QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: Which of the following characteristics are TRUE or FALSE about osteopetrosis in a child? 1. Growth retardation 2. Mental retardation 3. Multiple fracture 4. Cataract 5. Hepatosplenomegaly
Options:
A. 1,3, 5 True & 2,4 False
B. 1,3,4, True & 2,5 False
C. 1.3,4, True & 5,2 False
D. 2,3 False & 1,4,5 True

Rationale: It is an autosomal recessive disorder in which paly calcified cailaginous intercellular ground substance is not regularly reabsorbed and replaced by regular osteoid tissue & bone. Clinical features are Multiple fractures, hepatosplenomegaly, growth retardation, blindness, dental problems, macrocephaly, deafness, etc. Ref: Ghai, 6th Edition, Page 600; Nelson, 18th Edition, Page 2882

Answer: OPTION A IS CORRECT.
Question: Which is the most common ocular manifestation of Thyroid Eye disease?
Options:
A. Exophthalmos
B. Lid retraction
C. Congestion of blood vessels over the inseion of the lateral rectus
D. Corneal exposure keratopathy

Rationale: Lid signs: Retraction of the upper lids producing the characteristic staring and frightened appearance (Dalrymple's sign); Lid lag (von Graefe's sign) i.e., when globe is moved downward, the upper lid lags behind Fullness of eyelids due to puffy oedematous swelling (Enroth's sign) Difficulty in eversion of upper lid (Gifford's sign). Most common amongst these is lid retraction producing the characteristic staring look.

Answer: OPTION B IS CORRECT.
Question: Iris pearl is seen in –
Options:
A. Leprosy
B. Sarcoidosis
C. Tuberculosis
D. Chloasma

Rationale: Iris pearls (also called miliary leproma) are spherical yellowish opaque micronodules near pupillary margins. They are pathognomonic for leprosy.

Answer: OPTION A IS CORRECT.
Question: Treatment of choice for acute angle closure glaucoma is
Options:
A. Timolol
B. Pilocarpine
C. Steroid
D. Atropine

Rationale: B i.e. Pilocarpine

Answer: OPTION B IS CORRECT.
Question: Not true about blue sclera
Options:
A. Seen in osteogenesis impeca
B. Does not seen in Ehlers-danlos syndrome
C. Blue colour is produced by underlying uveal pigment
D. Seen in marfan's syndrome

Rationale: Answer- B. Does not seen in Ehlers-danlos syndromeBlue Sclera is characterized by marked, generalized blue discolouration of sclera due to thinning, The uveal pigment shines through the thin sclera and produces the blue colour.Causes of blue Sclera:Pseudoxanthoma elasticumOsteogenesis imperfectaEhlers-Danlos syndromeMarfan's syndromeAlkaptonuriaHypophosphatasiaJuvenile paget's diseaseNormal in newbornsVan der Hoeve's syndrome

Answer: OPTION B IS CORRECT.
Question: Uses of alpha 2 agonists are all EXCEPT
Options:
A. To produce sedation
B. Glaucoma
C. Benign hyperplasia of prostate
D. Hypeension

Rationale: Alpha 2 antagonists like prazosin, tamsulosin are used in BPH, as they relax urinary bladder neck and the prostate capsule. All the others are the uses of alpha 2 agonists. From medical pharmacology Padmaja 4th edition page no 101,103

Answer: OPTION C IS CORRECT.
Question: A patient has complaint of seeing coloured holoes in the evening and blurring of vision for last few days with normal IOP -
Options:
A. Prodromal phase of acute angle closure glaucoma
B. Acute angle closure glaucoma
C. Chronic glaucoma
D. Epidemic dropsy

Rationale: Coloured halos, blurring of vision and normal IOP suggest the diagnosis of latent PACG (Prodrome stage).

