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The Pharmacist Year 3 > Minor Ailments COPY > Flashcards

Minor Ailments COPY Flashcards

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1
Q

Give 5 potential causes of mouth ulcers

A
  • Stress
  • Trauma
  • Sensitivity to certain foods (“Have you noticed the ulcers appearing after eating certain food?”)
  • GI diseases (Ulcerative colitis or Crohn’s disease flare up)
  • Smoking
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2
Q

What are the age parameters for mouth ulcers?

A

Most common aged 20-40

Refer any children under 10

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3
Q

How long do mouth ulcers normally last? When should you refer?

A

Last 1-2 weeks

Refer if they have not resolved after 3 weeks or if there is no improvement after 1 week of treatment

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4
Q

Give 5 disease states that may make mouth ulcers more common.

A 
Coeliac disease
Crohn's
Reiter's syndrome
Immunodeficiency
B12 or iron deficient anaemia
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5
Q

Give 3 medicines that may make mouth ulcers more common.

A

NSAIDs
Nicorandil
Beta-blockers

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6
Q

What are the danger eliminations for mouth ulcers?

A
  • Duration >3 weeks
  • ADRs (NSAIDs)
  • Failed treatment
  • Ulcers bigger than 1cm (10p coin)
  • More than 5 ulcers
  • Painless ulcer
  • Recurrent ulcer
  • Unexplained weight loss
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7
Q

Give 3 treatment options for mouth ulcers.

A

Reduce inflammation and pain

Mouthwash:
- Difflam (Benzyldamine) mouthwash

Oral gels:
- Lidocaine (Anbesol/Iglu)
- Cetalkonium chloride 
(bonjela)
- Apply using clean fingers

Children:

  • Bonjela junior gel or soothing teething gel
  • Difflam spray (6+)

Counselling:

  • Ask if have had it before (establish current knowledge)
  • Ask opinion of which they would prefer
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8
Q

What lifestyle advice could you give to someone with a mouth ulcer?

A
  • Use a soft-bristled toothbrush
  • Drink cool drinks with a straw
  • Avoid eating hard foods e.g. toast and crisps
  • Avoid very hot or acidic drinks such as cola and fruit juice
  • Reduce stress (try exercise)
  • Limit smoking until ulcers have disappeared
  • Regular dentist visits
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9
Q

Give 3 potential causes of oral thrush?

A

Broad spectrum antibiotics
Immunosuppression (HIV, deficiency)
Inhaled steroids

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10
Q

What are the presenting symptoms of oral thrush?

A
  • White/Cream patches that can be wiped off
  • Bleed when wiped off
  • Discomfort but not painful
  • Cracks inside the mouth
  • Unpleasant taste/Loss of taste

Resolves in less than 3 weeks

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11
Q

How long does oral thrush normally last? When should you refer?

A

Refer if:

  • Over 3 weeks or infection is recurrent
  • If no improvement after one week of treatment
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12
Q

What are the danger eliminations for oral thrush?

A 
Diabetes
Recurrent infection
Failed meds
Painless lesions (cuts or sores should not be present)
Duration > 3 weeks
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13
Q

Give 2 treatment options for oral thrush.

A

Miconazole oral gel 2% (Daktarin)

  • Can be used in children over 4 months
  • Not to be used with warfarin or in pregnancy

Pregnancy:

  • Chlorhexidine mouthwash
  • May cause brown staining of teeth which can be minimised by brushing teeth before applying it and rinsing mouth after
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14
Q

What lifestyle advice could you give to someone with oral thrush?

A
  • Use a soft toothbrush
  • If asthmatic – rinse mouth after using inhaler or talk to GP about using a spacer device
  • Limit/stop smoking
  • Ensure good blood glucose control
  • Regular check-ups with dentist
  • Remove dentures overnight and clean them
  • Regularly sterilise/disinfect dentures, dummies, mouth toys
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15
Q

What are the differences between indigestion and heartburn?

A

Heartburn - burning sensation in centre of chest worsens when lying down
Indigestion - pain in stomach, bloated, full sensation

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16
Q

Give 7 potential causes of heartburn and indigestion?

A 
Pregnancy
Obesity
Tight clothing
Not chewing properly
Smoking
Skipping meals
Bending or lifting
Certain food/drink
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17
Q

How long does indigestion/heartburn normally last? When should you refer?

