OTC Flashcards
1
Q
When to refer pt who has vaginal thrush?
A
Yellow green discharge More than 2 attacks in the past 6 months First occurance of symptoms Pregnancy Previous history of STD Under 16 or over 60 Blood Lower abdominal pain No improvement within 7 days of treatment
2
Q
Treatment of vaginal thrush?
A
Clotrimazole pessary or cream or combo Fluconazole caps (for males as well if gf has thrush)
3
Q
Counselling points on vaginal thrush?
A
Oral treatment may take 12-24hrs Treatment of sexual partner with cream to apply to the penis is recommended Avoid nylon underwear, wear cotton Loose fitted clothes Avoid deodorants and perfumes
4
Q
When do pts with mouth ulcers need to be referred?
A
If longer than 3wks. Need to referred urge tly to a specialist to exclude oral cancer
5
Q
Treatment of oral ulcers?
A
Feirst line: Topical corticosteroids, hydrocortisone muco adhesive tavs should be allowed to dissolve in contact with ulcer QDS
Can combine with local analgesics like benzydamine
Choline Salicylate gel like bonjela can be applied 3hrly max 6 times a day to avoid Salicylate poisoning
Antiseptics like chlohexidine (can stain teeth so brush teeth after)
Max 14 days to prevent iodine absorption
6
Q
Licensing age of benzydamine mouthwash?
Benzydamine spray?
A
12 plus
6 plus
7
Q
Constipation accompanied by weight and appetite loss may indicate?
A
Carcinoma
8
Q
Constipation with weight gain, Lethargy, coarse hair or dry skin suggests?
A
Hypothyroidism
9
Q
Examples of drugs that can cause constipation?
A
Opioids Clozapine Antimuscarnics SSRIs TCAs Iron Bendroflumethiazide Propranolol Aluminium CCB
10
Q
Licensing age of isphagula husk?
A
6 plus
11
Q
Licensing age of Bisacodyl?
A
10 plus
12
Q
Licensing age of macrogol?
A
12+
13
Q
Licensing age of Docusate?
A
12+
14
Q
What is Docusate?
A
Stool softener
15
Q
Practical tips on constipation?
A
Plenty of fluids and fibrr
Reduce caffeine
Increase exercise
16
Q
Referral of diarrhoea?
A
Babies under 3 months is immediately
Children under 1 if longer than a day
Children under 3 if longer that 2 days
People with diabetes if longer than 1 day
Adults and children if longer than 3 days
N&V and fever all increase the risk of dehydration
Signs of dehydration
Change in bowel habit for over 50 with concurrent weight loss
17
Q
Signs of faecal impaction?
A
Alternating constipation and diarrhoea
18
Q
Drugs that can cause diarrhoea?
A
Theophylline Metformin Lithihm SSRIS NSAIDS antibiotjcs Ciclosporin Digoxin Magnesium Diuretics Iron
19
Q
What’s the drug group of magnesium hydroxide as a laxative?
Licensing age
A
Osmotic
6+
20
Q
Signs of dehydration?
A
Dry skin Sunken eyes Dry tongur Drowsiness Less urine Weakness Cold hand and feet
21
Q
Management of diarrhoea?
A
First line is oral rehydration therapy for all ages
(make up with water and taken after each loose stool, keep in fridge for 24hrs)
Second line is loperamide for 12 plus non pregnant or bf women
22
Q
What drugs need to be temporarily withheld during diarrhoea? And why?
A
ACEi NSAIDs Diuretics Metformin To prevent AKI
23
Q
About babies food and diarrhoea?
A
Formula feeds for babies should be diluted to quarter strength and built back up to normal over 3 days.
During period of diarrhoea, babies should be fed more frequently than normal and feeds supplemented with ORT
24
Q
What drugs can cause the symptoms of indigestion and heartburn?
A
TCAs
CCBs
NSAIDS
Caffeine
25
When to refer with indigestion and heartburn?
```
Children
Over 55 with new symptoms
ALARM
Previous ulcers
Taking antidispepsia for 4wks but no Chnage
Pts with liver disease
```
26
Drugs that has alginates?
Gaviscon
27
OTC licensing on ranitidine?
over 16 years (provided packs do not contain more than 2 weeks’ supply, (max. single dose 75 mg, max. daily dose 300 mg).
28
Important PPI interaction?
Increase conc of
Warfarin
Phenytoin
Diazepam
29
Which PPI can be sold OTC?
