Minor Illnesses Flashcards

1
Q

Give 5 features of acute bronchitis infection which indicate need for abx

A
  • co morbidity eg asthma, copd, bronchiectasis, immunosurpression
  • extremes of age
  • crackles on auscultation
  • deranged obs (high temp. RR, HR etc)
  • purulent sputum
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2
Q

How are viral upper resp tract infections managed?

A
  • no abx needed
  • advise may take 2-3 weeks to resolve
  • advise good hygiene
  • steam inhalation
  • vaporub
  • lozengers
  • cough medicines (no evidence for or against use)
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3
Q

What most commonly causes an upper resp tract infection?

A

rhinovirus and coronavirus mostly, can also be influenza, adneovirus etc

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4
Q

Describe the symptoms of a lower UTI

A
  • frequency
  • urgency
  • polyurea
  • pain on urination
  • haematuria
  • suprapubic tenderness
    If have 3 -empirical abx without need for dipstick
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5
Q

Give 3 risk factors for a UTI

A
  • female
  • catheters
  • abnormal anatomy (duplex ureters etc)
  • antibiotic use
  • sexually active
  • diabetes
  • immunocompromised
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6
Q

What results on a urine dip indicate a uti is present (3)

A
  • cloudy urine
  • nitrites
  • leukocyte esterase
  • blood
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7
Q

When should a urine sample from a suspected UTI not be sent for MSU?

A

Non pregnant woman of child bearing age, who hasnt already been tried with empirical antibiotics

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8
Q

When should you refer someone for cystoscopy or imaging due to a UTI?

A
  • persistantly not responded to treatment
  • visible haematuria
  • women with recurrent infections who are not responding to preventative measures
  • men with two or more episodes in three months
  • infant<3 months
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9
Q

What is management for uncomplicated UTI

A

pain relief

nitrofurantion (trimethoprim has lots of resistance) 3 days in females 7 in males

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10
Q

What is first line therapy for mild pyelonephritis

A

7-10 days ciprofloxacin

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11
Q

What is treatment option for recurrent UTIs with no structural abnormalities

A

if associated w/ sexual intercourse- low dose trimethoprim within 2 hrs
if not, low dose trimethoprim or nitro daily

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12
Q

What signs are concerning in UTI?

A
  • delirium
  • high fever
  • loin pain
  • N+V
  • sepsis red flags
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13
Q

State the factors which score a point on the fever pain score and when are abx indicated?

A
  • fever
  • pus on tonsils
  • attend within 3 days of symptom onset
  • Inflammed tonsils
  • No cough or coryza
    Score> 2-3= delayed abx, score > 4 = immediate abx
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14
Q

What is major complication of tonsilitis

A

Peristonsilar abscess (cannot open mouth, drooling, foul breath, hot potato voice, uvula deviation. high risk of necrotising fascitiis, airway compromise, aspiration)

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15
Q

What abx is reccommended in bacterial tonsilitis

A

phenoxymethylpenicillin (penicillin v)

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16
Q

Which abx is used in acute bronchitis, if abx are indicated?

A

amoxicillin

17
Q

How is community aquired pneumonia assesed? which abx is first line?

A

CURB 65

amox/ doxy

18
Q

What abx are indicated for treating UTIs in pregnancy

A

1st tri= nitro
2nd= nitro or trimeth
3rd= trimeth

19
Q

How does conjunctivitis present?

A

red eye
bilateral
gritty feeling
discharge- watery, purulent, sticky

20
Q

What are red flags for red eye? (6)

A
  • marked pain, photophobia, PMH autoimmune conditions (uveitis)
  • marked redness in one eye
  • reduced acuity (retinal involvement, uveitis. glaucoma)
  • hazy cornea, extreme pain, N+V w/ pain (glaucoma)
  • Rashes (herpes zoster ophthalmicus)
  • trauma (mechanical or chemical)
  • possible foreign body (invert eyelid)
21
Q

What viruses commonly cause conjunctivitis?

A
  • adenovirus
  • herpes simplex virus
  • herpres zoster ophthalmicus
  • chlamydia (in neonates)
22
Q

What bacteria commonly cause conjunctivitis? What symptoms point towards bacteria over virus

A

Staph species, strep pneumonia, haemophilus influenzae

Thick purulent discharge, mild photophobia (more severe= more likely viral), bilateral,

23
Q

How is bacterial conjunctivitis managed?

