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PHASE 3A > PRIMARY CARE - psych, opthalmology, derm, paeds, GU, sexual health, misc > Flashcards

PRIMARY CARE - psych, opthalmology, derm, paeds, GU, sexual health, misc Flashcards

1
Q

how is dementia investigated in primary care? (3)

A

1) initial assessment - hx (from px and family/friend) and examination (neuro signs, visual or auditory probs, cardio signs)
2) bloods to rule out organic causes - FBCs (anaemia), U&Es (metabolic), TFTs (hyper/hypo), serum B12 and folate (deficiency), calcium, HbA1c
3) assess cognition

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2
Q

examples of cognition screening tests that can be used when diagnosing dementia in primary care

A

10-point cognitive screener (10-CS), 6-item cognitive impairment test (6CIT), mini-cog

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3
Q

dementia management if the patient is severely disturbed/a health and safety risk OR if assessment in primary care isn’t appropriate?

A

arrange admission to secondary care

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4
Q

dementia management if urgent admission is not required?

A

refer to specialist dementia diagnostic service e.g. memory clinic

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5
Q

define fibromyalgia

A

chronic pain syndrome diagnosed by the presence of widespread body pain

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6
Q

epidemiology of fibromyalgia

A

more common in F

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7
Q

aetiology of fibromyalgia

A

unknown - associated with abnormalities in the stress response system and triggering events.

stressful event/s is a RF

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8
Q

signs and symptoms of fibromyalgia

A
  • diffuse tenderness on exam (commonly neck, shoulders, elbows, knees, buttocks)
  • chronic pain
  • fatigue unrelieved by rest
  • sleep & mood disturbance
  • stiffness
  • headaches
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9
Q

how is fibromyalgia diagnosed?

A

presence of >3 months of widespread pain and associated symptoms

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10
Q

management of fibromyalgia

A

NON PHARM
- exercise
- relaxation therapy
- CBT

PHARM
- analgesia e.g. paracetamol, weak opioids
- antidepressants e.g. amitriptyline or duloxetine

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11
Q

what is acne vulgaris? what is it caused by?

A

a chronic inflammatory skin condition affecting mainly the face (99%), back and chest

blockage and inflammation of the pilosebaceous unit (hair follicle, shaft and sebaceous gland)

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12
Q

define mild, moderate and severe acne

A

mild - a few non inflamed lesions with or without sparse inflammatory lesions

moderate - more widespread, more inflammatory papules and pustules

severe - widespread inflammatory papules, pustules, nodules and cysts. may have scarring

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13
Q

what is the name for non-inflammatory lesions in acne? what are the subtypes?

A

= comedones

blackheads - open comedones
whiteheads - closed comedones

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14
Q

types of inflammatory lesions in acne

A
  1. papules and pustules - superficial raised lesions <5mm
  2. nodules/cysts - deeper, palpable, painful, >5mm
  3. sinuses - a cluster of severe nodules
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15
Q

how does acne vulgaris present? what MUST be present for diagnosis?

A
  • usually pubertal age
  • most present with a mix of inflammatory and noninflammatory (comedones) lesions
  • comedones must be present
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16
Q

investigations for acne vulgaris

A

normally clinical diagnosis

take detailed history
- duration, type and distribution of lesions
- prev tx
- psychosocial impact
- fam hx e.g. endocrine, PCOS, acne, skin conditions
- potential underlying causes e.g. drug hx, hyperandrogenism

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17
Q

management of mild to moderate acne

A

1st line = 12-week course of topical combination therapy:
- topical adapalene with topical benzoyl peroxide (AB)
- topical tretinoin with topical clindamycin (TC)
- topical benzoyl peroxide with topical clindamycin (BC)

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18
Q

management of moderate to severe acne

A

1st line = 12-week course of one of the following:
- topical adapalene with topical benzoyl peroxide
- topical tretinoin with topical clindamycin
- topical adapalene with topical benzoyl peroxide + either oral lymecycline or oral doxycycline
- topical azelaic acid + either lymecycline or doxycycline

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19
Q

what is a complication of long-term abx use in patients with acne?

A

gram-negative folliculitis

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20
Q

alternative tx to oral antibiotics in women with acne

A

COCP
should be used in combo with topical agents

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21
Q

when should patients with acne be referred to a dermatologist?

