Community ophthalmology: chlamydial ophthalmia neonatorum: 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 · Community ophthalmology: chlamydial ophthalmia neonatorum

Sample item

A neonate born at home to a mother with untreated genital infection develops mucopurulent discharge and lid swelling on day 9. Cultures for gonococcus are negative. What is the appropriate treatment?

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

The answer and the reasoning

B. Oral erythromycin for the baby, with treatment of the parents

Chlamydial conjunctivitis appears 5 to 14 days after birth, later than chemical or gonococcal disease, and can be associated with pneumonitis. Systemic macrolide treatment is needed, because topical treatment does not clear the nasopharyngeal infection. Both parents need treatment to prevent reinfection.

Option by option

  • A. Intravenous ceftriaxone only

    Ceftriaxone is aimed at gonococcal infection, which cultures excluded.

  • B. Oral erythromycin for the baby, with treatment of the parents (correct)

    Correct. Oral erythromycin treats chlamydial ophthalmia and its systemic reservoir.

  • C. Silver nitrate drops

    Silver nitrate causes chemical conjunctivitis and is not a treatment.

  • D. Topical antibiotic drops alone

    Topical drops alone do not clear nasopharyngeal carriage and risk pneumonitis.

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 B, Oral erythromycin for the baby, with treatment of the parents. Chlamydial conjunctivitis appears 5 to 14 days after birth, later than chemical or gonococcal disease, and can be associated with pneumonitis.

Why is "Intravenous ceftriaxone only" not the answer?

Ceftriaxone is aimed at gonococcal infection, which cultures excluded.

Why is "Silver nitrate drops" not the answer?

Silver nitrate causes chemical conjunctivitis and is not a treatment.

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

Topical drops alone do not clear nasopharyngeal carriage and risk pneumonitis.

What concept does this question test?

It tests Community ophthalmology: chlamydial ophthalmia neonatorum in Ophthalmology. Systemic macrolide treatment is needed, because topical treatment does not clear the nasopharyngeal infection. Both parents need treatment to prevent reinfection.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Community ophthalmology: chlamydial ophthalmia neonatorum?

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.