OTC Cases 1 Flashcards
Symptoms
- moist/peeling/cracked between toes, itchy, white/red
Diagnosis/cause?
Treatment? (pick one, and give dose/directions)
Self care?
Referral points?
Diagnosis
- Tinea (athletes foot)
Causes/risk factors
- barefoot in showers/around pools, tight fitting/rubber shoes, sweaty feet, not drying feet properly, humid climate, diabetes/weakened immune system etc
Treatment
- anti fungal creams/gels/lotions/powders/sprays
Self care
- wash and dry skin well, use drying products, do not share towels, socks, hot wash all socks/underwear/bathmats, wear thongs in showers
Referral points
- oozing/weeping, does not improve with tx, nail looks yellow/thick/crumbly, diabetes/poor circulation/weakened immune system
Symptoms
- baby crying/screaming/fussing for hours, pulling knees up, clenching fists, not resolved by feeding/nappy change
Diagnosis/cause?
Treatment?
Self care?
Referral points?
Diagnosis
- infant colic
Cause
- unknown, possibly due to wind pain, muscle spasms, reflux, anxious baby, food sensitivities, mother smoking
Treatment
- mainly self care, other options e.g. Infacol (minimal evidence), formula change
Self care
- comforting child, wrapping child, pacifier, soft music, massage, burping baby after feed, care for parent e.g. share thoughts/feeling/baby care, relaxation techniques, don’t smoke near baby, don’t shake baby (lol)
Referral points
- blood in baby’s stools, loss of appetite, vomiting/diarrhoea >24hrs, high temp, sluggish, prolonged stomach swelling
Symptoms
- pain/swelling around back, occurred 24 hours ago after heavy lifting
Diagnosis?
Treatment?
Self care?
Referral points?
Diagnosis
- potential muscle strain (fibres of muscle/tendon are stretched too far and torn).
Treatment
- First Aid (within 72 hours of injury) - RICE, Rest, Ice, Compression, Elevation. Consider pain relief e.g. paracetamol, antiinflammatories, liniments, heat rubs, cooling rubs. First 72 hrs = NO HARM, NO heat, alcohol, running/exercise or massage (increases bleeding, swelling, worsens injury).
Self care
- Gradually increase movement as swelling reduces, may need to strap/support area, may take 1-6 weeks to heal, consider seeing physiotherapist
Referral points
- pain or swelling is severe, any numbness, cannot support weight, joint looks deformed.
Symptoms
- itching, soreness in and around vagina, white, thick, odourless discharge
Diagnosis/causes?
Treatment?
Self care?
Referral points?
Diagnosis
- vaginal thrush
Cause - infection, increased risk due to antibiotic use, diabetes, pregnancy, synthetic underwear, weakened immune system
Treatment
- oral antifungal capsule, anti fungal cream/pessaries
Self care
- avoid vaginal douching/deodorants, wear loose fitting cotton underwear, don’t get shampoo/soaps in vagina whilst bathing, dry genitals area well after bathing/swimming, wipe from front to back
Referral points
- change in colour/smell of discharge, bleeding or spotting at different time to period, under 16 or over 60 yoa, >3 infections per year, continued symptoms after treatment
Symptoms
- fever, headache, stiff neck, sleepiness, joints and body aches, eyes sensitive to light, rash
Diagnosis?
Treatment?
Self care?
Referral points?
Diagnosis
- meningitis (meningococcal disease), begins like flu but much quicker onset, Children <5, adolescents aged 15-24, during winter, smokers, people with no spleen.
Treatment
- immediate referral for treatment with IV antibiotics. Public health authorities to be notified and close contacts to seek treatment.
Self care
- have children vaccinated against meningococcal C, quick referral to hospital if suspected, cover mouth when sneezing/coughing, don’t smoke, eat healthy diet.
Referral points
- quick onset symptoms, especially rash
Symptoms
- burn like rash on skin in nappy area (red, swollen, moist, shiny), creases not affected, no defined border
Diagnosis?
Treatment?
Self care?
Referral points?
Diagnosis
- simple nappy rash, can be caused by urine/faeces, irritating chemicals e.g. detergents, friction (e.g. cloth nappies)
Treatment
- use barrier cream or ointment after each nappy change, use soap free bath oil to relieve irritation, offer paracetamol for pain relief if required. If fungal suspected (e.g. creases affected, defined border) consider anti fungal cream to use under barrier cream.
