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OTC meds > eyes, ears + oral health > Flashcards

eyes, ears + oral health Flashcards

1
Q

why does a baby under a month old need urgent referral if they present with sticky eyes

A

it can be a sign of chlamydia/ gonorrhoea infection from birth. Need to distinguish between this or conjunctivitis / simple sticky eyes.

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2
Q

what are the 3 causes of conjunctivitis

which is most common

A

can be caused by viral, bacterial, or allergy infection.

most common is viral infection

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3
Q

name the common symptoms of bacterial conjunctivitis

A
  • yellow white discharge
  • bilateral infection (infection in both eyes)
  • not itchy

it is usually self-limitinb

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4
Q

name the symptoms of allergic conjunctivitis

A
  • bilateral infection (infection in both eyes)
  • itchy
  • clear watery discharge
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5
Q

what eye symptoms can indicate a patient has acute glaucoma

A
  • pain in the eye that is more than just discomfort
  • impaired vision
  • eye may feel hard/tender

patient needs refer for further investigation

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6
Q

which bacteria commonly cause bacterial conjunctivitis

A

Staphylococcus and Haemophilus influenzae

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7
Q

TRUE OR FALSE:

most cases of bacterial + viral conjunctivitis are self limiting.

A

True

  • most cases recover within a week
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8
Q

how do you use chloramphenicol eye drops + eye ointments for periorbital or orbital cellulitis

A

chloramphenicol eye drops: use every 2 hours for the first 48 hrs, then use every 4 hours after that.

chloramphenicol eye ointment: use every 4 hours

For both: use for minimum of 5 days even if symptoms improve

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9
Q

what are brolene and golden eye used to treat?

what does the ointment preparation contain compared to the eye drops

A

used to treat injective conjuctivitis

ointment preparation contains dibromopropamidine isethionate which is antibacterial and antifungal. eye drops contain just propamidine isethionate which is antibacterial

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10
Q

what are the 2 types of treatment for allergic conjunctivitis

how do they work

A

topical antihistamines: Otrivine-antistin® which contains antazoline and xylometazoline. This contains a vasoconstrictor to relieve redness in eyes

topical mast cell stabilisers: sodium cromoglicate (e.g. Opticrom®). These work by preventing histamine and other inflammatory mediators from being relased by mast cells. need to be used regularly up to 4 times a day to see benefit

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11
Q

which eye drops for allergic conjunctivitis should only be used short term

A

topical antihistamines e.g Otrivine-antistin® which contains antazoline and xylometazoline

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12
Q

which eye drops for allergic conjunctivitis need to be used regularly to see a benefit

A

topical mast cell stabilisers: sodium cromoglicate (e.g. Opticrom®

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13
Q

why should people who wear contact lenses be especially aware of bacterial conjunctivitis

A

it can develop into bacterial keratitis (infection in the cornea) and threaten vision

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14
Q

what should contact lenses wearers do if there is a sign of eye infection

A

contact lenses should not be worn if theres a sign of infection, during treatment or for 24 hours after treatment has finished

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15
Q

what lifestyle advice can be given to prevent eye infections spreading

A
  • wash hands after touching eyes
  • avoid sharing towels and pillows
  • cold compress may soothe eyes with any type of conjunctivitis
  • if allergic conjunctivitis (try to avoid triggers)
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16
Q

when should you give an urgent referral to ophthalmology for a patient with conjunctivitis

A
  • reduced vision
  • orbital cellulitis (infection in fat or muscle around eye)
  • periorbital cellulitis (infection in eye lid or round eye)
  • eye pain, headache or photophobia (could be meningitis)
  • can’t open eye or keep it open
  • corneal infection in patients who wear soft contact lenses
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17
Q

what is the first line treatment for dry eyes

A

hypromellose (best value treatment and there is no evidence to say any other preparations are better)

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18
Q

why is simple eye ointment or Lacri-lube good to use at night time for dry eyes

A

because they provide long time lubrication of the eyes but can cause short-term blurring of the eyes

19
Q

what type of eye products should not be used in contact lens wearers

A

eye ointments

20
Q

what lifestyle advice can you recommend for good eye care

A
  • soak cotton wool in boiled and cooled water and gently clean eyelids for 2-3 mins at a time
  • can use cotton buds to gently remove any crusts from lower lid
21
Q

TRUE OR FALSE:

80% of middle ear infections
will resolve with no treatment in three days

A

true

22
Q

when should you refer a patient having an issue with their ears

A
  • if symptoms are unresolved after 3 days or severe
  • if you suspect a foreign body is stuck inside the ear (more likely with children)
  • if ear pain is severe or has lasted for more than 3 days
  • dulled hearing from otitis media with effusion (middle of ear filled with fluid that looks like glue)
  • treatments to remove wax unsuccessful
23
Q

what is Otitis externa and otitis media?

