Practice Test Missed Questions Flashcards by McKenna Scott

Which of the following tests measures an ocular deviation under associated conditions?
A) Von Graefe phoria
B) Cover test
C) Maddox rod
D) Fixation disparity

D) Fixation disparity

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All of the following are adverse effects of tetracyclines EXCEPT:
A) pigmented conjunctival cysts
B) ototoxicity
C) discoloration of teeth
D) pseudotumor cerebri

B) ototoxicity

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Which of the following ophthalmic dyes is MOST appropriate to evaluate corneal epithelial defects?
A) Fluorescein
B) Rose bengal
C) Lissamine green
D) Methylene blue

A) Fluorescein

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A patient complains that her frame is constantly falling down her nose. All of the following frame adjustments may help to tighten the frame on the nose except:
A) pull in the temples
B) tilt the nose pads down
C) bend the temple tips down
D) pull the nose pads out

D) pull the nose pads out

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Which of the following pathways carries information regarding touch, pressure, and vibration?
A) Medial lemniscus
B) Tectospinal
C) Trigeminothalamic
D) Spinothalamic

A) Medial lemniscus

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All of the following structures are located in the middle ear EXCEPT:
A) Tympanic cavity
B) Tensor tympani muscle
C) Semicircular canals
D) Stapedius muscle
E) Malleus, incus, and stapes bones

C) Semicircular canals

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Sensitivity is defined as the:
A) probability the patient does not have the disease given the test is negative
B) ability of a test to accurately detect the patient has the disease
C) ability of a test to accurately detect the patient does not have the disease
D) probability the patient has the disease given the test is positive

B) ability of a test to accurately detect the patient has the disease

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Which of the following statements correctly describes the net movement of K+ ions in the cornea?
A) Moved from the stroma into the aqueous humor
B) Moved from tears into the epithelial cells
C) Moved from the epithelial cells into the tears
D) Moved from the endothelial cells into the aqueous humor

A) Moved from the stroma into the aqueous humor

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Meibomian glands secrete meibum through which of the following methods?
A) Exocytosis
B) Apocrine
C) Holocrine
D) Merocrine

C) Holocrine

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Which of the following arteries does NOT directly contribute to the Circle of Willis?
A) Posterior cerebral
B) Anterior communicating
C) Internal carotid
D) Vertebral

D) Vertebral

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The parvocellular pathway in the visual system is responsible for all of the following functions EXCEPT:
A) perception of object shape
B) detection of color
C) detection of detail
D) perception of object size
E) detection of motion

E) detection of motion

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All of the following structures are located within the iris stroma EXCEPT the:
A) major arterial circle
B) minor arterial circle
C) sphincter muscle
D) long posterior ciliary nerves

A) major arterial circle

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Color vision is determined by which of the following responses?
A) The relative responses of photoreceptors based on the number of photons absorbed
B) The relative responses of photoreceptors based on the wavelengths of light absorbed
C) The total number of photons absorbed by a single photoreceptor
D) The wavelength of a photon absorbed by a single photoreceptor

A) The relative responses of photoreceptors based on the number of photons absorbed

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Which of the following lesions is the MOST common benign orbital tumor in children that may cause deprivation amblyopia?
A) Neuroblastoma
B) Cavernous hemangioma
C) Rhabdomyoscarcoma
D) Capillary hemangioma

D) Capillary hemangioma

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When measuring the back vertex power of a right spectacle lens on the lensometer, the clinician notes the center of the mires falls to the right of the bulls-eye target. What direction of prism is in the spectacles?
A) base out
B) base up
C) base in
D) base down

C) base in

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Fibers from which of the following sub-nuclei of cranial nerve III innervate the contralateral extraocular muscle?
A) medial rectus
B) inferior oblique
C) superior rectus
D) inferior rectus

C) superior rectus

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Carbon dioxide may be transported from tissues to the lungs through all of the following methods EXCEPT:
A) in the form of bicarbonate
B) bound to hemoglobin
C) in the form of carbonic acid
D) dissolved within blood plasma

C) in the form of carbonic acid

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Which portion of the nasolacrimal system is surrounded by the muscle of Horner that aids in tear drainage?
A) canaliculi
B) lacrimal sac
C) lacrimal puncta
D) nasolacrimal duct

A) canaliculi

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What is the most common site of metastasis for a choroidal melanoma?
A) kidneys
B) lungs
C) heart
D) liver

D) liver

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Which of the following corneal stromal dystrophies is unrelated to a mutation in the TGFB1 gene?
A) Granular
B) Lattice
C) Avellino
D) Macular

D) Macular

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Which of the following blood vessels supplies the intraocular optic nerve?
A) internal carotid artery
B) central retinal artery
C) short posterior ciliary arteries
D) pial mater arterial plexus

C) short posterior ciliary arteries

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Which of the following retinal layers contains the cell bodies of the photoreceptors?
A) photoreceptor
B) inner nuclear
C) outer nuclear
D) outer plexiform
E) inner plexiform

C) outer nuclear

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Binocular visual processing begins at which of the following locations within the visual pathway?
A) LGN cells
B) visual cortex
C) retinal ganglion cells
D) optic chiasm

B) visual cortex

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Which of the following immunoglobulins is involved in type 1 anaphylactic hypersensitivity reactions?
A) IgE
B) IgD
C) IgA
D) IgM

A) IgE

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``` The superior optic radiations travel through which of the following cerebral lobes BEFORE reaching the visual cortex of the occipital lobe? A) lateral geniculate B) temporal C) frontal D) parietal ```

D) parietal

Type 2 diabetes mellitus is caused by which of the following 2 etiologies? SELECT 2 A) insulin resistance B) destruction of beta cells in the pancreas C) abnormal beta cell secretion of insulin D) destruction of alpha cells in the pancreas

A) insulin resistance | C) abnormal beta cell secretion of insulin

``` Which of the following molecules maintains open Na+ channels to promote constant depolarization of the photoreceptors? A) ATP B) cAMP C) cGMP D) K+ ```

C) cGMP

``` Which of the following drugs may cause secondary angle closure by causing choroidal swelling? A) Fluoxetine B) Diphenhydramine C) Topiramate D) Chlorpromazine ```

C) Topiramate

``` Which of the following types of herpes simplex stromal keratitis is due to indirect invasion of the virus in the corneal stroma? A) Dendritic B) Interstitial C) Disciform D) Necrotizing ```

D) Necrotizing

``` Which of the following steroids is LEAST likely to cause an increase in IOP? A) Fluorometholone B) Difluprednate C) Dexamethasone D) Prednisolone acetate ```

A) Fluorometholone

``` Which of the following 3 classes of antibiotics inhibit bacterial cell wall synthesis? SELECT 3 A) Bacitracin B) Penicillins C) Aminoglycosides D) Cephalosporins E) Fluoroquinolones ```

A) Bacitracin B) Penicillins D) Cephalosporins

Insulin is responsible for which of the following 2 actions? SELECT 2 A) Decreases lipogenesis in the liver B) Decreases degradation of proteins C) Decreases uptake of amino acids by cells D) Decreases glycogenolysis in the liver

B) Decreases degradation of proteins | D) Decreases glycogenolysis in the liver

``` Which of the following glycosaminoglycans is found within the cornea? A) Keratan sulfate B) Chondroitin sulfate C) Hyaluronic acid D) Dermatan sulfate ```

A) Keratan sulfate

``` Which of the following 2 lasers are MOST commonly used for laser peripheral iridotomies? SELECT 2 A) Krypton B) Argon C) Nd:YAG D) Excimer E) Helium neon ```

B) Argon | C) Nd:YAG

``` Which of the following types of nystagmus is NOT considered physiological? A) End-point B) Latent C) Optokinetic D) Caloric ```

B) Latent

``` Contact dermatitis is due to which of the following hypersensitivity reactions? A) Cytotoxic B) Anaphylactic C) Delayed D) Immune complex ```

C) Delayed

``` Which of the following tests can be used to distinguish between anomalous trichromats and dichromats? A) Ishihara plates B) Nagel anomaloscope C) Farnsworth D-15 test D) HRR plates ```

B) Nagel anomaloscope

``` Which of the following 3 drugs may cause whorl keratopathy? SELECT 3 A) Promethazine B) Amiodarone C) Indomethacin D) Chlorpromazine E) Hydroxychloroquine F) Isotretinoin ```

B) Amiodarone C) Indomethacin E) Hydroxychloroquine

``` Which of the following retinal cells fine-tunes the neural signal sent from neighboring photoreceptors via lateral inhibition? A) Oligodendrocytes B) Muller C) Amacrine D) Horizontal ```

D) Horizontal

``` Which of the following topical ophthalmic drugs is a H1 receptor antagonist? A) Emedastine B) Ketotifen C) Lodoxamide D) Epinastine E) Cromolyn sodium ```

A) Emedastine

