genetic defect in the synthesis of type I collagen, due to decreased synthesis of the procollagen alpha1(1) amino acid chain. This defect (unlike that of the perinatal, lethal, type II form of osteogenesis imperfecta) is compatible with survival, but does cause skeletal fragility, dentinogenesis imperfecta (abnormal teeth), blue sclera, joint laxity, and hearing impairment. Unfounately, a number of families with this defect have had their children removed because of "abuse," only to find that the broken bones continue in the new environment. Type I collagen is found in skin, bone, tendons, and most other organs. Type II collagen is found in cailage and vitreous humor. Type III collagen is found in blood vessels, uterus, and skin. Type IV collagen makes basement membranes. Ref: Barbul A., Efron D.T. (2010). Chapter 9. Wound Healing. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.

Answer: OPTION A IS CORRECT.
Question: Relative contraindication of ECT is -
Options:
A. Raised Intra-Cranial Tension
B. Vascular Dementia
C. Diabetic Retinopathy
D. Peripheral Neuropathy

Rationale: Ans. is A Cerleti and Bini discovered electro convulsive therapy (ECT) Unilateral ECT is safer than the bilateral ECT, but the bilateral ECT is superior to unilateral ECT in effectiveness. Direct ECT is given in absence of muscle relaxant and G.A. and is only rarely used. Modified ECT is given with drug (suxamethonium) induced muscle relaxation and anaesthesia (thiopentone sodium). Indication of ECT Major severe depression With suicidal risk (first and most important indication for ECT) With stupor With poor intake of and food Severe catatonia (functional) With stupor With poor intake of fluid and food Severe psychosis (schizophrenia or mania) With risk of suicide, homicide or danger of physical assault Organic mental disorders Medical Disorders Organic catatonia Hypopituitarism Intractable seizure disorder Neuroleptic malignant syndrome Parkinsonism Some other indications of ECT Acute schizophrenic episode Postpartum psychosis Mania in I st trimester pregnancy Delirium tremens Bipolar mood disorder Depressive stupor Contraindications of ECT Absolute contraindication * None Relative contraindications a. Raised intracranial tension b. Recent myocardial infarction c. Cerebrovascular accident (CVA) Pregnancy and epilepsy are not contra indication of ECT Side effects of ECT Headache, bodyache and vomiting Confusion Amnesia (anterograde and retrograde both) Death (due to ECT is because of myocardial infarction).

Answer: OPTION A IS CORRECT.
Question: A patient has IDDM diagnosed at age of 15 years. The most reliable indicator for diabetic nephropathy is -
Options:
A. Urine albumin <50 mg per day in 3 consecutive samples
B. Urinary protein >550 mg per day for 3 consecutive samples
C. Development of diabetic retinopathy
D. Hematuria

Answer: OPTION B IS CORRECT.
Question: Polychromatic lusture is seen in-
Options:
A. Complicated cataract
B. Diabetes mellitus
C. Post radiation cataract
D. Congenital cataract

Rationale: In complicated cataract 'polychromatic luster'ie., appearance of iridescent coloured paicles of reds, greens and blue is a very characteristic sign (Rainbow cataract). IMG REF

Answer: OPTION A IS CORRECT.
Question: Hallpike test is done for -
Options:
A. Vestibular function
B. Corneal test
C. Cochlear function
D. Audiometry

Answer: OPTION A IS CORRECT.
Question: A patient had a road traffic accident and was put on mechanical ventilation. He is opening his eyes on verbal command and is able to move all his 4 limbs spontaneously. What will be his GCS score?
Options:
A. 12
B. 11
C. 9
D. 10

Rationale: Ans. D. 10Ideally it should have been 9NT according to the new update but this question was based on the old concept of verbal score being considered as one in an intubated patient. So the answer would be 9T or 10.

Answer: OPTION D IS CORRECT.
Question: Increased LDH in Aqueous Humor suggest a diagnosis of-
Options:
A. Galactosemia
B. Retinoblastoma
C. Glaucoma
D. Gyrate atrophy

Rationale: *LDH of aqueous humor is often used as a marker for retinoblastoma. Ref: Khurana 7th/e p.314.

