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Exams 1,2 & Final BUNDLE:NU664B/ NU 664B (NEW 2025/2026 Update) Guides|100% Correct- Regis
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glaucomal - acutel anglel closure Answer: ****ACUTEl ANGLEl CLOSUREl IFl ANl OCULARl EMERGENCY
openl anglel glaucoma Answer: openl anglel glaucomal isl al chronicl conditionl wherel thel aqueousl flowl isl alteredl resultingl inl damagel tol thel opticl nerve.l mayl gol forl yearsl withoutl noticingl managmentl focusesl onl loweringl intraocularl pressurel withl medications
Al clientl withl openl anglel glaucomal isl likelyl tol havel whichl vision problem? a.l poorl nearl vision b.l poorl distantl vision c.l peripherall visionl loss d.l lossl ofl centrall vision Answer: c
Al clientl withl thisl diagnosisl willl complainl of: a.l eyel pain b.l problemsl withl nightl vision c.l redness/itchiness/wateringl ofl thel eyes d.l usuallyl nothing Answer: d
Whatl willl youl findl onl fundoscopicl exam? a.l papilledema b.l increasedl cupl tol discl ratio c.l neovascularization d.l AVl nicking Answer: b
Alll ofl thel followingl arel atl increasedl riskl forl developingl openl angle glaucomal except: a.l thosel withl al positivel familyl historyl ofl thel disease b.l Africanl Americans c.l olderl age d.l farsightedness Answer: d
managingl glaucoma Answer: 2 l mainl classes: decreasel thel productionl ofl aqueousl fluidl (egl opthalmicl betal blockers)
d.Cataracts Answer: d
Riskl Factorsl forl cataractsl include? a.Diabetes b.Smoking c.Alcohol d.Sunlightl exposure e.Alll ofl thel above Answer: e ....butl biggestl riskl factorl isl agel redl lightl reflexl canl stilll bel illicitiedl ifl cataractl isl notl maturel (readyl tol bel removed)
Youl elderlyl clientl hasl painlessl lossl ofl centrall vision. Thisl isl consistentl with: a.Cataracts b.Glaucoma c.Macularl degeneration d.Iritis Answer: c
virall pharyngitis Answer: virall infectionl isl thel mostl commonl causel ofl sorel throat etiologicl agents:
physicall examl withl virall pharyngitis Answer: evaluationl ofl thel childl withl al complaintl ofl sorel throatl requiresl al carefull physicall examination,l particularlyl ofl thel pharynx stridor,l drooling,l orl respiratoryl distressl indicatel airwayl obstructionl andl mayl bel presentl inl thel patientsl withl conditionsl suchl asl epiglottitisl orl retropharyngeall abcess anl inflammedl eardruml suggestsl painl froml al non-phargeall sitel andl swellingl aroundl al toothl indicatesl al likelyl dentall abcess
adenovirus Answer: mostl commonl causel ofl virall pharyngitis prevalentl inl daycarel centersl andl inl householdsl withl youngl children presentsl with
s/sl ofl adenovirus Answer: pharyngitisl andl coryzal (stuffyl orl runnyl nose,l sneezing,l andl lossl ofl smell) pharyngitisl isl frequentlyl associatedl withl conjunctivitis,l layngotacheitis,l bronchitis,l otitisl medial orl pneumonia feverl andl otherl systemicl manifestationsl suchl asl malaise,l headache,l myalgia,l andl abdominall painl arel commonl inl manyl casesl exudativel tonsillitisl andl cervicall adenopathyl mayl bel present,l al syndromel thatl canl bel clinicallyl indistinguishablel froml groupl Al streptococcall infection adenovirusesl arel thel mostl commonl causel ofl tonsillitisl inl youngl children
Answer: abruptl onset,l feverl mod-high,l headache,l abdominall pain,l N/Vl andl sandpaperl rashl adiitionall mayl includel exudativel pharyngitis,l enlargedl tenderl anteriorl cervicall nodes,l palatall petechiae,l anl inflamedl uvula,l andl scarlatiniforml rash ****lackl ofl coughl orl nasall congestionl oftenl pointsl tol GABHS symptomsl usuallyl resolvel spontaneouslyl inl 3 - 5 l days
