ATI EXAM zm
Exam Solution zm
NP Cert Exam Eye Ear Nose and Throat Problems 2026
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A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERI
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FIED ANSWERS (D3A5E) zm zm
QUESTION 1 zm
2. A 39-year-
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old man presents with a complaint of bilaterally itchy, red eyes with tearing that occu
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rs inter- mittently throughout the year and is often accompanied by a rope-
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like eye discharge and clear nasal discharge. This is most consistent with conjunctival
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minflammation caused by: zm zm
A. a bacterium.
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B. a virus.
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C. an allergen.
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D. an injury.
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ANSWER
2. Correct:
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C. an allergen Bilateral, itchy eyes on an intermittent basis throughout the year points to allergic co
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njunctivitis. Incorrect: Bacterial (suppurative) conjunctivitis (
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A) is typically associated with unilateral involvement, while viral infection (
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B) is associated with a clear, watery discharge; neither of which would occur on an intermittent bas
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is throughout the year. There is no mention of injury in the patient history to consider this diagnosi
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s (D)
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QUESTION 2 zm
3. Common causative organisms of acute suppurative or bacterial conjunctivitis includ
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e all of the follow- ing except:
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A. S aureus.
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B. H influenzae.
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C. S pneumoniae.
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D. Pseudomonas aeruginosa.
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ANSWER
,3. Correct:
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D. Pseudomonas aeruginosa. In outpatient infections, P aeruginosa is an uncommon cause of infectio
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n inciding bacterial conjunctivitis. Incorrect: Bacterial or suppurative conjunctivitis is caused by selec
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t gram-positive (S pneumoniae [C] or S aureus (A]) or gram-
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negative (H influenzae [B]) organisms. Knowledge of the most likely causative organisms in infectiou
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s dis- eases is critical in selecting appropriate initial empirical antimicrobial therapy.
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QUESTION 3 zm
4. Keeping in mind patterns of bacterial resistance, currently recommended treatment
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options in suppu-
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rative or bacterial conjunctivitis include an ophthalmological preparation containing:
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A. tobramycin.
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B. levofloxacin.
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C. gentamicin.
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D. azithromycin.
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ANSWER
4. Correct:
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B. levofloracin. Ocular solutions of flucroquinolones (e.g., levofloxacin, moxifloxacin) are considered fi
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rst-line therapy as they remain highly effective against the most common caus-
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ative organisms. Incorrect: Empirical treatment of suppurative conjunctivitis should provide coverag
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e against common gram-positive (S pneu- moniae or S aureus) and gram-
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negative (H influenzae) organisms. Macrolides (e.g., azithromycin) (D), tobramy-
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cin (A), or gentamicin (
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C) are not preferred due to high rates of resistance exhibited by S pneumoniae.
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QUESTION 4 zm
5. Treatment options in acute and recurrent allergic conjunctivitis include all of the fo
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llowing except: zm
A. cromolyn ophthalmic drops.
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B. oral antihistamines.
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C. ophthalmological antihistamines.
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D. corticosteroid ophthalmic drops.
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ANSWER
5. Correct:
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D. corticostercid ophthalmic drops. The use of ophthalmic corticosteroid solution increases the risk o
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f eye infection, particularly among patients wearing contact lenses. Other adverse effects with the us
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e of corticosteroid eye drops include increased risk of cat-
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aracts and a rise in intraocular pressure that can lead to optic disk and visual field damage similar
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mto open-angle glaucoma. Incorrect: Treatment of allergic disorders includes the use of medi-
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cations to reduce production of inflammatory mediators, such as the mast cell stabilizer cromolyn (
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A), and medi- cations that block the action of inflammatory mediators, such as antihistamines (B, C).
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,QUESTION 5 zm
6. The most common virological cause of conjunctivitis is:
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A. coronavirus.
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B. adenovirus.
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C. rhinovirus.
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D. human papillomavirus.