``` Which of the following 3 conditions are most likely associated with episcleritis? SELECT 3 A) Rheumatoid arthritis B) Hypertension C) Syphilis D) Herpes simplex E) Hyperthyroidism F) Myasthenia gravis ```

A) Rheumatoid arthritis C) Syphilis D) Herpes simplex

``` Which of the following 3 retinal cells generate only graded potentials? SELECT 3 A) Photoreceptors B) Ganglion cells C) Horizontal cells D) Bipolar cells E) Amacrine cells ```

A) Photoreceptors B) Ganglion cells D) Bipolar cells

``` All of the following ocular structures are derived from neural crest cells EXCEPT: A) trabecular meshwork B) iris stroma C) choroid D) ciliary body epithelium ```

D) ciliary body epithelium

``` Which of the following lymphocytes allows for specific humoral immunity? A) B lymphocytes B) Killer T lymphocytes C) Natural killer cells D) Helper T lymphocytes ```

A) B lymphocytes

``` Which of the following wavelengths of light is completely absorbed by the tears, cornea, and aqueous humor? A) UV-A B) Infrared C) UV-C D) UV-B ```

C) UV-C

A patient's measured visual acuity represents which of the following functions? A) High spatial frequency cutoff on the temporal sensitivity function B) High spatial frequency cutoff on the contrast sensitivity function C) Low spatial frequency cutoff on the temporal sensitivity function D) Low spatial frequency cutoff on the contrast sensitivity function

B) High spatial frequency cutoff on the contrast sensitivity function

Which of the following side effects is NOT associated with amiodarone? A) Pigmentary retinopathy B) Whorl keratopathy C) Anterior subcapsular crystalline lens depostis D) Non-arteritic anterior ischemic optic neuropathy

A) Pigmentary retinopathy

Which of the following steps occurs first in the visual cycle within photoreceptors? A) Light absorption by a photoreceptor transforms all-trans retinal to all-trans retinol B) Light absorption by the RPE oxidizes all-trans retinol to 11-cis retinal C) Light absorption by a photoreceptor transforms 11-cis retinal to all-trans retinal D) Light absorption by the RPE oxidizes vitamin A to 11-cis retinal

C) Light absorption by a photoreceptor transforms 11-cis retinal to all-trans retinal

``` Which of the following wavelengths is the point of equal sensitivity of the photopic and scotopic systems? A) 580 nm B) 555 nm C) 507 nm D) 650 nm ```

D) 650 nm

``` Which of the following conditions is the MOST medically emergent cause of papilledema? A) Meningitis B) Malignant hypertension C) Idiopathic intracranial hypertension D) Space-occupying lesion ```

B) Malignant hypertension

``` Which of the following conditions is caused by hyperventilation? A) Respiratory alkalosis B) Metabolic acidosis C) Respiratory acidosis D) Metabolic alkalosis ```

A) Respiratory alkalosis

``` Which of the following aberrations is MOST likely to affect a low to medium powered spectacle lens? A) Distortion B) Spherical C) Coma D) Radial astigmatism ```

D) Radial astigmatism

Color vision at the level of the photoreceptors is governed by the: A) Trichromatic theory B) Color opponent channels C) Wavelength of light absorbed by a single photoreceptor D) Number of photons absorbed by a single photoreceptor

A) Trichromatic theory

What does the blur point represent when measuring smooth vergences? A) The limit of fusional and accommodative vergence B) The flexibility of the patient's binocular system C) The limit of fusional vergence D) The limit of accommodative vergence

C) The limit of fusional vergence

``` Hereditary color vision defects are most often diagnosed in males due to which of the following inheritance patterns? A) Autosomal recessive B) X-linked recessive C) X-linked dominant D) Autosomal dominant ```

B) X-linked recessive

``` Which of the following branches of the ophthalmic artery supplies the lacrimal sac? A) Lacrimal artery B) Long posterior ciliary arteries C) Dorsal nasal artery D) Ethmoid artery ```

C) Dorsal nasal artery

Which of the following statements regarding ON-center bipolar cells is CORRECT? A) Inhibited by glutamate; hyperpolarize when light is present B) Excited by glutamate; hyperpolarize when light is present C) Inhibited by glutamate; depolarize when light is present D) Excited by glutamate; depolarize when light is present

C) Inhibited by glutamate; depolarize when light is present

``` Which nerve provides innervation to the upper and lower eyelids? A) Zygomaticofacial B) Infratrochlear C) Supraorbital D) Infraorbital ```

B) Infratrochlear

``` All of the following conditions may cause superior limbic keratoconjunctivitis EXCEPT: A) myasthenia gravis B) contact lens wear C) keratoconjunctivitis sicca D) thyroid disease ```

A) myasthenia gravis

``` All of the following drugs may cause pseudotumor cerebri EXCEPT: A) tetracyclines B) oral contraceptives C) isoniazid D) nalidixic acid E) isotretinoin ```

C) isoniazid

Which of the following conditions may progress to a squamous cell carcinoma of the conjunctiva? A) Conjunctival nevus B) Primary acquired melanosis C) Actinic keratosis D) Conjunctival intraepithelilal neoplasia

D) Conjunctival intraepithelilal neoplasia

``` Oral carbonic anhydrase inhibitors should be avoided in all of the following conditions EXCEPT: A) Bradycardia B) Liver disease C) Severe COPD D) Renal disease ```

A) Bradycardia

Spectacle magnification compares which of the following retinal images? A) Uncorrected retinal image size to the corrected retinal image size B) Retinal image size with spectacles to the retinal image size with contact lenses C) Corrected retinal image size to the emmetropic retinal image size D) Uncorrected retinal image size to the emmetropic retinal image size

A) Uncorrected retinal image size to the corrected retinal image size

``` Infants begin to crawl at approximately: A) 15 months B) 9 months C) 12 months D) 6 months ```

B) 9 months

``` A 5-year old patient has 1.75 D of hyperopia. Which refractive error is he MOST likely to have at age 14? A) Myopia B) Cannot predict C) Emmetropia D) Hyperopia ```

D) Hyperopia

``` Children are first able to copy a circle at which of the following ages? A) 2 years B) 3 years C) 4 years D) 5 years ```

B) 3 years

``` Which of the following eyelid layers contains Muller's muscle? A) Subcutaneous areolar B) Submuscular areolar C) Tarsal D) Posterior muscular ```

D) Posterior muscular

``` Which of the following 2 wavelengths of light are absorbed by the corneal epithelium and Bowman's membrane? SELECT 2 A) UV-C B) Visible light C) UV-A D) UV-B ```

A) UV-C | D) UV-B

``` Which of the following 3 tests may be used to diagnose eccentric fixation? SELECT 3 A) Haidinger's brush B) Visuoscopy C) Bagolini lenses D) Maxwell's spot E) Bangerter filters ```

A) Haidinger's brush B) Visuoscopy D) Maxwell's spot

``` All of the following ion channels are involved in generating fast ventricular action potentials in the heart EXCEPT: A) K+ B) Cl- C) Na+ D) Ca2+ ```

B) Cl-

``` Which of the following ACA ratios is considered average for children? A) 6/1 B) 2/1 C) 8/1 D) 4/1 ```

D) 4/1

``` Which of the following 2 glands may be affected by an external hordeolum? SELECT 2 A) Wolfring B) Meibomian C) Zeis D) Moll ```

C) Zeis | D) Moll

Which of the following strategies is the MOST appropriate to minimize the systemic side effects of a topical ophthalmic drug? A) Nasolacrimal (punctal) occlusion and eyelid closure B) Use a lower concentration and higher frequency of the drug C) Use a higher concentration and lower frequency of the drug D) Chill the bottle of eye drops

A) Nasolacrimal (punctal) occlusion and eyelid closure

Which of the following statements regarding migraines without auras is FALSE? A) Neuro-imaging should be performed if patients have an initial episode after the age of 50. B) They develop due to abnormal dilation of blood vessels within the brain. C) They are known as classic migraines. D) They are associated with normal tension glaucoma.

C) They are known as classic migraines.

``` What is the MOST common cause of spontaneous vitreous hemorrhage in adult patients? A) Central retinal vein occlusion B) Acute posterior vitreous detachment C) Proliferative diabetic retinopathy D) Retinal break ```

C) Proliferative diabetic retinopathy

``` Autorefractors are MOST susceptible to overestimation of which type of refractive error? A) Myopia B) Presbyopia C) Hyperopia D) Astigmatism ```

A) Myopia

``` Which of the following topical ophthalmic medications inhibits DNA synthesis? A) Trimethoprim B) Azithromycin C) Tobramycin D) Moxifloxacin ```

D) Moxifloxacin

``` Which of the following is found in a high concentration in mature lens fibers? A) Collagen B) Fibroblasts C) Crystallins D) Hyaluronic acid ```

C) Crystallins

Which of the following is NOT an indication of ophthalmic sodium fluorescein? A) Retinal angiography B) Determination of a positive Seidel's sign C) Staining of the lacrimal sac prior to ocular surgery D) Evaluation of ocular surface integrity

C) Staining of the lacrimal sac prior to ocular surgery

Which of the following statements regarding absolute light detection threshold under scotopic conditions is INCORRECT? A) Two sub-threshold flashes of white light separated by 60 ms are more likely to be detected by the photopic system than the scotopic system. B) 1 photon absorption is sufficient to stimulate one rod cell. C) A stimulus of 507 nm wavelength will be detectable at a lower intensity than a stimulus of 600 nm. D) The photopic system will demonstrate a lower threshold for light detection than the scotopic system for wavelengths longer than 650 nm.

A) Two sub-threshold flashes of white light separated by 60 ms are more likely to be detected by the photopic system than the scotopic system.

