QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: All are parts of anterior segment of eye except
Options:
A. Lens
B. Cornea
C. Vitreous
D. None

Rationale: o The eyeball is divided into two segments : -
A. Anterior segment 

Part of eyeball anterior to posterior border of lens is called anterior segment.
It consists of lens, and structures anterior to it, i.e., cornea, iris and two aqueous humor-filled spaces, i.e., anterior and posterior chambers.

i. Anterior chambers : - It is bounded anteriorly by back of cornea and posteriorly by the iris & part of ciliary body. It contains aqueous humor.
ii. Posterior chamber: - This triangular chamber is bounded anteriorly by the posterior surface of the iris & ciliary body and posteriorly by the lens and it zonules. It also contains aqueous humor. Thus, both anterior and posterior chambers are part of anterior segment and both contain aqueous humor.
B. Posterior segment 

Part of eye ball posterior to lens is called posterior segment.
It consists of vitreous humor, retina, choroid and optic disc.

Answer: OPTION C IS CORRECT.
Question: Not true regarding corneal stroma
Options:
A. Measures 500 um
B. Type 1 collagen is most abundant, type 4 & 6 also found
C. Transmits 90% of incoming light
D. Derives its oxygen from aqueous humor

Rationale: Corneal Stroma * Thickest layer of the cornea * Measures 500 um * Type 1 collagen is most abundant, type 4 & 6 also found.Type 2 collagen is not found * Transmits 90% of incoming light * Derives its oxygen from precorneal tear film and not aqueous humor * MMP 2 is found in human stroma * Acellular & lamellar orientation of collagen fibres accounts for its transparency

Answer: OPTION D IS CORRECT.
Question: Erythropoietin is/are produced by -
Options:
A. Juxtaglomerular cells
B. Interstitial cells of the peritubular capillary bed of the kidneys
C. Pars recta of PCT
D. Macula densa

Rationale: Ans. B. Interstitial cells of the peritubular capillary bed of the kidneysErythropoietin is a glycoprotein hormone which stimulate erythrocyte production.In adults, about 85% of erythropoietin comes from the kidney (interstitial cells in peritubular capillary bed) and 15% from liver (Perivenous hepatocytes). Small amount is also produced in brain; and uterus and oviduct.

Answer: OPTION B IS CORRECT.
Question: All the following signs could result from infection with the right cavernous sinus except
Options:
A. Loss ofpupillary light reflex
B. Loss of corneal blink reflex
C. Ptosis
D. Right ophthalmoplegia

Rationale: Ptosis should be a feature as there is third nerve palsy. But due to proptosis ptosis is not appreciated Refer khurana 6/e 379

Answer: OPTION C IS CORRECT.
Question: A 45-year-old woman with long-standing rheumatoid ahritis complains of dry eyes and dry mouth. Bilateral enlargement of the parotids is noted on physical examination. The syndrome described here is best described as
Options:
A. Autoimmune
B. Infectious
C. Metabolic.
D. Metastatic

Rationale: Sjogren syndrome Chronic autoimmune disorder Characterized by dry eyes (keratoconjunctivitis sicca) & dry mouth (xerostomia) d/t immunologically mediated lymphocytic infiltration & parenchymal destruction of lacrimal & salivary glands.

Answer: OPTION A IS CORRECT.
Question: Visual impairment in pterygium is due to -
Options:
A. Astigmatism
B. Myopia
C. Hypermetropia
D. Hazy cornea

Rationale: Visual disturbances occur when it encroaches the pupillary area or due to corneal astigmatism induced due to fibrosis in the regressive stage. Occasionally diplopia may occur due to limitation of ocular movements. ref: A K KHURANA OPHTALMOLOGY,E4, Page-81

Answer: OPTION A IS CORRECT.
Question: Knudson's two stage hypothesis is for-
Options:
A. Glaucoma
B. Retinoblastoma
C. Optic glioma
D. Meningioma

Rationale: *Deletion or inactivation of RB gene by two mutations (knudson's two hit hypothesis) results in occurence of retinoblastoma. Ref: Khurana 7th/e p.314.

