QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: A 20-year-old woman presents with a 4-week history of dry mouth, fatigue, fever, and yellow sclerae. Physical examination shows mild jaundice and hepatomegaly Serum total bilirubin is 3.3 mg/dL. Serologic markers for viral hepatitis are negative. The anti-mitochondrial antibody test is negative. A liver biopsy discloses parenchymal and periportal inflammatory cell infiltrates composed primarily of lymphocytes and plasma cells. The patient's signs and symptoms abate following 2 months of treatment with steroids. Which of the following is the most likely diagnosis?
Options:
A. Autoimmune hepatitis
B. Extrahepatic jaundice
C. Primary biliary cirrhosis
D. Primary sclerosing cholangitis

Rationale: Autoimmune hepatitis is a type of chronic hepatitis, which is associated with circulating autoantibodies (e.g., antinuclear antibodies) and high levels of serum immunoglobulins. The disease typically affects young women but occasionally afflicts older women and men. It is often accompanied by other autoimmune diseases (e.g., Sjogren syndrome, systemic lupus erythematosus). None of the other choices respond to steroids. Primary biliary cirrhosis (choice C) features anti-mitochondrial antibodies. Primary biliary cirrhosis (choice C) and primary sclerosing cholangitis (choice D) do not manifest the described histologic findings.Diagnosis: Autoimmune hepatitis

Answer: OPTION A IS CORRECT.
Question: Which of the following is not lined by non-keratinized stratified squamous epithelium?
Options:
A. Hypopharynx and laryngopharynx
B. Oesophagus
C. Cornea
D. Tympanic membrane

Rationale: .

Answer: OPTION D IS CORRECT.
Question: A 63-year-old man is noticed to have asymmetric pupils. He is completely well and has no symptoms. On examination, the left pupil is small, round, and has a brisk response to light and near stimuli (accommodation). There is also ptosis of the left eyelid, but no other ocular movement abnormality or symptoms of double vision.For the above patient with a pupillary abnormality, select the most likely diagnosis.
Options:
A. essential anisocoria
B. Horner syndrome
C. tonic pupils (Holmes-Adie syndrome)
D. Argyll Robertson pupils

Rationale: Horner syndrome results in a small, round pupil on one side. Light and near reaction is brisk, and response to mydriatics and miotics is normal. The affected pupil will not dilate in the dark, so darkness accentuates the anisocoria. The syndrome is often idiopathic but can be caused by neoplasm, brain stem stroke, or carotid dissection.

Answer: OPTION B IS CORRECT.
Question: Conjunctival mucosal overgrowth over cornea-
Options:
A. Pterygium
B. Pingecula
C. Vernal keratoconjunctivitis
D. Herbe's pit

Rationale: Pterygium is a degenerative conjunctival fold which encroaches on the cornea in the palpebral area. It must be differentiated from pseudopterygium (an inflammatory fold of conjunctiva encroaching on cornea).Pterygium (L. Pterygion = a wing) is a wing-shaped fold of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure ref: A K KHURANA OPHTALMOLOGY,E4, Page-80 ref img

Answer: OPTION A IS CORRECT.
Question: Crystalline lens of the eye develops from
Options:
A. Mesoderm
B. Neural ectoderm
C. Surface ectoderm
D. Endoderm

Rationale: Answer: c) Surface ectoderm (PARSON 22nd ED, P-5)NEURAL ECTODERMSURFACE ECTODERMMESODERM# Epithelium of iris# Epithelium of ciliary body# Constrictor and dilator pupillae# Retinal pigment epithelium and its 9 sensory layers# Optic vesicle and cup# Optic nerve fibres# Melanocytes# Secondary vitreous# Epithelium of Conjunctiva# Epithelium of cornea# Lacrimal glands# Tarsal glands# Conjunctival glands# Crystalline Lens# Sclera# Corneal stroma# Descemet's membrane# Corneal endothelium# Iris# Choroid# Ciliary muscle# Sheaths of optic nerve# Blood vessels of the eye# Extraocular muscles# Trabecular meshwork# Primary vitreous

Answer: OPTION C IS CORRECT.
Question: A 6-year-old drowsy child came in emergency with history of vomiting, loose motion for 3 days. On examination he had sunken eyes, hypothermia, skin on pinching was taking 5 seconds to reve. What is your diagnosis?
Options:
A. No dehydration
B. Mild dehydration
C. Some dehydration
D. Severe dehydration

Rationale: In this case, sunken eyes and skin "goes back very slowly" (in 5 seconds) in a "lethargic" (drowsy) child, so it is a case of severe dehydration.

