Week 7 stuff

Question 1

What is the most common differential diagnosis of upper respiratory infections?

Answer 1

Allergic rhinitis

Question 2

What is the treatment for URIs?

Answer 2

Symptomatic treatment. Antipyretics and analgesics for fever and rose throat, nasal decongestants to reduce nasal obstruction.

Question 3

What are pulmonary changes in the elderly population?

Answer 3

Loss of alveolar surface area, decrease in # of cilia lining the airways, smoking adds chemical insult toe this as well.

Question 4

What is the most common initial symptom of URI in the elderly population/

Answer 4

Acute confusion. It is more common than fever, pain or tachycardia

Question 5

T or F: elders with URI will develop a fever and elevated WBC.

Answer 5

False. fever is not always present and leukocytosis may be minimal or absent even in serious conditions.

Question 6

T or F: fever, sputum and cough are reliable symptoms of Pneumonia in an elderly patient.

Answer 6

False. elders may not have cough or sputum 2/2 to decreased cough reflex. lung sounds are often normal and the initial CXR is normal. the only sx may be a change in appetite and functional status.

Question 7

How long does it take for a CXR to clear?

Answer 7

4 weeks

Question 8

What is a pinguecula? is it harmless?

Answer 8

it is a nodule of scleral conjunctive that is usually on the nasal side of the conjunctive. it is harmless

Question 9

What is a petergyium?

Answer 9

It is a wing-shaped fibrovascular conjunctival tissue growth and redness that potentially encroaches on the cornea.

Question 10

What are important “don’t miss” symptoms to ask about when assessing Red Eye?

Answer 10

discharge, ocular pain, and vision change.

Question 11

T or F: viral conjunctivitis has a generalized conjunctival injection pattern.

Answer 11

True

Question 12

T or F: viral conjunctivitis usually involves only one eye.

Answer 12

False! its both.

Question 13

T or F: viral conjunctivitis has mild ocular pruritus and/or a gritty sensation

Answer 13

True

Question 14

T or F: viral conjunctivitis usually has a mucoid looking ocular discharge.

Answer 14

True

Question 15

When can someone with red eye return to work or school?

Answer 15

When the eye discharge ceases.

Question 16

What are the primary symptoms of bacterial conjunctivitis?

Answer 16

Unilateral (to start), purulent ocular discharge, it is usually without systemic signs or symptoms in adults.

Question 17

If a patient wears contact lens, what bacteria should be covered and what antibiotic class should be prescribed?

Answer 17

Cover for Pseudomonas infection and prescribe a quinolones.

Question 18

What are the primary causes of ophthalmia neonaturm?

Answer 18

gonococcal or chlamydia.

Question 19

What are the s/s of Gonococcal conjunctivitis?

Answer 19

copious amounts of purulent discharge, preauricular adenopathy, usually is accompanied by GU or systemic s/s

Question 20

What is blepharitis?

Answer 20

Inflammation of the structure of the lid margin and presents as lid-margins redness, scaling and crusting.

Question 21

What is a Hordeolum?

Answer 21

inflammation or infection nodule of the meibomian glands (internal) or the glands of Zeis or lash follicles (external or sty)

Question 22

What is a Chalazion?

Answer 22

Sterile, granulomatous inflammation of a Zeis or meibomian gland.

Question 23

What is Acute Bacryocystitis?

Answer 23

inflammation of the tear ducts and/or lacrimal sales. focal tenderness to palpation and purulent discharge from tear duct with pressure.

Question 24

What is the treatment for Blepharitis?

Answer 24

lid hygiene measures and topical antibiotics.

Question 25

What is the treatment for Hordeolum and Chalazions?

Answer 25

aggressive warm compresses and topical antibiotic ointments. may need to refer to eye doctor for incision and curettage.

Question 26

What is the treatment for Acute Dacryocystitis?

Answer 26

warm compresses and oral antibiotics. A persistent localized abscess needs an I&D from an ophthalmologist.

Question 27

What are diagnostic criteria for a corneal abrasion?

Answer 27

sensation of foreign body, severe pain and photophobia, tearing and blepharospasm, decreased vision, conjunctival erythema, fluorescein stain increased uptake.