Neuro-ophthalmology and pupils: Miller Fisher syndrome: 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: Miller Fisher syndrome

Sample item

A young man two weeks after a diarrhoeal illness develops ophthalmoplegia, ataxia and loss of tendon reflexes. Which antibody is associated?

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

The answer and the reasoning

D. Anti-GQ1b

Miller Fisher syndrome, a variant of Guillain-Barre syndrome, features ophthalmoplegia, ataxia and areflexia, with anti-GQ1b antibodies. Anti-AChR and anti-MuSK are in myasthenia. Anti-aquaporin-4 is in neuromyelitis optica.

Option by option

  • A. Anti-aquaporin-4

    Anti-aquaporin-4 is found in neuromyelitis optica.

  • B. Anti-MuSK

    Anti-MuSK is found in a subset of myasthenia gravis.

  • C. Anti-acetylcholine receptor

    Anti-AChR antibodies occur in myasthenia gravis, which does not cause areflexia.

  • D. Anti-GQ1b (correct)

    Correct. Anti-GQ1b antibodies are linked to the syndrome.

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 D, Anti-GQ1b. Miller Fisher syndrome, a variant of Guillain-Barre syndrome, features ophthalmoplegia, ataxia and areflexia, with anti-GQ1b antibodies.

Why is "Anti-aquaporin-4" not the answer?

Anti-aquaporin-4 is found in neuromyelitis optica.

Why is "Anti-MuSK" not the answer?

Anti-MuSK is found in a subset of myasthenia gravis.

Why is "Anti-acetylcholine receptor" not the answer?

Anti-AChR antibodies occur in myasthenia gravis, which does not cause areflexia.

What concept does this question test?

It tests Neuro-ophthalmology and pupils: Miller Fisher syndrome in Ophthalmology. Anti-AChR and anti-MuSK are in myasthenia. Anti-aquaporin-4 is in neuromyelitis optica.

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: Miller Fisher syndrome?

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.