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Year 3 - GP Block > Minor Illnesses > Flashcards

Minor Illnesses Flashcards

1
Q

What are the incubation and contagious periods of chickenpox?

A

Incubation: 8-28 days

Contagious: 2 days before…

Onset of symptoms

Contagious: 5 days after onset

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2
Q

Treatment of Chickenpox

  1. Child
  2. Adult
A
  1. Calpol, antihistamines, calamine lotion

2. Aciclovir

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3
Q

Fifth disease cause, presentation, and natural history?

A
  1. Parvovirus (erythema infectiosum)
  2. Slapped cheek
  3. Self-limiting
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4
Q

What are the S + S of Conjunctivitis?

A
  1. Painless red eye
  2. Discharge
  3. Gritty sensation
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5
Q

What are the three causes of conjunctivitis and their management?

A
  1. Adenovirus
    - Supportive
  2. Bacteria (unilateral and ‘gooey’) - Chloramphenicol drops
  3. Allergic - Antihistamine/nasal steroid spray
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6
Q

Chalazion vs stye cause and symptoms?

A

Chalazion: Blocked oil gland - usually painless

Stye: Infected follicle - painful

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7
Q

Chalazion/stye(hordeola) treatment?

A

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

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8
Q

What are the S+S of Orbital cellulitis?

A
  1. Pain on movement and visual disturbance

2. Systemically unwell (febrile)

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9
Q

How to manage an ankle sprain (no bony injury)

A

90% - rest and time

P rotect
R est
ICE

Analgesic ladder: Ibuprofen gel, codeine

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10
Q

What is the algorithm for an ankle injury X Ray?

A

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
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11
Q

Otitis media management?

A

3 days self-resolving
Warm compress
Paracetamol and Ibuprofen

Not resolving
Amoxicillin
Co-amoxicalv

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12
Q

Apthous Ulcer Presentation and management

A
  1. Lower lip pain
    Minor (1cm) or Major (1cm+)
  2. Avoid trigger foods/drinks
  3. Consider IBD/Celiac
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13
Q

Headlice management?

A
  1. Diagnose with finding a live louse
  2. Wet combing
  3. Chemical then insecticidal shampoos
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14
Q

Scabies
Presentation
Management

A

Highly infectious and highly itchy

  1. Reduce physical contact
  2. Wash at 50°
  3. Cream/lotion for whole body
    - Permethrin
    - Ivermectin PO
  4. Antihistamine for days of itchiness
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15
Q

Nappy Rash
Presentation
Management

A
  1. Reassure and advise to avoid nappy and tightness where possible
  2. Change nappy regularly and clean skin thoroughly
  3. OTC ointments and barrier cream/oil
  4. If severe - Steroids and antifungals
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16
Q

Heel Pain 5DDs

A
  1. Plantar fasciitis
    • Overweight 40-60 or runners
    • Medial band of fascia attachment inflammation
  2. 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
  3. Fat pad atrophy
    • Centralized pain
    • Flattened surface on palpation
    • History of landing hard on heal (obese or athletic)
  4. Calcaneal fracture
    • Diffuse, warm swelling
    • Pain on squeezing calcaneum
    • Long distance walk with heavy pack
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17
Q

Knee OA

  1. Presentation
  2. Investigations
A
  1. Pain, locking, weakness
  2. Oxford knee score
    Osteophytes and pieces in joint space
18
Q

Fever pain score features?

A
  1. Fever - in past 24 hrs
  2. Cough or coryza (inflmmation of nasal m. membranes)
  3. Aches
  4. Length - <3 days? 4-7 or 7+
  5. Glands - Cervical/inflamed/pus?
19
Q

Oral Candidias

  1. S&S
  2. Mild Tx
  3. Severe treatment
A
  1. S&S
    • Creamy white/ yellow plaques
    • Cracks, ulcers, crusted fissures in angles
    • Discharge?
  2. Mild Tx
    • Topical cream - gentian violet (1%)
    • Tablet: clotrimazole, miconazole, nystatin
  3. Severe Tx
    • Fluconazole PO 200mg
    • Posaconazole PO 100mg
20
Q

Vaginal Candidiasis

  1. S&S
  2. Uncomplicated Tx
  3. Complicated Tx
A
  1. S&S
    • Dysuria/Pruritis/Dyspareunia/Erythema
    • Discharge: White, thick, cottage cheese-like, odourless
  2. 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
  3. Complicated Tx
    • Fluconazole 150 mg PO 3/7
21
Q

Vaginitis red flags (Lichenous vs Cancers)

A
  1. Lichen
    • Pruritis, intense vulvodynia and dyspareunia
    • Violaceous, flat-topped papules/plaques
  2. 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
22
Q

‘Honey crust’ infection management

A

Impetigo (Staph A. / Strep)

  1. Off school for 2 days
  2. Hydrogen peroxide cream
  3. Abx

A. Non-Buleous Impetigo (70% of cases)
Topical antibiotics

B. Bulleous Impetigo (5mm lesions)
Oral flucloxacillin

23
Q

Rubella

- Pres and Mx

A

Rubella S&S

  1. Red rash progresses from ears to body
  2. Head and neck lymphadenopathy
  3. Fever, cough, aches

Rubella Mx

  1. Rest and fluids
  2. Paracetamol/Ibuprofen

Teratogenic in pregnancy

24
Q

Assessing a lump (2 acronyms)

A
  1. Asymmetry
  2. Border
  3. Colour
  4. Diameter
  5. Evolution
S - Size
P - Pattern
E - Elevation
C - Colour
L - Location

