NR 602 EXAM STUDY GUIDE
1. A mother presents with her 3 month old child and complains of goopy eye that is
sometimes matted shut after naps. Upon exam the conjunctiva is clear with some mild
crusting to eye lashes. What is the diagnosis and patient teaching?
Answer Probable lacrimal duct obstruction.
-The baby will likely grow out if it somewhere between six and 12 months.
-You can do a daily lacrimal duct massage and warm compresses to help open up the duct.
-Watch for Periorbital cellulitis or bacterial conjunctivitis.
2. Nine-year-old patient presents with tender, swollen, eurythmic bump to eyelid. What
is the diagnosis and patient education?
Answer Hordeolum (sty)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when sty pops, if doesn't will refer to option.
3. What is blepharitis?
Answer inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
, NR 602 EXAM STUDY GUIDE
4. What is the treatment for blepharitis?
Answer Cleanse with baby shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tetracycline but not to pediatrics who don't have adult
teeth, can cause discoloration.
Pediatrics can have Bactrim.
5.A 9 year old patient presents with acute swelling and erythema to eyelid with flaky, scaly
debris to eyelid margins. Patient reports gritty, burning feeling to eyes. She has already
attempted warm compresses and washing eyelids with baby soap with minimal relief.
What is the diagnosis and treatment?
Answer Patient has anterior blepharitis
Treat with erythromycin ointment, ointment has longer contact with eye.
Can use azithromycin ointment x 4 weeks for long term treatment
Can use doxycycline or tetracycline for chronic in kids >8 years or Azithromycin oral for kids
<8
, NR 602 EXAM STUDY GUIDE
6.What organism is likely to cause viral conjunctivitis?
Answer -Adenovirus
-HSV
-Herpes
7.What organism is likely to cause bacterial conjunctivitis?
Answer-Staph aureus
-strep pneumoniae
-H. Influenza
8.A 10-year-old patient presents with unilateral conjunctivitis with watery discharge x 2
days along with itching of the eye. Mother denies any other associated symptoms. What
is the diagnosis and treatment?
Answer Viral Conjunctivitis Patient should apply cold compresses for comfort *Bacterial
conjunctivitis has purulent discharge.
9.What is herpes keratitis?
Answer Herpes viral infection to the eye caused by HSV.
10. A 19-year-old male presents with blurred vision, watery discharge, photophobia, and
eye redness. Upon exam you note fern-like lines under the woods lamp. What is the
diagnosis and tx?Answer Herpes Keratitis
, NR 602 EXAM STUDY GUIDE
Tx: Antivirals
11. A 16-year-old female presents with complaints of sudden onset of red, watery, and
painful left eye. She reports possible foreign body to eye. Upon inspection you visualize
a n erythemic lesion to the eye. When using woods lamp you note a small superficial
laceration. What is the dx and tx?
Answer Corneal abrasion, refer to optho emergently or send to ER.
12. A mother brings her nine-year-old overweight son to the clinic with complaints of
pain to the groin, knee, and right hip. She reports patient has been walking with a limp
for the last couple days but unable to ambulate today. Mother denies any recent trauma.
Upon inspection there is external rotation of the right foot. What is the dx and tx?
Answer Slipped capital femoral epiphysis Refer to ER, will need surgery. -most common in
adolescent, obese males.
13. Father presents with his four-year-old son and states that patient has been limping
since this morning and was crying all night complaining of left hip pain. Upon exam you
appreciate decreased range of motion of left hip but no external rotation or signs of
trauma. What is the probable diagnostics, and treatment?
Answer Toxic transient syndrome- most common cause of limp in peds. Order: CBC, ESR,
and X-ray. WBC and ESR will be elevated. X-RAY will be normal.
-advise father that will resolve in 2-6 weeks.
- patient needs bed rest, NWB to left leg, and NSAIDS.
- return if develops fever, swelling, pain that is unrelieved by rest or medication
1. A mother presents with her 3 month old child and complains of goopy eye that is
sometimes matted shut after naps. Upon exam the conjunctiva is clear with some mild
crusting to eye lashes. What is the diagnosis and patient teaching?
Answer Probable lacrimal duct obstruction.
-The baby will likely grow out if it somewhere between six and 12 months.
-You can do a daily lacrimal duct massage and warm compresses to help open up the duct.
-Watch for Periorbital cellulitis or bacterial conjunctivitis.
2. Nine-year-old patient presents with tender, swollen, eurythmic bump to eyelid. What
is the diagnosis and patient education?
Answer Hordeolum (sty)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when sty pops, if doesn't will refer to option.
3. What is blepharitis?
Answer inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
, NR 602 EXAM STUDY GUIDE
4. What is the treatment for blepharitis?
Answer Cleanse with baby shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tetracycline but not to pediatrics who don't have adult
teeth, can cause discoloration.
Pediatrics can have Bactrim.
5.A 9 year old patient presents with acute swelling and erythema to eyelid with flaky, scaly
debris to eyelid margins. Patient reports gritty, burning feeling to eyes. She has already
attempted warm compresses and washing eyelids with baby soap with minimal relief.
What is the diagnosis and treatment?
Answer Patient has anterior blepharitis
Treat with erythromycin ointment, ointment has longer contact with eye.
Can use azithromycin ointment x 4 weeks for long term treatment
Can use doxycycline or tetracycline for chronic in kids >8 years or Azithromycin oral for kids
<8
, NR 602 EXAM STUDY GUIDE
6.What organism is likely to cause viral conjunctivitis?
Answer -Adenovirus
-HSV
-Herpes
7.What organism is likely to cause bacterial conjunctivitis?
Answer-Staph aureus
-strep pneumoniae
-H. Influenza
8.A 10-year-old patient presents with unilateral conjunctivitis with watery discharge x 2
days along with itching of the eye. Mother denies any other associated symptoms. What
is the diagnosis and treatment?
Answer Viral Conjunctivitis Patient should apply cold compresses for comfort *Bacterial
conjunctivitis has purulent discharge.
9.What is herpes keratitis?
Answer Herpes viral infection to the eye caused by HSV.
10. A 19-year-old male presents with blurred vision, watery discharge, photophobia, and
eye redness. Upon exam you note fern-like lines under the woods lamp. What is the
diagnosis and tx?Answer Herpes Keratitis
, NR 602 EXAM STUDY GUIDE
Tx: Antivirals
11. A 16-year-old female presents with complaints of sudden onset of red, watery, and
painful left eye. She reports possible foreign body to eye. Upon inspection you visualize
a n erythemic lesion to the eye. When using woods lamp you note a small superficial
laceration. What is the dx and tx?
Answer Corneal abrasion, refer to optho emergently or send to ER.
12. A mother brings her nine-year-old overweight son to the clinic with complaints of
pain to the groin, knee, and right hip. She reports patient has been walking with a limp
for the last couple days but unable to ambulate today. Mother denies any recent trauma.
Upon inspection there is external rotation of the right foot. What is the dx and tx?
Answer Slipped capital femoral epiphysis Refer to ER, will need surgery. -most common in
adolescent, obese males.
13. Father presents with his four-year-old son and states that patient has been limping
since this morning and was crying all night complaining of left hip pain. Upon exam you
appreciate decreased range of motion of left hip but no external rotation or signs of
trauma. What is the probable diagnostics, and treatment?
Answer Toxic transient syndrome- most common cause of limp in peds. Order: CBC, ESR,
and X-ray. WBC and ESR will be elevated. X-RAY will be normal.
-advise father that will resolve in 2-6 weeks.
- patient needs bed rest, NWB to left leg, and NSAIDS.
- return if develops fever, swelling, pain that is unrelieved by rest or medication
