anand-s/m_qalm huggingface dataset:
Question: With regard to the inner nuclear layer of the retina, which statement is LEAST likely to be   correct?
A.  Amacrine  cells have their cell bodies along the border with the inner plexiform  layer
B.  Bipolar cell bodies occupy the border with the outer plexiform layer
C.  It contains the nuclei of the Müller's cells
D.  The cell bodies of the horizontal cells lie mainly a long the border of the inner  nuclear layer and the outer plexiform layer
Answer: B
Question: With regard to the extraocular muscles, which statement is LEAST likely to be correct?
A. All the rectus muscles arise from the annulus of Zinn
B.  The ciliary  ganglion lies between the lateral rectus and the optic nerve
C. The inferior oblique muscle passes between the globe and the inferior rectus
D. The medial rectus inserts at an average of 5.5mm from the corneal limbus
Answer: C
Question: With regard to the human lens, which statement is MOST likely to be correct?
A. The lens absorbs most light outside the visible spectrum, especially in the  ultraviolet range
B. The lens epithelial cells have neither nuclei nor mitochondria
C. The lens is made up of approximately 60% soluble proteins
D. The posterior epithelium is the source of new cells for the lens
Answer: A
Question: With regard to the blood supply to the visual pathway, whi ch statement is LEAST likely to   be correct?
A. The anterior choroid al artery supplies the optic tract
B. The calcarine artery is a branch of the posterior cerebral artery
C. The lateral striate artery supplies the optic radiations
D. The posterior communicating artery connects the posterior cerebral artery and  the middle cerebral artery
Answer: D
Question: With regard to the anatomy of the eyelids, which statement is MOST likely to be correct?
A. Muller’s muscle arises from the inferior part of the aponeurosis of levator  palpebrae superioris muscle
B. The infraorbital  branch of the maxillary nerve supplies the entire lower eyelid
C. The lateral palpebral artery is derived from the ophthalmic artery
D. The lymphatic drainage from the lateral canthus is to the submandibular nodes
Answer: A
Question: With regard to the  optic nerve, which statement is MOST likely to be correct?
A. It is completely myelinated at the time of full term birth
B. It is ensheathed by epineurium, perineurium and endoneurium
C. Schwann cells within the optic nerve are responsible for maintaining  myelination
D. The sub -arachnoid space is much narrower in the intracanalicular part than the  oribital part
Answer: D
Question: The external (dorsal) nasal nerve is a branch of which of these nerves?
A. Infraorbital nerve
B. Maxillary divis ion of the trigeminal nerve
C. Ophthalmic division of the trigeminal nerve
D. Supra trochlear nerve
Answer: C
Question: With regard to the anatomy of the lacrimal sac, which  statement is MOST likely to be   correct?
A. It is lateral to the angular vein
B. It is only related to the medial palpebral ligament posteriorly
C. It lies adjacent to the superior meatus of the nose
D. It lies in the lacrimal fossa
Answer: D
Question: Which ONE of these foraminae is found in the middle cranial fossa?
A. Caecum
B. Jugular
C. Lacerum
D. Magnum
Answer: C
Question: With regard to the sclera, which statement is LEAST likely to be correct?
A. It consists of regularly spaced collagen fibres
B. It fuses posteriorly with the dural sheath of the optic nerve
C. It is pierced by the vortex veins posterior to the equator
D. It is thinnest behind the insertions of the rectus muscles
Answer: A
Question: With regard to the development of periocular structures, which statement is MOST likely  to be correct?
A. The lacrima l gland is derived from ectoderm
B. The lacrimal sac develops from surface mesoderm
C. The orbicularis oculi is formed from the first pharyngeal arch
D. The puncta open into the eyelid after the eyelids have opened
Answer: A
Question: With regard to the chemical reactions occurring during phototransduction, which   statement BEST describes the sequence which leads to an electrical response?
A. Closure of cation channels as a result of hydrolysis of cAMP by  phosphodiesterase
B. Closure of  cation channels as a result of hydrolysis of cGMP by  phosphodiesterase
C. Opening of cation channels as a result of hydrolysis of cAMP by  phosphodiesterase
D. Opening of cation channels as a result of hydrolysis of cGMP by  phosphodiesterase
Answer: B
Question: With regard to the human lens, which statement is LEAST likely to be correct?
A. Major intrinsic protein of lens fibre -26 (aquaporin O) organises the packing of  crystallins in lens fibre cells
B. Secondary lens fibre cells lose their cytopla smic organelles during  differentiation
C. Secondary lens fibre cells lose thei r nuclei during differentiation
D. The lens capsule is a basement membrane
Answer: A
Question: Which description of burst cells in the RIGHT horizontal gaze centre in the pons  is MOST  likely to be correct?
