1
NR 569
Final Exam: NR 569 / NR569 (Latest Update )
Differential Diagnosis in Acute Care Practicum | Q&A | 100%
Correct | Grade A - Chamberlain
1. Conjunctivitis- Allergic
Symptoms and Management: Inflammation of the conjunctiva due to allergies is
common, occurring in
up to 40% of the population. Itching is the most consistent sign of allergic conjunctivitis;
it is also characterized by red eyes and other allergic disease symptoms such as sneezing.
2.Conjunctivitis- Infectious
Symptoms and Management: Bacterial Conjunctivitis: Bacterial conjunctivitis is the
second most com-
mon cause of infectious conjunctivitis. Red, itchy eyes are associated with this condition,
as is purulent or mucopurulent discharge in one or both eyes.
Toxic Conjunctivitis: Inflammation of the conjunctiva due to medications, chemicals, or
toxins can cause red, itchy eyes.
NR 569
, 2
NR 569
Viral Conjunctivitis: Viral conjunctivitis is the most common cause of infectious
conjunctivitis. Red, itchy eyes are associated with this condition, as is a watery discharge.
3.Otitis externa: Often bilateral Pain on manipulation of pinna Precipitated by:
excess moisture (swimmer's ear)
trauma
dermatitis (90%
bacterial, 10%
fungal)
4. otits media:
usually after URI
Pain is unilateral, deep, and severe
Irritability
Restlessness
Fever
Ear feels full
Physical findings:
tympanic membrane inflamed and bulging
Decreased light reflex
Decreased mobility on insufflation
NR 569
, 3
NR 569
5. Otitis barotrauma: aggravated by URI hay fever middle ear effusions stuffy nose
decent in airplane
6. Eustachitis: inflammation of the eustachian tube
Tympanic membrane shows decreased mobility
Decreased conductive hearing
Impedance
7. Ramsay Hunt Syndrome (RHS): Herpes zoster with vesicular rash, ipsilateral facial
paralysis, ear pain with vesicles in auditory canal, auricle.
May cause vertigo, headache, fever, malaise.
Risk factors: past varicella infection, age, immunocompromised, autoimmune disorders.
8. Malignant otitis externa (MOE): Necrotizing external otitis.
Severe otalgia and otorrhea unresponsive to topical treatment. Pain worse at night and
with chewing.
Risk factors: age, DM, immunocompromised.
9. Auricle Hematoma: Collection of blood within the outer ear cartilage.
Also referred to as "cauliflower ear".
Typically occurs due to blunt trauma/sports.
Ear swelling with or without pain.
NR 569
, 4
NR 569
10. cholesteatoma: Abnormal non-cancerous skin growth behind TM.
keratinized mass in the mastoid or middle ear which can be associated with intracranial
complications.
Patients suspected of having a cholesteatoma should be assessed for facial nerve
palsy and intracranial abscess. Causes: repeated AOM. Pain, foul-smelling drainage,
hearing loss, pressure, vertigo. May cause facial muscle paralysis.
11. ROS: EAR
Have you noticed any drainage or blood coming from the ear?: Purulent drainage is a
commonly reported finding with AOE and cholesteatoma but may not be present.
Drainage is not associated with AOM and OME unless the TM has ruptured.
12. Ear pain/infection: Differentials:
13. Otitis media with effusion (OME): Otitis media with effusion (OME) is fluid in the
middle ear, without the presence of infection.
Causes: URI, barotrauma, allergies, or a recent AOM infection. Mild pain, conductive
hearing loss may be present.
Air bubbles are seen behind the TM.
NR 569
NR 569
Final Exam: NR 569 / NR569 (Latest Update )
Differential Diagnosis in Acute Care Practicum | Q&A | 100%
Correct | Grade A - Chamberlain
1. Conjunctivitis- Allergic
Symptoms and Management: Inflammation of the conjunctiva due to allergies is
common, occurring in
up to 40% of the population. Itching is the most consistent sign of allergic conjunctivitis;
it is also characterized by red eyes and other allergic disease symptoms such as sneezing.
2.Conjunctivitis- Infectious
Symptoms and Management: Bacterial Conjunctivitis: Bacterial conjunctivitis is the
second most com-
mon cause of infectious conjunctivitis. Red, itchy eyes are associated with this condition,
as is purulent or mucopurulent discharge in one or both eyes.
Toxic Conjunctivitis: Inflammation of the conjunctiva due to medications, chemicals, or
toxins can cause red, itchy eyes.
NR 569
, 2
NR 569
Viral Conjunctivitis: Viral conjunctivitis is the most common cause of infectious
conjunctivitis. Red, itchy eyes are associated with this condition, as is a watery discharge.
3.Otitis externa: Often bilateral Pain on manipulation of pinna Precipitated by:
excess moisture (swimmer's ear)
trauma
dermatitis (90%
bacterial, 10%
fungal)
4. otits media:
usually after URI
Pain is unilateral, deep, and severe
Irritability
Restlessness
Fever
Ear feels full
Physical findings:
tympanic membrane inflamed and bulging
Decreased light reflex
Decreased mobility on insufflation
NR 569
, 3
NR 569
5. Otitis barotrauma: aggravated by URI hay fever middle ear effusions stuffy nose
decent in airplane
6. Eustachitis: inflammation of the eustachian tube
Tympanic membrane shows decreased mobility
Decreased conductive hearing
Impedance
7. Ramsay Hunt Syndrome (RHS): Herpes zoster with vesicular rash, ipsilateral facial
paralysis, ear pain with vesicles in auditory canal, auricle.
May cause vertigo, headache, fever, malaise.
Risk factors: past varicella infection, age, immunocompromised, autoimmune disorders.
8. Malignant otitis externa (MOE): Necrotizing external otitis.
Severe otalgia and otorrhea unresponsive to topical treatment. Pain worse at night and
with chewing.
Risk factors: age, DM, immunocompromised.
9. Auricle Hematoma: Collection of blood within the outer ear cartilage.
Also referred to as "cauliflower ear".
Typically occurs due to blunt trauma/sports.
Ear swelling with or without pain.
NR 569
, 4
NR 569
10. cholesteatoma: Abnormal non-cancerous skin growth behind TM.
keratinized mass in the mastoid or middle ear which can be associated with intracranial
complications.
Patients suspected of having a cholesteatoma should be assessed for facial nerve
palsy and intracranial abscess. Causes: repeated AOM. Pain, foul-smelling drainage,
hearing loss, pressure, vertigo. May cause facial muscle paralysis.
11. ROS: EAR
Have you noticed any drainage or blood coming from the ear?: Purulent drainage is a
commonly reported finding with AOE and cholesteatoma but may not be present.
Drainage is not associated with AOM and OME unless the TM has ruptured.
12. Ear pain/infection: Differentials:
13. Otitis media with effusion (OME): Otitis media with effusion (OME) is fluid in the
middle ear, without the presence of infection.
Causes: URI, barotrauma, allergies, or a recent AOM infection. Mild pain, conductive
hearing loss may be present.
Air bubbles are seen behind the TM.
NR 569
