QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: An HIV patient complains of visual disturbances. Fundal examination shows bilateral retinal exudates and perivascular haemorrhges. Which of the following viruses are most likely to be responsible for this retinitis -
Options:
A. Herpes simplex
B. Varicella zoster
C. Cytomegalovirus
D. EBV

Answer: OPTION C IS CORRECT.
Question: Not a feature of congenital rubella classical triad?
Options:
A. Cataract
B. CHD
C. Deafness
D. Glaucoma

Rationale: Ans. is 'd' i.e., Glaucoma Congenital rubella syndrome Maternal viremia associated with rubella infection during pregnancy may result in infection of the placenta and fetus. The most impoant factor in the pathogenicity of rubella virus for the fetus is gestational age at the time of infection. The earlier in pregnancy infection occurs, the greater the damage to the fetus. Maximum damage to fetus occurs when infection is acquired in first trimester of pregnacy. Infection in early 2nd trimester causes only deafness. Infection after 16 weeks causes no major abnormalities. The classical triad of congenital rubella consists of cataract, deafness and CHD. Presence of IgM in blood at bih is diagnostic, as is the persistance of IgG after 6 months of age.

Answer: OPTION D IS CORRECT.
Question: Latanoprost used topically in glaucoma primarily acts by –
Options:
A. Decreasing aqueous humour formation
B. Increasing uveoscleral outflow
C. Releasing pupillary block
D. Increasing trabecular outflow

Answer: OPTION B IS CORRECT.
Question: Which of the following diseases is not included in"Vision 2020 - Right to Sight" immediate goals?
Options:
A. Trachoma
B. Epidemic conjunctivitis
C. Cataract
D. Onchocerciasis

Rationale: Epidemic conjunctivitis Repeat from May 07 Vision 2020: The Right to Sight, is a global initiative launched by WHO in Geneva in 1999 in coalition with Task force of International NGOs' Globally. WHO has identified 5 major blinding eye conditions, for immediate attention: i ) Cataract ii) Childhood blindness iii) Trachoma iv) Refractive errors and low vision v) Onchocerciasis (River blindness) The Government of India has adopted 'Vision 2020: Right to Sight' under 'National Programme for Control of Blindness' in 2001. - Target diseases identified for intervention under 'Vision 2020' initiatives in India are: 1) Cataract ii) Childhood blindness iii) Trachoma iv) Refractive errors and low vision v) Corneal blindness vi) Diabetic retinopathy vii) Glaucoma Objective of Vision 2020 - is to eliminate avoidable blindness by the year 2020 and reduce the global burden of blindness.

Answer: OPTION B IS CORRECT.
Question: Stocker's line is seen in?
Options:
A. Pterygium
B. Glaucoma
C. Posterior scleritis
D. Diabetic retinopathy

Rationale: Ans. is 'a' i.e., Pterygium is line of iron deposition in the corneal epithelium seen adjacent to the head of the pterygium.

Answer: OPTION A IS CORRECT.
Question: Power of a reduced eye is normally -
Options:
A. 20 -D
B. 35 - D
C. 18 - D
D. 58 - D

Rationale: The most appropriate answer here is 58D. Power of schematic eye -+58D Power of reduced eye -+60D Reference: Optics of human eye 4th edition page15

Answer: OPTION D IS CORRECT.
Question: Most common cause of frequent change in presbyopic glasses among the following are:
Options:
A. Diabetic Retinopathy
B. Senile cataract
C. Age related macular degeneration
D. Glaucoma

Rationale: Glaucoma can cause frequent change of presbyopic glasses. Symptoms of primary open angle glaucoma Asymptomatic most commonly. Headache Frequent change of glasses Delayed dark adaptation Loss of field of vision in advanced cases

Answer: OPTION D IS CORRECT.
Question: The periphery of the retina is visualized by –
Options:
A. Indirect ophthalmoscopy
B. Direct ophthalmoscopy
C. Goniocopy
D. Contact lens

Rationale: Direct ophthalmoscopy is used to evaluate details of the optic disc, fovea centralis, retinal fixation and retinal vasculature.
Indirect ophthalmoscopy offers a broader overview of the fundus than the direct method, depending upon the refractive power of the employed lens. It readily allows examination of the fundus as far as to the periphery.

