MEDICAL SURGICAL NURSING COMPLETE
QUESTIONS AND VERIFIED ANSWERS
(100%PASS)| BRAND NEW!!!
what is papilloedema ? - ANSWER-Optic disc swelling, secondary to elevated
intercranial pressure
-Mass effect
•Increased CSF production (choroid plexus tumour)
•Reduced CSF drainage
•Malignant Hypertension?
symptoms of pipilloesema - ANSWER-Visual
1. Obscurations
2.Headache (often worse horizontally)
3 Nausea and vomiting
4. Pulsatile tinnitus
Signs of papilloedema ? - ANSWER-Mostly BILATERAL disc swelling -Early stage
:
Hyperaemic, blurred and elevated disc margin
Peripapillary NFL oedema
Dilated disc capillaries
Distended retinal veins
Absent SVP
Signs of acute papilloedema - ANSWER-Peripapillary haemorrhages
Cotton wool spots
,ontrop of :
Hyperaemic, blurred and elevated disc margin
Peripapillary NFL oedema
Dilated disc capillaries
Distended retinal veins
Absent SVP
Signs of chronic papilloedema - ANSWER-Drusen-like deposits
Optociliary shunt vessels at the dis
ontrop of :
Hyperaemic, blurred and elevated disc margin
Peripapillary NFL oedema
Dilated disc capillaries
Distended retinal veins
Absent SVP
MAnagement of papilloedema ? - ANSWER-Emergency referral to ED
•
Blood pressure monitoring
•medical emergency and no patient should be discharged from hospital
without exclusion of a mass lesion (a CT head scan is not sufficient)
•All patients MUST be referred to neurology on-call as well as have urgent neuroimaging. A
bedside assessment of vision (including visual fields and visual acuity) is also essential as a
baseline, should this deteriorate later, as part of the patient's neurological examination
,what is primary optic atrophy ? - ANSWER--degenteratio of nerve fibres without any
compliation process within the eye e.g. syphilitic
What is secondar optic atrophy? - ANSWER-Occrus following any pathological process which
produced optic neuritis of papilloedema
Presentation of optic atrophy ? - ANSWER-Bilateral + gradual vision loss
usial seen as pale well demarcated disco on funcoscopy,
*strictly speaking optic atrophy is a descriptive term, it is the optic neuropathy that results in
visual loss
acquired causes of optic atrophy? - ANSWER-•multiple sclerosis
•papilloedema (longstanding)
•raised intraocular pressure (e.g. glaucoma, tumour)
•retinal damage (e.g. choroiditis, retinitis pigmentosa)
•ischaemia
•toxins: tobacco amblyopia, quinine, methanol, arsenic, lead
•nutritional: vitamin B1, B2, B6 and B12 deficiency
inherited causes of optic atrophy? - ANSWER-•Friedreich's ataxia
•mitochondrial disorders e.g. Leber's optic atrophy
•DIDMOAD - the association of cranial Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy
and Deafness (also known as Wolfram's syndrome)
Likely history from patient with orbital fracture?
& observations? - ANSWER-likely known incident e.g. assault MVC/ trauma
-loss of vision can occur in globe or with optic nerve damage.
, -facial asymetry, Hyphema, subconjunctival haemorrhage & swelling (e.g. hypoglobus)
what imaging should be undertaken in suspected orbital fractures? - ANSWER-CT scan/ MRI of
head - looky for entrapment of muscle and bony strctures
problem assocaite with blowout fractures? - ANSWER--Orbital floor fractures can increase
volume of the orbit with resultant hypoglobus and enophthalmos.
-The inferior rectus muscle or orbital tissue can become entrapped within the fracture, resulting
in tethering and restriction of gaze and diplopia, these can then cause adhesions to surrounding
tissue,
- can also cause compressive optic enuropathy
what findings in the context of a blowout fracture would alert you to potential traumatic
compressive optic neuropathy? - ANSWER-puppilary dysnfunction with decreased VA should
alert one to the possibility of a trauma or compresion of the nerve
Who with a potential blowout fracture should receive a medical therpy (surger not indicated) -
ANSWER-pt presents w/o enopthalamos
when should surgical therapy indicated in a patient with blowout fracture (orbital fracture) ?
and what surgical approach is used - ANSWER-Restirctive strabissmus, CT eveidense of muscle
entrapment, enopthalmos <2mm, oculocardiac reflex, hypo-opthalmous, large floow fracture
<50%
-transconjunctival aproach : excelent exposure, conceal incisions well, prevent post-operative lid
retraction.
