Minor illness Flashcards
What potential complications can arise from bacterial tonsilitis?
Peritonsillar abscess Rheumatic fever Acute post-streptococcal glomerulonephritis IMpetigo Erysipela Necrotising fascitis
What immune components cause allergic rhinitis?
IgE antibodies
What is the pathophysiology of medication-overuse headache?
Occurs in patients who use pain relief to manage headaches
Down regulation of pain receptors, leading to a lack of efficacy of analgesics when they are used.
Medications associated with medication-overuse headache?
Paracetomol
NSAIDs
Weal opioids
Management of medication-overuse headache?
Withdraw offending drug
Consider restarting previously used drugs at a lower dose
Consider different drugs not previously used
Dyspepsia management in young patients without red flags?
Full dose proton pump inhibitor (PPI) for one month
Test for Helicobacter pylori infection, and treat if positive
What is CFS?
Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME). CFS/ME is characterised by persistent and disabling fatigue, post-exertional malaise (PEM), unrefreshing sleep, cognitive dysfunction and headaches. The symptoms in CFS/ME are not related to other medical or psychiatric conditions; however, symptoms are often preceded by a viral illness. There are no curative medications or treatments for chronic fatigue; instead, the primary goal of treatment is to manage symptoms and improve functional capacity. Therefore, initial treatment should include counselling and supportive care, helping patients to understand their condition and implement techniques to improve exercise tolerance.
When is imaging considered in patients presenting with headache?
A CT head or MRI head may be indicated if the patient has any red flags in their history suggesting a more serious secondary cause of headache. Indications of a more serious aetiology may include sudden onset headache, recent trauma, features of raised intracranial pressure (e.g. morning headache, nausea ± vomiting), features of meningism (e.g. photophobia, neck stiffness) and neurological phenomena (e.g. weakness, paraesthesia). In the absence of these features, a CT head and MRI head would not be indicated.
What is tension type headache?
TTH is a common primary headache disorder causing a generalised headache, typically described as ‘pressure’ or ‘tightness’ around the head. NICE guidelines recommend that if clinical features are consistent with TTH and a serious cause of headache is not suspected, then no further investigations are required. Therefore, TTH is most commonly a clinical diagnosis that does not necessitate additional imaging or investigation.
How might alcoholic neuropathy present?
This may accompany thiamine deficiency and other nutritional disturbances. Other symptoms may include loss of sensation and the patient should have a full neurological examination performed to elicit signs of peripheral neuropathy, including sensory loss in a ‘glove and stocking’ distribution, loss of vibration sense and impaired proprioception.
Treatment for pts presenting with erythema migrans?
NICE guidelines recommend that all people with erythema migrans, without any focal neurological signs or cardiac involvement, should be started on oral doxycycline as the first-line management.
What is Bell’s palsy
Bell’s palsy (e.g. idiopathic paralysis of cranial nerve VII). Not only is Bell’s palsy the most common cause of isolated facial nerve paralysis, but it is also 3x more common in pregnant women
Bell’s palsy vs stroke
Stroke forehead sparing
. This is due to the bilateral supranuclear input to the dorsal aspect of the facial nerve nucleus.
What is Ramsey Hunt syndrome?
Ramsay Hunt syndrome refers to LMN facial nerve palsy secondary to varicella-zoster virus and commonly presents with facial pain and vesicles in the ipsilateral ear. Trigeminal neuralgia presents with sudden onset, brief, unilateral pain in the distribution of the trigeminal nerve.
How does essential tremor present?
history of bilateral tremor that is worse with movement and better after drinking alcohol.
Family history of essential tremor
. If the patient finds this sufficiently bothersome to consider medical management, propranolol is recommended first-line if not contraindicated. Primidone can also be trialled.
