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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?

A.

Conjunctivitis

B.

Acute angle-closure glaucoma

C.

Retinal detachment

D.

Migraine with aura

Answer and Explanation

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 D

Explanation

A. Mild wheezing: Mild wheezing can be a common symptom in COPD and does not immediately indicate a severe complication unless it worsens suddenly.

B. Fatigue and general malaise: Fatigue and malaise are often chronic in COPD and do not necessarily indicate an acute complication.

C. Increased sputum production: While increased sputum could suggest an infection, it is not the most urgent sign of a severe complication.

D. Sudden onset chest pain and dyspnea: Sudden chest pain and dyspnea are concerning for a pneumothorax or pulmonary embolism, both of which are potential complications in COPD and require immediate attention.

Correct Answer is A

Explanation

A. Drink plenty of fluids to stay hydrated. Staying hydrated is essential in managing viral pharyngitis to prevent dehydration, soothe the throat, and promote recovery.

B. Take antibiotics as prescribed until the course is complete. Antibiotics are not indicated for viral infections; they are only used for bacterial infections.

C. Avoid all forms of physical activity until fully recovered. While rest is recommended, light activities may be acceptable depending on the patient’s energy levels and symptoms. Total avoidance of all physical activity is unnecessary.

D. Use throat lozenges as needed but avoid resting to prevent throat swelling. Resting is beneficial to recovery. Throat lozenges may soothe irritation, but avoiding rest would be counterproductive.

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