Nervous System
CANDIDATE INSTRUCTIONS
You are a medical student currently in Neurology rotation. The registrar has tasked you with performing a cranial nerve examination on one of the patients on the ward. You are not required to take a history.
Perform a cranial nerve examination of cranial nerves II, III, IV and VI and report your findings.
At 8 minutes, the examiner will ask further questions.
2 Minutes Reading Time
10 Minutes Station Time
Total 12 Minutes
EXAMINER INSTRUCTIONS
Timing Instructions: At 8 minutes, stop the candidate and ask the following questions:
Question 1: What are your differential diagnoses based on your physical examination findings?
Answer 1:
Optic neuritis
Age-related macular degeneration
Amblyopia
Diabetic Maculopathy
Refractive Error
Question 2: What is the most likely diagnosis?
Answer 2: Optic Neuritis
Question 3: What investigations can be used to support the diagnosis?
Answer 3: MRI Scan of brain and orbits with gadolinium contrast, lumbar puncture
Question 4: What neurological condition is highly associated with the diagnosis?
Answer 4: Multiple sclerosis
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Optic Neuritis
PATIENT INSTRUCTIONS
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Name: Patrick Keele
Age: 65 Years Old
Date of Birth: 19 March 1959
Location: Neurology Ward
Occupation: Retired Librarian
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CN II:
Visual acuity of left eye is 6/12, right eye normal
Colour vision of left eye shows reduction of red colour vision, right eye normal
Assessment of visual field shows loss of left central visual field, right eye normal
MARK SCHEME
Introduction
General Inspection
Eye Inspection
CN II (Optic) Examination
CN III (Oculomotor), CN IV (Trochlear) and CN VI (Abducens) Examination
Endpieces
Questions
Patient Scores
Enter Your Score Here: /36
SCORE GUIDE
High Pass: > 29
Pass: > 22
Borderline Pass: 18 – 22
Fail: < 18
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