424--Quiz 2 (eye/ear disorders)

Question 1

Conjunctivitis–types, S/S, & management.

Answer 1

Viral (adenovirus & flu)–viral illness going on at same time.
Bacterial (staph, NB chlamydia & gonorrhea)–itchy, pink, no pain, yellow/crusty discharge.
Allergic–itchy, swollen, no pain, watery discharge.
Nx: ed., hand-washing, warm compress, ABX only for bacterial.

Question 2

Nasolacrimal duct obstruction

Answer 2

= clogged tear duct, unilateral, usu resolve in 1 yr.
S/S: chronic tearing, mucopurulent discharge.
Tx: massage, watchful-waiting, ABX if infected.

Question 3

Eye lid disorders–list

Answer 3

Hordeolum, chalazion, blepharitis.

Question 4

Hordeolum

Answer 4

= (eyelid disorder) infect sebaceous gland of eyelid, external “sty” in eye.
S/S: painFUL.
Tx: ABX.

Question 5

Chalazion

Answer 5

= (eyelid disorder) chronic infect meibomian gland of eyelid, internal “sty” in eye.
S/S: painLESS.
Tx: resolves on own.

Question 6

Blepharitis

Answer 6

= (eyelid disorder) swelling eyelid.
S/S: scaling/discharge along eyelid margin.
Tx: ABX.

Question 7

Periorbital cellulitis

Answer 7

= bact infect eyelid & tissue around eye d/t bug bites/scratch.
Tx: warm soak, ABX (maybe IV).

Question 8

Visual disturbances–list

Answer 8

Refractive errors, astigmatism, strabismus, amblyopia, nystagmus, infantile glaucoma, congenital cataracts, retinopathy of prematurity, visual impairment

Question 9

Refractive errors

Answer 9

= most common cause of visual disturbances.

Question 10

Astigmatism

Answer 10

= (visual disturbance) uneven curvature of cornea ==> light enters eye unevenly.

Question 11

Strabismus

Answer 11

= (visual disturbance) misalignment of eyes.
Exotropia = eyes turn OUTward.
Esotropia = eyes turn INward.
Dx: cover test, CLR (corneal-light reflex)

Question 12

Amblyopia

Answer 12

= (visual disturbance) “lazy-eye,” poor visual development in a normal eye, eye & brain not communicating together, may be caused by differences btw 2 eyes (ex: astigmatism, strabismus, diff visual acuity).
Tx: patch, vision therapy, surgery if caused by strabismus.

Question 13

Nystagmus

Answer 13

= (visual disturbance) irreg rapid eye movement, usually d/t neuro problem.
Dx: see in EOM exam.

Question 14

Infantile glaucoma

Answer 14

= (visual disturbance) obstruct flow aqueous humor ==> increased intraocular P.
Tx: surgery.

Question 15

Congenital cataracts

Answer 15

= (visual disturbance) opacity of eye(s) at birth, ==> amblyopia is unTx’ed.

Question 16

Retinopathy of prematurity

Answer 16

= (visual disturbance) abnorm vessel devel in retina of premature baby

Question 17

Visual impairment

Answer 17

= (visual disturbance) acuity 20/60 - 20/200. Legal blind >20/200.
Nx: ed. parents regarding how to promote development despite visual impairment.

Question 18

Acute otitis media/otitis media w/ effusion

Answer 18

Usually viral, can be bacterial (Tx: ABX). Usually age 1-2 d/t position of Eustachian tubes.
Prevent: breastfeed, no bottles in bed, no 2nd hand smoke.

Question 19

Otitis externa

Answer 19

= “swimmer’s ear” infect outer ear.
Tx: gtts.
Nx: ed. warm gtts in hands, drop onto edge so can trickle down (if hit ear drum = painful), lie down 10 mins.

Question 20

Hearing loss

Answer 20

Condutive = sound doesn’t transmit to middle ear, usu wax/toy obstructing.
Sensorineural = damaged hair cells in cochlea.
Dx: Weber test (bone conduction), Rinne (air conduction–should be 2x longer than bone).