QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: A child of phenyl ketonuria mother may develop –
Options:
A. Microcephaly, mental retardation, congenital heart disease
B. Mental retardation, cataract, congenital heart disease
C. HydrocephaluS, cataract.
D. Microcephaly, cataract, renal dysplasia.

Rationale: Children born to phenyl ketonuria mothers have following features

Mental retardation             
Microcephaly      
Growth retardation 
Congenital heart disease

Answer: OPTION A IS CORRECT.
Question: Transverse carpal ligament is -
Options:
A. Flexor retinaculum of hand
B. Extensor retinaculum of hand
C. Radial collateral ligament
D. Intercarpal ligament

Rationale: Ans. is 'a' i.e., Flexor retinaculum of hand Transverse Carpal Ligament:o It is also called flexor retinaculum or anterior annular ligament.o It is a fibrous band on the palmar side of the hand near the wrist.o It arches over the carpal bones of the hands, covering them and forming the carpal tunnel.

Answer: OPTION A IS CORRECT.
Question: The pathognomonic finding in miliary TB is which of the following?
Options:
A. Bone marrow infiltrations
B. Choroid tubercles
C. Miliary mottling in chest X-Ray
D. Histological finding in liver biopsy

Rationale: Eye examination may reveal choroidal tubercles, which are pathognomonic of miliary TB, seen in up to 30% of cases. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 1349

Answer: OPTION B IS CORRECT.
Question: Which of the following is primary glaucoma –a) Juvenile glaucomab) Steroid induced glaucomac) Pigmentary glaucomad) Congenital glaucomae) Infantile glaucoma
Options:
A. ade
B. bde
C. abd
D. ad

Rationale: Primary glaucomas are :

i)  Congenital / developmental :- True congenital glaucoma, infantile glaucoma, juvenile glaucoma.
ii)  Adult :- Primary open angle glaucoma, primary angle closure glaucoma, primary mixed mechanism glaucoma.

Pigmentary glaucoma and steroid induced glaucoma are secondary glaucomas.

Answer: OPTION A IS CORRECT.
Question: Case of proven vitamin A deficiency in a child who has clouding of cornea is treated with_______
Options:
A. Oral vitamin A tablets 100 IU/day
B. Oral syrup of vitamin A single does 1,000 IU/day
C. IM injection vitamin A 5,000 IU once
D. IM injection vitamin A 50,000 IU once

Rationale: .One of the first signs of vitamin A deficiency is night blindness. A lack of vitamin A causes the cornea to become very dry, leading to clouding of the front of the eye,corneal ulcers and vision loss. Depending on the cause, treatment for corneal infections may include: Antibiotic, antibacterial, antifungal, or steroidal eye drops. Topical or oral antiviral medication. Phototherapeutic keratectomy (laser surgery) Corneal transplant. Reference: GHAI Essential pediatrics, 8th edition

Answer: OPTION D IS CORRECT.
Question: All of the following are true about Hashimoto's thyroiditis, except
Options:
A. Follicular destruction
B. Increase in lymphocytes
C. Oncocytic metaplasia
D. Orphan Annie eye nuclei

Rationale: Orphan Annie eye nuclei is a feature of papillary carcinoma of thyroid due to presence of finely dispersed chromatin. But Hashimotos thyroiditis is an autoimmune condition which causes follicular destruction due to presence of auto antibodies against thyroid cells. It also shows lymphocytic infiltration and oncocytic metaplasia. (Ref :ROBBINS textbook of pathology endocrinology) ref img

Answer: OPTION D IS CORRECT.
Question: Which muscarinic agonist is used in the treatment of angle closure glaucoma?
Options:
A. Pilocarpine
B. Neostigmine
C. Brimonidine
D. Dipiveffine

Rationale: Ans. is 'a' i.e., Pilocarpine Angle closure glaucomao Treatment of choice for acute congestive glaucoma - Laser iridotomy (1st choice), Peripheral iridectency (2nd choice)o Drug of choice for acute congestive glaucoma - Pilocarpineo Initially IOP is controlled (first drug used) - Systemic mannitol or acetazolamideOpen angle glaucomao Treatment of choiceo Drug of choiceo Surgery of choiceTopical antiglaucoma drugsb - blocker (Timolol, betaxolol, levobunalol)Argon or diode laser trabeculoplasty