Answer: OPTION A IS CORRECT.
Question: Which of the following metabolic disorders is associated with this finding seen on fundoscopic examination of eyes?
Options:
A. Galactosemia
B. Mitochondrial disorders
C. Albinism
D. GM1 Gangliosidosis

Rationale: b. Mitochondrial disordersBone spicule-shaped pigment deposits are present in the periphery along with retinal atrophy, while the macula is preserved

Answer: OPTION B IS CORRECT.
Question: The optic nerve terminates in the
Options:
A. Thalamus
B. Pituitary gland
C. Medulla Oblongata
D. Lateral Geniculate Body

Answer: OPTION D IS CORRECT.
Question: Retinoscopy is done for -
Options:
A. Field of vision
B. Error of refraction
C. Curvature of retina
D. None

Rationale: Ans. is 'b' i.e., Error of refraction Retinoscopyo Retinoscopy, also called skiascopy or shadow test, is an objective method of finding out the error of refraction by the method of neutralization.o Retinoscopy is based on the fact that when a light is reflected from a mirror into the eye, the direction in which the light will travel across the pupil will depend upon the refractive state of the eye.o With the help of a retinoscope, light is thrown onto the patient's eye and through a hole in the retinoscope's mirror the examiner observes of red reflex in the pupillary area of the patient,o Then the retinoscope is moved in horizontal the vertical meridia keeping a wratch on red reflex, which also moves when the retinoscope is moved.o Depending upon the movement of the red reflex when a plane mirror retinoscope is used at a distance of 1 meter, the results are interpreted as : -No movement of red reflex - Myopia of 1D.Red reflex moves along with retinoscope - it indicates any of the following : - (i) Normal eye (Emmetropia), or (ii) Hypermetropia, or myopia less than ID.Red reflex moves against to the retinoscope -> Myopia more than ID.

Answer: OPTION B IS CORRECT.
Question: Which of the following is a significant distinguishing feature of viral conjunctivitis?
Options:
A. Significant eye pain
B. Globular purulent discharge
C. Clear discharge
D. Eye

Rationale: Significant eye pain or decreased visual acuity is not consistent with the diagnosis of viral conjunctivitis. The hallmark of bacterial conjunctivitis is a continuous globular purulent discharge seen at the lid margins and in the corners of the eye. Viral conjunctivitis typically has a clear discharge with occasional scant mucoid discharge. Both may present with a history of the eye "matted shut" in the morning. Ref: Levsky M.E., DeFlorio P. (2010). Chapter 2. Ophthalmologic Conditions. In K.J. Knoop, L.B. Stack, A.B. Storrow, R.J. Thurman (Eds), The Atlas of Emergency Medicine, 3e.

Answer: OPTION C IS CORRECT.
Question: Indocyanine Green Angiography is most useful in detecting
Options:
A. Occult Choroidal Neovascularization (Occult CNV)
B. Classic choroidal Neovascularization (Classic CNV)
C. Angioid streaks with choroidal Neovascularization (CNV)
D. Polypoidal choroidal vasculopathy

Rationale: Fundus fluorescein angiography and indocyanine green angiography help in detecting choroidal neovascularization (CNV) in relation to foveal avascular zone. Which may be subfoveal, juxta foveal or extrafoveal CNV. Reference : A K KHURANA COMPREHENSIVE OPHTHALMOLOGY, Edition4 , page-275

Answer: OPTION A IS CORRECT.
Question: Triad of Meniere's disease is
Options:
A. Fluctuating hearing loss, vertigo, tinnitus
B. Conductive deafness, vertigo tinnitus
C. Vertigo, tinnitus, sense of fullness
D. Vertigo, tinnitus, cataract

