FNP 2 : MIDTERM NURS 5433 MIDTERM
STUDY GUIDE 2026 UPDATE WITH
COMPLETE SOLUTIONS
EENT System - Eye Disorders
Blepharitis
• Definition: Chronic ocular inflammation involving the eyelid margin.
• Common Associations: Dry eyes, rosacea, demodicosis.
• Types:
o Anterior: Affects eyelid skin, base of eyelashes, and follicles.
▪ Staphylococcal blepharitis: Characterized by scaling, crusting,
erythema; common in women in their 40s.
o Posterior: Affects meibomian glands.
▪ Symptoms: Excess foamy discharge, chalazion, rosacea.
• Features (Both Types):
o Conjunctival injection, burning sensation, excessive tearing,
photophobia, contact
lens intolerance, blurred/fluctuating vision.
• Risk Factors:
o Dry eye, frequent hordeola/chalazia, facial/scalp seborrhea,
immunocompromised
state, acne, diabetes, rosacea.
• Management:
o Non-Pharmacologic: Warm compresses, lid scrubs (baby shampoo),
meibomian
gland massage, avoid infected contacts.
o Pharmacologic:
▪ First-line: Bacitracin, erythromycin, quinolone ointments.
▪ Resistant cases: Oral antibiotics (Doxycycline 100
mg BID, Tetracycline 250 mg QID).
Hordeolum (Stye)
• Definition: Acute infection of the eyelid margin.
• Types:
o External: Affects hair follicles and eyelashes.
o Internal: Involves meibomian glands.
,• Symptoms: Erythema, tenderness, possible exudate.
• Treatment: Warm compresses, lid massage, antibiotics if needed.
,Chalazion
• Definition: Granulomatous inflammation of meibomian gland.
• Symptoms: Painless swelling, may initially be tender but evolves into a
nontender lump.
• Cause: Recurrent styes or blepharitis.
• Treatment: Warm compresses, lid massage, steroid injection if needed.
Conjunctivitis
• Definition: Inflammation of the conjunctiva.
• Types & Causes:
o Allergic: Triggered by allergens.
o Viral: Commonly caused by adenoviruses, coxsackie virus,
varicella, herpes zoster.
▪ Herpetic conjunctivitis: Fluorescein stain reveals
dendrites → Ophthalmology referral required.
o Bacterial: Caused by Staph, Strep, H. flu, M. catarrhalis,
Pseudomonas, Gonorrhea.
▪ Exudates present in bacterial conjunctivitis.
• Symptoms:
o Erythema, burning, exudate, foreign body sensation, preauricular
adenopathy,
tearing.
• Red Flags (Refer to Ophthalmology):
o Diminished visual acuity, photophobia, foreign body sensation,
corneal opacity,
fixed pupil, severe headache, proptosis.
• Management:
o Allergic: Antihistamine drops (Naphcon-A, Vasocon-A), mast cell
stabilizers
(Palatal, Optivar), allergen avoidance.
o Bacterial:
▪ First-line antibiotics: Azithromycin, erythromycin,
gentamicin, sulfacetamide, tobramycin,
bacitracin/polymyxin B, ciprofloxacin, ofloxacin.
▪ Severe cases: Moxifloxacin, gatifloxacin.
▪ Chlamydial/Gonococcal: Systemic + topical antibiotics
(Ceftriaxone, Doxycycline).
o Viral: Self-limiting, except herpetic cases (treat with vidarabine,
trifluridine, systemic herpes evaluation).
, Orbital & Periorbital Cellulitis
• Cause: Staph, Group A Strep, Strep pneumonia, H. influenza, fungal
infections.
• Management: Immediate referral to ophthalmology, hospitalization,
broad-spectrum antibiotics.
Pingueculum & Pterygium
• Cause: Chronic sun exposure, environmental irritants.
• Presentation:
o Pingueculum: Yellowish growth on nasal conjunctiva.
o Pterygium: Vascularized lesion extending to nasal cornea.
• Treatment: Lubricants, steroids. Surgical removal only if vision is affected.
Corneal Abrasion & Erosion
• Cause: Foreign bodies, trauma, sun overexposure.
• Symptoms: Pain, redness, photophobia, foreign body sensation.
• Diagnosis: Fluorescein stain, intraocular pressure measurement.
• Management:
o Prevention: Protective eyewear.
o Treatment: Antibiotics (Ciprofloxacin), reassess in 24-48 hours.
o Refer if no healing in 1-2 days.
Dry Eye
• Causes:
o Congenital or acquired (Sjogren’s, infections, trauma, Bell’s palsy,
medications,
menopause, prolonged screen time).
• Management (4 Levels):
1. Avoid irritants, artificial tears, lubricants.
2. Anti-inflammatory agents (Cyclosporine A, corticosteroids,
omega-3 fatty acids).
