Common Acute GP presentations Flashcards
what is strawberry tongue?
strep
triad of red flags for sore throat?
fever/malaise, night sweats….etc
centor criteria for sore throat?
The patients are judged on four criteria, with one point added for each positive criterion:
History of fever
Tonsillar exudates
Tender anterior cervical adenopathy
Absence of cough
how do you treat strep throat
penicillin…etc (not amoxicillin)
always use generic name!!!!!!! esp in exams
what is the strept score card?
what is the approach to the results
Criteria: Modified Centor (recommended)
Tonsillar exudate or erythema Anterior cervical adenopathy Cough absent Fever present Age ----Age 3 to 14 years: +1 point ----Age 15 to 45 years: 0 points ----Age over 45 years: -1 points
Approach: Clinical Suspicion based on scoring above
Strep Score 4 to 5 (or Strep Score 2 if patient unreliable)
Treat with antibiotics
Strep Score 2 to 3: Perform rapid antigen test
Antigen test positive: Treat with antibiotics
Antigen test negative: Throat Culture
Strep Score 0 to 1
Provide Pharyngitis Symptomatic Treatment
Interpretation (Clinic and ER probability based on original criteria)
Based on original criteria above
Score 0: Streptococcus probability 1% (3% in ER)
Score 1: Streptococcus probability 4% (8% in ER)
Score 2: Streptococcus probability 9% (18% in ER)
Score 3: Streptococcus probability 21% (38% in ER)
Score 4: Streptococcus probability 43% (63% in ER)
why would you not prescribe amoxcicillin for sore throat?
If for some reason the infectino turned our to be EBV, EBV reacts amoxicillin…
rash…widespread
define the flu
contagious, viral, quick onset, severe symptoms, fever, malaise, myalgia, DNA/RNA mutates every year,
advised to keep away from others—–flare ups of asthma, pneumonia etc
what is herpengina?
Herpangina, also called mouth blisters, is the name of a painful mouth infection caused by coxsackieviruses. Usually, herpangina is produced by one particular strain of coxsackie virus A (and the term “herpangina virus” refers to coxsackievirus A)[1] but it can also be caused by coxsackievirus B or echoviruses
drugs causing bone marrow supression—leading to increase in infections—-
methotrexate
carbimazole- hyperthyroid
chemo
age group for croup?
3months to 6 years…you can get it older, but over 6 years is unlikely- inflammation of the upper airway
kids can look generally well
gets a loss worse by night
medication prescribed for croup?
—-breathe in hot moist air…..
Acute cough—
when asking about recent infections and antibiotics etc what should you always ask?
where were the antibiotics prescribed?
community aquired pneumonia—-if AB prescribed in hospital, she was previously admitted, could be CAP
ask about confusion!!!!- alveoili not getting enough oxygen…check cyanosis
what is the cut off for oxygen sats?
92%
in 1st line treatment for CApneumonia ……if allergic to amoxicillin what would you give?
arythromyciin
waht to be wary of if child has abdominal pain & hx of gastroenteritis?
beware of appendicitis…must check….
waht is colicky pain?
pain which starts and stops abruptly. It occurs due to muscular contractions of a hollow tube (colon, ureter, gall bladder, etc.) in attempt to relieve an obstruction by forcing content out.