Rationale: A. i.e. (Fluctuating hearing loss, vertgo, tinnitus) (100 Dhingra 4th) (107-8 - Maqbool 11th)Cardinal symptoms of Meniere's disease1. Episodic vertigo2. Fluctuating hearing loss (Sensory neural)3. Tinnitus4. Sense of fullness or pressure in the involved ear** Recruitment phenomenon is seen in - Meniere's diseaseTREATMENTSMedical Surgical1. Reassurance, vitamins (Nicotinic acid and A and D)2. Bed rest. Diuretic (acetazolamide)3. Vestibular sedative (Dimanhydrinate, promethazine theoclate prochlorperazine, Diazepam)4. Vasodilators** (Betahistadine hydrochloride)(i) Inhalation of carbogen (5% CO2 with 95% O2)(ii) Histamine drip5. Intratympanic gentamicin therapy1. Labyrinthectomy2. Intermittent low pressure pulse therapy(Meniett device therapy)* LERMOYEZ'S SYNDROME - is a variant of Meniere syndrome in which hearing loss and tinnitus occurs first, followed by vertigo that appears suddenly and with it hearing and tinnitus improve

Answer: OPTION A IS CORRECT.
Question: Not a feature of optic neuritis:
Options:
A. Marcus gunn pupil
B. Reduced color vision
C. Central scotoma
D. Large cup of optic nerve head

Rationale: Large optic nerve head is seen in glaucoma, not in optic neuritis. Features of Optic Neuritis (ON) Abrupt vision loss with pain. RAPD (Marcus gunn pupil) Papillitis Macular star in neuroretinitis Decreased contrast sensitivity, colour vision, dark adaptation characteristic. Field defect: Swiss cheese visual field/central/ centrocecal scotoma Delayed VER (Visual Evoked Response) MC systemic disorder a/w Optic neuropathy is MS (Multiple sclerosis)

Answer: OPTION D IS CORRECT.
Question: Thirty years old G4P3L3 with 32 weeks pregnancy with single live fetus in cephalic presentation, Patient complains of easy fatigability and weakness since last 3 months which has gradually increased over last 15 days to an extent that she gets tired on doing household activities. Patient also complaints of breathlessness on exertion since last 15 days. Patient gets breathless on climbing 2 flight of stairs. It is not associated with palpitations or any chest pain. There is no history of pedal edema, sudden onset breathlessness, cough or decreased urine output. There is no history of asthma or chronic cough. There is no history of chronic fever with chills or rigors. There is no history of passage of worms in stool nor blood loss from any site. There is no history of easy bruisability or petechiae. There is no history of yellow discoloration of urine, skin or eyes. She did not take iron folate prophylaxis throughout her pregnancy.* She is suspected to be anemic and her blood sample was ordered for examination which showed.* Hb 7.4 gm% (12-14 gm%)* Hct 22% (36-44%)* MCV 72 fL (80-97 fL)* MCH 25 pg (27-33 pg)* MCHC 30% (32-36%)* Peripheral smear shows microcytic hypochromic RBCs with anisopoikilocytosis* Naked eye single tube red cell osmotic fragility test (NESTROFT) is negative. What is the most probable diagnosis:
Options:
A. Thalassemia
B. Iron deficiency anemia
C. Megaloblastic anemia
D. Vitamin B12 deficiency anemia.

Rationale: Ans. is b, i.e. Iron deficiency anemiaIn the question patient has Hb 7.4 gm%, hematocrit 22% and symptoms of early fatigue, which indicate she is anemic. Her complete blood picture shows MCV and MCH are low indicating microcytic anemia. Thus differential diagnosis could either be Iron deficiency anemia or thalassemia.Her NESTROFTS test (screening test for thalassemia) is negative, hence thalassemia is ruled out and diagnosis is confirmed as Iron deficiency anemia.

Answer: OPTION B IS CORRECT.
Question: The eye in the newborn is:
Options:
A. Hypermetropic with regular astigmatism
B. Hypermetropia
C. Hypermetropic with irregular astigmatism
D. Myopia

Rationale: At bih, eye is hypermetropic by +2 to +3D and usually becomes emmetropic by the age of 5 to 7 years This is because of smaller eyeball Eyeball length at bih is 16mm.

