Clinical skills - Viral diseases Flashcards
1
Q
Common NSAIDs
A
Ibuprofen Aspirin Neproxin Diclofenac Indomethacin
2
Q
Dysphagia
A
Difficulty breathing e.g stroke
3
Q
Dysepsis
A
Indigestion
4
Q
What can increased stomach acid lead to
A
Gastric ulcers - can also be caused by smoking
5
Q
How do you treat impetigo
A
Flucloxacillin 250-500mg QDS/ 7 days
Topical fusidic acid
6
Q
What is Staphylococcus resistant to
A
Amoxicillin
7
Q
How can Staphylococcus be treated by
A
Macrolides
8
Q
Examples of macrolides
A
Clarithromycin
Erythromycin
9
Q
Why is clarithromycin the preferred macrolide
A
BDS vs QDS in erythromycin
Less side effects
10
Q
Which surfaces does psoriasis present on
A
Flaky, silvery rash on extensor surfaces
11
Q
Which surfaces does eczema present on
A
Flexor surfaces
12
Q
Nerves in the hand
A
Median
Ulna
Radial
13
Q
RhA in heart
A
Endocarditis
14
Q
RhA in lung
A
Pleuritis
15
Q
Sero-ve spondyloarthropy
A
W/ out serum RhF
16
Q
What can long term use of NSAID’s lead to
A
Kidney issues - drugs metabolised in kidney
17
Q
Osgood - Schlatter
A
Infl of patellar ligament at the tibial tuberosity
18
Q
Common viruses in primary care
A
Hand, foot, mouth disease in children
Chickenpox
Shingles
Conjuctivitis
19
Q
Incubation of chicken pox
A
2 weeks
20
Q
PHN
A
Post hepatic neuralgia
21
Q
How to avoid PHN
A
Treating shingles with 2 days
22
Q
Types of conjuctivitis
A
Allergic
Viral
Bacterial
23
Q
Co-amoxicillin
A
Type of penicillin used when amoxicillin isn’t appropriate
24
Q
Dose of co-amoxicillin
A
250/ 125 mg very 8 hrs increased to 500/ 250 mg for severe infection
Can also be given intravenously in adults, 1.2g/ 8 hrs
25
Hep A vs B
A is transmitted by oral-faecal route
B is blood borne or sexually transmitted
Can also be caused by drugs and alcohol
26
When is tonsillectomy required
If you have tonsillitis 7 times in 2 years
27
Problems w/ abcess
Abx can't get into it - no blood supply
28
Ulceration
Break in mucosa
29
Treating genital warts
Cauterized
| Freezed off
30
Verucca
Ingrowing wart on foot
31
Determining likelihood of streptococcal infection
FeverPAIN
| Centor clinical prediction
32
What is GAS pharyngitis/ tonsillitis common in
Children and adolescents aged 5-15
| More common in winter
33
What is streptococcal infection suggested by
Fever > 38.5 degrees
Exudate on the pharynx/ tonsils
Anterior neck lymphadenopathy
Absence of cough
34
What is hand, foot and mouth disease caused by
Coxsackievirus A16
| Enterovirus 71
35
Oral lesions associated w/ hand, foot and mouth disease
Develop anywhere inside the mouth but most frequently appear on the hard palate, tongue, cheeks and gums
Begin as erythematous macule and papules
36
What do the erythematous macule and poapules progress into in h,f,m disease
Thin-walled vesicles that burst and form painful ulcers surrounded by red halo
Heal w/ out treatment over 5-10 days
37
Macules
Blisters
38
Papules
Flat, inflamed red spots
39
Chickenpox
Varicellar-zoster virus
| Charcterized by vesicular rash, often preceded by fever and malaise
40
Px for chickenpox
Aciclovir 800mg 5x/ day for a week in those who are immunocompromised
41
What should you avoid in chickenpox
Giving NSAIDs
| Paracetomol is fine if pain and fever is causing distressing
42
Rhinovirus
Brings on all the familiar symptoms of a cold
| Can cause mild fever and lead to ear or sinus infections in some people
43
Familiar symptoms of cold
```
Runny nose
Sneezing
Sore throat
Headache
Cough
Body aches
```
44
Epstein Barr Virus
```
V high temp or you feel hot and shivery
Severe sore throat