Answer: OPTION A IS CORRECT.
Question: Not a feature of NPCB-
Options:
A. Reduce backlog of cataract surgery
B. Strengthening of RIO
C. Increase community awareness
D. Reach out approach

Rationale: Reach in approach and not reach out approach is used in NPCB NATIONAL PROGRAM FOR CONTROL OF BLINDNESS * 100 % centrally funded scheme * Rapid Survey on Avoidable Blindness in 2006-07 showed reduction in prevalence of blindness from 1.1% (2001-02) to 1% (2006-07). * Target: 0.3% by 2020. Main causes of blindness- * Cataract (62.6%) > Refractive Error (19.70%) >Glaucoma (5.80%), Revised Strategies * Outreach activities o Shifted from eye camp approaches to fixed facilities surgical based approaches e.g. Reach In Programme o Making more comprehensive catering others cause of blindness (refractive errors and low vision, childhood blindness, corneal blindness, glaucoma, diabetic retinopathy) * Services in rural/tribal and other difficult areas-Infrastructures development and appointing contractual ophthalmic manpower * Strengthening Public Private Panership

Answer: OPTION D IS CORRECT.
Question: A man presents 6 hrs after head injury complaining of mild proptosis and scleral hyperemia:
Options:
A. Pneumo-orbit
B. Caroticocavernous fistula
C. Retro-orbital hematoma
D. Orbital cellulitis

Rationale: Ans. Retro-orbital hematoma

Answer: OPTION C IS CORRECT.
Question: Which drug is contraindicated in a glaucoma patient suffering from bronchial asthma:
Options:
A. Timolol maleate
B. Latanoprost
C. Betaxolol
D. Brimonidine

Answer: OPTION A IS CORRECT.
Question: What is true about Ophthalmodynamometry?
Options:
A. Measures the pressure of the ophthalmic aery
B. Measures the IOP of the eye
C. Measures the velocity of blood flow in the central retinal aery
D. Indirectly measures the pulsation of the central retinal vein

Rationale: Ophthalmodynamometry is used to estimate the pressure in the ophthalmic aery (OA) at the site of origin of the central retinal aery (CRA). Measurements are performed by increasing IOP by gradually applying pressure to the globe and observing the aeries on the optic disc until they begin to pulsate. The pressure required to produce aery pulsations on the optic disc reflects the OA diastolic pressure, whereas the force required to cause cessation of aerial pulsations reflects the OA systolic pressure. In OIS(occular ischemic syndrome), the CRA perfusion pressure is low and for this reason the pressure necessary for the pulsations to appear is reduced. Diastolic readings are decreased in OIS, and may improve or return to normal after carotid aery surgery. They are considered to be more reliable than systolic readings.

Answer: OPTION A IS CORRECT.
Question: Berlin's oedema occurs due to
Options:
A. Penetrating injury to eye
B. Blunt trauma to eye
C. Radiation injury to eye
D. Chemical injury to eye

Rationale: Also called commotio retinae is oedema at the macula due to blunt trauma .It present as cherry red spot at the macula Refer khurana 6/e 431

Answer: OPTION B IS CORRECT.
Question: True regarding the use of head mirror is/are?
Options:
A. Applied on right eye
B. Focal point should be within 6 inches
C. One eye should be closed while examining
D. Both eye should be open while focusing

Rationale: Answer- A. Applied on right eyeTwo types of illumination is used in otolaryngologcial examination:Semi mobile illumination like the Bull's lampMobile illumination like the Clair's head light, or cold light based head bands.Bull's lamp: is a semi mobile source of illumination.The approximate focal length of the mirror is about l0 inches.The mirror is fured over the right eye in such a way pa of the mirror touches the nose.The minor is adiusted while keeping the left eye closed and the right eye is kept open to focus. Then both eyes are opened while examining.

