recent
Recent

L10, 11_Lacrimal system_ Ophthalmology

Home

 Lecture video

Part1_anatomy, physio, inflammatory 

Part2_watery eye

Data of part1

Data of part2

Feedback


Questions


1- One of the following is not an indication for dacryo-cysto-rhinostomy:

a) Lacrimal fistula.

b) Acute dacryocystitis.

c) Chronic dacryocystilis.

d) Mucocele of the lacrimal sac.


2- Several ducts pass from the orbital portion of the lacrimal gland and open into:

a) The lateral aspect of the superior fornix.

b) The medial aspect of the superior fornix.

c) The medial aspect of the inferior fornix.

d) The lateral aspect of the inferior fornix.


3- From the punctum to the common canaliculus the lacrimal canaliculus measures

a) 2mm horizontal then 8mm vertical.

b) 3mm vertical then 8mm horizontal.

c) 3mm horizontal then 8mm vertical.

d) 2mm vertical then 8mm horizontal.


4- All about the naso-lacrimal duct is true except:

a) The upper 12 mm is the inter-osseous part and the lower 5 mm is the meatal part

b) It opens 5 mm below the vault of the anterior end of the inferior meatus.

c) It opens 5 mm below the vault of the anterior end of the middle meatus.

d) It measures 17 mm in length.


5- The tear film consists of:

a) Mucous and aqueous layer.

b) Mucous and lipid layer.

c) Lipid and aqueous layer

d) Lipid, aqueous and mucous layer.


6- The lipid layer function is:

a) Retardation of the tear evaporation.

b) Supplying nutrition to the cornea.

c) Converting the cornea into a hydrophilic surface.

d) Defense against microorganisms.


7- The aqueous layer function is:

a) Retardation of the tear evaporation.

b) Preventing the tear dropping over the cheeks.

c) Converting the cornea into a hydrophilic surface

d) Defense against micro-organisms.


8- The mucous layer function is:

a) Retardation of the tear evaporation.

b) Supplying nutrition to the cornea.

c) Converting the cornea into a hydrophilic surface.

d) Defense against micro-organisms.


9- Mucous part of the tear film is secreted by:

a) Main lacrimal gland.

b) Accessory lacrimal glands.

c) Goblet cells of the conjunctiva.

d) Meibomian glands.


10-On measuring the tear production using Schirmer test the result is abnormal if the wetting of the

filter paper is:

a) Less than 2mm in 5 minutes.

b) Less than 3mm in 5 minutes.

c) Less than 5 mm in 5 minutes.

d) Less than 7 mm in 5 minutes.



11-Tear film break-up time measures:

a) Tear film production

b) Tear film distribution

c) Tear film volume.

d) Tear film stability


12-The following can be utilized in the assessment of the pre-corneal tear film except:

a) Fluorescein break up time

b) Rose bengal stain

c) Schirmer's test.

d) Conjunctival swab.

e) Slit lamp examination


13-A patient complains of watering Of the eye. On pressing Over the medial canthal ligament,

regurgitation of fluid occurs. The best treatment is:

a) Systemic and local antibiotics

b) Probing of the naso-lacrimal duct

c) Dacryo-cyst-ectomy

d) Dacryo-cysto-rhinostomy


14-Mother noticed in her 3-month-old infant continuous epiphora and frequent muco-purulent

discharge. Your advice for primary treatment should be:

a) Syringing.

b) Antibiotics and massage

c) Dacryo-cyst-ectomy

d) Dacryo-cysto-rhinostomy


15-Probing of congenital naso-lacrimal duet should not be done before the age of:

a) Two months.

c) Six months.

b) Four months.

d) Nine months.


16-The lacrimal secretory system consists of the following parts except:

a) The lacrimal gland.

b) The accessory lacrimal gland.

c) The Goblet cells.

d) The lacrimal sac.


