GP Week 6 Flashcards
Diagnostic criteria for primary headache in adults: Episodic tension-type
- Headache lasting 30 minutes to 7 days
- At least two of:
a) bilateral location
b) non-pulsating quality
c) mild to moderate pain intensity
d) not worsened by routine physical activity - Neither of:
a) nausea and/or vomiting
b) photophobia and/or phonophobia
The following are diagnostic criteria for which primary headache in adults?
- Headache lasting 30 minutes to 7 days
- At least two of:
a) bilateral location
b) non-pulsating quality
c) mild to moderate pain intensity
d) not worsened by routine physical activity - Neither of:
a) nausea and/or vomiting
b) photophobia and/or phonophobia
- Episodic tension-type
Diagnostic criteria for primary headache in adults: Migraine.
- Headache lasting 4 - 72 hours.
- At least two of the following:
a) unilateral location
b) pulsating quality
c) moderate to sever pain intensity
d) worsened by routine physical activity - At least one of the following:
a) nausea and/ or vomiting
b) photophobia AND phonophobia
The following are diagnostic criteria for which primary headache in adults?
- Headache lasting 4 - 72 hours.
- At least two of the following:
a) unilateral location
b) pulsating quality
c) moderate to sever pain intensity
d) worsened by routine physical activity - At least one of the following:
a) nausea and/ or vomiting
b) photophobia AND phonophobia
- Migraine
Diagnostic criteria for primary headache in adults: Cluster.
- Headache lasting 15 - 180 minutes.
- Must have both:
a) unilateral location
b) severe to very severe pain around/ or above
the eye and/ or temple. - At least one of the following:
a) conjunctival injection and/ or lacrimation
b) nasal congestion and/ or rhinorrhoea
c) eyelid oedema
d) forehead and facial sweating
e) constricted pupil and/ or ptosis
f) restlessness or agitation - At least five attacks.
The following are diagnostic criteria for which primary headache in adults?
- Headache lasting 15 - 180 minutes.
- Must have both:
a) unilateral location
b) severe to very severe pain around/ or above
the eye and/ or temple. - At least one of the following:
a) conjunctival injection and/ or lacrimation
b) nasal congestion and/ or rhinorrhoea
c) eyelid oedema
d) forehead and facial sweating
e) constricted pupil and/ or ptosis
f) restlessness or agitation - At least five attacks.
- Cluster
GP adrenaline preparation, administration site and dose for anaphylaxis.
- 1:1000 adrenaline
- 0.01 mg/ Kg IM (Max dose 0.5 mg)
- Lateral thigh
- Repeat every 3 - 5 minutes
GP management of hypotension in anaphylaxis.
- Large bore IV
- Normal saline bolus at 20 mL/ Kg
- Consider additional bolus or IV adrenaline if not responsive to treatment
- If at hospital consider - metaraminol
Laboratory investigation for anaphylaxis.
- Mast cell tryptase (MCT)
Post acute GP care of anaphylaxis patient.
- Anaphylaxis management plan.
- Referral to immunologist
- Subcutaneous immunotherapy for insect allergy
What causes acute bronchiolitis?
- 80% Respiratory syncytial virus (RSV)
Treatment for mild to moderate croup.
- Prednisolone 1 mg/ Kg
Treatment for severe croup.
- Nebulised adrenaline - 4 ml 1:1000
AND - IM/IV Dexamethasone 0.06 mg/ Kg (Max 12 mg)
Signs and symptoms of meningococcal sepsis in children.
- Fever
- Reduced feeding
- Myalgia/ arthralgia
- Petechiae/ purpura
- Cold/ discoloured extremities
- Lethargy/ drowsiness/ confusion
- Shock
- Fever
- Reduced feeding
- Myalgia/ arthralgia
- Petechiae/ purpura
- Cold/ discoloured extremities
- Lethargy/ drowsiness/ confusion
- Shock
Signs and symptoms of meningococcal sepsis in children.
Signs and symptoms of meningococcal meningitis.
- Fever
- Headache
- Irritability
- Lethargy/ drowsiness/ confusion
- Vomiting
- Neck stiffness
- Photophobia
- Positive Kernig sign
- Positive Brudzinski sign
- Fever
- Headache
- Irritability
- Lethargy/ drowsiness/ confusion
- Vomiting
- Neck stiffness
- Photophobia
- Positive Kernig sign
- Positive Brudzinski sign
Signs and symptoms of meningococcal meningitis.
Pain on flexing hip to 90 degrees and knee extended.
- Positive Kernig sign.
How is a positive Kernig sign for meningococcal meningitis displayed?
- Pain on flexing hip to 90 degrees
2. Knees extended
Flexing neck causes flexion of hips and knees.
- Positive Brudzinski sign
How is a positive Brudzinski sign for meningococcal meningitis displayed?
- Flexing neck causes flexion of hips and knees.
First choice antibiotics for GPs in the treatment of meningococcal emergency.
Either:
1. Benzylpenicillin
OR
2. 3rd Generation cephalosporin - (ceftriaxone or cefotaxime)
Paediatric GCS: Verbal scoring for Infants
- Coos, babbles, fixes, follows.
- Irritable, cries but consolable.
- Cries to pain, inconsolable.
- Moans to pain.
- No response.
Paediatric GCS: Motor scoring for Infants.
- Moves spontaneously
- Withdraws to touch.
- Withdraws from pain.
- Decorticate to pain.
- Decerebrate to pain.
- No response.
Normal respiratory rates for paediatrics.
- Infant: 30 - 60
- Toddler: 24 - 40
- Preschooler: 22 -34
- School aged: 18 - 30
- Adolescent: 12 - 16
Normal heart rates for paediatrics.
- Infant: 100 - 160
- Toddler: 90 - 150
- Preschooler: 80 - 140
- School aged: 70 - 120
- Adolescent: 60 - 100
Minimum systolic blood pressures in mmHg for paediatrics.
- Infant: > 60
- Toddler: > 70
- Preschooler: > 75
- School aged: > 80
- Adolescent: > 90
Physiological differences in children: Airways.
- Head is proportionately larger
- Neck is shorter
- Trachea is more malleable
- Larger tongue
- Horse shoe epiglottis
- Obligate nasal breathers as infants
- Head is proportionately larger
- Neck is shorter
- Trachea is more malleable
- Larger tongue
- Horse shoe epiglottis
- Obligate nasal breathers as infants
- Physiological differences in children: Airways.
Physiological differences in children: Breathing.
- Small diameter throughout respiratory system
- Diaghragmatic breathing as infants
- Horizontal ribs as infants
- Increased metabolic rate
- Increased oxygen consumption
- Resulting in increased respiratory rates.
- Small diameter throughout respiratory system
- Diaghragmatic breathing as infants
- Horizontal ribs as infants
- Increased metabolic rate
- Increased oxygen consumption
- Resulting in increased respiratory rates.
- Physiological differences in children: Breathing.
Physiological differences in children: Circulation
- Small stroke volume that increase with age
- Relatively higher cardiac output, facilitated by higher heart rates
- Lower systemic vascular resistance
- Lower blood volume but higher circulating rate 80 - 100 ml.
- Small stroke volume that increase with age
- Relatively higher cardiac output, facilitated by higher heart rates
- Lower systemic vascular resistance
- Lower blood volume but higher circulating rate 80 - 100 ml.
- Physiological differences in children: Circulation