A
  1. if conglobate acne (rare, severe, nodules sinuses and cysts)
  2. if nodulo-cystic acne
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22
Q

what is
a) mean corpuscular volume (MCV)
b) mean corpuscular haemoglobin (MCH)
c) haematocrit

A

a) the average size of RBCs
macrocytic (>100fl), normocytic (80-100fl), microcytic (<80fl)

b) avg amount of haemoglobin in each RBC
hypochromic = less than normal

c) percentage expressed of the mass of RBCs compared to the plasma

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23
Q

normal haemoglobin in
a) men
b) women

A

a) 13-16 g/dl
b) 11-15 g/dl

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24
Q

what is iron deficiency anaemia?

what type of anaemia is it?

A

anaemia caused by lack of Fe > cannot support RBC production

microcytic anaemia

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25
Q

what is the most common cause of anaemia worldwide and in pregnancy?

A

iron deficiency

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26
Q

causes of Fe deficiency anaemia (4 categories)

A
  1. excessive blood loss
    - loss from GI (commonest in adult men and postmen women)
    - menorrhagia
  2. iron-poor diet
  3. failure of iron absorption
    - drugs e.g. tetracyclines and quinolones
    - antacids and PPIs (impairing absorption)
    - vit C deficiency
    - malabsorption conditions e.g. coeliac
    - gastrectomy
    - H.pylori infection
    - hookworm
  4. excessive iron requirements
    - rapid growth in kids
    - pregnancy
    - exfoliative skin disease
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27
Q

presentation of iron-deficiency anaemia

A

GENERAL
- pale skin + mucous mem
- tachycardia
- fatigue, lethargy
- dyspnoea
- palpitations
- headache

SPECIFIC
- brittle hair and nails
- atrophic glossitis
- koilonychia
- angular stomatitis

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28
Q

investigations for iron deficiency anaemia

A

FBC
- Hb low
- Fe low
- ferritin low
- reticulocytes low
- MCV low

Blood film - hypochromic microcytic

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29
Q

management of iron deficiency anaemia

A
  • address underlying cause e.g. treat menorrhagia, stop NSAIDs, eat more iron-rich food
  • 200mg oral ferrous sulphate/fumarate/gluconate daily
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30
Q

what is the most common cause of megaloblastic anaemia?

A

folate and B12 deficiency

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31
Q

which vitamin is low in folate deficiency?

A

vitamin B9

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32
Q

which vitamin is low in B12 deficiency? what is it needed for?

A

cobalamin

needed to form RBCs and DNA, needed in function and development of brain and nerve cells

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33
Q

causes of folate deficiency

A

MAIN = poor intake

dietary deficiency e.g. malabsorption (coeliacs etc), anorexia

excessive requirements e.g. pregnancy, infancy, malignancy, blood disorders

antifolate drugs

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34
Q

what is the most common cause of B12 deficiency? what is the pathophysiology?

A

PERNICIOUS ANAEMIA
- autoimmune destruction of intrinsic factor (IF)
- IF is produced by parietal cells in stomach
- B12 needs to bind with IF in distal ileum in order to be absorbed

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35
Q

other causes of B12 deficiency

A
  1. drugs - PPIs, colchicine, metformin, nitrous oxide
  2. gastric - atrophic gastritis, gastrectomy, H.pylori
  3. intestinal - crohn’s, malabsorption
  4. nutritional - malnutrition, veganism
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36
Q

presentation of B12/folate deficiency anaemia

A

symptoms
- cog changes
- dyspnoea
- headache
- indigestion
- loss of appetite
- palpitations
- tachypnoea
- weakness
- visual disturbance

signs
- anorexia
- angina
- angular cheilosis
- brown pigmentation in nail beds/skin creases
- diarrhoea
- glossitis
- mild jaundice
- mild pyrexia

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37
Q

what symptom is key for megaloblastic anaemia and a hallmark of folate deficiency?

A

loss of appetite/weight loss

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38
Q

which complications are strongly associated with B12 deficiency?

A

NEURO
- loss of mental/physical drive
- optic neuropathy
- muscle weakness
- psychiatric disturbance
- symmetrical neuropathy

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39
Q

investigations for B12/folate deficiency anaemia

A
  1. FBC
    - MCV high
    - haematocrit low
    - Hb low
    - reticulocytes low
    - WC/platelets may be low if severe
  2. blood film
    - macrocytic
    - may be megaloblasts
  3. either serum cobalamin or serum folate
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40
Q

management of folate deficiency anaemia

A

oral folic acid 5mg daily (check B12 levels before starting!!!)

diet - asparagus, broccoli, brown rice, brussel sprouts, chickpeas, peas

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41
Q

management of B12 deficiency anaemia
a) neuro involvement
b) no neuro involvement

A

a)
- urgent advice from neuro/haem
- consider starting B12 replacement while waiting

b)
- IM or oral B12 replacement e.g. hydroxocobalamin

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42
Q

what acne treatments are contraindicated in pregnant women?

