A 26 year old woman was brought by her father.-UKMLA PLAB AMC USMLE Prometric MCQ

A 26 year old woman was brought by her father.

on Sunday, March 25, 2012

Question Number 0007
Question:
A 26 year old woman was brought by her father. He described that she had been sleeping at his home one week after her husband had been killed in a traffic accident. That morning she had suddenly gone blind and was bumping into walls without hurting herself. On examination her pupils and visual evoked potentials were normal.
the likely cause of her visual symptoms is

a) presbyopia
b) age-related macular degeneration
c) bilateral occipital lobe infarcts
d) conversion disorder
e) retinal detachment

Correct Answer: D

Explanation:
This patient's syptoms are consistent with hysterical blindness. This is described as a conversion disorder which is defined as a disturbance of bodily functioning that does not conform to current concepts of the anatomy and physiology of the central or the peripheral nervous system. It typically occurs in a setting of stress and produces considerable dysfunction which do not conform to the usual neurological patterns. The signs and symptoms of a conversion disorder conform to the patient's concept of the medical condition.

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