A

Self limiting
Seek medical attention if not resolve in 2 weeks, eye pain, photophobia, loss of acuity
Lubricant OTC eyedrops
Avoid others
Remove contacts until 24 hrs after resolved
Topical abx (chloramphenicol) if not resolved or severe

24
Q

What are the red flag symptoms of dyspepsia/ indigestion? (4)

A
  • unintentional weightloss
  • recurrant vomiting
  • dysphagia
  • evidence of GI bleeding (anaemia, coffee ground vomit, malaena)
25
Q

How should dyspepsia be investigated?

A
  • consider FBC
  • consider barium swallow to look for hiatus hernia
  • consider H pylori test
26
Q

What things precipitate GORD? (5)

A
  • increase intra abdo pressure
  • alcohol
  • smoking
  • fat
  • coffee
  • pregnancy
  • tight cloths
  • NSAIDS
  • hiatus hernia
  • big meals
  • lying down soon after meals
  • anxiety and stress
    REDUCE THESE THINGS FIRST BEFORE USING DURGS
27
Q

What pharmacological treatment options are available for GORD

A
  • antacids (gaviscon)
  • Histamine antagonists (ranitidine)
  • PPI (omeprazole)
28
Q

How is H. pylori treated?

A

PPI + amoxicillin + metronidazole

29
Q

What medicines may precipitate GORD?

A

Alpha-blockers, anticholinergics, aspirin, benzodiazepines, beta-blockers, bisphosphonates, calcium-channel blockers, corticosteroids, nitrates, nonsteroidal anti-inflammatory drugs (NSAIDs), theophyllines, and tricyclic antidepressants

30
Q

Give 5 scenarios/ presentations where MSK injury needs immediate referral to A&E? (up to 9)

A
  • fracture
  • dislocation
  • nerve or circulation damage
  • tendon rupture
  • wound penetrating joint
  • known bleeding disorder
  • signs of septic arthritis
  • IM haematoma
  • tear of > half of muscle belly
31
Q

What is 1st and 2nd line pain relief for sprains and strains?

A

1st- paracetamol and topical NSAIDS

2nd- codeine oral NSAID (ibuprofen or naproxen)

32
Q

What is the PRICE management strategy for sprains and strains?

A

Protection (supports or straps)
Rest (avoid activity for 48-72 hrs after)
Ice (20 mins every 2-3 hrs for 3 days after injury)
Compression (elastic bandage to help control swelling)
Elevation (for up to 3 days)

33
Q

What should be avoided for first 72 hrs after a sprain/strain?

A

HARM
Heat - hot and cold therapy useful after >72hrs
Alcohol- increases bleeding and swelling, slows healing
Running- may cause further damage
Massage- causes bleeding and swelling, helpful after >72 hrs

34
Q

Whats the difference between a sprain and strain?

A

sprain- ligament tear

strain- muscle tear

35
Q

When should immobilisation be used for sprains and strains?

A

sprains: only in severe sprains and for short periods
Strains: only for a few days after injury, start active mobilization after a few days if the person has pain free use of basic movements and stretch is same as contralateral muscle

36
Q

Are sprains and strains routinely referred for physio?

A

Sprains are only referred in severe injuries

Moderate strains may be considered for referral.

37
Q

When should an ankle injury be xrayed? (ottawa rules)

A
  • Pain in malleolar or midfoot regions
    AND
  • unable to weight bear immediately and in A&E
    OR
  • tenderness at base of 5th metatarsal / medial
38
Q

How are sprains graded?

A

grade 1- ligament stretched with microscopic tearing. little/ no functional loss and no instability, pt partially weight bears
2- part tear, mod- severe swelling, functional loss, mild- mod instability, difficult weight bearing
3- complete rupture, severe swelling, cannot bear weight, unstable joint

39
Q

What is a syndesmotic ankle sprain

A

a high ankle sprain of the interosseous ligament caused by dorsiflexion, eversion and internal rotation. healing takes longer than standard lateral lig sprains (>6 weeks)