Q.1 Which is the most common primary intraocular malignancy in children?
Retinoblastoma
Uveal melanoma
Conjunctival lymphoma
Orbital rhabdomyosarcoma
Explanation - Retinoblastoma is the most common primary intraocular malignancy in children, usually presenting before the age of 5.
Correct answer is: Retinoblastoma
Q.2 Which mutation is most commonly associated with hereditary retinoblastoma?
RB1 gene mutation
BRAF gene mutation
TP53 mutation
GNAQ mutation
Explanation - Hereditary retinoblastoma arises due to germline mutations in the RB1 tumor suppressor gene.
Correct answer is: RB1 gene mutation
Q.3 What is the classic clinical sign of retinoblastoma on fundus examination?
Leukocoria
Cherry-red spot
Drusen
Cotton wool spots
Explanation - Leukocoria, a white pupillary reflex, is the hallmark sign of retinoblastoma.
Correct answer is: Leukocoria
Q.4 Which imaging modality is preferred for diagnosing intraocular tumors in children?
Ultrasound B-scan
X-ray orbit
CT brain
MRI orbit
Explanation - B-scan ultrasonography is the first-line imaging modality for detecting intraocular masses in children due to its safety and sensitivity.
Correct answer is: Ultrasound B-scan
Q.5 Which ocular tumor is most commonly associated with fair-skinned adults and sun exposure?
Uveal melanoma
Retinoblastoma
Lymphoma
Sebaceous carcinoma
Explanation - Uveal melanoma is the most common primary intraocular malignancy in adults and is linked to fair skin and UV exposure.
Correct answer is: Uveal melanoma
Q.6 What is the typical color of a choroidal melanoma on fundus examination?
Gray or brown
Bright red
Yellow
White
Explanation - Choroidal melanomas usually appear as dome-shaped gray or brown lesions on fundus examination.
Correct answer is: Gray or brown
Q.7 Which of the following is a risk factor for uveal melanoma metastasis?
Large tumor size
Younger age
Anterior location
Small tumor size
Explanation - Larger uveal melanomas have a higher risk of metastasis, particularly to the liver.
Correct answer is: Large tumor size
Q.8 Which systemic screening is recommended for patients with uveal melanoma?
Liver function tests and imaging
Chest X-ray only
Renal ultrasound
Brain MRI only
Explanation - Uveal melanoma frequently metastasizes to the liver, so liver function tests and imaging are critical for surveillance.
Correct answer is: Liver function tests and imaging
Q.9 Which is the most common primary orbital malignancy in children?
Rhabdomyosarcoma
Lymphoma
Neuroblastoma metastasis
Leiomyosarcoma
Explanation - Rhabdomyosarcoma is the most common primary orbital malignancy in children and typically presents with rapid proptosis.
Correct answer is: Rhabdomyosarcoma
Q.10 Which histological subtype of orbital rhabdomyosarcoma is most common in children?
Embryonal
Alveolar
Pleomorphic
Spindle cell
Explanation - The embryonal subtype is the most common histology of orbital rhabdomyosarcoma in children.
Correct answer is: Embryonal
Q.11 Which ocular surface malignancy is associated with UV exposure and HPV infection?
Conjunctival squamous cell carcinoma
Sebaceous carcinoma
Uveal melanoma
Retinoblastoma
Explanation - Conjunctival SCC is linked to UV light exposure and HPV infection, commonly affecting the limbus.
Correct answer is: Conjunctival squamous cell carcinoma
Q.12 What is the standard treatment for small, well-circumscribed uveal melanomas?
Plaque brachytherapy
Enucleation
Laser photocoagulation
Observation only
Explanation - Plaque brachytherapy is preferred for small uveal melanomas to preserve the eye and vision.
Correct answer is: Plaque brachytherapy
Q.13 Which tumor marker is often elevated in metastatic retinoblastoma?
