Review of Ophthalmology Supplemental Questions - Friedman - 2005

FRIEDMAN: REVIEW OF OPHTHALMOLOGY
SUPPLEMENTAL QUESTIONS OPTICS CHAPTER 1
OPTICS
1. Which of the following statements regarding the duochrome test is true
a. shorter wavelengths are refracted less
b. the letters in the red light are refracted more
c. the letters in the green light are imaged anterior to those in the red light
d. too much minus sphere has been added if the letters in the red light are darker
Answer
2. The spectacle prescription +2.50-3.00x60, written in plus cylinder notation is
a. 2.50+1.50x150
b. 0.50+3.00x150
c. 1.25+1.50x150
d. 2.50+3.00x150
Answer
3. Cataract surgery and IOL implantation is performed to achieve a target refraction of
2.00 sphere. The patients final refraction is 0.75 sphere. The most likely cause
for this error is
a. the axial length is shorter than measured
b. the corneal curvature is steeper than measured
c. viscoelastic trapped in the capsular bag behind the IOL
d. the IOL was placed in the sulcus and no power adjustment was made
Answer
4. Aniseikonia is best decreased by changing which lens parameter
a. base curve
b. central thickness
c. diameter
d. vertex distance
Answer
5. A 1mm error on A-scan biometry causes how much of a refractive change
a. 1D
b. 1.5D
c. 2D
d. 3D
Answer
Elsevier items and derived items 2005 by Elsevier Inc. Page 1 of 2

6. A patient is found to have a refractive error of +2D OD and 2D OS. The least
effective way of correcting this patients anisometropia is with
a. glasses
b. contact lenses
c. LASIK
d. lens exchange
Answer
7. Which of the following effects is most bothersome to the aphakic spectacle wearer
a. pincushion
b. jack in-the-box
c. image displacement
d. Stiles-Crawford
Answer
8. A pinhole causes
a. increased spherical aberration
b. increased diffraction
c. decreased internal reflectivity
d. decreased metamorphopsia
Answer
9. A patient with mixed astigmatism would have which of the following plus cylinder
and minus cylinder notation combinations
a. + sphere + cylinder; + sphere -cylinder
b. - sphere + cylinder; - sphere -cylinder
c. - sphere + cylinder; + sphere -cylinder
d. + sphere + cylinder; -sphere -cylinder
Answer
10. Which of the following statements about the properties of light is correct
a. energy is inversely proportional to wavelength
b. speed is inversely proportional to frequency
c. energy is inversely proportional to frequency
d. speed is inversely proportional to wavelength
Answer

OPTICS ANSWER
1. Which of the following statements regarding the duochrome test is true
c. the letters in the green light are imaged anterior to those in the red light
this red/green test of refraction is based on the principle that shorter
wavelengths are refracted more than longer wavelengths as they enter denser
optical material, thus green light is refracted more than red light and the letters
on the green background will be imaged anterior to those on the red background
(relative to the macula).
Back

OPTICS ANSWER
2. The spectacle prescription +2.50-3.00x60, written in plus cylinder notation is
b. 0.50+3.00x150
Back

OPTICS ANSWER
3. Cataract surgery and IOL implantation is performed to achieve a target refraction of
2.00 sphere. The patients final refraction is 0.50 sphere. The most likely cause
for this error is
a. the axial length is shorter than measured
Back

OPTICS ANSWER
4. Aniseikonia is best decreased by changing which lens parameter
d. vertex distance
Back

OPTICS ANSWER
5. A 1mm error on A-scan biometry causes how much of a refractive change
d. 3D
Back

OPTICS ANSWER
6. A patient is found to have a refractive error of +2D OD and 2D OS. The least
effective way of correcting this patients anisometropia is with
a. glasses
Back

OPTICS Answer
7. Which of the following effects is most bothersome to the aphakic spectacle wearer
b. jack in-the-box
Back

OPTICS ANSWER
8. A pinhole causes
b. increased diffraction
Back

OPTICS ANSWER
9. A patient with mixed astigmatism would have which of the following plus cylinder
and minus cylinder notation combinations
c. - sphere + cylinder; + sphere -cylinder
Back

OPTICS ANSWER
10. Which of the following statements about the properties of light is correct
a. energy is inversely proportional to wavelength
Back

SUPPLEMENTAL QUESTIONS PHARMACOLOGY CHAPTER 2
PHARMACOLOGY
1. All of the following are potential complications of intraocular antibiotics except
a. iritis
b. corneal edema
c. strabismus
d. macular infarction
Answer
2. Toxoplasmosis can be treated with any of the following regimens except
a. observation
b. clindamycin
c. prednisone
d. clindamycin and prednisone
Answer
3. A 68 year old woman with macular degeneration is taking high dose vitamin
supplements. If she smokes, which component of the preparation should be
avoided
a. vitamin A
b. vitamin C
c. vitamin E
d. zinc
Answer
4. Fluoroquinolones act by
a. inhibiting cell wall synthesis
b. inhibiting protein synthesis
c. inhibiting nucleic acid synthesis
d. inhibiting genetic replication
Answer
5. Restasis is most accurately classified as a/n
a. antiinflammatory
b. immunomodulator
c. secretogogue
d. antibiotic
Answer
Elsevier items and derived items 2005 by Elsevier Inc. Page 1of 2
6. Corneal epithelial cell morphology is most affected by

