Muhamad Na'im B Ab Razak (jacknaim) is a fresh graduate Muslim Doctor from Universiti Sains Malaysia and waiting for the enrollment into the housemanship program. Ambitious in pursuing master program in emergency and traumatology medicine and loves to spent his free time joining humanitarian missions, writing and speaks as an amateur public speaker in motivation and comparative religion. [HOME]

OSCE pro III series 14


Answers


1)Abnormalities
-Swollen optic disc
-Dilated vessels over the optic disc
-Blurring of the optic disc margin


2)Papilloedema


3)Causes of abnormalities
-Increase ICP
-Benign intracranial hypertension
-Malignant hypertension


4)Immediate management
-Confirm the diagnosis of Papilloedema and establish the cause (CT scan, ultrasound orbit)
-IV diuretic like carbonic anhydrase inhibitors (acetazolamide)
-Eye drop timolol or pilocarpine.
-Optic nerve sheath decompression



Notes


Papilloedema is bilateral, non inflammatory passive swelling of the optic disc mainly due to raise ICP.



Causes of papilloedema.


a)Raised ICP
-Congenital ventricular system stenosis
-Blocked ventricular system
-Obstruction of CSF absorption by the arachnoid villi
-Hyper secretion of CSF


b)Benign intracranial hypertension may cause gross papilloedema without neurological symptoms. Due to tetracycline, nalidixic acid, high dose vitamin A, corticosteroid and oral contraceptive


c)Malignant hypertension