Medical Officer Annual Assessment 2021
Name:
A) MCQs (Some may have more than 1 answer)
1. Choose the correct statement regarding Trigeminal Nerve.
a. Trigeminal ganglion is a sensory ganglion
b. Trigeminal nerve is a purely sensory nerve.
c. The long ciliary nerve arises from ciliary ganglion and travel in the nasociliary nerve to provide
sympathetic fibers to the dilator pupillae muscle.
d. Herpes zoster ophthalmicus (HZO), a potentially devastating form of acute herpes zoster, may
affect any branch of trigeminal nerve.
e. The medulla contains the motor and one of the 3 sensory trigeminal nuclei.
2. Which of the following is true.
a. There are 7 branches of ciliary arteries, 2 for each rectus mucles, except the medial rectus.
b. The lateral wall of cavernous sinus may include endosteal layer of dura and parietal lobe.
c. The straight sinus is an unpaired dural venous sinus.
d. The internal carotid artery and trochlear nerve lies medially in the cavernous sinus.
e. The medial wall of the orbit consists of lacrimal, ethmoidal, maxillary and palatine bone.
f. The easiest nerve to be damaged in blowout fracture is infraorbital nerve.
3. Choose true statements about angle of the eye.
a. The posterior most layer of the iris is continuous with the pigmented layer of ciliary epithelium.
b. Juxtacanalicular layer of the trabecular meshwork provides the most resistance to aqueous
outflow.
c. Uveoscleral pathway contributes to about 15% of aqueous outflow.
d. Schwalbe’s Line is the anterior border of trabecular meshwork and posterior border of
endothelium of cornea.
e. The iris sphincter muscle consists of circular muscles.
4. This question has 3 subquestions.
A 60-year-old black male presents with a three-day history of right eye pain, redness, right temporal
headache and epiphora for the past 3 days. He denies any history of recent eye trauma or eye
surgery. He has a history of poor vision in the right eye for many years. Past ocular history is
significant for cataract surgery with IOL in the left eye in the 1990s. He also has a history of diabetes,
hypertension and hyperlipidemia. Examination reveals hand motion vision in the right eye and 20/25
in the left eye. Intraocular pressures are 63 mmHg in the right eye and 16 mmHg in the left eye.
There is no relative afferent pupillary defect (RAPD). Slit lamp examination of the right eye reveals
2+ conjunctival injection, diffuse microcystic edema, 1+ anterior chamber cell and 2+ flare with
visible iridescent particles, a minimally reactive iris and a dense white cataract with irregular anterior
capsule. The angle appears open on gonioscopy but visualization is limited by the hazy cornea. There
is no view to the fundus; however, B-scan shows a posterior vitreous detachment.
i. What is the most likely diagnosis?
a. Neovascular glaucoma
b. Lens particle glaucoma
c. Phacoanaphylactic glaucoma
d. Phacolytic glaucoma
e. Aqueous misdirection
f. Phacomorphic glaucoma
ii. What is the definitive treatment?
a. Topical aqueous suppression
b. Oral carbonic anhydrase inhibitors
c. Cataract extraction
d. Glycerol
e. Trabeculectomy
iii. Elevated intraocular pressure can increase the chances of developing..
a. expulsive haemorrhage
b. choroidal effusion
c. CMO
d. corneal wound burn
e. (a) and (b)
f. (c) and (d)
5. Ophthalmoplegia is caused by all the following except:
a. An orbital mass
b. Splinting of the optic nerve by optic nerve sheath meningioma
c. Tethering of extraocular muscles or fascia in a blow out fractures
d. Non restrictive myopathy
6. The most common causative organism for these conditions are all the following except.
i. Orbital Cellulitis
a. S Pneumonia
b. S Aureus
c. Diphtheria
d. H Influenza
ii. Acute Bacterial Conjunctivitis
a. S Pneumonia
b. Strep Cocci
c. S Aureus
d. H Influenza
e. Moraxella Catarhalis
7. The causes of lagophthalmos include all except
a. Severe proptosis
b. 3rd nerve palsy
c. Eyelid scarring
d. Following blepharoplasty
8. Choose the correct description about conjunctival discharge
a. Watery discharge occurs in acute viral or chronic allergic conjunctivitis
b. Mucoid discharge is typical of acute allergic conjunctivitis and dry eye
c. Mucopurulent discharge typically occurs in acute viral conjunctivitis
d. Severe purulent discharge is typical of gonocococal infection.
e. Moderately purulent discharge is found in acute bacterial conjunctivitis.
9. Bacterias that are able to penetrate a normal corneal epithelium are the following, except:
a. Pseudomonas Aureginosa
b. N Gonorhea
c. N Meningitidis
d. C Diphtheria
e. H Influenza
10. The systemic disease associated with peripheral ulcerative keratitis includes all the following
except
a. Rheumatoid Arthritis
b. Wegener Granulomatosis
c. SLE
d. Ankylosing Spondilitis
e. Relapsing Polychondritis
11. The complications of Yag laser Capsulotomy include all the following, except
a. Damage to IOL
b. CME
c. Tractional RD
d. IOP elevation
e. Chronic Endopthalmitis
12. What are the risk factors for primary open angle glaucoma?
a. Older individuals
b. Family history of POAG
c. Diabetes Mellitus
d. IOP
e. Hypermetropia
f. Race
13. Neovascular glaucoma occurs after CRVO in interval of
a. From 2 weeks to 2 years
b. From 4 weeks to 2 years
c. From 1 week to 2 years
d. From 2 year to 5 years
14. Regarding phacolytic glaucoma. (all true except)
a. In association with hypermature cataract
b. Is closed angle glaucoma
c. Trabecular obstruction is caused by high molecular wight lens protein
d. Also called lens protein glaucoma
15. Following Hyphaema, secondary hemorhage may develop within
a. 3-5 days of the initial injury
b. 5-7 days of the initial injury
c. 1-2 days of the initial injury
d. 1-2 months of the initial injury
16. Which are the systemic side effects of systemic carbonic acid inhibitors?
a. Paresthesia
b. Gastrointestinal complex
c. Renal Stone formation
d. HypoK
e. Blood dyscrasias
17. Cherry red spot is seen in all except
a. Niemann Pick disease
b. CRAO
c. Tay Sachs disease
d. CRVO
18. A premature baby on examination shows BE ROP (Zone 1 Stage 2 with Plus). How will you
manage the baby?
a. Examine after 1 week
b. Examine after 2 days
c. Laser photocoagulation BE
d. Vitreoretinal surgery
19. Soft exudates are seen in all except
a. Hypertensive Retinopathy
b. CMV retinitis
c. Retinopathy of Prematurity
d. Diabetic Retinopathy
20. Ocriplasmin is a recombinant protease used to treat
a. Retinal break
b. DME
c. Vitreomacular adhesion
d. Submacular bleeding
B) Short answer Questions
1. State the difference between uveitis, endophthalmitis and panophthalmitis.
2. What is your choice of intravenous antibiotics in Orbital Cellulitis and why?
ANSWERS
1. a, d
2. c, f
3. b. c, e
4. d, c, e
5. d
6. c, b
7. b
8. d, e
9. a
10. d
11. c
12. a, b, c, d, f
13. b
14. b
15. a
16. all
17. d
18. c
19. c
20. c
Prepared By,
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