Swelling either side of your neck - swollen glands
Extreme tiredness or exhaustion
Tonsillitis that isn't getting better
```
45
Post viral syndrome
Chronic fatigue syndorme or myalgic encophalomyelitis (CFS/ME)
46
Symptoms of CFS/ME
```
Sleep problems
Muscle or joint pain
Headaches
Sore throat or sore glands w. no swelling
Flu like symptoms
```
47
Bronchitis vs bronchiolitis
Infl of URT vs LRT
Can affect any age vs infants < 2yrs
Same symptoms but cyanosis and vomiting is also seen in bronchiolitis
Diagnose w/ exam and X-ray but also RSV antigen test in bronchiolitis
48
Common respiratory viral infections
```
Adenovirus
Coronavirus
Influenza A/B
Parainfluenza
Rhinovirus
RSV
```
49
Risk factors for complicated influenza
Diabetes mellitus
Severe immunosuppression
65 yrs>
Morbid obesity (BMI 40 +)
50
What has a significant impact in reducing the spread of respiratory viral illnesses
Hand washing
51
How do serotypes 1 & 4 of HPV present
As common foot warts
52
How do serotypes 2, 3 and 10 of HPV present
Warts on the fingers
53
Low risk serotypes of HPV
```
1
4
2
3
10
```
54
What can high risk serotypes of HPV cause
```
Malignancy e.g
Cervical cancer
Some head and neck cancers
Penile cancer
Anal cancer
Vulval and vaginal cancer
```
55
HPV vaccine
Gardasil protects against 4 serotypes: 6, 11, 16 and 18
56
Which serotypes of HPV cause 90% of genital warts
6
| 11
57
Human Herpes Viruses
```
Herpes Simples type 1 and 2
Cytomegalovirus (CMV)
VZV (chickenpox and shingles)
EBV
HHV types 6, 6A, 7 and 8
```
58
Can you ever get rid of HHV
No
Once you have the infection, you keep it for life, usually in a dormant form
Reactivation can occur
59
What can CMV cause
Infection similar to EBV (but usually less pharyngitis or tonsillitis)
Congenital infections
Serious infection in immunocompromised
60
Infectious mononucleosis
EBV causing glandular fever
| Initial infection of oral epithelial cells w/ subsequent spread to B lymphocytes
61
Clinical disease caused by EBV
```
Infectious mononucleosis
Burkitt lymphoma
Lymphoproliferative diocese
Nasopharyngeal carcinoma
CNS lymphoma
```
62
Human Herpes virus type 6
Can be isolated from the saliva of about 85% of adults
| Causes roseola infants in children
63
Common viral rashes
Hand, foot and mouth disease
Parvovirus B19
Molluscum contageosum
64
Parvovirus B19
Causes a relatively mild infection in children but. ay have v serious effects if contracted in pregnancy
May cause arthritis in adults
65
Molluscum contageosum
Caused by a pox virus
Multiple lesions can occur, mainly in children
Clear spontaneously w/ out treatment but thus can take several years
66
Why might parents refuse consent for immunisations
Fear of side effects Misinformation spread by social media
Religious concerns
Concern that it might increase promiscuity / Concern that it might discourage safe sex practices
Lack of health literacy
Lack of confidence in Health services
67
Examples of wrong ideas about immunisations
Polio (a Western plot to make African women infertile)
| HPV (a cause of promiscuity in teenagers)
68
Evidence demonstrating effectiveness of HPV vaccine
Scotland, Australia & Denmark have seen a significant (at least a 50-70% in studies) reduction in cervical pre-cancer since immunisation has been introduced
69
Cause of impetigo
Bacterial skin infection caused by Staph or Strep
| Spread by direct contact with discharges from scab of infected person
70
Presentation of impetigo
‘Golden’, crusted skin lesions typically around mouth
| Lesions tend to be found on face, flexures and limbs not covered by clothing
