Paeds 2 presentations

Question 1

Management of functional constipation

Answer 1

Conservative:
* Good fibre and fluid
* Reward systems for toilet visits
* Set times to spend 5-10 mins on toilet
* Good support if new change eg starting school

Pharm:
* Osmotic laxative
* May need faecal impaction removal regime if this is present - suppositories?
* May be on regime a while

Question 2

Management of atopic eczema

Answer 2

• Emolients eg E45, dermol if mild
• Consider 1% hydrocortisone if mild or over delicate areas eg around eyes and on flexures
• If moderate provide stronger topical corticosteroid eg betamethasone valerate 0.025%
• Can use non-sedating anti-histamine for itch
• If itching in severe eczema afefcting sleep condier sedating antihistamine
• If suspect food cause link, do food diary to identify triggers

Question 3

Management of hayfever

Answer 3

Conservative:
* Check pollen level and avoid if high - close windows etc
* Do not dry bedding etc outside if pollen high
* Avoid dust and animal dander if these are triggers

Pharm:
* Intranasal corticosteroids or intranasal antihistamines
* Oral antihistamines (can be used with intranasal steroid)
* Can do both intranasals together if severe
* If eye symptoms have sodium cromoglicate(chromone)/antihistamine drops