1. In Dysphonia Plica Ventricularis
(Ventricular Dysphonia) voice is produced by
ventricular folds
vocal cords
aryepiglottic fold
Epiglottis
Ans A
Dysphonia Plica Ventricularis (Ventricular Dysphonia) Here voice is produced by ventricular folds (false cords) which have taken over the function of true cords. Voice is rough, low-pitched and unpleasant. Ventricular voice may be secondary to impaired function of the true cord such as paralysiS, fixation, surgical excision, or tumours.
Ventricular bands in these situations try to compensate or assume phonatory function of true cords. Functional type of ventricular dysphonia occurs in normal larynx . Here cause is psychogenic. In this type, voice begins normally but soon becomes rough when false cords usurp the function of true cords. Diagnosis is made on indirect laryngoscopy; the false cords are seen to approximate partially or completely and obscure the view of true cords on phonation. Ventricular dysphonia secondary to laryngeal disorders is difficult to treat but the function al type can be helped through voice therapy and psychological counsellin
2.Lupus of the larynx mostly affects
Posterior part
Anterior part
Subglottis
Hypopharynx
Ans B
Syphilis affects the larynx and produces ulcers. These may involve almost *any portion but usually they are anterior, involving the epiglottis. They are often associated with syphilitic manifestations in the mouth. Tuberculosis affects the posterior portion of the larynx and the bulb-like swellings of the arytenoids are almost pathognomonic. Ulcers when they occur are most marked posteriorly. This affection is associated with a blanching of the mucous membrane of the mouth and the presence of a white frothy mucus, which will lead the laryn-gologist to suspect the existence of the disease before a view of the larynx is obtained.
3. Lateral soft tissue X-Ray of neck may show "Thumb sign" in
acute epigiottitis
retropharyngeal abscess
laryngeal stenosis
fractures of larynx
Ans A
In radiology, the thumbprint sign, or thumbprinting, is a radiologic sign found on a lateral C-spine radiograph that suggests the diagnosis of epiglottitis. The sign is caused by a thickened free edge of the epiglottis, which causes it to appear more radiopaque than normal, resembling the distal thumb
4. Herpangina is caused by
Coxsackie virus
Herpes simplex
Staphylococcus
Fungus
Ans A
Herpangina, also called mouth blisters, is the name of a painful mouth infection caused by coxsackieviruses. Usually, herpangina is produced by one particular strain of coxsackie virus A (and the term "herpangina virus" refers to coxsackievirus A)[ but it can also be caused by coxsackievirus B or echoviruses.[2] Most cases of herpangina occur in the summer,[3] affecting mostly children. However, it occasionally occurs in adolescents and adults
5. 'Recruitment phenomenon' is seen in one of the following conditions.
Meniere's disease
Otosclerosis
Otitis media
Mastoiditis
Ans A
Most patients with Ménière's disease (MD) reveal abnormal vestibular-evoked myogenic potentials (VEMPs) and the recruitment phenomenon, whereas most sudden deafness patients display normal VEMPs without the recruitment phenomenon
6. Which of the following is called the "Gateway of tears" ?
Killian's dehiscence
Rathke's pouch
Waldeyer ring
Sinus of Morgagni
Ans A
Killian’s dehiscence is a potential triangular gap between the oblique fibers of thyropharyngeus and the transverse fibers of cricopharyngeus (Thyropharyngeus and cricopharyngeus are 2 parts of the inferior constrictor of pharynx)
It is named after German ENT surgeon – Gustav Killian
It is through this gap that the herniation of pharyngeal mucosa occurs in case of pharyngeal pouch (Zenker’s diverticulum)
It is also called ‘gateway of tears‘ as it is a common site for perforation during oesophagoscopy
7. Cold-air caloric test is done with
Dundas Grant tube
Montgomery T tube
Jackons tube
Fuller's tube
Ans A
Clinical tests for vestibular functions
Nystagmus
Test for gaze evoked nystagmus
Fistula test
Siegalization
Hennebert’s sign
Fitzgerald Hallpike bithermal caloric test
Canal paresis
Directional preponderance
Modified Kobrak test
Dundas Grant Cold air caloric test
Dix Hallpike manoeuvre
Nystagmus in BPPV
Epley’s manoeuvre
Tripod fracture is usually referred to as a fracture of
nasal bone
Mandible
Maxilla
Zygoma
Ans D
Fractures of zygoma are the most common fractures of the upper cheek, the most common of which is the tripod fracture of zygomatic bone involving 3 separate breaks of bones of skull, through: 1. infraorbital foramen and canal to the infraorbital groove 2. zygomaticoparietal suture of lateral margin of orbit 3. zygomatic arch usually at its narrowest point, where the suture between the zygomatic process of temporal bone and temporal process of zygomatic bone occurs.
8. Early Laryngeal cancer which neither impaired cord mobility nor invaded cartilage or cervical nodes is treated by
Chemotherapy
Radiotherapy –
Hemilaryngectomy
Total laryngectomy
Ans C
Hemilaryngectomy provided acceptable percent of local and regional recurrences, and good functional results: respiration, swallowing and voice quality. Therefore it could be the first choice surgery technique in treatment of T2 laryngeal carcinoma.
To discuss the treatment options for laryngeal cancer, one must differentiate early (I-II) and advanced (III-IV) stage disease.
