Orbit: carotid cavernous fistula: 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 · Orbit: carotid cavernous fistula

Sample item

After head trauma a patient develops pulsatile proptosis, a bruit, chemosis and dilated corkscrew episcleral vessels. What is the diagnosis?

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

The answer and the reasoning

B. Carotid-cavernous sinus fistula

A direct high flow fistula between the internal carotid artery and cavernous sinus transmits arterial pressure to orbital veins. It causes pulsating exophthalmos with a bruit, and endovascular closure is the treatment.

Option by option

  • A. Cavernous sinus thrombosis

    Thrombosis gives infection signs without a bruit.

  • B. Carotid-cavernous sinus fistula (correct)

    Correct. Pulsation with a bruit is typical.

  • C. Orbital cellulitis

    Cellulitis has fever and inflammation.

  • D. Thyroid eye disease

    Thyroid disease has lid retraction without a bruit.

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.

More Ophthalmology questions

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is B, Carotid-cavernous sinus fistula. A direct high flow fistula between the internal carotid artery and cavernous sinus transmits arterial pressure to orbital veins.

Why is "Cavernous sinus thrombosis" not the answer?

Thrombosis gives infection signs without a bruit.

Why is "Orbital cellulitis" not the answer?

Cellulitis has fever and inflammation.

Why is "Thyroid eye disease" not the answer?

Thyroid disease has lid retraction without a bruit.

What concept does this question test?

It tests Orbit: carotid cavernous fistula in Ophthalmology. It causes pulsating exophthalmos with a bruit, and endovascular closure is the treatment.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Orbit: carotid cavernous fistula?

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.