Answer: OPTION A IS CORRECT.
Question: Which is the most common oppounistic retinal infection associated with HIV
Options:
A. CMV retinitis
B. VZV
C. Syphilictic retinitis
D. Herpes simplex

Rationale: Cytomegalovirus (CMV) retinitis is a sight-threatening disease associated with AIDS (acquired immune deficiency syndrome) -- a serious disease of the immune system caused by infection with HIV (human immunodeficiency virus). In the past, about a quaer of active AIDS patients developed CMV retinitis. Ref ananthnarayana and panikers microbiology textbook 8/e

Answer: OPTION A IS CORRECT.
Question: If the 3rd supralabial scales are large and touching the eye and nasal shield, the snake may be
Options:
A. Krait
B. Pit viper
C. Saw scaled viper
D. Cobra

Rationale: If the head scales are large, it may be poisonous or non poisonous. Look for the 3rd supra labial and if it is touching the eye and the nasal shield, it is poisonous (cobra or coral snake) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 511

Answer: OPTION D IS CORRECT.
Question: Cataract associated with convulsion is seen in
Options:
A. Toxoplasmosis
B. Tay Sac's disease
C. Galactosemia
D. Bih asphyxia with prematurity

Rationale: C i.e. Galactosemia Galactosemia presents with B/I., oil droplet cataract, convulsion, Hepatosplenomegaly, ascitis, jaundice, and reluctance to ingest breast milk Q.

Answer: OPTION C IS CORRECT.
Question: Glasgow coma scale of a patient with head injury who is confused, able to localize on right side and does flexion on left side and opens eye for painful stimuli on sternum:
Options:
A. 6
B. 11
C. 12
D. 7

Rationale: Revised Glasgow Coma Scale 2014 Revised GCS (2014) Eye Opening Verbal Response Best Motor Response(M) Spontaneous 4 Oriented 5 Obeying commands 6 To speech 3 Confused 4 Localizing 5 To pressure 2 Words 3 Normal flexion(withdraw) 4 None 1 Sounds 2 Abnormal flexion 3 None 1 Extension 2 None 1 GCS specifically recommends avoiding sternal rubs as it causes bruising & responses can be difficult to interpret. They also do not recommend routine use of retromandibular pressure. Revised GCS (2014) changes are highlighted in the above table Best predictor of outcome: Motor response Repoing of non-testable score Aspects: In case of a non-testable aspect, the new GCS should be marked as NT, for "Not teste stable" For intubated patients or patients with tracheostomy, VNT is used it is no longer recommend to assign 1 point to non-testable elements, therefore a combined score should not use. Pupils Unreactive to Light Pupil Reactivity Score Both Pupils 2 One Pupil 1 Neither Pupil 0 How do I score GCS-P? * GCS-P is calculated by subtracting the Pupil Reactivity Score (PRS) from the Glasgow Coma Scale (GCS) total score GCP-P = GCS minus PRS GCS-P is Ranging from 15 to 1 From the given case of a patient with head injury: E: Pressure / Pain=2 V: Confused =4 Best Motor response M: Localizing =5 Total = 11

Answer: OPTION B IS CORRECT.
Question: Patient with open angle glaucoma with 71) of myopia, complains of blurring of vision on administration of pilocarpine. What is the reason for the blurring?
Options:
A. Small pupil
B. Increased myopic asymmetry
C. Increased hypermetropic asymmetry
D. Increased astigmatism

Rationale: Ans. is 'a' i.e., Small pupil Pilocarpine Pilocarpine induces contraction of the ciliary muscles and results in accommodation and ensuing fluctuating myopia. Pilocarpine is a miotic and thus results in the pin point pupils. This leads to decreased amount of light entering the eyes and thus worsens night blindness and also causes contraction of the peripheral visual field. Thus we can say that pilocarpinewosens the myopia in an already myopic patient and causes blurring of vision due to miosis (small/ pin point pupils, contraction of the ciliary muscles. It also causes decreased visual acuity in the patients with axial lens opacities.

