QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: Ohngren's classification of maxillary sinus carcinoma is based on
Options:
A. Imaginary plane between medial canthus of eye and angle of mandible
B. Imaginary plane between lateral canthus of eye and angle of mandible
C. Two horizontal lines, one passing through floor of orbit and other through floor of antrum
D. None

Rationale: Ohngren's classification: Imaginary plane is drawn extending between medial canthus of eye and angle of mandible Supra structures, growth above the plane has poor prognosis Infrastructures, growth below the plane has good prognosis Lederman's classification: It uses two horizontal lines of sebileau: one passing through the floor of orbit and another passing through the floor of antra Divides into supra structures, mesostructures and infrastructure.

Answer: OPTION A IS CORRECT.
Question: Satellite lesions in eye is caused by
Options:
A. Herpes zoster
B. Herpes simplex
C. Aspergillosis
D. Trachoma

Rationale: C i.e. Aspergillosis

Answer: OPTION C IS CORRECT.
Question: Regarding acute papilloedema:
Options:
A. Blind spot increases
B. Visual acuity normal; colour vision decrease
C. Colour vision normal; visual acuity decreases
D. There is always associated optic nerve inflammation

Rationale: Ans: b (Visual acuity normal; colour vision decrease)Ref: Khurana, Vision and Neuro Ophthalmology pg. 288The other options are features of papilitis.In chronic papillodema, there may be enlargement of blind spot. In papillodema, visual acuity is normal, pupillary reactions are brisk i.e., there is no RAPD in contrast to papilitis. Papillitis is optic neuritis due to inflammation.Clinical featuresPainful ocular movementsColor vision is decreasedVisual acuity decreasedRAPD Usually unilateral

Answer: OPTION B IS CORRECT.
Question: Chalazion of eyelid is:
Options:
A. Caseous necrosis
B. Chronic nonspecific inflammation
C. Chronic lipogranulomatous inflammation
D. Liposarcoma

Rationale: A chalazion is an inflammation of the meibomian glands, which may produce a tender nodule over the tarsus of the upper or lower lid. Chalazion tends to be recurrent if eyelid hygiene is poor. Obstruction of the eyelid margin meibomian glands with resultant inflammation, fibrosis, and granuloma formation. Eyelid nodule of variable size and localized erythema of the corresponding palpebral conjunctiva that may be associated with a yellow lipogranuloma, is observed clinically. Current Treatment options: Oral flax seed oil may also decrease the risk of recurrent chalazion. If incision and curettage are needed because the lesion is slow to resolve, the child will require a general anesthetic. Topical azithromycin (ophthalmic solution 1%) may also help decrease recurrence of chalazion, but is still under investigation Ref: Braverman R.S. (2012). Chapter 16. Eye. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.

Answer: OPTION C IS CORRECT.
Question: Rossette shaped cataract is seen in -
Options:
A. Congenital rubella
B. Blunt trauma to eye
C. Wilson's disease
D. Diabetes meilitus

Rationale: Ans. is 'b' i.e., Blunt trauma to eye DiseaseType of cataracto Myotonic dystrophyChristmas tree cataract. Blue dot cortical cataract, posterior subcapsular cataract.o Wilson's diseaseo Copper deposition (Chalcosis)o Penetrating traumaSunflower cataract (Petals of flower cataract)o Diabetes mellitusSnowflake cataract or Snowstrom cataracto Down's syndromeSnowflake cataracto Hypoparathyroidism (Hypocalcemia) Hvpovitaminosis DDiscrete white cortical opacities, Congenital lamellar (zonular) cataracto Atopic dermatitisBlue dot cortical cataract, posterior subcapsular cataracto Congenital rubellaNuclear cataract, Total congenital cataracto GalactosemiaOil drop cataract, Dust like lenticular opacitieso Complicated cataract(Iridocyclitis, High myopia)Posterior cortical breads's crumb appearance, Polychromatic lustyre/Rainbow cataracto Blunt traumaVossius ring on anterior surface of lens, Rosette shaped cataract

