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Review
of Clinical Signs

Argyll Robertson Pupil

Series Editor and Author: Frank L. Urbano, MD

1. The Argyll Robertson pupil is a miotic pupil that:
  1. Responds to accommodation and reacts to direct light
  2. Does not respond to accommodation but reacts to direct light
  3. Responds to accommodation but does not react to direct light
  4. Neither responds to accommodation nor reacts to direct light
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2. All of the following conditions can cause Argyll-Robertson pupil EXCEPT:

  1. Neurosyphilis
  2. Neurosarcoidosis
  3. Multiple sclerosis
  4. Diabetes mellitus
  5. Neurocysticercosis
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3. All of the following statements about neurosyphilis are true EXCEPT:
  1. Patients may present with ptosis and ataxia.
  2. Patients may present with mouth and tongue tremors.
  3. In these patients, the Argyll Robertson pupil is usually unilateral.
  4. Patients may have decreased deep tendon reflexes.
  5. Patients may have aortic insufficiency or Charcot’s arthropathy.
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4. All of the following statements about Adie’s pupil are true EXCEPT:

  1. It may be inappropriately confused with the Argyll Robertson pupil.
  2. It is caused by destruction of the ciliary ganglion.
  3. The reaction to light is absent or greatly diminished when tested in routine examination, but reacts slowly to light with prolonged maximal stimulation.
  4. The pupil tends to remain dilated and constricts very slowly once accommodation is complete.
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Updated 1/04/08 • kkj