FELLOWSHIP EXAMINATION - Microsoft



FELLOWSHIP EXAMINATION

JUNE/JULY 2004

VETERINARY OPHTHALMOLOGY

PAPER 1

BASIC SCIENCE AND PRINCIPLES

Perusal time: 20 minutes

Time allowed: THREE (3) Hours after perusal

Section A: Short Answer Questions

Allow One (1) Hour (value of Section A is one third of Paper 1)

Answer All Twenty (20) Questions

All questions within this section are of equal value

Subsections of questions within this section are of equal value

Section B: Essay Questions

Allow Two (2) Hours (value of Section B is two thirds of Paper 1)

Answer Only Four (4) Of the Five Questions

All questions within this section are of equal value

Subsections of questions within this section are of equal value

PAPER 1, SECTION A – SHORT ANSWER QUESTIONS

ANSWER ALL 20 QUESTIONS

1. List the four (4) layers of the mammalian iris.

2. In a recent study of glaucoma, pectinate ligament dysplasia (PLD) and relative width of the ciliary cleft (RWOCC) in English Springer Spaniels, what was the relationship (choose from: ‘no association’, ‘positive association’, ‘negative association’) between:

a. Degree of PLD and glaucoma ?

b. Narrowing of RWOCC and glaucoma ?

c. Increasing age and degree of PLD ?

d. Increasing age and narrowing of RWOCC ?

3. With respect to hyperlipidaemia in dogs and cats:

a. Which lipoproteins produce visible lipaemia ?

b. What are two possible acute ocular manifestations of a patient with visible lipaemia ?

4. What is the more specific name and structural nature of the tapetum in:

a. Carnivore eyes.

b. Herbivore eyes.

5. List four (4) characteristic features of the porcine ocular fundus.

6. State the mode or postulated mode of inheritance for the following hereditary retinal diseases:

a. Progressive rod-cone degeneration in dogs.

b. Multifocal retinal dysplasia in dogs.

c. Rod-cone dysplasia in Abyssinian cats.

d. Congenital stationary night blindness in Appaloosa horses.

Continued over/Section A/Paper 1/Ophthalmology 2004

Continued/Section A/Paper 1/Ophthalmology 2004

7. State the molecular or ultrastructural abnormality identified as responsible for the following hereditary diseases:

a. Rod-cone dysplasia type 1 in Irish Setters.

b. Progressive retinal atrophy in the Cardigan Corgi.

c. Neuronal ceroid lipofuscinosis in dogs.

d. Chediak-Higashi syndrome in Persian cats.

8. What nerve(s) innervate the:

a. Retractor bulbi muscle ?

b. Dorsal rectus muscle ?

c. Cornea ?

d. Iris sphincter muscle ?

9. Briefly outline the pathway of the preganglionic sympathetic innervation to mammalian eye and adnexa.

10. The parietal (‘third’) eye is:

a. A remnant of what structure ?

b. Found in which orders of what class of animal ?

11. Briefly define the principle of using parallax and the relative motion of objects for localizing the position of intraocular opacities when examining an eye.

12. With respect to Snellen chart fractions used for visual acuity estimates in humans:

a. What do the terms 20/20 and 6/6 mean ?

b. What do the terms 20/40 and 6/12 mean ?

c. What visual acuities do the bottom and second bottom lines of a Snellen chart equate to when these can be read?

d. What is the estimated visual acuity of dogs ?

Continued over/Section A/Paper 1/Ophthalmology 2004

Continued/Section A/Paper 1/Ophthalmology 2004

13. What is the effect of a single drop of topical tropicamide in the eye on the Schirmer Tear Test (STT) in:

a. Dogs ?

b. Cats ?

14. With respect to corneal sensitivity measured using a Cochet-Bonnet aesthesiometer in brachycephalic cat breeds and Domestic Short-haired cats, what are the differences between:

a. Peripheral and central cornea irrespective of breed groups ?

b. Central cornea of brachycephalic cat breeds compared with central cornea of Domestic Short-haired cats ?

15. With respect to ‘noise’ that can cause difficulties in interpretation of electroretinogram (ERG) traces, list four (4) major sources:

16. List four (4) topical ocular parasympatholytic agents and their duration of action in normal canine eyes.

17. With respect to topical 1% atropine applied to normotensive equine eyes:

a. What is the effect on intraocular pressure (IOP) in the majority of individuals ?

b. What is the proposed mechanism for this change in IOP ?

