NR 602 Final Exam questions with correct
answers
A mother presents with her 3 month old child and complains of goopy
eye that is sometimes matted shut after naps. Upon exam the conjunctiva
is clear with some mild crusting to eye lashes. What is the diagnosis and
patient teaching? Correct Answer-Probable lacrimal duct obstruction.
-The baby will likely grow out if it somewhere between six and 12
months.
-You can do a daily lacrimal duct massage and warm compresses to help
open up the duct.
-Watch for Periorbital cellulitis or bacterial conjunctivitis.
Nine-year-old patient presents with tender, swollen, erythemic bump to
eyelid. What is the diagnosis and patient education? Correct Answer-
Hordeolum (stye)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when stye pops, if doesn't will refer to optho.
What is blepharitis? Correct Answer-inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
,What is the treatment for blepharitis? Correct Answer-Cleanse with baby
shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tertracycline but not to pediatrics who
don't have adult teeth, can cause discoloration. Pediatrics can have
Bactrim.
A 9 year old patient presents with acute swelling and erythema to eyelid
with flaky, scaly debris to eyelid margins. Patient reports gritty, burning
feeling to eyes. She has already attempted warm compresses and
washing eyelids with baby soap with minimal relief. What is the
diagnosis and treatment? Correct Answer-Patient has anterior blepharitis
Treat with erythromycin ointment, ointment has longer contact with eye.
Can use azithromycin ointment x 4 weeks for long term treatment
Can use doxycycline or tetracycline for chronic in kids >8 years or
Azithromycin oral for kids <8
What organism is likely to cause viral conjunctivitis? Correct Answer--
Adenovirus
-HSV
-Herpes
,What organism is likely to cause bacterial conjunctivitis? Correct
Answer--Staph aureus
-strep pneumoniae
-H. Influenza
A 10-year-old patient presents with unilateral conjunctivitis with watery
discharge x 2 days along with itching of the eye. Mother denies any
other associated symptoms. What is the diagnosis and treatment?
Correct Answer-Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
What is herpes keratitis? Correct Answer-Herpes viral infection to the
eye caused by HSV.
A 19-year-old male presents with blurred vision, watery discharge,
photophobia, and eye redness. Upon exam you note fern-like lines under
the woods lamp. What is the diagnosis and tx? Correct Answer-Herpes
Keratitis
Tx: Antivirals
A 16-year-old female presents with complaints of sudden onset of red,
watery, and painful left eye. She reports possible foreign body to eye.
, Upon inspection you visualize a n erythemic lesion to the eye. When
using woods lamp you note a small superficial laceration. What is the dx
and tx? Correct Answer-Corneal abrasion, refer to optho emergently or
send to ER.
A mother brings her nine-year-old overweight son to the clinic with
complaints of pain to the groin, knee, and right hip. She reports patient
has been walking with a limp for the last couple days but unable to
ambulate today. Mother denies any recent trauma. Upon inspection there
is external rotation of the right foot. What is the dx and tx? Correct
Answer-Slipped capital femoral epiphysis
Refer to ER, will need surgery.
-most common in adolescent, obese males.
Father presents with his four-year-old son and states that patient has
been limping since this morning and was crying all night complaining of
left hip pain. Upon exam you appreciate decreased range of motion of
left hip but no external rotation or signs of trauma. What is the probable
diagnostics, and treatment? Correct Answer-Toxic transient syndrome-
most common cause of limp in peds.
Order: CBC, ESR, and X-ray. WBC and ESR will be elevated. X-RAY
will be normal.
-advise father that will resolve in 2-6 weeks.
answers
A mother presents with her 3 month old child and complains of goopy
eye that is sometimes matted shut after naps. Upon exam the conjunctiva
is clear with some mild crusting to eye lashes. What is the diagnosis and
patient teaching? Correct Answer-Probable lacrimal duct obstruction.
-The baby will likely grow out if it somewhere between six and 12
months.
-You can do a daily lacrimal duct massage and warm compresses to help
open up the duct.
-Watch for Periorbital cellulitis or bacterial conjunctivitis.
Nine-year-old patient presents with tender, swollen, erythemic bump to
eyelid. What is the diagnosis and patient education? Correct Answer-
Hordeolum (stye)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when stye pops, if doesn't will refer to optho.
What is blepharitis? Correct Answer-inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
,What is the treatment for blepharitis? Correct Answer-Cleanse with baby
shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tertracycline but not to pediatrics who
don't have adult teeth, can cause discoloration. Pediatrics can have
Bactrim.
A 9 year old patient presents with acute swelling and erythema to eyelid
with flaky, scaly debris to eyelid margins. Patient reports gritty, burning
feeling to eyes. She has already attempted warm compresses and
washing eyelids with baby soap with minimal relief. What is the
diagnosis and treatment? Correct Answer-Patient has anterior blepharitis
Treat with erythromycin ointment, ointment has longer contact with eye.
Can use azithromycin ointment x 4 weeks for long term treatment
Can use doxycycline or tetracycline for chronic in kids >8 years or
Azithromycin oral for kids <8
What organism is likely to cause viral conjunctivitis? Correct Answer--
Adenovirus
-HSV
-Herpes
,What organism is likely to cause bacterial conjunctivitis? Correct
Answer--Staph aureus
-strep pneumoniae
-H. Influenza
A 10-year-old patient presents with unilateral conjunctivitis with watery
discharge x 2 days along with itching of the eye. Mother denies any
other associated symptoms. What is the diagnosis and treatment?
Correct Answer-Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
What is herpes keratitis? Correct Answer-Herpes viral infection to the
eye caused by HSV.
A 19-year-old male presents with blurred vision, watery discharge,
photophobia, and eye redness. Upon exam you note fern-like lines under
the woods lamp. What is the diagnosis and tx? Correct Answer-Herpes
Keratitis
Tx: Antivirals
A 16-year-old female presents with complaints of sudden onset of red,
watery, and painful left eye. She reports possible foreign body to eye.
, Upon inspection you visualize a n erythemic lesion to the eye. When
using woods lamp you note a small superficial laceration. What is the dx
and tx? Correct Answer-Corneal abrasion, refer to optho emergently or
send to ER.
A mother brings her nine-year-old overweight son to the clinic with
complaints of pain to the groin, knee, and right hip. She reports patient
has been walking with a limp for the last couple days but unable to
ambulate today. Mother denies any recent trauma. Upon inspection there
is external rotation of the right foot. What is the dx and tx? Correct
Answer-Slipped capital femoral epiphysis
Refer to ER, will need surgery.
-most common in adolescent, obese males.
Father presents with his four-year-old son and states that patient has
been limping since this morning and was crying all night complaining of
left hip pain. Upon exam you appreciate decreased range of motion of
left hip but no external rotation or signs of trauma. What is the probable
diagnostics, and treatment? Correct Answer-Toxic transient syndrome-
most common cause of limp in peds.
Order: CBC, ESR, and X-ray. WBC and ESR will be elevated. X-RAY
will be normal.
-advise father that will resolve in 2-6 weeks.
