QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: A neonate is born at term with multiple problems. He is small for gestational age and has cataract, hepatosplenomegaly and thrombocytopenia with purpura. Fuher studies demonstrate patent ductus aeriosus, bone lucency, pneumonia, and meningoencephalitis. The mother is a 17-year-old girl who had no prenatal care and had a mild maculopapular rash in mid-pregnancy. Which of the following is the most likely diagnosis?
Options:
A. Congenital cytomegalovirus infection
B. Congenital rubella
C. Congenital syphilis
D. Congenital toxoplasmosis

Rationale: The rubella virus is one of the causes of devastating prenatal infection. In adults and older children, the virus can cause asymptomatic infection or a relatively mild febrile illness (German measles) with upper respiratory symptoms, lymphadenopathy, maculopapular rash, and sometimes joint symptoms. The effects on the fetus range from apparently asymptomatic infection to multiple anomalies to death in utero. Among the more common abnormalities are intrauterine growth retardation, involvement of the senses and nervous system (meningoencephalitis, cataracts, retinopathy, hearing loss), cardiac involvement (patent ductus aeriosus, pulmonary aerial hypoplasia), hepatosplenomegaly, purpura (due to thrombocytopenia), bluish red skin lesions (secondary to dermal erythropoiesis), and pneumonia. Apparently asymptomatic babies should be monitored for subsequent development of hearing loss, mental retardation, endocrinopathies, and (rarely) progressive encephalitis. Treatment is suppoive, as no specific antiviral therapy is available for this infection. The rubella vaccine should be given to women of childbearing age who are not pregnant at the time. Cytomegalovirus infections can cause asymptomatic to devastating disease in newborns; look for periventricular calcifications and mothers with a flu-like illness. Congenital syphilis can cause devastating disease in newborns and can occur in early forms (look for the rash of secondary syphilis) or late forms (look for bone and teeth abnormalities). Congenital toxoplasmosis can produce devastating infection in newborns; look for a maternal history of cleaning cat litter boxes.

Answer: OPTION B IS CORRECT.
Question: A 14-year-old boy complains of a 4-month history of fatigue, abdominal pain, and yellowing of his eyes and skin. Physical examination shows tremor of both hands, lack of coordination, and mild jaundice. An ophthalmic examination reveals Kayser-Fleischer rings. Degenerative changes are present in which of the following anatomic regions of the CNS in this patient?
Options:
A. Cerebellum
B. Corpus striatum
C. Paraventricular white matter
D. Pons

Rationale: Wilson disease is an autosomal recessive condition in which excess copper may deposit in the liver and brain. Chronic hepatitis leads to cirrhosis in young people. Ocular lesions, so-called Kayser-Fleischer rings, represent deposition of copper in Descemet membrane in the iris. Lack of coordination and tremor (extrapyramidal neurologic symptoms) are related to degenerative changes in the corpus striatum. Deposition of copper is not observed in the other anatomic regions of the brain.Diagnosis: Wilson disease

Answer: OPTION B IS CORRECT.
Question: Diabetic retinopathy is treated by:
Options:
A. Strict glycemic control
B. Panphotococagulation
C. Antihypeensive
D. All

Rationale: A i.e. Strict glycemic control; B i.e. Panphotocoagulation; C i.e. Antihypeensive Diabetic retinopathy is treated by - strict glycemic & hypeensive control, antioxidants, photocoagulation (pan retinal, focal argon laser or grid pattern laser burns), intravitreal steroids and anti-VGF (vascular endothelial growth factor)Q and continuous screening. LASIK is refractory surgery for high myopia and phacoemulsification is used for cataract surgery. General measures Strict control of blood glucose Q may delay the onset Control of hypeension Q when associated is essential Antioxidants Q are alsouseful for diabetics Aspirin- an antiplatelet factor has no role Pars plana vitrectomy is indicated for dense persistent vitreous hemorrhage, tractional retinal detachment and epiretinal membranes. Retinal detachment also requires surgery in DR. PDR= Proliferative Diabetic Retinopathy NPDR = Non-PDR Screening Yearly Till there is no-DR or there is mild NP-DR 6 monthly In moderate NPDR 3 monthly In severe NPDR 2 monthly In PDR with no high risk characteristic Pan retinal photocoagulation Focal argon laser burn Grid pattern laser burns * It consists of 1200-1600 spots, each 500 pm in It is applied to It is size and 0.1 sec duration individual applied in * It is applied 2-3 disc areas from the centre of microvascular macular macula extending peripherally to equator formations in the area for centre of hard diffuse * It is indicated in PDR (proliferative diabetic exudates' ring in focal macular retinopathy) with one of the high risk exudative edema characteristic maculopathy Photocoagulation