Answer: OPTION A IS CORRECT.
Question: Most common cause of neovascular glaucoma -
Options:
A. Diabetes
B. CRAO
C. CRVO
D. Eale's disease

Rationale: Ans. is 'a' i.e., DiabetesNeovascular glaucoma (Rubeosis iridis)o It is a secondary angle closure glaucoma which results due to formation of neovascular membrane over the iris i.e., neovascularization of iris (rubeosis iridis). Causes of rubeosis iridis are :-Common :- Diabetic retinopathy (most common cause% central retinal vein occlusion. Gale's disease, sickle- cell retinopathyRare causes: - Long standing retinal detachment, central retinal artery occlusion, intraocular inflammation (uveitis), intraocular tumors (choroidal melanoma, retinoblastoma), radiation retinopathy, ocular ischemic syndrome (carotid artery disease, carotid - cavernous fistula), Fuseli's heterochromic iridocyclitis.o In central retinal vein occlusion (CRVO), glaucoma manifests about 100 days after thrombosis of central vein, therefore, it is also called 100 days glaucoma.o The most widely accepted theory for neovascularization is that the hypoxic retina produces diffusible angiogenic factor (VEGF) that stimulates new vessel proliferation.o Treatment of choice is panretinal photocoagulation as it terminates the angiogenic stimulus for neovascularization of retina.

Answer: OPTION A IS CORRECT.
Question: Early stage non proliferative diabetic retinopathy is present as:
Options:
A. Microaneurysms
B. Dot and Blot hemorrhages
C. Hard exudates
D. Soft exudates

Rationale: Ans. (a) MicroaneurysmsRef.: A.K. Khurana 6th ed. /276-77DIABETIC RETINOPATHY* The retinal change seen in diabetes are called as diabetic retinopathy. In diabetes, there is pericytes necrosis. Normally ratio 1 pericytes: 1 endothelial cell. But in diabetic retinopathy 1 pericyte: 3 endothelial cell. The vessels wall is weakened and leakage occurs. Classification--# Non proliferative diabetic retinopathy# Proliferative diabetic retinopathyNon proliferative diabetic retinopathyProliferative diabetic retinopathy* Microaneurysms- early manifestation* Dot and Blot hemorrhages* Hard exudates* Soft exudates* Neovascularization of the disc* Neovascularization of anywhere else from the disc* Neovascularization of iris- RUBIOSSIS IRIDIS

Answer: OPTION A IS CORRECT.
Question: True about incontinenta pigmenti include the following except –
Options:
A. X-linked dominant
B. Primary skin abnormality
C. Avascularity of peripheral retina
D. Ocular involvement is seen in almost 100% cases and is typically unilateral

Rationale: Ocular involvement occurs in 20-35% of cases. Involvement is assynzetrical. The two pathognomic changes are -


Retinal pigmentary changes with mottled diffuse hypopigmentation.
Abnormal peripheral retinal vessels with areas of non perfusion (a vascularity).

Answer: OPTION D IS CORRECT.
Question: Endophthalmitis refers to inflammation of all of the following structures of the eye, EXCEPT:
Options:
A. Uvea
B. Sclera
C. Retina
D. Vitreous

Rationale: Endophthalmitis refers to inflammation of the inner structures of the eyeball such as uveal tissue, retina and vitreous humour. It is associated with pouring of exudates into the vitreous cavity, anterior chamber and posterior chamber. When sclera is involved along with the other coats of eye it is called panophthalmitis. Ref: Ophthalmology By A.K Khurana, 4th Edition, Page 151-2

Answer: OPTION B IS CORRECT.
Question: A 35-year-old man asks for advice regarding seasonal eye itching and runny nose. Recurrent conjunctivitis in this patient is most likely caused by which of the following mechanisms of disease?
Options:
A. Autoimmunity
B. Bacterial infection
C. Chemical toxicity
D. Hypersensitivity