S - Shape
C - Consistency
And
B - Borders

25
Q

Eczema Management

A
  1. Moisturise and cover
  2. File nails
  3. 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%)
26
Q

RAPRIOP

A
  1. Reassure
  2. Advise
    • Self-help
  3. Prescribe
    • Life-style?
  4. Refer
    • eg. Diabetic nurse/PT/OT/Prism
  5. Investigate
  6. Observe/follow-up
  7. Prevention
    • Flare-ups/attacks
    • Wholistic eg. BP/Rubella
    • Rescue
      • eg. Steroid + Antibiotics
27
Q

Varicose veins

- Mx

A
  1. Lifestyle
    - Weight loss and exercise
    - Leg elevation
  2. Compression
    - Bandage
    - Stockings
  3. Phlebectomy
    - Stab avulsion of portions of vein
  4. Foam sclerotherapy
    - Foamed solution (eg. Sodium tetradecyl sulphate)
    - Compression of vein
  5. Endovenous thermal ablation
    - Radiofrequence ablation (RFA) of great saphenous
    - Laser therapy (EVLT) under USS guidance
  6. Surgery
    - Stripping and ligation
    - Stenting or reconstruction if obstructed
28
Q

Varicose veins

- Ix

A

Varicose vein investigation

  1. ABPI
    - Ankle-brachial pressure index
    - Check for PAD
  2. Doppler ultrasound
    - Valve closure time
29
Q

Diarrhoea

- Classification by time

A

Diarrhoea

<14 days
- Acute

> 14 days
Persistent

> 4 weeks
Chronic

30
Q

Diarrhoea

- Differentials

A

Diarrhoea DDx

  1. Viral
    - Rotavirus
    - Norovirus
    - Enteric adenovirus
  2. Bacteria
    - Campylobacter
    - Shigella
    - Salmonella
    - E Coli
    - Clos dif
    - Staph
  3. Medication
  4. IBS
  5. IBD
31
Q

Rotavirus

- Hx

A

Rotavirus Hx

  1. Children from day care
  2. Immunocompromised
  3. Fever
  4. V&D
    - Watery
    - Yellow
    - No blood/mucous
32
Q

Norovirus

- Hx

A

Norovirus Hx

  1. Shellfish, prepared food, salad
  2. Nausea and abdo pain
  3. D&V
    - Watery (no b or m)
    - Moderate
  4. Malaise, myalgia, headache
33
Q

Viral Gastroenteritis

- Mx

A

Viral Gastroenteritis Mx

  1. Oral fluids
    - IV if severe dehydration
    [2. Anti-emetic
    - Odansetron or cyclizine
  2. Anti-diarrhoeal
    - Loperamide]
34
Q

Acute Food Poisoning

- Unknown Path Mx

A

Food Poisoning Mx

  1. Oral fluids
    - IV if severe dehydration
    [2. Anti-emetic
    - Odansetron or cyclizine
  2. Anti-diarrhoeal
    - Codeine if no fever]
  3. IBx
    - Ciprofloxacin
    - Erythromycin
    - Metronidazole
    - Co-Amoxiclav
35
Q

Acute Food Poisoning

- Known Pathogens Mx

A

Acute Food Poisoning Mx

  1. Shigella
    - Fluoroquinolone (cipro)
    - Cef or azithro
  2. Salmonella
    - Cipro
    - Trimeth/sulfamethoxazole
  3. Shiga EHEC
    - No ABx
    - NB HUS
  4. EC non-shiga
    - Cipro

Camyplobacter
- Cipro or erythro

36
Q

Simple UTI

- Mx

A

UTI Mx

Severe:
Dysuria+Nocturia+Cloudy-urine
+Positive Dip

3 Day course of ABx:

  1. Nitrofurantoin
    - eGFR>45
  2. Trimethoprim
    - low risk of resistance

Mild:
Dysuria OR nocturia OR cloudy
+Negative dip

37
Q

UTI >65

- Mx

A

UTI >65

Severe Sx:

Dysuria
or Temp/Frequency/Incontinence
Delirium/Suprapubic pain/VH

  • Immediate Antibiotics
  • 3 Days

Mild:
(Same Sx)

  • Back-up ABx
  • Safetynetting
38
Q

EBV

- Mx

A

EBV Mx

  1. Supportive
  2. Prednisolone
    - Upper airway obstruction
    - Haemolytic anaemia
  3. IVIG
    - Thrombocytopaenia
39
Q

Orbital cellulitis

- S&S

A

Orbital cellulitis S&S

  1. Recent sinus infection
  2. Red, swollen eye
  3. Ocular pain
  4. Decreased vision
  5. Proptosis
  6. Oedema
40
Q

Orbital cellulitis

- Mx

A

Orbital cellulitis

  1. Admit
  2. IV ABx
    - Cefotaxime
    - Clindamycin
    - Cefuroxime + Met
  3. Decongestant
    - Ephedrine drops
  4. Surgery
    - Canthalotomy
    - Orbitotomy and drainage
41
Q

Scabies

- Mx

A

Scabies Mx

  1. Permethrin topical
    - Wash after 12 hrs
  2. Repeat in 14 days
    - If still live mites
42
Q

Scabies

- Hx

A

Scabies Hx

  1. Infants or Older people
  2. Overcrowding
  3. Itching close contacts
  4. Generalised pruritis
    - Worse at night
  5. Burrows
  6. Papules, vesicles, excoriations

Year 3 - GP Block (13 decks)

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