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BAPS 2014A
11. The most common mechanism identified in patients with primary angle closure
glaucoma:
A. Pupillary block iris dilates, pupil dilates, then it crowds out the angle, and the
pressure can go up
B. Plateau iris
C. Angle recession
D. retinal detachment
*Normally, lights off pupil dilates, angles close; lights off pupils constrict, angles open.
12. A 35 year old male came in for a comprehensive eye examination as part of his
annual eye check. The following were the significant eye findings: unremarkable family
and past health history, visual acuity _____ on both eyes, suspicious visual field damage
on both eyes, suspicious nerve cupping on both eyes, IOP 23 mmHg on both eyes, and
asymptomatic. The most likely diagnosis would be:
A. Glaucoma suspect
B. Acute angle closure glaucoma
C. Secondary open angle glaucoma
D. Error of refraction
Glaucoma suspects: No Glaucoma; Pressure suspiciously high for the eye; suspicious
optic nerve damage; suspicious visual field damage
13. Position of papillomacular nerve bundle as it exits the globe
A. Nasal aspect of optic n.
B. Temporal aspect of optic n.
C. Central aspect of optic n.
D. Inferior aspect of optic n.
14. Optic nerve is made up of axons arising from:
A. Retinal ganglion cells
B. Photoreceptors
C. Pigment epithelium
D. Outer plexiform layer
15. Visual field defect in optic chiasm involvement
A. Central scotoma
B. temporal arcade defect
C. Altitudinal defect
D. Bitemporal hemianopsia
16. Length of the optic nerve
A. 30-40mm
B. 40-50mm
C. 50-60mm
D. 10-30mm ?
Intraorbital portion: 25-30mm (longest portion)
Intracanalicular portion: 4-9mm
Intracranial portion: 10mm
17. What is the reason for pain on movement of the eyeball in optic neuritis?
A. Extraocular muscles end close to swalbes line
B. Extraocular muscles converge in the annulus of rinn that surrounds optic nerve
C. Part of the inflammation of the optic nerve
D. Due to swollen nerves
18. Where do you see the thickest portion of the intraocular portion of the optic nerve
head?
A. superior
B. nasal
C. inferior and superior portion
D. superior and temporal portion
19. What is the longest portion of the optic nerve?
A. intraocular
B. intraorbital
C. intracanalicular - shortest
D. intracranial
20. What blood vessel when blocked produces an altitudinal defect?
ANS: Posterior Ciliary Artery
21. Occlusion of what blood vessel produces the cherry red spot?
A. Anterior choroidal artery
B. long ciliary artery
C. Central retinal artery
D. Short ciliary artery causes anterior ischemic optic neuropathy
22. What is the most distinguishing characteristic differentiating papillitis from
papilledema?
A. Disc edema
B. loss of SVP
C. Vision loss acute loss of vision within 1-5 days from onset of
inflammation
D. Ptosis
Papillitis: Dull pain of involved eye on movement ; Almost always unilateral in adults;
always bilateral in children
Papilledema: bilateral; progressive headache, projectile vomiting
23. The choice of treatment for acute optic neuritis
ANS: IV Methylprednisone then oral prednisone
24. What is the best management for a patient diagnosed to have papilledema?
A. MRI of the brain and orbits
B. CT scan of the brain
C. Immediate hospitalization always an emergency
D. Refer to a neurologist
*Do immediate hospitalization and refer to a neurologist for confinement and joint
management
25. Versus direct ophthalmoscopy, indirect ophthalmoscopy has the following advantage:
A. Upright image
B. Larger magnification
C. Wider field of view
D. Absence of depth perception
26. A painful end-stage complication of advanced vascular retinopathies brought on by
progressive retinal ischemia:
A. Neovascularrubeotic glaucoma
B. Tractional retinal detachment
C. Vitreous hemorrhage
D. Absence of depth of perception
27. Which of the following is a known risk factor for retinal detachment?
A. Malay race
B. male sex
C. Presbyopia
D. Myopia
28. A 57 year old man complains of flashing lights and a shade of darkness over his
inferior nasal quadrant in one eye. On exam the VA in this eye is 20/20. You found the
pressure a little lower on the affected eye and pigment cells behind the crystalline lens.
What condition would lead you to perform immediate surgical intervention?