Omeprazole
| Esomeprazole
30
OTC licensing of omeprazole and esomeprazole?
O= 10 mg for over 18 years, max. daily dose 20 mg for max. 4 weeks, and a pack size of 28 tablets.
E= 18 plus for 2wks
31
Common side effects of H2 receptor antagonists?
Headache
Dizziness
Diarrhoea
Skin rash rare
32
Common side effects of PPIs?
```
Headache
Abdominal pain
Constipation
Diarrhoea
Flatulence
N&V
```
33
What antacids are recommended for preg women, elderly and hypertention pts with heartburn?
A sodium free or low sodium antacid containing an alginate
34
When to refer with IBS?
Children
Adult over 45 presenting with symptoms for the first time
ALARM
Fever
Rectal bleeding may indicate IBD, gastric ulcer or carcinoma
If not had IBS diagnosed, refer them
35
Lifestyle advice on IBS?
```
Exercise
Increase fluid intake
Increase fibre
Low fat and caffeine
Avoid smoking and alcohol
```
36
Pts taking what drugs need to be referred when selling orlistat?
```
Ciclosporin as can decrease conc.
Warfarin
Oral Anticoagulants
Amiodaronee
Acarbose
```
Caution
Orlistat can reduce the effectiveness of oral contraceptives
Can reduce levothyroxine
37
Age licensing of Topical corticosteroids for haemorrhoids?
Plus 18
38
Another name for mouth ulcers?
Aphthous ulcers
39
When to refer mouth ulcers?
```
Persist longer than 3wks
Ulcers bigger than 10mm in diameter
More than 5
Weight koss
Recurrent diarrhoea
```
40
What drugs can cause mouth ulcers?
```
Nicorandil
NSAIDS
Cytotoxic drugs
Sulfasalazine
Herbal remedies like feverfew
```
41
What can contribute to developing oral ulcers?
Deficiency of iron, folate, zinc or vit B12
42
What local analgesics can be used in oral ulcers?
Benzydamine
| Choline Salicylate
43
Licensing age of Choline Salicylate
| And its contra indication?
It's for 16+
| Those taking methotrexate and Anticoagulants
44
What can Untreated gingivitis lead to?
Gingivitis is gum disease
| Leads to periodontitis which includes bad breath (halitosis), unpleasant taste in mouth, loose teeth, gum abscesses
45
When to refer with gingivitis?
```
When it is acute necrotising ulcerative gingivitis
Symptoms include
Bleeding, painful gums
Painful ulcers
Receding gums between teeth
Bad breath
Metallic taste in mouth
Excess saliva in mouth
Dysphagia
Fever
```
46
Management of gingivitis
Good oral hygiene
47
When to refer pts with oral thrush?
Recurrent infection
| Symptoms unresponsive to treatment
48
Treatment of oral thrush?
Miconazole (Daktarin oral gel) applied to plaques QDS after food.
49
Age restriction on miconazole 2% cream
4 months plus
50
Miconazole gel and breast feeding?
Reinfection from mother's nipples during BF or from contaminated bottles might happen so warn
Use is safe in P and BF
51
Treatment duration of miconazole for oral thrush?
Continued for at least 1wk after sympt. S have disappeared
52
When to refer pts with cold?
Under 2 have increased risk of contracting pneumonia so refer if more unqell than normal with SOB,cyanosis
Earache not resolving with Analgesia (most resolve self limitingly within 3 days)
Long term conditions like COPD, asthma, kidney, diabetes, compromised immune system
53
Names of oral decongestants?
Pseudoephedrine
| Phenylephrine
54
MoA of pseudoephedrine?
Constructs blood vessels
55
restriction on pseudoephedrine?
6yrs plus for 5 days
56
Who nerds to avoid pseudoephedrine ad ephedrine?
```
Hypertensive pts
DM
Bbs
MAOIs
Preganant (BF safe)
```
57
Age restriction on phenylephrine?
12yrs plus
58
What is oxymetazoline?
Decongestant
59
Age restriction on oxymetazoline?
12 plus
60
Age restriction on xylometazoline?
6 plus
61
What's diphenhydramine and why is it usdd in cold?
An antihistamine
| Relieves runny nose and sneezing by anticholinergic effect
62
Age restriction on diphenhydramine?
6 plus
63
Who needs to avoid antihistamines?
Pts with prostatic hypertrophy
Epilepsy
Glaucoma
Bc antimuscarnic effect increase urinary retention, seizures and pressure
64
When to refer coughs?