Subsite location of the primary tumor, glottic, supraglottic or subglottic is also an important consideration when selecting therapy.
Early-stage laryngeal carcinomas (stage I-II) are ideally treated with voice-saving surgery.
Popularized and legitimized by Steiner and Ambrosch, transoral laser microsurgery is ideal for the treatment of early-intermediate glottic and supraglottic cancer. It is performed under suspension micro-laryngoscopy with a CO2 laser.
Advanced-stage laryngeal carcinomas (stage III) are usually treated with concurrent chemo-radiation therapy for organ preservation.
On the other hand, advanced laryngeal cancer (stage IV) is usually treated with total laryngectomy, reconstruction, and adjuvant postoperative chemoradiation therapy
Larynx carcinoma is repeatedly
10. Gelle's test is a popular test done for
Presbycusis
Serous otitis media
Otosclerosis .
Meniere's disease
Ans C
Gelles test was once a popular test to find out stapes fixation in otosclerosis, but now has been superceeded by tympanometry
(Ventricular Dysphonia) voice is produced by
ventricular folds
vocal cords
aryepiglottic fold
Epiglottis
Ans A
Dysphonia Plica Ventricularis (Ventricular Dysphonia) Here voice is produced by ventricular folds (false cords) which have taken over the function of true cords. Voice is rough, low-pitched and unpleasant. Ventricular voice may be secondary to impaired function of the true cord such as paralysiS, fixation, surgical excision, or tumours.
Ventricular bands in these situations try to compensate or assume phonatory function of true cords. Functional type of ventricular dysphonia occurs in normal larynx . Here cause is psychogenic. In this type, voice begins normally but soon becomes rough when false cords usurp the function of true cords. Diagnosis is made on indirect laryngoscopy; the false cords are seen to approximate partially or completely and obscure the view of true cords on phonation. Ventricular dysphonia secondary to laryngeal disorders is difficult to treat but the function al type can be helped through voice therapy and psychological counsellin
2.Lupus of the larynx mostly affects
Posterior part
Anterior part
Subglottis
Hypopharynx
Ans B
Syphilis affects the larynx and produces ulcers. These may involve almost *any portion but usually they are anterior, involving the epiglottis. They are often associated with syphilitic manifestations in the mouth. Tuberculosis affects the posterior portion of the larynx and the bulb-like swellings of the arytenoids are almost pathognomonic. Ulcers when they occur are most marked posteriorly. This affection is associated with a blanching of the mucous membrane of the mouth and the presence of a white frothy mucus, which will lead the laryn-gologist to suspect the existence of the disease before a view of the larynx is obtained.
3. Lateral soft tissue X-Ray of neck may show "Thumb sign" in
acute epigiottitis
retropharyngeal abscess
laryngeal stenosis
fractures of larynx
Ans A
In radiology, the thumbprint sign, or thumbprinting, is a radiologic sign found on a lateral C-spine radiograph that suggests the diagnosis of epiglottitis. The sign is caused by a thickened free edge of the epiglottis, which causes it to appear more radiopaque than normal, resembling the distal thumb
4. Herpangina is caused by
Coxsackie virus
Herpes simplex
Staphylococcus
Fungus
Ans A
Herpangina, also called mouth blisters, is the name of a painful mouth infection caused by coxsackieviruses. Usually, herpangina is produced by one particular strain of coxsackie virus A (and the term "herpangina virus" refers to coxsackievirus A)[ but it can also be caused by coxsackievirus B or echoviruses.[2] Most cases of herpangina occur in the summer,[3] affecting mostly children. However, it occasionally occurs in adolescents and adults
5. 'Recruitment phenomenon' is seen in one of the following conditions.
Meniere's disease
Otosclerosis
Otitis media
Mastoiditis
Ans A
Most patients with Ménière's disease (MD) reveal abnormal vestibular-evoked myogenic potentials (VEMPs) and the recruitment phenomenon, whereas most sudden deafness patients display normal VEMPs without the recruitment phenomenon
6. Which of the following is called the "Gateway of tears" ?
Killian's dehiscence
Rathke's pouch
Waldeyer ring
Sinus of Morgagni
Ans A
Killian’s dehiscence is a potential triangular gap between the oblique fibers of thyropharyngeus and the transverse fibers of cricopharyngeus (Thyropharyngeus and cricopharyngeus are 2 parts of the inferior constrictor of pharynx)
It is named after German ENT surgeon – Gustav Killian
It is through this gap that the herniation of pharyngeal mucosa occurs in case of pharyngeal pouch (Zenker’s diverticulum)
It is also called ‘gateway of tears‘ as it is a common site for perforation during oesophagoscopy
7. Cold-air caloric test is done with
Dundas Grant tube
Montgomery T tube
Jackons tube
Fuller's tube
Ans A
Clinical tests for vestibular functions
Nystagmus
Test for gaze evoked nystagmus
Fistula test
Siegalization
Hennebert’s sign
Fitzgerald Hallpike bithermal caloric test
Canal paresis
Directional preponderance
Modified Kobrak test
Dundas Grant Cold air caloric test
Dix Hallpike manoeuvre
Nystagmus in BPPV
Epley’s manoeuvre
Tripod fracture is usually referred to as a fracture of
nasal bone
Mandible
Maxilla
Zygoma
Ans D
Fractures of zygoma are the most common fractures of the upper cheek, the most common of which is the tripod fracture of zygomatic bone involving 3 separate breaks of bones of skull, through: 1. infraorbital foramen and canal to the infraorbital groove 2. zygomaticoparietal suture of lateral margin of orbit 3. zygomatic arch usually at its narrowest point, where the suture between the zygomatic process of temporal bone and temporal process of zygomatic bone occurs.
