1.
Essential feature of glaucoma is:
Correct Answer
A. Optic neuropathy
Explanation
Glaucoma is a group of eye conditions that damage the optic nerve, leading to vision loss. Optic neuropathy refers to the damage or dysfunction of the optic nerve, which is a key characteristic of glaucoma. Raised intraocular pressure is a risk factor for glaucoma, but not all cases of glaucoma have elevated pressure. Reduced vision is a consequence of optic nerve damage in glaucoma, but it is not a defining feature. Painful eye can occur in some types of glaucoma, but it is not an essential feature and may be absent in many cases.
2.
Which of these is not a feature of ocular hypertension?
Correct Answer
B. Closed angle
Explanation
Closed angle is not a feature of ocular hypertension. Ocular hypertension refers to the increased pressure within the eye, which can lead to glaucoma if left untreated. Elevated intraocular pressure is a characteristic feature of ocular hypertension. Normal visual fields and normal optic discs are also typically seen in ocular hypertension, as these are signs that the increased pressure has not yet caused damage to the optic nerve. However, closed angle refers to a type of glaucoma called angle-closure glaucoma, which is a separate condition from ocular hypertension.
3.
Risk factors for glaucoma include:
Correct Answer
D. All of the above
Explanation
The correct answer is "All of the above." This is because all three options listed - cardiovascular diseases, family history of glaucoma, and hypothyroidism - are known risk factors for glaucoma. Cardiovascular diseases can affect blood flow to the optic nerve, increasing the risk of glaucoma. A family history of glaucoma indicates a genetic predisposition to the disease. Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone, has been associated with an increased risk of developing glaucoma. Therefore, all three factors contribute to the risk of glaucoma.
4.
Which of these is not a likely cause of painful red eye in a
patient?
Correct Answer
B. Closed angle glaucoma
Explanation
Closed angle glaucoma is not a likely cause of painful red eye in a patient. Closed angle glaucoma typically presents with sudden and severe eye pain, blurred vision, and halos around lights, but it does not usually cause redness of the eye. On the other hand, open angle glaucoma, conjunctivitis, and herpes simplex can all cause redness of the eye along with other symptoms.
5.
Drugs that facilitate aqueous humor outflow include:
Correct Answer
D. B and C only
Explanation
Timolol, Pilocarpine, and Epinephrine are drugs that facilitate aqueous humor outflow. Timolol is a beta-blocker that reduces the production of aqueous humor, while Pilocarpine is a cholinergic agonist that increases the outflow of aqueous humor. Epinephrine, on the other hand, stimulates the alpha-adrenergic receptors, leading to vasoconstriction and increased aqueous humor outflow. Therefore, the correct answer is B and C only.
6.
Which one of the following agents lowers intraocular pressure by
reducing aqueous production?
Correct Answer
B. Dorzolamide
Explanation
Dorzolamide is the correct answer because it is a carbonic anhydrase inhibitor that reduces the production of aqueous humor in the eye. By inhibiting carbonic anhydrase, dorzolamide decreases the formation of bicarbonate ions, which in turn reduces the production of aqueous humor and lowers intraocular pressure. Latanoprost, epinephrine, and pilocarpine do not directly reduce aqueous production, but instead work through different mechanisms to either increase outflow or decrease resistance to outflow of aqueous humor.
7.
Which class of drug is the first line of therapy for open angle
glaucoma when no contraindication exists?
Correct Answer
A. ß blockers
Explanation
ß blockers are the first line of therapy for open angle glaucoma when no contraindication exists. These drugs work by reducing the production of aqueous humor, thereby decreasing intraocular pressure. They are effective in managing glaucoma and are often prescribed as initial treatment due to their safety and efficacy. ß blockers can be administered topically as eye drops, making them convenient and well-tolerated by patients. Other classes of drugs, such as a agonists, carbonic anhydrase inhibitors, and prostaglandins, may be used as alternative or adjunctive therapy depending on the individual patient's needs and response to treatment.
8.
