BCSC Fundamentals and Principles of Ophthalmology (2016-2017)
If all the nerves passing through the annulus of Zinn were transected, what nerve would continue to function?
Superior division of cranial nerve III
Cranial nerve IV
Nasociliary branch of cranial nerve V
Optic nerve
Which extraocular muscle originates from the annulus of Zinn?
Levator palpebrae superioris
Superior oblique
Lateral rectus
Inferior oblique
What is the ratio of optic nerve axons that cross at the optic chiasm to those that do not cross at the optic chiasm?
67:33
50:50
30:70
53:47
A patient presents with left-sided ophthalmoplegia and forehead numbness. The lesion is most likely to be located at the
Brainstem
Cavernous sinus
Superior orbit
Intraconal space
The first cells to develop in the embryonic retina are the
Ganglion cells
Photoreceptors
Amacrine cells
Bipolar cells
Which disorder is associated with a defect in a nonmitochondrial gene?
Leber hereditary optic neuropathy
Chronic progressive external ophthalmoplegia
Neuropathy, atxia, and retinitis pigmentosa
Retinoblastoma
What characteristic of retinoblastoma may fcailitate its diagnosis as a familial condition?
It may be associated with chromosome 11 short-arm deletion syndrome and Wilms tumor
It affects approximately 1 per 100,000 live births in the United States
Approximately 90% of patients with hereditary retinoblastoma have a family history of the disease
The hereditary pattern in familial retinoblastoma is autosomal dominant, but the defect is mitochondrial at a cellular level.
Mutations in the rhodopsin gene are associated with what inherited ocular disease?
Juvenile glaucoma
Leber hereditary optic neuropathy
Retinitis pigmentosa
Stargardt disease
Mitochondrial inheritance is transmitted by what route?
Paternal mitochondria
Maternal mitochondria
Acquired mitochondria
De novo mitochondria
Mutations of PAX6 are associated with what disorder?
Aniridia
Retinal coloboma
Renal hypoplasia
Corneal granular dystrophy
An unaffected woman has a brother, maternal uncle, and son affected with retinitis pigmentosa. What is the most likely mode of inheritance?
Autosomal dominant
X-linked recessive
Autosomal recessive
Sporadic
What is the basis for complex genetic diseases?
A single recessive gene
X-linked genes
A single spontaneous genetic mutation
The resultant effect of many genes, in combination with health habits and environmental factors
What structure, if inflamed, would be considered a sign of uveitis?
Optic nerve
Descemet membrane
Choroid
Retinal pigment epithelium
What pair accurately matches a cell-type origin with the correct tear-layer product?
Goblet cells-lipid layer
Meibomian glands-mucin layer
Glands of Krause-aqueous layer
Glands of Wolfring-mucin layer
What option most accurately describes the immunoglobulin(s) that can be found in the tear film?
IgA only
IgA and IgG only
IgG and IgM only
IgA, IgG, IgM, and IgD
What intraocular structure is a true basement membrane (basal lamina)
Bowman layer
Zonule of Zinn
Descemet membrane
Anterior border layer of iris
What is the principal structural protein in the Descemet membrane?
Type I collagen
Type II collagen
Type III collagen
Type IV collagen
What mechanism holds the flap created during LASIK in place after surgery?
Endothelial-Descemet mbrane interaction
Endothelial pump
Bowman layer-stromal adhesions
Stromal collagen adhesions
What property of the retina redners it susceptible to oxidative stress?
High content of polyunsaturated fatty acids in photoreceptor outer segments
High concentration of carotenoids compared with other intraocular structures
Presence of vitamin E
Absence of retinal vessels in the foveal avascular zone
What pigment within the retinal pigment epithelium is responsible for the signal generated in fundus autofluorescence imaging?
Melanin
Lipofuscin
Rhodopsin
Lutein
The retinal pigment epithelium is the first site of melanogenesis in the body. Ocular melanin has been shown to participate in what process?
Pathogensis of retinitis pigmentosa
Vitamin A metabolism
Retinal adhesion
Retinal development and neuronal migration
Age-related loss of type IX collagen has been implicated in what process related to the vitreous?
Vitreous hemorrhage
Angiogenesis
Increased diffusion of oxygen from the anterior segment into the posterior segment
Vitreous liquefaction
What vitamin is most critical for the photoreceptor response to light
A
B
C
E
In prescribing for elderly patients, what pharmacologic adjustments must be considered?
Hepatic perfusion and enzymatic activity increases with age
Renal function decreases with age
Elderly patients have more albumin relative to weight
Elderly patients have more body water relative to weight
What technique or strategy improves the ocular absorption of eyedrops?
Rapid instillation of eyedrops one after the other without interruption
Application of digital pressure at the lateral canthus to prevent the eyedrop from escaping
Keeping the eye open and rolling the eye around after instillation of each drop
Increasing the viscosity of the delivery vehicle
Atropine, 1%, has how many milligrams of drug per drop, assuming 20 drops per milliliter?
1mg
0.5mg
0.1mg
0.05mg
How much epinephrine is present in 1 mL of the 1:10,000 epinephrine solution?
1 mg of epinephrine
Same amount of epinephrine as in 1 mL of 0.01% epinephrine
Same amount of epinephrine as in 1 mL of 1:1000 epinephrine
Same amount of epinephrine as in 1 mL of 0.1% epinephrine
Diret-acting muscarinic agents (miotics) have what clinical effect?
Hyperopic shift in refraction
Increased range of accommodation
Central anterior chamber deepening
Increased night vision
What management strategy has been shown to reduce postsurgical endophthalmitis?
Preoperative preparation of the eye with topical povidone-iodine
Intracameral vancomycin
Intracameral aminoglycosides
Subconjunctival fluoroquinolones
What property of latanoprost may limit its usefulness?
It is a prodrug of prostaglandin E2a
It reduces intraocular pressure by increasing trabecular meshwork outflow
It can cause darkening of the iris and periocular skin and hypertrichosis of the eyelashes
It increases the number of melanocytes
What systemic side effect may result from treatment with oral carbonic anyhdrase inhibitors?
Insomnia
Weight gain
Hyperkalemia
Aplastic anemia
What is a clinically important property of brimonidine?
Brimonidine is a selective a1-adrenergic agonist
Brimonidine is more lipophilic than apraclonidine
Brimonidine has been associated with tachycardia and hyperventilation when used in infants
Rates of tachyphylaxis and allergic reaction are higher in brimonidine than in apraclonidine
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