4th Year MBBS Eye OSPE by UHS (Set-2)

Special Thanks to Awais Zia (RMC) for uploading these at http://medilinks.blogspot.com. May Allah bless him . Ameen!

Following are the OSPE papers Set-2 of EYE by UHS with Answers/Key. 

● An elderly lady presents with painful,medial canthus swelling since 4 days

1. What is the D/D only enumerate?

• Acute Dacryocystitis
• Canaliculitis
• Infected  chronic dacryocystitis
• lacrimal duct obstruction

 2. What is the treatment of the condition (briefly)?

• Hot Fomentation. 
• Systemic Antibiotics, 
• Analgesics and Anti-inflammatory drugs.
• Incision and drainage if there is abscess formation

● A 60 year old man comes to the Eye OPD with chief complaints of redness, irritation,  watering, photophobia and gradual reduction of vision since 3 months

1. What is the diagnosis? 

•       Anterior Uveitis

2. What is the treatment? 

•       Mydriatic and Cycloplegics  e.g Atropine eye drops
•       Topical steroids
•       Antibiotics
•       Cytotoxic drugs for steroid resistant cases
  
  

 

●A child presents with a red eye of 15 days duration;

1.What is the most likely cause?

      Phlyctenular conjunctivitis

2.What laboratory investigations would you order?

      Investigations  for  T.B

      Conjunctival Cytology

● A middle ages man comes to Eye OPD with a history of sudden onset complete III nerve palsy;

1. What are the causes?

•    Cavernous sinus thrombosis
•    Trauma
•       Iatrogenic
•    Inflammation and infection 

2.Which investigation is mandatory in this case?

•   MRI

●  A child gives 3 year history of itching more severe in summers ;

1. What is the positive finding in the picture?

—Papillae (cobble-stone) type  in upper palpebral conjnuctiva.

2. Enumerate the corneal complications of this condition.

—Punctate epithelial erosions.

—Macroerosions.

—Shield ulcers and plaques.

—Ring Scar.

● A 5 year old child has esotropia since 2 years of age;

1. the patient has which type of esotropia?

—Accomodative esotropia.

2. What is the first line of treatment?

—Use of Bifocal Glasses (+3D)

● 
    1. What is this condition?

—Ocular Melanosis. 

2. What are the indications of surgical treatment of this condition?

—Extraocular spread.

—Increasing visual loss.

—Blind eye.

● A patient working with hammer and chisel presents with pain redness and blurring of vision;

1. What is the positive finding in the picture?

—Foreign body (in orbit).

2. Which investigation is contraindicated in this case?

—MRI.

● 
    1.What is this investigation?

      B-Scan.

2. What is the diagnosis in this case?

   Vitreous Shadow e.g.  hemorrhage

●
1. Which type of corneal ulcer is present in this patient?

—Herpetic Dendritic Ulcer.

2.What is the treatment?

—Topical Antiviral e.g. Acyclovir

—Debridement

—Topical Antibiotic

—Cycloplegic

●
1.What are the indications of surgery in this condition?

— Visual Impairment.

—Cosmetic reasons.

—Astigmatism.

—Diplopia.

2. Name the best operation for this condition

—Simple excision with key-hole keratoplasty.

 

   ●
   1. Which type of cataract is present in this patient?

     Hypermature Cataract.

2. Which intra-operative complications are more likely to occur in this patient?

—Rupture of  posterior Capsule.

—Vitreous loss.

—Nucleus drop into vitreous cavity.

—Expulsive Hemorrhage.

● This patient had  surgery for pterygium 15 days back;

1. What is the main positive finding in the picture?

—Pyogenic Granuloma.

2. What is the treatment?

—Surgical Excision.

●This patient had non healing corneal ulcer for 4 weeks;1. What are the two main causes of non healing corneal ulcers of such a duration?

—Corneal epithelial defects .

—D. Mellitus.

—Persistent infection.

2. What surgery has been done in this case?

—Keratoplasty.

●   
  1.What is the main positive finding in the picture?

—Proptosis. 
2. Enumerate the main investigations that will help you reach a diagnosis.

A)Radiological investigations:

—X-rays.

—CT-scan.

—MRI.

—Ultrasonography.

—

B) lab investigations:

—Routine tests: CBP, TLC, DLC, ESR , Urine examination.

—Special tests: Like T3, T4, TSH level of blood.