Answer: OPTION A IS CORRECT.
Question: SRK formula is used to calculate -
Options:
A. Power of intraocular lens
B. Corneal curvature
C. Corneal endothelial cell count
D. Extent of retinal detachment

Rationale: Intraocular lesn power calculation:- Which requires Keratometry (K), Axial length of eyeball or Biometry (L) and a constant (A). It is calculated SRK formula :- (Ref: Yanoff; Jay S. Duker 2009 Ophthalmology 3rd/e p.416-419)

Answer: OPTION A IS CORRECT.
Question: The most commonly affected tissues in cysticercosis is -
Options:
A. Brain
B. Eye
C. Muscle
D. Liver

Rationale: Man sometimes get infection in the same way as the pig .These cysticercus cellulosae may develop in any organ but are usually present in the subcutaneous tissues and muscles. The oncosphere is filtered out principally in the muscles,where they develop into larval stage in about 60-70 days Ref: panikers textbook of Medical parasitology 8th edition page 126

Answer: OPTION C IS CORRECT.
Question: Most resistant layer of Neurosensory retina
Options:
A. Ganglionic cell layer
B. Layer of Rods & cones
C. Retinal pigment epithelium
D. Nerve fibre layer

Rationale: Most resistant Layer - RPE.
Most resistant layer of Neurosensory retina - Ganglionic cell layer.

Answer: OPTION A IS CORRECT.
Question: Which type of congenital cataract presents with a disc of opacity involving the fetal and embyonal nucleus with many white dots looking like dust?
Options:
A. Lamellar cataract
B. Punctate cataract
C. Pulverulent cataract
D. Coronary cataract

Rationale: Cataract centralis pulverulenta (Embryonic nuclear cataract) -It has dominant genetic trait and occurs due to inhibition of the lens development at a very early stage and thus, involves the embryonic nucleus. -The condition is bilateral and is characterised by a small rounded opacity lying exactly in the centre of the lens. -The opacity has a powdery appearance (pulverulenta) and usually does not affect the vision.

Answer: OPTION C IS CORRECT.
Question: A patient is admitted in ICU due to increased intracranial pressure from secondary metastases. He developed left sided sixth nerve palsy. It would lead to:
Options:
A. Accommodation paresis of left side
B. Ptosis of left eye
C. Adduction weakness of left eye
D. Diplopia in left gaze

Rationale: Unilateral or bilateral abducens palsy is a classic sign of raised intracranial pressure. The sixth cranial nerve innervates the lateral rectus muscle. A palsy produces horizontal diplopia, worse on gaze to the side of the lesion. An abducens nuclear lesion produces a complete lateral gaze palsy from weakness of both the ipsilateral lateral rectus and the contralateral medial rectus. Ref: Hoon J.C. (2012). Chapter 28. Disorders of the Eye. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.

Answer: OPTION D IS CORRECT.
Question: A boy presents with eye deted laterally and slightly downward. The upward gaze is impaired and medial rotation is not possible. Which nerve is involved.
Options:
A. III
B. IV
C. V
D. All

Rationale: A. i.e. III

Answer: OPTION A IS CORRECT.
Question: Blue coloured sclera is frequently associated with:
Options:
A. Osteogenesis imperfecta
B. Ehler danlos syndrome
C. Chondrodysplasia
D. Alpo syndrome

Rationale: The disorder is frequently associated with blue sclerae, dental abnormalities and progressive hearing loss. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 3207

Answer: OPTION A IS CORRECT.
Question: Aldose reductase drugs are useful in
Options:
A. Cataract
B. Diabetes mellitus
C. Hereditary fructose intolerance
D. Essential fructosuria

Rationale: Aldose reductase (AR) is an enzyme of aldoketo reductase super-family that catalyzes the conversion of glucose to sorbitol in the polyol pathway of glucose metabolism. In this context, aldose reductase inhibitors (ARIs) have received much attention worldwide. Decreased sorbitol flux through polyol pathway by ARIs could be an emerging target for the management of major complications of diabetes. The ARIs developed vary structurally, and representative structural classes of ARIs include i) carboxylic acid derivatives (such as Epalrestat, Alrestatin, Zopalrestat, Zenarestat, Ponalrestat, Lidorestat, and Tolrestat), ii) spirohydantoins and related cyclic amides (such as Sorbinil, Minalrestat, and Fidarestat), and iii) phenolic derivatives (related to Benzopyran-4-one and Chalcone). Among these inhibitors, Epalrestat is the only commercially available inhibitor till date. In addition, some other ARIs such as Sorbinil and Ranirestat had been advanced into late stage of clinical trials and found to be safe for human use. Adapting ARIs could prevent sepsis complications, prevent angiogenesis, ameliorate mild or asymptomatic diabetic cardiovascular autonomic neuropathy and appear to be a promising strategy for the treatment of endotoxemia and other ROS-induced inflammatory diseases . Ref - pubmed.com

