Minor Illness

Question 1

What is an URTI?

Answer 1

Infection of the nose and upper airways (nose, sinuses, pharynx, larynx)

Question 2

What are the symptoms of a URTI?

Answer 2

Blocked, runny nose sneezing, difficulty sleeping, fatigue, lethargy, could, mild fever

Question 3

What would you advise a patient with an URTI ?

Answer 3

Paracetemol 
Ibruprofen 
Hydration 
Steam inhalation 
Saline nose drops

Question 4

What is a chest infection?

Answer 4

A lower resp tract infection, pneumonia and bronchitis are the most common
Bronchitis is normally viral and pneumonia is usually bacterial

Question 5

Who are chest infections common in?

Answer 5

Young children and elderly 
Smokers 
Pregnant women 
LTC- asthma, CF, IHD, DM, kidney disease and liver disease 
Weakened immune system

Question 6

What is the most common cause of bacterial tonsillitis?

Answer 6

Streptococcus pyogenes

Question 7

How can you determine whether someone with tonsillitis needs antibiotics or not?

Answer 7

Center/fever pain score 
Takes into account...
Fever (>38 degrees) 
Tonsillar exudates 
Absence of cough 
Lymphadenopathy 
Symptom onset less than 3 days (rapid attendance)

Question 8

What do you have to score on fever lain score to give antibiotics?

Answer 8

2 or 3 consider a delayed script
3 or more give antibiotics
Should give penicillin V a 10 day course

Question 9

How do you treat sinusitis?

Answer 9

Normally self limiting
If symptoms for less than ten days then don’t give antibiotics
If more than ten days then give high dose steroid nasal spray
If the symptoms are more than ten days and it is likely a bacterial cause then give delayed or immediate antibiotics
Penicillin V for 5 days

Question 10

What are the differentials for epigastric pain and nausea?

Answer 10

Heartburn/GORD 
Peptic ulcer 
Stomach cancer 
Cardiac 
History of Alcohol/NSAIDS/haematemesis/stress

Question 11

What is cauda equina syndrome?

Answer 11

Compression of the collection of nerve roots at the base of the spine due to a central disc prolapse, trauma, HAEMATOMA
May lead to an irreversible neurological damage

Question 12

What are the symptoms of cauda equina syndrome?

Answer 12

Saddle anaesthesia
Bilateral sciatica
Loss anal tone
Faecal incontinence
Urinary retention
Severe and progressive neurological deficits legs
Emergency decompression with 48 hours is needed

Question 13

What should be done in a patient with localised back pain?

Answer 13

Following trauma requires imaging to evaluate instability and involvement of spinal cord

Question 14

What is dis Discitis/spinal epidural abscess?

Answer 14

This is spinal infection

It presents with localised tenderness, severe progressive pain and a decreased range of movement.

Question 15

What are some red flags that may indicate discitis?

Answer 15

IVDU
Fever, sweats, malaise
TB
DM/ immunosuppresion

Question 16

How does mechanical back pain present?

Answer 16

Pain is worse during activity and is relieved by rest
Not associated with sciatica, leg weakness, claudication, systemic upset
Acute episodes are precipitated by bending, lifting or straining

Question 17

What is characteristic of mechanical back pain?

Answer 17

Pain resolves after a few weeks but persistent low grade symptoms are relatively common
It is important to keep active and use analgesia

Question 18

What specific area of pain would you see in the following dermatomes in sciatica…
L4, L5, S1

Answer 18

L4- anterior thigh, anterior knee, medial shin
L5- lateral thigh, lateral calf, dorsum of foot
S1- posteriorly thigh, posterior calf, heel, sole of foot
Paraesthesia at end of nerve route