A 42-Year-Old Man Comes to the Emergency Department Due to a Week

question 894

Multiple Choice

A 42-year-old man comes to the emergency department due to a week of eye pain and blurry vision.  Initially, he developed mild red eye and irritation, which he attempted to manage with artificial tear drops.  The patient works as a commercial fisherman and had assumed his symptoms were due to frequent sun and water exposure.  However, over the past few days, his eye pain has worsened, and he can "barely see" out of his left eye.  He has no medical history but has a family history of hypertension and diabetes.  Temperature is 37.2 C (99.1 F) .  Blood pressure is 128/82 mm Hg, pulse is 70/min, and respirations are 11/min.  There is copious clear drainage from the left eye, and a large ulceration is overlying the cornea; the right eye appears unremarkable.  Minimal sensation of the left cornea is noted during esthesiometry testing.  With fluorescein application, additional shallow linear, branched ulcerations are visualized along the margins of the central defect of the affected eye.  Routine Gram stain of the bacterial culture shows numerous white blood cells but no organisms.  Which of the following should be started immediately in this patient?

• A)Systemic antifungal
• B)Systemic steroid
• C)Topical antibiotic
• D)Topical antiviral
• E)Topical prostaglandin

---

Definitions:

Mental Models

Cognitive frameworks consisting of our assumptions and understanding of the world, which we use to interpret and respond to situations.

Categorical Thinking

The cognitive process of organizing information and perceptions into categories, which simplifies understanding but can lead to stereotypes or oversimplifications.

Categorical Thinking

The cognitive process of organizing information by grouping similar objects, ideas, or events into categories.

Comparative Process

Evaluating two or more objects, individuals, or situations against each other to understand their similarities or differences.