Important MCQs of FCPS Part 1 Ophthalmology with Keys

Very important MCQs from past papers + others with key

DrKhalid Khan

 

1) Sphincter and dilator puillae are originated from

 

  1. Mesoderm
  2. Ectoderm
  3. Neural crest
  4. endoderm

 

2) Epithelium of mebimian gland duct is

 

  1. Simple squamous
  2. Simple cuboidal
  3. Simple columnar
  4. Stratified columnar
  5. Stratified squamous

 

3) Retina is thickest

 

  1. Above optic disc
  2. Below optic disc
  3. Orra serrata
  4. equator

 

4) If light reaction is absent but accomudation is positive the lesion is in

  1. Optic nerve
  2. Optic chiasma
  3. Optic tract
  4. Pretectal necleus
  5. Edwinger westphall necleus

 

5) Irrigular constricted pupil which don’t respond to light

 

  1. Artificial pupil
  2. Argyl robertson pupil
  3. Adies pupil
  4. Horner syndrome

 

6) A patient having opacity in media

 

  1. a) Corneal dystrophy
  2. b) Macular degeneration
  3. c) Vitreous haemorrhage
  4. d) cataract

 

7) lacrimal nerve is made up of

  1. a) sensory fibres
  2. b) parasympathetic fibres
  3. c) sympathetic fibres
  4. d) sensory + motor
  5. e) sensory + sympathetic + parasympathetic

 

8) Epithelium of lacrimical canaliculi is

 

  1. Simple squamous
  2. Simple cuboidal
  3. Simple columnar
  4. Stratified columnar
  5. Stratified squamous

 

9) cornea become edematous when endothelial cells are decreased to

  1. a) 2000/ mm3

b ) 1600/ mm3

  1. c) 1000/ mm3
  2. d) 500/ mm3
  3. e) 300/ mm3

( Normal Adults=2400-3000/mm2. Normal Newborn= 6000/mm2)

 

10) Which of the following layer of cornea can regenerate

  1. a) bowmans layer
  2. b) stroma
  3. c) descement membrane
  4. d) endothelium

(Reference Frank Navell)

 

11) post gabglionic fibres of which ganglion supply lacrimal gland

  1. a) ciliary
  2. b) semilunar
  3. c) mackel
  4. d) otic

 

12) All branches of Anterior division on mandibular nerve are motor except

  1. a) buccal
  2. b) lateral pterygoid

c masseteric

  1. d) deep temporal

 

 

 

 

13) what is the volume of orbit?

  1. a) 10 ml
  2. b) 20 ml
  3. c) 30 ml
  4. d) 40 ml

 

14) Which is largest extraocular muscle?

  1. a) superior rectus
  2. b) inferior rectus
  3. c) medial rectus
  4. d) lateral rectus

 

15) Which is longest extraocular muscle?

  1. a) superior rectus
  2. b) inferior rectus
  3. c) medial rectus
  4. d) lateral rectus

 

16) Which extraocular muscle has longest tendon?

  1. a) superior rectus
  2. b) inferior rectus
  3. c) medial rectus
  4. d) lateral rectus

 

17) In adie’s pupil, lesion is at

  1. a) ciliary ganglion
  2. b) optic nerve
  3. c) pretectal nucleus
  4. d) edwinger westphal nucleus

 

18) a young patient is complaining of dry eye…which of the following structure is involved

  1. a) ciliary ganglion
  2. b) lacrimal gland
  3. c) otic ganglion
  4. d) pterygopalatine ganglion

 

19) Which of the following is site of fusion of binocular vision

  1. A) Optic nerve
  2. B) Optic chiasma
  3. C) Lgb
  4. D) Retina
  5. E) Visual cortex

 

 

20) optic nerve colobomas are usually

  1. a) infro temporal
  2. b) infro nasal
  3. c) supro temporal
  4. d) supro nasal

(Congenital colobomoas are usually Infero-nasal)

 

21) corneal nerves appear at which age of embryonic life

  1. a) 3 months
  2. b) 5 months
  3. c) 7 months
  4. d) 9 months

 

22) strongest margin of orbit

  1. a) medial
  2. b) lateral
  3. c) superior
  4. d) inferior

 

23) in embryonic life sclera strt developing from

  1. a) ant pole
  2. b) post pole
  3. c) at future recti insertion
  4. d) at future optic disc

 

24) Which is the thinnest wall of orbital cavity

  1. a) roof
  2. b) floor
  3. c) med wall
  4. d) lat wall

(Thinnest medial; weakest floor)

 

25) Which is the weakest wall of orbital cavity

  1. a) roof
  2. b) floor
  3. c) med wall
  4. d) lat wall

 

26) Greater wing of sphenoid take part in making which wall of the orbit

  1. a) roof
  2. b) floor
  3. c) med wall
  4. d) lat wall

 

 

27) Which of the following structure dont pass through common tendinuous ring of recti

  1. a) trochlear nerve
  2. b) occulumotor nerve
  3. c) nasociliary nerve
  4. d) abducent nerve

(1. Trochlea N,2. Lacrimal N, 3. Frontal N)

 

28) All paranasal sinuses are normally present at birth except

  1. a) frontal
  2. b) maxillary
  3. c) sphenoid
  4. d) ethmoid

 

29) a person has faulty dextroversion but can converge eyes normally. problem is with

  1. a) rt. MLF
  2. b) rt visual cortex
  3. c) rt PPRF
  4. d) rt optic radiation

 

30) Which of the following is a hormone as well as neurotransmitter

  1. a) vasopressin
  2. b) adrenaline
  3. c) acetylcholine
  4. d) serotonin
  5. e) histamine

 

31) largest diameter of eye ball is

  1. a) anterioposterior
  2. b) horizontal
  3. c) vertical

 

32) sclera is weakest

  1. a) ant pole
  2. b) post pole
  3. c) just post to recti insertion
  4. d) lamina cribrosa

 

33) cornea is insensitive to

  1. a) warm
  2. b) cold
  3. c) pain

 

34) in sphincter pupillae group of smooth muscle cells are in no.

  1. a) 2
  2. b) 4
  3. c) 8
  4. d) 12

 

35) which is the pigmented epithelium off iris

  1. a) anterior
  2. b) posterior
  3. c) both
  4. d) none

 

36) the anteroposterior diameter of anterior chamber is

  1. a) 1 mm
  2. b) 2 mm
  3. c) 3 mm
  4. d) 4 mm

 

37) mmp-9 is formed by

  1. a) corneal epithelium
  2. b) corneal bowmans layer
  3. c) corneal stroma
  4. d) corneal endothelium

 

38) capacity of lacrimal sac is

  1. a) 10 micro litr
  2. b) 20 micro litr
  3. c) 30 micro litr
  4. d) 40 micro litr

 

39) which type of collegen is not found in vitreous

  1. a) 2
  2. b) 4
  3. c) 5
  4. d) 11

(vitreous contains type 2, 5, 9 and 11)

 

40) Which of the following produce most severe papilledema

  1. a) pituitary tumor
  2. b) tumor of frontal lobe
  3. c) tumor of post fossa
  4. d) malignant melanoma
  5. e) melanocytoma

 

 

 

50) all recti are supplied by 2 muscular arteries from ant. ciliary except

  1. a) SR
  2. b) IR
  3. c) MR
  4. d) LR

 

51) effect of exercise on aqueous production

  1. a) inc formation
  2. b) dec formation
  3. c) no effect

 

52) which of the following structure cross the optic nerve below it 12 mm behind globe

  1. a) nerve to inf oblique
  2. b) ophthalmic artery
  3. c) nasociliary nerve
  4. d) nerve to inf rectus

 

53) which of the recti is supplied by 3 arteries

  1. a) SR
  2. b) IR
  3. c) MR
  4. d) LR

 

54) pie in the sky, lesion wld be in

  1. a) calcarine sulcus
  2. b) area 17
  3. c) mayers loop
  4. d) LGB

 

