USMLE Forum Archives - USMLE Step 3 - Optha- Sudden vision loss in elder
Optha- Sudden vision loss in elder
harry206 - 05-15-09 08:15
An 83-year-old Caucasian man comes to the emergency department because of a sudden onset, transient visual loss in his right eye. He is currently symptom-free, and denies any other new symptoms. His other medical problems include hypertension and peripheral vascular disease. His medications include aspirin, hydrochlorothiazide, and enalapril. His temperature is 36.7 C (98 F), blood pressure is 160/90 mmHg, pulse is 80/min., and respirations are 12/min. Which of the following signs is most likely to be found during the physical examination?
harry206 - 05-15-09 08:15
An 83-year-old Caucasian man comes to the emergency department because of a sudden onset, transient visual loss in his right eye. He is currently symptom-free, and denies any other new symptoms. His other medical problems include hypertension and peripheral vascular disease. His medications include aspirin, hydrochlorothiazide, and enalapril. His temperature is 36.7 C (98 F), blood pressure is 160/90 mmHg, pulse is 80/min., and respirations are 12/min. Which of the following signs is most likely to be found during the physical examination?
The correct answer and explanation will be available after you answer.
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#1
Re: Optha- Sudden vision loss in elder meduploader - 05-15-09 10:05 My answer is: e.
Amaurosis fugax
is caused by retinal emboli from ipsilateral carotid artery. The visual loss is usually monocular
and is transient. They typically describe this as ‘like a curtain falling down’. Ophthalmoscopy
reveals zones of whitened, edematous retina following the distribution of retinal arterioles.
This is usually seen in patients with atherosclerosis, cardiovascular disease, or hypertension.
Rarely cholesterol emboli or plaques can be visualized.
Treating atherosclerosis is important to reduce the risk of stroke. Noninvasive
evaluation of the carotids is useful in providing information regarding
the degree of stenosis.
#18
Re: Optha- Sudden vision loss in elder conym5 - 12-25-09 10:20 My answer is: e.
looks like stroke or transient ischemic attack ..blurry vision presented,but no more symptoms so may be transient ischemic attack..Carotid bruit ll be still present but not papilledema or hemorrage or exudates
#20
Re: Optha- Sudden vision loss in elder shekib - 12-26-09 09:45 My answer is: e.
its most likeky to be TIA that is why litsen with statcope the carotid burit
#22
Re: Optha- Sudden vision loss in elder conym5 - 04-11-10 08:53 Physical examination will often reveal a carotid bruit. Carotid Doppler evaluation is necessary to evaluate the extent of the disease and to assess the need for a carotid endarterectomy.
#28
Re: Optha- Sudden vision loss in elder babbu5508 - 09-30-10 12:55 My answer is: e.
the patient had amourosis fugax a transient loss of vision unilaterally commonly due to embolus from carotid artery....
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