3. Referral to ophthalmology, special contact lenses, punctal occlusion.
4. Surgical intervention.
STUDY GUIDE 2026 UPDATE WITH
COMPLETE SOLUTIONS
EENT System - Eye Disorders
Blepharitis
• Definition: Chronic ocular inflammation involving the eyelid margin.
• Common Associations: Dry eyes, rosacea, demodicosis.
• Types:
o Anterior: Affects eyelid skin, base of eyelashes, and follicles.
▪ Staphylococcal blepharitis: Characterized by scaling, crusting,
erythema; common in women in their 40s.
o Posterior: Affects meibomian glands.
▪ Symptoms: Excess foamy discharge, chalazion, rosacea.
• Features (Both Types):
o Conjunctival injection, burning sensation, excessive tearing,
photophobia, contact
lens intolerance, blurred/fluctuating vision.
• Risk Factors:
o Dry eye, frequent hordeola/chalazia, facial/scalp seborrhea,
immunocompromised
state, acne, diabetes, rosacea.
• Management:
o Non-Pharmacologic: Warm compresses, lid scrubs (baby shampoo),
meibomian
gland massage, avoid infected contacts.
o Pharmacologic:
▪ First-line: Bacitracin, erythromycin, quinolone ointments.
▪ Resistant cases: Oral antibiotics (Doxycycline 100
mg BID, Tetracycline 250 mg QID).
Hordeolum (Stye)
• Definition: Acute infection of the eyelid margin.
• Types:
o External: Affects hair follicles and eyelashes.
o Internal: Involves meibomian glands.
,• Symptoms: Erythema, tenderness, possible exudate.
• Treatment: Warm compresses, lid massage, antibiotics if needed.
,Chalazion
• Definition: Granulomatous inflammation of meibomian gland.
• Symptoms: Painless swelling, may initially be tender but evolves into a
nontender lump.
• Cause: Recurrent styes or blepharitis.
• Treatment: Warm compresses, lid massage, steroid injection if needed.
Conjunctivitis
• Definition: Inflammation of the conjunctiva.
• Types & Causes:
o Allergic: Triggered by allergens.
o Viral: Commonly caused by adenoviruses, coxsackie virus,
varicella, herpes zoster.
▪ Herpetic conjunctivitis: Fluorescein stain reveals
dendrites → Ophthalmology referral required.
o Bacterial: Caused by Staph, Strep, H. flu, M. catarrhalis,
Pseudomonas, Gonorrhea.
▪ Exudates present in bacterial conjunctivitis.
• Symptoms:
o Erythema, burning, exudate, foreign body sensation, preauricular
adenopathy,
tearing.
• Red Flags (Refer to Ophthalmology):
o Diminished visual acuity, photophobia, foreign body sensation,
corneal opacity,
fixed pupil, severe headache, proptosis.
• Management:
o Allergic: Antihistamine drops (Naphcon-A, Vasocon-A), mast cell
stabilizers
(Palatal, Optivar), allergen avoidance.
o Bacterial:
▪ First-line antibiotics: Azithromycin, erythromycin,
gentamicin, sulfacetamide, tobramycin,
bacitracin/polymyxin B, ciprofloxacin, ofloxacin.
▪ Severe cases: Moxifloxacin, gatifloxacin.
▪ Chlamydial/Gonococcal: Systemic + topical antibiotics
(Ceftriaxone, Doxycycline).
o Viral: Self-limiting, except herpetic cases (treat with vidarabine,
trifluridine, systemic herpes evaluation).
, Orbital & Periorbital Cellulitis
• Cause: Staph, Group A Strep, Strep pneumonia, H. influenza, fungal
infections.
• Management: Immediate referral to ophthalmology, hospitalization,
broad-spectrum antibiotics.
Pingueculum & Pterygium
• Cause: Chronic sun exposure, environmental irritants.
• Presentation:
o Pingueculum: Yellowish growth on nasal conjunctiva.
o Pterygium: Vascularized lesion extending to nasal cornea.
• Treatment: Lubricants, steroids. Surgical removal only if vision is affected.
Corneal Abrasion & Erosion
• Cause: Foreign bodies, trauma, sun overexposure.
• Symptoms: Pain, redness, photophobia, foreign body sensation.
• Diagnosis: Fluorescein stain, intraocular pressure measurement.
• Management:
o Prevention: Protective eyewear.
o Treatment: Antibiotics (Ciprofloxacin), reassess in 24-48 hours.
o Refer if no healing in 1-2 days.
Dry Eye
• Causes:
o Congenital or acquired (Sjogren’s, infections, trauma, Bell’s palsy,
medications,
menopause, prolonged screen time).
• Management (4 Levels):
1. Avoid irritants, artificial tears, lubricants.
2. Anti-inflammatory agents (Cyclosporine A, corticosteroids,
omega-3 fatty acids).
3. Referral to ophthalmology, special contact lenses, punctal occlusion.
4. Surgical intervention.
