Opthalmology 2nd long exam 2012B.doc by A6sNT6


									Opthalmology 2nd long exam 2012B                                                                         Infratrochlear Nerve
                                                                                        24.) The lower eyelid is a pain sensitive structure which gets its
     1.)    The most common cause of visual impairment in our country is:                     innervation from the
                       Retinopathy of prematurity                                                       Infraorbital Nerve
     2.)    All of the following is a common finding in a retinoblastoma                25.) This clinical presentation will have acute painless blurring of
            patient, except:                                                                  vision :
                       Large corneal diameter                                                           Central Retinal Artery Occlusion
     3.)    Possible consequences in amlyopia or lazy eye if not treated                26.) This condition will have a clinical presentation of gradual painless
            before 8 y/o are:                                                                 blurring of vision:
                       Abnormal extraocular muscle movement                                             Age Related Macular Degeneration
     4.)    Conditions that block the visual axis and prevent the clear image           27.) The longest section of the optic nerve is:
            in the eye, resulting in amblyopia are the following, except:                                Intraorbital Segment (Intraocular segment measures
                       Pupillary atrophy?                                                                1mm, Intracanalicular segment is 6-10mm, Intracranial
     5.)    Abnormal or unequal red-orange reflex has been associated with                                segment is 10mm, and Intraorbital segment is 25-30
            the following ocular conditions, except:                                                      mm and so this is the right answer).
                       Congenital ptosis                                               28.) Obstruction of this artery is responsible for anterior ischemic optic
     6.)    On a week old? infant weighing 800 grams was referred to the                      neuropathy:
            ophthalmology service was screened for:                                                      Short Posterior Ciliary Artery
                       Retinopathy of prematurity                                      29.) Optic nerve structure where optic nerve damage is due to
     7.)    A 2-day old infant presents with a purulent eye discharge.                        increased intraoptical and intracranial pressure
            Diagnosed with Chlamydia infection. Most likely diagnosis is:                                Laminar (__?__)
                       Opthalmia Neonatorum                                            30.) The blood supply of the optic nerve comes directly from the:
     8.)    A newborn infant, presenting with leukocoria accompanied by a                                Internal Carotid Artery
            heart problem and an ear infection. Mother had rubella infection            31.) (Sorry didn’t get the whole question, but the answer was Optic
            during the first trimester of the pregnancy. Most likely diagnosis                Neuritis. So if we are asked about a question about gradual and
            for this patient is:                                                              painful loss of vision, and somewhere along the line we spot “pain
                       Congenital Cataract (according to the Pediatric                       with movement of the eye, central field loss”, then its most likely
                        Opthalmology trans it is called Pediatric Cataract, pero              Optic Neuritis.
                        sabi sa recording Congenital Cataract)                          32.) Moderate progressive headache, more common early in the
     9.)     A 3-month old infant presented with progressive enlargement of                   morning, and worse….
            the globe, or opthalmos, and large corneal diameter. Digital                                 Papilledema
            palpation revealed a hard globe. The most likely diagnosis is:              33.) On and off transient blurring of vision occurring several times a
                       Congenital glaucoma                                                   day:
     10.)     The best way to diagnose retinoblastoma is by direct                                       Papilledema
            visualization of the lesion. It is used by performing what test?            34.) Complete optic nerve transaction results in:
                       Indirect opthalmoscopy                                                           Negative Light Perception
     11.)   Visual screening test that is used to perform by using an                   35.) Temporal lobe lesion would result in:
            opthalmoscope, except:                                                                       “Pie in the sky”
                       Uthoff’s Test (Test used for multiple sclerosis, so says        36.) Parietal lobe lesion would result in:
                        the audio recording. When patient is subject to warm                             “Pie on the floor”
                        environments, there is a presence of remarkable                 37.) Wedge-shaped scotoma are caused by:
                        neurological deficits, especially blurring of vision)                            Nasal radiating nerve fiber bundle defect
     12.)   Which is the most common site? of Basal Cell Carcinoma?                     38.) Intracameral administration of medications is the infusion of
                       Lower lid                                                             drugs through a space:
     13.)   Poor prognosis of retinoblastoma is generally associated with:                               Bordered by the cornea and the iris (Just remember
                       Optic Nerve invasion                                                              that Intracameral route is in the anterior chamber)
     14.)   Which of the following is an example of Choristoma?                         39.) Medications that are better absorbed by ocular tissue are drugs
                       Dermoid Cyst                                                          that are:
     15.)   A stage II squamous cell carcinoma has already invaded which                                 Lipid soluble
            tissue?                                                                     40.) Medications have to pass through this barrier formed by the non-
                       Substantia propria                                                    pigmented layer of the ciliary epithelium and the epithelium of
     16.)   What is the most common presenting clinical manifestation of                      the iris blood vessels
