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NBME p2ck_form6 Answers

step2ck_form6/Block 1/Question#31 (4.4 difficulty score)
A 37-year-old woman is brought to the ...
Right optic nerveπŸ”
tags: visualfielddefect visual_field_defect 

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submitted by sugaplum(376),

since she has total blindness just in one eye, right optic nerve lesion makes sense. The poor reactivity to light supports this because eyes receive light through optic nerve (CN2)

submitted by carolebaskin(49),

young woman with abrupt onset painful eye movements + decreased acuity + poor reactivity = optic neuritis = MS

Also notice they said the right pupil is poorly active to direct light

So maybe there's a Marcus Gunn pupil, which is when there's decreased bilateral pupillary constriction when light is shone directly into the affected eye, relative to the unaffected eye