55) sensory supply of cornea

  1. a) long ciliary nerve
  2. b) short ciliary nerve
  3. c) supra orbital nerve
  4. d) lacrimal nerve

 

56) most common congenital nerve lesion

  1. a) 3rd
  2. b) 4th
  3. c) 6th

 

57) most longest intracranial course of motor nerve

  1. a) 3rd
  2. b) 4th
  3. c) 6th
  4. d) 11th
  5. e) 12th

 

58) most inferiorly located motor nerve of eye

  1. a) 3rd
  2. b) 4th
  3. c) 6th

 

59) which lesion leads to contralateral temporal crescent defect

  1. a) strial cortex
  2. b) lgb
  3. c) ant aspect of calcarine sulcus
  4. d) posterolateral portion of occipital lobe

 

60) magnocellular lamina of lgb is

  1. a) area 1,2
  2. b) area 3,4
  3. c) area 5,6
  4. d) area 7,8

(Parvocellular=area 3-6)

 

61) smallest portion of optic nerve is

  1. a) intra ocular
  2. b) intra orbital
  3. c) intra canalicular
  4. d) intra cranial

 

62) which is the myelinated portion of intra ocular portion of optic nerve

  1. a) optic disc
  2. b) pre laminar
  3. c) laminar
  4. d) retro laminar

 

63) tensor veli palatini is supplied by

  1. a) nerve to medial pterygoid
  2. b) nerve to lateral pterygoid
  3. c) nerve to tensor veli
  4. d) lingual nerve

 

64) Which of the following cranial nerve has same component like 10th nerve

  1. a) 5th
  2. b) 7th
  3. c) 9th
  4. d) 11th

 

 

65) Transitional epithelium of bladder is derived from

  1. a) ectoderm
  2. B) endoderm
  3. c) mesoderm

 

66) epithelium of eye lids

  1. a) ectoderm
  2. b) endoderm
  3. c) mesoderm
  4. d) ecto + meso
  5. e) endo Meso

 

67) pigment cells derived from

  1. a) surface ectoderm
  2. b) neuro ectoderm
  3. c) neural crest
  4. d) mesoderm
  5. e) endoderm

 

68) lens capsule is most thinnest at

  1. a) ant pole
  2. b) post pole
  3. c) equator

 

69) which reflex involves cortex

  1. a) accommodation
  2. b) direct light
  3. c) indirect light

 

70)

 

71) what is not part of bruch membrane

  1. a) choroidal capillaries
  2. b) basement membrane of choroidal capillaries
  3. c) B.M. of RPE
  4. d) outer collagen layer

e)elastic layer

 

72) loss of 2 point discrimination, vibration of ryt lower limb…problem with

  1. a) fasciculus gracilus
  2. b) fasciculus cuneatus

 

73) on gonioscopy which cnt b seen

  1. a) trabecular meshwork
  2. b) schwabe line
  3. c) scleral spur
  4. d) aqeous vein
  5. e) ciliary body

 

74) viridian associated with

  1. a) biotin
  2. b) b12
  3. c) vit c
  4. d) vit D
  5. e) riboflavin

 

75) Which of the following don’t release in stress

  1. ADH
  2. Aldosterone
  3. Cortisol
  4. GH
  5. Insulin

 

76) Dopamine leads to

  1. Inhibition of GH
  2. Inhibition of prolactin
  3. Inhibition of GnRH

 

77) Which of the following is associated superior to origin of lateral rectus

  1. Sup ophthalmic vein
  2. Lacrimal nerve
  3. Occulumotor nerve
  4. Nasociliary nerve
  5. Abducent nerve

 

78) Which of the following passes from cavernous sinus

  1. 6th nerve
  2. 4th nerve
  3. 3rd nerve

 

79) Rods and cones contain discs, btw disc the area is filled with

  1. GAG
  2. Visual pigment

c.micro villi

 

80) Wilson disease leads to

  1. Cataract
  2. Kf ring

 

 

81) which of the following is INCORRECT

  1. pituitary adenoma causes bitemporal homonymous hemianopia
  2. craniopharyngeoma causes binasal hemianopia

(Pituitary adenoma=Bitemporal superior quadranopia;

Craniopharyngioma= Bitemporal inferior quadranopia)

 

82) in lesion of Lft optic tract

  1. bitemporal heminopia
  2. binasal heminopia
  3. loss of complete vision in ryt eye
  4. ryt temporal nd lft nasal visual defect
  5. ryt temporal nd lft nasal visual defect with macular sparing

 

83) which of the following abt sclera is incorrect

  1. it is thinnest at macula
  2. its max thickness is 1mm

 

84) Refractive power of lens depend upon

  1. curvature of lens

b..?

 

85) lateral inhibition is done by

  1. amacrine cells
  2. horizontal cells
  3. bipolar cells
  4. ganglion cells

 

86) miosis of pupil

  1. comfortable for night drive
  2. inc chromatic aberration
  3. inc spherical aberrations
  4. inc depth of focus

 

87)TRANSPARENCY OF CORNEA IS MAINLY MAINTAINED BY?

  1. Lattice arrangement of collagen fibres
  2. Tears
  3. Endothelium

(2nd=Endothelium; 3rd= Tears)

 

88) Antibodies formed in

  1. a) Thymus
  2. b) Plasma cells
  3. c) Lymphocytes
  4. d) Spleen
  5. e) liver

 

89) A man lying naked at operation table with room temprature 21.5 C” and 80% humidity by which mechanism heat transfer from body

  1. a) By Veporization
  2. b) Radiation and conduction
  3. c) sweating
  4. d) respiration
  5. e) urine

 

90) A man is diagnosed by a fatal illness which has v poor prognosis as a doctor what will u do

  1. a) Hide every thing
  2. b) tell the nature of illness to patient’s family only
  3. c) tell the nature of illness to patient and his family only
  4. d) tell the nature of illness only to the patient
  5. e) Give crispy and evidence based whole information of the illness to patient

 

91) Patient having AIDS is suffering from chorioretinitus, most common cause of this disease is

  1. CMV

b??

 

92) Features distinguishing benign from maliganant

  1. a) Metastasis
  2. b) Nvasive n infiltrative margins
  3. c) Analpsia

 

93) child with skin itching..stool examination reveal worms.. presence of which wd aid in diagnosis

  1. a) basophils
  2. b) eosinophils
  3. c) lymphocytes

 

94) A patient receives radiotherapy for Squamous Cell Carcinoma, some time later the there is scarring & ulceration to the skin because of:

 

a- Damage to the squamous epithelium

b- Endarteritis obliterans

c- infection

d- venous thrombosis

 

95) which carcinoma do not SPREAD to bones

a)kidney

b)breast

c)prostate

  1. d) liver

 

96) A boy having growth with finger on upper eyelid with finger like projections covered with benign epithelial tissue.

  1. a) papilloma
  2. b) adeno carinoma

c)papillary ca

 

97) Regarding middle meningeal artery which is correct

  1. a) middle meningeal artery divide at the level of pteryon
  2. b) its haemorrhage leads to sub dural haemorrhage
  3. c) it passes thru foramen spinosun

 

98) Regarding venous drainage of eye which is incorrect

  1. Drained by 2 venous systems
  2. Uvea is drained by vorticose vein
  3. Iris and ciliary body is drained bt ant ciliary vein
  4. 1 vortex vein drain thru eash quadrent

 

99) Regarding embryology of eye, lateral optic vesicle formation from forebrain start on

  1. 12 days
  2. 22 days
  3. 33 days

 

100) a person is walking and sumthng pinches on his toe, he with draw his foot due to pain…which of the following is true

  1. a) receptors involved in this pathway are encapsulated
  2. b) there is no interneuron pathway involved
  3. c) relaxation of the limb occur
  4. d) multi synaptic

 

101) which of the following is true about Functional rsidual capacity

  1. a) cant b measured by spirometry
  2. b) is sum of expiratory reserve volume and tidal volume

 

102) slow pain neuro transmitter

  1. a) substance p
  2. b) ….?

