NBE CME programme for DNB consultants - National Board Of ...

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NBE CME programme for DNB consultantsavoided due to the sequalate of a chronic draining fistula. Cervical lymphnode hyperplasia isubiquitous in human immunodeficiency virus (HIV) positive patient. Tender enlarging nodes shouldmake one suspicious of tuberculosis or nocardia species – infection, whereas non tender enlarginghead and neck nodes often indicates ‘Kaposi’s’ sarcoma or Burkitt’s lymphoma. Sequelae oftrauma occasionally present as a neck mass. In pediatric patients. Haematoma, due to forcepdelivery, can result a mass in anterior neck within the sternomasthoid muscle, which organizedlater on. Heat massage and observation are often associated with resolution. Continued growth orincreasing torticollis indicate surgical explorations. Pseudoaneurysm of major vessels areoccasionally associated with blunt trauma neck. Neuromas are small neck mass that found aftersurgery, especially radical neck dissection commonly in post triangle of neck. They occur fromsensory nerve ending commonly from great anvicular nerve (C2 – 3). Neuromas are tender,associated with sharp shooting pain on palpation, quite slow in growth and require excision.OPHTHALMOLOGYPtosisHistory - Taking-Mode and Age of Onset / Progression / Duration / Diurnal Variation; Diplopia;Decrease in Vision; Painful / Painless / Headache ; Trauma / Surgery; Difficulty in speaking andswallowingExamination- Visual acuity / Aided / Unaided / amblyopia; Head Posture and its significance; Facialfeatures Telecanthus, Epicanthus; Ptosis assessment( Mild / Moderate / Severe ); Measurementof Vertical fissure height in both eyes; Measurement of MRD1, MRD2, MRD3 wherever applicable;Measurement and Grading of Levator function; Ocular movements to R/O Cranial Nerve Palsy /Paresis; Bells phenomenon; Associated Squint; Pupillary Reactions; FundusInvestigations - Tensilon Test Indications, Technique, Precautions, Interpretation; EMG; CT / MRI/ MR Angio ( 3ed Nerve palsy); Tests for Myasthenia Gravis ; Any otherManagement / Discussion - Type of Ptosis; Myasthenia Gravis; III N palsy; BlephrophimosisSyndrome; Operative Procedure of choice; Farsenella Servat Surgery Indications surgical steps;Levator Resection Which procedure and how much resection Surgical Steps; Frontalis SlingIndications Technique Materials that can be used follow up; Management of Blehrophimosissyndrome; Management of amblyopia / Use of Crutch Glasses / Temporary management of Ptosis;Management of associated squintProptosisHistory-Taking- Onset / Progression / Constant / Intermittent ; Painful / painless / Laterality ; Diplopia/ Loss / dimness of vision; Trauma; Thyroid disease; Similar complaints in Past / Remission withsteroids / Treatment History; HeadacheExamination-Visual Acuity; Facial Features; Unilateral / Bilateral / Axial / Non axial Proptosis;Measurement of Proptosis; Signs of Inflammation; Pulsatile / Non Pulsatile / Reducible / NonReducible ; Signs of TRO Demonstration ; Ocular Movements / Squint evaluation / Other cranialnerves palsy ; Test Cranial Nerves ; cornea including corneal sensations Exposure Keratitis; IOP;Fundus evaluationInvestigations - Thyroid work up Normal Values; CT Scan; MRI Angio; Any OtherManagement - Causes of Proptosis; Management Plan; Management of TRO / IODD; Role ofsteroids / Immuno drugs; Role of Orbital Decompression; Squint surgery; Any OtherSquintHistory-Onset / Progression ; Intermittent / Constant / Association with fatigue / ; Headache /Vomiting / Giddiness; Trauma;Using Glasses / Occlusion therapy / Treatment History / Prismstherapy; Complaints about vision; Head Posture if told; Nystagmus; Diabetes / HypertensionExamination-Visual Acuity; Refraction / Cycloplegic Refraction acc to age ; Head posture / Nystagmus;Rule out Pseudosquint; Ocular Movements Ductions and Vergence; Pupillary Reactions; COVER100
