Eye and Ear disorders

Question 1

A 12 day old infant otherwise healthy presents with 2 day hx of bil eye irritation. No significant birth hx. Received proper neonatal care in nursery. Exam + bil lid swelling, + chemosis and + mucoid discharge. The most likely cause of this condition is:

a. Gonococcal conjunctivitis
b. Neonatal adenovirus infection
c. Chemical irritation from neonatal chemoprophylaxis
d. Chlamydial conjunctivitis

Answer 1

c. Chemical irritation from neonatal chemoprophylaxis

Question 2

Tim has suspected mononucleosis. Now he is febrile and was found to have bil AOM. Which of the following should not be prescribed?

a. Azithromycin
b. Ibuprofen
c. Amoxicillin
d. Tylenol

Answer 2

c. Amoxicillin

Question 3

When examining a patient who has otitis media with effusion, the pediatric primary care nurse practitioner expects to find:

a. Perforated TM
b. Decreased mobility of TM
c. Pain on manipulation of the externa auditory canal
d. Normal Hearing

Answer 3

b. Decreased mobility of TM

Question 4

A three-month-old patient with up-to-date immunizations has a runny nose, a low-grade fever, and a paroxysmal cough that has worsened over the past few days. The patient has coughed so hard that scleral hemorrhages are present with reported perioral cyanosis. The most likely diagnosis is:

a. Nasopharyngitis
b. Bronchitis
c. Pneumonia
d. Pertussis

Answer 4

d. Pertussis

Question 5

The pediatric primary care nurse practitioner treats a two-year-old patient with acute otitis media (AOM). The parents report a concern regarding speech delay. Review of the medical record reveals 4 additional AOM diagnoses in the past six months. The initial plan of care is to:

a. Monitor for ongoing ear infections
b. Obtain a referral for early intervention for speech evaluation
c. Refer the patient to ENT for consultation
d. Obtain audio evaluation for speech concerns

Answer 5

c. Refer the patient to ENT for consultation

Question 6

Confirming the diagnosis of chlamydia conjunctivitis in a newborn would be best done by obtaining which one of the following?

a. urine PCR of the mother
b. culture of the eye discharge
c. culture of the conjunctival scrapings
d. cervical swab of the mother

Answer 6

c. culture of the conjunctival scrapings

Question 7

Concurrent otitis media and conjunctivitis is likely due to which organism?

a. Streptococcus pneumonia
b. Haemophilus influenza
c. Moxarella catarrhalis
d. Staphylococcus aureus

Answer 7

b. Haemophilus influenza

Question 8

Which of the following eye findings would be considered an ophthalmic emergency?

a. Cobblestone-like appearance along the inner aspect of the upper eyelid in a 15-year-old
b. Bilateral redness along eyelid margins with tiny ulcerated areas in a 16-year-old
c. Unilateral vesicular lesions on the upper eyelid in a 3-week-old
d. Presence of chemosis in a 5 -year-old with bilateral upper eyelid edema

Answer 8

c. Unilateral vesicular lesions on the upper eyelid in a 3-week-old

Question 9

A 15-month-old failed treatment with Amoxicillin for otitis media. At his 2 week recheck, his TM remained red with distorted landmarks, and he persisted with nasal congestion and poor nighttime sleeping, and he had a 101 F fever for the past 2 days. the next best step would be to treat with:

a. A 3- week course of cephalosporin
b. Ceftriaxone and an antihistamine
c. A higher dose Amoxicillin and topical antibiotics
d. A 10-day course of high dose Augmentin

Answer 9

d. A 10-day course of high dose Augmentin

Question 10

Which foreign body in the nose requires immediate removal?

a. Salt
b. Battery
c. Stone
d. Bead

Answer 10

b. Battery