EXAM 1 NR 545 With Correct Solution
- bcorrect banswers✔✔
Allergic bconjunctivitis: b- bcorrect banswers✔✔IgE bmediated bdisease bin bresponse bto
btriggers. bCommon btriggers bcan bbe bseasonal bsuch bas bgrass, bpollens, band bmold.
bPersistent ballergic btriggers binclude bdust bmites band banimal bdander.
Bilateral, bitchy bred beyes bwith brope blike bdischarge band bclear bnasal bdischarge
Bilateral binjected bconjunctiva, bclear bdischarge
Treatment bbased bon bidentification band blimiting bexposure bto ballergen.
Medications binclude bcromolyn bophthalmic bdrops, boral bantihistamines, bantihistamine
beye bdrops
Viral bconjunctivitis: b- bcorrect banswers✔✔Most bcommonly bcaused bby bthe
badenovirus.
Unilateral bor bbilateral bred beyes, breports bof bcurrent bor brecent bviral binfection, bsuch
bas ba bUTI
Unilateral bor bbilateral binjected bconjunctiva, bwatery bdischarge
No bantibacterial btherapy bneeded.
Virus bresolves bin b2-3 bweeks
Bacterial bconjunctivitis: b- bcorrect banswers✔✔Common bbacteria binclude:
bStaphylococci, bstreptococci, bchlamydial borganisms band bgonococci.
Some bbacterial bcauses bcan bbe bquite bserious.
Gonococcal bconjunctivitis bcan bresult bin bblindness band bcan bindicate bunderlying
bsystemic binfection.
Usually bunilateral, bred band birritated
Eyelids bare b"stuck btogether" bupon bawakening.
Injected bpalpebral band bbulbar bconjunctiva, bpurulent bdrainage
Treatment bis bprovided bto bdecrease bspread bof bcontagion band bshorten bcourse bof
billness.
Eye bdrop btreatments binclude bPolymixin bB bplus btrimethoprim bor bazithromycin.
Otitis bExterna b- bcorrect banswers✔✔inflammation bof bthe bexterna bear bcanal, bis balso
bknown bcommonly bas bswimmer's bear. bOccurring bin bboth bchildren band badults, botitis
, bexterna bcan bpresent bas ba brange bof bphysical bsymptoms bfrom ba bminor
binflammation bto breports bof bintense bpain.
Otitis bExterna bRisk bFactors
Swimming
Impacted bcerumen
Use bof bhearing baids/ear bplugs
Trauma bfrom bcotton btip bapplicators bor bother bitems bused bto bclean bear bcanal
Foreign bbodies
Anatomic bcauses: bnarrow bear bcanals, bsharp bangles bin bthe bear bcanal bor bexcessive
bhair bin bthe bcanal
The bnormally bacidic bpH bof bthe bear bcanal btends bto binhibit bmicroorganism bgrowth.
bSwimming bin ba bpool bwhere bthe bpH bis busually balkaline bcan bresult bin baltered bpH
bof bthe bear bcanal. bIt bis bthought bthat bit bis bthis balteration bin bpH bcreates ba bfavorable
benvironment bfor bbacteria bor bfungal bgrowth. bThe bmost bcommon bcausative bagent bis
bP. baeruginosa, bother bcauses binclude bCandida bor bAspergillus bspecies.
Common bcomplaints b(subjective bfindings):
Children: birritability, bcrying, bdisrupted bsleep. bUnilateral bear btugging, bunilateral
botalgia
Adults: bunilateral botalgia
Physical bexam b(objective bfindings): bEar bpain bis bincreased bupon bpalpation bof
btragus. bThe bexternal bear bcanal bepithelium bedema bmay bextend bfrom bthe bpinna ball
bthe bway bto bthe btympanic bmembrane. bPurulent bor bserous bdischarge bis bnoted bin
bthe bcanal.
Medication bmanagement bdepends bupon bthe bcausative bfactors:
Pain bmanagement: bOTC banalgesics binclude bibuprofen bor bacetaminophen bas
bappropriate bfor bage band bweight
Bacterial bOtitis bexterna bcan bbe btreated bwith bantimicrobial botic bdrops, bwhich binclude
bpolymyxin bB bplus bneomycin bwith bor bwithout bhydrocortisone, bofloxacin, band
bciprofloxacin bHC botic bdrops
In bcases bof bsevere binflammation, binsertion bof ban bear bwick bmay bbe brequired bto
bensure bmedication binstillation bto baffected bareas.
Otitis bMedia b(AOM) b- bcorrect banswers✔✔Middle bear binflammation bwhich bresults
bfrom band bobstruction bof bthe bEustachian btube. bThe bEustachian btube bdysfunction
bresults bin bnegative bpressure bwithin bthe bmiddle bear, benabling bpharyngeal
bpathogens bto bbe baspirated binto bthe bmiddle bear. bThe bcauses bcan bbe bviral,
bbacterial bor ballergy bmediated.
Viral bMost bcommon bcause bof botitis bwhich boften boccurs bin bassociation bwith ban
bupper brespiratory btract binfection. bMost bcommon borganisms binclude brespiratory
bsyntactical bvirus, bhuman brhinovirus, bandenovirus band binfluenza bvirus.
bBacterial bColonization bis ba bmost boften bthe bresult bof bfluid bstasis bfrom ba
brespiratory bvirus. bStreptococcus bpneumoniae band bH. bfluenzae bare bthe bmost
bcommon bbacterial bpathogens bfound bin bmiddle bear bfluid.