A. They initiate a pursuit eye movement to the left side
B. They initiate a pursuit eye movement to the right side
C. They initiate a saccadic eye movement to the left side
D. They initiate a saccadic eye movement to the right side
Answer: D
Question: With regard to retinal bipolar cells, which statement is LEAST likely to be correct?
A. Acetylcholine is the major neurotransmitter that conveys excitatory signals  from amacrine cells to bipolar cells
B. Bipolar cell s form synapses with rods or cones but not both
C. GABA is a neurotransmitter that conveys excitatory signals from horizontal cells  to bipolar cells
D. Glutamate is the major neurotransmitter between photoreceptor cells and  bipolar cells
Answer: A
Question: With regard to the normal electroretinogram (ERG), which statement is MOST likely to be  correct?
A. A negative a wave produced by Muller cells and a positive b wave produced by  photoreceptors
B. A negative a wave produced by photoreceptors and a posi tive b wave produced  by Muller cells
C. A positive a wave produced by Muller cells and a negative b wave produced by  photoreceptors
D. A positive a wave produced by photoreceptors and a negative b wave produced  by Muller cells
Answer: B
Question: Which of these equations correctly links intraocular pressure (IOP), force applied to   the cornea (F), tear meniscus force (M), corneal rigidity (N) and the area of cornea   applanated (A) when using the Goldmann tonometer?
A. IOP = (F + M + N)/ A
B. IOP =  (F + M - N)/ A
C. IOP = (F - M - N)/ A
D. IOP = (F - M + N)/ A
Answer: B
Question: With regard to the lacrimal gland and its secretions, which statement is MOST likely to be  correct?
A. Basal secretion occurs via an Na+/K+ ATPase pump
B. Mucin is a  significant component of the secretion
C. Secretion is upregulated by sympathetic neural stimulation
D. The lacrimal gland has a basal secretion of 100 μl/minute
Answer: A
Question: Which ONE of these combinations of muscles constitutes a yoke pair?
A. Right superior rectus and left inferior oblique
B. Right superior rectus and left superior oblique
C. Right superior rectus and right inferior oblique
D. Right superior rectus and right superior oblique
Answer: A
Question: Which ONE of these hormones  is secreted from the anterior pituitary gland?
A. Adrenocorticotrophic Hormone
B. Oxytocin
C. Somatostatin
D. Vasopressin
Answer: A
Question: Which ONE of these statements BEST describes Sherrington’s law?
A. Each movement of the eye from the primary  position to any other position  involves a rotation around a single axis lying in the equatorial plane
B. To each position of the line of sight belongs a definite orientation of the  horizontal and vertical retinal meridians relative to the coordinates of s pace
C. Whenever an agonist receives an impulse to contract, an equivalent inhibitory  impulse is sent to its antagonist, which relaxes and lengthens
D. Whenever an impulse to initiate an eye movement is sent out, corresponding  muscles of each eye receive e qual innervations to contract or relax
Answer: C
Question: Which ONE of these is an early pathological feature of diabetic retinopathy?
A. Capillary basement membrane thinning
B. Increased retinal blood flow
C. Loss of capillary pericytes
D. Retinal capillary closure
Answer: C
Question: With regard to basal cell carcinomas, which statement is MOST likely to be correct?
A. In the eyelid they may arise from the gland of Moll
B. Neglected medial canthal lesions are at risk of orbi t extension
C. Regional lymph node metastases are more common than for sebaceous gland  carcinoma
D. The margins of the sclerosing subtype can be easily defined by palpation
Answer: B
Question: Xeroderma pigmentosum is associated with which ONE of these?
A. Decreased liver function
B. Failure of DNA repair
C. Ocular albinism
D. Tyrosinase deficiency
Answer: B
Question: With regard to pathological changes in cells and tissues, wh ich statement is MOST likely to   be correct?
A. Atrophy is a decrease in cell size or number
B. Differentiation is the extent to which tumour cells resemble each other
C. Hypertrophy is an increase in cell number
D. Metaplasia is loss of uniformity of individual cells as well as their architectural  orientation
Answer: A
Question: With regard to the pathogenesis of tumours, which statement is MOST likely to be correct?
A. Choroidal melanoma is the most common tumour to result from inactivation of  the retinoblastoma (Rb) tumour suppressor gene
B. Chromosomal translocations have been identified in some malignant  lymphomas
C. In situ carcinomas have invaded through basement membranes but have not    metastasized
D. Most oncogenes inhibit apoptosis
Answer: B
Question: Which of these routine culture media is MOST appropria te for the culture of Neisseria   gonorrhoea?
