QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: Which of the following antiglaucoma medications can cause drowsiness
Options:
A. Latanoprost
B. Timolol
C. Brimonidine
D. Dorzolamide

Rationale: Ans. is 'c' i.e., Brimonidine Impoant systemic side effects of topical agents n-blockers : Bronchospasm, bradycardia, .cardiac output, hypotension, depression, impotence, altered lipid profile (hypercholesterolemia). Sympathomimetics Non selective (Dipivefrine, epinephrine) :- Hypeension, arrhythmias Selective a-2 (Brimonidine):- Drowsiness, fatigue, BP changes Selective a-1 & a2 (Apraclonidine) :- Drowsiness, Headache, fatigue Chlinomimetics (Pilocarpine) :- Sweating, salivation, urinary frequency, diarrhea, bronchospasm. Carbonic anhydrase inhibitors (Dorzolamide, brinzolamide) :- Bitter taste, headache, asthenia, renal calculi. Prostaglandin analogues (Latanoprost) :- Headache, symptoms of UI.

Answer: OPTION C IS CORRECT.
Question: In Optic neurities in children all symptoms are present EXCEPT:
Options:
A. Afferent pupillary defect
B. Headache and vomiting
C. Pain on movement of eye ball
D. Sudden visionloss

Rationale: B i.e. Headache and vomiting Papilloedema (not papillitis) is caused by raised intracranial pressure and it presents with headache & vomiting . Features Papillitis (Optic neuritis) Papilloedema Aetiology Inflammation of intraocular pa of optic nerve Q (or optic disc). Non inflammatory Q hydrostatic oedema of optic disc due to raised intracranial pressure Q Laterality Usually unilateral Usually bilateral Onset Sudden Q Insidious Q Loss of vision Sudden and marked Q Depressed light brightness & coloured objects appear faded (pulfrich phenomenon). Gradual Q & negligible in the initial stage Recurrent attacks of transient black out (blurred vision) Q i.e. amaurosis fugax. Pupillary reflex Sluggish and ill sustainedQ Relative afferents papillary defect (RAPD or Marcus Gunn's pupil)Q Visual acquity & pupillary reaction remain normal until optic atrophy sets in Pain Present on ocular movements Q Absent Q Tenderness Present at inseion of medial rectus and superior rectus Q Absent Q Swelling of disc Moderate (2-3 dioptres) Marked (> 3 dioptres) Q Visual field defects Central or centro-cecal scotoma Q Enlargement of blind spot Q and concentric constriction of field Posterior vitreous Fine opacities Clear

Answer: OPTION B IS CORRECT.
Question: A young, tall, thin, male with archnodactyly has ectopia lentis in both eyes. The most likely diagnosis is
Options:
A. Marfan's syndrome
B. Marchesani's syndrome
C. Homocystinuria
D. Ehler's danlos syndrome

Rationale: Answer is A (Marfan's syndrome): Arachnodactyly and ectopia lends (dislocation of lens) in tall thin male suggests a charachteristic diagnosis of Marfan's syndrome. Marfan Syndrome : Review Marfan's syndrome is a genetic disorder of the connective tissue of the body manifested principally by changes in the skeleton, eye and cardiovascular system.

Answer: OPTION A IS CORRECT.
Question: Which of these is a pathognomonic feature of miliary TB?
Options:
A. Snow storm appearance in CXR
B. Choroid tubercles on fundus examination
C. Pericardial TB
D. Peritoneal TB

Rationale: Snow storm appearance in CXR can be seen in silicosis also Pericardial TB &Peritoneal TB- features of disseminated TB Choroid tubercles on fundus examination is a pathognomic feature of Miliary TB.