Answer: OPTION B IS CORRECT.
Question: A man fell down from a height of 35 feet. Eyewitnesses say that he landed on his feet. Which of the following injury is possible?
Options:
A. Gutter fracture skull with cervical spine injury'
B. Pond fracture skull with cerv ical spine injury
C. Depressed fracture skull with cervical spine injury'
D. Ring fracture of foramen magnum with lumbar spine injury

Rationale: Ans. d. Ring fracture of foramen magnum with lumbar spine injury (Ref: Ready 33/e p247; Parikh's 6/4.94-4.97)"Ring fracture: This term is commonly used to signify any fracture around the foramen magnum. Technically it means a fissured fracture about 3.5 cm outside the foramen magnum at the back, involving middle ear sideways and roof of nose anteriorly. It is rare and usually requires a lot of force to produce. It results from fall from a height on feet or buttocks, sudden violent turn of head on spine, severe blow on the vertex which drives the skull downwards on the vertebral column or heavy blow directed underneath the occiput or chin. "Ring or Foramen FracturesIt is fissured fracture, which encircles the skull in such a manner that the anterior third is separated at its junction with the middle and posterior third.But usually the term is applied to a fracture, which runs at about 3 to 5 cm outside the foramen magnum at the back and sides of the skull, and passes forwards through the middle ears and roof of the nose, due to which the skull is separated from the spine.They are rare and occur after falls from a height on to the feet or buttocks.QSkull-vault fractureType of fractureDescriptionDiastatic fracture(sutural fractures)* Separation of suturesQ* Occurs only in young persons due to blow with blunt weapon or from cerebral edemaQFissured fracture* A linear fracture or crack involving the outer or inner table or both.* Fracture only involving inner table cannot be detected on X-ray. It can be detected at autopsyDepressed fracture* Caused by a heavy weapon with a small striking surface e.g., hammer* Its shape may indicate the type of weapon with which it is produced. It is therefore called as signature fractureQ.Comminuted fracture* It has stellate appearance when there is no displacement of fragments.* Also called spider web fractureQPond fracture* Occurs in children due to elasticity of their bones* Also called indented fracturesQGutter fracture* When a part of thickness of bone is removed to form a gutter e.g., glancing oblique bullet woundsQElevated fracture* Result from a blow of moderately heavy sharp edge weapon e.g., axe which elevate one end of bone above the surface while other end may dip down to injured duraQRing fracture* Any fracture around the foramen magnumQ

Answer: OPTION D IS CORRECT.
Question: Parvocellular pathway carries signal for detection of
Options:
A. Color contrast
B. Luminous contrast
C. Temporal frequency
D. Saccadic eye movements

Rationale: From the Lateral geniculate Nucleus (LGN), a magnocellular pathway (from layers 1 and 2) and a parvocellular pathway (from the rest of the layers) project to the visual coex. Parvocellular Pathway Magnocellular pathway Receive input entirely from type X retinal ganglion cells, trasmit color. Formed by Y ganglion cells, project to magnocellular layers of LGN Convey accurate point-to-point spatial information Color blind, transmitting only black- and white information Terminate in layer 4 C of primary visual coex Terminate in layer 4 C of primary visual coex Moderate velocity of conduction Rapidly conducting pathway Carries signals for color vision, texture, shape , and fine details Carrie signals for detection of movement, depth, and flicker Ref: Guyton and Hall 13th edition Pgno: 663

