Retina: early worsening with glycaemic control: 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: early worsening with glycaemic control

Sample item

A diabetic with HbA1c of 12.5 percent starts intensive insulin. Three months later he has more cotton wool spots and haemorrhages. What is this?

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

The answer and the reasoning

B. Transient early worsening after rapid glycaemic improvement

A rapid fall in blood glucose can temporarily worsen retinopathy, and baseline retinal examination before intensification is advised. Long-term control still lowers risk. The other causes lack an exposure in the history.

Option by option

  • A. Steroid retinopathy

    No steroid exposure is described to cause such changes.

  • B. Transient early worsening after rapid glycaemic improvement (correct)

    Correct. Rapid glycaemic improvement can worsen retinopathy transiently.

  • C. Hypertensive retinopathy

    Hypertensive retinopathy needs high blood pressure, which is not described.

  • D. Radiation retinopathy

    Radiation retinopathy needs prior irradiation, which is absent.

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 B, Transient early worsening after rapid glycaemic improvement. A rapid fall in blood glucose can temporarily worsen retinopathy, and baseline retinal examination before intensification is advised.

Why is "Steroid retinopathy" not the answer?

No steroid exposure is described to cause such changes.

Why is "Hypertensive retinopathy" not the answer?

Hypertensive retinopathy needs high blood pressure, which is not described.

Why is "Radiation retinopathy" not the answer?

Radiation retinopathy needs prior irradiation, which is absent.

What concept does this question test?

It tests Retina: early worsening with glycaemic control in Ophthalmology. Long-term control still lowers risk. The other causes lack an exposure in the history.

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: early worsening with glycaemic control?

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.