| CRQS MRCOphth
PART 3 MARCH 2005: NEWCASTLE
1. Retinoblastoma
Describe histological slide: FW rosettes
and fleurettes
Prognostic factors
4 possible differential diagnosis for
retinoblastoma i.e. leukocoria
Tumour suppressor gene and its role
in retinoblastoma
2. Choroidal melanoma
(It might have been choroidal haemangioma)
Describe pathological specimen and histological
slide (low magnification)
What other cells would you see i.e.
on high magnification
Ultrasound characteristics
3. Giant cell arteritis
Describe histological features i.e.
slide of blood vessel shown
Why could it still be GCA even if the
biopsy is negative?
3 ocular complications
2 non ocular complications
4. Prion diseases
What is a prion?
How do prions cause disease?
Name 3 prion diseases
How would you prevent the risk of prion
diseases in ophthalmology?
A case scenario of a young keratoconic
patient awaiting corneal grafting and he is concerned about this risk.
How would you counsel him?
5. Vasculitis
What is the clinicopathological classification?
Wegeners and role of ANCA
Describe histological slide
Complications of Wegeners
6. Pleomorphic adenoma
Describe CT
Describe histological slide
Malignant lacrimal gland tumours
7. Endophthalmitis
Patient presents 2 days following
phaco with endophthalmitis
Name 2 most likely organisms
Name most important procedure for diagnosis
What 4 culture media would you request
for culture?
2 advantages of vitrectomy
Another patient has a penetrating trauma
related endophthalmitis. Name 4 likely Gram -ve organisms.
8. MRSA
Describe the picture: Agar plate showing
colonies. 4 circular pieces of paper impregnated with antibiotics,
only sensitive to vancomycin.
What is the organism?
Management of MRSA patient on the ward
9. Acanthamoeba
Name 2 routine stains used (not calcofluor
white)
In what forms do acanthamoeba exist?
Name 2 treatment used
What culture medium would you use for
fungal keratitis?
10. Conjuntival slides
Rather odd looking, supposedly according
to the caption there is elastotic degeneration
3 possible causes for this picture
How would you differentiate them clinically
and histologically?
11. Ocular cicatricial pemphigoid
Describe immunofluorescence slides
Name one linear IgG disease with systemic
manifestations
Stevens Johnson: What are the immunological
mechanisms and histopathological features?
12. Retina
Histological slide of retina showing
all the layers. Mark on the drawing where you would expect the pathology
to be:
Hard exudates
Retinitis pigmentosa
Cotton wool spots
Glaucoma
Sturge-Weber
13. Phacolytic glaucoma
Describe slide of drainage angle
Mechanism of raised IOP
Name 4 ocular tissues affected by high
IOP
14. Optic neuritis
Visual prognosis in optic neuritis
What is the risk of MS?
What are the histopathological features
of MS?
15. Giant papillary conjunctivitis
CRQs MRCOphth Part 3:
Southampton,September 2005
1. Picture of macroscopic and microscopic
histology of a pilomatrixoma stem Patient presented with a lesion
diagnosed as a pilomatrixoma
Q1. Give 4 histological features
seen
Q2. Which 2 places are these commonly
found?
Q3. There are 2 syndromes in which
these are found. Name one.
2. Picture of a corneal section. 20 yr
old patient with worsening vision despite refraction.
Q1. What are the 3 histological features
seen in the slide? ( Descemets break at the edge, but not much else seen
except for artefactual stromal splitting)
Q2. What is the diagnosis?
Q3. What would you call it if there is
a sudden break in the Descemet's in this condition?
3. Picture of a colour Doppler with an
arrow at a stenosis. A 74 yr old presented with visual loss of less than
24 hours.
Q1. What is the name for this symptom?
Q2. What investigation is this?
Q3. What is the pathophysiology of this
symptom?
Q4. What treatment would you recommend?
Q5. What evidence is there for this treatment?
4. Picture of exenterated orbit with large
ulcer at the lateral canthus with 2 histological slides of BCC). A ~50
year old was operated on for a large ulcer at his lateral canthus.
