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TB Chapter 19- Disorders of Visual Function

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TB Chapter 19- Disorders of Visual Function

Institution
Porth\\\'s Pathophysiology
Course
Porth\\\'s Pathophysiology

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10/15/24, 10:04 TB Chapter 19- Disorders of Visual
AM Function




1. A care aide at a long-term care facility has informed a resident physician that an
80- year-old woman's eyes appear to be inflamed and that her eyelids are caked
with sticky secretions. The woman has been subsequently diagnosed with
posterior blepharitis. Which of the following treatments is the physician likely to
initiate?
A) Surgical repair of the woman's blocked meibomian glands
B) Warm compresses to be applied regularly to her eyes in addition to oral antibiotics
C) Regularly scheduled cleansing of the woman's eyes with normal saline
D) Intravenous steroids coupled with topical antibiotic
ointment Ans: B
Feedback:
Treatment of posterior blepharitis is determined by associated conjunctival and
corneal changes. Initial therapies can include warm compressing of the lids and use
of flaxseed or fish oil tablets to provide omega-3 fatty acid benefits to meibomian oil
secretions.
Long-term, low-dose systemic antibiotic therapy guided by results of bacterial
cultures along with short-term topical steroids may also be needed.


2. The father of a third grade girl has brought his daughter to a walk-in clinic because
he believes the girl has pink eye, which has been going around the students in her
class. The nurse at the clinic concurs with the father's suspicion of conjunctivitis.
Which follow-up explanation by the nurse is most accurate?
A) “The insides of her eyelids have become infected. This often produces
severe discomfort.”
B) “The surfaces of her eyes have bacteria or a virus established, and it's important
to maintain good hand hygiene until it goes away.”
C) “An antibiotic ointment will likely resolve her infection, but pain control will
be necessary in the mean time.”
D) “It's important to aggressively treat this in children, since damage to her sight can
result if it's not treated.”
Ans: B
Feedback:
Conjunctivitis often spontaneously resolves. The pain associated with conjunctivitis
usually produces only mild discomfort compared with severe discomfort associated
with corneal lesions or deep and severe pain associated with acute glaucoma.
Conjunctivitis may spread to other family members. The corneal surface is not
primarily involved, and pain that is severe suggests corneal involvement rather than
conjunctivitis. Sight damage is not likely to result.




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, 10/15/24, 10:04 TB Chapter 19- Disorders of Visual
AM Function




3. A 32-year-old man is complaining of burning, itching, photophobia, and severe pain
in his right eye after swimming in the ocean. To determine that the eye condition
was a corneal rather than a conjunctival disease, which of the following would be the
distinguishing symptom?
A) Burning
B) Itching
C) Photophobia
D) Severe
pain Ans: D
Feedback:
While burning, itching, and photophobia are all important symptoms of conjunctivitis,
severe pain suggests corneal rather than conjunctival disease.


4. A 30-year-old woman has sought care because of her recurrent photophobia, tearing,
and eye irritation. During assessment, her care provider asks about any history of cold
sores or genital herpes. What is the rationale for the care provider’s line of
questioning?
A) Herpes simplex virus (HSV) conjunctivitis indicated a need for antiviral rather
than antibacterial treatment.
B) HSV infection of the cornea is a common cause of corneal ulceration
and blindness.
C) Chronic viral infection of the eyes can result in HSV autoinoculation of the
mouth and labia.
D) A history of HSV with eye irritation is suggestive of
glaucoma. Ans: B
Feedback:
Herpes simplex virus (HSV) keratitis (not conjunctivitis) with stromal scarring is the
most common cause of corneal ulceration and blindness in the Western world.
Autoinoculation from the eyes to other sites is not common, and glaucoma is not
noted to be a consequence or symptom of HSV infection.




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