A 19 y/o man presents with a chief complaint of a red, irritated right eye for the past 48 hours with eyelids that were “stuck together” this morning when he awoke. Examination reveals injected palpebral and bulbar conjuctiva and reactive pupils; vision screen with the Snellen chart evaluation reveals 20/30 in the right eye, left eye, and both eyes; and purulent eye discharge on the right .This presentation is most consistent with:
- suppurative conjunctivitis
- viral conjunctivitis
- allergic conjunctivitis
- mechanical injury
suppurative conjuntivitis
A 19 y/o woman presents with a complaint of bilaterally itchy, red eye s with tearing that occurs intermittently throughout the year and is often accompanied by a rope like eye discharge and clear nasal discharge. This is most consistent with conjunctival inflammation caused by a(n):
- bacterium
- virus
- allergen
- injury
-allergen
Common causative organisms of acute suppurative conjunctivitis include all of the following except:
- Staphyloccoccus aureus
- haemophilus influenzae
- streptococcus pneumoniae
- Pseudomonas aeruginosa
Pseudomonas aeruginosa
Treatment options in suppurative conjunctivitis include all of the following ophthalmic preparations except:
- polymyxin B plus trimethoprim
- levofloxacin
- polymyxin
- azithromycin
polymyxin
Treatment options in acute and recurrent allergic conjunctivitis include all of the following except:
- cromolyn ophthalmic drops
- oral antihistamines
- ophthalmological antihistamines
- corticosteroid ophthalmic drops
corticosteroid ophthalmic drops
The most common virological cause of conjunctivitis is:
- coronavirus
- adenovirus
- rhinovirus
- human papilloma virus
-adenovirus
Treatment of viral conjunctivitis can include:
- moxifloxacin ophthalmic drops
- polymyxin B ophthalmic drops
- oral acyclovir
- no antibiotic therapy needed
no antibiotic therapy needed
Anterior epistaxis is usually caused by:
- HTN
- bleeding disorders
- localized nasal mucosa trauma
- a foreign body
localized nasal mucosa trauma
1st line intervention for anterior epistaxis includes:
- nasal packing
- application of topical thombin
- firm pressure to the area superior to the nasal alar cartilage
- chemical cauterization
firm pressure to the area superior to the nasal alar cartilage
the most common clinical finding in patients with severe or refractory epistaxis is:
- DMII
- HTN
- acute bacterial sinusitis
- anemia
HTN
A 22 y/o man with recurrent epistaxis episodes fails to respond to simple pressure. Alternative approaches include all of the following except:
- initiating systemic prothrombotic therapy
- nasal packing
- chemical cautery
- topical antifibrinolytic agents
initiating systemic prothrombotic therapy
All of the following are componenets of the classic ophthalmological emergency except:
- eye pain
- purulent eye discharge
- red eye
- new onset change in visual acuity
purulent eye discharge
Mrs. Murphy is a 58 y/o woman presenting with a sudden left-sided HA that is most painful in her left eye. Her vision is blurred, and the left pupil is slightly dilated and poorly reactive. The left conjuctiva is markedly injected, and the eyeball is firm. Vision screen with the Snellen chart is 20/30 OD and 20/90 OS. The most likely dx is:
- unilateral herpetic conjunctivitis
- open-angle glaucoma
- angle-closure glaucoma
- anterior uveitis
angle-closure glaucoma
In caring for Mrs. Murphy, the most appropriate next action is:
- prompt referral to an ophthalmologist
- to provide analgesia and repeat the evaluation when the patient is more comfortable
- to instill a corticosteroid ophthalmic solution
- to patch the eye and arrange for f/u in 24hrs
prompt referral to an ophthalmologist
A 48 y/o man presents with a new onset right eye vision change accompanied by dull pain, tearing, and photophobia. The right pupil is small, irregular, and poorly reactive. Vision testing obtained by using the Snellen chart is 20/30 OS and 20/80 OD. The most likely dx is:
- unilateral herpetic conjunctivitis
- open-angle glaucoma
- angle-closure glaucoma
- anterior uveitis
anterior uveitis
Mrs. Allen is a 67 y/o woman iwth DMII who c/o seeing flashing lights & floaters, decreased visual acuity, and metamorphopsia in her L eye. The most likely dx is:
- open-angle glaucoma
- central retinal artery occlusion
- anterior uveitis
- retinal detachment
retinal detachment
For Mrs. Allen, the most appropriate next course of action is:
- placement o an eye shield and f/u in 48h
- initiate tx with an ophthalmic antimicrobial solution
- initiate tx with a corticosteroid ophthalmic solution
- immediate referral to an ophthalmologist
immediate referral to an ophthalmologist
A 46 y/o man presents with eye pain. He reports that he was cutting a tree with a chain saw when some wood fragments is his eye. You consider all of the following except:
- education the patient on the use of appropriate eye protection for primary prevention of eye trauma
- immediately removing any protruding foreign body from the eye
- using fluorescein staining to detect small objects in the eye
- prompt referral to an eye care specialist
prompt referral to an eye care specialist
*Which of the following is a common vision problem in the person with untreated primary open-angle glaucoma (POAG)?
- peripheral vision loss
- blurring of near vision
- difficulty with distant vision
- need for increased illumination
peripheral vision loss
POAG is primarily caused by:
-degeneration of the optic nerve
-hypotension in the anterior maxillary artery
elevated intraocular pressure
Which of the following is most likely to be found on the fundoscopic examination in a patient with untreated POAG?
- excessive cupping of the optic disk
- arteriovenous nicking
- papilledema
- flame-shaped hemorrhages
excessive cupping of the optic disk
Risk factors for POAG include all of the following except:
- African ancestry
- DMII
- advance age
- blue eye color
blue eye color
Key diagnostic findings in POAG include which of the following?
- intraocular pressure greater than 25mmHG
- papilledema
- cup to disk ratio greater than 0.4
- sluggish pupillary response
intraocular pressure greater than 25mmHG
Adults at high risk for POAG should undergo a complete eye exam every:
1-2 yrs
3-4 yrs
5-6 yrs
3-6 months
1-2 yrs
