Retina: Hollenhorst plaque: 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.

Try it

Ophthalmology · Retina: Hollenhorst plaque

Sample item

A 66-year-old smoker has had a brief episode of curtain-like vision loss in one eye. Fundus shows a bright, refractile yellow plaque at a retinal arteriolar bifurcation. Which source should be investigated?

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

The answer and the reasoning

D. Ipsilateral carotid artery atheroma

Hollenhorst plaques are cholesterol emboli, most often from an ipsilateral carotid atheromatous plaque, and signal stroke risk. Carotid Doppler imaging is the next step. Cardiac sources usually give fibrin-platelet or calcific emboli instead.

Option by option

  • A. Retinal vasculitis

    Vasculitis gives sheathing and ischaemia, not refractile plaques.

  • B. Optic nerve glioma

    Optic nerve glioma is a childhood tumour and does not embolise.

  • C. Left atrial myxoma

    Atrial myxoma may embolise but gives tumour or fibrin emboli, not refractile cholesterol plaques.

  • D. Ipsilateral carotid artery atheroma (correct)

    Correct. Cholesterol emboli point to carotid atheroma and need duplex scanning.

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 D, Ipsilateral carotid artery atheroma. Hollenhorst plaques are cholesterol emboli, most often from an ipsilateral carotid atheromatous plaque, and signal stroke risk.

Why is "Retinal vasculitis" not the answer?

Vasculitis gives sheathing and ischaemia, not refractile plaques.

Why is "Optic nerve glioma" not the answer?

Optic nerve glioma is a childhood tumour and does not embolise.

Why is "Left atrial myxoma" not the answer?

Atrial myxoma may embolise but gives tumour or fibrin emboli, not refractile cholesterol plaques.

What concept does this question test?

It tests Retina: Hollenhorst plaque in Ophthalmology. Carotid Doppler imaging is the next step. Cardiac sources usually give fibrin-platelet or calcific emboli instead.

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: Hollenhorst plaque?

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.