Short Answer Questions for the MRCOphth Part 1

Nathanial Knox-Cartwright, Petros Carvounis

• Publisher: CRC Press
• Year: 2018
• ISBN:
  9781315344560
• Edition: 1
• Topic: Medicine
• Subtopic: Surgery & Surgical Medicine

This book is an essential revision aid for those revising for the short answer paper of the Part 1 MRCOphth examination in the United Kingdom and similar examinations elsewhere. It covers many of the frequently asked questions and presents answers in a format that can be reproduced under examination conditions. It covers the basic sciences, and is also a useful reference to refresh the knowledge of experienced ophthalmologists and allied health professionals.

Q96 Write short notes on the development of the retina

• The optic vesicle is fully formed by day 25 of gestation and after it invaginates the thickened inner invaginated layer, known as the retinal disc, is destined to differentiate into the neural retina whereas the outermost layer of the optic cup is destined to become the retinal pigment epithelium (RPE). There is a sharp transition between these two layers at the optic cup margin.
• The outer layer, or future RPE, consists of pseudostratified columnar cells. Pigment granules are present from as early as the third week of gestation. These cells continue to divide late into fetal life. The basal lamina of the RPE is incorporated into Bruch’s membrane.
• The primitive neural retina is formed from the inner layer of the optic cup and consists of an outer nuclear zone and an inner marginal (or acellular) zone. The outer nuclear zone is homogeneous to the proliferative neuroepithelium of the neural tube.
• Mitotic activity in the primitive neural retina is greatest in the outer part of the outer nuclear zone and is completed by 15 weeks. Differentiation begins as mitosis ends. Differentiation is initiated in the marginal zone, commencing at the posterior pole and progressing in a centrifugal manner.
• From about 7 weeks’ gestation newly formed cells migrate vitread from the nuclear zone into the marginal zone to form the inner neuroblastic layer. From this time the nuclear zone becomes known as the outer neuroblastic layer.
• The inner neuroblastic layer goes on to produce ganglion and amacrine cells whereas the outer neuroblastic layer gives rise to horizontal and bipolar elements.
• Photoreceptors are thought to be derived from cilia found in the outer nuclear zone.

Lamination is essentially complete by four and...

