BCSC Fundamentals and Principles of Ophthalmology (2016-2017)

If all the nerves passing through the annulus of Zinn were transected, what nerve would continue to function?

Superior division of cranial nerve III

Cranial nerve IV

Nasociliary branch of cranial nerve V

Optic nerve

Which extraocular muscle originates from the annulus of Zinn?

Levator palpebrae superioris

Superior oblique

Lateral rectus

Inferior oblique

What is the ratio of optic nerve axons that cross at the optic chiasm to those that do not cross at the optic chiasm?

67:33

50:50

30:70

53:47

A patient presents with left-sided ophthalmoplegia and forehead numbness. The lesion is most likely to be located at the

Brainstem

Cavernous sinus

Superior orbit

Intraconal space

The first cells to develop in the embryonic retina are the

Ganglion cells

Photoreceptors

Amacrine cells

Bipolar cells

Which disorder is associated with a defect in a nonmitochondrial gene?

Leber hereditary optic neuropathy

Chronic progressive external ophthalmoplegia

Neuropathy, atxia, and retinitis pigmentosa

Retinoblastoma

What characteristic of retinoblastoma may fcailitate its diagnosis as a familial condition?

It may be associated with chromosome 11 short-arm deletion syndrome and Wilms tumor

It affects approximately 1 per 100,000 live births in the United States

Approximately 90% of patients with hereditary retinoblastoma have a family history of the disease

The hereditary pattern in familial retinoblastoma is autosomal dominant, but the defect is mitochondrial at a cellular level.

Mutations in the rhodopsin gene are associated with what inherited ocular disease?

Juvenile glaucoma

Leber hereditary optic neuropathy

Retinitis pigmentosa

Stargardt disease

Mitochondrial inheritance is transmitted by what route?

Paternal mitochondria

Maternal mitochondria

Acquired mitochondria

De novo mitochondria

Mutations of PAX6 are associated with what disorder?

Aniridia

Retinal coloboma

Renal hypoplasia

Corneal granular dystrophy

An unaffected woman has a brother, maternal uncle, and son affected with retinitis pigmentosa. What is the most likely mode of inheritance?

Autosomal dominant

X-linked recessive

Autosomal recessive

Sporadic

What is the basis for complex genetic diseases?

A single recessive gene

X-linked genes

A single spontaneous genetic mutation

The resultant effect of many genes, in combination with health habits and environmental factors

What structure, if inflamed, would be considered a sign of uveitis?

Optic nerve

Descemet membrane

Choroid

Retinal pigment epithelium

What pair accurately matches a cell-type origin with the correct tear-layer product?

Goblet cells-lipid layer

Meibomian glands-mucin layer

Glands of Krause-aqueous layer

Glands of Wolfring-mucin layer

What option most accurately describes the immunoglobulin(s) that can be found in the tear film?

IgA only

IgA and IgG only

IgG and IgM only

IgA, IgG, IgM, and IgD

What intraocular structure is a true basement membrane (basal lamina)

Bowman layer

Zonule of Zinn

Descemet membrane

Anterior border layer of iris

What is the principal structural protein in the Descemet membrane?

Type I collagen

Type II collagen

Type III collagen

Type IV collagen

What mechanism holds the flap created during LASIK in place after surgery?

Endothelial-Descemet mbrane interaction

Endothelial pump

Bowman layer-stromal adhesions

Stromal collagen adhesions

What property of the retina redners it susceptible to oxidative stress?

High content of polyunsaturated fatty acids in photoreceptor outer segments

High concentration of carotenoids compared with other intraocular structures

Presence of vitamin E

Absence of retinal vessels in the foveal avascular zone

What pigment within the retinal pigment epithelium is responsible for the signal generated in fundus autofluorescence imaging?

Melanin

Lipofuscin

Rhodopsin

Lutein

The retinal pigment epithelium is the first site of melanogenesis in the body. Ocular melanin has been shown to participate in what process?

Pathogensis of retinitis pigmentosa

Vitamin A metabolism

Retinal adhesion

Retinal development and neuronal migration

Age-related loss of type IX collagen has been implicated in what process related to the vitreous?

Vitreous hemorrhage

Angiogenesis

Increased diffusion of oxygen from the anterior segment into the posterior segment

Vitreous liquefaction

In prescribing for elderly patients, what pharmacologic adjustments must be considered?

Hepatic perfusion and enzymatic activity increases with age

Renal function decreases with age

Elderly patients have more albumin relative to weight

Elderly patients have more body water relative to weight

What technique or strategy improves the ocular absorption of eyedrops?

Rapid instillation of eyedrops one after the other without interruption

Application of digital pressure at the lateral canthus to prevent the eyedrop from escaping

Keeping the eye open and rolling the eye around after instillation of each drop

Increasing the viscosity of the delivery vehicle

Atropine, 1%, has how many milligrams of drug per drop, assuming 20 drops per milliliter?

1mg

0.5mg

0.1mg

0.05mg

How much epinephrine is present in 1 mL of the 1:10,000 epinephrine solution?

1 mg of epinephrine

Same amount of epinephrine as in 1 mL of 0.01% epinephrine

Same amount of epinephrine as in 1 mL of 1:1000 epinephrine

Same amount of epinephrine as in 1 mL of 0.1% epinephrine

Diret-acting muscarinic agents (miotics) have what clinical effect?

Hyperopic shift in refraction

Increased range of accommodation

Central anterior chamber deepening

Increased night vision

What management strategy has been shown to reduce postsurgical endophthalmitis?

Preoperative preparation of the eye with topical povidone-iodine

Intracameral vancomycin

Intracameral aminoglycosides

Subconjunctival fluoroquinolones

What property of latanoprost may limit its usefulness?

It is a prodrug of prostaglandin E2a

It reduces intraocular pressure by increasing trabecular meshwork outflow

It can cause darkening of the iris and periocular skin and hypertrichosis of the eyelashes

It increases the number of melanocytes

What systemic side effect may result from treatment with oral carbonic anyhdrase inhibitors?

Insomnia

Weight gain

Hyperkalemia

Aplastic anemia

What is a clinically important property of brimonidine?

Brimonidine is a selective a1-adrenergic agonist

Brimonidine is more lipophilic than apraclonidine

Brimonidine has been associated with tachycardia and hyperventilation when used in infants

Rates of tachyphylaxis and allergic reaction are higher in brimonidine than in apraclonidine

BCSC Fundamentals and Principles of Ophthalmology (2016-2017)

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