Hay fever

Question 1

Hay fever - key symptoms

Answer 1

• Sneezing
• Coughing
• Runny nose
• Congestion
• Irritated eyes (watery, itchy, red)
• Headache
• Loss of smell
• Should be seasonal

Question 2

Hay fever - red flag symptoms

Answer 2

• Issues breathing, wheezing, SOB
• Tightness in chest
• Ear pain
• Coloured discharge (infection)
• Severe symptoms that are unresponsive to treatment

Question 3

Hay fever - extra questions

Answer 3

• Colour to discharge from nose or eyes
• Issues breathing
• Affecting sleep
• Affecting work
• Other conditions (asthma)
• Anyone else in the family
• Tightness in chest
• Ear pain

Question 4

Hay fever - what is it

Answer 4

Allergy to pollen which is why it only occurs during spring and summer

Question 5

Hay fever - what causes it

Answer 5

Body reacting to pollen and grass causing mild allergic reaction

Question 6

Hay fever - treatment overview

Answer 6

Antihistamine
Eye drops (mast cell stabiliser)
Nasal decongestants (drops or spray)
Nasal corticosteroid spray
Oral decongestants

Question 7

Nasal drop instructions

Answer 7

Gently blow the nose to try and clear it.
Shake the container well.
Tilt the head backwards.
Place the drops in the nostril
Keep the head tilted and sniff gently to let the drops penetrate.
Repeat for the other nostril, if required.

Question 8

Instructions for nasal spray

Answer 8

• Shake the container well and look down.
• Using the right hand for the left nostril, put the nozzle just inside the nose aiming for the outside wall.
• Squeeze once or twice in different directions, while breathing in gently through the nose. Do not sniff hard.
• Change hands, then repeat for the other nostril.

Question 9

Hay fever - antihistamines details

Answer 9

blocks signals in your brain that release the chemical histamine that causes the allergy
* Reduces sneezing and itchiness
* Drowsy and non-drowsy
* Loratadine for non-drowsy (Claritin)
* Over 2 years
* Chlorphenamine for drowsy (Piriton)
* Over 6 years

Question 10

Mast cell stabiliser - details

Answer 10

reduces histamine in the eyes
* Sodium cromoglicate (Optrex hayfever allergy drops)
* Over 6 years
* QDS
* Discard after 4 weeks
* Use before going outside

Question 11

Nasal decongestants - details

Answer 11

relieves congestion by narrowing the blood vessels
* Otrivine
* Can be used in combination with antihistamines
* Good for before nasal corticosteroid
* Max 5-7 days (risk of rebound congestion)

Question 12

Nasal corticosteroid spray - details

Answer 12

reduces inflammation
- Beconase (beclomethasone)
* Over 18s
* After other inhaled products tried
* Moderate to severe symptoms
* Congestion and irritated eyes
* Use before exposure OD or BD
* Use for 2-3 weeks before symptoms

Question 13

Oral decongestants - details

Answer 13

• Sudafed
• Pseudoephedrine
• Over 12s
• Every 4-6 hours
• Longer duration of action

Question 14

Hay fever - improvement time

Answer 14

No improvement after using medicines
No improvement after 2-4 weeks
GP may prescribe something stronger

Question 15

Hay fever - lifestyle

Answer 15

Vaseline in nose
Wrap around sunglasses
Shower and change clothes when you return home
Keep windows shut if possible
Vacuum regularly and use damp cloth for dusting
Pollen filters for cars
Avoid grassy spaces
Avoid smoking/smokers

Question 16

Hay fever - referrals

Answer 16

No improvement after 2-4 weeks
Issues breathing - particularly asthma

Question 17

IBS - symptoms

Answer 17

• Abdominal pain/discomfort
• Bloating
• Change between diarrhoea and constipation
• Longer than 6 months
• Symptoms in response to certain foods
• Rectal mucus
• Lethargy, back pain, nausea, headache

Question 18

IBS - extra questions

Answer 18

• Does it affect your work/daily life
• Have you experienced unintentional weight loss
• Is there blood in your stools
• Any breathing issues
• Is the discomfort relieved after going to the toilet
• Family history

Question 19

IBS - what it is and the cause

Answer 19

Common condition that affects your bowel and the rate at which you pass stools. The exact cause is unknown

Question 20

IBS - treatment overview

Answer 20

Ant-diarrhoeal
Laxative
Anti-spasmodic

Question 21

IBS - anti-diarrhoeal details

Answer 21

• Imodium (loperamide)
• Slows the gut movement, allowing your stools to properly form before passing
• 12 years and above
• 1 capsule after each loose stool
• Adjust dose depending on stool consistency (soft, well-formed

Question 22

IBS - laxative details

Answer 22

• Fybogel sachet
• Over 6 years
• Bulks up the stool to make it softer and easier to pass
• For constipation
• Avoid lactulose – worsens bloating
• Adjust dose depending on stool consistency (soft, well-formed)

Question 23

IBS - anti-spasmodic details

Answer 23

• Buscopan (hyoscine butylbromide)
• Over 6 years
• Relaxes muscles in your gut
• Relieves stomach cramps
• Prn

Question 24

IBS - lifestyle

Answer 24

• Regular meals, dont rush
  Dont skip means
  8 cups of water (dehydration and stools)
  Avoid caffeine
  Avoid alcohol and fizzy drinks
• Reduce insoluble fibre foods (whole grains and bran)
• Increase soluble fibre (oats, carrots, lentils)
• Reduce processed foods, harder for body to digest
• Limit to 3 portions of fresh fruit
• Diarrhoea – avoid sorbitol (found in artificial sweeteners e.g sugar free sweets)
• Keep physically where possible (150 minutes per week of moderate intensity)
• Try probiotics

Question 25

IBS - referrals

Answer 25

No improvement after treatment
Children

Question 26

Scabies