GP - Cough, Rhinitis, Rhinorrhoea Flashcards
1
Q
RECAP - What are the sections that should be covered in any medical history?
A
- History of Presenting Complaint
- Past Medical History
- Drug History
- Family History
- Social History
- Systems Review
- ICE
2
Q
What are the possible causes of cough? PART 1
A
- VASCULAR - i.e pulmonary oedema
- INFECTIVE i.e viral/bacterial infections
- INFLAMMATORY i.e Allergies, asthma, COPD, post-nasal drip, pulmonary fibrosis
- TRAUMA - i.e foreign bodies/pneumothorax
3
Q
What are the possible causes of cough? PART 2
A
- AUTOIMMUNE i.e sarcoidosis
- METABOLIC
- IATROGENIC i.e medication such as ACE inhibitors
- IDIOPATHIC
- NEOPLASTIC - Lung/laryngeal cancers
4
Q
Based on the VITAMIN acronym, what could be the causes of nasal congestion?
A
- V - Haematoma
- I - Viral/Bacterial - Nasal Polyps/ Adenoid Hypertrophy
- T - Broken Nose/Septal Deviation
- A
- M
- I - Foreign Bodies
- N - Squamous Cell Carcinoma
5
Q
Based on the VITAMIN acronym, what could be the causes of rhinorrhoea?
A
- V
- I - Viral/ Bacterial - Allergy/Hay Fever/Nasal Polyps
- T - CSF (MAJOR RED FLAG)
- A
- M
- I - Medication e.g cocaine
- N
6
Q
Based on the VITAMIN acronym, what could be the causes of sneezing?
A
- V
- I - Viral/Bacterial - Allergy/Irritants
- T
- A
- M
- I - Steroid Nasal Spray
- N
7
Q
Would you give antibiotics for a cold?
A
NO!!!!!!!!!!!!!!!!!!!!!!
8
Q
How would you discuss antibiotics for patients with colds? PART 1
A
- Ask about patient’s concerna
- Summarise history and results of physical examination
- Ask about their expectations - ‘How do you feel about antibiotics?’
- Provide explanation for symptoms
9
Q
How would you discuss antibiotics for patients with colds? PART 2
A
- Be specific about usual course of cough
- Explain shortcomings and side effects of antibiotics (only reduce cough by 1 day in a 3-4 week illness.)
10
Q
How would you discuss antibiotics for patients with colds? PART 3
A
- Provide patients with specific information on red-flag symptoms and when further help is seeked
- Provide safety-netting advice (paracetamol to help pain and soother inflammation. Drink enough water - needed for immune system to function properly)
