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y3 gp > Minor illnesses > Flashcards

Minor illnesses Flashcards

1
Q

What virus is fifth disease/erythema infectiousm caused by?

A

Parvovirus B19

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1
Q

What is a severe complication of fifth disease?

A

Aplastic crisis

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2
Q

What are childhood exanthems?

A

Skin rashes commonly associated with viral infections in children

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3
Q

What bacteria is Scarlet fever caused by?

A

Strep A

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4
Q

What is the management of scarlet fever?

A

10 day course of Penicillin V.
Phenoxymethylpenicillin.

If penicillin allergy then clarithromycin for 10 days (macrolide)

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5
Q

What virus causes chicken pox?

A

Varicella Zoster

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6
Q

How do you treat chicken pox?

A

conservative

keep cool, trim nails
calamine lotion
school exclusion: NICE Clinical Knowledge Summaries state the following: Advise that the most infectious period is 1–2 days before the rash appears, but infectivity continues until all the lesions are dry and have crusted over (usually about 5 days after the onset of the rash).
immunocompromised patients and newborns with peripartum exposure should receive varicella zoster immunoglobulin (VZIG). If chickenpox develops then IV aciclovir should be considered

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7
Q

What was the use of chicken pox parties?

A

Chicken pox is deadly as an adult.
Convenient to do the parties in the holidays.

Chicken pox parties were popular in the pre-vaccine era as a way to make sure your child was infected with chickenpox at a young age when the infection would more likely be mild and not lead to serious complications. However, now it is recommended by the Centers for Disease Control and Prevention that all children receive the vaccine to prevent chickenpox at 12-15 months with a booster at age 4.

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8
Q

What are some rare side effects of chicken pox?

A

Chicken pox pneumonitis and encephalitis

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9
Q

What is common from chickenpox?

A

Chicken pox scarring

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10
Q

What do you do when a pregnant lady tells you she has been exposed to chickenpox?

A

Check her immunity- antibody test. Antibodies are IgG. Implies previous exposure and memory antibodies. IgM= active infection. Look to give them varicella immunoglobulins if they have no immunity.

If you have had chickenpox then your child is safe.

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11
Q

How does shingles present?

A

Shooting/electrical pains that present before the rash. Can be mis-diagnosed as ischemic pain.

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12
Q

Ramsay-hunt syndrome

A

Inflammation of the facial nerve, it can have eye involvement.

Caused by the varicella-zoster virus

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13
Q

Why is Rubella part of a pre-conception test?

A

It can cause congenital malformations in an unborn child.

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14
Q

What is Conjunctivitis?

A

Inflammation of the conjunctival membrane. Usually a viral infection, referred to as a gritty feeling.

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15
Q

What is a stye?

A

Infected, painful eyelash follicle, red with a white punctum

Different from a Meibomian cyst which is deeper within the lid, painless and is a blocked duct.

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16
Q

What advice would you give someone with conjunctivitis?

A

It’s contagious, prescribe eye drops. Self-limiting.

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17
Q

What eye drops do you prescribe in conjunctivitis?

A

Chloramphenicol (broad spectrum antibiotics)

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18
Q

What is marsupilisation for a stye?

A

Making a hole in the duct to help drain it.

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19
Q

What is the mnemonic to treat a sprain?

A

PRICE
Protection- use a support, lace up shoes
Rest
Ice
Compression
Elevation-

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20
Q

What is the mnemonic of what to avoid after a sprain?

A

HARM
Heat
Alcohol
Running
Massage- increases bleeding and swelling

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21
Q

With a sprain, what would make you consider a referral to orthopaedics?

A

Recovery is slower than expected
There are worsening or new symptoms
Symptoms are out of proportion to the mechanism or degree of trauma

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22
Q

What would make you think about compartment syndrome?

A
  • Deep constant poorly localised pain
  • Aggravated by passive stretch of muscle group
  • Paraestheisa
  • Swollen and shiny skin
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23
Q

What is the analgesia for a sprain?

A

1st line= paracetamol of a topical NSAID
Oral NSAID

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24
Q

What is the most common ligament affected in ankle sprains?

A

Lateral collateral ligament. Once torn, generally tends to heal with scar tissue making them more prone in the future.

Physio is not easy to get in Leicester and most patients have to manage at home.

So important that once the swelling has subsided- start mobilizing appropriately. Try and get back function and strength.

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25
Q

How can you determine whether a patient needs an x-ray after an MSK injury?

A

Whether they can weight bear or not. IF they can, likely it’s not fractured.

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26
Q

What are possible causes for apthous ulcers?

