CASES

PHP 16,000

What surgical procedure for the most common cause of visual impairment in the Philippines is covered by a specific PhilHealth benefit?

PHP 18,000

A glaucoma patient requires a procedure covered by a PhilHealth package; which surgical intervention does this likely include along with PF and HCI costs for fistulization or trephination?

SDG 5

Efforts to address the higher prevalence of vision impairment among women primarily support which specific Sustainable Development Goal?

Engineering controls

In the hierarchy of controls, where does the installation of hand tool guards to deflect flying particles rank in effectiveness compared to administrative controls?

15 minutes

A worker suffers a chemical splash from a solvent; what is the minimum duration they must flush their eyes while keeping them wide open to prevent permanent damage?

Rigid shield without pressure

A construction worker presents with a metal shard embedded in his eyelid; what is the correct first aid management before transport to a medical facility?

Cold compress without pressure

A worker is struck in the eye by a blunt object, resulting in a contusion; what is the recommended immediate aid to reduce pain and swelling?

91 or 92 dB

If an idling bulldozer produces 85 dB and the noise source is doubled twice in a specific workspace (i.e., four identical bulldozers), what is the resulting decibel level?

8 hours

According to OSHA, what is the maximum permissible exposure limit (PEL) for a worker exposed to a continuous 90 dB environment?

Semi-aural caps

A worker frequently transitions between a quiet office and a 100 dB manufacturing floor; which HPD is most convenient for this specific pattern despite its lower NRR?

Baseline audiogram

A new employee starts at a rock quarry; within what maximum timeframe must they receive their first audiometric test to establish a reference for future shifts?

Sol layer

Which specific layer of the nasal mucus blanket contains immune components like lysozyme and lactoferrin while allowing the cilia to immerse and move?

Sympathetic stimulation

A patient presents with severe nasal congestion; the physiological process of blood vessel constriction to decongest the turbinates is primarily driven by which branch of the nervous system?

Shortened sleep (< 6 hours)

Which behavioral factor has been evidence-based to significantly increase a person's susceptibility to viral rhinitis infections?

NARES

A 30-year-old woman presents with classic allergic rhinitis symptoms, but her skin prick tests are negative and her nasal cytology shows significant eosinophilia; what is the diagnosis?

Rhinitis medicamentosa

A patient who has used over-the-counter nasal sprays daily for three weeks presents with severe rebound congestion; what is the specific term for this condition?

Atrophic rhinitis

A patient with a history of aggressive nasal surgery presents with a "wide open" nasal cavity, thick crusting, and foul-smelling breath; what is the diagnosis?

Histamine

In the pathophysiology of allergic rhinitis, which chief mast cell product is primarily responsible for the symptoms of sneezing and itching?

Leukotrienes (B4/C4/D4) and Prostaglandins (D2/E2/I2)

Which groups of inflammatory mediators released during mast cell degranulation are the primary causes of nasal blockage?

Mild persistent

A patient experiences allergic rhinitis symptoms 5 days a week for over a month but reports normal sleep and no impairment at work; how is this classified under ARIA?

Rhinovirus and Adenovirus

Which two viral agents together account for approximately 40–50% of all infectious cases of sore throat?

ACE2

Through which specific cell surface protein receptor does the SARS-CoV-2 virus gain entry into the respiratory epithelium?

Modified McIsaac Scoring

A physician is evaluating a 10-year-old with a sore throat; which clinical scoring system specifically accounts for the patient's age to predict GABHS risk?

Culture of throat swab in sheep agar

What is considered the gold standard for the laboratory diagnosis of bacterial pharyngitis due to its 90–95% sensitivity?

Starting antibiotics within 9 days

What is the critical intervention window for a patient with GABHS pharyngitis to prevent the development of Acute Rheumatic Fever?

Peritonsillar abscess (Quinsy)

A patient with a history of strep throat presents with a "potato voice" and severe throat pain; what is the most likely suppurative complication?

Lemiérre’s Syndrome

A 19-year-old presents with sepsis and a tender neck following a sore throat; imaging shows suppuration of the jugular vein. Which rare syndrome is most likely?

Fusobacterium necrophorum

What is the specific etiologic agent responsible for the postanginal sepsis and metastatic lung infections seen in Lemiérre’s Syndrome?

Woody edema of the tongue

In a patient with Ludwig’s Angina starting from an infected molar, what is the hallmark physical finding that leads to airway obstruction?

