Minor Illnesses Flashcards
What are the incubation and contagious periods of chickenpox?
Incubation: 8-28 days
Contagious: 2 days before…
Onset of symptoms
Contagious: 5 days after onset
Treatment of Chickenpox
- Child
- Adult
- Calpol, antihistamines, calamine lotion
2. Aciclovir
Fifth disease cause, presentation, and natural history?
- Parvovirus (erythema infectiosum)
- Slapped cheek
- Self-limiting
What are the S + S of Conjunctivitis?
- Painless red eye
- Discharge
- Gritty sensation
What are the three causes of conjunctivitis and their management?
- Adenovirus
- Supportive - Bacteria (unilateral and ‘gooey’) - Chloramphenicol drops
- Allergic - Antihistamine/nasal steroid spray
Chalazion vs stye cause and symptoms?
Chalazion: Blocked oil gland - usually painless
Stye: Infected follicle - painful
Chalazion/stye(hordeola) treatment?
Both
Warm compress for a few weeks
Stye
Topical ophthalmic bacitracin or erythromycin
ABx PO if significant cellulitis (cefalexin/co-amox)
Referral for incision if distorting vision/refractory to tx
Chalazion
Referal for CTS injection or incision if refractory
What are the S+S of Orbital cellulitis?
- Pain on movement and visual disturbance
2. Systemically unwell (febrile)
How to manage an ankle sprain (no bony injury)
90% - rest and time
P rotect
R est
ICE
Analgesic ladder: Ibuprofen gel, codeine
What is the algorithm for an ankle injury X Ray?
Ottowa Ankle Rules
- Malleolar pain
Posterior edge
Tip of malleolus - Midfoot pain
Base of 5th metatarsal
Navicular - Inability to weight-bear immediately after AND in ED
Otitis media management?
3 days self-resolving
Warm compress
Paracetamol and Ibuprofen
Not resolving
Amoxicillin
Co-amoxicalv
Apthous Ulcer Presentation and management
- Lower lip pain
Minor (1cm) or Major (1cm+) - Avoid trigger foods/drinks
- Consider IBD/Celiac
Headlice management?
- Diagnose with finding a live louse
- Wet combing
- Chemical then insecticidal shampoos
Scabies
Presentation
Management
Highly infectious and highly itchy
- Reduce physical contact
- Wash at 50°
- Cream/lotion for whole body
- Permethrin
- Ivermectin PO - Antihistamine for days of itchiness
Nappy Rash
Presentation
Management
- Reassure and advise to avoid nappy and tightness where possible
- Change nappy regularly and clean skin thoroughly
- OTC ointments and barrier cream/oil
- If severe - Steroids and antifungals
Heel Pain 5DDs
- Plantar fasciitis
- Overweight 40-60 or runners
- Medial band of fascia attachment inflammation
- Achiles tendonitis (calcaneal spur)
- Tenderness along tendon on palpation
- Radiation when extending foot or tiptoes
3 Baxter’s neuritis - Parasthesia with percussion
- Burning pain, may be present at rest
- Fat pad atrophy
- Centralized pain
- Flattened surface on palpation
- History of landing hard on heal (obese or athletic)
- Calcaneal fracture
- Diffuse, warm swelling
- Pain on squeezing calcaneum
- Long distance walk with heavy pack
Knee OA
- Presentation
- Investigations
- Pain, locking, weakness
- Oxford knee score
Osteophytes and pieces in joint space
Fever pain score features?
- Fever - in past 24 hrs
- Cough or coryza (inflmmation of nasal m. membranes)
- Aches
- Length - <3 days? 4-7 or 7+
- Glands - Cervical/inflamed/pus?
Oral Candidias
- S&S
- Mild Tx
- Severe treatment
- S&S
- Creamy white/ yellow plaques
- Cracks, ulcers, crusted fissures in angles
- Discharge?
- Mild Tx
- Topical cream - gentian violet (1%)
- Tablet: clotrimazole, miconazole, nystatin
- Severe Tx
- Fluconazole PO 200mg
- Posaconazole PO 100mg
Vaginal Candidiasis
- S&S
- Uncomplicated Tx
- Complicated Tx
- S&S
- Dysuria/Pruritis/Dyspareunia/Erythema
- Discharge: White, thick, cottage cheese-like, odourless
- Uncomplicated Tx
- Butoconazole 2% Vaginal cream daily at night
- Clotrimazole (1%) cream daily at night
- Miconazole (2%) daily at night
- Fluconazole (150mg) PO
- Nystatin 100,000 unit vaginal tablet nightly 14/7
- Complicated Tx
- Fluconazole 150 mg PO 3/7
Vaginitis red flags (Lichenous vs Cancers)
- Lichen
- Pruritis, intense vulvodynia and dyspareunia
- Violaceous, flat-topped papules/plaques
- Cancer background:
Vulval
- Abnormal vaginal bleeding - Odorous or blood-stained discharge - Persistent pelvic/vaginal pain
Cervical:
- Vaginal bleeding, dyspareunia - Pain in lower back/pelvis - Foul-smelling discharge - Severe bleeding, GI effects
‘Honey crust’ infection management
Impetigo (Staph A. / Strep)
- Off school for 2 days
- Hydrogen peroxide cream
- Abx
A. Non-Buleous Impetigo (70% of cases)
Topical antibiotics
B. Bulleous Impetigo (5mm lesions)
Oral flucloxacillin
Rubella
- Pres and Mx
Rubella S&S
- Red rash progresses from ears to body
- Head and neck lymphadenopathy
- Fever, cough, aches
Rubella Mx
- Rest and fluids
- Paracetamol/Ibuprofen
Teratogenic in pregnancy
Assessing a lump (2 acronyms)
- Asymmetry
- Border
- Colour
- Diameter
- Evolution
S - Size P - Pattern E - Elevation C - Colour L - Location
S - Shape
C - Consistency
And
B - Borders
Eczema Management
- Moisturise and cover
- File nails
- Steroid creams
Face - Hydrocortisone eg. Eumovate (Clobetasone butyrate 0.05%)
Non-face - Strong creams eg. Betnovate (Betamethasone valerate 0.1%)
Palms and soles - Potent eg. Dermovate (clobetasol propionate 0.05%)
RAPRIOP
- Reassure
- Advise
- Self-help
- Prescribe
- Life-style?
