Ophthalmology fact fixer: 240 MCQs with explanatory answers

153 Pages·2017·14.25 MB·English

by  C. N.

Ophthalmology
Fact Fixer
240 MCQs
with explanatory answers
Chung Nen Chua
Li Wern Voon
and
Siddhartha Goel
Radcliffe Medical Press
Radcliffe Medical Press Ltd
81 Marcham daoR
Abingdon
Oxon OX14 1AA
United Kingdom
www.radcliffe-oxford.com
ehT Radcliffe Medical sserP electronic catalogue and online ordering facility.
Direct selas to anywhere ni the world.
© 2002 The authors
All rights .devreser No part of this publication may be reproduced, stored ni a retrieval system
or transmitted, ni any form or by any ,snaem electronic, mechanical, photocopying, recording or
otherwise without the prior permission of the copyright owner.
hsitirB Library Cataloguing ni Publication Data
A catalogue record for this book si available from ehT hsitirB Library.
NBSI 1 57758 809 7
Typeset by Aarontype ,dtL ,notsaE lotsirB
Printed and bound by JT International ,dtL Padstow, Cornwall
Preface
This book is designed to help residents, ophthalmologists and optometrists prepare
for the MRCOphth, MRCS, FRCS and final optometry examinations respectively. It also
serves as a guide to help comprehensive ophthalmologists update and expand their
knowledge of ophthalmology. It is a useful aid for continuing medical education.
The content includes updates in recent scientific trials and studies, medical thera
peutics and surgical procedures, covering the subspecialities of cornea and external
disease, refractive surgery, cataract, glaucoma, orbital disease and oculoplastics, surgi
cal and medical retina, paediatric ophthalmology, neuro-ophthalmology, uveitis, ocular
oncology and pathology. To our knowledge, many of the other previously published
self-assessment books have been found to be deficient in these aspects.
A Fact Finder is provided at the back of the book.
Chung Nen Chua
September 2002
tuobA eht srohtua
Chung Nen Chua
tsilaicepS rartsigeR
Oxford eyE Hospital
Oxford
iL Wern Voon
Clinical laenroC wolleF
Oxford eyE Hospital dna dleiffuN Laboratory of Ophthalmology
University of Oxford
Oxford
dna
rartsigeR
ehT eyE Institute
Department of Ophthalmology
naT Tock gneS Hospital
eropagniS
Siddhartha Goel
Ophthalmologist
tneK County Ophthalmic dna Aural Hospital
Maidstone
How to master MCQs
Multiple choice questions (MCQs) are an effective way of assessing the candidate's
knowledge and are an important part of the final MRCOphth/MRCS.
Apart from possessing good knowledge of the subject, we suggest the following tips
which we hope will help you excel in the examination.
Remember ot answer hguone snoitseuq
The questions featured in the MRCOphth/MRCS/FRCS examinations are similar. Each
question has five parts to be answered. Answers may be True, False or Don't know.
+
1 mark is given for a correct answer and -1 mark for an incorrect one. No marks are
given or deducted for an unanswered question. This system of marking is called nega
tive marking.
The fear of making mistakes may lead to answering too few questions. If the pass
mark is 50%, and only half of the questions have been answered with confidence, one
may score poorly, as a significant number of answered questions may be wrong. It is
recommended that candidates attempt two-thirds of the questions. While this implies
making guesses for some of the questions, an intelligent guess based on some back
ground knowledge will more often be right than wrong.
skcirT desu yb eht examiners
1 Pay attention to the phrasing of the question. Phrases that contain the words
'never' or 'always' are usually false, whereas phrases with the word 'may be' are
usually true. Good MCQs tend to avoid using these words as much as possible.
Other examples are words such as 'typical' or 'rarely'. A sentence may be correct in
essence, but not when these phrases are used. For example:
Retinoblastoma:
si inherited ni the majority of sesac
sesira from receptor sllec of the retina
si detaicossa with deletion of chromosome 31
si typically present with pseudo hypopyon
that involves the optic nerve sah poor .sisongorp
Question illustrates the delicacy of correct phrasing. Pseudohypopyon si a known
presentation of retinoblastoma, however, it si not typical.
2 Beware of statements that contain dual information. The first part of the statement
may be correct, whereas the second part si incorrect. Mistakes can easily be made
if the question si read ni a hurry. For example:
nI malignant hypertension:
intracranial erusserp si desiar
a macular rats si desuac by the breakdown of the tight junction of the retinal
pigment epithelium
there si bilateral optic csid swelling with a relative afferent pupillary defect
fluorescein angiography may show a dark choroid due to choroidal ischaemia
phaeochromocytoma si the most common .esuac
nI this example, question <,~:L< contains a correct statement ni the first part of the
question .e.i( malignant hypertension sesuac bilateral optic disc swelling) but na incorrect
statement in the last part .e.i( relative pupillary defect si not a feature of malignant
hypertension).
3 Numerical serugif in questions era tricky, sa they can easily be altered to trick the
unwary. It si advisable not to answer these questions sselnu there si great certainty.
roF example:
ehT following era true about primary open-angle glaucoma:
relatives of the affected have na increased incidence of steroid-induced glaucoma
the incidence of a first-degree relative developing the emas condition si 1 %
dilatation of the pupil always sesaercni the intraocular erusserp
abnormality of the trabecular meshwork si often observed during gonioscopy
lausiv dleif ssol nac occur in the presence of normal cup:disc ratio.
When answering this question, en)( may vaguely remember the value 1 % and
be pleased to ees it ni question . ehT true answer si in fact 10%.
4 Avoid reading too much into the question. For example:
sitirI si a feature :fo
systemic supul erythematosus
psoriatic arthropathy
ulcerative colitis
s'techeB esaesid
rheumatoid arthritis.
While rheumatoid arthritis does not cause ,SitIrI some may reason that rheumatoid
arthritis-induced scleritis or peripheral corneal melts can give esir to cells in the anterior
chamber and hence iritis.
5 Some easy questions may be rendered unanswerable by the use of uncommon
vocabulary. For example:
Deuterano maly:
si desuac by na abnormal eneg ni the X-chromosome
si desuac by na abnormality ni the neerg pigment
occurs ni about 5% of the naeporuE population
si more common than protanomaly
is associated with decreased visual acuity.
nI the question above, deuteranomaly si another term for red-green colour .ssendnilb
fI one si uncertain of the medical term, it may dael to difficulties ni answering the
question.
Noting the slraep above will eb useful nI helping candidates lecxe nI any multiple
choice question examination.