Mr. Roberts, a 65-year-old male. presents to the emergency department with sudden onset of severe pain in his right eye. blurred vision, seeing halos around lights, nausea, and vomiting. His right eye is red the cornea appears cloudy, and his intraocular pressure is elevated. What is the most likely diagnosis?
Conjunctivitis
Acute angle-closure glaucoma
Retinal detachment
Migraine with aura
The Correct Answer is B
A. Conjunctivitis. Conjunctivitis generally presents with redness and discharge but does not cause elevated intraocular pressure, severe pain, or visual disturbances like halos.
B. Acute angle-closure glaucoma. Acute angle-closure glaucoma is characterized by sudden severe eye pain, blurred vision, halos around lights, nausea, and vomiting, along with elevated intraocular pressure and a cloudy cornea.
C. Retinal detachment. Retinal detachment may cause sudden vision loss or flashing lights but typically lacks pain, nausea, or vomiting, and does not affect intraocular pressure.
D. Migraine with aura. A migraine with aura may cause visual disturbances but does not present with eye pain, red eye, or elevated intraocular pressure.
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Correct Answer is C
Explanation
A. Frequent urination: Frequent urination is not associated with osteomyelitis, a bone infection.
B. Increased range of motion: Osteomyelitis typically causes pain and restricted movement, not increased range of motion.
C. Localized bone pain and tenderness: Osteomyelitis commonly presents with localized bone pain, tenderness, and possibly swelling due to infection.
D. Hyperpigmentation of the skin: Hyperpigmentation is not a typical sign of osteomyelitis.
Correct Answer is C
Explanation
A. "I should monitor my temperature regularly and report any fevers to my healthcare provider." This statement shows correct understanding. Fever may indicate worsening infection or complications, so it’s important to monitor and report any fevers.
B. "I need to inform my healthcare provider about any new symptoms, such as shortness of breath or chest pain." This statement shows understanding. New symptoms, especially respiratory or cardiac, could signify complications, and should be reported.
C. "I can stop taking my antibiotics once I feel better." This indicates a need for further teaching. Completing the full course of antibiotics is crucial to ensure the infection is completely eradicated, even if symptoms improve.
D. "I will need to take antibiotics before dental procedures." Patients with infective endocarditis often require prophylactic antibiotics before dental procedures to prevent bacterial entry into the bloodstream.