Untitled PDF - Ophthalmology Past Exam Questions PDF

Question 1 A 39-year-old female presents to your clinic with pain in her right eye. She has had at least two previous episodes of this eye pain and complains of pain in her hands in the morning. You diagnose her with an anterior uveitis. Which of the foll...

Question 1 A 39-year-old female presents to your clinic with pain in her right eye. She has had at least two previous episodes of this eye pain and complains of pain in her hands in the morning. You diagnose her with an anterior uveitis. Which of the following is the best management of this patient? Prescribe Pred Forte 1% 1 gtt q1hr OD only. Instill 1 drop of atropine in-office OD only. Recommend over the counter NSAID’s to manage the joint pain. Return to clinic the next day for follow-up. Prescribe Pred Forte 1% 1 gtt q1hr OD only. Return to clinic in 2 days for follow-up. Prescribe Tobradex 1 gtt QID OD only. Instill 1 drop of atropine in-office OD only. Return to clinic in 2 days. Prescribe Pred Forte 1% 1 gtt q1hr OD only. Instill 1 drop of atropine in-office OD only. Refer the patient to the rheumatologist for consultation. Return to clinic the next day for follow-up. Prescribe Pred Forte 1% 1 gtt q1hr OD only. Instill 1 drop of atropine in-office OD only. Return to clinic the next day for follow-up. Question 2 Which of the following is a possible side effect of DMARD(s)? Deposits on the lens Weight loss Choroidal Effusion Kidney Toxicity Paranoia Question 3 A 27-year-old female presents to your clinic for a comprehensive eye exam. During case history, the patient notes a history of left knee pain for the past 20 years due to “arthritis.” She is unsure of the specific medical condition she has. Untitled 1  She denies any other significant medical history. What is the most likely diagnosis for her condition? Rheumatoid Arthritis Pauciarticular Juvenile Rheumatoid Arthritis Still’s Disease Polyarticular Juvenile Rheumatoid Arthritis Osteoarthritis Question 4 Which of the following tests is the most appropriate to perform on a 52-year-old Caucasian female who has been taking Plaquenil for the past 6 years? OCT of the Optic Nerve Head 30-2 Sita-Fast Humphrey Visual Field 10-2 Sita-Fast White Humphrey Visual Field 10-2 Sita-Fast Red Humphrey Visual Field Red Cap Desaturation Test Question 5 Based on the picture below, what is the most likely systemic diagnosis? Behcet’s Disease Lyme Disease Gout Psoriatic Arthritis Reactive Arthritis Question 1 A 75-year-old woman presents with new onset of a headache that she describes as different from any headache she has had in the past. She also reports fatigue, Untitled 2  weight loss, and jaw pain when chewing. On physical exam, there is tenderness upon palpation of the temporal artery. What is the most likely diagnosis? Rheumatoid arthritis Giant Cell Arteritis Osteoarthritis Migraine Temporal lobe tumor Question 2 Which of the following arteries is most commonly affected in Giant Cell Arteritis? Ophthalmic artery Temporal artery Internal carotid artery Maxillary artery Vertebral artery Question 3 Which of the following is a hallmark symptom of jaw claudication seen in Giant Cell Arteritis? Jaw pain during talking Jaw pain at rest Jaw pain that occurs only after prolonged chewing Jaw pain when swallowing Jaw pain immediately after starting to chew Question 4 What diagnostic test is considered the gold standard for confirming Giant Cell Arteritis? Erythrocyte Sedimentation Rate (ESR) C-Reactive Protein (CRP) Temporal artery biopsy (TAB) Untitled 3  Magnetic Resonance Imaging (MRI) Complete Blood Count (CBC) Question 5 Which of the following criteria is necessary to diagnose Giant Cell Arteritis? Age at onset greater than 50 years Headache that worsens in the morning Scalp tenderness only on palpation History of rheumatoid arthritis Chronic tinnitus Question 6 Which blood test is elevated in 95% of patients with Giant Cell Arteritis, but a normal result does not exclude the diagnosis? C-Reactive Protein (CRP) Complete Blood Count (CBC) Platelet Count White Blood Cell Count Serum Ferritin Question 7 Which of the following systemic symptoms is commonly associated with Giant Cell Arteritis? Fever and weight loss Abdominal pain Nausea and vomiting Shortness of breath Blurred vision Question 8 A patient diagnosed with Giant