a. cocaine
b. lidocaine
c. tetracaine
d. proparacaine
Answer
7. Which of the following glaucoma medications would be safest to use in a
pseudophakic diabetic patient 4 weeks after cataract surgery
a. Lumigan
b. Propine
c. Rescula
d. Alphagan
Answer
8. The topical fluoroquinolone antibiotic with the broadest spectrum is
a. Ciprofloxacin
b. Levofloxacin
c. Moxifloxacin
d. Ofloxacin
Answer
9. Diquafosol is effective in the treatment of dry eye syndrome by
a. increasing aqueous
b. increasing mucin
c. increasing lipid
d. decreasing lipid
Answer
10. Which antibiotic was not evaluated in the Endophthalmitis Vitrectomy Study
a. gentamycin
b. amikacin
c. ceftazidime
d. vancomycin
Answer
PHARMACOLOGY ANSWER
1. All of the following are potential complications of intraocular antibiotics except
c. strabismusthis can occur from subconjunctival (not intraocular) antibiotic
injection causing EOM toxicity.
Back
PHARMACOLOGY ANSWER
2. Toxoplasmosis can be treated with any of the following regimens except
c. prednisoneprednisone can be used in conjunction with antibiotics but not
alone.
Back
PHARMACOLOGY ANSWER
3. A 68 year old woman with macular degeneration is taking high dose vitamin
supplements. If she smokes, which component of the preparation should be
avoided.
a. vitamin Asmokers who take high dose vitamin A are at increased risk of lung
cancer
Back
PHARMACOLOGY ANSWER
4. Fluoroquinolones act by
d. inhibiting genetic replication
Back
PHARMACOLOGY ANSWER
5. Restasis is most accurately classified as a/n
b. immunomodulatoralthough cyclosporine is FDA approved for the treatment
of inflammatory dry eye disease, its mechanism of action is to inhibit activated
T-cells and thus it is categorized as an immunomodulator.
Back
PHARMACOLOGY ANSWER
6. Corneal epithelial cell morphology is most affected by
a. cocaine
Back
PHARMACOLOGY ANSWER
7. Which of the following glaucoma medications would be safest to use in a
pseudophakic diabetic patient 4 weeks after cataract surgery
d. Alphaganall of the other medicines may increase the risk of developing
cystoid macular edema.
Back
PHARMACOLOGY ANSWER
8. The topical fluoroquinolone antibiotic with the broadest spectrum is
c. Moxifloxacinlike gatifloxacin is a 4th generation fluoroquinolone and has an
extended spectrum of action against gram positives, anaerobes, and atypical
mycobacteria.
Back
PHARMACOLOGY ANSWER
9. Diquafosol is effective in the treatment of dry eye syndrome by
b. increasing mucin
Back
PHARMACOLOGY ANSWER
10. Which antibiotic was not evaluated in the Endophthalmitis Vitrectomy Study
a. gentamycin
Back
SUPPLEMENTAL QUESTIONS EMBRYOLOGY/PATHOLOGY CHAPTER 3
EMBRYOLOGY/PATHOLOGY
1. Which culture media is best used for anaerobic bacteria
a. blood
b. chocolate
c. thioglycolate
d. sabourauds
Answer
2. All of the following are examples of Type III hypersensitivity reactions except
a. Stevens-Johnson Syndrome
b. Moorens ulcer
c. scleritis
d. retinal vasculitis
Answer
3. The three types of giant cells are
a. Langhans, Touton, and epithelioid
b. Langhans, Touton, and foreign body
c. Touton, epithelioid, and foreign body
d. Langhans, epithelioid, and foreign body
Answer
4. All of the following are examples of diffuse granulomatous inflammation except
a. sympathetic ophthalmia
b. sarcoidosis
c. juvenile xanthogranuloma
d. lepromatous leprosy
Answer
5. Bladder cells are characteristic of which type of cataract
a. posterior subcapsular
b. cortical
c. nuclear sclerotic
d. anterior subcapsular
Answer

6. Which of the following in not a characteristic of phthisis

a. corneal opacification
b. retinal detachment
c. lens calcification
d. scleral thinning
Answer
7. The best medium for sending a lymphoma specimen to the lab for
immunohistochemical evaluation is
a. ethyl alcohol
b. glutaraldehyde
c. formalin
d. sterile water
Answer
8. Which of the following conditions does not demonstrate intraocular cartilage
a. PHPV
b. trisomy 13
c. medulloepithelioma
d. choroidal hemangioma
Answer
9. Which of the following is a choristoma
a. neurofibroma
b. trichoepithelioma
c. dermatolipoma
d. hemangiopericytoma
Answer
10. Which histologic feature is not characteristic of an eyelid basal cell carcinoma
a. Indian-file pattern
b. pagetoid spread
c. peripheral palisading
d. keratin pearls
Answer

EMBRYOLOGY/PATHOLOGY ANSWER
1. Which culture media is best used for anaerobic bacteria
c. thioglycolate
Back

2. All of the following are examples of Type III hypersensitivity reactions except
b. Moorens ulcerthis is a Type II (cytotoxic) hypersensitivity reaction rather
than a Type III (immune complex deposition) reaction.
Back

3. The three types of giant cells are
b. Langhans, Touton, and foreign bodyare the three types of giant cells.
They are composed of epithelioid histiocytes which are activated macrophages
that fuse to form giant cells.
Back

4. All of the following are examples of diffuse granulomatous inflammation except
b. sarcoidosisis an example of discrete granulomatous inflammation.
Back

5. Bladder cells are characteristic of which type of cataract
a. posterior subcapsular
Back

6. Which of the following in not a characteristic of phthisis
d. scleral thinningscleral thickening (not thinning) occurs in phthisis
Back

7. The best medium for sending a lymphoma specimen to the lab for
immunohistochemical evaluation is
a. ethyl alcoholthis is used for cytology
Back