Answer: OPTION B IS CORRECT.
Question: Lesion at which pa of visual pathway causes homonymous hemianopia?
Options:
A. Optic tract
B. Optic nerve
C. Optic Chiasma
D. Retina

Rationale: A left homonymous hemianopsia can be caused by a lesion in the right optic tract or the right side of the brain. With a tract lesion, the pupillary reflex is lost if light is only projected from the blind hemifield; the pupil reacts when the lesion is posterior to the geniculate body in the optic radiations or occipital lobe. Transient homonymous hemianopsia may occur with migraine. Ref: LeBlond R.F., DeGowin R.L., Brown D.D. (2009). Chapter 7. The Head and Neck. In R.F. LeBlond, R.L. DeGowin, D.D. Brown (Eds), DeGowin's Diagnostic Examination, 9e.

Answer: OPTION A IS CORRECT.
Question: A 25 year old female presents with a 12 month history of palpitations, intermittent diarrhea, anxiety, and a 1-month history of "bulging of both eyes." What is the most likely cause of her symptoms?
Options:
A. Graves' disease
B. Hashimoto's thyroiditis
C. Multinodular toxic goiter
D. Papillary carcinoma

Rationale: Graves' disease is the most common cause of hypehyroidism in a young female and is the only one that causes exophthalmos ("bulging of both eyes"). Grave's disease is an autoimmune disorder in which a thyroid-stimulating IgG immunoglobulin (TSI) binds to the TSH receptors causing increased release of thyroid hormone. The exophthalmos is caused by lymphocytic infiltration of the extraocular muscles. Hashimoto's thyroiditis results in hypothyroidism and is associated with a diffusely enlarged thyroid gland and antimicrosomal antibodies against the thyroid parenchyma. Multinodular toxic goiter causes hypehyroidism, but does not result in exophthalmos. Papillary carcinoma will only very rarely present as a hypersecreting nodule. Most cases will be nonsecreting, cold nodules. There is no exophthalmos. This is the most common thyroid cancer and has the best prognosis of all thyroid cancers. Ref: Cooper D.S., Ladenson P.W. (2011). Chapter 7. The Thyroid Gland. In D.G. Gardner, D. Shoback (Eds), Greenspan's Basic & Clinical Endocrinology, 9e.

Answer: OPTION A IS CORRECT.
Question: Homonymus hemianopia may be seen in lesion of all of the following, except:
Options:
A. Optic nerve
B. Optic chiasma
C. Optic tract
D. Optic radiation

Rationale: Optic nerve

Answer: OPTION A IS CORRECT.
Question: Ionic pump in corneal endothelium is necessary for maintaining deturgescence of the cornea and thus transparency. It can be blocked by:
Options:
A. Inhibition of anaerobic glycolysis
B. Activation of anaerobic glycolysis
C. Inhibition of Kreb's cycle
D. Inhibition of HMP pathway

Rationale: Ans. Inhibition of anaerobic glycolysis

Answer: OPTION A IS CORRECT.
Question: Wernicke&;s hemianopic pupillary reaction indicates lesions at the level of
Options:
A. Distal pa of optic nerve
B. Optic tract
C. Optic chiasma
D. Optic radiation

Rationale: Lesions of optic tract: These are characterised by incongruous homonymous hemianopia associated with contralateral hemianopic pupillary reaction (Wernicke's reaction). These lesions usually lead to paial descending optic atrophy and may be associated with contralateral third nerve paralysis and ipsilateral hemiplegia. Common causes of optic tract lesions: Include syphilitic meningitis or gumma, tuberculosis and tumours of optic thalamus and aneurysms of superior cerebellar or posterior cerebral aeries. Ref:- A K KHURANA; pg num:-290

Answer: OPTION B IS CORRECT.
Question: Late onset endophthalmitis after cataract surgery is caused by?
Options:
A. Staphylococcus
B. Candida
C. Bacillus cereus
D. Propionibacterium acnes

