ANP CASE STUDY
QUESTION 1
1. Kari is a relatively healthy 42-year-old female with well-managed diabetes. She reports occasional alcohol intake, smokes cigarettes only when drinking, and exercises 3-4 times a week. She has a history of mild myopia, which she has corrected with glasses and contacts since she was 14 years old. Kari has been having trouble seeing at night. It has been gradually getting worse and she was tripped on a rug and bumped into a few walls within the last week. She has also noticed that small text seems blurrier than usual. Kari always makes sure to schedule annual visits to her eye doctor. Luckily, it’s almost time for this year’s check-up because she thinks she might need a new prescription for her glasses and contacts. Kari’s mild myopia means:
| Light is focused on the fovea centralis. | ||
| She has trouble focusing on objects close to her face. | ||
| Light is focused behind her retina. | ||
| She has trouble seeing objects at a distance. |
1 points
QUESTION 2
1. Of the limited history you are given, which item could NOT be related to the vision issues she is experiencing?
| Diabetes | ||
| Exercising 3-4 times a week | ||
| Smoking tobacco | ||
| Alcohol intake |
1 points
QUESTION 3
1. Myopia becomes more prevalent as one ages.
True
False
1 points
QUESTION 4
1. Kari has two grandparents who had glaucoma in their lifetime. Do any of Kari’s symptoms support a diagnosis of glaucoma? If so, which one(s)?
1 points
QUESTION 5
1. Kari’s ophthalmologist measures her intraocular pressure and finds that it is normal. With this information, which of the following diagnoses can be ruled out?
| Myopia | ||
| Glaucoma | ||
| Hyperopia | ||
| Cataracts |
1 points
QUESTION 6
1. During her annual visit, her doctor asks Kari for more specific information regarding her current symptoms. Which of the following symptoms would NOT be suggestive of cataracts?
| Loss of peripheral vision | ||
| Faded colors | ||
| Trouble with bright lights | ||
| Halos around lights |
1 points
QUESTION 7
1. A cataract consists of clouding in which structure?
| Sclera | ||
| Retina | ||
| Cornea | ||
| Lens |
1 points
QUESTION 8
1. Over the next several months, Kari’s eyes begin to look like this: Considering her history and symptoms, which of the following conditions is most likely?
| Cataracts | ||
| Hyperopia | ||
| Presbyopia | ||
| Glaucoma |
1 points
QUESTION 9
1. If Kari is diagnosed with glaucoma, what is the most likely treatment? Describe the treatment briefly, in your own words.
1 points
QUESTION 10
1. If Kari is diagnosed with cataracts, what is the most likely treatment? Describe the treatment briefly, in your own words.
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1 points
QUESTION 11
1. Maddie is a 6-year-old female with no prior history of major medical issues. She complained of right ear pain after an awkward head-first fall from a diving board yesterday. She landed in the pool and did not seem to have any apparent physical injuries, so her parents assumed she had headache from the impact and gave her acetaminophen. However, the pain persisted for a full day, so her parents have taken her to her pediatrician. Her parents have noticed that she is less responsive when speaking to her from her right side and are worried that she has suffered hearing loss from the fall. Maddie’s physician explains that there are different types of hearing loss. Damage to which of the following structures would cause conductive hearing loss?
| Tympanic membrane | ||
| Vestibule | ||
| Semicircular canals | ||
| Cochlea |
1 points
QUESTION 12
1. Maddie’s physician explains that there are different types of hearing loss. Damage to which of the following structures would cause sensorineural hearing loss?
| Malleus | ||
| Incus | ||
| Cochlea | ||
| Tympanic membrane |
1 points
QUESTION 13
1. When Maddie’s physician examines her ear, he explains to her parents that she has a perforated eardrum. Which of the following statements is NOT true?
| Maddie has sensorineural hearing loss due to the perforated eardrum. | ||
| Maddie’s eardrum will likely heal on its own and she will not need surgery. | ||
| Maddie is at higher risk for ear infections due to the perforation. | ||
| A perforated “eardrum” means that there is a tear or hole in Maddie’s tympanic membrane. |
1 points
QUESTION 14
1. Maddie’s doctor performs tuning fork tests to help determine the source of her hearing loss. Which of the following tests compares bone conduction to air conduction?
| Weber test | ||
| Rinne test |
1 points
QUESTION 15
1. If Maddie’s hearing loss persists after her perforation is healed, which of the following scenarios is likely?
| Maddie will likely lose hearing in her left ear, too, but less severely. | ||
| Maddie suffered sensorineural AND conductive hearing loss from the head injury in the pool. | ||
| Maddie will continue to lose hearing bilaterally as she ages. | ||
| Her hearing loss is genetic and will be passed on to her future children. |
1 points
QUESTION 16
1. Medicine or surgery can often fix which type of hearing loss?
| Conductive hearing loss | ||
| Sensorineural hearing loss |
1 points
QUESTION 17
1. Which of the following is a common cause of sensorineural hearing loss?
| Ruptured tympanic membrane | ||
| Fluid trapped in the middle ear | ||
| Aging | ||
| Cerumen build up |
1 points
QUESTION 18
1. Identify and explain (in your own words) at least one possible complication of Maddie’s perforated eardrum.
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1 points
QUESTION 19
1. Which of the following structures is not part of the physiology of hearing?
| Incus | ||
| Cochlea | ||
| Utricle | ||
| Auditory canal |
1 points
QUESTION 20
1. A ruptured tympanic membrane DIRECTLY affects the movement/vibration of which ossicle?
| Malleus | ||
| Anvil | ||
| Incus | ||
| Stapes |
1 points
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