Answer: OPTION B IS CORRECT.
Question: Glasgow coma scale includes:a) Eye openingb) Motor responsec) Swallowing reflexd) Sensory responsee) Verbal response
Options:
A. abc
B. bcd
C. abe
D. acd

Answer: OPTION C IS CORRECT.
Question: Central artery of Retina is branch of -
Options:
A. External carotid artery
B. Internal carotid artery
C. Ophthalmic artery
D. Basilar artery

Answer: OPTION C IS CORRECT.
Question: Waldeyer's ring consists of all of the following except?
Options:
A. Palatine tonsils
B. Pharyngeal tonsils
C. Tubal tonsils
D. Post auricular nodes

Rationale: In relation to the oropharyngeal isthmus, there are several aggregations of lymphoid tissue that constitute the WALDEYER'S lymphatic ring.
The most important aggregations are the right and left palatine tonsils.
Posteriorly and above is the pharyngeal tonsil.
Laterally and above are the tubal tonsils
Inferiorly there is the lingual tonsil over the posterior part of the dorsum of the tongue.

Answer: OPTION D IS CORRECT.
Question: Painful loss of vision is seen in –a) Senile cataractb) Primary open angle glaucomac) Primary angle closure glaucomad) Anterior uveitis
Options:
A. ab
B. cd
C. bd
D. ac

Rationale: Causes of sudden painful loss of vision are:- Acute angle-closure glaucoma, acute iridocyclitis (acute uveitis), chemical or mechanical injury to eye, endophthalmitis and optic neuritis.

Answer: OPTION B IS CORRECT.
Question: Which among the following subtypes of Osteogenesis imperfecta is not associated with blue sclera?
Options:
A. Type I
B. Type II
C. Type III
D. Type IV

Rationale: Ans. (d) Type IV(Ref: Robbins 9th/pg 140; 8th/pg 140)Classification of Osteogenesis Imperfecta (OI)TypeBone FragilityBlue ScleraAbnormal DentitionHearing LossInheritanceIMildPresentPresent in somePresent in mostADIIExtremePresentPresent in someUnknownS, rarely ARIIISevereBluish at birthPresent in someHigh incidenceAD, rarely ARIVVariableAbsentAbsent in IVA, present in IVBHigh incidenceADVModerate to severeAbsentAbsent ADVIModerate to severeAbsentAbsent UnknownVIIModerateAbsentAbsentAbsentAR

Answer: OPTION D IS CORRECT.
Question: True about congenital Rubella syndrome is:-
Options:
A. Blueberry muffin rash is seen
B. Virus can be isolated only upto 6months after bih
C. Triad of CRS are cataract, cardiac defects, cerebral palsy
D. Infection is most serious after five months of pregnancy

Rationale: Virus can be isolated up to 12 months after bih. Tired of CRS is cardiac defects, cataract and sensory neural defects. Infection is not serious after 5 months of pregnancy Blueberry muffin rash is seen in congenital rubella syndrome.

Answer: OPTION A IS CORRECT.
Question: Type of collagen absent in sclera ?
Options:
A. collagen 1
B. collagen 2
C. collagen 3
D. collagen 4

Rationale: Type 2 is absent in sclera Type 1 is predominamt type of collagen found in sclera with haphazardous arrangement of collagens CORNEA- regular arrangement of collagen bundles of Type 1 (major) and type 3 (minor) in descemet's membrane -collagen type 4 is found.

Answer: OPTION B IS CORRECT.
Question: Anterior vitreous cells are least likely to be found in
Options:
A. CMV
B. Serpiginous Choroidopathy
C. Chronic cyclitis
D. Retinitis pigmentosa

Rationale: Anterior vitreous cells are least likely to be found in Retinitis pigmentosa.