CLinical signs of Retinal detachment? - ANSWER-RAPD ( if extensive)
Haemorrhage in vitreus - tobacco dust
QUESTIONS AND VERIFIED ANSWERS
(100%PASS)| BRAND NEW!!!
what is papilloedema ? - ANSWER-Optic disc swelling, secondary to elevated
intercranial pressure
-Mass effect
•Increased CSF production (choroid plexus tumour)
•Reduced CSF drainage
•Malignant Hypertension?
symptoms of pipilloesema - ANSWER-Visual
1. Obscurations
2.Headache (often worse horizontally)
3 Nausea and vomiting
4. Pulsatile tinnitus
Signs of papilloedema ? - ANSWER-Mostly BILATERAL disc swelling -Early stage
:
Hyperaemic, blurred and elevated disc margin
Peripapillary NFL oedema
Dilated disc capillaries
Distended retinal veins
Absent SVP
Signs of acute papilloedema - ANSWER-Peripapillary haemorrhages
Cotton wool spots
,ontrop of :
Hyperaemic, blurred and elevated disc margin
Peripapillary NFL oedema
Dilated disc capillaries
Distended retinal veins
Absent SVP
Signs of chronic papilloedema - ANSWER-Drusen-like deposits
Optociliary shunt vessels at the dis
ontrop of :
Hyperaemic, blurred and elevated disc margin
Peripapillary NFL oedema
Dilated disc capillaries
Distended retinal veins
Absent SVP
MAnagement of papilloedema ? - ANSWER-Emergency referral to ED
•
Blood pressure monitoring
•medical emergency and no patient should be discharged from hospital
without exclusion of a mass lesion (a CT head scan is not sufficient)
•All patients MUST be referred to neurology on-call as well as have urgent neuroimaging. A
bedside assessment of vision (including visual fields and visual acuity) is also essential as a
baseline, should this deteriorate later, as part of the patient's neurological examination
,what is primary optic atrophy ? - ANSWER--degenteratio of nerve fibres without any
compliation process within the eye e.g. syphilitic
What is secondar optic atrophy? - ANSWER-Occrus following any pathological process which
produced optic neuritis of papilloedema
Presentation of optic atrophy ? - ANSWER-Bilateral + gradual vision loss
usial seen as pale well demarcated disco on funcoscopy,
*strictly speaking optic atrophy is a descriptive term, it is the optic neuropathy that results in
visual loss
acquired causes of optic atrophy? - ANSWER-•multiple sclerosis
•papilloedema (longstanding)
•raised intraocular pressure (e.g. glaucoma, tumour)
•retinal damage (e.g. choroiditis, retinitis pigmentosa)
•ischaemia
•toxins: tobacco amblyopia, quinine, methanol, arsenic, lead
•nutritional: vitamin B1, B2, B6 and B12 deficiency
inherited causes of optic atrophy? - ANSWER-•Friedreich's ataxia
•mitochondrial disorders e.g. Leber's optic atrophy
•DIDMOAD - the association of cranial Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy
and Deafness (also known as Wolfram's syndrome)
Likely history from patient with orbital fracture?
& observations? - ANSWER-likely known incident e.g. assault MVC/ trauma
-loss of vision can occur in globe or with optic nerve damage.
, -facial asymetry, Hyphema, subconjunctival haemorrhage & swelling (e.g. hypoglobus)
what imaging should be undertaken in suspected orbital fractures? - ANSWER-CT scan/ MRI of
head - looky for entrapment of muscle and bony strctures
problem assocaite with blowout fractures? - ANSWER--Orbital floor fractures can increase
volume of the orbit with resultant hypoglobus and enophthalmos.
-The inferior rectus muscle or orbital tissue can become entrapped within the fracture, resulting
in tethering and restriction of gaze and diplopia, these can then cause adhesions to surrounding
tissue,
- can also cause compressive optic enuropathy
what findings in the context of a blowout fracture would alert you to potential traumatic
compressive optic neuropathy? - ANSWER-puppilary dysnfunction with decreased VA should
alert one to the possibility of a trauma or compresion of the nerve
Who with a potential blowout fracture should receive a medical therpy (surger not indicated) -
ANSWER-pt presents w/o enopthalamos
when should surgical therapy indicated in a patient with blowout fracture (orbital fracture) ?
and what surgical approach is used - ANSWER-Restirctive strabissmus, CT eveidense of muscle
entrapment, enopthalmos <2mm, oculocardiac reflex, hypo-opthalmous, large floow fracture
<50%
-transconjunctival aproach : excelent exposure, conceal incisions well, prevent post-operative lid
retraction.
CLinical signs of Retinal detachment? - ANSWER-RAPD ( if extensive)
Haemorrhage in vitreus - tobacco dust