Rationale: Hypersensitivity. Although the incorrect choices may cause eye irritation, seasonal conjunctivitis is typically caused by allergies to pollens that are released during a particular time of the year. Allergic rhinitis (hay fever) is the most common type I hypersensitivity disease in adults. It may be caused by pollen, house dust, animal dandruff, and many other allergens. Antigens inhaled react with the IgE attached to basophils in the nasal mucosa, thereby triggering the release of vasoactive substances stored in cytoplasmic granules. Histamine, the main mediator released from mast cells, increases the permeability of mucosal vessels, causing edema and sneezing.Diagnosis: Conjunctivitis, hypersensitivity reaction

Answer: OPTION D IS CORRECT.
Question: Which among the following doesn't affect Eyes?
Options:
A. Onchocerca volvulus
B. Trypanosoma
C. Loa loa
D. Trichuris

Rationale: Trichuris REF: Jawetz, Melnick, & Adelberg's Medical Microbiology, 24TH edition chapter 46 Table 46-4 "Trichinella infectes by ingestion of undercooked pork which contains encysted larvae in the straited muscle" About option (B); Infective forms of T cruzi do not pass to humans by triatomine a bug bite (which is the mode of entry of the nonpathogenic T rangeli); rather, they are introduced when infected bug feces are rubbed into the conjunctiva, the bite site, or a break in the skin. For other options See APPENDIX-74 for "DISEASES DUE TO HELMINTHS"

Answer: OPTION D IS CORRECT.
Question: Corneal transparency is maintained by all except:
Options:
A. Relative dehydration
B. Increased mitotic figures in centre of cornea
C. Unmyelinated nerve fibers
D. Uniform spacing of collagen fibrils

Rationale: Ans. Increased mitotic figures in centre of cornea

Answer: OPTION B IS CORRECT.
Question: In a patient with acoustic neuroma, all are seen except
Options:
A. Facial nerve may be involved
B. Reduced corneal reflex
C. Cerebellar signs
D. Acute episode of veigo

Rationale: Clinical features: Progressive unilateral sensory neural healing loss often accompanied by tinnitus. Vestibular symptoms seen are unsteadiness and rarely veigo. Cranial nerve involvement: Vth cranial nerve: Reduced corneal sensitivity, numbness or paraesthesia of face. VIIth nerve: Hypoesthesia of posterior metal wall, loss if taste and reduced lacrimation. IX and X nerves: Dysphagia and hoarseness due to palatial, pharyngeal and laryngeal paralysis. XI and XII, III, IV and VI are affected. Brainstem involvement: Ataxia, weakness and numbness of the arms and legs with exaggerated tendon reflexes. Cerebellar involvement: Pressure symptoms. Finger-nose test, knee heel test, dysdiadochokinesia, ataxia gait and inability to walk along a straight line with the tendency to fall to the affected side. Raised intracranial tension: Headache, nausea, vomiting, diploma, papilloedema. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 125

Answer: OPTION D IS CORRECT.
Question: A 65-year-old woman presents with a 5-week history of yellow skin and sclera, anorexia, and epigastric pain. Her past medical history is significant for insulin-dependent diabetes mellitus. She smoked one pack of cigarettes a day for the past 20 years. Physical examination reveals jaundice and a palpable gallbladder. Laboratory studies show a serum bilirubin level of 10 mg/dL, mostly in the conjugated form, and an elevated alkaline phosphatase (260 U/L). A CT scan of the abdomen discloses a mass in the head of the pancreas and multiple nodules in the liver measuring up to 3 cm. Which of the following is the most important risk factor for the neoplasm arising in the patient?
Options:
A. Alcohol abuse
B. Cholelithiasis
C. Cigarette smoking
D. Diabetes mellitus type 1

Rationale: Cigarette smoking is associated with a fivefold increased risk for adenocarcinoma of the pancreas. Cholelithiasis (choice B) and alcohol abuse (choice A) are associated with pancreatitis, not pancreatic adenocarcinoma.Diagnosis: Pancreatic adenocarcinoma

Answer: OPTION C IS CORRECT.
Question: Not true regarding vitreous wick syndrome:
Options:
A. More commonly seen in ICCE or ECCE
B. Vitreous comes in anterior chamber
C. Can cause secondary glaucoma
D. Seen in phacomorphic glaucoma

Rationale: Vitreous wick syndrome is not seen in phacomorphic glaucoma. Vitreous Wick Syndrome Can be seen In: ICCE ECCE PHACOEMULSIFICATION with Posterior Capsular Rent Etiology: Vitreous comes in Anterior Chamber. Clinical Features Cause pupillary peaking. Corneal endothelium damage. Secondary glaucoma. Increase chances of Retinal Detachment. Cystoid macular edema.

