QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: Chyriasis is deposition of
Options:
A. Silver in stroma of cornea
B. Gold in stroma of cornea
C. Iron in basement membrane
D. Copper in descement's membrane

Rationale: Chryiasis is deposition of gold in stroma of cornea. Type of Pigment Name of Deposit Disorder Location in Cornea Iron Stocker's line Pterygium Epithelium Hudson-Stahli line In old age Epithelium Ferry's line Filtering bleb Epithelium Fleischer's ring Keratoconus Epithelium Coat's white ring Previous Metallic foreign body injury Bowman's layer Siderosis Stroma Blood staining of cornea Stroma Copper Kayser-Fleischer ring Wilsons's Disease Descement's membrane Melanin Krukenberg's spindle Pigment dispersion syndrome Endothelium Silver Argyrosis Stroma Gold Chrysiasis Stroma

Answer: OPTION B IS CORRECT.
Question: All of the following are true about layers of cornea except :
Options:
A. Predescemet's layer is also known sd Dua's layer
B. Type 2 & type 4 type of collagen are present in Descement membrane
C. Corneal Stroma is the thickest layer of the cornea
D. Endothelium is responsible for maintaining relatively dehydrated state of cornea

Rationale: Descement membrane: toughest layer of cornea Descement's Membrane : *Act as a basement membrane for the endothelial cells *Type 4 & type 8 are most common type of collagen in DM *Toughest layer that provides protection from perforation *Responsible for descemetocele formation. *Site of deposition of copper as KF ring in wilson's disease (. If dua layer is in option then go for that) Endothelium is responsible for behaving like a pump that maintains the relatively dehydrated state of the cornea thereby maintaining its transparency The other options are all true

Answer: OPTION B IS CORRECT.
Question: Which drug can cause macular toxicity when given intravitreally ?
Options:
A. Gentamicin
B. Vancomycin
C. Dexamethasone
D. Ceftazidime

Rationale: Gentamycin causes macular infarction (retinotoxic). Preferably the aminoglycosides should be avoided intravitreally. Ref : Khurana page no. 169

Answer: OPTION A IS CORRECT.
Question: Ionic exchange in the corneal endothelium depends upon the metabolic rate. Which of the following can block Ionic exchange in corneal endothelium?
Options:
A. Inhibition of anaerobic glycolysis
B. Activation of anaerobic glycolysis
C. Activation of cAMP phosphodiesterase inhibitors
D. Interference with electron chain transpo

Rationale: A i.e. Inhibition of anaerobic glycolysis Endothelium provides a leaky barrier to aqueous humor by allowing molecules & electrolytes of small size (2-3nm) to penetrate through focal tight junctions (maculae occludentes). This barrier function is Ca" dependent. The delicate balance between fluid entering corneal stroma (barrier function) and fluid egressing (4-5 Ju1/cm2/hour) the stroma (Na+ K+ ATPase pump function) maintain the corneal hydration at a fixed level of 78%. Any change would cause corneal oedema. Corneal stroma contains glycosaminoglycans (GAG) which is the main cause of corneal hydration and swelling pressure (50mmHg). GAG has anionic charges 1/t separation of one molecule from other making it a sponge like structure that can swell & get hydrated The GAG anionic repulsion expands the tissue and sucks in fluid with equal pressure called imbibation pressure (-30 mmHg) Intraocular pressure (20) = Swelling pressure (50) + Imbibation pressure (-30) Corneal oedema occurs if IOP exceeds SP as in glaucoma or if SP is low (with normal 10P) as in endothelial dystrophy. Endothelial pump is dependent on presence of Cl- & HCO3- and can be slowed down by carbonic anhydrase inhibitor. Basolateral Na+/2HCO3 cotranspo, Na+/KV2C1- cotranspo, C1-/HCO3- exchange, apical anion channels permeable to both Cl- & HCO3- and carbonic anhydrase mediated CO2 diffusion mode of apical HCO3 flux are various anion transpo mechanisms in endothelium. When ATP produced by both glycolysis and aerobic respiration was inhibited by 0.1 mmol/l iodoacetamide, the endothelial cells could not survive but when ATP synthesis alone by aerobic respiration was inhibited by 1.0 mmol/L KCN, the endothelial cells survived for at least 1 week on the ATP produced by anaerobic glycolysisQ.