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ANSWER
6. Correct:
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B. adenovirus. Adenovirus is the most common virological cause of conjunctivitis. Incorrect: Coronavi
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rus (A), rhinovirus (C), and human papilloma- virus (
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D) are not typical causes of conjunctivitis. In viral conjunctivitis, the patient often exhibits signs and
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msymp- toms of a viral upper respiratory tract infection. Trans-
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mission of virus to the eye can occur through accidental inoculation of viral particles from the pati
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ent's hands or by contact with infected upper respiratory droplets.
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QUESTION 6 zm
7. Treatment of viral conjunctivitis can include:
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A. moxifloxacin ophthalmic drops.
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B. polymyxin B ophthalmic drops.
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C. oral acyclovir.
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D. cool artificial tear solution.
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ANSWER
7. Correct:
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D. cool artificial tear solution. Treatment should focus on relieving irritative symptoms, such as with
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mthe use of cold artificial tear solution. Incorrect: Viral conjunctivitis is most often self-
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limiting and will resolve without the use of antibiotics over days to weeks. The use of antibacterials,
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msuch as moxifloxacin (
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A) or polymyxin (B), or antivirals such as acyclovir (
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C) are not warranted. The development of a secondary bacterial ophthalmological infection after vira
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l con- junctivitis is rare.
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QUESTION 7 zm
8. All of the following are components of the classic ophthalmological emergency exce
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pt:
A. eye pain.
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B. nausea and vomiting.
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C. red eye.
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D. new-onset change in visual acuity.
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ANSWER
8. Correct:
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B. nausea and vomiting. Nausea, vomiting, and even headache can occur in select emergency conditi
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, ons, such as angle-closure glaucoma, but are not considered the classic symptoms for an oph-
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thalmological emergency. Incorrect: Severe eye pain (A), red eye (C), and new-
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onset change in visual acuity (
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D) are the major classic signs/symp-
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toms of ophthalmological emergency. In more limiting eye problems, such as viral or bacterial conj
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unctivitis, there are no visual changes (once eye discharge is wiped away), and the eye can be irrita
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ted but not pain- ful and can have a slightly red "pink eye" appearance.
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QUESTION 8 zm
10. In caring for Ms. Levine, the most appropriate next action is:
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A. prompt referral to an ophthalmologist.
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B. to provide analgesia and repeat the evaluation when the patient is more comfortabl
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e.
C. to instill a corticosteroid ophthalmic solution.
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D. to patch the eye and arrange for follow-up in 24 hours.
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ANSWER
10. Correct:
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A. prompt referral to an ophthalmologist. For a patient diagnosed with angle-
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closure glaucoma, prompt referral to ophthalmology is needed to confirm diagnosis and initiate ther
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apy to preserve vision. If the IOP is not lowered within a few hours (with IOP-
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lowering medications and/or laser or incisional surgical therapy), permanent vision loss is possible.
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mIncorrect: As such, treating the symptoms, such as with an anal- gesic (B), and delaying treatment (
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D) to reduce IOP are not appropriate. The use of a topical corticosteroid (
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C) is not warranted for angle-closure glaucoma.
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QUESTION 9 zm
13. For Mrs. Sanchez, the most appropriate next course of action is:
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A. placement of an eye shield and follow-up in 48 hours.
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B. to initiate treatment with an ophthalmic antimicrobial solution.
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C. to initiate treatment with a corticosteroid ophthalmic solution.
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D. immediate referral to an ophthalmologist.
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ANSWER
13. Correct:
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D. immediate referral to an ophthalmologist. In primary care, a high index of suspicion is needed for
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vision-
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threatening conditions. For retinal detachment, early diagnosis and treatment by an ophthalmologist
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are needed to prevent permanent vision loss. Incorrect: There is no sign of infection or localized infl
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ammation; thus, treatment with an antimicrobial (
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B) or topical corticosteroid (
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C) is not necessary. Delaying treatment with the use of an eye shield (
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A) causes pupillary dila- tion that can worsen IP and lead to permanent vision loss.