A

Refer if lasted over 2 weeks, or 1 week with treatment

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18
Q

What are the danger symptoms of heartburn/indigestion?

A
  • Persistent symptoms (>5 days)
  • ADRs (NSAIDs)
  • Pain worsens on effort
  • Pain is severe
  • Regurgitation
  • Children
  • Blood in vomit or stools (“Have you seen anything like coffee grounds/pink or read streaks in your vomit?”“Are your stools black or tar-like?”)
  • Difficulty swallowing
  • Unintentional weight loss
  • Failed treatment
  • First time sufferers who are >45 years
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19
Q

Give 4 treatment options for indigestion and heartburn.

A

Antacids (neutralise stomach acid - fast relief but short acting):

  • Aluminium hydroxide (asilone
  • Calcium and magnesium carbonate (Rennies): safe in pregnancy
  • Sodium alginate (Gaviscon) reduce acid reflux
  • Zanprol tablets (Omeprazole) reduce acid secretion
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20
Q

What lifestyle advice could you give to someone with indigestion or heartburn?

A
  • Eat small, regular meals
  • Avoid eating late at night
  • Avoid trigger foods (spicy food, alcohol, caffeine, fatty food)
  • Eat sitting down
  • Chew food properly
  • Exercise regularly but not immediately before or after a meal
  • Cut down smoking
  • Alleviate position in bed using pillows
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21
Q

Give potential causes of nausea and vomiting

A

Gastroenteritis
Pregnancy
Alcohol

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22
Q

What are the age parameters for nausea/vomiting?

A

Refer children under 2 and elderly due to dehydration risk

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23
Q

How long does nausea and vomiting normally last? When should you refer?

A

Refer adults with symptoms over 2 days, may give them rehydration therapy in the meantime

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24
Q

Give 3 medicines that may make nausea and vomiting more common.

