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Ophthalmology · Retina: Roth spots
Sample itemA patient with fever and a new cardiac murmur has retinal haemorrhages with white centres. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Infective endocarditis
Roth spots are retinal haemorrhages with pale centres seen in bacterial endocarditis, but they also occur in anaemia and leukaemia. The white centre is thought to be fibrin or inflammatory cells.
Option by option
A. Infective endocarditis (correct)
Correct. Roth spots are a recognised sign of endocarditis.
B. Hypertensive crisis only
Hypertensive retinopathy gives flame haemorrhages and exudates.
C. Toxoplasmosis
Toxoplasmosis gives a focal necrotising lesion.
D. Central retinal artery occlusion
CRAO has a pale retina.
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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