Ophthalmic Pathology Ast. Prof. MAR AMARIN
Ophthalmic Pathology Quiz
Test your knowledge and expertise in ophthalmic pathology with our comprehensive quiz designed for medical professionals and students alike. With 101 carefully curated questions, this quiz covers various aspects of ocular diseases, diagnostic methods, and treatment options.
Key Features:
- 101 engaging questions
- Multiple choice format
- Focus on essential ophthalmic pathology concepts
What is a lesion composed of normal, mature tissue in an abnormal location?
Granuloma
Choristoma
Hemangioma
Hamartoma
Which of the following cells would most likely be observed on histologic examination of a specimen of a bacterial corneal ulcer?
Eosinophils
Epithelioid histiocytes
Basophils
Neutrophils
Which of the following choices is a general histologic sign of malignancy?
Nuclear/cellular pleomorphism
Dyskeratosis
Dysplasia
Calcification
When glaucoma occurs in association with angle recession, it is most commonly because of which of the following?
Damage to the trabecular meshwork
A tear in the ciliary body muscle
Associated lens subluxation
Iridodialysis
If a conjunctival biopsy is being performed for suspicion of ocular cicatricial pemphigoid, then half of the specimen should be submitted in formalin for routine histology and the other half should be submitted in what medium for immunofluorescence studies?
Glutaraldehyde
Absolute alcohol
Saline
Michel medium
What is the first step in preparing a specimen for electron microscopy?
Thin sections
Osmification process
Glutaraldehyde fixation
Thick sections
Frozen sections are appropriate for which one of the following?
To interpret a conjunctinllesion
To make a formal diagnosis
To interpret a cutaneous lesion
To surgically control the margins of a neoplasm
What is the best way to diagnose orbital hemangiopericytoma?
Ultrasound testing
Radiologic imaging
Clinical symptoms and examination
Fine-needle aspiration or open orbital biopsy
A 40-year-old man has a painless, palpable mass in the right superolateral orbit that displaces the globe down and inward. A CT scan shows a heterogeneous mass in the region of the lacrimal gland with adjacent bone remodeling. Which biopsy approach is correct?
Total primary excision through a lateral orbitotomy
Total primary excision through a medial orbitotomy
Incisional biopsy through a lateral orbitotomy
Incisional biopsy through a medial orbitotomy
What method can identify infectious agents, neoplastic cells, or degenerative conditions and distinguish lesions of neuroectodermal origin from neuroendocrine lesions?
Routine histologic examination
Immunohistochemistry
Chromatography
Gram stain
Which of the following corneal stromal dystrophies is characterized by both hyaline and amyloid deposits?
Avellino
Granular
Macular
Lattice
Which of the following forms of infectious keratitis displays double-walled cysts in the corneal stroma on histology?
Herpetic keratitis
Acanthamoeba keratitis
Pseudomonal ulcer
Fusarium keratitis
A 55-year-old diabetic black female has unilateral elevated intraocular pressure associated with long-standing intraocular hemorrhage. The pertinent slit-lamp finding consists of golden brown cells in the anterior chamber. What is the most likely etiology of her elevated intraocular pressure?
Aqueous fluid overproduction
Traumatic pupillary block
Artifactual readings due to corneal edema
Outflow obstruction due to red blood cell membrane rigidity
What disease may be diagnosed by finding Heinz bodies on red blood cell membranes in an anterior chamber aspirate?
Lymphoma
Ghost cell glaucoma
Pseudoexfoliation
Siderosis
A 35-year-old woman, recently diagnosed with rheumatoid arthritis, presents with a violaceous scleral nodule. The biopsy will most likely reveal which of the following?
Circumscribed proliferation of spindle cells in chronically inflamed, richly vascular, and myxoid stroma
Sparse inflammatory infiltrate composed of lymphocytes and plasma cells
Colonies of gram-negative bacteria associated with acute necrotizing inflammation
Palisading arrangement ofhistiocytes/giant cells around necrotic/necrobiotic collagen fibers
The pathophysiology of posterior subcapsular cataract may best be described by which of the following?
Infiltration of the posterior lens by inflammatory cells
Retention of lens fiber nuclei
Disorganization of posterior lens fibers
Posterior migration oflens epithelial cells
What is the histopathologic appearance of the anterior chamber angle in a case of phacolytic glaucoma?
