OTC Cases 2 Flashcards
Symptoms
- slow onset joint pain, made worse by movement/cold weather, stiffness, limited range of motion, swelling of joint, crackling/grating feeling and sound around joints
Diagnosis/causes?
Treatment?
Self care?
Referral?
Diagnosis
- osteoarthritis, caused by cartilage breakdown between bone
Treatment
- pain relief e.g. regular paracetamol use, NSAIDS for short term use (oral or topical), corticosteroids, injectable hylans, complementary medicines e.g. glucosamine/chondroitin, liniments/heat rubs, TENS machine, physiotherapy, heat/cold therapy
Self care
- recognise need to rest, relaxation techniques, good posture, suitable footwear, walking stick/brace, household assistance e.g. hand rails/reaching aids, regular exercise, warm water therapy e.g. heated pool, healthy diet/weight range, podiatrist/occupational therapist input
Referral
- to doctor/physio/OT/podiatrist, severe pain/disability, ineffective treatment etc
Symptoms
- flu like symptoms (muscle aches, swollen glands), itching/tingling/soreness around genital area, painful lesions which start as small blisters around genitals/buttocks
Diagnosis/cause?
Treatment?
Self care?
Referral?
Diagnosis
- genital herpes (herpes simplex virus type 1 or 2, type 2 most common in genital herpes). Caused by virus transferred by skin to skin contact usually during sexual intercourse.
Initial outbreak, followed by dormant period(s). Can be triggered (reactivated) by stress, hormone changes, illness, exposure to sun, friction e.g. during sexual intercourse
Treatment
- antiviral medication prescribed by a doctor
Self care
- bathe lesions with salt water, maintain hydration, urinate while in warm water to prevent painful urination, wear loose underwear, avoid soaps/gels on affected areas, use condoms even when no lesions, do not touch lesions (wash hands well after any contact), inform sexual partners, consider genital herpes counselling services
Referral
- if suspected, to have test/confirm virus, if pregnant or planning to become pregnant (to minimise risk to baby)
Symptoms
- straining to pass faeces, passing faeces less often than normal, discomfort, bloating, nausea
Diagnosis/cause?
Treatment?
Self care?
Referral?
Diagnosis
- constipation
Causes
- low fibre intake, low water intake/losing fluid, inactivity, diet change, pregnancy, hormonal changes, stress, medical conditions (e.g. thyroid disorder, IBS), medications (e.g. iron, calcium, verapamil, pain relievers)
Treatment
- laxatives available in many different forms (e.g. granules, tablets, syrups, suppositories, enemas) depending on action in bowel/time to efficacy. Bulk forming (e.g. fibre supplements), osmotic (e.g. macrogols), stimulant (e.g. senna), stool softeners (e.g. liquid paraffin).
Self care
- increase fibre (via fruits, vegetables), drink enough waster, exercise, do not ignore urge to open bowels, relaxation techniques, sitting position on toilet
Referral
- sudden bowel habit changes in >50 yoa, altered constipation/diarrhoea, blood stained faeces, regular laxative use required, >7 days sx with no apparent cause, liquid faeces leaking out of anus
Symptoms
- feeling tired, irritable, anxious, difficulty concentrating, waking up during the night, trouble falling asleep, restless sleep, not feeling refreshed
Diagnosis/causes?
Treatment?
Self care?
Referral?
Diagnosis
- sleeping problem
Causes
-pain/discomfort, snoring, stress/anxiety, napping duringg day, uncomfortable bed, excess stimulation e.g. caffeine/exercise, illicit drug use, nicotine use (e.g. NRT), jet lag, pregnancy, some medicines, medical conditions (e.g. depression)
Treatment
- find and manage cause. Consider sleeping tablets to correct a sleeping problem, at lowest dose for shortest time possible (preferably for less than 14 days in a row) -can cause dependency, day time sedation
Self care
- sleep in dark, quiet room, use comfortable mattress, limit alcohol/caffeine, go to sleep and wake up at the same time each day, have calming routine e.g. peaceful music, warm drink, don’t watch TV in bedroom, don’t have heavy meals before bed
Referral
- can’t sleep due to pain/illness, have been taking sleeping tablets for >4 weeks continuously, always tired during the day, wake up coughing/wheezing/unable to breathe
Symptoms
- mixture of whiteheads and blackheads, and nodules/cysts on face, neck, shoulders and upper back
Diagnosis/causes?