Answer: OPTION B IS CORRECT.
Question: Scissor reflex is seen in ?
Options:
A. Open angle glaucoma
B. Phlyctenular conjunctivitis
C. Keratoconus
D. Interstitial keratitis

Rationale: Ans. is 'c' i.e., Keratoconus Keratoconus is a progressive, noninflammatory, bilateral ectatic corneal disease, characterizedparaxiastromal thinning and weakening that leads to corneal surface distoion. Essential pathological changes are thinning and ectasia which occur as a result of defective synthesis of mucopolysaccharide and collagen tissue. It usually stas at pubey and progresses slowly. Symptoms usually begins as blurred vision with shadowing around images. Vision becomes progressively more blurred and distoed with associated glare, halos around lights, light sensitivity and ocular irritation. Visual loss occurs primarily from irregular astigmatism and myopia. and secondarily from corneal scarring The hallmark of keratoconus is central or paracentral stromal thinning, apical protrusion of anterior corneaand irregular astigmatism. The cornea thins near the centre and progressively bulges forwards, with the apex of cone always being slightly below the centre of the cornea. Impoant findings an examination are - Distaed window reflex (Corneal reflex)Q. Fleisher's rine. Yawning reflex (Scissor reflex). Oil drop reflex. Munson's signs Treatment includes :? Spectacles for regular or mild irregular astigmatism. Rigid gas permeable contact lens for higher astigmatism. Epikeratoplasty in patients intolerant to lens and without significant corneal scarring. Keratoplasty penetrating or deep lamellar if there is significant corneal scarring.

Answer: OPTION C IS CORRECT.
Question: Indirect ophthalmoscopy is done for:
Options:
A. Central retina
B. Periphery of retina
C. Sclera
D. Angle of ant. Chamber

Rationale: B i.e. Periphery of retina Indirect ophthalmoscopy is done for examination of periphery of retina upto ora serrata Q where as direct ophthalmoscopy can show slightly beyond equator.

Answer: OPTION B IS CORRECT.
Question: False about chalazion
Options:
A. Lipogranulomatous inflammation of meibomian gland
B. Also called meibomian cyst or tarsal cyst
C. Presents as lid swelling
D. Incision & curettage is done from conjunctival side by a horizontal incision

Rationale: Conjunctival side - Vertical incision.
Skin side - Horizontal incision.

Answer: OPTION D IS CORRECT.
Question: Which type of osteogenesis imperfecta is also known as imperfecta with blue sclera?
Options:
A. Type 1
B. Type 2
C. Type 3
D. Type 4

Rationale: Clinical types of osteogenesis imperfecta:

Osteogenesis imperfecta, type I  

Osteogenesis imperfecta tarda 
Osteogenesis imperfecta with blue sclerae 


Osteogenesis imperfecta congenital; type II

Osteogenesis imperfecta congenital, neonatal lethal
Vrolik type of osteogenesis imperfecta


Osteogenesis imperfecta, progressively deforming, with normal sclerae: type III  

Gene map locus 17q21.31-q22,7q22.1


Osteogenesis imperfecta, type IV  

Osteogenesis imperfecta with normal sclerae  



Ref: Shafer's textbook of oral pathology 7th edition page 699

Answer: OPTION A IS CORRECT.
Question: All are features of BAD syndrome except:
Options:
A. Bell's palsy
B. Corneal anaesthesia
C. Dry eye
D. Exposure keratitis

Rationale: Ans) a (Bell's palsy) Ref The facial nerve By Mark MayBAD syndrome consists of lack of bells phenomenon, which may lead to poor corneal coverage and lack of tear distribution; corneal anesthesia, due to exposure or fifth nerve deficit, as may occur in resection of a large posterior fossa tumour and dryness, due to loss of tear production as with lesions at or proximal to the geneculate ganglion.this condition can leads to comeal ulcer and exposure keartitis.Term BAD syndrome was coined by Guibor.It is a serious situation which requires immediate rehabilitation by eye closure and protection.Therefore, BAD syndrome does not contain Bells palsy as a component.