Answer: OPTION A IS CORRECT.
Question: A 7 yr patient came to opd with nodule on conjunctiva. He has history of taking TB treatment in the past. The nodule with has now encroached the limbus. What is the possible diagnosis.
Options:
A. Trachoma
B. Vernal keratoconjunctivits
C. Phylectenular keratoconjunctivitis
D. Limbus stem cell deficiency

Rationale: The hints point towards phlyctenular keratoconjunctivitis Phlyctenular conjunctivitis * Nodular response of conjunctival epithelium to endogenous antigen * Organisms: TB, S. aureus (mc), M. axenfield * Age: 3-15 yr * Girls > Boys * Predisposition in Low Socioeconomic status, Unhygenic surroundings Pathophysiology * Stage of Nodule Formation * Ulceration * Granulation * Healing Types : Conjunctival Involvement * Simple * Necrotizing * Miliary Corneal Involvement * Ulcerative: Sacrofulaceous/ Fascicular/ Miliary * Diffuse infiltative Treatment * Topical steroids * Antibiotic ointment * Atropine (1%) in case of corneal involvement

Answer: OPTION C IS CORRECT.
Question: In normal kidneys, which of the following is true of the osmolarity of renal tubular fluid that flows through the early distal tubule in the region of the macula densa?(2018)
Options:
A. Usually isotonic compared with plasma
B. Usually hypeonic compared with plasma
C. hypeonic compared with plasma in antidiuresis
D. Usually hypotonic compared with plasma

Rationale: distal tubule, paicularly its first pa, is in an extension of the thick segment of the ascending limb. It is relatively impermeable to water, and continued removal of the solute in excess of solvent fuher dilutes the tubular fluid(hypotonic fluid). Ref:- Ganong, pg num:-684

Answer: OPTION D IS CORRECT.
Question: Newborn eye with respect to refractive error is -
Options:
A. Emmetropic
B. Hypermetropic
C. Myopic
D. Astigmatic

Rationale: Ans. is 'b' i.e., Hypermetropic Eve at birtho Anteroposterior diameter of eye ball is about 16 5 mm (70% of adult size). Adult size is attained by 7-8 yearso Corneal diameter is about 10 mm. Adult size (11.7 mm) is attained by 2 years of age.o Anterior chamber is shallow and angle is narrowo Lens is spherical at birth.o RetinaApart from macular area, the retina is fully differentiated. Macula differentiates 4-6 months afterbirtho Myelination of optic nerve fibres has reached the lamina cribrosao New born is usually hypermetropic by +2 to +3D.o Orbit is more divergent (50deg) as compared to adult (45deg).o Lacrimal gland is still underdeveloped and tears are not secreted.

Answer: OPTION B IS CORRECT.
Question: A 2-year-old intellectutually disabled child is having blue eyes, blonde hair and fair skin. He also have a peculiar body odour. What is the diagnosis?
Options:
A. MSUD
B. Isovaleric aciduria
C. Phenyl ketonuria
D. Canavan's disease

Rationale: Ans. C. Phenyl ketonuriaIdentifying features:* Blue eyes, blonde hair and fair skin is a classical description of a case of PKU. The child is intellectually disabled and they have mousy body odour.

Answer: OPTION C IS CORRECT.
Question: YAG laser is used in -
Options:
A. Retinal detachment
B. Diabetes
C. After-cataract
D. Refractive errors

Rationale: After cataract is treated by Nd-YAG laser posterior capsulotomy

Answer: OPTION C IS CORRECT.
Question: A patient presents with retinoblastoma. He has a single tumor in one eye. Which of the following test could be used to determine whether this is a heritable or sporadic tumor?
Options:
A. DNA footprinting
B. Fluorescence-activated cell soing (FACS)
C. Nohern blotting
D. PCR