8. Early Laryngeal cancer which neither impaired cord mobility nor invaded cartilage or cervical nodes is treated by
Chemotherapy
Radiotherapy –
Hemilaryngectomy
Total laryngectomy
Ans C
Hemilaryngectomy provided acceptable percent of local and regional recurrences, and good functional results: respiration, swallowing and voice quality. Therefore it could be the first choice surgery technique in treatment of T2 laryngeal carcinoma.
To discuss the treatment options for laryngeal cancer, one must differentiate early (I-II) and advanced (III-IV) stage disease.
Subsite location of the primary tumor, glottic, supraglottic or subglottic is also an important consideration when selecting therapy.
Early-stage laryngeal carcinomas (stage I-II) are ideally treated with voice-saving surgery.
Popularized and legitimized by Steiner and Ambrosch, transoral laser microsurgery is ideal for the treatment of early-intermediate glottic and supraglottic cancer. It is performed under suspension micro-laryngoscopy with a CO2 laser.
Advanced-stage laryngeal carcinomas (stage III) are usually treated with concurrent chemo-radiation therapy for organ preservation.
On the other hand, advanced laryngeal cancer (stage IV) is usually treated with total laryngectomy, reconstruction, and adjuvant postoperative chemoradiation therapy
Larynx carcinoma is repeatedly
10. Gelle's test is a popular test done for
Presbycusis
Serous otitis media
Otosclerosis .
Meniere's disease
Ans C
Gelles test was once a popular test to find out stapes fixation in otosclerosis, but now has been superceeded by tympanometry
11. Aqueous flare in inclocyclifis is due to
A. Platelets
B. pigments
C. RBCs
D. Proteins
Ans D
• Aqueous flare is a pathognomonic sign of uveitis and is due to breakdown of the blood-ocular barrier with subsequent leakage of proteins into the anterior chamber. Aqueous flare is best detected using a very focal, intense light source in a totally darkened room. The passage taken by the beam of light is viewed from an angle. In the normal eye, a focal reflection is seen where the light strikes the cornea. The beam is then invisible as it traverses the almost protein- and cell-free aqueous humor in the anterior chamber. The light beam is visible again as a focal reflection on the anterior lens capsule and then as a diffuse beam through the body of the normal lens due to presence of lens proteins. If uveitis has allowed leakage of serum proteins into the anterior chamber then these will cause a scattering of the light as it passes through the aqueous. Aqueous flare is therefore detected when a beam of light joining the focal reflections on the corneal surface and the anterior lens capsule is visible traversing the anterior chamber. A slit lamp provides ideal conditions for detecting flare, however the beam produced by the smallest circular aperture on the direct ophthalmoscope held as closely as possible to the cornea in a completely darkened room and viewed transversely will also provide excellent results. The slit beam on the direct ophthalmoscope is not as intense and does not provide as many "edges" of light where flare can be appreciated most easily. Assessment of flare may be easier after complete pupil dilation due to the apparent dark space created by the pupil. Combined assessment of IOP and aqueous flare should be performed whenever glaucoma or uveitis is suspected because of the frequency with which these conditions co-exist.
12. The following laser beam is used in LAS 1K (Laser-Assisted in Situ Keratomileusis)
A. Excimer
B. Argon
C. Diode
D. Krypton
Ans A
LASIK is a surgical procedure which combines a micro-keratome (an automated knife for shaving the cornea) and an Excimer Laser (an ultraviolet light beam) to reshape the cornea.
A. Platelets
B. pigments
C. RBCs
D. Proteins
Ans D
• Aqueous flare is a pathognomonic sign of uveitis and is due to breakdown of the blood-ocular barrier with subsequent leakage of proteins into the anterior chamber. Aqueous flare is best detected using a very focal, intense light source in a totally darkened room. The passage taken by the beam of light is viewed from an angle. In the normal eye, a focal reflection is seen where the light strikes the cornea. The beam is then invisible as it traverses the almost protein- and cell-free aqueous humor in the anterior chamber. The light beam is visible again as a focal reflection on the anterior lens capsule and then as a diffuse beam through the body of the normal lens due to presence of lens proteins. If uveitis has allowed leakage of serum proteins into the anterior chamber then these will cause a scattering of the light as it passes through the aqueous. Aqueous flare is therefore detected when a beam of light joining the focal reflections on the corneal surface and the anterior lens capsule is visible traversing the anterior chamber. A slit lamp provides ideal conditions for detecting flare, however the beam produced by the smallest circular aperture on the direct ophthalmoscope held as closely as possible to the cornea in a completely darkened room and viewed transversely will also provide excellent results. The slit beam on the direct ophthalmoscope is not as intense and does not provide as many "edges" of light where flare can be appreciated most easily. Assessment of flare may be easier after complete pupil dilation due to the apparent dark space created by the pupil. Combined assessment of IOP and aqueous flare should be performed whenever glaucoma or uveitis is suspected because of the frequency with which these conditions co-exist.
