50-year-old man with abnormal funduscopic examination

A 50-year-old man with no prior medical history presents to you for an annual physical examination. He does not have any symptoms and does not take any medications.

Vitals are: blood pressure 120/80 mm Hg, pulse 80 beats/minute, respiratory rate 14 breaths/minute, oxygen saturation 100% on room air, and temperature 99 °F.

Findings on general physical and neurologic examinations are within normal limits. However, you notice something abnormal on funduscopic examination (see Figure).

Based on these findings, what is the next best step in the management of this patient's condition?

• Check glycated hemoglobin.
• Check lipid profile.
• Perform HIV and rapid plasma reagin testing.
• Check erythrocyte sedimentation rate and C-reactive protein level.

This question appears in Med-Challenger Family Medicine Exam Review with CME

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