Answer: OPTION A IS CORRECT.
Question: Which of the following agents is not used in the treatment of Diabetic Macular Edema/Retinopathy:
Options:
A. Ruboxistaurim
B. Pyridazinones
C. Benfotiamine
D. Tamoxifen

Rationale: Ans. (d) TamoxifenRef: Yanoff 3/e, p. 645Tamoxifen is known to cause retinopathy and macular edema as an adverse effect. It is not used in the treatment of Diabetic Macular edema or retinopathy.* Ruboxistaurin - PKC inhibitor* Pyridazinones/Spiroimides/corbotyliz acid -- aldose reductase inhibitors* Benfoliamine -|levels of AGE's

Answer: OPTION D IS CORRECT.
Question: A child presents with lid lag and an enlarged cornea with a diameter of 13 mm. Examination of the eye reveals double contoured opacities concentric to the limbus. Which of the following is the most likely diagnosis?
Options:
A. Superficial keratitis
B. Deep keratitis
C. Thyroid Endocrinopathy
D. Congenital Glaucoma

Rationale: Ans. (d) Congenital GlaucomaRef: Kanski 7/e, p. 374; Parson's 22/e, p. 304; Shields 6/e, p. 210, 223An enlarged globe with an enlarged corneal diameter > 13 mm along with characteristic Haabs striae (double contoured opacities concentric to limbus) suggests the diagnosis of congenital glaucoma.

Answer: OPTION D IS CORRECT.
Question: A 10-month-old infants present with acute intestinal obstruction. Contrast enema X-ray shows the intussusceptions, likely cause is –
Options:
A. Peyer's patch hypertrophy
B. Meclde's diverticulum
C. Mucosal polyp
D. Duplication cyst

Rationale: Pathogenesis of intussusception 

Between the age of 3 to 9 months, the cause of acute intussusception is idiopathic.
It is postulated that gastrointestinal infection or the introduction of new food proteins result in swollen Peyer's patches in the terminal ileum. The prominent mounds of tissue leads to mucosal prolapse of the ileum into the colon thus causing an intussusception.
In 2-8% of patient, recognizable lead points for the intussusception are found, such as a Meckel's diverticulum, intestinal polyp, neurofibroma, intestinal duplication, hemangioma or malignant condition such as lymphoma.

Answer: OPTION A IS CORRECT.
Question: Erlen Meyer Flask Deformity is seen in?
Options:
A. Osteopetrosis
B. Thalassemia
C. Craniometaphyseal dysplasias
D. All

Rationale: Mnemonics for Erlen Meyer Flask Deformity (CHONG) C: craniometaphyseal dysplasias/Pyles disease H: haemoglobinopathies thalassemia sickle cell disease O: osteopetrosis N: Niemann-Pick disease G: Gaucher disease Radiographs showed a nondisplaced fracture and undeubulation of the distal femoral diaphysis -- a condition known as Erlenmeyer-flask deformity.

Answer: OPTION D IS CORRECT.
Question: An elderly woman was admitted with a fracture of the neck of right femur which failed to unite. On examination an avascular necrosis of the head of femur was noted. The condition would have resulted most probably from the damage to
Options:
A. Superior gluteal aery
B. Inferior gluteal aery
C. Acetabular branch of obturator
D. Retinacular branches of circumflex femoral aeries

Rationale: The major blood supply of femoral head is by lateral(superior) retinacular branch of medial circumflex aery. REF : MAHESWARI 9TH ED

Answer: OPTION D IS CORRECT.
Question: Earliest field defect in primary open angle glaucoma:
Options:
A. Reidel's scotoma
B. Scotoma in Bjerrumns field
C. Arcuate scotoma
D. Nasal spur

Rationale: Ans. is 'b' i.e. Scotoma in Bjerrum's field Visual field defects in Glaucoma:Baring of blind spotScotoma in Bjerrum's fieldArcuate scotomaSeidel's scotomaRing or double arcuate scotoma.Roenne's central nasal step.Advanced field defect:At the last only a small island of central vision {tubular vision) and an accompanying temporal island are left.The temporal island is usually extinguished before the central island although occasionally this sequence is reversed.

