Pupils and Reflexes in Ophthalmology

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Questions and Answers

Which muscle is responsible for miosis?

  • Ciliary
  • Sphincter (correct)
  • Pupillary
  • Dilator (radial)

Which cranial nerve is responsible for carrying motor impulses from the CNS to the muscles of the iris?

  • Cranial nerve II
  • Cranial nerve V
  • Cranial nerve III (correct)
  • Cranial nerve VII

What is the purpose of the swinging flashlight test?

  • To diagnose cranial nerve III palsy
  • To test for afferent pupillary defect (correct)
  • To check for Horner's Syndrome
  • To measure the pupil's response to light

What is the result of a lesion anterior to the chiasm?

<p>Afferent pupillary defect (D)</p> Signup and view all the answers

What is the function of the Edinger-Westphal nucleus?

<p>To regulate the pupillary light reflex (A)</p> Signup and view all the answers

What is the term for the phenomenon of rhythmic fluctuations in pupillary size due to an imbalance between sympathetic and parasympathetic innervation?

<p>Pupillary hiccup (D)</p> Signup and view all the answers

What is the term for the measurement of the relative difference in pupillary constriction between the two eyes?

<p>RAPD (B)</p> Signup and view all the answers

What is the purpose of using neutral density filters in pupillary testing?

<p>To quantify the relative afferent pupillary defect (C)</p> Signup and view all the answers

What is the significance of the direct response being equal to the consensual response?

<p>The afferent arc is intact (D)</p> Signup and view all the answers

What should you check if the pupil size difference is larger in dim or bright illumination?

<p>The near/accommodative reflex (D)</p> Signup and view all the answers

What is the primary concern in a patient with isolated III CN palsy and pupil involvement?

<p>Ruling out PCA aneurysm (A)</p> Signup and view all the answers

What is the recommended course of action for a patient with pupil-sparing isolated III CN palsy and a history of diabetes or hypertension?

<p>Close monitoring for pupillary involvement (B)</p> Signup and view all the answers

At what age should a patient with pupillary sparing isolated III CN palsy be referred for neurotesting, regardless of underlying medical conditions?

<p>50 years old (A)</p> Signup and view all the answers

What is the typical resolution time for most ischemic causes of isolated III CN palsy?

<p>90 days (D)</p> Signup and view all the answers

What is the recommended follow-up time for a patient with isolated III CN palsy and a history of vascular disease?

<p>5-7 days (A)</p> Signup and view all the answers

What should be suspected in a patient with isolated III CN palsy and a history of giant cell arteritis?

<p>Vascular disease affecting CN III central fibers (D)</p> Signup and view all the answers

In children under 10 years old, what is the recommended course of action for isolated III CN palsy, regardless of pupillary involvement?

<p>Ordering neurotesting immediately (D)</p> Signup and view all the answers

What type of anisocoria is characterized by being equal in dim and bright illumination, without ptosis?

<p>Physiological anisocoria (D)</p> Signup and view all the answers

What is the name of the condition in which the light reflex is absent or abnormal, but the near response is intact?

<p>Argyll Robertson Pupil (C)</p> Signup and view all the answers

Which of the following substances can cause mydriasis of up to 8 mm?

<p>Tropicamide (C)</p> Signup and view all the answers

What is the name of the condition characterized by unilateral or bilateral tonically reacting pupils developing in otherwise healthy patients?

<p>Adie's Tonic Pupil (D)</p> Signup and view all the answers

What is the name of the substance used to treat hemorrhoids and also has a non-clinical use to decrease eye bags?

<p>Phenylephrine (A)</p> Signup and view all the answers

What is the name of the condition caused by an afferent defect, essentially a 'blind eye'?

<p>Amaurotic pupil (D)</p> Signup and view all the answers

What is the purpose of instilling dilute Pilocarpine 0.125% in the eyes?

<p>To diagnose Adie's Tonic Pupil (D)</p> Signup and view all the answers

What is the mechanism of action of apraclonidine in diagnosing Horner's Syndrome?

<p>It acts on the delayed sensitivity of alpha 1 receptors in the dilator muscle. (B)</p> Signup and view all the answers

What is the purpose of pharmacologic diagnostic testing in anisocoria?

<p>To differentiate between physiologic anisocoria and Horner's Syndrome. (B)</p> Signup and view all the answers

What is the characteristic pupillary response in Horner's Syndrome?

<p>Anisocoria with the affected eye being smaller. (A)</p> Signup and view all the answers

What is the purpose of hydroxyamphetamine testing?

<p>To differentiate between central and preganglionic lesions. (B)</p> Signup and view all the answers

What is the most common cause of isolated III CN palsy with pupil involvement?

<p>Posterior communicating artery aneurysm. (D)</p> Signup and view all the answers

What is the mechanism of action of cocaine in diagnosing Horner's Syndrome?

<p>It blocks the reuptake of norepinephrine at the neuroeffector junction. (B)</p> Signup and view all the answers

What is the significance of a negative hydroxyamphetamine test result?

<p>It indicates a postganglionic lesion. (B)</p> Signup and view all the answers

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