A 15-year-old is complaining of right ear pain and a feeling…

A 15-year-old is complaining of right ear pain and a feeling of fluid in his right ear for the past 3 days. He feels likes it is getting worse. He says his hearing is slightly decreased in the right ear in comparison to the left. He stated these symptoms started after he came back from a camping trip where he went swimming in a lake several times. Physical exam reveals a left ear that is WNL. His right ear is painful when the auricle is tugged. The ear canal is edematous and erythematous. Whitish exudate is present in the right ear, and due to the amount of exudate, the tympanic membrane was only partially visible. The portion seen was intact and nonerythematous. The most likely cause is: 

A 40 year, Ms. Zack, presents to the emergency room with a f…

A 40 year, Ms. Zack, presents to the emergency room with a feeling that the walls and room are moving around even though she is not moving. Vertigo is confirmed.  The are various causes of vertigo.   Answer the following questions:   1- What are causes of benign positional vertigo and how would you be able to distinguish this cause of vertigo in comparison to other cause of peripheral type vertigo such as vestibular neuritis or Meniere’s disease? (3 points)   2- What are central causes of vertigo and what are clinical findings that would be more likely in central vertigo vs. peripheral vertigo? (2 points)    

Mark is 15 years old and plays sports.  He is complaining of…

Mark is 15 years old and plays sports.  He is complaining of anterior knee pain that has occurred intermittently over the past 2 to 3 months.  The pain worsens with walking up or down the stairs.  The pain decreases with rest.  Mark denies fever, weight loss, or systemic symptoms.  Physical exam reveals a tender, swollen tibial tuberosity in the affected knee.  Pain can be reproduced with resisted active extension and passive hyperflexion of the knee.  No effusion is noted.  The patient is not under acute distress.  What is the likely diagnosis? 

An 8 year old boy is brought in by his father and he is comp…

An 8 year old boy is brought in by his father and he is complaining of red, itchy eyes for 2 days. His father said it started in one eye and then got to the other. His eyes have a clear/mucous discharge. He denies eye pain but says he feels like he has sand in his eyes, he denies visual acuity change. He does have rhinitis, a productive cough with clear to yellowish phlegm, NO Fever. His father says a lot of kids at his school have been sent home with colds this past week. Allergies: NKDA Vital signs wnl General: WDWN 8 y/o boy in NAD Skin: pink, supple no lesions EENT: Canal clear, no vesicles; Tympanic membrane pearly gray, landmarks intact; nares with moderate amount whitish/tinge yellow discharge no oral lesions, no pharyngeal edema, Eyes: Bilateral edematous eyelids, clear, mucous drainage on lashes, conjunctiva erythematous, injected. Cornea and eyelid margins, no ulceration. PERRL bilaterally, OS 20/20, OD20/20. Fundoscopic well marginated discs, no AV nicking Neck: No lymphadenopathy, no goiter Heart: S1, S2 no gallops, rubs, murmurs Lungs: clear & equal bilaterally 1- What is the most likely type of conjunctivitis in this patient?   Discuss why you chose this answer. (3 points) 2- What is a common organisms in this type of conjunctivitis? How are infections acquired? What is the mode of transmission? (2 points)