QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: Patient with fixed dilated pupil, with iris atrophy and secondary glaucoma after penetrating keratoplasty is suggestive of:
Options:
A. Benedict's syndrome
B. Posner-Shlossman syndrome
C. Kaufmann's syndrome
D. Urrets Zavalia syndrome

Rationale: Ans. d. Urrets Zavalia syndrome (Ref: style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">icles/PMC1770988)A fixed dilated pupil following penetrating keratoplasty is a well recognized if rare postoperative complication.The mydriasis following penetrating keratoplasty was first described by Castroviejo but it was Urrets-Zavalia who first published his observations on a series of six cases and suggested an association of fixed dilated pupil, iris atrophy, and secondary glaucoma.The pupil can become abnormally dilated following penetrating keratoplasty for keratoconus, particularly if dilating drops are used.In addition to the pupil and iris abnormalities, Urrets-Zavalia also described other features--iris ectropion, pigment dispersion, anterior subcapsular cataract and posterior synechiae.Urrets Zavalia SyndromeUrrets Zavalia Syndrome is characterized by triad of: Secondary glaucoma + Iris atrophy + Fixed dilated pupilQUrrets-Zavalia syndrome (UZS) consists of a fixed dilated pupil associated with iris atrophy.It is a poorly understood complication following penetrating keratoplasty for keratoconus.Posner Shlossman syndromeIt is also called as glaucomatocyclitic crisis.Episodic unilateral mild anterior uveitis, photophobia, reduced vision and colored rings around lights (from secondary corneal edema)Benedict's SyndromeIf red nucleus is involved, tremors and jerky movements occur in contralateral side of the body.This condition combined with ipsilateral 3rd nerve paralysis is called as Benedict's syndrome.McKusick-Kaufmann SyndromeMcKusick-Kaufman syndrome: A rare genetic disorder characterized by hydrometrocolpos (fluid buildup in vagina and uterus), extra fingers and congenital heart defects.

Answer: OPTION D IS CORRECT.
Question: A 10-year-old male child with sho stature presented to the pediatric OPD with complaints of frequent headaches over the past 6 months along with slowly progressive loss of vision of the right eye. Lately the child has also staed having trouble in walking along with frequent mood changes and excessive thirst. MRI brain showed a tumour in the sellar region which was resected. HPE examination showed reticular epithelial cells that have appearances reminiscent of the enamel pulp of developing teeth along with calcifications and wet keratin nodules. The gene involved in causing the above condition is also involved in causing which other condition: -
Options:
A. Hepatocellular carcinoma
B. Melanoma
C. Neuroblastoma
D. CML

Rationale: This is a case of Craniopharyngioma. Benign tumour Arise in sellar/suprasellar region Arise from vestigial remnants of Rathke's pouch Bimodal age distribution Presents with headache and visual disturbance May present with sho stature due to GH deficiency (Pituitary hypofunction). Most commonly due to abnormalities in WNT signaling pathway including the activating mutations of the beta-catenin. MRI image shows a mass in the suprasellar region- likely craniopharyngioma OTHER CANCERS DUE TO WNT PATHWAY Mutations in b-catenin are present in: - 50% of hepatoblastomas. 20% of Hepatocellular carcinomas GENES INVOLVED IN: - Melanoma- NRAS, FGF3, HST1 Neuroblastoma- N-MYC, ALK CML- ABL

Answer: OPTION A IS CORRECT.
Question: A 44-year-old patient comes to his primary care physician complaining of double vision. On examination, he is unable to adduct or abduct his right eye- On further examination, he is also found to be unable to adduct his left eye. The remainder of the physical examination is normal. 
which of the following is the most likely location of the patient’s lesion?
Options:
A. Left abducens nerve
B. Left abducens nucleus and left medial longitudinal fasciculus
C. Right abducens nerve
D. Right abducens nucleus and right medial longitudinal fasciculus

Answer: OPTION A IS CORRECT.
Question: Normal axial length of the eye -
Options:
A. 18mm
B. 20 mm
C. 24mm
D. 28 mm