- Refer
- eg. Diabetic nurse/PT/OT/Prism
- Investigate
- Observe/follow-up
- Prevention
- Flare-ups/attacks
- Wholistic eg. BP/Rubella
- Rescue
- eg. Steroid + Antibiotics
Varicose veins
- Mx
- Lifestyle
- Weight loss and exercise
- Leg elevation - Compression
- Bandage
- Stockings - Phlebectomy
- Stab avulsion of portions of vein - Foam sclerotherapy
- Foamed solution (eg. Sodium tetradecyl sulphate)
- Compression of vein - Endovenous thermal ablation
- Radiofrequence ablation (RFA) of great saphenous
- Laser therapy (EVLT) under USS guidance - Surgery
- Stripping and ligation
- Stenting or reconstruction if obstructed
Varicose veins
- Ix
Varicose vein investigation
- ABPI
- Ankle-brachial pressure index
- Check for PAD - Doppler ultrasound
- Valve closure time
Diarrhoea
- Classification by time
Diarrhoea
<14 days
- Acute
> 14 days
Persistent
> 4 weeks
Chronic
Diarrhoea
- Differentials
Diarrhoea DDx
- Viral
- Rotavirus
- Norovirus
- Enteric adenovirus - Bacteria
- Campylobacter
- Shigella
- Salmonella
- E Coli
- Clos dif
- Staph - Medication
- IBS
- IBD
Rotavirus
- Hx
Rotavirus Hx
- Children from day care
- Immunocompromised
- Fever
- V&D
- Watery
- Yellow
- No blood/mucous
Norovirus
- Hx
Norovirus Hx
- Shellfish, prepared food, salad
- Nausea and abdo pain
- D&V
- Watery (no b or m)
- Moderate - Malaise, myalgia, headache
Viral Gastroenteritis
- Mx
Viral Gastroenteritis Mx
- Oral fluids
- IV if severe dehydration
[2. Anti-emetic
- Odansetron or cyclizine - Anti-diarrhoeal
- Loperamide]
Acute Food Poisoning
- Unknown Path Mx
Food Poisoning Mx
- Oral fluids
- IV if severe dehydration
[2. Anti-emetic
- Odansetron or cyclizine - Anti-diarrhoeal
- Codeine if no fever] - IBx
- Ciprofloxacin
- Erythromycin
- Metronidazole
- Co-Amoxiclav
Acute Food Poisoning
- Known Pathogens Mx
Acute Food Poisoning Mx
- Shigella
- Fluoroquinolone (cipro)
- Cef or azithro - Salmonella
- Cipro
- Trimeth/sulfamethoxazole - Shiga EHEC
- No ABx
- NB HUS - EC non-shiga
- Cipro
Camyplobacter
- Cipro or erythro
Simple UTI
- Mx
UTI Mx
Severe:
Dysuria+Nocturia+Cloudy-urine
+Positive Dip
3 Day course of ABx:
- Nitrofurantoin
- eGFR>45 - Trimethoprim
- low risk of resistance
Mild:
Dysuria OR nocturia OR cloudy
+Negative dip
UTI >65
- Mx
UTI >65
Severe Sx:
Dysuria
or Temp/Frequency/Incontinence
Delirium/Suprapubic pain/VH
- Immediate Antibiotics
- 3 Days
Mild:
(Same Sx)
- Back-up ABx
- Safetynetting
EBV
- Mx
EBV Mx
- Supportive
- Prednisolone
- Upper airway obstruction
- Haemolytic anaemia - IVIG
- Thrombocytopaenia
Orbital cellulitis
- S&S
Orbital cellulitis S&S
- Recent sinus infection
- Red, swollen eye
- Ocular pain
- Decreased vision
- Proptosis
- Oedema
Orbital cellulitis
- Mx
Orbital cellulitis
- Admit
- IV ABx
- Cefotaxime
- Clindamycin
- Cefuroxime + Met - Decongestant
- Ephedrine drops - Surgery
- Canthalotomy
- Orbitotomy and drainage
Scabies
- Mx
Scabies Mx
- Permethrin topical
- Wash after 12 hrs - Repeat in 14 days
- If still live mites
Scabies
- Hx
Scabies Hx
- Infants or Older people
- Overcrowding
- Itching close contacts
- Generalised pruritis
- Worse at night - Burrows
- Papules, vesicles, excoriations
