Minor Illnesses Flashcards
How does an influenza viral infection present?
Sore throat, rhinnorhea, blocked nose, fever, cough, malaise, fatigue, generalised myalgia (aches and pains). Usually resolves in 5 days - however fatigue and weakness can remain for longer
A lady calls to discuss her child. She thinks he has a throat infection. What symptoms may he present with?
Sore throat, tonsils exudate, pain on swallowing, fever.
You are a GP and are supervising students doing parallel consultations. A student confidently diagnoses acute otitis media. What would be present in the history and examination?
History - unilateral otalgia, fever, otorrhea which relieves otalgia, hearing loss. On examination -TM is erythematous and convex appearing/bulging. If sutured. pus may fill ear canal
How does a complicated UTI differ to the presentation of an uncomplicated UTI?
Complicated would be a man, child or pregnant woman. Uncomplicated only includes a woman who is not pregnant.
Describe the typical presentation of a UTI
Dysuria, nocturne, back pain, increased urinary frequency, cloudy utrine, (offensive smelling)
How would the presentation of thrush distinguish from BV?
Thrush - itchy vulva, creamy white discharge that is odourless. (cottage cheese like), dyspareunia.
BV - watery, grey discharge with a typical fishy smell. Does not cause soreness or itching in the vagina.
How does a chest infection present?
Cough - usually productive, purulent sputum, fever, dyspnea, wheeze, pleuritic chest pain.
A lady presents with numbness in her lower limbs. What symptoms/signs would you ask about to rule out cauda equina?
Saddle anaesthesia, bilateral sciatica, painless urinary retention, urinary incontinence, fecal incontinence.
A man presents with burning in his chest. What further symptoms would direct you towards a Dx of GORD?
Reflux of acid. Chest pain. Acidic taste in the mouth/oral cavity. Sore throat. Cough. Heartburn. Brought on by specific foods - alcohol, citrus fruits, coffee, spicy food
A woman attends because she wants to be put on oral contraception. You find out she does have migraines. How would these migraines present?
SITE: Unilateral - so only one side of the head. Temporal or frontal. QUALITY: Throbbing or pulsating in nature. INTENSITY: Disabling. TIME: continue for a long period of time 4-72 hrs. AGG: lack of sleep, periods, stress. REL: oral paracetamol, ibuprofen. SECSYMPT: nausea, photophobia, flashing lights, tingling, numbness, dizzy
Management to advise for a common cold?
Supportive - analgesia such as 500mg paracetamol and 200mg ibuprofen, OTC.
Fluids
Rest
Ddx for common cold presentation ?
Covid, influenza, sinus infection
Complications of common cold?
Can lead to exacerbations of asthma/copd.
Can get secondary infections - pneumonia, sinusitis, bronchitis, tonsillitis
RF for influenza?
Over 65
COPD, asthma
Weak resp muscles - in MS.
Management for viral throat infection?
Symptom relief - painkillers.
salt water gargle
Fluids
Rest
Management for bacterial throat infection
Symptom relief - painkillers. salt water gargle Fluids Rest. Safety net - no improvement within 3-7 days = may need abx If have v high fever - may need abx.
Ddx for throat infection
Glandular fever
Pharyngitis
Who is at risk of getting throat infection?
Children
Immunocompromised
Complications of throat infection?
Quinsy’s abscess (peritonsillar abscess)
Rheumatic fever
Retropharyngeal abscess
How can Quinsy’s abscess (peritonsillar) present?
Severe throat pain Fever Bad breath Drooling Hard to open mouth PMH of untreated/partially treated tonsillitis
Is tonsillitis usually viral or bacterial?
VIRAL
bacterial only make up 40% cases in GP
Complications of acute otitis media?
Glue ear/otitis media with effusion
Perforation
Facial nerve involvement
Define uncomplicated UTI
UTI in non-pregnant woman
Who is considered complicated when diagnosing UTI?
Pregnant women, men, children
Pt has uncomplicated UTI. How do you manage it?
Urine dip. Urine sample for culture and sensitivity.
3 day course 100mg nitrofurantoin
If contra = 3 day course 200mg trimethoprim
Pt has complicated UTI. How do you manage it?
7 days 100mg nitrofurantoin or 7 days 200mg trimethoprim
Ddx for dysuria, offensive smelling urine, cloudy urine, urinary frequency,
suprapubic pain, back pain.
UTI
STI
Thrush
Pylonephritis
RF for chest infection
Older patients Smoker COPD Asthma Pre-existing lung condition
Main investigation for suspected thrush?
High vaginal swab to culture for thrush
Ddx for thrush?
STI
BV
Vaginismus
RF for thrush?
Previous abx use (e.g. for recurrent UTIs)
COCP
Management for thrush?
Antifungal cream for external use.
Add fluconzole oral tablet +/or clomitrazole intravaginal pessary
Management for BV?
Metronidazole 400mg BD 7/7
Ddx for BV and importance of ruling it out?
STI
Ensure PID is prevented
Investigation for suspected BV?
High vaginal swab
Screen for STI
RF for BV?
Being sexually active
Inv for pt with D&V?
Stool sample to send off if pt has fever, blood is present in stool or pt has returned from tropical climate
Also discuss: Contact with people w symptoms Medications currently taken Other symptoms hydration status Abdominal masses/tenderness?
Management of GORD?
Lifestyle modifications
Lose weight
Avoid trigger foods
Antacids, PPIs - lansoprazole or omeprazole
Ddx for GORD?
MI/cardiac cause
Gastritis
Anxiety
RF for GORD?
Overweight, heavy NSAId use, alcohol
Complications of GORD?
Barrett’s oesophagus
Oesophageal cancer
Oesophagitis
Strictures
How does tension headache presnet?
Generalised - frontal and occipital regions
Tight band
Radiates to neck
How does cluster headache present?
Unilateral
Behind the eyes
Sharp stabbing pain
At night = v severe and intense
Triggers for tension headache?
long days, stress, lack of sleep, lack of water
Triggers for cluster headache?
Alcohol, smells, lack of sleep, warm temperature
Management for tension headaches?
Painkillers OTC Remove triggers (drink more water, sleep better, reduce stress)
Management of cluster headaches?
Oxygen
Triptans
Presentation of ankle sprain?
After trauma. Pain in joint ankle swollen slight bruising 1-2 days after injury Passive inversion is painful
A pt has a partial tear ankle sprain. How should this be managed?
RICE
Crepe bandaging and active exercise.