Rationale: Ans. is 'd' i.e., Propionibacterium acnes * Organisms depends upon the type of endophthalmitis A) Exogenous endophthalmitis 1) Post - operative i) Acute post - operative (within 1-7 days after surgery) :- S. epidermidis, S.aureus, Streptococcus, Gram negative bacilli. ii) Delayed onset (a week to months after surgery);- Fungi (Most common), Propionibacterium acne (2nd most common). 2) PosttraumaticBacillus, S.epidermidis, fungi, streptococcus spp. B) Endogenous endophthalmitis .--Bacillus cereus (especially in i.v. drug abusers), S. aureus, streptococci, H.influenzae, meningococci, Mucor & Candida. D Propionibacterium acnes. (Ref 2 . Retina: color atlas and synopsis of clinical ophthalmology By Allen C. Ho pg. 115) Propionibacterium acnes LATE ONSET ENDOPHTHALMITIS Definition: * Intraocular infection involving the vitreous cavity after previous ocular surgery (more than 6 weeks). Epidemiology and etiolgogy: * The usual causative organism is Propionibacterium acnes, but infection may also be caused by Stahylococcus epidermidis or fungi (Candida). Presentation: * May occur up to 2 or more yrs after surgery. History: * Patients have variable decreased vision with photophobia, and gradual onset of symptoms. Infection may be painless. Important clinical signs: * Vitritis, with or without hypopyon, more than 4 - 6 weeks after surgery; anterior chamber keratic precipitates; white plaque on intraocular lens or posterior lens capsule. * Associated conjunctival injection may be present. D/D: * Postoperative inflammation. * Rebound inflammation after discontinuing steroids. Diagnostic evaluation: * Clinical exam and USG showing vitritis and variable sclero-choroidal thickening. Prognosis and management: * Intravitreal tap and injection of vancomycin (or clindamycin, 1 mg/0.1 mL) may not be curative. Patients may require vitrectomy with capsulotomy or, sometimes, explantation of the IOL and entire lens capsule. Host flora is usually responsible for early cases of endophthalmitis and Staphylococcus epidermitis is the most common organism. Gram-negative organisms such as H. influenzae are isolated most frequently from late onset endophthalmitis

Answer: OPTION D IS CORRECT.
Question: Which of the following should arouse suspicion of streptococcal sore throat?
Options:
A. Exudates in throat
B. Tender enlarged cervical nodes
C. Absence of nasal and conjunctival injection
D. All of the above

Rationale: Ans. D. All of the aboveSore throat is due to acute inflammation of the pharynx and tonsils. Most often, it is associated with viral infections of the upper respiratory tract such adenovirus, influenza and parainfluenza viruses. A possibility of acute pharyngitis due to group A beta haemolytic streptococci may be considered in a patient who has exudates in the throat, tender enlarged cervical lymph nodes along with absence of nasal and conjunctival congestion.

Answer: OPTION D IS CORRECT.
Question: Vitamin A is stored mainly as retinol esters in
Options:
A. Kidney
B. Muscle
C. Liver
D. Retina

Rationale: retinal is reduced to retinol by retinal reductase in the intestinal mucosa intestine is the major site of absorption vitamin is transpoed and stored in the liver as retinol palmitate ref DM Vasudevan 8th ed page 454

Answer: OPTION C IS CORRECT.
Question: The posterior end of which muscle inseion lies near the macula ?
Options:
A. Inferior oblique
B. Superior oblique
C. Superior rectus
D. Inferior rectus

Rationale: Ans. Inferior oblique

Answer: OPTION A IS CORRECT.
Question: The tubuloglomerular feedback is me­diated by:
Options:
A. Sensing of Na+  concentration in the macula densa
B. Sensing of HCO3 - concentration in macula densa
C. Sensing NaCl concentration in the macula densa
D. Opening up of voltage gated Na+ channels in afferent arteriole

Rationale: Macula densa sense both Na+ and Cl- , but Cl- is more important.

Answer: OPTION C IS CORRECT.
Question: Which among the following is the earliest sign of vitamin-A deficiency in developing countries?
Options:
A. Conjunctival xerosis
B. Nyctalopia
C. Retinopathy
D. Pain

Rationale: Night blindness is the earliest symptom. Dryness of the conjunctiva (xerosis) and the development of small white patches on the conjunctiva (Bitot spots) are early signs. Ulceration and necrosis of the cornea (keratomalacia), perforation, endophthalmitis, and blindness are late manifestations. Xerosis and hyperkeratinization of the skin and loss of taste may also occur. Ref: Baron R.B. (2013). Chapter 29. Nutritional Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013.

Answer: OPTION A IS CORRECT.
Question: Deposition of anti ds DNAAb in kidney, skin, choroid plexus and joints is seen in -
Options:
A. SLE
B. Good pasture
C. Scleroderma
D. Raynauds disease

Answer: OPTION A IS CORRECT.
Question: A 60yr old man has both HTN and DM for 10 years. There is reduced vision in one eye. On fundus examination there is a central bleed and the fellow eye is normal. The diagnosis is:
Options:
A. Diabetic retinopathy
B. Retinal tear
C. Optic neuritis
D. All