Self care
- check and replace nappies often, clean and pat skin dry (do not rub), encourage nappy free time, use disposable nappies if possible
Referral points
- rash spreads outside nappy area, no improvement after 5 days of treatment, broken skin/severe rash, pus/weeping/blistering rash, additional fever/irritation/illness
Symptoms
- intense itch (worse at night after showering), raised, grey track marks around inner wrists/between fingers, red blotchy, lumpy rash around hands, feet, groin area, armpits
Diagnosis?
Treatment?
Self care?
Referral?
Diagnosis
- scabies (parasitic mite infestation), caused by skin to skin contact with infested person/from infested clothing/bedding towels. Easily spread between same household/close knit communities/nursing homes.
Treatment
- lotion/cream, applied to entire body from jawline to toes, including areas that are not itchy. Second treatment often applied seven days later. Include soles of feet, between skin folds, external genital areas, leave overnight then wash next day.
Self care
- avoid scratching skin, itch may continue for several weeks after treatment (side effect of ‘treatment’), treat all people in close physical contact with affected, hot was all bedding/clothing/toys (or tightly seal in plastic bag for 1 week), stay home from work/school until day after treatment starts
Referral
- pregnant/breastfeeding/child <2, frail elderly, weakened immune system, weeping/yellow discharge, itching for >4 weeks after treatment
Symptoms
- mild fever, headache, runny nose, before rash develops on face/back/chest –> presents as small red spots/bumps which quickly turn into itchy blisters for 3-5 days
Diagnosis?
Treatment?
Self care?
Referral?
Diagnosis
- chicken pox (herpes virus, varicella zoster, spread by moisture droplets breathed out into air by coughing/sneezing, also spread by fluid from blisters)
Itchy blisters last 3-5 days, then dry to form scabs (takes several days to heal)
Treatment
- relieve itching, fever and discomfort. Bath oils/oatmeal added to baths, hydrogel wound dressings, creams/lotions to relieve itch, antihistamines, paracetamol to relieve pain/fever, chickenpox vaccine (free at 12-18 months, or 10-13 years old - ‘catch up dose’)
Self care
- cool wet compresses, rest, fluid intake, resist scratching to reduce infection/scarring, good personal hygiene, avoid school/work until blisters have dried
Symptoms
- vomiting, diarrhoea, nausea, poor appetite, stomach pain, fever
Diagnosis/cause?
Treatment?
Self care?
Referral points?
Diagnosis
- vomiting/diarrhoea (duh)
Causes
- viral gut infection, bacterial gut infection, parasitic gut infection, non-GI infection (e.g. ear infection), medical conditions (e.g. IBS), medicines (e.g. chemotherapy), food intolerances e.g. lactose, alcohol, anxiety
Treatment
- rehydration (most important, know how to identify e.g. dry mucous membranes, dark urine, thirst, rapid breathing, skin turgor, sunken soft spot on top of baby’s head) e.g. oral rehydration solutions, medicines to control diarrhoea e.g. loperamide (if appropriate), probiotics, prescription antiemetics
Self care
- continue breastfeeding affected infant (still offer ORS), if bottle fed give ORS first then restart formula when vomiting eases, sip fluids, eat if hungry (plain, starchy foods - avoid spicy, fatty, sweet foods), stay at home if ill, wash hands after toilet/changing nappies/before touching food, refrigerate foods promptly, correctly cook food.
Referral points
- baby <6 months/elderly, pregnant, extreme dehydration, vomiting>24 hours, vomiting blood, bloody faeces, high fever, weight loss, underlying medical condition e.g. epilepsy, recent travel
Symptoms
- chest discomfort/heaviness/pressure, nausea, dizziness, heavy arms, jaw discomfort, cold sweat
Diagnosis/cause?
Treatment?
Self care?
Referral points?
Diagnosis
- warning signs of heart attack (usually last for at least 10 minutes, vary from person to person), blockage of blood flow from coronary artery to heart (causing muscle death)
Treatment
- stop what the person is doing, tell someone how they are feeling, CALL 000 for ambulance, await operator instructions. If applicable, carry nitrate medicine for angina and use when required, as directed.
Self care
- prevention eg don’t smoke, healthy diet and body weight, limit alcohol, moderate exercise, regularly check blood pressure and cholesterol, take prescription medicines as directed, tell family and friends of warning signs
Refer
- ASAP for warning signs, fast treatment increases survival risk