A

topical and oral retinoid tx e.g. tretinoin

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43
Q

what is atopic dermatitis?

A

aka eczema - a chronic inflammatory skin condition affecting people of all ages

an episodic disease of flare-ups

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44
Q

when does atopic dermatitis most frequently present?

A

<5 years old (10-30% of all children)

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45
Q

risk factors for atopic dermatitis

A
  • atopy
  • family hx
  • environmental factors e.g. urban areas, smaller families, higher socioeconomic class
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46
Q

common triggers for atopic dermatitis

A
  • soap and detergents
  • animal dander
  • house-dust mites
  • extreme temps
  • rough clothing
  • pollen
  • foods
  • skin infections
  • stress
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47
Q

describe the typical rash that presents in atopic dermatitis. where does it tend to appear?

A
  1. dry
  2. red
  3. pruritic
  4. weeping/blistered/crusty/scaling/thickened
  5. in…
    adults - hands/limb flexures
    children - limb flexures
    infants - face
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48
Q

investigations for atopic dermatitis

A

clinical diagnosis

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49
Q

management for mild atopic dermatitis (2)

A
  1. emollients
  2. mild topical corticosteroid e.g. hydrocortisone 1%
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50
Q

management for moderate atopic dermatitis, including flare up and preventative tx (4)

A
  1. emollients
  2. moderately potent topical corticosteroid e.g. betamethasone valerate 0.025% (continue for 48h after flare has been controlled)
  3. antihistamine e.g. cetirizine if severe itch
  4. preventative tx = maintenance regime of topical corticosteroid
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51
Q

management for severe atopic dermatitis, including flare up and preventative tx (6)

A
  1. consider admission/referral
  2. emollients
  3. potent topical corticosteroid e.g. betamethasone valerate 0.1% for flares
  4. antihistamine for itch (if affecting sleep, consider sedating antihistamine e.g. chlorphenamine)
  5. if eczema causing psychological distress - oral prednisolone 30mg
  6. maintenance regime of topical corticosteroids
52
Q

when are routine/urgent referrals to dermatology indicated for atopic dermatitis?

A

routine - current management not working

urgent - eczema is severe and not responding to tx within 1 week

53
Q

what is otitis media?

A

infection of the middle ear (sits between tympanic membrane and inner ear)

54
Q

what often precedes otitis media?

A

viral URT infection

55
Q

what is the most common bacterial cause of otitis media in both children and adults?

A

Streptococcus pnuemoniae

56
Q

other bacterial causes of otitis media (3)

A
  1. H.influenzae
  2. Moraxella catarrhalis
  3. S.aureus
57
Q

RFs for otitis media in children? (5)

A
  1. young age (6-12m)
  2. male
  3. passive smoking
  4. bottlefeeding
  5. craniofacial abnormalities
58
Q

general sx of otitis media

A
  1. EAR PAIN
  2. reduced hearing
  3. fever
  4. malaise
  5. coryzal sx
  6. maybe cough/sore throat (URT infection)
59
Q

signs of ear pain in an infant with otitis media

A
  • tug at ear that hurts
  • irritable
  • disinterested in food
  • vomiting
60
Q

investigations and results for otitis media

A
  1. otoscopy - erythematous and bulging TM, if perforated may see tear and discharge in ear canal
  2. may do bloods if systemically unwell
61
Q

management of otitis media

A
  • normally self-revolving (3d-1w)
  • simple analgesics e.g. paracetemol
62
Q

when would abx be indicated for otitis media? which would be used?

A
  • if pt has significant comorbidities/systemically unwell/immunocompromised
  • or if sx aren’t clearing up
  • amoxicillin 5-7d
63
Q

what is benign paroxysmal positional vertigo (BPPV)? what is it characterised by?

A

a disorder of the inner ear characterised by repeated episodes of POSITIONAL vertigo (sx occur with changes of head position)

64
Q

what causes BPPV/what is it’s pathophys?

