Surgery — Eye and ENT Emergencies, NMC MBBS licence examination syllabus (Nepal Medical Council).
Eye and ENT emergencies — NMC-style practice questions
Practice questions written for this chapter. These are not past NMC papers.
📋 About these questions: These are practice questions written to test the reasoning in this chapter. They are NOT reproduced from any past Nepal Medical Council examination, and no verified past NMC questions were supplied for this chapter. All doses come from national guidance.
Level 1–2 — recall and understanding
Q1. Topical steroid should NEVER be given for an undiagnosed
red eye because:
A. It causes allergy
B. It accelerates HERPETIC and FUNGAL keratitis and can
cost the eye
C. It is expensive
D. It stings
ANSWER: B.
Why: steroid suppresses the inflammatory response while the
organism continues destroying the cornea, so the eye feels
better while it is being lost.
LEARNING POINT: contact lens wear raises microbial keratitis —
refer rather than treating empirically.
Q2. Correct first aid for epistaxis is to:
A. Lean back and pinch the bony bridge
B. Sit FORWARD and pinch the SOFT part of the nose
C. Lie flat with a cold compress
D. Pack the nose immediately
ANSWER: B.
Why: leaning back sends blood into the airway and stomach, and
the bleeding point in most anterior bleeds is compressed by
pinching the soft cartilaginous part rather than the bone.
LEARNING POINT: most epistaxis is anterior and controlled by
correct pressure.
Level 3–4 — application and clinical reasoning
Q3. A 62-year-old has severe headache, vomiting, haloes
around lights and a red hard eye. The likely diagnosis is:
A. Migraine
B. ACUTE ANGLE CLOSURE GLAUCOMA
C. Conjunctivitis
D. Raised intracranial pressure
ANSWER: B.
Why: haloes with a red hard eye and a mid-dilated poorly
reactive pupil are characteristic. The headache and vomiting
dominate, which is why the eye is so often not examined.
LEARNING POINT: sight is lost within hours — same-day
referral.
Q4. A 71-year-old has new headache, scalp tenderness and jaw
pain on chewing, with transient visual blurring. You
should:
A. Await inflammatory markers before treating
B. TREAT IMMEDIATELY on clinical suspicion
C. Arrange biopsy first
D. Reassure and review in a week
ANSWER: B.
Why: this suggests giant cell arteritis. Visual loss is
sudden, painless and irreversible, and the second eye is at
risk within days.
LEARNING POINT: biopsy remains informative for a period after
treatment begins — treatment is not delayed for it.
Q5. A worker arrives with cement powder in both eyes. The
FIRST action is:
A. Take a full history
B. IRRIGATE IMMEDIATELY with copious water or saline
C. Arrange urgent referral before treating
D. Apply an eye pad
ANSWER: B.
Why: cement is alkaline, and alkali penetrates deeply and
continues to damage tissue while present. This is the one
ophthalmic situation where treatment precedes assessment.
LEARNING POINT: irrigate to a pH endpoint rather than for a
fixed time.
Level 5 — exception-based
Q6. Flashes and floaters followed by a curtain spreading
across the vision suggest:
A. Migraine aura
B. RETINAL DETACHMENT
C. Conjunctivitis
D. Cataract
ANSWER: B — retinal detachment.
Why: the sequence is characteristic, and outcome depends
substantially on whether the macula is still attached — which
makes it a same-day referral.
LEARNING POINT: sudden painless visual loss also includes
retinal artery and vein occlusion and vitreous
haemorrhage.
Q7. In suspected PENETRATING eye injury you should:
A. Remove any visible foreign body
B. Do NOT press on the eye, SHIELD it and refer urgently
C. Irrigate vigorously first
D. Pad the eye firmly
ANSWER: B.
Why: pressure on a penetrated globe can extrude intraocular
contents, and removing an embedded object may worsen the
injury.
LEARNING POINT: high-velocity work such as hammering or
grinding suggests an intraocular foreign body.
Syllabus points
Recall and understanding questions
Application and clinical reasoning questions
Exception-based questions
Create a free account to tick topics off, take notes as you read, watch the video lessons and get a day-by-day study plan built around your exam date.