8. Which of the following conditions does not demonstrate intraocular cartilage
d. choroidal hemangiomathis may calcify but does not contain cartilage.
Back

9. Which of the following is a choristoma
c. dermatolipomathe others are hamartomas.
Back

10. Which histologic feature is not characteristic of an eyelid basal cell carcinoma
d. keratin pearlsthese are found in squamous cell (not basal cell) carcinoma.
Back

SUPPLEMENTAL QUESTIONS NEURO-OPHTHALMOLOGY CHAPTER 4
NEURO-OPHTHALMOLOGY
1. The Knee of von Willebrand refers to which retinal fibers that cross in the optic
chiasm and course anteriorly into the contralateral optic nerve before running
posteriorly
a. inferotemporal
b. inferonasal
c. superotemporal
d. superonasal
Answer
2. Which of the following statements about the lateral geniculate body is false
a. P-cells subserve color vision
b. crossed fibers project to layers 1, 4, and 6
c. fibers are rotated 90 degrees
d. M-cells are contained in layers 3-6
Answer
3. A pie-in-the-sky visual field defect is caused by a lesion in the
a. optic chiasm
b. optic tract
c. temporal lobe
d. parietal lobe
Answer
4. Which of the following structures is not associated with vertical gaze
a. riMLF
b. PPRF
c. CN 3
d. CN4
Answer
5. Besides the optic nerve, in which area is it possible to have a lesion that causes a
monocular visual field defect
a. optic tract
b. lateral geniculate body
c. optic radiation
d. primary visual cortex
Answer

6. Nerve fibers in the optic tract are rotated

a. 0 degrees
b. 45 degrees
c. 90 degrees
d. 180 degrees
Answer
7. A patient with cortical blindness is least likely to have which of the following
findings
a. nystagmus
b. intact pupillary response
c. visual hallucinations
d. denial of blindness
Answer
8. Which type of nystagmus is correctly paired with its localizing lesion
a. convergence-retraction; cervicomedullary junction
b. dissociated; posterior fossa
c. downbeat; cerebellopontine angle
d. gaze-evoked; suprasellar
Answer
9. Rapid, chaotic, eye movements in all directions is found in which disorder
a. oscillopsia
b. ocular motor apraxia
c. opsoclonus
d. ocular myoclonus
Answer
10. Which of the following syndromes involves a lesion of CN 6
a. Nathnagels
b. Webers
c. Claudes
d. Fovilles
Answer

NEURO-OPHTHALMOLOGY ANSWER
1. The Knee of von Willebrand refers to which retinal fibers that cross in the optic
chiasm and course anteriorly into the contralateral optic nerve before running
posteriorly
b. inferonasal
Back

2. Which of the following statements about the lateral geniculate body is false
d. M-cells are contained in layers 3-6M-cells are contained in layers 1 and 2.
Back

3. A pie-in-the-sky visual field defect is caused by a lesion in the
c. temporal lobeadjacent to Meyers loop which is part of the optic radiations.
Back

4. Which of the following structures is not associated with vertical gaze
b. PPRFthe paramedian pontine reticular formation is the horizontal gaze
center.
Back

5. Besides the optic nerve, in which area is it possible to have a lesion that causes a
monocular visual field defect
d. primary visual cortexthe temporal crescent in each visual field is only seen
by nasal retina of the ipsilateral eye. This area is located most anteriorly in the
primary visual cortex, and it may be the only portion of the visual field spared
after occipital lobe damage.
Back

6. Nerve fibers in the optic tract are rotated
c. 90 degreeslower fibers lie laterally.
Back

7. A patient with cortical blindness is least likely to have which of the following
findings
a. nystagmusis not a feature of biliateral occipital lobe damage.
Back

8. Which type of nystagmus is correctly paired with its localizing lesion
b. dissociated; posterior fossa
Back

9. Rapid, chaotic, eye movements in all directions is found in which disorder
c. opsoclonus
Back

10. Which of the following syndromes involves a lesion of CN 6
d. Fovillesthe others are all syndromes of CN 3.
Back

SUPPLEMENTAL QUESTIONS PEDIATRICS/STRABISMUS CHAPTER 5
PEDIATRICS/STRABISMUS
1. The best prophylactic treatment for ophthalmia neonatorum is
a. silver nitrate solution
b. erythromycin ointment
c. sulfacetamide drops
d. viroptic drops
Answer
2. Which of the following statements regarding neuroblastoma is not correct
a. the average age of diagnosis of orbital neuroblastoma is 8 years old
b. Horners syndrome may occur in neuroblastoma
c. neuroblastoma may originate in the adrenal gland, mediastinum, or neck
d. 15% of childhood deaths are due to neuroblastoma
Answer
3. A 7 year old boy is found to have an ET which measures 20 prism diopters in
upgaze, 30 PD in primary gaze, and 45 PD in downgaze. Inferior oblique overaction
is confirmed. The best surgical treatment is
a. MR recession with upward transposition
b. MR recession and IO anteriorization
c. LR resection with upward transposition
d. LR recession with IO anteriorization
Answer
4. Goldenhars syndrome is not associated with
a. Duanes syndrome
b. vertebral anomalies
c. hypertelorism
d. eyelid colobomas
Answer
5. A paralytic can be distinguished from a restrictive muscle disorder by
a. forced duction test
b. 3-step test
c. double Maddox rod test
d. 4 prism diopter test
Answer

