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THE ROYAL COLLEGE OF
OPHTHALMOLOGISTS
DUKE ELDER PRIZE EXAMINATION 2009
INFORMATION FOR CANDIDATES
Duke Elder Prize Examination May 2009
!!!!!!Please read the following information carefully!!!!!!
This examination is intended for medical students who have
completed their ophthalmology undergraduate teaching, but it is
open to all medical undergraduates provided they have not
graduated at the time of the examination. Students may take the
examination on more than one occasion provided they have not
yet graduated and have not previously won the prize.
All candidates will be given a PASS or FAIL mark, a percentage
score and a rank.
Candidates will be charged a cheque deposit of £15. If you
attend this examination your deposit will be returned to you.
(Cheques should be made payable to “The Royal College of
Ophthalmologists”).
The 1 ½ hour examination will be held on Wednesday 6th May
2009 at 2.30pm.
Candidates should liaise with the Medical School organiser if
they wish to sit this examination. The College will only accept
candidates that liaise with their medical school. We will not
accept individual applications.
Candidates must ensure that they have given their name prior
to the closing date of 11th March 2009. This date is one week
prior to the deadline by which the Medical School organiser
will be sending the names to the Royal College of
Ophthalmologists. No candidate will be accepted after 11th
March 2009.
If you have any further queries please contact the:
Examinations Department
Royal College of Ophthalmologists
17 Cornwall terrace
London
NW1 4QW
Email: [email protected]
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Duke Elder Prize Examination May 2009
THE DUKE-ELDER UNDERGRADUATE PRIZE IN
OPHTHALMOLOGY
An undergraduate prize examination will be sponsored again this
year on a national basis by The Royal College of
Ophthalmologists. This examination is intended for medical
students who have completed their ophthalmology undergraduate
teaching, but it is open to all medical undergraduates provided they
have not graduated at the time of the examination. Students may
sit the examination on more than one occasion provided they have
not yet graduated and have not previously won the prize. There
will be a cash prize of £400 for the candidate gaining the highest
mark. If there is more than one candidate gaining the highest mark
this amount will be split respectively. There is no second prize.
The examination consists of an extended matching question paper
of 20 questions with 3 stems to each question. Candidates will
have to pick their answer from a list of options. Marking is on the
basis of +1 for a correct answer, 0 for an incorrect answer, and 0
marks for no answer or "don't know”. The previous system of
marking -0.5 for an incorrect answer no longer applies.
The standard is high and candidates should anticipate a stiffer
examination than encountered in the undergraduate class.
Questions are mostly based on clinical ophthalmology but other
areas covered include ocular physiology, anatomy and pathology
as well as genetics of eye conditions and socioeconomic medicine
relevant to ophthalmology e.g. blind registration or world blindness.
In the clinical questions all the sub-speciality areas within
ophthalmology are covered including:
Cornea and external eye disease
Cataract
Glaucoma
Medical retina and vitreo-retinal surgery
Strabismus and paediatric ophthalmology
Neuro-ophthalmology
Ocular adnexal and orbital disease
Refractive errors and optics
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Duke Elder Prize Examination May 2009
Extended matching questions are multiple choice items organised
into sets that use one list of items in the set. The extended
matching set includes four components:
1.
2.
3.
4.
A theme
An option list
A lead in statement
Three item stems
Example Questions
1. Options –Theme/ Topic
A. Acute angle closure glaucoma
B. Age-related macular degeneration
C. Anterior ischemic optic neuropathy
D. Cataract
E. Central retinal artery occlusion
F. Optic neurtis
G. Papiloedema
H. Retinal detachment
I. Retinal vein occlusion
J. Vitreous haemorrhage
Lead in: For each patient with loss of vision select the most likely
diagnosis.
Stems:
1. An 80- year old Caucasian woman complains of recent
problems with reading vision, specifically words appearing
distorted and blank patches being present.
Ans B
2. A 32- year old female patient experiencing weakness and
numbness in her left arm gives a three day history of increasing
loss of vision in her right eye and pain on moving the eye Ans F
3. A 54-year-old man complains of headaches that are made
worse by coughing. They appear to be increasing in frequency. He
admits to occasionally losing vision but only for a few seconds at a
time. His visual acuities are normal.
Ans G
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Duke Elder Prize Examination May 2009
2. Options
A. Bitemporal hemainopia
B. Fifth cranial nerve palsy
C. Fourth cranial nerve palsy
D. Homonymous hemianopia
E. Miosed pupil
F. Optic atrophy
G. Relative afferent papillary
H. Seventh cranial nerve palsy
I. Sixth cranial nerve palsy
J. Third cranial nerve palsy
Lead in: Select the most appropriate option that would fit with the
clinical scenario.
Stems:
1. A 68-year-old hypertensive man with poorly controlled diabetes
(Type 2) presents with sudden onset horizontal diplopia. Ans H
2. A fit 48-year-old woman complains of a very severe headache
and droopy left upper lid she gets double vision when she lifts up
her eyelid.
Ans J
3. An 82-year-old hypertensive woman collapses at home. In
casualty she is found to have a right hemiparesis, an up-going
planter reflex and is dysphasic.