A. Macula-off rhegmatogenous retinal detachment
B. Epi-retinal membrane involving the macula
C. Dense vitreous hemorrhage in the inferior nasal quadrant
D. Mid-peripheral horseshoe retinal tear with surrounding sub-retinal fluid
(macula-on)
* Rhegmatogenous retinal detachment you see vestiges of a flap; posterior edge is
being rolled in itself; Macula on detachment is considered an emergency because you
need to save the macula to preserve the eyesight
29. Put the following retinal layers in order from inside (next to vitreous) to outside:
A. Ganglion cells, photoreceptors, choroid, then sclera on the outside
B. Photoreceptors, ganglion cells, choroid, then sclera on the outside
C. Choroid, photoreceptors, ganglion cells, then sclera on the outside
D. Choroid, ganglion cells, photoreceptors, then sclera on the outside
30. The most common cause of visual loss in diabetic retinopathy is:
A. Macular edema
B. Vitreous hemorrhage
C. Acute neovascular glaucoma
D. Traction retinal detachment
31. Proliferative diabetic retinopathy denotes presence of:
A. Hard lipid exudates consequence of chronic leakage in diabetic retinopathy
B. Retinoblastoma
C. PHPV
D. Retinopathy of prematurity
47. A 6 month old infant born to an alcoholic was rushed to the ER with depressed
sensorium. Upon retinal examination, patient had retinal hemorrhages. A CT scan was
done and a subdural hematoma was seen. The most likely diagnosis:
A. leukemia
B. Vitamin K deficiency
C. Shaken baby syndrome
D. Von Willebrand disease
48. A remnant of the hyaloids artery that would present as leukocoria is due to:
A. Congenital cataract
B. PHPV
C. Retinopathy of prematurity
D. Retinoblastoma
49. Which sequence of visual axis structures from anterior to posterior is correct?
A. Optic nerve, vitreous, lens, anterior chamber, pupil, cornea, tear film
B. Tear film, camera, lens, pupil, vitreous, retina, and optic nerve
C. Optic nerve, retina, lens, pupil, anterior chamber, cornea, tear film
D. tear film, cornea, anterior chamber, pupil, lens, vitreous, optic nerve
50. 70 year old, with cherry red spots, pale retina and blurring of vision
A. Cataracts
B.Central retinal vein occlusion
C. Primary open angle glaucoma
D. Central retina artery occlusion
51. A 70 year old female diabetic patient complains of progressive painless BOV
described as cloudiness with monocular diplopia and glare. The primary consideration is:
A. Cataract most common cause of monocular diplopia presenting with clouding of
vision with color vision abnormalities.
B. Anterior chamber optic neuropathy
C. Age-related macular degeneration distorted vision or metamorphosia
D. Intermittent angle closure glaucoma painful BOV
54. This sign commonly occurs in uveitis
A. Miotic pupil
B. mid- dilated nonreactive pupil Acute Angle Closure Glaucoma
C. Iridodialysis Traumatic hyphema
D. AOTA
Better absorbed drugs: lipid soluble, non-ionized, water soluble, more viscous, presence
of surfactants and polymers.
87. Medications have to pass through this barrier formed by the nonpigmented ciliary
epithelium and endothelium of the iris vessels to attain therapeutic intraocular
concentrations:
A. Corneal barrier
B. blood aqueous barrier
C. Blood retinal barrier junction between retinal pigmented epithelium & retinal
vessel endothelium
D. Episcleral vessel wall
Question 88-90.
88. A 20 year old male patient consults at the OPC because of BOV for near vision of the
right eye 4 days after applying 3 days of self-prescribed eye medications in a red-capped
bottle. On examination you note anisocoria with a dilated non-reactive pupil on the right
eye. The eye medication used is most likely:
A. Phenylephrine
B. Tropicamide
C. Atropine long-acting; anisocoria & dilated non-reactive pupil observed even
days after appn
D. Combination of Phenylephrine and Tropicamide
89. The patient begins to complain of headache, eye pain and worsening BOV the
following day. He notes halos and colors around light. A few hours later he begins to
experience nausea and vomiting because of worsening right-sided headache. He is
transferred to the ER and initial examination reveals a hazy cornea OD and shallow
anterior chambers OU on oblique penlight test. The patient most likely developed:
A. Hypersensitivity reaction
B. Acute angle closure glaucoma
C. Migraine
90. His condition deteriorated and he was weak and obtunded. Tonometry revealed an
IOP of OD50 and OS19. Initial management at the ER:
A. Acetazolamide
B. glycerin
C. Mannitol used to lower IOP in AACG by dehydrating vitreous body
D. Propacainex
91. A 35 year old consults at the OPC because of painless progressive BOV. Patient was
prescribed with
93. A glaucoma patient treated with anti-glaucoma eye drops on right eye develops
redness and itchiness OD. You note that his right eye has palpebral conjunctival injection
with papillary reaction. This is most likely:
A. Betaxolol
B. brinzolamide
C. Brimonidine side effects include allergic or papillary conjunctivitis (presents
with redness, itchiness and papillary reaction)
D. Bimatoprost