Answer: OPTION D IS CORRECT.
Question: Modified Glasgow coma scale defines neurologic impairment in terms of:
Options:
A. Pupillary size, level of consciousness and motor function
B. Speech, cardiovascular status a consciousness
C. Sensory, motor function and speech
D. Eye opening, best verbal response and motor function

Rationale: (D) Eye opening, best verbal response and motor function > Scale comprises three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered.> Lowest possible GCS (the sum) is 3 (deep coma or death), whilst the highest is 15 (fully awake person).> Best eye response (E):> There are 4 grades starting with the most severe:> No eye opening> Eye opening in response to pain. (Patient responds to pressure on the patient's fingernail bed; if this does not elicit a response, supraorbital and sternal pressure or rub may be used.)> Eye opening to speech. (Not to be confused with an awaking of a sleeping person; such patients receive a score of 4, not 3.)> Eyes opening spontaneously> Best verbal response (V):

Answer: OPTION D IS CORRECT.
Question: All of the following are true about Duret hemorrhage, EXCEPT:
Options:
A. Seen in conjunctiva
B. ICT increase
C. Cushing's triad
D. Seen in brain

Rationale: Duret haemorrhage: "Progressive rise in ICP cause fuher downward herniation into the foramen magnum or coning. This result in shearing of perforators supplying the brain stem causing haemorrhage known as duret haemorrhage. Tractional damage to pituitary stalk can result in diabetes insipidus. With progressive herniation the pupils become midsize & non reacting. These are invariably irreversible events leading to brainstem death". In case of increased ICP downward herniation of brainstem occur, which cause stretching of perforators of basilar aery & may results in bleed (duret haemorrhage). The local syndrome may include cushing's triad (aerial hypeension, bradycardia & respiratory irregularity). Duret haemorrhage is small area of bleeding in ventral & paramedian pa of upper brainstem (midbrain and pons). It usually indicates a fatal outcome, however survival has been repoed. Diagnosis is made on CT or MRI". Ref: Love & Bailey, 24th Edition, Page 611; Operative Neurological Techniques by Henry, 5th Edition, Page 35

Answer: OPTION A IS CORRECT.
Question: Which of the following is true of lepromatous leprosy  a) Bacterial index + to ++  b) Involvement of earlobes  c) Symmetrical involvement  d) Only a few bacilli are seen in the lesion  e) Loss of eyebrows
Options:
A. abc
B. bce
C. ade
D. cde

Answer: OPTION B IS CORRECT.
Question: The most common complication of hypermature sclerotic cataract is:
Options:
A. Dislocation of the lens
B. Phakomorphic glaucoma
C. Uveitis
D. Neovascularization of retina

Rationale: A i.e. Dislocation of lens

Answer: OPTION A IS CORRECT.
Question: 28-year old male while playing was hit on the head by a cricket ball . This hit fractures the orbit and damage the optic canal. Which of the following structures are most likely to be damaged during this hit are -
Options:
A. Optic nerve and ophthalmic aery
B. Ophthalmic vein and occulomotor aery
C. Ophthalmic aery and olfactory nerve
D. Ophthalmic nerve and optic nerve

Rationale: Floor of Anterior Cranial Fossa is formed by :- 1)Cribriform plate of ethmoid bone 2)Frontal bone 3)Lesser wing of sphenoid Frontal bone and lesser wing of sphenoid contribute in forming roof of orbit Lesser wing of sphenoid contains optic canal for passage of ophthalamic aery and optic nerve (2nd CN) Ophthalmic aery is a branch of internal carotid aery (associated with sympathetic fibers) Ant view Post view