Cell Arteritis is treated with oral steroids. Which of the following values would you expect to elevate in response to this treatment? Untitled 4  Erythrocyte Sedimentation Rate (ESR) Platelet count Hemoglobin levels White blood cell count Glucose levels Question 1 A 70-year-old patient with a history of Giant Cell Arteritis presents with sudden, painless vision loss in the right eye. Fundus examination reveals a pale, swollen optic disc. What is the most likely diagnosis? Optic neuritis Central retinal vein occlusion Arteritic Anterior Ischemic Optic Neuropathy (AAION) Non-arteritic Anterior Ischemic Optic Neuropathy Retinal detachment Question 2 Arteritic Anterior Ischemic Optic Neuropathy (AAION) is most commonly caused by ischemia of which artery? Central Retinal Artery Posterior Ciliary Artery Ophthalmic Artery Internal Carotid Artery Superior Temporal Artery Question 3 Which of the following symptoms is most characteristic of Arteritic Anterior Ischemic Optic Neuropathy (AAION)? Gradual vision loss over weeks Untitled 5  Painful vision loss Bilateral vision loss Sudden, painless vision loss Fluctuating vision loss Question 4 What is the goal of treatment for patients with Arteritic Anterior Ischemic Optic Neuropathy (AAION)? Preserving remaining vision and preventing involvement of the fellow eye Reducing intraocular pressure Improving vision in the affected eye Managing pain associated with the condition Reducing headache frequency Question 5 What is the appropriate initial treatment for a patient diagnosed with Arteritic Anterior Ischemic Optic Neuropathy (AAION)? Oral or IV steroids Anti-VEGF injections Topical beta-blockers Laser photocoagulation Oral antibiotics Question 6 Which of the following is a key diagnostic test that should be performed within two weeks of starting treatment for AAION? Temporal artery biopsy (TAB) Optical Coherence Tomography (OCT) Fluorescein angiography Magnetic Resonance Imaging (MRI) Complete Blood Count (CBC) Untitled 6  Question 7 Which of the following values should be closely monitored in a patient with AAION undergoing steroid therapy? Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) White blood cell count Hemoglobin levels Platelet count Serum sodium levels Question 1 Which demographic group is most commonly affected by Systemic Lupus Erythematosus (SLE)? Young, non-white women of child-bearing age Elderly men Middle-aged white women Young Caucasian men Children under 10 years old Question 2 Which of the following medications can trigger drug-induced lupus? Hydralazine, Phenytoin, Isoniazid Acetaminophen, Ibuprofen, Omeprazole Lisinopril, Metformin, Warfarin Amoxicillin, Metoprolol, Amlodipine Aspirin, Codeine, Albuterol Question 3 Which of the following is a diagnostic criterion for Systemic Lupus Erythematosus (SLE)? Untitled 7  Malar (butterfly) rash Blisters on the palms Hyperpigmentation of the skin Skin tags on the neck Pustules on the scalp Question 4 Which of the following is true regarding arthritis in Systemic Lupus Erythematosus (SLE)? It occurs in 50% of patients It occurs in 90% of patients It is always accompanied by joint deformities It is typically painless It is primarily seen in the hips Question 5 Which of the following lab tests is most likely to be positive in patients with Systemic Lupus Erythematosus (SLE)? Rheumatoid factor (RF) Hemoglobin electrophoresis D-dimer Antinuclear antibody (ANA) C-reactive protein (CRP) Question 6 A patient with Systemic Lupus Erythematosus presents with inflammation of the heart and pleura. Which of the following diagnostic criteria does this symptom meet? Serositis Hematologic disorder Neurologic disorder Untitled 8  Immunologic disorder Photosensitivity Question 7 Which of the following is NOT a potential complication of Systemic Lupus Erythematosus (SLE)? Pneumonitis Diabetes mellitus Interstitial lung disease Raynaud’s phenomenon Mesenteric vasculitis Question 1 What is the most common ocular manifestation of Systemic Lupus Erythematosus (SLE)? Optic neuritis Discoid rash of the periocular skin Anterior uveitis Dry eye Retinal detachment Question 2 Which of the following statements about lupus retinopathy is true? It is the most common ocular manifestation of lupus It is associated with hypopigmentation of the retina It is associated with immune complex deposition