12. The following laser beam is used in LAS 1K (Laser-Assisted in Situ Keratomileusis)
A. Excimer
B. Argon
C. Diode
D. Krypton
Ans A
LASIK is a surgical procedure which combines a micro-keratome (an automated knife for shaving the cornea) and an Excimer Laser (an ultraviolet light beam) to reshape the cornea.
13. Cobblelstone appearance of the palpebral conjunctiva is seen in
A. Trachoma
B. Spring Catarrh
C. Ophthalmia nodosa
D. Long term use of miotics
Ans b
Allergic conjunctivitis is suggested by bilateral itchy eyes, a history of atopy, and a ‘cobblestone’ appearance of the upper palpebral conjunctiva.
• Signs of VKC can be described in three clinical forms.
1. Palpebral form- Usually upper tarsal conjunctiva of both the eyes is involved. Typical lesion is characterized by the presence of hard, flat-topped papillae arranged in cobblestone or pavement stone fashion. In severe cases papillae undergo hypertrophy to produce cauliflower-like excrescences of 'giant papillae'.
2. Bulbar form- It is characterised by dusky red triangular congestion of bulbar conjunctiva in palpebral area, gelatinous thickened accumulation of tissue around limbus and presence of discrete whitish raised dots along the limbus (Tranta's spots).
Mixed form- Shows the features of both palpebral and bulbar types
14. Subconjunctival haemorrhage freluently is seen in children with
A. Whooping cough
B. Measles
C. Influenza
D. Chicken pox
Ans A
Causes of Subconjunctival haemorrhage
• Eye trauma
• Congenital or acquired (coagulation disorder)
• Diving accidents - Mask squeeze (volume inside in mask creates increased pressure with increased depth)
• Head injury
• Whooping cough or other extreme sneezing or coughing [1] [2]
• Severe hypertension
• LASIK
• Acute hemorrhagic conjunctivitis (caused by Enterovirus 70 or Coxsackie A virus)
• Leptospirosis
• Increased venous pressure (e.g., extreme g-force, straining, vomiting, choking, or coughing)
Subconjunctival hemorrhages in infants may be associated with scurvy (a vitamin C deficiency),] abuse or traumatic asphyxia syndrome
15. Acute hydrops is seen in
A. Keratoglobus
B. Buphthalmos
C. Keratoconus
D. Bullous keratopathy
Ans C
Acute Corneal Hydrops
CLINICAL DESCRIPTION:
Corneal hydrops is an uncommon complication seen in patients with keratoconus. It is characterized by significant corneal edema resulting from a spontaneous rupture in Descemet's membrane. Clinical findings include dense stromal and epithelial edema with corneal protrusion, possible conjunctival hyperemia and irregular epithelium secondary to microcystic edema
The location and area of the involved cornea is variable
16. Ciliary staphyloma is due to
A. Scleritis
B. irido cyclitis
C. degenerative Myopia
D. choroiditis
Ans a
Ciliary staphyloma
As the name implies, it is the bulge of weak sclera lined by ciliary body, which occurs about 2–3 mm away from the limbus. Its common causes are thinning of sclera following perforating injury, scleritis & absolute glaucoma.
Posterior staphyloma
In the posterior segment of the eye, typically diagnosed at the region of the macula, deforming the eye in a way that the eye-length is extended associated with myopia (nearsightedness). It is diagnosed by ophthalmoscopy, which shows an area of retinal excavation in the region of the staphyloma.
17. If you have to treat a patient with active trachoma all of the following drugs will be effective against Chlamydia, EXCEPT
A. Azithromycin
B. Ivermectin
C. Rifampicin
D. Erythromycin
Ans C
• Topical therapy regimes. It is best for individual cases. It consists of 1 percent tetracycline or 1 percent erythromycin eye ointment 4 times a day for 6 weeks or 20 percent sulfacetamide eye drops three times a day along with 1 percent tetracycline eye ointment at bed time for 6 weeks. The continuous treatment for active trachoma should be followed by an intermittent treatment especially in endemic or hyperendemic area.
• Systemic therapy regimes. Tetracycline or erythromycin 250 mg orally, four times a day for 3-4 weeks or doxycycline 100 mg orally twice daily for 3-4 weeks or single dose of 1 gm azithromycin has also been reported to be equally effective in treating trachoma.
• Combined topical and systemic therapy regime. It is preferred when the ocular infection is severe (TI) or when there is associated genital infection. It includes: (i) 1 per cent tetracycline or erythromycin eye ointment 4 times a day for 6 weeks; and (ii) tetracycline or erythromycin 250 mg orally 4 times a day for 2 weeks.
