Distraught at the persistent ringing in his ears and his ...

[K@]

Distraught at the persistent ringing in his ears and his inability to alleviate it, a 50-year-old man has visited his health care provider.
 
  After diagnostic testing, no objective cause (like impacted cerumen or vascular abnormality) was found. Given these testing results, which of the following teaching points by the care provider is most appropriate?
  A)
  This is most often the result of a psychological disturbance, and therapy is often useful in relieving tinnitus.
  B)
  There are many drugs such as blood pressure pills, relaxants, heart medications, and antihistamines that can cause tinnitus.
  C)
  A specialist can listen with a sensitive microphone to determine whether you are actually hearing these sounds.
  D)
  There are some treatments like tinnitus retraining therapy, which includes the extended use of low-noise generators, which has shown good success.

Question 2

A 46-year-old male has presented to the emergency department because of the eye pain, severe headache, and blurred vision that have followed an eye exam at an optometrist's office earlier in the day.
 
  The client tells the triage nurse that he received eye drops during the exam to keep my pupils wide open. What differential diagnosis will the care team first suspect?
  A)
  Infectious conjunctivitis
  B)
  Keratitis
  C)
  Corneal trauma
  D)
  Angle-closure glaucoma

[sylvia]

Answer to Question 1

Ans:
D

Feedback:

Current treatment modalities for tinnitus address the symptoms of the problem rather than curing the underlying etiology. While therapy can be of some use, it is inaccurate to characterize tinnitus as a psychological disturbance. Medications, including antihistamines, anticonvulsant drugs, calcium channel blockers, benzodiazepines, and antidepressants, have been used for tinnitus alleviation; they are not implicated as a cause. While listening to differentiate between objective and subjective tinnitus is possible, the absence of objective sounds does not mean that tinnitus does not exist, rather that it is subjective. The use of tinnitus retraining therapy, which includes directive counseling and extended use of low-noise generators to facilitate auditory adaptation to the tinnitus, has met with considerable success.

Answer to Question 2

Ans:
D

Feedback:

Symptoms of acute angle-closure glaucoma are related to sudden, intermittent increases in intraocular pressure. These occur after prolonged periods in the dark, emotional upset, and other conditions that cause extensive and prolonged dilation of the pupil. Administration of pharmacologic agents such as atropine that cause pupillary dilation (mydriasis) also can precipitate an acute episode of increased intraocular pressure in persons with the potential for angle-closure glaucoma. Attacks of increased intraocular pressure are manifested by ocular pain and blurred or iridescent vision. The man's symptomatology is not characteristic of conjunctivitis, corneal trauma, or keratitis.

[K@]

Thank you

[sylvia]

No problemo