Treatment?
Self care?
Referral?
Diagnosis
- agne vulgaris (skin condition caused by change in oil glands and hair follicles in the skin, usually related to hormone changes that occur during puberty - more severe form of blackheads and pimples).
Causes
- puberty (hormonal changes), worsened by family history, some skin care products than increase amount of oil on skin, working with oils/greases, scrubbing/picking skin, perspiration, high humidity, stress/anxiety, smoking, some medicines
Treatment
- unblock hair follicles, reduce sebum production and reduce bacteria and inflammation. Non prescription e.g. skin cleansers, antiseptics washes, salicylic acid creams/lotions, benzoyl peroxide, azaleas acid formulations. Prescription products e.g. antibiotics (creams, gels, tablets), retinoids (creams and tablets - reserved for severe acne), hormones e.g. OCP.
Self care
- gently cleans twice a day and after exercise using acne cleanser or soap free cleanser, use lukewarm watering pat dry with soft towel, do not pop or squeeze, avoid oil based creams and cosmetics/sunscreens, keep hair clean and away from face, regular healthy diet, hydration, avoid smoking.
Symptoms
- blocked nose, pain/pressure over sinus area, loss of smell, headache, sore throat, post-nasal drip
Diagnosis/cause?
Treatment?
Self care?
Referral points?
Diagnosis
- sinus problem (lining of sinus becomes inflamed/swollen, or normal mucus drainage blocked
Causes
- infection (viral or bacterial), irritation eg cigarette smoke, pressure changes e.g. air travel, some medicines/medical conditions, obstruction e.g. broken nose/nasal polyps
Treatment
- decongestants (tablets, syrups, nose sprays/drops - avoid using for more than 5 days in a row), pain relievers (e.g. paracetamol, ibuprofen), antihistamines (to reduce mucus in nose, e.g. tablets, nose spray, combo products), corticosteroids e.g. nasal sprays, antibiotics (for bacterial sinus infection).
Self care
- increase fluid intake to help this mucus, use steam inhalation to loosen mucus, warm compress for discomfort, gently blood nose, rest, avoid irritants, don’t smoke
Symptoms
- constant pain felt on both sides of head, feels like band of tightness around head, neck also affected, lasts 1-2 hours.
Diagnosis/causes?
Treatment?
Self care?
Referral points?
Diagnosis
- most likely tension type headache (migraine = more throbbing, usually occurs on one side of head, other sx e.g. nausea, sensitivity to light, may last 4-72 hours), (sinus headache = pain and tenderness near eyes/cheeks/forehead, pain worse when bending forward), (medication overuse headache = associated with pain relievers being used for >10 days/month for >3 months)
Causes
- stress, allergy, caffeine withdrawal, alcohol, smoke, excess/insufficient sleep, bright lights, eye strain, some medicines, jaw/dental problems, poor posture
Treatment
- prescription and non prescription pain relievers (consider soluble), rx migraine prevention, decongestants/antihistamines
Self care
- identify patterns/triggers, reduce stress, moderate exercise, sufficient sleep, stay hydrated, limit caffeine/alcohol, healthy diet, avoid triggers where possible, wear sunglasses, take regular work breaks
Referral points
- not relieved by non prescription medicines, occurs >15 days/month, disturbs sleep, developed after head injury, develop while on OCP/HRT, are severe/getting worse, develop suddenly/new type of headache, associated with confusion/rash/weakness/visual disturbances
Symptoms
- burning, tingling sensation on skin in a band across left side of back (turns into painful rash with fluid filled blisters)
Diagnosis/cause?
