1.
Vitamin A is essential in the function of which of the following eye components?
Correct Answer
A. Rods
Explanation
Vitamin A is essential in the function of rods, which are a type of photoreceptor cells in the retina of the eye. Rods are responsible for vision in low light conditions and are important for peripheral vision. Vitamin A is necessary for the production of a pigment called rhodopsin, which is found in the rods and is crucial for the absorption of light and the initiation of the visual process. Without sufficient vitamin A, the rods cannot function properly, leading to impaired vision, particularly in dim lighting.
2.
What is the pathophysiology of chalazion?
Correct Answer
A. Chronic irritation and granuloma formation of a mebomian gland
Explanation
The pathophysiology of chalazion involves chronic irritation and granuloma formation of a meibomian gland. The meibomian glands are located in the eyelids and produce an oily substance that helps lubricate the eyes. When there is chronic irritation or blockage of the gland, it can lead to the formation of a chalazion. This is characterized by the accumulation of inflammatory cells and granulation tissue around the blocked gland, resulting in a painless, firm, and non-infectious lump on the eyelid.
3.
Through what structure does the aqueous humor in the posterior chamber pass to reach the anterior chamber of the eye?
Correct Answer
A. Pupil
Explanation
The pupil is the correct answer because it is the opening in the center of the iris that allows light to enter the eye. The aqueous humor, a clear fluid, flows through the pupil from the posterior chamber to the anterior chamber of the eye.
4.
A 19 year old college freshman comes to the student health center complaining of fever and headache. She had been in her usual good state of health until that morning, when she developed a fever to 103F that didn't improve with acetaminophen. On exam the patient is alert and oriented, complaining that light hurts her eyes. What physical exam will be MOST useful to guide your next steps?
Correct Answer
D. Fundoscopic exam for papilledema
Explanation
The most useful physical exam to guide the next steps in this case would be a fundoscopic exam for papilledema. The patient's complaint of headache, fever, and sensitivity to light, along with the lack of improvement with acetaminophen, suggests the possibility of increased intracranial pressure. Papilledema, which is swelling of the optic disc, can be an indication of increased intracranial pressure. Therefore, a fundoscopic exam would be essential in assessing for this finding and determining the appropriate course of action.
5.
A ten year old girl is brought to urgent care with complaint of swollen eye. What clinic strongly suggest this is orbital cellulitis rather than pre-septal cellulitis?
Correct Answer
A. Eye movement is painful
Explanation
The presence of painful eye movement suggests that the inflammation is occurring within the orbit (eye socket), rather than in the tissues in front of the orbital septum (pre-septal). In orbital cellulitis, the infection can spread to the muscles and tissues surrounding the eye, causing pain and limited movement. This is a more serious condition compared to pre-septal cellulitis, which typically presents with eyelid swelling but without painful eye movement. The other symptoms mentioned, such as fever, difficulty opening the eye, and red conjunctiva, can also be present in both conditions but do not specifically differentiate between orbital and pre-septal cellulitis.
6.
Which of the following on physical exam BEST indicates post-septal cellulitis?
Correct Answer
A. Extraocular eye motions limited by pain
Explanation
Post-septal cellulitis refers to an infection that occurs behind the orbital septum, which is a thin layer of tissue that separates the anterior and posterior parts of the eye. Extraocular eye motions limited by pain would indicate post-septal cellulitis because the infection can cause inflammation and swelling of the muscles that control eye movements, leading to restricted motion and discomfort. This symptom is specific to post-septal cellulitis and helps differentiate it from other conditions. The other options may be seen in various eye infections or inflammations but are not specific to post-septal cellulitis.
7.
Which of the following symptoms or signs BEST matches the diagnosis of dacryostenosis?
Correct Answer
A. Tears overflowing the eye margin
Explanation
dah cryer got stenosis
8.
Which of the following is MOST LIKELY represents an allergic, rather than infectious, condition of the eye?