• Ivermectin Inhibits Growth of Chlamydia trachomatis
18. Angular conjunctivitis is typically due to "Moraxella lacunata" which is a
A. Gram negative diplococci
B. Gram positive diplococci
C. Gram negative diplobacilli
D. Gram positive diplobacilli
Ans C
Morax-Axenfeld diplobacillus or Moraxella lacunata is a rod-shaped, Gram negative, non motile bacteria, generally present as diploid pairs. They cause one of the commonest forms of catarrhal conjunctiviti
19. Which one of the following lenses is manufactured from
19 Hydroxyethylmethacrylate (HEMA) ?
A. Hard lenses
B. Gas permeable lenses
C. Soft lenses
D. None of the above
Ans C
More common monomers in contact lens materials include:
Methylmethacrylate (MMA), which contributes hardness and strength l
Silicone (SI), which increases flexibility and gas permeability through the material's silicon-oxygen l
Fluorine (FL), lbonds but has the disadvantage of poor wettability which also adds a smaller degree of gas permeability and improves wettability and
deposit resistance in silicone-containing lenses
Hydroxyethyl-methacrylate (HEMA), the basic water-absorbing monomer of most soft lenses l
Methacrylic acid (MAA) and n vinyl pyrolidone (NVP) mono-mers, both of which absorb high amounts l
of water and are usually adjuncts to HEMA to increase lens water content
Ethylene glycol dimethacrylate (EGDMA), a cross-linking agent that l adds dimensional stability and stiffness but reduces water content
Hydroxyethylmethacrylate or HEMA is the monomer that is used to make the polymer polyhydroxyethylmethacrylate. The polymer is hydrophobic; however, when the polymer is subjected to water it will swell due to the molecule's hydrophilic pendant group. Depending on the physical and chemical structure of the polymer, it is capable of absorbing from 10 to 600% water relative to the dry weight. Because of this property, it was one of the first materials to be successfully used in the manufacture of flexible contact lenses
20 By using which one of the instruments corneal thickness can be best measured ?
A. Optometer
B. Ophthalmometer
C. Ultrasonic Pachymeter
D. Tensiometer
Ans c
A pachymeter is a medical device used to measure the thickness of the eye's cornea. It is used to perform corneal pachymetry prior to LASIK surgery, for Keratoconus screening, LRI surgery [8] and is useful in screening for patients suspected of developing glaucoma among other uses. Modern devices use ultrasound technology, while earlier models were based on optical principles. The ultrasonic Pachymeters traditionally have been devices that provide the thickness of the human cornea in the form of a number in micrometres that is displayed to the user. The newer generation of ultrasonic pachymeters.[9] work by way of Corneal Waveform (CWF).[10] Using this technology the user can capture an ultra high definition echogram of cornea,[11] think of it as a corneal A-scan. Pachymetry using the corneal waveform allows the user to more accurately measure the corneal thickness, have to ability to check the reliability of the measurements that were obtained, have the ability to superimpose corneal waveform[12] to monitor the change of patients cornea over time, and ability to measure structures within the cornea such as micro bubbles created in the cornea during femto-second laser flap cu
21. The engaging diameter in 'brow' presentation is
A. sub mentobregmatic
B. mento vertical
C. sub occipito frontal
D. occipito frontal
Ans B
The different presenting antroposterior diameters of the fetus are presented below:
• attitude = flexed; presentation = vertex; mean presenting diameter = suboccipito-bregmatic (9.5 cm)
• attitude = deflexed +; presentation = deflexed; mean presenting diameter = occipito-frontal (11.5 cm)
• attitude = deflexed ++; presentation = brow; mean presenting diameter = mento-vertical (13.5 cm)
• attitude = deflexed +++; presentation = face; mean presenting diameter = submento-bregmatic (9.5 cm)
22. During normal involution, uterus becomes a pelvic organ by the end of
A. first week
B. second week
C. fourth week
D. sixth week
Ans B
by end of second week uterus becomes a pelvic organ
23. For the Rhesus positive new born of a Rhesus negative mother, all are indications for exchange transfusion EXCEPT
A. Cord blood bilirubin level > 4 mg/dl
B. Cord blood haemoglobin level < 11 gm/dl
C. Rising level of bilirubin is over 1 mg/dl/hour despite phototherapy
D. Total bilirubin level 10 mg/dl
Ans d
Early exchange transfusion has usually been performed because of anemia (cord hemoglobin < 11 g/dL), elevated cord bilirubin level (>70 µmol/L or 4.5 mg/dL), or both.
A rapid rate of increase in the serum bilirubin level (>15-20 µmol/L /h or 1 mg/dL/h) was an indication for exchange transfusion, as was a more moderate rate of increase (>8-10 µmol/L/h or 0.5 mg/dL/h) in the presence of moderate anemia (11-13 g/dL).
The serum bilirubin level that triggered an exchange transfusion in infants with hemolytic jaundice was 350 µmol/L (20 mg/dL) or a rate of increase that predicted this level or higher. Strict adherence to the level of 20 mg/dL has been jocularly referred to as vigintiphobia (fear of 20).
24. Which of the following is NOT a feature of severe pre-eclampsia ?
A. BP 160 /110 mmHg
B. Visual disturbances
C. Oliguria
D. Convulsions
Ans D
one of the following findings is also necessary for a diagnosis of severe preeclampsia:
• Signs of central nervous system problems (severe headache, blurry vision, altered mental status)
• Signs of liver problems (nausea and/or vomiting with abdominal pain)
• At least twice the normal measurements of certain liver enzymes on blood test
• Very high blood pressure ( greater than 160 systolic or 110 diastolic)
• Thrombocytopenia (low platelet count)
• Greater than 5g of protein in a 24-hour sample
• Very low urine output (less than 500mL in 24 hours)
• Signs of respiratory problems (pulmonary edema, bluish tint to the skin)
• Severe fetal growth restriction
• Stroke
25. All may be associated with oligo-hydramnios EXCEPT
A. Amnion nodosum
B. Placental insufficiency
C. Fetal renal agenesis
D. Rhesus isoimmunization
Ans D
Amnion nodosum are nodules on the fetal surface of the amnion, and is frequently present in oligohydramnios
It is typically caused by fetal urinary tract abnormalities such as unilateral renal agenesis ( Potter's syndrome ), fetal polycystic kidneys, or genitourinary obstruction. Uteroplacental insufficiency is another common cause. Most of these abnormalities can also be detected by obstetric ultrasound. It may also occur simply due to dehydration of the mother, maternal use of angiotensin converting enzyme inhibitors, or without a determinable cause (idiopathic).
