Assignment
Advanced Diagnostics and Skills Case Study
The purpose of the case study is to evaluate a clinical situation and determine the appropriate treatment based on the principles learned.
Case Study
Jack is a 5-year-old Asian American boy who presents to your office because he was sent home from school today by the school nurse who said he had "pink eye." He is accompanied by his mother and his 19-month-old sister.
You talk with Jack and his mother about his symptoms and she reports:
He woke up this morning with a crusted shut right eye. After his mother applied a warm washcloth to his face, the crusting disappeared. He had more yellow drainage out of his right eye while on the bus to school. He continued to have yellow drainage and a red eye at school, so his teacher sent him to the school nurse. He states his eye is not itchy or burning. Jack and his mother do not recall any trauma to the eye. Jack does not have any cough, rhinorrhea, fever, or ear or throat pain. He does not have any history of allergic rhinitis either. Upon further questioning, he tells you other children have been sent home from his class for "pink eye" this week, including the boy who sits next to him.
VS: Temp 98.0, HR 80, RR 20, BP 80/50, Ht. 40 inches, Wt. 39 pounds.
Upon physical examination, Jack is nontoxic in appearance and cooperative with your exam. His right eyelid margin and corners of his eye have purulent yellow discharge. His right eye has an injected, red conjunctiva. His left eye is normal without discharge or conjunctival injection. He has 20/20 vision in both eyes. His pupils are both equal and reactive to light and his extraocular muscles are intact without any pain upon movement of either eye. He does not have any photophobia. His ear exam is normal without any bulging or erythema of his tympanic membranes. Examination of his nose does not reveal any bogginess of the mucosa or nasal drainage. His oropharynx is normal without any erythema or cobblestoning. He does not have any lymphadenopathy.
Task
I. What is the Epidemiology of Conjunctivitis?
II. Identify the distinguishing signs and symptoms of bacterial, viral, and allergic conjunctivitis.
III. Discuss the different treatments of bacterial, viral, and allergic conjunctivitis.
IV. Identify when patients need to be referred to an ophthalmologist for treatment of conjunctivitis.
V. What is your treatment plan for Jack? Including teaching points for Jack's Mom?