Rationale: Ans. is 'c' i.e., 24 mm o The length of the eyeball is approximately 24 mm, So the distances from the cornea / crystalline lens to the retina and the focal length of optical rays focused by the comea/crystalline lens propagating in the vitreous humor and imaging on the retina, are also about 24 mm.Dimensiosn of an adult eyeAnteroposterior diameter (Length)24 mmHorizontal diameter23-5mmVertical diameter23 mmCircumference75 mmVolume6-5 mlWeight7 gm

Answer: OPTION C IS CORRECT.
Question: Best way to prevent infection after cataract surgery is
Options:
A. Antibiotics
B. Eye brow shaving
C. Through irrigation
D. None of the above

Rationale: Topical antibiotics such as tobramycin or gentamicin or ciprofloxacin QID for 3 days just before surgery is advisable as prophylaxis against endophthalmitis.Ref: Khurana; 4th edition; Pg- 184

Answer: OPTION A IS CORRECT.
Question: In children which of the following virus has been implicated in the pathogenesis of choroid plexus tumour?
Options:
A. Simian virus 40
B. HIV
C. Herpes simplex
D. Hepa s B

Rationale: Simian virus 40

Answer: OPTION A IS CORRECT.
Question: Vogt Koyanagi Harada syndrome is -
Options:
A. Cataract
B. C.N.S. tumour
C. Uveitis
D. Polycystic kidney

Rationale: Ans. is 'c' i.e., UveitisClinical manifestations of Vogt Kavanadi Harada syndromeOccular involvementC.N.S. involvementAuditory manifestationCutaneous manifestationOccular involvementB/L panuveitis ino Meningismuso Hearing losso VitiligoB/L panuveitis inassociation with serouso Headacheo Tinnituso Alopeciaassociation w'ith serousretinal detachmento C.S.F. Pleocytosis retinal detachmentAccording to American uveitis society the criteria for diagnosis of VKH syndromeo No history' of ocular trauma or surgery.o At least three of four of the following signsBilateral chronic iridocyclitis.Posterior uveitis, including exudative retina! detachment, disc hyperemia or edema and sunset glow fundus.Neurological sign of tinnitus, neck stiffness cranial nerve or CNS problems or CSF pleocytosis.Cutaneous finding of alopecia, poliosis or vitiligo.

Answer: OPTION C IS CORRECT.
Question: The early changes in coicosteroid-induced cataract are in the form of:
Options:
A. Central posterior subcapsular lens changes
B. Anterior coical lens changes
C. Nuclear changes
D. Diffuse lens changes

Rationale: Ans. Central posterior subcapsular lens changes

Answer: OPTION A IS CORRECT.
Question: Blindness in child is most commonly due to
Options:
A. Keratomalacia
B. Congenital cataract
C. Glaucoma
D. Injuries

Rationale: Most common cause of childhood blindness is vitamin A deficiency Refer: Khurana 6th edition page number 382

Answer: OPTION A IS CORRECT.
Question: In which layer of cornea, copper is deposited to form Kayser-Fleischer ring in Wilsons disease?
Options:
A. Bowman's layer
B. Corneal stroma
C. Descemet's membrane
D. Corneal endothelium

Rationale: Nearly all patients with neurologic involvement in Wilson disease develop eye lesions called Kayser-Fleischer rings, green to brown depositsof copper in Descemet membrane in the limbus of the cornea.Wilson disease is an autosomal recessive disorder caused by mutation of the ATP7B gene, resulting in impaired copper excretion into bile and a failure to incorporate copper into ceruloplasmin. This disorder is marked by the accumulation of toxic levels of copper in many tissues and organs, principally the liver, brain, and eye.Ref: Robbins Pathology; 9th edition; Page no: 849

Answer: OPTION C IS CORRECT.
Question: Von-Meyenburg's complexes are seen in -
Options:
A. Brain
B. Liver
C. Kidney
D. Spleen

Rationale: Von Meyenburg Complexes

Close to or within the portal tract, these are small clusters of modestly dilated bile ducts embedded in a fibrous, sometimes hyalinised stroma.
Although these "bile duct microhamartomas" may communicate with the biliary tree, they generally are free of the pigmented material tree.
They presumably arise from residual embryonic bile duct remnants. Occasionally, a triangular bile duct hamartoma may lie just under Glisson's capsule.

Polycystic liver disease

There are multiple diffuse cystic lesions in the liver.