```
Longer than 3wks
Coloured sputum
Blood in sputum (if pink, suggests HF)
Condition
Harsh barking cough (croup)
SOB
Difficulty breathing
Wooping cough
Night time cough
ACEi
```
65
What's used for dry irritation non productive coughs?
Cough suppressants
66
What drugs work as cough suppressants?
Demulcents = simple linctus, honey and lemon, (good for any cough), Glycerol
Anti tussives = codeine and dexomethrophan
67
Whats used for productive chesty coughs?
Expectorant like guafenacin (best)
Ammonium chloridr
Ipecacuanha
Squill
68
How can antihistamines be used for coughs?
Drys up secretions that may be triggering the cough
69
Guafenacin licensing?
200mg QDS for 6+
70
Pholcodeine licensing?
6 plus
71
Simple linctus age licensing?
1 months plus
72
How long can pholcodeine be used for?
No longer than 5 days
73
When to refer sore throats?
Longer than 10 days
Dysphagia
Red and swollen tonsils or and lymph glands
74
What analgesics can be used for sore throat?
Paracetamol
NSAIDS
Flurbiprofen (strefen) lozenges
75
Flurbiprofen (strefen) otc licensing age and duration?
12+
| For 5 doses per day 3 days max
76
Local anaesthetics used for sore throat?
Benzocainr
Lidocaine
Sprays or lozenges
77
Licensing age and duration for Benzocaine lozenges? Spray?
3+ for max 5 days
6+ for max 5 days
78
Local antiseptic used for sore throat?
Benzalkonium in lozenges
79
What is benzydamine and its licensing age?
An inflammatory DIFFLAM! for sore throat
Rinse for 12+
Spray for 6+
80
What pollen is major in April?
Tree pollen
81
What pollen is major in May-July?
Grass pollen
82
Examples of intranasal corticosteroids?
Beclomethasobe
Budesonide
Fluticasone
12hrs onset with max efficacy reached after few days
Begin treatment 2-3wks before the allergic season and continue throughout
Max 3 months for 18+
83
What's first choice OTC product for child with seasonal allergy?
Sodium cromoglicate
84
What OTC drug is not permitted for athlete's in competition?
Ephedrine
85
What OTC drug is not permitted for athlete's in competition?
Ephedrine
86
Honey is contraindicated in what age?
Under 12 months
| Use simple linctus instead for 1 months plus
87
Licensing age for sodium cromoglicate eye drops?
| Nasal?
6+
5+
Safe in preg as well
88
Licensing age for acrivastine?
12+
Avoid in preg and BF
89
Licensing age jn Cetirizine and Loratadine?
2+
| Avoid in preg and BF
90
Licensing age in Chlorphenamine?
1+
Safe in preg
91
How to take hyoscine hydrobromide?
Take tabs 30mins before travel to last for 6-8hrs
92
How to take antihistamines for motion sickness?
Cinnarizine, promethazine, meclozine
| Take 2hrs before and effective for 8hrs
93
Non drug treatment for motion sickness?
Ginger
| Accupressyre bands
94
Headache referral?
First episode of migraine over the age of 40
Any headache that doesn't respond to OTC within a day
Dull pain that is deep seated and Aggravated by lying down or pain that is worse in the morning and improved during the day may indicate raised intracranial headache
Women on COC
Headache longer than 4hrs
Under 12
Neck stiffness
Flowing recent trauma
95
Why is caffeine included in headache preparations?
Can improve the absorption of analgesics but caffeine can cause withdrawal headaches
96
Why is codeine not recommended in migraine?
Can reduce gastric motility and has an emetic action so may worsen nausea
97
What drugs can potentially cause insomnia?
```
Fluoxetine
MAOIS
phenytoin
Theophylline
Corticosteroids
```
98
When to refer insomnia?
Suspected depression
| Under 16
99
Antihistamine is contraindicated in?
Glaucoma
| Prostatic hypertrophy
100
What antihistamine are used for insomnia and their licensing age?
Promethazine
Diphenhydramine
16+
101
What's the name of Head lice?
Pediculus capitis
Grey brown 1-3mm long
Female lays eggs on the hair shaft near scalp surface
Egg is firmly affached and not washed awag
Hatches in 7 days and leave shell/nits
Nymph lice take 12/7 to adulthood
102
Names of insecticides used for head lice?
Permethrin and malathion
103
MoA of dimeticone?
Different to insecticides
| Traps and suffocated the lice
104
How to apply insecticides?