Answer: OPTION D IS CORRECT.
Question: True about measles –a) Rash appear first on legb) Koplik spots are seen in retinac) Long term complication follows in form of SSPEd) Caused by RNA viruse) IP–IS 2–3 day
Options:
A. cd
B. bc
C. bd
D. ac

Answer: OPTION A IS CORRECT.
Question: The most predictive and dangerous side effect of propranolol that makes it to be avoided in known patient of COPD is induction of -
Options:
A. Respiratory failure
B. Acute asthmatic attack
C. Glaucoma
D. Pleural effusion

Answer: OPTION B IS CORRECT.
Question: Chubby cheeks, eyes are blue and staring at the sky is a feature of
Options:
A. Cherubism
B. Fibrous dysplasia
C. Ectodermal dysplasia
D. Sicca syndrome

Answer: OPTION A IS CORRECT.
Question: Fusion of two eyelids by thin tags is called-
Options:
A. Ankyloblepharon filiforme adnatum
B. Euryblepharon
C. Ablepharon
D. Epiblepharon

Rationale: Ans. is 'a' i.e., Ankyloblepharon filiforme adnatum * In ankyloblepharon filiforme adnatum the upper and lower eyelids are joined by thin tags; most cases are sporadic. Treatment involves transection with scissors; anaesthesia is not required.* Ablepharon consists of deficiency of the anterior lamellae of the eyelids; treatment involves reconstructive skin grafting.* Euryblepharon refers to horizontal enlargement of the palpebral fissure with associated lateral canthal malposition and lateral ectropion; lagophthalmos and exposure keratopathy may result.* Epiblepharon comprises an extra horizontal fold of skin stretching across the anterior lid margin; it is very common in individuals of Eastern Asian ethnicity.

Answer: OPTION A IS CORRECT.
Question: Hashimoto's thyroiditis-True are all EXCEPT
Options:
A. Follicular destruction
B. Increase in lymphocytes
C. Oncocytic metaplasia
D. Orphan Annie eye nuclei

Answer: OPTION D IS CORRECT.
Question: Snowflake cataract is associated with: September 2008
Options:
A. Hypeension
B. Adult diabetes
C. Trauma
D. Juvenile diabetes

Rationale: Ans. D: Juvenile diabetes Snowflake Cataracts: This type of cataract represents dots of various sizes (and sometimes various colours) distributed throughout the coex surrounding the nucleus for 360deg. This is the most common cataract seen in Down Syndrome (extra copy of chromosome 21 also called trisomy 21) and juvenile diabetes mellitus. These usually have very little effect on vision. Adult diabetic cataract shows coical and/or nuclear and/or subcapsular (same as age related)

Answer: OPTION D IS CORRECT.
Question: A patient diagnosed with schizophrenia came with acute exacerbation of symptoms. Inj.Haloperidol was administered in the casuality and suddenly the patient had deviation of eye balls and torticollis. What is the diagnosis?
Options:
A. Akathisia
B. Acute dystonia
C. Malignant hyperthermia
D. Drug induced parkinsonism

Rationale: Acute dystonia is the earliest side effect seen immediately after the administration of antipsychotics. Acute dystonia is treated using anticholinergics like Benztropine, Promethazine.

