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Phase 2 - General Practice Placement > Minor Illnesses > Flashcards

Minor Illnesses Flashcards

1
Q

for how long can a cough be considered acute?

A

less than 3 weeks

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2
Q

what are the common causes of an acute cough?

A
  • URTI
  • croup
  • LRTI
  • exacerbation of asthma
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3
Q

what are the common symptoms of an URTI?

A
  • acute cough
  • +/- productive with sputum
  • +/- fever
  • feeling unwell
  • +/- wheeze
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4
Q

what are the common signs of an URTI?

A
  • pyrexia
  • irritated throat
  • no focal chest sounds on auscultation
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5
Q

how would you manage a URTI?

A
  • explain to patient this is likely a viral infection and therefore does not require antibiotic treatment.
  • advise on OTC medication, rest, and fluids
  • advise to come back if issue does not resolve or get worse
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6
Q

when would you refer a patient for a chest xray?

A
  • focal chest signs
  • suspected inhalation of a foreign body
  • suspected lung cancer
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7
Q

if a patient presents with signs of a LRTI, what would you prescribe them?

A

amoxicillin 500mg TDS

doxycycline 100mg OD

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8
Q

what is the most common organism causing a UTI?

A

e. coli

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9
Q

what are the risk factors for a UTI?

A
  • prior infection
  • DM
  • stones
  • dehydration
  • sex
  • urinary stasis
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10
Q

what are the common presentations of a lower UTI?

A
  • urinary symptoms: frequency, dysuria, urgency, cloudy, smelly urine
  • lower abdominal pain
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11
Q

what are the common presentations of pyelonephritis?

A
  • loin pain
  • fever
  • feeling unwell
  • haematuria
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12
Q

what are the differentials for a patient presenting with dysuria?

A
  • UTI
  • interstitial cystitis
  • menopause
  • tumour/ stone
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13
Q

what are the differentials for a patient presenting with frequency?

A
  • UTI
  • detrusor instability
  • external pressure (e.g. pregnancy)
  • enlarged prostate
  • drugs (diuretics)
  • fluid intake
  • DM
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14
Q

what initial investigation would you do in a patient presenting with an uncomplicated UTI?

A

urine dip

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15
Q

when would you send an MSU sample for cultures and consider further investigations?

A
  • infection unresolved post abx
  • recurrent UTI
  • man with a UTI
  • pregnant woman
  • child
  • haematuria (frank or not)
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16
Q

how would you manage a patient with an uncomplicated UTI?

A
  • increase fluid intake

- nitrofurantoin 100mg BD/3days

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17
Q

what is blepharitis?

A

chronic, low-grade inflammation of the meibomian glands and lid margins

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18
Q

how does blepharitis present?

A

long history of irritable, dry, burning, red eyes

eyelids will have red margins +/- scales on the eyelashes

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19
Q

how do you manage blepharitis?

A

long term treatment (2-3 months)

  • warm compress to open up meibomian glands
  • massage with cotton buds to move glands secretions
  • clean with tea tree oil
  • treat dry eyes with liquid tears
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20
Q

what are the red flag symptoms for a patient presenting with red eye?

A
  • decreased visual acuity
  • pain deep in the eye
  • absent or slow pupil response
  • history of trauma
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21
Q

what would you do if a patient has red flag red eye symptoms?

A

refer the patient immediately to be seen on the same day

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22
Q

how does conjunctivitis present?

A
  • unilateral/ bilateral red eye with surface irritation
  • eye discharge
  • sticking of eyelids
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23
Q

how do you manage acute conjunctivitis?

A

most are self limiting and settle within a few days

  • bathe eye in warm and cold water
  • maintain good eye hygiene (no contact lenses)
  • if not resolved give OTC chloramphenicol qds/5days
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24
Q

what is considered acute lower back pain?

A

a new episode of lower back pain <6 weeks in duration

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25
Q

what is considered chronic lower back pain?

A

back pain lasting >3 months

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26
Q

what are important associated symptoms to investigate in lower back pain?

A

numbness, weakness, bowel/bladder symptoms

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27
Q

what is important to look out for in an examination of the lower back?

A
  • any deformity (kyphosis, loss of lumbar lordosis, scoliosis)
  • check lower limbs for neurological changes and sciatica
28
Q

what does a kyphosis deformity look like and what can it indicate?

A

concaved thoracic spine indicating ankylosing spondylitis

29
Q

what does a loss of lumbar lordosis indicate?

A

acute mechanical back pain

30
Q

how do you manage a patient presenting with acute back pain?

A
  • prescribe analgesia
  • advise for bed rest
  • if not resolved in 4 weeks come back and request physio
31
Q

what are common causes of back pain in people <30 years old?

A
  • trauma
  • ankylosing spondylosis
  • prolapsed disc
32
Q

what are the common causes of back pain in people 30-50 years old?

A
  • prolapsed disc
  • discitis
  • degenerative joint disease
33
Q

what are the common causes of back pain in people >50 years old?

A
  • degenerative
  • malignancy
  • osteoporotic collapse
34
Q

what are some other common causes of back pain in people of all ages?

