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  11. Concerning congenital ptosis A. There is no indication for surgery B. Amblyopia will occur only if the lid covers the pupil C. amblyopia cannot occur once the lid is surgically elevated D. Ptosis may occur in association with other ocular or systemic disothers E. frontalis suspension surgery is used for mild cases of ptosis 12. A 3-mo-old girl is presented with tearing and mucous discharge from her left eye that has been present since near birth. Her external examination is otherwise normal. Appropriate forms of threatment would include: A. Nasolacrimal massage B. Topical antibiotics for infections if ther occur C. Cleansing of the lids D. Probing of the nasolacrimal duct if the symptoms do not resolve with time E. All of the above 13. Causes of megalocephaly include of the following a. Thalassemia b. Chronic subdural effusions c. Hydrocephalus d. Canavan disease e. Congenital CMV infection 14. Characteristic features of muscular dystrophies include which of the following except? a. They are a primary myopathy b. They have a genetic basis c. The course is progressive d. Degeneration and death of muscle fibers occur at some stage of the disease e. All of the above 15. All of the following disorders may present as a congenital corneal opacity except A. Sclerocornea B. Congenital cataract  C. Infantile glaucoma D. Peters anomaly E. Epibulbardermoid 16. Important factors in the visual prognosis following the removal of cataract include following except: A. Whether a contact lens or an intraocular lens implant is used B. The compliance with patching for amblyopia C. The length of time the cataract was present D. The age of the child at presentation E. The health status of the posterior segment of the eye 17. A young girl is found to have bilateral iritis on routine examination. On further questioning, it is found that she has been limping for the last several weeks. The most likely diagnosis is: A. Sympathetic ophthalmia B. Juvenile rheumatoid arthritis C. Herpes simplex D. Toxoplasmosis E. Kawasaki disease 18. Regarding Duchenne muscular dystrophy, the following are false a. It is the most common hereditary neuromuscular disease b. The gene on the X chromosome at the Xq21 locus c. Symptoms are rarely present at birth or in early infancy d. The serum creatine kinase is consistently greatly decreased e. It is more common in males 19. Characteristic clinical manifestations of Duchenne muscular dystrophy include: a. Cardiomyopathy b. Intellectual impairment c. Weakness of respiratory muscles d. Scoliosis e. All of the above 20. All of the following are associated with constant muscle weakness except:  a. Hypothyroidism b. Hyperparathyroidism c. Corticosteroids d. Hyperaldosteronism e. Conn syndrome 21. A 2-yr-old boy with the spastic diplegia form of cerebral palsy is being evaluated. MRI of his brain is most likely to show the following except: a. Multicysticencephalomalacia b. Periventricular leukomalaciass c. Normal anatomy d. Basal ganglia abnormalities e. Agenesis of the corpus callosum 22. A 6-mo-old female infant is evaluated after the mother notes that she is strongly left-handed and delayed in sitting and in using the right hand. MRI of the brain reveals a large porencephalic cyst in the distribution of the left middle cerebral artery. Which of the following information is most likely to contribute to contribute to establishing the cause of this disorder a. Results of an EGG b. Chromosome analysis c. Evaluation for thrombophilic d. History of delivery e. History of maternal drug ingestion 23. A 6-yr-old child with neurofibromatosis (NF1) is found to have an opticglioma on a routine MRI study, confined to the right optic nerve. Findings on the neurologic, physical, and retina examinations are normal. The visual acuity is 20/20 bilaterally, uncorrected. Which of the following is the correct management? a. Surgical removal of the tumor b. MRI of the optic nerve every 3 mo c. Chemotherapy d. Annual examination by a pediatric ophthalmologist e. none of the above  24. A 10-yr-old girl is being evaluated for new onset of school problems, obsessive-compulsive behavior, and occasional uncontrolled movements of the hands. She has been healthy and has not taken any medications. Further evaluation is most likely to reveal: a. Brain tumor in the posterior fossa b. Partial complex epilepsy c. Evidence of streptococcal infection d. Hydrocephalus e. Tardive dyskinesia 25. A 10-yr-old girl has had diplopia and ptosis and weakness of her neck flexors for 2 mo. Symptoms are worse in the evening and are usually less severe on awakening in the morning. She has no fasciculations or myalgias tendon reflexes are 1-2+. The most likely diagnosis is: a. Hyterical weakness b. muscular dystrophy c. Spinal muscular atrophy d. Botulism e. Syndeham chorea 26. The following statements regarding congenital neuromuscular disorders are true. a. Most are hereditary b. Most are non progressive conditions c. The definitive diagnosis is best made by electromyography d. Diagnosis for some disorders may be confirmed by geneticanalyses of lymphocytes e. Hypotonia is a common feature 27. The Gowers sign demonstrates the following: a. Poor reflexes b. Spinal dysraphism c. Tethered cold d. Proximal motor weakness e. Distal muscle weakness 28. Which of the following is the earliestand most consistent sign of myasthenia gravis ? a. Gowers sign
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