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REFRACTIVE ERROR - Multiple Choice Questions

Total questions: 46

Worksheet time: 4mins

Name
Class
Date
1.

What is the most common refractive error in children?

a)

Hyperopia

b)

Myopia (nearsightedness)

c)

Astigmatism

d)

Presbyopia

2.

Which condition is characterized by blurred distance vision but clear near vision?

a)

Hyperopia

b)

Myopia

c)

Astigmatism

d)

Amblyopia

3.

What is the primary cause of myopia progression in children?

a)

Genetic factors

b)

Excessive near work and limited outdoor activity

c)

Vitamin D deficiency

d)

Premature birth

4.

Which refractive error is common in infants but typically resolves by age 2–3 years?

4 lines
5.

What is the gold standard for diagnosing refractive errors in children?

a)

Snellen chart

b)

Cycloplegic refraction (using atropine or cyclopentolate)

c)

Corneal topography

d)

Visual evoked potential (VEP)

6.

Which treatment can slow myopia progression in children?

a)

Oral beta-carotene

b)

Low-dose atropine eye drops (0.01%)

c)

Blue-light-blocking glasses

d)

Vitamin A supplements

7.

What is the threshold anisometropia that can cause amblyopia?

a)

≥1.5 D difference between eyes

b)

≥0.5 D

c)

≥3.0 D

d)

No specific threshold

8.

Which device is used to screen for refractive errors in preschoolers?

a)

Tonometry

b)

Photoscreener or autorefractor

c)

OCT (Optical Coherence Tomography)

d)

Gonioscopy

9.

What is the first-line management for hyperopia causing strabismus or amblyopia?

a)

Observation

b)

Corrective glasses (full cycloplegic correction)

10.

Which condition is associated with "lazy eye" due to untreated refractive error?

a)

Strabismus

b)

Amblyopia

c)

Nystagmus

d)

Cataract

11.

What type of lens corrects astigmatism?

a)

Spherical lens

b)

Cylindrical lens

c)

Bifocal lens

d)

Prism lens

12.

Which intervention is recommended for children with progressive myopia?

a)

Orthokeratology (overnight rigid contact lenses)

b)

Pilocarpine eye drops

c)

Laser surgery (PRK)

d)

Intraocular lens implantation

13.

What is the recommended outdoor activity duration to reduce myopia risk?

a)

15 minutes/day

b)

≥2 hours/day

c)

30 minutes/week

d)

No proven benefit

14.

Which refractive error is linked to prematurity and retinopathy of prematurity (ROP)?

a)

High myopia

b)

Hyperopia

c)

Presbyopia

d)

Keratoconus

15.

When should a child with suspected refractive error be referred to a pediatric ophthalmologist?

a)

Only if vision is worse than 20/40

b)

If amblyopia, strabismus, or anisometropia is detected

c)

After age 10 years

d)

Only if parents request it

16.

What is the most common bacterial cause of acute otitis media (AOM) in children?

a)

Staphylococcus aureus

b)

Streptococcus pyogenes

c)

Streptococcus pneumoniae

d)

Pseudomonas aeruginosa

17.

Which symptom is most specific for acute otitis media (AOM)?

a)

Fever

b)

Bulging tympanic membrane

c)

Cough

d)

Diarrhea

18.

According to the AAP, when is antibiotic therapy strongly recommended for AOM?

a)

All cases of AOM

b)

Children <6 months with AOM

c)

Only if symptoms last >7 days

d)

Only if the child has a fever

19.

What is the first-line antibiotic for AOM in a penicillin-allergic child?

a)

Amoxicillin

b)

Azithromycin

20.

Which condition is characterized by fluid in the middle ear without signs of infection?

a)

Acute otitis media (AOM)

b)

Otitis media with effusion (OME)

c)

Chronic suppurative otitis media (CSOM)

d)

Mastoiditis

21.

What is the most common complication of untreated AOM?

a)

Meningitis

b)

Tympanic membrane perforation

c)

Cholesteatoma

d)

Facial nerve palsy

22.

Which test is most useful for diagnosing otitis media with effusion (OME)?

a)

Throat culture

b)

Tympanometry

c)

Audiometry

d)

CT scan

23.

When should tympanostomy tubes be considered for recurrent AOM?

a)

After 1 episode

b)

≥3 episodes in 6 months or ≥4 episodes in 1 year

c)

Only if hearing loss is permanent

d)

Never in children under 2 years

24.