The diagnostic approach to polyhydramnios consists of (1) physical examination of the mother with an investigation for diabetes mellitus, diabetes insipidus, and Rh isoimmunization; (2) sonographic confirmation of polyhydramnios and assessment of the fetus; (3) fetal karyotyping; and (4) maternal serologic testing for syphilis.
26. For ultrasound diagnosis of chronic polyhydramnios, the amniotic fluid index should be more than
A. 6 cm
B. 12 cm
C. 18 cm
D. 25 cm
Ans D
Polyhydramnios (polyhydramnion, hydramnios, polyhydramnios) is a medical condition describing an excess of amniotic fluid in the amniotic sac. It is seen in about 1% of pregnancies] It is typically diagnosed when the amniotic fluid index (AFI) is greater than 24 cm
A. Azithromycin
B. Ivermectin
C. Rifampicin
D. Erythromycin
Ans C
• Topical therapy regimes. It is best for individual cases. It consists of 1 percent tetracycline or 1 percent erythromycin eye ointment 4 times a day for 6 weeks or 20 percent sulfacetamide eye drops three times a day along with 1 percent tetracycline eye ointment at bed time for 6 weeks. The continuous treatment for active trachoma should be followed by an intermittent treatment especially in endemic or hyperendemic area.
• Systemic therapy regimes. Tetracycline or erythromycin 250 mg orally, four times a day for 3-4 weeks or doxycycline 100 mg orally twice daily for 3-4 weeks or single dose of 1 gm azithromycin has also been reported to be equally effective in treating trachoma.
• Combined topical and systemic therapy regime. It is preferred when the ocular infection is severe (TI) or when there is associated genital infection. It includes: (i) 1 per cent tetracycline or erythromycin eye ointment 4 times a day for 6 weeks; and (ii) tetracycline or erythromycin 250 mg orally 4 times a day for 2 weeks.
• Ivermectin Inhibits Growth of Chlamydia trachomatis
18. Angular conjunctivitis is typically due to "Moraxella lacunata" which is a
A. Gram negative diplococci
B. Gram positive diplococci
C. Gram negative diplobacilli
D. Gram positive diplobacilli
Ans C
Morax-Axenfeld diplobacillus or Moraxella lacunata is a rod-shaped, Gram negative, non motile bacteria, generally present as diploid pairs. They cause one of the commonest forms of catarrhal conjunctiviti
19. Which one of the following lenses is manufactured from
19 Hydroxyethylmethacrylate (HEMA) ?
A. Hard lenses
B. Gas permeable lenses
C. Soft lenses
D. None of the above
Ans C
More common monomers in contact lens materials include:
Methylmethacrylate (MMA), which contributes hardness and strength l
Silicone (SI), which increases flexibility and gas permeability through the material's silicon-oxygen l
Fluorine (FL), lbonds but has the disadvantage of poor wettability which also adds a smaller degree of gas permeability and improves wettability and
deposit resistance in silicone-containing lenses
Hydroxyethyl-methacrylate (HEMA), the basic water-absorbing monomer of most soft lenses l
Methacrylic acid (MAA) and n vinyl pyrolidone (NVP) mono-mers, both of which absorb high amounts l
of water and are usually adjuncts to HEMA to increase lens water content
Ethylene glycol dimethacrylate (EGDMA), a cross-linking agent that l adds dimensional stability and stiffness but reduces water content
Hydroxyethylmethacrylate or HEMA is the monomer that is used to make the polymer polyhydroxyethylmethacrylate. The polymer is hydrophobic; however, when the polymer is subjected to water it will swell due to the molecule's hydrophilic pendant group. Depending on the physical and chemical structure of the polymer, it is capable of absorbing from 10 to 600% water relative to the dry weight. Because of this property, it was one of the first materials to be successfully used in the manufacture of flexible contact lenses