Answer: OPTION A IS CORRECT.
Question: Which of the following type of corneal degeneration is associated with formation of drop like excrescences of hyaline material which project into the anterior chamber around the corneal periphery?
Options:
A. Vogt's limbal girdle
B. Hassall henle bodies
C. Lipoid keratopathy
D. Hyaline degeneration

Rationale: Hassall henle bodies are drop like excrescences of hyaline material which project into the anterior chamber around the corneal periphery. They arise from the descemet's membrane. It is the most common senile change seen in the cornea. In pathological conditions when they become larger and invade the central area it is called cornea guttata. Vogt's limbal girdle appear as bilateral chalky white opacities in the interpalpebral area both nasally and temporally. This opacity is at the level of Bowman's membrane. Ref: Ophthalmology By A. K. Khurana page 136.

Answer: OPTION B IS CORRECT.
Question: Elsching pearls are seen in
Options:
A. Wilsons disease
B. Secondary cataract
C. Complicated cataract
D. Congenital cataract

Rationale: After cataract: It is also known as 'secondary cataract'. It is the opacity which persists or develops after extracapsular lens extraction.Causes. (i) Residual opaque lens matter may persist as after cataract when it is imprisoned between the remains of the anterior and posterior capsule, surrounded by fibrin (following iritis) or blood(the following hyphaema). (ii) Proliferative type of after cataract may develop from the left-out anterior epithelial cells. The proliferative hyaline bands may sweep across the whole posterior capsule.Clinical types. After cataract may present as a thickened posterior capsule, or dense membranous after cataract or Soemmering's ring which refers to a thick ring of after cataract formed behind the iris, enclosed between the two layers of the capsule or Elschnig's pearls in which the vacuolated subcapsular epithelial cells are clustered like soap bubbles along the posterior capsule.Treatment is as follows :i. Thin membranous after cataract and thickened posterior capsule are best treated by YAG-laser capsulotomy or desiccation with cystitome or Zeigler&;s knife.ii. Dense membranous after cataract needs surgical membranectomy.iii. Soemmering's ring after cataract with clean central posterior capsule needs no treatment.iv. Elschnig's pearls involving the central pa of the posterior capsule can be treated by YAG laser capsulotomy or desiccation with cystitome.Ref: Khurana; 4th edition; Pg. 201

Answer: OPTION B IS CORRECT.
Question: Best investigation for optic nerve damage amongst the following is:
Options:
A. Opthalmoscopy
B. Flourscence angiograhy
C. Ultrasound
D. Perimetry

Rationale: D i.e. Perimetry Investigations for Optic Nerve Disease Perimetry : Visual field defects are best detected by Goldmann kinetic perimetry (full-field) & Humphery automated threshold perimetry MRI: Best investigation for imaging of optic nerves Visually evoked potential Fluorescein angiography: Occasionally helpful in differentiating papilloedema(showsdisc leakage) from optic disc drusen (no leakage). Ophthalmoscopic appearance of the disc may vary considerably from normal to elevated to arophied, so they may not help in diagnosis, though may be useful in differential diagnosis. USG is not used for evaluation of optic nerve but for retinal function and structure.

Answer: OPTION D IS CORRECT.
Question: Painful eye movement is a feature of :
Options:
A. Iridocyclitis
B. Papilledema
C. Corneal ulcer
D. Vernal catarrh

Rationale: Anterior uveitis , also known as iridocyclitis and iritis, is the inflammation of the iris and anterior chamber. Anywhere from two-thirds to 90% of uveitis cases are anterior in location. Injection, photophobia, pain, and blurred vision usually accompany iritis (anterior uveitis or iridocyclitis). Ref : Braverman R.S. (2012). Chapter 16. Eye. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.