6. Crouzons syndrome is associated with all of the following ophthalmic findings

except
a. optic atrophy
b. telecanthus
c. nystagmus
d. exotropia
Answer
7. Conditions that cause a chin-up position include all of the following except
a. V pattern XT
b. double elevator palsy
c. bilateral SO palsy
d. A pattern ET
Answer
8. A 5 year old child with an amblyopic left eye is best treated with
a. part time patching of the left eye for 4 weeks
b. atropinization of the right eye for 6 weeks
c. optical degradation of the left eye for 5 weeks
d. full time patching of the right eye for 3 weeks
Answer
9. The most appropriate management of neonatal inclusion conjunctivitis is
a. topical erythromycin ointment only
b. topical erythromycin and oral erythromycin syrup
c. topical erythromycin for the neonate, oral erythromycin for the mother
d. topical erythromycin and oral erythromycin syrup for the neonate, oral
doxycycline for the mother
Answer
10. The best procedure to dampen nystagmus in a patient with nystagmus and a head
turn is
a. Harado Ito
b. Faden suture
c. Kestenbaum
d. Knapp
Answer

PEDIATRICS/STRABISMUS ANSWER
1. The best prophylactic treatment for ophthalmia neonatorum is
b. erythromycin ointment
Back

2. Which of the following statements regarding neuroblastoma is not correct
a. the average age of diagnosis of orbital neuroblastoma is 8 years oldthe
average age of diagnosis is actually 2 years old; rhabdomyosarcoma commonly
presents at age 8.
Back

3. A 7 year old boy is found to have an ET which measures 20 prism diopters in
upgaze, 30 PD in primary gaze, and 45 PD in downgaze. Inferior oblique overaction
is confirmed. The best surgical treatment is
b. MR recession and IO anteriorizationthe correct surgery for the ET is MR
recession or LR resection, to fix the V pattern due to oblique overaction the IO
muscle is weakened (the rectus muscles are not transposed).
Back

4. Goldenhars syndrome is not associated with
c. hypertelorism
Back

5. A paralytic can be distinguished from a restrictive muscle disorder by
a. forced duction test
Back

6. Crouzons syndrome is associated with all of the following ophthalmic findings
except
b. telecanthus
Back

7. Conditions that cause a chin up head posture include all of the following except
c. bilateral SO palsypatients with this condition usually have IO overaction
with a V pattern ET and chin down head position.
Back

8. A 5 year old child with an amblyopic left eye is best treated with
d. full time patching of the right eye for 3 weeksthe goal of amblyopia
treatment is to force the use of the poorer seeing (amblyopic) eye by limiting the
use of the better eye with occlusion or image degradation. The duration of full
time occlusion must not exceed 1 week per year of age in order to prevent
occlusion (deprivation) amblyopia.
Back

9. The most appropriate management of neonatal inclusion conjunctivitis is
d. topical erythromycin and oral erythromycin syrup for the neonate, oral
doxycycline for the motherit is important to treat the mother and any sexual
partners for chlamydia with oral antibiotics.
Back

10. The best procedure to dampen nystagmus in a patient with nystagmus and a head
turn is
c. Kestenbaumthis is a bilateral resection/recession that surgically moves the
eyes toward the direction of the head turn to dampen the nystagmus.
Back

SUPPLEMENTAL QUESTIONS ORBIT/LIDS/ADNEXA CHAPTER 6
ORBIT/LIDS/ADNEXA
1. The most common cause for failure of a DCR is obstruction at which site
a. common canaliculus
b. nasolacrimal sac
c. nasolacrimal duct
d. valve of Hasner
Answer
2. The least effective treatment of Kaposis sarcoma of the eyelid is
a. chemotherapy
b. cryotherapy
c. radiotherapy
d. surgical excision
Answer
3. A patient with a facial nevus flameus involving the eyelids would be likely to have
which eye finding
a. choroidal astrocytic hamartoma
b. choroidal hemangioma
c. retinal angioma
d. retinal cavernous hemangioma
Answer
4. The most common orbital tumor found in children is
a. capillary hemangioma
b. rhabdomyosarcoma
c. neuroblastoma
d. optic nerve glioma
Answer
5. A 37 year old obese man with sleep apnea and a chronic papillary conjunctivitis
would benefit most from which procedure
a. tarsorrhaphy
b. dacryocystorhinostomy
c. horizontal eyelid tightening
d. frontalis suspension
Answer

6. A patient with Graves disease notices a deterioration in her vision. The least likely
cause of the altered vision is
a. choroidal folds
b. optic neuropathy
c. corneal ulceration
d. macular edema
Answer
7. Botox injection is least acceptable for the treatment of which condition
a. strabismus
b. blepharospasm
c. myokymia
d. hemifacial spasm
Answer
8. Orbital apex syndrome is most commonly associated with
a. idiopathic orbital inflammation
b. mucormycosis
c. thyroid-related ophthalmopathy
d. Wegeners granulomatosis
Answer
9. A patient with blepharochalasis may exhibit all of the following except
a. fat prolapse
b. painless edema
c. atrophic changes
d. redundant skin
Answer
10. Which of the following disorders is incorrectly matched with the type of ptosis it
causes
a. chronic progressive external ophthalmoplegia; myogenic
b. CN 3 palsy; neurogenic
c. myotonic dystrophy; myogenic
d. myasthenia gravis; neurogenic
Answer

ORBIT/LIDS/ADNEXA - ANSWER
1. The most common cause for failure of a DCR is obstruction at which site
a. common canaliculusDCR failure is usually due to obstruction at the
common canaliculus or at the bony ostomy site.
Back

2. The least effective treatment of Kaposis sarcoma of the eyelid is
b. cryotherapy
Back

3. A patient with a facial nevus flameus involving the eyelids would be likely to have
which eye finding
b. choroidal hemangiomathis is the lesion present in Sturge-Weber syndrome
that gives the characteristic tomato-ketchup fundus appearance.
Back