A

NSAIDs
Chemotherapy
Antibiotics

Reduce symptoms by taking with food

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25
What are the danger symptoms of nausea and vomiting?
- Duration of more than 48 hours in adults - Refer if child is under 2 years old - Blood in the vomit or stools
26
Give 3 treatment options for nausea and vomiting.
- Hyoscine Hydrobromide (JoyRides) - N&V caused by motion sickness - Dioralyte ORT - Domperidone liquid - Prochlorperazine buccal
27
What lifestyle advice could you give to someone with nausea and vomiting?
- Replace lost fluid with regular sips of water - Ginger biscuits can help alleviate nausea Motion sickness: - Take first dose before the journey in order to be effective - Take regular breaks to stretch legs - Breathe slowly and deeply - Focus on objects in the distance Pregnancy: - Drink and eat little and often - Avoid food/smells which trigger nausea
28
What are the danger eliminations for motion sickness?
- Glaucoma - Failed treatment - Seek advice if symptoms continue after you stop travelling
29
What is the most common treatment for motion sickness?
APPLY BEFORE TRAVELLING Hyoscine (Joy rides, Kwells) - Take 20-30 minutes before travelling - Can be given from age 3 onwards - Can cause dry mouth - alleviate by sucking on something like a lolly to simulate saliva
30
What lifestyle advice could you give to someone with motion sickness?
- Minimise motion by sitting at the front or middle of a boat - Look straight ahead at a fixed point - Close eyes and breath slowly - Fresh air and regular breaks - Ginger can help with nausea
31
Give potential causes of constipation
- Not enough fibre or fluids in the diet - Pregnancy - Old age - Laxative abuse - Change in diet or routine ADRs (Iron, antihypertensives, codeine) - Stress/Depression - Sedentary lifestyle
32
What are the age parameters for treatment of constipation?
Children may be given a single glycerin suppository Avoid stimulant laxatives in pregnancy Elderly should be given bulk forming laxatives but maintain fluid intake
33
Timescale for referral
Refer if no change in symptoms after: - 1 week if OTC treatment provided - 2 weeks with dietary advice only
34
What are the danger symptoms of constipation?
- Change in bowel habit of 2 weeks or longer - Failed medication - ADRs (Opioids - Codeine) - Blood in the stools - Presence of abdominal pain, vomiting
35
Name 2 stimulant laxatives
Bisacodyl Senna Glycerin suppositories
36
Name 2 faecal softeners.
Lactulose solution | Docusate sodium
37
Name a bulk forming laxative.
Ispaghula husk
38
What lifestyle advice could you give to someone with constipation?
- Increase fibre and fluid intake (fruit, veg, wholegrain, cereal) - Regular exercise - Avoid holding back when you have the urge to go to the toilet
39
What are the age parameters for diarrhoea?
Refer infants and babies due to dehydration risk
40
How long does diarrhoea normally last? When should you refer?
Refer if symptoms have lasted one week | If no improvement after 2 days of treatment (1 in infants) refer
41
Give 2 medicines that may make diarrhoea more common.
Antibiotics | Antacids containing magnesium
42
What are the danger symptoms of diarrhoea?
Signs of dehydration Bloody/dark stools Severe abdominal/rectal pain Returning from holiday with a fever
43
Give 3 treatment options for diarrhoea.
Dioralyte ORT Loperamide Bismuth (bacterial diarrhoea)
44
What lifestyle advice could you give to someone with diarrhoea?
``` Drink plenty of water Follow good toilet hygiene Avoid foods that aggravate diarrhoea Tackle stress/anxiety Drink bottled water on holiday ```
45
What key symptom is indicative of IBS?
Pain in the lower left quadrant of abdomen
46
What are the age parameters for IBS?
Refer children, the elderly or pregnant women | Usually affects people under 40
47
How long does IBS normally last?
Tends to be episodic | Symptoms may occur in a pattern over months or years
48
What are the danger symptoms of IBS?
``` Over 45s with change in bowel habits Blood in stools or rectum Unexplained weight loss Unresponsive to treatment Family history of IBD or cancer Previous bowel surgery ```
49
What are the two most common treatments for symptomatic relief of IBS?
Fybogel- constipation relief | Immodium- diarrhoea relief
50
Give 3 treatment options for IBS.
Hyoscine Mebeverine Peppermint oil
51
What lifestyle advice could you give to someone with IBS?
``` Have regular meals Drink plenty of water Reduce tea/coffee intake Reduce alcohol and fizzy drink intake Avoid aggravating factors ```
52
What is the key to treating threadworms?
The entire family should be treated even without symptoms
53
What are the danger symptoms of threadworms?
Travel abroad Medication failure Perianal skin broken/weeping
54
Give the most common treatment option for threadworms.
Mebendazole
55
What lifestyle advice could you give to someone with threadworms?
