Board Certified Ophthalmologist Uveitis and Ocular Inflammation 2

Question 1

Which laboratory test is most useful in the initial workup of a patient with suspected sarcoid uveitis?

Accepted Answer

Serum angiotensin-converting enzyme (ACE)

Answer

Antinuclear antibody (ANA)

Answer

HLA-B27 typing

Answer

Antineutrophil cytoplasmic antibody (ANCA)

Question 2

What is the most common cause of infectious posterior uveitis in immunocompetent patients in the United States?

Accepted Answer

Toxoplasma gondii

Answer

Cytomegalovirus (CMV)

Answer

Herpes simplex virus (HSV)

Answer

Candida albicans

Question 3

Which fundus finding is most characteristic of active toxoplasmic retinochoroiditis?

Accepted Answer

White fluffy lesion adjacent to an old pigmented scar ('headlight in fog')

Answer

Dalen-Fuchs nodules at the level of the RPE

Answer

Perivascular candle-wax dripping exudates

Answer

Epiretinal membrane over the macula

Question 4

An AIDS patient develops painless progressive vision loss with a 'pizza pie' fundus appearance showing retinal whitening and hemorrhage. What is the most likely diagnosis?

Accepted Answer

CMV retinitis

Answer

Toxoplasmic retinitis

Answer

Acute retinal necrosis (ARN)

Answer

Progressive outer retinal necrosis (PORN)

Question 5

Which anterior chamber finding is characteristic of Fuchs heterochromic iridocyclitis (FHI)?

Accepted Answer

Fine stellate KPs distributed across the entire corneal endothelium without posterior synechiae

Answer

Large mutton-fat KPs with posterior synechiae

Answer

Posterior synechiae and iris bombe

Answer

Dense hypopyon with fibrin in the anterior chamber

Question 6

In a patient receiving long-term systemic corticosteroids for uveitis, which ocular complication is most characteristic of steroid use?

Accepted Answer

Posterior subcapsular cataract

Answer

Anterior subcapsular cataract

Answer

Nuclear sclerotic cataract

Answer

Cortical cataract

Question 7

What is the mechanism of action of cyclosporine when used as a steroid-sparing agent in uveitis?

Accepted Answer

Blocks calcineurin, preventing IL-2 transcription and T-cell activation

Answer

Inhibits TNF-alpha production by macrophages

Answer

Inhibits dihydrofolate reductase and lymphocyte proliferation

Answer

Depletes peripheral B lymphocytes via CD20 targeting