Chap 8

Question 1

An acutely presenting, erythematous, tender lump within the eyelid is called:

a. Blepharitis
b. Hordeolum
c. Chalazion
d. Iritis

Answer 1

Hordeolum

Question 2

The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?

a. Viral conjunctivitis
b. Keratoconjunctivitis
c. Bacterial conjunctivitis
d. Allergic conjunctivitis

Answer 2

Bacterial conjunctivitis

Question 3

Which subtype of cataracts is characterized by significant nearsightedness and a slow indolent course?

a. Nuclear cataracts
b. Cortical cataracts
c. Posterior cataracts
d. Immature cataracts

Answer 3

Nuclear cataracts

Question 4

Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts?

a. The body converts bilberry to vitamin A, which helps to maintain a healthy lens.
b. Bilberry blocks an enzyme that leads to sorbitol accumulation that contributes to cataract formation in diabetes.
c. Bilberry boosts oxygen and blood delivery to the eye.
d. Bilberry is a good choice for patients with diabetes as it does not interact with antidiabetic drugs.

Answer 4

Bilberry boosts oxygen and blood delivery to the eye.

Question 5

A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?

a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist.
d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.

Answer 5

Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist.

Question 6

Acute angle-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure?

a. 0 to 7 mm Hg
b. 8 to 21 mm Hg
c. 22 to 40 mm Hg
d. 40 to 80 mm Hg

Answer 6

8 to 21 mm Hg

Question 7

As diabetic retinopathy progresses, the presence of ‘cotton wool’ spots can be detected. Cotton wool spots refer to:

a. Nerve fiber layer infarctions
b. Blood vessel proliferation
c. Venous beading
d. Retinal hemorrhage

Answer 7

Nerve fiber layer infarctions

Question 8

Which of the following is an example of sensorineural hearing loss?

a. Perforation of the tympanic membrane
b. Otosclerosis
c. Cholesteatoma
d. Presbycusis

Answer 8

presbycusis

Question 9

The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient’s mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinician know when the sound fades away. This is an example of which type of test?

a. Weber test
b. Schwabach test
c. Rinne test
d. Auditory brainstem response (ABR) test

Answer 9

Rinne test

Question 10

A patient presents to the clinician complaining of ear pain. On examination, the clinician finds that the patient has tenderness on traction of the pinna as well as when applying pressure over the tragus. These findings are classic signs of which condition?

a. Otitis media
b. Meniere’s disease
c. Tinnitus
d. Otitis externa

Answer 10

otitis externa

Question 11

Otitis media is considered chronic when:

a. Inflammation persists more than 3 months with intermittent or persistent otic discharge.
b. There are more than six occurrences of otitis media in a 1-year period.
c. Otitis media does not resolve after two courses of antibiotics.
d. All of the above

Answer 11

Inflammation persists more than 3 months with intermittent or persistent otic discharge.

Question 12

The most significant precipitating event leading to otitis media with effusion is:

a. Pharyngitis
b. Allergies
c. Viral upper respiratory infection (URI)
d. Perforation of the eardrum

Answer 12

c. Viral upper respiratory infection (URI)

Question 13

Patients with acute otitis media should be referred to a specialist in which of the following situations?

a. Concurrent vertigo or ataxia
b. Failed closure of a ruptured tympanic membrane
c. If symptoms worsen after 3 or 4 days of treatment
d. All of the above

Answer 13

All of the above

Question 14

Which immunoglobulin mediates the type 1 hypersensitivity reaction involved in allergic rhinitis?

a. IgA
b. IgE
c. IgG
d. IgM

Answer 14

IgE

Question 15

Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis?

a. Vasomotor rhinitis
b. Rhinitis medicamentosum
c. Atrophic rhinitis
d. Viral rhinitis

Answer 15

Vasomotor rhinitis

Question 16

Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than:

a. 4 weeks
b. 8 weeks
c. 12 weeks
d. 16 weeks

Answer 16

12 weeks

Question 17

Which of the following antibiotics provides the best coverage in acute or chronic sinusitis when gram-negative organisms are suspected?

a. Penicillin V
b. Amoxicillin
c. Levofloxacin
d. Clindamycin

Answer 17

Levofloxacin

Question 18

In which of the following situations would referral to a specialist be needed for sinusitis?

a. Recurrent sinusitis
b. Allergic sinusitis
c. Sinusitis that is refractory to antibiotic therapy
d. All of the above

Answer 18

All of the above

Question 19

Which type of stomatitis results in necrotic ulceration of the oral mucous membranes?

a. Vincent’s stomatitis
b. Allergic stomatitis
c. Apthous stomatitis
d. Herpetic stomatitis

Answer 19

Vincent’s stomatitis

Question 20

The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection?

a. HSV type 2
b. HIV
c. Pneumonia
d. Syphilis

Answer 20

HIV

Question 21

Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens?

a. Coxsackievirus
b. Cytomegalovirus
c. Francisella tularensis
d. Group A streptococcus

Answer 21

Group A streptococcus

Question 22

A patient presents with the following signs and symptoms: gradual onset of low-grade fever, marked fatigue, severe sore throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which of the following conditions is most likely the cause?

a. Gonorrhea
b. Mononucleosis
c. Influenza
d. Herpes zoster

Answer 22

MONONUCLEOSIS

Question 23

A patient presents to the clinician with a sore throat, fever of 100.7F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
c. A throat culture should be performed to confirm the results of the rapid strep test.
d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

Answer 23

A throat culture should be performed to confirm the results of the rapid strep test.

Question 24

Which of the following medications used in the treatment of glaucoma works by constricting the pupils to open the angle and allow aqueous fluid to escape?

a. Pilocarpine
b. Timolol
c. Brinzolamide
d. Acetazolamide

Answer 24

Pilocarpine

Question 25

You have a patient who is a positive for Strep on rapid antigen testing (rapid strep test). You order amoxacillin after checking for drug allergies (patient is negative) but he returns 3 days later, reporting that his temperature has gone up, not down (101.5 F in office). You also note significant adenopathy, most notably in the posterior and anterior cervical chains, some hepatomegaly, and a diffuse rash. You decide:

a. to refer the patient.
b. that he is having an allergic response and needs to be changed to a macrolide antibiotic.
c. that his antibiotic dosage is not sufficient and should be changed.
d. that he possibly has mononucleosis concurrent with his strep infection.

Answer 25

d. that he possibly has mononucleosis concurrent with his strep infection.

Question 26

You are in the park playing with your children when you see that your friend is screaming for help. Her toddler has fallen and there is a stick lodged in his eye. The child is kicking and screaming and grabbing for the stick. You:

a. instruct his mother to hold him securely and not allow him to touch the stick, then carefully remove the stick from the eye.
b. stabilize the foreign object and accompany the mother and child to the local ER.
c. find a water fountain, hold the child to the water, and flush the eye.
d. call 911.

Answer 26

stabilize the foreign object and accompany the mother and child to the local ER.

Question 27

Indicate whether the statement is true or false.

1.	Severe pain associated with acute otitis media signifies perforation of the tympanic membrane

Answer 27

FALSE