Treat all family members Reassure that it is very common Cut fingernails short Wash hands and brush nails after using the bathroom Wear pyjamas to reducing itching at night Have bath/shower each morning
56
How long should symptoms of threadworms last before referring?
If no improvement after 7-14 days with treatment, refer.
57
What are the age parameters for haemorrhoids?
Refer children | Incidence increases with age
58
How long do haemorrhoids normally last? When should you refer?
Refer if present longer than 3 weeks | Refer if no improvement with treatment after 1 week
59
Give 5 potential causes of haemorrhoids?
``` Pregnancy Irregular eating patterns Poor toilet habits Obesity Regular straining/heavy lifting in work or sport ```
60
What are the danger symptoms of haemorrhoids?
``` Presence of blood in stool Change in bowel habits Abdominal pain Severe, sharp pain when defecating Persistent/recurrent inflammation ```
61
Give 3 treatment options for haemorrhoids.
``` Anusol Anusol HC (hydrocortisone) Lidocaine ```
62
What lifestyle advice could you give to someone with haemorrhoids?
``` Promote soft stools Try not to strain Avoid excessive caffeine intake Avoid opioid analgesics Topical treatments will provide relief but cannot cure ```
63
How long does a cold/flu normally last? When should you refer?
Cold symptoms can last 2-14 days Flu symptoms last around 1 week Refer if symptoms persist for 2-3 weeks Refer if no improvement with treatment after 1-2 weeks
64
What are the danger symptoms of cold and flu?
``` Shortness of breath Difficulty breathing Blood in phlegm Phlegm is green/yellow Chest pain on coughing Rash/stiffness Earache not settling with analgesia ```
65
Give 2 examples of decongestants.
Xylometazoline | Pseudoephedrine
66
What lifestyle advice could you give to someone with cold/flu?
``` Get plenty of rest Keep hydrated Inhale steam to loosen and help bring up phlegm Increase vitamin C and zinc Avoid smoking See if you are eligible for flu vaccine ```
67
What is the difference between a chesty cough and a dry/tickly cough?
Chesty coughs tend to be productive, bring up sputum
68
What is the key identifier of chronic bronchitis?
Tends to be worse in the morning
69
How long does a cough normally last? When should you refer?
Refer if over 3 weeks or no improvement with treatment after 2 weeks
70
What medicines or conditions may cause cough?
ACE inhibitors Emphysema Bronchitis Lung disease
71
What is the key identifier of congestive heart failure with a cough?
Worse when lying down, may be swelling in legs
72
What are the danger symptoms of a cough?
``` Green/yellow phlegm Blood in phlegm Shortness of breath Noisy/difficult breathing Chest pain Rash/stiff neck Ear pain Unintentional weight loss- TB ```
73
Give an example of a demulcent formulation for a cough.
Beechams honey and lemon
74
Give examples of expectorants.
Guaifenesin Pseudoephedrine Diphenhydramine Levomenthol
75
Give the main example of a cough suppressant.
Dextromethorphan
76
What lifestyle advice could you give to someone with a cough?
``` Keep hydrated Rest Suck on a hard candy Cut down smoking If worsened by dry air, get a humidifier If worse at night take something that will make you drowsy ```
77
How long does a sore throat normally last? When should you refer?
Refer if lasted over 2 weeks or if no improvement with treatment after 1 week
78
What are the danger symptoms of a sore throat?
``` Extreme pain Skin rash Fever Spots on throat or tongue Neck stiffness Difficulty swallowing ```
79
What is the key differential diagnosis of a sore throat?
Glandular fever
80
Give 3 treatment options for a sore throat.
Dichlorobenzyl alcohol (strepsils) Benzalkonium antiseptic Benzocaine spray
81
What lifestyle advice could you give to someone with a sore throat?
Drink plenty of fluids Gargle with salty water Avoid smoking Avoid food or drink that is too hot
82
What is the main difference between hay fever and perennial rhinitis?
Hayfever is seasonal from April to September
83
What are the age parameters for allergic rhinitis?
Common in children | Symptoms often become milder as you get older
84
What are the danger symptoms of allergic rhinitis?
``` Wheezing, shortness of breath Chest pain Earache/facial pain Redder eyes, coloured and sticky discharge One sided nasal discharge Failed treatment Pregnancy ```
85
What timescale should you refer allergic rhinitis?
If symptoms do not improve within 5 days of commencing treatment
86
Give an example of a mast cell stabiliser.
Sodium cromoglicate
87
Give 5 treatment options for allergic rhinitis.
``` Loratidine Chlorphenamine Sodium cromoglicate Xylometazoline Beclometasone spray ```
88
What lifestyle advice could you give to someone with allergic rhinitis?
``` Avoid triggers Sleep with windows closed Avoid being outside when pollen count is high Wear dark glasses Limit pets to certain areas of the house ```
89
Name 4 types of headache.
Tension Sinus Hangover Medication overuse
90
How might someone describe a tension headache?