Answer: OPTION A IS CORRECT.
Question: A patient presented with pain in left eye associated with visual distrubance, also a history of blunt trauma to eye 4 month back, first investingation of choice is
Options:
A. Introcular tension
B. Ophthalmoscopy
C. Perimetry
D. Ultrasound

Rationale: A i.e. Intraocular tension This is a case of angle recession glaucoma

Answer: OPTION A IS CORRECT.
Question: Frontal mucocele presents as:
Options:
A. Swelling above medial canthus,below the floor of frontal sinus
B. Swelling above eyebrow lateral to grabella
C. External proptosis
D. Intianasal swelling

Rationale: Mucocele of the frontal sinus: presents in the superomedial quadrant of the orbit (90%) and displaces the eyeball forward, downward and laterally. The swelling is cystic and nontender; egg-shell crackling may be elicited. Sometimes, it presents as a cystic swelling in the forehead (10%). Patient's complaints are usually mild and may include headache, diplopia and proptosis. Imaging of the frontal sinus usually reveals clouding of the sinus with loss of scalloped outline which is so typical of the normal frontal sinus . Treatment is frontoethmoidectomy with free drainage of frontal sinus into the middle meatus. Ref: Dhingra 7e pg 252

Answer: OPTION A IS CORRECT.
Question: All are features of iridocyclitis except
Options:
A. Pain
B. Mucopurulent discharge
C. Constricted pupil
D. Circum corneal congestion

Rationale: Ans) b (Mucopuntlent discharge) Ref: Kansk, 6th ed p447-448Mucopurulent discharge is seen in conjunctivitis Symptoms of iridocyclitis-Sudden onset painPhotophobiaRednessLacrimationSignsVisual acuity decreased,Circumcomeal congestionMiosisKeratic precipitatesAqueous cells and flare, hypopyon occAnterior vitreous cellsPosterior synechiaLow IOP

Answer: OPTION B IS CORRECT.
Question: All the following are true about Retinitis spunctata albescens except NOT RELATED-OPTHALMOLOGY
Options:
A. Autosomal dominant
B. Retinal pigmenta on in epithelium
C. Paicularly involves posterior pole of retina
D. White dots on fundus examination

Rationale: .

Answer: OPTION C IS CORRECT.
Question: What is the diagnosis of the following examination of the fundus
Options:
A. Diabetic retinopathy
B. Hypeension retinopathy
C. Optic atrophy
D. Central retinal vein occlusion

Rationale: This is the case of Hypeensive retinopathy with scattered flame (splinter) haemorrhages and cotton-wool spots. Hypeensive retinopathy is retinal vascular damage caused by hypeension. Signs usually develop late in the disease. Funduscopic examination shows aeriolar constriction, aeriovenous nicking, vascular wall changes, flame-shaped hemorrhages, cotton-wool spots, yellow hard exudates, and optic disk edema. Ref khurana 6th edition pg 234

Answer: OPTION B IS CORRECT.
Question: Leprosy involves all except
Options:
A. Uterus
B. Ovary
C. Nerve
D. Eye

