Infections and Infestations Flashcards
What are symptoms of threadworms?
Itching around the anus
Disturbed sleep
Actually seeing the threadworms
How are threadworms contracted?
They are contracted when the patient swallows the female eggs. This can be contracted from eating undercooked meat, sharing bedding or toys with an infected person.
Why are threadworms most commonly found with children?
Have poor personal hygiene. Often will scratch around the anus and then put their hands in their mouth which causes an reinfection and continuation of the cycle.
What are some of the alarm symptoms of threadworms?
If the child is under 2 Rectal bleeding Failure of OTC product Recently travelled abroad Repeated infestation If the patient has any medical conditions
What OTC product is available for threadworms?
Mebendazole
What dose of Mebendazole is recommended?
100mg and then repeated 2 weeks later
All household members are required to have this
Who is excluded from taking mebendazole?
Pregnant women and infants under 2
Lifestyle advice for dealing with threadworms?
Rigorous cleaning measures for 6 weeks
Dust with a damp cloth and hoover daily
Washing hands before meals and after nappy changes (scrub under the nails)
Wear underwear and night to prevent scratching
Shower and wash the anus
Clean toys
Do children need to be off school with nits or threadworms?
No but the school should be alerted
What are the alarm symptoms for head lice?
The lice have not been seen Crusty, yellow scalp Patient has a skin condition Repeated infestation Failure of OTC product Resistant to product is suspected Patient is asthmatic
What are the three treatment options for head lice?
Malathion
Permethrin
Dimeticone
How long is each treatment required to be on the hair?
Malathion: 12 hours
Permethrin: 8-12 hours
Dimeticone: 8 hours
What counselling advice is required for head lice?
2-3 days after the treatment, wet combing is required to see if it is successful
Repeat treatment 7 days later
How does scabies occur?
Scabies is caused by a parasite burrowing into the skin and laying eggs which hatch in 14 days after the parasite is first present under the skin.
It is passed on by close contact with an infected person.
What are the main symptoms of scabies?
Intense itching particularly at night
A rash that usually appears firstly between the fingers
What are the referral symptoms for scabies?
Child is under 2
Patient is receiving treatment for another skin condition
Long term health conditions are also present
Repeated infestations
Compromised immune system
Widespread rash
Scratching has led to broken skin
What treatment options are available for scabies?
Permethrin 5% cream or Malathion
How would you counsel a patient for treatment of scabies?
Apply the cream all over the body and leave on for 8-12 hours and then rinse with a bath or shower.
Ensure all household members do this.
Repeat in a weeks time
What are the two types of Herpes Simplex?
Type 1: Cold sores
Type 2: Genital herpes
Describe the timeline of a cold sore.
Prodromal phase: patient experiences tingling on their lip.
The cold sore then begins to appear firstly as a red patch and then it fills with fluid before it bursts and blisters over.
What is the time scale of a cold sore?
7-10 days
How is HSV1 spread?
Via the saliva of an infected person. Often contracted in childhood and then stays dormant until it is reactivated later in life.
What are some of the referral symptoms of a cold sore?
The cold sore is not on the lips or they are inside of the mouth The cold sore is weeping Very frequent reappearance Blisters are spreading Patient is on other medication Large number at once Other symptoms No obvious cause
How do aciclovir and penciclovir work?
Inhibit the enzymes involved in the virus and speed up the healing process.
When should aciclovir and penciclovir be applied?
In the prodromal phase
What triggers cold sores to reappear?
Menstrual cycle
Spending lots of time in the sun
Stress
Feeling run down
What two organisms cause fungal infections?
Dermatophytes or yeast
What conditions are dermatophytes responsible for?
Athlete’s foot, Ringworm and Fungal nail infections
What are some of the symptoms of Athlete’s foot?
The skin breaking and weeping
Usually occurs between the crack between the fourth and fifth toe due to the warm, moist conditions
Red, itchy and sore skin
Skin may smell
Can be spread across the foot and to the nail if left untreated
When should you refer to the Pharmacist with Athlete’s foot?
If the infection is producing pus, bleeding and weeping It is causing pain Elderly patient Young child Patient has other medical conditions Failure of OTC product
What are the two treatments for Athlete’s foot and give OTC examples.
Imidazoles: Miconazole, Clotrimazole and Ketoconazole
Allylamines: Terbinafine
What lifestyle advice would you provide to somebody with Athlete’s foot? (Similar for Fungal Nail infection)
Avoid sharing towels Good foot hygiene (wash them daily) Breathable shoes Change socks daily Dusting powder in socks and shoes
Are creams or ointments best for Athlete’s foot?
Creams
What are some of the symptoms of fungal nail infection?
The nail becomes thickened and changes colour
It can be lifted from the nail bed, eventually crumbles away
Nail changes shape
Essentially it can change in colour, texture and shape.
Normally this begins at the tip of the nail
What are some of the referral symptoms for fungal nail infections?
Young child Toe is bleeding/ discharge from the nail Patient is on other medication Patient has a medical condition Repeated infection Spread to other toes Trauma to the nails Fingernails are affected More than 50% of the nail is affected OTC failure
What treatment option is available for fungal nail infections?
Amorolfine laquer is used. Painted onto the affected toe like nail vanish once a week.
May have to be used for up to 12 months.
What are the key symptoms of ring worm?
A red rash that resembles a circular shape.
Less red at the centre in comparison to the outside
Rings may be feel raised to touch
Patches can be itchy
Patches can grow and merge together
What symptoms of ring worm would you refer to a Pharmacist for?
If the rash is on the hands or face or torso
If the rash is cracked or bleeding
More than two patches of ringworm
What treatments can be used for ringworm?
Imidazole cream or Terbinafine cream
