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NHS > Responding To Symptoms > Flashcards

Responding To Symptoms Flashcards

1
Q

What about cold?

A

It is viral and self-limiting

More common in children and those at high risk like diabetes as they increase risk of pneumonia.

Usually last 7- 14 days

Fever usually indicate a flu

Earache is a complication of cold ( para or Ibu but if fever or vomiting present then refer.

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2
Q

When do we need antibiotics in sinusitis?

A

If > 10 days or fever >38 or discoloured nasal discharge. Give decongestants if nasal decongestion for max 1 week.

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3
Q

Flu?

A

Similar,symptoms to cold plus temperature. It can be complicated to pneumonia in high risk groups such as sever products cough or persistent fever.

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4
Q

Decongestants?

A

It should not be used more than 7 days causes rebound decongestion with topical applications but not orally.

Oxymetazoline last up to 6h

Pseudophedrine and ephedrine cause insomnia.

For high risk groups use menthol inhalation, sitting in steamy room. Saline nasal drops.

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5
Q

Is non sedating ANTIHISTAMINES less effective in cold?

A

Yes

Older ones ( chlorphenamine) are drowsy so avoid with benzos, phenothiazines, hyoscine, TCA, oxbytinin, betahistine, tiotrpium.

Avoid them with angle closure glaucoma and prostatic problems.

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6
Q

Echinacea?

A

Can cause allergic reactions and rash.

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7
Q

Is menthol and eucalyptus inhalation recommend to children?

A

No avoid in younger than 3 months risk of scalding and children.

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8
Q

Nasal Sprays or drops ?

A

Spray for over 6 yrs as it reaches the nostril

Under 6 years drops as nostril is not wide enough

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9
Q

Prevention of cold and flu?

A

Vaccination for high risk groups

Flu nasal spray for over 1 to 4 yrs
2-17 if at high risk

Handwashing for at least 20 sec

Ethanol hand sensitizers

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10
Q

Cough?

A

It is viral. Sputum leads to cough or when cilia is not working properly like in smokers.

Clear sputum is uninfected and known as mucoid.

Wheezing need referral

If green or yellow sputum might need antibiotics.

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11
Q

Croup?

A

Barking cough

Develops 1 day after a cold.

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12
Q

CVD and coughing?

A

Coughing can be a symptoms of HD if there is a history of CVD

More than 3 weeks the referral

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13
Q

Managements of cough?

A

Simple linctus useful for children and pregnant to soothe the cough

Suppressatns: codeine and pholcodien but they are drowsy.

Pholcodie 5mg over 6 yrs
Adults 15 mg tds

Expectorants: guaifensin 100 -200mg

U can also give antihistamines in cough that can dry the musuc but avoid them with expectorants.

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14
Q

Theophylline and cough?

A

Theophylline is used in cough for its bronchdilator effects. Avoid in inhibitors.

120mg tds

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15
Q

Sore throat?

A

It is viral and self limiting. If cough is present usually is not an infection.

Streptococoaal bacterial present in children.

If there is no cough or cold then refer after 24h

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16
Q

When do you refer hoarseness?

A

After 3 weeks

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17
Q

Can beclometasone and budesonide cause hoarseness?

A

Yes

Carbimaozle, methotrexate and azathioprine cause blood dyscrasisi so refer

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18
Q

What is glandular fever?

A

Viral throat infection caused by Epstein Barr virus.

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19
Q

Management of a SORE THROAT?

A

1) paracetamol, aspirin, or ibuprofen.
2) Benzydamine spray over 6 years ( mouthwash over 12 yrs).

3) flurbiprofen lozenges over 12 yrs one tab dissolved in the mouth every 3-6 h ( max 5 a day for 3 days).
4) iodised throat lozenges avoid in pregnancy affect baby throat.

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20
Q

Allergic rhinitis ( hay fever)?

A

Symptoms start in April.

