COST Ocular Pathology & Disease Recognition 1 — Questions and Answers
Question 1: Which type of cataract is most commonly associated with corticosteroid use and diabetes mellitus?
- Nuclear cataract
- Cortical cataract
- Posterior subcapsular cataract (Correct answer)
- Anterior subcapsular cataract
Correct answer: Posterior subcapsular cataract
Posterior subcapsular cataracts form at the back of the lens capsule and are strongly associated with chronic corticosteroid use, diabetes, and radiation exposure.
Question 2: The primary pathological mechanism in primary open-angle glaucoma involves:
- Pupillary block preventing aqueous flow
- Decreased production of aqueous humor
- Impaired drainage through the trabecular meshwork (Correct answer)
- Increased vitreous humor production
Correct answer: Impaired drainage through the trabecular meshwork
Open-angle glaucoma results from progressive impairment of aqueous outflow through the trabecular meshwork, leading to elevated intraocular pressure and optic nerve damage.
Question 3: Drusen deposits in age-related macular degeneration (AMD) are located between which two layers?
- Retinal pigment epithelium and Bruch's membrane (Correct answer)
- Inner nuclear layer and outer plexiform layer
- Choroid and sclera
- Vitreous and internal limiting membrane
Correct answer: Retinal pigment epithelium and Bruch's membrane
Drusen are extracellular deposits that accumulate between the retinal pigment epithelium (RPE) and Bruch's membrane, a hallmark finding in AMD.
Question 4: Which finding is characteristic of non-proliferative (background) diabetic retinopathy?
- Neovascularization of the optic disc
- Microaneurysms and dot-blot hemorrhages (Correct answer)
- Vitreous hemorrhage
- Tractional retinal detachment
Correct answer: Microaneurysms and dot-blot hemorrhages
Non-proliferative diabetic retinopathy is characterized by microaneurysms, dot-blot hemorrhages, hard exudates, and cotton-wool spots without new vessel formation.
Question 5: Exudative (serous) retinal detachment differs from rhegmatogenous retinal detachment in that it:
- Results from a full-thickness retinal break
- Is caused by vitreous traction on the retinal surface
- Involves subretinal fluid without any retinal tear or break (Correct answer)
- Always presents with photopsia and floaters
Correct answer: Involves subretinal fluid without any retinal tear or break
Exudative retinal detachment occurs when fluid accumulates beneath the retina from leaking blood vessels or inflammation without a break in the retina.
Question 6: A pterygium is a fibrovascular growth that typically originates from:
- The nasal conjunctiva and extends toward the cornea (Correct answer)
- The iris and extends to the corneal stroma
- The posterior capsule of the crystalline lens
- The retinal pigment epithelium
Correct answer: The nasal conjunctiva and extends toward the cornea
A pterygium is a wing-shaped fibrovascular overgrowth of conjunctival tissue that characteristically advances from the nasal limbal conjunctiva across onto the cornea.
Question 7: Fuchs' endothelial corneal dystrophy primarily causes vision loss by affecting which corneal layer?
- Epithelium
- Bowman's layer
- Stroma
- Endothelium (Correct answer)
Correct answer: Endothelium
Fuchs' dystrophy involves progressive degeneration of corneal endothelial cells, which normally pump fluid out of the cornea, leading to stromal edema and vision loss.
COST Ocular Pathology & Disease Recognition 1
Which type of cataract is most commonly associated with corticosteroid use and diabetes mellitus?