Answer: OPTION B IS CORRECT.
Question: Optic nerve fibres once cut, do not regenerate because they are not covered by
Options:
A. Myelin sheath
B. Neurilemma
C. Both of the above
D. None of the above

Rationale: Optic nerve It is a continuation of the nerve fibre layer of the retina, which consists of the axons originating from the ganglion cells. It also contains the afferent fibres of the pupillary light reflex. Morphologically and embryologically, the optic nerve is comparable to a sensory tract. Unlike peripheral nerves it is not covered by neurilemma (so it does not regenerate when cut). Reference :- A K KHURANA; pg num:-287

Answer: OPTION B IS CORRECT.
Question: Dalen fuch's nodule is seen in:
Options:
A. Sympathetic ophthalmitis
B. Myopia
C. Retinal detachment
D. Spring catarrah

Rationale: A i.e. Sympathetic opthalmitis

Answer: OPTION A IS CORRECT.
Question: A man of age 30 years came to clinic with inability to close his left eye, tears flowing over the left cheek and saliva dribbling from his left angle of the mouth.
Options:
A. Facial nerve palsy
B. Mandibular nerve lesion
C. Maxillary nerve injury
D. None of above.

Rationale: The reason for this condition is facial nerve palsy also called Bell`s palsy. It can be compressed at the stylomastoid foramen. Facial nerve supplies all the muscles of facial expression and can be checked by asking the patient to:- 1) Fill air in mouth to test buccinator 2) Close the eyes tightly to test orbicularis oculi 3) Look upwards to check the normal horizontal wrinkles

Answer: OPTION A IS CORRECT.
Question: Orphan Annie-eye nuclei seen in
Options:
A. Papillary carcinoma of thyroid
B. Medullary carcinoma of thyroid
C. Anaplastic carcinoma of thyroid
D. Follicular carcinoma of thyroid

Rationale: Ground-glass cytoplasmic inclusions (Orphan Annie eyes) confirm the diagnosis of papillary carcinoma of the thyroidPapillary carcinoma is the most common thyroid malignancy.The disease is known for its propensity for lymph node metastasesRef: Bailey and love, page no: 818

Answer: OPTION A IS CORRECT.
Question: Loss of vision may occur due to occlusion of -
Options:
A. Optic artery
B. Superior Ophthalmic artery
C. Central Retinal artery
D. External carotid artery

Rationale: Ans. is 'c' i.e, Central Retinal artery * Occlusion (usually embolic, but can be thrombotic, inflammatory or traumatic) of the bloodflow in the Central retinal artery leading painless loss of vision.* The main artery supplying the globe is the ophthalmic artery. The portion of the ophthalmic artery that enters the eye at the optic nerve is called the central retinal artery (CRAO). This artery then divides into a superior and an inferior branch retinal artery that each then further subdivides to supply retinal vessels to the retina.

Answer: OPTION C IS CORRECT.
Question: A 24-year-old male presented with a swelling on anterior aspect of neck. On examination the swelling was firm and moved with deglutination. Biopsy from the lesion has been shown. What is the typical finding and diagnosis?
Options:
A. Orphan Annie eye nuclei; Follicular Ca thyroid
B. Orphan Annie eye nuclei; Papillary Ca thyroid
C. Hurthle cell change; Follicular Ca thyroid
D. Hurthle cell change; Papillary Ca thyroid

Rationale: Ans. (b) Orphan Annie eye nuclei; papillary Ca thyroid*High power shows nuclei of papillary carcinoma cells contain finely dispersed chromatin, which imparts an optically clear or empty appearance, giving rise to the ground glass or Orphan Annie eye nuclei. In addition, invaginations of the cytoplasm may give the appearance of intranuclear inclusions ("pseudoinclusions") or intranuclear grooves. The diagnosis of papillary carcinoma can be made based on these nuclear features, even in the absence of papillary architecture.