Answer: OPTION D IS CORRECT.
Question: A 65-year-old male comes to the OPD complaining of ongoing double vision which is worse when he is watching TV in the evening. He has also noticed that he feels weaker towards the end of the day and that his face is slightly puffy. On inspection, there is a paial ptosis of the left eye lid and his mouth hangs slightly open at rest. On examination, there are visibly distended neck veins. What is the most likely diagnosis?
Options:
A. Myasthenia gravis
B. Lambe Eaton syndrome
C. Paraneoplastic cerebellar degeneration
D. Multiple system atrophy

Rationale: Diagnosis : Double vision + Ptosis at the end of the day + weaker at the end of the day= Myasthenia Gravis Option B- Feels stronger at the end of the day. Option C- Presents with gait ataxia, nystagmus, head impulse test negative. Option D- Atypical parkinsonism associated with Cog wheel rigidity, Bradykinesia, Postural instability. Myasthenia gravis (MG) is a relatively common neuromuscular disorder that is caused by antibody-mediated autoimmune destruction of acetylcholine receptors at the neuromuscular junction(Post Synaptic) * Type V Hypersensitivity reaction > Type II Hypersensitivity Reaction. * Receptor of Acetyl choline are affected. It is a post junctional defect. Diagnosis: 1. Anti Ach Receptor blocking Antibody 2. Anti-MUSK Antibody 3. Anti LRP 4 Antibody 4. Single fiber electromyography (SFEMG)=Jitter and blocking - Confirmatory test 5. Repetitive nerve stimulation test. 6. Tensilon test, Or Anticholinesterase test. The treatment of MG may include: Anticholinesterase medications (Pyridostigmine), Immunosuppression, IVIg or plasmapheresis, Surgical intervention( Thymectomy).

Answer: OPTION A IS CORRECT.
Question: A 25 year old male present with decrease in vision in both eyes following a viral illness. On examination he had mild decrease in visual acuity and paracentral scotomas. Examination of the fundus showed wedge-shaped parafoveal retinal lesions. What is he MOST likely suffering from?
Options:
A. Serpiginous Choroidopathy
B. Birdshot Retinochoroidopathy
C. Acute Macular Neuroretinopathy
D. Acute zonal occult outer retinopathy

Rationale: Patient is showing features of acute macular neuroretinopathy. It usually occur in young adults following acute viral illness. It is characterised by the acute onset of paracentral scotomas and mild loss of visual acuity of one or both eyes. Examination reveals presence of wedge-shaped parafoveal retinal lesions in the deep sensory retina. In this condition retinal lesions fade but scotomas persists and would be symptomatic. Birdshot Retinochoroidopathy: This syndrome is characterized by diffuse cream-colored patches at the level of the pigment epithelium and choroid, retinal vasculitis associated with cystoid macular edema, and vitritis. Ref: Fletcher E.C., Chong N., Augsburger J.J., Correa Z.M. (2011). Chapter 10. Retina. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.

Answer: OPTION C IS CORRECT.
Question: Deletion of both Rb (retinoblastoma) genes in the same developing cell is most characteristically associated with the development of
Options:
A. Blue sclera
B. No iris
C. Subluxed lens
D. White pupil

Rationale: Retinoblastoma is the most common malignant tumor of the eye in children. Clinically, retinoblastoma may produce a white pupil (leukocoria). This is seen most often in young children in the familial form of retinoblastoma, which is due to a deletion involving chromosome 13. These familial cases of retinoblastoma are frequently multiple and bilateral, although like all the sporadic, nonheritable tumors they can also be unifocal and unilateral. Histologically, rosettes of various types are frequent (similar to neuroblastoma and medulloblastoma). There is a good prognosis with early detection and treatment; spontaneous regression can occur but is rare. Retinoblastoma belongs to a group of cancers (osteosarcoma, Wilms tumor, meningioma, rhabdomyosarcoma, uveal melanoma) in which the normal cancer suppressor gene (antioncogene) is inactivated or lost, with resultant malignant change. Retinoblastoma and osteosarcoma arise after the loss of the same genetic locus--hereditary mutation in the q14 band of chromosome 13. In contrast, a blue sclera can be seen with osteogenesis imperfect, while a yellow sclera is seen with jaundice. Lack of an iris (aniridia) can sometimes be associated with Wilms tumor of the kidney, while a subluxated lens can be found in individuals with either Marfan's syndrome or homocystinuria.

