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Miosis 1

Topic: Behavior

Created on Friday, February 22 2013 by jdmiles

Last modified on Friday, February 22 2013.

A famous elderly, retired model presents to the E.R. She had no neurologic defecits prior to this morning, when she awoke to find changes in the way her face looks, as shown in the image above.
Of the following choices, which ONE other finding would you MOST expect to see in this patient?

 
        A) Tongue deviation to the right
 
        B) A left internuclear ophthalmoplegia (INO)
 
        C) A right internuclear ophthalmoplegia (INO)
 
        D) Loss of sweating on the left side of the face
 
        E) Loss of sweating on the right side of the face
 

 


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This question was created on February 22, 2013 by jdmiles.
This question was last modified on February 22, 2013.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Tongue deviation to the right

This answer is incorrect.


This image demonstrates miosis and ipsilateral ptosis, two of the classic features of Horner syndrome. The third part of the triad is ipsilateral facial anhydrosis. Hypoglossal palsy is not an expected feature of the Horner syndrome.  (See References)

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B) A left internuclear ophthalmoplegia (INO)

This answer is incorrect.


This image demonstrates miosis and ipsilateral ptosis, two of the classic features of Horner syndrome. The third part of the triad is ipsilateral facial anhydrosis. Internuclear ophthalmoplegia is not an expected feature of the Horner syndrome.  (See References)

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C) A right internuclear ophthalmoplegia (INO)

This answer is incorrect.


This image demonstrates miosis and ipsilateral ptosis, two of the classic features of Horner syndrome. The third part of the triad is ipsilateral facial anhydrosis. Internuclear ophthalmoplegia is not an expected feature of the Horner syndrome.  (See References)

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D) Loss of sweating on the left side of the face

This answer is correct.


This image demonstrates miosis and ipsilateral ptosis, two of the classic features of Horner syndrome. The third part of the triad is ipsilateral facial anhydrosis.  (See References)

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E) Loss of sweating on the right side of the face

This answer is incorrect.


This image demonstrates miosis and ipsilateral ptosis, two of the classic features of Horner syndrome. The third part of the triad is ipsilateral (not contralateral) facial anhydrosis.  (See References)

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References:

1. Walton, K.A., and Buono, L.M. (2003). "Horner syndrome." Curr Opin Ophthalmol, 14(6) 357-63. (PMID:14615640)
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behavior
Miosis 1
Question ID: 022213191
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 02/22/2013
Modified: 02/22/2013
Estimated Permutations: 600

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