Q1. What is the type of lesion?
Q2. What does this lesion cause around
it within the dermal structures?
Q3. How would you excise this lesion if
it wasnt clinically obvious?
5. Picture of a (choroidal melanoma) invading
through posterior sclera in a mushroom shape. A patient previously treated
for ocular melanoma presented with pain and reduced vision.
Q1. What are the histological features
seen?
Q2. Give 4 modalities of treatment for
this condition.
Q3. What 2 investigations would you perform
on this patient?
6. Microscopic histological picture of
normal retina. Mark on the picture the layer in which each of these conditions
present.
Q1. Neovacularization in diabetes
Q2. Microcystoid degeneration.
Q3. Coats disease where is the macrophage
with ingested pigment
Q4. Drusen
Q5. Central retinal artery occlusion
7. Histological picture of a (ragged red
muscle fibre). This patient presents with peripheral pigmentary retinopathy
and ophthalmolplegia and had a muscle biopsy.
Q1. What is the diagnosis?
Q2. Which muscle would you biopsy?
Q3. How would you transport this specimen
to the lab?
Q4. What is the diagnostic appearance
of the biopsy for this condition?
8. Picture of lymphocytes in a vitreous
tap. Patient presented with hazy vision with vitritis. CD 20+ cells found
in this vitreous tap.
Q1. What is the diagnosis?
Q2. What is the prognosis?
Q3. What is the treatment?
Q4. What are the other simple investigations
you would perform?
9. Picture of a corneal section (with
?vessels). Patient who had a graft presented with worsening vision
and an endothelial line. Not a recurrence of the primary cause for a graft.
Q1. What is the diagnosis?
Q2. What are the 4 causes of graft rejection
Q3. Which cells mediate rejection?
Q4. What are the histological features
seen?
10. Picture of a ?dermoid cyst. This patient
presents from birth but patient presented late due to failure to keeping
appointment.
Q1. What is the diagnosis?
Q2. Where is the commenest site for this
lesion?
11. Muscle histopathology slide. Muscle
biopsy of a patient with proptosis
Q1. Describe the histopathological features
Q2. Which cells mediate this?
Q3. What is the diagnosis
Q4. Does treating the thyroid condition
alter the TED?
Q5. What blood investigations would you
perform?
CRQS MARCH 2006 - MRCOphth
PART 3, NOTTINGHAM
1. The patient has a certain systemic syndrome
associated with a Pituitary mass.
Cut-off limit of pituitary mass , Macroscopic
differentiation on size
MC Hormone secreted and ass syndrome
Features of ''mass effect'' of pituitary
lesions.
Endocrine effects of pituitary mass
lesions in Males & Females.
DD for calcification
Visual field defect
2. Photomicrographs of Exenteration
specimen shown.
MC malignant orbital tumor in adults
MC orbital tumour in children
What do you see in cross section
What do you see in the histological
section( Sebaceous cell ca)
3 other malignat orbital tumours
3. Scenario of 25-yr old soft contact lens
wearer with painful red eye.
Types of ulcers?
Appropriate investigations?
Treatment of choice?
Types of culture media?
(Question was regarding P Aeruguinosa
)
4. Known pt. with AIDS , specimen is being
transported to the LAB.
Precautions for the Porter?
Precautions for the LAB staff?
Common HIV related eye conditions?
5. 77- yr old man with history of blurring
of vision for 1 week.
(Coloured photograph
shown.)
Diagnosis BRAO / Cilio retinal BRAO
6. 61- yr old patient with Bilateral upper
eyelid yellowish lesions
Diagnosis Xanthelesma
Histology describe
Systemic conditions associated with
it
7. Retinoblastoma
8. Herpes Zoster Ophthalmicus picture
of globe
Gross features
Long term complications
Histological features of scleral inflammation
From which stage can virus be isolated
9. A lady with medial canthal swelling
Diagnosis- Acute dacryocystitis
Gram staining positive/Negative
What could the organism be?
Management
|