20 By using which one of the instruments corneal thickness can be best measured ?
A. Optometer
B. Ophthalmometer
C. Ultrasonic Pachymeter
D. Tensiometer
Ans c
A pachymeter is a medical device used to measure the thickness of the eye's cornea. It is used to perform corneal pachymetry prior to LASIK surgery, for Keratoconus screening, LRI surgery [8] and is useful in screening for patients suspected of developing glaucoma among other uses. Modern devices use ultrasound technology, while earlier models were based on optical principles. The ultrasonic Pachymeters traditionally have been devices that provide the thickness of the human cornea in the form of a number in micrometres that is displayed to the user. The newer generation of ultrasonic pachymeters.[9] work by way of Corneal Waveform (CWF).[10] Using this technology the user can capture an ultra high definition echogram of cornea,[11] think of it as a corneal A-scan. Pachymetry using the corneal waveform allows the user to more accurately measure the corneal thickness, have to ability to check the reliability of the measurements that were obtained, have the ability to superimpose corneal waveform[12] to monitor the change of patients cornea over time, and ability to measure structures within the cornea such as micro bubbles created in the cornea during femto-second laser flap cu
21. The engaging diameter in 'brow' presentation is
A. sub mentobregmatic
B. mento vertical
C. sub occipito frontal
D. occipito frontal
Ans B
The different presenting antroposterior diameters of the fetus are presented below:
• attitude = flexed; presentation = vertex; mean presenting diameter = suboccipito-bregmatic (9.5 cm)
• attitude = deflexed +; presentation = deflexed; mean presenting diameter = occipito-frontal (11.5 cm)
• attitude = deflexed ++; presentation = brow; mean presenting diameter = mento-vertical (13.5 cm)
• attitude = deflexed +++; presentation = face; mean presenting diameter = submento-bregmatic (9.5 cm)
22. During normal involution, uterus becomes a pelvic organ by the end of
A. first week
B. second week
C. fourth week
D. sixth week
Ans B
by end of second week uterus becomes a pelvic organ
23. For the Rhesus positive new born of a Rhesus negative mother, all are indications for exchange transfusion EXCEPT
A. Cord blood bilirubin level > 4 mg/dl
B. Cord blood haemoglobin level < 11 gm/dl
C. Rising level of bilirubin is over 1 mg/dl/hour despite phototherapy
D. Total bilirubin level 10 mg/dl
Ans d
Early exchange transfusion has usually been performed because of anemia (cord hemoglobin < 11 g/dL), elevated cord bilirubin level (>70 µmol/L or 4.5 mg/dL), or both.
A rapid rate of increase in the serum bilirubin level (>15-20 µmol/L /h or 1 mg/dL/h) was an indication for exchange transfusion, as was a more moderate rate of increase (>8-10 µmol/L/h or 0.5 mg/dL/h) in the presence of moderate anemia (11-13 g/dL).
The serum bilirubin level that triggered an exchange transfusion in infants with hemolytic jaundice was 350 µmol/L (20 mg/dL) or a rate of increase that predicted this level or higher. Strict adherence to the level of 20 mg/dL has been jocularly referred to as vigintiphobia (fear of 20).
24. Which of the following is NOT a feature of severe pre-eclampsia ?
A. BP 160 /110 mmHg
B. Visual disturbances
C. Oliguria
D. Convulsions
Ans D
one of the following findings is also necessary for a diagnosis of severe preeclampsia:
• Signs of central nervous system problems (severe headache, blurry vision, altered mental status)
• Signs of liver problems (nausea and/or vomiting with abdominal pain)
• At least twice the normal measurements of certain liver enzymes on blood test
• Very high blood pressure ( greater than 160 systolic or 110 diastolic)
• Thrombocytopenia (low platelet count)
• Greater than 5g of protein in a 24-hour sample
• Very low urine output (less than 500mL in 24 hours)
• Signs of respiratory problems (pulmonary edema, bluish tint to the skin)
• Severe fetal growth restriction
• Stroke
25. All may be associated with oligo-hydramnios EXCEPT
A. Amnion nodosum
B. Placental insufficiency
C. Fetal renal agenesis
D. Rhesus isoimmunization
Ans D
Amnion nodosum are nodules on the fetal surface of the amnion, and is frequently present in oligohydramnios
It is typically caused by fetal urinary tract abnormalities such as unilateral renal agenesis ( Potter's syndrome ), fetal polycystic kidneys, or genitourinary obstruction. Uteroplacental insufficiency is another common cause. Most of these abnormalities can also be detected by obstetric ultrasound. It may also occur simply due to dehydration of the mother, maternal use of angiotensin converting enzyme inhibitors, or without a determinable cause (idiopathic).
The diagnostic approach to polyhydramnios consists of (1) physical examination of the mother with an investigation for diabetes mellitus, diabetes insipidus, and Rh isoimmunization; (2) sonographic confirmation of polyhydramnios and assessment of the fetus; (3) fetal karyotyping; and (4) maternal serologic testing for syphilis.
26. For ultrasound diagnosis of chronic polyhydramnios, the amniotic fluid index should be more than
A. 6 cm
B. 12 cm
C. 18 cm
D. 25 cm
Ans D
Polyhydramnios (polyhydramnion, hydramnios, polyhydramnios) is a medical condition describing an excess of amniotic fluid in the amniotic sac. It is seen in about 1% of pregnancies] It is typically diagnosed when the amniotic fluid index (AFI) is greater than 24 cm
22. During normal involution, uterus becomes a pelvic organ by the end of
A. first week
B. second week
C. fourth week
D. sixth week
Ans B
by end of second week uterus becomes a pelvic organ
23. For the Rhesus positive new born of a Rhesus negative mother, all are indications for exchange transfusion EXCEPT
A. Cord blood bilirubin level > 4 mg/dl
B. Cord blood haemoglobin level < 11 gm/dl
C. Rising level of bilirubin is over 1 mg/dl/hour despite phototherapy
D. Total bilirubin level 10 mg/dl
Ans d
Early exchange transfusion has usually been performed because of anemia (cord hemoglobin < 11 g/dL), elevated cord bilirubin level (>70 µmol/L or 4.5 mg/dL), or both.
A rapid rate of increase in the serum bilirubin level (>15-20 µmol/L /h or 1 mg/dL/h) was an indication for exchange transfusion, as was a more moderate rate of increase (>8-10 µmol/L/h or 0.5 mg/dL/h) in the presence of moderate anemia (11-13 g/dL).
