Ophthalmology MCQ Flashcards
(29 cards)
A 4 year old presents to clinic with irritation and mild photophobia to the right eye. He is rubbing it repeatedly because he feels there is something in the eye. On exam, there is inflammation to the right upper eyelid with some crusting to the base of the eyelashes with no conjunctivitis.
What is the most likely diagnosis?
A) Chalazion
B) Dacryocystitis
C) Corneal abrasion
D) Blepharitis
Blepharitis
4 year old boy is a refugee who arrived from Subsaharan Africa. On exam, you find out there is decreased visual acuity in the left eye and there is corneal scarring on the same eye. What is the most likely cause?
A. Retinopathy of prematurity
B. Vitamin A deficiency
C. Glaucoma
D. Congenital toxoplasma
Vitamin A deficiency
When should you start screening for visual acuity?
0-12 months
1-3 years
3-5 years
5-7 years
3-5 years
Child with photophobia, squinting and tearing. Rt pupil bigger than left. Watery discharge and conjunctival injection of Rt eye. They are afebrile. Normal pupillary response and EOM but cornea is cloudy. What is the most likely diagnosis:
A) cataract
B) orbital cellulitis
C) glaucoma
D) uveitis
glaucoma
8yo boy with right sided eye pain. There is no proptosis and he has full, non-painful EOM. There is mild conjunctival injection and hyperemia. He has decreased visual acuity and corneal clouding. The left side is non-painful with mild conjunctival injection and hyperemia. What is the best treatment?
A. Anti-histamines
B. Methylprednisolone
C. Azathioprine
D. Psychotherapy
Methylprednisolone
9 month old with seizure at home. In ED was mildly hypotonic. Fundoscopy shows (picture below). What is the most likely diagnosis?
A. Abusive head trauma (AHT)
B. Toxoplasmosis
C. Tay-sachs
D. Sturge weber
Abusive head trauma (AHT)
8 year old with bilateral conjunctivitis. Received topical antibiotics with no improvement. Does not describe pain, but a sandpaper feeling foreign body feeling. He has associated photophobia and tearing. On exam, there are pseudomembranes. What is the most likely diagnosis?
A. Adenovirus keratoconjunctivitis
B. Allergic conjunctivitis
C. Bacterial conjunctivitis
D. Anterior uveitis
Adenovirus keratoconjunctivitis
12 yo boy has right eye pain after sweeping plaster fragments at home. Fluorescein drops show fluorescein uptake to 1 and 3 o clock of the right eye. Management?
A. Topical anesthetic
B. Topical antibiotics x 1 week
C. Antibiotic ointment with eye patch
D. Evert right upper eyelid to look for foreign body
Evert right upper eyelid to look for foreign body
6 month old with unilateral L congenital cataract of left eye. Parents have noticed a change in iris color from brown to beige in the L eye. Otherwise no other symptoms. Non dysmorphic. Normal eye movements, no pain, no conjunctival injection. Pupil is slightly larger on the left but reactive. What is the diagnosis?
A. Glaucoma
B. Retinoblastoma
C. Simple Heterochromia
D. CMV Chorioretinitis
Retinoblastoma
Teenager who wears contact has conjunctivitis and purulent discharge of one eye. He is started on topical ciprofloxacin drops. He returns 36 hours later with no improvement. What is the next step?
Switch to fucidic acid eye drops
Tell them to continue and reassess in 48 hr
Send to Ophthalmology clinic
Admit + IV Ceftriaxone
Send to Ophthalmology clinic
Baby with truamatic birth. Otherwise okay. Description of complete brachial plexus injury including horners - next step:
a. Physiotherapy
b. CT c spine and thorax
c. MR brain
d. urine catecholamines
Physiotherapy
Kid with orbital cellulitis of the right eye being treated with ceftriaxone. Next day lethargic and swelling/erythema of the left eye develops. What do you do?
A. Add vancomycin
B. Consult surgery to drain an orbital abscess
C. MRI brain
Add vancomycin
Child with symptoms consistent with orbital cellulitis. What should be done?
a. IV Ceftriaxone
b. surgical drainage
c. PO clindamycin
IV Ceftriaxone
A 10 year old boy comes to the emerg with eye pain. On exam, there is conjunctival injection and tearing of the eye. There is no purulent discharge. There is no periorbital rash. He has a cold sore on his lip. What is the next step in management?
a. Do a slit lamp exam with fluorescein
b. Prescribe polytrim eye drops
c. Prescribe topical steroid eye drops
Do a slit lamp exam with fluorescein
A 29+2 week GA infant in the NICU. When should ROP screening start?
a) 31 weeks
b) 32 weeks
c) 33 weeks
d) 34 weeks
33 weeks
10 year old girl diagnosed with optic neuritis 3 months ago. She is currently asymptomatic. How do you counsel her mother:
a. Chance of recurrence is low
b. The gamma globulin she received protects against recurrence
c. Risk of macular degeneration
d. She is at significant risk of developing MS
She is at significant risk of developing MS
Who is most at increased risk of glaucoma?
a. Infant who had congenital cataracts surgically removed
b. Infant with cystinosis
c. A child with trisomy 21 who has Brushfield spots
d. A child who has had laser surgery for myopia
Infant who had congenital cataracts surgically removed
When is it indicated an eye screening in newborn?
A. Newborns <31 weeks or <1250g
B. Newborns < 1500gr
C. Patients who had received Indo and ibuprofen treatment and are less than <31 weeks
D. Newborns <31 weeks
Newborns <31 weeks or <1250g
Cataracts picture above from boy immigrated from India. What is the most likely cause?
a) Rubella
b) Galactosemia
c) Idiopathic
d) Cystinosis
Rubella
Classic triad: Cataracts, PDA, SNHL
4 year old with loss of vision, bilateral eye injection, iris fused (sounded like uveitis): treatment ?
a) oral steroids
b) topical steroids
oral steroids
A 3 month old baby presents with a chronic history of mucopurulent discharge from one eye and occasional crusting from the other eye. The conjunctiva are not red. What do you do:
a. Refer to ophthalmology
b. Dacryocystectomy
c. Nothing
d. Antimicrobial eyedrops
Antimicrobial eyedrops
3 mo mucoid discharge from left eye and yellow crusting from other eye. Conjunctiva normal. What do you do?
a. refer to ophthalmologist
b. reassure
c. give antibiotic drops
reassure
Child with hyphema, when is rebleeding most likely to occur
a. 24 h
b. 4 days
c. 1 week
d. 2 week
4 days
8 year old with red eye for 3 days with clear, mucoid discharge. No visual symptoms, no
proptosis, and other eye is not affected. Few family members had same symptoms that resolved last week. You should:
a. supportive treatment only
b. topical polymyxin eye drops
c. ciprofloxacin eye drops
d. topical steroid
supportive treatment only
