Paper I
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min

Question

Patient: Mrs. Rose, a 68-year-old woman, Chief Complaint: Gradual loss of vision in both eyes, particularly in the peripheral vision. Medical History: Hypertension, Type 2 Diabetes, and Hyperlipidaemia. No known drug allergies. Family History: Her father had glaucoma. Presenting Symptoms: Mrs. Rose reports difficulty seeing objects in her peripheral vision for the past 6 months. She has had a gradual decrease in her night vision as well. Ophthalmologic Exam: Intraocular pressure (IOP): 28 mmHg in both eyes Visual field: Decreased peripheral vision, with a loss in the superior field. Optic disc: Cupping noted in both eyes. Diagnosis: Open-angle glaucoma.

Which is the diuretic of choice in treatment of acute congestive glaucoma

  • a) Furosemide
  • b) Hydrochlorothiazide
  • c) Mannitol
  • d) Spironolactone
Qxv1 marksMCQs (Case)

Answer

Correct answer: c) Mannitol

Mannitol, an osmotic diuretic, produces a rapid osmotic reduction in intraocular pressure by drawing water out of the eye across an osmotic gradient — used as emergency treatment for acute angle-closure (congestive) glaucoma, where rapid IOP reduction is needed to prevent optic nerve damage while definitive treatment (iridotomy) is arranged. Note this is a distinct scenario from this patient’s own diagnosis of chronic open-angle glaucoma, for which mannitol has no routine role.

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