Answer: OPTION B IS CORRECT.
Question: 8 year old boy presented with swelling in the left eye of three months duration examination revealed proptosis of the left eye with preserved vision right eye is normal CT Scan revealed incredible extraconal mass lesion biopsy revealed embryonal rhabdomyosarcoma metastatic workup was normal the standard line of treatment is
Options:
A. Chemotherapy only
B. Wide local excision
C. Enucleation
D. Chemotherapy and Radiation therapy

Rationale: Rhabdomyosarcoma is very responsive to radiotherapy Refer khurana 6/e p 425

Answer: OPTION D IS CORRECT.
Question: Posterior capsulotomy after cataract is done using-
Options:
A. Argon Laser
B. Nd YAg
C. Holmium
D. Diode laser

Rationale: Ans. is 'b' i.e., Nd YAg o After cataract, if thin, can be cleared centrally by Nd: YAG laser capsulotomy. Discission with cystitome or zeigler's knife may also be used. Thick membranous after cataract needs surgical membranectomy.

Answer: OPTION B IS CORRECT.
Question: A 23 year old girl presented with the complaint that her soft contact lenses, bought only 6 months back, were causing blurring of vision. VA was 6/18 in one eye with refraction of - 7.0/+3.5 X145.
Options:
A. Nuclear cataract
B. Dry Eyes
C. Keratoconus
D. Irregular astigmatism

Rationale: Nuclear cataract and a dry eye is unlikely to occur in a 23 year old, as it is mostly seen in old people. Irregular astigmatism usually occurs in conditions leading to scarring of cornea and there is no such history given. The girl is suffering from keratoconus which can no longer be controlled by soft contact lenses. Keratoconus is more commonly seen in female patient and refers to abnormal protrusion of cornea. * Clinical features: Patient presents with a defective vision due to progressive myopia and irregular astigmatism, which does not improve fully despite full correction with glasses. * Signs. Following signs may be elicited: Window reflex is distoed. Placido disc examination shows irregularity of the circles . Keratometry depicts extreme malalignment of mires. Photokeratoscopy reveals distoion of circles. Slit lamp examination may show thinning and ectasia of central cornea, opacity at the apex and Fleischer's ring at the base of cone, folds in Descemet's and Bowman's membranes. Very fine, veical, deep stromal striae (Vogt lines) which disappear with external pressure on the globe are peculiar feature. On retinoscopy a yawning reflex (scissor reflex) and high oblique or irregular astigmatism is obtained. On distant direct ophthalmoscopy an annular dark shadow (due to total internal reflection of light) is seen which separates the central and peripheral areas of cornea (oil droplet reflex). Munson's sign, i.e. localised bulging of lower lid when patient looks down is positive in late stages.

Answer: OPTION C IS CORRECT.
Question: A patient presented with uveitis with raised intraocular pressure (secondary glaucoma). Drug used is: March 2004
Options:
A. 1% pilocarpine
B. 1% atropine
C. Timolol
D. Acetazolamide

Rationale: Ans. B i.e. 1% atropine

Answer: OPTION B IS CORRECT.
Question: All are presentation of retinoblastoma except -
Options:
A. Leucocoria
B. Accommodative squint
C. Cataract
D. Glaucoma

Rationale: Leucocoria(60%), strabismus (20%) ,accommodative squint,glaucoma, nystagmus and painfull red eye. Ref: ak khurana 6th edition

Answer: OPTION C IS CORRECT.
Question: Which of the following is beneficial for patient suffering from gyrate atrophy of choroid due to deficiency of enzyme Ornithine trans carbomylase
Options:
A. Ornithine free diet
B. Arginine free diet
C. Folic acid & pyridoxine
D. Angiod Streaks

Rationale: B i.e. Arginine free diet Gyrate atrophy of choroid due to deficiency of ornithine amino transferase (OAT) enzyme is treated by arginine free diet (treatment of choice) and vitamin B6 (pyridoxine) supplementationQ.