Answer: OPTION B IS CORRECT.
Question: A diabetic patient is at greatest risk of developing which of the following type of retinal detachment?
Options:
A. Serous
B. Traction
C. Hemorrhagic
D. Rhegmatogenous

Rationale: Traction retinal detachment is most commonly caused due to proliferative diabetic retinopathy. This traction is due to formation of vitreal, epiretinal, or subretinal membranes consisting of fibroblasts and glial and retinal pigment epithelial cells. The tractional forces formed actively pull the sensory retina away from the underlying pigment epithelium toward the vitreous base. Rhegmatogenous retinal detachment is the most common type of retinal detachment. It is characterized by a full-thickness break in the sensory retina, variable degrees of vitreous traction, and passage of liquefied vitreous through the break into the subretinal space. 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 B IS CORRECT.
Question: Macula lies from disc at a distance of ..... from temporal margin of disc.
Options:
A. 0.3 mm
B. 33 mm
C. 3 mm
D. 0.03 mm

Rationale: 3 mm

Answer: OPTION C IS CORRECT.
Question: Which is not an AR disorder –
Options:
A. Gyrate atrophy
B. Goldmann syndrome
C. Bardet - Biedi syndrome
D. Butterfly macular dystrophy

Rationale: Butterfly macular dystrophy is autosomal dominant inherited. Other three options are autosomal recessive inherited.

Answer: OPTION D IS CORRECT.
Question: True about hemochromatosis is -
Options:
A. Iron deficiency anemia is caused
B. Kayser Fleischer ring is seen in eyes
C. DM and slate grey discolouration of skin
D. Autosomal dominant is the most common form

Rationale: (C) (DM and slate gray discoloration of the skin) (42, 627 Harsh Mohan 6th) (629 Robbins Basic pathology 9th)HemochromatosisTRIAD:1) Pigmentary liver cirrhosis.2) Diabetes mellitus (Pancreatic damage)3) Skin Pigmentation]BRONZE DIABETES* The most common form is an autosomal recessive disease of adult onset caused by a mutation in the HFE gene.A) Idiopathic or hereditary hemochromatosis:* There is a defect in the regulation of intestinal absorption of dietary iron, leading to net iron accumulation of 0.5 to 1.0 g/year.* Hepcidin, produced by the liver, form a web of iron, metabolic control networks that are only recently become elucidated.* Deposits sites - liver, pancreas, spleen, heart and endocrine glands *** Manifests typically after 20 gm of storage iron has accumulated.B) Secondary or acquired hemochromatosis:* Multiple blood transfusion.* Ineffective erythropoiesis (as in G thalassemia and myelodysplastic syndrome).* Increased iron intake.The occurrence of hepatocellular carcinoma is a late complication of hemochromatosis - induced cirrhosis.* K.F. Ring (produced by the alloy of copper in the eye seen in Chalcosis - deposited in Descemet's membrane of the cornea.

Answer: OPTION C IS CORRECT.
Question: Commotio retinae affect which pa of the retina?
Options:
A. Posterior pole
B. Peripheral retina
C. Inferior-nasal pa
D. Superior-nasal pa

Rationale: (Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 431) Berlin's edema, also called commotion retinae, occurs in blunt trauma to the eyeIt manifests as milky white cloudiness involving a considerable area of the posterior pole with a 'cherry-red' spot in the foveal regionIt may disappear after some days or may be followed by pigmentary changes Commotio Retinae or Berlin's Oedema is grey-white discolouration of the retina due to disruption of outer segment photoreceptor layer following blunt trauma. This is caused due to contrecoup injury. Shock waves caused due to impact traverses the fluid- filled eye and then strike retina

Answer: OPTION A IS CORRECT.
Question: Diagnose the ocular pathology.
Options:
A. Primary optic atrophy
B. Primary open angle glaucoma
C. Papilledema
D. Central retinal artery occlusion

Rationale: Ans. (c) PapilledemaOption a - should be a pale - white disc.Option b - POAG should present with loss of nasal neuro- retinal rim and Cupping (large cup, c/d ratio >0.5) along with vascular changes.Option d - CRAO - no occlusion can be seen, all arteries (thinner cross-section, red colour) and veins (thicker cross section, darker red color) are seen to be patientOption c - Papilledema - earliest sign is blurring of the disc margins, which is visible in the image.