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Exam Solution zm
NP Cert Exam Eye Ear Nose and Throat Problems 2026
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A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERI
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FIED ANSWERS (D3A5E) zm zm
QUESTION 1 zm
2. A 39-year-
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old man presents with a complaint of bilaterally itchy, red eyes with tearing that occu
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rs inter- mittently throughout the year and is often accompanied by a rope-
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like eye discharge and clear nasal discharge. This is most consistent with conjunctival
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minflammation caused by: zm zm
A. a bacterium.
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B. a virus.
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C. an allergen.
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D. an injury.
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ANSWER
2. Correct:
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C. an allergen Bilateral, itchy eyes on an intermittent basis throughout the year points to allergic co
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njunctivitis. Incorrect: Bacterial (suppurative) conjunctivitis (
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A) is typically associated with unilateral involvement, while viral infection (
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B) is associated with a clear, watery discharge; neither of which would occur on an intermittent bas
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is throughout the year. There is no mention of injury in the patient history to consider this diagnosi
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s (D)
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QUESTION 2 zm
3. Common causative organisms of acute suppurative or bacterial conjunctivitis includ
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e all of the follow- ing except:
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A. S aureus.
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B. H influenzae.
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C. S pneumoniae.
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D. Pseudomonas aeruginosa.
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ANSWER
,3. Correct:
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D. Pseudomonas aeruginosa. In outpatient infections, P aeruginosa is an uncommon cause of infectio
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n inciding bacterial conjunctivitis. Incorrect: Bacterial or suppurative conjunctivitis is caused by selec
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t gram-positive (S pneumoniae [C] or S aureus (A]) or gram-
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negative (H influenzae [B]) organisms. Knowledge of the most likely causative organisms in infectiou
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s dis- eases is critical in selecting appropriate initial empirical antimicrobial therapy.
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QUESTION 3 zm
4. Keeping in mind patterns of bacterial resistance, currently recommended treatment
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options in suppu-
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rative or bacterial conjunctivitis include an ophthalmological preparation containing:
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A. tobramycin.
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B. levofloxacin.
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C. gentamicin.
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D. azithromycin.
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ANSWER
4. Correct:
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B. levofloracin. Ocular solutions of flucroquinolones (e.g., levofloxacin, moxifloxacin) are considered fi
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rst-line therapy as they remain highly effective against the most common caus-
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ative organisms. Incorrect: Empirical treatment of suppurative conjunctivitis should provide coverag
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e against common gram-positive (S pneu- moniae or S aureus) and gram-
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negative (H influenzae) organisms. Macrolides (e.g., azithromycin) (D), tobramy-
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cin (A), or gentamicin (
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C) are not preferred due to high rates of resistance exhibited by S pneumoniae.
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QUESTION 4 zm
5. Treatment options in acute and recurrent allergic conjunctivitis include all of the fo
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llowing except: zm
A. cromolyn ophthalmic drops.
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B. oral antihistamines.
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C. ophthalmological antihistamines.
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D. corticosteroid ophthalmic drops.
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ANSWER
5. Correct:
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D. corticostercid ophthalmic drops. The use of ophthalmic corticosteroid solution increases the risk o
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f eye infection, particularly among patients wearing contact lenses. Other adverse effects with the us
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e of corticosteroid eye drops include increased risk of cat-
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aracts and a rise in intraocular pressure that can lead to optic disk and visual field damage similar
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mto open-angle glaucoma. Incorrect: Treatment of allergic disorders includes the use of medi-
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cations to reduce production of inflammatory mediators, such as the mast cell stabilizer cromolyn (
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A), and medi- cations that block the action of inflammatory mediators, such as antihistamines (B, C).
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,QUESTION 5 zm
6. The most common virological cause of conjunctivitis is:
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A. coronavirus.
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B. adenovirus.
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C. rhinovirus.
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D. human papillomavirus.