18. In a recent study on the effects of atracurium on the intraocular pressure (IOP) of isoflurane-anaesthetised dogs, what was the effect of:

a. A 0.2mg/kg intravenous dose of atracurium on eye position? (choose from: ‘no effect’, ‘eye rotates from ventromedial to central position’, ‘eye rotates from central to ventromedial position’)

b. A 0.2mg/kg intravenous dose of atracurium on IOP ? (choose from: ‘no effect’, ‘increases’, ‘decreases’)

c. Hyperventilation and resultant hypocapnoea on IOP ? (choose from: ‘no effect’, ‘increases’, ‘decreases’)

d. Hyperventilation and resultant hypocapnoea on duration of effect of atracurium ? (choose from: ‘no effect’, ‘increases’, ‘decreases’)

Continued over/Section A/Paper 1/Ophthalmology 2004

Continued/Section A/Paper 1/Ophthalmology 2004

19. With respect to a study of the efficacy of oral supplementation of L-lysine in healthy cats latently infected with feline herpes virus, what was the effect in lysine supplemented versus non-lysine supplemented control cats (choose from: ‘ no effect’, ‘increases’, ‘decreases’) on:

a. Incidence of conjunctivitis ?

b. Viral shedding episodes ?

c. Mean plasma L-lysine concentrations 3 hours post administration ?

a. Mean plasma arginine concentrations?

20. Briefly state the mechanism of the immunosuppressive mode of action for each of the following drugs:

a. Cyclosporin.

b. Azathioprine.

END OF SECTION

PAPER 1, SECTION B – ESSAY QUESTIONS

Answer four (4) of the five questions

1. a. Describe the possible developmental anomalies of the equine eye.

b. Briefly outline the aetiopathogenic mechanisms by which these anomalies can develop.

2. a. Discuss the indications, precautions, and contraindications for use of each class of antibiotics available for use in veterinary ophthalmology.

b. Outline your rationale and likely choice when selecting an appropriate antibiotic(s) and delivery route for the following conditions when bacterial infection is suspected:

- Ulcerative keratitis.

- Eyelid pyogranuloma.

- Endophthalmitis.

3. a. Outline the anatomy and pathways of aqueous drainage in the cat, highlighting any differences between aqueous drainage in the cat and the dog.

b. Outline the known or proposed aetiopathogenic mechanisms for forms of glaucoma recorded in the cat. For each mechanism briefly comment on your choice of therapy and justify your choice.

4. a. Describe the ocular clinical and histological manifestations of feline systemic hypertension.

b. Describe the pathophysiological mechanisms leading to these changes.

5. a. Describe the neuroanatomical pathways controlling eye position, eye movements and the blink reflex in the dog.

b. Outline the clinical observations and tests available for identifying and localizing abnormalities in these pathways.

END OF PAPER

FELLOWSHIP EXAMINATION

JUNE/JULY 2004

VETERINARY OPHTHALMOLOGY

PAPER 2

CLINICAL PRACTICE & APPLICATIONS

Perusal time: 20 minutes

Time allowed: THREE (3) Hours after perusal

Section A: Short Answer Questions

Allow One (1) Hour (value of Section A is one third of Paper 2)

Answer All Twenty (20) Questions

All questions within this section are of equal value

Subsections of questions within this section are of equal value

Section B: Essay Questions

Allow Two (2) Hours (value of Section B is two thirds of Paper 2)

Answer Only Four (4) Of the Five Questions

All questions within this section are of equal value

Subsections of questions within this section are of equal value

PAPER 2, SECTION A – SHORT ANSWER QUESTIONS

Answer all 20 questions

1. List four (4) possible aetiologies for blepharitis in dogs.

2. What is the primary cause of keratoconjunctivitis in:

a. Sheep ?

b. Goats ?

3. With respect to infectious keratoconjunctivitis in cattle:

a. What is the effectiveness of an autogenous Moraxella bovis bacterin (manufactured by using M.bovis recovered from the herd), administered to calves by either subcutaneous injection or subconjunctival injection ?

b. Is there any significant gender based difference in susceptibility to infection and if so what is it ?

4. List four (4) complications that can develop following parotid duct transposition surgery.

5. Define and give an example of the following:

a. Allogenic corneal graft.

b. Xenogenic corneal graft.

6. In ophthalmic refractive surgery

a. For what does the abbreviation PRK stand ?

b. For what does the abbreviation LASIK stand ?

