Year 2 semester 2 (patho+oculoplasty

1. Techniques for entropion repair include all this followings except:

lid retractor reattachment.

botulinum toxin injection.

Quickert-Rathbun sutures.

transverse tarsorrhaphy.

Kuhnt-Szymanowski procedure.

2. Distichiasis is characterised by all of the following except:

An extra row of cilia is present

Normal row of cilia is present anterior to the openings of the meibomian glands

Extra row of cilia occupies a position posterior to the openings of the Meibomian glands

Cilia of the extra row may rub the cornea

3. In severe cases of essential blepharospasm, one may see all the followings except:

bruxism.

decreased tear production.

brow ptosis.

ectropion.

oromandibular dystonia.

4. Complications of exenteration include all the following except:

severe blood loss.

cerebrospinal fluid leakage.

“phantom limb” pain from the cut optic nerve.

skin graft infection.

chronic sino-orbital fistulas.

5. Stye is an acute suppurative inflammation of:

Gland of Zeis

Gland of Moll

Meibomian gland

All of the above

6. Hordeolum internum is a suppurative inflammation of the:

Gland of Zeis

Gland of Moll

Meibomian gland

All of the above

7. Of the following conditions most painful is:

Stye

Hordeolum internum

Ulcerative blepharitis

Inflammation of gland of Moll

8. In a chalazion with multiple recurrences at the same site the incision and currettage should be:

Followed by cauterisation with carbolic acid

Preceded by cryotherapy

Preceded by intralesional injection of triamcinolone

Replaced by excision biopsy

9. Pseudotrichiasis is seen in:

Entropion

Ectropion

Distichiasis

Healed membranous conjunctivitis

10. Simple and effective method of treatment for segmental trichiasis is:

Epilation

Electrolysis

Cryolysis

Surgical correction

11. All of the following operations are employed to correct senile entropion except:

Modified Wheeler’s operation

Modified Ketssey’s operation

Weiss operation

Bick’s procedure with Reeh’s modification

12. Which of the following types of entropion is not known:

Spastic entropion

Paralytic entropion

Cicatricial entropion

Involutional entropion

13. Senile ptosis is:

Neurogenic

Myogenic

Aponeurotic

Mechanical

14. Severe ptosis in a new born should be operated at the age of:

1 year

3 years

5 years

Earliest possible

15. All of the following are pre-cancerous conditions of the lids except:

Naevi

Solar keratosis

Xeroderma pigmentosa

Carcinoma-in-situ

16. The commonest malignant tumour of the lids is:

Basal-cell carcinoma

Squamous cell carcinoma

Adenocarcinoma

Melanocarcinoma

17. The most common site of basal cell carcinoma of the lids is:

Upper lid

Lower lid

Medial canthus

Lateral canthus

18. Neuroblastoma that is metastatic to the orbit:except:

arises in the abdomen in 90% of cases.

first appears as an orbital mass in 8% of cases.

is the second most common malignant orbital tumor of childhood.

affects both orbits in 40% of children.

rarely advances to orbital bones.

19. Hydroxyapatite orbital implant after enucleation: except

is usually wrapped in donor sclera.

receives the four rectus muscles.

requires a peg to produce maximal movement of the implant.

may be rejected by the body’s immune system.

generally undergoes drilling 6 to 12 months after placement.

