OSCE - Danger Elim. Flashcards
1
Q
Mouth Ulcers danger elimination
A
Lasting longer than 3 weeks More than 5-10 at one time More than 1cm in size Failed treatment No pain Unexplained weight loss Under tongue Rash Diarrhoea
2
Q
Oral Thrush danger elimination
A
Failed medication Recurrence Painless lesions Pain/difficulty swallowing Diabetic
3
Q
Heartburn danger elimination
A
Recurrence Difficulty swallowing Regurgitation Pain radiating to arms Failed medication Long duration Increasing severity Caused by medication
4
Q
Nausea and Vomiting danger elimination
A
Lasting more than 48 hours
Children less than 2 years
Blood in vomit/stools
Chronic
5
Q
Motion Sickness danger elimination
A
Continues after journey Persistent vomiting Chest pain Headache Difficulty hearing
6
Q
Constipation danger elimination
A
Change in bowel habits for 2 weeks or longer
Weight loss
Blood in stools
Abdominal pain
OTC medication used for more than 1 week with no effect
Caused by prescribed medication
Vomiting
7
Q
Diarrhoea danger elimination
A
>24 hours in children <1yr >48 hours in children <3yrs or elderly >72 hours in older children and adults After antibiotics And vomiting Fever, high temp. Food poisoning outbreak Recent travel abroad Pregnancy Reaction to medication Blood or mucus in stools Accompanied by fever/ringing in ear
8
Q
IBS danger elimination
A
Children or pregnant women Unexplained weight loss Failed treatment Blood in stools Signs of bowel obstruction First time in elderly Patients over 55 with changed bowel habits
9
Q
Threadworms danger elimination
A
Suspected other infection Recent travel abroad Medication failure Children under 2 years Pregnancy and breastfeeding
10
Q
Haemorrhoids danger elimination
A
Lasts longer than 3 weeks Change in bowel habits Severe pain with bleeding Bleeding from back passage Abdominal pain/vomiting Weight loss, malaise Fever
11
Q
Cold and Flu danger elimination
A
Earache doesn't settle with medication Very young children Elderly Heart or lung disease, compromised immune system Persisting fever and productive cough Delirium Pleuritic-type chest pain Asthma
12
Q
Coughs danger elimination
A
Longer than 2-3 weeks Yellow, green, blood-stained sputum Croup, whooping cough Difficulty breathing/shortness of breath Persistent nocturnal cough in children Significant fever, malaise Elderly (distressing cough) Comorbidities Chest pain ADR Failed medication
13
Q
Sore Throat danger elimination
A
Longer than 1 week Recurrent infection Hoarseness for 3 weeks or more Difficulty swallowing Coloured sputum Failed medication Temperature
14
Q
Allergic Rhinitis danger elimination
A
Unclear diagnosis Wheezing and shortness of breath Tight chest Painful ear or sinuses Purulent conjunctivitis Severe symptoms not fully resolved by OTC treatment Failed medication
15
Q
Headache danger elimination
A
Severe, lasting more than 4 hours In children <12 years Previous head injury/trauma N&V Frequently recurring Location and type of pain - Across back of head Neck stiffness High temperature ADR Worse in morning then improves Drowsiness, unsteadiness, visual disturbances
16
Q
Migraines danger elimination
A
Frequent episodes >5 times a month Pain uncontrolled by OTC analgesics Sudden blinding pain Stroke symptoms Headache with stiff neck and rash Contraceptives
17
Q
Sprains and Strains danger elimination
A
Falls/bruising from ADRs Swelling, floppy Not able to put weight on it Severe pain Medication failure Recurrent falls Suspected arthritis
18
Q
Muscle Pain danger elimination
A
Severe back pain with pins and needles Severe swelling/redness Occurs after taking statins Pain in middle/upper back Extreme muscle weakness Doesn't improve with self care
19
Q
Repetitive Strain Disorder danger elimination
A
Swollen, inflamed tissue
Persistent symptoms
Changing routine doesn’t help
20
Q
Vaginal Thrush danger elimination
A
Unusual bleeding
Common recurrence - more than twice in 6 months
Under 16 years or over 60 years
Pregnancy or suspected - clear before delivery
First occurrence
Hypersensitivity to vaginal antifungals
Previous STD exposure/recent exposure
Abnormal bleeding
Blood-stained discharge
Vulval or vaginal sores, ulcers or blisters
Abdominal pain
Adverse effects of treatment
No improvement within 7 days of treatment