Answer: OPTION A IS CORRECT.
Question: Stemcells are seen in
Options:
A. Retina
B. Endometrium
C. Base of intestinal crypts
D. None of the above

Rationale: Sterm cells are located in the lower half (base) of intestinal glands (Crypts of Lieberkuhn).The new epithelial cells are formed from the stem cells, and they migrate upwards and reach the tips of the villi.These cells have rapid turnover and are shed after about every 5 days.

Answer: OPTION C IS CORRECT.
Question: Hallpike maneuver is done for:
Options:
A. Vestibular function
B. Audiometry
C. Cochlear function
D. Corneal test

Rationale: Hallpike maneuver is done for BPPV (benign paroxysmal positional veigo) due to displacement of otoconia into posterior semicircular canal. Diagnosis confirmed by Hallpike's maneuver. The Patient sits on a couch & examiner holds the patients head, turn it 450 to the right and then places the patient in a supine position so that his head hangs 300 below the horizontal. Patients eyes are observed for nystagmus. test is repeated with head turned to left and then again in straight head hanging position. In BPPV - veigo, nystagmus appears after a latent period of 2-20 seconds lasts for less than 1min.

Answer: OPTION A IS CORRECT.
Question: A 42-year-old man who has been employed by a company for the past 2 years believes that,h is fellow employees have hatched a conspiracy to get him fired, he believes that they have tapped his phone and that they follow him home. He frequently checks his home for cameras as he believes that fellow employees are keeping an eye on him. He denies having auditory hallucinations and there are no other symptoms. Which of the following is the most appropriate diagnosis for this man?
Options:
A. Paranoid schizophrenia
B. Catatonic schizophrenia
C. Delusional disorder (paranoid type)
D. Paranoid personality disorder

Rationale: This 42-year-old man who believes that his fellow employees are conspiring to get him fired is most likely to have delusional disorder, paranoid type. This disorder is characterized by one chronic and fixed non-bizarre delusional system such as the patient's belief in a non-existent conspiracy. Hallucinations are usually absent in such patients

Answer: OPTION C IS CORRECT.
Question: In acute congestive glaucoma, best prophylaxis for the other eye is:
Options:
A. Laser Iridotomy
B. Topical steroids
C. Trabeculectomy
D. Surgical peripheral Iridectomy

Rationale: Ans. (a) Laser Iridotomy\Ref.: A.K. Khurana 6th ed. 1247-48* Please refer to above explanation* Treatment of choice for primary angle closure glaucoma (fellow eye, latent stage, subacute or intermittent stage , chronic stage) is laser iridotomy* Peripheral surgical iridectomy can also be used.* In acute congestive stage of PACG drug of choice is Pilocarpine, till the time laser iridotomy can be performed. Treatment of choice for fellow eye | | |Primary open angle glaucoma Primary angle closure glaucoma | | Laser trabeculoplasty Nd YAG Laser Iridotomy

Answer: OPTION A IS CORRECT.
Question: Minimum vision loss is seen in which cataract?
Options:
A. Blue dot
B. Zonular
C. Anterior polar
D. Posterior polar

Rationale: Blue dot cataract: It is also called cataracta punctata-caerulea. It usually forms in the first two decades of life. The characteristic punctate opacities are in the form of rounded bluish dots situated in the peripheral pa of an adolescent nucleus and deeper layer of the coex. Opacities are usually stationary and do not affect vision. However, large punctate opacities associated with coronary cataract may marginally reduce the vision.Ref. Khurana; 4th edition; Pg. 173

Answer: OPTION A IS CORRECT.
Question: Ocular lesions of leprosy includes all except
Options:
A. Iritis
B. Cataract
C. Secondary glaucoma
D. Fasicular keratitis

Rationale: Other manifestation
Madarosis, Lagophthalmos, episcleritis,Uveitis...etc.

Answer: OPTION D IS CORRECT.
Question: Complication of vernal kerato conjunctivitis:
Options:
A. Cataract
B. Keratoconus
C. Retinal detachment
D. Vitreous hemorrhage

Rationale: Ans. Keratoconus

Answer: OPTION B IS CORRECT.