Dull ache in forehead, temples or back of the neck | Tight band around head or heavy weight on top of head
91
What often accompanies a hangover headache?
Nausea and vomiting
92
What are the key symptoms of a medication overuse headache?
Oppressive | Worse in the morning or after exercise
93
What are the age parameters for a headache?
Refer children, especially with trauma
94
Give 2 likely causes of headaches.
Alcohol | Straining eyes/using a computer
95
What are the danger symptoms of headaches?
``` Sudden, severe headache Nausea and vomiting Persistent and recurring Fever, stiff neck Blurred vision Trauma Increasing severity or frequency Numbness, tingling of limbs ```
96
What are the benefits of dispersible as opposed to traditional tablets in headache?
Achieve peak effect in 30 minutes rather than 2 hours
97
Why may levomenthol be useful in headache?
Available as cooling strips to apply topically
98
What lifestyle advice could you give to someone with a headache?
``` Plenty of rest Regular breaks when concentrating for long periods Try to avoid known triggers Regular eye tests Apply ice pack to painful areas Well hydrated ```
99
What are the key symptoms of a migraine?
``` Headache on one side Blurred Vision Flashing/coloured lights Nausea and vomiting Tingling in hands or arms ```
100
How long can a migraine last?
Lasts 4-60 minutes | Complete recovery in 4-72 hours
101
With what medication should a migraine be referred?
COCP
102
What are the danger symptoms of migraines?
First time | Vision/hearing/sensory loss
103
When can sumatriptan be sold in migraine?
With previous GP diagnosis
104
Give 3 treatment options for migraines.
Sumitriptan Migraleve pink and yellow Midrid capsules
105
What lifestyle advice could you give to someone with migraines?
Keep a diary in order to try and identify triggers During attack, lie down, try to sleep, in dark and quiet room Maintain good nutrition
106
Define a sprain.
Injury to ligament supporting a joint
107
Define a strain.
Injury to muscles and tendons that move the bones of a joint.
108
What are the danger symptoms of muscoskeletal injuries?
Unable to bare weight Severe pain or swelling Numbness and severe deformity Popping sound upon injury
109
What are the age parameters for muscoskeletal injury?
Refer children and elderly due to fracture risk
110
How long do sprains/strains normally last? When should you refer?
Refer if over 4 days or treatment does not improve symptoms within 4 days
111
What are the potential causes of backache?
Pregnancy Awkward bending Sitting for long periods
112
How long does backache normally last? When should you refer?
Refer if constant or no improvement after 10-14 days
113
What are the danger symptoms of backache?
``` Fever, nausea and vomiting Weight loss Inflammation/swelling Pain that travels to chest Loss of bowel control Kidney pain Severe pain radiating into legs ```
114
Define tennis elbow.
Swelling around outer edge of the elbow, pain during movement.
115
Define golfer's elbow.
Swelling on the inside of the elbow | Pain during movement and when quickly flexing arm/hand
116
How long does tennis/golfer elbow normally last? When should you refer?
Usually around 2 days, after this refer | If no improvement with treatment after 4 days refer
117
What lifestyle advice could you give to someone with muscoskeletal injury?
``` Protect Rest Ice Compression Elevate ``` After first 48 hours, inflammation reduced, may apply heat for pain
118
What is frozen shoulder?
Stiffness and pain | Reduced movement
119
How long does frozen shoulder normally last? When should you refer?
Aching/stiffness can last 2-9 months Adhesive stage- stiffness and muscle wasting many last 4-12 months Recovery stage can take 5-12 months
120
What lifestyle advice could you give to someone with frozen shoulder?
Shoulder exercise to maintain movement | Saving the shoulder can increase stiffness and cause muscle wasting
121
How long does rheumatism normally last? When should you refer?
Refer if over 6 weeks If they haven't seen their doctor in 6 months, refer back If no improvement with treatment after 7 days, refer
122
What lifestyle advice could you give to someone with rheumatoid arthritis?
Plenty of rest during flare ups Exercise is important to maintain mobility Non-weight bearing exercise such as swimming
123
Presenting symptoms of vaginal thrush
- Itching - Soreness - Discharge (colourless/watery/white) **distinguishing symptom from cystitis**
124
How long does vaginal thrush normally last? When should you refer?
Lasts 1-2 weeks Refer if > 2 weeks or if symptoms do not improve within 1 week of treatment
125
What are the danger symptoms of vaginal thrush?
- Diabetes - Duration > 2 weeks - Treatment failure - Pregnancy or suspected pregnancy - Under 16 or over 60 - First occurrence ("Have you experienced this before? Is it the same?") - Blood stained or strong smelling discharge ("Are you sexually active") - More than 2 attacks in 6 months
126
What lifestyle advice could you give to someone with vaginal thrush?