Apply once and leave on hair for 12hrs
Then apply another 7 days after
Average hair requires 50mls
105
Alcohol formulations are preferred in head lice treatment except for who?
Asthmatic
| Severe eczema where aqueous formulations are safer
106
How to apply alcohol liquids for head lice?
Allow to dry naturally and avoid swimming as chlorine in activates
107
How to apply alcohol liquids for head lice?
Allow to dry naturally and avoid swimming as chlorine in activates
108
How to apply dimeticone (hedrin)
Leave on for 8hrs and reapply again after 7 days
109
How to wet comb head lice?
Wet hair renders lice motionless so they can be removed
Repeat every 4 days over a 14 days period until no lice seen on 2 consecutive occasions
Best option for preg and BF and under 2yrs
Electric comb exists as well when electric current kills lice but not eggs
110
Who needs to be treated with head lice?
Only those in the household who ate affected and apply on the same day to avoid reinfestation
111
Headline advice to pt?
Products can stain clothes, bedding, pillow cases and can have strong smell
112
What is scabies?
Scabies mites burrow beneath the skin surface to cause allergic reaction.
Very intense itching especially at night
Fine silvery Rash appears when female burrows into skin and lay eggs
113
When to refer scabies?
Babies and children. Red flag if baby under 2
Sexondary infection of skin
Treatment failure
Unclear diagnosis
114
What's the treatmrnent of scabies?
Everyone in the household must be treated even if asymptomatic
First line is premethrin 5%
Second line is malathion 0.5% (first line in preg or Bf)
115
Premethrin age licensing?
2yr plus
116
How to apply premethrin and malathion?
Apply all over the body and wash off after 8-12hrs for permethrin
24hrs for malathion
Reapply 7 days after
Do not apply after hot bath as increase systemic absorption
117
How to apply malathion in BF women?
Remove from nipple before feeds and then reapply
118
Pt advice on scabies?
Wash everything at 50 degrees to kill
Itch will continue for 2-3 wks even after treatment
119
When to refer threadworm?
```
Appetite loss=weight losee
Insomnia due to itchiness
Recent travel abroad
Failed treatment
Children under 2
```
120
Treatment of threadworm?
Mebendazole 100mg STAT repeat after 14 days if reinfection susoected
All memebers of the family should be treated
121
Licensing on mebendazole?
2yr plus
| Not for preg or Bf
122
Practical tips on threadworm?
```
Close fitting oj bottoms to avoid shedding eggs
Shower first thing in the morning
Cut fingernails short
Good hygiene around toilet and food prep
Wash bedding and towels daiks
Vaccum daily
```
123
Symptoms of cystitis?
Dysuria
Urgency to urinate
Cloudy and smelly urine
124
When to refer cystitis?
```
Children
Men
Preg
Blood in urine
Vaginal discharge
Fever, N&V
Loon pain
Longer than 2 days
Failed treatment
```
125
Treatment of cystitis?
Potassium or sodium citrate for 2 days
126
Potassium citrate should not be used in pts with?
Pts taking K sparing diuretics
| ARB or ACEi
127
Sodium citrate should not be given to pts with?
Hypertention
Pts with heart disease
Pregs
128
Symptoms of dysmenorrhoea?
Lower abdo, pelvic pain that can radiate to back and thighs before or during menstruation
Most severe ar the start of period and can include headache, N&V, dizziness
129
When to refer dysmenorrhoea?
```
GI bleed
Hypersensitivity to NSAIDs
Asthmatics
HF, kidney and liver djsease
Preg or BF
```
130
Naproxen licensing for OTC?
For 15-50
500mg STAT then 250mg 6-8HRS later
No more than 3 tabs each day
No more than 3 days treatment in any one month
131
What drug is available OTC for Menorrhagia?
Tranexamic acid
132
Licensing age of tranexamic acid?
18+
| Women with regular 25-35day cycle with no more than 3 days individual variability in cycle duration
133
Dose of tranexamic acid?
Start taking once heavy bleeding has started.
2 tabs TDS for max 4 days
Max 4g per day
If no improvement within 3 Menstural cycle, stop using
134
Drug names of artificial tears usdd for dry eyes?
Hypromellose PRN
Discard after 28 days
Carmellose
Polyvinyl alcohol
Carbomer gel
Wool fats
135
Drugs of lubricant ointment/ tear substitute used for dry eyes?
Lacrilube
Prolonged lubrication of the eye so good to use ON
Transient blurring and so not for use while wearing contact lenses
136
What preservatives are usdd in eye drops?
