NR569 Differential Diagnosis in Acute Care Final Study Guide NR569 Differential Diagnosis in Acute Care Final Study Guide
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1. Allergic Conjunctivitis: - Inflammation of the conjunctiva due to allergies is - Symptoms: Usually presents bilaterally, but symptoms often start in 1 eye 1-2
common, occurring in up to 40% of the population. Itching is the most consistent days prior. Pain and burning are the MOST PROMINENT symptoms, and eyes are
sign of allergic conjunctivitis; it is also characterized by red eyes and other allergic very red with copious tearing. Preauricular lymph node may be palpated, which is
disease symptoms such as sneezing. relatively specific to viral etiology. **Symptoms tend to worsen for the first few days,
and generally resolve within 1-2 weeks.**
- Symptoms: severe itching (MOST PROMINENT) , generalized hyperemia of the
conjunctiva, & mild-moderate tearing. Rubbing of eyelids can lead to eyelid edema **Hand washing and contact precautions are imperative to prevent the spread of
and temporary hyperpigmentation (allergic shiners/raccoon eyes). Allergic conjunc- infection.** If hospital staff become infected, they will have to be off for 7 days after
tivitis often accompanied by s/s of allergic rhinitis, including the presence of a crease symptoms start in SECOND eye.
on the nose from frequent manipulation (toddler salute). 5. Blepharitis: - Blepharitis, or inflammation of the eyelids, is characterized by
redness at the margins of the eyelids. Symptoms of blepharitis include: dry, red, itchy
- Treatment: Mild-moderate symptoms ma be managed with artificial tears and eyelids that may be crusted.
cool/cold compresses. Severe s/s may require an ophthalmology consultation, and
immune modulation with topical antihistamine, mast cell stabilizer, or mild steroid. - TREAT - Treatment involves supportive care and antibiotics. Supportive care:
2. Bacterial Conjunctivitis: Bacterial conjunctivitis is the second most common Use warm compresses to loosen the eyelid crusting. Gently scrub the eyelids with
cause of infectious conjunctivitis, Red, itchy eyes are associated with this condition, diluted baby shampoo at least twice daily. Use artificial tears to lubricate eyes as
as is purulent or mucopurulent discharge in one or both eyes. needed. Discontinue eye make-up until condition resolves and then re-start with new
products. Topical antibiotics: Agents with gram positive coverage - erythromycin or
- Symptoms: copious mucopurulent discharge (MOST PROMINENT), often unilat- ciprofloxacin ophthalmic ointment.
eral (helps distinguish from allergic/viral etiology) but may spread to both eyes via 6. Corneal Abrasion: - Corneal abrasion is characterized by an alteration in the
hands when rubbing eyes, and pain/irritation with severe hyperemia. **There should epithelial layer of the cornea due to trauma, foreign bodies, or chemical exposure.
be NO frank vision loss.** This condition is characterized by redness; however, pain, tearing, and sensitivity to
light are the more typical symptoms. Corneal abrasion is typically unilateral given
- Treatment: Usually with topical antibiotic ointments or drops. the etiology.
**Otherwise immunocompetent patients with unilateral disease may be treated
empirically with topical fluoroquinolones such as moxifloxacin or gatifloxixin. If no - TREAT - Treatment involves removal of foreign body and supportive care. Dis-
improvement within 48 hours, cultures should be repeated and ophthalmology continue contact lens use. Consider topical ophthalmic antibiotics appropriate for
should be consulted. the etiology of the abrasion (i.e., organic material, finger cat scratch), such as
3. Toxic Conjunctivitis: - Inflammation of the conjunctiva due to medications, erythromycin ointment or trimethoprim-polyumyxin B. Consider pseudomonas with
chemicals, or toxins can cause red, itchy eyes. contact lens, mascara, organic material as a foreign body etiology: treat with topical
fluoroquinolone. If evidence of bacterial keratitis, corneal opacification, or corneal
4. Viral Conjunctivitis: - Viral conjunctivitis is the most common cause of infectious infection, or globe penetration, EMERGENT OPHTHALMOLOGY CONSULTATION
conjunctivitis. Red, itchy eyes are associated with this condition, as is a watery IS INDICATED.
discharge. 7. Subconjunctival Hemorrhage: Subconjunctival hemorrhage is bleeding below
**65-90 % of viral conjunctivitis are caused by adenoviruses, which are highly conta- the conjunctiva and is characterized by a red patch on the sclera of the eye, rather
gious and spread through direct contact. Communicability is estimated to be 10-14 than generalized redness and/or itching.
days. Topical ophthalmic antihistamines (preferably OTC) may be recommended to
reduce itching and soothe the eyes. - TREAT - Treatment for subconjunctival hemorrhage is supportive care. Assess INR
level if patient is on warfarin.
