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PATHOLOGY
1. Endophthalmitis-management
2. What is bevacizumab?what
organisms cauese endoph after intravitreal bevacizumab?
3. Keratoconus-Prussian blue
stain of epithelium,.what are the characteristic features?
4. Sebaceous gland carcinoma
5. Basal cell carcinoma
6. Large round lesions on the
cornea-organisma causing and mechanism -wrote infectious crystalline keratopathy-biofilm
by strep viridans
7. Most common hormone secreted
by pituitary and syndrome it causes, clinical manifestations-wrote prolactin,galactorrhea
amenorrhea syndrome
8. Very confusing - shown a
globe enucleated with a gritty mass inside-what is the gene causing it?
What is the syndrome associated, had no idea.(most people didnt know) thats
all I remember everyone was short of time because there were too many sub-questions.
Be prepared to think as you write and go fast from the word go every station
the pathology paper is too long for the time given.
EMQS-were ok, only
one on statistics about sensitivity, positive predictive value of a test.
CLINICAL EXAM
Anterior segment
1. Case of nebular corneal opacity,
one half of iris atrophic with transillumination defect, one posterior
synechiae, pigments on endothelium.said trauma as first diagnosis, then
herpetic uveitis.was the latter. said will check corneal sensation to differentiate.
Was asked to check for activity and was reprimaned for not increasing the
magnification to see that.
2. Case of lid scar of reconstruction
surgery, with multiple freckle like lesions on face and elsewhere and a
raised lesion on left cheek-was Gorlin Goltz syndrome. Was asked inheritance(didnt
know).
3. Peripheral corneal thinning
especially superiorly said terriens first and other PUKs as differential.
4. Conjunctiva showing uveal
pigments showing thru at the inferotemporal limbus,part of iris missing
in that area,itraocular lens and pigments on endothelium,said penetrating
injury causing cataract as firast diagnosis. Was asked for alternate one-iris
or ciliary melanoma resected-was asked prognosis, said better for iris
melanomas.
Posterior segment
1. PRP scars on indirect-settings,common
indication,rationale
2. Juxtapapillary CNV with
exudates-described what I saw, got the diagnosis only after prompting.
3. FFA of NPDR with capillary
nonperfusion,idiopathic juxtafoveal telangiectasia,armd, and window defect
Glaucoma
1. Aniridia with capsular
tension ring, IOL and glaucomatous optic atrophy and trabeculectomy - said
congenital but was post-trauma.
2. Pigment dispersion syndrome.
3. Humphrey Visual Field test
- was asked reliabilty indices, how the machine tests them, and to explain
each figure on the printout including global indices.
Neurology
1. Horners pupil-other causes
of small pupil, including can an Adies pupli be small(yes, little old Adie).
2. Proptosis,down but said
thyroid because had lid retraction and lid lag (asked to demonstrate)also
inferior and medial rectus involvement) asked to examine thyroid status.management,order
of surgery.
3. Picture of child with inflamed
looking proptosis, said orbital cellulitis and will also consider rhabdomyosarcoma.
Medicine
1. Inferotemporal rd demarcated
by laser -examination on 90d.asked dd-schisis.how will you differentiate.(why
this case was kept in this station i quite beyond me).
2. Angioid straks, disc drusen
and pigments at macula. Was asked to look for systemic diagnosis.
Looked at neck for chicken skin appearance( said puckered ) elbows and
knees for Ehler-Danlos, acromegaly. Was pseudoxanthoma elasticum - what
are the complications (valvular disease-which valve-didnt know,gi bleeds)what
advice-avoid contact sports and trauma (choroidal rupture).
3. Precautions before steroid
therapy (longterm) he wanted me to say varicella vaccination while I carried
on about worsening of diabetes, osteoporosis etc - having not worked in
the UK, needed to be prompted.
Communications-
Child with juvenile rheumatoid
arthritis needs catarct surgery, counsel mother.
Advised cataract extraction
without IOL. Need for early surgery to avoid amblyopia and need for contact
lenses. Mother kept on repeating any other options, kept on telling her
she has to have contact lens correction. Then thought maybe she wanted
me to say IOL ,so doubtfully gave her that option still saying it wouldd
be inadvisable. In the discussion, examiner said you were right about management
and said all the right reasons then why did you change, said that I thought
she was leading me to that option, we dont implant lens in JRA in India
where I work but not sure of the management in the UK. Examiners seemed
quite pleased so was not worried.
In all,was a fairly good attempt
because there were no CVS or neurological examination which I dreaded so
I was lucky. Anyway,results out and passed, so thank god and thanks to
Chua website. Three cheers and good luck to all ye who embark on this arduous
journey. |