Wednesday, July 13, 2011

multistation..



about multistation and clinical tests for malaysian students
* multistation ( ophthalmology mcq)  test will be 25 image each for 2 marks and whole exam for 50 mark
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* the question may come for diagnosis only or ask you about treatment or causative organism or any thing form written part
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.* also deferential diagnosis and ocular examination chapters are  included in this exam
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* this some lecture but it is in Arabic but i think it will be easy coz it is a video and you are going to understand it  inshaa Allah
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* if you didn't attend the revision for clinical test and some of retinal picture you can download this lecture choose one link

or


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* for retina and nero explanation for dr \ ahmed  download this file( NB this  file only include 22 picture for retina but dr \ tharwat ( head master of ophthalmology ) said that all retinal picture is included in the exam so take care of the rest .
or 

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*  lecture for dr\ taher  for clinical tests ( how to do the test)
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this some notes i have written in the lecture

how to examine the conjunctiva


make the patient look upward to examine lower bulbar conjunctiva

make the patient look downward to examine upper bulbar conjunctiva

for examination of the upper palpebral conjunctiva

make the patient look downward

gently elevate the upper eye lid and hold the middle part of the lashes and Evert the eye lid


...... advices

you should use the torch in examination

don't forget to elevate the eye lid before holding lashes or you are going to hold both eye lashes

make sure that the patient is looking downward and not closing the eye

gently elevate the eye lid


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how to examine ocular movement


firstly there are 9 directions should be examined

(up, down , left , right , up and left , up& right , down &left , down& right, finally forward) 9 directions

you can examine either by order ( look to right , look to left and so on )or follow and object or torch light( the movement should through the wrist joint and always make sure that the light is directed on the pupil )


what is the difference between order and follow examination

doctor always say it is (of)

in Order examination you examine frontal lobe

in Follow examination you examine Occipital lobe


how to examine 7 th cranial nerve only

make the patient close his eyes firmly and not to open it

you try to open it

not easily opened = normal

opened easily = defect in the 7 th cranial nerve my due to bell's palsy or any other defect in the facial nerve



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hoe to do corneal test or corneal sensation

other form to the question


how can you test 5 and 7 cranial nerves


5 cranial nerve is responsible for sensation

7 cranial nerve is responsible for reflex


test done by touching the cornea by fine object lead to reflex closer of the eye


fine object ( small cotton piece about 3 cm and not very tapered (you are not going to harm the patient ))


you should be in front of the patient not behind him


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how to examine near reflex

make the patient look to very near object

distance should be very small ( i don't remember the number )


what will happen


conversion

myosis

accommodation of lens .....can't be seen



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how to test the pressure of the eye


normal pressure is 10-12 above the atmospheric pressure


this called digital method to detect IOP

when you press on the check it is soft but the nose is more harder and the eye is in between

support of the hand on the forehead of the patient

examine by both index fingers press by one and other to detect



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make the patient look down

and fix the frontalis muscle by good fixation of the eye brows then tell the patient to look upward

if eye lid elevated = good levator muscle

if not = some thing wrong in levator muscle

links before any test is just image for example .................................................. * there are other notes i will write them as soon as i can and good luck for all of you

-dahsyatkan potensi dirimu, raih prestasi luar biasa-

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