managementl ofl GAS Answer: diagnosisl inl childrenl andl adolescentsl shouldl bel confirmedl withl throatl culturel beforel treatment incubationl periodl isl twol tol fourl days.l feverl andl constitutionall symptomsl usuallyl resolvel withinl threel tol fourl days,l evenl inl thel absencel ofl antimicrobiall therapy clinicall improvementl hasl beenl observedl upl tol 48 l hoursl soonerl inl patientsl receivingl penicillin
treatmentl forl GAS Answer: ***orall pencillinl Vl isl thel agentl ofl choicel forl treatmentl ofl GASl pharyngitisl givenl itsl provenl efficacy,l safety,l narrowl spectrum,l andl lowl cost.l 10 l days amoxicillinl isl oftenl usedl inl placel ofl orall penicillinl inl childrenl sincel thel takel isl morel palatablel thanl pencillin.l canl alsol bel givenl asl oncel daily,l eitherl immediatel releasel orl asl anl extendedl releasel tablet macrolids,l azythromycin,l arel anl acceptablel alternativel forl penicillin-allergicl pts forl ptsl withl knownl orl suspectedl macrolid-resistantl GASl whol cannotl toleratel cephalosporins,l wel treatl withl al 10 l dayl coursel ofl clindamycinl (canl causel cl diff)
goall ofl therapyl withl GAS Answer: reducingl symptoml severityl andl duration preventionl ofl acutel complications,l suchl asl otitisl media,l peritonsillarl abscessesl orl otherl invasivel infections
preventionl ofl delayedl complicationsl orl immunel sequalae,l particularlyl acutel rheumaticl fever preventionl ofl spreadl tol others
superlativel andl nonsuperlativel complicationsl ofl GAS/l tonsillopharyngitis Answer: nonsupperativel (nol pus)
otherl GASl complications Answer: preventionl ofl acutel rheumaticl feverl isl onel ofl thel mainl indicationsl forl abxl treatmentl ofl streptoccall pharyngitis acutel rheumaticl feverl andl rheumaticl heartl diseasel arel amongl thel leadingl causesl ofl cardiovascularl deathl worldwide datal onl thel benefitsl ofl abxl inl prevenitnl otherl nonsupperativel complicationsl arel limited-l besidesl probablyl preventingl poststreptococcall glomerulonephritis changel toothl brushesl afterl abx,l lossl pacifer
epiglottitis Answer: inflammationl ofl thel epiglottis,l tissuel thatl liesl anteriorl tol thel larynx presentsl withl abruptl onsetl andl rapidl progressionl (hours)l ofl dysphagia,l drollingl andl distressl (3l D's)arel hallmarkl epiglottisl developsl rapidlyl andl canl bel lifel threatening maintenancel ofl thel airwayl isl thel focusl ofl treatment
tripodl positon
coup Answer: epiglottitisl isl distinguishedl froml croupl byl thel absencel ofl 'barking'l coughl andl thel presencel ofl anxietyl andl drooling childrenl withl croupl generallyl arel comfortablel inl thel supinel positionl andl havel al normall appearingl epiglottis
croupl tx Answer: softl tissuel laterall neckl radiographsl (needl tol bel specificl thatl youl needl softl tissue)l canl confirml thel diagnosisl ofl epiglottitisl butl arel notl necessaryl inl manyl casesl inl whichl thel liklihoodl ofl epiglottitisl isl suffiecentlyl lowl (egl immunoizedl childrenl withl al hoarsel voicel andl characteristicl coughl ofl croup) inl thesel salutationl nol imagingl isl necessaryl ceftiaxonel orl cefotaxaminel PLUS vancomycinl orl clindamycinl orl oxacillinl orl Nafxillinl orl cefazolin
mononucleosis Answer: s/sl typicall features
splenomegalyl isl seenl inl 50 - 60%l ofl patientsl withl IMl andl usuallyl beginsl tol recedel byl thel 3rdl weekl ofl thel illness maculopapular,l urticariall orl petechiall rashl isl occasionallyl seen.l thel rashl almostl awaysl occursl followingl thel administrationl ofl ampicillinl orl amoxicillin