 

103) Which of the following is inhibitor of growth hormone

  1. Stress
  2. Sleep
  3. Starvation
  4. Puberty
  5. sometomedins

 

104) most unlikely about REM sleep?

a.Active dreaming

b.Extra ocular muscle movement

c.Beta waves

d.increase motor tone

 

105) crystalline lens absorbs

  1. A) visible radiation
  2. B) ultraviolet light
  3. C) infrared light
  4. D) x rays

 

106) Eclipse burns on retina are produced by

  1. A) visible light
  2. B) ultraviolet light
  3. C) infrared light
  4. D) xrays

 

107) most common type of colour blindness is

  1. A) protanomaly
  2. B) deuteranomaly
  3. C) tritanomaly

 

108) blue-yellow colour blindness is related to

  1. A) chromosome X
  2. B) chromosome Y
  3. C) chromosome 22
  4. D) chromosome 7
  5. E) chromosome 17

 

109) Which one of the following bones does not form part of the orbit?

  1. palatine.
  2. frontal.
  3. zygomatic.
  4. nasal.
  5. ethmoid

 

110)How many bones compose the lacrimal sac fossa?

  1. 1.
  2. 2.
  3. 3.
  4. 4.
  5. none—a fossa is a hole.

 

111) In which bone does the lacrimal gland fossa lie?

  1. frontal.
  2. lacrimal.
  3. maxillary.
  4. zygomatic.
  5. ethmoid.

 

112) Which orbital wall is the strongest?

  1. medial.
  2. inferior.
  3. lateral.
  4. superior.
  5. all are equally strong.

 

113) Which of the following is/are not transmitted in the optic canal?

  1. optic nerve.
  2. ophthalmic artery.
  3. sympathetic plexus.
  4. central retinal artery.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

114) Which one of the following structures does not insert into the lateral orbital tubercle of Whitnall?

  1. check ligament of the lateral rectus.
  2. suspensory ligament of the eyeball (Lockwood’s ligament).
  3. lateral canthal tendon.
  4. aponeurosis of the levator muscle.
  5. Whitnall’s ligament

 

115) How many axons compose a healthy adult optic nerve?

  1. 100,000.
  2. 300,000.
  3. 600,000.
  4. 1.2 million.
  5. 2.4 million.

 

116) On entry to the orbit, the ophthalmic artery turns in what relation relative to the optic nerve?

  1. inferior.
  2. lateral.
  3. superior.
  4. medial.
  5. variable

(turns from lateral to medial side of nerve crossing it from it superiorly)

 

117) Which of the following statements about ocular glands is/are true?

  1. The glands of Wolfring and Krause are cytologically similar to the lacrimal gland.
  2. Almost all reflex tear secretion is produced by the accessory lacrimal glands.
  3. The glands of Moll are of the apocrine type.
  4. The meibomian glands are holocrine oil glands that are associated with cilia.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

118) The ciliary ganglion:

  1. has three roots, is located 1 cm posterior to the globe, and is medial to the optic nerve.
  2. has four roots, is located 1 cm posterior to the globe, and is lateral to the optic nerve.
  3. has four roots, is located 1 cm anterior to the orbital apex, and is medial to the optic nerve.
  4. has three roots, is located 1 cm posterior to the globe, and is lateral to the optic nerve.
  5. has three roots, is located 1 cm anterior to the orbital apex, and is lateral to the optic nerve.

 

119) What are the average adult corneal diameters?

  1. 11 mm horizontally and vertically.
  2. 12 mm horizontally and vertically.
  3. 12 mm horizontally and 11 mm vertically.
  4. 11 mm horizontally and 12 mm vertically.
  5. 10 mm horizontally and vertically.

 

120) The correct order of angle structures, from central to peripheral, is:

  1. scleral spur (SS), pigmented trabecular meshwork (TM), nonpigmented TM, the Schwalbe line (SL), ciliary body band (CBB).
  2. SL, pigmented TM, nonpigmented TM, CBB, SS.
  3. SL, pigmented TM, nonpigmented TM, SS, CBB.
  4. SL, SS, pigmented TM, nonpigmented TM, CBB.
  5. SL, nonpigmented TM, pigmented TM, SS, CBB.

 

121) The average anteroposterior diameter of a 40-year-old lens is:

  1. 2 to 3 mm.
  2. 3 to 4 mm.
  3. 4 to 5 mm.
  4. 5 to 6 mm.
  5. 6 to 7 mm.

(Equatoria Diameter= 9-10mm)

 

122) The site of greatest resistance to aqueous outflow is the:

  1. uveal meshwork.
  2. corneoscleral meshwork.
  3. anterior, nonpigmented trabecular meshwork (TM).
  4. posterior, pigmented TM.
  5. juxtacanalicular TM.

 

123) Choose the one correct statement about the iris from the following:

  1. The iris is composed of six layers, three of which are epithelial.
  2. Clump cells are part of the anterior border layer of the iris.
  3. The iris dilator and iris sphincter are posterior to the iris pigment epithelium.
  4. The cell bodies of the anterior iris pigment epithelium give rise to the iris dilator muscle.
  5. The color of the iris is determined by the number and size of macrophages in the iris pigment epithelium.

 

124) The average equatorial diameter of a 40-year-old lens is:

  1. 6 to 7 mm.
  2. 7 to 8 mm.
  3. 8 to 9 mm.
  4. 9 to 10 mm.
  5. 10 to 11 mm.

 

125) Which one of the following statements about retinal photoreceptors is correct?

  1. Rods contain photopigment discs that are not attached to the cell membrane and synapse with bipolar cells at a rod pedicle.
  2. Cones contain photopigment discs that are not connected to the cell membrane and synapse with bipolar cells at a cone pedicle.
  3. Rods contain photopigment discs that are attached to the cell membrane and synapse with bipolar cells at the rod spherule.
  4. Cones contain photopigment discs that are attached to the cell membrane and synapse with bipolar cells at a cone pedicle.
  5. None of the above

 

 

126) Select the correct description of autonomic innervation to the eye:

  1. The iris sphincter muscle receives sympathetic innervation via the short ciliary nerves; the iris dilator muscle receives parasympathetic innervation via the short ciliary nerves.
  2. The iris sphincter muscle receives parasympathetic innervation via the short ciliary nerves; the iris dilator muscle receives sympathetic innervation by the short ciliary nerves.
  3. The iris sphincter muscle receives parasympathetic innervation via the short ciliary nerves; the iris dilator muscle receives sympathetic innervation via the long ciliary nerves.
  4. The iris sphincter muscle receives parasympathetic innervation via the long ciliary nerves; the iris dilator muscle receives sympathetic innervation via long ciliary nerves.
  5. The iris sphincter muscle receives sympathetic innervation via the short ciliary nerves; the iris dilator muscle receives parasympathetic innervation via the long ciliary nerves.

 

127) Select the correct neuronal sequence for intraretinal processing:

  1. photoreceptor to Müller’s cell to ganglion cell.
  2. photoreceptor to bipolar cell to ganglion cell.
  3. photoreceptor to horizontal cell to amacrine cell.
  4. photoreceptor to horizontal cell to ganglion cell.
  5. photoreceptor to amacrine cell to bipolar cell.

 

128) In the entire retina, rods outnumber cones by a ratio of approximately:

  1. 2:1.
  2. 5:1.
  3. 20:1.
  4. 50:1.
  5. 1.25:1.

 

129) Which one of the following statements about Müller’s cells is correct?

  1. The external limiting membrane (ELM) and internal limiting membrane (ILM) of the retina are the basement membranes of Müller’s cells.
  2. Müller’s cells are the only nonneural (glial) cellular element found within the neural retina.
  3. Müller’s cells do not generate any detectable light-induced transretinal voltages.
  4. Müller’s cells intimately envelop virtually all retinal neurons.
  5. None of the above.

 

 

130) A cilioretinal artery contributes to some portion of the macular circulation in approximately:

  1. 5% of individuals.
  2. 15% of individuals.
  3. 25% of individuals.
  4. 40% of individuals.
  5. 50% of individuals.

