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Clinical MCQs: Set 2 (Questions 21–40) MCQs
MBBS Professional Review: Medicine · MBBS / Medicine · 26 practice questions
- Ophthalmology - Refractive Errors
- Endocrinology/Hypertension - Secondary Causes
- Radiology - Abdominal Imaging
- Psychiatry - Perceptual Phenomena
- Ophthalmology - Visual Acuity Testing
- Orthopaedics - Shoulder Injuries
1. An 18-year-old student fails her driver's licence test. She reads well but has difficulty seeing at night. Visual acuity is Right 6/24, Left 6/36, correctable to 6/6 bilaterally with a pinhole. Fundi and ocular pressures are normal. What is the most appropriate corrective measure?
- AVitamin A 50,000 IU orally daily
- BOrthoptic exercises
- CConvex lenses
- DConcave lenses
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D. Concave lenses The pinhole correcting her vision to 6/6 confirms a refractive error rather than retinal or vitamin-related pathology. Her acuity denominators are greater than 6 (6/24, 6/36), indicating myopia, which is corrected with concave lenses.
2. An 18-year-old woman, anxious about an upcoming flight, reports a strong sense of familiarity in an Emergency Department she has never actually visited before, with no other autonomic, visceral, or perceptual symptoms. What is the most likely explanation for this experience?
- ATemporal lobe epilepsy aura
- BDepersonalisation
- CCapgras syndrome in a patient with schizophrenia
- DA normal mental state phenomenon
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D. A normal mental state phenomenon In the absence of other autonomic, visceral, or perceptual disturbances (which would suggest temporal lobe epilepsy), and without an unpleasant sense of unreality (depersonalisation) or delusional misidentification (Capgras), isolated déjà vu associated with anxiety and fatigue is most likely a normal mental state phenomenon, especially in adolescence.
3. A 48-year-old man notices increasing difficulty reading small print up close, though his distance vision remains excellent. He has no history of eye disease. Which mechanism best explains this new visual complaint?
- AThe eyeball has become too long, causing distant objects to focus in front of the retina
- BThe cornea has become excessively curved, shifting the focal point anterior to the retina
- CThe lens has become less elastic with age, making it harder to accommodate for near objects
- DThe eyeball has become too short, preventing distant objects from focusing on the retina
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C. The lens has become less elastic with age, making it harder to accommodate for near objects The text describes presbyopia: with increasing age from the mid-forties, the lens becomes less elastic and harder to squeeze, making close work difficult, despite unaffected distance vision.
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