EXAM 1 NR 545 UPDATED ACTUAL
Exam Questions and CORRECT Answers
- CORRECT ANSWER -
Allergic conjunctivitis: - CORRECT ANSWER - IgE mediated disease in response to
triggers. Common triggers can be seasonal such as grass, pollens, and mold. Persistent allergic
triggers include dust mites and animal dander.
Bilateral, itchy red eyes with rope like discharge and clear nasal discharge
Bilateral injected conjunctiva, clear discharge
Treatment based on identification and limiting exposure to allergen.
Medications include cromolyn ophthalmic drops, oral antihistamines, antihistamine eye drops
Viral conjunctivitis: - CORRECT ANSWER - Most commonly caused by the adenovirus.
Unilateral or bilateral red eyes, reports of current or recent viral infection, such as a UTI
Unilateral or bilateral injected conjunctiva, watery discharge
No antibacterial therapy needed.
Virus resolves in 2-3 weeks
Bacterial conjunctivitis: - CORRECT ANSWER - Common bacteria include:
Staphylococci, streptococci, chlamydial organisms and gonococci.
Some bacterial causes can be quite serious.
Gonococcal conjunctivitis can result in blindness and can indicate underlying systemic infection.
Usually unilateral, red and irritated
Eyelids are "stuck together" upon awakening.
Injected palpebral and bulbar conjunctiva, purulent drainage
Treatment is provided to decrease spread of contagion and shorten course of illness.
Eye drop treatments include Polymixin B plus trimethoprim or azithromycin.
, Otitis Externa - CORRECT ANSWER - inflammation of the externa ear canal, is also
known commonly as swimmer's ear. Occurring in both children and adults, otitis externa can
present as a range of physical symptoms from a minor inflammation to reports of intense pain.
Otitis Externa Risk Factors
Swimming
Impacted cerumen
Use of hearing aids/ear plugs
Trauma from cotton tip applicators or other items used to clean ear canal
Foreign bodies
Anatomic causes: narrow ear canals, sharp angles in the ear canal or excessive hair in the canal
The normally acidic pH of the ear canal tends to inhibit microorganism growth. Swimming in a
pool where the pH is usually alkaline can result in altered pH of the ear canal. It is thought that it
is this alteration in pH creates a favorable environment for bacteria or fungal growth. The most
common causative agent is P. aeruginosa, other causes include Candida or Aspergillus species.
Common complaints (subjective findings):
Children: irritability, crying, disrupted sleep. Unilateral ear tugging, unilateral otalgia
Adults: unilateral otalgia
Physical exam (objective findings): Ear pain is increased upon palpation of tragus. The external
ear canal epithelium edema may extend from the pinna all the way to the tympanic membrane.
Purulent or serous discharge is noted in the canal.
Medication management depends upon the causative factors:
Pain management: OTC analgesics include ibuprofen or acetaminophen as appropriate for age
and weight
Bacterial Otitis externa can be treated with antimicrobial otic drops, which include polymyxin B
plus neomycin with or without hydrocortisone, ofloxacin, and ciprofloxacin HC otic drops
In cases of severe inflammation, insertion of an ear wick may be required to ensure medication
instillation to affected areas.
Otitis Media (AOM) - CORRECT ANSWER - Middle ear inflammation which results
from and obstruction of the Eustachian tube. The Eustachian tube dysfunction results in negative
pressure within the middle ear, enabling pharyngeal pathogens to be aspirated into the middle
ear. The causes can be viral, bacterial or allergy mediated.
Exam Questions and CORRECT Answers
- CORRECT ANSWER -
Allergic conjunctivitis: - CORRECT ANSWER - IgE mediated disease in response to
triggers. Common triggers can be seasonal such as grass, pollens, and mold. Persistent allergic
triggers include dust mites and animal dander.
Bilateral, itchy red eyes with rope like discharge and clear nasal discharge
Bilateral injected conjunctiva, clear discharge
Treatment based on identification and limiting exposure to allergen.
Medications include cromolyn ophthalmic drops, oral antihistamines, antihistamine eye drops
Viral conjunctivitis: - CORRECT ANSWER - Most commonly caused by the adenovirus.
Unilateral or bilateral red eyes, reports of current or recent viral infection, such as a UTI
Unilateral or bilateral injected conjunctiva, watery discharge
No antibacterial therapy needed.
Virus resolves in 2-3 weeks
Bacterial conjunctivitis: - CORRECT ANSWER - Common bacteria include:
Staphylococci, streptococci, chlamydial organisms and gonococci.
Some bacterial causes can be quite serious.
Gonococcal conjunctivitis can result in blindness and can indicate underlying systemic infection.
Usually unilateral, red and irritated
Eyelids are "stuck together" upon awakening.
Injected palpebral and bulbar conjunctiva, purulent drainage
Treatment is provided to decrease spread of contagion and shorten course of illness.
Eye drop treatments include Polymixin B plus trimethoprim or azithromycin.
, Otitis Externa - CORRECT ANSWER - inflammation of the externa ear canal, is also
known commonly as swimmer's ear. Occurring in both children and adults, otitis externa can
present as a range of physical symptoms from a minor inflammation to reports of intense pain.
Otitis Externa Risk Factors
Swimming
Impacted cerumen
Use of hearing aids/ear plugs
Trauma from cotton tip applicators or other items used to clean ear canal
Foreign bodies
Anatomic causes: narrow ear canals, sharp angles in the ear canal or excessive hair in the canal
The normally acidic pH of the ear canal tends to inhibit microorganism growth. Swimming in a
pool where the pH is usually alkaline can result in altered pH of the ear canal. It is thought that it
is this alteration in pH creates a favorable environment for bacteria or fungal growth. The most
common causative agent is P. aeruginosa, other causes include Candida or Aspergillus species.
Common complaints (subjective findings):
Children: irritability, crying, disrupted sleep. Unilateral ear tugging, unilateral otalgia
Adults: unilateral otalgia
Physical exam (objective findings): Ear pain is increased upon palpation of tragus. The external
ear canal epithelium edema may extend from the pinna all the way to the tympanic membrane.
Purulent or serous discharge is noted in the canal.
Medication management depends upon the causative factors:
Pain management: OTC analgesics include ibuprofen or acetaminophen as appropriate for age
and weight
Bacterial Otitis externa can be treated with antimicrobial otic drops, which include polymyxin B
plus neomycin with or without hydrocortisone, ofloxacin, and ciprofloxacin HC otic drops
In cases of severe inflammation, insertion of an ear wick may be required to ensure medication
instillation to affected areas.
Otitis Media (AOM) - CORRECT ANSWER - Middle ear inflammation which results
from and obstruction of the Eustachian tube. The Eustachian tube dysfunction results in negative
pressure within the middle ear, enabling pharyngeal pathogens to be aspirated into the middle
ear. The causes can be viral, bacterial or allergy mediated.