 

131) The inner retinal circulation’s most exterior level of penetration is the:

  1. ganglion cell layer.
  2. inner plexiform layer.
  3. inner nuclear layer.
  4. outer plexiform layer.
  5. outer nuclear layer.

 

132) Select the correct association of retinal layer and synaptic connections:

  1. outer plexiform layer: bipolar and ganglion cells.
  2. inner plexiform layer: bipolar and ganglion cells.
  3. outer plexiform layer: photoreceptor and ganglion cells.
  4. inner plexiform layer: photoreceptor and ganglion cells.
  5. inner plexiform layer: photoreceptor and bipolar cells.

 

133) Which of the following sites represent firm uveoscleral attachment?

  1. optic nerve (peripapillary tissue).
  2. vortex veins.
  3. scleral spur (SS).
  4. ora serrata.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

134) On entering the cranial cavity, the optic nerve runs:

  1. lateral to the internal carotid artery and inferior to the anterior cerebral artery.
  2. medial to the internal carotid artery and inferior to the anterior cerebral artery.
  3. medial to the internal carotid artery and superior to the anterior cerebral artery.
  4. lateral to the internal carotid artery and superior to the anterior cerebral artery.
  5. lateral to the internal carotid artery and lateral to the anterior cerebral artery.

 

135) Which of the following statements about ganglion axon decussation is true?

  1. More fibers cross in the chiasm than do not cross in the chiasm.
  2. Fewer numbers of ganglion cells cross than do not cross in the chiasm.
  3. A much greater proportion of macular fibers cross in the chiasm than peripheral fibers do.
  4. A much greater portion of peripheral fibers cross in the chiasm than macular fibers do.
  5. None of the above.

 

136) Which one of the extraocular muscles is served by a single nucleus that is shared by both the oculomotor nerve nuclei?

  1. superior rectus.
  2. medial rectus.
  3. inferior oblique.
  4. levator palpebrae superioris.
  5. inferior rectus.

 

137) Which one of the following statements about the pupillomotor fibers of the third cranial nerve is true?

  1. These fibers run central in the nerve, in the superior division.
  2. These fibers run central in the nerve, in the inferior division.
  3. These fibers run peripheral in the nerve, in the superior division.
  4. These fibers run peripheral in the nerve, in the inferior division.
  5. These fibers are distributed evenly throughout the superior division.

 

138) Which is the only muscle supplied by the oculomotor nerve that receives crossed innervation?

  1. superior rectus.
  2. medial rectus.
  3. inferior oblique.
  4. levator palpebrae superioris.
  5. inferior rectus

 

139) Which of the following structures do not travel in the wall of the cavernous sinus at the level of the pituitary fossa?

  1. third and fourth cranial nerves.
  2. fourth and fifth cranial nerves.
  3. fifth and sixth cranial nerves.
  4. sixth cranial nerve and the internal carotid artery.
  5. the internal carotid artery only.

 

140) Mesenchymal structures of the head, including the eye, are all derived from:

  1. mesoderm.
  2. neural crest cells.
  3. a combination of mesoderm and ectoderm.
  4. a combination of neural crest cells and ectoderm.
  5. a combination of neural crest cells and mesoderm

 

 

141) Neural crest cells give rise to the following structures:

  1. corneal epithelium, stroma, endothelium, and ciliary muscle.
  2. the entire sclera, optic nerve sheath, uveal melanocytes, entire choroid.
  3. orbital bones, fat, trochlear cartilage, extraocular muscles, and orbital connective tissues.
  4. ciliary body, ciliary epithelium, iris stroma, orbital bones, and orbital connective tissues.
  5. optic nerve sheath, uveal melanocytes, choroidal stroma and iris stroma.

 

142) The mesoderm gives rise to:

  1. the pupillomotor muscles, ciliary muscle, and extraocular muscles.
  2. all vascular endothelia, extraocular muscles, and the trochlea.
  3. all vascular endothelia, pupillomotor muscles, and all blood vessels.
  4. all vascular endothelia, all extraocular muscles, and temporal sclera.
  5. ciliary muscle, extraocular muscles, all orbital blood vessels, and some orbital connective tissue

 

 

143) The surface ectoderm supplies all of the following structures except:

  1. the lacrimal gland.
  2. the lens.
  3. the vitreous.
  4. the corneal epithelium.
  5. the substantia propria of the conjunctiva.

 

144) What factor distinguishes anophthalmia from microphthalmia?

  1. the size of the globe.
  2. the presence or absence of a globe.
  3. the presence or absence of lid fusion.
  4. the presence or absence of organic abnormalities of a globe.
  5. the presence or absence of nervous system disorders.

 

145) What factor distinguishes microphthalmia from nanophthalmia?

  1. the size of the globe.
  2. the presence or absence of a globe.
  3. the presence or absence of lid fusion.
  4. the presence or absence of organic abnormalities of a globe.
  5. the presence or absence of nervous system disorders.

 

146) All of the following conditions may present as a cystic bulge within the palpebral fissure except:

  1. cystic coloboma.
  2. orbital encephalocele.
  3. microphthalmos.
  4. nanophthalmos.
  5. congenital rhabdomyosarcoma.

(Microphthalmos=small eye with small socket;                  Nanophthalmos= Small eye)

 

147) Which one of the following statements about dermoids is false?

  1. Dermoids represent hamartomas of epidermal and connective tissues.
  2. Dermoids may be found in the conjunctiva and/or in the orbit.
  3. The solid variety of the dermoids is most frequently found at the limbus.
  4. Dermolipomas are usually solid, most commonly located between the lateral and superior rectus muscles, and often lack dermal adnexal structures (unlike a dermoid).
  5. Epibulbar dermoids are associated with Goldenhar’s syndrome.

 

148) Which one of the following statements about anterior segment dysgeneses is false?

  1. All varieties of anterior segment dysgeneses may be inherited as autosomal-dominant traits and may be either unilateral or bilateral.
  2. Posterior embryotoxon is the mildest of the peripheral varieties of anterior segment dysgeneses.
  3. Rieger’s anomaly consists of Axenfeld’s anomaly plus iris atrophy.
  4. Rieger’s syndrome is Rieger’s anomaly plus facial and musculoskeletal anomalies.
  5. In Peters’ anomaly, the central cornea is always opacified, and the lens is always densely adherent to the posterior corneal surface.

 

 

149) Which one of the following statements about pediatric lenticular disorders is true?

  1. Microspherophakia is most often associated with Marfan’s syndrome.
  2. In Lowe’s syndrome, there are typically cataracts, glaucoma, and aminoaciduria, and girls are affected more frequently than boys.
  3. Cataracts in the congenital rubella syndrome are generally dense nuclear cataracts.
  4. Defects in the rubella syndrome are typically isolated (i.e., there are usually no other systemic abnormalities).
  5. Glaucoma and cataracts are frequently coincident in the congenital rubella syndrome.

 

150) Which one of the following statements about aniridia is false?

  1. Generally, no iris tissue is present on histopathology.
  2. Aniridia may be either familial or sporadic.
  3. Foveal and optic nerve hypoplasia are often present in aniridia, leading to nystagmus and reduced visual acuity.
  4. There is an association of aniridia with Wilms’ tumor, genitourinary anomalies, and mental retardation.
  5. In aniridia associated with Wilms’ tumor, there is frequently a deletion on the short arm of chromosome 11.

 

151) Which one of the following statements about persistent hyperplastic primary vitreous (PHPV) is false?

  1. PHPV is generally unilateral.
  2. Long-term visual prognosis is usually excellent.
  3. PHPV is most easily differentiated from retinoblastoma by the presence of microphthalmos or cataract.
  4. PHPV may calcify.
  5. PHPV is almost always sporadic.

 

152) Which one of the following statements about tear secretion is false?

