Diagnostics

Question 1

A 22-year-old man comes into the pharmacy seeking advice about his eyes. He first noticed his symptoms two days ago whilst out walking. He reports a feeling of grittiness in both eyes, but no change in vision but are red and swollen. He has no medical conditions and is not on any regular medication.

Which one of the following is the most likely cause of this man’s symptoms?

• allergic conjunctivitis
• bacterial conjunctivitis
• blepharitis
• cytomegalovirus retinitis
• subconjunctival haemorrhage

Answer 1

Allergic Conjunctivitis

Question 2

When you your refer in a patient with a cough?

Answer 2

• If longer than two weeks and not improving
• Chest pain
• Shortness of breath
• Wheezing
• Recurring cough present at night
• Whooping cough/croup
• Cough or wheezing that may be drug induced eg ACEi and beta blocker
• Yellow, green, brown or blood stained phlegm/sputum
• Offensive or foul smelling phlegm/sputum

Question 3

It’s 5 pm on a Wednesday a very worried looking woman comes into your Pharmacy what is three-year-old child she explains that she is worried about a red rash that has developed on both cheeks. The child has had some cold symptoms a few days ago but it’s now well with no symptoms apart from the facial rash.

The rash covers the child’s cheeks and is red and slightly swollen, but no blotches scales or whelps of any kind.

What it is the most appropriate advice?

• antihistamine and paracetamol for the child symptoms
• Immediate referral to the child’s GP as the rash could be serious
• No treatment is required and the child can be safely managed at home
• The child should see the GP the following day for assessment
• The child should attend A&E in case of possible complications

Answer 3

No treatment is required and the child can be safely managed at home 

Question 4

When do you refer a patient with a cold?

Answer 4

• Ear ache is severe
• Vulnerable patient groups eg. Very young, very elderly, heart disease, lung disease, asthma
• Fever and cough that is persistent
• Chest pain
• Shortness of breath that cannot be explained

Question 5

When do you refer a patient with a sore throat?

Answer 5

• Dysphagia
• Longer than 7-10 days
• Hoarseness persisting for more than three weeks
• Sore throat with skin rash
• White spots, exudate or pus on the tonsils with a high temperature and swollen glands
• Recurrent bouts of infections
• Suspected adverse drug reactions eg. Carbimazole
• Failed treatment
• Breathing difficulty

Question 6

When do you refer a patient with built up ear wax?

Answer 6

• Foreign body in the ear
• Pain
• Dizziness
• Tinnitus
• Treatment Failure

Question 7

When do you refer a patient with a headache?

Answer 7

• Headache associated with recent head injury/trauma
• Children under 12
• Associated with stuff neck, fever and/or rash
• Sudden onset and/or severe pain
• Suspected adverse drug reaction eg oral contraceptive pill
• Associated with drowsiness, blackouts, unsteadiness, visual disturbances or vomiting
• Recurring headache

Question 8

What are the signs of colic?

Answer 8

• high pitched, sudden onset crying, unable to be consoled
• crying at the same/similar times in the day, often afternoon or evening
• May draw up their legs/swollen tummy
• Clenches hands
• flushed face
• Crying for minutes or hours
• often calms down once baby is exhausted or when they pass wind or stool