Emergency Medicine Exam 4 | Actual Questions and Answers
Latest Updated 2026/2027 (Graded A+)
your 23yo male pt presents c/o a painful red bump on his eye, he stats it showed up
over night. no associated sx. On Pe you note an edematous, erythematous bump with a
visible pustule on the lid margin.
• Question
dx/tx what is the pathogen
Correct Answer: hordeolum
warm compresses, erythromycin ophthalmic ointment bid for 7-10d
s. aureus
your 30yo pt c/o a painless red lump on her eyelid that has been growing over the last
week, there is mild erythema and no associated symptoms.
• Question
dx/tx pathogen?
Correct Answer: chalazion
warm compresses, may resolve on its own
not a bacterial infection- its a blockage.
your 16yo pt presents with an irritated, red left eye. On PE you note mucopurulent
discharge and his eyelash is matted. Conjunctival inflammation is present. This pt does
not wear contacts.
• Question
dx/tx
Correct Answer: bacterial conjunctivitis
erythromycin ointment, trimethoprim-polymyxin drops your 12 yo male pt comes in c/o
an irritated, red right eye. He states the eye has been tearing a lot. You note watery d/c,
chemosis, and palpable periauricular lymph nodes
• Question
dx/tx/ pathogen what needs to be ruled out
Correct Answer: viral conjunctivitis
,cool compresses, artificial tears
adenovirus
r/o HSV w fluorosceine stain
your 43yo female pt c/o a painful left eye with blurred vision. On PE you note chemosis,
conjunctival inflammation. On flurosceine stain you see dendritic lesions.
• Question
dx/tx
Correct Answer: herpes simplex
emergent ophthalmologist referral--> antiviral trifluorothymidine drops
your 60yo male pt presents with a U/L rash and eye pain on the left side of his face. He
c/o photophobia and states the rash tingles. On PE, you note blisters on the tip of his
nose.
• Question
dx/tx what is this sign called.
Correct Answer: I. herpes zoster opthalmicus
II. hutchinson's
III. acyclovir PO + erythromycin ophth ointment
IV. refer all to ophth
Your 13yo pt comes in c/o a red, itchy eyes bilaterally. He denies any pain, states he
noticed it when his parents got him a new hamster. he has a pmhx of eczema. on PE you
note papillae in the conjunctival fornix, watery d/c, and prominent chemosis.
• Question
dx/tx
Correct Answer: allergic conjunctivitis
eliminate allergen, cool compresses, topical ahx- olopatadine, cromolyn
23yo male patient, Blake, presents with severe, purulent discharge from his left eye. He
states the onset was over a day after coming home from the Bahamas and "has no idea
what it could be" (I have an idea)
, • Question
sx/dx
Correct Answer: gonococcal conjunctivitis
emergent ophth consult + cx, rocephin IM
10yo female brought in by mom, she states she had some congestion and a cough a
week ago and is now presenting with eyelid swelling, fever, eye pain and erythema. on
PE you note no pain with eye movement.
• Question
dx/tx
Correct Answer: preseptal cellulitis
amoxicillin/clav and 24hr f/u with ophth
7yo male brought in by dad, c/o chemosis, eyelid swelling, fever, and eye pain. He
states his son had a sinus infection recently hes still getting over. You note proptosis on
PE and pain with eye movement
• Question
how do you dx/dx/tx
Correct Answer: post septal cellulitis
dx with CT
immediate ophth consult, IV cefuroxime or ceftriaxone 40yo pt presenting with a red,
painful eye, stating it feels like there is something stuck in her eye. She also reports
photophobia and blurry vision. She currently wears contact lenses. on PE you note a
round, irregular ulcer w a white hazy base
• Question
dx/tx/pathogen
Correct Answer: corneal ulcer
emergent ophth referral -->fluoroquinolone drops
pseudomonas
44yo pt who recently had eye surgery presents with pain and decreased VA. on exam
you note hyperemia, chemosis and a hypopyon.
