All of the following are the features of Horner's syndrome EXCEPT:

Appeared in: DSSSB October 2024

Explanation

Nystagmus is the correct answer as it is not a feature of Horner's syndrome.
Nystagmus is characterized by involuntary, rhythmic, and repetitive eye movements.
It is typically caused by disorders of the vestibular system, cerebellum, or brainstem, which control balance and eye movement coordination.
Horner's syndrome is caused by a disruption of the sympathetic nerve pathway, which does not cause nystagmus.

Option A: Ptosis, or drooping of the upper eyelid, is a classic sign of Horner's syndrome.
Option C: Miosis, or constriction of the pupil, is a hallmark feature of Horner's syndrome.
Option D: Anhidrosis, or decreased sweating on one side of the face, is a key component of the Horner's syndrome triad.

Clinical Relevance

Nursing practice connection: Knowing Clinical features of Horner's syndrome helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing the triad of Horner's syndrome is a critical nursing assessment skill, as it is often a sign of a more serious underlying medical condition.
A nurse observing these signs should report them promptly, as the patient may need urgent investigation to rule out causes like a tumor, stroke, or arterial dissection.
What if? - If a patient presented with the Horner's triad plus sudden, severe headache and neck pain, the priority would be to suspect a carotid artery dissection, a medical emergency requiring immediate intervention to prevent a stroke.

How to Approach the Question

First, identify the keyword "EXCEPT" in the question stem. This tells you that three of the options are correct features of Horner's syndrome, and one is not.
Recall the classic clinical triad of Horner's syndrome: ptosis, miosis, and anhidrosis.
Systematically evaluate each option against this knowledge.
You will recognize Ptosis (A), Miosis (C), and Anhidrosis (D) as the core signs.
Nystagmus (B) is not part of this classic triad. It relates to a different set of neurological pathways.
Therefore, Nystagmus is the exception and the correct answer.

Concept Tested & Keywords

Concept Tested: Clinical features of Horner's syndrome
Stem keywords: Horner's syndrome, features
Lead-in keywords: EXCEPT
Negative lead-in flag: The question asks for the feature that is NOT present (EXCEPT).

QDi_1mV07nnEKf7SIBpfga

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1730-1732

E6 Medicine Harrison 22e Part 1 p. 275-277

Practise the full DSSSB October 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.