Iii Year Mbbs Question Bank Ophthalmology & Ent (Short Answers)
Iii Year Mbbs Question Bank Ophthalmology & Ent (Short Answers)
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CLARENDONZ’16 TVMC
UPDATED BY TNMSA ACADEMIC WING
CLARENZ’ 16 Ophthalmology TVMC
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39. Nyctalopia :
Also called Night blindness
Conditions where functioning of rods is deranged lead to Nyctalopia
Causes :
Vitamin A Deficiency
Tapetoretinal degeneration
Congenital high myopia
Familial congenital night blindness
Oguchi’s disease
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47. Presbyopia
Physiological insufficiency of accommodation leading to a progressive fall in near vision
Condition of failing near vision due to age related decrease in the amplitude of accommodation
or increase in punctum proximum is called Presbyopia
Causes :
(i) Age related changes in lens – decrease in elasticity or Sclerosis of lens
(ii) Age related decline in ciliary muscle power
Symptoms :
(i) Difficulty in near vision
(ii) Asthenopic symptoms due to fatigue of ciliary muscle
Treatment :
(i) Appropriate convex glasses for near work
(ii) Presbyopic spectacles
(iii) Presbyopic bifocal LASIK
49. Phlycten
Nodule occurring as an allergic response of conjunctival and Corneal epithelium to some
endogenous allergens
Causative allergens :
(I) Tuberculous Proteins
(II) Staphylococcal proteins
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50. Cycloplegics
Cause paralysis of accommodation and dilate the pupil
Commonly used Cycloplegics –
(i) Atropine 1% ointment
(ii) Homatropine 2% drops
(iii) Cyclopentolate 1% drops
Retinoscopy performed after instilling cycloplegics is called Wet Retinoscopy
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59. Atropine
Commonly used Cycloplegic
Available as 1% Atropine sulphate eye drops or ointment
In iridocyclitis, Atropine
(i) Gives comfort and rest to eye by relieving spasm of iris sphincter and ciliary muscle
(ii) Prevents the formation of synechiae and break already formed synechiae
(iii) Reduces exudation, relives hyperaemia, reduce vascular permeability
(iv) Increases blood supply to Anterior uvea
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68. Buphthalmos
Also called as Bull’s eye
Corneal enlargement seen in Congenital Glaucoma is termed as Buphthalmos
It occurs when the onset of congenital glaucoma is especially before 3 years
Normal Corneal diameter in infant is about 10.5 mm
Diameter more than 13 mm confirms Buphthalmos
Lacrimation, photophobia and blepharospasm - classical triad of congenital glaucoma
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Fetal factors –
(I) Fetal anoxia (III) Congenital anomalies – Lowe
(II) Metabolic – Galactosemia, syndrome, Myotonia Dystrophica
Galactokinase deficiency (IV) Persistent Hyperplastic Primary
Vitreous
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Lid signs - retraction of upper eye lid : staring frightened appearance (dalrymple sign)
1.Lid lag(Von graefe's sign)
2.Fullness of lid(Enroth sign)
3.Difficulty in Eversion of upper lid( Gifford's sign)
4.Infrequent blinking ( Stellwag's sign)
5.Increased pigmentation of lid(Jellinek’s sign)
6.Poor forehead wrinkling on looking up (Joffroy's sign)
Conjunctional signs- deep injection and chemosis)
Papillary signs- inequality of pupil dilation
Ocular mobility defect- Mobius sign, restrictive ocular myopathy
Exophthamos
Exposure keratitis
Optic neuropathy
two features-
a.pannus formation ,
b.corneal opacity ,
c.trichiasis
1. Corticosteroids
2. Phenothiazine
3. Strong mitotics
CLARENZ’16 ophthalmology TVMC
Direct Indirect
opthalmoscopy opthalmoscopy
Condensing lens: not required Required
Loss of lustre
2. Haller cell
Peritonsillar abscess
Tonsillolith
Peritonsillar abscess
Ludwig angina
6. Carharts notch
Seen in otosclerosis
8. Cottles line
Imaginary line extending from anterior nasal spine of maxilla to nasal spine of
frontal bone
Haemorrhage
pneumothorax
Aspiration of food
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12. Laryngomalacia
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Squamous papilloma
Chondroma
Hemangioma
Dislocation of incus
Thyroid
Cricoid
Epiglottis
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Accidental trauma
Bronchogenic cancer
Immediate Delayed
Surgical emphysema
Tonsillar remnants
Types:
Skin in this area is incised vertically and cricothyroid membrane cut with
transverse incision and the space kept open
Anterior ethmoidal A.
Septal br of superior labial A.
Septal br. Of sphenopalatine A.
Greater palatine A.
