Test 35
(Matching Paper: Microbiology)
In response to considerable discussion the Examinations Committee of the College has decided to update the format of the Part 3 MRCOphth Examination from April, 2003.
An extended matching paper will replace the existing MCQs and they will be no negative marking. The test will probably be easier than the previous format. To familiarize the candidates with the new formats, test 34 and onward will follow the new style as described below by the College.
40 questions over a 3-hour period.
The questions will be divided as follows.
  • 5 pathology questions
  • 5 microbiology questions
  • 15 general ophthalmology questions
  • 15 Medicine and Neurology in relation to ophthalmology
Extended matching questions are multiple choice items organized into sets that use one list of items in the set. The extended matching set includes four components 
    1.A theme 
    2.an option list 
    3.a lead in statement 
    4.at least four item stems, as illustrated below 
This will involve 40 questions (probably 200 stems) over a period of 3 hours.

1. Match the stem questions (a-d) with the options (A-L) listed below:
A. Gram positive coccus
B. Gram negative coccus
C. Gram positive bacillus
D. Gram negative bacillus
E. Acid fast bacilli 
F. Cytoplasmic inclusion bodies
    on Giemsa staining
G. Multi-nucleated cells and inclusion bodies 
     on Tzanck test
H. Grow on agar plate overlaid with E.coli
I.   Stained with Gomori methenamine silver
J.   Stained with Congo red
K.  Stained with Sudan black
L.   Stained with Ziehl-Neelsen stain
a. A 25 year old woman presented with a painful right corneal ulcer
with thick mucous adherent to the defect. 24 hours earlier, she scratched
her right cornea while removing a soft contact lens. 

b. A 25 year old man has a right follicular conjunctivitis that recurs when 
topical steroid is stopped. He is also under the genitourinary clinic for 
non-specific urethritis.


c. A 70 year old man develops vesicles in his right forehead which are painful.
The right eye is red and has mucous discharge.


d. A 25 year old male intravenous drug user presents with blurring of the 
right eye. Examination reveals the presence of vitritis and multiple fluffy
white lesions.

2. Match the stem questions (a-d) with the options (A-L) listed below:
A. Gram positive coagulase positive coccus
B. Gram positive coagulase negative coccus
C. Gram positive aerobic bacillus
D. Gram negative catalase positive coccus
E. Gram negative catalase negative coccus
F. Gram negative bacillus
G.  double-stranded DNA virus
H.  single-stranded DNA virus
I.   double-stranded RNA virus
J.   single-stranded RNA virus
K.  acid-fast bacilli
L.  acid-fast coccus

a. A new born child has bilateral cataracts and neurosensory deafness. Fundoscopy reveals pigmentary changes of the retina.

b. A 70 year old develops recurrent iritis four months after an uneventful cataract 
surgery. The iritis recurs when topical steroid is discontinued. Slit-lamp 
examination reveals a plaque in the posterior capsule.


c.  A 35 year old man who is HIV positive develops a white lesion in the peripheral
retina with mild vitritis. The lesion enlarges over the next two weeks with dot

d.  A 2 day old baby has bilateral purulent ocular discharge. The mother has a history
of vaginal discharge but receives no treatment.

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