Deck 14: Hearing and Balance: the Eighth Cranial Nerve

Question 1

A 52-year-old executive complains to her family physician of blurred vision. Examination reveals she is unable to adduct her left eye when looking right. She also is unable to adduct her right eye when looking to the left. Medial rectus function in her left and right eyes appears normal as she focuses on near targets. Which of the following most accurately explains her condition?

A) Compression of the left oculomotor nerve
B) A lesion in the abducens nucleus
C) Bilateral internuclear ophthalmoplegia
D) Convergence insufficiency
E) Impaired smooth pursuit

Answer 1

C

Question 2

A 31-year-old woman complains to her ophthalmologist that a large dark spot is obstructing vision in her right eye. The woman states that the spot has developed over a few months. Ophthalmologic examination reveals a hemorrhage near the optic disc. Based on these findings, what is the most likely diagnosis?

A) Optic neuritis
B) Right scotoma
C) Presbyopia
D) Retinal detachment
E) Amblyopia

Answer 2

B

Question 3

A 66-year-old man has an ophthalmologic examination. He complains that his vision has dimmed in the left visual field of his left eye. Ophthalmoscopic examination indicates a significantly increased cup-to-disc ratio in the left eye. Which of the following most specifically characterizes the condition in this man?

A) Visual agnosia
B) Prosopagnosia
C) Glaucoma
D) Mydriasis
E) Presbyopia

Answer 3

C

Question 4

A 14-year-old girl is taken to her pediatrician after complaining to her mother of blurred vision and difficulty seeing at night. Ophthalmoscopic examination indicates visual acuity of 20/60 OS and 20/70 OD, gliosis of the optic nerve head, and reduced peripheral vision. Based on these findings, what is the most likely diagnosis?

A) Scotoma
B) Retinal detachment
C) Bitemporal hemianopia
D) Balint's syndrome
E) Retinitis pigmentosa

Question 5

The parents of a 2-year-old girl notice that she is constantly tilting her head to one side and her right eye is deviated upward. Ophthalmologic exam reveals that the girl is unable to move her right eye downward after first looking left. All other eye movements are normal. These deficits are consistent with a lesion involving which of the following?

A) Right oculomotor nerve
B) Right abducens nucleus
C) Right trochlear nerve
D) Right oculomotor nucleus
E) Right medial rectus muscle