Ophthalmic Surgery Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Ophthalmic Surgery. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Ophthalmic Surgery Indian Medical PG Question 1: Which of the following statements are correct regarding primary survey/management of traumatic head injury patient?
I. Ensure adequate oxygenation and circulation
II. Exclude hypoglycaemia
III. Check for mechanism of injury
IV. Check pupil size and response
Select the answer using the code given below :
- A. II, III and IV
- B. I, III and IV
- C. I, II and III
- D. I, II and IV (Correct Answer)
Ophthalmic Surgery Explanation: ***I, II and IV***
- **Primary survey** in trauma management, including head injury, focuses on immediately life-threatening conditions (Airway, Breathing, Circulation, Disability, Exposure). Ensuring adequate **oxygenation and circulation** (Statement I) is paramount to prevent secondary brain injury.
- Exclude **hypoglycemia** (Statement II) is critical because altered mental status due to low blood sugar can mimic head injury and delay appropriate treatment, making it an essential part of the 'D' (disability) assessment. Checking **pupil size and response** (Statement IV) is also part of the 'D' assessment, providing vital information about potential brain stem compromise or intracranial pressure changes.
*II, III and IV*
- While excluding hypoglycemia and checking pupil response are crucial parts of the primary survey, Statement III, "Check for mechanism of injury," is typically part of the **secondary survey** or initial assessment but not immediately life-saving like ABCD.
- The primary survey prioritizes immediate threats to life, and while understanding the mechanism of injury informs subsequent care, it does not directly address a patient's immediate physiologic stability.
*I, III and IV*
- This option includes checking the mechanism of injury (Statement III) as part of the primary survey, which is generally conducted after the **life-threatening conditions** are addressed.
- It omits the critical step of excluding **hypoglycemia** (Statement II), which is an immediate reversible cause of altered mental status that must be ruled out during the primary assessment.
*I, II and III*
- This option correctly includes ensuring adequate **oxygenation and circulation** (Statement I) and excluding **hypoglycemia** (Statement II) as part of the primary survey.
- However, it incorrectly includes checking for the **mechanism of injury** (Statement III) as a primary survey component and omits checking **pupil size and response** (Statement IV), which is an essential part of the 'Disability' assessment in the primary survey for head injury.
Ophthalmic Surgery Indian Medical PG Question 2: All of the following are complications of traumatic hyphema except which of the following?
- A. Pupillary Block
- B. Posterior synechiae
- C. Rebleeding
- D. Corneal Ulcer (Correct Answer)
Ophthalmic Surgery Explanation: ***Corneal Ulcer***
- A **corneal ulcer** is typically caused by infection, trauma, or exposure keratitis and is not a direct complication of blood in the anterior chamber from a **traumatic hyphema**.
- While prolonged elevation of **intraocular pressure** from hyphema could theoretically impair corneal health, a direct ulcer is not a typical or primary complication.
*Rebleeding*
- **Rebleeding** is a common and serious complication of hyphema, usually occurring 2-7 days after the initial injury.
- It often results in a more significant bleed and carries a higher risk of complications such as **elevated intraocular pressure** and **blood staining of the cornea**.
*Pupillary Block*
- **Pupillary block** can occur if the amount of blood from the hyphema prevents the flow of aqueous humor from the posterior to the anterior chamber.
- This blockage leads to a buildup of **aqueous humor** in the posterior chamber, causing the iris to bow forward and potentially precipitating **acute angle-closure glaucoma**.
*Posterior synechiae*
- **Posterior synechiae** can develop due to inflammation (uveitis) associated with the hyphema, where the iris adheres to the anterior lens capsule.
- This complication can lead to **irregular pupil shape**, **pupillary block glaucoma**, or other visual disturbances.
Ophthalmic Surgery Indian Medical PG Question 3: Which of the following is not a treatment option for glaucoma?
- A. Trabeculectomy
- B. Trabeculotomy
- C. Vitrectomy (Correct Answer)
- D. Viscocanalostomy
Ophthalmic Surgery Explanation: ***Vitrectomy***
- A **vitrectomy** is a surgical procedure to remove the **vitreous humor** from the eye, typically performed for conditions like **retinal detachment**, **diabetic retinopathy**, or **vitreous hemorrhage**, not glaucoma.
