Neuro-ophthalmology and pupils: neuromyelitis optica treatment caution: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Neuro-ophthalmology and pupils: neuromyelitis optica treatment caution

Sample item

A woman with aquaporin-4 antibody positive neuromyelitis optica is being considered for long-term therapy. Which drug used for multiple sclerosis can worsen her disease and should be avoided?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Interferon beta

Interferon beta and some other multiple sclerosis disease-modifying drugs can worsen neuromyelitis optica. Acute attacks are treated with intravenous methylprednisolone and plasma exchange, and relapse prevention uses rituximab, azathioprine or targeted antibody therapies. Correct classification therefore changes treatment.

Option by option

  • A. Rituximab

    Rituximab is used for relapse prevention in neuromyelitis optica.

  • B. Interferon beta (correct)

    Correct. Interferon beta may aggravate neuromyelitis optica.

  • C. Azathioprine

    Azathioprine is an accepted maintenance immunosuppressant.

  • D. Oral prednisolone

    Oral prednisolone is used for attack recovery and bridging, not harmful.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is B, Interferon beta. Interferon beta and some other multiple sclerosis disease-modifying drugs can worsen neuromyelitis optica.

Why is "Rituximab" not the answer?

Rituximab is used for relapse prevention in neuromyelitis optica.

Why is "Azathioprine" not the answer?

Azathioprine is an accepted maintenance immunosuppressant.

Why is "Oral prednisolone" not the answer?

Oral prednisolone is used for attack recovery and bridging, not harmful.

What concept does this question test?

It tests Neuro-ophthalmology and pupils: neuromyelitis optica treatment caution in Ophthalmology. Acute attacks are treated with intravenous methylprednisolone and plasma exchange, and relapse prevention uses rituximab, azathioprine or targeted antibody therapies. Correct classification therefore changes treatment.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuro-ophthalmology and pupils: neuromyelitis optica treatment caution?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.