17-The lacrimal drainage system consists of the following parts except:

a) The puncti.

b) The Canaliculi.

c) The lacrimal sac.

d) The Goblet cells.


18-The orbital portion of the lacrimal gland is responsible for:

a) Reflex tears secretion.

b) Basic tear secretion.

c) Mucin layer secretion.

d) None of the above.


19-The lacrimal sac is :

a) Related to the medial palpebral ligament.

b) Related to the lateral palpebral ligament

c) Related to the roof of the orbit

d) Not related to the lacrimal portion of the orbicularis muscle.



20-A +ve regurge test is diagnostic of

a) Nasolacrimal duct obstruction.

b) Canalicular obstruction.

c) Punctal occlusion.

d) Ectropion.


21-Concerning the nasolacrimal duct, the following statements are true except:

a) Its direction is downward, backward and medially.

b) It is guarded by a valve.

c) It opens into the nose.

d) It carries tears from the lacrimal sac to the nose.


22-The mucin layer of the pre-corneal tear film is secreted by:

a) The goblet cells.

b) The lacrimal gland

c) The meibomian gland.

d) The limbal stem cells


23-The oily layer of the pre-corneal tear film is secreted by:

a) The goblet cells.

b) The lacrimal gland.

c) The meibomian gland.

d) None of the above.


24-Deficiency of the watery layer of the pre-corneal tear film can mainly be diagnosed by:

a) Schirmer test.

c) Fluorescein test.

b) Jones dye test.

d) Regurge test.


25-The pre-corneal tear film is formed by the following layers except:

a) Oily layer.

b) Watery layer

c) Mucin layer.

d) Cellular layer.


26-All the following statements about the pre-comeal tear film are correct except:

a) It provides nutition to the cornea.

b) It protects the cornea through its anti-bacterial effect.

c) It lubricates the corneal surface.

d) It is not affected by deficiency of the Goblet cells.


27- The most common cause of nasolacrimal duct obstruction in infants is:

a) Imperforate Hasner's valve.

b) Venous congestion of the peri-ductal venous plexus.

c) Adhesions around the nasolacrimal duct.

d) Tumors of the bony canal in which the duct passes.


28- Investigations done in a case of epiphora include all of the following except:

a) Examination of the cheeks and face for scars.

b) Examination of the lid margin.

c) Jones dye test.

d) Fluorescein angiography.


29- The first line of treatment in a case of congenital nasolacrimal duct obstruction during the first 4

months of life is:

a) Massage

b) Probing and syringing.

c) Dacryocystectorny.

d) Dacryocystorhinostomy.


30- The most common causative organism in a case of acute dacryocystitis is:

a) Staphylococcus aureus.

b) Streptococci.

c) Pneumococci.

d) None of the above.


31-Complications of acute dacryocystitis include all of the following except:

a) Cavernous sinus thrombosis.

b) Orbital cellulitis.

c) Fistula

d) Squint


32- The most common causative organism in a case of chronic daryocystitis is:

c) Diphtheria bacilli.

a) Pneumococci.

b) Staphylococci.

d) None of the above.



33-A case diagnosed as having chronic dacryocystitis will present with the following clinical picture

except:

a) Fullness related to the medial canthus.

b) Epiphora.

c) Swelling below the medial canthus.

d) -ve regurge test.


34-The 1st line of treatment in such a case would be:

a) Massage and antibiotic eye drops.

b) Probing and syringing.

c) Dacryocystorhinostomy.

d) None of the above.


35-The most common causative organism in such a case is:

a) Staphylococcus aureus.

b) Pneumococci.

Diphtheria bacilli.

d) Streptococci.


36-The 1st line of treatment in such a case is:

a) Systemic antibiotics with drainage of the pus through a skin incision.

b) Fistulectomy.

c) Dacryocystectomy.

d) Dacryocystorhinostomy.



37-The hard stop met in probing and irrigation done in a case of epiphora corresponds to:

a) The junction of the common canaliculus with the lacrimal sac.

b) The medial wall of the sac.

c) The punctum.

d) None of the above.