NBE CME programme for DNB consultantsTESTS and its interpretations; Hirschberg test; ; Amount of Squint by PRISMS with / without glasses/ Distance / Near / Upgaze / Down Gaze / either Eye Fixing; Primary and Secondary Deviation; PRISMBAR COVER TESTS ; Synaptophore examination Status of Binocularity and the confirmation ofamount of squint and state of Retinal correspondence; Measurement of AC/A ratio ; Diplopia charting;Examination of other Cranial nerves; Order ENT Exam in 6 th Nerve Paralysis; Worth 4 D Test andother sensory tests; Look out for special squint syndromes like Duane’s / Brown; FundusExaminationManagement - Paralytic / Non Paralytic Squint; Role of Refractive error / Accommodation in Squint/Management of Accommodative / Non Accommodative Esotropia? Role of AC/A Ratio; SensoryAdaptations in squint; Management of paralytic Squint / Optical / surgical Management; Principlesof Squint surgery / Muscle weakening / strengthening procedures / role of releasable sutures;Surgical steps of resection and Recession surgeries; Management of NystagmusComplicated CataractHistory- Symptoms Duration; Redness of Eyes / Pain in eyes / ; Use of drugs; Any other systemicdisease / Diabetes / Myotonia ; High Myopia ; Intraocular surgery; Any OtherExamination- BCVA; Cornea Any Corneal Lesion ; Anterior Chamber depth and activity includingFlare and cells; Iris Iris atrophy patches, Tran illumination defects; Posterior Synechie; Pupillaryreaction; Ring / annular synechie/ Total Posterior synechie; Lens / polychromatic Lusture / snowflake cataract / Posterior sub capsular cataract; Vitreous; Detailed fundus Evaluation to look forlesions in retina and Choroid; IOP; USG; Examination of other eyeManagement- Causes; Problems during Surgery and how to handle them; Which IOL to implant;Post Operative complications / problems and how to handle themPterygiumHistory- Duration / symptoms / any previous pterygium surgery / occupation;Injury / RednessExamination - True Pterygium / Pseudo Pterygium; Progressive / Regressive; Any otherManagement - Pterygium excision techniques; Use of MMC / Autograft Advantages and Disadvantagesoperative stepsPost Penetrating KeratoplastyHistory - Dimness of Vision; INDICATION Injury / corneal Ulcer / Keratoconus; Post operative course;Treatment HistoryExamination - Visual Acuity / BCVA; Cornea Clarity; Graft Host Junction / Endothelial Status / EpithelialEdema; Anterior chamber Reaction; Lens Status / Pseudophakia / Aphakia / Triple Procedure; IOP;Fundus; Look in other eye the indication of P K / Keratoconus/ Corneal dystrophy; Whether cornealgraft is Successful / FailureDiscussion - P K / lamellar Graft Indications; Corneal Storage Medium / Eye banking / Donor TissueAssessment; Causes of corneal decompensation; Procedure of PK /LK; Complications;Management of Astigmatism following PK; any OtherPoly Ocular TraumaHistory- Nature of Injury Suffered; Occupation; Medico Legal AspectExamination- Assessment of Adnexeal Injuries Fracture Floor of the Orbit; Visual Acuity at presentationPR status; Corneal Tear / Scleral tear / Importance of dangerous zone / ; whether Retained IOFB ornot / Siderosis / Chalcosis; Lens status / Dislocation / Subluxation / Cataract Changes; Presence/ Absence of RAPD Importance; Vitreous disturbance; Retinal Tear / Detachment; Importance of IOPManagement and discussion- Investigations including Gonioscopy / USG / CT Scan / MRI Indications;Management of Adnexal Injuries / Lid Repair Principles / Cannicular Repair / ; Management ofCorneal Scleral tear / Importance of Suture Placement / Importance of prophylactic Cryo or Endolaser;Management of Infections; Traumatic Endophthalmitis; Role of IOFB removal at first / secondsurgery / VR SURGERY101
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