Quiz on common cases – Accordion Style
Quiz on common cases – Accordion Style
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A 70-year-old man with atrial fibrillation and hypertension presents to the emergency department with sudden onset of inability to see objects on his right side in both eyes. He also reports mild numbness in his right hand. Examination confirms a right homonymous hemianopia. He arrived 1 hour after symptom onset.
- Which vascular territory is most likely affected in this patient?
- A) Middle cerebral artery
- B) Anterior cerebral artery
- C) Posterior cerebral artery
- D) Basilar artery
- What is the most appropriate initial imaging study?
- A) Carotid Doppler ultrasound
- B) Noncontrast CT of the head
- C) Skull X-ray
- D) Electroencephalogram
- What is the recommended time window for intravenous thrombolysis in acute ischemic stroke?
- A) Within 12 hours of symptom onset
- B) Within 4.5 hours of symptom onset
- C) Within 24 hours of symptom onset
- D) Within 72 hours of symptom onset
- What is the expected outcome if thrombolysis is administered promptly in patients with isolated homonymous hemianopia due to stroke?
- A) No improvement in visual field
- B) More than half will improve, and many will have good functional outcomes
- C) High risk of symptomatic intracranial hemorrhage
- D) Visual field loss is always permanent
A 27-year-old contact lens wearer presents with a painful red eye, photophobia, and reduced vision. Slit-lamp exam shows a central corneal ulcer with surrounding infiltrate and hypopyon
- What is the most likely diagnosis?
- What is the next step in management?
- How to do corneal scrapes? What culture media are used?
- How to test corneal sensation?
- What is your differential diagnosis?
A 30-year-old swimmer who wears contact lenses presents with severe ocular pain disproportionate to clinical signs. Ring infiltrates are noted on slit-lamp examination.
- What is the most likely diagnosis?
- What other organisms can you suspect in a CL wearer?
- What investigations would you request?
- What organisms are in the differential diagnosis?
A 45-year-old man presents with rapid onset of corneal melting after minor trauma with plant material. Culture reveals Pseudomonas aeruginosa.
- What is the most likely causative organism?
- What is the initial empiric therapy?
- What are the complications to monitor?
A 35-year-old woman wakes with sudden onset eye pain and tearing. She has a history of previous minor corneal trauma
- What is the most likely diagnosis?
- What are the treatment options?
- What underlying conditions may contribute to this presentation?
A 20-year-old man presents with sharp eye pain and tearing after being scratched by a tree branch. Fluorescein staining reveals a linear epithelial defect.
- What is the most likely diagnosis?
- What is the initial management?
- When should you refer this patient?
A 60-year-old diabetic patient presents with a painless red eye and a persistent epithelial defect despite treatment. Corneal sensation is reduced.
- What is the most likely diagnosis?
- What is the most common cause in this patient?
- How would you manage this condition?
A 40-year-old presents with recurrent red eye, photophobia, and dendritic epithelial lesions on fluorescein staining.
- What is the most likely diagnosis?
- What is the treatment of choice?
- What are the complications of delayed treatment?
A 70-year-old presents with a painful vesicular rash in the V1 dermatome and associated red eye. Hutchinson’s sign is positive.
- What is the most likely diagnosis?
- What is the next step in treatment?
- What complications should you monitor?