Congenital hepatic fibrosis

Portal tracts are enlarged by irregular, broad bands of collagenous tissue, forming septa that divide the liver into irregular islands.
Variable numbers of abnormally shaped bile ducts are embedded in the fibrous tissue and are in continuity with the biliary tree.

Caroli disease

The larger ducts of the intrahepatic biliary tree are segmentally dilated and contain inspissated bile.

Answer: OPTION B IS CORRECT.
Question: An 8-month-old child presented with reduced appetite, abdominal distension and pain and psychomotor retardation. The child was normal at bih and both parents are normal. O/E: - Hepatosplenomegaly Moderate lymphadenopathy Abnormal posturing of the limbs, trunk, and face Impaired voluntary rapid eye movements Cheery red spot on fundus examination. Bony defects Lymph node-histopathology and electron microscopy. EM findings Which of the following enzymes is most likely deficient in the above disease: -
Options:
A. Hexosaminidase A
B. Alpha-galactosidase A
C. Glucocerebrosidase
D. Sphingomyelinase

Rationale: This is a case of Niemann-pick disease. 1. Autosomal recessive disease 2. Divided into 2 groups depending on deficiency: - Deficiency of acid sphingomyelinase enzyme- Type A and B Impaired intracellular cholesterol trafficking- Type C and D 3. Normal at bih 4. Presents with hepatosplenomegaly, lymphadenopathy and cherry red spot on fundus examination. 5. HPE image shows Niemann-pick cells- These are foam cells with soap suds appearance (Distention of Lysosomes due to sphingomyelin and cholesterol) 6. Electron microscopy shows Zebra bodies - These are concentric lamellated myelin figures (in engorged secondary lysosomes). OTHER ENZYME DEFICIENCIES: - Hexosaminidase A- Tay-sach's disease Alpha-galactosidase A - Fabry's disease Glucocerebrosidase - Gaucher's disease

Answer: OPTION D IS CORRECT.
Question: A 60-year-old man with diabetes acutely develops double vision and discomfort in his left eye. On examination, there is ptosis of the left eyelid, the eye is rotated down and out, and the pupil is 3 mm and reactive to light. The right eye is normal. Which of the following is the most likely diagnosis?
Options:
A. fourth nerve palsy
B. diabetic autonomic neuropathy
C. third nerve palsy
D. sixth nerve palsy

Rationale: Third nerve palsy can result in ptosis of the eyelid. There is also loss of the ability to open the eye, and the eyeball is deviated outward and slightly downward. With complete lesions, the pupil is dilated, does not react to light, and loses the power of accommodation. In diabetes, the pupil is often spared. The sixth cranial nerve can also be affected by diabetes, but this is much less common.

Answer: OPTION C IS CORRECT.
Question: Stocker&;s line is seen in
Options:
A. Pinguecula
B. Pterygium
C. Congenital ocular melanosis
D. Conjunctival epithelial melanosis

Rationale: Pterygium It presents as a triangular fold of conjunctiva encroaching the cornea in the area of the palpebral apeure, usually on the nasal side, but may also occur on the temporal side. Deposition of iron seen sometimes in corneal epithelium anterior to advancing head of the pterygium called as stocker's line. Pas. A fully developed pterygium consists of three pas: i. Head (apical pa present on the cornea), ii. Neck (limbal pa), and iii. Body (scleral pa) extending between limbus and the canthus. Stocker's line in pterygium. Pterygium is a fibrovascular proliferative disorder in which conjunctival tissue grows medially to cover the clear cornea. On slit-lamp examination showed marked pterygium that extend from the nasal side of bulbar conjunctiva onto the cornea in the left eye Ref: Khurana; 4th ed; Pg 80

Answer: OPTION B IS CORRECT.
Question: Glaucoma drug which is b-1 selectve p-blocker is ?
Options:
A. Timolol
B. Laevobuno I ol
C. Caeolol
D. Betaxolol

Rationale: Ans. is 'd' i.e., Betaxolol o Among the given options, only betaxolol is 0-1 selective.

