AAI

Question 1

Nasal itching
Sneezing
Conjunctival symptoms
Stuffy nose
Watery eyes
Trigger:
House dust mites
Animal fur
Pollen
Occupational (e.g. latex)

Answer 1

ALLERGIC RHINITIS/HAY FEVER

Question 2

When to refer HAYFEVER

Answer 2

Not help with OTC
Symptoms longer than 1 weeks
Swollen face / lips
Difficulty breathing

Question 3

Treatment for HAYFEVER

Answer 3

Drowsy: Chlorphenamine, Promethazine
Do not drive
Dry mouth
Blurred vision
Non-drowsy: Cetrizine, Loratidine
Headache
Dry mouth
Sick

Question 4

Treatment for BLOCKED NOSE?

Answer 4

Xylometazoline/Phenylephrine
1 spray 1-3 times daily
DO NOT use more than 7 days
Not for hypertension
Not for pregnant
Not for children

Question 5

Nose only HAYFEVER symptoms?

Answer 5

Fluticasone
Rapid onset
Only nose symptoms
Do not use more than 1 mth
STB
Look down
Using right hand for left nostril, put nozzle inside nose aiming towards outside wall
Squirt once/twice diff directions
Change hands and repeat
Do not sniff hard

Question 6

Eye only HAYFEVER symptoms?

Answer 6

Sodium cromoglicate (Hay fever)
Eye drops
1-2 drops, 4 times daily

Question 7

Advice for HAYFEVER

Answer 7

Stay indoors during high pollen count, close window
Wash clothes after returning outdoors
Wear face coverings

Question 8

• redness, itchy, dryness
• creases of elbow and knee

Answer 8

ECZEMA

Question 9

When to refer ECZEMA

Answer 9

Infection (fever)
Pain
If OTC no help

Question 10

When to refer ECZEMA

Answer 10

Infection (fever)
Pain
If OTC no help

Question 11

Treatment for ECZEMA

Answer 11

E45 cream - emollient
Apply liberally 2-3 times daily
Smoothing in downwards
Leave at least 30 mins between different creams

Hydrocortisone 1%
Once daily
Affected area only
No more than 7 days
Skin irritation: See GP
>10 yrs
OK for pregnancy
Not for broken skin

Question 12

Advice for ECZEMA

Answer 12

Fingertip units - 1 ftu = 2 palms
Wear cotton/soft materials
Children can wear cotton mittens at night to reduce scratching
Wash sheets and vacuum beds and carpets frequently to control dustmites
Avoid soaps and detergent
Do not scratch

Question 13

• red, flaky, crusty with silvery scale
• extensor surface and scalp
  Trigger:
  NSAIDS
  Lithium, ACE, Beta blocker, Chloroquine

Answer 13

PSORIASIS

Question 14

When to refer for PSORIASIS

Answer 14

First time: Go GP
Develop to other areas

Question 15

Advice for PSORIASIS

Answer 15

Diet
Stop smoking
Cut alcohol

Question 16

• itchy, red
  Trigger:
  Insect bite
  Nettle stings

Answer 16

URTICARIA / HIVES

Question 17

When to refer URTICARIA

Answer 17

Swelling of face and tongue
Shortness of breath

Question 18

Treatment of URTICARIA

Answer 18

Antihistamine (Benadryl Allergy)

Question 19

Counselling for ASTHMA

Answer 19

Check inhaler techniques
Avoid sports with continuous activity
Warm up and cool down before exercise
Cold weather: Breathe with nose instead of mouth, wear scarf covering nose and mouth, keep warm and dry
Good to exercise: walking, yoga, taichi

Question 20

How to use NASAL SPRAYS

Answer 20

Shake the bottle gently and remove cap
Gently blow your nose
Close one nostril and put the nozzle into the other.
Tilt head forward slightly
Breathe in slowly and squirt a spray of fine mist into your nose by pressing down once with your fingers
Breathe out through mouth. Repeat is necessary
Remove nozzle and breathe out through the mouth
Repeat for other nostril
Wipe nozzle carefully with a clean handkerchief or tissue and replace the dust cap

Question 21

How to use peak flow meter and what is the usual reading?

Answer 21

Sit upright / stand
Push the pointer back to the first line of the scale nearest the mouthpiece
hold the peak flow meter so it’s horizontal and make sure that your fingers are not obstructing the measurement scale
Breathe in as deeply as you can and place your lips tightly around the mouthpiece
Breathe out as quickly and as hard as you can
Make a note of your reading
Repeat 3 times, and the highest of the 3 measurements should be recorded as your peak flow score.
80-100% of personal best is good, <80% review meds
Normal adult: 400-700 L/min

Question 22

How to use pMDI inhaler

Answer 22

Prime inhaler:
Take the cap off
Shake inhaler well
Point the mouthpiece away from you & press canister to release two puffs into the air
Inhaler is ready to use
Use inhaler:
Hold inhaler upright, take cap off, check nothing inside mouthpiece
Shake inhaler well
Sit / stand upright
Breathe out gently away from inhaler
Put lips around mouthpiece of the inhaler to make a tight seal
Breathe in slowly and at the same time press the canister on the inhaler once
Continue to breathe in until lungs feel full
Remove inhaler and with your lips closed hold your breath up to ten seconds
Breathe out gently away from inhaler
Wait 30 secs to a minute before repeating for second puff
Rinse mouth if inhaler contains steroids (prevent oral thrush)

Question 23

How to use DRY POWDER INHALER

Answer 23

Insert the capsule:
Open the lid
Open the chamber
Take out one capsule from the blister pack and insert into the hole
Close chamber until u hear a click
Press the button on the side to pierce the capsule
Using the inhaler
Turn your head away and breathe out
Close your mouth tightly around the mouthpiece while holding the device flat
Breathe in fast and deep through the mouthpiece.
After you breathe the medicine in, hold your breath for a count of 10.
Remove inhaler, then slowly breathe out away from inhaler
Wipe the mouthpiece and discard the capsule.
Close the device when you’re finished so it will be ready for your next dose.
Rinse your mouth out with water or brush your teeth after using dry powdered inhalers.