American College of Emergency Physicians Section of Pediatric Emergency Medicine
Brent King, MD, FACEP
Chair, Department of Emergency Medicine and
Professor of Emergency Medicine and Pediatrics
University of Texas at Houston Medical School; Houston, TX
Billy's overly protective (and somewhat stingy) parents refused to get him the skateboard ramp and grind rail that he wanted for Christmas. Undeterred, Billy began constructing his own ramp. While hammering a nail into one of the boards he felt something hit his eye. He had immediate pain and photophobia. In the emergency department, his eye was noted to be red and chemotic. His pupil was constricted but seemed to be reactive to light. Which of the following is the most critical diagnostic test?
After his recovery, Billy is chasing his little brother through the house with a ski pole (he just watched "A Knight's Tale"; what can I say, the kid is impressionable). Billy's brother zigged and Billy, who should have zigged, zagged striking his face on the edge of a doorway. He is brought to the emergency department for evaluation. In the ED, Billy is noted to be unable to look up with his right eye, though his left works just fine. What is his diagnosis?
After the family decorates the Christmas tree, Billy begins to experience discomfort in both eyes. By the time that his (now exasperated) family brings him to the emergency department, he has red eyes and with thin, hemorrhagic exudates and significant chemosis. He is also complaining of sore throat. What is Billy's diagnosis?
Billy's older brother Timmy has been complaining of headaches. He has recently had what his mother described as a "severe cold" and his recovery has been slower than she expected. On the day of his emergency department visit, he began complaining of double vision. His mother noted that his right eye seemed more swollen than the left and it seemed to her to be "bugged out". The source of Timmy's problem is:
Which of the following statements is most correct:
Copyright 2004 American College of Emergency Physicians. Pediatric Emergency Medicine Section quizzes may be reproduced for educational purposes only. To obtain permission to reprint for any other purpose, please submit your written request to: Deputy Executive Director, American College of Emergency Physicians, PO Box 619911, Dallas, TX 75261.