Rationale: B i.e. Retinal tear There is confusion b/w DR, HTNR & retinal tear only. Although normally retinal tears are usually peripheral and typically occur in equatorial and ora serrata regions of retina. In diabetic patients, retinal breaks are usually in the posterior pole near areas of fibrovascular change. The tears are oval and result from tangential traction from proliferative tissue and vitreous. In diabetics, retinal detachment (RD) may be rhegmatogenous (d/t retinal break formation) and nonrhegmatogenos (caused by traction alone). When RD is rhegmatogenous, the borders of elevated retina usually extend to the ora serrata. The retinal surface is dull & grayish and undulates b/o retinal mobility d/t shifting of subretinal fluid. Oval breaks are usually present in the posterior pole. Whereas in non rhegmatogenous (traction) RD, the detached retina is concave toward the pupil with taut and shiny surface. It is usually confined to the posterior fundus and infrequently extends more than 2/3rd of the distance to the equator. No shifting of subretinal fluid occurs. Diabetic retinopathy is usually and hypeensive retinopathy is invariably bilateral. (Kanski-567). So asymmetric involvement (normal fellow eye) almost rules out both. But diabetic vitreous haemorrhage occur during sleep, possibly b/o increase in BP secondary to early morning hypoglycemia.

Answer: OPTION B IS CORRECT.
Question: Timolol is preferred in glaucoma over pilocarpine, because -
Options:
A. It is more effective than pilocarine
B. Enhances uveo-scleral outflow
C. Produces less ocular side effects
D. It has no contraindications

Rationale: Ans. is 'c' i.e., Produces less ocular side effects Advantages of topical p-blockers (timolol) over miotics (pilocarpine) No change in pupil size (no miosis) o No fluctuation in I.O.T. No induced myopia o Convenient once/twice daily applications No ciliary spasm (no spasm of accomodation) o Few systemic side effects.

Answer: OPTION C IS CORRECT.
Question: The congenital rubella syndrome
Options:
A. May be prevented by vaccination in early pregnancy
B. Causes IUGR
C. Cuases cataract
D. Causes deafness only if acquired only if acquired before 16 weeks of gestation

Rationale: Congenital rubella syndrome cause communication problem& developmental retardation REF:<\p> ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.555

Answer: OPTION B IS CORRECT.
Question: Ralimar, a 30 year old male, sewage worker is brought to hospital with hempotysis and altered mental status. His relatives gives a history that he was suffering from fever, headache and severe myalgia for 5 days. On examination he was found to be severely jaundiced, had petechiae on oral and conjunctival mucosa. Lab investigations showed features of liver and renal failure. What is the most likely causative organism of this condition?
Options:
A. Leptospira
B. Plague
C. Yersinia
D. Rickettsial fever

Rationale: This patient is suffering from Wiel's disease caused by Leptospira. Weils syndrome (icteric leptospirosis) is the most severe form of leptospirosis. It is characterized by impaired kidney and liver function, abnormal mental status and hemorrhagic pneumonia and hypotension.

Answer: OPTION A IS CORRECT.
Question: A two year old unimmunized child presents to a primary health centre with fever since 5 days. Mother also gives a history of rash staing behind ear-pinna a day before coming to OPD. On examination, child is having running nose and congested eyes. Most probable diagnosis is:-
Options:
A. Rubella
B. Mumps
C. Measles
D. Chickenpox

Rationale: MEASLES Incubation period :10-14 days Causative agent: RNA paramyxovirus Source of infection: cases Period of communicability: 4 days before & 4 days after the appearance of rash Measles has no second attacks Pathognomic clinical feature of measles: koplik spots Other clinical features: coryza, fever, red eyes, cough MC complication of measles in young children: otitis media.

Answer: OPTION C IS CORRECT.
Question: Ratio of motor units to number of muscle fibers in striated muscle of eyes is?
Options:
A. 1:03
B. 1:30
C. 0.25
D. 2.125

Rationale: Ans. is'a'i.e., 1:3The innervations ratio refers to the number of muscle fibers supplied by a single motor neuron.In striated muscles the ratio varies between different muscle groups according to their function.

Answer: OPTION A IS CORRECT.
Question: An 18 year old boy comes to the eye casuality with history of injury with a tennis ball. On examination there is no perforation but there is hyphaema. The most likely source of the blood is -
Options:
A. Iris vessels
B. Circulus iridis major
C. Circulus iridis minor
D. Short posterior ciliary vessels

Rationale: When a blunt object strikes the front of the eye, the eye is quickly shortened in antero-posterior direction and, in a compensating fashion, is stretched laterally. This stretching causes breakage of iris vessels, with blood spilling into the anterior and posterior chamber. The most common source of blood is circulus iridis major.

Answer: OPTION B IS CORRECT.