A 62-Year-Old Man with a History of Poor Medical Follow-Up

question 428

Multiple Choice

A 62-year-old man with a history of poor medical follow-up comes to the office due to difficulty seeing.  He has had blurry vision for the last 2 weeks.  A day ago, he noticed a shadow develop suddenly across the visual field of his right eye.  The patient has had no recent headaches, double vision, vertigo, light sensitivity, or nausea.  On examination, pupils are equal and reactive to light.  Visual field testing by confrontation reveals patchy loss of vision.  A flame-shaped retinal hemorrhage in the right eye is noted on funduscopic examination, as shown in the image below. Which of the following is the most likely cause of his visual disturbance?

• A)Central retinal artery occlusion
• B)Cigarette smoking
• C)Closed-angle glaucoma
• D)Giant cell arteritis
• E)Hyperlipidemia
• F)Hypertension
• G)Migraine
• H)Thyroid eye disease

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Definitions:

Physical Harm

Injury or damage to the body of a person caused by external force or violence.

Duress

A condition where a person performs an act as a result of violence, threat, or other pressure against the person.

Disparagement

A business tort that occurs when a statement is intentionally used to defame a business product or service.

Negligent Misrepresentation

A false statement made carelessly that leads another to act on it to their detriment.