Directions

Students should complete one (1) case (your choosing) from Part 1. All students should complete one (1) case (your choosing) from Part 2. Note: All case studies are provided as a learning tool for students who wish to have them.

Part 1: Choose 1

Review the various conjunctivitis cases and determine the most likely cause, including pathogen and mode of transmission. Discuss data that supports your decision and treatment strategies. Health Cases Questions Case Study

Case 1

A 5-year-old girl has had a cough and runny nose (yellowish discharge) for the past 3 days. Her mother brought her for an evaluation as her left eye became pink and the right eye is also starting to get pink. Her daughter keeps rubbing them. The mother says there was a little discharge that was like mucus, but she wiped it away before coming to get checked. The physical examination reveals an active, alert girl. Her ears and lungs are within normal limits (WNL). Yellowish discharge is noted from the nose, and her oropharynx is mildly erythematous; however, there is no tonsillar enlargement or exudate. Her eyes have conjunctival erythema and mild edema—the left eye greater than the right eye. Mild crusting at the lid but no discharge is noted.

Provide responses to the items below.

• • Most likely cause including pathogen –
  • Mode of transmission –
  • Discuss data that supports your decision –
  • Treatment strategies –
    

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Case 2

A 40-year-old woman is complaining of itching, redness, and watery discharge in both her eyes. She feels like she has sand in her eyes. She also starting sneezing and has a clear nasal discharge. She thinks the symptoms started after petting a cat 2 days before at a friend’s house. She stated this reaction never happened before around animals, but she does get hay fever a few times a year. She has a past medical history of eczema. The physical examination reveals alert woman in no acute distress. Her ears, nose, throat, and lungs are WNL. There is evidence of bilateral stringy “ropelike” discharge and conjunctival erythema.

Provide responses to the items below.

• • Most likely cause including pathogen –
  • Mode of transmission –
  • Discuss data that supports your decision –
  • Treatment strategies –

Case 3

An 18-month-old boy has a runny nose (yellowish discharge) and has been rubbing his left ear for 3 days. His parents kept him home from day care and brought him in for an evaluation as both his eyes became pink and were full of crust and yellowish discharge this morning. He has been fussy, not eating well, and had a temperature of 100°F. The physical examination reveals a fussy, alert boy. His throat and lungs are WNL. There is evidence of yellowish discharge from the nose, and his left ear canal is clear, but the tympanic membrane is bulging and red, and fluid is noted behind the tympanic membrane. His eyes have a yellowish discharge and conjunctival erythema bilaterally.

Provide responses to the items below.

• • Most likely cause including pathogen –
  • Mode of transmission –
  • Discuss data that supports your decision –
  • Treatment strategies –

Part: Choose 1

Review the various hearing disorder cases and determine whether the disorder causes a conductive, sensorineural, or combination of both types of hearing loss. Once you identify the type of hearing loss, explain the part of the ear that is affected and describe the disorder.

Case 1

A 45-year-old woman noticed that she feels like her left ear is full and she cannot hear as well from her left ear as from her right. She states these symptoms started after she was cleaning the inside of her ears with a cotton-tip applicator. Physical exam reveals a right ear that is WNL. Her left ear canal has dark cerumen occluding her ear canal.

Provide responses to the items below.

1. Determine whether the disorder causes a conductive, sensorineural, or combination of both types of hearing loss.
2. Explain the part of the ear that is affected and describe the disorder.

Case 2

A 15-year-old is complaining of right ear pain and a feeling of fluid in his right ear for the past 3 days. He feels likes it is getting worse. He says his hearing is slightly decreased in the right ear in comparison to the left. He stated these symptoms started after he came back from a camping trip where he went swimming in a lake several times. Physical exam reveals a left ear that is WNL. His right ear is painful when the auricle is tugged. The ear canal is edematous and erythematous. Whitish exudate is present in the right ear, and due to the amount of exudate, the tympanic membrane was only partially visible. The portion seen was intact and nonerythematous.

Provide responses to the items below.

1. Determine whether the disorder causes a conductive, sensorineural, or combination of both types of hearing loss.
2. Explain the part of the ear that is affected and describe the disorder.

Case 3

An 80-year-old man states that he has been gradually having a harder time understanding what people are saying when he is with several people (e.g., like a party). He also states that he has a harder time understanding his grandchildren, and some words he hears well and other he does not. He states his hearing loss is equal in both ears. Physical exam is noncontributory and WNL.

Provide responses to the items below.

1. Determine whether the disorder causes a conductive, sensorineural, or combination of both types of hearing loss.
2. Explain the part of the ear that is affected and describe the disorder.