- While glaucoma can sometimes coexist with these conditions, vitrectomy itself is not a direct treatment for addressing the **intraocular pressure** or **optic nerve damage** characteristic of glaucoma.
*Trabeculectomy*
- **Trabeculectomy** is a common surgical procedure for glaucoma that creates a new drainage pathway for **aqueous humor** to reduce **intraocular pressure**.
- It involves removing a small piece of the **trabecular meshwork** and sclera to form a filtering bleb.
*Trabeculotomy*
- **Trabeculotomy** is a surgical procedure primarily used in **congenital glaucoma** or some forms of **open-angle glaucoma** to improve the outflow of aqueous humor.
- It involves incising the **trabecular meshwork** to open up the natural drainage channels.
*Viscoanulostomy*
- **Viscocanalostomy** (not viscoanulostomy) is a non-penetrating glaucoma surgery that aims to reduce **intraocular pressure** by improving the outflow of **aqueous humor** through the **Schlemm's canal**.
- It involves dissecting the outer wall of **Schlemm's canal** and injecting viscoelastic material to dilate the canal, without creating a full-thickness fistula.
Ophthalmic Surgery Indian Medical PG Question 4: Calcified canal is explored with all of the given instruments except:
- A. 10 K file (Correct Answer)
- B. 6 K file
- C. C+ file
- D. Profinder
Ophthalmic Surgery Explanation: ***10 K file***
- **#10 K-files** are typically used for initial negotiation of **larger, more accessible canals**, not for exploring highly calcified or severely constricted canals.
- Their larger diameter (0.10 mm) makes them too stiff and prone to ledge formation or perforation in extremely calcified areas.
*6 K file*
- **#6 K-files** are extremely small and flexible (0.06 mm in diameter), making them ideal for initial penetration through tight, calcified canal orifices.
- Their fine tip and flexibility help in navigating complex anatomy and overcoming initial resistance without causing iatrogenic damage.
*C+ file*
- **C+ files** are specifically designed for calcified or severely curved canals due to their **stiffer shaft, non-cutting tip**, and improved resistance to buckling.
- They are offered in multiple diameters, including very small sizes like 06 and 08, which are suitable for initial exploration of challenging canal anatomy.
*Profinder*
- **ProFinder files** are specialized stainless steel hand files with a **triangular cross-section** and non-cutting tip, designed for initial negotiation of difficult and calcified canals.
- Their enhanced tip design and shaft stiffness facilitate easy insertion into tight orifices and help maintain the canal pathway.
Ophthalmic Surgery Indian Medical PG Question 5: A patient sustained blunt trauma to the eye, after which he developed sudden loss of vision with deep anterior chamber. Most likely cause is:
- A. Retinal haemorrhage
- B. Lens dislocation (Correct Answer)
- C. Berlin's oedema
- D. Recession of angle of AC
Ophthalmic Surgery Explanation: ***Lens dislocation***
- **Blunt trauma** can cause **zonular rupture**, leading to **lens dislocation** into the vitreous or anterior chamber.
- A dislocated lens in the vitreous space results in a **deep anterior chamber** and sudden vision loss due to loss of the refractive power of the lens.
*Retinal haemorrhage*
- While blunt trauma can cause **retinal haemorrhage**, it typically does not present with a **deep anterior chamber**.
- Vision loss from retinal haemorrhage depends on its size and location, but it's not directly associated with changes in anterior chamber depth.
*Berlin's oedema*
- Also known as **commotio retinae**, this condition involves **retinal oedema** due to blunt trauma, causing sudden vision loss.
- However, Berlin's oedema is a retinal condition and does not typically alter the **depth of the anterior chamber**.
*Recession of angle of AC*
- **Angle recession** is a common consequence of blunt trauma, where the ciliary body detaches from the scleral spur, causing a widening of the **anterior chamber angle**.
- While it can lead to **secondary glaucoma** over time, it typically does not cause **sudden profound vision loss** immediately after trauma and does not necessarily result in a *deep* anterior chamber.
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