            retinoblastoma?                                                                              Blood-aqueous barrier
                       Leukocoria                                                 For questions 41-43
     17.)   The ocular tissue that has absolutely no malignant potential is the:        41.) 20/M patient consulted at the OPD presented with blurring of
                       Lens                                                                  vision on the right eye for 4 days after applying 3 drops of self-
     18.)   Which among the following features carries the best prognosis in                  prescribed eye medication with a red-capped bottle. Upon
            Choroidal melanoma?                                                               examination, there was anisocoria with a dilated, non-reactive
                       (Sorry, couldn’t understand this part. But just                       pupil on the right eye. The eye medication that was most likely
                        remember these points to determine prognosis of                       used was:
                        Choroidal melanoma: epithelioid cells, number of                                 Atropine
                        mitoses, extrascleral extension, large tumor size, CB           42.) The patient begins to complain of headache, eye pain, and
                        involvement & greater pigmentation )                                  worsening of blurring of vision. Began to experience vomiting. He
     19.)   What is the best recommended management of a 7-year old                           was admitted at the ER and PE revealed a hazy cornea in the right
            female with a large orbital capillary hemangioma?                                 eye, and shallow anterior chamber on both eyes. The patient
                       Intra-lesional steroid injection                                      most likely developed:
     20.)   What is the most common intraocular tumor?                                                   Acute Angle Closure Glaucoma
                       Metastatic CA                                                   43.) His condition deteriorates as he becomes weak and complains of
     21.)   A tumor recurrence in an enucleated retinoblastoma patient may                    severe pain and vomiting. Tonometry revealed an IOP of 50mmHg
            necessitate:                                                                      of the right eye and 19 mmHg for the left eye. Initial treatment at
                       Chemotherapy                                                          the ER would be:
     22.)   The Iris is a pain-sensitive structure which gets its innervation                            Mannitol
            from the:                                                              For questions 44-45
                       Nasociliary Nerve                                               44.) 35/F consulted at the the OPD because of painless progressive
     23.)   The extraocular muscles contains sensitive structures which gets                  blurring of vision. Patient had been taking a medication for
            its innervation from the                                                          treatment for bronchial asthma for the past 15 years. Leukocoria
       was noted on the left eye and firm hard orbits on Digital                               Pupillary block
       Tonometry for both eyes. This condition may be due to long term         66.) 35/M came in for comprehensive eye exam as part of his annual
       treatment with:                                                              eye check. The ff were taken in his eye findings: unremarkable
                  Prednisone (Long term use of corticosteroids = cataract          past health and family hx, VA 20/20 both eyes, suspicious ___, eye
                   formation)                                                       pressure 23 mmHg both eyes. Most likely dx?
45.)   Patient was referred to an ophthalmologist to confirm the                               Glaucoma suspect
       presence of lens opacity on the left eye ocular hypertension for        67.) In children, the organism found in conjunctivitis:
       both eyes. She was given a medication to control the increased                          H influenzae
       IOP which causes an asthmatic attack. Eye medication that was           68.) On a newborn presented with central conjunctivitis, these
       given to her was most likely:                                                organisms are considered:
                  Timolol                                                                     Chlamydia and Gonococcus
46.)   A glaucoma patient being treated with anti-glaucoma eyedrops on         69.) This type of conjunctivitis is usually unilateral and with
       the right eye developed ____. Right eye developed palpebral                  mucopurulent discharge
       conjunctival injection with papillary reaction. Anti-glaucoma                           Bacterial conjunctivitis
       eyedrops given was most likely:                                         70.) The usual serotype of virus which causes conjunctivitis is
                  Brimonidine                                                                 Adenovirus Type 8, 19, 29, 37
47.)   Topical anesthetics may aid in the examination of patients with         71.) ___
       ____ spasm because of ___ … should not be used in the long term         72.) The usual complication of adenovirus
       treatment because of eye pain because of::                                              Subepithelial cornea infiltration
                  All of the above                                            73.) A person complained of recurring eye redness and itchiness ___
48.)   The ___ retinal detachment ___ rhegmatogenous retinal                                   Allergic conjunctivitis
       detachment                                                              74.) A patient with corneal ulcer
                  Vitreal retinal traction?                                   75.) The most common cause of bacterial corneal ulcer:
49.)   Direct ___ Best achieved by performing:                                                 Gonococcus
                  Vitrectomy                                                  76.) Hx of trauma and exposure of plants and soil indicates a strong
50.)   In the treatment of Proliferative Diabetic Retinopathy, this area is         possibility of what type of keratitis?
       spared during Laser Panretinal Photocoagulation (PRP):                                  Fungus (Fungal type keratitis)
                  Macula                                                      77.) A history of contact lens wear, the keratitis is due to
51.)   In a retinal drawing, the Universal Color Code in Fundus Drawing                   
       for an Attached Retina is:                                              78.) R
                  Red                                                         79.) W/c of the ff is not true of retinoblastoma?
