Candidate 36                                      Centre: Glasgow
FRCS (Glasgow)                                                 Date: March, 2003

Medicine and neurology                
  • Deep Vein Thrombosis, in an old lady , post op, heparinisation

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  • ECG-- T inversion, was present,  the physician went on to ask about streptokinase therapy

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  • Myasthenia , and the Tensilon test

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  • Steroid therapy in ophthalmology and its side-effects on eye

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  • Basics of Sympathetic and para sympathetic nervous system. 

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  • Thyroid Eye disease... systemic manifestation of hyper and hypo thyroid state, and history to ask the patient , investigations for thyroid disease, 
 
Ophthalmology Viva 
  • Hemi visual field defect- altitudinal, and differential diagnosis, 

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  • Causes of vitreous haemorrhage, went on to vasculitis, and investigations for a suspected vasculitis case

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  • Methods of drug delivery to the eye 

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  • Anti Glaucoma drugs 
              
Ophthalmic surgery and pathology .
  •  Suture material...  started as " why is Catgut not used here any more? " i said increased tissue reaction, then he said ,but its one of the best suture materials and still used a lot abroad... then i said ,  disease transmission, slow  virus, BSE.. which was  what he was looking for .....  the examiner also , asked about the statistics regarding how many patients had been infected via contaminated suture material.. 

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  • Lid surgery, 

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  • Squint surgery and complications, cataract, and complications.   
  • Post retrobulbar anaesthesia complications and management, 
 
 Clinical cases
      
It was  all  short cases , most of them spot diagnosis,  in 30 minutes, 
            
  • Tattooing of the cornea, 

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  • Optic nerve head drusen,

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  • Krukenburge spindle, 

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  • Internuclear ophthalmoplegia-- bilateral,  this case also has upbeat nystagmus, I was asked on both findings, 

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  • Lid lesion.-- long-standing, elderly male patient , I gave about 6 differentials, said it was probably benign,

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  • White scar at  the macula of a young male, unilateral, I said trauma, which was correct. 

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  • Moebius Syndrome, 

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  • Orbit case... Idiopathic Orbital inflammation, disease. 

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  • Myotonic dystrophy-- was asked to shake hands with the pt, and asked,  "what does a myotonic dystrophic. pt do to enable them to release the grip? " I didn't know the answer, i said extend the wrist, what he (examiner) wanted was flex the wrist. 

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  • Indirect ophthalmoscopy.  for a sitting patient... my last case... didn't complete it , was asked to look at the inferotemporal quadrant in the right eye .... "  where would you tell the pt to look ? "was the question, 

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  • Child -- Duanes, but upgaze was also absent , ( it was apparently, a bilateral Duanes with bilateral Browns Syndrome. ) 
            
I managed to see 12 cases, cant remember the last few.  I think the emphasis in this exam was on, the more you see and get correct the better it is, they told us at the start... "many of you are introducing yourself to the patients, don't have to do that , patients don't mind, see the cases as fast as you can , the more you see the better,  "what they wanted was spot diagnoses, and then went on to ask 3 to 4 questions about the case while  the candidate shifted to the next case.. 
 
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