Rationale: Uterus Uterus is the least likely site of involvement in Leprosy "Although Leprosy rarely involves the female genital tract, the ovary is the most commonly involved gynaecological site" - Blaustein's Pathology of the Female Genital Tract "There is little or no involvement of the female genital tract. 3 The repoed incidence of involvement of the ovary ranges from none or very litile,63.73'141 to almost half (47%) of cases."- International Journal of Dermatology: Visceral leprosy, Andria M. Klioze MD The above mentioned aicle has classified visceral organs into 3 categories: Uterus Uterus is the least likely site of involvement in Leprosy "Although Leprosy rarely involves the female genital tract, the ovary is the most commonly involved gynaecological site" - Blaustein's Pathology of the Female Genital Tract "There is little or no involvement of the female genital tract. 3 The repoed incidence of involvement of the ovary ranges from none or very litile,63.73'141 to almost half (47%) of cases."- International Journal of Dermatology: Visceral leprosy, Andria M. Klioze MD The above mentioned aicle has classified visceral organs into 3 categories: Organs with significant degree of infiltration or dysfunction Skin yes Peripheral nerves asopharynx arynx Kidney Liver esticles Organs with mild to moderate degree of infiltration or dysfunction Tongue Autonomic nervous system Spleen Bone marrow Adrenals Bone Lymph nodes Joints Peripheral vasculature Organs with none or minimal degree of infiltration or dysfunction Brain Striated muscle Cerebellum Ureter Leptomeninges Bladder Spinal cord Urethra Pancreas Prostate Lungs Seminal vesicles Hea External genitalia Great vessels Breasts Gallbladder Vagina Pancreas Uterus Esophagus Ovaries Stomach Thyroid gland Small intestine Parathyroid gland Large intestine Pituitary gland Striated muscle Pineal gland So according to this aicle both uterus and ovaries are none or minimally involved. Now this aicle fuher describes leprosy involvement of each and every organ system in detail. Under its description of Female reproductive system the aicle describes involvement of only ovary and does not even mention uterus. The exact lines are quoted below: 'There is little or no involvement of the female genital tract. The repoed incidence of involvement of the ovary ranges from none or very little, to almost half (47%) of cases. Menarche, menstruation, feility, and menopause do not seem to be affected." So to summarize: we have 2 Reference clearly stating that female genital tract is very rarely involved, and if there is any involvement, ovary is the most common genital organ to be involved.

Answer: OPTION A IS CORRECT.
Question: Refractive condition of the eye at bih is:
Options:
A. Hypermetropia of 2 D
B. Myopia of 2 D
C. Hypermetropia of 5 D
D. Myopia of 5 D

Rationale: A i.e. Hypermetropia of 2 D

Answer: OPTION A IS CORRECT.
Question: All of the following are seen in retinitis pigmentosa except: September 2009
Options:
A. Prominent retinal vessels
B. Ring scotoma
C. Pigmentation around the retinal veins
D. Pale disc

Rationale: Ans. A: Prominent retinal vessels The condition is abiotrophic in nature (premature senility and death of tissue) and genetically determined. Autosomal recessive is the most common and is very severe. Autosomal dominant is benign and is symptomatic only in adult life. X-linked recessive is least common. It is also a very severe form. Degeneration of rods commences near the equator. Macular region is not affected until late in the disease. The symptoms of retinitis pigmentosa are characteristic, the most prominent being defective vision in the dusk (night blindness/nyctalopia). It is due to degeneration of rods, which are primarily responsible for vision in low illumination. The visual field show concentric reduction. In early cases a paial or complete annular/ring scotoma is found. As the disease progresses the field becomes gradually smaller until at last it is reduced to a restricted area around the fixation point (tubular vision).Hence person has difficulty in moving about. Initially the equatorial region is affected. Ophthalmoscopic findings in the affected zones shows the retina studded with small, jet black spots resembling bone corpuscles with a spidery outline. The retinal pigment epithelium becomes transparent so that the choroid vessels become visible and the fundus appears tessellated or tigroid. The retinal veins, never the aeries, often have a sheath of pigment for pa of their course. The retinal vessels becomes extremely attenuated and thread like. The disc exhibits the characteristics of primary optic atrophy. It is pale and have a wax like yellowish appearance and is often termed as 'consecutive optic atrophy' (Ganglion cells destroyed with degeneration of the axial cylinders and optic nerve is known as consecutive atrophy). Ocular associations of retinitis pigmentosa are myopia, chronic simple glaucoma. Systemic associations of retinitis pigmentosa are in the form of various syndromes: Laurence - Moon - Biedl syndrome - obesity, hypogonadism, polydactyly and mental retardation. Usher's syndrome - deaf mutism. Secondary retinitis pigmentosa due to infections like syphilis, mumps, German measles (rubella) and due to drug like chloroquine must be differentiated from primary retinitis pigmentosa. Treatment: is unsatisfactory Vasodilators - nicotinic acid. High doses of Vitamin A.