4. The most common orbital tumor found in children is
a. capillary hemangioma
Back

5. A 37 year old obese man with sleep apnea and a chronic papillary conjunctivitis
would benefit most from which procedure
c. horizontal eyelid tighteningthis patient suffers from floppy eyelid syndrome
with autoeversion of the upper eyelids during sleep.
Back

6. A patient with Graves disease notices a deterioration in her vision. The least likely
cause of the altered vision is
d. macular edemathis is not associated with thyroid-related ophthalmopathy.
Back

7. Botox injection is least acceptable for the treatment of which condition
c. myokymiais an intermittent, self-limited focal muscle fasciculation for which
botox is not indicated. The other disorders are all indications for botox
injection.
Back

8. Orbital apex syndrome is most commonly associated with
b. mucormycosisoptic nerve compression can occur in IOI and TRO and optic
nerve edema can be seen in Wegeners, but orbital apex syndrome is associated
with orbital cellulitis especially mucormycosis.
Back

9. A patient with blepharochalasis may exhibit all of the following except
a. fat prolapsethis occurs in dermatochalasis, not blepharochalasis.
Back

10. Which of the following disorders is incorrectly matched with the type of ptosis it
causes
d. myasthenia gravis; neurogenicmyasthenia gravis causes a myogenic ptosis.
Back

SUPPLEMENTAL QUESTIONS CORNEA/EXTERNAL DISEASE CHAPTER 7
CORNEA/EXTERNAL DISEASE
1. A 27 yr old female presents with eye pain and redness, which you suspect may be
caused by herpes simplex. HSV is least likely in which situation
a. bilateral conjunctivitis
b. unilateral reduced corneal sensation
c. unilateral iritis and low intraocular pressure
d. unilateral eyelid lesions
Answer
2. Management of a patients first episode of HSV epithelial keratitis includes all of
the following except
a. topical viroptic
b. oral acyclovir
c. debridement of the involved epithelium
d. topical steroids
Answer
3. Patients with pellucid marginal degeneration
a. Are considered good candidates for LASIK
b. Typically have significant against-the-rule astigmatism
c. Exhibit the Lobster Claw sign on corneal topography
d. Have an area of steepening in the superior portion of the cornea
Answer
4. BIGH-3 linked corneal dystrophies include all of the following except
a. Granular
b. Avellino
c. Lattice
d. Macular
Answer
5. All of the following corneal dystrophies have an AD inheritance pattern except
a. Meesmanns
b. Macular
c. Granular
d. Reis-Bucklers
Answer
6. Which of the following clinical signs is least characteristic of a corneal transplant

rejection
a. elevated intraocular pressure
b. corneal edema
c. epithelial rejection line
d. subepithelial infiltrates
Answer
7. Which of the following LASIK flap complications does not preclude continuation of
the procedure
a. complete epithelial defect
b. incomplete flap
c. buttonhole flap
d. free cap
Answer
8. PRK and LASEK are similar procedures. The main difference is
a. For LASEK, a microkeratome is used to cut a stromal flap.
b. For LASEK, a sheet of epithelium is preserved.
c. For PRK, 8 incisions are created with a diamond blade.
d. For PRK, astigmatism cannot be corrected.
Answer
9. The most effective treatment for patients with dry eye related to meibomian gland
disease is
a. warm compresses and oral minocycline
b. ice packs
c. oral antihistamines
d. topical NSAID drops
Answer
10. The best initial treatment of a 1.5mm corneal perforation is
a. Gunderson flap
b. lamellar keratoplasty
c. cyanoacrylate glue and contact lens
d. penetrating keratoplasty
Answer
CORNEA/EXTERNAL DISEASE ANSWER

1. A 27 yr old female presents with eye pain and redness, which you suspect may be
caused by herpes simplex. HSV is least likely in the following situation:
c. unilateral iritis and low intraocular pressure typically herpes iritis causes
increased IOP.
Back


2. Appropriate management of a patients first episode of HSV epithelial keratitis
includes all of the following except
d. topical steroids
Back


3. Patients with pellucid marginal degeneration
c. exhibit the Lobster Claw sign on corneal topographyannular steepening
of the inferior cornea
Back


4. BIGH-3 linked corneal dystrophies include all of the following except
d. Macular
Back

5. All of the following corneal dystrophies have an AD inheritance pattern except

b. Macularwhich is AR.
Back


6. Which of the following clinical signs is least characteristic of a corneal transplant
rejection
a. elevated intraocular pressurethe pressure can be high or low with an acute
graft rejection
Back


7. Which of the following LASIK flap complications does not preclude continuation of
the procedure
d. free capthe cap can be replaced at the end of the laser treatment with a
bandage contact lens and rarely requires sututes. LASIK should be postponed
for all of the other flap complications.
Back


8. PRK and LASEK are similar procedures. The main difference is
b. For LASEK, a sheet of epithelium is preserved.
Back


9. The most effective treatment for patients with dry eye related to meibomian gland
disease is
a. warm compresses and oral minocycline
Back


10. The best initial treatment of a 1.5mm corneal perforation is
c. cyanoacrylate glue and contact lensis usually the best initial tectonic
solution for a small perforation until definitive surgical repair can be performed.
Back