Correct Answer
A. Itching
Explanation
Itching is most likely to represent an allergic condition of the eye rather than an infectious one. Allergies can cause itching in the eyes due to the release of histamines, which can lead to discomfort and irritation. Infectious conditions may also cause itching, but it is more commonly associated with allergies.
9.
What is the treatment for most hordeolums?
Correct Answer
A. Warm moist compress
Explanation
hordeolum is infection of perfollicular gland (like a pimple)
10.
A patient who does not wear contact lenses complains of gradual onset over the past 24 hours of the left eye pain and photophobia. On fluorescein exam of the cornea you see tiny linear epithelial defect in the cornea. The pupil is reactive to light. The MOST likely diagnosis is
Correct Answer
A. Corneal abrasions
Explanation
The patient's symptoms of left eye pain and photophobia, along with the finding of a tiny linear epithelial defect on fluorescein exam of the cornea, suggest a diagnosis of corneal abrasions. Corneal abrasions are typically caused by trauma to the cornea, such as a scratch or foreign body, and can result in symptoms such as pain, light sensitivity, and blurred vision. The absence of contact lens wear and the reactive pupil make other causes such as herpes virus infection, Chlamydia trachomatis infection, corneal ulceration, and pterygium less likely in this case.
11.
Which of the following is a post-inflammatory granuloma that creates a firm nodule pointing to the inside of the eyelid, often irritating the eye every time it blinks?
Correct Answer
A. Chalazion
Explanation
A chalazion is a post-inflammatory granuloma that forms when the meibomian gland in the eyelid becomes blocked. It creates a firm nodule that points towards the inside of the eyelid, causing irritation every time the eye blinks. This condition is commonly seen in individuals with chronic blepharitis or meibomian gland dysfunction. The other options listed, such as infected meibomian gland, pinguecula, pterygium, and blocked tear duct, do not match the description provided for a chalazion.
12.
When placing cocaine eye drops in the eye to help diagnose Horner’s syndrome, why does it take at least an hour before effect on the pupil can be seen?
Correct Answer
A. Cocaine is an indirect agonist
Explanation
Cocaine being an indirect agonist means that it enhances the release or inhibits the reuptake of neurotransmitters. In the case of diagnosing Horner's syndrome, cocaine acts by blocking the reuptake of norepinephrine, leading to increased levels of the neurotransmitter. This increased norepinephrine then stimulates the dilator muscle of the iris, causing dilation of the pupil. However, it takes at least an hour for this effect to be seen because cocaine is rapidly taken up into presynaptic vesicles, which delays its action on the pupil.
13.
Which of the following drugs acts as a direct alpha adrenergic receptor agonist in the eye?
Correct Answer
A. Apraclonidine
Explanation
no cocaine test. Horners. Amphenamine test would show pre-ganglionic horners issue
14.
A pt with bells palsy is using prednisone and acyclovir in order to help the pressure on nerve, everytime they eat they cry, what is going on?
Correct Answer
A. Re-routing of CN 7 from salivary gland to lacrimal gland where CN 5 is
Explanation
CN 7 causes jaw movement helping with secretion at the superior salivary nucleus
15.
Which structure protects the eye from infection
Correct Answer
A. Periosteum
Explanation
The periosteum is a protective layer that covers the outer surface of the eye socket, providing a barrier against infection. It helps to prevent bacteria or other pathogens from entering the eye and causing an infection. The nose, lacrimal bone, and ethmoid bone do not directly protect the eye from infection, making them incorrect options.
16.
Which structure of the eye holds the lens in place and causes the lens to change shape
Correct Answer
A. Ora serrata
Explanation
The ora serrata is the structure of the eye that holds the lens in place and causes the lens to change shape. It is located at the front of the retina, where the retina meets the ciliary body. The ciliary body is responsible for controlling the shape of the lens, allowing it to focus on objects at different distances. Therefore, the ora serrata plays a crucial role in the process of accommodation, which is the ability of the eye to adjust its focus.
17.
Where does the inferior oblique muscle originate in the eye
Correct Answer
A. Maxilla (orbital surface)
Explanation
The inferior oblique muscle originates in the eye from the maxilla, specifically the orbital surface of the maxilla.