Allergic bResponses bresulting bin binflammation bcan blead bto bobstruction bof bthe
bEustachian btube
Common bcomplaints b(subjective bfindings):
- bcorrect banswers✔✔
Allergic bconjunctivitis: b- bcorrect banswers✔✔IgE bmediated bdisease bin bresponse bto
btriggers. bCommon btriggers bcan bbe bseasonal bsuch bas bgrass, bpollens, band bmold.
bPersistent ballergic btriggers binclude bdust bmites band banimal bdander.
Bilateral, bitchy bred beyes bwith brope blike bdischarge band bclear bnasal bdischarge
Bilateral binjected bconjunctiva, bclear bdischarge
Treatment bbased bon bidentification band blimiting bexposure bto ballergen.
Medications binclude bcromolyn bophthalmic bdrops, boral bantihistamines, bantihistamine
beye bdrops
Viral bconjunctivitis: b- bcorrect banswers✔✔Most bcommonly bcaused bby bthe
badenovirus.
Unilateral bor bbilateral bred beyes, breports bof bcurrent bor brecent bviral binfection, bsuch
bas ba bUTI
Unilateral bor bbilateral binjected bconjunctiva, bwatery bdischarge
No bantibacterial btherapy bneeded.
Virus bresolves bin b2-3 bweeks
Bacterial bconjunctivitis: b- bcorrect banswers✔✔Common bbacteria binclude:
bStaphylococci, bstreptococci, bchlamydial borganisms band bgonococci.
Some bbacterial bcauses bcan bbe bquite bserious.
Gonococcal bconjunctivitis bcan bresult bin bblindness band bcan bindicate bunderlying
bsystemic binfection.
Usually bunilateral, bred band birritated
Eyelids bare b"stuck btogether" bupon bawakening.
Injected bpalpebral band bbulbar bconjunctiva, bpurulent bdrainage
Treatment bis bprovided bto bdecrease bspread bof bcontagion band bshorten bcourse bof
billness.
Eye bdrop btreatments binclude bPolymixin bB bplus btrimethoprim bor bazithromycin.
Otitis bExterna b- bcorrect banswers✔✔inflammation bof bthe bexterna bear bcanal, bis balso
bknown bcommonly bas bswimmer's bear. bOccurring bin bboth bchildren band badults, botitis
, bexterna bcan bpresent bas ba brange bof bphysical bsymptoms bfrom ba bminor
binflammation bto breports bof bintense bpain.
Otitis bExterna bRisk bFactors
Swimming
Impacted bcerumen
Use bof bhearing baids/ear bplugs
Trauma bfrom bcotton btip bapplicators bor bother bitems bused bto bclean bear bcanal
Foreign bbodies
Anatomic bcauses: bnarrow bear bcanals, bsharp bangles bin bthe bear bcanal bor bexcessive
bhair bin bthe bcanal
The bnormally bacidic bpH bof bthe bear bcanal btends bto binhibit bmicroorganism bgrowth.
bSwimming bin ba bpool bwhere bthe bpH bis busually balkaline bcan bresult bin baltered bpH
bof bthe bear bcanal. bIt bis bthought bthat bit bis bthis balteration bin bpH bcreates ba bfavorable
benvironment bfor bbacteria bor bfungal bgrowth. bThe bmost bcommon bcausative bagent bis
bP. baeruginosa, bother bcauses binclude bCandida bor bAspergillus bspecies.
Common bcomplaints b(subjective bfindings):
Children: birritability, bcrying, bdisrupted bsleep. bUnilateral bear btugging, bunilateral
botalgia
Adults: bunilateral botalgia
Physical bexam b(objective bfindings): bEar bpain bis bincreased bupon bpalpation bof
btragus. bThe bexternal bear bcanal bepithelium bedema bmay bextend bfrom bthe bpinna ball
bthe bway bto bthe btympanic bmembrane. bPurulent bor bserous bdischarge bis bnoted bin
bthe bcanal.
Medication bmanagement bdepends bupon bthe bcausative bfactors:
Pain bmanagement: bOTC banalgesics binclude bibuprofen bor bacetaminophen bas
bappropriate bfor bage band bweight
Bacterial bOtitis bexterna bcan bbe btreated bwith bantimicrobial botic bdrops, bwhich binclude
bpolymyxin bB bplus bneomycin bwith bor bwithout bhydrocortisone, bofloxacin, band
bciprofloxacin bHC botic bdrops
In bcases bof bsevere binflammation, binsertion bof ban bear bwick bmay bbe brequired bto
bensure bmedication binstillation bto baffected bareas.
Otitis bMedia b(AOM) b- bcorrect banswers✔✔Middle bear binflammation bwhich bresults
bfrom band bobstruction bof bthe bEustachian btube. bThe bEustachian btube bdysfunction
bresults bin bnegative bpressure bwithin bthe bmiddle bear, benabling bpharyngeal
bpathogens bto bbe baspirated binto bthe bmiddle bear. bThe bcauses bcan bbe bviral,
bbacterial bor ballergy bmediated.
Viral bMost bcommon bcause bof botitis bwhich boften boccurs bin bassociation bwith ban
bupper brespiratory btract binfection. bMost bcommon borganisms binclude brespiratory
bsyntactical bvirus, bhuman brhinovirus, bandenovirus band binfluenza bvirus.
bBacterial bColonization bis ba bmost boften bthe bresult bof bfluid bstasis bfrom ba
brespiratory bvirus. bStreptococcus bpneumoniae band bH. bfluenzae bare bthe bmost
bcommon bbacterial bpathogens bfound bin bmiddle bear bfluid.
Allergic bResponses bresulting bin binflammation bcan blead bto bobstruction bof bthe
bEustachian btube
Common bcomplaints b(subjective bfindings):