Lack of significant inflammatory cell infiltrate
Infiltration by hemosiderin-laden macrophages
Infiltration by neutrophils
Infiltration by protein-laden macrophages
Of the following, which anatomic boundary is not a component of the vitreous'
Hyaloid face
Hyaloideocapsular ligament
Internal limiting membrane
Vitreous base
Which of the following vitreous degenerations is not age related?
Posterior vitreous detachment
Vitreous syneresis
Asteroid hyalosis
Macular hole
Pathologic examination of cystoid macular edema reveals cysts in which retinal layer?
Internal limiting membrane
Retinal pigment epithelium
Bruch membrane
Outer plexiform
A 6-week-old child is brought by his parents because of a 1-cm reddish mass on the left upper eyelid, which prevents the eye from opening fully. It has grown rapidly since birth. MRI shows an enhancing vascular lesion. Which entity is most likely?
Capillary hemangioma
Plexiform neurofibroma
Benign mixed tumor of the lacrimal gland
Acute dacryocystitis
Histopathologically, the uveitis seen in\ ogt-Koyanagi-Harada syndrome most closely resembles the uveitis seen in which one of the following diseases?
Pars planitis
Intraocular lymphoma
Sympathetic ophthalmia
Juvenile idiopathic arthritis
An asymptomatic, dome-shaped, orange mass is noted in the midperipheral fundus of a 30-year-old woman. An overlying exudative retinal detachment is present. A-scan ultrasonography shows high internal reflectivity. Which entity is most likely?
Posterior scleritis
Central serous retinopathy
Circumscribed choroidal hemangioma
Amelanotic choroidal melanoma
Which pathologic finding would differentiate between a ruptured dermoid and ruptured epidermoid cyst?
Lamellated keratin
Hair follicles
Squamous epithelium
Mixed inflammation
What is the most common type of intraocular tumor?
Melanoma
Retinoblastoma
Lymphoma
Metastatic neoplasm
A 25-year-old white male with a history of conjunctivitis presents with a flesh-colored mass with a central umbilication on the upper eyelid. Examination of the pathologic specimen reveals invasive lobular acanthosis, a central umbilication, and eosinophilic and basophilic intracytoplasmic inclusions. What is the most likely diagnosis?
Molluscum contagiosum
Squamous papilloma
Xanthelasma
Basal cell carcinoma
A 22-year-old female presents with a painless, nontender, flesh-colored, hyperkeratotic eyelid mass. Pathologic examination shows acanthotic epithelium surrounding a fibrovascular core. What is the most likely etiology?
Bacterial
Viral
Inflammation
Sun exposure
Squamous cell carcinoma in situ is defined as a pathologic anatomic limitation by which one of the following?
Basement membrane
Basal epithelium
Stromal keratocytes
Superficial epithelium
With which of the following is aniridia most commonly associated?
Optically empty vitreous
Glaucoma
Optic nerve coloboma
Retinal pigment epithelial hyperplasia
What physiologic changes are associated with acquired optic atrophy?
Increased myelin and shrinking of the subarachnoid space
Shrinkage of the nerve diameter with widening of the subarachnoid space
Uniform changes across the nerve without variation
Increased myelin with thinning of the pial septa
What is optic nerve glioma most frequently associated with?
Neurofibromatosis type 2
Sturge-Weber syndrome
Peters anomaly
Neurofibromatosis type 1
Which of the following is not a clinical risk factor for metastatic disease in patients with uveal melanoma?
Extraocular extension
Young age
Ciliary body involvement
Large tumor size
Which of the following is the most important risk factor for the development of uveal melanoma?
Ocular melanocytosis
Light-colored complexion
Ultraviolet light exposure
Dysplastic nevus syndrome
At the time a choroidal melanoma is diagnosed, which test is recommended to help rule out metastasis?
Abdominal imaging
Serum glucose
Bone marrow biopsy
Brain MRI
With which of the following organs must the ophthalmologist be most concerned about in a patient with retinal capillary hemangioblastoma?
Organs of the immune system and central nervous system
Bowel and skin
Liver and lung
Brain and kidney
What association distinguishes von Hippel-Lindau syndrome from von Hippel disease?
