........part 8 catch in the diagnosis! - roentgen

[ArchivalUser]

A patient with earlier history of road traffic accident about a year back presents with non-corresponding size of pupil on examintion.In normal condition the Lt pupil measures smaller than the Rt one.Both the eyes are treated with topical hydroxyamphetamine and phenylephrine respectively
and show following response.

Normal/Without treatment: Rt 1Xmm/Lt0.75X mm
With topical hydroxyamphetamine: Rt 1.75X mm/Lt0.75X mm
With topical Phenylephrine: Rt 1.5X mm/Lt 2X mm
X is a constant value

In nut shell:Normal state Lt smaller,With HydroxyAmphtm Lt remains same but Rt dilated,
with phenyephrine both dilated but Lt disproportinately more.

What is the diagnosis?
1.MAO A inhibitor deficiency/inhibition
2.MAO B inhibitor def/inhibition
3.Acetycholinesterase deficiency/inhibition
4.Alpha adrenergic blockade
5.Sympathetic denervation

[ArchivalUser]

i guess 5

[ArchivalUser]

ONCE AGAIN. I REQUEST ALL FORUM MEMBERS POSTING RESPONSES TO PROVIDE RATIONALE BEFORE OPTING FOR ANY CHOICE

[ArchivalUser]

5? did the same Q from kaplan pharma....Here i go....

---Left eye did not change with amphetamine----which is an indirect agonist --acts thru uptake 1 -- indirect agoinists have no action on the denervated tissue
----But left eye dilated with pheny leprine as it is Aplha 1 agonits --direct acting---dilates the radial muscle --causing dilatation of both eyes. this is an exaggarated response of PANS as sans is denervated.

[ArchivalUser]

5 expln provided by vij is best anyone can do

[ArchivalUser]

Congrats both of you...........
Quest solved!

[ArchivalUser]

Out of my 8 parts of catch series 3 were from question banks.........and you people picked them instantly!
If actual exam contains any of the qbank questions in one or the other form............your 99 is secured!
All the best and keep posting!