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+--- Thread: nb2-blurred vision - hal (/showthread.php?tid=80636)
nb2-blurred vision - hal - ArchivalUser - 03-25-2006
A previously healthy 57-year-old woman comes to the physician because of three episodes of blurred vision in the right eye over the past 3 weeks; each episode lasts approximately 5 minutes. Retinal examination shows a small refractile body at the bifurcation of a retinal artery. The remainder of the examination shows no abnormalities. Which of the following is the most appropriate next step in diagnosis?
A) Cerebral angiography
B) Echocardiography
C) Electroencephalography
D) Duplex scan of the carotid arteries
E) MRI of the brain
0 - ArchivalUser - 03-25-2006
i think its d.
0 - ArchivalUser - 03-25-2006
I also think D.
0 - ArchivalUser - 03-25-2006
Can we reach up to Retinal artery by Carotid duplex.I donot know.If I am wrong pl excuse me.Could the ans be A
0 - ArchivalUser - 03-25-2006
D to find the source of the emboli
0 - ArchivalUser - 03-26-2006
i think this is a anurism at the biforcation of the retinal artery (refractile)so the best choise is A.....
0 - ArchivalUser - 03-26-2006
I agree it is D.
0 - ArchivalUser - 03-26-2006
WE NEED D 1ST THEN FOR PREOP OR FOR MORE IX WILL NEED A
BUE NOW D
0 - ArchivalUser - 03-26-2006
this lady has hollehorst plaque which was detahed from carotid artery and is in the eye now caused transient blindness and was pushed forward and vision problem was temporarily solved. since carotid is throwing those plaqes it will need duplex usg first to find out the percentage of occulusion / upto 70% oculusion will be benifiitted by endarterectomy
had not she has that opthalmologic finding it could have been optic neuritis of multiple sclerosis and i wd have gone for MRI
ECG AND ECHO ARE HELPFUL BUT LATER
cerebral angiography in suspected aneurysm and avm
0 - ArchivalUser - 03-26-2006
D-
next step in DIAGNOSIS- do a carotid U/S ( There is no direct treatment of the visible emboli. In fact, because blood often can flow through an apparently complete blockage, direct removal is not necessary)
but however next step in "Mangement" would be to r/o possible CVA/ MI (most common COD) later which a a major complication by doing angio and echo, since all these pts have underlying systemic dz.
but thats my thinking