The serum bilirubin level that triggered an exchange transfusion in infants with hemolytic jaundice was 350 µmol/L (20 mg/dL) or a rate of increase that predicted this level or higher. Strict adherence to the level of 20 mg/dL has been jocularly referred to as vigintiphobia (fear of 20).
24. Which of the following is NOT a feature of severe pre-eclampsia ?
A. BP 160 /110 mmHg
B. Visual disturbances
C. Oliguria
D. Convulsions
Ans D
one of the following findings is also necessary for a diagnosis of severe preeclampsia:
• Signs of central nervous system problems (severe headache, blurry vision, altered mental status)
• Signs of liver problems (nausea and/or vomiting with abdominal pain)
• At least twice the normal measurements of certain liver enzymes on blood test
• Very high blood pressure ( greater than 160 systolic or 110 diastolic)
• Thrombocytopenia (low platelet count)
• Greater than 5g of protein in a 24-hour sample
• Very low urine output (less than 500mL in 24 hours)
• Signs of respiratory problems (pulmonary edema, bluish tint to the skin)
• Severe fetal growth restriction
• Stroke
25. All may be associated with oligo-hydramnios EXCEPT
A. Amnion nodosum
B. Placental insufficiency
C. Fetal renal agenesis
D. Rhesus isoimmunization
Ans D
Amnion nodosum are nodules on the fetal surface of the amnion, and is frequently present in oligohydramnios
It is typically caused by fetal urinary tract abnormalities such as unilateral renal agenesis ( Potter's syndrome ), fetal polycystic kidneys, or genitourinary obstruction. Uteroplacental insufficiency is another common cause. Most of these abnormalities can also be detected by obstetric ultrasound. It may also occur simply due to dehydration of the mother, maternal use of angiotensin converting enzyme inhibitors, or without a determinable cause (idiopathic).
The diagnostic approach to polyhydramnios consists of (1) physical examination of the mother with an investigation for diabetes mellitus, diabetes insipidus, and Rh isoimmunization; (2) sonographic confirmation of polyhydramnios and assessment of the fetus; (3) fetal karyotyping; and (4) maternal serologic testing for syphilis.
A. first week
B. second week
C. fourth week
D. sixth week
Ans B
by end of second week uterus becomes a pelvic organ
23. For the Rhesus positive new born of a Rhesus negative mother, all are indications for exchange transfusion EXCEPT
A. Cord blood bilirubin level > 4 mg/dl
B. Cord blood haemoglobin level < 11 gm/dl
C. Rising level of bilirubin is over 1 mg/dl/hour despite phototherapy
D. Total bilirubin level 10 mg/dl
Ans d
Early exchange transfusion has usually been performed because of anemia (cord hemoglobin < 11 g/dL), elevated cord bilirubin level (>70 µmol/L or 4.5 mg/dL), or both.
A rapid rate of increase in the serum bilirubin level (>15-20 µmol/L /h or 1 mg/dL/h) was an indication for exchange transfusion, as was a more moderate rate of increase (>8-10 µmol/L/h or 0.5 mg/dL/h) in the presence of moderate anemia (11-13 g/dL).
The serum bilirubin level that triggered an exchange transfusion in infants with hemolytic jaundice was 350 µmol/L (20 mg/dL) or a rate of increase that predicted this level or higher. Strict adherence to the level of 20 mg/dL has been jocularly referred to as vigintiphobia (fear of 20).
24. Which of the following is NOT a feature of severe pre-eclampsia ?
A. BP 160 /110 mmHg
B. Visual disturbances
C. Oliguria
D. Convulsions
Ans D
one of the following findings is also necessary for a diagnosis of severe preeclampsia:
• Signs of central nervous system problems (severe headache, blurry vision, altered mental status)
• Signs of liver problems (nausea and/or vomiting with abdominal pain)
• At least twice the normal measurements of certain liver enzymes on blood test
• Very high blood pressure ( greater than 160 systolic or 110 diastolic)
• Thrombocytopenia (low platelet count)
• Greater than 5g of protein in a 24-hour sample
• Very low urine output (less than 500mL in 24 hours)
• Signs of respiratory problems (pulmonary edema, bluish tint to the skin)
• Severe fetal growth restriction
• Stroke
25. All may be associated with oligo-hydramnios EXCEPT
A. Amnion nodosum
B. Placental insufficiency
C. Fetal renal agenesis
D. Rhesus isoimmunization
Ans D
Amnion nodosum are nodules on the fetal surface of the amnion, and is frequently present in oligohydramnios
It is typically caused by fetal urinary tract abnormalities such as unilateral renal agenesis ( Potter's syndrome ), fetal polycystic kidneys, or genitourinary obstruction. Uteroplacental insufficiency is another common cause. Most of these abnormalities can also be detected by obstetric ultrasound. It may also occur simply due to dehydration of the mother, maternal use of angiotensin converting enzyme inhibitors, or without a determinable cause (idiopathic).
The diagnostic approach to polyhydramnios consists of (1) physical examination of the mother with an investigation for diabetes mellitus, diabetes insipidus, and Rh isoimmunization; (2) sonographic confirmation of polyhydramnios and assessment of the fetus; (3) fetal karyotyping; and (4) maternal serologic testing for syphilis.
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