Answer: OPTION B IS CORRECT.
Question: Earliest manifestation of diabetic retinopathy is
Options:
A. Soft exudates/Cotton wool spot
B. Dot haemorrhage
C. Hard exudates
D. Microaneurysm

Rationale: D i.e. Microaneurysm Microaneurysms are located in the inner nuclear layer and are the earliest and most characteristic ocular lesion Q of diabetic retinopathy.

Answer: OPTION D IS CORRECT.
Question: All of the following statement regarding measles are true except -a) Rash appears first on legb) Koplik spot are seen on retinac) Long term complication may be seen in form of SSPEd) Caused by RNA viruse) I-P is 2-3 days
Options:
A. abc
B. bcd
C. cde
D. abe

Rationale: Measles 

Measles is caused by a RNA virus of paramyxovirus.
Measles in also known as rubella
The only source of infection is a case of measles, carriers are not known to occur.
Infective period → 4 days before and 5 days after the appearance of rash.
Infective material → Secretions of nose, throat and respiratory tract
Age group → 6 month to 3 years.
Immunity → One attack of measles generally confers lifelong immunity. 
Transmission → 


Droplet infection through respiratory tract
Infection through conjunctiva.


Incubation period →


10 days from exposure to onset of fever.
14 days from exposure to appearance of rash.
7 days for live vaccine of measles.

Clinical manifestations
1) Prodromal stage

Begins 10 days after the infection and lasts until day 14.
Characterized by fever, coryza with sneezing and nasal discharge, redness of the eyes, lacrimation and photophobia.
A day or two before the appearance of rash, Koplik's spots appear on buccal mucosa opposite the 1st and 2nd lower molars.
Koplik's spots are pathognonzonic of measles.

2)    Eruptive phase

Maculopapular rash which begins behind the ear and spread rapidly in a few hour over the face and neck extends doWn the body.

3) Post measles stage

Weight loss                      
Growth retardation          
Diarrhea
Cancrum oris        
Reactivation of pulmonary TB     
Candidiasis

Answer: OPTION D IS CORRECT.
Question: Which of the following is derived from ectoderm?
Options:
A. Epithelium of iris
B. Ciliary muscles
C. Vascular endothelium
D. Sclera

Rationale: Some epithelia derived from ectoderm- the epithelium of the skin , hair follicles, sweat glands, sebaceous glands, and mammary glands - the epithelium over cornea and conjunctiva, external acoustic meatus and the outer surface of the tympanic membrane- the epithelium of some pa of the mouth, the lower pa of the anal canal, terminal pa of the male urethra, pas of the female external genitaliaRef: Human Embryology; Inderbir Singh; Tenth Edition; Page No: 95

Answer: OPTION A IS CORRECT.
Question: Ring of Sommerring is seen in -
Options:
A. Galactosemia
B. Dislocztion of lens
C. Acute congestive glaucoma
D. After cataract

Rationale: Ring of sommerring and Elsching's are seen in after cataract. (Ref: Parson's 22nd/e p.285 & 21st/e p.279)

Answer: OPTION D IS CORRECT.
Question: Thickness of cornea is best measured by:
Options:
A. Keratometer
B. Pachymeter
C. Optometer
D. Pentoscope

Rationale: Ans. Pachymeter

Answer: OPTION B IS CORRECT.
Question: Blockade of Central Retinal Artery leads to temporary blindness is also known as:
Options:
A. Amaurosis fiigax
B. Gaze related amaurosis
C. Amblyopia ex anopsia
D. Amblyopia

Rationale: (A) Amaurosis fugax > Amaurosis Fugax is transient ischemic attack of retina characterized by transient sudden loss of vision lasting for few minutes, due to occlusion by minute emboli. It may be a premonitory symptom of CRAO.> D/D of "cherry red" spot on fundus CRAO, blunt injury (Berhin's edema of macula), Tay-Sach's disease, Niemann-Pick disease, Sandboffs disease & quinine ambliopia.> Cattle-track appearance is other important feature of CRVO, apart from Hol/enhorst plauge.

