DX Flashcards
32yo F presents for problem visit, CC: “my eyes are red and feel scratchy.” No significant PMH, but she reports she is just getting over a cold or some kind of URI. Symptoms started suddenly yesterday morning to both eyes. Discharge from the eyes is clear and watery. On physical exam, bilateral conjunctiva are erythematous with mild preauricular adenitis. Visual acuity is intact, PERRLA.
You suspect….
viral conjunctivitis
most commonly caused by adenovirus
25yo F presents for a problem visit, CC: “my eyes hurt and look all red.” No significant PMH. Symptoms started suddenly a few days ago, first her right eye was “all crusty” when she woke up and the next day they both were and both eyes also looked red. She notes her eyelids are matted together when she wakes up in the morning with a yellow crust. On physical exam, bilateral conjunctiva are erythematous. Visual acuity is intact, PERRLA.
You suspect….
bacterial conjunctivitis
21yo F presents for a problem visit, CC: “my eyes are all red and feel scratchy.” PMH significant for seasonal allergies and asthma. Symptoms have been going on for a few months with itching, tearing, and redness. Discharge from the eye is clear and watery. On physical exam, bilateral conjunctiva are erythematous and tearing. Visual acuity is intact, PERRLA.
You suspect….
allergic conjunctivitis
32yo F presents for a problem visit, CC: “I feel like there is grit in my right eye and it hurts, its all red, but I can’t see anything in it.” No significant PMH. Symptoms started suddenly 2 days ago, she noticed getting home after her soccer game. Pain is 4/10. Associated photophobia and blurry vision that does not clear with blinking. On physical exam, her right eye appears erythematous. PERRLA, visual acuity intact bilaterally.
You suspect….
corneal abrasion, recommend flourescein stain
19yo F presents for a problem visit, CC: “my eyes still hurt and look all red.” PMH significant for bacterial conjunctivitis diagnosed last week. Her symptoms started last week suddenly, first her right eye was “all crusty” when she woke up and the next day they both were and both eyes also looked red. She notes her eyelids are matted together when she wakes up in the morning with a yellow crust. She was prescribed topical erythromycin ointment but notes no improvement. On physical exam, bilateral conjunctiva are markedly erythematous and purulent discharge is copious. Visual acuity is intact, PERRLA. On further questioning, she notes that she also is having purulent vaginal discharge. She had her first sexual encounter last week before the symptoms started and they did not use condoms.
You suspect….
bacterial conjunctivitis, possibly gonorrhea or chlamydia in nature. recommend cultures
50yo presents for a problem visit, CC: “changing skin mole” No significant PMH. On physical exam, you note a 1cm waxy, semi-translucent nodule with rolled borders, central ulceration, and telangiectasia on the forearm.
You suspect….
basal cell carcinoma
30yo presents for a problem visit, CC: “skin rash” No significant PMH. On physical exam, you note a 1cm erythematous lesion to the trunk with central clearing surrounded by an advancing red, scaly, elevated border.
You suspect….
tinea corporis