Answer: OPTION D IS CORRECT.
Question: All can occur due to blunt trauma of eye except -
Options:
A. Berlin's edema
B. Angle recession
C. Sympathetic ophthalmitis
D. Rosette cataract

Rationale: 1. Lids: Ecchymosis, Black eye, avulsion of the lid, traumatic ptosis. 2. Orbit: Fracture of the orbital walls, orbital haemorrhage, orbital emphysemas. 3. Lacrimal apparatus: Laceration of canaliculi, dislocation of lacrimal gland. 4. Conjunctiva: Subconjunctival haemorrhage, chemosis, lacerating tears of the conjunctiva. 5. Cornea: Abrasion, paial or complete corneal tear, deep corneal opacity. 6. Sclera: Scleral tear. 7. Anterior chamber: Traumatic hyphaema, Collapse of the anterior chamber following perforation. 8. Iris, pupil and ciliary body: Traumatic miosis, traumatic mydriasis, radiating tears in iris stroma, iridodialysis, traumatic aniridia, traumatic cyclodialysis, traumatic uveitis. 9. Lens: Vossius ring, Concussion cataract, Early rosette cataract, Late rosette cataract, Total cataract, Subluxation of the lens, Dislocation of the lens. 10. Vitreous: Traumatic vitreous degeneration, Traumatic vitreous detachment, Vitreous haemorrhage. . Retina: Commotio retinae (Berlin's oedema), retinal haemorrhages, retinal tears, retinal detachment, traumatic macular oedema, traumatic macular degeneration. sympathetic Ophthalmities is seen in perforating injuries. Ref.. Khurana 6/e p564

Answer: OPTION C IS CORRECT.
Question: Surest sign of brain stem death
Options:
A. Absent Doll's eye reflex
B. Fixed dilated pupil not reacting to light
C. Cheyne Stokes breathing
D. Decerebrate posture

Rationale: B i.e. Fixed dilated pupil not responding to light Cooling of body & rigor mois is a sign of molecular or cellular death. - Somatic (systemic, clinical or brain) death is cessation of spontaneous breathing, circulation and brain activity (as indicated by flat isoelectric EEG, deep unconsciousness with no response to external stimuli or internal need). Surest sign of brain stem death is fixed dilated pupil not constricting (responding) to light.Q

Answer: OPTION B IS CORRECT.
Question: Which of the following best defines the "Saccade"-
Options:
A. Voluntary slow eye movements
B. Involuntary slow eye movement
C. Abrupt, involuntary slow eye movements
D. Abrupt, involuntary rapid eye movements

Rationale: Saccades are sudden, jerky conjugate eye movements that occur as the gaze shifts from one object to another. Supranuclear eye movement systems include : Saccadic system Smooth pursuit system Vergence system Vestibular system Optokinetic sysytem Position maintenance system Ref;A.K.Khurana;6th edition; Page no: 341

Answer: OPTION D IS CORRECT.
Question: Ketocanozole is useful in all except -
Options:
A. T. cruris
B. T.versicolor
C. T.capitis
D. T.corpoiris

Answer: OPTION C IS CORRECT.
Question: Swimmer after coming out frm swimming pool presents with redness and mucopurulent discharge. There is no history of contact lens wear. On examination, no corneal involvement seen. Probable diagnosis is -
Options:
A. Acanthamoeba keratitis
B. Adul inclusion conjunctivitis
C. Vernal keratoconjunctivitis
D. Angular conjunctivitis

Rationale: This is case of Swimming pool conjunctivits/granuloma-Which is adult inclusion conjunctivitis caused by chlamydia trachomatis. Ref: Khurana 7th/e p.73 & 4th/e p.63,68

Answer: OPTION B IS CORRECT.
Question: Essential atrophy of the choroid is due to inborn error of metabolism of which amino acid?
Options:
A. Cystine
B. Cysteine
C. Arginine
D. Ornithine

Rationale: Ans.D.) Ornithine. Ornithine aminotransferase deficiency (also known as gyrate atrophy of the choroid and retina) is an inborn error of ornithine metabolism, caused by decreased activity of the enzyme ornithine aminotransferase. Biochemically, it can be detected by elevated levels of ornithine in the blood. Clinically, it presents initially with poor night vision, which slowly progresses to total blindness. It is believed to be inherited in an autosomal recessive manner.