Answer: OPTION A IS CORRECT.
Question: Treatment of choice for the other eye in open angle glaucoma is
Options:
A. Peripheral iridectomy
B. Laser trabeculoplasty
C. Laser iridotoomy
D. Trabeculectomy

Rationale: Ans. (b) Laser trabeculoplasty* Please refer to above explanation* Treatment of choice for primary angle closure glaucoma (fellow eye, latent stage, subacute or intermittent stage , chronic stage) is laser iridotomy* Peripheral surgical iridectomy can also be used.* In acute congestive stage of PACG drug of choice is Pilocarpine, till the time laser iridotomy can be performed. Treatment of choice for fellow eye | | |Primary open angle glaucoma Primary angle closure glaucoma | | Laser trabeculoplasty Nd YAG Laser Iridotomy

Answer: OPTION B IS CORRECT.
Question: Aqueous humor is produced by the
Options:
A. Choroid plexus
B. Trabecular meshwork
C. Ciliary processes
D. Vitreous body

Rationale: Aqueous humor is produced by the ciliary processes of the ciliary body. It flows from the posterior chamber, through the pupil, into the anterior chamber, and finally to the canal of Schlemm, which empties into the extraocular/episcleral veins.

Answer: OPTION C IS CORRECT.
Question: Most common type of astigmatism in keratoconus is
Options:
A. Simple myopia
B. Simple hypermetropia
C. Irregular astigmatism
D. Regular astigmatism

Rationale: Keratoconus usually have irregular astigmatism * B/L Non inflammatory ectatic condition of cornea Clinical Presentation * Young females with constantly changing power of glasses with myopia & high cylinder and irregular astigmatism SIGNS IN KERATOCONUS Munson sign Enlarged corneal nerves Oil droplet reflex( on DDO) Rizutti sign Hydrops Fleischer ring

Answer: OPTION C IS CORRECT.
Question: Keratan sulfate I and II is found in
Options:
A. Cornea
B. Cartilage
C. Loose connective tissue
D. All of the above

Rationale: Biologically Important GAGs:

Answer: OPTION D IS CORRECT.
Question: In the incidence of primary angle closure glaucoma, male to female ratio is:
Options:
A. 1:01
B. 1:02
C. 1:03
D. 1:04

Rationale: Ans. 1:4

Answer: OPTION D IS CORRECT.
Question: Maximum density of goblet cells is seen in
Options:
A. Superior conjunctiva
B. Inferior conjunctiva
C. Temporal conjunctiva
D. Nasal conjunctiva

Rationale: Goblet cells form the mucus layer of the tear film They are maximum nasally and least superiorly REF:Refer Khurana 6th edition page number 59

Answer: OPTION D IS CORRECT.
Question: Which of the following malignancy is associated with invasion of Voex Vein?
Options:
A. Retinoblastoma
B. Malignant melanoma
C. Optic nerve gliomas
D. Medullo-epitheliomas

Rationale: Malignant melanoma of the choroid is the most common primary intraocular tumor of adults usually between the age group 40-70 years. It is rare in blacks and is more common in whites. It arise from the neural crest derived pigment cells of the uvea as a solitary tumor and is usually unilateral. This tumor during the stage of extraocular extension burst through the sclera at limbus. This extraocular spread occur through the perivascular spaces of voex veins or ciliary vessels. Ref: Comprehensive Ophthalmology By AK Khurana, 4th Edition, Pages 162-5.

Answer: OPTION B IS CORRECT.
Question: Causes of exudative retinal detachment are all except -
Options:
A. Toxemia of pregnancy
B. Scleritis
C. High myopia
D. Central serous retinopathy

Rationale: Occurs due to the retina being pushed away by a neoplasm or accumulation of fluid beneath the retina following inflammatory or vascular lesions. Etiology: Systemic diseases- toxaemia of pregnancy, retinal HTN, blood dyscrasias. Ocular diseases- scleritis, central serous retinopathy, orbital cellulitis, retinoblastoma, malignant melanoma of choroid. Ref: Khurana 5th edition , page no 298

Answer: OPTION C IS CORRECT.
Question: Hirschberg test is used to detect
Options:
A. Optic atrophy
B. Squint
C. Glaucoma
D. Field defects