20. Epiphora in a patient with seventh nerve palsy is most likely due to:

Eversion of lower punctum

Lateral lower lid ectropion

Failure of lacrimal pump system

All of the above

21. Ptosis with lid lag is seen in:

Traumatic ptosis

Myogenic ptosis

Synkinesis

Congenital ptosis

22. Tylosis refers to:

Hypertrophy and drooping of eyelid

Inversion of eyelid

Senile eversion of eyelid

Distortion of cilia

23. The commonest fungal lesion of the eyelid is:

Candida

Aspergillosis

Sporothrix

None

24. Epilation is not indicated in:

Ulcerative blepharitis

Phthiriasis

Trichiasis

Madarosis

25. Sling surgery should be avoided in cases of ptosis with:

Very poor levator action

Poor Bell’s phenomenon

Weak Muller’s muscle

Multiple failed surgeries

26. All are complications of chronic staphylo-coccal blepharoconjunctivitis except:

Chalazion

Marginal conjunctivitis

Follicular conjunctivitis

Phylectenular conjunctivitis

27. Fasanella Servat operation is specifically indicated in:

Congenital ptosis

Steroid induced ptosis

Myasthenia gravis

Horner’s syndrome

28. The operation of plication of inferior lid retractors is indicated in:

Senile ectropion

Senile entropion

Cicatricial entropion

Paralytic entropion

29. A recurrent chalazion should be subjected to histopathologic evaluation to exclude the possibility of:

Squamous cell carcinoma

Sebaceous cell carcinoma

Malignant melanoma

Basal cell carcinoma

30. Fusion of palpebral and bulbar conjunctiva is:

Symblepharon

Trichiasis

Ectropion

Tylosis

31. Eyelid drooping in/are seen in:

Damage to edinger-westphal nucleus

Damage to motor part of facial nerve

Damage to sympathetic nerve supply

Damage to lacrimal nerve

32. A patient with ptosis presents with retraction of ptotic eye lid on chewing. This represents:

Marcus gunn Jaw winking syndrome

Third nerve misdirection syndrome

Abducent palsy

Occulomotor palsy

33. S shaped eyelid is seen in:

Plexiform neurofibroma

Hemangioma

Arterio venious fistula

Varix

34. Innermost stratum of tear film is:

Mucus layer

Aqueous layer

Oily layer

None of the above

35. Thickest layer of tear film is:

Mucus layer

Aqueous layer

Oily layer

None of the above

36. Orbital dermoid cysts:except:

may be subtotally resected with good results.

may lie deep in the orbit.

are lined with epithelium and fi lled with keratinized material.

are choristomas.

represent 25% of all orbital and lid masses.

37. Keratoconjunctivitis sicca refers to:

Aqueous tear deficiency dry eye

Mucin deficiency dry eye

Lipid deficiency dry eye

All types of dry eye

38. Normal values of tear film break up time range from:

5 to 10 seconds

10 to 15 seconds

15 to 20 seconds

15 to 30 seconds

39. Schirmer-I test measures:

Total tear secretions

Basal tear secretions

Reflex tear secretions

All of the above

40. Normal values of Schirmer-I test are:

5 mm

10 mm

15 mm

15 mm or above

41. All of the following are features of Sjogren’s syndrome except:

It is an autoimmune chronic inflammatory disease

Typically occurs in women after the menopause

In primary Sjogren’s syndrome, keratoconjunctivitis sicca is associated with rheumatoid arthritis

In secondary Sjogren’s syndrome, dry eye and/ or xerostomia (dry mouth) is associated with rheumatoid arthritis

42. Tear film break-up-time is the time:

Between the last blink and the appearance of first dry spot on the cornea

Taken for appearance of dry spot between two blinks

Taken by successive blinks to break the tear film

Taken for disappearance of dry spots on the cornea

43. Tear lysozyme levels are decreased in:

Keratoconjunctivitis sicca

Stevens Johnson syndrome

Ocular pemphigoid

All of the above

44. Plexiform neurofibroma: except:

is the most common benign peripheral nerve tumor involving the eyelids and orbit.

is characteristic of neurofi bromatosis.

is not invasive.

is not metastatic.

has a propensity for sensory nerves.

45. Most common site of congenital blockage in the nasolacrimal duct is:

At the upper end

In the middle

At the lower end

Whole of the duct

46. Optimum age for performing dacryocystorhinostomy operation in a child with congenital dacryocystitis is:

2 years

4 years

6 years

8 years

47. In dacryocystorhinostomy operation the communication of the sac is established with:

Middle meatus

Superior meatus

Inferior meatus

All of the above

48. Functional efficiency of lacrimal drainage system may be assessed by:

Lacrimal syringing

Subtraction macrodacryocystography

Radionucleotide dacryocystography

All of the above

49. Most common site of obstruction in chronic dacryocystitis in adults is:

At upper end of nasolacrimal duct

At lower end of nasolacrimal duct

In the lacrimal sac

In the common canaliculus

50. Normal pH of tears is:

5.7

6.7

7.5

7.9

51. Tears are produced in the new born after:

1 Week

2 Weeks

3 Weeks

4 Weeks

52. A 3 month old infant was brought with complaints of profuse lacrimation. On pressure pus exudes from the puncta. The best line of management is:

Dacryocystorhinostomy

Syringing

Massaging of sac with antibiotics

Syringing and probing

53. Initial treatment of congenital dacryocystitis:

A. Massaging=1

B. Probing

C. DCR

D. Ointment

E. No treatment required

54. A 60 year old man presented with watering from his left eye since 1 year. Syringing revealed a patent drainage system. Rest of the ocular examination was normal. A provisional diagnosis of lacrimal pump failure was made. Confirmations of the diagnosis would be by:

Dacryoscintigraphy

Dacryocystography

Pressure syringing

Canaliculus irrigation test

55. Unilateral lacrimal gland destruction may be caused by:

Inferior orbital fissure fracture

Fracture of roof of orbit

Fracture of lateral wall

Fracture of sphenoid

56. Length of naso lacrimal duct is:

10 mm

11 mm

12 mm

9 mm

57. Intermittent proptosis is a sign of:

Pseudotumour

Carotico-cavernous fistula

Capillary haemangioma

Orbital varices

58. Marcus Gunn pupil along with proptosis indicates:

Involvement of ciliary ganglion

Compression of optic nerve

Compression of inferior division of 3rd nerve

Compression of sympathetic nerves of the eyeball

59. Postural exophthalmometric changes are diagnostic of:

Orbital varix

Carotico-cavernous aneurysm

Haemangioma

Thyroid ophthalmopathy

All of the above

60. Intraorbital calcification in a patient with proptosis is observed in all except:

Retinoblastoma

Orbital varix

Hydatid cyst

Pseudotumour

61. Dehiscence of bone can be seen as X-rays findings in a patient with proptosis in all except:

Mucocele

Neurofibroma

Lacrimal gland tumour

Rhabdomyosarcoma

62. Orbital lesions of childhood include all of the following except:

Lymphangioma

Secondary orbital meningioma

Cavernous haemangioma

Neurofibroma

63. Pseudoproptosis is a feature of:

Buphthalmos

High axial myopia

Upper lid retraction

All of the above

64. Opticociliary shunts observed on fundoscopy are a feature of:

Meningioma

Cavernous haemangioma

Orbital varix

All of the above

65. Horner’s syndrome is characterised by all of the following except:

Contralateral enophthalmos

Ipsilateral miosis

Ipsilateral ptosis

Anhydrosis of the affected side of face

66. Ocular Graves disease is associated with:

Hyperthyroidism

Hypothyroidism

Euthyroid state

All of the above

67. Dalrymple’s sign of ocular Graves’ disease refers to:

Retraction of the upper lid

Lid lag

Proptosis

All of the above combinedly

68. The most common ocular motility defect noted in ocular Graves’ disease is due to involvement of:

Inferior rectus

Medial rectus

Superior oblique

Inferior oblique

69. The walls of the orbit which are removed in the two wall decompression for proptosis of thyroid ophthalmopathy include part of:

