Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth
Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth
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Chapter 38- Disorders of Special Sensory Function
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | A client presents to the clinic complaining, “I have something in my eye.” When questioned, the client admits to a scratching and burning sensation and light sensitivity. The health care provider suspects the client has developed: | |
| A) | Conjunctivitis | |
| B) | Retinal detachment | |
| C) | Acute glaucoma | |
| D) | Corneal edema | |
| Ans: | A | |
| Feedback: | ||
| Conjunctivitis causes bilateral tearing, itching, burning, foreign body sensation, and morning eyelash crusting and eye redness. The primary symptom of retinal detachment is painless changes in vision. Commonly, flashing lights or sparks, followed by small floaters or spots in the field of vision, are early symptoms. Attacks of glaucoma (increased intraocular pressure) are manifested by ocular pain, excruciating headache, blurred or iridescent vision, and corneal edema with hazy cornea, dilated (mydriasis), and fixed pupil; with repeated or prolonged attacks, the eye becomes reddened. With corneal edema, the cornea appears dull, uneven, and hazy; visual acuity decreases; and iridescent vision (i.e., rainbows around lights) occurs. | ||
| 2. | Which of the following people are at high risk for developing nonulcerative inflammation of the cornea? Select all that apply. | |
| A) | A welder with inadequate eye protection | |
| B) | A contact lens wearer who is noncompliant with cleaning and sterilizing the lens | |
| C) | A female who uses a tanning bed four to five times/week | |
| D) | A person who touched the fever blister and then rubbed the eye | |
| E) | A ski patrol who works 12 hours/day in bright, sunny mountain tops | |
| Ans: | A, C, E | |
| Feedback: | ||
| In nonulcerative keratitis, all the layers of the epithelium may be affected, but the epithelium remains intact. There are a number of causes of epithelial keratitis, including epidemic keratoconjunctivitis caused by adenoviruses 8 and 19 and ultraviolet (UV) light exposure keratitis. Most cases of UV keratitis occur in welders with inadequate eye protection, but may also occur with tanning booth and other UV lamp exposure, and from sun reflecting off snow. Most cases of herpes keratitis are caused by HSV type 1 (labial [lip] herpes) and is ulcerative in nature. Acanthamoeba keratitis is a rare but sight-threatening complication that typically occurs in people who wear soft contact lens, particularly overnight or without proper disinfection. | ||
| 3. | During accommodation, pupillary dilation partially compensates for the reduced size of the retinal image by: | |
| A) | Thickening the lens | |
| B) | Contracting the ciliary muscle | |
| C) | Increasing light entering the pupil | |
| D) | Narrowing the palpebral opening | |
| Ans: | C | |
| Feedback: | ||
| Accommodation is the process whereby a clear image is maintained as gaze is shifted from far to near objects. During accommodation, pupillary dilation partially compensates for the reduced size of the retinal image by increasing the light entering the pupil. Accommodation requires convergence of the eyes, pupillary constriction, and thickening of the lens through contraction of the ciliary muscle, which is controlled mainly by the parasympathetic fibers of the oculomotor cranial nerve (CN III). A third component of accommodation involves reflex narrowing of the palpebral opening during near vision and widening during far vision. | ||
| 4. | A client develops fever, headache, and burning/itching in the periorbital area. After a few days, a vesicular rash appears around the eyelid margins. The health care provider will likely prescribe: | |
| A) | Topical antimicrobial for infection caused by overuse of contact lens | |
| B) | Oral antibiotics to treat chlamydial infection | |
| C) | Topical mast cell stabilizer to treat allergies | |
| D) | Antiviral medication for herpes zoster ophthalmicus | |
| Ans: | D | |
| Feedback: | ||
| Herpes zoster ophthalmicus usually presents with malaise, fever, headache, and burning and itching of the periorbital area. These symptoms commonly precede the ocular eruption by a day or two. The rash, which is initially vesicular, becomes pustular and then develops crusts. Treatment includes the use of oral and intravenous antiviral drugs. Initiation of treatment within the first 72 hours after the appearance of the rash reduces the incidence of ocular complications but not the postherpetic neuralgia. Chlamydial conjunctivitis is commonly spread by contact with genital secretions. It is treated with antimicrobial medications. Causes of ulcerative keratitis include infectious agents, exposure to trauma, and use of extended-wear contact lenses. The first manifestations of recurrent herpes keratitis are irritation, photophobia, and tearing. A history of fever blisters or other herpetic infection is often noted. Allergic conjunctivitis encompasses a spectrum of conjunctival conditions usually characterized by itching. Allergic conjunctivitis also has been successfully treated with topical mast cell stabilizers, histamine type 1 (H1) receptor antagonists, and topical nonsteroidal anti-inflammatory drugs. | ||
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