A 22-year-old college student presents to your urgent care clinic complaining of a rash.
She was recently on spring break and spent every night in the
... [Show More] hot tub at her hotel. On physical exam, she has multiple small areas of 1- to 2-mm erythematous pustules that are present mostly where her bathing suit covered her buttocks. What is the most likely pathogen causing these lesions?
Streptococcus.
Staphylococcus aureus.
Klebsiella.
Pseudomonas aeruginosa.
This is a common cause of hot tub folliculitis. Staph and Strep can cause folliculitis but it is not the most common pathogens in hot tubs. Klebsiella can cause folliculitis in the immunocompromised patient.
A 10-year-old male presents to the office with his mother with complaints of itchy and
red eyes for 1 day. He reports watery drainage in both eyes, associated with repetitive itching. He has no fever or constitutional symptoms. The patient has a sibling that just
started day care recently. Upon examination, vision is 20/20 OU with glasses. He has mild to moderate conjunctival hyperemia with bilateral preauricular lymph nodes that are inflamed. What is the patient’s diagnosis?
Bacterial conjunctivitis.
Allergic conjunctivitis.
Blepharitis.
Viral conjunctivitis.
This is the classic presentation of viral conjunctivitis. The patient also has exposure to kids at school and a sibling with day care exposure.
A 25-year-old male presents with “bleeding in my eye” for 1 day. He awoke this morning with a dark area of redness in his eye. He has no visual loss or changes. He denies constitutional symptoms, pruritus, drainage, or recent trauma. The redness presents on physical exam as a dark red area in the patient’s sclera of the right eye only and takes up less than 50% of the eye. The patient’s remaining sclera is clear and white. He also notes he was drinking alcohol last night and vomited afterward. What is the best treatment?
Reassurance that this lesion will resolve without any treatment in 2 to 4 weeks.
Cold compresses and frequent handwashing.
Sending the patient to the emergency department for immediate ophthalmology consult.
Topical steroids and close follow-up with an ophthalmologist.
This is the classic presentation of a subconjunctival hemorrhage. It will resolve without treatment in 2 to 4 weeks. Vomiting probably caused his hemorrhage.
Henry, 64 years old, is having difficulty getting rid of a corneal infection. He asks why. How do you respond?
“We can’t determine the causative agent.”
“Because the cornea doesn’t have a blood supply, an infection can’t be fought off as usual.”
“Systemic antibiotics have difficulty getting to that area of the eye.”
“Because the infection was painless, it was not treated early enough.”
Because the cornea is an avascular organ, immune defenses have difficulty fighting off infections.
A 25-year-old male presents to your urgent care clinic complaining of genital pruritus. On physical exam, the patient has small, erythematous, excoriated papules in his pubic hair. No mites are identified. There is no penile discharge, and the patient has no constitutional symptoms. He is sexually active but wears condoms during all sexual experiences. What is the most likely diagnosis?
Gonorrhea.
Chlamydia. [Show Less]