Theme: Autoimmune disorders

Options:
A. Psoriatic arthritis
B. Reiter syndrome
C. Rheumatoid arthritis
D. Steven-Johnson syndrome
E. Cicatricial pemphegoid
F. Polyarteritis nodusa
G. Systemic Lupus erythematosus
H. Ankylosing spondylitis
I. Systemic sclerosis
J. Tuberous sclerosis
K. Ulcerative colitis
L. Chron’s disease


Lead in statement: The following patients all presented with red-eyes. Please choose the most appropriate systemic diagnosis from the list above.

Stems:

1. A 55-year-old man with known spine problems presents with red-eyes. He was recently discharged from hospital after successful treatment of pulmonary infection. Blood tests showed raised ESR and positive HLA-B27. There was no history of previous eye problems.

2. A70-year-old woman presents to eye casualty with red-eyes. On examination she has multiple mouth ulcers which are healing without scarring. Slit-lamp examination reveals cicatrising conjunctivitis. She is HLA-B12 positive.

3. A 55-year-old man presents with a red eye. On questioning he gives a history of palpitation, joint pains and weight loss. Slit-lamp examination reveals a peripheral ulcerative keratitis. His blood pressure was 190/140 mm Hg. Blood tests reveal signs of renal impairment, additionally a test for hepatitis-B surface antigen was positive.

Theme: Retinal detachment

Options:
A. Macular detachment.
B. Gronblad-Stranberg syndrome
C. Exudative retinal detachment
D. Tractional retinal detachment
E. Sickle cell disease
F. Sarcoidosis
G. Uveal effusion syndrome
H. Vogt-Koyanagi-Harada syndrome
I. CMV infection
J. Rhegmatogenous retinal detachment
K. Old retinal detachment
L. Retinopathy of prematurity
M. Norrie syndrome
N. Stickler syndrome
O. Malignant hypertension



Lead in statement: The following patients all presented with retinal detachment. Please choose the most appropriate diagnosis from the list above.

Stems:

1. A 79-year-old woman with bilateral loss of vision. Fundus examination shows SRF under the maculae. FFA showed RPE rips. She gives a history of left mastectomy 4 years ago.

2. A 40-years-old man with bilateral loss of vision, headaches and nausea. He is pyrexial and complaining of tinnitus. There are +2 cells in AC bilaterally. CSF showed pleocytosis.

3. A 75-year-old man noticed loss of vision in his right-eye on coincidentally covering the other eye. He gives a history of being severely short-sighted before cataract surgeries. Fundus examination of the right-eye shows raised dome shaped macula with a central hole.