Oculoplatic and lacrimal

1. With regard to ptosis:

    a. the most common abnormality in congenital ptosis is in the levator

    b. lid lag on downgaze is a feature of senile ptosis

    c. in Horner's syndrome, ptosis is due to paralysis of the Muller's

    d. the levator function is good in aponeurotic defect

    e. raised skin crease is a feature of congenital ptosis.


2. True statements about eyelid lesions include:

    a. basal cell carcinoma affects the upper lid more commonly than
        the lower lid

    b. recurrent follicular conjunctivitis can be the result of molluscum

    c. keratoacanthoma can resolve spontaneously without treatment

    d. sebaceous cell carcinoma has a worse prognosis than squamous
        cell carcinoma

    e. basal cell carcinoma is common in patients with xeroderma


3. The following are true about tumours arising from hair follicles:

    a. trichoepithelioma is commoner in women than men

    b. women with multiple trichilemmomas have an increased risk of
        breast cancer

    c. calcification is a feature of pilomatrixoma

    d. pilomatrixoma is commoner in children than adult

    e. malignant transformation is common in pilomatrixoma


4. In blepharochalasis:

    a. most affected patients are in their 40s

    b. there are recurrent lid oedema

    c. there are levator disinsertion

    d. the condition is associated with Ascher's syndrome

    e. systemic steroid is useful


5. The nasolacrimal canal is made up of the following bones:

    a. maxillary

    b. lacrimal

    c. inferior turbinate

    d. palatine

    e. frontal


6. The Müller's muscle:

    a. is innervated by the parasympathetic nerve

    b. has the peripheral arcade of the upper lid running
        on its anterior surface

    c. is about 5 mm long

    d. arises from the superior rectus

    e. elevates the upper lid by about 2 mm


7. The following are true about the treatment of basal cell carcinoma:

    a. Mohs' micrographic excision should be performed in all cases of
        lower lid basal cell carcinoma

    b. Mohs' micrographic excision is useful for the diagnosis of basal
        cell carcinoma

    c. Mohs' micrographic excision allows three dimensional examination
        of tumour margins

    d. aggressive tissue removal is avoided in Mohs' micrographic

    e. before Mohs' tissue excision the skin is spread with zinc sulphate


8. The following are true:

    a. in epicanthus tarsalis, the medial canthal skin fold arises from the
        lower lid

    b. epicanthus inversus is a cause of in-growing eye lashes

    c. euryblepharon is a feature of Treacher-Collin's syndrome

    d. in distichiasis, there is an extra row of eyelashes in the orifices of
        the meibomian gland

    e. ankyloblepharon refers to the fusion of the upper and lower eyelids


9. Blepharophimosis:

    a. is an autosomal dominant condition

    b. epicanthus inversus is a feature

    c. has nasal bridge hypoplasia

    d. has hypertelorism

    e. is associated with mental retardation


10. In congenital obstruction of the nasolacrimal duct:

    a. the success rate of probing at 12 months of age is about 60%

    b. 85% of the cases are bilateral

    c. the blockage is found most commonly at the common canaliculus

    d. in congenital dacryocystocele, the skin is usually inflamed and hot

    e. in congenital dacryocystocele, the sac contains amniotic fluid


11. Upper lid retraction may be seen in:

    a. Grave's eye disease

    b. an eye with contralateral ptosis

    c. hepatic failure

    d. hydrocephalus in children

    e. Parinaud's syndrome


12. During dacryorhinostomy, the following are usually removed:

    a. maxillary bone

    b. frontal bone

    c. lacrimal bone

    d. lacrimal fossa

    e. ethmoid bone

13. The following are true about chronic canaliculitis caused by

    a. it is the most common cause of chronic canaliculitis

    b. this infection is caused by a fungus

    c. bloody tear is a feature

    d. syringing is usually normal despite epiphora

    e. dacryorhinostomy is the treatment of choice


14. Features of eyelid keratoacanthoma include:

    a. malignant transformation in 50% of cases

    b. loss of eyelashes

    c. rapid growth

    d. ulcerated surface filled with keratin

    e. spontaneous resolution


15. Features of Goldenharg's syndrome:

    a.  eyelid coloboma

    b. Duane's syndrome

    c. optic nerve hypoplasia

    d. ptosis

    e. lipodermoid


16. Hypertelorism is seen in:

    a. Curzon's syndrome

    b. frontal encephalocele

    c. blepharophimosis

    d. capillary haemangioma

    e. Turner's syndrome


17. The following are contributory  factors in senile (involution)

    a. atrophy of the orbital fat

    b. migration of the preseptal orbicularis over the pretarsal muscle

    c. dehiscence of the lower lid retractor

    d. horizontal lower lid laxity

    e. fat herniation through the orbital septum


18. The following are true about Jones dye test in epiphora:

    a. it is used to diagnose complete obstruction of the lacrimal drainage

    b. if the Jones 1 (primary) test is normal, the cause may be due to
        hypersecretion of tear

    c. if the Jones 1 (primary) test is negative, the obstruction is in the
        common canaliculus

    d. if the Jones II (secondary) test is negative, the abnormality may be
        due to pump failure

    e. if the Jones II (secondary) test is positive, there is a partial
       nasolacrimal duct obstruction


19. True statements about cavernous haemangioma include:

    a. it is commoner is female than male

    b. spontaneous resolution is common

    c. it is well-encapsulated

    d. retina striae is a recognized sign

    e. the proptosis increases with Valsalva's manoeuvre


20. In a patient with laceration to the upper lid:

    a. the presence of fat herniation indicates the orbital septum is

    b. the presence of lacrimal gland indicates the orbital septum is

    c. the orbital septum should be resutured if penetrated

    d. in the presence of ptosis, exploration should be delayed for at least
        72 hours to avoid retrobulbar haemorrhage

    e. ptosis is usually caused by damage to the oculomotor nerve


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