  1. Adrenocorticotropic hormone (ACTH) and androgens can stimulate tear secretion from the main lacrimal gland.
  2. The glands of Wolfring are located along the orbital margin of each tarsus, with the glands of Krause in the conjunctival fornix.
  3. The accessory glands of Krause and Wolfring account for approximately 50% of total lacrimal secretory mass.
  4. Both sympathetic and parasympathetic nerve stimuli are important for reflex tear secretion.
  5. The cornea, conjunctiva, and meibomian glands also contribute to the tear film.

 

153) Which one of the following statements about corneal metabolism is false?

  1. Oxygen is provided to the cornea by tears, aqueous humor, and lid vasculature.
  2. Most of the metabolic fuel for the cornea is derived from aqueous humor.
  3. Molecules with low lipid solubility have greater penetration through the corneal epithelium and stroma.
  4. Mature corneal stromal fibers are composed of type I collagen.
  5. The type and distribution of glycosaminoglycan in the cornea are crucial for corneal clarity.

 

154) Which one of the following statements about Descemet’s membrane and corneal endothelium is false?

  1. Descemet’s membrane consists of type IV collagen.
  2. Posterior keratoconus can be differentiated from Peters’ anomaly by the presence of fetal Descemet’s membrane.
  3. Fetal Descemet’s membrane can be differentiated from adult Descemet’s membrane by its banding pattern.
  4. The number of endothelial cells substantially increases with age.
  5. The corneal endothelium actively maintains corneal deturgescence by a pump system that depends on Na+/K+-adenosine triphosphatase (ATPase) function and carbonic anhydrase.

 

 

155) Aqueous humor enters the posterior chamber from the ciliary processes by:

  1. diffusion.
  2. ultrafiltration.
  3. secretion/active transport.
  4. carbonic anhydrase II activity.
  5. all of the above.

 

156) Which one of the following statements about prostaglandins is false?

  1. The cyclooxygenase (COX) reaction culminates in the production of prostaglandins, prostacyclin, and thromboxane.
  2. In general, prostaglandins cause mydriasis.
  3. Corticosteroids inhibit both the COX and lipoxygenase (LOX) pathways of arachidonic acid metabolism.
  4. The effect of prostaglandins on intraocular pressure (IOP) is complex, with low doses decreasing IOP and high doses increasing IOP.
  5. Prostacyclin is a potent vasodilator synthesized primarily in endothelial cells, whereas thromboxane is a potent vasoconstrictor synthesized primarily in platelets.

 

157) Which of the following enzymes is/are normally present at functioning levels in the aqueous humor?

  1. carbonic anhydrase.
  2. lysozyme.
  3. hyaluronidase.
  4. lactate dehydrogenase.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

 

158) The partial pressure of oxygen in aqueous humor is:

  1. 40 mm Hg.
  2. 55 mm Hg.
  3. 75 mm Hg.
  4. 85 mm Hg.
  5. 100 mm Hg.

 

159) The most mitotically active lens epithelium cells are located:

  1. at the anterior pole (AP).
  2. at the posterior pole.
  3. at the equator.
  4. in a ring around the anterior lens.
  5. in a ring around the posterior lens

 

160) Which one of the following statements about the protein fractions of the lens is false?

  1. Lens fiber proteins are separated into two major groups—water-soluble and water-insoluble.
  2. The water-insoluble fraction is further divided into three types of crystallin proteins.
  3. Alpha-crystallin is the largest of the lens crystallins.
  4. Beta-crystallin is the most abundant of the lens crystallins.
  5. Most crystallins are expressed outside the lens and have other roles in addition to their function as refractile elements within the lens.

 

161) The vitreous syneresis of aging is associated with:

  1. diffuse decreases in hyaluronic acid concentration.
  2. diffuse decreases in collagen concentration.
  3. focal decreases in collagen concentration.
  4. motion-induced collagen damage.
  5. light-induced collagen damage.

 

162) Which of the following conditions are associated with significant decreases in both collagen and hyaluronic acid concentrations in human vitreous humor?

  1. myopia.
  2. aphakia.
  3. diabetes mellitus (DM).
  4. a. and b.
  5. a. and c.

 

163) Which one of the following statements about the effects of light on rod outer segment metabolism is false?

  1. In the dark, high concentrations of cyclic guanosine monophosphate (cGMP) maintain sodium channels open and rod outer segments depolarized.
  2. Light absorption leads to configurational changes in rhodopsin and activation of transducin.
  3. Transducin, through an amplification cascade, activates phosphodiesterase (PDE).
  4. PDE causes a fall in cGMP levels.
  5. Falling intracellular cGMP concentration leads to closure of sodium channels, with subsequent further depolarization of the rod outer segment.

 

Ans E

 

 

164) All the following methods of increasing ocular absorption of topically applied materials (without increasing systemic absorption) are effective except:

  1. adding a second eyedrop immediately after the first.
  2. waiting 5 to 10 minutes between administration of different medications.
  3. nasolacrimal sac compression.
  4. closing the eyes for 3 to 5 minutes after administration.
  5. addition of topical anesthetic immediately before administration.

 

Ans A

 

 

165) All the following factors increase the amount of medication penetrating the cornea except:

  1. higher concentration of the drug.
  2. higher viscosity of the vehicle.
  3. higher pH of the drug.
  4. higher lipid solubility of the drug.
  5. addition of benzalkonium chloride.

 

Ans C

*pH extremes trigger reflex tearing, with subsequent dilution of the drug. Benzalkonium chloride, like local anesthetics, disrupts the corneal epithelium

 

 

166) Which of the following ocular structures have physiologically important cholinergic receptors?

  1. extraocular muscles.
  2. ciliary body muscle.
  3. lacrimal gland tissue.
  4. iris sphincter muscle.
  5. all of the above.

 

Ans E

 

167) Unwanted side effects of direct cholinergic agonists include all of the following except:

  1. poor dark adaptation.
  2. decreased vision in older patients.
  3. headache in younger patients.
  4. possible aggravation or induction of angle-closure glaucoma.
  5. induced hyperopia.

 

Ans E

 

168) Following a unilateral dose of apraclonidine, the eye that received the medication can be identified by its:

  1. lid retraction.
  2. increased conjunctival injection.
  3. miosis.
  4. all of the above.
  5. none of the above

 

Ans A

 

169) Beta-adrenergic agonists generally:

  1. increase aqueous humor production, decrease outflow facility, and increase intraocular pressure (IOP).
  2. increase aqueous humor production, increase outflow facility, and increase IOP.
  3. increase aqueous humor production, increase outflow facility, and decrease IOP.
  4. decrease aqueous humor production, decrease outflow facility, and decrease IOP.
  5. decrease aqueous humor production, increase outflow facility, and decrease IOP.

 

Ans C

 

170) Dipivalyl epinephrine (dipivefrin) is converted to epinephrine in the:

  1. tears.
  2. conjunctiva.
  3. cornea.
  4. aqueous humor.
  5. iris stroma.

 

Ans C

 

171) Which would be the best single medication for treatment of primary open-angle glaucoma (POAG) in a 69-year-old patient with aphakia with chronic bronchitis, labile hypertension, and chronic depression treated with monoamine oxidase inhibitors (MAOIs)?

  1. epinephrine.
  2. dipivefrin.
  3. pilocarpine.
  4. timolol.
  5. acetazolamide

 

Ans C

 

 

172) Carbonic anhydrase inhibitors (CAIs) should be used with great caution in all of the following types of patients except:

  1. patients with a remote history of nephrolithiasis.
  2. patients with chronic liver failure.
  3. patients on thiazide diuretics.
  4. patients on digoxin.
  5. patients with chronic schizophrenia.

 

Ans A

*A remote history of spontaneous nephrolithiasis (>5 years earlier) is not thought to be a contraindication for starting carbonic anhydrase inhibitor (CAI) therapy. Recent renal stones (<5 years earlier) may be a contraindication

 

 

173) Which one of the following statements about glucocorticoid effects is false?

