FMGE 2017 — Ophthalmology

Q: In uveitis, site of keratic precipitate is:

Corneal endothelium. ***Corneal endothelium*** - **Keratic precipitates (KPs)** are inflammatory cellular deposits that adhere to the **posterior surface of the cornea**, specifically the endothelial layer, in uveitis. - They represent aggregates of inflammatory cells, such as macrophages and lymphocytes, that have migrated from the inflamed anterior chamber. *Lens anterior capsule* - The **anterior capsule of the lens** is a smooth, acellular membrane and does not typically accumulate inflammatory deposits like **keratic precipitates**. - While inflammatory cells can be observed in the **anterior chamber**, they do not specifically adhere to the lens capsule in this manner. *Lens posterior capsule* - Similar to the anterior capsule, the **posterior capsule of the lens** is not the site for deposition of **keratic precipitates**. - Inflammation affecting the lens would typically present as cataract formation or direct lens inflammation, not KPs. *Corneal stroma* - The **corneal stroma** is the thickest layer of the cornea and is primarily composed of collagen fibrils and keratocytes. - While inflammation can affect the stroma (e.g., in stromal keratitis), **keratic precipitates** specifically form on the **innermost layer**, the endothelium, facing the anterior chamber. [Practice more Ophthalmology PYQs on OnCourse]

Q: All of the following are false about eye lid signs in GRAVES DISEASE except?

Stellwag's sign: Incomplete and infrequent blinking. **⚠️ QUESTION ISSUE: All four options are TRUE statements about Graves' disease, making this question technically flawed.** ***Stellwag's sign: Incomplete and infrequent blinking*** ✓ - **Stellwag's sign** is correctly defined as **incomplete and infrequent blinking**, causing a characteristic staring appearance. - This is a **TRUE** sign of **Graves' ophthalmopathy** due to sympathetic overactivity. - **Marked as correct answer**, but all options are actually true. *Mobius sign: convergence insufficiency* ✓ - **Moebius sign** is correctly defined as **convergence insufficiency** (inability to converge eyes for near vision). - This is a **TRUE** sign of **Graves' disease**. - Statement is medically accurate. *Dalrymple sign: lid retraction* ✓ - **Dalrymple's sign** is correctly defined as **lid retraction** (upper eyelid retraction exposing sclera above iris). - This is a **TRUE** and classic sign of **Graves' ophthalmopathy**. - Statement is medically accurate. *Von Graefe's sign: lid lag on downgaze* ✓ - **Von Graefe's sign** is correctly defined as **lid lag on downgaze** (upper eyelid lags behind eyeball during downward gaze). - This is a **TRUE** sign of **Graves' disease**. - Statement is medically accurate. **Educational Note:** This FMGE-2017 question is problematic because all four eyelid sign descriptions are medically accurate. In the actual exam, Stellwag's sign was likely considered the "best" answer, possibly because it's the most specific or commonly tested. [Practice more Ophthalmology PYQs on OnCourse]

2 Previous Year Questions with Answers & Explanations

Questions

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In uveitis, site of keratic precipitate is:

All of the following are false about eye lid signs in GRAVES DISEASE except?

FMGE 2017 - Ophthalmology FMGE Practice Questions and MCQs

Question 1: In uveitis, site of keratic precipitate is:

A. Lens anterior capsule
B. Corneal endothelium (Correct Answer)
C. Lens posterior capsule
D. Corneal stroma

Explanation: ***Corneal endothelium*** - **Keratic precipitates (KPs)** are inflammatory cellular deposits that adhere to the **posterior surface of the cornea**, specifically the endothelial layer, in uveitis. - They represent aggregates of inflammatory cells, such as macrophages and lymphocytes, that have migrated from the inflamed anterior chamber. *Lens anterior capsule* - The **anterior capsule of the lens** is a smooth, acellular membrane and does not typically accumulate inflammatory deposits like **keratic precipitates**. - While inflammatory cells can be observed in the **anterior chamber**, they do not specifically adhere to the lens capsule in this manner. *Lens posterior capsule* - Similar to the anterior capsule, the **posterior capsule of the lens** is not the site for deposition of **keratic precipitates**. - Inflammation affecting the lens would typically present as cataract formation or direct lens inflammation, not KPs. *Corneal stroma* - The **corneal stroma** is the thickest layer of the cornea and is primarily composed of collagen fibrils and keratocytes. - While inflammation can affect the stroma (e.g., in stromal keratitis), **keratic precipitates** specifically form on the **innermost layer**, the endothelium, facing the anterior chamber.

Question 2: All of the following are false about eye lid signs in GRAVES DISEASE except?

A. Stellwag's sign: Incomplete and infrequent blinking (Correct Answer)
B. Mobius sign: convergence insufficiency
C. Dalrymple sign: lid retraction
D. Von Graefe's sign: lid lag on downgaze

Explanation: **⚠️ QUESTION ISSUE: All four options are TRUE statements about Graves' disease, making this question technically flawed.** ***Stellwag's sign: Incomplete and infrequent blinking*** ✓ - **Stellwag's sign** is correctly defined as **incomplete and infrequent blinking**, causing a characteristic staring appearance. - This is a **TRUE** sign of **Graves' ophthalmopathy** due to sympathetic overactivity. - **Marked as correct answer**, but all options are actually true. *Mobius sign: convergence insufficiency* ✓ - **Moebius sign** is correctly defined as **convergence insufficiency** (inability to converge eyes for near vision). - This is a **TRUE** sign of **Graves' disease**. - Statement is medically accurate. *Dalrymple sign: lid retraction* ✓ - **Dalrymple's sign** is correctly defined as **lid retraction** (upper eyelid retraction exposing sclera above iris). - This is a **TRUE** and classic sign of **Graves' ophthalmopathy**. - Statement is medically accurate. *Von Graefe's sign: lid lag on downgaze* ✓ - **Von Graefe's sign** is correctly defined as **lid lag on downgaze** (upper eyelid lags behind eyeball during downward gaze). - This is a **TRUE** sign of **Graves' disease**. - Statement is medically accurate. **Educational Note:** This FMGE-2017 question is problematic because all four eyelid sign descriptions are medically accurate. In the actual exam, Stellwag's sign was likely considered the "best" answer, possibly because it's the most specific or commonly tested.