HHPD midterm 2
c6j0kg
1. A 29-year-old physical therapist presents for evalua- B. Exophthalmos
tion of an eyelid problem. On observation, the right
eyeball appears to be protruding forward. Based on Exophthalmos is
this description, what is the most likely diagnosis? the condition when
the eyeball pro-
A. Ptosis trudes forward. If
B. Exophthalmos it is bilateral, it
C. Ectropion suggests the pres-
D. Epicanthus ence of Graves'
disease. If it is
unilateral, it could
still be caused
by Graves' dis-
ease. Alternatively,
it could be caused
by a tumor or in-
flammation in the
orbit.
2. A 12-year-old presents to the clinic with his father for C. Hordeolum
evaluation of a painful lump in the left eye. It started
this morning. He denies any trauma or injury. There A hordeolum, or
is no visual disturbance. Upon physical examination, sty, is a painful,
there is a red raised area at the margin of the eyelid tender, erythema-
that is tender to palpation; no tearing occurs with pal- tous infection in a
pation of the lesion. Based on this description, what gland at the mar-
is the most likely diagnosis? gin of the eyelid.
A. Dacryocystitis
B. Chalazion
C. Hordeolum
D. Xanthelasma
3. A 15-year-old high school sophomore presents to the D) Subconjuncti-
emergency room with his mother for evaluation of an val hemorrhage
area of blood in the left eye. He denies trauma or injury
but has been coughing forcefully with a recent cold. A subconjuncti-
He denies visual disturbances, eye pain, or discharge val hemorrhage
from the eye. On physical examination, the pupils are is a leakage
, HHPD midterm 2
c6j0kg
equal, round, and reactive to light, with a visual acuity of blood outside
of 20/20 in each eye and 20/20 bilaterally. There is a of the vessels,
homogeneous, sharply demarcated area at the lateral which produces
aspect of the base of the left eye. The cornea is clear. a homogenous,
Based on this description, what is the most likely sharply demarcat-
diagnosis? ed bright red area;
it fades over sev-
A) Conjunctivitis eral days, turn-
B) Acute iritis ing yellow, then
C) Corneal abrasion disappears. There
D) Subconjunctival hemorrhage is no associat-
ed eye pain, oc-
ular discharge, or
changes in vi-
sual acuity; the
cornea is clear.
Many times it is as-
sociated with se-
vere cough, chok-
ing, or vomiting,
which increase ve-
nous pressure. It is
rarely caused by a
serious condition,
so reassurance is
usually the only
treatment neces-
sary.
4. A 67-year-old lawyer comes to your clinic for an annu- D. Pterygium
al examination. He denies any history of eye trauma.
He denies any visual changes. You inspect his eyes A pterygium is
and find a triangular thickening of the bulbar conjunc- a triangular thick-
tiva across the outer surface of the cornea. ening of the
He has a normal pupillary reaction to light and accom- bulbar conjuncti-
modation. Based on this description, what is the most va that grows
likely diagnosis? slowly across the
outer surface of
A. Corneal arcus the cornea, usual-
, HHPD midterm 2
c6j0kg
B. Cataracts ly from the nasal
C. Corneal scar side. Reddening
D. Pterygium may occur, and it
may interfere with
vision as it en-
croaches on the
pupil. Otherwise,
treatment is un-
necessary.
5. A sudden, painless unilateral vision loss may be A. Retinal detach-
caused by which of the following? ment
A. Retinal detachment Corneal ulcer,
B. Corneal ulcer acute glaucoma,
C. Acute glaucoma and uveitis are
D. Uveitis almost always
accompanied by
pain. Retinal de-
tachment is gener-
ally painless, as is
chronic glaucoma
6. Sudden, painful unilateral loss of vision may be D. Optic neuritis
caused by which of the following conditions? In multiple sclero-
sis, sudden painful
A. Vitreous hemorrhage loss of vision may
B. Central retinal artery occlusion accompany optic
C. Macular degeneration neuritis. The oth-
D. Optic neuritis er conditions are
usually painless.
7. Diplopia, which is present with one eye covered, can D. An irregularity in
be caused by which of the following problems? the cornea or lens
A. Weakness of CN III Double vision in
B. Weakness of CN IV one eye alone
C. A lesion of the brainstem points to a prob-
D. An irregularity in the cornea or lens lem in "process-
, HHPD midterm 2
c6j0kg
ing" the light rays
of an incoming
image. The other
causes of diplop-
ia result in a mis-
alignment of the
two eyes.
8. A patient complains of epistaxis. Which other cause B. Hematemesis
should be considered?
Although the
A. Intracranial hemorrhage source of epis-
B. Hematemesis taxis may seem
C. Intestinal hemorrhage obvious, other
D. Hematoma of the nasal septum bleeding locations
should be on
the differential. He-
matemesis can
mimic this and
cause delay in
life-saving thera-
pies if not consid-
ered. Intracranial
hemorrhage and
septal hematoma
are instances of
contained bleed-
ing. Intestinal he-
morrhage may
cause hemateme-
sis if there is ob-
struction distal to
the bleeding, but
this is unlikely.
