EENT

Question 1

Name some referral points for eye OTC

Answer 1

true eye pain/not gritty foreign body type
vision affected
photophobia
contact lens wearer
trauma
eye surgery in last 6 months 
inflammation with rash on face

Question 2

Common symptoms of conjunctivitis

Answer 2

Sticky, purulent discharge, gritty and red

Question 3

If a patient is presenting with purulent discharge from eye, cloudy eye, blurred/halo vision and headache/vomiting, what is this risk and appt action?

Answer 3

Red flags for acute angle closure glaucoma - need to refer to A&E asap due to risk of eyesight loss

Question 4

When would you NOT use chloramphenicol for conjunctivitis otc?

Answer 4

<2 yrs
Family history of blood dysgrasias/myelosuppression
glaucoma/contact lenses/any of the ed flag referrals, dry eye syndrome
recently had conjunctivitis

Question 5

what is the dosing instructions for chloramphenicol eye drops and key counselling

Answer 5

every 2 hours for the first 48hrs then every 4 hours during waking hours fo 5 days use
store in frridge

Question 6

What is fist line treatment for localised non bullous impetigo

Answer 6

hydrogen peroxide 1% cream, applied 2-3x a day for 5 days

Question 7

Which antibiotics should be AVOIDED in sore throats?

Answer 7

Amoxicillin - avoid because if glandular fever (epstein barr) can cause maculopapular rash

Question 8

In what situation would you give antibiotics for otitis media

Answer 8

No improvement in 72hrs
systemic involvement
mastoiditis (pain swelling behind ear)
bilateral otitis media in <2 years old

Question 9

If a child <12 years comes in with typical symptoms of otitis externa (e.g. swimmer, itchy, inflammation and pain in ear canal) what would you do?

Answer 9

Refer because no products otc for <12

Question 10

What is main treatment of otitis externa otc

Answer 10

topcal acetic acid 2 sptray (ear calm) in 12+ = 2days use

Question 11

Which ear wax products are to be avoided in patients with peanut allergy?

Answer 11

cerumol as contains arachis oil

Question 12

When would you refer in terms of duration of fever symptoms in
3-6 months old
>6 months old

Answer 12

3-6 months old= refer if >24hrs

>6months=refer if >72hrs

Question 13

What is the temperature cut off for referral in <3 months and 3-6months

Answer 13

<3 months= >38degrees

3-6months =39 degrees