Neuro-Ophthalmology Flashcards
7 cards from real ABO practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Neuro-Ophthalmology flashcards as text
A 52-year-old presents with acute headache, ptosis, and a dilated, poorly reactive left pupil with limited adduction and elevation. What is the most appropriate next step?
Answer: Urgent CT angiography or MR angiography
Pupil-involving third nerve palsy with headache suggests a posterior communicating artery aneurysm requiring urgent vascular imaging.
In a patient with suspected Horner syndrome, topical apraclonidine 0.5% typically produces which result?
Answer: Dilation of the affected pupil and elevation of the ptotic lid
Denervation supersensitivity of alpha-1 receptors causes the Horner pupil to dilate and the lid to rise, reversing anisocoria.
A young woman has a unilaterally dilated pupil with poor light reaction, slow tonic near response, and sectoral iris paralysis. Which test supports the diagnosis?
Answer: Constriction with dilute pilocarpine 0.125%
Adie tonic pupil shows cholinergic denervation supersensitivity and constricts to dilute pilocarpine.
According to the Idiopathic Intracranial Hypertension Treatment Trial, which intervention combined with weight loss improved visual field outcomes in mild visual loss?
Answer: Acetazolamide
IIHTT showed acetazolamide plus diet improved perimetric mean deviation versus diet alone.
A patient has a right hypertropia that worsens on left gaze and on right head tilt. Which muscle is paretic?
Answer: Right superior oblique
The Parks-Bielschowsky three-step test localizes this pattern to a right superior oblique (fourth nerve) palsy.
A 28-year-old with multiple sclerosis cannot adduct the right eye on left gaze, and the left eye shows abducting nystagmus; convergence is intact. Where is the lesion?
Answer: Right medial longitudinal fasciculus
Internuclear ophthalmoplegia is named for the side of the adduction deficit, localizing to the ipsilateral MLF.
Which finding came from the Optic Neuritis Treatment Trial?
Answer: Oral prednisone alone increased the risk of recurrent optic neuritis
Standard-dose oral prednisone alone was associated with a higher recurrence rate and is not recommended.