``` If your patient has an aneurysm of the internal carotid artery as it passes through the cavernous sinus, which extraocular muscle would be affected first? A) Inferior oblique B) Superior rectus C) Lateral rectus D) Superior oblique E) Medial rectus ```

C) Lateral rectus

``` The protein lactoferrin is an important component of the secretions from the: A) goblet cells B) meibomian glands C) lacrimal gland D) glands of Moll ```

C) lacrimal gland

``` A 43-year-old male patient presents with a trace anterior chamber reaction, an intraocular pressure of 48 mmHg, and an open angle on gonioscopy OD. Which of the following is the MOST likely cause of this patient's uveitis? A) Fuchs' heterochromic iridocyclitis B) Posner-Schlossman syndrome C) HLA-B27 spondyloarthropathy D) Juvenile rheumatoid arthritis ```

B) Posner-Schlossman syndrome

Using the linear filament after-image test, which of the following patients will see the same after-image pattern as a patient with normal binocular vision (assuming no eccentric fixation)? A) Esotropes with NRC B) All of the above because the test is monocular C) Esotropes with harmonious ARC D) None of the above because the test is independent of ARC

A) Esotropes with NRC

A photoreceptor hyperpolarized by light: A) decreases glutamate release, causing an on-bipolar cell to release more glutamate B) Increases glutamate release, causing an on-bipolar cell to release less glutamate C) increases glutamate release, causing an on-bipolar cell to release more glutamate D) decreases glutamate release, causing an on-bipolar cell to release less glutamate

A) decreases glutamate release, causing an on-bipolar cell to release more glutamate

A myope requires a -7.00 DS contact lens. When reading a target 40 cm from the ocular surface, what is the difference in accommodative demand if he wears contact lenses versus the appropriate spectacle prescription at a 14 mm vertex distance? A) Difference of 0.46 D, greater demand with contact lenses B) Difference of 1.02 D, greater demand with spectacles C) Difference of 3.64 D, greater demand with contact lenses D) Difference of 0.85 D, greater demand with spectacles

A) Difference of 0.46 D, greater demand with contact lenses

Which of the following is TRUE regarding corneal deturgescence? A) Cl- absorption and Na+ absorption drive corneal dehydration B) Cl- excretion and Na+ absorption drive corneal dehydration C) Cl- absorption and Na+ excretion drive corneal dehydration D) Cl- excretion and Na+ excretion drive corneal dehydration

B) Cl- excretion and Na+ absorption drive corneal dehydration

Which of the following statements regarding the trochlear nerve is INCORRECT? A) Injury to the nerve results in poor coordination of the eyes when looking downwards B) Injury to the nerve results in an inability to focus on near objects C) It emerges from the posterior aspect of the brainstem D) It innervates the superior oblique

B) Injury to the nerve results in an inability to focus on near objects

Which nerve would not be affected by a space-occupying tumor located within the muscle cone? A) Superior division of the oculomotor nerve B) Inferior division of the oculomotor nerve C) Abducens nerve D) Nasociliary nerve E) Trochlear nerve

E) Trochlear nerve

Manifest hyperopia is the amount of hyperopia that: A) is masked by accommodation B) is corrected by the maximum plus lens to obtain BCVA C) exceeds the maximal accommodative response D) can be revealed only under cycloplegia

B) is corrected by the maximum plus lens to obtain BCVA

Which of the following infections is LEAST likely to spread to the orbit? A) Dacryocystitis B) Infection of the ethmoid sinus C) Dental infection D) Infection of the maxillary sinus after trauma

A) Dacryocystitis

``` Which layer of the cornea is the first to become edematous under hypoxic conditions? A) Endothelium B) Bowman's membrane C) Epithelium D) Stroma ```

C) Epithelium

``` An internal hordeolum involves which eyelid gland? A) Lacrimal B) Moll C) Meibomian D) Zeis ```

C) Meibomian

Which of the following is NOT a known cause for cicatricial entropion? A) Ocular pemphigoid B) Stevens-Johnson syndrome C) Thermal burn restricted to the lower lid epidermis D) Chemical burn of the ocular surface E) Trachoma

C) Thermal burn restricted to the lower lid epidermis

``` MOST fluid reabsorption by the kidneys occurs in the: A) descending loop of Henle B) collecting duct C) proximal tubule D) distal tubule E) ascending loop of Henle ```

C) proximal tubule

``` The accessory lacrimal glands produce part of the tear film and are located: A) in the conjunctival stroma B) within the tarsal plate C) near Riolan's muscle D) in a fossa in the frontal bone E) in conjunctival epithelium ```

A) in the conjunctival stroma

``` Which of the following findings is MOST commonly seen with orbital cellulitis? A) Proptosis B) Normal visual acuity C) Normal extraocular motilities D) Painful swelling of eyelid tissue ```

A) Proptosis

``` The obstruction to aqueous outflow in primary open angle glaucoma is most likely in the: A) aqueous veins B) trabecular meshwork C) ciliary body D) episcleral veins ```

B) trabecular meshwork

An impulse can travel from one neuron to another in only one direction because the: A) synapse limits the direction of travel B) myelin sheath limits the direction of travel C) nerve fiber permits conduction in only one direction D) cell body must be stimulated before the nerve fiber will conduct an impulse

A) synapse limits the direction of travel

``` Which of the following types of arthritis is MOST likely associated with an acute, anterior, non-granulomatous, unilateral uveitis? A) Osteoarthritis B) Gouty arthritis C) Psoriatic arthritis D) Rheumatoid arthritis ```

C) Psoriatic arthritis

``` Which of the following 3 conditions are characterized by abnormal collagen synthesis? SELECT 3 A) Scurvy B) Ehlers-Danlos syndrome C) Sarcoidosis D) Pernicious anemia E) Beriberi F) Osteogenesis imperfecta ```

A) Scurvy B) Ehlers-Danlos syndrome F) Osteogenesis imperfecta

All of the following would indicate that your 12-year-old patient is overminused EXCEPT: SELECT 2 A) NRA @ 40 cm = +1.25 D B) difficulty with minus lenses during binocular and monocular accommodative facility testing C) icreased esophoria during near testing D) NRA @ 40 cm = +3.50 D E) increased exophoria during near testing

A) NRA @ 40 cm = +1.25 D | E) increased exophoria during near testing

A patient with high hyperopia notes color fringes in the periphery of his Trivex spectacle lenses. Which of the following 3 modifications may help to reduce his symptoms? SELECT 3 A) Switch from Trivex to CR-39 plastic lenses B) Induce pantoscopic tilt C) Switch from Trivex to polycarbonate lenses D) Increase vertex distance E) Decrease vertex distance

A) Switch from Trivex to CR-39 plastic lenses B) Induce pantoscopic tilt E) Decrease vertex distance

``` What amount of accommodation is required when a stand magnifier is used in its standard situation? A) 4.00 D B) 2.00 D C) 6.00 D D) 0.00 D ```

A) 4.00 D

``` The crystalline lens develops from: A) surface ectoderm B) neural crest C) neural ectoderm D) mesoderm ```

A) surface ectoderm

``` Which of the following describes the first event that occurs after a quantum of light is absorbed by rhodopsin? A) cGMP --> GMP B) all-trans retinal --> 11-cis retinal C) GMP --> cGMP D) 11-cis retinal --> all-trans retinal ```

D) 11-cis retinal --> all-trans retinal

``` Which 2 vergence systems are being used when a patient is behind the phoropter for distance phoria testing? A) Tonic B) Proximal C) Accommodative D) Dissociated E) Fusional ```

A) Tonic | B) Proximal

Which of the following occurs when accommodation is relaxed in a patient with compound hyperopic astigmatism? A) Once principle meridian focuses on the retina and the other focuses behind the retina B) Both principal meridians focus behind the retina C) One principal meridian focuses in front of the retina and the other focuses on the retina D) Both principal meridians focus in front of the retina

B) Both principal meridians focus behind the retina

``` Methicillin resistant Staphylococcus aureus (MRSA) is MOST susceptible to which of the following topical ophthalmic medicaitons? A) Trimethoprim B) Tobramycin C) Azithromycin D) Levofloxacin ```

A) Trimethoprim

``` A patient presents with a spectacle prescription of -5.00 DS OD and K readings of 41.75 @ 180/44.75 @ 090. Which of the following contact lens types is MOST appropriate? A) Soft spherical lens B) Rigid front toric lens C) Rigid spherical lens D) Hybrid lens ```

A) Soft spherical lens

``` Strabismic amblyopes forced to fixate with the amblyopic eye while the better eye is occluded will: A) often exhibit eccentric fixation B) accurately fixate the target C) suffer severe diplopia D) see normally ```

A) often exhibit eccentric fixation

``` What is the MOST likely compensatory head movement for a patient with an acquired Brown syndrome affecting the left eye? A) right head turn B) left head tilt C) right head tilt D) left head turn ```

B) left head tilt

An electrician with a known color deficiency would like to be able to differentiate between red and green wires more easily while at work. Which of the following techniques would be the MOST successful? A) Teach the patient to compare the appearance of the wires with and without a red filter, explaining that the red wires will appear brighter when looking through the red filter. B) Recommend the patient. constantly view wires through a red filter while at work. C) Teach the patient to compare the appearance of the wires with and without a red filter, explaining that the green wires will appear brighter when looking through the red filter. D) Recommend the patient constantly view wires through a neutral density filter while at work.

