NR 602 Final Exam
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?
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.
Nine-year-old patient presents with tender, swollen, erythemic bump to eyelid. What is the
diagnosis and patient education?
Hordeolum (stye)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when stye pops, if doesn't will refer to optho.
What is blepharitis?
inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
,What is the treatment for blepharitis?
Cleanse with baby shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tertracycline but not to pediatrics who don't have adult teeth,
can cause discoloration. Pediatrics can have Bactrim.
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?
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
What organism is likely to cause viral conjunctivitis?
-Adenovirus
,-HSV
-Herpes
What organism is likely to cause bacterial conjunctivitis?
-Staph aureus
-strep pneumoniae
-H. Influenza
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?
Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
What is herpes keratitis?
Herpes viral infection to the eye caused by HSV.
, 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?
Herpes Keratitis
Tx: Antivirals
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?
Corneal abrasion, refer to optho emergently or send to ER.
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?
Slipped capital femoral epiphysis
Refer to ER, will need surgery.
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?
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.
Nine-year-old patient presents with tender, swollen, erythemic bump to eyelid. What is the
diagnosis and patient education?
Hordeolum (stye)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when stye pops, if doesn't will refer to optho.
What is blepharitis?
inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
,What is the treatment for blepharitis?
Cleanse with baby shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tertracycline but not to pediatrics who don't have adult teeth,
can cause discoloration. Pediatrics can have Bactrim.
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?
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
What organism is likely to cause viral conjunctivitis?
-Adenovirus
,-HSV
-Herpes
What organism is likely to cause bacterial conjunctivitis?
-Staph aureus
-strep pneumoniae
-H. Influenza
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?
Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
What is herpes keratitis?
Herpes viral infection to the eye caused by HSV.
, 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?
Herpes Keratitis
Tx: Antivirals
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?
Corneal abrasion, refer to optho emergently or send to ER.
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?
Slipped capital femoral epiphysis
Refer to ER, will need surgery.
