RESPIRATORY Flashcards
What are the referral symptoms for respiratory ailments?
wheezing/shortness of breath Dry, night-time cough. Barking. Coloured sputum, yellow/green. Blood stained sputum Cough lasting >3 weeks Pain on inspiration Chest pain Drug induced cough/wheeze (ACE-inhibitors) NSAIDS etc.
What are the red flags for respiratory illnesses?
Cough lasting >3 weeks
Chest pain.
What are the three types of cough?
Productive (chesty)
Non-productive (tickly, dry)
Congested (tight, hard cough)
What type of cough occurs when there is mucus present in lungs that cannot be cleared?
Congested
What type of cough occurs when there is sputum produced?
Productive.
How would you treat a congested cough?
Expectorants to remove mucus from chest/airways.
Benylin chesty, Guaifenesin.
How would you treat a non-productive dry irritant cough?
Suppressants such as codeine, pholcodeine, dextromethorphan. Suppress the cough.
How would you treat very young children who cannot take cough suppressants?
Demulcents like simple linctus, honey and lemon.
Codeine containing products are no longer recommended for who?
Codeine containing products are no longer recommended for under 18’s
Lacks evidence for efficacy in this age group
Concerns over its central mode of action and variability in its metabolism to morphine in this age group
What are the referral criteria for a sore throat?
Adverse drug reaction - if an associated skin rash.
Duration.
If patient cannot swallow.
Symptoms which suggest a bacterial infection.
What advice should be given to those suffering from sore throats?
Stimulation of saliva will help sooth the throat/lubricate it.
Gargles have shorter duration of action than lozenges.
Diabetics should only take sugar free lozenges.
Mouthwashes should not be swallowed.
How can sore throats be treated?
Symptomatic relief:
- local anaesthetics
- Benzocaine
- Lidocaine
analgesics etc.
How old must a patient be before they can gargle aspirin?
- Reyes syndrome.
How can a cold be differentiated from influenzae?
Influenza will have: Sudden onset of symptoms Shivers Chills Malaise Marked aching of limbs Insomnia Non-productive cough and loss of appetite.
Patients presenting with suspected colds should be referred if
Facial pain/severe frontal headache Ear pain Patients with symptoms of flu: esp vulnerable groups. Persistent fever Chest pain.
Why are anti-histamines used in the treatment of colds?
Can lessen the symptoms of sneezing and a runny nose/post nasal drip.
Occurs due to anti-cholinergic actions.
What referral symptoms are there for allergic rhinitis?
Wheezing/shortness of breath
Treatment failure
Unilateral discharge - especially in children.
What is first line treatment for allergic rhinitis?
Allergen avoidance. Systemic antihistamines Intranasal corticosteroids Occular mast cell stabilisers Decongestants -systemic and intranasal
What anti-histamines are available for allergic rhinitis?
Sedating ones: chlorphenamine.
non-sedating: loratadine, cetirizine.
For who can intranasal corticosteroids be recommended?
Those over 18 suffering from allergic rhinitis.
What are opticrom allergy eye drops for?
Allergic rhinitis.
Mast cell stabilisers.
What questions should be asked for a child presenting with a cough? [7]
How old are they?
What type of cough? chesty, dry, productive?
Any mucus being produced?
Any fever, aches, loss of appetite, lethargy?
Any treatments tried?
Are they asthmatic?
Is there a wheeze or shortness of breath?
For which patients would a glycerol cough syrup not be recommended?
Diabetic
What type of laxative is first line in pregnancy for constipation treatment?
Bulk forming laxative
Should patients taking antihypertensives be taking decongestants?
NO.
Decongestants could cause an increase in blood pressure.
Guaifenesin should be used for:
Chesty cough
OTC cough suppressants containing codeine should be avoided in people under what age?
18
OTC cough suppressants cannot be given to children under what age?
6 years old.
What is the first line treatment for rhinitis?
Allergen avoidance.
What drug can cause a sore throat?
Carbimazole
What is quinsy?
Sore throat with an abscess at the back of the throat
Robitussin chesty contains what ingredient?
Guafenesin: used to treat chesty cough.
What two local anaesthetics can be used in sore throat treatment?
Benzocaine
Lidocaine
Patients with what conditions would not be offered decongestants?
Glaucoma
Hyperthyroidism
Hypertension
Decongestants increase blood pressure and can exacerbate those conditions.
What is the age limit for calcough infant?
> 3 months
What is the age limit for calcough?
> 6 years
How do the active ingredients differ between calcough infant and calcough?
Calcough infant has glycerine
Calcough has guafenesin
Why can anusol HC not be used in pregnancy?
Contains hydrocortisone.
What type of inhaler is blue?
A reliever inhaler. For on the spot relief of asthma symptoms.
If you need your relief inhaler more than 3 times a week, your asthma is not well managed and u need to see GP or asthma nurse.
If a patient is using their blue inhaler more than _____ they should be referred.
3 times in any 7 day period.
What colour is a preventer inhaler?
Normally brown.
How should a preventer inhaler be used?
Every day, usually morning and evening.