monol dxl criteria Answer: lymphocytosis 10%l atypicalyl lymphocytesl onl peripherall smear positivel epstein-barrl titer positivel mono-spot
monol laboratoryl data Answer: thel mostl commonl laboratoryl findingl isl lymphocytosis,l definedl asl anl absolutel countl
4500/microL,l orl onl peripherall smear,l al differentiall countl >50l %l (significantl atypicall lymphocytosis) totall WBCl inl pts.l withl IMl averagesl 12k-18k/microL elevatedl liverl enzymesl arel seenl inl thel vastl majoritiyl ofl patients,l abnormalyl liverl functionl testsl inl al ptl withl pharyngitisl stronglyl suggestl thel possibilityl ofl IM **EBV-shouldl bel suspectedl whenl anl adolescentl complainsl ofl al sorel throat,l fever,l
malaise,l lymphadenopathyl andl pharyngitisl onl PE
Monospot Answer: donel tol checkl thel bloodl forl antibodiesl tol EBV,l resultsl inl al fewl min mayl notl detectl thel infectionl duringl thel firstl 1 - 2 l weeksl ofl thel illlness,l basedl onl thel detectionl ofl heterophilel abx bloodl testl forl EBVl specificl antibdiesl ifl monospotl isl - ptsl withl suspectedl IMl basedl uponl thel hxl andl PEl shouldl havel al WBCl wl diffl andl al heterophilel test
age-specificl ratel forl AOMl peaksl betweenl 6 - 18 l monthsl ofl age highestl riskl factor=l URI others=smoking,l airl polution,l bottlel feeding,l dayl carel centers
commonl pathogeniesl ofl AOM Answer: bacterial
S/Sl ofl AOM Answer: earl painl (otalgia)l isl thel mostl commonl complaintl inl childrenl withl AOM childrenl olderl thanl 2 l yearsl complainedl ofl earl painl morel oftenl thatl withl childrenl younger infantsl inl particularl mayl presentl with:
AOMl withl effusion Answer: bulgingl ofl thel tympanicl membrane
sequelael ofl OM Answer: hearingl loss:l mostl ptsl withl middlel earl effusionl havel persistentl ofl fluctuatingl conductivel hearingl loss fluidl fillingl thel middlel earl spacel preventsl thel tympanicl membranel froml vibratingl adequately,l therebyl diminishingl movementl ofl thel ossicularl chain hearingl lossl remainsl asl longl asl fluidsl fillsl thel middlel ear
AOMl treatment Answer: nol concomitantl purulentl conjunctivitisl andl nol hxl ofl recurrentl AOM-l firstl linel ifl amoxicillinl 90mg/kgl perl dayl dividedl intol 2 l dosesl forl 10 l days recurrentl purulentl conjunctivitisl orl hxl ofl AOMl andl unresponsivel tol amox:l secondl linel isl augmentinl orl beta-lactaml antibiotic.l ifl childrenl hasl concominentl purulentl conjuncitivits,l heavyl nasall congestion,l productivel couch childrenl allergicl tol PCNl arel treatedl withl macrolidsl suchl asl azithromycin
choicel ofl treatmentl strategyl AOM Answer:
AOMl pedsl diagosticl criteria Answer: moderatl tol severel bulgingl ofl TMl orl ottorrheal notl duel tol OE mildl bulgingl ofl TMl andl recentl onsetl (lessl thanl 48 l hrs)l ofl earl pain,l tugging,l rubbingl inl nonl verball childrenl orl intensel erythema dol notl diagnosl AOMl inl childrenl whol dol notl havel middlel earl effusion
mist,l antipyretics,l fluids coldl nightl air nol hotl waterl steam
coupl seekl medicall attn Answer: stridorl atl rest.l can'tl breath,l pallorl orl cyanosis,l severel coughingl spells,l droolingl orl difficultyl swallowing,l fatigue,l feverl >38.5,l symptomsl >7l days,l suprasternall retractions
bronchitis Answer: lowerl respiratoryl tractl infectionl thatl primarilyl affectsl thel smalll airwaysl (bronchioles),l commonl causel ofl illnessl andl hospitalizationl inl infantsl andl youngl children mostl casesl arel causedl byl RSV typicallyl afectsl infantsl underl 2,l inl falll andl winter peakl incidencel betweenl twol andl sixl monthsl ofl agel andl remiansl al significantl causel ofl respiatoryl diseasel duringl thel firstl fivel yearsl ofl life.