18.
Cranial nerve 6 motor function is
Correct Answer
A. Lateral rectus
Explanation
LR6 SO4
19.
Cranial nerve 4 motor function
Correct Answer
A. Superior oblique
Explanation
LR6 SO4
20.
A pt comes to the office worried they are having a stroke. Their left eyelid is drooping however they can still open the eye, the same side of face is not sweating and is flushed, and their pupil is constricted whereas the right pupil is dilated. What is likely the cause?
Correct Answer
A. Horners syndrome
Explanation
this is due to a loss of sympathetic responce in the face. proptosis is eye pressure bulge,
21.
A pt has burning, very red eyes with watery discharge in both eyes, swollen preauricular lymph, and follicular conjunctiva which is likely the cause
Correct Answer
A. Chlamydia
Explanation
viral conjuctivitis. Key points one eye is likely more bacterial, nonfollicular, discharge will reappear after wiping and is thick
22.
Pt presents with r eye pain and discharge. they use extended wear contact lenses. there is thick, globular, yellow discharge in the medial part of the eye corner and lid margins. the cornea is ulcerated and scleral injection. what is the diagnosis
Correct Answer
A. Pseudomonal keratitis
Explanation
corneal ulcer big white spot over eye. Scleral injection means bloodshot eyes from conjunctival vessels over sclera
23.
Where does aqueous fluid for the eye come from
Correct Answer
A. Ciliary process in posterior
Explanation
The aqueous fluid for the eye comes from the ciliary process in the posterior part of the eye. The ciliary process is responsible for producing the aqueous humor, which is a clear fluid that fills the front part of the eye. This fluid helps maintain the shape of the eye and provides nutrients to the cornea and lens.
24.
Vitreous gel has an area that keeps it tethered
Correct Answer
A. Hyaloid canal
Explanation
The hyaloid canal is a structure that runs through the vitreous gel in the eye. It acts as a tether, keeping the vitreous gel in place and preventing it from moving around too much within the eye. This helps to maintain the overall stability and structure of the eye, ensuring that the vitreous gel does not detach or cause any damage to other parts of the eye.
25.
Which neuron senses color
Correct Answer
A. Cones
Explanation
Cones are the neurons in the retina of the eye that are responsible for sensing color. They are highly sensitive to different wavelengths of light and are concentrated in the central part of the retina, called the fovea. Cones contain different pigments that allow them to detect and respond to specific colors, such as red, green, and blue. This enables us to perceive a wide range of colors and have color vision. Unlike rods, which are responsible for vision in low light conditions, cones are specifically specialized for color perception.
26.
In the retina Rhodopsin is created by
Correct Answer
A. Transforming Vitamin A into retinal and attaching it to opsin protein
Explanation
In the retina, rhodopsin is created by transforming Vitamin A into retinal and attaching it to opsin protein. Rhodopsin is a pigment found in the rod cells of the retina that is responsible for vision in low light conditions. The process of converting Vitamin A into retinal involves a chemical reaction that allows the retinal to bind with the opsin protein, forming rhodopsin. This transformation is essential for the functioning of the visual system and the perception of light.
27.
Color blindness is a disorder due to
Correct Answer
A. Rhodopsin having no vitamin A responce
Explanation
Color blindness is a disorder caused by the absence of a proper response from rhodopsin, a pigment found in the rods and cones of the eye. Rhodopsin is responsible for detecting different wavelengths of light, which allows us to perceive colors. However, when there is no response from rhodopsin due to a deficiency in vitamin A, the brain is unable to interpret the detected color information, resulting in color blindness.
28.
What if each pupil constricts when you shine a light into it separately, but there is no consensual response? where is the problem?
Correct Answer
A. ED
Explanation
The problem is likely cranial nerve 3 damage. Cranial nerve 3 is responsible for controlling the pupillary constriction in response to light. If each pupil constricts when light is shone into it separately but there is no consensual response, it suggests that the cranial nerve 3 is not functioning properly. This could be due to damage to the nerve, leading to a loss of bilateral field of vision.