Answer: OPTION B IS CORRECT.
Question: A 50-Year-old diabetic patient presented with orbital pain, swelling and chemosis along with fever. He has been treated for an infection in the orbit presumably orbital cellulitis 10 days ago. O/E: - 3rd, 4th and 6th cranial nerves involvement seen Trigeminal neuropathy affecting V1 and V2 divisions The neuropathy was observed initially on left side but later right side was also affected. CT venogram of the patient Which vein is most likely responsible for the above condition: -
Options:
A. Inferior ophthalmic vein
B. Superior ophthalmic vein
C. Central vein of retina
D. Internal cerebral vein

Rationale: This is a case of cavernous sinus thrombosis post orbital cellulitis meaning the septic thrombi came the superior ophthalmic vein. It is a life-threatening condition. Presents as orbital/facial pain Orbital swelling and chemosis is seen. 3rd, 4th, 5th and 6th cranial nerves are affected Occurs secondary to infection from orbital cellulitis and sinusitis CT venogram shows distended cavernous sinus with a non-fat density filling defect-likely thrombus. Pathways of spread of infection to cavernous sinus. FACIAL VEIN - ANGULAR VEIN - SUPERIOR OPTHALMIC VEIN - CAVERNOUS SINUS DEEP FACIAL VEIN - PTERYGOID PLEXUS - CAVERNOUS SINUS

Answer: OPTION B IS CORRECT.
Question: A 24-year-old woman with 36 weeks of pregnancy, suddenly complains of headache and blurring of vision. Her B.P. is 170/110 mm of Hg. Urinary albumin is +++ and fundus examination shows areas of retinal hemorrhage. The line of further management would be:
Options:
A. Conservative treatment
B. Anticonvulsive therapy
C. Induction of labour
D. Cesarean delivery

Rationale: The patient in the question has BP 170 / 110 mm of Hg (i.e. > 160 / 110 mm), Urine albumin +++, Headache, Blurring of vision and fundal examination shows areas of retinal hemorrhage. All these features point towards severe preeclampsia. Now there is a lot of controversy regarding this question. Some feel cesarean section should be done while others feel induction of labor is the correct answer. Rest all believe anticonulsive therapy with MgSO4 is the option of choice. Putting an end to all the controversies. I am quoting text from the latest edition of High Risk Pregnancy
by Fernando Arias 3/e, p 420 – “If the gestational age is > 34 weeks the best approach is to treat with magnesium sulfate for the prevention of seizures, give antihypertensives to control the blood pressure and deliver by cesarean section or by induction of labor if the cervix is ripe.”
So this leaves no doubt that further line of management in this question is Anticonvulsive therapy. If the question would have been – best management then termination of pregnancy would have been the answer.

Answer: OPTION B IS CORRECT.
Question: Snow-flake cataract seen in
Options:
A. Diabetes
B. Trauma
C. Chalcosis
D. Posterior subcapsular

Rationale: Ans. is 'a' i.e Diabetes In diabetes.Senile cataractappears at an early age and progresses rapidlyTrue diabetic cataract:rare condition,usually occuring in young adults,bilateral known as Snow flake cataract or snow storm cataractOther imp types of cataractRosette shaped cataract*-TraumaSunflower cataract*-Chalcosis, Wilsons diseaseOil drop cataract*-GalactosemiaChristmas tree*-Myotonic dystrophicaBread crumb* posterior capsular-Complicated

Answer: OPTION A IS CORRECT.
Question: Ocular symptom not seen in Herpes zoster is-
Options:
A. Nummular keratitis
B. Glaucoma
C. Uveitis
D. Satellite lesions

Rationale: The ocular lesions of herpes zoster ophthalmicus include conjunctivitis,zoster keratitis,episcleritis and scleritis,iridocyclitis,acute retinal necrosis,secondary glaucoma,anterior segment necrosis and phthisis bulbi and associated neurological complications such as motor nerve palsies.Reference:Comprehensive ophthalmology,AK Khurana,6th edition,page no.111

Answer: OPTION D IS CORRECT.
Question: Classic triad of congenital rubella includes all except -
Options:
A. Cataract
B. Deafness
C. Retinitis
D. CHD

Rationale: Cardiac defects, cataract, deafness constitute a classical triad REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.555

Answer: OPTION C IS CORRECT.
Question: Enlarging dot sign in fundus fluorescein scanning is seen in -
Options:
A. Cystoid macular edema
B. Central serous retinopathy
C. Significant macular edema
D. Coat's disease

Rationale: Fundus fluorescein angiography helps in confirming the diagnosis. Two patterns are seen: Ink-blot pattern. It consists of small hyperfluorescent spot which gradually increases in size Smoke-stack pattern. It consists of a small hyperfluorescent spot which ascends veically like a smoke-stack and gradually spreads laterally to take a mushroom or umbrella configuration. Ref : AK Khurana 6thE pg 293

Answer: OPTION B IS CORRECT.
Question: Inverse Hypopyon is seen in:
Options:
A. Fungal Endophthalmitis
B. Bacterial Endophthalmitis
C. Post vitreoretinal surgery with silicon oil
D. Anterior uveitis

Rationale: Inverse hypopyon is seen because of silicon oil in anterior chamber. Hypopyon : Dense infiltrate of cells/ infective organisms/ paiculate in the anterior chamber Types: Inverse hypopyon- Silicon oil in AC Mobile hypopyon- Behcets Disease Infected hypopyon- Fungal corneal ulcer Inverse Hypopyon

Answer: OPTION C IS CORRECT.
Question: All of the following contains Bipolar neurons except
Options:
A. Retina
B. Sensory ganglia of cochlear and Vestibular Nerve
C. Dorsal root ganglion
D. Olfactory epithelium

Rationale: Dorsal root ganglion contains pseudounipolar neurons, not bipolar neurons.

Answer: OPTION C IS CORRECT.
Question: Shoening of 2 mm of axial length of eye ball causes-
Options:
A. 3D myopia
B. 6D myopia
C. 3D hypermetropia
D. 6D hypermetropia

Rationale: Axial hypermetropia is by far the commonest form. In this condition the total refractive powerof eye is normal but there is an axial shoening of eyeball. About 1-mm shoening of the anteroposterior diameter of the eye results in 3 dioptres of hypermetropia. So shoening of eyeball about 2mm results in 6D hypermetropia Reference : A K KHURANA OPHTALMOLOGY,Edition 4, page-29

Answer: OPTION D IS CORRECT.
Question: For Dextroelevation of eye, muscles acting are ?
Options:
A. Right lateral rectus and left medial rectus
B. Right superior rectus and left inferior oblique
C. Right inferior rectus and left superior oblique
D. Bilateral superior recti and inferior obliques

Rationale: Ans. is 'b' i.e., Right superior rectus and left inferior oblique

Answer: OPTION B IS CORRECT.
Question: Choose the appropriate lettered structure in this radiograph of the lateral view of the head. Cerebrospinal fluid is formed by vascular choroid plexus in which structure?
Options:
A. A
B. B
C. C
D. D

Rationale: (a) Cerebrospinal fluid is formed by vascular choroid plexus in the ventricles in the brain; the letter "A" indicates the lateral ventricle.

Answer: OPTION A IS CORRECT.
Question: Pathologically the deposits associated with lattice corneal dystrophy is
Options:
A. Glycosaminoglycan
B. Amyloid
C. Cholesterol crystals
D. Hyaline

Answer: OPTION B IS CORRECT.
Question: Which of the following is false regarding frontal sinusitis
Options:
A. Pain shows periodicity
B. Most common sinus involved in infants and children
C. Pain is referred to as office headache
D. Tenderness is present just above the medial canthus of eye

Rationale: Clinical features of frontal sinusitis:

A frontal headache: showing periodicity and tenderness. 
Oedema of upper eyelids with suffused conjunctiva and photophobia.
Nasal discharge: a vertical streak of mucopus is seen high up in the anterior part of middle meatus
 X-ray: opacity of affected sinus seen. Both Waters' and lateral views should be taken.
CT scan is preferred modality.

Answer: OPTION B IS CORRECT.
Question: Technique of Cataract extraction  used in care of subluxated lens
Options:
A. Extracapsular Cataract extraction
B. Intracapsular Cataract extraction
C. Placoemusification
D. Small incision Cataract surgery

Rationale: Though intracapsular Cataract extraction is obsolete, it is only indicated in subluxation of Lens.

Answer: OPTION B IS CORRECT.
Question: Structure superficial to flexor retinaculum?
Options:
A. FDS
B. FPL
C. Ulnar aery
D. Median nerve

Rationale: Structures deep to flexor retinaculumLateral compament : Flexor carpi radialis tendon with its synol sheath lodged in the groove on the palmar surface of trapezium.Medial compament : (carpal tunnel proper).Median nerveFlexor pollicis longus with its synol sheath (radial bursa)4 tendons each of flexor digitorum superficialis and profundus enclosed by common flexor synol sheath (ulnar bursa).Structures superficially to flexor retinaculum Palmaris longus tendon continuous with apex of palmar aponeurosis.Palmar cutaneous branch of median nerve.Palmar cutaneous branch of ulnar nerve.Ulnar nerve.Ulnar vessels protected superficially by volar carpal ligament (superficial pa of the flexor retinaculum).

Answer: OPTION C IS CORRECT.
Question: The immune ring is a feature of
Options:
A. Interstitial keratitis
B. Fungal corneal ulcer
C. Bacterial corneal ulcer
D. Herpes simplex keratitis

Rationale: A typical fungal corneal ulcer has following salient features: The corneal ulcer is dry-looking, greyish white, with elevated rolled out margins. Delicate feathery finger-like extensions are present into the surrounding stroma under the intact epithelium. A sterile immune ring (yellow line of demarcation) may be present where fungal antigen and host antibodies meet. Multiple, small satellite lesions may be present around the ulcer. Usually, a big hypopyon is present even if the ulcer is very small. Perforation of mycotic ulcer is rare but can occur. Corneal vascularization is conspicuously absent. The term fungal keratitis refers to a corneal infection caused by fungi. One type of fungus that can infect the cornea is Fusarium.This increased occurrence of fungal keratitis is a result of the frequent use of topical coicosteroids along with antibacterial agents in treating patients with keratitis Ref: Khurana; 4th edition; Pg no.100

Answer: OPTION B IS CORRECT.
Question: All are Neural crest derivatives EXCEPT
Options:
A. Odontoblasts
B. Sympathetic ganglia
C. Iris muscles
D. C cells of thyroid gland

Rationale: - Neural crest cells themselves are coming from epiblasts which contribute to numerous structures in body like peripheral nervous system etc. Derivatives of Neural Crest Cells: - Sensory neurons of cranial ganglia - V, VII, VIII, IX, X - Sensory neurons of spinal dorsal root ganglia & their peripheral sensory receptors - Satellite cells in all sensory ganglia - Sympathetic ganglia & plexuses - Neurons & satellite cells - Parasympathetic ganglia & plexuses - Neurons & satellite cells - Enteric plexuses - Neurons & glial cells - Schwann cells of all peripheral nerves - Medulla of suprarenal gland, chromaffin cells - Carotid body type I cells (and type II, satellite type cells) - Calcitonin-producing cells ( c-cells) - Melanocytes - Mesenchymal derivatives in the head - Frontal, parietal, squamous temporal, nasal, vomer, palatine bones, maxillae & mandible - meninges - Choroid, sclera, iris & ciliary body (controversial) (Iris muscles- Sphinctor & dilator pupillae - from neural plate ectoderm) - Connective tissue of lacrimal, nasal, labial, palatine, oral & salivary glands. - Dentine of teeth (odontoblasts - Connective tissues of head, including cailage, ligaments & tendons - Connective tissues of thyroid gland & of pharyngeal pouches i.e, parathyroid glands & thymus - Tunica media of outflow tract of hea & the great vessels.

Answer: OPTION C IS CORRECT.
Question: Sarcoidosis is associated with –
Options:
A. Band keratopathy
B. Systemic amyloidosis
C. Angioid streaks
D. Cataracta nigra

Rationale: Sarcoidosis is associated with band keratopathy from metabolic derrangement resulting in hypercalcemia.

Answer: OPTION A IS CORRECT.
Question: Posner-schlossman syndrome is -
Options:
A. Ipsilateral optic atrophy with contralateral papilloedema
B. Unilateral glaucomatous changes with mild anterior uveitis
C. Granulomatous uveitis with iris heterochromia
D. None of the above

Rationale: It is also known as glaucomatocyclitic crisis. It shows mild uveitis with severe rise of IOP. Disease typically effects young adults, 40% of whom are positivs for HLA-BW54 REF:khurana page no. 167

Answer: OPTION B IS CORRECT.
Question: Subconjunctival hemorrhage does not occur in
Options:
A. High intraocular tension
B. Trauma
C. Peussis
D. Eye rubbing

Rationale: .

Answer: OPTION A IS CORRECT.
Question: Ocular hypeension carries a high risk of progression to open angle glucoma . All of the statements given below are associated with the progression except :
Options:
A. Corneal thickness has no co-relation with the progression
B. Myopics have increased risk for progression
C. Progression can be delayed by controlling IOP
D. Progression is seen more commonly in Caucasian population

Rationale: Various risk factors for progression of Occular Hypeension to POAG include- African , Caucasians race Thin Cornea predisposes to POAG Myopics Elderly Trabecular fibrosis Myocillin gene Optineurin Gene OCULAR HYPEENSION GLAUCOMA Low tension Glaucoma Increased IOP(>22 mmHg) Increased IOP (>22 mmHg) Normal IOP(10-21mmHg) Normal visual field Visual field defects Seen Visual field defects Seen No optic disc change Optic disc change seen Optic disc change seen

Answer: OPTION A IS CORRECT.
Question: 23 year old lady sony develops brown macular lesions over bridge of nose and cheek following exposure to light. The probable diagnosis is
Options:
A. SLE
B. Acne Rosacea
C. Chloasma
D. Photodermatitis

Rationale: C i.e. Chloasma

Answer: OPTION C IS CORRECT.
Question: A 26-year-old woman presents to her primary care physician with fever, malaise, and "yellow eyes." She denies alcohol abuse, but admits to indulging in a dozen raw oysters at happy hour 3 weeks ago. In addition to scleral icterus, physical examination reveals a mildly enlarged liver with tenderness to palpation. Laboratory studies demonstrate a markedly increased aspaate aminotransferase and alanine aminotransferase and increased IgM and anti hepatitis A titers. Which of the following is the most likely result of this infection?
Options:
A. Cirrhosis
B. Complete resolution
C. Establishment of a chronic carrier state
D. Fulminant hepatitis

Rationale: The patient has a case of hepatitis A (HAV), most likely associated with the consumption of uncooked shellfish. Complete resolution occurs in an overwhelming majority of cases. Although possible, fulminant hepatic failure is unlikely with HAV infection. There is no association of HAV with either cirrhosis or hepatocellular carcinoma, as there is for hepatitis B and C.

Answer: OPTION B IS CORRECT.
Question: A 2-week-old female infant has a head circumference of 40 cm (>98%), with a large, tense fontanelle and downward deviation of the eyes. She has been vomiting her formula and she is irritable. Common cause of her symptoms include all EXCEPT:
Options:
A. Intraventricular hemorrhage
B. Brain tumor
C. Meningitis
D. Aqueductal stenosis

Rationale: Ans. B. Brain tumorThe common causes of hydrocephalus in neonates are intraventricular (subarachnoid) hemorrhage, infection; and congenital malformations (e.g., aqueductal stenosis, Arnold-Chiari malformation). Brain tumors rarely occur in the first year of life, and if present at this age, they are most likely to be supratentorial. When hydrocephalus occurs in infants and is associated with signs of raised intracranial pressure (especially without fever), vomiting, and irritability, an infratentorial brain tumor must be suspected.

Answer: OPTION B IS CORRECT.
Question: A 30 years old male from a rural background presents to the ophthalmology clinic with history of difficulty in vision for 10 days. He gives history of vegetative material falling into left eye about 15 days back. On examination an ulcerative lesion in the cornea with feathery margins and creamy exudates is seen. Few satellite lesions were also noted. The most likely diagnosis etiologic agent is:
Options:
A. Corynebacterium diphtheriae
B. Fusarium species
C. Acanthomoeba species
D. Streptococcus pneumonia

Rationale: Ans. (b) Fusarium speciesRef: Parson's 21/e, p. 199; Kanski 7/e, p. 180 - 181; Yanoff 3/e, p. 271History of trauma to eye involving vegetative matter and corneal infiltrate with feathery/fluffy margins is typically of fungal keratitis (Fusarium).

Answer: OPTION B IS CORRECT.
Question: β-blockers act in glaucoma by -
Options:
A. Increased aqueous outflow
B. Decreased aqueous production
C. Reduce vitreous volume
D. None

Answer: OPTION B IS CORRECT.
Question: A child has got a congenital cataract involving the visual axis which was detected by the parents right at bih. This child should be operated:
Options:
A. Immediately
B. At 2 months of age
C. At 1 year of age when the globe becomes normal sized
D. After 4 years when entire ocular and orbital growth becomes normal

Rationale: Ans. Immediately

Answer: OPTION A IS CORRECT.
Question: Most common site of angioedema:
Options:
A. Hands
B. Lips
C. 3rd week
D. Eyelid

Rationale: Ans. B. Lipsa. Angioedema is the swelling of deep dermis, subcutaneous, or submucosal tissue due to vascular leakage.b. Acute episodes often involve the lip, eyes, and face; however, angioedema may affect other parts of body, including respiratory and gastrointestinal (GI) mucosa.c. Most common site of angioedema: LIPS > Tongued. Laryngeal swelling can be life-threatening.

Answer: OPTION B IS CORRECT.
Question: Treatment of cataract in infant is
Options:
A. Lensectomy
B. ECCE
C. Phacoemulsification
D. All of the above

Rationale: ICCE is contraindicated in children, because there is a strong adhesion between the posterior capsule of the lens and vitreous called hyaloidocapsular ligament Dissicision is an obsolute procedure Refer: Khurana 6th edition page number 201

Answer: OPTION D IS CORRECT.
Question: Diabetes mellitus can lead to:
Options:
A. Vitreous haemorrhage
B. Rubeosis iridis
C. Retinal detachment
D. All

Rationale: A i.e. Vitreous haemorrhage; B i.e. Rubeosis iridis; C i.e. Retinal detachment

Answer: OPTION D IS CORRECT.
Question: Not a risk factor for primary Angle closure glaucoma among the following
Options:
A. Female gender
B. Small eyeball
C. Myopia
D. Type A personality

Rationale: Hypermetropia is a risk factor for primary Angle closure glaucoma not myopia.

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: Ophthalmic aery arises from Internal Carotid Aery as it emerges from the roof of the Cavernous Sinus, enters the Orbit through Optic canal inferolateral to the optic nerve, both lying in a common dural sheath. Gives central aery to retina (an end aery), and also supplies ethmoidal sinuses by giving ethmoidal aeries.

Answer: OPTION D IS CORRECT.
Question: Corneal endothelial cell count is measured by ?
Options:
A. Specular microscope
B. Ophthalmoscope
C. Synoptophore
D. Amsler's grid

Rationale: Ans. is 'a' i.e., Specular microscope Corneal endothelium is examined with specular microscope, which allows a clear morphological study of endothelial cells including photographic documentation. The cell density of endothelium is around 3000 cells/mm2 in young adults, which decreases with advancing age.

Answer: OPTION A IS CORRECT.
Question: The following Rosette cataract is seen with:
Options:
A. Steroid induced cataract
B. Traumatic cataract
C. Syndermatotic cataract
D. Rose thorn injury to lens

Rationale: Ans. (b) Traumatic cataract.

Answer: OPTION B IS CORRECT.
Question: The Anterior Segment of the eye includes all except
Options:
A. Anterior chamber
B. Posterior chamber
C. Vitreous
D. Lens

Rationale: Anterior Segment:- Anterior to the lens -Cornea -Iris -Lens -Two aqueous humor filled chambers Anterior chamber between corneal endothelium, angle and iris plane Posterior chamber between iris plane, anterior lens capsule and ciliary body-zonule complex Posterior Segment:- Posterior to the lens -Vitreous humor -Retina -Optic Disc -Choroid

Answer: OPTION C IS CORRECT.