A 60-year-old hypertensive patient has fundoscopy showing arteriovenous nipping, copper wiring of arterioles, and cotton wool spots. There are no hemorrhages, exudates, or papilloedema. This corresponds to which Keith-Wagener-Barker grade of hypertensive retinopathy?

• A Grade II ✓
• B Grade I
• C Grade III
• D Grade IV

Explanation

Grade II hypertensive retinopathy includes arteriolar narrowing, arteriovenous nipping, copper or silver wiring, and cotton wool spots. Grade I shows only mild narrowing. Grade III adds flame-shaped hemorrhages, hard exudates, and cotton wool spots. Grade IV adds papilloedema. The absence of hemorrhages and papilloedema rules out grades III and IV. This classification is important for staging hypertensive damage.

Reference: Harrison's Principles of Internal Medicine, 20th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.