Treatment?
Self care?
Referral?
Diagnosis
- shingles (herpes zoster), virus which affects nerve fibres
Cause
- after a person has chickenpox, some of that virus stays in the body and lies dormant in nerve cells, can be reactivated and spread along nerve path to the skin causing rash and pain, can reactivate due to age (e.g. >50 yoa), stress, illness, weakened immune system. Virus spreads from person to person in fluid from blisters.
Treatment
- antiviral medication (within 72 hours of rash starting), pain relief, topical treatment, wound coverings, chickenpox vaccine (not during outbreak)
Self care
- seek medical advice asap, keep area clean and covered, don’t scratch, plenty of sleep/rest, relaxation techniques
Referral
- asap if shingles suspected, pregnant women, people with weakened immune system, people who have never had chickenpox or vaccine, babies <12 months
Symptoms
- cravings after ceasing smoking, feeling irritable/hungry/anxious, poor concentration, sleeplessness
Diagnosis?
Treatment?
Self care?
Referral?
Diagnosis
- nicotine withdrawal after smoking cessation
Treatment
- can be treated (and increase changes of successfully quitting) with nicotine replacement therapy. NRT does not contain toxins in cigarettes, and will help resist urge to smoke/withdrawal symptoms. Allows for gradual reduction of nicotine.
Available in patches, lozenges, sublingual tablets, chewing gums, inhalers, sprays. Can be purchased with or without prescription. Goal is to gradually reduce dose and need.
Self care
- stay motivated, avoid situations of temptation (e.g. drinking alcohol), consider counselling/support group, healthy diet, regular exercise, stay hydrated, limit alcohol
Referral
- refer if pregnant, breastfeeding, recent/severe heart or circulation problems, treatment failure, young e.g. <12 yoa
Match the vitamin to the likely signs of deficiency, and sources of vitamin
VITAMIN
a) Vit A
b) Beta carotene
c) B vitamins
d) Ascorbic acid
e) Colecalciferol
f) Vit E (tocopherol)
g) Vit K
h) Folic acid
SIGNS OF DEFICIENCY
a) muscle weakness, low immunity, nerve damage, heart disease
b) low immunity
c) anaemia, neural tube defects in unborn babies
d) soft weak bones, muscle weakness
e) poor night vision, dry eyes and skin, poor growth
f) blood takes longer to clot, inc bleeding
g) scurvy, poor wound healing, bruising/bleeding
h) low energy, weakness, red cracked tongue, dry skin, lack of sleep, confusion
SOURCES
a) fruits (citrus) and vegetables
b) sunlight on skin, fatty fish, liver, eggs
c) green leafy vegetables, liver, eggs, injection given at birth
d) yeast extract, liver, kidney, heart, legumes, nuts
e) orange and red fruits and vegetables
f) liver, kidney, dairy products, eggs, fish
g) liver, kidney, meat, poultry, fish, eggs (e.g. - vegan deficiency!)
h) vegetable oils, grains, seeds, nuts, eggs, legumes
a) Vit A - poor night vision, dry eyes and skin, poor growth - liver, kidney, dairy products, eggs, fish
b) Beta carotene - low immunity - orange and red fruits and vegetables
c) B vitamins - low energy, weakness, red cracked tongue, dry skin, lack of sleep, confusion - liver, kidney, meat, poultry, fish, eggs
d) Ascorbic acid - scurvy, poor wound healing, bruising/bleeding - fruits (citrus) and vegetables
e) Colecalciferol - soft weak bones, muscle weakness - sunlight on skin, fatty fish, liver, eggs
f) Vit E (tocopherol) - muscle weakness, low immunity, nerve damage, heart disease - vegetable oils, grains, seeds, nuts, eggs, legumes
g) Vit K - blood takes longer to clot, inc bleeding - green leafy vegetables, liver, eggs, injection given at birth
h) Folic acid - anaemia, neural tube defects in unborn babies - yeast extract, liver, kidney, heart, legumes, nuts