Answer: OPTION B IS CORRECT.
Question: Corneal deturgescence is maintained by -
Options:
A. Epithelium
B. Endothelium
C. Stroma
D. Descmet's membrane

Rationale: Endothelium consists of single layer of flat ploygonal epithelilal cells.It contains 'active pump' mechanism which keeps cornea dehydrated. Reference:Comprehensive Ophthalmology,AK Khurana,6th edition,pg no.96

Answer: OPTION B IS CORRECT.
Question: Iris cyst formation induced by
Options:
A. Atropine
B. Pilocarpine
C. Latanoprost
D. Timolol

Rationale: Local side-effects are encountered more frequently with long-acting miotics. These include problems due to miosis include myopia and frontal headache, retinal detachment, lenticular opacities, iris cyst formation, mild iritis, lacrimation and follicular conjunctivitisAmong the given drugs pilocarpine is Parasympathomimetic drugs (Miotics)

Answer: OPTION B IS CORRECT.
Question: Which one among the following is not used in opthalmia neonatorum?
Options:
A. Erythromycin
B. Bacitracin eye ointment
C. Gentamycin
D. Local penicillin

Rationale: The most common etiologies of ophthalmia neonatorum are chemical conjunctivitis (hyperemia and mucoid discharge during the first 24 hours postpaum) caused by silver nitrate or erythromycin prophylaxis, herpes simplex, Neisseria gonorrhoeae and N. meningitidis, and Chlamydia trachomatis. Systemic treatment of erythromycin, gentamycin and bacitracin are used for the treatment. Topical treatment is not effective. Please note that local preparations of penicillin is barred in India.

Answer: OPTION D IS CORRECT.
Question: Retinal cells which secrete acetyl choline?
Options:
A. Bipolar cells
B. Ganglion cells
C. Amacrine cells
D. H cells

Rationale: Ans. C. Amacrine cellsAmacrine cells secrete at least eight types of transmitter substances, including GABA, glycine, dopamine, acetylcholine and indolamine, all of which normally function as inhibitory neurotransmitters.

Answer: OPTION C IS CORRECT.
Question: Neocerebellum is concerned with which of the following functions?
Options:
A. Eye movements
B. Motor planning
C. Equilibrium
D. Motor execution

Rationale: Lateral poion of cerebellar hemisphere is called cerebrocerebellum or neocerebellum. It interacts with the motor coex in planning and programming movements. Lesion of the neocerebellum results in: Ataxia of extremities, asynergy Dysmetria Dysdiadochokinesia Intentional tremor Rebound phenomenon Lesion of archicerebellum result in: Loss of equilibrium Nystagmus Lesion of Paleocerebellum result in: Truncal ataxia and drunken gait Ref: Review of Medical Physiology by William F Ganong, 22nd Edition, Page 221

Answer: OPTION B IS CORRECT.
Question: "Ferry line" is found in
Options:
A. Head of Pterygium
B. Base of keratoconus
C. Sclera
D. Eyelid

Rationale: Ferry line is found in sclera Ferry&;s Li Reference: AK Khurana 7th edition

Answer: OPTION C IS CORRECT.
Question: States and stages of human sleep are defined on the basis of characteristic patterns in all of the following except:
Options:
A. Electrooculogram (EOG—a measure of eye-movement activity)
B. Electroencephalogram (EEG)
C. Electromyogram (EMG)
D. Electrocardiogram (ECG)

Rationale: States and stages of human sleep are defined on the basis of characteristic patterns in the electroencephalogram (EEG), the electrooculogram (EOG—a measure of eye-movement activity), and the surface electromyogram (EMG) measured on the chin and neck. The continuous recording of this array of electrophysiologic parameters to define sleep and wakefulness is termed polysomnography. Polysomnographic profiles define two states of sleep: (1) rapid-eye-movement (REM) sleep and (2) nonrapid-eye-movement (NREM) sleep. NREM sleep is further subdivided into three stages, characterized by increasing arousal threshold and slowing of the cortical EEG. REM sleep is characterized by a low amplitude, mixed-frequency EEG similar to that of NREM stage N1 sleep. The EOG shows bursts of REM similar to those seen during eyes-open wakefulness. Chin EMG activity is absent, reflecting the brainstem mediated muscle atonia that is characteristic of that state.