Orbital floor and medial wall

Orbital floor and lateral wall

Orbital roof and medial wall

Medial and lateral walls

70. All of the following are the features of orbital apex syndrome except:

Ophthalmoplegia

Enophthalmos

Ophthalmic nerve anaesthesia

Amaurosis

71. Most often the first sign of involvement of opposite side in cavernous sinus thrombosis is:

Paralysis of opposite lateral rectus muscle

Proptosis of the opposite side

Paralysis of opposite 3rd nerve

Paralysis of opposite 4th nerve

All of the above

72. Simultaneous thrombosis of both the cavernous sinuses usually occurs in:

Diseases of the sphenoid sinuses

Septic wounds of the face

Pyogenic meningitis

Patients with cerebral abscess

73. The most common mucocele of the paranasal sinuses involving the orbit arises from:

Frontal sinus

Ethmoidal sinus

Maxillary sinus

Sphenoidal sinus

74. The most commonly seen primary orbital tumour in children is:

Rhabdomyosarcoma

Glioma of optic nerve

Optic nerve sheath meningioma

Retinoblastoma

75. Ophthalmoscopic sign pathognomonic of optic nerve sheath meningioma is:

Papilloedema

Optic atrophy

Opticociliary shunt

All of the above

76. The diagnostic triad of exophthalmos, diabetes insipidus and bone lesions is characteristic of:

Hand-Schuller Christian disease

Letterer-Sieve disease

Fibrous dysplasia

Osteoporosis

77. Cause of lid retraction include:

Graves’ ophthalmopathy

Hypokalemic periodic paralysis

Cirrhosis of the liver

Hydrocephalus

All of the above

78. Secondary tumour may spread to the orbit by all of the following except:

Direct spread from the lids

Via blood stream

Via lymphatic channels

Directly from the cranial cavity

79. The most common tumour that spreads into the orbit from the intracranial cavity is:

Astrocytoma

Pituitary adenoma

Sphenoid wing-meningioma

Neurofibroma

80. One of the early symptoms of orbital involvement by basal cell carcinoma of the lid is:

Diplopia

Defective vision

Proptosis

Severe pain

81. Intraorbital abscess formation occurs most commonly in which quadrant of the orbit?

Superotemporal

Superonasal

Inferonasal

Inferotemporal

82. The most common cause of pulsating exophthalmos is:

Orbital varices

Neurofibromatosis

Cavernous haemangioma

Caroticocavernous fistula

83. The most common cause of intermittent exophthalmos is:

Orbital varices

Cavernous haemangioma

Lymphangioma

Carotico-cavernous fistula

84. The most common benign tumour of the orbit is:

Optic nerve glioma

Meningioma

Benign-mixed tumour

Haemangioma

85. Superior orbital fissure syndrome is frequently caused by:

Carotid aneurysms

Meningioma

Arachnoiditis

All of the above

86. All of the following structures are located in the lateral wall of the cavernous sinus except:

Abducent nerve

Oculomotor nerve

Trochlear nerve

Ophthalmic nerve

87. Contracted socket occurs because of all the following except:

Chronic low grade infection

Chronic mechanical irritation

Irradiation

Loss of fatty tissue during surgery of enucleation

88. A man presents 6 hrs after head injury complaining of mild proptosis and scleral hyperemia:

Pneumo-orbit

Caroticocavernous fistula

Retro-orbital hematoma

Orbital cellulitis

89. Blow-out fracture of orbit is characterized by all except:

Diplopia

‘Tear drop” sign

Positive forced duction test

Exophthalmos

90. All of the following signs could result from infection within the right cavernous sinus, except:

Loss of pupillary light reflex

Loss of corneal blink reflex

Ptosis

Right ophthalmoplegia

91. Commonest cause for bilateral proptosis in children is:

Cavernous hamangioma

Chloroma

Fibrous histiocyloma

Rhabdomyosarcoma

92. A patient presented with unilateral proptosis, which was compressible and increases on ending forward. No thrill or bruit was present. MRI shows a retro-orbital mass with enhancement. The likely diagnosis is:

AV malformations

Orbital encephalocoecle

Orbital varix

Neurofibromatosis

93. Thyroid ophthalmopathy a/w:

External ophthalmoplegia

Internal ophthalmoplegia

Proptosis

Large extra-ocular muscle

Lid lag

94. A 19 years old young girl with previous history of repeated pain over medial canthus and chronic use of nasal decongestants, presented with abrupt onset of fever with chills and rigor, diplopia on lateral gaze, moderate proptosis and chemosis. On examination optic disc is congested. Most likely diagnosis is:

Cavernous sinus thrombosis

Orbital cellulitis

Acute ethmoidal sinusitis

Orbital apex syndrome

95. A young man following RTA presented with proptosis and pain in right eye after four days. On examination there is bruise on forehead and right eye. What is the diagnosis:

Cavernous sinus thrombosis

Internal carotid artery aneurysm

Carotico-cavernous fistula

Fracture of sphenoid

96. A young adult presents with proptosis and pain in eye after 4 days of trauma to eye. Chemosis, conjunctival congestion and extraocular muscle palsy with inability to move eye are seen. Investigation of choice:

MRI

Digital subtraction angiography

MR angiography

97. Blow out fracture of the orbit, most commonly leads to fracture of:

Posteromedial floor of orbit

Medial wall of orbit

Lateral wall of orbit

Roof of orbit

98. Most common cause of fracture of roof of orbit:

Blow on back of head

Blow on parietal bone

Blow on the forehead

Blow on the upper jaw

99. Which of the following signs is classic for CT scanning in Graves ophthalmopathy:

Nodular muscle enlargement

Solitary muscle enlargement

Fusiform muscle enlargement with sparing of tendoms

Kinking of extraocular muscles.

100. Vascular congestion over insertions of the rectus muscles (particularly lateral rectus) is seen in:

Lymphoma

Hemangioma

Graves ophthalmopathy

Trauma

Ophthalmic Pathology: 100 mcqs (Ast. Prof. MAR AMARIN)

1. What is a lesion composed of normal, mature tissue in an abnormal location?

Hamartoma

Choristoma

Hemangioma

Granuloma

2. Which of the following cells would most likely be observed on histologic examination of a specimen of a bacterial corneal ulcer?

Eosinophils

Basophils

Epithelioid histiocytes

Neutrophils

3. Which of the following choices is a general histologic sign of malignancy?

Nuclear/cellular pleomorphism

Dyskeratosis

Dysplasia

Calcification

4. When glaucoma occurs in association with angle recession, it is most commonly because of which of the following?

Damage to the trabecular meshwork

Associated lens subluxation

Iridodialysis

A tear in the ciliary body muscle

5. 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?

