Candidate 99                                            Centre: Bristol
Final MRCOphth                                                        Date: March, 2007

CRQ's

 

1) CMV retinitis histology.

 

2) RD histology-6 features.

 

3) Fungal Keratitis cross-section of cornea-questions on staining.

 

4) Granular dystrophy of cornea.

 

5) Chalazion.

 

6) Clinical governence questions on endophthalmitis.

 

7) Pinguecula histology slide.

 

8) Chronic blepheritis-cross-section of upper lid showing conjunctival epithelial hyperplasia.

 

9) Lymphoid hyperplasia/Lymphoma differential diagnosis.

 

10) ? Malignant melanoma.

 

11) CIN - III/Carcinoma of conjunctiva.

 

12) Dermoid cyst with a tooth (?) in it.

 

13) MRI showing demyelination plaques.

 

14) Dysphagia; microcytic hypochromic anaemia; deranged LFT's with proptosis

DD: GI malignancy with metastasis.

 

15) Cavernous hemangioma.

 

 

 

EMQ's

Reasonable paper, could answer most of them

 

 

 

OSCE's

 

Anterior segment:

  • Proptosis with scleral injection: Discussed the differential diagnosis such as AVM, CCF, etc.

  • Fuch's endothelial dystrophy

 

Posterior segment:

  • Indirect ophthalmoscopy of Inferior RD: Patient had a small pupil-difficult examination but managed to get it.

  • Macular BRVO: Asked to demonstrate Amsler grid testing, VA tests, differential diagnosis.

 

Glaucoma and Cataract:

 

  • PXF with glaucoma and advanced cupping.

  • HVF and GVF of end stage glaucoma: Discussed other causes such as RP, PRP, etc.

  • Bilateral Trab's: One functional bleb and another encysted and vascularized bleb.

 

Ocular motility and Neurophthalmology:

  • Myotonic dystrophy: Asked to demonstrate dystrophy on quadriceps and thenar eminence, discussion went deep into genetics etc.

  • Restictive external ophthalmoplegia secondary to childhood surgery for orbital cellulitis.

  • Optic disc coloboma.

Medicine:

  • AAU with spondyloarthropathy: differential diagnosis.

  • Blue sclera secondary to repeated attacks of scleritis, asked to look for signs of vasculitis in the eye, mentioned PUK-examiner was pleased, discussion was very dynamic-one of the best stations for me.

 

Communication skills:

  • Myopic lady with features of RD: 7 minutes of history taking and rest of the time explain, counsel and console about RD and management plan.

 

I thought I was average in most stations but I was sure I did not make any mistakes or miss any signs. I am glad I passed in my first attempt.