Which of the following is a classic presenting symptom of retinoblastoma?

Appeared in: DSSSB -28 August 2019 (Shift-2)

Explanation

The correct option is 'Cat's eye reflex,' which is the common term for leukocoria.
Leukocoria is the most frequent initial sign of retinoblastoma, a malignant tumor of the retina.
It appears as a white or yellowish pupillary reflex, caused by light reflecting off the surface of the intraocular tumor.
This sign is often first noticed by parents in flash photographs, where one pupil appears red (normal red reflex) and the affected pupil appears white.

Option A: Brushfield's spots are tiny white or greyish spots on the iris.
Option B: Brudzinski's sign is a physical examination finding related to the central nervous system.
Option D: Reed-Sternberg cells are a specific type of cell identified through histology.

Clinical Relevance

Nursing practice connection: Knowing Recognizing the classic presenting symptom of retinoblastoma helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must perform a red reflex examination at birth and at every subsequent well-child visit. An absent, white, or asymmetrical reflex is an urgent red flag.
Patient education is crucial. Nurses should advise parents to seek immediate ophthalmologic consultation if they notice a 'white pupil' in photos or observe a new-onset squint (strabismus) in their child.
What if? If a child presents with strabismus (crossed eyes) instead of leukocoria, it should still be taken seriously. Strabismus is the second most common presenting sign of retinoblastoma, as the tumor can interfere with vision and lead to misalignment of the eyes.

How to Approach the Question

First, identify the core subject of the question, which is 'retinoblastoma'.
The question asks for a 'classic presenting symptom,' which means you need to recall the most common or well-known signs of this specific disease.
Evaluate each option by associating it with the condition it represents.
Option A, Brushfield's spots, is linked to Down syndrome.
Option B, Brudzinski's sign, is linked to meningitis.
Option C, Cat's eye reflex (leukocoria), is the hallmark sign of retinoblastoma.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 pp. 952-954, 1765-1767

Practise the full DSSSB -28 August 2019 (Shift-2)

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