Answer: OPTION D IS CORRECT.
Question: A young adults presents with night blindness and tubular vision. On examination, IntraocularPressure was observed to be 18mm and the anterior segment was unremarkable. Fundoscopyshowed attenuation of aerioles and waxy pallor of the optic disc with bony corpuscles like spicules of pigmentation in mid peripheral retina. Ring scotomas were observed on perimetry. Which of thefollowing is the most likely diagnosis -
Options:
A. Pigmentary Retinal Dystrophy
B. Primary Open Angle Glaucoma
C. Lattice degeneration of Retina
D. Diabetic Retinopathy

Rationale: RETINITIS PIGMENTOSA This primary pigmentary retinal dystrophy is a hereditary disorder predominantly affecting the rods more than the cones. Inheritance Most common mode is autosomal recessive, followed by autosomal dominant. X-linked recessive is the least common. Incidence  It occurs in 5 persons per 1000 of the world population.  Age. It appears in the childhood and progresses slowly, often resulting in blindness in advanced middle age.  Race. No race is known to be exempt or prone to it.  Sex. Males are more commonly affected than females in a ratio of 3:2.  Laterality. Disease is almost invariably bilateral and both the eyes are equally affected. Clinical features (A) Visual symptoms 1. Night blindness. It is the characteristic feature and may present several years before the visible changes in the retina appear. It occurs due to degeneration of the rods. 2. Dark adaptation. Light threshold of the peripheral retina is increased; though the process of dark adaptation itself is not affected until very late. 3. Tubular vision occurs in advanced cases. 1. Retinal pigmentary changes. These are typicallyperivascular and resemble bone corpuscles in shape. Initially, these changes are found in the equatorial region only and later spread both anteriorly and posteriorly. 2. Retinal aerioles are attenuated (narrowed) and may become thread-like in late stages. 3. Optic disc becomes pale and waxy in later stages and ultimately consecutive optic atrophy occurs 4. Other associated changes which may be seen are colloid bodies, choroidal sclerosis, cystoid macular oedema, atrophic or cellophane maculopathy. (C) Visual field changes Annular or ring-shaped scotoma is a typical featurewhich corresponds to the degenerated equatorial zone of retina. As the disease progresses, scotoma increases anteriorly and posteriorly and ultimately only central vision is left (tubular vision). Eventually even this is also lost and the patient becomes blind. Ref : AK khurana 4/e page no 268.

Answer: OPTION A 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 antemoem 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: Specimen tested in rabies are corneal smears and skin biopsy in ante moem analyzed by immunoflurescent REF:ANANTHANARYANAN TEXTBOOK OF MICROBIOLOGY 9EDITION PGNO.534

Answer: OPTION B IS CORRECT.
Question: Sunflower cataract is due to:
Options:
A. Diabetes mellitus
B. Injuries
C. Chalcosis
D. Infections

Rationale: Chalcosis

Answer: OPTION C IS CORRECT.
Question: Posterior staphyloma is seen in -
Options:
A. Corneal Ulcer
B. Degenerative high axial myopia
C. Chronic Uncontrolled glaucoma
D. Complication of cataract surgery

Rationale: Ans. is 'b' i.e., Degenerative high axial myopia

Answer: OPTION B IS CORRECT.
Question: All of the following can cause a white pupillary reflex except:
Options:
A. Retinoblastoma
B. Cataract
C. Retrolental fibroplasias
D. Glaucoma

Rationale: D i.e. Glaucoma

Answer: OPTION D IS CORRECT.
Question: shifting fluid sign is seen in ?
Options:
A. Exudative Retinal detachment
B. Traumatic Retinal detachment
C. Rhegmatogensus Retinal detachment
D. Retinal dialysis

Rationale: Exudative R D: increased fluid from choroid outer barrier break by inflammation fluid shift sign present ref : ak khurana 7th ed

Answer: OPTION A IS CORRECT.
Question: An elderly male with heart disease presents with sudden loss of vision in one eye; examination reveals cherry red spot; diagnosis is –
Options:
A. Central retinal vein occlusion
B. Central retinal artery occlusion
C. Amaurosis fugax
D. Acute ischemic optic neuritis

Rationale: Amongst the given options only CRAO causes sudden painless loss of vision along with cherry red spot.

Answer: OPTION B IS CORRECT.