Michel medium

Glutaraldehyde

Saline

Absolute alcohol

6. What is the first step in preparing a specimen for electron microscopy?

Glutaraldehyde fixation

Thick sections

Thin sections

Osmification process

7. Frozen sections are appropriate for which one of the following?

To surgically control the margins of a neoplasm

To interpret a conjunctinllesion

To interpret a cutaneous lesion

To make a formal diagnosis

8. What is the best way to diagnose orbital hemangiopericytoma?

Radiologic imaging

Ultrasound testing

Fine-needle aspiration or open orbital biopsy

Clinical symptoms and examination

9. 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

Incisional biopsy through a lateral orbitotomy

Incisional biopsy through a medial orbitotomy

Total primary excision through a medial orbitotomy

10. What method can identify infectious agents, neoplastic cells, or degenerative conditions and distinguish lesions of neuroectodermal origin from neuroendocrine lesions?

Gram stain

Chromatography

Routine histologic examination

Immunohistochemistry

11. Which of the following corneal stromal dystrophies is characterized by both hyaline and amyloid deposits?

Granular

Lattice

Avellino

Macular

12. Which of the following forms of infectious keratitis displays double-walled cysts in the corneal stroma on histology?

Pseudomonal ulcer

Herpetic keratitis

Acanthamoeba keratitis

Fusarium keratitis

13. 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

Artifactual readings due to corneal edema

Outflow obstruction due to red blood cell membrane rigidity

Traumatic pupillary block

14. What disease may be diagnosed by finding Heinz bodies on red blood cell membranes in an anterior chamber aspirate?

Lymphoma

Siderosis

Pseudoexfoliation

Ghost cell glaucoma

15. 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?

Palisading arrangement ofhistiocytes/giant cells around necrotic/necrobiotic collagen fibers

Sparse inflammatory infiltrate composed of lymphocytes and plasma cells

Colonies of gram-negative bacteria associated with acute necrotizing inflammation

Circumscribed proliferation of spindle cells in chronically inflamed, richly vascular, and myxoid stroma

16. The pathophysiology of posterior subcapsular cataract may best be described by which of the following?

Posterior migration oflens epithelial cells

Disorganization of posterior lens fibers

Infiltration of the posterior lens by inflammatory cells

Retention of lens fiber nuclei

17. What is the histopathologic appearance of the anterior chamber angle in a case of phacolytic glaucoma?

Infiltration by hemosiderin-laden macrophages

Lack of significant inflammatory cell infiltrate

Infiltration by neutrophils

Infiltration by protein-laden macrophages

18. Of the following, which anatomic boundary is not a component of the vitreous'

Hyaloid face

Internal limiting membrane

Hyaloideocapsular ligament

Vitreous base

19. Which of the following vitreous degenerations is not age related?

Vitreous syneresis

Macular hole

Posterior vitreous detachment

Asteroid hyalosis

20. Pathologic examination of cystoid macular edema reveals cysts in which retinal layer?

Outer plexiform

Bruch membrane

Internal limiting membrane

Retinal pigment epithelium

21. 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?

Plexiform neurofibroma

Acute dacryocystitis

Capillary hemangioma

Benign mixed tumor of the lacrimal gland

22. Histopathologically, the uveitis seen in\ ogt-Koyanagi-Harada syndrome most closely resembles the uveitis seen in which one of the following diseases?

Juvenile idiopathic arthritis

Intraocular lymphoma

Pars planitis

Sympathetic ophthalmia

23. 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

Amelanotic choroidal melanoma

Circumscribed choroidal hemangioma

24. Which pathologic finding would differentiate between a ruptured dermoid and ruptured epidermoid cyst?

Hair follicles

Lamellated keratin

Mixed inflammation

Squamous epithelium

25. What is the most common type of intraocular tumor?

Melanoma

Retinoblastoma

Lymphoma

Metastatic neoplasm ( +)

26. 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?

