Retinopathy: The Daily PANCE Blueprint

Home Retinopathy: The Daily PANCE Blueprint

Retinopathy: The Daily PANCE Blueprint

A 74-year-old female with a history of uncontrolled hypertension, hyperlipidemia, and CAD (s/p PCI) presents to the ER complaining of a throbbing, severe headache x 2 hours. She endorses nausea, emesis, and blurry vision as well. On fundoscopic exam, you notice marked swelling of the optic disk. Which of the following is the most likely diagnosis?

A. Hypertensive emergency
B. Subacute lacunar infarct
C. Basilar migraine
D. Cerebral venous sinus thrombosis
E. Subdural hematoma

Answer and topic summary

The answer is A. Hypertensive emergency

Hypertensive retinopathy is defined by changes to retinal vessels due to high blood pressure. On fundoscopic exam, you may appreciate cotton wool spots, flame-shaped hemorrhages, hard exudates, AV nicking, and marked swelling of the optic disk. Patients may have symptoms in severe cases, such as blurred vision and headaches. There are different grades of retinopathy, with papilledema being part of grade IV.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Disorders of the Eye (PEARLS) ⇒ Retinal disorders (PEARLS) => Retinopathy

Also covered as part of the Family Medicine EOR topic list

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