Nursing 620 Exam 1 2023| 216
Questions and solved Answers |100%
Correct |A Grade.
Dry Eye - -Is a common syndrome affecting mostly those > 40 yo
More prevalent in Hispanics and Asians
Affects both eyes - usually
-How do patients describe Dry Eye? - -Feels like sand in the eye
Eyes feel hot
Irritated and red
Burning
Itching
Excessive tearing
Photophobia
Is worse in smoky and dry environments
-Dry Eye occurs as a result of: - -1) Mechanical Abnormality such as eye ball protrusion,
eyelid abnormalities and misuse of contact lenses
2) Lacrimal Gland Dysfunction
3) Mucin Deficiency
-Differential Diagnosis of Dry Eye Include: - -Conjunctivitis
Blepharitis
Contact lens complications
Exophthalmos
Bell's Palsy
Medicamentosa
Sjogrens Syndrome
,Age-related changes
Hormonal changes
Systemic vitamin A deficiency
Drug Action
-What is Epiphora? - -Excessive tearing
-Differential Diagnosis for Epiphora include: - -Allergens
Dry eye syndrome
Viral or Bacterial Conjunctivitis
Blocked Lacrimal Duct
Ectropion
Trauma (foreign body or corneal abrasion)
Environmental pollutants
Glaucoma
-What is the most important thing for the clinician to know when dealing with eye pain?
- -When to refer to an ophthalmologist
-Conditions requiring immediate referral include: - -Sudden vision loss
Sudden non-traumatic eye pain
When the physical exam reveals:
corneal abrasion
suspected herpes zoster ophthalmicus
hazy cornea
irregular pupils
elevation of fundus on exam
papilledema
limbal flush
muscle paresis
Management Issues:
steroid therapy
,no improvement in pt condition after treatment
-Recommendation #1 to begin empiric therapy is guided by the following three typical
presentations.
These are made to help distinguish between Acute Bacterial Rhinosinusitis and
uncomplicated Viral URI. Once the diagnosis has been made treatment should not be
delayed.
The three typical presentations are: - -1. Onset with persistent symptoms that last > 10
days and not improving
2. Onset with severe symptoms, characterized by high fever of at least 39 C or 102 F and
purulent nasal discharge for at least 3-4 consecutive days at the beginning of the illness.
3. Onset with worsening symptoms characterized by typical viral URI symptoms that
appear to improve followed by the sudden onset of worsening symptoms after 5-6 days
(double-sickening)
-What is the typical triad of symptoms for Acute Bacterial Rhinosinusitis in Adults? - -1.
Headache
2. Facial Pain
3. Fever
----Onset with persistent symptoms is far more frequent
-In children with Acute Bacterial Rhinosinusitis, what is the usual presenting
condition? - -1. The most common is a cough (80%)
2. Nasal discharge (76%)
3. Fever (63%)
Parents of preschoolers often report malodorous breath
-Differential Diagnosis for Mouth Sores: - -• Food or drug allergies
• Chemical irritation
, • Dry mouth
• Mechanical or Thermal injury
• Infections (fungal, viral or bacterial)
• Host Immunosupression
• Nutritional deficiency
-Differential Diagnosis for Hoarseness: - -• Infection
• Inflammation
• Overuse
• Vocal cord pathology
• Vocal cord paralysis
• Muscle atrophy (aging)
• Gastroesophageal reflux
• Chronic Allergies
-Differential Diagnosis for Sore Throat: - -• Streptococcal pharyngitis
• Tonsillitis
• HSV
• Gonococcus
• Candidiasis
• Aphthous ulceration
• Rhinovirus, adenovirus, Epstein-Barr virus, Coxsackievirus
• Mycoplasma
-What are Common Eye Complaints? - -• Redness
• Dry eye
• Watery or purulent eye discharge
• Eye pain
• Impaired vision
• Ocular itching
• Swelling of the eyelid
Questions and solved Answers |100%
Correct |A Grade.
Dry Eye - -Is a common syndrome affecting mostly those > 40 yo
More prevalent in Hispanics and Asians
Affects both eyes - usually
-How do patients describe Dry Eye? - -Feels like sand in the eye
Eyes feel hot
Irritated and red
Burning
Itching
Excessive tearing
Photophobia
Is worse in smoky and dry environments
-Dry Eye occurs as a result of: - -1) Mechanical Abnormality such as eye ball protrusion,
eyelid abnormalities and misuse of contact lenses
2) Lacrimal Gland Dysfunction
3) Mucin Deficiency
-Differential Diagnosis of Dry Eye Include: - -Conjunctivitis
Blepharitis
Contact lens complications
Exophthalmos
Bell's Palsy
Medicamentosa
Sjogrens Syndrome
,Age-related changes
Hormonal changes
Systemic vitamin A deficiency
Drug Action
-What is Epiphora? - -Excessive tearing
-Differential Diagnosis for Epiphora include: - -Allergens
Dry eye syndrome
Viral or Bacterial Conjunctivitis
Blocked Lacrimal Duct
Ectropion
Trauma (foreign body or corneal abrasion)
Environmental pollutants
Glaucoma
-What is the most important thing for the clinician to know when dealing with eye pain?
- -When to refer to an ophthalmologist
-Conditions requiring immediate referral include: - -Sudden vision loss
Sudden non-traumatic eye pain
When the physical exam reveals:
corneal abrasion
suspected herpes zoster ophthalmicus
hazy cornea
irregular pupils
elevation of fundus on exam
papilledema
limbal flush
muscle paresis
Management Issues:
steroid therapy
,no improvement in pt condition after treatment
-Recommendation #1 to begin empiric therapy is guided by the following three typical
presentations.
These are made to help distinguish between Acute Bacterial Rhinosinusitis and
uncomplicated Viral URI. Once the diagnosis has been made treatment should not be
delayed.
The three typical presentations are: - -1. Onset with persistent symptoms that last > 10
days and not improving
2. Onset with severe symptoms, characterized by high fever of at least 39 C or 102 F and
purulent nasal discharge for at least 3-4 consecutive days at the beginning of the illness.
3. Onset with worsening symptoms characterized by typical viral URI symptoms that
appear to improve followed by the sudden onset of worsening symptoms after 5-6 days
(double-sickening)
-What is the typical triad of symptoms for Acute Bacterial Rhinosinusitis in Adults? - -1.
Headache
2. Facial Pain
3. Fever
----Onset with persistent symptoms is far more frequent
-In children with Acute Bacterial Rhinosinusitis, what is the usual presenting
condition? - -1. The most common is a cough (80%)
2. Nasal discharge (76%)
3. Fever (63%)
Parents of preschoolers often report malodorous breath
-Differential Diagnosis for Mouth Sores: - -• Food or drug allergies
• Chemical irritation
, • Dry mouth
• Mechanical or Thermal injury
• Infections (fungal, viral or bacterial)
• Host Immunosupression
• Nutritional deficiency
-Differential Diagnosis for Hoarseness: - -• Infection
• Inflammation
• Overuse
• Vocal cord pathology
• Vocal cord paralysis
• Muscle atrophy (aging)
• Gastroesophageal reflux
• Chronic Allergies
-Differential Diagnosis for Sore Throat: - -• Streptococcal pharyngitis
• Tonsillitis
• HSV
• Gonococcus
• Candidiasis
• Aphthous ulceration
• Rhinovirus, adenovirus, Epstein-Barr virus, Coxsackievirus
• Mycoplasma
-What are Common Eye Complaints? - -• Redness
• Dry eye
• Watery or purulent eye discharge
• Eye pain
• Impaired vision
• Ocular itching
• Swelling of the eyelid