Squamous papilloma

Xanthelasma

Basal cell carcinoma

Molluscum contagiosum

27. 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

Inflammation

Sun exposure

Viral

28. Squamous cell carcinoma in situ is defined as a pathologic anatomic limitation by which one of the following?

Superficial epithelium

Stromal keratocytes

Basal epithelium

Basement membrane

29. With which of the following is aniridia most commonly associated?

Retinal pigment epithelial hyperplasia

Optic nerve coloboma

Glaucoma

Optically empty vitreous

30. What physiologic changes are associated with acquired optic atrophy?

Increased myelin with thinning of the pial septa

Shrinkage of the nerve diameter with widening of the subarachnoid space

Uniform changes across the nerve without variation

Increased myelin and shrinking of the subarachnoid space

31. What is optic nerve glioma most frequently associated with?

Sturge-Weber syndrome

Neurofibromatosis type 1

Peters anomaly

Neurofibromatosis type 2

32. Which of the following is not a clinical risk factor for metastatic disease in patients with uveal melanoma?

Large tumor size

Ciliary body involvement

Young age

Extraocular extension

33. Which of the following is the most important risk factor for the development of uveal melanoma?

Dysplastic nevus syndrome

Light-colored complexion

Ocular melanocytosis

Ultraviolet light exposure

34. At the time a choroidal melanoma is diagnosed, which test is recommended to help rule out metastasis?

Serum glucose

Brain MRI

Bone marrow biopsy

Abdominal imaging

35. With which of the following organs must the ophthalmologist be most concerned about in a patient with retinal capillary hemangioblastoma?

Brain and kidney

Liver and lung

Bowel and skin

Organs of the immune system and central nervous system

36. What association distinguishes von Hippel-Lindau syndrome from von Hippel disease?

Intracranial calcifications, ash-leaf spots, retinal astrocytomas

Cafe-au-lait spots, Lisch nodules, optic pathway gliomas

Pheochromocytomas, cerebellar hemangioblastomas, renal cell carcinomas

Limbal dermoids, upper eyelid colobomas, preauricular tags

37. Which of the following is the most important histopathologic risk factor for mortality in the enucleated globe from a patient with retinoblastoma?

The presence of anterior segment involvement

The extent of retinal detachment

The extent of optic nerve and choroidal invasion

The size of the tumor

38. Which of the following clinical characteristics is typical of Coats disease?

Unilateral

Associated with HLA-B27

Found in female patients

Bilateral

39. Intraocular calcification in the eye of a child is most diagnostic of what disease?

Retinoblastoma

Toxocariasis

Persistent fetal vasculature

Coats disease

40. What is the most common secondary tumor in retinoblastoma patients?

Fibrosarcoma

Melanoma

Pinealoblastoma

Osteosarcoma

41. When a parent has bilateral retinoblastoma, which risk factors apply to the affected parent's children?

85% risk of developing retinoblastoma

Risk of bilateral disease in all affected children

Risk of developing retinoblastoma in males only

45% risk of developing retinoblastoma

42. What is the primary treatment for a 2-year-old child with unilateral retinoblastoma classified as International Classification Group E?

Systemic chemotherapy alone

Intra-arterial chemotherapy

Enucleation

Radiation alone

43. What is the treatment of choice for metastatic carcinoma to the eye?

Chemotherapy

External-beam radiation

Brachytherapy

Individually tailored in each case

44. What is the most common finding in ocular involvement in leukemia?

Retinal hemorrhages

Aqueous cells

Retinal perivascular sheathing

Vitreous cells

45. \Vhat tumor frequently occurs in conjunction with central nervous system involvement?

Basal cell carcinoma of the eyelid

Primary intraocular lymphoma

Retinoblastoma

Ciliary body melanoma

46. Leukemic retinopathy may cause hemorrhages in which level(s) of the retina?

Preretinal (subhyaloidal) and intraretinal

Subretinal

Choroidal

Leukemic retinopathy does not cause retinal hemorrhages.

47. Sebaceous carcinoma: Except

Is usually bilateral

Has a yellowish appearance

Of the conjunctiva only occurs as a result of pagetoid spread from the eyelid

Metastasis usually haematogenous

48. In sympathetic ophthalmia: Except

The choriocapillaris are occluded by macrophages

Dalen-Fuch's nodules are found on the inner surface of the Bruch's membrane

Dalen-Fuch's nodules are pathognomonic of this condition

Removal of the damaged eye reduces the inflammation

49. Rhabdomyosarcoma of the orbit:

Causes systemic fever

Has better prognosis than extraorbital type

Of the alveolar type is the most common

Is resistant to radiotherapy

50. Typical peripheral cystoid degeneration of the retina:

Produces cystic spaces in the nerve fibre layer

Increases the risk of retinal detachment

Has overlying liquefied vitreous

Gives rise to retinoschisis through coalescence of the cystic spaces

51. Sturge-Weber's syndrome is associated with:

Localized form of choroidal haemangioma

Meningeal haemangioma

Neovascular glaucoma

Optic glioma

52. The following are true about orbital meningioma: Except

It is commoner in female than male

It usually arises from intracranial extension.

