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* nbme 5
 #139099  
  angioplasty - 11/16/06 16:54
 
  5. A 55-year-old Hispanic welder comes to the office for an initial visit because of a lesion in his right eye that has been present for several months. During this time his right and left eyes have been increasingly sensitive to wind. He has not had double vision and has not seen "spots" in his field of vision. He says that he has been generally healthy and has not seen a physician during the past 30 years. He takes no medications. He does not wear corrective lenses. Family history is significant for blindness in his mother at age 77 years. The patient has smoked a half pack of cigarettes daily for the past 40 years, and he drinks an occasional six-pack of beer on weekends. Vital signs today are temperature 37.2°C (99.0°F), pulse 110/min, respirations 20/min, and blood pressure 140/85 mm Hg. Examination of the right eye discloses the finding shown in the photograph. Visual acuity is 20/40 in both eyes. Musculoskeletal examination discloses symmetric enlargement of the proximal and distal interphalangeal joints of both hands. The joints are firm to palpation and cool to the touch. The remainder of the physical examination is noncontributory. Which of the following is the most likely diagnosis?

A

) Corneal abrasion

B

) Glaucoma

C

) Keratitis

D

) Pterygium

E

) Stye
 
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* Re:nbme 5
#561247
  dr_nuri - 11/16/06 16:58
 
  d..  
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* Re:nbme 5
#561260
  angioplasty - 11/16/06 17:08
 
  hmmm no photo
looks like that u r correct nuri
 
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* Re:nbme 5
#561351
  anand11anupa - 11/16/06 18:10
 
  no photoggraphs so cant tell exactly but stye is an acute inflammatory condition and cant persist for months.
exposure to enviornment predisposes for pterygium.
 
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* Re:nbme 5
#561363
  joscohmd - 11/16/06 18:19
 
  d...  
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* Re:nbme 5
#561407
  livelife - 11/16/06 18:53
 
  a or c  
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* Re:nbme 5
#561600
  pedres - 11/16/06 21:37
 
  D phalanges have spina ventosa  
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* Re:nbme 5
#562927
  tea - 11/17/06 17:25
 
  d
 
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