A
  • Anxiety
  • Local trauma
  • Autoimmune conditions
  • Iron/folate/B12 deficiency
  • Smoking cessation
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27
Q

What is your advice/management for mild apthous ulcers

A

Bonjela, topical anesthetic and reasurrance.

IF severe pain- topical corticosteroid.

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28
Q

When should you suspect malignancy in an apthous ulcer?

A

Appears for more than 3 weeks, grows outwards, cervical lymphadenopathy, chewing tobacco, smoking.

Betel nut- Asian community. Postprandial.

Painless ulcer.

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29
Q

What is the difference between nits and headlice?

A

Nits are the eggshells and the lice are bigger.

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30
Q

How is headlice spread?

A

Sharing combs, towels and head to head contact.

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31
Q

How do you diagnose an active infection of headlice?

A

If there is a live louse. Detecting combing is the best way to find out.

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32
Q

How do you treat headlice?

A

Physical insecticide
Traditional insecticide
Wet combing

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33
Q

What is a physical insecticide treatment for head lice?

A

Dimeticone- apply to hair for 8 hours adn wash off. Repeat 7 days later to kill any that have hatched since. It creates a physical barrier and suffocates any lice.

34
Q

What are some side effects of Malathion?

A

Traditional insecticide for head lice. Can irritate the scalp in children.

35
Q

What is general advice for head lice?

A

Children can still attend school
No evidence that head lice prefer either clean or dirty hair
No need to treat clothing or bedding. Only live 1-2 days off a head.
Not possible to prevent head lice infestation.
Children of primary school age should be examined regularly at home using a detection comb.

36
Q

What is the risk of alcohol based treatments for head lice?

A

Alcohol based treatments are flammable. If there are smokers in the house, children hair can catch fire.

37
Q

What is Scabies?

A

Caused by mites which burrow into the skin and lay eggs which then hatch, this causes an inflammatory response which casues the itching.

38
Q

What should you do about bedding with scabies?

A

Wash at 60 degrees, dry cleaning (hot temp) or seal in bag for 72 hours.

39
Q

Why should you avoid scratching with scabies

A

Secondary bacterial infections

40
Q

What cream should you prescribe for adults and children with scabies?

A

Permethrin 5% cream

41
Q

Where should you apply Permethrin cream for scabies?

A

Between fingers and toes, under nails, wrists, armpits, external genitalia, breasts and buttocks.

42
Q

What is important to note about the cream used for scabies?

A

Flammable

It can cause itching so commonly prescribed with an anti-histamine

43
Q

What is a nappy rash?

A

Inflammation of a baby’s skin caused by prolonged contact with a damp nappy
Scaly dry skin, itchy or painful bottom, red or raw patches on baby’s bottom

44
Q

What are causes of nappy rash

A

Nappy rubbing
Allergic reaction to soap
Contact with faeces for a prolonged time.

45
Q

What are some do’s with nappy rash?

A
  • Change dirty nappies regularly
  • Keep skin clean and dry
  • Use highly absorbent nappies
  • Leave nappies off when possible
  • Make sure nappies fit properly
  • Clean baby’s skin with water of fragrance free lotions
46
Q

How can you treat nappy rash?

A

If mild and asymptomatic- sudocream

If inflamed- topical hydrocortisone
candida- Clotrimaozle and miconazole

Bacterial- flucloxacillin

Air exposure is the most important thing.

47
Q

What is plantar fasciitis?

A

Persistent pain associated with degeneration of the plantar fascia because of repetitive microtears

48
Q

What is the pain pattern of plantar fasciitis?

A

Initial gradual onset of heel pain, intense pain during the first steps after waking or inactivity.
Pain reduces with moderate activity but then worsens

49
Q

How can you manage plantar fasciitis?

A

Try to rest the foot as much as possible
Wear shoes with good arch support
Avoid walking barefoot
Simple analgesia
Self exercises to stretch the plantar fascia
Apply ice packs for 15-20 minutes

50
Q

What is a surgical management of plantar fasciitis?

A

Consider referral to orthopaedic surgeon for surgical division of the plantar fascia/extracorporeal shockwave therapy.

51
Q

What are the two most common bacteria that cause impetigo?

A

Staphylococcus aureus or Streptococcus pyogenes.

52
Q

How should Impetigo be managed?

A

Hydrogen peroxide
Fusidic acid

53
Q

What advice should you give regarding children starting back in school with Impetigo?

A

Children should be excluded from school until the lesions are crusted and healed or 48 hours after commencing antibiotic treatment.

54
Q

What practical advice should be given to their parent in terms of the management plan for impetigo?

A

Good hand hygiene
Avoid scratching
Keep nails short
Clean and disinfect items

55
Q

What are some common causes of insect bites?

A

Midges, gnats, mosquitoes, flies, fleas, mites and ticks.

