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I would like to share some of my
experiences with friends. Always be spontaneous and avoid thinking too
much in front of the examiners. Here were the questions I faced in my
second attempt in Sept 2009 in Delhi.
Oral
Pathology and surgery
First examiner showed me a slide of a
salmon patch in the superior conjunctiva. i started off with nodular
episcleritis but explained it is an unsusual area and when asked what
is the differential diagnosis if not cured with streoids - answered
lymphoma. Shown a pathology slide -well differentiated B cell
lymphoma, commented no mitotic figures, was asked what else would I
see in such a slide to consider lymphoma. Luckily could answer all and
the examiner was impressed when I said no mitotic figures.
The other examiner showed a total hyphema, viva on the management,
indications of surgery for such a case.
Then both switched to instruments-calipers, squnit hook, irrigation
cannula for VRsx-mistaked it first for Ac maintainer but corrected
immediately!
Ophth medicine-
1st examiner showed OCT with side by photo not recognizable..
commented on findings... looked like either PED sec to CSR or a CNVM..
was not clear.. asked m,/m, cns of photocoagn in CSR.
Shownfield with altitudinal defect-gave all the possible differential
diagnosis - looked glaucomatous but he wanted AION-still gaveall
possible D/D. then asked scenario if normal fields, ONH etc-NTG- when
will you treat-qouted OHTS criteria for treating.
2nd examiner asked D/D young male with sudden DOV
-told the imp ones Eales with VH, optic neuritis, RD etc-avoid giving
all irrelevant D/D.asked few questions on M/m-bell rang-happy!
General medicine-
Slide showing ophthalmic herepes zoster
-commented on periorbital swelling- asked M/m in detauils, hutchisons
rule, etc-was satisfied.....then asked if this pt gets dyspnoeic
attack of asthma, what will i do-
all t/t in steps- wanted all classes of drugs for asthma including
aminophylline!-satisfied.
Other examiner asked old male diabetic maculopathy for FFA collapses
what will i do-mentioned all D?D with signs-vasovagal, anaphylactic,
hypoglycemia and also he wnated MI-aksed M/M-missed saying i would
make pt lie down and when i said that- he said thank you-thats what
you would do first!so people reaLLY say everything exactly in
steps!!but anyway satisfied and then bell rang!!
passed!!
Clinical-was able to see 5 cases-
1
Adult male with hypo, exo, with prominet
eye with orbital fullness-gave allD/D-was asked to demonstrate EOM,
coevr/uncover etc...was asked to see glasses-high myope-said i cannot
explain hypo in a high myope.
2
Slit lam checked settings first and
found slit lamp wasn't working-then worked-young boy with keratoconus
with vogt stria-mentione that and he was very happy! everted
lids-asked why are you seeing-said VKC or atopic-happy-asked m/m.
3
-adult female with uveitis and compl
cat-asked findings, d/d. m/m-forgot to mention masquerade but exa
miner didnt seem to want that!.
4
-asked to do I/O-typical RP (did all
steps correctly but forgot to put off light which examiner himesf put
off-lucky he didnt mids but do not do that mistake)-asked what
next-assns, invns, m/m, role of anticoxidants, follow up, etc
5
-asked to do 90d, young female with
total optic atrophy le, then asked to do same other eye undilated,
wasable to do it, temp pallo-commneted on d/d and invs-imp fields
which he was happy-asked if bitemp what lesions-bell rang-whew!
I almost fainted when i saw my no in the pass list.
Apart from chua eye page, i went thru pics and short comments in the
will eye atlas of ophthal before my orals.. helped a lot... also go
thru videos in chua-very good and also for systemic examination see
videos in univ of utah web site, ecg from the online courses.....
thanks for dr chua and all the best to all those
appearing......remember-we all know a lot but we have to give it to
them in a way they want it!! thats all... be spontaneous and
confident..a void too much thinking..... practise and rehearse steps
of examination alone or on pts.....
Aparna Rao.
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