DSSSB 6 September 2024
Medical & Surgical Nursing
Easy
Corneal arcus is mainly due to the deposition of:
Appeared in: DSSSB 6 September 2024
Explanation
- Corneal arcus, also known as arcus senilis in older adults, is a visible greyish-white ring that forms at the edge of the cornea.
- This ring is caused by the extracellular deposition of lipids, primarily cholesterol and phospholipids, that have infiltrated from the limbal blood vessels into the corneal stroma.
- While it is a common and benign finding in the elderly, its presence in individuals younger than 40 (arcus juvenilis) is a significant indicator of hyperlipidemia and increased cardiovascular risk.
Why Other Options Were Wrong
- Option A: Copper deposition in the cornea does not cause corneal arcus. It results in a different clinical sign.
- Option B: Iron deposition in the cornea is associated with specific conditions but does not cause the generalized ring of corneal arcus.
- Option D: Lead does not deposit in the cornea to form a visible ring.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of corneal deposits as background academic context rather than a clinical decision trigger.
- A key nursing responsibility during a physical assessment is to observe and document any abnormalities. Identifying a corneal arcus is an important finding.
- The clinical significance of corneal arcus is highly dependent on the patient's age. In an older patient, it's often noted as 'arcus senilis' and is considered a benign, age-related change.
- In a younger patient (under 40-50 years), the finding is termed 'arcus juvenilis' and is a red flag for potential hypercholesterolemia. This requires notifying the provider and educating the patient about the need for a lipid panel and cardiovascular risk assessment.
How to Approach the Question
- First, identify the key term in the question stem: 'Corneal arcus'.
- This is a factual recall question that tests your knowledge of pathophysiology. Access your memory about what substance causes this specific clinical sign.
- Systematically evaluate each option. Recall or deduce what clinical sign is associated with the deposition of each substance (Copper, Iron, Lipids, Lead).
- Copper deposition is linked to Kayser-Fleischer rings (Wilson's disease).
- Iron deposition is linked to Fleischer rings (Keratoconus).
- Lead deposition is linked to a Burton line on the gums.
Concept Tested & Keywords
- Concept Tested: Pathophysiology of corneal deposits
- Stem keywords: Corneal arcus, deposition
- Lead-in keywords: mainly due to
Question ID
Qok12zeKeb8OAtr6ZIPBs_
Reference Book
E6 Medicine Harrison 22e Part 2 p. 1243-1245
E6 PATHOLOGY QUICK REVIEWBased on Harsh Mohan Textbook of PATHOLOGY p. 17-19
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 13484-13486
Practise the full DSSSB 6 September 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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