COMAT Emergency Medicine Practice Test

The "blood and thunder" appearance observed during a fundoscopic examination is classically associated with central retinal vein occlusion (CRVO). This term describes the characteristic finding of extensive retinal hemorrhages, often in a diffuse pattern that resembles a stormy or tumultuous scene, hence the phrase "blood and thunder."

In CRVO, the obstruction of the central retinal vein leads to increased venous pressure and subsequent leakage of blood into the retinal layers. This results in cotton wool spots, retinal edema, and widespread retinal hemorrhages that can be seen as flame-shaped and dot-and-blot types. The presence of these multiple hemorrhages and associated findings collectively contribute to the "blood and thunder" description during the examination.

In contrast, other conditions listed present with different fundoscopic findings. For example, acute closure angle glaucoma typically reveals a mid-dilated pupil and corneal edema rather than retinal hemorrhages. Uveitis may show signs of inflammation within the eye such as inflammatory cells in the anterior chamber or vitreous but does not produce the distinctive pattern of hemorrhages seen in CRVO. Diabetic retinopathy is characterized by a variety of findings, including microaneurysms and neovascularization, rather than the