  1. Glucocorticoids inhibit neovascularization.
  2. Glucocorticoids do not affect immunoglobulin E (IgE) titers.
  3. Glucocorticoids act through impairing the efferent limb of the immune response.
  4. Glucocorticoids impair epithelial healing.
  5. Glucocorticoids act by blocking release of arachidonic acid from phospholipids.

 

Ans D

 

174) Which one of the following statements about penicillins and cephalosporins is false?

  1. Both penicillins and cephalosporins act by inhibiting bacterial cell wall synthesis.
  2. Both penicillins and cephalosporins contain beta-lactam bonds.
  3. These antibiotics have greater activity against Gram-positive organisms because of the oligopolysaccharide (OPS) coat of many Gram-negative bacteria.
  4. Probenecid counteracts resistance mechanisms by inactivating the beta-lactamase enzyme of bacteria.
  5. The most prominent mode of bacterial resistance to this group of antibiotics is the production of beta-lactamase enzymes.

 

Ans D

 

175) Given a history of a hypersensitivity reaction to penicillin, the probability of a similar reaction to cephalosporin is approximately:

  1. 1%.
  2. 5%.
  3. 10%.
  4. 15%.
  5. 20%.

 

Ans C

 

176) Which one of the following statements about antibiotic mechanisms is false?

  1. Sulfonamides act by inhibiting bacterial deoxyribonucleic acid (DNA) synthesis.
  2. Tetracycline is poorly water soluble but may be dissolved in eye drops containing mineral oil.
  3. Chloramphenicol use is most strongly associated with aplastic anemia when used orally.
  4. Aminoglycoside efficacy mostly depends on anaerobically supported antibiotic uptake.
  5. Erythromycin acts by inhibiting bacterial protein synthesis.

 

Ans D

 

177) Which one of the following statements about vancomycin is false?

  1. Vancomycin inhibits bacterial replication by blocking cell wall synthesis.
  2. Empirical use of vancomycin in patients with neutropenia is recommended for infection prophylaxis.
  3. Vancomycin is one of the drugs of choice in filtering bleb-related endophthalmitis.
  4. Because of its poor gastrointestinal (GI) uptake, vancomycin is an excellent drug for pseudomembranous colitis.
  5. The nephrotoxicity of vancomycin is generally potentiated by concomitant use of aminoglycosides

 

Ans B

 

 

178) The aminoglycoside that most frequently induces a topical hypersensitivity reaction is:

  1. gentamicin.
  2. tobramycin.
  3. kanamycin.
  4. amikacin.
  5. neomycin.

 

Ans E

 

179) Which one of the following statements about the ocular antiviral agents is false?

  1. Vidarabine is an analog of adenine, whereas idoxuridine and trifluridine are analogs of thymidine.
  2. Trifluridine is more soluble than vidarabine or idoxuridine.
  3. Trifluridine is the most effective of the three ocular antiviral agents.
  4. Cross-resistance to different agents is commonly seen.
  5. The combination of topical trifluridine and interferon has been shown to speed epithelial healing in herpes simplex keratitis.

 

Ans D

 

180) Which one of the following statements about trisomy 13 (Patau’s syndrome) is false?

  1. Less than 5% of patients with Patau’s syndrome will survive to 3 years of age.
  2. Commonly, the central nervous system (CNS) is severely affected.
  3. A clenched fist deformity is characteristic of Patau’s syndrome.
  4. Cardiovascular and renal defects are very common in Patau’s syndrome.
  5. Patau’s syndrome has been seen only in complete trisomy of chromosome 13.

 

Ans E

 

181) Which one of the following statements about trisomy 18 (Edwards’ syndrome) is false?

  1. Edwards’ syndrome is the second most common chromosomal nondisjunction syndrome.
  2. Survival in trisomy 18 tends to be shorter than in trisomy 13.
  3. Outstanding features of Edwards’ syndrome include mental retardation and numerous musculoskeletal abnormalities.
  4. The effect of maternal age is important in trisomy 18.
  5. Glaucoma is more likely with trisomy 18 than with trisomy 13.

 

Ans B

 

182) Which one of the following statements about Down’s syndrome is false?

  1. Ninety-five percent of Down’s syndrome are caused by meiotic nondisjunction, whereas the remaining 5% are translocation errors.
  2. A specific region of the long arm of chromosome 21 is responsible for the pathogenesis of Down’s syndrome.
  3. Classic findings of Down’s syndrome include the simian crease, hypoplasia of the middle phalanx of the fifth finger, and congenital heart disease.
  4. Patients with Down’s syndrome frequently have low serum purine levels.
  5. Down’s syndrome is the most common chromosomal syndrome, with an incidence of approximately 1:800 live births.

 

Ans D

 

 

183) Which one of the following statements about Turner’s syndrome is false?

  1. Turner’s syndrome is the only disorder of sex chromosomes with characteristic eye findings.
  2. Physical findings of Turner’s syndrome include short stature, webbing of the neck, nonpitting edema, and coarctation of the aorta.
  3. The incidence of dyschromatopsia in women with Turner’s syndrome is identical to that in healthy women.
  4. Classic eye findings of Turner’s syndrome include prominent epicanthal folds, ptosis, and blue sclera.
  5. Patients with Turner’s syndrome are always sterile

 

Ans C

 

184) Increasing paternal age has been associated with all of the following disorders except:

  1. the craniosynostoses.
  2. Treacher Collins’ syndrome.
  3. neurofibromatosis.
  4. Down’s syndrome.
  5. Waardenburg’s syndrome

 

Ans D

 

185) In Marfan’s syndrome, the presence of ectopia lentis, arachnodactyly, aortic aneurysm, and tall habitus are examples of genetic:

  1. penetrance.
  2. variable expressivity.
  3. pleomorphism.
  4. phenocopying.
  5. pleiotropism.

 

Ans E

 

186) From the following list, select the racial predilection that is incorrect:

  1. Riley-Day syndrome: Ashkenazi Jews.
  2. Glucose-6-phosphate dehydrogenase deficiency: Mediterraneans.
  3. Oguchi disease: Chinese.
  4. sickle cell hemoglobinopathy: African Americans.
  5. diabetes mellitus, type 2: Pima Indians.

 

Ans C

 

187) An investigator attempts to show that a new topical medication is effective in reducing intraocular pressure (IOP). He states that patients who took his medication had significantly lower IOP than the patients who were given the placebo and says that his p value is equal to 0.01. Which one of the following statements about this situation is false?

 

  1. He is willing to reject the null hypothesis with a significance level >0.01.
  2. If the difference in IOP between his treatment and placebo groups was actually due to chance, he is falling victim to type I statistical error.
  3. There is a 1% chance that the results that occurred were a result of chance alone.
  4. If he chooses to accept the null hypothesis because he feels his probability level is too high, when in fact there was a true treatment difference, then he is falling victim to type II statistical error.
  5. The power of his test is 0.99, or 1 minus his type I error.

 

Ans E

 

 

188) Which of the following structures is/are transmitted in the inferior orbital fissure or infraorbital groove/canal?

  1. infraorbital nerve.
  2. inferior division of the oculomotor nerve.
  3. nerve from the pterygopalatine ganglion.
  4. superior ophthalmic vein.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

Ans B

 

189) Which one of the following statements about the genetics of aniridia is true?

  1. The autosomal-dominant form is the only form to feature aniridia with no other ocular abnormalities.
  2. The aniridia associated with Wilms’ tumor is most often inherited.
  3. Aniridia is usually sporadic.
  4. When confronted with a patient with newly diagnosed aniridia, an ophthalmologist should undertake a careful examination of the patient’s family members.
  5. Most cases of aniridia are unilateral.