Latest Updated 2026/2027 (Graded A+)
your 23yo male pt presents c/o a painful red bump on his eye, he stats it showed up
over night. no associated sx. On Pe you note an edematous, erythematous bump with a
visible pustule on the lid margin.
• Question
dx/tx what is the pathogen
Correct Answer: hordeolum
warm compresses, erythromycin ophthalmic ointment bid for 7-10d
s. aureus
your 30yo pt c/o a painless red lump on her eyelid that has been growing over the last
week, there is mild erythema and no associated symptoms.
• Question
dx/tx pathogen?
Correct Answer: chalazion
warm compresses, may resolve on its own
not a bacterial infection- its a blockage.
your 16yo pt presents with an irritated, red left eye. On PE you note mucopurulent
discharge and his eyelash is matted. Conjunctival inflammation is present. This pt does
not wear contacts.
• Question
dx/tx
Correct Answer: bacterial conjunctivitis
erythromycin ointment, trimethoprim-polymyxin drops your 12 yo male pt comes in c/o
an irritated, red right eye. He states the eye has been tearing a lot. You note watery d/c,
chemosis, and palpable periauricular lymph nodes
• Question
dx/tx/ pathogen what needs to be ruled out
Correct Answer: viral conjunctivitis
,cool compresses, artificial tears
adenovirus
r/o HSV w fluorosceine stain
your 43yo female pt c/o a painful left eye with blurred vision. On PE you note chemosis,
conjunctival inflammation. On flurosceine stain you see dendritic lesions.
• Question
dx/tx
Correct Answer: herpes simplex
emergent ophthalmologist referral--> antiviral trifluorothymidine drops
your 60yo male pt presents with a U/L rash and eye pain on the left side of his face. He
c/o photophobia and states the rash tingles. On PE, you note blisters on the tip of his
nose.
• Question
dx/tx what is this sign called.
Correct Answer: I. herpes zoster opthalmicus
II. hutchinson's
III. acyclovir PO + erythromycin ophth ointment
IV. refer all to ophth
Your 13yo pt comes in c/o a red, itchy eyes bilaterally. He denies any pain, states he
noticed it when his parents got him a new hamster. he has a pmhx of eczema. on PE you
note papillae in the conjunctival fornix, watery d/c, and prominent chemosis.
• Question
dx/tx
Correct Answer: allergic conjunctivitis
eliminate allergen, cool compresses, topical ahx- olopatadine, cromolyn
23yo male patient, Blake, presents with severe, purulent discharge from his left eye. He
states the onset was over a day after coming home from the Bahamas and "has no idea
what it could be" (I have an idea)
, • Question
sx/dx
Correct Answer: gonococcal conjunctivitis
emergent ophth consult + cx, rocephin IM
10yo female brought in by mom, she states she had some congestion and a cough a
week ago and is now presenting with eyelid swelling, fever, eye pain and erythema. on
PE you note no pain with eye movement.
• Question
dx/tx
Correct Answer: preseptal cellulitis
amoxicillin/clav and 24hr f/u with ophth
7yo male brought in by dad, c/o chemosis, eyelid swelling, fever, and eye pain. He
states his son had a sinus infection recently hes still getting over. You note proptosis on
PE and pain with eye movement
• Question
how do you dx/dx/tx
Correct Answer: post septal cellulitis
dx with CT
immediate ophth consult, IV cefuroxime or ceftriaxone 40yo pt presenting with a red,
painful eye, stating it feels like there is something stuck in her eye. She also reports
photophobia and blurry vision. She currently wears contact lenses. on PE you note a
round, irregular ulcer w a white hazy base
• Question
dx/tx/pathogen
Correct Answer: corneal ulcer
emergent ophth referral -->fluoroquinolone drops
pseudomonas
44yo pt who recently had eye surgery presents with pain and decreased VA. on exam
you note hyperemia, chemosis and a hypopyon.