Immunocompromised
21
Q
Cystitis danger elimination
A
Lasting longer than 3 days Blood in urine Pain in side, tenderness Fever, N&V Male Recurrent cystitis Pregnancy Children Abnormal vaginal discharge Failed medication
22
Q
Dysmenorrhoea (Period Pain) danger elimination
A
Irregular periods Thick or odorous discharge Normal pattern of periods changes Heavy period or severe pain Pain during sex Pain with late period Severe intermenstrual pain and bleeding Fever Medication failure
23
Q
Insomnia danger elimination
A
Suspected depression Chronic problem (longer than 4 weeks) Children under 16 years Snoring, sleep apnoea, restless legs Associated physical conditions Suspected alcohol problems/dependency Recreational drug dependence
24
Q
Atopic Eczema danger elimination
A
Evidence of infection (weeping, crusting, spreading)
Severe eczema
Failed medication
No identifiable cause (unless already diagnosed)
No improvement after 1 week with topical corticosteroids
25
Acne danger elimination
```
Large, hard lumps
Affecting self-esteem
Severe acne
Pregnancy
First time in adult life
Signs of infection
Side effects of medication
Persistent
Red, inflamed, pustular spots
```
26
Athlete's Foot danger elimination
```
Failed treatment
Red, hot painful feet
Immunocompromised
Recurrent episodes
Diabetic
Not just affecting toes
Signs of bacterial infection
Fungal toenails
Not treated after 2 weeks
```
27
Cold Sores danger elimination
```
Lasting longer than 2 weeks
Pregnancy
Very large or painful
Immunocompromised
Babies or young children
Failure to resolve
Worsening sore
Frequent cold sores
Painless
Eczema
Affects eyes
Uncertain diagnosis
```
28
Warts and Verrucas danger elimination
```
Worried about a growth
Very large or painful
On face or genitals
Recurrence
Bleeding/change in appearance
Itching
Immunocompromised
```
29
Scabies danger elimination
```
Lasting longer than 4 weeks
Babies and young children
Crusting
Outbreak in schools/homes
Through sexual contact
Infected skin
Treatment failure
Unclear diagnosis
```
30
Dandruff danger elimination
```
Other areas of skin red and scaly - psoriasis
Severe dandruff
Scalp is red or swollen
Anti-dandruff shampoos not worked after 1 month
Severe itching
Immunocompromised
Infection signs
Treatment does not work
```
31
Hair Loss danger elimination
```
Sudden hair loss
Bald patches
Affecting wellbeing
Hair loss in large clumps
Itching/burning skin
Anaemia, hyperthyroidism
Caused by drugs
```
32
Psoriasis danger elimination
```
Severe flare ups
Joint stiffness/pain
Bleeding from psoriatic plaques
Pustular plaques
Extensive
Affects nails
No improvement of flare up within 4 weeks
Less than 50% reduction in 12 weeks
```
33
Nappy Rash danger elimination
```
Broken skin and severe rash
Unwell baby
Signs of infection
Affects other body areas
Persistent rash
Does not resolve within a month
```
34
Childhood Rashes danger elimination
```
Signs of meningitis - Stiff neck, glass test
Red-brown rash
Pink-red rash with sandpaper texture
Recurrent raised, itchy spots
Flu-like symptoms
Vomiting
Headache
Spots or bruises or rashes that do not blanch when pressed
```
35
Allergic Conjunctivitis danger elimination
Purulent discharge
Pain in the eye
Eyes sticking when waking
Vision affected
36
Infective Conjunctivitis danger elimination
```
Painful eyes
Discomfort to light
Lasts longer than 1 week
Problems with vision
Marked redness
```
37
Earwax danger elimination
History of perforated tympanic membrane
Severe hearing problems
No previous diagnosis
38
Otitis Media danger elimination
```
Children under 2 years
Pain lasts more than a few days
Restlessness
Discharge from the ear
High fever
Vomiting
```
39
Colic danger elimination
```
Vomiting
High temperature
Abnormal cry
Abnormal responses
Blood in nappy
Abnormal breathing
Rash
Grey skin
```
40
Teething danger elimination
Check for signs of other illness before determining symptoms are teething
41
Head Lice danger elimination
Eczema
Redness on scalp
Other symptoms of more serious infection (high temp., rash)
42
Indigestion danger elimination
```
>55years
Unexplained weight loss
Difficulty swallowing
Persistent or recurrent N&V
Anaemia
Lump in stomach
Blood in stools or vomit
Abdominal pain
H2 antagonist/PPI treatment failed
Associated with NSAIDs
Children
```