52.)   Rhegmatogenous retinal detachment differs from Diabetic retinal                         It is a rare tumor occurring reported at 1/(15,000 or
       detachment in that it exhibits                                                           50,000) live births
                  More rapid deterioration of vision                                          May nag-complain daw na hindi ito daw yung sagot,
53.)   A physical sign for advanced or end-stage dry/non-neovascular                            but I still included the answer based on the audio
       AMD is:                                                                                  recording. Ultimately, it was decided that “they would
                  Geographic atrophy of RPE in macular region                                  get back to it later”…)
54.)   The clinical manifestation of impaired capillary ____ vascular          80.) The second most common clinical presentation in retinoblastoma
       leakage in Diabetic Retinopathy:                                             is:
                  Presence of Hard Exudates                                                   Eye misalignment
55.)   Initial symptom chronic___ ____ wet type ARMD                           81.) Which is the following workup for retinoblastoma is effective in
                  Metamorphopsia                                                   detecting Optic Nerve involvement?
56.)   72/M white man history of Type 1 DM presented to you                                    MRI
       complaining of incomplete vision. He has not seen an eye doctor         82.) What is the best tx for retinoblastoma tumors measuring 3mm in
       in years. On examination, there are presence of numerous dot-                diameters and 3mm thickness located behind the ___?
       blot hemorrhages, hard exudates and areas with abnormal                                 Photocoagulation (just remember that if the mass is
       vasculature in the retina. Panretinal Photocoagulation might be                          small enough and is located predominantly anteriorly,
       done in this patient to:                                                                 don’t think of enucleation right away. The problem is, I
                  Cure? the ischemic retina                                                    don’t know the cutoff size to indicate enucleation for
57.)   Conjunctival hyperemia, ___of eyelashes, ocular pruritus, ocular                         RB patients…)
       dryness, visual disturbance, ocular burning?, foreign body              83.) Extraretinal fiber vascular proliferation is seen in what stage of
       sensation, eye pain, pigmentation of the periocular skin, perforitis,        active retinopathy of prematurity?
       cataract, superficial ____, ocular irritation island erythema, are                      Stage 3
       complications when taking this anti-glaucoma medication                 84.) What type of retinal detachment is seen in active retinopathy of
                  Bimatoprost                                                      prematurity?
58.)   Which of the ff best characterizes primary open angle glaucoma?                         Tractional RD
                  It is a gradually progressive blinding disease              85.) W/c of the ff is not a key feature of persistent hyperplastic
59.)   One of the ff is a risk factor for the dev’t of glaucoma:                    primary vitreous?
                  Intake of oral steroids                                                     It is usually bilateral
60.)   60/F complains of difficulty of driving characterized as inability to   86.) Tx of choice for unilateral retinoblastoma?
       see the sidewalk for the past 6 mos. Past health history reveals                        Enucleation
       that she is diabetic for 5 years. She claims that she has a sister      87.) ___
       who is blind. Eye exam show VA of 20/20 both eyes, eye pressure                         Initially associated with clear lens/minimal lens opacity
       30 mmHg, open ___. Most likely diagnosis is:                                             that may later become dense cataract
                  Primary Open Angle Glaucoma                                 88.) The pathognomonic sign of active ROP
61.)   Diagnostic test that would identify the mechanism of glaucoma                           Dev’t of a thin gray white line?
                  Gonioscopy                                                  89.) W/c of the ff structures form part of the ant. segment of the eye?
62.)   The most preferred first line of treatment for newly diagnosed                          Ciliary bodies
       mild open angle glaucoma                                                90.) The combined convergence power of cornea and lens is 50
                  Latanoprost                                                      diopters. This is divided into:
63.)   In the tx of glaucoma, Timolol should not be given to patients with                     40 diopters (cornea) + 20 diopters (lens)
                  Bronchial Asthma                                            91.) What type of refractive error does the px have if the image falls
64.)   Aqueous fluid is introduced in which chamber?                                behind/focuses at the back of the retina?
                  Posterior chamber                                                           Hyperopia
65.)   The most common mechanism identified in patients with primary           92.) Error of refraction wherein the images of distant objects focus in
       angle closure glaucoma is:                                                   front of the retina in an unaccomodated eye
                 Myopia
93.) Convex lenses converge light towards the retina, to correct what
      type of error of refraction?
                 Hyperopia (
94.) What type of laser is used for cornea ___
95.) Which of the ff errors of refraction are not indications for corneal
      refractive surgery?
                 Presbyopia
96.) This type of corneal refractive radiosurgery reshapes the cornea
      by direct ablating the Bowman’s and stromal layers without
      creating a corneal flap?
                 Photorefractive Keratectomy (PRK)
97.) This type of corneal refractive radiosurgery reshapes the cornea
      by direct ablating the Bowman’s and stromal layers after creating
      a corneal flap?
                 LASIK
98.) Advantage of LASIK vs. PRK
                 Less pre-op pain
99.) W/c of the ff is not an indication for corneal transplant? (I didn’t
      hear the correct answer very well, but just remember these
      indications for corneal transplant):
                 Bullous Keratopathy – cornea opacifies due to S/P
                  cataract surgery wherein cornea fails or there is
                  trauma during the surgery
                 Keratoconus – failing of cornea that makes the cornea
                  to prolapsed
                 Corneal Dystrophy
                 Corneal Scarring
100.) In cataract surgery, this method is the removal of the lens
      including the anterior and posterior capsule:
                 Intracapsular cataract extraction

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