Controlled DM II with visual difficulties - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 03-12-2011
Seetal's Avatar
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 919
Threads: 134
Thanked 1,301 Times in 364 Posts
Reputation: 1324
Send a message via MSN to Seetal
Question Controlled DM II with visual difficulties

A 56-year-old woman with a well controlled diabetes mellitus type 2 complains of decreased vision. She reports decreased ability to visually differentiate between objects with both her eyes. This is worse at night and she describes “rings around lights” at night. She does not experience pain and there is no diplopia (‘double vision”).
Which one of the following is the most likely diagnosis?
A. Cataracts
B. Closed-angle glaucoma
C. Temporal arteritis
D. Diabetic retinopathy
E. Macular degeneration
Reply With Quote Quick reply to this message
The above post was thanked by:
step1an (10-02-2011)



  #2  
Old 03-12-2011
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 70
Threads: 0
Thanked 6 Times in 6 Posts
Reputation: 16
Default

the absence of pain, halos at night, her age...............i'll go with cataract
Reply With Quote Quick reply to this message
  #3  
Old 03-12-2011
USMLE Forums Veteran
 
Steps History: 1 + CS
Posts: 209
Threads: 34
Thanked 92 Times in 30 Posts
Reputation: 122
Default

painless. decreased night visiom halos ---- cataracts
Reply With Quote Quick reply to this message
  #4  
Old 03-12-2011
1TA2B's Avatar
USMLE Forums Guru
 
Steps History: CK Only
Posts: 475
Threads: 39
Thanked 351 Times in 169 Posts
Reputation: 374
Default

Rainbow rings around lights is typical presentation of angle-closure glaucoma! Lack of pain doesn't suggest the diagnosis though.

Still I would go with B.
__________________
Skill+Hardwork+Preparation=Success
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
  #5  
Old 03-12-2011
mle guy's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS+3
Posts: 264
Threads: 16
Thanked 349 Times in 165 Posts
Reputation: 359
Default

I'l go with A. Cataract
Both cataracts and diabetic retinopathy are commonly seen in diabetics.
Reply With Quote Quick reply to this message
The above post was thanked by:
benzo (06-03-2011)
  #6  
Old 03-13-2011
1TA2B's Avatar
USMLE Forums Guru
 
Steps History: CK Only
Posts: 475
Threads: 39
Thanked 351 Times in 169 Posts
Reputation: 374
Default

WOW-a few go for cataract!

What's the right answer Seetal? Thanks
__________________
Skill+Hardwork+Preparation=Success
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
  #7  
Old 03-13-2011
USMLE Forums Scout
 
Steps History: Not yet
Posts: 19
Threads: 4
Thanked 12 Times in 7 Posts
Default

cataract
Reply With Quote Quick reply to this message
  #8  
Old 03-13-2011
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 244
Threads: 16
Thanked 198 Times in 86 Posts
Reputation: 208
Default

I will say glaucoma - cataracts due to variation in glucose levels can be expected but the stem says tht she is a "well controlled" case. and its a little premature for cataracts - senile ones.

I am not sure, but rings around lights at night seem to point towards glaucoma - lack of pain is again a contradicting point...
Reply With Quote Quick reply to this message
  #9  
Old 03-16-2011
1TA2B's Avatar
USMLE Forums Guru
 
Steps History: CK Only
Posts: 475
Threads: 39
Thanked 351 Times in 169 Posts
Reputation: 374
Default

Could it be non-acute angle closure glaucoma because pain is lacking?
__________________
Skill+Hardwork+Preparation=Success
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
  #10  
Old 03-20-2011
Seetal's Avatar
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 919
Threads: 134
Thanked 1,301 Times in 364 Posts
Reputation: 1324
Send a message via MSN to Seetal
Default

glaukoma seems a closer answer. because it is well controlled DM. sorry guys i dont have the answer.
Reply With Quote Quick reply to this message
  #11  
Old 10-01-2011
USMLE Forums Newbie
 
Steps History: Step 1 Only
Posts: 2
Threads: 0
Thanked 0 Times in 0 Posts
Reputation: 10
Default cataract

cataract is correct answer
Reply With Quote Quick reply to this message
  #12  
Old 10-01-2011
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 515
Threads: 88
Thanked 505 Times in 231 Posts
Reputation: 515
Default

I go for Cataracts
Reply With Quote Quick reply to this message
  #13  
Old 10-02-2011
Aussie Guy's Avatar
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 40
Threads: 2
Thanked 20 Times in 15 Posts
Reputation: 30
Smile

Halos are seen in corneal edema only eg in glaucoma.
only 10% of closed angle glaucoma present with acute crisis which require surgery.in clinical practice it may present as painless also.
__________________
Life is living on the edge...so watch out your every step
Reply With Quote Quick reply to this message
  #14  
Old 10-02-2011
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 515
Threads: 88
Thanked 505 Times in 231 Posts
Reputation: 515
Default

The answer of this Q (in most of the answers between cataracts & glaucoma.
The absence of pain, halos at night, age, decreased night vision & DM (the fact that DM is well controlled doesn’t mean no complications) point to cataracts.
Rings around lights at night points towards glaucoma. It is true Visual halos in glaucoma (seen halos around objects or lights)
Other important symptoms of closed angle glaucoma are not present :
Severe eye pain
Severe headache
Tender eyeball
Hard eyeball
Red eye
Swollen eye
Nausea

Remember:
Causes of Visual halos:
  • Short-sighted
  • Diabetes
  • Diabetic lens osmosis
  • Glaucoma
  • Cataract
For that I go with Cataracts.
Reply With Quote Quick reply to this message
The above post was thanked by:
busterbee (10-02-2011), drssbaz (05-12-2012), dryogi (10-02-2011), iron (10-03-2011), mle guy (10-02-2011), Salvia (10-04-2011), step1an (10-06-2011)
  #15  
Old 10-06-2011
Seetal's Avatar
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 919
Threads: 134
Thanked 1,301 Times in 364 Posts
Reputation: 1324
Send a message via MSN to Seetal
Default cataract

wow this is what a few more months of reading does to u. i looked at the question n tried a second guess n now i believe it is cataract. i still dun have the answer, but im pretty sure its cataract now from seeing a ring around light especially.
Reply With Quote Quick reply to this message



  #16  
Old 10-08-2011
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 34
Threads: 3
Thanked 34 Times in 13 Posts
Reputation: 44
Default


Cataract

particularly in high-risk groups such as diabetics, it may be advisable to seek medical opinion if a "halo" is observed around street lights at night, especially if this phenomenon appears to be confined to one eye only.
Reply With Quote Quick reply to this message



Reply

Tags
Endocrinology-, Internal-Medicine-, Ophthalmology-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Visual reflexes concept lemontea88 USMLE Step 1 Forum 5 12-06-2012 02:35 PM
Anatomy and Physiology Made Incredibly Visual! FreakingOut USMLE Step 1 Forum 2 07-24-2010 03:25 PM
UWORLD does not prepare you for audio-visual clips sharvaree19 USMLE Step 1 Forum 10 10-10-2009 10:21 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)