Round 7 (Headache)


Case Introduction

Just a routine day at your hospital, your next patient has a chief complaint of headache…

Initial Vitals
  • Temp 98.8
  • HR 88
  • RR 16
  • BP 130/80
  • O2 99%
Critical Actions
  • Identify Acute Angle Closure Glaucoma
  • Initiate Appropriate Treatment for Acute Angle Closure Glaucoma
  • Emergent Consult to Ophthalmology
  • Recheck Intra-Ocular Pressure After Initiating Treatment
Dangerous Actions
  • Giving NSAIDS (The Patient Had This on Allergy List)
  • Performing a Lateral Canthotomy
Final Diagnosis

Acute Angle Closure Glaucoma

Tips and Tricks

Do not be surprised or scared when an examiner has a monotone voice and flat affect

Additional Reading


  1. Anon

    Hello, would acetazolamide be contraindicated in this patient since she has kidney disease? Cool podcast

    • Zack

      My understanding is that acetazolamide is contraindicated if patient has severe renal implement. When in doubt, I call pharmacy.

      • Anon

        Thanks for your reply! Do you think they would take points off if you gave it without consulting pharmacy in this case (or not, because the severity nor any h/o kidney transplant wasn’t mentioned)?

        • Zack

          I doubt they would take off many points for that

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