m i n o r i l l n e s s e s Flashcards
describe how the dx of a UTI is made
MSU sample for MCS
or CSU for MCS if they have a catheter
management of UTI
trimethoprim
nitrofurantoin
amoxicillin
what are the sx of UTI
dysuria frequency urgency foul smelling urine malaise/fever
what are three ddx for chest infections in the community
acute bronchitis
COVID
HAP
what are three ddx for chest infections in the community
acute bronchitis
COVID
HAP
describe the causative viruses for acute bronchitis
rhinovirus
enterovirus
influenza A and B
coronavirus
describe the management of acute bronchitis
usually mild and self limiting illness
advice on adequate fluid intake,
paracetamol and ibuprofen for sx relief,
OTC cough medicines
stop smoking
seek help if sx do not improve 3-4 weeks or become systemically unwell
amoxicillin if systemically unwell
for CAP, speed of recovery after starting abx (1 week, 4 weeks, 6 week, 3 months, 6 months)
1 week — fever should have resolved.
4 weeks — chest pain and sputum production should have substantially reduced.
6 weeks — cough and breathlessness should have substantially reduced.
3 months — most symptoms should have resolved but fatigue might still be present.
6 months — symptoms should have fully resolved.
additional care for pt with CAP
stop smoking
offer person written infromation on pneumonia - NHS
COVID 19 viral pneumonia may be more likely if pt presents with
- Presents with a history of typical COVID‑19 symptoms for about a week.
- Has severe muscle pain (myalgia).
- Has loss of sense of smell (anosmia).
- Is breathless but has no pleuritic pain.
- Has a history of exposure to known or suspected COVID‑19, such as a household or workplace contact.
an immediate antibiotic prescribing in URTI approach may be considered for:
children younger than 2 years with bilateral acute otitis media
children with otorrhoea who have acute otitis media
patients with acute sore throat/acute pharyngitis/acute tonsillitis when 3 or more Centor criteria are presen
what is the centor criteria for URTI
presence of tonsillar exudate
tender anterior cervical lymphadenopathy or lymphadenitis
history of fever
absence of cough
how long should respiratory tract infections last
acute otitis media: 4 days acute sore throat/acute pharyngitis/acute tonsillitis: 1 week common cold: 1 1/2 weeks acute rhinosinusitis: 2 1/2 weeks acute cough/acute bronchitis: 3 weeks
describe the management of candidiasis
antivirals = miconazole
presentation of candidiasis
widespread infection (such as oesophageal candidiasis, characterized by difficulty or pain on swallowing, or retrosternal pain).
what are the side effects of a stoke/TIA
mobility problems sensory problems continence problems pain fatigue problems with swallowing sexual dysfunction
management of suspected acute stroke
- Arrange immediate emergency admission to an acute stroke facility for anyone with suspected acute stroke or emergent transient ischaemic attack (TIA).
- Do not start anticoagulation (for example in people with atrial fibrillation) or antiplatelet treatment in people following ischaemic stroke until intracerebral haemorrhage has been excluded by brain imaging
- give supplemental oxygen if sats are reduced
management of suspected TIA
- Offer aspirin 300 mg immediately with PPI
- refer pt to specialist assessment to be seen withinn 24 hrs
3
hypercholesteremia what investigations are needed
ck - can be associated with lipid lowering therapy
liver function tests - non alcoholic fatty liver disease
renal function - egfr - ckd and use of lipid loerinf drugs
HbA1c = DM
TFT = hypothyroidism
QRISK3
likelihood of cardiovascular event in next 10 years
heart attack or stroke
primary prevention dose of statins vs secondary dose
20mg = primary 80mg = secondary
management of high cholesterol
start atorvastatin 80 mg
repeat lipids in 3 months time= 40 percent reduction in non HDL cholesterol = check compliance and increase or change med
check lfts at 3 to 12 months - nafld
check ck for unexplained muscle sx
lx required in high cholesterol
total cholesterol
HDL
LDL
QRISK
annual review of high cholesterol
compliance
side effects
lifestyle advice/ address risk factors
check non-fasting hdl cholesterol
hypercholestoremia management
aim
aim of treatment is to achieve a greater than 50% reduction in baseline low-density lipoprotein (LDL) cholesterol levels.
associated sx of headache
aura; nausea and vomiting; motion sensitivity; photophobia and/or phonophobia (may suggest migraine).
types of headache
migrane
cluster headache
tension headache
medication overuse headache
GCA, TIA, STROKE
aura sx
Visual symptoms such as zigzag lines, flickering lights, and/or scotoma (visual aura is the most common type of aura).
Sensory symptoms such as numbness or pins and needles of the hand, arm, and/or face.
Speech and/or language disturbance such as aphasia.
ipsilateral associations of cluster headache
Conjunctival injection and/or lacrimation. Nasal congestion and/or rhinorrhoea. Eyelid swelling. Forehead and facial sweating. Forehead and facial flushing.
tension type head is
bilateral
management of migraines
- self care advice = pt information on nhs website, diary to help with triggers, ensure women with migrate with auras stop COCP
- offer simple analgesia = ibuprofen, aspirin, paracetamol
- triptan - sumatriptan
- antiemetic if nausea and vomiting
follow up in 2-8 weeks
anaphylaxis signs and sx
angioodema
urticaria
difficulty breathing
anaphylaxis management
A-E
give oxygen, monitor pt
Remove trigger if possible
IM adrenaline/ epipen 1 to 1000 = anterolateral aspect o middle third of thigh repeat after 5 mins if not working
consider inhaled salbutamol
following MI/ PCI = driving advice and work
Off work for 4-6 weeks
Can return to driving after 1 week
Only need to notify DVLA if driving for work
heart failure classification
NYHA
Class 1 no symptoms or limitation of activity
Class 2 mild symptoms, slight limitation of activity, ordinary activity causes symptoms
Class 3 moderate symptoms, less than ordinary activity causes symptoms
Class 4 severe symptoms, symptoms present at rest
HF management
Medications that improve prognosis: Beta blockers ACE inhibitors Spironolactone Hydralazine Medications that improve symptoms: Loop diuretics Thiazide diuretics Secondary prevention Aspirin Statins