Table of contents

• Cover
• Title Page
• Copyright Page
• Content
• Preface
• About this book
• Q1 Define (a) standard deviation, (b) standard error of the mean and (c) 95% confidence interval
• Q2 Define sensitivity, specificity and positive predictive value of screening
• Q3 Write short notes on the factors determining drug penetration into the eye
• Q4 Write short notes on drug metabolism
• Q5 Describe the pupillary responses and their modification by drugs
• Q6 List, with examples, pharmacological ways of lowering intraocular pressure
• Q7 Write short notes on the pharmacology of cycloplegic drugs
• Q8 Write short notes on carbonic anhydrase inhibitors
• Q9 Write short notes on the side effects of β-blockers
• Q10 Write short notes on the mode of action of drugs that lower blood glucose
• Q11 Write short notes on the mode of action of drugs that lower blood pressure
• Q12 Write short notes on the side effects of aminoglycosides
• Q13 What are the side effects of corticosteroids?
• Q14 What are the current therapeutic strategies in the human immunodeficiency virus (HIV)?
• Q15 Write short notes comparing rods and cones
• Q16 Describe the mechanisms regulating aqueous outflow
• Q17 Describe the structures and relationships of different retinal ganglion cell types, including their connection to higher visual pathways
• Q18 Write short notes on autoregulation of blood low
• Q19 Outline the differences between the sympathetic and parasympathetic branches of the autonomic nervous system
• Q20 Write short notes on steroid receptors. Illustrate your answer with reference to the glucocorticoid receptor
• Q21 Describe the physiological and pharmacological mechanisms involved in water transfer through tissue
• Q22 Write short notes on endocytosis. Illustrate your answer with an example from the eye
• Q23 Discuss mechanisms by which bacteria destroy tissue
• Q24 List the ophthalmic manifestations of the acquired immunodeficiency syndrome (AIDS)
• Q25 List the clinical manifestations of giant cell arteritis
• Q26 Discuss the pathological effects of ionising radiation
• Q27 Draw a diagram of the normal retinal capillary. How is the structure altered in diabetes?
• Q28 Write short notes on the pathogenesis of atheromatous plaques
• Q29 Describe the causes and effects of ulcers
• Q30 What are free radicals? Write short notes explaining why retinal photoreceptors are particularly vulnerable to free radicals
• Q31 Describe ways in which cells die
• Q32 Write short notes on viral replication
• Q33 Contrast Gram-negative and Gram-positive bacteria
• Q34 Describe the chief mechanisms by which bacteria acquire resistance to antibiotics
• Q35 Discuss the microbiology of Pseudomonas aeruginosa
• Q36 What precautions would be taken to prevent spread of methicillin-resistant Staphylococcus aureus (MRSA) infection from patient to patient on an ophthalmic ward?
• Q37 Write short notes on the principles of sterilisation
• Q38 Compare and contrast bacteria, viruses and chlamydia
• Q39 Write short notes on genetic linkage analysis. Give an example
• Q40 Discuss the genetic mechanisms involved in neoplasia
• Q41 Write short notes on prenatal testing
• Q42 Write short notes on the polymerase chain reaction
• Q43 What is a chromosomal translocation? Illustrate your answer with an example associated with ocular disease
• Q44 Describe the causes and effects of occlusive disease occurring in muscular arteries and arterioles
• Q45 List the major roles of complement
• Q46 Describe the structure and function of immunoglobulins
• Q47 Write short notes on histocompatibility antigens and list three examples of disease associations
• Q48 Write short notes on the mechanism of allograft rejection
• Q49 Describe how antigen is presented to T lymphocytes
• Q50 Discuss the local and systemic effects of neoplasia
• Q51 Compare and contrast the innate and adaptive immune responses
• Q52 Describe the histology of hypertensive vasculopathy
• Q53 Describe the structure and function of mitochondria
• Q54 Write short notes on the bony anatomy of the orbit
• Q55 Write short notes on the blood supply to the anterior segment of the eye
• Q56 Outline the blood supply to the visual pathway
• Q57 List the actions of the extraocular muscles and list the differences between extraocular muscles and other skeletal muscles
• Q58 Write short notes on the crystallins
• Q59 Write short notes on carbohydrate metabolism in the lens
• Q60 List, with a brief explanation, the protective mechanisms against oxidative damage to the lens
• Q61 Draw a dark adaptation curve and identify the component parts and their significance
• Q62 Describe the mechanisms of visual adaptation
• Q63 What is known of the function of retinal pigment epithelial cells?
• Q64 Write short notes on the electrophysiological investigations of the visual pathway
• Q65 Describe the absorption of ultraviolet, visible and infrared light by the eye and discuss their harmful effects
• Q66 Describe the retinotopic organisation of the visual pathway. Use an image in the left superior visual field as an example
• Q67 Write short notes on the classification of visual acuity
• Q68 Discuss the cortical contribution to visual function
• Q69 Write short notes on the normal visual field and how it can be measured
• Q70 Write short notes on the principles of intraocular pressure measurement
• Q71 Discuss the mechanisms of aqueous secretion and their modification by drugs
• Q72 Write short notes on the supranuclear control of eye movements
• Q73 Describe the mechanism of colour perception
• Q74 Draw a cross-section of the upper eyelid. Label all important structures and write short notes on each
• Q75 Describe the structure and function of the conjunctiva
• Q76 Draw a diagram of the anterior chamber drainage angle and write short notes on the anatomy of the structure
• Q77 Describe the structure and function of the ciliary body
• Q78 Describe the lacrimal gland. Include a short note on its development
• Q79 Discuss the anatomy of the cerebellum, including its blood supply and neuronal connections
• Q80 Write short notes on the anatomy of the third cranial nerve nucleus
• Q81 Write short notes on the third cranial nerve
• Q82 Write short notes on the fourth cranial nerve
• Q83 Give an account of the origin, course, relations and functions of the sixth cranial nerve
• Q84 Give an account of the structure and function of the primary visual cortex and its neuronal connections
• Q85 Write short notes on the paranasal air sinuses
• Q86 Write short notes on the ventricles of the brain
• Q87 Write short notes on the major photochemical events involved in phototransduction
• Q88 Write short notes on retinal neurotransmitters
• Q89 List the factors that determine corneal hydration
• Q90 Discuss the anatomical features of the extraocular muscles
• Q91 What are the Golgi apparatus? How are they involved in the secretion of proteins? Describe this process in relation to mast cells
• Q92 Compare and contrast the magnocellular and parvocellular pathways
• Q93 Write short notes on the development of the cornea
• Q94 Write short notes on the prenatal development of the lens. Use annotated diagrams where possible
• Q95 Write short notes on the early development of the vitreous
• Q96 Write short notes on the development of the retina