General medicine questions for ophthalmology residents
General medicine for ophthalmologists covers the systemic diseases, medications and emergencies that shape eye care. It maps to BCSC Section 1, Update on General Medicine, and spans diabetes, hypertension, cardiovascular and cerebrovascular disease, endocrine and rheumatologic disorders, infectious diseases such as HIV, syphilis and tuberculosis, hematologic conditions, cancer, and the ocular adverse effects of systemic drugs, together with the epidemiology and biostatistics used to appraise clinical studies.
Board questions in this area rarely test internal medicine for its own sake. They ask what a systemic finding means for the eye, or what an eye finding means for the patient: the retinal artery occlusion that demands an urgent stroke work-up, the acute anterior uveitis that points to HLA-B27 disease, the visual field constriction that follows vigabatrin, the floppy iris predicted by tamsulosin. Drug toxicity, serologic testing and screening decisions recur because they combine ophthalmic and systemic reasoning.
Use practice questions to build fast recognition of drug–eye associations and systemic work-ups, then study the explanation and decision flowchart for every miss. Biostatistics rewards repetition: calculate sensitivity, specificity and predictive values from a two-by-two table until the method is automatic, and let spaced repetition resurface the drug toxicities you keep forgetting.
Free general medicine practice questions
General medicine questions are in the OphthoMentor app: create a free account to practise them with explanations, flowcharts and spaced-repetition review.
High-yield general medicine topics for boards
- Diabetes trials: DCCT and UKPDS, intensive control reduces microvascular complications
- Hypertensive retinopathy and choroidopathy: Elschnig spots, Siegrist streaks, disc edema
- Carotid disease: amaurosis fugax, Hollenhorst plaques, ocular ischemic syndrome
- Retinal artery occlusion as a stroke equivalent requiring urgent vascular work-up
- Giant cell arteritis: jaw claudication, ESR and CRP, temporal artery biopsy
- Thyroid eye disease: Graves disease, smoking, radioactive iodine exacerbation
- HLA-B27 spondyloarthropathies and recurrent acute anterior uveitis
- Rheumatoid arthritis: keratoconjunctivitis sicca, necrotizing scleritis, peripheral ulcerative keratitis
- Granulomatosis with polyangiitis: PR3-ANCA, scleritis, orbital inflammation
- Sarcoidosis: granulomatous uveitis, serum ACE and lysozyme, chest imaging
- Syphilis: treponemal and nontreponemal serology; ocular syphilis managed as neurosyphilis
- HIV: CMV retinitis at low CD4 counts, immune recovery uveitis
- Latent tuberculosis screening (IGRA or tuberculin skin test) before immunosuppression
- Sickle cell disease: proliferative retinopathy most common in HbSC
- Hydroxychloroquine retinopathy: bull's-eye maculopathy, SD-OCT and automated field screening
- Ethambutol optic neuropathy: dyschromatopsia, central or cecocentral scotoma
- Amiodarone: vortex keratopathy and optic neuropathy
- Tamsulosin floppy iris; topiramate ciliochoroidal effusion with angle closure
- Medical emergencies: anaphylaxis, vasovagal syncope, local anesthetic systemic toxicity
- Biostatistics: sensitivity, specificity, predictive values, prevalence, study design
How general medicine is examined
On the OKAP and the ABO written examination, the material covered in BCSC Section 1 is usually tested through clinical vignettes that link a systemic diagnosis to an ocular finding, a medication to its ocular toxicity, or a presentation to the correct systemic work-up. Biostatistics and study-design questions also appear, typically asking you to interpret a diagnostic test or a trial result.
The EBOD, FRCOphth and ICO examinations generally test this knowledge within clinical scenarios. Systemic disease is embedded in uveitis, neuro-ophthalmology, retina and perioperative questions, such as screening a patient on hydroxychloroquine, investigating suspected giant cell arteritis or preparing an anticoagulated patient for surgery.
In oral examinations, general medicine surfaces whenever a case requires systemic reasoning: recognizing that an eye finding signals a medical emergency, choosing the right investigations and knowing when to involve physicians. Candidates are expected to explain that reasoning, not just name the diagnosis.