Minor Ailments Deck 1 Flashcards
what are the 6 stages of change
pre contemplation, contemplation, preparation, action, maintenance, termination
what drug interaction mechanism does st johns wort have
3a4 and pgp inducer
for patients experiencing a first episode of depression, how long should they stay on antidepressant once “cured”
6-9 months
what stage of quitting smoking do you chose a quit date
preparation- this is ideally within next 2 weeks
3s for nicotine withdrawal
3 minutes to get over a craving, 3 days physical dependence, 3 weeks psych???
red flags for headache
fever, change in mental status or consciousness, change in vision, first headache or worst ever, one sided weakness, stiff nech
differences between tension and migraine HA
tension has no N/V, may have photo or phono but not both. Bilateral pain, non pulsating, not agravated by exercise. Migraine must have one of N and or V, OR photo and phono, may or may not have aura. Usually unilateral, throbbing or pulsating, aggravated by activity.
how many days per month should analgesics be used to prevent medication overuse headaches
less than 15 for analgesics and less than 10 for opioids
how long should a med for migraine proph be trialed to assess efficacy
2 months
fever as defined in CTMA
over and including 37.8
how to respond to a parent worried abut their child’s fever
its a sign of illness, not a disease. The reason for fever should be determined- its an important monitoring parameter telling us something else may be going on. Antipyretics don’t cure anything, just make them more comfortable
when to refer with fever
under 6 months, over 40.5, associated with stiff neck or seizure, child appears very ill and is inconsolable, rash also present, confusion or delerium, fever persists for more than 24 hours after trying therapy and no obvious cause, or more than 72 hours despite therapy
route of choice to measure temp in those over 5
mouth, then ear or armpit
how many times should fever be reasonably taken per day
2-4times
what is a stye (hordeolum)
infection of sebaceous gland of eyelid
how to treat stye
non pharm- don’t touch, wash hands after contact, change towels, don’t let eye drop bottles touch, warm compress 10-15minutes per day. Refer if no drainage in 48 hours- they might do it and give topical ABX to prevent infection
distinguish viral vs bact vs allergic eye sx
only allergic itches, all red, viral is profuse discharge more thin and watery, bacterial is moderate mucopurulant or purulent, allergic is more mucoid
is acute bacaterial conunctivitis self limiting
yes usually resolves in 2 weeks- treatment decreases person to person spread, more seriosu compl, and disease length.
treatment for bacterial conjunctivitis
polymixin/gramicidin eye drops 4-6x/day for 7-10 days . Continue treatment 2 days after sx resolved. If no improvement in 48 hours, doc. If want rx- many ABX prescribed.
what are antihistamine eyedrops good for
to stop itching, won’t take away redness
what are decongestant eyedrops good for
can cause rebound ocular congestion- they decrease redness
how to adjust the ear for drops based on age
over three- up and back (taller), three and under down and back
what is the age cut off for who nasal steroids are safe in
over two
decongestant cut off for age
over six-below this, use saline drops or spray before eating and sleeping
what should be avoided in pregnancy to treat allergic or cold sx
decongestants in the first trimester (oral) avoid- topical at any time
shortest available needles for diabetes
5 mm
range of gauge size- what is smallest?
larger numbers are smallest diameter. 28-32 is range
when to refer constipation
under 2yo, persistent abdominal pain, vomitting, diarrhea alternating with const, unexplained weight loss, blood in stool, fever
how much fibre should kids have
their age plus 5g
how much fibre should adults have
25-38g daily for const prev- getting 10g should be sufficient
how to take bulk forming laxatives and why
with at least 250mL water or juice to prevent fecal impaction or esophageal obstruction. Don’t take within 2 hours of other meds as it can decrease their abs. Start low and increase dose for improved tolerability. 2-3 months for max effect
positive about PEG vs other osmotic laxatives
less flatulance and bloating and may even be more effective vs others
which population should not use MOM for const
renal dysfx
can lactulose be used by diabetics?
yes- not absorbed systemically
what can be used in infants for constipation (under 1)
glycerin supp, corn syrup, lactulose, sorbitol
what can be used by kids over 1 for constipation
PEG, lactulose, sorbitol are first line. Senna and bisacodyl can be used only if others failed as rescue.
constipation in pregnancy
first line increase fibre, lactulose, PEG. Stimulant lax are only for short term when others failed
when to see a doc in constipation
no BM in 7 days, red flags, very uncomfortable
what might indicate infective diarrhea? what should you do
abdominal pain, HA, fever, chills, NV- refer and ORT
how to treat diarrhea
loperamide (mod-sev), bismuth (mild-mod), psyllium or attapulgite (mild)- all with ORT. If try and no improvement in 48 hours, try loperamide if hasn’t been tried yet. No resolvement after 24 hours loperamide therapy? refer
diarrhea in preg
bulk agents first, reserve loperamide for severe
rx to treat travellors diarrhea
FQ or azith
prevention of travelers diarrhea
loperamide not recommended, can use bismuth subsal