It is associated with type I neurofibromatosis

Psamomma bodies are essential for histological diagnosis

53. The following are False, Except

Glaucoflecken are found in the posterior surface of the lens

Elschnig's pearl arises from cortical remains of the lens

Soemerring's ring causes posterior capsule opacities

Duplication of the lens epithelium occurs in siderosis

54. With regard to giant cells: Except

They are the hallmark of granulomatous lesion

They are derived from macrophages

Foreign body giant cells occur in chalazion

Langhan's giant cells occur in sarcoidosis

55. The following are of prognostic importance in choroidal melanoma: Except

Size of the tumour

Location of the tumour

Presence of blood vessels within the tumour

Types of tumour cells

56. In pthisis bulbi: Except

The intraocular pressure is increased

Calcification of the lens is common

The sclera is thickened

The size of the globe is reduced

57. Common features of retinoblastoma include: Except

Calfication

Necrosis

Presence of extracellular DNA

Neovascularization

58. Optic glioma:

Has a peak incidence in the middle age

Is associated with type I neurofibromatosis

Arises from the oligodendrocytes

Contains Rosenthal fibres which are essential for its diagnosis

59. The following histological feature are present in lattice degeneration: Except

Overlying liquefied vitreous

Atrophy of the outer layer of the retina

Adherence of vitreous to the margin of the lesion

Closure of the retinal vessels

60. In malignant lymphoma of the orbit:

Hodgkin's disease is the most common

Most common cell type is B cell lymphoma

Follicular pattern is commonly seen

The tumour is resistant to radiotherapy

61. 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.

62. In ocular trauma:

Angle recession results from a tear in the ciliary body

Commotio retinae is caused by retinal oedema

Voss's ring is associated with progressive cataract

Retinal dialysis is most common in the superotemporal region.

63. Blood staining of the cornea:

Is a common complication following trabeculectomy

Red blood cells are seen in the stroma

Iron is found in the keratocytes

Causes siderosis bulbi

64. Bitot's spots: Except

Occur in patients with fat malabsorption

Are caused by hyperplasia of the goblet cells

Usually precede keratopathy

Resolve with oral vitamin A

65. Oncocytoma:

Is most commonly found in the caruncle

Is malignant in 50% of cases

Arises from the stroma

Has a high recurrence rate following excision

66. The following are true about staining in the microbes: Except

Gram negative bacteria appear red

Gram positive bacteria appear blue

Gomori methamine silver stains fungi green

Ziehl-Neelsen's stain give acid fast bacteria a red colour

67. Molluscum contagiosum: Except

Is caused by a poxvirus

Causes acanthosis

Is an AIDS-defining disease in HIV positive patients

Is sensitive to acyclovir

68. Capillary haemangioma: Except

Often undergoes spontaneously resolution

Is commoner in males than females

Most commonly occurs in the eyelids

Is associated with thrombocytopenia in Kasabach-Merrit's syndrome

69. Posterior embryotoxon:

Is caused by thickening of the Schwalbe's line

Is caused by anterior displacement of the Schwalbe's line

Is a normal finding in 10% of the population

Is associated with glaucoma in 50% of cases

70. Flexner-Wintersteiner's rosettes:

Occurs in retinocytoma

Can be found in pinealblastoma

Are primitive ganglion cells

Is associated with favourable prognosis in retinoblastoma

71. In diabetic retinopathy: Except

Flame-haemorrhages occur in the nerve fibre layer.

Dot and blot haemorrhages occur in the inner plexiform layer.

Cotton wool spots result from ischaemia of the nerve fibre layer.

IRMA (intraretinal microvascular abnormalities) show profuse leakage with fluorescein Angiography.

72. Parakeratosis occurs in:

Seborrheic keratosis

Squamous cell carcinoma

Molluscum contagiosum

Basal cell carcinoma

73. Lisch's nodules in neurofibromatosis:

Are found in both type I and type II neurofibromatosis

Are iris naevi

Are found at the edge of the iris

Are highly vascular

74. The following are true about phacolytic glaucoma: Except

It occurs in hypermature cataract

Liquefaction of the cortex is part of the process

The lens capsule is usually ruptured

Anterior chamber aspiration shows swollen macrophages

75. The following stromal dystrophies are dominantly inherited: Except

Lattice dystrophy

Granular dystrophy

Macular dystrophy

Fleck dystrophy

76. With regard to retinoblastoma: Except

94% of cases are sporadic

Patients with sporadic retinoblastoma does not pass their genes to their offspring