A) Teach the patient to compare the appearance of the wires with and without a red filter, explaining that the red wires will appear brighter when looking through the red filter.

``` What is the most common primary site of a tumor that has metastasized to the eye? A) Breast B) Colon C) Prostate D) Lung ```

A) Breast

``` A patient's spectacle prescription is +8.00-3.00x180 OD and +4.00-1.00x180 OS. How much prism is induced in each eye if the patient looks 10 mm to the right of the lens centers? A) 4 PD BI just in the OD B) 8 PD BI just in the OD C) 5 PD BI just in the OD D) 3 PD BI just in the OS ```

B) 8 PD BI just in the OD

``` Which of the following lenses would completely correct for radial astigmatism? A) Aspheric lens B) Orthoscopic doublet lens C) Point focal lens D) Percival form lens ```

C) Point focal lens

Which of the following statements is TRUE regarding severe ocular chemical burns? A) They result in scleral blanching and decreased intraocular pressure B) They result in scleral blanching and elevated intraocular pressure C) They cause severe conjunctival injection and mild superficial punctate keratitis D) Alkali chemical burns have a better prognosis than acidic chemical burns

B) They result in scleral blanching and elevated intraocular pressure

``` Which uveal layer is composed of myoepithelium? A) Sphincter muscle B) Suprachoroid C) Anterior iris epithelium D) Supraciliaris E) Anterior border layer ```

C) Anterior iris epithelium

``` Monochromatic light of wavelength 650 nm is MOST likely to be absorbed by: A) middle wavelength sensitive cones B) rods C) long wavelength sensitive cones D) short wavelength sensitive cones ```

C) long wavelength sensitive cones

``` Which of the following is known to decrease high-density lipoprotein (HDL) levels? SELECT 2 A) Beta adrenergic blockers B) Obesity C) Thiazide diuretics D) Modest consumption of alcohol ```

A) Beta adrenergic blockers | B) Obesity

``` A patient matches pure red with a luminance of yellow much lower than a patient with normal color vision would use on the Nagel anomaloscope. Which of the following is the MOST likely diagnosis? A) Protanomalous trichromat B) Deutoranopia C) Deuteranomalous trichromat D) Protanopia ```

D) Protanopia

``` A patient has a far point of -10 cm from the spectacle plane. What is the patient's distance prescription? A) +5.00 D B) -5.00 D C) +10.00 D D) -10.00 D ```

D) -10.00 D

``` Which ocular tissue has the highest rate of blood flow? A) Retina B) Iris C) Choroid D) Ciliary muscle ```

C) Choroid

``` A 9.00 D myope with a central corneal thickness of 510 microns wishes to undergo LASIK. The surgeon plans on cutting a 180 micron flap and leaving 250 microns below the ablation zone. Based on the Munnerlyn equation, what is the LARGEST ablation zone diameter that can be safely applied in this patient? A) 10.48 mm B) 15.49 mm C) 9.31 mm D) 5.16 mm ```

D) 5.16 mm AD = (AZD^2 x D)/3 ``` AD= ablation depth AZD= ablation zone diamter in mm D= diopters of correction ```

Which of the following statements regarding visual development is INCORRECT? A) Stereopsis reaches adult levels at 6 months of age B) Saccades are hypometric until approximately 6 years of age C) Accommodation and fusional vergence are present at birth D) Near point of convergence is not detectable until 6 months of age

C) Accommodation and fusional vergence are present at birth

Which of the following CORRECTLY defines the exit pupil? A) It is the image of the aperture stop formed by the lenses behind the aperture stop. B) It is the image of the field stop formed by the lenses in front of the field stop. C) It is the image of the field stop formed by the lenses behind the field stop. D) It is the image of the aperture stop formed by the lenses in front of the aperture stop.

A) It is the image of the aperture stop formed by the lenses behind the aperture stop.

``` AREDS 1 multivitamins for advanced age-related macular degeneration contain all of the following EXCEPT: A) zinc B) lutein C) vitamin C D) vitamin A ```

B) lutein

Excitation-contraction coupling in skeletal muscles is mediated by which of the following? A) Release of acetylcholinesterase from nerve terminals B) Release of calcium from the sarcoplasmic reticulum C) Efflux of potassium ions from transverse tubules D) Binding of calcium and calmodulin

B) Release of calcium from the sarcoplasmic reticulum

``` Which of the following can be utilized to produce ketone bodies during starving conditions? A) NADPH B) Lactate C) Glycerol D) Acetyl CoA ```

D) Acetyl CoA

``` Which of the following vascular structures are formed by branches from the arteries that supply the extraocular muscles? A) Major circle of the iris B) Circle of Zinn-Haller C) Haller's layer of the choroid D) Minor circle of the iris ```

A) Major circle of the iris

``` The horizontal cell synapses with: A) ganglion cell dendrite B) outer plexiform layer C) photoreceptor layer D) an amacrine process E) a bipolar axon ```

B) outer plexiform layer

``` Which topical ophthalmic drug has the greatest potential for adverse effects in the CNS? A) Tropicamide B) Lidocaine C) Phenylephrine D) Cyclopentolate ```

D) Cyclopentolate

Topical ophthalmic cycloplegic drugs cause all of the following beneficial effects in the treatment of anterior uveitis EXCEPT: A) decreased intraocular inflammation B) stabilization of the blood aqueous barrier C) prevention of posterior synechie D) immobilization of the inflamed iris

A) decreased intraocular inflammation

``` Your hyperopic patient wishes to order progressive addition lenses. Her reading add is +2.50 D. How much yoked base down prism will be present in her progressive lenses? A) 2.50 PD B) 1.66 PD C) 1.25 PD D) 0.83 PD ```

B) 1.66 PD PALs have BD ground in, usually 2/3 times the add power

``` Which of the following wavelengths of light is MOST likely to damage the retina of a phakic elderly adult? A) 285 nm B) 370 nm C) 210 nm D) 310 nm ```

B) 370 nm

Which of the following statements is CORRECT regarding the performance of the scotopic and photopic systems in terms of luminance detection? A) The scotopic system demonstrates superior absolute sensitivity while the photopic system demonstrates superior contrast sensitivity. B) The photopic system demonstrates superior absolute sensitivity while the scotopic system demonstrates superior contrast sensitivity. C) The scotopic system demonstrates superior absolute sensitivity and contrast sensitivity compared to the photopic system. D) The photopic system demonstrates superior absolute sensitivity and contrast sensitivity compared to the scotopic system.

A) The scotopic system demonstrates superior absolute sensitivity while the photopic system demonstrates superior contrast sensitivity.