 

Ans D

*Sporadic aniridia (i.e., nonfamilial), often associated with glaucoma or cataract, can be caused by a new deletion of an interstitial segment of chromosome 11 (11p13). This deletion also results in genitourinary malformations (which may be subtle in females), mental retardation, and Wilms’ tumor. Hereditary aniridia can occur with autosomal-dominant or autosomal-recessive inheritance patterns and is associated with other ocular anomalies, including nystagmus, cataract, glaucoma, corneal abnormalities, and hypoplasia of the optic nerve. Hereditary aniridia is only rarely associated with Wilms’ tumor. Examination of family members may differentiate sporadic from hereditary aniridia. Most cases of aniridia are bilateral. Two thirds of cases are familial

 

 

190) Which of the following bones do not form part of the orbital floor?

  1. zygomatic.
  2. sphenoid.
  3. maxillary.
  4. ethmoid.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.d. 4 only.e. 1, 2, 3, and 4

 

Ans C

 

191) Which of the following muscles is/are supplied by the superior division of the oculomotor nerve?

  1. iris sphincter.
  2. iris dilator.
  3. inferior rectus.
  4. levator palpebrae superioris.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

Ans D

 

192) With which of the following nerves does parasympathetic innervation to the iris sphincter travel?

  1. nerve to the levator palpebrae superioris.
  2. nerve to the inferior oblique.
  3. nerve to the superior rectus.
  4. nerve to the superior oblique.
  5. long ciliary nerves.

 

Ans B

 

193) Which of the following are innervated by cranial nerve V (trigeminal nerve)?

  1. corneal sensation.
  2. pterygoid muscles.
  3. masseter muscles.
  4. orbicularis oculi.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

Ans A

 

194) Which of the following extraocular muscles does not originate mechanically from the orbital apex?

  1. superior rectus.
  2. superior oblique.
  3. inferior rectus.
  4. inferior oblique.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

Ans C

 

195) Which of the following extraocular muscles does not originate anatomically from the orbital apex?

  1. superior rectus.
  2. superior oblique.
  3. inferior rectus.
  4. inferior oblique.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

Ans D

 

196) Which one of the following sets of nerve fibers synapses in the ciliary ganglion?

  1. sympathetic fibers to iris dilator.
  2. sympathetic fibers to choroid and ciliary body.
  3. parasympathetic fibers to iris sphincter.
  4. parasympathetic fibers to choroid and ciliary body.
  5. sensory fibers from the anterior globe (i.e., cornea, iris, ciliary body).

 

Ans C

 

197) Which of the following structures enter(s) the orbit outside the annulus of Zinn?

  1. nasociliary nerve.
  2. lacrimal nerve.
  3. inferior division of the third cranial nerve.
  4. fourth cranial nerve.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

Ans C

 

198) Which of the following structures is not transmitted within the superior orbital fissure?

  1. superior ophthalmic vein.
  2. superior division of the third cranial nerve.
  3. ophthalmic artery.
  4. inferior division of the third cranial nerve.
  5. fourth cranial nerve.

 

Ans C

 

199) In general, the last muscle to be rendered akinetic with a retrobulbar anesthetic block is the:

  1. superior rectus.
  2. superior oblique.
  3. inferior rectus.
  4. inferior oblique.
  5. levator palpebrae superioris.

 

Ans B

 

200) Which is the only extraocular muscle typically supplied by one anterior ciliary artery?

  1. superior rectus.
  2. medial rectus.
  3. inferior rectus.
  4. lateral rectus.
  5. superior oblique

 

Ans D

 

201) Which upper-eyelid structure is considered to be analogous to the capsulopalpebral fascia of the lower eyelid?

  1. Müller’s muscle.
  2. levator palpebrae superioris.
  3. levator aponeurosis.
  4. Whitnall’s ligament.
  5. orbital septum.

 

Ans C

*The capsulopalpebral fascia is a condensation of noncontractile fascia from the sheaths of the inferior oblique and inferior rectus muscles. Like the aponeurosis of the levator muscle, it retracts the tarsus

 

202) The suspensory ligament of the globe is also known as:

  1. Whitnall’s ligament.
  2. Lockwood’s ligament.
  3. levator aponeurosis.
  4. capsulopalpebral fascia.
  5. lateral rectus check ligament.

 

Ans B

 

203) Which one of the following about photoreceptors is false?

  1. Tight junctions between photoreceptors and the retinal pigment epithelium (RPE) help maintain apposition between these layers.
  2. The major protein isolated from rod outer segments is rhodopsin.
  3. The chromophore for all the visual pigments is 11-cis-retinaldehyde.
  4. Differences in spectral absorption are due to different interactions between the chromophore and the protein (opsin) to which it is bound.
  5. The four visual pigment proteins have considerable sequence homology, implying a common ancestry.

 

Ans A

 

204) Which one of the following statements about the arterial supply to the globe is correct?

  1. There are two long posterior ciliary arteries (LPCAs), and these arteries enter the sclera posteriorly near the optic nerve at the 3- and 9-o’clock positions.
  2. There are 10 to 12 LPCAs, and these arteries enter the sclera posteriorly in a circle around the optic nerve.
  3. There are seven LPCAs, and these arteries terminate in the rectus muscles.
  4. There are seven LPCAs, and these arteries terminate in the major arterial circle of the iris after providing feeders to the rectus muscles.
  5. There are two LPCAs, and these arteries enter the sclera posteriorly near the optic nerve at the 6- and 12-o’clock positions.

 

Ans A

 

205) Indirectly acting miotics (e.g., phospholine iodide) may dangerously increase systemic sensitivity to which of the following medications?

  1. ester-type local anesthetics (tetracaine).
  2. monoamine oxidase inhibitors.
  3. depolarizing paralytic agents.
  4. amide-type local anesthetics (lidocaine).
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

Ans B

 

206) Which one of the following about photoreceptor dynamics is false?

  1. Rods shed their outer segments shortly after dawn.
  2. Steady, constant dark adaptation will rapidly ablate rod outer segment shedding.
  3. Only the cis configuration of 11-retinaldehyde can initiate the light absorption cascade.
  4. The first step in regeneration of the chromophore is the formation of all-trans retinal.
  5. The chromophore is aligned parallel to the outer segment disc to enhance light capture.

 

Ans B

 

207) The cell most commonly used for karyotypic analysis is the:

  1. erythrocyte.
  2. platelet.
  3. neutrophil.
  4. B lymphocyte.
  5. T lymphocyte

 

Ans E

 

208) The first retinal cells to differentiate a recognizable level are:

  1. photoreceptor cells.
  2. bipolar cells.
  3. ganglion cells.
  4. Müller’s cells.
  5. horizontal cells

 

Ans C

 

209) What is the diameter of the anatomic human fovea?

  1. 0.5 mm (500 µm).
  2. 1.0 mm (1,000 µm).
  3. 1.5 mm (1,500 µm).
  4. 2.0 mm (2,000 µm).
  5. 2.5 mm (2,500 µm

Ans C

 

210) Which one of the following extraocular muscles is served by a contralateral brainstem subnucleus?

  1. superior rectus.
  2. medial rectus.
  3. inferior oblique.
  4. levator palpebrae superioris.e. inferior rectus

 

Ans A

 

211) A 19-year-old woman in the seventh month of her first pregnancy presents to an ophthalmologist complaining of visual loss. Potential explanations include each of the following except:

  1. acute glaucoma.
  2. occipital lobe infarct.
  3. central serous chorioretinopathy.
  4. ischemic optic neuropathy.
  5. exudative retinal detachment

 

Ans A

 

212) The risk of progression to proliferative diabetic retinopathy in a patient who is pregnant who has no or mild nonproliferative diabetic retinopathy before pregnancy is approximately:

  1. 0%.
  2. 0.2%.
  3. 1%.
  4. 5%.
  5. 10%.

 

Ans D

 

213) Pregnancy may aggravate each of the following conditions except:

  1. Graves’ disease.
  2. pituitary adenoma.
  3. meningioma.
  4. myasthenia gravis.
  5. diabetic retinopathy

 

Ans D

 

214) Which one of the following statements about tamoxifen is false?

  1. The antiestrogenic effects of tamoxifen are particularly useful for adjunctive therapy for estrogen receptor-positive breast cancers.
  2. Ocular toxicity has not been reported with cumulative doses of <10 g.
  3. Ocular toxicity has reportedly developed in 1% to 6% of treated patients in previous studies.
  4. Potential ocular findings following low-dose treatment (10 to 20 mg/day) include cornea verticillata, focal retinal pigment epithelium (RPE) damage, and crystalline retinopathy.
  5. Once retinal crystals have been detected, therapy should be continued with close follow-up.

 

Ans D

 

215) Approximately what percentage of patients with newly diagnosed essential hypertension will remain well controlled on one antihypertensive agent?

  1. 10%.
  2. 25%.
  3. 50%.
  4. 67%.
  5. 75%.

 

Ans C

 

216) Which type of organ transplantation procedure is most likely to be complicated by disseminated opportunistic fungal infection, including endophthalmitis?

  1. liver transplantation.
  2. kidney transplantation.
  3. pancreas transplantation.
  4. heart transplantation.
  5. lung transplantation

 

Ans A

 

217) Which of the following antiviral agents are commonly used to treat herpes zoster (shingles)?

  1. valacyclovir.
  2. famciclovir.
  3. acyclovir.
  4. ganciclovir.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

Ans A

 

218) Which of the following cataract types is most often associated with steroid use?

  1. nuclear.
  2. cortical.
  3. posterior subcapsular.
  4. b. and c.
  5. a., b., and c.

 

Ans C

 

219) Which of the following cataract types is most clearly associated with cigarette smoking?

  1. nuclear.
  2. cortical.
  3. posterior subcapsular.
  4. b. and c.
  5. a., b., and c.

 

Ans A

 

220) Which of the following cataract types is most often associated with diabetes mellitus?

  1. nuclear.
  2. cortical.
  3. posterior subcapsular.
  4. b. and c.
  5. a., b., and c

 

Ans D

 

221) Which of the following cataract types is most often associated with ultraviolet light exposures?

  1. nuclear.
  2. cortical.
  3. posterior subcapsular.
  4. b. and c.
  5. a., b., and c.

 

Ans B

 

222) Which of the following cataract types is most often associated with lower educational levels?

  1. nuclear.
  2. cortical.
  3. posterior subcapsular.
  4. b. and c.
  5. a., b., and c.

 

Ans E

 

223) Each of the following statements are valid conclusions of the Diabetes Control and Complications Trial (DCCT) except:

 

  1. Among patients with no retinopathy at the outset of the study, the risk of progression of retinopathy was reduced to approximately 80% by intensive blood sugar control.
  2. Among patients with mild to moderate retinopathy at the outset of the study, the risk of progression of retinopathy was reduced to 65% by intensive blood sugar control.
  3. The study confirmed that there was an “early worsening” effect among patients initiated with intensive blood sugar control.
  4. Following documented progression, subsequent recovery was equally likely in the conventional versus intensive treatment groups.
  5. Patients with more severe retinopathy at baseline enjoyed the same reduction in risk of progression as patients with milder retinopathy.

 

Ans D

 

 

224) Each of the following statements is true about valacyclovir except:

  1. Valacyclovir acts as a “prodrug” because it is converted into acyclovir in the small intestine and liver.
  2. Oral valacyclovir is substantially more bioavailable than oral acyclovir.
  3. Valacyclovir may reduce the incidence of postherpetic neuralgia, if given within 72 hours of onset of symptoms.
  4. Although a typical regimen for herpes zoster may be less expensive than acyclovir, the standard dosing of valacyclovir is more frequent than that for acyclovir.
  5. Concurrent use of cimetidine can increase plasma concentrations of the active drug.

 

Ans D

 

225) Approximately what percentage of patients with diabetes will develop asymmetric retinopathy (proliferative disease with high-risk characteristics in one eye and no greater than moderate nonproliferative retinopathy in the other eye)?

  1. 1%.
  2. 5%.
  3. 10%.
  4. 15%.
  5. 20%.

 

Ans B

 

226) Which of the following conditions retards the progress of diabetic retinopathy?

  1. ipsilateral glaucoma.
  2. ipsilateral severe carotid stenosis.
  3. ipsilateral chorioretinal scarring.
  4. ipsilateral aphakia.
  5. 1, 2, and 3.
  6. 1 and 3.
  7. 2 and 4.
  8. 4 only.
  9. 1, 2, 3, and 4.

 

Ans B

 

227) When should a patient with newly diagnosed type 1 diabetes undergo an initial screening ophthalmic examination?

  1. immediately.
  2. 1 year later.
  3. 2 years later.
  4. 3 years later.
  5. 5 years later.

 

Ans E

*Patients with newly diagnosed type 1 diabetes rarely develop retinopathy within the first 5 years of diagnosis

 

228) Which one of the following agents presents the lowest risk of corneal or conjunctival toxicity as a preoperative antiseptic?

  1. chlorhexidine gluconate 4% (Hibiclens).
  2. povidone-iodine solution 5%.
  3. hydrogen peroxide 100%.
  4. benzalkonium chloride 100%.
  5. silver nitrate 1%.

 

Ans B

 

229) When should a patient with newly diagnosed type 2 diabetes undergo an initial screening ophthalmic examination?

  1. immediately.
  2. 1 year later.
  3. 2 years later.
  4. 3 years later.
  5. 5 years later

 

Ans A

 

230) Which of the following preoperative regimens most effectively reduces conjunctival bacterial colony counts?

  1. topical antibiotic for 3 days preoperatively.
  2. topical povidone-iodine for 3 days preoperatively.
  3. topical antibiotic for 3 days preoperatively, followed by topical povidone-iodine at the time of surgery.
  4. topical povidone-iodine at the time of surgery.
  5. topical povidone-iodine at the time of surgery, followed immediately by vigorous saline flush

 

Ans C

 

231) Cigarette smoking has been most strongly associated with which manifestation of age-related macular degeneration?

  1. hard drusen.
  2. soft drusen.
  3. focal retinal pigment epithelium (RPE) hyperplasia.
  4. choroidal neovascularization.
  5. geographic atrophy.

 

Ans D

 

232) What is the shortest duration of cataract surgery that has resulted in photic maculopathy?

  1. 5 minutes.
  2. 20 minutes.
  3. 55 minutes.
  4. 75 minutes.
  5. 90 minutes.

 

Ans C

 

233) Potential side effects of topical prostaglandins or their analogs include each of the following except:

  1. bradycardia.
  2. red eye.
  3. iris hyperpigmentation.
  4. eczema.
  5. superficial punctate keratitis (SPK).

 

Ans A

 

234) Compared with timolol 0.5% taken daily, latanoprost:

  1. has a lesser peak effect on intraocular pressure (IOP).
  2. is more likely to be associated with wide variations in IOP.
  3. is more likely to cause cardiovascular complications.
  4. has comparable or superior efficacy if administered once daily, in the evening.
  5. causes less red eye

 

Ans D

 

235) Each of the following is true about the vaccination for varicella zoster virus except:

  1. For children between the ages of 1 and 12 years, a single dose is sufficient.
  2. Two doses, 4 to 8 weeks apart, are recommended for individuals older than 12 years.
  3. The vaccine has been shown to reduce the incidence of shingles in immunocompetent adults with a history of childhood varicella infection.
  4. The vaccine is contraindicated during pregnancy.
  5. Salicylates should be avoided within the first 6 weeks following immunization

 

Ans C

 

236) “First pass” metabolism by the hepatic cytochrome P450 enzyme system of many drugs, including calcium-channel blockers and cyclosporine, may be considerably inhibited, leading to increased drug plasma concentrations, by which one of the following:

  1. herbal teas.
  2. grapefruit juice.
  3. home-distilled alcohol (moonshine).
  4. high-dose vitamin A.
  5. tanning beds.

 

Ans B

 

237) Which of the following is most likely to be an extraocular focus of infection for endogenous bacterial endophthalmitis?

  1. liver abscess.
  2. endocarditis.
  3. orbital cellulitis.
  4. meningitis.
  5. septic arthritis

 

Ans A




 

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