Intracranial calcifications, ash-leaf spots, retinal astrocytomas
Limbal dermoids, upper eyelid colobomas, preauricular tags
Pheochromocytomas, cerebellar hemangioblastomas, renal cell carcinomas
Cafe-au-lait spots, Lisch nodules, optic pathway gliomas
Which of the following is the most important histopathologic risk factor for mortality in the enucleated globe from a patient with retinoblastoma?
The extent of retinal detachment
The size of the tumor
The presence of anterior segment involvement
The extent of optic nerve and choroidal invasion
Which of the following clinical characteristics is typical of Coats disease?
Bilateral
Associated with HLA-B27
Found in female patients
Unilateral
Intraocular calcification in the eye of a child is most diagnostic of what disease?
Retinoblastoma
Persistent fetal vasculature
Coats disease
Toxocariasis
What is the most common secondary tumor in retinoblastoma patients?
Melanoma
Pinealoblastoma
Osteosarcoma
Fibrosarcoma
When a parent has bilateral retinoblastoma, which risk factors apply to the affected parent's children?
Risk of developing retinoblastoma in males only
45% risk of developing retinoblastoma
Risk of bilateral disease in all affected children
85% risk of developing retinoblastoma
What is the primary treatment for a 2-year-old child with unilateral retinoblastoma classified as International Classification Group E?
Enucleation
Systemic chemotherapy alone
Intra-arterial chemotherapy
Radiation alone
What is the treatment of choice for metastatic carcinoma to the eye?
External-beam radiation
Chemotherapy
Brachytherapy
Individually tailored in each case
What is the most common finding in ocular involvement in leukemia?
Vitreous cells
Retinal perivascular sheathing
Retinal hemorrhages
Aqueous cells
Vhat tumor frequently occurs in conjunction with central nervous system involvement?
Ciliary body melanoma
Primary intraocular lymphoma
Basal cell carcinoma of the eyelid
Retinoblastoma
Leukemic retinopathy may cause hemorrhages in which level(s) of the retina?
Leukemic retinopathy does not cause retinal hemorrhages.
Preretinal (subhyaloidal) and intraretinal
Choroidal
Subretinal
Sebaceous carcinoma: Except
Metastasis usually haematogenous
Of the conjunctiva only occurs as a result of pagetoid spread from the eyelid
Is usually bilateral
Has a yellowish appearance
In sympathetic ophthalmia: Except
Dalen-Fuch's nodules are found on the inner surface of the Bruch's membrane
The choriocapillaris are occluded by macrophages
Removal of the damaged eye reduces the inflammation
Dalen-Fuch's nodules are pathognomonic of this condition
Rhabdomyosarcoma of the orbit:
Causes systemic fever
Is resistant to radiotherapy
Has better prognosis than extraorbital type
Of the alveolar type is the most common
Typical peripheral cystoid degeneration of the retina:
Has overlying liquefied vitreous
Increases the risk of retinal detachment
Produces cystic spaces in the nerve fibre layer
Gives rise to retinoschisis through coalescence of the cystic spaces
Sturge-Weber's syndrome is associated with:
Localized form of choroidal haemangioma
Neovascular glaucoma
Meningeal haemangioma
Optic glioma
The following are true about orbital meningioma: Except
It is commoner in female than male
It usually arises from intracranial extension.
Psamomma bodies are essential for histological diagnosis
It is associated with type I neurofibromatosis
The following are False, Except
Glaucoflecken are found in the posterior surface of the lens
Duplication of the lens epithelium occurs in siderosis
Elschnig's pearl arises from cortical remains of the lens
Soemerring's ring causes posterior capsule opacities
With regard to giant cells: Except
Foreign body giant cells occur in chalazion
They are the hallmark of granulomatous lesion
They are derived from macrophages
Langhan's giant cells occur in sarcoidosis
The following are of prognostic importance in choroidal melanoma: Except
Presence of blood vessels within the tumour
Size of the tumour
Location of the tumour
Types of tumour cells
In pthisis bulbi: Except
The size of the globe is reduced
The sclera is thickened
The intraocular pressure is increased
Calcification of the lens is common
Common features of retinoblastoma include: Except
Neovascularization
Calfication
Presence of extracellular DNA
Necrosis
Optic glioma:
Arises from the oligodendrocytes
Contains Rosenthal fibres which are essential for its diagnosis
Has a peak incidence in the middle age
Is associated with type I neurofibromatosis
The following histological feature are present in lattice degeneration: Except
Overlying liquefied vitreous c.