A
  • postural
  • cauda equina
  • referred pain
35
Q

what are the common causes of heartburn?

A
  • GORD
  • peptic ulcer disease
  • stomach cancer
  • functional dyspepsia
36
Q

true or false: functional dyspepsia is the most common cause of dyspepsia

A

true

37
Q

what are some differential diagnoses for heart burn?

A
  • cardiac pain
  • gall stone disease
  • pancreatitis
38
Q

how does a patient with heart burn commonly present?

A
  • epigastric/retrosternal pain
  • fullness, bloating
  • nausea and vomiting
  • burning sensation up the oesophagus
39
Q

what should you look at in a patient history before treating heart burn?

A
  • drugs (NSAIDs, Ca2+ blockers)

- any palpable masses (2 week wait referral)

40
Q

what do you prescribe to treat heart burn?

A

PPI - omeprazole 20mg OD for a month

41
Q

what is the next step one month PPI treatment has not helped the heartburn?

A

test for H. pylori

42
Q

what is the test for H. pylori?

A

urease breath test

43
Q

what is the treatment for H. pylori?

A

PPI - omeprazole 20mg BD

amoxicillin 1g BD and clarithromycin 500mg BD for 1 wk

44
Q

what other drugs can be given to treat heart burn?

A

H2 receptor antagonist rantidine 150mg BD

45
Q

what lifestyle advice should be given to a patient with heartburn?

A
  • smoking cessation
  • decrease fatty/spicy foods
  • decrease alcohol consumption
  • eating earlier
46
Q

what should you examine in a patient presenting with a headache?

A
  • signs of infection (fever, skin rash)
  • BP
  • neurological exam (vision, sensation, gait)
  • neck stiffness or tenderness
47
Q

what are red flags in a headache history?

A
  • fever with meningism and rash = meningitis
  • thunderclap headache = subarachnoid haemorrhage
  • recent head injury < 3months
  • papilloedema = raised ICP
  • change in cognition or personality
48
Q

what are common causes for an acute new episode headache?

A
  • meningitis
  • encephalitis
  • subarachnoid haemorrhage
  • head injury
49
Q

what are common causes for an acute recurrent headache?

A
  • migraine
  • cluster headache
  • exertional headache
  • trigeminal neuralgia
  • glaucoma
50
Q

what is the most common cause for a subacute headache?

A

giant cell arteritis

51
Q

what are common causes for a chronic headache?

A
  • tension headache
  • medication overuse
  • raised ICP
52
Q

how does a headache caused by meningitis present and how should it be treated?

A
  • fever, photophobia, stiff neck, rash

- IV/IM penicillin V and admission

53
Q

how does a headache cause by encephalitis present and how should it be treated?

A
  • fever, confusion, low GCS

- immediate admission

54
Q

how does a SAH headache present and how should it be treated?

A
  • thunder clap headache, stiff neck “worst headache ever”

- immediate admission

55
Q

how does a head injury headache present and how should it be treated?

A
  • bruising/injury, low GCS, lucid periods, amnesia

- consider admission

56
Q

how does a migraine present and how should it be treated?

A
  • aura, visual disturbances, nausea vomiting, triggers
  • acute attack: sumatriptan 50mg
  • prophylaxis: propranolol 80mg OD
57
Q

how does a cluster headache present and how should it be treated?

A
  • nightly pain in 1 eye, tearing, redness around the eye
  • refer for specialist advice and imaging
  • acute attack: sumatriptan 6mg SC and high flow O2
  • prophylaxis: verapamil 80mg TDS if attacks are frequen
58
Q

how does a exertional headache present and how should it be treated?

A
  • suggested by history of association

- NSAIDs or propranolol before attacks

59
Q

how does a trigeminal neuralgia present and how should it be treated?

A
  • intense stabbing pain lasting seconds in the trigeminal nerve distribution
  • refer to neurology if <50y and treat with carbamazepine
60
Q

how does a glaucoma headache present and how should it be treated?

A
  • red eye, haloes, loss of visual acuity, pupil abnormality

- requires regular optometry check ups to check intraocular pressures

61
Q

how does a giant cell arteritis headache present and how should it be treated?

A
  • > 50y, scalp tenderness, raised ESR, decrease in visual acuity
  • prednisolone 40-60mg OD and refer to opthalmology or rheumatology for temporal artery biopsy
62
Q

how does a tension type headache present and how should it be treated?

A
  • band around the head, stress, low mood
  • reassure no underlying pathology and to alleviate stress
  • treat with paracetamol PRN
63
Q

how does a medication overuse headache present and how should it be treated?

A
  • rebound headache on stopping analgesia
  • advise to stop overused medication abruptly for 1month
  • consider specialist referral if taking strong opioids or failed recurrent attempts to stop meds
64
Q

how does a raised ICP headache present and how should it be treated?

A
  • worse on waking/ coughing, low pulse, high BP, neurological signs
  • refer to specialist
65
Q

what are common triggers of headaches?

A 
CHOCOLATE
Chocolate
Hangovers
Orgasms
Cheese/Caffeine
Oral contraception
Lie-ins
Alcohol
Tumult
Exercise

Phase 2 - General Practice Placement (10 decks)

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