Answer: OPTION D IS CORRECT.
Question: In acute congestive glaucoma, pupil is:
Options:
A. Oval and horizontal
B. Oval and veical
C. Circular
D. Slit like

Rationale: B i.e. Oval & veical In acute congestive glaucoma pupil is veically oval, dilated & nonreacting Q and anterior chamber is very shallow Q; where as in acute anterior uveitis pupil is small, irregular & sluggishly reacting Q and anterior chamber is deep.

Answer: OPTION B IS CORRECT.
Question: Conjunctiva in vitamin A deficiency shows
Options:
A. Hyperplasia of squamous epithelium
B. Actinic degeneration
C. Macrophage infiltration
D. Hyperplasia of goblet cells

Rationale: In vitamin A deficiency there is metaplasia of squamous epithelium and goblet cell atrophy Refer: Khurana 6th edition page number 382

Answer: OPTION A IS CORRECT.
Question: Pinch purpura around eyelids is one of the most common finding in -
Options:
A. Fabry's disease
B. Primary systemic amyloidosis
C. Porphyria cutanea tarda
D. None of the above

Rationale: Ans. is 'b' i.e.. Primary systemic amyloidosis o Purpura of the eyelids following pinching (pinch purpura) is a characteristicfeature of primary systemic amyloidosiso Pinch purpura of the eyelids are seen in about 30% of the cases ofprimary systemic amyloidoses.o It occurs due to involvement of cutaneous blood vessels in primary1 systemic amyloidosis.o The most common skin lesions are pete hie or ecchymoses due to amyloid deposition within blood vessel walls with subsequent fragility and dermal hemorrhage.o These are o ften seen at sites predisposed to trauma, such as the hands or intertriginous areas.o Pinching the skin gives charaterstic purpura lesions known as "pinch purpura".o Purpura around the eyes may occur spontaneously but is also seen following proctoscopy or vomiting (postproctoscopic purpura).o Dermatological involvement occur in about 30% - 40% patients with systemic amyloidosis.o Other dermatological manifestations include waxy or translucent papules and lets frequently tense hemorrhagic bullae.o Histopathology of the cutaneous lesions reveal amyloid deposits in the dermis.o Occular findings in primary generalized amyloidosis includes :Purpura of the eyelids.B/l symmetrical small amyloid papules of the skin of the eyelids.PtosisOphthalmalgia or evidence of amyloid neuropathes affective pupillary function or both.Subconjunctival hemorrhages.

Answer: OPTION B IS CORRECT.
Question: Which of the following is the cause of recurrent bilateral conjunctivitis occurring during hot weather in young boys with symptoms of burning, itching, and lacrimation with polygonal raised areas in the palpebral conjunctiva?
Options:
A. Trachoma
B. Phlyctenular conjunctivitis
C. Atopic Keratoconunctivitis
D. Vernal Keratoconjunctivitis

Rationale: Vernal Keratoconjuctivits is bilateral, recurrent, interstitial, self-limiting, allergic inflammation of the conjunctiva which has seasonal incidence. It is usually seen in boys of age group 4-20 years especially during the summer season. Children usually presents with severe burning and itching sensation in the eye. Other associated symptoms include photophobia, lacrimation and ropy discharge from the eyes. Vernal keratoconjunctivitis, also known as "spring catarrh," "seasonal conjunctivitis" or "warm weather conjunctivitis". The upper palpebral conjunctiva often has giant papillae that give a cobblestone appearance. A stringy conjunctival discharge and a fine, fibrinous pseudomembrane (Maxwell-Lyons sign) may be noted. Patients with atopic dermatitis (eczema) often also have atopic keratoconjunctivitis. The symptoms and signs are a burning sensation, mucoid discharge, redness, and photophobia. Ref: Comprehensive Ophthalmology By A.K Khurana, 4th Edition, Page 745 ; Nijm L.M., Garcia-Ferrer F.J., Schwab I.R., Augsburger J.J., Correa Z.M. (2011). Chapter 5. Conjunctiva & Tears. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.