Answer: OPTION A IS CORRECT.
Question: A patient (pigeon handler) presents with interstitial pneumonitis accompanied by headache, backache, and a dry, hacking cough. A pale, macular rash is also found on the trunk (Horder's spots). Likely organism is:
Options:
A. Histoplasma
B. Chlamydiae
C. Mycoplasma
D. Aspergillus

Rationale: Chlamydiae

Answer: OPTION B IS CORRECT.
Question: 100 day glaucoma is seen in which of the following conditions?
Options:
A. Central retinal vein occlusion (CRVO)
B. Steroid induced glaucoma
C. Neovascular glaucoma
D. Central retinal aery occlusion (CRAO)

Rationale: CRVO cause hypoxia and release of VEGF causing neovascularisation of iris and thus neovascular glaucoma in 20% cases within 3 months (also known as 90days/100days glaucoma).

Answer: OPTION A IS CORRECT.
Question: Anesthetics usually check for BP and pulse when ophthalmologist maneuvers medial rectus muscle in squint surgery. This is to prevent?
Options:
A. Vasovagal attack
B. Hypotension syndrome
C. Oculocardiac reflex
D. None

Rationale: Ans. is 'c' i.e., Oculocardiac reflex * Oculocardiac reflex is most common in pediatric patients undergoing strabismus surgery. Traction on extraocular muscle (especially medial rectus) causes a wide variety of cardia arrhythmias.Oculocardiac reflex* Traction on the extraocular muscles or pressure on globe (eye ball) causes bradycardia, AV block, ventricular ectopy or asystole. It is especially seen with traction on the medial rectus, but can occur with stimulation of any of the orbital contents, including the periosteum.* The reflex is trigeminovagal, i.e., afferent is via trigeminal and efferent is via vagal pathway.* The oculocardiac reflex is most common in pediatric patients undergoing strabismus surgery. Nonetheless, it can be evoked in all age groups and during a variety of ocular procedures including cataract extraction, enucleation, and retinal detachment repair.* Anticholinergic drugs (atropine, glycopyrrolate) is often helpful in preventing oculocardiac reflex.* Management of oculocardiac reflex includes cessation of surgical stimulus; adequate ventilation, oxygenation & anesthesia; intravenous atropine; infiltration of rectus muscles with local anesthetic.

Answer: OPTION C IS CORRECT.
Question: A 36-year-old, alcoholic woman presents with a 1-week history of yellow skin and sclerae. She has suffered persistent headaches. Her vital signs are normal. Physical examination reveals jaundice. Laboratory studies disclose markedly elevated levels of AST and ALT (956 and 1,400 U/L, respectively). A few days later, she develops hepatic encephalopathy and renal failure. A liver biopsy shows prominent centrilobular necrosis. Which of the following is the most likely diagnosis?
Options:
A. Acetaminophen toxicity
B. Fatty liver of pregnancy
C. Metastatic carcinoma
D. Reye syndrome

Rationale: Drug toxicity should be suspected in all cases of acute hepatitis. In this case, centrilobular necrosis suggests acetaminophen toxicity. The toxic dose of acetaminophen after a single acute ingestion is in the range of 150mg/kg in children and 7 g in adults. Acetaminophen is rapidly absorbed from the stomach and small intestine and conjugated in the liver to nontoxic agents, which then are eliminated in the urine. In cases of acute overdose, normal pathways of acetaminophen metabolism become saturated. Excess acetaminophen is then metabolized in the liver via the mixed function oxidase P450 system, yielding oxidative metabolites that cause predictable, hepatocellular necrosis. The centrilobular zones are particularly affected (centrilobular necrosis). Centrilobular necrosis is not seen in the other choices. Reye syndrome (choice D) occurs in children. Fatty liver of pregnancy (choice B) features micro vesicular steatosis.Diagnosis: Acetaminophen toxicity, hepatorenal syndrome

