Minor Illnesses Flashcards
what are symptoms of the common cold?
- sore throat
- nasal irritation, congestion, discharge
- cough
- hoarse voice
- general malaise
- (fever, headache, loss of smell/taste)
what is the management of a common cold?
- self limiting !
- adequate fluid and healthy food
- adequate rest
- paracetamol/ibuprofen if antipyretic or have headaceh
- steam inhalation/nasal drops/cough medicine/decongestants
what are the differentials for a sore throat?
- tonsilitis (viral or bacterial)
- pharyngitis
- quinsy
- influenza
- hand foot and mouth disease
what is the feverPAIN prediction score?
score one point for each - with a higher score there is more likely chance of isolating streptococcus
- fever over 38 degrees
- Purulence
- Attend rapidly (3 dyas or less)
- severly Inflamed tonsils
- No cough
what would be the idfference ebtween pharyngitis and tonsilitis?
pharyngitis -> associated with pharyngeal exudate and cervical lymphadenopathy
tonsillitis -> associated with tonsillar exudate and enlargement and erythema of tonsils with anterior cervical lymphadenopathy
what other symptoms may you have with a sore throat?
- headache, nausea, vomiting, abdo pain
- fever
what is the treatment of bacterial tonsilitis?
phenoxymethylpenicillin 500g QID for 10 days
if penicillin allergy -> clarythromycin
what is teh managment of a sore throat in primary care?
- adequeate fluid
- ibuprofen and paracetamol
- salt water gargling, lozenges
how many times a year does a patient need to have recurrent tonsilitis to be referred to ENT?
x7
what are the symptoms of acute sinusitis?
- nasal blockage
- nasal discharge
- facial pain/pressure
- reduction in sense of smell
- cough
what is teh difference between acute bacterial and acute viral sinusitis?
acute bacterial:
- symtoms for longer than 10 days
- discolored or purulent nasal discharge
- fever >38 degrees
what is the management for acute viral sinusitis?
acute sinusitis usually cuased by virus and is self limiting
- ibuprofen/paracetamol fro pain/fever
- nasal saline/decongestants
what is teh managment for acute bacterial sinusitis?
- consider high dose nasal corticosteroid (mometasone) for 14 days
- can give ‘back up’ ABX prescription (phenyoxymethylpenicillin 500mg QID for 5 days) if sypmtoms worse rapidly for pt. or do not improve within 7 days
what are the main symptoms of acute bronchitis?
- cough
- sputum
- wheeze
- breathlessness
- chest wall pain when coughing
what are teh main ysmptoms of CAP?
dsypnoea sputum production plueral pain sweating fever shivers aches pains confusion tachypnoea tachycardia
what woudl be different when examining a chest with acute bronchitis vs CAP?
CAP;: focal chest signs, decreased breath sounds, dullness to percussion, coruse crepitations, vocal fremitus
whereas acute bronchitis would jsut present with a wheeze
what is the treatment fro acute bronchitis?
- OTC cough medicine
- stop smoking
- self limiting and cough usually lasts 3-4 weeks !
- if systemically unwell then offer: oral doxycycline 200mg first day, then 100mg for 4 more days
what is the treatment for CAP?
- do CURB 65 score first (if 3 or more = hospital, if 1/2 hospital considered)
- analgesia given, adequeate fluid intake, rest
- amoxicillin 500mg TID for 5 days (or doxycycline is penicillin allergic)
when would you consider prescribing antivirals for someone with influenza?
- if patient is ‘at risk’: asplenia, chronic resp/heart/kidney/liver/ neurological disease, diabetes, immunosuppression, obesity, >65y/o, <6 months, pregnant
- the person is able to start treatment within 48 hours of onset of symptoms
which antivirals would you prescribe for influenza?
oral oseltamivir
what are the causes of acute diarrhoea?
- virus’
- bacterial: parasitic
- drugs
- anxiety
- food allergy
- acute appendicitis
- intenstinal ischaemia
what are teh causes of chronic diarrhoea?
- IBS
- IBD
- diet
- microscopic colitis
- coeliac disease
- colorectal cancer
- causes of malabsorption
- bile acid diarrhoea
- drugs