ASSESSMENT SECTION MULTIPLE QUESTIONS UVEITIS CHAPTER 8
UVEITIS
1. Patients with granulomatous uveitis
a. may have Koeppe nodules
b. typically have elevated eye pressure
c. often have Fuchs heterochromic iridocyclitis
d. are usually early adolescents
Answer
2. Posterior uveitis is least likely to occur with
a. Sarcoidosis
b. Reiters syndrome
c. Tuberculosis
d. Syphilis
Answer
3. Patients with Behcets disease are least likely to have
a. genital ulcers
b. deafness
c. oral aphthous ulcers
d. erythema nodosum
Answer
4. Anterior chamber cells are most likely to be seen in
a. Primary open angle glaucoma
b. Posner-Schlossman syndrome
c. Urretts-Zhavalia syndrome
d. Progressive outer retinal necrosis
Answer
5. Three months after cataract surgery, a patient returns with low grade uveitis. A
white plaque is noted on the posterior capsule. The most likely cause of this
condition is a
a. gram-negative rod
b. gram-positive anaerobic rod
c. gram-positive catalase positive cocci
d. gram- negative diplococci
Answer

ASSESSMENT SECTION MULTIPLE QUESTIONS UVEITIS CHAPTER 8
6. The lesions of multiple evanescent white dot syndrome (MEWDS) are best
described as
a. multiple creamy yellow-white plaque-like lesions
b. granular retinal appearance with small (100-200m) white spots at level of RPE
c. small (100-300m) yellow or gray inner choroidal lesions
d. clusters of hyperpigmented spots (300-400m) surrounded by yellow-white halos
Answer
7. A patient with which of the following intraocular infections has the best prognosis
for survival
a. CMV retinitis
b. Acute retinal necrosis (ARN)
c. Candida endophthalmitis
b. Progressive outer retinal necrosis (PORN)
Answer
8. Which of the following conditions that can cause uveitis is not commonly associated
with oral lesions
a. Behcet's disease
b. Reiter's syndrome
c. HSV
d. Fuchs heterochromic iridocyclitis
Answer
9. Fuchs heterochromic iridocyclitis is
a. typically bilateral
b. associated with congenital Horners syndrome
c. characterized by diffuse small white stellate KP
d. associated with a white forelock
Answer
10. The test that would be least helpful in the work-up of a patient with a granulomatous
uveitis is
a. VDRL
b. ACE
c. HLA-B27
d. PPD
Answer

SUPPLEMENTAL QUESTIONS UVEITIS CHAPTER 8
UVEITIS ANSWER
1. Patients with granulomatous uveitis
a. may have Koeppe nodules
Back

UVEITIS ANSWER
2. Posterior uveitis is least likely to occur with
b. Reiters syndrome
Back

UVEITIS ANSWER
3. Patients with Behcets disease are least likely to have
b. deafness
Back

UVEITIS ANSWER
4. Anterior chamber cells are most likely to be seen in
b. Posner-Schlossman syndrome
Back

UVEITIS ANSWER
5. Three months after cataract surgery, a patient returns with low grade uveitis. A white
plaque is noted on the posterior capsule. The most likely cause of this condition is
b. gram-positive anaerobic rodthis scenario is most suggestive of chronic
endopthalmitis due to Proprionibacterium acnes.
Back

UVEITIS ANSWER
6. The lesions of multiple evanescent white dot syndrome (MEWDS) are best described
as
b. granular retinal appearance with small (100-200m) white spots at level of
RPE
Back

UVEITIS ANSWER
7. A patient with which of the following intraocular infections has the best prognosis for
survival
b. Acute retinal necrosis (ARN)ARN occurs in healthy individuals while the
other infections occur in immunocompromised patients.
Back

UVEITIS ANSWER
8. Which of the following conditions that can cause uveitis is not commonly associated
with oral lesions
d. Fuchs heterochromic iridocyclitis
Back

UVEITIS ANSWER
9. Fuchs heterochromic iridocyclitis is
c. characterized by diffuse small white stellate KP
Back

UVEITIS ANSWER
10. The test that would be least helpful in the work-up of a patient with a granulomatous
uveitis is
c. HLA-B27is associated with disorders causing nongranulomatous uveitis.
Back

SUPPLEMENTAL QUESTIONS GLAUCOMA CHAPTER 9
GLAUCOMA
1. Central corneal thickness is an important measurement for glaucoma patients
because
a. Prostaglandin analogues work better in patients with thin corneas
b. Intraocular pressure can appear artificially elevated in thin corneas
c. Intraocular pressure can appear artificially low in corneas with a thickness of
470 microns
d. Thicker corneas respond better to selective laser trabeculoplasty
Answer
2. Chronic use of which medication is most likely to cause a steroid response
a. Fluorometholone 0.1%
b. Loteprednol 0.5%
c. Dexamethasone 0.1%
d. Rimexilone 1%
Answer
3. Elevated intraocular pressure and a red eye is most likely to occur with
a. Pseudomonas corneal ulcer
b. Herpes simplex iridocyclitis
c. Adenovirus conjunctiivits
d. Sarcoid-related uveitis
Answer
4. Which of the following medications is least likely to alter pupil size
a. Pilocarpine
b. Carbachol
c. Alphagan
d. Trusopt
Answer
5. Which topical beta-blocker can worsen a patients serum lipid profile by decreasing
the HDL levels
a. carteolol
b. timolol
c. optipranolol
d. betaxalol
Answer