Ans D
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Duke Elder Prize Examination May 2009
3. Options
A. Aciclovir ointment
B. Antibiotic drops
C. Beta-blocker drops
D. Corticosteroids drops
E. Intravenous antibiotic
F. Oral acetazolamide
G. Oral acyclovir
H. Oral corticosteroids
I. Oral cyclosporin
J. Prostaglandin drops
Lead in: Select the most appropriate therapy for the clinical
scenario.
Stems:
1. A 55-year-old man has intra-ocular pressures of 32mmHg in
each eye. His optic discs are pathologically cupped. He is using a
salbutamol inhaler for his asthma.
Ans J
2. A 73-year-old woman develops a painful rash on the right side of
her forehead. Her right eye is closed because of associated lid
oedema. She feels generally unwell.
Ans G
A 32-year-old gardener develops a red eye with a purulent
discharge. After two days it spreads to the other eye. His young
daughter has a similar problem.
Ans B
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Duke Elder Prize Examination May 2009
4. Options
A. Amblyopia
B. Astigmatism
C. Congenital cataract
D. Congenital glaucoma
E. Hypermetropia
F. Myopia
G. Optic disc hypoplasia
H. Optic neuritis
I. Retinoblastoma
J. Retinopathy of prematurity
Lead in: What is the most likely cause of the poor vision?
Stems:
1. A six-week-old baby is noted to have wobbly eyes and poor
vision. On examination neither eye has a red reflex. There is a
family history of eye disease.
Ans C
2. A ten-year-old boy with past history of squint surgery is found to
have poor vision in his left eye that cannot be improved with
glasses.
Ans A
3. A three-year-old girl is found to have reduced vision in both
eyes. Her vision improves with glasses with convex lenses.
Ans E
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Duke Elder Prize Examination May 2009
5. Options
A. Anterior ischaemic optic neuropathy
B. Background diabetic retinopathy
C. Cataract
D. Central retinal artery occlusion
E. Diabetic maculopathy
F. Neovascular glaucoma
G. Optic neuritis
H. Proliferative diabetic retinopathy
I. Retinal detachment
J. Vitreous haemorrhage
Lead in: Select the most appropriate option that would fit with the
clinical scenario.
Stems:
1. A 46-year-old diabetic (Type 1) of 25 years duration and
incipient renal failure presents with red, painful, blind right eye.
Ans F
2. A 42-year-old diabetic (Type 1) male complains of a sudden
onset of floaters in his right eye. They gradually settle after one
month.
Ans J
3. A 46-year-old woman with Type 1 Diabetes has noticed
gradually deteriorating vision in both eyes for 12 months. She is
also troubled by glare, when driving her car at night.
Ans C
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Duke Elder Prize Examination May 2009
Name: Dr J Bloggs
Number: 12345
THE ROYAL COLLEGE OF OPHTHALMOLOGISTS
DUKE ELDER PRIZE EXAMINATION MAY 2009
Instructions to candidates taking Extended Matching
Question papers
1)
CANDIDATES MUST USE THE PENCIL PROVIDED ON THE DESK TO
COMPLETE EMQ ANSWER SHEETS. BIROS AND PENS MUST NOT BE USED.
2)
Candidates must PRINT their names on the EMQ Answer Sheet and fill in the box
headed Candidate Number.
The Royal College of Ophthalmologists
Last Name
Other Names
Examination
Bloggs
Joe
Duke Elder Prize
1
2
3
4
5
Candidate Number
=1= =2= =3= =4= =5=
=1= =2= =3= =4= =5=
=1= =2= =3= =4= =5=
=1= =2= =3= =4= =5=
=1= =2= =3= =4= =5=
3) Candidates must decide which item is correct and mark the Answer Sheet BOLDLY
with the pencil provided by filling in the appropriate response for each item.
e.g. If you think the answer to question 1 is E then complete the mark sheet as
follows:
1.
=A= =B= =C= =D= =E= =F= =G= =H= =I= =J=
ONLY ONE BOX SHOULD BE FILLED IN FOR EACH ITEM.
4)
CANDIDATES SHOULD MARK THEIR ANSWERS CLEARLY.
5)
THE FOLLOWING SYSTEM OF MARKING WILL APPLY:
1 CORRECT
0 INCORRECT
0 DON’T KNOW
If an answer is left blank it will be read as a Don’t Know.
6)
Candidates may change their selection by erasing them completely with the rubber
provided and may then make an alternative selection.
7)
Candidates are advised to go right through the paper, answering what questions they
can, and then return to the other questions. PLEASE MAKE SURE YOU LEAVE
ENOUGH TIME TO TRANSFER YOUR ANSWERS TO THE ANSWER SHEET.
8)
CANDIDATES SHOULD REMAIN IN THEIR PLACES AT THE END OF THE
EXAMINATION until their Question Papers, Answer Sheets, pencils and rubbers
have been collected by an Invigilator.
EMQ PAPERS, CANDIDATE NAME CARDS, TIMETABLES AND INSTRUCTIONS ON
THE COMPLETION OF EMQ PAPERS MUST NOT BE REMOVED FROM THE
EXAMINATION HALL. IF ANY OF THESE GO MISSING, THE CANDIDATE CAN BE
IDENTIFIED AND THE MATTER WILL BE REFERRED TO THE COLLEGE COUNCIL.
TIME ALLOWED FOR EACH EXAMINATION: 1½ HOURS
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