1. You see a 9-year-old after he was hit in the eye with a foreign body. Flourescein staining reveals a vertical line abrasion lateral to the iris. The pupils are equal in size and reactive; a positive red reflex is present bilaterally. There are no abnormal extraocular movements. Visual acuity...
1 you see a 9 year old after he was hit in the eye with a foreign body flourescein staining reveals a vertical line abrasion lateral to the iris the pupils are equal in size and reactive a pos
1. You see a 9-year-old after he was hit in the eye with a foreign body.
Flourescein staining reveals a vertical line abrasion lateral to the iris. The
pupils are equal in size and reactive; a positive red reflex is present
bilaterally. There are no abnormal extraocular movements. Visual acuity is
normal. An appropriate plan of care includes follow-up in 48 to 72 hours and:
a Prescribing ophthalmic steroid drops three times a day but not applying
.
an eye patch
b Prescribing ophthalmic antibiotic drops three to four times daily and
.
placing a patch over the eye for 24 to 48 hours
c Prescribing topical ophthalmic steroid drops three times a day and
.
placing a patch over the eye for 24 to 48 hours
d Prescribing ophthalmic antibiotic drops three to four times daily but not
.
applying an eye patch
QUESTION 2
1. A 3-year-old has a history of upper respiratory tract infection 2 weeks
ago. She recently started awakening at night. Physical exam reveals a
normothermic child. She is smiling, playful, and sitting on the father’s lap.
The TMs are gray with scattered bubbles and good motility. What is the best
treatment?
a Amoxicillin at 80 mg/kg/day in two divided doses
.
for 10 days
b Observation without therapy; recheck in 1 month
.
c Nasal corticosteroids daily
.
d Referral to an otolaryngologist
,QUESTION 3.
1.Therapeutic treatment for Coxsackie infections include:
a Antiviral treatment like acyclovir
.
b Immunoglobulin
.
c Supportive care
.
d Antimicrobial treatment like amoxicillin or
.
cephalexin
QUESTION 4
1. A 10-year-old comes to your school-based clinic with complaint of a
painful sore on the upper lip for 5 days. The sore is getting better since
yesterday, but today the right eyelid is swelling and there are blisters on the
eye. The best management is to:
a Suggest warm compresses three times a day
.
b Start topical antibiotic drops like polymixin B
.
(Polytrim)
c Immediately refer to ophthalmology
.
d Start oral antiviral treatment like acyclovir
.
QUESTION 5
1. John, age 5, was diagnosed with a ruptured tympanic membrane as a
result of acute otitis media 2 weeks ago. He was treated with oral antibiotics
at the time of diagnosis and has finished his course. He has no purulent
drainage, but he still has a TM perforation. His plan of care should include:
a Refer child to an ENT for evaluation and treatment.
.
b Educate the parents about strategies to prevent water from
.
entering the middle ear.
c Continue the oral antibiotics to prevent infection until the tympanic
.
membrane heals.
d Use topical antibiotic drops to prevent infection until the tympanic
.
membrane heals.
, QUESTION 6
1. Each of the following is a risk factor for the development of acute otitis
media EXCEPT:
a Breastfeeding
.
b Group child care
.
attendance
c Respiratory viral
.
infection
d Ambient tobacco
.
smoke
QUESTION 7
1. Mikayla is a 15-month-old female who has had recurrent bouts of acute
otitis media. Her mother is concerned about future school performance.
Which of the following statements regarding otitis media is true?
a The incidence of acute otitis media is highest from 18 to 24 months of
.
age.
b Bilateral otitis media with effusion does not cause hearing deficits.
.
c Potential aggravating factors for Mikayla include pacifier use, bottle use,
.
and cigarette smoke exposure.
d There is a correlation between the number of school days missed due to
.
acute otitis media and IQ measurement.
QUESTION 8
1. You see a 6-month-old with a diagnosis of dacryocystitis. The mother
states “her left eye tears all the time and it has since birth.” The infant was
seen in urgent care last week and was prescribed antibiotic eye drops that
“don’t seem to help.” You confirm the diagnosis of dacryocystitis without
evidence of infection. What education and counseling do you provide?
a The infant should see an ophthalmologist since the condition has
.
persisted for 6 months.
b The infant should get another course of antibiotic eye drops to prevent
.
secondary infection.
c The blockage in the tear duct is probably the result of a neonatal eye
.
infection.
, d Spontaneous resolution usually occurs by 9 to 12 months.
.
QUESTION 9
1. Kelly is a 9-year-old who presents to your office with complaint of nasal
congestion, nasal obstruction, and facial pain with radiation to her teeth and
jaw for the last 14 days. The pain is described as throbbing and is worsened
by abrupt movements, walking, or bending over. Her temperature is
currently 100.4°F. Your most likely diagnosis is:
a Dental infection
.
b Chronic rhinitis
.
c Maxillary sinusitis
.
d Allergic rhinitis
.
QUESTION 10
1. A 7-year-old presents with a complaint of ear pain with purulent
discharge. He states it hurts when he is lying on the affected side and when
anyone touches his pinna. The most likely diagnosis is:
a Otitis media with
.
effusion
b Acute otitis media
.
c Otitis interna
.
d Otitis externa
.
QUESTION 1
1. A 7-year-old presents to your office with several linear, curved lines
approximately 4 millimeters in length that end in a papule. The lines are near
the umbilicus and waist area. He complains about severe itching that is
worse at night. You suspect:
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