Answer: OPTION D IS CORRECT.
Question: All of the following are seen in Iridocorneal endothelial syndrome except
Options:
A. Cataract
B. Corectopia
C. Iris cysts
D. Iris atrophy

Rationale: Ans. (a) Cataract; (c) Iris cystsRef: Shields 6/e, p. 262-266Refer to Image 2 for detailed explanationOption a - In ICE syndrome, a retrocorneal membrane may grow over the anterior lens surface simulating the anterior lens capsule. It can be removed by Nd:YAG laser anterior capsulotomyOption b - Corectopia - seen in Progressive iris atrophyOption c - pigmented, pedunculated iris nodules are seen in Chandler syndrome, not iris cystsOption d - Iris atrophic holes seen in progressive iris atrophy

Answer: OPTION A IS CORRECT.
Question: Which of the following is not affected in leprosy: September 2011
Options:
A. Uterus
B. Testes
C. Nerve
D. Eye

Rationale: Ans. A: Uterus Main organs/ tissue involved in leprosy are skin and peripheral nerves Systemic (eyes, testes and reticuloendothelial system) involvement is common Leprosy: Hansens disease Virchow cells are seen CNS, ovaries, lungs are NOT commonly involved in leprosy TT is the MC type of leprosy in India Tuberculoid leprosy: - Infective form Ulnar nerve is a commonly affected nerve - Followed by posterior auricular nerve Lepromatous leprosy: - Presents with gyanecomastia, madrosis, collapse of nasal bridge - Histologically, the dermis characteristically contains highly vacuolated cells (foam cells) and fewer or absent non-caseating granuloma 1st line drug: - Rifampicin - Dapsone - Clofazimine DOC in neuritis: Steroids Nerve abscess treated by: Incision and drainage Lepra reaction type 1: - Coicosteroids are the DOC - Unresponsive to thalidomide Lepra reaction type II: - Also known as erythema nodosum leprosum - Seen in lepromatous leprosy - Thalidomide is effective Lepromin test indicates strong immunity

Answer: OPTION A IS CORRECT.
Question: An EEG technician can look at an electroencephalogram and tell that the subject was awake, but relaxed with eyes closed, during generation of the recording. She can tell this because the EEG recording exhibits:
Options:
A. Alpha rhythm
B. Beta rhythm
C. Theta rhythm
D. Delta rhythm

Rationale: Ans. A. Alpha rhythmAlpha waves are noted in the EEG in a relaxed, awake person whose eyes are closed. An alert state is indicated by beta waves. Theta and delta waves are noted during sleep. Variability in the wave forms might indicate a seizure or damage locus.

Answer: OPTION A IS CORRECT.
Question: Loss of lateral 1/3rd of eyebrow is seen in -
Options:
A. Lepromatous leprosy
B. Taenia capitis
C. Tuberculosis
D. Tetanus

Answer: OPTION A IS CORRECT.
Question: A 16 years old girl failed in her final examination. Disgusted with life , she cut across the front of wrist at the flexor retinaculum . She was rushed to hospital and the surgeon noticed that the cut was superficial. All the following structures would have been damaged by this cut EXCEPT?
Options:
A. Ulnar nerve
B. Median nerve
C. Palmar cutaneous branch of median nerve
D. Superficial branch of radial aery

Rationale: Median nerve lies deep to the flexor retinaculum and is not damaged by cuts which are superficial. Structures crossing superficial to flexor retinaculum are:From medial to lateral:Superficial branch of ulnar nerve and ulnar aeryTendon of palmaris longusPalmar cutaneous branch of median nerveOrigin of the thenar musclesStructures passing deep to flexor retinaculum are:Median nerveTendons of flexor digitorum superficialisTendon of flexor digitorum profundusTendon of flexor pollicis longusUlnar bursa and radial bursa

Answer: OPTION B IS CORRECT.
Question: Coloboma of the iris is defined as: March 2012
Options:
A. Persistent anterior vascular sheath of lens
B. Absent iris
C. Poorly developed uveal tissues
D. Pink coloured iris