Rationale: Foy percent of retinoblastomas are heritable; the child inherits one mutant allele through the germline and a somatic mutation in the other allele occurs, resulting in the loss of function of that gene. This leads to tumor development, often with multiple tumors in both eyes. Penetrance, however, is not complete, since the second mutation is a chance event. Sixty percent of retinoblastomas are sporadic; both alleles are inactivated by somatic mutation. Because this is a rare event, tumors usually are in only one eye and present at a later age. To detect a mutation in the Rb gene and differentiate between heritable and sporadic cases of retinoblastoma, PCR is the most appropriate technique of the choices given. Using the appropriate primers, a deletion can be detected as a change in size of the DNA band amplified. In heritable cases, one chromosome will show the altered length from the deletion or the translocation in any cell in the body. In sporadic retinoblastoma, samples isolated from anywhere other than the tumor should have two normal alleles. DNA footprinting is a protocol used to detect specific protein binding to DNA molecules by comparing the fragmentation patterns of DNA bound with the protein of interest vs. unbound DNA following digestion with DNase I. If the bound protein protects against DNase I digestion, the position of the protein on the DNA can be deduced by the loss of the characteristic fragment. FACS uses antibodies coupled to fluorescent markers to determine cell surface molecules on whole cells. It is very useful for determining the stage of development or activation of cells, but does not give you any insight into the DNA. Nohern blotting, the RNA counterpa to Southern blotting, will determine the size and abundance of mRNA of a specific gene in a given sample of RNA. RNA is not able to be cleaved by restriction enzymes the way the DNA can; however, RNA molecules for different proteins are of different lengths. The sample is separated by agarose gel electrophoresis, transferred to a nitrocellulose membrane, and probed with a specific, labeled probe. This will be exposed to film and the bands will appear, revealing the size and the abundance of specific mRNAs.

Answer: OPTION D IS CORRECT.
Question: Which of the following arachidonic acid derivative is used in treatment of glaucoma?
Options:
A. Latanoprost
B. Iloprost
C. Alprostadil
D. None of the above

Rationale: Latanoprost, a stable long-acting PGF2derivative, was the first prostanoid used for glaucoma. The success of latanoprost has stimulated development of similar prostanoids with ocular hypotensive effects, and bimatoprost, travoprost, and unoprostone are now available. These drugs act at the FP receptor and are administered as drops into the conjunctival sac once or twice daily. Adverse effects include irreversible brown pigmentation of the iris and eyelashes, drying of the eyes, and conjunctivitis. Ref: Katzung 11th edition Chapter 18.

Answer: OPTION A IS CORRECT.
Question: Onabotulinum toxin A can be used for the treatment of:
Options:
A. Cervical dystonia.
B. Chronic migraine.
C. Blepharospasm.
D. Strabismus.

Rationale: Onabotilinum toxin A has recently been approved to prevent a headache in adult patients with chronic migraine.

Answer: OPTION B IS CORRECT.
Question: Cata ract in diabetes -
Options:
A. Snowflake
B. Sunflower
C. Nuclear cataract
D. Oil drop

Rationale: Ans. is 'a' i.e., SnowflakeDiabetic cataracto Cataract is considered as a major cause of visual impairment in diabetic patients. Senile cataract tends to develop at an earlier age and more rapidly than usual in diabetic patients,o The enzyme aldolase reductase catalyzes the reduction of glucose to sorbitol through the polyol pathway, a process linked to the development of diabetic cataract.NADPH* dependent aldolase reductase reduces excessive glucose to sorbitol and intracellular accumulation of sorbitol leads to osmotic changes resulting in hydropic lens fibers that degenerate and form sugar cataract,o The typical diabetic cataract is snowflake cataract, i.e., dense white subcapsular opacities in the anterior and posterior cortex resembling a snowstorm.o As blood- sugar levels fluctuate, visual acuity and refractive error can change - Fluctating refractive error. This causes frequent change in optimal eyeglass prescription.

