Conjunctiva: hyperacute gonococcal conjunctivitis: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Conjunctiva: hyperacute gonococcal conjunctivitis

Sample item

A sexually active young man has profuse purulent discharge, severe lid swelling and chemosis since 24 hours, with a Gram stain showing Gram-negative intracellular diplococci. Which treatment is essential in addition to local saline irrigation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Systemic ceftriaxone

Neisseria gonorrhoeae can penetrate intact corneal epithelium and cause perforation, so systemic ceftriaxone is needed along with topical antibiotics. Partners must also be treated and chlamydial coinfection covered. Delay can result in loss of the eye.

Option by option

  • A. Systemic ceftriaxone (correct)

    Correct. Systemic ceftriaxone is required to prevent corneal perforation.

  • B. Topical steroid drops alone

    Steroids would worsen a bacterial infection.

  • C. Oral acyclovir

    Acyclovir is for herpetic disease.

  • D. Topical lubricants only

    Lubricants do not treat infection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is A, Systemic ceftriaxone. Neisseria gonorrhoeae can penetrate intact corneal epithelium and cause perforation, so systemic ceftriaxone is needed along with topical antibiotics.

Why is "Topical steroid drops alone" not the answer?

Steroids would worsen a bacterial infection.

Why is "Oral acyclovir" not the answer?

Acyclovir is for herpetic disease.

Why is "Topical lubricants only" not the answer?

Lubricants do not treat infection.

What concept does this question test?

It tests Conjunctiva: hyperacute gonococcal conjunctivitis in Ophthalmology. Partners must also be treated and chlamydial coinfection covered. Delay can result in loss of the eye.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Conjunctiva: hyperacute gonococcal conjunctivitis?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.