This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Ophthalmology
[{'content': 'All the following changes are caused in the retina by benign hypertension except – \nSelect and explain. \nA. Narrowing of arterioles, B. Exudates, C. Cotton wool spots, D. Retinal hemorrhage', 'role': 'user'}, {'content': "Answer: C \nExplanation: The major objection to Keith-Wagener classification is that, it does not clearly distinguish between the retinal changes of benign and malignant hypertension. So, by looking keith - wagener classification, you can not differentiate the retinal lesions of benign and malignant hypertension. For example, soft exudates (cotton wool spots are characteristic of malignant hypertension and hard exudates are usually seen in elderly patients with benign hypertension; however, both are included in keith-wagner's grade III. Therefore, Fishberg and oppenheimer proposed a classification which draws a distinction between retinal lesions of benign hypertension (i.e., retinal arteriosclerosis with arteriosclerotic retinopathy) and retinal lesions of malignant hypertension ( hypertensive neuroretinopathy).\n\nRetinal arteriosclerosis with arteriosclerotic retinopathy (Benign hypertension)\n\nArteriolar narrowing (diffuse)\nFocal arteriolar narrowing\nArteriovenous crossing changes\nBroadening of light reflex (copper wire or silver wiring)\nPerivasculitis\nSolitary round hemorrhage\nHard exudates\nCentral or branch venous occlusion\n\nHypertensive uenroretinopathy (Malignant hypertension)\n\nGeneralized arteriolar narrowing\nStriate (flame-shaped) hemorrhage\nCotton - wool spots (soft exudates)\nBilateral papilledema\nMacular star", 'role': 'assistant'}]