Benzalkonium chloride
| Can cause eye irritation so use preservative free
137
Symptoms of blepharitis?
```
Itchy sore red eyelids
Stick stogerthrr
Eyelashes become crusty
A burning gritty sensation
Increased sensitivity to light (photophobia)
Abnormal eye lash growth or loss
```
Both eyes tend to be affected
138
When to refer blepharitis?
```
Unresponsive to treatmebt
Concurrent coniunctivitis
Stte
Eye pain
Worsening vision
```
139
If blepharitis doesn't responsed to gentle cleaning with warm soaked cotton, what can be used?
OTC eye drop/ointment containing dibrompropamidine isetionate
Or
Propamidine isetionate
Called Golden eye or Brolene ointment
140
When to refer ear wax ears?
Unusual discharge from the ear
Persistent pain from within the ear
Tinnitus (ringing in the ear)
Unresolved after 3 days
141
How to manage ear wax?
soften ear wax with cerumenolytics (urea hydrogen peroxide which hydrates the was allowing it to be removed)
Or Glycerol, Salicylate (softeners)
Docusate (surfactant)
Apply and lie with ear uppermost for 5-10mins
142
When to refer otitis externa?
```
Deafness
Persistent pain from within the ear
Tinnitus
Vertigo
Blocked ears
Discharge
Bleeding
N&V
Children under 12
```
143
Management of otitis externa on pharmacy?
Refer to doctor to confirm diagnosis
| But could use acetic acid 2% spray for 12+
144
Acetic acid pt advice?
Use should be stopped and medical advice sought if no improvement is seen within 2 days of treatment
145
Chicken pox symptoms?
3ish days of fever, headache, sore throat and malaise
Then small red limps rapidly develop and develop into vesicles/blisters in about 12hrs ish usually on the face, scalp and trunk
Vesicles burst forming crusted spots over a few days then healing over the next 1-2wks
146
What causes chickenpox?
Varicella zoster
147
What causes shingles?
Reinfection by the varicella zoster virus
148
Symptoms of shingles?
An infection of the nerve and skin around it. Usually when older, stressed, taking meds that weaken the immune system, has weak immune system from HIV etc
Usually affects a specific area on one side of the body and does not cross over the midline of the body
149
Measel symptoms?
After 2 or 3 days of fever, cold symptoms and malaise, the typical rash of red, confluent, blotchy begins at the hairline and progresses down to cover the whole body and lasts for 3 days.
Complications include otitis media, laryngitis, pneumonia and rarely fatal progressive encephalitis
It's a dangerous disease because of its complications
150
Treatment of measles?
Paracetamol
Hydration
Clean eyes with damp cotton swabs to help with crusting around the eyes
Stay away from school for about 4 days after rash appears
151
What is MMR vaccine and who gest it?
Measles, mumps and rubella
| Offered to 12_13 months
152
Treatment of mumps?
Paracetamol or ibuprofen for symptomatic relief
Keep hydratrf
Avoid citrus juices as may worsen the oaun
Stay away from school for about 5 days after the swelling appears
153
What causes mumps?
Paramyxovirus
154
Complications of mumps?
Enceohalitis
Pancreatitis
Orchitis (infection of the testes in post oubertial males may cause infertility)
155
Rubella symptoms?
Cold fever and then 7 days later ish, macula rash appears on the face and spreads to trunk and limvs
BLANCH with pressure
Spots do not become confluent like measoes
Rash lasts for 3 to 5 days
Swollen glands may be present
In adults, rubella may be associated with painful joint
156
Complication of rubella?
High risk of damage to the foetus if contracted in early oregnancy
157
Treatment of rubella?
Hydration
Paracetamol or ibuprofrn
Stay away from school for 6 days after rash appears
158
When is the vaccine for whooping cough done?
2 months baby
159
What can cause a bacterial meningitis?
Neisseria meningitis
| Streptococcus pneumonia
160
What causes viral meningitis?
Enteroviruses
| Herpes simplex virus
161
What is cradle cap?
Seborrhoeic dermatitis seen on the scalp
Red sharply marinated lesions with greasy looking scales
Caused by malssezia ocale
Chronic condition rgaf will flare and remit
Scales are yellow brown in colour
162
Treatment of cradle cap?
Regularly wash scalp with baby shampoo with soft brush to loosen scales
Can use oild followed by shampoo
Could suggest ketoconazole 2% shampoo twice a week
163
Colic symptoms?