``` The resilience of the tear film to changes in pH is PRIMARILY a result of: A) bicarbonate and protein buffers B) continuous drainage of tears C) reflex tearing D) evaporation of the tear film ```

A) bicarbonate and protein buffers

``` At what age range does the visual acuity of a child approach an adult? A) 3-6 months B) 8-10 years C) 3-4 years D) 1-3 months ```

C) 3-4 years

Which of the following statements regarding the motor fibers of the trigeminal nerve is INCORRECT? A) They pass through the foramen ovale B) They originate in the trigeminal ganglion C) They are distributed entirely within the mandibular region D) They innervate the muscles of mastication

B) They originate in the trigeminal ganglion

``` Which of the following is released by the posterior pituitary gland? A) Angiotensin II B) Adrenocorticotropic hormone C) Antidiuretic hormone D) Aldosterone ```

C) Antidiuretic hormone

``` Which of the following 2 findings are signs of keratoconus? A) Vogt's striae B) Limbal thinning C) Kayser-Fleischer ring D) High oblique astigmatism ```

A) Vogt's striae | D) High oblique astigmatism

``` Which of the following veins does NOT contribute to the formation of the superior ophthalmic vein? A) Angular B) Supraorbital C) Supratrochlear D) Central retinal ```

D) Central retinal

``` Which of the following 2 lens materials are considered the LEAST safe for spectacle lenses for an 8-year-old boy who plays soccer? SELECT 2 A) Polycarbonate B) Trivex C) Flint glass D) CR-39 E) Crown glass ```

C) Flint glass | E) Crown glass

``` Which of the following are 3 side effects of cocaine? A) Tachycardia B) Mydriasis C) Weight gain D) Localized injection E) Sweating ```

A) Tachycardia B) Mydriasis E) Sweating

You perform Nott's method of retinoscopy to evaluate the accuracy of your patient's accommodative response. With a near point target and retinoscope both at 40 cm, you notice "with" motion. Does this patient have a lag or lead of accommodation, and which direction should you move the retinoscope to achieve neutrality? A) Lead of accommodation; move retinoscope away from the patient B) Lag of accommodation; move retinoscope toward the patient C) Lag of accommodation; move retinoscope away from the patient D) Lead of accommodation; move retinoscope toward the patient

C) Lag of accommodation; move retinoscope away from the patient

``` Which of the following are 4 common clinical applications of Nd:YAG lasers? SELECT 4 A) Selective laser trabeculoplasty B) Panretinal photocoagulation C) Laser peripheral iridotomy D) Barrier treatment of retinal holes E) Cyclodestruction of the ciliary body F) Posterior capsulotomy ```

A) Selective laser trabeculoplasty C) Laser peripheral iridotomy E) Cyclodestruction of the ciliary body F) Posterior capsulotomy

Which of the following 3 defense mechanisms are utilized by the eye to prevent bacterial invasion of the conjunctiva from lid infections? SELECT 3 A) Resident pathogenic bacteria exotoxins B) Non-pathogenic bacteria that provide competitive protection C) Bacteriostatic lysozymes and immunoglobulins D) No inflammation in the presence of foreign antigens E) The shearing force of the blink

B) Non-pathogenic bacteria that provide competitive protection C) Bacteriostatic lysozymes and immunoglobulins E) The shearing force of the blink

``` A patient fails with minus lenses during binocular accommodative facility testing. Which of the following 2 diagnoses are MOST likely? A) Accommodative infacility B) Convergence excess C) Convergence insufficiency D) Accommodative insufficiency E) Accommodative excess ```

B) Convergence excess | D) Accommodative insufficiency

Which of the following correctly pairs the patient's age with the most appropriate visual acuity test? A) 11-month-old infant without visual concerns; Allen symbols B) 24-month-old toddler who sits too close to the TV; broken wheel testing C) 30-month-old toddler who squints; teller acuity cards D) 9-month-old infant with a suspected right esotropia; optokinetic drum

B) 24-month-old toddler who sits too close to the TV; broken wheel testing

``` Which of the following 3 structures store glycogen? SELECT 3 A) Crystallins B) Muller cells C) Corneal epithelial cells D) Iris pigmented epithelium E) Vitreous humor F) Ciliary body ```

B) Muller cells C) Corneal epithelial cells E) Vitreous humor

``` Normal monocular accommodative facility testing and difficulty clearing minus lenses on binocular accommodative facility testing is associated with which of the following conditions? A) Convergence excess B) Convergence insufficiency C) Basic exophoria D) Divergence insufficiency ```

A) Convergence excess

A facial nerve palsy is MOST likely to affect which of the following 2 actions? SELECT 2 A) Opening of the eyelid B) Accommodation C) Reflex tearing in response to bright light D) Ciliary touch sensation E) Eyelid closure F) Vergence eye movement

C) Reflex tearing in response to bright light | E) Eyelid closure

Which of the following statements regarding the limbus is INCORRECT? A) It is the source of stem cells that migrate to the basal layer of the corneal epithelium B) It serves as a passage way for aqueous humor drainage C) It provides nutrients to the cornea, conjunctiva, and sclera D) It is supplied by the long posterior ciliary arteries via capillary loops from the conjunctiva and episcleral vessels

D) It is supplied by the long posterior ciliary arteries via capillary loops from the conjunctiva and episcleral vessels

``` A 62-year-old patient presents with sudden onset diplopia and a notable strabismus of the right eye. When testing Worth 4 Dot with red lens over the patient's right eye, he reports seeing 5 dots, with the three green dots to his left. In what head position would you expect his strabismus to have the highest magnitude? A) Head tilt to the right B) Head turn to the left C) Head turn to the right D) Head tilt to the left ```

B) Head turn to the left

``` Which of the following ganglia does NOT directly innervate the ciliary body? A) Semilunar B) Oculomotor C) Ciliary D) Superior cervical ```

B) Oculomotor

Which of the following changes is NOT expected during overnight contact lens wear? A) Increased tear pH B) Increased lactate concentration in the cornea C) Decreased oxygen supply to the cornea D) Increased corneal thickness

A) Increased tear pH

``` Which of the following malignant eyelid conditions is LEAST likely to be caused by exposure to ultraviolet light? A) Squamous cell carcinoma B) Basal cell carcinoma C) Sebaceous cell carcinoma D) Malignant melanoma E) Merkel cell carcinoma ```

C) Sebaceous cell carcinoma

Which of the following statements is TRUE regarding critical duration and temporal resolution in the scotopic and photopic systems? A) The scotopic system has better temporal resolution than the photopic system, as evidenced by the longer critical duration in the scotopic system. B) The photopic system has better temporal resolution than the scotopic system, as evidenced by the shorter critical duration in the photopic system. C) The scotopic system has better temporal resolution than the photopic system, as evidenced by the shorter critical duration in the scotopic system. D) The photopic system has better temporal resolution than the scotopic system, as evidenced by the longer critical duration in the photopic system.

B) The photopic system has better temporal resolution than the scotopic system, as evidenced by the shorter critical duration in the photopic system.

``` Preganglionic parasympathetic fibers that innervate various ocular structures pass through which of the following? A) Hypoglossal canal B) Stylomastoid foramen C) Foramen ovale D) Superior orbital fissure ```

D) Superior orbital fissure

How does wavelength and frequency change as light passes from air into the eye? A) Wavelength stays the same and frequency decreases B) Both wavelength and frequency stay the same C) Both wavelength and frequency decrease D) Wavelength decreases and frequency stays the same

D) Wavelength decreases and frequency stays the same

``` Which of the following are 4 potential causes of scleritis? SELECT 4 A) Systemic vasculitis B) Uveitis C) Episcleritis D) Surgical trauma E) Bisphosphonate medications F) Idiopathic ```

A) Systemic vasculitis D) Surgical trauma E) Bisphosphonate medications F) Idiopathic

``` A patient's near visual acuity is measured as 0.25m/3.0M. Which telemicroscope will allow this patient to read 1.0M print at a distance of 25 cm? A) 3X telescope; +4.00 D reading cap B) 3X telescope; +3.00 D reading cap C) 4X telescope; +4.00 D reading cap D) 4X telescope; +3.00 D reading cap ```

A) 3X telescope; +4.00 D reading cap

You wish to experimentally determine a dark adaptation curve for a normal patient under different conditions. Which of the following will produce the earliest rod-cone break? A) Spot size covering central 10 degrees of retina, wavelength of 610 nm B) Spot size covering central 10 degrees of retina, wavelength of 465 nm C) Spot size covering central 0.5 degrees of the fovea, wavelength of 500 nm D) Spot size covering central 10 degrees of retina, wavelength of 650 nm

B) Spot size covering central 10 degrees of retina, wavelength of 465 nm

``` Which of the following ganglia causes vasodilation of the choroidal vessels? A) Ciliary B) Superior cervical C) Trigeminal D) Pterygopalatine ```

D) Pterygopalatine

``` Cycloablation results in a significant decrease in intraocular pressure due to changes in which of the following structures? A) Ciliary muscle B) Juxtacanalicular tissue C) Corona ciliaris D) Orbicularis ciliaris ```

C) Corona ciliaris

``` Which of the following structures is NOT affected by loss of astrocytes? A) Photoreceptors B) Internal limiting membrane C) Optic nerve D) Retinal capillaries ```

A) Photoreceptors

``` A patient presents with 6 PD exophoria at near with BI 10/15/12 and BO 20/25/15 vergence ranges. What is the magnitude of the relative compensating vergence? A) 20 PD BO B) 10 PD BI C) 16 PD BI D) 26 PD BO ```