A

loose calcium carbonate debris (otoconia) in the semi-circular canals of the inner ear

head movement causes otoconia to move which moves inner ear fluid > vertigo

65
Q

RFs for BPPV (9)

A
  • older age
  • head injury
  • prolonged recumbent position e.g. dentist/hairdresser
  • ear surgery
  • inner ear pathology
  • migraine
  • recent viral infection
  • female
66
Q

how does BPPV present? what is NOT affected?

A
  1. vertigo sx brought on by specific movements/positions of head e.g. lying down, turning over, bending over
    - lasts less than 1 minute
    - asymptomatic between attacks
  2. may have associated N&V, light-headedness, imbalance
  3. may also have positional nystagmus

will NOT have affected hearing or tinnitus

67
Q

investigations for BPPV

A

not normally required

  • neuro exam
  • Dix-Hallpike manoevre (provoke vertigo/nystagmus)
68
Q

management of BPPV

A
  1. can watch and wait - sx should settle within 4 weeks
  2. if not settling - offer Epley manouvre and consider Brandt-Daroff exercises which pt can do at home
69
Q

what is benign prostatic hyperplasia (BPH)?

A

a non-neoplastic condition involving enlargement of the prostate, obstructing bladder outlet and causing LUTS

70
Q

at what age are almost all men affected by BPH?

A

70 and over

71
Q

where in the prostate does BPH mainly effect? why do LUTS happen sooner than in prostate cancer?

A

hyperplasia of the transitional zone (v central) - so immediately causing problems for ureter which passes through

prostate cancer most commonly affects the peripheral zone - takes a while to get big enough to press on ureter

72
Q

presentation of BPH

A

storage and voiding symptoms

storage:
- frequency
- urgency
- nocturia
- incontinence

voiding:
- hesitancy
- weak stream
- dribbling
- dysuria
- straining

73
Q

examinations and investigations for BPH (4)

which scoring system can be used?

A
  1. DRE - smooth, enlarged
  2. abdo exam - palpable bladder
  3. urinalysis - normal (rule out cancer, UTI)
  4. consider PSA test

consider International Prostate Symptom Score assessment

74
Q

management for BPH (symptoms not bothersome)

A

behavioural management!
- reducing fluids at night
- limiting caffeine/alcohol
- avoiding/modifying diuretic use

75
Q

management for BPH (symptoms bothersome)
a) medical
b) surgical

A

a) 1st line = either…
- alpha-blockers e.g. terazosin, doxazosin
- 5-alpha-reductase inhibitors e.g. finasteride
- PDE-5 inhibitors e.g. tadalafil

b) TUIP (minimally invasive) or TURP (moderately invasive)

76
Q

what is mastitis? who does it usually occur in and why?

A

a painful inflammatory condition of the breast
usually occurs in lactating women as is commonly caused by milk stasis

77
Q

what is a breast abscess? who is it common in and what is it caused by?

A

a localised collection of pus within the breast (may or may not be associated with mastitis)

women aged 14-45

most often s.aureus

78
Q

RFs for mastitis/breast abscess

A
  • poor breastfeeding technique
  • lactation
  • milk stasis
  • nipple injury/damage
  • hx of mastitis
  • nipple piercing
79
Q

presentation of mastitis

A
  • painful, tender, red hot breast (pain esp on breastfeeding)
  • fever and general malaise may be present
80
Q

signs that mastitis is infected

A
  1. nipple fissure
  2. purulent discharge
  3. flu and pyrexia lasting >24h
81
Q

if untreated, what can mastitis develop into?

A

a breast abscess

82
Q

management for mastitis

what and when should abx be considered?

A

1st line = continue breastfeeding!
simple measures - analgesia and warm compresses

consider abx (oral flucloxacillin 10-14 days) IF
- systemically unwell
- nipple fissure present
- symptoms don’t improve after 12-24h of effective milk removal
- culture indicates infection

83
Q

how is a breast abscess generally treated?

A

referral to secondary care for incision and drainage

84
Q

bronchiolitis:
a) cause
b) presentation
c) diagnosis

A

a) RSV

b) child <1, increasing then peaking sx at 3-5 days - low grade fever, nasal congestion, rhinorrhoea, dry cough, feeding difficulties, inspiratory crackles and expiratory wheeze

c) clinical diagnosis if pt has coryzal syndrome lasting 1-3 days followed by…
- persistent cough AND
- either tachypnoea/chest recession AND
- wheeze or crackles

85
Q

when should a child with bronchiolitis be referred to hospital (999)?

