10-23-2008, 08:08 AM
A 47-year-old woman comes to the office with newly diagnosed type 2 diabetes mellitus for a follow-up visit regarding laboratory studies that you had ordered. She has no complaints at this time. Her temperature 37 C (98.6 F), blood pressure is 122/80 mm Hg, pulse is 82/min, and weight is 116 kg (255 lb). Visual acuity is 20/20 in both eyes. Her hemoglobin A1C is 6.0% and her fasting blood glucose is 132 mg/dL. During your discussion with her, she relates that her father had diabetes and "went blind." She asks you if she should go to an ophthalmologist. The most appropriate response is:
A. "Good visual acuity is an accurate predictor of the absence of diabetic retinopathy."
B. "I will perform yearly funduscopic exams and will refer you for ophthalmology consultation at the first sign of diabetic retinopathy."
C. "Ophthalmology consultation is recommended 5 years after the diagnosis of diabetes and yearly thereafter."
D. "With well-controlled diabetes you will prevent diabetic visual complications making a visit to an ophthalmologist unnecessary at this point."
E. "Yearly ophthalmology appointments should begin now."
A. "Good visual acuity is an accurate predictor of the absence of diabetic retinopathy."
B. "I will perform yearly funduscopic exams and will refer you for ophthalmology consultation at the first sign of diabetic retinopathy."
C. "Ophthalmology consultation is recommended 5 years after the diagnosis of diabetes and yearly thereafter."
D. "With well-controlled diabetes you will prevent diabetic visual complications making a visit to an ophthalmologist unnecessary at this point."
E. "Yearly ophthalmology appointments should begin now."