A. Blood agar
B. Chocolate agar
C. Lowenstein Jensen medium
D. MacConkey’s agar
Answer: B
Question: With regard to toll receptors, which statement is LEAST likely to be correct?
A. Each cell type expresses a  different toll receptor
B. Lymphocytes involved in adaptive immunity express toll receptors
C. They are major mediators of innate immunity
D. They are present on all cells
Answer: A
Question: With regard to cutaneous squamous cell carcinoma, which  statement is MOST likely to be   correct?
A. It can spread to local lymph nodes
B. It has an amyloid rich stroma
C. It is the commonest malignant tumour of the eyelid in Europe
D. It typically has a pallisaded histological appearance
Answer: A
Question: Which ONE of these is NOT one of the cellular mechanisms for ageing and death?
A. Cross -linking of DNA
B. Free radical generation
C. Telomere lengthening
D. Time -dependent activation of ageing and death genes
Answer: C
Question: Autoimmune disease may be caused by a defect in which ONE of these?
A. Immune complex formation
B. MHC Class II antigens
C. Topoisomerase
D. T regulatory cells
Answer: D
Question: Which ONE of these drugs is MOST likely to cause an optic neuropathy?
A. Chloroquine
B. Ethambutol
C. Thioridazine
D. Vigabatrin
Answer: B
Question: With regard to the action of botulinum toxin on cholinergic transmission, which statement  is MOST likely to be correct?
A. It acts as a competitive acetylcholine receptor antagonist
B. It acts as a depolarising neuromuscular blocking agent
C. It acts as a non -depolarising neuromuscular blocking agent
D. It acts as an inhibitor of acetylcholine release from the presynaptic membrane
Answer: D
Question: With regard to the m echanism of action of penicillin, which statement is MOST likely to be  correct?
A. It binds to cell membrane phospholipids, increasing membrane permeability
B. It binds to the 50S subunit of bacterial ribosomes to block peptidyl transferase
C. It inhibits  DNA gyrase to interfere with DNA synthesis
D. It inhibits peptide cross -linking of the polysaccharide chains of peptidoglycan
Answer: D
Question: With regard to the action of dexamethasone, which  statement is MOST likely to be   correct?
A. It increases  production of leukotrienes
B. It increases production of phospholipase A2
C. It increases synthesis of lipocortin
D. It increases the release of arachidonic acid
Answer: C
Question: A patient has developed a Horner’s syndrome due to dissection of the ri ght carotid   artery. Cocaine drops are applied to each eye. W hich ONE of these statements is   CORRECT?
A. The right pupil dilates because of denervation hypersensitivity
B. The right pupil dilates because of stimulated release of noradrenaline
C. The right pupil does not dilate because of blockage of alpha receptors
D. The right pupil does not dilate because of lack of noradrenaline in the synaptic    cleft
Answer: D
Question: With regard to the mechanism by which pyridostigmine can reduce t he symptoms of   muscle fatigue in myasthenia gravis, which statement is MOST likely to be correct?
A. It blocks reuptake of acetylcholine by the pre -synaptic membrane
B. It inhibits the breakdown of acetylcholine
C. It stimulates the release of acetylcholine from pre -synaptic vesicles into the  synapse
D. It stimulates upregulation of muscarinic receptors in the post -synaptic  membrane
Answer: B
Question: With regard to X -linked inheritance, which statement is MOST likely to be correct?
A. Daug hters of a carrier female have a 100% risk of being carriers
B. Daughters of an affected male have a 50% risk of being carriers
C. Sons of an affected male have a 50% risk of being affected
D. Sons of an affected male will not be affected
Answer: D
Question: Which ONE of these instruments utilises the optical principal of total internal reflection?
A. Endolaser fibreoptic probe
B. Focimeter
C. Koeppe gonioscope
D. Prism bar
Answer: A
Question: In hypermetropic anisometropia, aniseikonia  can be reduced by which ONE of these  methods?
A. Decreasing the distance between the spectacle lens and cornea
B. Increasing the front curvature of the spectacle lens without changing the lens  power
C. Reducing the thickness of the spectacle lens without  changing the lens power
D. Using high refractive index glass
Answer: A
Question: With regard to Purkinje -Sanson Images (catoptric),  which statement is MOST likely   to be correct?
A. All of the images are virtual
B. One image is inverted
C. The dimmest image is reflected from the anterior lens surface
D. The image from the front of the cornea is in front of the image from the back of  the cornea
Answer: B
Question: With regard to the compound microscope, which  statement is MOST likely to be   correct?