Rationale: Hirschberg corneal reflex test: It is a rough but handy method to estimate the angle of manifest squint. In it the patient is asked to fixate at point light held at a distance of 33 cm and the detion of the corneal light reflex from the centre of pupil is noted in the squinting eye. Roughly, the angle of squint is 15deg and 45deg when the corneal light reflex falls on the border of pupil and limbus, respectively. Ref:- A K KHURANA; pg num:-327

Answer: OPTION B IS CORRECT.
Question: Not true regarding meibomian glands
Options:
A. Arranged veically
B. More in upper lid than in lower lid
C. Modified sebaceous glands
D. Open in follicles of eyelashes

Rationale: * Meibomian glands open in eyelid margins Meibomian glands Arranged veically More in upper lid than in lower lid Modified sebaceous glands Open in eyelid margins Constitute the oily layer of tear film Internal Hordeolum is the infection of meibomian gland

Answer: OPTION D IS CORRECT.
Question: Esotrotropia is most commonly associated with
Options:
A. Hyperopia
B. Myopia
C. presbyopia
D. Astigmatism

Rationale: Near vision impaired they try to compensate by increasing their accomodation Infants are hyperopic by 2.5 D they are esotropic at bih ref : ak khurana 7th ed

Answer: OPTION A IS CORRECT.
Question: NOT a feature of trachoma:
Options:
A. Corneal opacity
B. Chalazion
C. Entropion
D. Herbe's pits

Rationale: Clinical features of trachoma - Lacrimation Photophobia Red eyes Hall mark - Sago grain follicles Herbe's pits seen Arlt's line on upper palpebral conjunctiva seen - sub conjunctival line of fibrosis Arlt's triangle seen in anterior uveitis - lower 1.3rd of the corneal endothelium where Keratic Precipitates settle due to the normal aqueous flow dynamics Pannus seen (nonspecific sign) Chalazion are not associated with trachoma- chronic inflammatory granuloma of the meibomian gland Seen in people with Oily skin Ocular rosacea

Answer: OPTION B IS CORRECT.
Question: Bull's neck is characteristically seen in:
Options:
A. Hamaoma of Lung
B. Diphtheria
C. Glaucoma
D. Hepatic Candidiasis

Rationale: Faucial diphtheria : commonest type of diphtheria. Characterized by fever, sore throat, pseudo membrane over fauces. Cervical adenitis with sub-mandibular edema is called bull neck.

Answer: OPTION B IS CORRECT.
Question: A 59-vear-old man with type 2 diabetes goes for a screening eve examination. The ophthalmologist reports that the patient has developed non-proliferative retinopathy. (List the findings.)For the above patient with a complication of diabetes, select the most likely diagnosis or findings.
Options:
A. microaneurysms and hemorrhage (dot and blot)
B. vitreal hemorrhage
C. dilated veins
D. open-angle glaucoma

Rationale: Background retinopathy is present in about 90% of diabetes after 25-30 years of disease. Microaneurysms, dilated veins, dot and blot hemorrhages, cotton-wool spots, and hard exudates are common findings.

Answer: OPTION A IS CORRECT.
Question: Which of the following is known as "Gateway of tears" -
Options:
A. Killian's dehiscence
B. Rathke's pouch
C. Waldeyer's ring
D. Sinus of Morgagni

Rationale: Inferior constrictor muscle has 2 parts; thyropharyngeus with oblique fibres and cricopharyngeus with transverse fibres. Between these 2 parts, there is a potential gap called as killians dehiscence or gateway of tears as perforation can occur at this site during oesophagoscopy and it is also the site for herniation of pharyngeal mucosa in case of the pharyngeal pouch.

Answer: OPTION A IS CORRECT.
Question: NOT a feature of ligature strangulation: Kerala 08
Options:
A. Horizontal ligature mark
B. Incomplete ligature mark
C. Marked congested face
D. Sub-conjunctival hemorrhage

Rationale: Ans. Incomplete ligature mark

Answer: OPTION B IS CORRECT.