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WorksheetsAMD, LEUKOCORIA
Total questions: 20
Worksheet time: 10mins
Which of the following histopathological findings is the hallmark of the early stage of Age-Related Macular Degeneration (AMD)?
Neovascularization arising from the retinal vessels
Cystoid macular edema due to inflammatory vitreous cells
Drusen deposits between the retinal pigment epithelium (RPE) and Bruch's membrane
Loss of ganglion cells in the peripheral retina
A 72-year-old patient reports that straight lines appear wavy and distorted when looking with their right eye. This symptom is known as metamorphopsia. Which clinical tool is most appropriate for monitoring this specific symptom at home?
Ishihara Plates
Goldmann Applanation Tonometer
Snellen Chart
Amsler Grid
Which of the following molecules is most important for the primary driver of the pathophysiology in neovascular (wet) AMD and is the main target for current pharmacological therapy?
Placental Growth Factor (PlGF)
Vascular Endothelial Growth Factor (VEGF)
Insulin Like Growth Factor (ILGF)
Pigment Epithelial Drive Factor (PEDF)
Which antioxidant formulation is recommended to reduce the risk of progression in patients with intermediate AMD?
Vitamin B complex and Magnesium
High-dose Omega-3 fatty acids monotherapy
Vitamin A, Beta-carotene, and Selenium only
Vitamin C, Vitamin E, Zinc, Copper, Lutein, and Zeaxanthin
A patient with advanced AMD asks about the expected course of their vision loss. Which description is most accurate?
Fluctuating vision that improves significantly with blinking
Rapid, painful loss of vision over a few days
Slow, progressive loss of central vision with preservation of peripheral navigation vision
Sudden onset of curtain-like shadow across the visual field
Which of the following genetic alterations is the primary cause of retinoblastoma?
Mutation of the TP53 gene on chromosome 17
Translocation t(11;22) resulting in the EWS-FLI1 fusion protein
Overexpression of the N-MYC proto-oncogene on chromosome 2
Inactivation of the RB1 tumour suppressor gene on chromosome 13
What is the most common initial presenting sign of retinoblastoma in children?
Exophthalmos
Leukocoria
Strabismus
Hyphema
A 2-year-old presents with a large, unilateral retinoblastoma filling >15% of the globe with suspected optic nerve invasion. There is no evidence of metastasis. What is the generally preferred management?
External Beam Radiotherapy (EBRT)
Intravitreal chemotherapy only
Enucleation
Observation
Survivors of heritable retinoblastoma are at a significantly increased risk for developing which secondary malignancy later in life?
Pancreatic Adenocarcinoma
Osteosarcoma
Renal Cell Carcinoma
Colorectal Cancer
Which of the following describes the primary pathological mechanism underlying a rhegmatogenous retinal detachment?
Passage of liquefied vitreous fluid through a full-thickness retinal break into the subretinal space
Contraction of fibrous membranes on the retinal surface pulling the neurosensory retina away from the pigment epithelium
Atrophy of the retinal pigment epithelium leading to gradual separation of retinal layers
Accumulation of subretinal fluid due to breakdown of the blood-retinal barrier or choroidal pathology, without a retinal break
A 55-year-old male presents with a sudden onset of 'flashing lights' (photopsia) and a shower of dark spots in his vision, followed by a shadow appearing in his peripheral visual field. These symptoms are most suggestive of:
Central Retinal Artery Occlusion
Aged Related Macular Degeneration
Acute Angle-Closure Glaucoma
Posterior Vitreous Detachment typically progressing to Retinal Detachment
Which procedure is appropriate for a patient with a superior retinal detachment caused by a single retinal tear, where an expanding gas bubble is injected into the vitreous cavity to tamponade the break?
Scleral Buckling
Pneumatic Retinopexy
Pars Plana Vitrectomy
Panretinal Photocoagulation
A 18-month-old child is referred for a white pupillary reflex (leukocoria) in the right eye. B-scan ultrasonography reveals a solid intraocular mass with high internal reflectivity and acoustic shadowing, indicating intratumoral calcification. Which diagnosis is most likely?
Congenital Cataract
Coats Disease
Retinoblastoma
Persistent Fetal Vasculature (PFV)
A newborn is diagnosed with a dense, unilateral congenital cataract. The ophthalmologist recommends surgical removal within the first 4 to 6 weeks of life. What is the primary reason for this urgency?
To allow for immediate implantation of a multifocal lens
To prevent the development of deprivation amblyopia
To reduce the risk of secondary glaucoma immediately
To prevent the cataract from spreading to the other eye
A 25-year-old male presents with a red, painful right eye and photophobia. Slit-lamp examination reveals white blood cells floating in the anterior chamber and protein leakage (flare). What is the correct anatomical classification of this uveitis?
Panuveitis
Intermediate Uveitis
Posterior Uveitis
Anterior Uveitis (Iritis/Iridocyclitis)
Which of the following slit-lamp findings is specific to Granulomatous Uveitis (e.g., in Sarcoidosis or Tuberculosis)?
Fine, dust-like keratic precipitates
Mutton-fat keratic precipitates (KPs)
Ciliary flush
Hypopyon
A 30-year-old male with recurrent acute anterior uveitis complains of lower back pain and stiffness that improves with exercise. Which genetic marker is most likely positive in this patient?
ANA (Antinuclear Antibody)
HLA-B27
RF (Rheumatoid Factor)
HLA-DR4
In the management of acute anterior uveitis, cycloplegic drops (like Atropine or Cyclopentolate) are prescribed alongside topical steroids. What is the primary purpose of the cycloplegic agent?
To prevent the formation of posterior synechiae and relieve pain from ciliary spasm
To reduce the permeability of the blood-aqueous barrier
To lower intraocular pressure
To act as an antibiotic prophylaxis
Which of the following risk factors is most important?
UV exposure
Alcohol
Smoking
Fatty diet
A 32-year-old male with a 'Type A' personality presents with sudden unilateral blurred vision and metamorphopsia (distortion). Fundoscopy reveals a well-demarcated, dome-shaped serous elevation of the neurosensory retina at the macula. Which of the following is the strongest modifiable risk factor associated with this condition (Central Serous Chorioretinopathy)?
Dietary Calcium deficiency
Systemic or topical corticosteroid use
Hypotension
Vitamin B12 deficiency