Answer: OPTION C IS CORRECT.
Question: Secondary detion of the eye is an example of the following law
Options:
A. Herring's
B. Listing's
C. Sherrington's
D. Donder's

Rationale: Secondary detion: It is detion of the normal eye seen under cover, when the patient is made to fix with the squinting eye. It is greater than the primary detion. This is due to the fact that the strong impulse of innervation required to enable the eye with paralysed muscle to fix is also transmitted to the yoke muscle of the sound eye resulting in a greater amount of detion. This is based on Hering's law of equal innervation of yoke muscles. Ref:- A K KHURANA; pg num:-331

Answer: OPTION A IS CORRECT.
Question: Lacrimal punctum of upper and lower eyelids are ?
Options:
A. They are opposed
B. No relation
C. Upper punctum is medial
D. Upper punctum is lateral

Rationale: Ans. is 'a' i.e., They are opposed

Answer: OPTION A IS CORRECT.
Question: "Dalen Fuch" nodules are seen in
Options:
A. Hypertensive retinopathy
B. Diabetic retinopathy
C. Sympathetic ophthalmia
D. All of the above

Rationale: Ans. c (Sympathetic ophthalmia) (Ref. Schlote, Pocket Atlas of Ophthalmology, p. 132).Dalen-Fuchs Nodules (chorioretinal lesions) are small, discrete, yellow, elevated infiltrates are commonly seen in the midperipheral fundus of patients with sympathetic uveitis. They consist of lymphocytes and epithelioid cell collections between Bruch's membrane and retinal pigment epithelium, although not pathognomonic for Sympathetic ophthalmia, are quite suggestive of this condition; They may be found in VKH syndrome.SYMPATHETIC OPHTHALMIA# Sympathetic ophthalmia is a bilateral, granulomatous panuveitis that classically occurs following a penetrating injury of the eye with uveal involvement.# It can also result from ocular surgery.# Etiology/pathogenesis- T cell-mediated autoimmune reaction, caused by release of uveal antigens (probably from melanocytes).- Genetic predisposition (association with HLADRB1* 04 and DQA1*03).# Epidemiology- Very rare; Manifestation may be days to many years after the causative trauma (90% within one year).# Features:- The visual acuity is variable.- Greasy-appearing deposits on the back of the cornea- Variable anterior chamber inflammation- Inflammatory cells in the vitreous.- Choroidal thickening, Papillitis, Retinal vascular sheathing- Fuchs-Dalen nodules (small white infiltrates in the middle periphery of the fundus)- Macular edema, Exudative retinal detachment, and Optic atrophy.# Diagnosis- Diagnosis is made clinically when panuveitis from other causes is excluded.# Differential diagnosis- Endophthalmitis, Other forms of panuveitis, and Masquerade syndromes (intraocular lymphoma).# Treatment# There is high risk of blindness without adequate treatment if bilateral.# Administration of local and systemic corticosteroids constitutes the basic therapy.# Use of immunosuppressants (e.g., cyclosporine A) is often also required.# Prognosis# Recurrences are frequent following reduction or cessation of therapy.# Long-term or even lifetime treatment is therefore necessary.# The most common complications interfering with vision are macular edema, secondary cataract, and secondary glaucoma.Also remember:Berlin, Koeppe, Busacca nodules are found on iris in granulomatous uveitis. Koeppe's are seen on papillary border, while Busacca are found mid-iris. Berlin are present in angle.6

Answer: OPTION C IS CORRECT.
Question: Method followed to decrease post-op infection in cataract surgery –a) Pre – op antibioticsb) Intra op antibioticsc) Post op subconjunctival gentamicin injectiond) Post op IV antibiotics
Options:
A. ac
B. a
C. ad
D. ab

Answer: OPTION D IS CORRECT.
Question: Under the WHO 'Vision 2020' programme. the 'SAFE' strategy is adopted for which of the following diseases?
Options:
A. Glaucoma
B. Diabetic retinopathy
C. Onchocerciasis
D. Trachoma

Rationale: SAFE strategy was devised by WHO for the treatment of trachoma. SAFE stands for: S - Surgery (of the lids for trichiasis) A - Antibiotics F - Facial cleanliness E - Environmental change Ref : Park's Textbook of Preventive medicine

Answer: OPTION D IS CORRECT.