21 December #2

Question 1

What are features of vitreous haemorrhage?

Answer 1

Painless loss of vision

Visual haze
Floaters
Cloudy vision
Smoke signals
Perception of shadows/cobwebs
Photophobia

Normal pupils
Haemorrhages change colour from red/pink to orange/ yellow

Question 2

What genotype is Behcet disease associated with?

Answer 2

HLA B5/51

Common in Japanese/Mediterranean descent

Question 3

What are features of trachoma?

Answer 3

Caused by chlamydia

Causes chronic conjunctival infection
Turned in eyelashes causes corneal irritation and can lead to blindness

Treat with oral azithromycin

Question 4

What are features of sebacious cell carcinoma?

Answer 4

More often on upper lid
Eyelash loss
Any chalazion or blepharo-conjunctivitis that has not resolved in 3 months warrants further investigation

Question 5

What is Dacryocystitis?

Answer 5

Inflammation of the lacrimal sac which can be recurrent

Pain
Swelling
Epiphora (excess tear production)

Question 6

What are features of choroiditis/Chorioretinitis?

Answer 6

Gradual loss of vision
Caused by
- toxoplasmosis
-CMV
- TB
- Sarcoidosis
- Syphilis

Treat with steroids and treat underlying cause

Question 7

What are features of riber blindness?

Answer 7

Caused by Onchocerca volvulus
Transmitted by black flies- long incubation period

Subcutaneous nodules
Pruritis
Papular rash
Weight loss
myalgia
Eye problems

Treat with ivermectin

Question 8

What is the management of primary open angle glaucoma?

Answer 8

1) Selective Laser Trabeculoplasty
2) Latanoprost

Question 9

What medications can cause urinary retention?

Answer 9

TCAs
Disopyramide
Anticholinergics
NSAIDS
Opiates

Question 10

What is the management of aortic dissection?

Answer 10

Ascending
- surgery
- target BP systolic 100-120

Descending
- medical management
- labetabol to reduce BP

Question 11

How can you differentiate between Cushing disease and Cushing Syndrome?

Answer 11

Cushing disease will have cortisol and ACTH suppressed with high dose dexamethasone test

Whereas Cushing Syndrome will have ACTH suppressed but not cortisol

Question 12

What is the management of mild-moderate acne

Answer 12

12 week course topical combined therapy

1) topical adapalene with Bnezyl peroxide
2) Topical tretinoin with topical clindamycin
3) Topical benzoyl peroxide with topical clindamycin

Question 13

What is the management of moderate to severe acne?

Answer 13

12 week course of one of the following

1)Topical adapalene with Topical Benzoyl peroxide
2) Topical tretinoin and topical clindamycin
3) topical adapalene with topical Benzoyl peroxide and either lymecycline or doxycycline
4) Topical azelaic acid and either oral lymecycline or doxycycline

Question 14

How can you differentiate between bergers disease and post streptococcal glomerulonephritis?

Answer 14

Bergers disease onsets within 1-2 days post infection

Question 15

When are ACEi indicated in CKD?

Answer 15

CKD and diabetes with ACR >3mg/mmol
ACR >70
HTN

Can add on SGLT2 inhibitors

Question 16

What are features of mitral stenosis?

Answer 16

Caused by Rheumatic fever

SoB, pink frothy sputum, malar flush

Mid diastolic murmur

ECG broad, bifid P waves in Lead II

Treat- treat HF first
Surgery if required

Question 17

What is the investigation and management of metastatic spinal cord compression?

Answer 17

MRI whole spine within 24 hours

Flat bed rest
Steroids 16mg dexamethasone
PPI co- prescribed
Do not give if concerns of lymphoma
Further management- radiotherapy or surgery

Question 18

What are features of Paget Disease of the bone?

Answer 18

> 50 years
Bone pain most common complain
Fractures
Hearing loss

Isolated ALP
Ca, Ph and PTH normal

Manage with Bisphosphonates (IV zoledronate)