Rationale: Ans: C i.e. Poorly developed uveal tissues Conditions & their definitions Continued existence of pa of the anterior vascular sheath of the lens (a foetal structure which normally disappears sholy before bih) is known as persistent papillary membrane Absence of iris is known as aniridia In colobomata, the tissues of the uvea & the associated retinal tissues or their prolongation onto the back of the iris are badly developed/ deficient Owing to the absence of the pigment in the eye in patients of albinism, iris looks pink

Answer: OPTION C IS CORRECT.
Question: Skull base fracture is associated with all of the following except:
Options:
A. Racoon eyes
B. Hemiparesis
C. CSF Rhino-otorrhea
D. Battle sign

Rationale: Anterior cranial fossa fracture Middle cranial fossa fracture Posterior cranial fossa fracture MC type of skull base fracture Caused by fracture of cribriform plate Clinical features: Subconjunctival hematoma CSF rhinorrhea Epistaxis Anosmia Periorbital hematoma or "Raccoon eyes" Carotico cavernous fistula Frontal lobe contusion Caused by fracture of petrous pa of temporal bone. Clinical features: CSF otorrhea Paradoxical rhinorrhea Hemotympanum Battle sign: Bruising or ecchymosis behind ear Ossicular disruption VII & VIII cranial nerve palsies Temporal lobe contusion Caused by fracture of occipital bone. Clinical features Visual disturbances VI cranial nerve injury Jugular foramen syndrome (Vernet syndrome): paresis of IX, X, XI cranial nerves Basilar aery injury Occipital contusion

Answer: OPTION B IS CORRECT.
Question: Best site for IOL implantation –
Options:
A. Iris
B. Capsular bag
C. Anterior chamber
D. Sulcus

Rationale: The best position of IOL is within the capsular bag in posterior chamber.

Answer: OPTION B IS CORRECT.
Question: A 32-year old male presents with unilateral diminished vision in the right eye. On examination, there is mild iritis, vitretis and a focal necrotic lesion is seen at the macula. The most likely diagnosis is:
Options:
A. Multiple Evanescent White Dot syndrome
B. Ocular toxoplasmosis
C. Multifocal chorioditis
D. Ocular sarcoidosis

Rationale: Ans. b. Ocular toxoplasmosis (Ref: Parson's 21/e p242-43; Kanski 7/e p429-30, 457-63; Yanoff Ducker 3/e p828-30, 785; Harrison 19/e 40e-6f 1400, 1402, 1404, 18/e p229, 1724, 1726)A 32-year-old male presents with unilateral diminished vision in the right eye. On examination, there is mild iritis, vitretis and a focal necrotic lesion is seen at the macula. The most likely diagnosis is ocular toxoplasmosis."Ocular toxoplasmosis presents with localized necrotizing chorioretinitis involving macula, satellite lesions, spill over granular anterior uveitis, vitritis (leading to head light in fog appearance) with floaters (due to vitritis), diminished vision, pain, redness and photophobia in young adults/infants."Ocular ToxoplasmosisToxoplasmosis is one of the most frequently identifiable causes of uveitis worldwide.MC cause of infectious posterior uveitis in non-immunocompromised individualsQ2nd MC cause of infectious posterior uveitis in patients with HIV/AIDS (MC cause: CMV retinitis)QIt usually presents in infants or adults of 10-35 yearsQ.Clinical Features:Depends on patient age, location, size and severity of retinochoroiditis.Ocular manifestations include floaters and blurred vision.Decreased visual acuity may occur as a result of macular involvement or severe vitreous inflammation.Ocular toxoplasmosis presents withNecrotizing chorioretinitis (destroying choroid and retina producing punched out heavily pigmented macular scar)QSatellite lesion (solitary inflammatory focus near old pigmented scar)Spill over anterior uveitis (may be granular resembling Fuchs syndrome)Severe vitritis (so dense as to prohibit an adequate view of posterior segment i.e. head light in fog appearance)Q.Bilateral macular involvement is common (in immunocompromised).Triad of congenital toxoplasmosis: Convulsion + Chorioretinitis + Intraeranial calcificationQDiagnosis:Diagnosis of ocular toxoplasmosis is often made by clinical features.Diagnostic tests include demonstration of parasite. Sabin-Feldman dye test (serological test require live T. gondii organism with a titer >1:16), complement fixation test, indirect hemagglutination test and ELISA for IgG and IgM.Treatment:MC treatment for ocular toxoplasmosis (''classic therapy"): Pyrimethamine and sulfadiazine plus corticosteroidsQ.Alternative treatment: Quadruple drug therapy (classic regimen plus clindamycin), as well as single or combined use of clindamycin, trimethoprim/sulfamethoxazole, spiramycin, minocycline, azithromycin, atovaquone and clarithromycin.