A) 20 PD BO

``` A patient presents with a left horizontal nystagmus that has its lowest amplitude when she turns her head to the right. What would be the BEST option for using prism to minimize the oscillations? A) Base out OD, base out OS B) Base in OD, base out OS C) Base in OD, base in OS D) Base out OD, base in OS ```

D) Base out OD, base in OS

A patient presents with a history of panretinal photocoagulation (PRP) for proliferative diabetic retinopathy OD and OS. Why would this patient NOT complain about night blindness after receiving 360 degree PRP? A) Rod photoreceptors that are primarily responsible for visual acuity in dim illumination are located within the fovea, which is not destroyed by PRP. B) Melanin within the retinal pigment epithelium directly absorbs energy from the argon laser in PRP, thus preventing destruction of the overlying rod photoreceptors. C) PRP Is applied in a grid pattern, leaving areas of rod photoreceptors that can provide visual acuity in dim illumination. D) PRP is not applied to the area just outside the perifovea, which has the greatest rod photoreceptor density.

D) PRP is not applied to the area just outside the perifovea, which has the greatest rod photoreceptor density.

Your patient requires 4 PD BI OD and 2 PD BU OS. Balance the prisms for a spectacle lens prescription. A) OD 1.25 PD @ 027 degrees; OS 1.25 PD @ 027 degrees B) OD 2.24 PD @ 027 degees; OS 2.24 PD @ 027 degrees C) OD 2.00 PD @ 333 degrees; OS 2.00 PD @ 153 degrees D) OD 2.24 PD @ 333 degrees; OS 2.24 PD @ 153 degrees

D) OD 2.24 PD @ 333 degrees; OS 2.24 PD @ 153 degrees

``` Which corneal layer is considered to be the most metabolically active? A) Stroma B) Endothelium C) Epithelium D) Descemet's membrane E) Bowman's membrane ```

B) Endothelium

Among the following pairs of anti-infective agents, which represents the BEST treatment option for the initial empirical therapy of a patient suspected to have ocular MRSA? A) Topical ophthalmic besifloxacin and oral trimethoprim/sulfamethoxazole B) Topical ophthalmic ciprofloxacin and oral doxycycline C) Topical ophthalmic erythromycin and oral amoxicillin D) Topical ophthalmic azithromycin and oral doxycycline

A) Topical ophthalmic besifloxacin and oral trimethoprim/sulfamethoxazole

``` A 34-year-old female presents with a complaint of a sudden change in vision. Systemic history is positive for multiple sclerosis. The patient denies pain on eye movement during versions testing, but has an adduction deficit in the right eye. Dilated fundus examination is unremarkable. What is the MOST likely diagnosis? A) CN VI palsy B) Internuclear ophthalmoplegia C) Microvascular CN III palsy D) Compressive CN III palsy E) Retrobulbar optic neuritis ```

B) Internuclear ophthalmoplegia

``` Your patient takes the Developmental Eye Movement (DEM) test and has a normal vertical time, and abnormally high horizontal score, and an abnormally high ratio. What is the MOST appropriate diagnosis? A) Type I behavior B) Type IV behavior C) Type II behavior D) Type III behavior ```

C) Type II behavior

``` A patient presents with persistent bleeding of the gums, poor wound healing, and skin discoloration. This patient MOST likely has a deficiency of: A) vitamin D B) vitamin A C) vitamin C D) vitamin E ```

C) vitamin C

Which of the following statements regarding orthokeratology is TRUE? A) It is effective in reducing myopia by redistributing anterior corneal epithelial and stromal tissue to change the corneal curvature. B) It is more effective in patients with smaller than average corneal diameters. C) A central island topography pattern results from a lens that is fitting too flat. D) A large optical zone helps to minimize glare around lights.

A) It is effective in reducing myopia by redistributing anterior corneal epithelial and stromal tissue to change the corneal curvature.

``` Which of the following 3 arteries provide blood supply to the eyelids? SELECT 3 A) Branches of the facial arteries B) Medial palpebral arteries C) Short posterior ciliary arteries D) Muscular arteries E) Ethmoid arteries F) Lateral palpebral arteries ```

A) Branches of the facial arteries B) Medial palpebral arteries F) Lateral palpebral arteries

``` Which of the following is characteristic of the early symptoms associated with systemic toxicity secondary to local (injectable) anesthetic overdose? A) Hypotension B) Respiratory depression C) Tachycardia D) Loss of consciousness ```

C) Tachycardia

``` What bifocal segment type would most offset the BD prism effect caused from the distance Rx of a -12.00 DS spectacle lens when the patient reads below the distance optical center (OC)? Assume the reading level is 5 mm below the top of the bifocal segment. A) Flat top 28 B) Round 28 C) Ultex 22 B D) Executive ```

D) Executive

``` Which of the following is NOT a complication of juvenile retinoschisis? A) Retinal detachment B) Choroidal folds C) Vitreous hemorrhage D) RPE atrophy ```

B) Choroidal folds

A patient presents with a high AC/A ratio, high esophoria at near, and insufficient negative fusional vergence ranges at near. What MEM finding should you expect? A) A lag of accommodation B) A lead of accommodation C) Normal accommodative response

A) A lag of accommodation

``` A 64-year-old female presents complaining of new onset horizontal diplopia. When holding a Maddox rod over her left eye, she reports the line and the light are aligned in primary gaze and left gaze, but in right gaze she says the line is to the right of the light. What is the MOST likely diagnosis? A) Left internuclear ophthalmoplegia B) Right lateral rectus palsy C) Right internuclear ophthalmoplegia D) Left lateral rectus palsy ```

A) Left internuclear ophthalmoplegia

``` The entoptic phenomenon of colored halos around lights is MOST likely a result of: A) corneal edema B) macular edema C) posterior vitreous detachment D) dislocated crystalline lens ```

A) corneal edema

How do the size of the circle of least confusion and the length of the near and far lines change as the amount of cylinder power is decreased? A) The size of the COLC will decrease and the length of the astigmatic lines will increase. B) The size of the COLC will increase and the length of the astigmatic lines will decrease. C) The size of the COLC and the length of the astigmatic lines will both decrease. D) The size of the COLC and the length of the astigmatic lines will both increase.

C) The size of the COLC and the length of the astigmatic lines will both decrease.

``` A 100 cm tall object located 1 m in front of a patient's right eye creates a reflected corneal image that is +4.6 mm tall. What is the approximate radius of curvature of the cornea? A) 8.26 mm B) 6.51 mm C) 7.32 mm D) 9.24 mm ```

D) 9.24 mm

A patient is prescribed topical ophthalmic dorzolamide in order to lower his IOP through competitive inhibition of the enzyme carbonic anhydrase in the ciliary body. How does this drug change Km and the x- and/or y-intercepts of the Lineweaver-Burke plot? A) Km will decrease, causing the y-intercept to shift down B) Km will increase, causing the x-intercept to shift towards the left C) Km will decrease, causing the y-intercept to shift up D) Km will increase, causing the x-intercept to shift towards the right

D) Km will increase, causing the x-intercept to shift towards the right

``` Systemic diuretics affect reabsorption at all parts of the nephron EXCEPT: A) proximal convoluted tubule B) ascending loop of Henle C) descending loop of Henle D) distal convoluted tubule ```

C) descending loop of Henle

``` A patient presents with a sudden increase in blood pressure, heart palpitations, and sweating. These symptoms are MOST likely caused by excessive secretion of products from which of the following? A) Anterior pituitary B) Adrenal medulla C) Posterior pituitary D) Adrenal cortex ```

B) Adrenal medulla

A 10-year-old female patient presents with a small white subepithelial corneal infiltrate with injection of the proximal limbal vessels OS. You correctly diagnose phlyctenulosis. Which of the following statements regarding the patient's condition is INCORRECT? A) It may be associated with tuberculosis B) It may be associated with Staphylococcus blepharitis C) It will most often resolve spontaneosly D) It is a result of a type II delayed hypersensitivity reaction

D) It is a result of a type II delayed hypersensitivity reaction

``` You are assessing your patient's retinal correspondence using the amblyoscope (synoptophore). You measure 30 PD constant alternating exotropia. The patient reports the targets appear superimposed with 30 PD BO OU. What is the correct diagnosis? A) Harmonious retinal correspondence B) Normal retinal correspondence C) Unharmonious retinal correspondence D) Paradoxical retinal correspondence ```

D) Paradoxical retinal correspondence

``` You test a patient on a Nagel anomaloscope. He is able to achieve a match when the mixture field is at 0 by increasing the brightness of the test field to a very high level. He is also able to make a match when the mixture field is at 73 by decreasing the brightness to a very low level. What is the MOST likely diagnosis for this patient? A) Protanomalous trichromat B) Deuteranope C) Deuteranomalous trichromat D) Protanope ```

D) Protanope

Which of the following statements regarding the iris is INCORRECT? A) The anterior iris stromal leaf contains the anterior border layer and a small portion of the iris stroma in the ciliary zone. B) Schwalbe's contraction furrows are located at the iris pupillary margin and represent variations in the thickness of the posterior pigmented iris epithelium. C ) The posterior iris stromal leaf contains most of the iris stroma in the ciliary zone and all of the iris stroma and the anterior border layer in the pupillary zone. D) Radial streaks are located in the ciliary and pupillary zones and are remnants of the fetal pupillary membrane during embryological development.