56
Q

Advice for avoiding insect bites when outside?

A
  • Wear insect repellent
  • Avoid brightly coloured clothes, cosmetics, perfumes
    -Don’t lie directly on the grass- use a blanket.
57
Q

With an insect bite, when should you advise the patient to seek urgent medical advice?

A

Systemically unwell, high grade fever, drowsiness, reduced oral intake, reduced urine output, difficulty breathing- as in some cases an infection of the bite can lead to sepsis and cellulitis.

58
Q

How should you treat an insect bite?

A
  • Wash skin with soap and water to decrease the chance of infection
  • Antihistamines
  • Hydrocortisone cream
59
Q

How can you reduce scratching in children?

A

Cut the child’s nails

60
Q

What is key about immunity with chicken pox and shingles?

A

You can catch chicken pox from shingles, but you cannot catch shingles from chicken pox.

61
Q

What dermatological feature is diagnostic in chickenpox?

A

Vesicles

62
Q

When do shingle vaccinations start?

A

65 and above

63
Q

Why is it more important to treat shingles in the elderly than younger?

A

Elderly patients are more likely to have neuralgic pain

64
Q

How does a shingles rash present?

A

Vesicular rash along a dermatome

65
Q

What is hypopyon?

A

Pus in the anterior chamber of the eye

66
Q

Most common organism causing ear drum inflammation?

A

Haemophilus influenzae

67
Q

How do you treat tonsilitis caused by Strep A?

A

Penicillin V for 5-10 days

68
Q

What is the relationship between strep and rheumatic heart disease?

A

Untreated strep throat can lead to rheumatic heart disease

69
Q

What is the difference between strep pyogenes and strep A?

A

They are the same thing

70
Q

How do you empirically treat a tonsillar abscess?

A

Penicillin and Cephalosporin

71
Q

In UHL, what is the 1st and 2nd line for an uncomplicated LUTI in non-pregnant woman?

A

1st= Nitrofurantoin for 3 days

2nd= Trimethoprim for 3 days

72
Q

When do you do a monospot test for EBV?

A

Antibody test in the second week when they are ill.

73
Q

What should you tell your patient if they are infected with EBV?

A

Avoid contact sports for the first month when infected due to a risk of splenomegaly.

74
Q

What is Imodium?

A

Loperamide

75
Q

How can you remember that Ramsay-hunt syndrome is inflammation of the facial nerve?

A

Ramsay
Gordon Ramsay
Idiot Sandwich
He holds two pieces of bread on her cheeks- face
Facial nerve

76
Q

What is the difference between infectious mononucleosis and streptococcal sore throat?

A

Posterior cervical lymphadenopathy in IM and anterior in SS

Splenomegaly is associated with IM not SS

77
Q

What is the paul bunnel test?

A

Heterophil antibody test sensitive but not specific for IM, the causative Ebstein-Barr virus. False positives results can occur with other viruses and leukaemia.

78
Q

Why do patients with infectious mononucleosis get a rash when prescribed amoxicillin?

A

In infectious mononucleosis (IM), the immune system is sensitized to certain antigens, including those from the Epstein-Barr virus (EBV).

Amoxicillin, an antibiotic commonly used to treat bacterial infections, contains a structure that can be mistaken for EBV antigens, leading to an allergic reaction.

This allergic reaction can manifest as a rash, particularly in patients with a history of penicillin allergies.

79
Q

Why do you need to be careful with prescribing NSAIDs for patients with chickenpox?

A

Increases the risk of necrotizing fascitis
NSAIDs may increase the risk of necrotising fasciitis in patients with chickenpox due to their immunosuppressive effects, masking of infection symptoms, and potential association with promoting the growth of bacteria like Group A Streptococcus.

80
Q

What antibiotics are associated with clostridium difficile?

A

Broad spectrum antibiotics
Penicillin V
Co-Amoxiclav
Clindamycin
Ciprofloxacin
Cefuroxime

81
Q

What toxins are associated with clostridium difficile?

A

Toxins A and B

82
Q

What is the first line treatment for head lice?

A

Dimeticone 4%

The most important element of treatment is Dimeticone 4% (alternative spelling, Dimethicone). This can come in a lotion or spray that is applied once weekly for 2 doses; rub into dry hair and scalp, allow to dry naturally and shampoo after minimum 8 hours. The product sticks to the live lice and suffocates, yet it does not successfully kill the eggs therefore two doses are required one week apart to complete treatment.

83
Q

What is the second line treatment for headlice?

A

Malathion 0.5% is second line for treatment of headlice. It can be used as an alternative to Dimeticone 4% yet evidence suggests lower success rates.

y3 gp (13 decks)

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