Papilledema: The Daily PANCE Blueprint
A 52-year-old patient presents to the ER with a headache and altered mentation. He is severely hypertensive (224/136 mmHg). Fundoscopy reveals an edematous optic disc with blurry margins. Which of the following best describes the finding on fundoscopy?
A. Central retinal vein occlusion
B. Papilledema
C. Optic neuritis
D. Acute angle closure glaucoma
E. None of the above
Answer and topic summary
The answer is B. Papilledema
Papilledema refers to the swelling of the optic disc secondary to elevated intracranial pressure (ICP). It is a clinical sign, not a disease, and can result from conditions such as hypertensive emergencies, intracranial tumors, hydrocephalus, and pseudotumor cerebri. In this patient’s case, the severe hypertension has led to increased ICP, resulting in papilledema.
Key Features of Papilledema:
- Symptoms: May include headache, visual changes, or altered mental status, depending on the underlying cause of elevated ICP
- Fundoscopy Findings: Edematous optic disc with blurry margins, often bilateral
- Diagnosis: Requires evaluation for the cause of elevated ICP (e.g., imaging and lumbar puncture if indicated)
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint EENT ⇒ ⇒
Also covered as part of the Family Medicine Rotation and Emergency Medicine Rotation topic lists