Adherence of vitreous to the margin of the lesion
Closure of the retinal vessels
Overlying liquefied vitreous
In malignant lymphoma of the orbit:
Follicular pattern is commonly seen
Most common cell type is B cell lymphoma
Hodgkin's disease is the most common
The tumour is resistant to radiotherapy
The following are true about dermoids: Except
They are most commonly found in the superotemporal region of the orbit
They are lined by columnar epithelium
Rupture causes granulomatous reaction with foreign body giant cell formation.
The wall contains adnexal structures.
In ocular trauma:
Commotio retinae is caused by retinal oedema
Angle recession results from a tear in the ciliary body
Retinal dialysis is most common in the superotemporal region.
Voss's ring is associated with progressive cataract
Blood staining of the cornea:
Red blood cells are seen in the stroma
Iron is found in the keratocytes
Causes siderosis bulbi
Is a common complication following trabeculectomy
Bitot's spots: Except
Usually precede keratopathy
Resolve with oral vitamin A
Occur in patients with fat malabsorption
Are caused by hyperplasia of the goblet cells
Oncocytoma:
Is malignant in 50% of cases
Has a high recurrence rate following excision
Arises from the stroma
Is most commonly found in the caruncle
The following are true about staining in the microbes: Except
Ziehl-Neelsen's stain give acid fast bacteria a red colour
Gram positive bacteria appear blue
Gomori methamine silver stains fungi green
Gram negative bacteria appear red
Molluscum contagiosum: Except
Is an AIDS-defining disease in HIV positive patients
Is sensitive to acyclovir
Is caused by a poxvirus
Causes acanthosis
Capillary haemangioma: Except
Is commoner in males than females
Is associated with thrombocytopenia in Kasabach-Merrit's syndrome
Most commonly occurs in the eyelids
Often undergoes spontaneously resolution
Posterior embryotoxon:
Is caused by anterior displacement of the Schwalbe's line
Is associated with glaucoma in 50% of cases
Is caused by thickening of the Schwalbe's line
Is a normal finding in 10% of the population
Flexner-Wintersteiner's rosettes:
Occurs in retinocytoma
Is associated with favourable prognosis in retinoblastoma
Can be found in pinealblastoma
Are primitive ganglion cells
In diabetic retinopathy: Except
Cotton wool spots result from ischaemia of the nerve fibre layer.
Flame-haemorrhages occur in the nerve fibre layer.
IRMA (intraretinal microvascular abnormalities) show profuse leakage with fluorescein angiography)
Dot and blot haemorrhages occur in the inner plexiform layer.
Parakeratosis occurs in:
Molluscum contagiosum
Seborrheic keratosis
Squamous cell carcinoma
Basal cell carcinoma
Lisch's nodules in neurofibromatosis:
Are found at the edge of the iris
Are iris naevi
Are highly vascular
Are found in both type I and type II neurofibromatosis
The following are true about phacolytic glaucoma: Except
It occurs in hypermature cataract
The lens capsule is usually ruptured
Anterior chamber aspiration shows swollen macrophages
Liquefaction of the cortex is part of the process
The following stromal dystrophies are dominantly inherited: Except
Macular dystrophy
Lattice dystrophy
Granular dystrophy
Fleck dystrophy
With regard to retinoblastoma: Except
Reese-Ellsworth classification is useful in predicting visual prognosis following radiotherapy
Patients with sporadic retinoblastoma does not pass their genes to their offspring
94% of cases are sporadic
Calcification in the tumour can be detected on ultrasound scan
True statement about papilloma of the eyelid include: Except
It is associated with malignant transformation in 20% of cases
A central fibrovascular cord is a feature
Hyperkeratosis is a feature
Acanthosis is a feature
Focal thickening of the internal lens capsule (excrescence) occurs in: Except
Aniridia
Down's syndrome
Lowe's syndrome
Marfan's disease
The following pairing is correct:
Choristoma - limbal dermoid
Choristoma - cavernous haemangioma
Choristoma - congenital hypertrophy of RPE
Hamartoma - orbital dermoid
The following intraocular foreign bodies are well tolerated by the eye:
Lead
Copper
Zinc
Gold
A patient has large intraocular tumor and was enucleated. The pathology reveals Flexner-Wintersteiner rosette in the lesion. This patient is at higher risk for which of the following secondary tumor?