Answer: OPTION B IS CORRECT.
Question: A baby presents with multiple deformities, cleft lip, cleft palate, microcephaly, small eyes, scalp defect and polydactyly. Following manifestations are associated with which of the following chromosomal anomaly?
Options:
A. Trisomy 13
B. Trisomy 18
C. Trisomy 21
D. Monosomy 2

Rationale: The baby in the question stem is showing features of trisomy 13. Babies with trisomy 13 often have normal bih weight, CNS malformations, eye malformations, cleft lip and palate, polydactyly or syndactyly, and congenital hea disease. Infants with trisomy 18 are small for gestational age, have characteristic facies, overlapping fingers and rocker bottom feet and ventricular septal defect or patent ductus aeriosus. Physical findings in a newborn with trisomy 21 are flattened occiput, upslanting palpebral fissures, epicanthal folds, midface hypoplasia, small dysplastic pinnae, endocardial cushion defects or other septal defects and esophageal and duodenal atresias. Ref: Tsaic A.C., Manchester D.K., Elias E.R. (2012). Chapter 37. Genetics & Dysmorphology. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.

Answer: OPTION A IS CORRECT.
Question: A 45-year old man presents with a daily headache. He describes two attacks per day over the past 3 weeks. Each attack lasts about an hour and awakens the patient from sleep. The patient has noted associated tearing and reddening of his right eye as well as nasal stuffiness. The pain is deep, excruciating, and limited to the right side of the head. The neurologic examination is nonfocal. The most likely diagnosis of this patient's headache is :
Options:
A. Migraine headache
B. Cluster headache
C. Tension headache
D. Brain tumour

Rationale: Answer is B (Cluster headache): Cluster Headache Lateralized , periorbital or less commonly temporal All ages above 10 yrs with peak at 30-50 yrs Male preponderance (90%). Men affected 7-8 times more than females. Hereditary factors usually absent Presentation: Pain (periodic attacks 1-2/day) begins without warning reaches crescendo within 5 minutes lasts for 45 minutes Q excruciating, deep, explosive pain but only rarely pulsatile - commonly awakens the patients from sleep Associated symptoms : These are typical and characteristic : - homolateral lacrimation - reddening of eye nasal stuffiness - Ptosis and - nausea Migraine Lateralised ,usually frontotemporal may be generalised All age groups are affected Females are affected more than males Family history present Presentation :Pain often preceded by aura builds up gradually - may lasts for several hours or longer - usually throbbing but may be dull - onset is after awakening & quietened by sleep Associated symptoms include : - nausea, vomiting, diarrhea photophobia and visual disturbance in the form of photopsia and foification spectra paraestheisias with tingling and numbness other focal neurological symptoms such as clumsiness and weakness.

Answer: OPTION B IS CORRECT.
Question: A 35 years old hypermetrope is using 1.50 D sphere both eyes. Whenever his glasses slip downward on his nose he will feel that his near vision:
Options:
A. Becomes enlarged
B. Becomes distoed
C. Becomes decreased
D. Remains the same

Rationale: The images will appear larger because of the convex lens. Ref: Ocular Anatomy and Physiology By Al Lens, Sheila Coyne Nemeth, Janice K. Ledford, 2007, Page 159

Answer: OPTION A IS CORRECT.
Question: A total of 3500 patient with thyroid cancer are identified and surveyed by patient interviews with reference to past exposure to radiation. The study design most appropriately illustrates -
Options:
A. Case series report
B. Case control study
C. Case report
D. Clinical trial

Answer: OPTION A IS CORRECT.