Answer: OPTION A IS CORRECT.
Question: A 60-year-old man is brought to the emergency department because of new symptoms of double vision and discomfort in his left eye. He reports no other neurologic symptoms. On physical 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, and there are no other focal neurological deficits. 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: Criteria for Brainstem death includes:
Options:
A. Positive Doll's eye Reflex
B. Absent pupillary light reflex and delated pupils
C. Pinpoint pupils
D. Positive vestibulo-ocular reflex

Rationale: Brainstem death is defined by the absence of all brainstem mediated cranial nerve reflexes. Pupillary Light Reflex is a brainstem mediated cranial nerve reflex that is absent in brainstem death. The pupils are usually midsized but may be dilated (should not however be small). Occulo-cephalic (Doll&;s eye) reflex and Vestibulo-ocular (Caloric) reflex are both brainstem mediated cranial nerve reflexs that should be absent in Brainstem death. Criteria for Brain Death/Brainstem death The definition of Brain stem death requires simultaneous demonstration that the patient has irreversibly lost the capacity of consciousness (Coma) and the capacity to breathe (Apnoea) both of which are dependent on intact brainstem. Clinical assessment of the integrity of Brainstem has two components including assessment of the integrity of brainstem mediated cranial nerve reflexes and the Apnea test. REF: Harrison book of internal medicine 21ST EDITION

Answer: OPTION B IS CORRECT.
Question: Central macular fixation developed at :
Options:
A. 3 weeks
B. 3 months
C. 6 weeks
D. 6 months

Rationale: The critical period of developed of fixation reflex is 5-6 months of age.
This is the reason why unilateral cataracts in children should be operated early. Remember –
Binocular vision develops at 5-6 years.

Answer: OPTION D IS CORRECT.
Question: Optical coherence tomography is most useful in disorders of:
Options:
A. Macula
B. Crystalline lens
C. Refractive errors
D. Intraocular tumours

Rationale: Ans. Macula

Answer: OPTION A IS CORRECT.
Question: Which of the following is NOT a side effect of amiodarone?
Options:
A. Pulmonary fibrosis
B. Corneal microdeposits
C. Photosensitivity
D. Tachycardia

Rationale: Ans. is 'd' i.e., Tachycardia * Amiodarone is a broad spectrum anti - arrhythmic drug which belongs to class III of the anti - arrhythmic drugs.* Following are the adverse effects -i) Fall in BP, bradycardia and myocardial depression occurs on i.v. injection.ii) Photosensitization and skin pigmentation occurs in about 10% of patients.iii) Corneal microdeposits may cause headlight dazzle, but is reversible on discontinuation.iv) Pulmonary fibrosis and alveolitis is most serious side effect seen on prolonged use.v) Peripheral neuropathy generally manifests as the pelvic and shoulder muscle weakness.vi) Amiodarone interferes with thyroid function and prevents peripheral conversion of T4 to T3 and hypothyroidism.

Answer: OPTION D IS CORRECT.
Question: True for diurnal variation of intraocular pressure (IOP) is
Options:
A. IOP is usually low in the morning hours
B. IOP is usually higher in the morning hours
C. IOP variation is related to plasma acetylcholine level
D. In normal eye lOP fluctuation is <10 mm of Hg.

Rationale: Diurnal variation of IOP: Usually, there is a tendency of higher IOP in the morning and lower in the evening. This has been related to diurnal variation in the levels of plasma coisol. Normal eyes have a smaller fluctuation (< 5 mm of Hg) than glaucomatous eyes (> 8 mm of Hg). Reference :- A K KHURANA; pg num:-210

Answer: OPTION B IS CORRECT.
Question: Axial length of eye ball is:
Options:
A. 16 mm
B. 20 mm
C. 24 mm
D. 28 mm

Rationale: Dimension of eye ball Anteroposterior- 24mm Circumference- 75mm Volume of each eye- 6 ml Volume of each orbit = 30 ml Weight- 7gm

Answer: OPTION C IS CORRECT.
Question: Leucokoria can be seen in all except -
Options:
A. Persistant hyperplastic primary vitreous
B. Congenital glaucoma
C. Fungal endopthalmitis
D. Retinoblastoma