6. Three days after uncomplicated cataract surgery, a patient is found to have an IOP
of 27 mm Hg. The least likely cause of this elevated pressure is
a. malignant glaucoma
b. steroid response
c. retained viscoelastic
d. pupillary block
Answer
7. Malignant glaucoma occurs when
a. patients with malignant melanoma have metastases to the eye
b. patients who undergo intraocular surgery develop misdirection of aqueous flow
c. patients who undergo vitrectomy develop a vitreous hemorrhage
d. patients have an intraocular pressure higher than 50 mm Hg
Answer
8. An increased risk of developing POAG exists in a patient of which race
a. Native American
b. Asian
c. Caucasian
d. African American
Answer
9. Which of the following is characteristic of ICE syndrome
a. typically bilateral
b. elevated intraoclar pressure
c. open angles without PAS
d. more common in men
Answer
10. Patients with pseudoexfoliation and cataracts should be advised that
a. Pseudoexfoliation is a risk factor for elevated intraocular pressure
b. There is a reduced risk of vitreous loss during cataract surgery
c. Cataract surgery will cure the pseudoexfoliation
d. Cataract surgery is considered dangerous and should be avoided
Answer

GLAUCOMA ANSWER
1. Central corneal thickness is an important measurement for glaucoma patients
because
c. Intraocular pressure can appear artificially low in corneas with a
thickness of 470 micronsless than 550 microns is considered a thinner than
normal cornea.
Back

GLAUCOMA ANSWER
2. Chronic use of which medication is most likely to cause a steroid response
c. Dexamethasone 0.1%
Back

GLAUCOMA ANSWER
3. Elevated intraocular pressure and a red eye is most likely to occur with
b. Herpes simplex iridocyclitisiridocyclitis usually causes reduced intraocular
pressure, but HSV is associated with a paradoxical elevated intraocular
pressure.
Back

GLAUCOMA ANSWER
4. Which of the following medications is least likely to alter pupil size
d. Trusoptpilocarpine and carbachol are strong miotic drops, and alphagan
causes a milder degree of pupillary constriction.
Back

GLAUCOMA ANSWER
5. Which topical beta-blocker does not worsen a patients serum lipid profile by
decreasing the HDL levels
a. carteololthis drop is the only beta-blocker that increases serum HDL.
Back

GLAUCOMA ANSWER
6. Three days after uncomplicated cataract surgery, a patient is found to have an IOP
of 27 mm Hg. The least likely cause of this elevated pressure is
b. steroid responseit usually takes more than a week for a steroid response to
occur.
Back

GLAUCOMA ANSWER
7. Malignant glaucoma occurs when
b. patients who undergo intraocular surgery develop misdirection of aqueous
flow
Back

GLAUCOMA ANSWER
8. An increased risk of developing POAG exists in a patient of which race
d. African American
Back

GLAUCOMA ANSWER
9. Which of the following is characteristic of ICE syndrome
b. elevated intraocular pressure
Back

GLAUCOMA ANSWER
10. Patients with pseudoexfoliation and cataracts should be advised that
a. Pseudoexfoliation is a risk factor for elevated intraocular pressure
Back

SUPPLEMENTAL QUESTIONS ANTERIOR SEGMENT CHAPTER 10
ANTERIOR SEGMENT
1. Pigment dispersion syndrome is
a. more common in sedentary, elderly females
b. associated with a 90% chance of progressing to pigmentary glaucoma within 5
years of presentation
c. treated with immediate pepripheral iridectomy to prevent rapid onset of
pigmentary glaucoma
d. associated with increased pigment deposition in the angle
Answer
2. A suspicious pigmented iris lesion near the angle appears to have grown over the
previous year. The most appropriate management is
a. immediate surgical resection
b. photodocumentation and ultrasonography
c. Nd:YAG laser photodisruption
d. fine needle aspiration
Answer
3. Which of the following statements regarding Marfans syndrome is true
a. its inheritance pattern is autosomal recessive
b. it is associated with an increased risk of ectopia lentis with subluxation of the
crystalline lens inferiorly
c. it is necessary to have a cardiac examination on a regular basis
d. it is not associated with an increased risk of retinal detachment
Answer
4. Patients with homcystinuria
a. have a normal life expectancy
b. have early loss of accommodation
c. have ectopia lentis in their 40s
d. have short stature and stubby fingers
Answer

5. Cohesive viscoelastics offer an advantage over dispersive viscoelastics in which

phase of cataract surgery
a. superior maintenance of the anterior chamber during keratome entry
b. better control of the capsulorrhexis with less likelihood of the tear extending
peripherally
c. more protection of the corneal endothelial during phacoemulsification
d. easier removal after intraocular lens placement
Answer
6. An expulsive suprachoroidal hemorrhage is most likely to occur during which of the
following surgeries
a. Trabeculectomy with mitomycin-C
b. Penetrating keratoplasty
c. Secondary anterior chamber IOL insertion through a 6 mm incision
d. Scleral tunnel phacoemulsification through a 3.5 mm incision
Answer
7. Copper deposition in the lens capsule (chalcosis lentis)
a. does not typically occur in Wilsons disease
b. may occur in patients with a Kayser-Fleischer ring
c. is not associated with multiple myeloma
d. makes the lens appear copper-colored
Answer
8. Myotonic dystrophy
a. is inherited in an autosomal recessive fashion
b. does not affect the retinal appearance
c. is associated with a Christmas tree cataract
d. is linked to chromosome 13
Answer
9. Weill-Marchesani syndrome is characterized by all of the following except
a. high hyperopia
b. microspherophakia
c. short stature
d. ectopia lentis
Answer

10. True exfoliation

a. is a risk factor for glaucoma
b. is seen as delamination of the anterior lens capsule forming scrolls
c. is caused by a chemical injury
d. is associated with exfoliation of the liver capsule
Answer
11. All of the following statements about Irvine-Gass syndrome are true except
a. angiographic findings are more common than clinical signs
b. it is more common if the posterior capsule is not intact
c. vitreous adhesion to the wound is a risk factor
d. it is not associated with staining of the optic nerve on fluorescein angiography
Answer

