Eyes, ears, mouth

Question 1

What is an S2 treatment option for bacterial conjunctivitis?

Answer 1

Propamidine

Question 2

What are some referral points for conjunctivitis?

Answer 2

Glaucoma, dry eye syndrome, contact lense user, recent eye surgery, age <2

Question 3

What prescription medication can be given for bacterial conjunctivitis?

Answer 3

Aminoglycosides (gentamycin, tobramycin, framycetin) or quinolones (ciprofloxacin, ofloxacin)

Question 4

What medications can be used in allergic conjunctivitis?

Answer 4

Antihistamines (azelastine, ketotifen, levocabastine), mast cell stabilisers (cromoglycate, lodoxamide), combination (olopatadine S4), NSAIDS (diclofenac, ketorolac S4), corticosteroids (dexamethasone, fluorometholone, hydrocortisone, prednisolone S4)

Question 5

What can be used for acute diffuse otitis externa?

Answer 5

Corticosteroids +/- antifungal or antibacterial: dexamethasone /framycetin/ gramicidin; flumethasone with clioqunol, ciprofloxacin/hydrocortisone etc; oral antihistamines (loratadine, fexofenadine), pain relief (benzocaine +phenazone), paracetamol, ibuprofen

Question 6

What can be used for acute localised otitis externa?

Answer 6

Systemic antibiotics - di/flucloxacillin, cephalexin, clindamycin

Question 7

What drugs or combinations to avoid when suspecting damage to the tympanic membrane?

Answer 7

Aminoglycosides - neomycin, framycetin
Hydrocortisone/ciprofloxacin
Cerumenolytics
Local analgesics

Question 8

What drugs are safer in suspected damage to tympanic membrane?

Answer 8

Ciproprofloxacin alone
Chloramphenicol
Clioquinol/flumethasone
Acetic acid

Question 9

What is the most common cause of otitis media?

Answer 9

Viral infection after a cold. Sometimes, there is a bacterial infection.

Question 10

When do you treat otitis media?

Answer 10

Only if there are systemic symptoms or in Aboriginal and Torres Strait populations, immunocompromised and children <6m

Question 11

What is the treatment for otitis media in children with systemic symptoms?

Answer 11

Amoxycillin; or amoxycillin + clavulanic acid

Question 12

What is glue ear?

Answer 12

Persistent otitis media with no further systemic symptoms that lasts up to 3 months. Children will have effusion, a liquid discharge from ear.

Question 13

What is the standard treatment for glue ear?

Answer 13

Antibiotics for the acute infection or grommets if risk of hearing loss.

Question 14

What is a risk of barotrauma?

Answer 14

altitude changes: flying, diving

Question 15

What is Meniere’s Disease

Answer 15

Increased pressure in the labyrinth causing vertigo, tinnitus and nausea

Question 16

What can be used to manage Meniere’s Disease?

Answer 16

prochlorperazine or antihistamines, betahistine

Question 17

What products can be used to prevent gingivitis?

Answer 17

Chlorhexidine or cetylpyridinium chloride mouth wash

Question 18

What can be used to manage aphthous ulcers?

Answer 18

Barrier paste (orabase), chlorhexidine mouth wash, benzydamine (anti inflammatory) mouth gel, choline salicylate topical analgesic, benzocaine/lignocaine gel, triamcinolone in orabase gel (s3)

Question 19

When to refer a mouth ulcer?

Answer 19

Uneven coloration, no discomfort, first ulcer, >14 days, >1cm, occurs often, other signs of illness

Question 20

What medicines can be used for Herpes simplex?

Answer 20

Aciclovir, penciclovir, idoxuridine (topical, S2)
Famciclovir (S3) single dose
Valaciclovir, aciclovir (S4) oral