bronchitisl clinicall presentation Answer: feverl usuallyl <38.3l (101),l cough,l respiraotryl distressl (increasedl RR,l retractions,l wheezing,l crackles,l nasall flaring,l retractions,l grunting) oftenl precededl byl onel tol threel dayl hxl ofl URIl symptomsl (nasall congestionl and/orl discharge) respl ditres,l increasedl workl ofl breathing,l RRl andl oxygenationl canl alll changel rapidlyl withl crying,l coughingl andl agitation
managmentl ofl bronchilitis Answer: avoidl OTCl decongestantsl andl coughl medicines,l nol provenl benefitl andl mayl havel seriousl s/e
nol pharml interventionl isl recommendedl forl childrenl whol arel immunocompetentl andl nonseverel b/cl nol improvedl outcomesl bronchodilatorsl don'tl help,l neitherl dol glucocorticoidsl andl leukotrienel inhibitors dol notl treatl withl nebulizedl hypertonicl salinel highl flowl o2l canl bel usedl tol avoidl endotrachiall intubationl hospitalizel ifl toxicl appearing,l poorl feeding,l lethargyl orl dehydration
pneumonial inl peds Answer: acutel infectionl ofl thel pulmonaryl parenchymal ofl ptl whol hasl aquiredl nosocomiall pnemonia
clinicall evall withl pnemonia Answer: identifcaitonl ofl clinicall syndromel (e.gl pnemonia,l bronchitis,l asthma) considerationl ofl etiologicl agentl (bacyeria,l virus) assessmentl ofl severityl ofl illness
clinicall recommendationsl withl pedsl pnemonia Answer: childhoodl vaccines,l includesl heptavalentl pnemococcall vaaine,l helpl decreasel thel incidencel ofl invasivel pneomococcall disesase CBC,l CRPl andl ESRl dol notl helpl determinel thel etiologyl ofl CAP. Chestl radiographl isl notl helpfull inl differitaingl cause mayl needl tol givel empericl treatmentl basedl onl age/l symptoms
clinicall evaluationl forl pnemonial inl pediatrics Answer: strongestl predictorl forl pnemonial inl childrenl arel fever,l cyanosis,l andl morel thanl onel ofl thel followingl s/sl ofl respiratoryl distress
managmentl ofl CAPl pnemonia Answer: streptoccusl pneumoniael isl thel mostl commonl bacteriall causel ofl pneumonial inl childrenl ofl alll ages ampicillinl ofl penicllinl Gl providesl adequatel coverage thirdl generationl cephalosporinl (el cefotaxmine,l ceftiaxone)l forl childrenl youngerl thanl 12 l monthsl third-generationl cephalosporinsl providel coveragel forl thel beta-l lactamasel producingl pathogensl (egl Hl influenzael andl Ml catarrhalis) forl childrenl withl morel severel illnessl thirdl generationl cephalosporinsl providel coveragel forl al broaderl rangel ofl pathogensl floroquinolones:l levofloxacin,l moxifloxacin,l mayl bel reasonablel empiricl therapyl forl thel olderl childl andl adolescentl withl suspectedl atypicall pneumonial whol couldl actuallyl havel pneumococcal pneumonia
allergiesl defined Answer: anl adversel effectl froml al specificl immunel responsel thatl isl reproduciblel onl exposurel tol al givenl food foodl isl definedl asl anyl substancel intendedl forl humanl consumptionl including,l drinks,l chewingl gum,l foodl additives,l andl dietaryl supplements foodl allergyl isl anl IgEl mediatedl reactionl thatl isl potentiallyl systemicl andl characteristicallyl rapidl inl onset
typesl ofl foodl allergies Answer: IgEl mediated:l foodsl penetratel mucosall barriersl andl reachl specificl IgEl antibodiesl boundl tol mastl cellsl suchl asl histamine leukotrienesl arel releasedl inducingl anl immediatel hypersensl reactionl leadingl tol symptomsl suchl asl wheezingl orl uticarial non-l IgEl mediated
allergiesl s/s
Answer: swellingl ofl thel lipds,l mouth,l uvulal andl glottis generalizedl urticaria wheezing severel reactions,l anaphylaxisl N/V/D cramping lightl headnessl orl syncope
foodl intolerance Answer: adversel reactionl tol foodsl andl substancel ingestedl inl food
mostl commonl foodl allergies Answer: cow'sl milkl allergyl isl thel mostl commonl foodl allergyl amongl infantsl andl youngl children.l resolutionl isl graduall throughoutl childgoodl andl adolescence eggl allergyl isl onel ofl thel mostl commonl foodl allergiesl ofl childhoodl andl itl isl frequentlyl outgrownl duringl childhoodl orl adolescence thel presencel ofl eggl allergyl isl al markerl forl subsequentl sensitizationl tol aeroallergens,l asl welll asl thel laterl developmentl ofl asthmal peanutsl &l treel nuts:l althoughl itl wasl initiallyl believedl tol bel al lifelongl sensitivityl inl nearlyl alll cases,l subsequentl studiesl havel shownl thatl tolerancel canl developl inl appropriatelyl 20 - 25%l ofl patients wheatl allergy:l commonl childhoodl foodl allergiesl thatl isl usuallyl outgrownl byl adolescence seafoodl (fishl andl shellfish):l developl inl childhood,l althoughl adultl onsetl isl believedl tol bel morel common
relatedl conditionsl tol foodl allergies Answer: