Candidate 27                                        Centre: Cambridge
                                                             Date:   Sept, 2002
Ophthalmology

Case 1
Treated diabetic maculopathy with hard exudate and laser scars.
Questions on indications for treatment and the findings of ETDRS.

Case 2
Myopic fundi (disc and lacquer crack) and posterior vitreous detachment.
No evidence of Foster-Fuchs' spots.
Questions on posterior vitreous detachment and the risk of retinal detachment

Case 3
Constant exotropia with poor vision in the same eye.
Questions on orthoptist assessment prior to squint surgery.

Case 4
Peripheral retinal pigmentation. Possible retinitis pigmentosa but may be choroideremia.
Asked to give a differential diagnosis. The findings of ERG in retinitis pigmentosa and indications of carrier.

Case 5 
Lower lid basal cell carcinoma.
Asked about the clinical type (nodular vs morphea) and different modalities of treatment. Discussion of repair following treatment such as Tenzel's flap.
 

Medicine

Case 1
Optic disc drusen.
Questions on association (angioid streaks and retinitis pigmentosa). Causes of sudden visual deterioration (peripapillary SRNVM)

Case 2
Mechanical mitral valve replacement.
Signs of mitral valve stenosis (malar flush, atrial fibrillation, tapping apex, platform pulse, opening snap and diastolic murmur). Possible ocular complications (thrombus and septic emboli).

Case 3
Subtle pituitary type field defect. 
No signs of obvious bitemporal hemianopia. Only picked up by colour desaturation across the mid-line.

Case 4
Discussion of optic neuritis including breaking news to the patients, the value of MRI, further investigation. Also clinical trials ONTT, CHAMPS.
 

Pathology

First half session (2 slides)

First slide showed an intraocular lens with lens substances.
Discussion on Soemering's ring and Elschnig's pearls.
Endophthalmitis and treatment.

Second slide showed a cataract.
Discussion on pathological basis of cataract formation.
Posterior capsule opacification after cataract surgery.

Second half session (2 photographs)

First photograph showed a picture of basal cell carcinoma. Questions on differential diagnosis and treatment.

Second photograph is a picture of retinoblastoma histology. Questions on treatment of retinoblastoma, prognostic factors. Differential diagnosis of leukocoria.

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