Archives: Medical Student Finals

MSFinals-3803

As part of a learning exercise, an elderly person drew a small black square and a black circle, 4 inches horizontally apart, on a piece of white paper. The elderly person then held the paper at arm’s length and closed their left eye, while focusing on the black square, which was to the left of the black circle, with their right eye. They moved the paper slowly towards them until the black circle disappeared.
Which of the following anatomical structures is responsible for the disappearance of the black circle?

MSFinals-3804

A 40-year-old woman comes to the Emergency Department complaining of left eye pain for the third time. She reports experiencing blurred vision and a sensation of something being stuck in her eye each time. She typically wears contact lenses and has accidentally scratched her eye multiple times in the past.
Investigations reveal an epithelial defect with surrounding corneal edema on slit lamp examination, as well as an area of increased uptake on fluorescein examination. What is the most likely diagnosis based on these findings?

MSFinals-3805

A 52-year-old man presents to the Emergency Department with a 2-day history of an increasingly painful and swollen right eye. He complains of blurring of vision and pain, especially with eye movements, which are quite restricted.
On examination, the visual acuity is 6/18 in the right eye and 6/6 in the left. The periorbital area of the right eye is very swollen and erythematosus. The eye itself is red and proptosed. The conjunctiva was chemosed. Eye movements in the right eye are quite restricted in all directions. There is relative afferent pupillary defect on the right.
Vital observations were as follows:
Blood pressure 120/70 mmHg
Heart rate 75 bpm
Respiratory rate 18 per minute
Oxygen saturation 98% on air
Temperature 37.9 °C
What is the most important step in your management plan to determine the cause of this patient’s eye problem?

MSFinals-3806

A 28-year-old man presents with a 5-day history of increasing pain, blurry vision and lacrimation in the left eye. He also feels a foreign body sensation in the affected eye. He had been doing some DIY work at home without wearing any goggles for the past few days prior to the onset of pain.
On examination, his visual acuities are 6/18 in the left and 6/6 in the right. The conjunctiva in the left is red. The cornea is tested with fluorescein and it shows an uptake in the centre of the cornea which looks like a dendrite. On examination of his face, there are some small vesicles at the corner of his mouth as well.
What is the most likely diagnosis?

MSFinals-3785

A 5-year-old child with a suspected squint is referred to an ophthalmologist by her General Practitioner. The ophthalmologist makes a diagnosis of amblyopia (lazy eye) and suggests occlusion therapy.
What is occlusion therapy and how is it used to treat amblyopia in a 5-year-old child?

MSFinals-3786

A 26-year-old woman comes to the clinic complaining of a headache and blurred vision that have been present for 2 days. Upon fundoscopy, it is discovered that she has optic neuritis on the right side. She had a previous episode of arm weakness 5 months ago that was also accompanied by blurred vision. What is the most probable diagnostic test for this patient?

MSFinals-3788

A 50-year-old woman with uncontrolled diabetes visits her doctor reporting sudden vision loss in her right eye without any pain. She also mentions seeing flashes of light in the periphery of her vision. What could be the possible diagnosis?

MSFinals-3789

A 54-year-old man comes to the emergency department complaining of a severe headache that is concentrated on the right side, retro-orbitally. He reports a decrease in visual acuity in his right eye and says that it has been excessively tearing. Upon examination of the right eye, the conjunctiva appears red and the cornea looks hazy. The left pupil reacts normally to light, but the right pupil is non-reactive.
What is the probable diagnosis, and what is the initial management plan?

MSFinals-3790

A 32-year-old woman presents to her GP with complaints of itchy, red, and watery eyes. She reports that the symptoms started in her left eye four days ago and have since spread to her right eye. Upon examination, bilateral redness and watery discharge are observed in both eyes. The patient has a history of using reusable contact lenses and reports that her 4-year-old son had similar symptoms a week ago. What management advice should the GP provide for this likely diagnosis?