A
  • apnoea
  • looks seriously unwell
  • severe resp distress e.g. grunting, marked chest recession, RR >70
  • central cyanosis
86
Q

when should a child with bronchiolitis be considered a referral to hospital?

A
  • RR >60
  • difficulty breastfeeding/inadequate intake
  • clinical dehydration
  • persistent O2 sats <92% on air
87
Q

how are most non-severe bronchiolitis cases treated in primary care?

A

advise parents to support at home with fluids, nutrition and temperature control
safety-netting - return if getting worse

88
Q

a) what is vulvovaginal candidiasis?
b) what is it most commonly caused by?
c) define acute/recurrent thrush

A

a) symptomatic inflammation of the vagina and/or vulva

b) caused by Candida yeast families (FUNGUS) - most common is candida albicans

c) acute = first/single isolated presentation
recurrent = four or more symptomatic episodes in one year

89
Q

presentation of vulvovaginal candidiasis (4)

A
  1. defining symptom = vulval/vaginal ITCHING
  2. non-offensive white discharge, ‘cheese-like’
  3. dyspareunia
  4. dysuria
90
Q

investigations for vulvovaginal candidiasis

A

often clinical, but can do…
1. self-collected LVS or HVS, STI screening
2. if recurrent, consider HVS for culture of secretions

91
Q

acute tx for vulvovaginal candidiasis
what if 1st line is contraindicated?
what can be used for vulval sx?

A

1st line = fluconazole 150mg oral capsule OD

if contraindicated - clotrimazole pessary

topical imidazole e.g. clotrimazole for vulval sx

92
Q

tx for recurrent vulvovaginal candidiasis

A

induction = three doses oral fluconazole 150mg
maintenance = oral fluconazole once weekly for 6m

93
Q

what is candida?

A

a yeast-like fungus part of the normal commensal flora of the GI tract

94
Q

RFs for oral thrush (pseudomembranous candidiasis) (8)

A
  1. extremes of age
  2. immunocompromised
  3. recent/concurrent drug use e.g. broad spec abx, inhaled corticosteroids
  4. DM
  5. endocrine disorders
  6. poor dental hygiene
  7. smoking
  8. poor diet/nutritional deficiency
95
Q

how does oral thrush present?

A

non-painful, curd-like, white/yellowish plaques on cheeks/gums/palate/tongue

96
Q

how is oral thrush treated?

A

first line = oral miconazole gel for 14 days

97
Q

what bacteria causes chlamydia?

A

Chlamydia trachomatis

98
Q

which parts of the body does Chlamydia trachomatis affect in…
a) adults
b) children

A

a) non-squamous epithelium e.g. urethra, endocervical canal, rectum, pharynx, conjunctiva
b) conjunctiva

99
Q

signs and symptoms of chlamydia

A

usually ASYMPTOMATIC!
- discharge
- friable cervix (easy bleeding) or abnormal bleeding
- penile discharge
- dysuria

100
Q

investigations for a) females and b) males for chlamydia

A

a) self-collected vulvovaginal swab
b) first void urine

NAAT - nucleic acid amplification test

101
Q

tx for chlamydia:
a) first-line
b) who is this contraindicated in?
c) alternative tx for contraindicated pts

A

a) doxycycline 100mg for 7 days

b) contraindicated in pregnant women

c) azithromycin, erythromycin, amoxicillin

102
Q

when should pts with chlamydia be advised to return to sexual activity?

A

only when 7 day tx is completed

103
Q

non-medical tx for chlamydia

A

partner notification and tx of partners

104
Q

define chronic fatigue syndrome

A
  • persistent fatigue for a minimum of 6 weeks
  • significantly impairs every day activities
  • cannot be explained by other illness
105
Q

diagnostic criteria for chronic fatigue syndrome (6)

A
  1. fatigue worsened by activity
  2. not caused by cognitive/physical/emotional/social exertion
  3. not relieved by rest
  4. post-exertional malaise (disproportionate to activity)
  5. sleep problems
  6. cognitive difficulties
106
Q

chronic fatigue syndrome is diagnosed by ruling out other conditions. suggest some investigations for this and what they would help rule out. (10)

A
  1. FBC, serum ferritin - anaemia, polycythaemia, malig
  2. ESR/CRP - infection, inflammation, autoimmunity, neoplasms
  3. LFTs - liver probs
  4. renal function - kidney disease/electrolytes
  5. TFTs - hypothyroidism
  6. HbA1c - diabetes
  7. IgA tissue transglutaminase - coeliac
  8. urinalysis - renal infection, inflammation, diabetes
  9. creatinine kinase - neuromusc cause
  10. bone chemistry and myeloma screen (if >60yrs)
107
Q

management options for chronic fatigue syndrome

A
  1. referral to secondary care specialist (if diagnostic criteria met)
  2. manage associated stress/depression
  3. advice on sleep hygiene
  4. referral to physio/OT
  5. pain management
  6. CBT
  7. review in primary care at least 1/year
108
Q
A
109
Q

what is the conjunctiva? what is its job?

