Referrals

Question 1

When do you refer athlets foot?

Answer 1

1) toenails becoming black or discoloured
2) if fungal infection spreads.
3) if skin is broken (weeping, pus, yellow crusts)
4) Diabetics

Question 2

Burns?

Answer 2

1) chemical or electircal burns.
2) if its involve face, scalp, han, feet and joints
3) respiratory burns
4) if its >10% for a child, 15% for a adult.
5) children <12 yes
6) if below knees for elderly.

Question 3

Cold sores?

Answer 3

1) if not resolved within 2 weeks
2) if it is painless ( risk of carcinoma)
3) if affecting the eye.
4) children <12 yes
5) atopic eczema
6) discharge, bus , yellow crushing
7) immunocompromised pts

Question 4

Cold?

Answer 4

1) children <1 yr ( temperature, poor feeding, abnormal breathing.

2) severe earache
3) persistent fever and cough > 48h in children and > 5 days in adults that is getting worse.

4) chest pain
5) worsening asthma or copd
6) ongoing malasie, purlent mucus.

Question 5

Constipation?

Answer 5

1) longer than 14 days
2) if present with vomiting, bloating, abdominal pain
3) blood or mucus in stools
5) weight loss
6) fluctuations with diarrhoea or constipation
7) children < 12 yrs
8) pain on defecation ( might be fissures)

Question 6

Cough?

Answer 6

1) ACE
2) production of green or brown- foul smelling.
3) haemoptysis
4) asthmatics
5) wheezing
6) persistent symptoms > 7 days.
7) Dry cough in children if not associated with URTI in the past 2-4 weeks.
8) < 1 year
9) whooping cough
10) worsening coup in copd or increased sputum.
11) cough associated with smoking

Question 7

Cystitis?

Answer 7

1) men
2) children under 12
3) associated with fever
4) loin pain
5) haemturia
6) vaginal discharge
7) associated with increased thirst
8) recurrent cystitis
9) longer than 2 days
10) over 60 and under 16
11) pregnancy

Question 8

Diarrhoea over 5 yrs?

Answer 8

1) > 5 days
2) severe vomiting or fever
3) presence of blood or mucus in stools
4) recent travel

Question 9

Diarrhoea under 5 yrs?

Answer 9

1) younger than 1,year for more than 1 day
2) under 3 who had more than 2 days
3) if accompanied rash
4) if fever or vomiting

Question 10

Earach ?

Answer 10

1) pain not improve after 24- 48h
2) if discharge or bleeding
3) forigh body in ear
4) neck stiffness
5) tinnitus, deafness, N&V
6) temepratrie or swelling and under 12 yrs

Question 11

Hayfever?

Answer 11

1) painful ear

2) purulent conjunctivitis

Question 12

Mouth ulcers?

Answer 12

1) if no improvement after a week
2) if there is diarrheao
3) if has blistering
4) rash
5) longer than 3 weeks
6) under 3 years

Question 13

Nappy rash?

Answer 13

1) weeping or yellow crusting ( bacterial infection)
2) if there is oral thrush
3) if > than a week

Question 14

Fever?

Answer 14

1) under 6 months
2) if > 24h in a child.
3) if child drowsy and not well
4) if calf pain or recerent travel
5) severe pain
6) fever with heart or asthma risk of pneumonia
7) persistent cough with fever and sputum
8) fever lead to stiff neck, vomiting,
9) fever with rash
10) temperature >41
11) febrile seizures
12) cellulitis
13) immunocomprozed

Question 15

Soft tissue injury?

Answer 15

1) sudden injury
2) swelling and lose of function
3) history of injury of sport or OA or gout
4) with head injury or fall
5) if they cant hold weight
6) pain and inflammation didnt resolve in 5-7 days
7) pregnant, breast feeding and < 1 yrs

Question 16

Sore throat?

Answer 16

1) carbimazole or methotrexate
2) young children, pregnancy and breastfeeding
3) sore throat longer than 7- 10 days
4) sore throat with discharge from ear or not improved after 48 hours
5) sore throat with skin rash
6) hoarseness > 5 days in children and > 3 weeks in adults.
7) history of endocarditis

Question 17

Sunburn?

Answer 17

1) unrespone to treatment after 2 days
2) with vomiting
3) with rash
4) suddent flare up of burn
5)

Question 18

Teething?

Answer 18

1) if fever persists
2) with diarreah
3) poor fluid intake

Question 19

Vaginal candida?

Answer 19

1) no improvement within 7 days
2) low abdominal pain with dysuria
3) >2 times in last 6 months
4) discharge change in appearance or smell
5) clear or watery discharge
6) irregular menstrual bleeding
7) previously sexually transmitted infection
8) pregnancy

Question 20

Verruca?

Answer 20

1) diabetes
2) history of vascular disease
3) immunocomprised
4) under 6 yrs
5) bleeding or itching
6) persistent infection
7) angionital or facial verruca
8) verruca against nail fold
9) if on steroids on anticoagulant
10) pigmented or change in size

Question 21

Wart?

Answer 21

Same as verrucas

Question 22

Threadworms?

Answer 22

Under 2 yrs