Answer: OPTION A IS CORRECT.
Question: All are masodermal in origin EXCEPT
Options:
A. Ciliary body
B. Cyclic membrane
C. Adrenal cortex
D. Trigone of bladder

Rationale: i.e. (Ciliary body): (320-IBSth Embryology 8th)CILIARY BODY - (8 - Khurana 4th)* The two layers of epithelium of ciliary body develop from the anterior part of the two layers of optic cup (Neuroectodermal)* Stroma of ciliary body, ciliary muscle and blood vessels are developed from the vascular layer of mesenchyme surrounding the optic cupThe cells of the adrenal cortex arise from coelomic epithelium (Mesoderm). The cells of adrenal medulla are derived from the neural crest (ectoderm) (300 - IBS- Embryology 8th)DERIVATIVES OF MESODERM1. All connective tissues including loose areolar tissue filling the interstics between other tissues, superficial and deep fascia, ligaments, tendons, aponeuroses and dermis of the skin2. Specialized connective tissues like adipose tissue reticular tissue, cartilage and bone3. Dentine of teeth4. All muscles (smooth, striated and cardiac Except the musculature of the iris (ectoderm) and ciliary muscle (neural crest?)5. Heart, all blood vessels and lymphatics, and blood cells6. Kidney, ureters, trigone of bladder, posterior wall of part of the female urethra, posterior wall of upper half of prostatic part of male urethra and the inner glandular zone of the prostate7. Ovary, uterus, uterine tubes, upper part of vagina8. Testis, epidydimis, ductus deferens, seminal vesicle, ejaculatory duct9. Lining mesothelium of pleural, pericardial and peritoneal cavities and of tunica vaginalis10. Lining mesothelium of bursae and joints11. Substance of cornea; sclera; choroid12. Substance of ciliary body and iris13. Duramater; pia - arachnoid (?) microglia14. Adrenal cortexSTRUCTURES DERIVED FROM THE EMBRYONIC LAYERSSurface EctodermNeural EctodermAssociated paraxial mesenchyme / Mesoderm* The crystalline lens* Epithelium of the cornea* Epithelium of the conjuctiva* Lacrimal gland* Epithelium of eyelids and its derivatives viz cilia, targal glands and conjunctival glands* Epithelium lining the lacrimal apparatus* Retina with its pigment epithelium* Epithelial layers of the ciliary body* Epithelial layers of iris* Sphincter and dilator pupillae muscles* Optic nerve (neuroglia and nervous elements only)* Melanocytes* Secondary vitreous* Ciliary zonules (tertiary vitreous)* Blood vessels of choroid, iris, ciliary vessels, central retinal artery, other vessels* Primary Vitreous* Substantia propria, Descemet's membrane and endothelium of cornea* Sclera* Stroma of iris* Ciliary muscle* Sheaths of optic nerve* Extraocular muscles* Upper and medial walls of the orbit* Connective tissue of upper eyelid

Answer: OPTION A IS CORRECT.
Question: Secondary glaucoma associated with angle recession is seen in
Options:
A. Concussion injury
B. Radiation injury
C. Penetrating injury
D. Chemical injury

Rationale: A i.e. Concussion injury Angle recession involves rupture of face of ciliary body, the poion that lies between the iris root and the scleral spur. It is detected gonioscopically as widening of ciliary body band. It is seen in large number of blunt trauma Q patients but glaucoma Q develops in 6-9%.

Answer: OPTION A IS CORRECT.
Question: Corneal thickness is measured by all Except
Options:
A. OCT
B. Utrasonography
C. Orbscan
D. Javal Schiotz method

Rationale: The Javal-Schiotz model keratometer consists of two illuminated 'mires' (A and B) fixed on a rotatable circular arc (C) and a viewing telescope T. The double images (aa1 and bb1) of the mires (A and B) are formed on the cornea. Keratometry readings are obtained by coinciding the images a1 and b. The readings are noted first in the horizontal meridian and then the arc is rotated by 90o and the readings are noted in the veical meridian. Reference : A K KHURANA Comprehensive Ophthalmology; edition 4, page-554

Answer: OPTION D IS CORRECT.
Question: Scarpa's Staphyloma is seen in
Options:
A. Retinal Detachment
B. Myopia
C. Glaucoma
D. Iridocyclitis