A

thin mucous membrane lining the eyelids and covering the sclera - keeps eye lubricated and protected from irritants

110
Q

what is conjunctivitis? what is it caused by? (5)

A

inflammation of conjunctiva due to…

  1. allergic/immunological reaction
  2. infection
  3. mechanical irritation
  4. neoplasia
  5. contact with toxic substances
111
Q

most common cause of conjunctivitis

A

infective - mainly viral, then bacterial

112
Q

presentation of conjunctivitis

A
  • acute onset conjunctival erythema
  • discomfort e.g. grittiness sensation, burning
  • watering and discharge
113
Q

indications of conjunctivitis being caused by a:
a) bacterial
b) viral
c) atopic/allergic

A

a) purulent discharge, crusting of lids sticking together
b) less discharge/more watery, may have URTI
c) may be recurrent due to seasonal or environmental factors

114
Q

investigations for conjunctivitis

A

clinical diagnosis

115
Q

red flags for conjunctivitis

A
  1. reduced visual acuity
  2. pain/headache
  3. red sticky eye in neonate
  4. hx of trauma/foreign body
  5. contact lens use
  6. copious rapidly progressive discharges (indicates gonococcal)
116
Q

conjunctivitis management:
a) viral
b) bacterial

A

a) self-limiting, self care e.g. bathing eyelids with saline soaked cotton wool, artificial tears

b) mostly self limiting but IF severe or sx don’t resolve in 3 days, consider topical abx - chloramphenicol 0.5%

117
Q

what is contact dermatitis? what are the two types? which is more common?

A

an inflammatory skin condition affecting the epidermis and dermis caused by exposure to irritant/allergen

  1. allergy CD - type IV (delayed) hypersensitivity reaction occurring after sensitisation and re-exposure
  2. irritant CD - non immunological reaction caused by direct physical/toxic effects of an irritant

irritant is more common

118
Q

acute vs chronic irritant contact dermatitis

A

acute - single overwhelming exposure
chronic - repeated exposure to weaker irritants e.g. detergents, soap, dust

119
Q

what is the most common irritant contact dermatitis in the first year of life?

A

nappy rash

120
Q

common allergens for allergen contact dermatitis

A
  1. products e.g. cosmetics, skincare, nail varnish, fragrances, sunscreen
  2. metals e.g. nickel and cobalt in jewellery
  3. topical meds e.g. corticosteroids
  4. plants
121
Q

common irritants for irritant contact dermatitis

A
  1. nappies
  2. sweat
  3. detergent. soap, cleaning agents
  4. solvents
  5. acid and alkalis
  6. reducing/oxygen agents e.g. sodium hypochlorite
  7. powders, dust, soil
122
Q

general features of contact dermatitis

A

acute - erythema, vesiculation, dry, scaling, bullae
chronic - dry, lichenification, fissuring

123
Q

indications of irritant vs allergy contact dermatitis

A
  1. varying sx e.g. stinging, burning, smarting, tightness, chapping
  2. protected areas e.g. under gloves remain clear
  3. anatomical distribution e.g. dermatitis in webs of fingers/under ring from repetitive exposure to water or detergents
  4. avoidance of causative = resolution within DAYS
124
Q

indications of allergy vs irritant contact dermatitis

A
  1. reaction 24-72hr following re exposure
  2. dominant sx = ITCHING
  3. blistering, weeping, oedema (severe)
  4. may affect areas not directly in contact e.g. transfer of nail varnish from finger to eye
  5. resolution = many days
125
Q

gold standard investigation for contact dermatitis

A

patch testing

126
Q

management of contact dermatitis

A

MAINSTAY = IDENTIFY AND AVOID CAUSATIVE AGENT
emollient
consider topical steroids

if can’t avoid - prevent/minimise e.g. rinse after, substitution of products, gloves, avoid accumulation of water/chemicals under jewellery

PHASE 3A (11 decks)

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