7. List four (4) clinical features typical of uveitis associated with iris cyst formation in Golden Retrievers.

Continued over/Section A/Paper 2/Ophthalmology 2004

Continued/Section A/Paper 2/Ophthalmology 2004

8. With respect to canine uveodermatological (Vogt-Koyanagi-Harada-like) syndrome:

a. List the most commonly affected dog breeds.

b. List the characteristic dermatological signs.

c. List the characteristic histological findings from skin biopsy specimens.

d. What additional signs (if any) are seen with Vogt-Koyanagi-Harada syndrome in humans ?

9. With respect to Bartonella spp and feline ocular infections:

a. What ocular diseases have been associated with high titres for this organism ?

b. What treatments are effective at eradicating Bartonella infection ?

10. List four (4) common histopathological findings in canine eyes that have been enucleated after unsuccessful cataract surgery.

11. With respect to non-steroidal anti-inflammatory drugs (NSAIDs) and the cyclooxygenase (COX) pathway of inflammation:

a. Define the difference between COX-1 and COX-2 isoenzymes.

b. Give two (2) examples of COX-2 selective NSAIDs.

12. List four (4) different organ diseases that can be seen with taurine deficiency in cats.

13. With respect to a recent study of blood pressure measured with a non-invasive oscillometric technique in healthy cats and hypertensive cats:

a. Hypertensive retinopathy was associated with systolic blood pressures greater than (choose from: 148, 158, 168, 178) mm Hg.

b. There was an increased risk for hypertensive retinopathy in cats greater than (choose from: 6, 10, 12, 14) years old.

c. The risk of chronic renal failure (choose from: ‘increases’, ‘decreases’, ‘does not change’) as systolic blood pressure increases.

d. Blood pressure measurements (choose from: ‘increase’, ‘decrease’, ‘do not change’) with age in healthy cats.

14. List four (4) non-ocular organ diseases that may be associated (cause or effect) with systemic hypertension in cats.

Continued over/Section A/Paper 2/Ophthalmology 2004

Continued/Section A/Paper 2/Ophthalmology 2004

15. List four (4) possible causes for swelling ventromedial to the canine eye.

16. Head-shaking or tossing behaviour in horses is a not uncommon reason for referral to veterinary ophthalmologists for rule out of ocular lesions initiating the behaviour. With respect to photic head-shaking in horses:

a. What is the effect of diminishing the amount of light striking the eyes ?

b. What is the suggested causative mechanism ?

c. What medical agent can be used in its treatment ?

d. What surgical procedure can be used in its treatment ?

17. With respect to exopthalmos in cattle:

a. Briefly describe how systemic corticosteroid treatment in Holstein cattle can cause exophthalmos.

b. State two (2) other causes of exophthalmos commonly recorded in cattle.

18. With respect to systemic enrofloxacin therapy in cats:

a. What clinical ocular side effects have been reported from overdosed cats ?

b. What histological ocular changes have been reported from overdosed cats ?

c. What is the current recommended dose rate in cats which should not be exceeded to avoid ocular side effects ?

d. How does the recommended dose rate in cats compare to the recommended dose rate in dogs ?

19. With respect to accidental closantel overdose in sheep and goats, name the two (2) lesions that contribute to blindness.

20. Avian influenza (‘bird flu’) has recently ravaged the poultry industries of South-East Asia:

a. What are the ocular signs ?

b. What avian species apart from chickens, turkeys and ducks are affected ?

c. The avian influenza virus is a member of what family of viruses ?

d. Can avian influenza directly affect humans ?

END OF SECTION

PAPER 2, SECTION B – ESSAY QUESTIONS

Answer four (4) from five questions

1. You are presented with a ‘typical’ case of bilateral lower lid entropion in a 12 month old Rottweiler. Indicating your preferred choices, review the surgical options for correcting this problem (including typical eyelid incision/excision dimensions with each technique in such a case) and comment on suture materials and aftercare.

2. a. Describe the variety of clinical manifestations of the various ocular condition(s) in the dog which include the terms ‘episcleritis’, ‘episclerokeratitis’ or ‘scleritis’ in their name.

b. For each clinical entity review the:

i. histological characteristics

ii. treatment options available.

3. Discuss the management options for equine recurrent uveitis (ERU) with reference to potential aetiopathogenic mechanisms.

4. a. Outline the DNA tests currently available for detecting inherited canine retinal diseases, including their limitations.

b. Describe how the practical use of these tests can be used to assist the diagnosis and management of canine inherited retinal diseases.

5. With respect to retrobulbar neoplasia in the dog and cat:

a. Describe the clinical presentations.

b. Outline and justify your diagnostic approach to this problem.

c. List the most common types of tumour with their relative frequency and prognosis.

END OF PAPER

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