Complete Solutions
What is dependency?
Use resulting in tolerance, withdrawal symptoms, decline in
normal activities, unsuccessful attempts to cut down or control
use
Use for longer period or larger amounts than intended, Use
consumes a lot of time to acquire and/or recover from effects,
continued use despite knowledge that is caused physical and/or
psychological problems
What are some differences in male vs. female sources of
prescription medications?
-males obtain from peers
-females from family, females more likely than males to report
prior lifetime medical use of opioids
What is I-STOP?
Internet System for Tracking Over-Prescribing, accessed
through the health commerce system
How often does NYS require prescribers to take a mandatory
education course on opioid prescribing?
Every 3 years
How often should an adult have an eye exam?
Under age 30, once if healthy
Under age 40, twice if healthy
,Age 40, baseline comprehensive exam
follow up depends on findings
Over age 60, every 1-2 years
exceptions: known eye disease, diabetes, trauma, contact lens
wearer
What are the characteristics of bacterial conjunctivitis?
•Purulent, thick discharge, crusted lids in morning.
•Normal acuity
•Sandy, gritty feeling
•Moderately heavy, diffuse conjunctival abnormality
•Can effect both eyes
•Typically fall & winter
What are the characteristics of viral conjunctivitis?
•Watery discharge
•Normal acuity
•Itching
•Moderate diffuse conjunctival abnormality
•Often bilaterally
•Palpable preauricular lymph nodes
•Highly contagious
•Often associated with URI
What are the characteristics of chemical conjunctivitis?
-Stringy mucoid discharge
-Normal acuity
-Itching & burning
-Mild diffuse conjunctival abnormality
,-Usually bilateral
-Associated with rhinorrhea, sneezing, watery eyes
-Occurs fall & spring
What are the characteristics of allergic conjunctivitis
-Discharge more mucus than pus
-Burning & itching
-Conjunctival hyperemia
-Eyelids swell, become thickened & excoriated
-Usually bilateral
-Mild cases the cornea will show punctate epithelial staining
with fluorescein.
-More severe have lg epithelial erosions & corneal ulceration
What antibiotics are used for the treatment of bacterial
conjunctivitis?
Erythromycin ointment
-1 cm in eye 4-6 times per day x 7-10 days
Polytrim
-1 drop in eye 4-6 times per day x 7 - 10 days
Cipro drops (contact lens wearer)
-1-2 drops in eye every 2 hours while awake x 2 days, then
every 4 hours x 5 days
What is keratitis?
inflammation of the cornea, very serious, can lead to loss of
vision
, Findings: corneal ulceration, upper eyelid edema, conjunctival
hyperemia, adherent mucopurulent exudate, surrounding corneal
inflammation
REFER, REFER, REFER - may need a corneal biopsy
Treatment - Specialized antibiotic drops and scheduling (every
hour)
What is a subconjunctival hemorrhage?
Hemorrhage over the sclera.
Painless
Normal vision
DT minor trauma: cough, sneeze
Tx: reassure
What is herpes zoster ophtalmicus?
shingles involving the trigeminal nerve, symptoms include eye
pain, fever, malaise, HA, neck stiffness, unilateral eye pain,
redness, vision changes, tearing, rash
*MAY lead to to vision loss, REFER to optho
acyclovir 800mg 5x/day
What is acute angle closure glaucoma?
The angle in the anterior chamber between the iris and the
cornea becomes shallow or narrow due to blockage
Dx:
-2 of the following: sudden onset severe ocular pain, N/V, or
intermittent blurring with halos
-3 of the following: IOP >21, conjunctival injection, corneal
epithelial edema, mild-dilated nonreactive pupil, or shallow