Excessive crying in an otherwise well baby
At least 3hrs/day, 3days/week for at least 3wks
Usually from a few weeks to 4-5months
High pitches crying
Same time each dag
Swollen tummy
Red in face
164
When to refer colic?
Weight loss
165
Drugs that contain simeticone?
Infacol
Dentinox
COLIEF
166
When to refer nappy rash?
```
Yellow crusts or weeping as it may indicate a bacterial infection
Broken skin
Symptoms for longer that 2wjs
Concomitant oral thrush
Other body areas affected by rash
```
167
Treatment of nappy rash?
Barrier cream like sudocream or metanium to protect skin from faeces and excess moisturr
If fungal infection (small red lesions) antifungal creams BD to TDS for 7-10 days
Could use oik to provide water resistant barrier
Lanolin as an effective emollient
Zinc as soothing agent
168
When tk refer eczema?
```
Signs of infection
Severe symptoms (cracked, bleeding)
Symptoms unresponsive to tretment
Not been diagnosed and unidentified cause
Symptoms lasting longer than 2wks
```
169
Urea are used jn cream because?
Act as a hydrating agent
170
Licensing age for hydrocortisone 1% cream?
Over 10
171
Licensing age for clobetasone 0.05%?
12+
172
Whay drugs can cause acne?
```
Lithium
Phenytoin
Progestogens
Levonorgestrel
Noresthisterobe
```
173
When to refer acne?
If its acne rosacea where middle aged pts present with reddening cheeks and for head alongside pupils and pustules but confined to face only
Symptoms unresponsive to 8wks of treatment
174
Treatment of acne?
Benzoyl peroxide use low strength and titrate if necessar
175
When to refer cold sores?
```
Painless lesions as may indicate cancerous
Babies
Lasting longer than 2wks
Eye affected
Immunocompromisrd
```
176
Treatment of cold sores?
Aciclovir esp effective if started proderomal phase
Applied five times /dat
Hydroxollid patch
177
Where does planter warts (verrucae) appear?
Sole and heel
178
Where does plane warts appear?
Feca or hands
179
When to refer warts?
Facial and genital
Change in appearance (as may suggest cancer)
Bleeding
Itching
Immunocompromisrd
No significant improvements within 3 months of OTC
Diabetes
180
Treatment of warts?
Not needed unless causing pain or stress
Salicylic acid to soften and destroy skin
Apply daily and protect surrounding skin
Gutaraldehydte and lactic acid (Bazooka) for 3 months to see if improvement
181
Pt advice on warts?
Tretment works better if applied after soaking the affected hands or foot in warm water for 5-10mins
Remove dead skin with the use of emery board
182
Treatment of dandruff?
Ketoconazole 2% shampoo is first line used twice a week for 2-4wks
Selenium 2.5% twice weekly for the first 2wks and then weekly for the next 2wks then PRN
Both treatment should be left for 5mins before rinsing
183
Symptoms of psoriasis?
Silvery white scales on the extensor surfaces of the elbow and knee and sometimes Lowe back and scalp
Itchy
Tirggered by stress and fingernails might show pitting
184
What drugs can trigger psoriasis?
Lithium
NSAIDS
BB
Chloroquine
185
Referral of psoriasis?
Pts not being diagnosed yet
| Moderate to severe
186
Treatment of psoriasis?
Emollien esp in acute flare
POM include tar based, Salicylic, dithranol, calcipotriol
Topical steroids are Not licensed OTC
187
Distinctive symptoms of tinea infection?
Has a distinctive active border around the red and scaly rash
188
What can you use to treat tinea pedis?
Athlete's foot
Use cream if soggy skin, ointment if dry
First line is imidazole cream or Terbinafine
Clotrimazole and miconazole Topical are safe in preg and BF
189
How to manage tinea corporis? Or tinea cruris?
Ring worm and genitals infection
Imidazole creams or terbjna
190
When to refer impetigo?
If first time refer
Self limiting but treat as risk of transmission
First line is 1% hydrogen peroxide the only available OTC product
Keep child away from school until 48hrs after of healing
191
Management of teething in children?
Para or ibu
A chilled teething
Petroleum jelly around the mouth and chill will prevent rash and soreness from excessive drubbing
192
When to refer back pain?
```
Following major trauma
New back pain in unde 20 or over 50
Weight loss
Past history of malignancy
Associated Bladder ot bowel symptoms motor weakness in legs
Fever
```
193
Treatment of sweat rush?
Imidazole