Croup

A 3-year-old presents at night with a barking cough and stridor; which subglottic infection is the most likely clinical diagnosis?

Steeple sign

On an AP neck X-ray of a child with a barking cough, what classic radiographic sign indicates narrowing of the subglottic tracheal air shadow?

Acute Epiglottitis

A patient presents sitting forward and drooling with a "cherry red" structure seen on laryngoscopy; what is the diagnosis?

Thumbprint sign

What is the key diagnostic finding on a lateral neck X-ray for a patient with suspected Haemophilus influenzae type B supraglottic infection?

Rifampicin

A child is diagnosed with Hib-associated epiglottitis; which antibiotic should be administered to the household contacts as prophylaxis?

Staphylococcus aureus

What is the most common infectious etiologic agent for both internal and external hordeolums?

Chalazion

A patient presents with a non-healing granulomatous inflammation of the Meibomian gland that requires drainage; what is this called?

Adenovirus

What is the most common viral pathogen responsible for conjunctivitis, often presenting with a "gritty" sensation and preauricular lymphadenopathy?

Hyperacute Bacterial Conjunctivitis

A patient presents with severe ocular pain and copious discharge; what is the diagnosis, given the risk of progression to meningitis?

Neisseria gonorrhoeae

Which pathogen is the primary cause of Ophthalmia Neonatorum, typically transmitted through the birth canal during delivery?

Trachoma

Which condition, caused by Chlamydia trachomatis serotypes A–C, involves pannus formation and is the leading cause of preventable blindness?

McCoy cell cultures

What is the gold standard diagnostic method for identifying Chlamydia trachomatis in a patient with suspected inclusion conjunctivitis?

Acanthamoeba Keratitis

A contact lens wearer presents with photophobia and intense eye pain out of proportion to redness; what is the likely diagnosis?

Trigeminal ganglion

Where does the Herpes Simplex Virus 1 (HSV-1) reside during its latent phase before reactivating to cause corneal ulcers?

Toxoplasma gondii

What obligate intracellular coccidian parasite is the most common cause of posterior uveitis?

Acute post cataract surgery

What is the most common clinical event leading to the development of Endophthalmitis?

Bacillus cereus

Which saprophytic, motile, and hemolytic Gram-positive rod is a major concern in endophthalmitis following penetrating eye trauma?

Pseudomonas aeruginosa

What is the predominant etiologic agent for both acute and chronic diffuse otitis externa?

Granulation tissue

What hallmark physical finding located at the posteroinferior ear canal wall distinguishes invasive otitis externa in diabetic patients?

Skull base osteomyelitis

What is the most dangerous potential bone complication resulting from the extension of malignant otitis externa?

Eustachian tube dysfunction

What is the primary underlying physiological failure that leads to the development of Otitis Media?

Bulging tympanic membrane

What is the most characteristic physical finding on otoscopy for a patient with symptomatic acute otitis media?

Cholesteatoma

In active chronic otitis media, what keratinic debris formation has the potential to erode bone and promote meningitis?

Mastoiditis

A patient with untreated otitis media presents with a displaced pinna and swelling at the mastoid process; what is the diagnosis?

50–60%

What percentage of acute bacterial rhinosinusitis cases are caused by the combination of Streptococcus pneumoniae and non-typable H. influenzae?

Maxillary sinus

In which paranasal sinus does rhinosinusitis most commonly occur, often causing pain that is heavier when prone?

Aspergillus

Which saprobe is the most common cause of noninvasive chronic fungal sinusitis, often forming a "fungus ball"?

11% decrease

Comparing the 2018 Philippine Eye Disease Study to the 2002 survey, what was the reported change in cataract prevalence?

Non-ionized radiation (NIR)

A welder works without goggles and develops a "sunburn" of the cornea; which category of occupational hazard does this light source fall under?

Sound level meter

Which device would an OSH officer use to obtain an immediate measurement of sound intensity in a specific high-noise work area?

Personal dosimeter

Which device is used to measure the average noise exposure over an 8-hour shift for a chosen sample population?

In-ear dosimeter

What is the only noise measurement device that provides a real measure of the personal noise dose an individual worker is receiving?

Earmuffs

Which HPD is preferred for high-frequency noise protection but can be uncomfortable in hot environments?

Foam insert earplugs

Which inexpensive HPD provides better protection at lower frequencies but requires strict hand hygiene?

