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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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View Related questions

Correct Answer is ["A","C","E"]

Explanation

A. A clean catch urinalysis and urine culture: A urinalysis and culture are essential to identify the presence of infection, type of bacteria, and appropriate antibiotic sensitivity.

B. Foley catheter placement: Foley catheters are not routinely indicated for suspected urinary tract infections (UTIs) unless there is an issue with urinary retention or other specific medical indication.

C. Broad-spectrum antibiotic: Initiating a broad-spectrum antibiotic may be appropriate while waiting for culture results to address infection.

D. 0.9% sodium chloride infusion at 100 ml/hr: IV fluids are not typically necessary for a UTI unless the patient is dehydrated or unable to take oral fluids.

E. WBC count: A WBC count can help assess the systemic inflammatory response and gauge the severity of the infection.

F. Blood cultures × 2: Blood cultures are generally reserved for cases where a systemic infection or sepsis is suspected, which is not indicated by this patient's symptoms alone.

Correct Answer is C

Explanation

A. Deep vein thrombosis. Deep vein thrombosis typically causes constant pain, swelling, and redness and does not improve with rest.

B. Restless leg syndrome. Restless leg syndrome is characterized by an uncontrollable urge to move the legs, usually at rest, and is not associated with walking.

C. Intermittent claudication. Intermittent claudication is a common symptom of PAD where muscle pain or cramping occurs during activity and is relieved with rest due to insufficient blood flow.

D. Varicose veins. Varicose veins generally cause aching and swelling rather than pain triggered specifically by walking.

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