Side effects of oral carbonic anhydrase inhibitors include:
Correct Answer
D. All of the above
Explanation
Oral carbonic anhydrase inhibitors are medications that are used to treat conditions such as glaucoma and epilepsy. These medications work by inhibiting the action of an enzyme called carbonic anhydrase. However, they can also have certain side effects. Tingling sensation in the extremities, nausea and vomiting, and fatigue are all potential side effects of these medications. Therefore, the correct answer is "All of the above."
9.
Dorzolamide is a:
Correct Answer
B. Topical carbonic anhydrase inhibitor
Explanation
Dorzolamide is a topical carbonic anhydrase inhibitor. This means that it is a medication that is applied directly to the eye, specifically to reduce intraocular pressure in patients with glaucoma. Carbonic anhydrase inhibitors work by decreasing the production of fluid in the eye, thereby reducing pressure. Since dorzolamide is specifically used as a topical medication for the eye, it is classified as a topical carbonic anhydrase inhibitor.
10.
Which one of the following statements regarding pilocarpine is
true?
Correct Answer
C. It can be employed in the treatment of both open angle and closed angle glaucoma
Explanation
Pilocarpine can be employed in the treatment of both open angle and closed angle glaucoma. This means that it can be used to treat both types of glaucoma, which are different conditions that affect the eye. Open angle glaucoma is a chronic condition where the drainage angle of the eye becomes less efficient over time, leading to increased eye pressure. Closed angle glaucoma, on the other hand, is a sudden and severe form of glaucoma where the drainage angle becomes completely blocked, causing a rapid increase in eye pressure. Pilocarpine can help reduce eye pressure in both types of glaucoma.
11.
Uveo-scleral outflow of aqueous humor is increased by:
Correct Answer
D. Carbonic anhydrase inhibitors
Explanation
Carbonic anhydrase inhibitors increase the uveo-scleral outflow of aqueous humor. Carbonic anhydrase is an enzyme that plays a role in the production of aqueous humor. By inhibiting this enzyme, the production of aqueous humor is reduced, leading to an increase in uveo-scleral outflow. This helps to lower intraocular pressure, making carbonic anhydrase inhibitors a common treatment for glaucoma.
12.
Which of the following are not suitable adjuncts?
Correct Answer
B. Pilocarpine and betaxolol
Explanation
Pilocarpine and betaxolol are not suitable adjuncts because they both belong to different classes of drugs used to treat glaucoma. Pilocarpine is a cholinergic agonist, which works by constricting the pupil and increasing the outflow of aqueous humor. On the other hand, betaxolol is a beta-blocker, which works by reducing the production of aqueous humor. Using these two drugs together may have conflicting effects and could potentially worsen the condition.
13.
In treatment of glaucoma, to achieve better effect blockers can be
combined well with:
Correct Answer
D. Any of the above
Explanation
To achieve better effects in the treatment of glaucoma, blockers can be combined with miotics, topical carbonic anhydrase inhibitors, or prostaglandins. This means that any of these options can be used in combination with blockers to enhance the treatment outcomes for glaucoma.
14.
A 75 year old lady with a long standing history of asthma
treated with steroids presents to the clinic because of decreased
vision. She is found to have posterior capsular opacities as well as an
intraocular pressure of 28 mmHg. Which of the following medication
should be prescribed?
Correct Answer
C. Latanoprost
Explanation
Latanoprost should be prescribed because the patient has increased intraocular pressure, which is a symptom of glaucoma. Latanoprost is a medication used to treat glaucoma by reducing intraocular pressure. The other options, Timolol and Pilocarpine, are also used to treat glaucoma, but Latanoprost is the most effective in lowering intraocular pressure. Therefore, it is the most appropriate medication to prescribe for this patient.
15.
Neuroprotection is well established with:
Correct Answer
B. Brimonidine
Explanation
Brimonidine is well established for neuroprotection. This means that it has been proven to protect the nerves in the body, particularly in the case of certain medical conditions or treatments. It is likely that studies or research have shown that brimonidine has a positive effect on neuroprotection, making it a reliable option for this purpose.