Test 36
(Matching Paper: Retina)
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-N) listed below:
A. Leber's congenital amaurosis
B. myotonic dystrophy
C. Kearn-Sayre syndrome
D. Wagner's syndrome
E.  Stickler's syndrome 
F.  Bardet-Biedl syndrome
G. Refsum's disease
H. Friedreich's ataxia
I.  Bassen-Kornzweig syndrome
J.  Usher's syndrome
K. gyrate atrophy
L.  birdshot retinopathy
M. punctate inner choriopathy
N. Stargardt's disease
a. A 30 year old man has cerebellar sign, deafness, elevated phytanic acid and 
pigmentary retinopathy.

b. A 15 year old girl has absence of low-density plasma lipoproteins with abnormal
shape red blood cells and pigmentary retinopathy.


c. A 30 year old man has empty vitreous with myopia of -11.00D. He also has
mid-facial hypoplasia and peripheral arthropathy.


d. A 19 year old woman has been wheel-chair bound since the age of 12 with 
kyphoscoliosis, cerebellar signs and pigmentary retinopathy.

2. Match the stem questions (a-d) with the options (A-N) listed below:

A. Oguchi's disease
B. Chediak-Higashi syndrome
C. Hermansky-Pudlak syndrome
D. Nettleship-Falls albinism
E. Stargardt's disease
F. Leber's congenital amaurosis
G. congenital rubella
I.   gyrate atrophy
J.   retinopathy of prematurity
K.  Coat's disease
L.  achromatopsia
M. vitamin A defiency
N.  Norrie's disease.
a. A 20 year old man has poor vision for the past few years. Fundoscopy reveals white flecks in both eyes. Fluorescein angiography shows reduced fluorescence from the choroidal circulation..

b. A 17 year old boy has white hair and nystagmus. Ocular examination pink iris and 
blond fundus. He is prone to recurrent infection. 


c.  A 25 year old man has poor vision at night. The ERG shows normal full-field
ERG. The fundi show colour changes during dark adaptation.

d.  A 2 year old boy has poor vision since the age of 5 months old with absent ERG and 
poor pupillary reaction to light. He also has the tendency to rub his eyes with his 

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