Wilm’s tumor
Lymphoma
Osteogenic sarcoma
Dermal melanoma
Which one of the following conditions is associated with formation of iris granuloma?
Juvenile xanthogranuloma
Neurofibromatosis
Pseudoxanthoma elasticum
Pseudoexfoliation syndrome
What is the different characteristic between the Trochlear nerve palsy and the skew deviation?
Head tilt contralateral to the hypertropic eye
Incomitant hypertropia
Cyclotorsion of the hypertropic eye
Hypertropia in primary position
True statements about the conjunctiva include: except
Accessory glands of Wolfring produce oily layer of the tear film
The substantia propria is thinnest over the tarsus
It is made up of stratified, non-keratinized squamous epithelium
Goblet cells are most numerous in the fornices
Compared with limbal dermoid, dermolipomas: except
Are not seen in Goldenhar's syndrome
Most frequently occur in the superotemporal quadrant of the fornix.
Have absent dermal adnexal structures
Are soften than limbal dermoids
In persistent hyperplastic primary vitreous (PHPV): Except
Microphthalmos is common
Phthisis bulbi is common if untreated
Calcification is common on X-ray
The lens is reduced in size
Ocular features of trisomy 13 include: Except
Iris coloboma
Corneal opacities
Microphthalmia
Optic nerve hypoplasia
The following are true about conjunctival papillae: Except
Clinically, they appear as flat top elevations
They are seen in bacterial conjunctivitis
They contain lymphoid tissue
They contain small central arteries
In central retinal artery occlusion: Except
Gliosis is a prominent repair mechanism
Liquifactive infarction of the retinal nerve fibre layer is a feature
The occlusion typically occurs near the optic nerve head
The most common cause is arteriosclerosis of the retinal artery
During hammering, a piece of iron foreign body entered a patient's eye and became embedded in the retina. Slit-lamp examination revealed iris transillumination and cataract. The following are true:
The patient had a penetrating corneal wound
The patient had a perforating iris wound
The patient had a penetrating lens wound
Phacolytic glaucoma is a complication
The following are true about cornea:
Pannus occurs between the Bowman's layer and the epithelium
In cystinosis, the crystals are found in the epithelium
Amiodarone is deposited in the anterior stroma
In Wilson's disease, copper is deposited in the descemet membrane
The following are true about phakomatoses: Except
Sturge-Weber's syndrome is the only condition that is not inherited
They are characterized by disseminated hamartomas
Astrocytic hamartoma is found only in tuberous sclerosis
Ataxia-telangiectasia is the only condition that is inherited in an autosomal recessive pattern
True statement about papilloma of the eyelid include: Except
Hyperkeratosis is a feature
It is associated with malignant transformation in 20% of cases
Acanthosis is a feature
A central fibrovascular cord is a feature
Mucormycosis of the orbit: Except
Causes central retinal artery occlusion
Is associated with injury involving vegetation
Commonly causes tissue necrosis
Usually begins in the sinus
Alcian blue stains the following blue: Except
Hyaluronic acid in the vitreous
Macular dystrophy
Granular dystrophy
Schnabel's optic atrophy
Parakeratosis occurs in:
Seborrheic keratosis
Basal cell carcinoma
Molluscum contagiosum
Actinic keratosis
Multiple basal cell carcinoma is a feature in the following conditions:
Muir-Torre's syndrome
Cowden's disease
Xeroderma pigmentosa
Gardner's syndrome
The following stains are used to stain amyloid:
Verhoeff von Gieson
Von Kossa
Crystal violet
Perl's stain
The following is true about orbital neuroblastoma: Except
Homer-Wright's rosettes can be found in the tumour
Bilaterality is rare
Lid ecchymosis is common because the tumour is highly vascular
It is the result of metastasis
The following are features of Muir-Torre's syndrome: Except
Meningioma
Adenocarcinoma of the proximal bowel
Multiple keratoacanthoma
Multiple sebaceous carcinoma
Medulloepithelioma: Except
Arises from the non-pigmeneted retinal pigment epithelium
Is a benign tumour
May contain striated muscle histologically
Causes neovascular glaucoma
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