38-Contrast dacryocystography is indicated in the following conditions:

a) To confirm the site of obstruction especially prior to lacrimal surgery.

b) To aid in the diagnosis of diverticula and fistula.

c) To diagnose the filling defects caused by tumors or stones.

d) All of the above.


39-As regarding the primary Jones dye test, all of the following statements are true except:

a) It differentiates partial obstruction of the lacrimal passages from primary hypersecretion.

b) Fluorescein recovered from the nose indicates patency of the drainage system.

c) A-ve test indicates a partial obstruction where the site of obstruction is known.

d) A-ve test necessitates the performance of the secondary Jones dye test.


40-Tear film break-up time measures:

a) Tear film production

b) Tear film distribution

c) Tear film volume

d) Tear film stability


41-Chronic dacryocystitis increases the risk of:

a) Phlyctenular conjunctivitis

b) Vernal conjunctivitis

c) Pneumococcal corneal ulcer

d) Dendritic corneal ulcer


42-Contraindications of dacryocystorhinostomy (DCR) include all of the following except:

a) Atrophic rhinitis.

b) Periostitis of the nasal bone

c) Tumors of the lacrimal sac.

d) Lacrimal fistula.


43- To diagnosis dry eye, the followings are useful except:

a) Schirmer test.

b) Fluroscine break-up time.

c) Rose bengal stain.

d) Methylene blue stain.


44- The most important organism responsible for chronic dacryocystits is:

a) Morax axenfeild

b) Pneumococci

c) Candida albicans

d) Streptococci


45-Flurosceine breakup test is used to test:

a) Patency of the lacrimal passage

b) Presence of comeal ulcers

c) Amount of tears production

d) Stability of the tears film


46-Chronic dacryocystits may cause the following except:

a) Recurrent conjunctivitis

b) Recurrent dendretic ulcer

c) Corneal ulcer with hypopyon

d) Post-operative endopthahnitis


47-The aqueous layer of tear film:

a) Minimize the rate of the evaporation of tears

b) Supplies oxygen & nutrients to the cornea

c) Fills the irregularities of corneal epithelium

d) Lies in direct contact with the corneall epithelium


48-Pneumococci can cause

a) Acute dacryocystitis

b) Chronic dacryocystitis

c) Atypical hypopyon ulcer

d) Ulcerative blepharitis


49-Staphylococci can cause

a) Acute dacryocystitis

b) Stye

c) Atypical hypopyon ulcer

d) Ulcerative blepharitis

e) All of the above


50-The commonest cause of Epiphora in a new born is

a) Sinusitis

b) Ophthalmia neonatorum

c) Non canalization of nasolacrimal duct

d) Stenosed lacrimal punctum


51-Which of the following are symptoms of dry eye syndrome

a) Burning or stinging eyes

b) Excessive tearing

c) A decreasing tolerance of contact lenses

d) All of the above


52-Which of the following is a test for dry eye syndrome

a) Schirmer

b) Sjogren's

c) Punctual drug

d) All of the above


53-The risk factors for dry eye are

a) Aging

b) Menopause

c) Autoimmune diseases

d) All of the above


Answers

  1. B

  2. A

  3. D

  4. B

  5. D

  6. A

  7. D

  8. C

  9. C

  10. C

  11. D

  12. D

  13. D

  14. B

  15. D

  16. D

  17. D

  18. A

  19. A

  20. A

  21. A

  22. A

  23. C

  24. A

  25. D

  26. D

  27. A

  28. D

  29. A

  30. A

  31. D

  32. A

  33. D

  34. A

  35. A

  36. A

  37. B

  38. D

  39. C

  40. D

  41. C

  42. D

  43. D

  44. B

  45. D

  46. D

  47. D

  48. B

  49. E

  50. C

  51. D

  52. A

  53. C



google-playkhamsatmostaqltradent