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

http://jumbofiles.com/n3rmtxbuzqmk

or

http://www.mediafire.com/?yf78xrcsnwqr8w2

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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 .

http://www.mediafire.com/?317j3m3vlco77kc

or 

http://jumbofiles.com/701un5y4nrq0

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*  lecture for dr\ taher  for clinical tests ( how to do the test)

http://www.mediafire.com/?05g2i5p7u2hck02

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this some notes i have written in the lecture

http://meduniver.com/Medical/Anatom/Img/672.jpg

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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http://www.biomedsearch.com/attachments/display/00/20/07/68/20076806/1757-1626-3-1-1.jpg

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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http://www.eophtha.com/eophtha/Ejo/EJO13/Picture8.JPG

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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http://www.rainbowreaders.co.uk/resources/convergence.jpg

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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http://www.mda.org/publications/quest/images/q164/q164Eyesgraphic.jp how to test levator muscle

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-

Methods of answer for Ophthalmology..

 some important notes about method of answer in ophthalmology by dr afifi ( written by our college dr\ Abdelrahman Amer)

 dr\ tharwat said that answer should be according to the requested in the question but he didn't talk about the correction of the paper let's see test duration is 2.5 hoursincluding 10 questions so about 15 minutes for each question after you write the requested information you should add some information coz the mark of the question is big

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* for any subject it is better to add

 def +etoilogy ( shortly)

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  *if there are ttt  STEROID OR ATROPINE in the disease you should write the details mentioned in Iridocyclitis

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1.complications

(def + compications +ttt of dse + ttt of .complications )

example :

complications of diptheritic conjunctivitis

= def +complications +

ttt of diptheritic conjunctivitis (shortly)  +ttt of complications esp symblepharon

NB. IN PURULENT CONJUNCTIVITIS add complications of perforated ulcer

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2. causes of papilledema

def+ causes + details from cause as CRVO causes in papiledema causes

investigations + dd + c/p  papilledema ( just the head lines)

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3.C/P of Buphthalmus

=def + symptoms +signs + fate & complications

DD ( just names of the diseases)

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4.ttt of Spring Catarrh

def +ttt

+ topical steroid details from iridocyclitis

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5.ttt of corneal ulcer or purulent conjunctivitis

def +etoilogy (shortly)

ttt +ATROPINE mention the details from  Iridocyclitis

NB:ttt of corneal ulcer = Hypopyon + dendritic

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6.types of ptosis or congenital cataract or senile cataract

def + types +

 (signs) investigations  (shortly)

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7. diagnosis

= C/P +investigations

symptoms +signs + fate & complications +dd

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8.local causes of complicated cataract

def + causes + examinations + dd (table)+ ttt names

..thanks for dr\ Afifi & for our college dr\Abdelrahman Amerand i hope that all of us get full marks ♥

-dahsyatkan potensi dirimu, raih prestasi luar biasa-

target questions for ophthal..

sape geram tgk baby ni angkat tgn~ haha..

this is example for questions by dr \ tharwat

1-Comp. Of diphtheritic Conjunctivitis .

2-C/P of Buphthalmus -à Symp., Signs & DD.

3-ttt of Spring Catarrh.

4-Central Retinal Artery Occlusion

5-Comp. Of High Myopia

6-ttt of Corneal Ulcer

this question should include this in the answer

General ttt + Specific ttt of each type (Herpetic-Dendritic)

this important questions written by one of our college dr\ Ahmed Ȝbdou

severe >> require massive studying = every detail is needed

moderate >> require moderate studying

mild >> require mild studying..

.

 1st : Conj.

Sever :

1 - spring catarhh

2 - memb. ( diphitirc ) conj. ( complications )

3 - phylecten

4 - MPC

Moderate :

1 - purulunt conj. + ophth. neonatorum

Mild :

1 - Gross anatomy

2 - Trachoma

3 - pterygium

.

.

 2 nd : Errors of refraction

Sever :

 1 - Astigmatism

2 - high myopia ( compilication )

Mild :

1 - Aphakia

2 - Anisometropia

3 - Contact lens

.

.

3rd : Retina

Severe :

1 - CRAO

2 - CRVO

3 - Diabetic retinopathy

Moderate :

1 - R.D ( Diagnosis )

Mild :

1 - R.P

2 - Hypertensive retinopathy

3 - Histology and bl. supply of retina

4 - normal fundus exam. 

.

.

4 th : Cornea

Severe :

1 - ttt of corneal ulcer ( general + each tyoe )

2 - Dendritic ulcer

3 - Keratoconous

Moderate :

1 - perforated corneal ulcer ( comp.)

Mild :

1 - Herpes zoster

2 - non - inf. keratitis ( esp. Keratomalacia )

.

.

5 th : Eyelid

Sever :

1 - ectropion ( comp. , types , ttt )

2 - Ptosis ( causes ** , ttt * )

3 - entropion ( comp. , types , ttt )

Moderate :

1 -  Lagophthalmos ( CP , comp. )

2 - Trichiasis ( CP , ttt )

3 - Chalazion

Mild :

1 - draw vertical section of upper lid and enumerate structures

2 - Symblepharon ( comp. )

3 -  Blepharitis ( types , comp. )

.

.

6 th : Uvea

Severe :

1 - acute iridocyclitis ( causes , CP , comp. , ttt )

Mild :

1 - malignant melanoma

.

.

7 th : Occular trauma

Sever :

1 - Chemical injury ( CP * , ttt ** )

2 - F.B ( effects , management )

Moderate :

1 - Comp. of blunt trauma ( very long )

Mild :

1 - Sympathetic ophthalmitis

.

.

8 th : Glaucoma

Sever :

1 - Buphthalmus ( CP , ttt )

2 - Acute congestive glaucoma

3 - 2ry open angle glaucoma ( causes )

Moderate :

1 - 2ry closed angle glaucoma ( causes )

2 - D.D of acute red painful eye

Mild :

1 -  Signs of POAG ( esp. Field changes )

2 -  anatomy of ant. chamber + aqueous  secretion and circulation

3 - management of glaucoma ( POAG , PCAG )

.

.

9 th : Lens

Sever :

1 - complicated cataract ( causes , management )

2 - congenital cataract ( types , management )

Moderate :

1 - Diff. () aphakia and pseudophakia

2 - types of senile cataracts ( table )

3 - Hypermature cataract ( diagnosis and comp. )

.

.

10 th : Neuro

Sever :

1 - causes of papilledema

2 - Optic atrophy ( causes and signs )

Moderate :

1 - Orbital cellulitis

2 - Diff. () papilledema and papillitis

Mild :

1 - Optic neuritis

2- papillitis

.

.

wish you all the best

-dahsyatkan potensi dirimu, raih prestasi luar biasa-