AMC MCQ Ophthalmology and ENT 2

Question 1

A 58-year-old with poorly controlled diabetes presents with new retinal vessels and a recent vitreous haemorrhage. What stage of diabetic retinopathy does this represent?

Accepted Answer

Proliferative diabetic retinopathy

Answer

Proliferative diabetic retinopathy is defined by neovascularization (new vessel formation) on the retina or disc, which can rupture and cause vitreous haemorrhage or lead to tractional retinal detachment.

Question 2

A 70-year-old with atrial fibrillation develops sudden painless monocular vision loss. Fundoscopy shows a pale, oedematous retina with a 'cherry red spot' at the fovea. What is the diagnosis?

Accepted Answer

Central retinal artery occlusion

Answer

Central retinal artery occlusion causes inner retinal ischaemia, producing a pale retina with a cherry red spot at the fovea where the choroidal circulation preserves the thinner foveal tissue.

Question 3

A 32-year-old with ankylosing spondylitis presents with a painful red eye, photophobia, blurred vision, and lacrimation. Slit-lamp examination reveals keratic precipitates and a hypopyon. What is the diagnosis?

Accepted Answer

Acute anterior uveitis (iritis)

Answer

Anterior uveitis presents with a painful red eye, photophobia, and keratic precipitates on slit-lamp examination; it is commonly associated with HLA-B27-positive conditions such as ankylosing spondylitis.

Question 4

A 3-year-old child is brought in after parents notice a white reflex (leukocoria) in the left eye in photographs. What is the most critical diagnosis to exclude urgently?

Accepted Answer

Retinoblastoma

Answer

Leukocoria in a child must prompt urgent ophthalmological referral to exclude retinoblastoma, the most common intraocular malignancy in children, which is life-threatening if diagnosis is delayed.

Question 5

A 48-year-old presents with a 2-month history of unilateral nasal obstruction, blood-stained nasal discharge, and a firm cervical lymph node. There is unilateral serous otitis media. CT shows a nasopharyngeal mass. What is the most likely diagnosis?

Accepted Answer

Nasopharyngeal carcinoma

Answer

Nasopharyngeal carcinoma presents with unilateral nasal obstruction, epistaxis, cervical lymphadenopathy, and unilateral serous otitis media due to Eustachian tube obstruction; it is strongly associated with EBV.

AMC MCQ Practice Test

AMC MCQ Practice Test

AMC MCQ Ophthalmology and ENT 2