CDM Exam 3 - PRACTICE QS
A 23 year-old graduate student presents with a sudden onset of severe dizziness, with nausea
and vomiting for the past couple of hours. She denies hearing loss or tinnitus. She has had a
recent cold. Which of the following is the most likely diagnosis?
A) Ménière's disease
B) Vestibular neuronitis
C) Benign positional vertigo
D)Vertebrobasilar insufficiency
B) Vestibular neuronitis
A patient presents with a complaint of sudden onset of recurrent episodic vertigo for one week
that happens when rolling onto the left side. The patient states that this sensation lasts
approximately 30 seconds and then goes away. The patient admits to associated nausea. The
patient denies associated hearing difficulties or tinnitus. Which of the following is the most likely
diagnosis?
A) Benign positional vertigo
B) Ménière's disease
C)Acoustic neuroma
D)Vestibular neuronitis
A) Benign positional vertigo
Which of the following organisms is not a common pathogen causing bacterial conjunctivitis?
A) Streptococcus pneumoniae
B) Staphylococcus aureus
C) Haemophilus aegyptius
D) Moraxella sp.
E) Chlamydia trachomotis
E) Chlamydia trachomotis
,A 32-year-old woman comes to your office with a 1-week history of bilateral red eyes associated
with tearing and crusting, a sore throat with difficulty swallowing, and a cough that was initially
nonproductive but has become productive during the past few days. The patient displays
significant fatigue and lethargy, is hoarse, and is having great difficulty performing any of her
routine daily chores.
On physical examination, there is bilateral conjunctival injection. Her visual acuity is normal.
There is significant pharyngeal erythema but no exudate. Cervical lymphadenitis is not present.
Examination of the chest reveals a few expiratory crackles bilaterally.
What is the most likely diagnsosis?
Viral Conjunctivitis (adenovirus)
A 7 year old boy presents to your clinic with thick purulent discharge from her right eye which
was significantly worse this morning. What should you do next?
A) take a sample of the discharge and send it to the lab for culture.
B) send the patient home to perform warm compresses for 20 minutes 3 times daily tell them to
come back if symptoms become worse
C) moxifloxacin 0.5% drops tid for 7 to 10 days
D) topical 1% prednisolone acetate qid
C) moxifloxacin 0.5% drops tid for 7 to 10 days
A 12 year old present to your office with red eyes, itching and tearing bilaterally. He has a past
medical history significant for asthma. As you examine the inner eyelid what finding do you
expect to see?
A) cobblestone mucosa
B) Kayser-Fleischer rings
C) mucopurulent discharge
D) dendritic ulcerations
A) cobblestone mucosa
A 17-year-old girl comes to your office with a 1-day history of red eye. She describes not being
able to open her right eye in the morning because of crusting and discharge. The right eye feels
swollen and uncomfortable, although there is no pain. On examination, she has a significant
redness and injection of the right bulbar and palpebral conjunctivae. There is a mucopurulent
, discharge present. No other abnormalities are present on physical examination. Her visual
acuity is normal.
A) bacterial conjunctivitis
B) viral conjunctivitis
C) allergic conjunctivitis
D) autoimmune conjunctivitis
A) bacterial conjunctivitis
A 12 year-old presents with complaint of both eyes "watering." He also complains of sinus
congestion and sneezing for two weeks. On exam vital signs are T-38°C, P-80/minute, and
RR-20/minute. The eyes reveal mild conjunctival injection bilaterally, clear watery discharge,
and no matting. Pupils are equal, round, and reactive to light and accommodation. The
extraocular movements are intact. The funduscopic exam shows normal disc and vessels. The
TMs are normal and the canals are clear. The nasal mucosa is boggy, with clear rhinorrhea.
Which of the following is the most helpful pharmacologic agent?
A) Artificial tears
B) Tobramycin drops
C) Erythromycin ointment
D) Naphazoline (Naphcon-A) drops
D) Naphazoline (Naphcon-A) drops
A patient is evaluated in the office with a red eye. The patient awoke with redness and a watery
discharge from the eye. The eyelids were not matted together. Examination reveals a palpable
preauricular node. Which of the following is the most likely diagnosis?
A) bacterial conjunctivitis
B) viral conjunctivitis
C) allergic conjunctivitis
D) gonococcal conjunctivitis
B) viral conjunctivitis
A 23 year-old sexually active female presents with a 4 day history of painless bilateral eye
exudates which she describes as copious. Visual acuity is 20/20, generalized conjunctival
inflammation with sparing of the cornea is noted on physical examination. Gram stain of the
exudate reveals gram negative diplococci. Appropriate management of this case is
A) ceftriaxone (Rocephin)
B) polymyxin ophthalmic drops (Aerosporin)
C) ciprofloxacin (Cipro)
A 23 year-old graduate student presents with a sudden onset of severe dizziness, with nausea
and vomiting for the past couple of hours. She denies hearing loss or tinnitus. She has had a
recent cold. Which of the following is the most likely diagnosis?