in the retinal vasculature and RNFL It rarely leads to retinal ischemia It is most often asymptomatic Untitled 9  Question 3 Which of the following findings is typically associated with lupus retinopathy? Retinal neovascularization Cotton wool spots Pigment epithelial detachments Cherry-red spot at the macula Serous retinal detachment Question 4 Which of the following joints is most commonly affected by rheumatoid arthritis (RA)? Hips Spine Interphalangeal and metacarpophalangeal joints Elbows Shoulders Question 5 Which of the following is a common feature of rheumatoid arthritis (RA)? Morning stiffness lasting less than 30 minutes Bilateral and symmetric involvement of joints Asymmetrical joint involvement Improvement of symptoms with rest Primarily affects large weight-bearing joints Question 6 Which of the following is NOT a diagnostic criterion for rheumatoid arthritis (RA)? Morning stiffness lasting longer than an hour Positive antinuclear antibody (ANA) Rheumatoid nodules Untitled 10  Radiographic evidence of arthritis Arthritis involving three or more joints Question 1 Which of the following systemic complications is commonly associated with rheumatoid arthritis (RA)? Bronchiectasis Pleural effusions and pulmonary fibrosis Cardiomegaly Liver cirrhosis Gallstones Question 2 Which of the following ocular conditions is most strongly associated with rheumatoid arthritis (RA)? Anterior uveitis Optic neuritis Peripheral ulcerative keratitis (PUK) Retinal detachment Central serous chorioretinopathy Question 3 Scleritis is a serious ocular complication of rheumatoid arthritis. What is the most severe form of scleritis associated with RA? Simple episcleritis Diffuse anterior scleritis Necrotizing scleritis Posterior scleritis Sectoral scleritis Untitled 11  Question 4 Sjogren’s Syndrome (SS) is commonly associated with which other autoimmune conditions? Rheumatoid arthritis and lupus Crohn’s disease and ulcerative colitis Multiple sclerosis and Guillain-Barré syndrome Psoriasis and ankylosing spondylitis Celiac disease and Hashimoto’s thyroiditis Question 5 Which of the following is NOT a typical sign of Sjogren’s Syndrome (SS)? Elevated intraocular pressure Enlarged salivary glands Decreased tear break-up time (TBUT) Dry, fissured tongue Poor dental health Question 6 Which of the following describes primary Sjogren’s Syndrome? It is caused by viral infections It occurs independently without association with other autoimmune conditions It is always secondary to rheumatoid arthritis It is primarily associated with gastrointestinal issues It is caused by a deficiency of Vitamin D Question 1 What is the most common symptom associated with Sjogren’s Syndrome (SS)? Untitled 12  Optic neuritis Xerostomia and keratoconjunctivitis sicca (dry mouth and dry eye) Photophobia Proptosis Macular edema Question 2 Which of the following symptoms is NOT typically seen in Sjogren’s Syndrome? Proptosis Polydipsia Vaginal dryness Fatigue GI symptoms including constipation and acid reflux Question 3 According to the diagnostic criteria for Sjogren’s Syndrome, how many points are required to make a diagnosis? 4 points 6 points 2 points 3 points 5 points Question 4 Which of the following findings provides the highest point value in the diagnostic criteria for Sjogren’s Syndrome? Anti-Ro/SSA positive Schirmer’s test (without anesthetic) ≤ 5mm/5min Ocular staining score ≥ 5 Lip biopsy with focus ≥ 1 foci/4mm² Untitled 13  Unstimulated salivary flow rate ≤ 0.1 mL/min Question 5 Which of the following is a key management strategy for Sjogren’s Syndrome? Over-the-counter and prescription dry eye treatments Beta-blockers for controlling inflammation High-dose steroids to reduce gland atrophy Laser treatment for corneal abrasions Oral NSAIDs for joint pain only Question 6 Which of the following is typically included in a dry eye work-up for patients with Sjogren’s Syndrome? Tear production, tear osmolarity, tear film stability, and meibomian gland evaluation Visual field testing Retinal photography Fluorescein angiography Gonioscopy Question 1 Which of the following genetic mutations is most commonly associated with spondyloarthropathies (SpA)? HLA-B27 HLA-A1 BRCA1 CFTR JAK2 Question 2 Untitled 14  Ankylosing spondylitis is most commonly associated with inflammation in which area of the body? Spine (sacroiliitis) Hands and wrists Jaw and temporomandibular joint Shoulders Elbows Question 3 Which of the following conditions is classified as a peripheral spondyloarthropathy? Ankylosing spondylitis Reactive arthritis Juvenile idiopathic arthritis Osteoarthritis Fibromyalgia Question 4 What is the classic clinical presentation of reactive arthritis? Painful swelling of the hands and feet “Can’t see, can’t pee, can climb a tree” (conjunctivitis, urethritis, arthritis) Severe headaches and nausea Intermittent fevers and night sweats Erythema nodosum and fatigue Question 5 Which pathogen is most commonly associated with reactive arthritis? Neisseria gonorrhoeae Chlamydia trachomatis Streptococcus pneumoniae Untitled 15  Escherichia coli Mycobacterium tuberculosis Question 6 Psoriatic arthritis most often affects which joints? Distal joints Spine and sacroiliac joints Elbows and knees Temporomandibular joint Ankle and foot joints Question 7 What nail changes are often associated with psoriatic arthritis? Onycholysis and Beau’s lines Nail pitting and leukonychia Nail ridges and splinter hemorrhages Subungual hematoma and clubbing Hyperpigmentation and thickening Question 1 What is the most common symptom of axial spondyloarthropathies (SpA)? Chronic, inflammatory lower back pain Migratory joint pain Severe morning stiffness in the knees Widespread muscle cramps Fever and night sweats Question 2 Untitled 16  Which of the following is a common feature of spondyloarthropathies (SpA) affecting the lower extremities? Pain in both hips equally Asymmetric joint pain affecting less than five joints Bilateral involvement of the ankles and knees Only affecting weight-bearing joints Involvement of the elbows and shoulders Question 3 Dactylitis, a key finding in SpA, is commonly described as: Sausage fingers and toes Shortened digits with joint fusion Reddened skin over large joints Swelling of the palms and soles Loss of fingernails Question 4 Which of the following is the initial treatment of choice for spondyloarthropathies (SpA)? Corticosteroids NSAID monotherapy Methotrexate Biologic DMARDs Physical therapy alone Question 5 In the case of NSAID treatment failure in axial SpA, which type of medication is commonly used next? Topical steroids Biologic agents such as TNF-alpha inhibitors or IL-17 inhibitors Antimalarial drugs Untitled 17  Oral antibiotics COX-1 inhibitors Question 6 Which ocular manifestation is most commonly associated with spondyloarthropathies (SpA)? Posterior uveitis Retinal detachment Acute anterior uveitis Keratoconus Cataract formation Question 7 Conjunctivitis is most commonly seen in which type of spondyloarthropathy? Ankylosing spondylitis Psoriatic arthritis Juvenile idiopathic arthritis Reactive arthritis Gout Question 1 Which of the following is the primary treatment for limiting pain and maintaining joint function in spondyloarthropathies (SpA)? Corticosteroids NSAID monotherapy Antimalarial medications Methotrexate Antibiotics Untitled 18  Question 2 If NSAID treatment fails in patients with axial spondyloarthropathy, what is the next step in treatment? Topical steroids Biologics such as TNF-alpha inhibitors or IL-17 inhibitors Corticosteroid injections DMARDs such as methotrexate NSAID dose escalation Question 3 What is the most common ocular manifestation of spondyloarthropathies (SpA)? Conjunctivitis Episcleritis Acute anterior uveitis Posterior uveitis Keratitis Question 4 Which of the following types of uveitis is typically associated with reactive and psoriatic arthritis? Bilateral, chronic anterior uveitis Unilateral, granulomatous uveitis Bilateral, recurrent anterior uveitis Posterior uveitis Diffuse uveitis with keratic precipitates Question 5 According to clinical pearls, which condition should be a top differential when encountering severe dry eye or uveitis that is not unilateral and acute? Sarcoidosis Multiple sclerosis Untitled 19  Ankylosing spondylitis Systemic lupus erythematosus Graves’ disease Question 6 For patients on hydroxychloroquine therapy, which of the following steps should be taken regularly? Communication with the patient’s rheumatologist Discontinuing the medication if side effects arise Administering monthly retinal exams Adjusting the dosage of hydroxychloroquine Recommending MRI of the spine every six months Untitled 20