- Avoid tight fitting clothing as they create a warm, moist environment which can trigger thrush - Avoid strong soaps and douches - Application of live yoghurt can soothe and restore bacterial/fungal cell balance - Male partners can use clotrimazole cream to stop spreading
127
What treatment options are there for vaginal thrush?
ASK WHERE THE ITCH IS - Internal or External Clotrimazole (topical - Canesten): - External cream (2%) - Internal cream (10%) - Pessary (500mg) - Canesten combi (Pessary + external cream) Fluconazole (oral tablet): - 24 hours to act
128
What are the presenting symptoms of cystitis? Potential causes?
- Pain, burning or stinging when you pee - Needing to pee more often and urgently than normal - Urine that's dark, cloudy or strong smelling - Pain low down in your tummy - Feeling generally unwell, achy, sick and tired Causes: - Bacterial infection (50%) - Physical activity - Dehydration
129
How long does cystitis normally last? When should you refer?
Refer if treatment for 2 days gives no improvement
130
What are the danger symptoms of cystitis?
- Failed medication - Diabetics (sign of uncontrolled blood glucose) - All men and children - Fever, nausea and vomiting - Blood in urine - Pregnancy (increased likelihood of complications) - Back pain - Recurrent cystitis
131
What is the mainstay treatment for cystitis?
Potassium citrate - Alkanalise urine - Oral solution, sachets (cystopurin) and tablets (Effercitrate) Pain relief: Nitrofurantoin (can give to relieve pain whilst they wait for referral)
132
What are the presenting symptoms of dysmenorrhea?
- Painful cramps - Headache, backache - Nausea, vomiting constipation - Faintness, dizziness, fatigue - Premenstrual syndrome (PMS)
133
How long does dysmenorrhoea normally last? When should you refer?
Around 3 days Refer if no improvement with treatment over 2 cycles
134
What are the danger symptoms of dysmenorrhoea?
- Abnormal discharge (colour) or heavy bleeding - Fever - Severe pain between periods - Repeated medication failure
135
Give 3 treatment options for dysmenorrhoea.
Ibuprofen (Anadin period, feminax express, nurofen) - Add Paracetamol if not effective enough) Naproxen (Feminax ultra) Tranexamic or Mefenamic Acid
136
What are the guidelines for giving tranexamic acid in dysmenorrhoea?
Over 18 Regular cycle Commence treatment when period starts Treat for no more than 4 days
137
What is lifestyle advice for dysmenorrhea?
- Exercise during menstruation may be beneficial - some evidence that moderate aerobic exercise can improve symptoms of PMS. “There are a couple things that have been shown to help but you may not feel up - Start painkillers before period is due – may prevent pain from building up - Hot water bottle/heat packs
138
What are the danger symptoms of insomnia?
Suspected depression/anxiety - ASK “Can you think of anything that has triggered this?”/“How are you feeling at the moment?” THEN “You might want to go to the GP about the things you’ve said to me” - Insomnia lasting more than 3 weeks - Children under 16 - Medication failure
139
What are the treatment options for insomnia?
Diphenhydramine (nytol) ``` Promethazine Hydrochloride (Phenergan, Day&Nurse) - Longer lasting than Diphenhydramine ``` All available as tablets or oral solution
140
What lifestyle advice could you give to someone with insomnia?
- Avoid daytime naps - Avoid caffeine, nicotine, alcohol and heavy meals 6 hours before bed - Regular exercise can help but avoid 4 hours before bed - Try having warm bath or milky drink before bed - Try relaxation techniques such as deep breathing
141
How long does insomnia normally last? When should you refer?
Refer if over 3 weeks or 1 week if no improvement with treatment
142
What are the differences between irritant and allergic contact dermatitis?
Irritant can become chronic and occurs within 48 hours of contact Allergic can have a delay of hours or days before symptoms seen
143
How long does contact dermatitis normally last? When should you refer?
If over 2 weeks or no improvement after 1 week with treatment refer
144
Give potential causes of contact dermatitis.
``` Nickel in jewellery Soaps Detergents Hair dye Chromates (cement) Plasters ```
145
What are the danger symptoms of contact dermatitis?
Infection Severe condition Cracked or bleeding skin
146
What are the danger symptoms of acne?
Signs of infection Pregnancy Adult suffering for the first time
147
Give potential causes of acne.
``` Stress Make up Contraceptive pill Exfoliation Before period ```
148
How long does acne normally last? When should you refer?
Refer if no improvement with 8 week treatment
149
What is the treatment for acne?
Benzyl peroxide
150
What lifestyle advice could you give to someone with acne?
Wash skin gently twice daily Avoid very hot water and strong detergents Wash hair regularly, especially with fringe Resist temptation to squeeze sports Natural sunlight helps Choose water based cosmetics
151
What are the danger symptoms of athlete's foot?
