Final Exam Latest Update

NR-569 Differential Diagnosis in Acute Care Practicum

Final Exam (Latest Update)

Question:

Hordeolum (Stye)

Answer:

The infection, and subsequent inflammation, of the eyelid. Though infection can occur on either the outer or inner part of the eyelid, the term "stye" commonly refers to an infected eyelash follicle on the external part of the eyelid.After the initial infection, pus builds up in the eyelash follicle. The stye will continue to grow and swell for a few days before it eventually bursts and drains. Most styes heal on their own, but in rare occurrences, the pus may harden and progress into chalazion.

• TREAT - Treatment involves warm compresses. The condition is usually

self-limiting and resolves on its own. If there is evidence of associated abscess or cellulitis, topical or oral antibiotics may be required.

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Question:

Hordeolum (Stye) Etiology

Answer:

Caused by a bacterial infection in the oil-producing glands of the eyelid.

Question:

Hordeolum (Stye) HPI

Answer:

• Red, painful bump along the edge of the upper or lower eyelid near the

base of the eyelashes.

• Swelling of the eyelid (sometimes the entire eyelid).
• Crusting along the eyelid.
• Sensitivity to bright light.
• Sore, scratchy, foreign body sensation in the eye.
• Tearing.
• History of blepharitis or skin conditions, such as acne rosacea or seborrheic

dermatitis.

• Diabetes.
• Hormonal changes.
• Elevated low-density lipoproteins (LDL)

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Question:

Hordeolum (Stye) Exam Findings

Answer:

• A small, yellowish pustule typically develops at the base of an eyelash,

surrounded by hyperemia, induration, and diffuse edema.

• Within a few days, the abscess ruptures, draining exudate which tends to

relieve the pain and resolve the lesion.

Question:

Periorbital/Preseptal Cellulitis

Answer:

- Anatomy involved: Infection anterior to the orbital septum (eyelid and

surrounding tissues).

- Patho: May be caused by sinusitis, a break surrounding skin, or from the

spread of systemic infection through blood or lymph.

- Complications: Usually minimal.

• TREAT with empiric oral antibiotics based on likely pathogen.

Question:

Periorbital/Preseptal Cellulitis Possible HPI

Answer:

• Recent/current URI and sinusitis.
• Penetrating lid trauma.
• Dental infection. 3 / 4

• Hordeolum (stye)
• Insect bite
• History of exposure to eye antibiotics causing allergic etiology as

differential (this is usually bilateral)

Question:

Periorbital/Preseptal Cellulitis Clinical Presentation

Answer:

• Unilateral erythema, swelling, warmth, and tenderness of eyelid.
• May become life threatening.
• No restriction of extraocular eye movements.
• No proptosis
• No chemosis
• Normal visual acuity
• Assess for sinusitis, dental infection, or skin redness

Question:

Periorbital/Preseptal Cellulitis Diagnosis

Answer:

• Based on history and clinical exam. Cultures are rarely needed.

**Clinical Diagnosis**

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