Answer: OPTION D IS CORRECT.
Question: The function of vitamin A is/are related to which of the following?
Options:
A. Retinol
B. Retinal
C. Retinoic acids
D. All of the above

Answer: OPTION D IS CORRECT.
Question: . A neonate is seen crying with eyes closed and moving all his limbs. What is the Neonatal Behavioral response scale -
Options:
A. Scale 1
B. Scale 3
C. Scale 5
D. Scale 6

Rationale: Scale 6 Neonatal behavior assessment scale It is a scale developed by T. Berry Brazelton for evaluating the neurological conditions and behavior of newborn by assessing his or her aleness, motor maturity, irritability and interaction with people. Scores SLEEP STATE I)Deep sleep: - Sleep with regular breathing, eyes closed, no spontaneous activity except stales or jerky movements at quite regular intervals. 2)Light sleep: - Sleep with eyes closed: rapid eye movements can often be observed under closed lids; low activity level with random movements and stales. AWAKE STATE 3)Drowsy: - Drowsy or semidozing; eyes may be open but dull and heavylidded, or closed, eyelids fluttering; activity level minimal, Movements are usually smooth, although there may be stales. "Some infants may also show fuss/ cry vocalizations in this state"Q. What distinguishes state 3 from state 5 when both are accompanied by fuss/ cry vocalizations is the minimal movement in state 3 and considerable movement in state 5 4)Quiescent ale: - Ale, eyes open with bright look. Motor activity is minimal there can be a glazed look that is easily changed into a brighter look with appropriate stimulation. 5)Active ale : - Eyes likely to be open; considerable motor activity, with thrusting movements of the extremities, and even a few spontaneous stales reactive to external stimulation with increase in stales or motor activity. 6)Crying:- Crying characterized by intense, loud, rhythmic, and sustained cry vocalizations that are difficult to break through with stimulation; motor activity is hige. Eyes may be tightly closed.

Answer: OPTION D IS CORRECT.
Question: A 15 year old girl was admitted to the infectious disease hospital with a provisional diagnosis of rabies. The most suitable clinical sample that can confirm the antemortem diagnosis is-
Options:
A. Serum for anti-rabies IgG antibody
B. Corneal impression smear for immunofluorescence stain
C. CSF sample for viral culture
D. Giemsa stain on smear prepared from salivary secretions

Rationale: For the antemortem diagnosis of rabies, viral antigens can be demonstrated in the corneal smear, skin biopsy from the face or neck or saliva.

Answer: OPTION B IS CORRECT.
Question: Synchysis refers to
Options:
A. Collapse of the vitreous
B. Black spots in front of the eyes
C. Liquefaction of the vitreous
D. Detachment of the vitreous

Rationale: VITREOUS LIQUEFACTION (SYNCHYSIS) Vitreous liquefaction (synchysis) is the most common degenerative change in the vitreous. Causes of liquefaction: 1. Degenerations such as senile, myopic, and that associated with retinitis pigmentosa. 2. Post-inflammatory, paicularly following uveitis. 3. Trauma to the vitreous which may be mechanical (blunt as well as perforating). 4. Thermal effects on vitreous following diathermy, photocoagulation and cryocoagulation. 5. Radiation effects may also cause liquefaction. Ref:- A K KHURANA; pg num:-244

Answer: OPTION C IS CORRECT.
Question: All are seen in blunt injury of the eye except:
Options:
A. Hyphema
B. Iridocyclitis
C. Double perforation
D. Retinal detachment

Rationale: Ans. Double perforation

Answer: OPTION C IS CORRECT.
Question: Which one of the following ultrasound marker is associated with greatest increased risk for Trisomy 21 in fetus
Options:
A. Echogenic foci in heart
B. Hyperechogenic bowel
C. Choroid plexus cysts
D. Nuchal edema

Rationale: (D) Nuchal edemaINCIDENCE OF MAJOR & MINOR DEFECTS/MA Trisomy 21NormalLikelihood ratio for isolated marker* Nuchal Fold33.5%0.6%9.8* Short humerus33.4%1.5%4.1* Short femur41.4%5.2%1.6* Hydronephrosis17.6%2.6%1.0* Echogenic focus in heart28.2%4.4%1.1* Echogenic bowel13.3%0.6%3.0* Major defect21.4%0.65%5.2