Study online at https://quizlet.com/_dscg88 Study online at https://quizlet.com/_dscg88
1. Allergic Conjunctivitis: - Inflammation of the conjunctiva due to allergies is - Symptoms: Usually presents bilaterally, but symptoms often start in 1 eye 1-2
common, occurring in up to 40% of the population. Itching is the most consistent days prior. Pain and burning are the MOST PROMINENT symptoms, and eyes are
sign of allergic conjunctivitis; it is also characterized by red eyes and other allergic very red with copious tearing. Preauricular lymph node may be palpated, which is
disease symptoms such as sneezing. relatively specific to viral etiology. **Symptoms tend to worsen for the first few days,
and generally resolve within 1-2 weeks.**
- Symptoms: severe itching (MOST PROMINENT) , generalized hyperemia of the
conjunctiva, & mild-moderate tearing. Rubbing of eyelids can lead to eyelid edema **Hand washing and contact precautions are imperative to prevent the spread of
and temporary hyperpigmentation (allergic shiners/raccoon eyes). Allergic conjunc- infection.** If hospital staff become infected, they will have to be off for 7 days after
tivitis often accompanied by s/s of allergic rhinitis, including the presence of a crease symptoms start in SECOND eye.
on the nose from frequent manipulation (toddler salute). 5. Blepharitis: - Blepharitis, or inflammation of the eyelids, is characterized by
redness at the margins of the eyelids. Symptoms of blepharitis include: dry, red, itchy
- Treatment: Mild-moderate symptoms ma be managed with artificial tears and eyelids that may be crusted.
cool/cold compresses. Severe s/s may require an ophthalmology consultation, and
immune modulation with topical antihistamine, mast cell stabilizer, or mild steroid. - TREAT - Treatment involves supportive care and antibiotics. Supportive care:
2. Bacterial Conjunctivitis: Bacterial conjunctivitis is the second most common Use warm compresses to loosen the eyelid crusting. Gently scrub the eyelids with
cause of infectious conjunctivitis, Red, itchy eyes are associated with this condition, diluted baby shampoo at least twice daily. Use artificial tears to lubricate eyes as
as is purulent or mucopurulent discharge in one or both eyes. needed. Discontinue eye make-up until condition resolves and then re-start with new
products. Topical antibiotics: Agents with gram positive coverage - erythromycin or
- Symptoms: copious mucopurulent discharge (MOST PROMINENT), often unilat- ciprofloxacin ophthalmic ointment.
eral (helps distinguish from allergic/viral etiology) but may spread to both eyes via 6. Corneal Abrasion: - Corneal abrasion is characterized by an alteration in the
hands when rubbing eyes, and pain/irritation with severe hyperemia. **There should epithelial layer of the cornea due to trauma, foreign bodies, or chemical exposure.
be NO frank vision loss.** This condition is characterized by redness; however, pain, tearing, and sensitivity to
light are the more typical symptoms. Corneal abrasion is typically unilateral given
- Treatment: Usually with topical antibiotic ointments or drops. the etiology.
**Otherwise immunocompetent patients with unilateral disease may be treated
empirically with topical fluoroquinolones such as moxifloxacin or gatifloxixin. If no - TREAT - Treatment involves removal of foreign body and supportive care. Dis-
improvement within 48 hours, cultures should be repeated and ophthalmology continue contact lens use. Consider topical ophthalmic antibiotics appropriate for
should be consulted. the etiology of the abrasion (i.e., organic material, finger cat scratch), such as
3. Toxic Conjunctivitis: - Inflammation of the conjunctiva due to medications, erythromycin ointment or trimethoprim-polyumyxin B. Consider pseudomonas with
chemicals, or toxins can cause red, itchy eyes. contact lens, mascara, organic material as a foreign body etiology: treat with topical
fluoroquinolone. If evidence of bacterial keratitis, corneal opacification, or corneal
4. Viral Conjunctivitis: - Viral conjunctivitis is the most common cause of infectious infection, or globe penetration, EMERGENT OPHTHALMOLOGY CONSULTATION
conjunctivitis. Red, itchy eyes are associated with this condition, as is a watery IS INDICATED.
discharge. 7. Subconjunctival Hemorrhage: Subconjunctival hemorrhage is bleeding below
**65-90 % of viral conjunctivitis are caused by adenoviruses, which are highly conta- the conjunctiva and is characterized by a red patch on the sclera of the eye, rather
gious and spread through direct contact. Communicability is estimated to be 10-14 than generalized redness and/or itching.
days. Topical ophthalmic antihistamines (preferably OTC) may be recommended to
reduce itching and soothe the eyes. - TREAT - Treatment for subconjunctival hemorrhage is supportive care. Assess INR
level if patient is on warfarin.