D) Radial streaks are located in the ciliary and pupillary zones and are remnants of the fetal pupillary membrane during embryological development.

``` Deficiency of stem cells at the limbal Palisades of Vogt is associated with all of the following EXCEPT: A) keratoconus B) Stevens-Johnson syndrome C) aniridia D) alkali corneal burns ```

A) keratoconus

An infection of the superficial skin near the nose is capable of spreading to the brain because: A) the angular vein communicates with the cavernous sinus via the inferior ophthalmic vein B) the superficial temporal vein communicates with the cavernous sinus via the maxillary vein C) the supraorbital vein communicates with the cavernous sinus via the inferior ophthalmic vein D) the facial vein communicates with the cavernous sinus via the pterygoid plexus and inferior ophthalmic vein

D) the facial vein communicates with the cavernous sinus via the pterygoid plexus and inferior ophthalmic vein

The primary barrier to corneal penetration of a hydrophilic drug is: A) zonular occludens junctions between corneal epithelial cells B) spacing of corneal stromal collagen fibrils C) corneal endothelial cell hydrophilicity D) corneal stromal hydrophobicity

A) zonular occludens junctions between corneal epithelial cells

A patient presents with an acute abducens nerve palsy affecting the left eye. He is shown a Worth 4 dot target while wearing red-green glasses with the green lens over his right eye. What will he see? A) 3 green dots on the left, 2 red dots on the right, worse in right gaze B) 3 green dots on the right, 2 red dots on the left, worse in right gaze C) 3 green dots on the right, 2 red dots on the left, worse in left gaze D) 3 green dots on the left, 2 red dots on the right, worse in left gaze

C) 3 green dots on the right, 2 red dots on the left, worse in left gaze

``` A patient presents with new onset vertical diplopia and a right hypertropia in primary gaze after having suffered a stroke that affected the superior division of the oculomotor nerve. In what 2 head positions would you expect the hypertropia to worsen? SELECT 2 A) left head tilt B) left head turn C) right head turn D) right head tilt ```

A) left head tilt | C) right head turn

``` A 30-year-old patient presents with new onset miosis and mild ptosis OD. Which of the following tests is MOST appropriate? A) Orbital CT B) MRI C) Chest X-ray D) Carotid ultrasound ```

C) Chest X-ray

``` Which of the following topical ophthalmic solutions does NOT cause miosis in a physiological normal iris? A) Pilocarpine 4% B) Brimonidine 0.1% C) Brimonidine 0.2% D) Apraclonidine 0.5% ```

D) Apraclonidine 0.5%

``` A posterior sclerostomy is indicated for the treatment of choroidal effusion because it drains excess fluid from the: A) scleral stroma B) suprachoroid lamina C) supraciliaris D) choriocapillaris ```

B) suprachoroid lamina

``` Total light transmission through an untinted and uncoated crown glass lens is closest to: A) 95% B) 91% C) 98% D) 89% ```

B) 91%

``` What is the total light transmission (to the nearest 0.1%) through a tinted polycarbonate lens having a center thickness of 3 mm if the transmission factor of the tint is 0.6 per millimeter of lens thickness? A) 18.50% B) 21.50% C) 20.50% D) 19.40% ```

D) 19.40%

``` Clinical findings in ocular ischemic syndrome may include all of the following EXCEPT: A) dilated retinal arteries B) cherry red spot at the fovea C) retinal hemorrhage D) anterior uveitis E) iris neovascularization ```

A) dilated retinal arteries

``` You correctly diagnose your patient with episcleritis. Which of the following tests would be LEAST likely to aid in the diagnosis of an associated systemic condition? A) Antinuclear antibody B) Erythrocyte sedimentation rate C) FTA-ABS and VDRL D) Sacroiliac x-ray E) Chest x-ray ```

E) Chest x-ray

``` You note corneal haze OD in a 2-week-old infant due to a forceps injury at birth. Which of the following 3 conditions is the patient at risk for developing later in life? SELECT 3 A) increased hyperopia B) amblyopia C) irregular corneal astigmatism D) corneal stromal thinning E) bullous keratopathy ```

B) amblyopia C) irregular corneal astigmatism E) bullous keratopathy

``` A 62-year-old female with a history of keratoconjunctivitis sicca presents with multiple gray-white elevated nodules in the mid-peripheral cornea OD. What is the most likely diagnosis? A) Salzmann's nodular degeneration B) Terrien's nodular degeneration C) Recurrent corneal erosion D) Phlyctenular keratoconjunctivitis ```

A) Salzmann's nodular degeneration

A 51-year-old male presents with intraocular pressures of 16 mmHg OD, OS. You observe anterior trabecular meshwork as the most posterior structure on gonioscopy, as well as isolated areas of pigment clumping within the trabecular meshwork OD, OS. You also note progressive thinning of his neuroretinal rims. What is the most likely diagnosis? A) Compressive optic neuropathy B) Intermittent angle closure glaucoma C) Bilateral non-arteritic anterior ischemic optic neuropathy D) Normal tension glaucoma

B) Intermittent angle closure glaucoma

When testing the wavelength sensitivity of trichromats with normal color vision and dichromats, all of the following occur EXCEPT: A) Dichromats show two peaks in sensitivity at specific wavelengths B) The sensitivity peaks in trichromats correspond with the peaks of the three cone photopigments C) Trichromats with normal color vision show three peaks in sensitivity at specific wavelengths D) The peak of the photopic luminance function is shifted toward shorter wavelengths in protanopes

B) The sensitivity peaks in trichromats correspond with the peaks of the three cone photopigments

What mechanism explains the iris color change sometimes noted in patients on topical ophthalmic latanoprost activity? A) Increased pigmentation associated with proliferation of melanocytes B) Decreased pigmentation associated with atrophy of iris stromal tissue C) Increased pigmentation associated with increase of melanin within iridial melanocytes D) Increased pigmentation associated with neoplasia of iris stromal melanosomes

C) Increased pigmentation associated with increase of melanin within iridial melanocytes

``` Corneal edema is commonly associated with all of the following EXCEPT: A) Daily gas permeable contact lens wear B) Acute angle closure glaucoma C) Herpetic keratitis D) Fuch's corneal dystrophy ```

A) Daily gas permeable contact lens wear

``` The most common infectious cause of post-operative endophthalmitis is: A) gram negative bacteria B) gram positive bacteria C) fungi D) mycobacteria ```

B) gram positive bacteria

``` Zeaxanthin and lutein are xanthophyll pigments that are primarily located within the: A) inner segments of photoreceptors B) retinal pigment epithlium C) Henle's fiber layer D) outer segments of photoreceptors ```

A) inner segments of photoreceptors

Using a high powered add will have all of the following effects EXCEPT: A) decreased working distance B) decreased field of view C) decreased lateral magnification D) increased relative distance magnification

C) decreased lateral magnification

``` What is the index of refraction for an ideal thin film that minimizes reflections for an anterior chamber IOL (n=1.45) within the aqueous humor? A) 1.937 B) 1.392 C) 1.204 D) 1.156 ```

B) 1.392

You suspect an acquired color vision defect in a patient with asymmetric visual acuity. Which of the following statements is true regarding how to detect the color vision defect? A) Ishihara plates are the best screening test for acquired color defects B) Perform the test monocularly, starting with the eye with the poorer visual acuity C) Perform bilateral color testing D) Perform the test monocularly, starting with the eye with the better visual acuity

B) Perform the test monocularly, starting with the eye with the poorer visual acuity

``` Which group of vessels exits the outer wall of Schlemm's canal? A) Deep scleral plexus B) External collector channels C) Internal collector channels D) Intrascleral plexus ```

B) External collector channels

``` Which of the following is NOT an association of an acute, unilateral, non-granulomatous uveitis? SELECT 3 A) Juvenile rheumatoid arthritis B) Behcet's disease C) Fuchs' heterochromic iridocyclitis D) Ankylosing spondylitis E) Reactive arthritis F) Tuberculosis ```

A) Juvenile rheumatoid arthritis C) Fuchs' heterochromic iridocyclitis F) Tuberculosis

Which of the following is most consistent with the pathogenesis of phacolytic glaucoma? A) Anterior displacement of the crystalline lens capsule, resulting in pupillary block B) Accumulation of protein-laden macrophages within the trabecular meshwork C) Posterior capsular rupture with vitreous prolapse into the trabecular meshwork D) Anterior rotation of the ciliary body and subsequent peripheral angle closure

B) Accumulation of protein-laden macrophages within the trabecular meshwork

What is the mechanism of action of topical ophthalmic trifluridine? A) It prevents viral DNA synthesis by inhibiting topoisomerase IV and DNA gyrase B) It prevents viral protein synthesis within the host cell by interfering with ribosomal subunits C) It prevents viral DNA replication by inhibiting thymidine synthetase D) It prevents viral DNA transcription from RNA by inhibiting nucleoside reverse transcriptase

C) It prevents viral DNA replication by inhibiting thymidine synthetase

``` Which of the following wavelengths of light is most likely to damage the retina of a phakic elderly adult? A) 285 nm B) 370 nm C) 310 nm D) 210 nm ```