Answer: OPTION D IS CORRECT.
Question: Glaucomflecken are seen in:
Options:
A. Open angle glaucoma
B. Uveitis
C. Retinitis pigmentosa
D. Angle closure glaucoma

Rationale: Angle-closure glaucoma can have the appearance of glaucomflecken. Glaucomflecken are small anterior subcapsular opacities secondary to lens epithelial necrosis resulting from acute angle-closure glaucoma. - Signs of Angle closure glaucoma :Stony hard eye, steamy cornea, Veically oval mid-dilated non reacting pupil - Symptoms: Severe pain, coloured halos, sudden drop in vision. Symptoms occurs in late night - Nd-Yag Laser iridotomy is done for management of Angle closure glaucoma

Answer: OPTION D IS CORRECT.
Question: True about Moorens ulcer: March 2007, March 2013
Options:
A. Painless condition
B. Affects cornea
C. Sudden loss of vision
D. Bilateral in majority of cases

Rationale: Ans. B: Affects cornea Mooren's ulcer is a rare, painful, inflammatory condition affecting one or both eyes that results in the destruction of corneal tissue. The cause of Mooren's ulcer is unknown. It is generally agreed that it is an autoimmune condition. Pain is almost always associated with the onset of Mooren's ulcer. One or both eyes may be involved at either the same time or one following the other. Approximately two thirds of cases affect one eye only. Mooren's ulcer is more common in men than women. Damage begins at the edge of the cornea and may progress to involve the central cornea. A serious complication of Mooren's ulcer is formation of a perforation or hole, in the cornea. Conditions that can cause similar eye problems are rheumatoid ahritis, systemic lupus erythematosus and Wegener's granulomatosis.

Answer: OPTION B IS CORRECT.
Question: All are true except:
Options:
A. The infantile nucleus is completely formed by one year of age
B. The embryonic nucleus is situated between the two Y sutures
C. Congenital blue dot cataracts are associated with development of senile cataract at an early stage
D. Zonular cataracts typically affect the outer pa of the fetal or the inner pa of the adult nucleus

Rationale: Ans. The infantile nucleus is completely formed by one year of age

Answer: OPTION A IS CORRECT.
Question: Corneal lesion seen in Hutchinson triad associated with congenital syphilis is: September 2006
Options:
A. Disciform keratitis
B. Interstitial keratitis
C. Phylectenular keratitis
D. Mooren ulcer

Rationale: Ans. B: Interstitial keratitis Hutchinson's triad is named after Sir Jonathan Hutchinson. It is a common pattern of presentation for congenital syphilis, and consists of three phenomena: interstitial keratitis, Hutchinson incisors (notching of the two upper central incisors in the permanent dentition), and eighth nerve deafness

Answer: OPTION B IS CORRECT.
Question: Traumatic eye lesion can cause:
Options:
A. Vitreous haemorrhage
B. Corneal opacity
C. Exudative retinal detachment
D. All

Rationale: A. i.e. Vitreous hemorrhage; B. i.e. Corneal opacity; C i.e. Exudative retinal detachment

Answer: OPTION D IS CORRECT.
Question: Ocular manifestations of neurofibromatosis
Options:
A. Neurofibromas of lids & Orbit
B. Glioma of optic nerve
C. Congenital glaucoma
D. All the above.

Rationale: Ocular - a,b,c
Cutaneous - cafe-au-lait spots to neurofibromota.

Answer: OPTION D IS CORRECT.
Question: which layer of cornea helps in maintaining hydration OF stroma of cornea
Options:
A. Descement membrane
B. Endothelium
C. Epithelium
D. stroma

Rationale: REF : AK KHURANA 7TH ED

Answer: OPTION B IS CORRECT.
Question: Tricyclic antidepressant are contraindicated in:
Options:
A. Glaucoma
B. Brain tumor
C. Bronchial asthma
D. Hypeension

Rationale: Due to anticholinergic action, TCAs should be avoided in glaucoma These agents block muscarinic acetylcholine receptors, resulting in anticholinergic effects (e.g., dry mouth, blurred vision, urine retention, constipation); they are contraindicated in patients with glaucoma.

Answer: OPTION A IS CORRECT.