9. Glaucoma is the leading cause of blindness in A. Increased
African-Americans and the second leading cause of cup-to-disc ratio
blindness overall. What features would be noted on
funduscopic examination? It is important to
c6j0kg
1. A 29-year-old physical therapist presents for evalua- B. Exophthalmos
tion of an eyelid problem. On observation, the right
eyeball appears to be protruding forward. Based on Exophthalmos is
this description, what is the most likely diagnosis? the condition when
the eyeball pro-
A. Ptosis trudes forward. If
B. Exophthalmos it is bilateral, it
C. Ectropion suggests the pres-
D. Epicanthus ence of Graves'
disease. If it is
unilateral, it could
still be caused
by Graves' dis-
ease. Alternatively,
it could be caused
by a tumor or in-
flammation in the
orbit.
2. A 12-year-old presents to the clinic with his father for C. Hordeolum
evaluation of a painful lump in the left eye. It started
this morning. He denies any trauma or injury. There A hordeolum, or
is no visual disturbance. Upon physical examination, sty, is a painful,
there is a red raised area at the margin of the eyelid tender, erythema-
that is tender to palpation; no tearing occurs with pal- tous infection in a
pation of the lesion. Based on this description, what gland at the mar-
is the most likely diagnosis? gin of the eyelid.
A. Dacryocystitis
B. Chalazion
C. Hordeolum
D. Xanthelasma
3. A 15-year-old high school sophomore presents to the D) Subconjuncti-
emergency room with his mother for evaluation of an val hemorrhage
area of blood in the left eye. He denies trauma or injury
but has been coughing forcefully with a recent cold. A subconjuncti-
He denies visual disturbances, eye pain, or discharge val hemorrhage
from the eye. On physical examination, the pupils are is a leakage
, HHPD midterm 2
c6j0kg
equal, round, and reactive to light, with a visual acuity of blood outside
of 20/20 in each eye and 20/20 bilaterally. There is a of the vessels,
homogeneous, sharply demarcated area at the lateral which produces
aspect of the base of the left eye. The cornea is clear. a homogenous,
Based on this description, what is the most likely sharply demarcat-
diagnosis? ed bright red area;
it fades over sev-
A) Conjunctivitis eral days, turn-
B) Acute iritis ing yellow, then
C) Corneal abrasion disappears. There
D) Subconjunctival hemorrhage is no associat-
ed eye pain, oc-
ular discharge, or
changes in vi-
sual acuity; the
cornea is clear.
Many times it is as-
sociated with se-
vere cough, chok-
ing, or vomiting,
which increase ve-
nous pressure. It is
rarely caused by a
serious condition,
so reassurance is
usually the only
treatment neces-
sary.
4. A 67-year-old lawyer comes to your clinic for an annu- D. Pterygium
al examination. He denies any history of eye trauma.
He denies any visual changes. You inspect his eyes A pterygium is
and find a triangular thickening of the bulbar conjunc- a triangular thick-
tiva across the outer surface of the cornea. ening of the
He has a normal pupillary reaction to light and accom- bulbar conjuncti-
modation. Based on this description, what is the most va that grows
likely diagnosis? slowly across the
outer surface of
A. Corneal arcus the cornea, usual-
, HHPD midterm 2
c6j0kg
B. Cataracts ly from the nasal
C. Corneal scar side. Reddening
D. Pterygium may occur, and it
may interfere with
vision as it en-
croaches on the
pupil. Otherwise,
treatment is un-
necessary.
5. A sudden, painless unilateral vision loss may be A. Retinal detach-
caused by which of the following? ment
A. Retinal detachment Corneal ulcer,
B. Corneal ulcer acute glaucoma,
C. Acute glaucoma and uveitis are
D. Uveitis almost always
accompanied by
pain. Retinal de-
tachment is gener-
ally painless, as is
chronic glaucoma
6. Sudden, painful unilateral loss of vision may be D. Optic neuritis
caused by which of the following conditions? In multiple sclero-
sis, sudden painful
A. Vitreous hemorrhage loss of vision may
B. Central retinal artery occlusion accompany optic
C. Macular degeneration neuritis. The oth-
D. Optic neuritis er conditions are
usually painless.
7. Diplopia, which is present with one eye covered, can D. An irregularity in
be caused by which of the following problems? the cornea or lens
A. Weakness of CN III Double vision in
B. Weakness of CN IV one eye alone
C. A lesion of the brainstem points to a prob-
D. An irregularity in the cornea or lens lem in "process-
, HHPD midterm 2
c6j0kg
ing" the light rays
of an incoming
image. The other
causes of diplop-
ia result in a mis-
alignment of the
two eyes.
8. A patient complains of epistaxis. Which other cause B. Hematemesis
should be considered?
Although the
A. Intracranial hemorrhage source of epis-
B. Hematemesis taxis may seem
C. Intestinal hemorrhage obvious, other
D. Hematoma of the nasal septum bleeding locations
should be on
the differential. He-
matemesis can
mimic this and
cause delay in
life-saving thera-
pies if not consid-
ered. Intracranial
hemorrhage and
septal hematoma
are instances of
contained bleed-
ing. Intestinal he-
morrhage may
cause hemateme-
sis if there is ob-
struction distal to
the bleeding, but
this is unlikely.
9. Glaucoma is the leading cause of blindness in A. Increased
African-Americans and the second leading cause of cup-to-disc ratio
blindness overall. What features would be noted on
funduscopic examination? It is important to
