Ophthalmology

Question 1

Painful red eye, decreased visual acuity, haloes, semi-dilated pupil

Answer 1

Acute angle closure glaucoma

Question 2

Painful red eye, blurred vision, photophobia, small fixed pupil

Answer 2

Anterior uveitis

Question 3

Painful, tender, red eye, pain worse on movement

Answer 3

Scleritis

Question 4

Painful red eye, visual loss, post intraocular surgery

Answer 4

Endophthalmitis

Question 5

Peripheral visual field loss, decreased visual acuity, optic disc cupping + pallor

Answer 5

Primary open angle glaucoma

Question 6

Flashes in periphery, floaters on temporal side

Answer 6

Post vitreous detachment

Question 7

Shadow progressing towards central vision

Answer 7

Retinal detachment

Question 8

Sudden visual loss or dark spots, diabetes/anticoagulants

Answer 8

Vitreous haemorrhage

Question 9

Cherry red spot on pale retina, afferent pupillary defect, acute vision loss

Answer 9

Central retinal artery occlusion

Question 10

Retinal haemorrhages, HTN/polycythaemia, acute vision loss

Answer 10

Central retinal vein occlusion

Question 11

Amaurosis fugax (curtain coming down), acute vision loss

Answer 11

Ischaemic - atheroma/embolus/optic neuropathy/vasculitis/TIA

Question 12

Unilateral dilated pupil, slowly reactive to accommodation

Answer 12

Holmes-Adie pupil, can be associated with absent ankle/knee reflexes (H-A syndrome)

Question 13

Constricted pupil, irregular shape, no light reflex, brisk accommodation

Answer 13

Argyll-Robertson. DM/syphilis.

Question 14

Microaneurysm, blot haemorrhages, cotton wool spots, venous beading

Answer 14

Moderate non proliferative diabetic retinopathy

Question 15

Blot haemorrhages and microaneurysms in 4 quadrants, venous beading in 2 quadrants

Answer 15

Severe non proliferative diabetic retinopathy

Question 16

Retinal neovascularisation, vitreous haemorrhage, fibrous tissue ant to retinal disc, DM

Answer 16

Proliferative diabetic retinopathy

Question 17

Miosis, ptosis, enophthalmos, anhidrosis face, arm and trunk

Answer 17

Central horner’s - stroke, syringomyelia, MS, tumour

Question 18

Miosis, ptosis, enophthalmos, anhidrosis of face only

Answer 18

Pre-ganglionic horner’s - Pancoast’s tumour, thyroidectomy, trauma, cervical rib

Question 19

Miosis, ptosis, enophthalmos, no anhidrosis

Answer 19

Post-ganglionic horner’s - carotid artery dissection, carotid aneurysm, cavernous sinus thrombosis, cluster headache

Question 20

Arteriolar narrowing and tortuosity, silver wiring

Answer 20

Stage 1 hypertensive retinopathy

Question 21

Arteriovenous nipping

Answer 21

Stage II hypertensive retinopathy

Question 22

Cotton-wool exudate, flame and blot haemorrhages

Answer 22

Stage III hypertensive retinopathy

Question 23

Papilloedema

Answer 23

Stage IV hypertensive retinopathy

Question 24

Painful red eye, photophobia, foreign body sensation

Answer 24

Keratitis - Staph aureus, pseudomonas in contact lens wearers, amoebic if soil/water exposure, HSV