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Green Book > Paper 3 CRQ > Flashcards

Paper 3 CRQ Flashcards

1
Q

What does the term cutis refer to

A

The outer layers of the skin

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2
Q

What layers of the skin does the cutis comprise of

A

Superficial epidermis
Deeper dermis

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3
Q

Micronodular vs Nodular BCC. Which one is more aggressive

A

Micronodular- subclinical spread with potential to spread beyond macroscopic boundaries making it harder to clear margins during excision

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4
Q

What are the 4 histological subtypes of BCC

A

Nodular (solid)
Superficial
Infiltrative (morphoeic)
Micronodular

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5
Q

Histological features of Nodular BCC

A

Well circumscribed with clear palisading and easily excised

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6
Q

Histological features of Superficial BCC

A

Appear as lobules localised to dermal - epidermal junction

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7
Q

Histological features of Morphoeic BCC

A

Grow aggressively in strands with reduced peripheral palisading and an indistinct border

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8
Q

Histological features of Micronodular BCC

A

Multiple small nodular aggregates of tumour

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9
Q

Which 2 types of BCC have the potential for subclinical spread

A

Both infiltrative BCCs and micronodular BCCs

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10
Q

Exenteration vs Enucleation vs Evisceration

A

Exenteration: Removal of all contents of orbits including EOM

Enucleation: Removal of eye leaving EOM and other contents behind

Evisceration: Removal of globe contents leaving sclera, fat, EOM and other adjacent structures of the eye intact and sometimes the cornea in place

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11
Q

2 principal risk factors for developing BCC

A

Sun exposure
Fair skin

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12
Q

Treatment for superficial BCC

A

Imiquimod- an effective topical treatment for superficial BCCs with histological clearance rates of 82–90%

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13
Q

Inherited syndromes with multiple BCC’s

A
  • Gorlin Goltz- AD
  • Xeroderma pigmentosum- AS
  • Albinism- AR
  • Bazex syndrome (Bazex–Dupré–Christol syndrome)- X linked recessive
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14
Q

What distortion do high powered convex lens cause

A

Pincushion distortion
Jack in the box
Ring phenomenon

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15
Q

What distortion do high powered concave lenses cause

A

Barrel distortion

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16
Q

Prismatic power formula

A

P=FxD
P is the induced prismatic power in prism dioptres;
F is the power of the decentered lens in dioptres; and
D is the decentration in centimetres.

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17
Q

Antibody associated with hyperthyroidism

A

Thyroid stimulating hormone (TSH) receptor antibodies (TRAb)

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18
Q

Is radioiodine contraindicated in pregnancy

A

Yes

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19
Q

Sight threatening complications of Thyroid eye disease

A

Exposure keratopathy
Acute optic neuropathy

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20
Q

Which blood retinal barrier is primarily affected in diabetic maculopathy/retinopathy

A

breakdown of the inner blood–retinal barrier with extensive leakage from capillaries and microaneurysms

21
Q

Between which layers of the retina does the oedema occur first in diabetic retinopathy

A

between the inner nuclear and outer plexiform layers

22
Q

How does aflibercept work

A

a recombinant fusion protein which binds VEGF block these actions, and can stabilise or improve vision by reducing macular oedema.

23
Q

Aetiology of CN VI palsy

A
  • Microvascular ischaemia
  • Tumours (e.g. cavernous sinus lesion, acoustic neuroma)
  • Basal skull fracture
  • Vasculitis (e.g. GCA)
  • Demyelination
  • Raised intracranial pressure (usually bilateral, unlike this case)
24
Q

When does the lens vesicle separate from the surface ectoderm

A

at the start of day 36, i.e. after 5 weeks.

25
Q

What is coma aberration

A

a variant of spherical aberration which occurs with light originating from points away from the principal axis. Light rays passing through the lens periphery are deviated more than those passing through the central portion of the lens. This consequently leads to a composite image that is elongated like the tail of a comet.

26
Q

What type of aberration are people with keratoconus susceptible to

A

Coma aberration

27
Q

In using the red green chart post refraction in a colour blind patient, how do you use it

A

asked whether the letters are clearer on the upper or lower row

28
Q

Which type of aberration does mydriasis induce

A

Spherical aberration

29
Q

Types of defects causing hyperfluorescence on FFA

A

Leakage
Pooling
Staining
Window

30
Q

Types of defects causing hypofluorescence on FFA

A

Blockage
Filling defect

31
Q

How is ischaemia detected on FFA

A

The findings of new vessels (neovascularisation) and capillary dropout indicate ischaemia.

32
Q

How is the blood retinal barrier maintained

A

maintained by tight junctions between retinal capillary endothelial cells and the outer blood–retinal barrier (maintained by tight junctions between retinal pigment epithelium cells)

33
Q

Incidence of anaphylaxis in FFA

A

incidence of severe anaphylaxis is 1:1,900, and of fatal anaphylaxis is 1:220,000.

34
Q

Incidence of seizures in FFA

A

The risk of seizures is reported as 1:14,000.

35
Q

What does Neisseria Gonorrhoea appear like under staining

A

Gram-negative Diplococcus

36
Q

Microbes causing Ophthalmia Neonatorium

A

Neisseria Gonorrhea
Chalmydia Trachomitis

37
Q

Growth medium for Neisseria Gonorrhoea

A

Chocolate agar is a non-selective growth medium whereas
Thayer-Martin is selective for Neisseria.

38
Q

Between Chlamydia and Gonorrhea which is the most common cause of neonatal conjunctivitis

A

Chlamydia

39
Q

How to test for Chlamydia

A
  • Immunofluorescent staining (monoclonal antibody fluorescence microscopy)
  • Polymerase chain reaction (PCR) or other nucleic acid amplification tests (NAAT)
  • Enzyme-linked immunosorbent assay (ELISA)
  • Culture
  • Giemsa stain
40
Q

Optics of the compound microscope

A

The compound microscope consists of two lenses. The objective lens has the higher power of the two, and the object is placed very near it, just outside of its principal focus. The real, magnified, inverted image formed, image I1, then acts as the object for the eyepiece lens. However, this time the ‘object’ (image I1) falls within the principal focus and so the final image seen by the observer through the eyepiece lens is virtual, further magnified and remains inverted. Importantly, it is further from the eyepiece lens (and the observer) than image I1, which makes it easier to view.

41
Q

Difference between lenses in Compound microscope and Keplerian Telescope

A

consist of two convex lenses.
The compound microscope, with the objective as the more powerful lens, magnifies very close objects.
Conversely, the astronomical telescope has a more powerful eyepiece lens and magnifies very distant objects .

42
Q

In a compound microscope what is the sum of the focal lengths of the lenses in relation to the distance between them

A

the sum of the focal lengths is smaller than the distance between the lenses.

43
Q

Which prism can be used to invert an inverted image

A

Porro Prism- deviates by 180 to make image erect

44
Q

How does a slit lamp use compound microscopes to give a binocular view

A

Two compound microscopes (one for each eye) are used, mounted at a 13–14 degree angle to each other.

45
Q

What is the statistical definition of the median

A

is the age of the patient who is younger than half of the patients in that arm and older than the other half, i.e. the patient at the 50th percentile

46
Q

Formula to calculate the NNT

A

1/ARR

47
Q

What is a type 1 error

A

the null hypothesis is rejected when it is true, i.e. a ‘false positive’

48
Q

What is a type 2 error

A

when a study fails to reject a null hypothesis when it is false (i.e. a ‘false negative’)

49
Q

What is the statistical definition of the P value

A

The probability of finding a difference at least as dramatic as that seen in the results as a chance occurrence.

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