ABIM Exam Prep Break – Laughter: The Best Medicine
Need a little break studying from the ABIM board exam? Let’s try humour…Seen in yesterday’s comic pages from your local newspaper:
http://news.yahoo.com/lightbox/frank-and-ernest-slideshow/20130423-fk130423-gif-photo-050432533.html
Frank may think conjunctivitis refers to a phobia of conjunctions, but you, of course, know better.
It’s defined as inflammation or infection of the conjunctiva, which lines the inner surface of the eyelid and covers the sclera.
The lay public refers to it as “pink eye.” While children more commonly are affected, adults are certainly susceptible. There are three main causes of conjunctivitis. Distinguishing them is important as the treatments differ.
• Allergic: Usually leads to redness, itching and tearing of the eyes bilaterally. Treatment is to remove or avoid the irritant (e.g. pollen, smoke, chlorine, cosmetic ingredients, etc), followed by cold compresses, antihistamine eye drops (e.g. otc ketotifen or prescription olopatadine), and artificial tears. For persistent cases, steroid eye drops may be required.
• Bacterial: Usually leads to redness and purulent discharge of unilateral eye but may have bilateral involvement if spread occurs by rubbing eyes. Treatment is erythromycin ointment and/or polymyxin-trimethoprim drops. Although patients may note improvement in the first 2-3 days of treatment, be sure to have them complete the antibiotic course for 7 days.
• Viral: Usually leads to redness and watery discharge of unilateral eye but may have bilateral involvement if spread occurs by rubbing eyes. Viral conjunctivitis may arise after a URI. Treatment is symptomatic with cold compresses and artificial tears. Symptoms may persist for weeks.
If Frank’s patient actually had infectious conjunctivitis, Frank would have to remind him not to touch the eye with his hands and to wash his hands thoroughly. This precautionary measure prevents self-inoculation to the non-infected eye and spread to other people…I mean, cartoon characters.
Back to studying for the ABIM certification…
