ABNORMAL PUPIL REACTIONS

Question 1

Categories of abnormal pupil reactions

Answer 1

Marcus Gunn pupil
Parinaud’s syndrome
Agryll Robertson pupil

Question 2

(T or F) Any lesion located from the retina to the pretectal nucleus is considered a relative efferent pupillary defect

Answer 2

F- relative afferent pupillary defect

Question 3

(T or F) Any lesion located from pre-ganglionic to postganglionic fiber is considered a relative afferent pupillary defect

Answer 3

F- relative efferent pupillary defect

Question 4

Also known as relative afferent pupillary defect

Answer 4

Marcus Gunn Pupil

Question 5

Other name for Marcus Gunn Pupil

Answer 5

Pupillary escape

Question 6

This indicates damage at or anterior to the LGN (afferent pathway) specifically the retinal ganglion cells to optic chiasm of one eye

Answer 6

MGP

Question 7

Marcus Gunn Pupil is caused by a damage that is bilateral or asymmetric as seen in several retinal dse.

Answer 7

F- unilateral

Question 8

Diseases that causes Marcus Gunn Pupil

Answer 8

CRAO
CRVO
BRVO
Optic Atrophy
Marked retinal detachment
Asymmetric POAG

Question 9

(T or F) Loss of vision due to corneal, lenticular, vitreous, refractive or emotional causes will produce the Marcus Gunn response

Answer 9

F- will not produce

Question 10

(T or F) In swinging flashlight test, an eye affected with MGP, the consensual response is greater than the direct response.

Answer 10

TRUE

Question 11

Also known as Whore’s Pupil

Answer 11

Argyll Robertson Pupil

Question 12

A parasympathetic condition that is central and bilateral in nature

Answer 12

Argyll Robertson Pupil

Question 13

Characteristics of Argyll Robertson Pupil

Answer 13

1. Dilates poorly in the darkness
2. Responds poorly or does not respond to light
3. Normal near response

Question 14

(T or F) Argyll Robertson is caused by any interruption in the pattern of CN3 to CN4

Answer 14

F- CN2 to CN3

Question 15

Common causes for Argyll Robertson pupil

Answer 15

Neurosyphilis
Long term diabetes
Alcoholism

Question 16

Neurosyphilis is caused by

Answer 16

Treponema pallidum

Question 17

Is a bacterial infection by the brain or spinal cord

Answer 17

Neurosyphilis

Question 18

It occurs in people who have untreated syphilis for many years

Answer 18

Neurosyphilis

Question 19

4 types of neurosyphilis

Answer 19

Primary
Secondary
Latent
Tertiary

Question 20

A sexually transmitted infection that spreads through direct contact with syphilis sores

Answer 20

Neurosyphilis

Question 21

Is a chronic disorder of carbohydrate metabolism due to relative or absolute insulin deficiency

Answer 21

Long term diabetes

Question 22

Is a disease of the pancreas

Answer 22

Long term diabetes milletus

Question 23

In Parinaud’s syndrome the affected part on pupillary pathway is the ____

Answer 23

Pretectal nucleus

Question 24

In Argyll Robertson Pupil, the affected part on the pupillary pathway is the _____

Answer 24

Edinger Westphal

Question 25

A central defect

Answer 25

Parinaud’s syndrome

Question 26

(T or F) In Parinaud’s syndrome, there is a lesion affecting the anterior commissure and pretectal nuclei

Answer 26

F- Posterior commissure

Question 27

(T or F) In Parinaud’s syndrome there is an interruption to the more dorsal efferent light pathway

Answer 27

F- afferent

Question 28

Symptoms of Parinaud’s syndrome

Answer 28

Large pupils Constrict briskly to an accommodative target Constrict poorly to light

Question 29

Other name for Parinaud’s Syndrome

Answer 29

Dorsal midbrain Pretectal Sylvian aqueduct Koerbersalus-Elshnig Syndrome

Question 30

Associated signs and symptoms for Parinaud’s syndrome

Answer 30

Vertical gaze deficit Collier’s sign Convergence-retraction nystagmus

Question 31

triad of tabes dorsalis

Answer 31

gait unsteadiness lightning pain urinary incontenence

Question 32

2 types of anisocoria

Answer 32

Physiological Pathological

Question 33

Due to normal difference in balance of parasympathetic and sympathetic drive to the 2 pupils

Answer 33

Physiological anisocoria

Question 34

Due to denervation of the parasympathetic and sympathetic block

Answer 34

Pathological anisocoria

Question 35

Type of metabolism in sympathetic NS

Answer 35

Catabolic

Question 36

Type of metabolism for parasympathetic NS

Answer 36

Anabolic

Question 37

Nickname for sympathetic NS

Answer 37

Fight or flight