A) Ménière's disease
B) Vestibular neuronitis
C) Benign positional vertigo
D)Vertebrobasilar insufficiency
B) Vestibular neuronitis
A patient presents with a complaint of sudden onset of recurrent episodic vertigo for one week
that happens when rolling onto the left side. The patient states that this sensation lasts
approximately 30 seconds and then goes away. The patient admits to associated nausea. The
patient denies associated hearing difficulties or tinnitus. Which of the following is the most likely
diagnosis?
A) Benign positional vertigo
B) Ménière's disease
C)Acoustic neuroma
D)Vestibular neuronitis
A) Benign positional vertigo
Which of the following organisms is not a common pathogen causing bacterial conjunctivitis?
A) Streptococcus pneumoniae
B) Staphylococcus aureus
C) Haemophilus aegyptius
D) Moraxella sp.
E) Chlamydia trachomotis
E) Chlamydia trachomotis
,A 32-year-old woman comes to your office with a 1-week history of bilateral red eyes associated
with tearing and crusting, a sore throat with difficulty swallowing, and a cough that was initially
nonproductive but has become productive during the past few days. The patient displays
significant fatigue and lethargy, is hoarse, and is having great difficulty performing any of her
routine daily chores.
On physical examination, there is bilateral conjunctival injection. Her visual acuity is normal.
There is significant pharyngeal erythema but no exudate. Cervical lymphadenitis is not present.
Examination of the chest reveals a few expiratory crackles bilaterally.
What is the most likely diagnsosis?
Viral Conjunctivitis (adenovirus)
A 7 year old boy presents to your clinic with thick purulent discharge from her right eye which
was significantly worse this morning. What should you do next?
A) take a sample of the discharge and send it to the lab for culture.
B) send the patient home to perform warm compresses for 20 minutes 3 times daily tell them to
come back if symptoms become worse
C) moxifloxacin 0.5% drops tid for 7 to 10 days
D) topical 1% prednisolone acetate qid
C) moxifloxacin 0.5% drops tid for 7 to 10 days
A 12 year old present to your office with red eyes, itching and tearing bilaterally. He has a past
medical history significant for asthma. As you examine the inner eyelid what finding do you
expect to see?
A) cobblestone mucosa
B) Kayser-Fleischer rings
C) mucopurulent discharge
D) dendritic ulcerations
A) cobblestone mucosa
A 17-year-old girl comes to your office with a 1-day history of red eye. She describes not being
able to open her right eye in the morning because of crusting and discharge. The right eye feels
swollen and uncomfortable, although there is no pain. On examination, she has a significant
redness and injection of the right bulbar and palpebral conjunctivae. There is a mucopurulent
, discharge present. No other abnormalities are present on physical examination. Her visual
acuity is normal.
A) bacterial conjunctivitis
B) viral conjunctivitis
C) allergic conjunctivitis
D) autoimmune conjunctivitis
A) bacterial conjunctivitis
A 12 year-old presents with complaint of both eyes "watering." He also complains of sinus
congestion and sneezing for two weeks. On exam vital signs are T-38°C, P-80/minute, and
RR-20/minute. The eyes reveal mild conjunctival injection bilaterally, clear watery discharge,
and no matting. Pupils are equal, round, and reactive to light and accommodation. The
extraocular movements are intact. The funduscopic exam shows normal disc and vessels. The
TMs are normal and the canals are clear. The nasal mucosa is boggy, with clear rhinorrhea.
Which of the following is the most helpful pharmacologic agent?
A) Artificial tears
B) Tobramycin drops
C) Erythromycin ointment
D) Naphazoline (Naphcon-A) drops
D) Naphazoline (Naphcon-A) drops
A patient is evaluated in the office with a red eye. The patient awoke with redness and a watery
discharge from the eye. The eyelids were not matted together. Examination reveals a palpable
preauricular node. Which of the following is the most likely diagnosis?
A) bacterial conjunctivitis
B) viral conjunctivitis
C) allergic conjunctivitis
D) gonococcal conjunctivitis
B) viral conjunctivitis
A 23 year-old sexually active female presents with a 4 day history of painless bilateral eye
exudates which she describes as copious. Visual acuity is 20/20, generalized conjunctival
inflammation with sparing of the cornea is noted on physical examination. Gram stain of the
exudate reveals gram negative diplococci. Appropriate management of this case is
A) ceftriaxone (Rocephin)
B) polymyxin ophthalmic drops (Aerosporin)
C) ciprofloxacin (Cipro)