Rationale: Ans. (b) MyopiaRef: Clinical ophthalmology By Sandeep Saxena 2/e, p. 445'The presence of posterior staphyloma (Scarpa's Staphyloma) is pathognomonic of pathologic myopia'

Answer: OPTION B IS CORRECT.
Question: In open-angle glaucoma investigation least done is
Options:
A. Indirect ophthalmoscopy
B. Tonometry
C. Direct ophthalmoscopy
D. Perimetry

Rationale: Investigations to be done in open-angle glaucoma are :Slit lamp examinationTonometryGonioscopyDirect ophthalmoscopyPerimetry

Answer: OPTION A IS CORRECT.
Question: Macula involvement is common in -
Options:
A. Toxoplasma
B. Malaria
C. CMV
D. Syphilis

Rationale: Decreased visual acuity may occur as a result of macular involvement or severe vitreous inflammation. ... An active toxoplasmic retinochoroiditis is whitish and moderately exudative with ill-defined borders and involves the macula in a majority of patients.

Answer: OPTION A IS CORRECT.
Question: In a prospective study, 1200 patients were randomly selected to study the effect of a new drug. The drug will be given for 5 years and its association with cataract will be studied. What tyepe of study is this?
Options:
A. Case control study
B. Cohort study
C. Randomized clinical trial
D. Cross-sectional study

Rationale: (Refer: K. Park’s Textbook of Preventive and Social medicine, 24th edition, pg no: 74, 76, 87)
THE INFORMATION IN THE QUESTION IS INSUFFICIENT TO CONCLUDE

It may be a Quasi randomized trial or it can be just clinical trial where the patient may serve as his control
Since association is determined, hence it can be indirectly understood as there are 2 groups
There is an intervention in the study – so it is not a case control or cohort study or cross sectional study
There is no mention of randomization of intervention in the groups which is the heart of RCT

Answer: OPTION C IS CORRECT.
Question: A 4-year-old child presented with fatigue, malaise, fever, sore throat, headache, nausea, abdominal pain and myalgia. On examination generalized lymphadenopathy and hepatosplenomegaly was noted. There was marked tonsillar enlargement along with palatal petechiae, rashes and edema of the eyelids. Peripheral smear is given below.Paul Bunnel test was performed and was positive. All of the following except one can be caused by the above organism?
Options:
A. Nasopharyngeal carcinoma
B. Non Hodgkins Lymphoma
C. Diffuse gastric carcinoma
D. Primary effusion lymphoma.

Rationale: 1st image shows tonsillitis with membrane formation in infectious mononucleosis. Peripheral blood film shows atypical lymphocytes or Downey cells are lymphocytes that become large as a result of antigen stimulation.

Answer: OPTION D IS CORRECT.
Question: In methyl alcohol poisoning there is CNS depression,cardiac depression and optic nerve atrophy.These effects are produced due to:
Options:
A. Formaldehyde and formic acid
B. Acetaldehyde
C. Pyridine
D. Acetic acid

Rationale: Methanol is metabolised to formic acid & formaldehyde ,which produces these kinds of symptoms. Ref: kKD Tripathi 8th ed.

Answer: OPTION A IS CORRECT.
Question: Iris is thinnest at:
Options:
A. Ciliary zone
B. pupil margin
C. Base
D. Collarette

Rationale: The iris is thinnest at its attachment to the ciliary body (base) so that if it tends to give way in this region.

Answer: OPTION C IS CORRECT.
Question: A Radiological sign of meningioma:
Options:
A. "Mother-in-law" sign
B. Owl eye sign
C. Tiger eye sign
D. Inveed napoleon hat sign

Rationale: *Meningiomas show intense contrast enhancement with Early enhancement and Delayed Washout (Early to come and Late to Go) which has been referred to as Mother in Law Sign *Owls eye sign - spinal cord ischemia *Tiger Eye Sign - Halloverden Spatz Disease *Inveed Napolean Hat Sign - b/l Spondylolisthesisof L5 over S1 in frontal pelvic radiograph

Answer: OPTION A IS CORRECT.
Question: Complication of cyclosporine therapy is:
Options:
A. Hypeension
B. Pulmonary fibrosis
C. corneal deposits
D. Nephrotoxicity