Rationale: Persistant hyperplastic primary vitreous,Fungal endopthalmitis,Retinoblastoma ,coloboma of choroid, exudative retinopathy of coats and retinopathy of prematurity. Ref: ak khurana 6th edition

Answer: OPTION B IS CORRECT.
Question: A 6 year old boy has been complaining of headache, ignoring to see the objects on the sides for four months. On examination, he is not mentally retarded, his grades at school are good, and visual acuity is diminished in both the eyes. Visual chaing showed significant field defect. CT scan of the head showed suprasellar mass with calcification. Which of the following is the most probable diagnosis?
Options:
A. Astrocytoma
B. Craniopharyngioma
C. Pituitary adenoma
D. Meningioma

Rationale: Answer is B (Craniopharygioma): Presence of headache, visual field defects and suprasellar calcification suggests a diagnosis of suprasellar neoplastic lesions. The most common suprasellar neoplastic lesion in children (6 years) associated with suprasellar calcification is craniopharyngioma which is the single best answer of choice.

Answer: OPTION B IS CORRECT.
Question: The arrow marked structure is ?
Options:
A. Macula
B. Utricle
C. Saccule
D. Endolymphatic sac

Rationale: - The diagram is showing inner ear & the arrow marked structure is endolymphatic sac .

Answer: OPTION D IS CORRECT.
Question: Commonest cause of uniocular diplopia
Options:
A. Cataract
B. Subluxated lens
C. Third nerve palsy
D. Astigmatism

Rationale: In Unilocular diplopia an object appears double from the affected eye even when the normal eye is closed. CAUSES Subluxated clear lens. Subluxated intraocular lens. Keratoconus (irregular refraction from corneal surface) Double pupil (congenital / large iridectomy / iridodialysis) Incipient cataract (this usually causes polyopia - due to irregular refraction due to multiple water clefts within the lens) Ref;A.K.Khurana; 6th edition; Page no:344

Answer: OPTION B IS CORRECT.
Question: Glaucoma capsulare is caused by
Options:
A. Neovascular glaucoma
B. Pseudoexfoliative glaucoma
C. Pigmentary glaucoma
D. Angle recession glaucoma

Rationale: Occurrence of glaucoma in eye with pseudoexfoliation is called glaucoma capsulareReference: Aravind FAQS in Ophthalmology; First Edition; Page no: 232

Answer: OPTION B IS CORRECT.
Question: Orphan Annie eye nuclei appearance is characteristic of:
Options:
A. Papillary carcinoma thyroid
B. Carcinoma pituitary
C. Paraganglioma
D. Meningioma

Rationale: - Nuclei of papillary carcinoma cells contain finely dispersed chromatin, which impas an optically clear or empty appearance of nuclei, giving rise to designation ground-glass or Orphan Annie eye nuclei.

Answer: OPTION A IS CORRECT.
Question: Gonioscopy is used to study –
Options:
A. Ant. Chamber
B. Post chamber
C. Angle of anterior chamber
D. Retina

Rationale: Gonioscopy 

Owing to the lack of transparency of corneoscleral junction and total internal reflection of light at the anterior surface of cornea, it is not possible to visualize the angle of anterior chamber directly.
Therefore, a device (goniolens) is used to divert the beam light and this technique of biomicroscopic examination of the angle of anterior chamber is called gonioscopy.
In many conditions such as glaucoma, foreign bodies or tumours, a close inspection of this region is important.

Answer: OPTION C IS CORRECT.
Question: Which of following is not a feature in diabetic retinopathy on fundus examination
Options:
A. Microaneurysms
B. Retinal hemorrhages
C. Aeriolar dilatation
D. Neovascularisation

Rationale: C i.e. Aeriolar dilatation In diabetic retinopathy aeriolar changes consist of narrowing Q (not dilation) silver-wiring and obliteration resembling branch retinal aery occlusion. And venous changes are bending, looping and sausage like segmentation.

Answer: OPTION C IS CORRECT.