ANTERIOR SEGMENT ANSWER

1. Pigment dispersion syndrome is
d. associated with increased pigment deposition in the angle
Back


2. A suspicious pigmented iris lesion near the angle appears to have grown over the
previous year. The most appropriate management is
b. Photodocumentation and ultrasonography
Back


3. Which of the following statements regarding Marfans syndrome is true
c. it is necessary to have a cardiac examination on a regular basisdue to an
increased risk of aortic dissection and other cardiovascular abnormalities.
Back


4. Patients with homocystinuria
b. have early loss of accommodationdue to disintegration of zonular fibers at
an early age.
Back


5. Cohesive viscoelastics offer an advantage over dispersive viscoelastics in which
phase of cataract surgery
d. easier removal after intraocular lens placement
Back


6. An expulsive suprachoroidal hemorrhage is most likely to occur during which of the
following surgeries
b. Penetrating keratoplastywhen the patients cornea is removed and the
pressure in the eye is zero, any small hemorrhage can rapidly become expulsive,
as there is no pressure to limit its expansion.
Back


7. Copper deposition in the lens capsule (chalcosis lentis)
b. may occur in patients with a Kayser-Fleischer ringchalcosis lentis is
associated with Wilsons disease
Back


8. Myotonic dystrophy
c. is associated with a Christmas tree cataract
Back


9. Weill-Marchesani syndrome is characterized by all of the following except
a. high hyperopiathis syndrome is associated with myopia
Back


10. True exfoliation
b. is seen as delamination of the anterior lens capsule forming scrolls
Back


11. All of the following statements about Irvine-Gass syndrome are true except
d. it is not associated with staining of the optic nerve on fluorescein
angiography
Back

SUPPLEMENTAL QUESTIONS POSTERIOR SEGMENT CHAPTER 11
POSTERIOR SEGMENT
1. The Studies of the Ocular Complications of AIDS (SOCA) Trial reported that
a. Foscarnet was equal to ganciclovir at controlling CMV retinitis
b. There was no difference in mortality between the patients receiving foscarnet
and ganciclovir
c. Patients with lower CD4 counts had lower mortality with combination treatment
d. Viral resistance was a major cause of retinitis relapses
Answer
2. Patients with Sorsbys fundus dystrophy

a. have peripheral vision loss
b. should restrict their arginine intake
c. can have color vision abnormalities before fundus changes
d. have a good prognosis
Answer
3. Patients with idiopathic juxtafoveal retinal telangiectasis

a. have no systemic associations
b. with unilateral disease are classified as Group 1
c. are best treated with focal laser photocoagulation
d. do not have capillary non-perfusion
Answer
4. Patients with radiation retinopathy

a. respond well to grid laser photocoagulation
b. present within 3 months of radiation exposure
c. have damaged vascular bed, but minimal ischemia
d. should receive panretinal photocoagulation when neovascularization develops
Answer
5. The clinical picture of Lebers congenital amaurosis includes

a. presentation in second decade of life
b. nystagmus
c. associated systemic findings
d. relative afferent pupillary defect
Answer

6. Patients with circumscribed choroidal hemangioma

a. have high internal reflectivity on ultrasound
b. can develop neovascularization
c. can have a hereditary component
d. require a systemic work up
Answer
7. Bests macular dystrophy is characterized by

a. abnormal ERG
b. bulls eye maculopathy
c. underlying RPE abnormality
d. poor vision starting in childhood
Answer
8. High dose anti-oxidants and vitamins

a. should be taken by family members of patients with any AMD
b. should be taken when exudative AMD is present in both eyes
c. causes regression of drusen
d. should not be taken when only a few small drusen are present
Answer
9. All of the following are symptoms of ocular ischemic syndrome except

a. sharp eye pain with eye movement
b. prolonged retinal arterial venous transit time
c. elevated intraocular pressure
d. amaurosis fugax
Answer
10. Patients with angioid streaks do not have

a. full-thickness breaks in Bruchs membrane
b. association with abetalipoproteinemia
c. better prognosis than AMD
d. association with Pagets disease of bone
Answer

POSTERIOR SEGMENT - ANSWER
1. The Studies of the Ocular Complications of AIDS (SOCA) Trial reported that
a. Foscarnet was equal to ganciclovir at controlling CMV retinitis
Back

2. Patients with Sorsbys fundus dystrophy

c. can have color vision abnormalities before fundus changes
Back

3. Patients with idiopathic juxtafoveal retinal telangiectasis

b. with unilateral disease are classified as Group 1
Back

4. Patients with radiation retinopathy

d. should receive panretinal photocoagulation when neovascularization
develops
Back

5. The clinical picture of Lebers congenital amaurosis includes

b. nystagmus
Back

6. Patients with circumscribed choroidal hemangioma

a. have high internal reflectivity on ultrasound
Back

7. Bests macular dystrophy is characterized by

c. underlying RPE abnormality
Back

8. High dose anti-oxidants and vitamins

b. should be taken when exudative AMD is present in both eyesespecially if
vision better than 20/200
Back

9. All of the following are symptoms of ocular ischemic syndrome except

a. sharp eye pain with eye movementdull pain in or around the eyes is
characteristic
Back

10. Patients with angioid streaks do not have

c. better prognosis than AMDthey have a much worse prognosis with very
recurrence rates and poor response to treatment
Back

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FRIEDMAN: REVIEW OF OPHTHALMOLOGY

SUPPLEMENTAL QUESTIONS OPTICS CHAPTER 1

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6. Corneal epithelial cell morphology is most affected by

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6. Which of the following in not a characteristic of phthisis

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6. Nerve fibers in the optic tract are rotated

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6. Crouzons syndrome is associated with all of the following ophthalmic findings

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