``` Base of nail discoloured, brittle Weeping, yellow crusts Swollen foot Large blisters/ulcers Diabetes ```
152
What should be suggested in treatment failure of athlete's foot?
Consider adherence If tried daktarin, recommend lamisil Give lamisil once if compliance issues Continue treatment for 2 weeks after infection has cleared
153
Give 4 treatment options for athlete's foot.
Miconazole (daktarin) Terbinafine (lamisil) Miconazole and hydrocortisone (daktarin HC) Amorolfine (curanail)
154
What lifestyle advice could you give to someone with athlete's foot?
``` Wash and dry feet thoroughly Wear socks made of cotton or wool Avoid shoes made of synthetic material Powder feet and inside of shoes with anti fungal Spend time bare foot when possible ```
155
How long does athlete's foot normally last? When should you refer?
Refer if present for over 2 weeks or no improvement with 7 days of treatment
156
How do cold sores present?
Tingling in skin for 6-24 hours before appearance Weeping/crusting at 4th day after appearance Total episode usually lasts 1-2 weeks
157
What can cause cold sores?
``` Stress Illness Strong sunlight Menstruation Fatigue Cold weather ```
158
What are the danger symptoms of cold sores?
``` Failure to resolve Severe or worsening History of frequent occurrence Painless Eye affected ```
159
Give 2 treatment options for cold sores.
Acyclovir 5% (Zovirax) | Lidocaine 2% gel
160
What are the key differences between warts and verrucae?
Warts- rough, scaly papules that are normally painless Occur on hands, elbows and knees Verrucae- flat, thickened skin with black centre, painful when pressure applied Occur on weight bearing ares, soles of feet
161
What are the danger symptoms of warts/verrucae?
``` Cracked skin Weeping Itching Bleeding Genital or facial ```
162
What is the treatment of verrucae?
Salicylic acid
163
What lifestyle advice could you give to someone with a wart or verruca?
Treatment takes up to 3 months, refer if no improvement after 12 weeks Keep feet dry Do not scratch or pick Cover with swimming socks or plaster
164
How long does scabies normally last? When should you refer?
Symptoms appear 2-6 weeks after infestation | Refer if treatment does not show improvement in 7-14 days
165
What are the danger symptoms of scabies?
``` Babies and children Pregnancy Diabetes Asthma Infected or broken skin ```
166
How is scabies treatment applied?
To entire body from the neck down and left for at least 8 hours before washing off.
167
Give 2 treatment options for scabies.
Permethrin | Malathion
168
What are the symptomatic treatment options in scabies?
Chlorphenamine and Eurax cream to stop itching
169
What lifestyle advice could you give to someone with scabies?
Very contagious Bed linen, towels should be machine washing on hot wash after treatment Any linen that cannot be washed should be contained in plastic bag for 3 days until mites die Itching may continue for 3 weeks after successful treatment All household members should be treatment on the same day
170
Give 3 potential causes of dandruff.
Not brushing hair regularly Nutritional deficiencies High sugar diet
171
What are the danger symptoms of dandruff?
``` Pregnancy Yellow, greasy looking skin Inflammation Red and crusty skin Knees or elbows- psoriasis ```
172
Give 3 treatment options for dandruff.
Salicylic acid shampoo Selenium sulphide shampoo Ketoconazole 2% shampoo
173
What lifestyle advice could you give to someone with dandruff?
Brush hair daily, wash at least 3 times per week Use medicated shampoo every 1-2 weeks to prevent recurrence Avoid chemical dyes Avoid scratching
174
When should symptoms of dandruff improve?
Within 12 weeks of starting treatment
175
What are the features of psoriasis?
Occurs on scalp, knees, elbows and can affect finger nails | Thickened red patches of skin, look scaly
176
How long does psoriasis last?
Usually occurs in cycles of weeks to months | Refer if no visible improvement after 1 week of treatment
177
What are the danger symptoms of psoriasis?
Weeping Crusting Crack skin Infection
178
What are the 2 main treatment options for psoriasis?
Coal tar | Hydrocortisone 1% cream
179
What lifestyle advice could you give to someone with psoriasis?
Keep skin lubricated Use soap free cleansers if possible Exposure to sun can help Bathing in hot water can reduce scaling
180
How long does nappy rash normally last? When should you refer?
Refer if present for over 2 weeks or with treatment if symptoms do not improve in 1 week
181
What are the danger symptoms of nappy rash?
Signs of infection Small, red dots or extension beyond nappy area suggestive of fungal infection Darker, purple spots (meningitis)
182
What are the mainstays for treatment of nappy rash?
Canesten or daktarin followed by barrier cream
183
What lifestyle advice could you give for nappy rash?
Increase frequency of nappy changes Use warm water and cotton to clean bottom Pat nappy area dry Leave nappy off for as long as possible Talc and baby wipes can be irritant Barrier creams can help to protect the skin