Neuron-specific enolase
CEA
AFP
Beta-HCG
Explanation - Neuron-specific enolase can be elevated in patients with metastatic retinoblastoma.
Correct answer is: Neuron-specific enolase
Q.14 Which is a key differential diagnosis of leukocoria in children?
Congenital cataract
Glaucoma
Optic neuritis
Keratoconjunctivitis
Explanation - Congenital cataract can also present with leukocoria, similar to retinoblastoma, and must be differentiated.
Correct answer is: Congenital cataract
Q.15 Which ocular malignancy is most strongly associated with immunosuppression?
Conjunctival lymphoma
Retinoblastoma
Choroidal melanoma
Rhabdomyosarcoma
Explanation - Conjunctival lymphoma is more common in immunocompromised patients, including those with HIV or post-transplant.
Correct answer is: Conjunctival lymphoma
Q.16 What is the most common site of metastasis for uveal melanoma?
Liver
Lungs
Brain
Bone
Explanation - Uveal melanoma metastasizes most commonly to the liver due to hematogenous spread via the vortex veins.
Correct answer is: Liver
Q.17 Which orbital tumor in adults is most commonly bilateral?
Lymphoma
Rhabdomyosarcoma
Metastatic carcinoma
Dermoid cyst
Explanation - Orbital lymphomas in adults often present bilaterally and are usually of B-cell origin.
Correct answer is: Lymphoma
Q.18 Which ocular tumor is known for the 'diffuse' growth pattern and subtle presentation?
Sebaceous carcinoma
Retinoblastoma
Uveal melanoma
Rhabdomyosarcoma
Explanation - Sebaceous carcinoma often grows diffusely on the eyelid, mimicking benign conditions like chalazion.
Correct answer is: Sebaceous carcinoma
Q.19 Which ocular malignancy can be treated with systemic chemotherapy as the first-line therapy?
Retinoblastoma
Uveal melanoma
Conjunctival SCC
Choroidal hemangioma
Explanation - Systemic chemotherapy (chemoreduction) is often the first-line treatment for bilateral or large retinoblastoma to preserve vision.
Correct answer is: Retinoblastoma
Q.20 Which ocular tumor is associated with the 'Feeder vessel' sign on slit-lamp examination?
Conjunctival squamous cell carcinoma
Retinoblastoma
Uveal melanoma
Rhabdomyosarcoma
Explanation - Conjunctival SCC often shows prominent vascularization with feeder vessels supplying the tumor.
Correct answer is: Conjunctival squamous cell carcinoma
Q.21 Which pediatric orbital malignancy often presents with rapid onset proptosis and eyelid swelling?
Rhabdomyosarcoma
Lymphoma
Dermoid cyst
Neuroblastoma metastasis
Explanation - Rapidly progressive proptosis and eyelid swelling in a child is most commonly due to orbital rhabdomyosarcoma.
Correct answer is: Rhabdomyosarcoma
Q.22 Which ocular malignancy is most likely to show calcifications on imaging?
Retinoblastoma
Uveal melanoma
Orbital lymphoma
Sebaceous carcinoma
Explanation - Intratumoral calcifications are characteristic of retinoblastoma and can be detected on CT or ultrasound.
Correct answer is: Retinoblastoma
Q.23 Which tumor is commonly associated with a 'salmon patch' appearance in the conjunctiva?
Conjunctival lymphoma
Conjunctival melanoma
Conjunctival SCC
Sebaceous carcinoma
Explanation - Conjunctival lymphoma often appears as a painless, pink, fleshy 'salmon patch' lesion.
Correct answer is: Conjunctival lymphoma
Q.24 Which systemic condition increases the risk of ocular melanoma?
BAP1 tumor predisposition syndrome
Marfan syndrome
Down syndrome
Neurofibromatosis type 1
Explanation - BAP1 germline mutations predispose individuals to uveal melanoma and other malignancies.
Correct answer is: BAP1 tumor predisposition syndrome