A. It can be used as a low vision aid
B. Rays leaving the system are convergent
C. The eye -piece lens must be stronger than the objective lens
D. The first image is real
Answer: D
Question: With regard to the use of a Porro prism, which  statement is MOS T likely to be   correct?
A. It is stuck onto glasses to correct strabismus
B. It is to double the image in some instruments
C. It is to obtain a magnified image in some instruments
D. It is to shorten the length of some instruments
Answer: D
Question: Which IOL power formula requires a measured anterior chamber depth (ACD)?
A. Haigis
B. Hoffer Q
C. Holliday 1
D. SRK-T
Answer: A
Question: With regard to spherical aberration, which statement is MOST likely to be correct?
A. A concave lens causes light passing through the periphery of the lens to be  refracted more th an when passing through its centre
B. It is least in a plano -convex lens when the plane surface faces the object
C. It is reduced in the eye by the decreasing radius of curvature towards the  periphery of the cornea
D. It may be reduced by decreasing the ap erture in front of the lens
Answer: D
Question: With regard to the calculation of the power of the lens to be implanted during cataract   surgery, which statement is MOST likely to be true?
A. Axial length values as measured by ultrasound are slightly  higher than when  optical (partial coherence interferometry) techniques are used
B. Excess pressure applied to the cornea during A -scan axial length measurement  may lead to unintended postoperative myopia
C. Keratometry values are not influenced by recent contact lens wear
D. To achieve the same refraction, the power of an anterior chamber lens needs  to be approximately two dioptres greater than the power of a posterior  chamber lens
Answer: B
Question: All individuals presenting to a local eye departmen t with soft macular drusen were   enrolled in a study and information gathered on  their diet, smoking habits and   alcohol consumption in the previous year. For comp arison a group of patients with   nuclear cataract were also asked about their  diet, smoking habits and alcohol   consumption.  Which of the following study designs BEST describes this study.
A. Case -control study
B. Cohort study
C. Cross -sectional study
D. Randomised control study
Answer: A
Question: Which of these values represents the logMAR equivalent of a visual acuity of 6/6?
A. 0.0
B. 0.1
C. 0.66
D. 1.0
Answer: A
Question: With regard to investigations for the diagnosis of thyrotoxicosis, which statement is MOST  likely to be correct?
A. Microsomal antibodies are rarely elevated
B. The T3 is a less sensitive measure than T4
C. The TSH level is low
D. Thyroglobulin autoantibodies are lower than normal
Answer: C
Question: A four year old boy is seen in the Emergency Department with an 8mm laceration of the  upper lid not involving the lid margin.  He says that he injured his eye on the corner of the  table.  He has mild ptosis on the left side and there is herniation of orbital fat through the  laceration.  The eye examination is normal.  Which of the following is the next MOST  appropriate step?
A. CT of the orbit
B. Glue the laceration
C. MRI o f the orbit
D. Ultrasound the orbit
Answer: A
Question: Which one of the following statements is MOST likely to be correct for a patient presenting  with a symptomatic retinal dialysis?
A. Other signs of blunt ocular trauma are usually present
B. The duration of the retinal detachment is generally a week or less
C. The macula is likely to be detached
D. The site of the dialysis is most commonly infero -nasal
Answer: C
Question: A 40 year old man has been having chemotherapy f or acute leukaemia.  He has slowly  developed orbital inflammation and proptosis.  A CT scan of the orbit shows inflammation  in the ethmoid and maxillary sinuses with some bony erosion and a low density area  adjacent to the ethmoid sinus in the orbit.  The organism responsible was difficult to  culture but did stain with haematoxylin and eosin.  Which of the following is the MOST  likely diagnosis?
A. Aspergillosis
B. Mucormycosis
C. Staphylococcus aureus
D. Treponema pallidum
Answer: A
Question: A 32 year old man presents with a sudden onset of painful right sided proptosis and  ophthalmoplegia following a fall from a ladder.  What is the MOST likely diagnosis?
A. Direct carotid cavernous fistula
B. Fracture of zygomatic arch
C. Indirect carotid cavernous fistula
D. Orbital varices
Answer: A
Question: A 77 year old woman presents with deteriorating vision in the  left eye for several years. On  examination the eye is red and painful, the intraocular pressure is 60mmHg left eye and  18mmHg right eye.  There is left corneal oedema.  The anterior chambers are deep  particularly on the left.  There is flare and cells on the left and a white lens.  What is the  MOST likely diagnosis?