Rationale: Cyclosporine selectively suppresses cell-mediated immunity, prevents graft rejection and vet leaves the recipient with enough immune ctivity to combat bacterial infection. Unlike cytotoxic immunosuppressants, it is free of toxic effects on bone marrow and RE system. Humoral immunity remains intact. However, it is a nephrotoxic-the major limitation and impairs liver function. Other adverse effects are sustained the rise in BP, precipitation of diabetes, anorexia, lethargy, hyperkalemia, oppounistic infections, hirsutism, gum hyperplasia, tremor and seizures. Cyclosporine is the most effective drug for the prevention and treatment of graft rejection reaction. It is routinely used in the renal, hepatic, cardiac, bone marrow and other transplantations. For induction, it is staed orally 12 hours before the transplant and continued for as-long-as needed. ESSENTIALS of MEDICAL PHARMACOLOGY SIXTH EDITION -KD TRIPATHI Page:854

Answer: OPTION A IS CORRECT.
Question: What is the most common complication in recurrent anterior uveitis –
Options:
A. Staphyloma
B. Glaucoma
C. Cataract
D. Vitreal haemorrhage

Rationale: The most common complication of recurrent anterior uveitis is a cataract.

Answer: OPTION C IS CORRECT.
Question: Mitomycin C drops are used in: September 2012
Options:
A. Pterygium
B. Ophthalmia nodosa
C. Spring catarrh
D. Dry eye

Rationale: Ans. A i.e. Pterygium Pterygium Elastatoic degeneration with proliferation of vascularized granulation tissue, Stocker's line is seen

Answer: OPTION A IS CORRECT.
Question: All of the following are implicated in the pathogenesis of macular oedema in diabetic retinopathy, EXCEPT:
Options:
A. Retinal pigment epithelium dysfunction
B. Oxidative stress
C. VEGF (vascular endothelial growth factor)
D. Increased protein kinase-C

Rationale: Diabetic macular edema (DME) / Can develop at any stage of retinopathy. Now the leading cause of vision loss in persons with diabetes. Increased vascular permeability causes plasma leaks from the macular vessels, leading to swelling and formation of hard exudates at the central retina. Incidence over 10 years (1) 20% in persons with type 1 DM (2) 25% in persons with type 2 DM who require insulin (3) 14% in persons with type 2 DM who do not require insulin Very Impoant VEGF (vascular endothelial growth factor) is one of the many cytokines that plays an impoant role in diabetic retinopathy. VEGF is a marker for oxidative stress and induces hyperpermeability of macular capillaries, contributing to macular oedema. The molecular mechanisms involved in endothelial damage and macular ischemia are complex and involves sorbitol pathway, AGE formation (advanced glycation end products), protein kinase C, renin-angiotensin system, inflammation, oxidation and alterations in gene expression. Ref: Diabetic Retinopathy, By David J. Browning, Page 205, Springer, 2010.

Answer: OPTION A IS CORRECT.
Question: When the largest diameter and shortest diameter are perpendicular to each other the type o astigmatism is:
Options:
A. Regular
B. Irregular
C. Lenticular
D. Oblique

Rationale: Ans: d (Oblique) Ref: AK Khurana, ed, p. 60-61; 4th p. 36Astigmatism: A type of refractive error in which refraction varies in different meridian so that light entering the eye cannot converge to a point focus but form focal lines.Regular astigmatism: Refractive index changes uniformly: 2 principal mediaIrregular astigmatism: Irregular change of refractive index in different meridian multiple mediaAccording to etiologyTypes of regular astigmatism(depending on axis & angle between two principal meridian)1. Comeal astigmatism2. Lenticular astigmatisma. Curvaturalb. Posturalc. Index3. Retinal astigmatism1. With the rule astigmatism: Two principal meridian right angle to one another but more curved than vertical2. Against the rule: Horizontal media more curved than vertical3. Oblique astigmatism: Two principal media are not horizontal or vertical though these are at right angles to each other4. Bioblique astigmatism: Two principle meridian are not vertical or horizontal and also not perpendicular to each other.

Answer: OPTION D IS CORRECT.