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ANSWER
6. Correct:
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B. adenovirus. Adenovirus is the most common virological cause of conjunctivitis. Incorrect: Coronavi
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rus (A), rhinovirus (C), and human papilloma- virus (
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D) are not typical causes of conjunctivitis. In viral conjunctivitis, the patient often exhibits signs and
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msymp- toms of a viral upper respiratory tract infection. Trans-
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mission of virus to the eye can occur through accidental inoculation of viral particles from the pati
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ent's hands or by contact with infected upper respiratory droplets.
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QUESTION 6 zm
7. Treatment of viral conjunctivitis can include:
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A. moxifloxacin ophthalmic drops.
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B. polymyxin B ophthalmic drops.
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C. oral acyclovir.
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D. cool artificial tear solution.
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ANSWER
7. Correct:
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D. cool artificial tear solution. Treatment should focus on relieving irritative symptoms, such as with
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mthe use of cold artificial tear solution. Incorrect: Viral conjunctivitis is most often self-
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limiting and will resolve without the use of antibiotics over days to weeks. The use of antibacterials,
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msuch as moxifloxacin (
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A) or polymyxin (B), or antivirals such as acyclovir (
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C) are not warranted. The development of a secondary bacterial ophthalmological infection after vira
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l con- junctivitis is rare.
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QUESTION 7 zm
8. All of the following are components of the classic ophthalmological emergency exce
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pt:
A. eye pain.
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B. nausea and vomiting.
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C. red eye.
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D. new-onset change in visual acuity.
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ANSWER
8. Correct:
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B. nausea and vomiting. Nausea, vomiting, and even headache can occur in select emergency conditi
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, ons, such as angle-closure glaucoma, but are not considered the classic symptoms for an oph-
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thalmological emergency. Incorrect: Severe eye pain (A), red eye (C), and new-
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onset change in visual acuity (
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D) are the major classic signs/symp-
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toms of ophthalmological emergency. In more limiting eye problems, such as viral or bacterial conj
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unctivitis, there are no visual changes (once eye discharge is wiped away), and the eye can be irrita
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ted but not pain- ful and can have a slightly red "pink eye" appearance.
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QUESTION 8 zm
10. In caring for Ms. Levine, the most appropriate next action is:
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A. prompt referral to an ophthalmologist.
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B. to provide analgesia and repeat the evaluation when the patient is more comfortabl
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e.
C. to instill a corticosteroid ophthalmic solution.
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D. to patch the eye and arrange for follow-up in 24 hours.
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ANSWER
10. Correct:
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A. prompt referral to an ophthalmologist. For a patient diagnosed with angle-
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closure glaucoma, prompt referral to ophthalmology is needed to confirm diagnosis and initiate ther
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apy to preserve vision. If the IOP is not lowered within a few hours (with IOP-
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lowering medications and/or laser or incisional surgical therapy), permanent vision loss is possible.
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mIncorrect: As such, treating the symptoms, such as with an anal- gesic (B), and delaying treatment (
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D) to reduce IOP are not appropriate. The use of a topical corticosteroid (
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C) is not warranted for angle-closure glaucoma.
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QUESTION 9 zm
13. For Mrs. Sanchez, the most appropriate next course of action is:
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A. placement of an eye shield and follow-up in 48 hours.
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B. to initiate treatment with an ophthalmic antimicrobial solution.
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C. to initiate treatment with a corticosteroid ophthalmic solution.
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D. immediate referral to an ophthalmologist.
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ANSWER
13. Correct:
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D. immediate referral to an ophthalmologist. In primary care, a high index of suspicion is needed for
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vision-
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threatening conditions. For retinal detachment, early diagnosis and treatment by an ophthalmologist
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are needed to prevent permanent vision loss. Incorrect: There is no sign of infection or localized infl
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ammation; thus, treatment with an antimicrobial (
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B) or topical corticosteroid (
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C) is not necessary. Delaying treatment with the use of an eye shield (
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A) causes pupillary dila- tion that can worsen IP and lead to permanent vision loss.
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