Candidate 134

Final FRCS

Centre:    Delhi

   Date:    September2009

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.


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!!

-was able to see 5 cases-

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.


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.

-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!.

-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

-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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