65–70 dB

Below what decibel level is the use of hearing protection considered "overprotection," potentially creating a safety risk?

1–2%

What percentage of viral rhinitis cases typically progress to a secondary bacterial infection?

Staphylococcus, Streptococcus, and H. influenzae

What are the three most common bacterial pathogens that take advantage of viral damage to the epithelium in bacterial rhinitis?

Mucormycosis

An uncontrolled diabetic with ketoacidosis presents with orbital swelling and inability to move the eye; which acute fungal infection is likely?

Broad aseptate hyaline hyphae branching at acute angles

What is the characteristic microscopic finding on a KOH wet mount for a patient with rhinocerebral mucormycosis?

MRI (or CT scan)

Which imaging modality shows hyperintensities in the sinuses on T2 axial sequences for fungal rhinosinusitis?

Rhinovirus

Which virus is the most common cause of the common cold but has no vaccine due to having over 150 serotypes?

Enterovirus

To which specific subgroup of the Picornaviridae family does the Coxsackie virus belong?

Group A Beta-hemolytic Streptococcus (GAS)

Which pathogen is the most important bacterial cause of pharyngitis, accounting for 15% of adult cases?

Streptolysin O

Which specific hemolysin produced by GAS is antigenic and used in ASO titers to determine previous infection?

Acute glomerulonephritis

Which non-suppurative complication of GABHS pharyngitis has an incidence that is not affected by antibiotic treatment?

Bacteroides spp.

What is the primary etiologic agent of Vincent’s Angina, a condition also characterized by halitosis?

Submandibular and sublingual spaces

Cellulitis of which two anatomical spaces characterizes the clinical presentation of Ludwig’s Angina?

Neisseria meningitidis and Neisseria gonorrhoeae

Which two Gram-negative diplococci are the primary causes of Hyperacute Bacterial Conjunctivitis?

Elementary Body

In the developmental cycle of Chlamydia, which form is considered the infectious stage?

Reticulate Body

In the developmental cycle of Chlamydia, which form is the non-infectious, replicating intracellular stage?

Serotype D-K

Which specific serotypes of Chlamydia trachomatis are responsible for causing inclusion conjunctivitis?

Slit lamp microscopy

What is the primary diagnostic tool used in a clinic to identify Acanthamoeba keratitis?

Treponema pallidum

Which motile spirochete is responsible for syphilitic uveitis and cannot be grown in artificial media?

Tachyzoite

Which form of Toxoplasma gondii is the active, rapidly multiplying stage found during an acute infection?

Oocyst

Which form of Toxoplasma gondii is shed in cat feces and can cause infection in humans if ingested?

Chorioretinal scar

What is the classic fundoscopic finding characteristic of a previous congenital Toxoplasma infection?

Aqueous and vitreous humor

Endophthalmitis is defined as an infection of the internal structures of the eye containing which two fluids?

Bacterial endocarditis

Endophthalmitis can occur via hematogenous seeding (Roth's spots) from which systemic condition?

10-20%

What percentage of work-related eye injuries result in temporary or permanent vision loss?

Elimination

Which hierarchy of control is demonstrated by replacing welding with adhesive bonding?

Substitution

Which safety control is used when incandescent lighting is replaced with LEDs to protect against NIR?

20-20-20 rule

Which administrative control requires looking 20 feet away for 20 seconds every 20 minutes to prevent digital strain?

ANSI Z87.1

Protective eyewear must be marked with "Z87," indicating compliance with which specific standard?

10 feet or 10 seconds

An eyewash station must be located within what maximum distance or travel time from a hazardous work process?

Corneal abrasion

What is the specific medical term for a scratch on the cornea caused by a fingernail or dirt?

Welder’s flash burn

A worker walking near a welding operation unprotected develops pain and light sensitivity; what is the diagnosis?

1000x/min

At what coordinated frequency do nasal cilia beat to move the gel layer posteriorly towards the nasopharynx?

C-fibers

The symptoms of pruritus and sneezing in rhinitis are caused by the stimulation of which specific nerve endings?

Venous sinusoidal engorgement

Nasal obstruction is primarily caused by the pooling of blood in turbinate capacitance vessels; what is this called?

Zinc lozenge

Which medication, if taken within 24 hours of cold symptom onset, may reduce the duration of the infection?

Hormonal rhinitis

What type of rhinitis affects approximately 22% of pregnant women, causing persistent congestion?