A. Fuch’s heterochromic uveitis
B. Phacolytic glaucoma
C. Phacomorphic glaucoma (intumescent lens)
D. Posner -Schlossman uveitis
Answer: B
Question: A 63 year old man presented with an intraocular pressure (IOP) of 23mmHg. He is currently  using topical G latanoprost and timolol once daily to both eyes.  He now has an IOP of  18mmHg in both eyes with corneal thickness of 500 microns. The optic discs show a cup  disc ratio of 0.6 right eye with no field loss. In the left eye, the disc is 0.9, with an  increasing nasal arcuate field loss. According to NICE CG85 wh at would be the MOST  appropriate next line of management for the left eye?
A. Add G brimonidine twice a day
B. Augmented trabeculectomy
C. MRI scan of orbit and brain
D. Selective laser trabeculoplasty
Answer: B
Question: A 60 year old woman with a family history of glaucoma is referred by the optometrist with  deteriorating vision and an arcuate field defect in the left eye.  The corrected visual acuity  is 6/9 right eye and 6/18 left eye.  The media are clear.  The intraocular pressure is 25mm  Hg in both eyes with corneal thickness of 580 microns.  The left eye has mild optic atrophy  and peripapillary choroidal atrophy.  What would be the MOST appropriate next line of  management?
A. MRI scan of orbit and brain
B. Review in 3 -4 months with further vis ual fields
C. Start treatment with latanoprost eye drops
D. Visual evoked potentials
Answer: A
Question: A 60 year old man presents with double vision on left gaze.  Examination findings include  reduced adduction in the right eye but normal  convergence.  Which one of the following is  the MOST likely diagnosis?
A. Duane's syndrome Type 3
B. Internuclear ophthalmoplegia
C. Moebius syndrome
D. Sixth nerve palsy
Answer: B
Question: “V” pattern strabismus is MOST likely to be associated with which of the following?
A. Brown’s syndrome
B. Inferior oblique overaction
C. Inferior rectus weakness
D. Superior oblique overaction
Answer: B
Question: A two year old girl is referred because her mother suspects poor sight.  There is no family  history of eye disease.  The parents are first cousins.  Fundal examination is difficult  because of photophobia, but there is no gross retinal abnormality.  Electroretinography  indicates a reduced photopic ERG, a normal scotopic ERG and an absent flicker ERG.  What  is the MOST likely diagnosis?
A. Achromatopsia
B. Albinism
C. Congenital stationary night blindness
D. Leber’s congenital amaurosis
Answer: A
Question: According to the ETROP study, the presence of which one of the following would indicate  that a patient should be treated for retinopathy of prematurity (ROP)?
A. Any form of zone 2 disease
B. Greater than five hours of stage 3 disease
C. Persistent Tunica vasculosa lentis
D. Plus disease
Answer: D
Question: Which one of the following statements regarding Coat’s disease is MOST likely to be  correct?
A. Anti-VEGF is the first line treatment
B. It can present in adults
C. Telangiectasia is limited to the macula region
D. Treatment often includes vitrect omy and laser treatment
Answer: B
Question: As per the NICE guideline (TA274) on diabetic macular oedema (DMO), what is the MOST  likely initial treatment option for DMO more than 400um with foveal involvement?
A. Argon laser treatment
B. Dexamethasone implant
C. Fluocinolone acetonide implant
D. Intravitreal course of Ranibizumab injections
Answer: D
Question: In the International Vitreomacular Traction Study Classification system which one of the  following is LEAST likely to be correct?
A. Classification is based on macula OCT findings
B. Full thickness macular holes <250 um can be managed by pharmacological  vitreolysis
C. The size of vitreomacular traction is considered focal if <1500 um in extent
D. Vitreomacular adhesion is e quivalent to a Gass Stage 1 macular hole
Answer: D
Question: A 65 year old Asian man has an acute submacular haemorrhage in one eye and a sero - sanguinous retinal pigment epithelial detachment in the other eye.  Which one of the  following is the MOST likely diagnosis?
A. Doyne’s honeycomb macular dystrophy
B. Macular telangiectasia
C. Polypoidal choroidal vasculopathy
D. Retinal vasculitis
Answer: C
Question: A 28 year old diabetic woman, who has had no previous laser, has a recurrent vitreous  haemorrhage limiting retinal visualisation.  Which one of the following is the MOST  appropriate course of action?
A. Intravitreal anti -VEGF injection
B. Pan retinal photocoagulation (PRP) under local anaesthesia
C. Prompt vitrectomy and laser
D. Wait two months to allow spontaneous clearing, followed by vitrectomy and  laser if not
Answer: C