Answer: OPTION D IS CORRECT.
Question: Which among the following is the commonest type of congenital cataract?
Options:
A. Nuclear
B. Zonular
C. Capsular
D. Coralliform

Rationale: Lamellar or zonular cataract is the most common type of congenital cataract, accounting for about 50% cases. Here, development of the lens is interfered at a later stage. Typically, this cataract occurs in a zone of foetal nucleus surrounding the embryonic nucleus. The main mass of the lens internal and external to the zone of cataract is clear, except for small linear opacities like spokes of a wheel (riders) which may be seen towards the equator. Ref: Ophthalmology by Khurana, 2005, Page 187.

Answer: OPTION B IS CORRECT.
Question: Brain death indicated by suppression of reflexes all except?
Options:
A. Oculovestibular
B. Corneal
C. Pharyngeal
D. Patellar tendon

Rationale: Ans. is 'd' i.e., Patellar tendon Clinical criteria for diagnosis of brain death is : Coma (widesperead coical destruction) : There is unresponsiveness to all form of stimuli. Stimuli do not produce any motor responceexcept spinally mediated reflexes, i.e. spinal reflexes may be intact e.g. deep tendon reflex. Absent of brainstem reflexes : Pupillary reflex, oculovestibular reflex, corneal reflex, pharyngeal and tracheal reflexes. Signs of brain stem (lower) destruction : Apnea, pulse rate invariant and unresponsive to atropine.

Answer: OPTION D IS CORRECT.
Question: Alkali injury to eye causes
Options:
A. Globe perforation
B. Retinal detachment
C. Optic neuritis
D. Symblepharon

Rationale: Symblepharon is adhesion of bulbar conjunctiva with palpebral conjunctiva Refer Khurana 6th edition page number 374

Answer: OPTION D IS CORRECT.
Question: An old patient Ram Kishore having asthma and glaucoma is to receive a β blocker. Regarding β blocking drugs:
Options:
A. Metoprolol blocks β2 receptors selectively
B. Esmolol's pharmacokinetics are compatible with chronic topical use
C. Nadolol lacks β2 blocking action
D. Timolol lacks the local anaesthetic effects of propranolol

Answer: OPTION D IS CORRECT.
Question: A 25-year-old woman presents with a 2-week history of febrile illness and chest pain. She has an erythematous, macular facial rash and tender joints, paicularly in her left wrist and elbow. A CBC shows mild anemia and thrombocytopenia. Coicosteroids are prescribed for the patient. This medication induces the synthesis of an inhibitor of which of the following enzymes in inflammatory cells?
Options:
A. Lipoxygenase
B. Myeloperoxidase
C. Phospholipase A2
D. Superoxide dismutase

Rationale: Coicosteroids Used to suppress the tissue destruction associated with many chronic inflammatory diseases, including RA and systemic lupus erythematosus. Induce the synthesis of an inhibitor of phospholipase A2 and block the release of arachidonic acid from the plasma membranes of inflammatory cells. Myeloperoxidase catalyzes the conversion of H2O2 , in the presence of a halide (e.g., chloride ion) to form hypochlorous acid. Superoxide dismutase reduces the superoxide radical to H2O2.

Answer: OPTION C IS CORRECT.
Question: Not a feature of Mature Senile Cataract among the  following is
Options:
A. Pearly white colored
B. Diminision of Vision
C. Glare
D. Iris shadow

Rationale: Iris shadow is absent in mature senile cataract.

Answer: OPTION D IS CORRECT.
Question: Cotton wool spots in diabetic retinopathy are due to:
Options:
A. Retinal nerve infarcts
B. Retinal holes
C. Retinal haemorrhage
D. Macular degeneration

Rationale: Retinal nerve infarcts

Answer: OPTION A IS CORRECT.
Question: Uveal effusion syndrome may be associated with all of the following except:
Options:
A. Myopia
B. Ciliochoroidal detachment
C. Structural defect in Sclera
D. Nanophthalmos

Rationale: Ans. Myopia

Answer: OPTION A IS CORRECT.