Ocular Infections

Question 1

Exudates & discharge w/o photophobia, eye pain, or blurred vision is a sign of?

Answer 1

Conjunctivitis

Question 2

Blurred vision, eye pain, photophobia, exudate, corneal clouding, and discharge is a sign of?

Answer 2

Keratitis

Corneal ulceration

Question 3

Blurred vision, eye pain, photophobia, without exudate or discharge is a sign of?

Answer 3

Acute iritis

Inflammation of the iris

Question 4

Itching is most assoc. with {{BLANK}} conjunctivitis

Answer 4

Allergic

Question 5

PMNs and profuse exudate are assoc. with {{BLANK}} conjuncitivis

Answer 5

Bacterial

Question 6

{{BLANK}} conjuncitivis is assoc. w/ monocytes and lack of exudate

Answer 6

Viral

Question 7

{{BLANK}} is the most common virus leading to conjuncitivis

Answer 7

Adenovirus

Question 8

Swimming pool conjunctivitis is typically assoc. w/?

Answer 8

Adenovirus

Question 9

Opthalmia neonatorum is assoc. w/?

Answer 9

Gonococcal infection

Question 10

Purulent inclusion conjunctivitis is assoc. w/?

Answer 10

Chlamydia trachomatis

Question 11

Is C. trachomatis infection dangers?

Answer 11

• Initial conjunctivitis stimulates Ab production that can lead to granulation (w/ repeat infections)
• Can damage cornea (trichosis & scratching) leading to scarring & blindness

Question 12

What are the most common causes of blepharitis?

Answer 12

• S. aureus
• S. epidermidis
• Viruses (incl. HSV-1)

Tx: warm compress w/ possible ABx

Question 13

Keratitis is usually positive for photobia except in cases caused by {{BLANK}} in which photophobia is minimal

Answer 13

Herpetic keratitis (HSV-1)

Question 14

HSV-1 keratitis can be visualized utilizing {{BLANK}} or {{BLANK}} dyes to elucidate dendritic ulcers

Answer 14

• Fluorescein
• Rose bengal

Question 15

An elderly patient presents with a unilateral painful rash along their upper torso with a minor rash above their right eye. They report the rash is painful and you can also see they are having trouble keeping their right eye open. You diagnose them with VZV keratitis. What are viral characteristics assoc. w/ VZV?

Answer 15

• Enveloped
• dsDNA

Question 16

A patient wearing contact lenses left their cleaning solution at home and had to use some of their friend’s solution. Days later they are diagnosed with keratitis. You tell them the contact solution may have been contaminated with?

Answer 16

Acanthamoeba

Known to affect contaminated storage/wash solutions

Question 17

A patient comes to you complaining of eye pain and sensitivity. You acquire a PMH along with noting they do not change their contact lenses very often, in fact, the ones they are currently wearing have been in for approx. 3 weeks. What is the likely pathogen leading to their keratitis?

Answer 17

P. aeruginosa

Question 18

A patient is diagnosed with endophthalmitis after cataracts surgery. It has only been 4 weeks since surgery. What is the most likely pathogen?

fluid in ant chamber, inflammation of intraocular cavities

Answer 18

• S. aureus (< 6 weeks)
• If > 6 weeks = Propionibacterium acnes

Nosocomial = P. aeruginosa

Question 19

What are characteristics of CMV retinitis?

Answer 19

• Hemorrhagic necrosis of retina
• Immunocompromised pt
• Scotomas (black spots) in HIV+

Tx: Cidofovir; Intravitreal ganciclovir (implant); Foscarnet

Question 20

{{BLANK}} may be the sole ocular finding in AIDS patients

Answer 20

Retinopathy

Question 21

A patient w/ HIV+ & T2DM comes to you with a white film overlying their eye. You scrap the ulceration and find pseudohyphae. What is your suspected diagnosis?

Answer 21

Ocular candidiasis

Question 22

A person went cave diving in KY. They were attacked by bats on their way in. Two weeks later, they develop vision issues. You perform an ocular exam and suspect what organism?

Answer 22

Histoplasma capsulatum

Ednemic to Ohio, Mississipii Valleys, KY; Assoc. bird/bat droppings

Question 23

A deer fly bit a child & later they develop calabar swelling. What is your Dx?

Answer 23

Onchocerca volvulus

Question 24

A patient comes to you with conjunctivitis. They have a PMH of arthritis, HLA-B27+, and recently suffered an infection from Salmonella. What is your Dx?

Answer 24

Reiter syndrome

Question 25

What are the characteristics of adenoviruses?

Answer 25

• Non-enveloped
• dsDNA

Question 26

What is the most likely pathogen?

Answer 26

S. aureus

Question 27

An infant born to C-section displayed hepatosplenomegaly, intracranial calcifications, and microcephaly. Fundoscopy reveals findings pictured. What is your Dx?

Answer 27

Toxoplasma gondii