Retina: arteriovenous crossing changes: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Retina: arteriovenous crossing changes

Sample item

A 55-year-old man with long-standing hypertension has retinal veins that appear to taper and be compressed where a thickened arteriole crosses them. What is this sign called?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Arteriovenous nipping (Gunn sign)

In chronic hypertension the arteriolar walls thicken and share an adventitial sheath with the vein at crossings, so the vein looks narrowed on either side of the crossing. This is arteriovenous nipping, also called Gunn sign. It indicates long-standing hypertensive arteriolosclerosis rather than acute change.

Option by option

  • A. Arteriovenous nipping (Gunn sign) (correct)

    Correct. Venous tapering at arteriolar crossings is arteriovenous nipping.

  • B. Salus sign of venous dilatation

    Salus sign refers to deflection of the vein at the crossing, a different change from tapering.

  • C. Elschnig spot

    Elschnig spots are choroidal infarcts seen in acute severe hypertension.

  • D. Roth spot

    A Roth spot is a haemorrhage with a pale centre seen in endocarditis and anaemia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is A, Arteriovenous nipping (Gunn sign). In chronic hypertension the arteriolar walls thicken and share an adventitial sheath with the vein at crossings, so the vein looks narrowed on either side of the crossing.

Why is "Salus sign of venous dilatation" not the answer?

Salus sign refers to deflection of the vein at the crossing, a different change from tapering.

Why is "Elschnig spot" not the answer?

Elschnig spots are choroidal infarcts seen in acute severe hypertension.

Why is "Roth spot" not the answer?

A Roth spot is a haemorrhage with a pale centre seen in endocarditis and anaemia.

What concept does this question test?

It tests Retina: arteriovenous crossing changes in Ophthalmology. This is arteriovenous nipping, also called Gunn sign. It indicates long-standing hypertensive arteriolosclerosis rather than acute change.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Retina: arteriovenous crossing changes?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.