Question

guy is a 65 y/o male who comes to the clinic with the following chief complaint: \i have been feeling feverish, have chills, and am tired all the time. my heart also makes a funny sound. in the physical exam the np auscultates a heart murmur, and notices that he patient has subungual hemorrhages, petechiae on the palate, violet colored nodes on the fingers and feet, and nontender red nodes on the palms and soles of his feet. in a patient with guys diagnosis, on funduscopic exam one might see: a. cotton wool spots b. silver wire vessels c. retinal hemorrhages d. a & b only

Explanation:

The patient's symptoms such as fever, chills, fatigue, heart murmur, subungual hemorrhages, petechiae, and specific skin - colored nodes are highly suggestive of infective endocarditis. In infective endocarditis, funduscopic exam may reveal retinal hemorrhages. Cotton - wool spots are more associated with conditions like hypertension or diabetes, and silver - wire vessels are seen in hypertensive retinopathy.

Answer:

C. Retinal hemorrhages