426 group C2 Ophtha OSCE 2009-2010

Hi everyone  Here are some instructions you should know : - The OSCE exam was nice and easy you just have to concentrate - You have 20 slides each has 2 questions on it and you have 2 mins for each slide There is 2 mins rest after the 10th slide and at the end also, so you can complete your answers Please make sure all the answers are correct from the book cause this is just our answers Good luck and la tensoona min da3watkom 

1 This was a bilateral finding in a young obese woman with 120/80 BP. CT scan imaging was negative. Q. What is the most likely diagnosis? A. Pseudotumor cerebri (some students said that we were asked for the finding not the diagnosis and therefore wrote papilledema). Q. How would you manage her? A. 1.Medical: weight reduction and carbonic-anhydrase inhibitors (e.g. acetazolamide) 2.Surgical: CSF shunt.

A 2 year old child presented with this condition Q. What is this sign? A. Leucokoria in the right eye. Q. Mention 2 differential diagnoses. A. Congenital cataract, retinoblastoma.

A patient with a history of wearing contact lenses 3 A patient with a history of wearing contact lenses Q. What is the diagnosis? A. Corneal ulcer. Q. How would you manage this patient? A. Remove the contact lenses and swab and culture and topical antibiotics.

4 Q. What is the diagnosis? A. Herpitic keratitis (dendritic ulcer) Q. What is the name of the stain that was used? A. Fluorescein dye.

A 60 year old patient with a history of blurred vision 5 A 60 year old patient with a history of blurred vision Q. What is the diagnosis? A. Senile cataract. Q. Mention 2 postoperative complications for this condition. A. Endophthalmitis, hemorrhage.

A patient with a history of an operation done in the iris 6 A patient with a history of an operation done in the iris Q. What is this procedure called? A. Peripheral iridotomy. Q. What is the indication of this procedure?. A. Acute closed angle glaucoma, narrow angle glaucoma.

A 25 year old patient with a history of sinusitis and fever 7 A 25 year old patient with a history of sinusitis and fever Q. What is the diagnosis? A. Orbital cellulites in left eye Q. Name three complications is this is left untreated ?? Cerebral abscess , meningitis, cavernous sinus thromboses, permanent vision loss, optic neuritis

20 year old female with this coetaneous manifestation 8 20 year old female with this coetaneous manifestation Q. Name the diagnosis for this condition ?? SLE causing butterfly rash Q. Name one ocular manifestation associated with this disease ?? Retinopathy & Keratitis (make sure of the answer plz) lupus retinopathy consists of cotton–wool spots, perivascular hard exudates, retinal haemorrhages and vascular tortuosity

9 Pt complaining of redness and itch and foreign body sensation since one week Q. What is the diagnosis ?? Acute belphyritis Q. What is your management ?? 1) Lid hygiene. 2) Antibiotic ointment. 3) Hot compressors

2 year old child that has fever and pain 10 2 year old child that has fever and pain Q. What’s your diagnosis ?? A. Acute dacryocystitis in left eye Q. What’s your management ?? A. Systemic antibiotics & Stab incision (drain)

11 Patient came to E.R complaining of pain and red eyes and gave history of trauma to the eye by his finger nail Q. what’s your diagnosis ?? Corneal abrasion Q. what’s the complication mention one ?? A. Corneal scarring

Patient came to the E.R with history of blunt trauma 12 Patient came to the E.R with history of blunt trauma Q. what’s your diagnosis ?? Hyphema (anterior chamber hemorrhage) Q. What is your management?? Bed rest to prevent rebleeding topical steroids & topical cycloplegics systemic antifibrinolytic agents

13 Q. what’s your diagnosis ?? Sub-conjunctival hemorrhage in right eye Q. Name 2 causes for this condition ?? Trauma – bleeding disorder – old age – spontaneous

This is a 30 year old patient's visual field 14 This is a 30 year old patient's visual field Q. what’s the name of this visual field ?? Bitemporal hemianopain Q. Name one cause for this condition ?? Optic chiasm defect for example pituitary adenoma or meningioma

15 Q. Describe the kind of defect in the right picture ?? Tunnel vision Q. Name the condition that causes this field ?? A. chronic open angle glaucoma

16 Q. What is this sign ?? We didn’t know the name of the sign but this is a vitreous hemorrhage But I got this from a web site saying : Vitreous hemorrhage within the Berger space tends to settle and form a crescent-shaped pool overlying the hyaloideocapsular ligament. Q. Name three causes for this ?? A. DM – HPT – age related macular degeneration (make sure of the answers plz)

17 Q. Name the sign in this picture ?? Cupping of the optic disk (increase disk to cup ratio) Q. What is the cause of this condition and mention the visual field defect?? A. Chronic open angle Glaucoma – peripheral field visual loass + arcaute scotoma

2 years old boy with this defect since birth 18 2 years old boy with this defect since birth Q. What is you diagnosis ?? Congenital ptosis in right eye Q. Name one complication if left untreated ?? A. Amblyopia

6 moths year old boy with this defect since birth 19 6 moths year old boy with this defect since birth Q. What’s your diagnosis ?? Congenital capillary hemangioma in upper left lid Q. what’s your management ?? A. Intralesional steroid injection

20 Q. Identify structure 2 ?? Optic chiasm Q. Identify structure 6 ?? A. Left visual cortex

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