how do you treat it

A

otitis externa = inflammation of the outer ear canal/ surface of ear
otitis media= inflammation/infection in middle of ear

These are usually self limiting. simple pain killers can be used in the mean time (paracetamol / ibuprofen)

24
Q

when should you refer ear pain

A

if the ear pain is severe or has lasted for more than 3 days

25
Q

name some products that can be used to remove ear wax

A
  • olive or almond oil
  • urea-hydrogen peroxide
  • sodium bicarbonate
  • sodium chloride 0.9%
  • warm tap water

little/no evidence to show one is better than another

26
Q

what ear treatment should NOT be used in patients with a nut allergy

A

almond oil

27
Q

when should you refer a patient with an ulcer

A

if an ulcer has lasted more than 3 weeks (need to exclude oral cancer)

28
Q

what are the 4 treatment options for a mouth ulcer

A
  • topical corticosteroid to aid healing + pain relief
  • local pain killer: e.g benzydamine (difflam) mouthwash to reduce pain + discomfort or
    Choline salicylate gel (bongela) to reduce pain
    and inflammation
  • antiseptic mouthwash e.g chlorhexidine to prevent secondary bacterial infection
29
Q

what lifestyle advice can you give to manage mouth ulcers

A
  • use a softer toothbrush
  • if there are obvious food causes, avoid them
  • reduce stress with relaxation techniques
30
Q

why should you not use bongela (choline salicylate) in children under 16?

A

because there is a theoretical risk it can cause reyes disease

31
Q

which medication can increase risk of oral thrush (OROPHARYNGEAL CANDIDIASIS)

A
  • inhaled corticorsteroids

- broad- spectrum antibacterials

32
Q

what are they symptoms of oral thrush

A
  • white plaques on throat/ tongue/gums/cheeks that can’t easily be scraped away
  • sore/painful mouth
  • burning tongue
  • altered taste

can be asymptomatic

33
Q

TRUE OR FALSE:

smoking is a risk factor for all candidas infections

A

true

34
Q

what lifestyle advice can be given to reduce risk of oral thrush

A
  • rinse mouth with water/ mouthwash after using an inhaled corticosteroid inhaler
  • clean dentures
  • sterilise bottles/dummies
35
Q

what is the treatment for oral thrush

how do you use it

A

miconazole 2% gel (daktarin)

  • use the gel after food/drink and hold the gel in the mouth for as long as possible. continue using gel for 2 days after symptoms have cleared
36
Q

which patients can use OTC miconazole 2% gel to treat thrush

A

it is licensed to be used in anyone from 4 months old

37
Q

when should you refer a patient with oral thrush

A
  • for babes under 4 months old
  • diabetics with oral thrush (to check blood glucose control)
  • no improvement in symptoms after using miconazole gel for one week
38
Q

what is angular cheilitis

A

painful cracks in the corner of the mouth that may bleed or crust. it is caused by dry skin, eczema and licking the lips

39
Q

what is the treatment for angular cheilitis (cracked corners of mouth)

when do you refer

A

antifungal cream e.g clotrimazole

if symptoms don’t improve in one week, refer to gp

40
Q

what lifestyle advice can be given to reduce risk of angular cheilitis (cracked corners of mouth)

A
  • avoid licking lips
  • use a paraffin-based lip balm
  • use properly fitted dentures
  • improve dental hygiene
41
Q

when do you refer a patient with a sore throat

A
  • a very high temperature or patient feels hot/shivery (could be glandular fever or quinsy)
  • unable to swallow saliva/ fluids
  • difficulty breathing
  • if patient is taking carbimazole (could be a sign of a blood disorder)
  • swallowed a foreign object with has not been removed
  • worsening symptoms even after 3 days of using otc meds
42
Q

what is the otc treatment for sore throat

A
  • oral pain killers e.g paracetamole (first line) or NSAIDS (benzydamine)
  • local anesthetics e.g benzocaine or lidocaine
  • glycerl/honey/lemon act as demulcent (create a soothing film on throat)
  • local antiseptics e.g benzalkonium chloride and hexylresorcinol . thought to reduce risk of secondary bacterial infections but value is questionable

(little evidence to support use of gargles. only one small study found garling benzydamine useful)

43
Q

TRUE OR FALSE:

babies can pass oral thrush on through breastfeeding

A

True.

This can cause nipple thrush in mothers (causes pain in nipples. can be severe)

44
Q

why should choline salicylate gel (bongela) not be applied to dentures

A

excessive application of this gel or keeping the gel on for too long can cause irritation and create an ulcer. once you’ve applied the gel, wait 30 minutes before putting dentures

OTC meds (5 decks)

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