B) 370 nm

Which of the following is an example of an anastomosis between the internal and external carotid arteries that supply ocular structures? A) The infraorbital artery joins the facial artery to supply the lower eyelid and lacrimal sac B) The angular artery communicates with the dorsal nasal artery to supply the medial canthus C) The superficial temporal artery communicates with the facial artery to supply the superficial skin around the orbit D) The dorsal nasal artery communicates with the supratrochlear artery to supply the lacrimal sac

B) The angular artery communicates with the dorsal nasal artery to supply the medial canthus

``` Your patient's palpebral fissure OD appears wider vertically compared to OS due to trauma. His right eye is non-seeing. The patient desires a spectacle lens OD that will cosmetically equalize (narrow) the appearance of his right eye in the vertical meridian only. What is the power of the right lens that would best address this patient's request? A) +1.00 -1.00 x180 B) +1.00 -1.00 x090 C) plano -2.00 x180 D) plano -2.00 x090 ```

C) plano -2.00 x180

The greatest risk for developing a macular hole is: A) ocular trauma B) history of macular hole in the fellow eye C) posterior vitreous detachment D) increasing age E) intraocular surgery

D) increasing age

If the trigeminothalamic pathway were severed at the level of the medulla, which of the following would most likely be affected? A) proprioception B) taste C) light touch from the contralateral side of the face D) pain from the ipsilateral side of the face

D) pain from the ipsilateral side of the face

How do interferons provide resistance against corneal epithelial dendritic keratitis? A) They prevent the replication and production of new viruses within neighboring cells B) They secrete perforins that open pores within the cell membrane of infected cells C) They destroy the antigen through direct phagocytosis D) They release IL-2 to stimulate cytotoxic T lymphocytes to destroy the antigen

A) They prevent the replication and production of new viruses within neighboring cells

Which of the following statements regarding visual development of the infant is false? A) Approximately half of the changes necessary for development of the adult eye occur within the first six months of life. B) The sclera in an infant is approximately half the thickness of the sclera in an adult. C) A newborn has the same average intraocular pressure as an adult. D) The lacrimal system is patent at birth but does not reach full development until 3-4 years of age.

C) A newborn has the same average intraocular pressure as an adult.

``` Peripheral anterior synechiae and posterior synechiae are rarely found in uveitis associated with which of the following conditions? A) Sarcoidosis B) HLA-B27 spondyloarthropathy C) Juvenile rheumatoid arthritis D) Fuchs' heterochromic iridocyclitis ```

D) Fuchs' heterochromic iridocyclitis

``` A 20-year-old patient presents with a central retinal vein occlusion due to thrombosis. She denies a history of diabetes mellitus and hypertension. All of the following conditions may be the cause of this patient's condition EXCEPT: A) oral contraceptive use B) antithrombin III deficiency C) thrombocytopenia D) protein C and S deficiency E) smoking ```

C) thrombocytopenia

``` Increased water content in a traditional hydrogel contact lens results in which of the following? A) Better handling B) Improved visual acuity C) Decreased depositing D) Greater stability ```

A) Better handling

``` Which of the following are contraindications of oral carbonic anhydrase inhibitors such as acetazolamide? A) Postoperative cataract care B) Severe COPD C) Tachycardia D) Pregnancy E) Liver disease F) Systemic hypertension ```

B) Severe COPD D) Pregnancy E) Liver disease

``` Your patient has a distance prescription of -2.00 DS OD and OS with a +2.00 add OU. The spectacle frame has a 50 mm eye size with an 18 mm DBL. The patient's PD is 64mm/60mm. What is the required bifocal segment inset per lens? A) 4 mm out B) 2 mm in C) 2 mm out D) 4 mm in ```

B) 2 mm in

Which of the following statements regarding retinopathy of prematurity are correct? SELECT 3 A) Screening for ROP should be performed at the hospital after birth for all babies who weigh less than 2000 grams. B) Patients with ROP may present with a "dragged" appearance of the macula. C) Unlike infants born at a normal birth weight, infants with ROP demonstrate an incomplete development of the macula at birth. D) Increased oxygen exposure immediately after birth leads to an increased risk of development of ROP. E) ROP may be associated with the development of high myopia in infants.

B) Patients with ROP may present with a "dragged" appearance of the macula. D) Increased oxygen exposure immediately after birth leads to an increased risk of development of ROP. E) ROP may be associated with the development of high myopia in infants.

``` Which of the following serum laboratory results ins diagnostic of acute pancreatitis? A) Elevated lipase B) Elevated alkaline phosphatase C) Decreased albumin D) Decreased amylase ```

A) Elevated lipase

Which of the following statements regarding the conjunctiva is incorrect? A) The conjunctiva moves in conjunction with the eye because the forniceal conjunctiva is attached to the fascia surrounding the extraocular muscles B) The marginal conjunctiva is continuous with the epithelium of the skin at the mucocutaneous junction of the lid C) The submucosa of the bulbar conjunctiva is loosely attached to Tenon's capsule until approximately 3 mm from the cornea D) The submucosa of the tarsal conjunctiva is thin and loosely attached to the tarsal plate

D) The submucosa of the tarsal conjunctiva is thin and loosely attached to the tarsal plate

``` The gain of the vestibulo-ocular reflex (VOR) is approximately: A) 4:1 B) 3:1 C) 2:1 D) 1:1 ```

D) 1:1

``` Which of the following conditions is most likely to result in permanent loss of vision? A) Atopic keratoconjunctivitis B) Perennial allergic conjunctivitis C) Seasonal allergic conjunctivitis D) Vernal keratoconjunctivitis ```

A) Atopic keratoconjunctivitis

Which of the following statements regarding the clinical properties of the topical ophthalmic combination agent brinzolamide/brimonidine is true? A) The FDA-approved dosing frequency is BID B) This medication is the only combination agent for the treatment of elevated IOP that does not contain an adrenergic antagonist C) This medication should be avoided in patients with asthma or COPD D) This medication is less effective than either of its components used singly or in combination

B) This medication is the only combination agent for the treatment of elevated IOP that does not contain an adrenergic antagonist

A lesion that impacts only the parvocellular pathway would have the most effect on which of the following? A) Contrast sensitivity for low spatial frequency stimuli B) Ability to resolve high-frequency flickering stimuli C) Ability to detect high velocity motion D) Ability to discern colors in isoluminant gratings

D) Ability to discern colors in isoluminant gratings

Which of the following statements regarding metamers is incorrect? A) Metamer theory applies to dichromats but not trichromats B) They are visual stimuli that are physically different but result in identical visual perception C) Increasing the intensity of the two metamers will change both metamers, but they will still appear identical D) Adding light of the same wavelength and radiance to two metamers will change both metamers, but they will still appear identical

A) Metamer theory applies to dichromats but not trichromats

``` In what direction of gaze will motility be restricted in a patient with Brown syndrome affecting the left eye? A) Down and to the right B) Up and to the right C) Down and to the left D) Up and to the right ```

D) Up and to the right

The photoreceptor dark current is characterized by all of the following except: A) resting membrane potential that is more negative than other cells B) high outer segment membrane permeability to Na+ ions C) net flow of cations into the outer segment and out of the inner segment D) high outer segment membrane permeability to Ca2+ ions

A) resting membrane potential that is more negative than other cells

Spontaneous corneal epithelial erosions may occur in which of the following conditions? SELECT 2 A) Keratoconus B) Following trauma C) Epithelial basement membrane dystrophy D) Fuchs' endothelial dystrophy

A) Keratoconus | C) Epithelial basement membrane dystrophy

Which of the following statements regarding topical ophthalmic besifloxacin is incorrect? A) It is effective for both gram-positive and gram-negative organisms, including Pseudomonas B) It incorporates Durasite vehicle for longer retention time on the ocular surface C) The topical form of this medication was derived from systemic formulations D) It is as effective as vancomycin for all staph aureus isolates, including MRSA

C) The topical form of this medication was derived from systemic formulations

``` A patient wears a CR-39 lens with a round 28 bifocal segment. The image placement due to the bifocal add is 1.8 PD BU, and the image displacement due to the distance Rx is 2.8 PD BD. What is the total image displacement? A) 4.6 PD BD B) 1.0 PD BU C) 4.6 PD BU D) 1.0 PD BD ```

D) 1.0 PD BD

``` Which of the following topical ophthalmic drugs does NOT provide rapid relief of ocular itching? A) Lodoxamide B) Emedastine C) Epinastine E) OIopatadine ```

A) Lodoxamide

``` A patient presents with a pupil-sparing, right, complete CN III palsy. He is shown a Worth 4 dot target with the red lens over the left eye. What is the most likely response? A) 3 green dots B) 4 dots C) 5 dots, green to the right of the red D) 5 dots, red to the right of the green E) 2 red dots ```

E) 2 red dots

Practice Test Missed Questions Flashcards

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