Which vaccine has reduced the incidence of AOM caused by S. pneumoniae?

a)

Hepatitis B vaccine

b)

Pneumococcal conjugate vaccine (PCV13)

c)

MMR vaccine

d)

Varicella vaccine

25.

What is the most common cause of hearing loss in children?

a)

Noise exposure

b)

Otitis media with effusion (OME)

c)

Congenital deafness

d)

Ototoxicity

26.

Which of the following is a risk factor for recurrent AOM?

a)

Day-care attendance

b)

Breastfeeding >6 months

c)

Lack of vaccinations

d)

High-fiber diet

27.

What is the most serious complication of AOM?

a)

Otitis externa

b)

Mastoiditis

c)

Tinnitus

d)

Vertigo

28.

How long should OME be observed before considering intervention?

a)

1 week

b)

3 months (if asymptomatic)

c)

6 months

d)

Immediate referral

29.

Which organism is commonly associated with chronic suppurative otitis media (CSOM)?

a)

Streptococcus pneumoniae

b)

Haemophilus influenzae

c)

Pseudomonas aeruginosa

d)

Moraxella catarrhalis

30.

The treatment of choice for mastoiditis is:

a)

Myringotomy with intravenous antibiotics

b)

Oral antihistamines

c)

Topical ear drops only

d)

Observation without treatment

31.

Which of the following is the recommended treatment for a severe skin infection?

a)

Oral amoxicillin

b)

IV antibiotics (e.g., ceftriaxone) ± surgical drainage

c)

Antiviral therapy

d)

Steroids

32.

What is the hallmark symptom of atopic dermatitis (AD) in children?

a)

Pruritus (itchiness)

b)

Painful blisters

c)

Hair loss

d)

Thickened nails

33.

Which age group most commonly develops atopic dermatitis?

a)

Adolescents

b)

Adults

c)

Infants and young children (onset before age 5 in 90% of cases)

d)

Elderly

34.

Which of the following is a major diagnostic criterion for AD (Hanifin & Rajka criteria)?

a)

Fever

b)

Chronic or relapsing dermatitis

c)

Joint pain

d)

Weight loss

35.

What is the first-line treatment for mild atopic dermatitis?

a)

Oral steroids

b)

Emollients (moisturizers) and gentle skin care

c)

Antibiotics

d)

UV therapy

36.

What is a common trigger for AD exacerbations in children?

a)

Dry skin and irritants (e.g., soaps, wool)

b)

High-fiber diet

c)

Cold weather only

d)

Excessive sunlight

37.

Which complication is associated with severe AD?

a)

Secondary bacterial infection (e.g., Staphylococcus aureus)

b)

Hypertension

c)

Diabetes

d)

Bone fractures

38.

When should topical calcineurin inhibitors (e.g., tacrolimus) be used?

a)

As first-line therapy

b)

For steroid-resistant AD or sensitive areas (face, eyelids)

c)

Only in adults

d)

For fungal infections

39.

Which systemic medication may be used for severe, refractory AD?

a)

Oral immunosuppressants (e.g., cyclosporine, dupilumab)

b)

Antivirals

c)

Insulin

d)

Chemotherapy

40.

What is the role of antihistamines in AD management?

a)

Reduce itching (especially sedating types like hydroxyzine at night)

b)

Cure AD permanently

41.

Which food is most commonly associated with AD exacerbations in infants?

a)

Rice

b)

Cow’s milk

c)

Bananas

d)

Carrots

42.

What is the "atopic triad"?

a)

AD + allergic rhinitis + asthma

b)

AD + psoriasis + vitiligo

c)

AD + diabetes + hypertension

d)

AD + eczema herpeticum + impetigo

43.

Which sign suggests eczema herpeticum (a medical emergency)?

a)

Clustered vesicles with punched-out erosions + fever

b)

Mild dryness

c)

Hyperpigmentation

d)

Bruising

44.

What is the primary goal of AD management?

a)

Complete cure

b)

Symptom control and flare prevention

c)

Avoiding all baths

d)

Eliminating all allergens

45.

Which bathing practice is recommended for children with AD?

a)

Short, lukewarm baths with gentle cleansers

b)

Hot baths to kill bacteria

c)

Avoid bathing entirely

46.

Which of the following is the best bathing practice for sensitive skin?

a)

Short, lukewarm baths with gentle cleansers

b)

(Option not visible)

c)

(Option not visible)

d)

Scrubbing with loofahs