Sample Multiple Choice Questions from the Royal College of Ophthalmologists

Immunology 1. Interferon production: a. is a fundamental cell response to foreign nucleic acid b. is a low molecular weight protein c. acts directly on virus particles d. can be produced by almost all cells when stimulated e. viruses are the most potent stimulators of interferon production.
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Ocular anatomy 2. The ciliary body: a. consists of the pars plicata and pars plana b. produces aqueous humour c. derives its blood supply from the short posterior ciliary arteries d. is responsible for accommodation e. extends 10 mm from the corneoscleral junction
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3. Lymphatics of the bulbar conjunctiva: a. join with lymphatics of the lid at the palpebral commisures b. on the medial side drain to the submandibular lymph

nodes c. communicate with intraocular lymphatics d. are arranged in a deep and superficial plexus e. drain aqueous by direct communications with the canal of Schlemm
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4. The medial wall of the orbit includes: a. the body of the sphenoid b. the trochlear fossa c. the frontal process of the maxilla d. the palatine bone e. the anterior and posterior ethmoidal canals
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Head and neck anatomy 5. The posterior triangle of the neck: a. is bounded anteriorly by the sternomastoid muscle b. is traversed by the phrenic nerve c. is traversed by the internal jugular vein d. is divided into equal parts by the accessory nerve e. is crossed by the anterior jugular vein
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CNS anatomy 6. The blood supply of the visual pathways is as follows:

a. intracanalicular part of the optic nerve is supplied by the axial branch of the central retinal artery b. intracranial part of the optic nerve is supplied by the axial branch from the internal carotid artery c. occipital pole of the cerebral cortex is supplied by the middle cerebral artery d. lateral geniculate body is partly supplied by the deep optic branch of the middle cerebral artery e. optic tract is entirely supplied by pial plexus
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General pathology 7. The pathological changes in sarcoidosis include: a. tubercles containing epithelioid cells b. tubercles with central areas of necrosis c. giant cells containing calcified inclusions d. rise in serum globulin e. reduced serum calcium
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8. Atheroma of the major vessels is associated with: a. hypertrophy of the media b. deposition of lipid material in the intima c. the presence of calcium salts in the intima d. increased lymphocytic infiltration of intima e. the late development of aneurysmal dilatation.
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9. Hypertrophy of a tissue is associated with: a. proliferation of the cells b. an enlargement of the size of the individual cells c. increased functional activity d. increased blood supply e. a change of one cell type to another
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General microbiology 10. Neisseria gonorrhoea: a. is a gram positive coccus b. is aerobic c. survives for long periods outside the body d. produces its toxicity by means of an endotoxin e. can infect most laboratory animals
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11. Herpes simplex virus: a. is an ovoid virus of 300 to 350 um in length b. can be detected in cell nuclei 12 hours after infection c. produces an eosinophilic inclusion body d. produces a final elementary body which has a double membrane e. produces elementary bodies which are released by total rupture of host cells

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Ocular microbiology 12. The following diseases are associated with cell-mediated tissue damaging reactions in the eye: a. systemic lupus erythematosus b. pemphigus vulgaris c. chronic tuberculosis d. contact dermatitis e. Goodpasture's syndrome
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Ocular embryology 13. In the development of the cornea: a. the superficial epithelial layer is derived from mesoderm b. keratocytes invade the cornea just before birth c. at birth the horizontal corneal diameter is about 10 mm d. Descemet's membrane is secreted by the keratocytes e. the cornea is clear at all stages of its development
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Genera physiology 14. With respect to hearing: a. the elaborate design of the middle ear largely solves the mechanical problem of transmitting sound from air to fluid b. the frequency of firing of auditory nerve fibres always matches the frequency of the sound that stimulates them

c. sound is converted into neural signals in the inner ear where it causes vibrations of the basilar membrane d. at frequencies below 1500 Hz differences in the time of arrival of a sound at the two ears form a useful clue to the direction of sound e. at high frequencies natural sounds which are on one side or the other tend to have different amplitudes at the two ears
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15. Insulin: a. is released from the pancreas by the action of somatostatin b. is bound to a plasma protein c. stimulates gluconeogenesis d. tends to decrease plasma potassium levels e. promotes active membrane transport of glucose into hepatocytes
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Ocular and visual physiology 16. The following are found in higher concentrations in aqueous than in plasma: a. protein b. glucose c. ascorbic acid d. urea e. lactic acid
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17. Accommodation: a. is abolished by sympathomimetic drugs

b. produces an increased curvature of the anterior surface of the lens c. is dependent on the elasticity of the lens capsule d. is regulated with the help of chromatic aberration e. is essential for the appreciation of stereopsis
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18. Retinal pigment epithelial cells: a. phagocytose rod outer segment discs that are shed in the mornings b. esterify and store excess retinol c. are independent units and do not communicate electrically or metabolically with each other d. are secured laterally to each other by tight junctions (zonulae occludentes) e. cannot undergo mitosis in response to injury
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General pharmacology 19. Acetazolamide acts as a carbonic anhydrase inhibitor and has a direct effect at the following sites: a. ciliary body b. the gall bladder c. the choroid plexus of the cerebral ventricles d. the renal tubule e. the gastric mucosa
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20. Topical metipranolol:

a. antagonizes the effects of isoprenaline b. has a mild local anaesthetic effect c. decreases plasma uric acid levels d. carries no increased risk of inducing airways obstruction e. has 1 and 2 blockade effects

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Ocular pharmacology 21. Pyrimethamine: a. produces its effects by antagonism to folic acids b. passes in high concentrations across the blood aqueous barrier c. can produce thrombocytopenia d. when used to treat patients with toxoplasmosis, folic acid should be used to abort side effects e. acts synergistically with sulphonamide drugs
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22. The following drugs increase aqueous secretion: a. methazolamide b. digitalis c. salbutamol d. adrenaline e. pilocarpine
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