Ophthalmology
CANDIDATE INSTRUCTIONS
Mrs Anne Doe is a 68 year old lady who presents today to clinic complaining of blurry vision.
Take a focused history
Explore her ideas, concerns and expectations
Answer the questions asked by the examiner at the end of the station
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:
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Answer 1: Proliferative, non-proliferative and maculopathy
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Answer 2: Microaneurysms, blot haemorrhages, hard exudates, cotton wool spots
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Answer 3:
Optimise glycaemic, BP control
Regular ophthalmology review and observation
If severe, consider panretinal laser photocoagulation
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Diabetic Retinopathy
PATIENT INSTRUCTIONS
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Name: Anne Doe
Age: 68 years old
Date of Birth: 10 December 1956
Occupation: Office clerk
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"My eyes have been progressively getting worse over the last year."
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Site: Both my eyes have been getting worse, neither is better than the other!
Onset: I would say fr the last year
Character: No pain. Just blurry, occasionally I think I get some double vision
Precipitant: Old age?!
Assoc Sx:
No redness
No discharge or watering
Both near and far vision affected
I think its worse at night as well, I’ve stopped driving at night now
Exacerbating Factors: None
Relieving Factors: None
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Recent illness: None.
Recent travel: None.
Previous episodes: Never experienced this before.
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Ideas: "I think it’s probably just old age catching up to me"
Expectations: “I would have left it, but my husband insisted I get it checked out!"
Concerns: “I just want to make sure it’s nothing sinister and also to reassure my husband"
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Bowel habits: Nil
Urinary habits: Nil
Appetite: Same as usual.
Sleep: Same as usual
Weight: No change
Pain in the chest/abdomen: None
Headaches: None
Fever: None
Cardiology: Normal
Respiratory: Normal
Upper limb neurology: None
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Previous hospital admissions: None
Previous surgeries: None
Medical conditions:
T2DM
Hypertension
Medications:
Metformin
Gliclazide
Dapagliflozin
Amlodipine
Allergies:
None.
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My dad had bad eyesight all his life and worse glasses
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Smoking: Never
Alcohol: None
Recreational drugs: Never
Diet: I cook most of my meals
Exercise: I do some garderning
Ill contacts: No one around me was recently ill
Home: Lives with husband in a single storey house
Active Daily Living: Independent with all ADLs
Occupation: I am a retired primary school teacher
MARK SCHEME
Introduction
Ideas, Concerns & Expectations
Presenting Complaint
History of Presenting Complaint
Systems Review
Past Medical History
Drug History
Family History
Social History
Questions
Patient Scores
Enter Your Score Here: /47
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SCORE GUIDE
High Pass: > 38
Pass: > 28
Borderline Pass: 24 - 28
Fail: < 24