AMC MCQ Ophthalmology and ENT 1 — Questions and Answers
Question 1: A 65-year-old presents with gradual painless vision loss. Fundoscopy shows a cup-to-disc ratio of 0.8 and intraocular pressure is 28 mmHg bilaterally. What is the most likely diagnosis?
- Cataracts
- Primary open-angle glaucoma (Correct answer)
- Age-related macular degeneration
- Central retinal vein occlusion
Correct answer: Primary open-angle glaucoma
Primary open-angle glaucoma presents with elevated IOP, increased cup-to-disc ratio, and gradual painless peripheral vision loss due to progressive optic nerve damage.
Question 2: A 50-year-old presents with sudden severe eye pain, nausea, vomiting, and halos around lights. The eye is red with a mid-dilated fixed pupil and corneal haze. What is the immediate first-line management?
- Topical antibiotics and eye patching
- Oral acetazolamide and topical beta-blockers (Correct answer)
- Systemic corticosteroids
- Topical antihistamines
Correct answer: Oral acetazolamide and topical beta-blockers
Acute angle-closure glaucoma is an emergency requiring immediate IOP reduction with systemic acetazolamide and topical agents such as beta-blockers and pilocarpine to prevent permanent vision loss.
Question 3: A 72-year-old complains of central vision distortion and sees straight lines as wavy (metamorphopsia). Fundoscopy reveals drusen deposits and pigmentary changes in the macula. What is the most likely diagnosis?
- Diabetic maculopathy
- Optic neuritis
- Age-related macular degeneration (Correct answer)
- Retinal detachment
Correct answer: Age-related macular degeneration
Age-related macular degeneration presents with central vision distortion, metamorphopsia, and drusen deposits on fundoscopy, predominantly affecting patients over 60 years.
Question 4: A 38-year-old with recurrent sinusitis presents with nasal polyps, bronchial asthma, and develops bronchospasm after taking aspirin for a headache. What is this triad called?
- Kartagener syndrome
- Churg-Strauss syndrome
- Wegener's granulomatosis
- Samter's triad (aspirin-exacerbated respiratory disease) (Correct answer)
Correct answer: Samter's triad (aspirin-exacerbated respiratory disease)
Samter's triad (aspirin-exacerbated respiratory disease) consists of asthma, nasal polyps, and aspirin/NSAID sensitivity caused by aberrant arachidonic acid metabolism.
Question 5: A 2-year-old presents with fever, ear pain, and a bulging erythematous tympanic membrane. There is no perforation. What is the most appropriate first-line management?
- Observation alone for 48-72 hours
- Amoxicillin for 10 days (Correct answer)
- Ciprofloxacin ear drops
- Urgent myringotomy
Correct answer: Amoxicillin for 10 days
Children under 2 years with acute otitis media should receive antibiotics (amoxicillin) because they have a higher risk of complications and less ability to mount an adequate immune response.
Question 6: A 55-year-old presents with sudden painless monocular vision loss described as a 'curtain descending from above.' There is no pain or redness. What is the most likely diagnosis?
- Central retinal vein occlusion
- Vitreous haemorrhage
- Optic neuritis
- Retinal detachment (Correct answer)
Correct answer: Retinal detachment
Retinal detachment classically presents as a shadow or 'curtain' advancing across the visual field, representing progressive separation of the retina from the underlying retinal pigment epithelium.
Question 7: A 28-year-old presents with unilateral progressive sensorineural hearing loss, constant tinnitus, and mild vertigo. MRI reveals an enhancing lesion at the right cerebellopontine angle. What is the most likely diagnosis?
- Vestibular schwannoma (acoustic neuroma) (Correct answer)
- Meniere's disease
- Labyrinthitis
- Cholesteatoma
Correct answer: Vestibular schwannoma (acoustic neuroma)
Vestibular schwannoma presents with unilateral progressive sensorineural hearing loss, tinnitus, and vertigo, and appears as an enhancing cerebellopontine angle mass on gadolinium-enhanced MRI.
AMC MCQ Ophthalmology and ENT 1
A 65-year-old presents with gradual painless vision loss.
Fundoscopy shows a cup-to-disc ratio of 0.8 and intraocular pressure is 28 mmHg bilaterally.
What is the most likely diagnosis?