184
What are the 3 types of conjunctivitis.
Infective Allergic Irritant
185
Describe the difference in symptoms of infective and allergic conjunctivitis.
Infective- starts in one eye and spreads, sticky discharge, whites of the eyes look pink, eyes feel gritty and irritated Allergic- both eyes develop symptoms at the same time, watery and itchy eyes
186
How long does conjunctivitis normally last? When should you refer?
Usually resolves itself but refer if over one week | Refer if no improvement within 48 hours of treatment
187
What could be the cause of conjunctivitis?
``` Contact lenses Allergy Pollution Smoke Chlorine Bright lights ```
188
What are the danger symptoms of conjunctivitis?
``` Worsening symptoms Vision disturbance Glaucoma Recurrence Pregnancy Abnormal pupil ```
189
What are the 2 treatment options for infective conjunctivitis?
Propamidine | Chloramphenicol
190
What are the 2 treatment options for allergic conjunctivitis?
Sodium cromoglicate | Xylometazoline
191
What are the 2 treatment options for irritant conjunctivitis?
Witch hazel | Naphazoline
192
What lifestyle advice could you give for conjunctivitis?
Do not rub eyes Infective is highly contagious Pus/crustiness may be removed with warm slaty water
193
Describe the presenting features of excess earwax.
``` Difficulty hearing Pain Tinnitus Blocked feeling Temporary deafness after swimming or showers ```
194
Describe the presenting features of otitis media.
``` Pus Fluid Inflammation Severe earache Hearing loss Fever Tinnitus ```
195
Describe the presenting features of otitis externa.
Pain and itching Dulled hearing Ear discharge
196
What are the age parameters for ear problems?
Refer children under 12 with wax problems
197
How long do ear problems normally last? When should you refer?
Refer if no improvement of excess wax in 3 days, persistent otitis external for 7 days Refer if no improvement with treatment after 7 days
198
What are the danger symptoms of ear problems?
``` Severe pain Complete deafness Fever in glue ear Otitis media Otitis externa accompanied by foul smelling discharge or fever ```
199
What is key to point out with treatments for ear problems?
Some products contain peanuts or soya | Drops should be used at room temperature
200
Give 3 treatment options for softening ear wax.
Arachis oil and chlorobutanol Almond oil, archis and camphor oil Urea hydrogen peroxide
201
What may be given for treatment of otitis external?
Acetic acid spray | Isopropyl alcohol
202
What lifestyle advice could you give for ear problems?
Cotton buds can compact ear wax Avoid smoky environments with glue ear Use ear plugs when swimming
203
When does teething generally occur?
Around 6-9 months
204
What are the danger symptoms of teething?
Excessive diarrhoea | Temperature over 38
205
What are the 4 treatment options for teething?
Paracetamol Ibuprofen Bonjela Lidocaine and cetalkonium (abnesol)
206
What lifestyle advice could you give for teething?
Plenty of fluids Teething rings- can also be cooled in fridge to soothe Brush teeth as soon as they appear
207
When does head lice generally occur?
Common aged 4-11, symptoms occur a long time after initial infection Refer if no improvement with treatment after 1-2 weeks
208
What is the best method for treating head lice?
Wet combing method | Every 4 days for at least 2 weeks
209
Give the 3 treatment options for headline.
Phenothrin Malathion Dimeticone
210
What lifestyle advice could you give for head lice?
Avoid direct head to head contact Minimise itching Protect eyes and face when treating Treat all members of the family
211
What are the danger symptoms of hair loss?
Patchy hair loss Hypothyroidism Anaemia
212
What is the main treatment option for hair loss? Who can receive it?
Minoxidil 2% for women | Minoxidil 5% for men
213
Where does eczema most commonly present?
Babies- nappy area, neck, belly, back of scalp, limb creases Children- skin creases, ankles, around the eyes Adults- neck, back of hands, ankles, groin
214
What are the danger symptoms of eczema?
Infection | Pain
215
What lifestyle advice could you give for eczema?
``` Aggravating factors Stress can worsen eczema Avoid itching Use non-biological washing powders Keep skin moist and supple to avoid cracking ```
216
Give lifestyle advice for cystitis
*Would you like some advice on how to prevent this happening again? What have you already tried? Can you think of anything that you think that has triggered it?* - Staying well hydrated – drinking plenty of fluids may help to stop bacteria multiplying in your bladder - Avoid tea, coffee and alcohol as they cause dehydration - Empty your bladder as soon as possible after having sex - Drinking cranberry juice has traditionally been recommended as a way of reducing your chances of getting cystitis. - Wipe front to back

The Pharmacist Year 3 (5 decks)

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