WBR0077

Author	Kalsang Dolma
Exam Type	USMLE Step 2 CK
Main Category	Pathology
Sub Category	Head and Neck
Prompt	A 48-year-old man presents to the primary care clinic with a two-day history of eye pain, excessive watering of the eyes, and the sensation of foreign bodies in the eyes. He reports he has had multiple similar episodes in the past. On examination with Woods lamp and flourescein dye, multiple corneal erosions are noted. This condition results from failure of attachment between which of the following two structures?
Answer A	Corneal epithelial cells and the basement membrane (Bowman's layer)
Answer A Explanation	The disorder of recurrent corneal erosion occurs due to a poor adhesion between the corneal epithelial cells and the basement membrane cells (Bowman's layer).
Answer B	The basement membrane (Bowman's layer) and the corneal stroma
Answer B Explanation	The disorder of recurrent corneal erosion occurs due to a poor adhesion between the corneal epithelial cells and the basement membrane cells (Bowman's layer).
Answer C	The corneal stroma and Descemet's membrane
Answer C Explanation	The disorder of recurrent corneal erosion occurs due to a poor adhesion between the corneal epithelial cells and the basement membrane cells (Bowman's layer).
Answer D	The corneal epithelial cells and Descemet's membrane
Answer D Explanation	The disorder of recurrent corneal erosion occurs due to a poor adhesion between the corneal epithelial cells and the basement membrane cells (Bowman's layer).
Answer E
Answer E Explanation
Right Answer	A
Explanation	The patient is most likely diagnosed with recurrent corneal erosions. It is a disorder of the eyes characterized by the failure of the cornea's outermost layer of epithelial cells to attach to the underlying basement membrane (Bowman's layer). The condition is frequently painful because the loss of these cells results in the exposure of sensitive corneal nerves. Patients presents with recurring attacks of acute eye pain, foreign-body sensation, photophobia (i.e. sensitivity to bright lights), and tearing often at the time of awakening or during sleep when the eyelids are rubbed or opened. Educational Objective: References:
Approved	No
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