Calcification in the tumour can be detected on ultrasound scan

Reese-Ellsworth classification is useful in predicting visual prognosis following radiotherapy

77. 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

78. Focal thickening of the internal lens capsule (excrescence) occurs in: Except

Down's syndrome

Lowe's syndrome

Marfan's disease

Aniridia

79. The following pairing is correct:

Hamartoma - orbital dermoid

Choristoma - limbal dermoid

Choristoma - cavernous haemangioma

Choristoma - congenital hypertrophy of RPE

80. The following intraocular foreign bodies are well tolerated by the eye:

Copper

Lead

Gold

Zinc

81. 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?

Osteogenic sarcoma

Wilm’s tumor

Lymphoma

Dermal melanoma

82. Which one of the following conditions is associated with formation of iris granuloma?

Neurofibromatosis

Juvenile xanthogranuloma

Pseudoexfoliation syndrome

Pseudoxanthoma elasticum

83. What is the different characteristic between the Trochlear nerve palsy and the skew deviation?

Cyclotorsion of the hypertropic eye

Head tilt contralateral to the hypertropic eye

Hypertropia in primary position

Incomitant hypertropia

84. True statements about the conjunctiva include: except

It is made up of stratified, non-keratinized squamous epithelium

The substantia propria is thinnest over the tarsus

Goblet cells are most numerous in the fornices

Accessory glands of Wolfring produce oily layer of the tear film

85. Compared with limbal dermoid, dermolipomas: except

Most frequently occur in the superotemporal quadrant of the fornix.

Are soften than limbal dermoids

Have absent dermal adnexal structures

Are not seen in Goldenhar's syndrome

85. In persistent hyperplastic primary vitreous (PHPV): Except

Microphthalmos is common

The lens is reduced in size

Calcification is common on X-ray

Phthisis bulbi is common if untreated

86. Ocular features of trisomy 13 include: Except

Optic nerve hypoplasia

Microphthalmia

Iris coloboma

Corneal opacities

87. The following are true about conjunctival papillae: Except

They contain lymphoid tissue

They contain small central arteries

Clinically, they appear as flat top elevations

They are seen in bacterial conjunctivitis

88. In central retinal artery occlusion: Except

The occlusion typically occurs near the optic nerve head

The most common cause is arteriosclerosis of the retinal artery

Liquifactive infarction of the retinal nerve fibre layer is a feature

Gliosis is a prominent repair mechanism

89. 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

90. The following are true about cornea:

Amiodarone is deposited in the anterior stroma

Pannus occurs between the Bowman's layer and the epithelium

In cystinosis, the crystals are found in the epithelium

In Wilson's disease, copper is deposited in the descemet membrane

91. The following are true about phakomatoses: Except

They are characterized by disseminated hamartomas

Ataxia-telangiectasia is the only condition that is inherited in an autosomal recessive pattern

Sturge-Weber's syndrome is the only condition that is not inherited

Astrocytic hamartoma is found only in tuberous sclerosis

92. 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

93. Mucormycosis of the orbit: Except

Usually begins in the sinus

Causes central retinal artery occlusion

Commonly causes tissue necrosis

Is associated with injury involving vegetation

94. Alcian blue stains the following blue: Except

Hyaluronic acid in the vitreous

Schnabel's optic atrophy

Granular dystrophy

Macular dystrophy

95. Parakeratosis occurs in:

Actinic keratosis

Seborrheic keratosis

Molluscum contagiosum

Basal cell carcinoma

96. Multiple basal cell carcinoma is a feature in the following conditions:

Gardner's syndrome

Cowden's disease

Xeroderma pigmentosa

Muir-Torre's syndrome

97. The following stains are used to stain amyloid:

Crystal violet

Verhoeff von Gieson

Von Kossa

Perl's stain

98. The following is true about orbital neuroblastoma: Except

It is the result of metastasis

Bilaterality is rare

Lid ecchymosis is common because the tumour is highly vascular

Homer-Wright's rosettes can be found in the tumour

99. The following are features of Muir-Torre's syndrome: Except

Multiple keratoacanthoma

Multiple sebaceous carcinoma

Meningioma

Adenocarcinoma of the proximal bowel

100. Medulloepithelioma: Except

Arises from the non-pigmeneted retinal pigment epithelium

Is a benign tumour

Causes neovascular glaucoma

May contain striated muscle histologically

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