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1A- Submental
1B- Submandibular
3- Midjugular
4- Lower jugular
5- Posterior triangle
7- upper mediastinal
Diagnosis:
Negative rinne test, lateralisation of Weber’s test to ear with greater conductive
loss
Medical management:
Sodium fluoride given to hasten the maturity of focus and to arrest cochlear loss
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Ear discharge
Diplopia
Pyriform sinus/fossa
Postcricoid region
Crust forming disease seen in patients who work in hot,dry, dusty conditions
33. Laryngocele
Rx- excision
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Esophageal speech
Electrolarynx
Tracheoseophageal speech
Symptoms:
Weakness of voice
Hoarseness
Severe radiating pain to ears
Dysphasia
Signs:
Comprises the area bounded by nose, upper lip and corners of mouth
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Causes:
Seen in congenital syphilis when 3 functioning windows are present- oval window,
round window, extra window- fistula of semicircular canal or fenestration
operation.
Due to unstable autonomic nervous system and hyper reactive nasal mucosa
which responds to nonspecific stimuli
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Boundaries
Meal time syndrome- intermittent swelling of gland and pain due to obstruction to
outflow of saliva at meal time
Used in otitis media with effusion when other treatment methods fail
T3/T4 lesion
Acute mastoiditis
Petrositis
facial paralysis
Labyrinthitis
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51. Tonsillolith
By staphylococcus aureus
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Frontal sinus
Cribriform plate
Sphenoid sinus
57 . Laryngeal papillomatosis
Adult type- single, smaller, arise from anterior half of vocal cord
Rx: micro-laryngoscopy, CO2 laser excision, IFN 2alpha, 13 CIS retinoic acid
Recurrent, superficial ulcers of oral cavity sparing hard palate and gingiva
Minor form- more common, ulcers are 2-10 mm size, multiple with central
necrosis & red halo
Major form- 2-4 cm size, heals with scar followed by another ulcer
Bleeding Perforation
Septal hematoma Depression of nasal bridge
Septal abscess Flapping of nasal septum
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Detailed history
Clinical examination
Blood investigation to know nutritional status and to rule out Plummer Vinson
syndrome
Chest X-ray
Esophagoscopy
62. Quinsy
Presents with septicaemia, severe throat pain, hot potato voice, trismus
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4 stages:
Presents as dyspnea/stridor
It is a measure of threshold of hearing by air and bone conduction and thus degree
and type of hearing loss
66. Masking
When difference in air conduction thresholds between two ears is 40dB or more
masking is done
Due to its pressure effect it causes absorption of meatal bone exposing facial
nerve
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Etiology:
69. Rhinolith
Stone formation around the nucleus of small foreign body, blood clot or inspissated
secretions by slow deposition of ca and mg
Nasal congestion
Rhinorrhea
Increased lacrimation
Apnea occurring during sleep due to collapse of upper airway—> CO2 retention—>
pulmonary constriction —> congestive heart failure, cardiac hypoxia, hypertension
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Due to the presence of a clot which prevents the clipping action of superior constrictors
Here, Rt. Subclavian A. Arises from thoracic aorta and passes in front of or behind the
esophagus
In the presence of fistula between external auditory canal and labyrinth, pressure
changes in external canal can be transmitted to labyrinth producing nystagmus.
Done by applying intermittent pressure to Targums or by siegels speculum
Positive in cholesteatoma, fenestration operation, post stapedectomy fistula,
round window membrane rupture
False positive in congenital syphilis, meniere disease (hennebert sign)
False negative in cholesteatoma covering the fistula site
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77. Rhinoscleroma
Boundaries:
“In a progressive lesion of recurrent laryngeal nerve, the abductors are paralysed first
before the adductors”
In complete paralysis of recurrent laryngeal nerve the cord lies in the paramedian
position because the ntact cricothyroid muscle adducts the cord.
Components
Nasal polyps
Bronchial asthma
Aspirin insensitivity
Infrahyoid epiglottis
Anterior commissure
Subglottis
Ventricle
Apex of pyriform fossa
Includes
94. Rhinomanometry
Rx: steroids
Otosclerotic patient hears better in noisy than in quiet surroundings. This is because a
normal person will raise his voice in noisy surroundings
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• Aetiology
H.influenza B
• Radiological findings
Thumb sign – lateral soft tissue x-ray of neck may show swollen epiglottis
• AV shunts
Congenital AV malformations
• Arterial bruit
Carotid aneurysm
Carotid atenosis
• Venus hum
3) Palatal myoclonus.
5) clicking of TM joint.
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Bony (or)
cartilaginous (or)
• Aetiology:
Nasal trauma
As a complication of SMR
a. Hematoma or abscess
b. Leprosy
c. Tuberculosis
d. Syphilis
• Treatment:
Augmentation rhinoplasty.
structures seen:
• maxillary sinus
• frontal sinus
• sphenoid sinus( if the flim is taken with open mouth)
• zygoma
• zygomatic arch
• nasal bone
• frontal process of maxilla
• superior orbital fissure
• intra temporal fossa
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