Symptoms ( runny nose, congestio , clea eyes) can be complicated by otitis media such as pain or discharge from ears and watery eyes like If eyes were clear and become watery mean secondary infection.

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21
Q

Management of HAY FEVER?

A

1) Antihistamiens ( loratadine over 2 yrs or cetrizine OD over 6 yrs)

ACRIVASTINE TDS over 12 yrs

2) ICS nasal sprays take few days to work ( beclometasone, mometasone or fluticasone) all over 18 yrs for up to 3 months.
3) sodium cromoglycate should start 1 week before hey fever QDS.
4) Azelastine nasal spray should start 2-3 weeks before hay fever starts. Over 5 yrs.
3) nasal congestion if they have

4)

22
Q

Managements of IBS?

A

1) peppermint, alverine, hyosine ( they relax the mouth muscle)

Alverine 60- 120mg max TDS with water.

Peppermint oil ( one to two caps TDS - DONT shew- 15- 30 mins before food) not for children.

Mebevirine: 135mg TDS 20 min before food.
Avoid under 10yrs

Bran is no longer good for IBS
Oats are good. Ispaghula husk is also good.

23
Q

Which drugs causes contact dermatitis?

A

Topical ICS
Neomycin
Lanolin
Cetyl stearly alcohol

24
Q

Atopic eczema?

A

Usually combined with hayfever or asthma.

25
Q

Management of eczema?

A

Greasy preparation is most effective like white soft paraffin. Emollients

In emulsifying ointment should be mixed with water before add to the bath.

Topical ICS however if there is cold sore, athletes foot then avoid and use max 1 week ( alclometasone 0.05%, clobetasone 0.05% available OTC. Avoid using on groin, between the toes.

Calamine or crotamiton lotion or cream

26
Q

ACNE?

A

Caused by excess of sebum which causes overgrowth of bacteria.

27
Q

Which drugs causes ACNE?

A

Lithium, phenytoin, progesterone, levonorgestrel، norethisterone.

28
Q

Management of Benzoyl peroxide?

A

It causes reddening and soreness. Treatment should start 2.5% - 5% then move to 10%. Wash off after 15 min …. should use minimum of 6- 8 weeks.

Can bleach clothes.

Chlorhexdine.

Topical erythromycin or clindamycin.

Sun is good for it.

29
Q

What is the management of athletes foot?

A

1) make sure have a good hygiene keep it cool and dry and wear cotton socks.
2) terbinafine most effective for recurrence, ketoconazole both for 1 week.
Terbinafine over 16 yrs

Griseofulvin 1% spray OD for 4 weeks.

Tolnaftate BD for 6 weeks.

30
Q

Practical points for cold sores?

A

1) tea tree oil topically or Balm mint.
2) HSV1 is contagious so avoid contact and wash hands.

3) use sunscreen spf 15 or higher
4) atopic eczema patients should avoid contacting anyone with cold sores.

31
Q

Verruca?

A

Known as plantar wart

Caused by human papillomavirus.

Both veruca and watt caused by the same virus.

Warts known as cauliflower.

Warts will usually disappear around 6 - 2 years. If change in appearance then refer.

Can use the freezing method cryotherapy.

Salicylic acid OD at night but wash it before using. However it can burn areas that are not infected so u can use petroleum jelly.

32
Q

Scabies?

A

Itching can take several 6-8 weeks to develop it

Permethrin cream apply to whole body and leave for 8-12 h.

Malathion lotion should apply for 24h

Crotamiton cream relieve symptoms.
Sedating antihistamine too

Better to apply before bedtime.

All family should be treated.

Pts might not develop for up to 3 weeks. And incubation is 3 weeks.

Scabies can live for 1 day once they leave their host.

33
Q

Dandruff?

A

It is overgrowth of yeast malassezia

Greyish white flakes of scalp ( cradle cap)

Ketoconazole 2% twice a week for 2-4 weeks.

Zinc pyrithione shampoo twice weekly then once weekly.

Selenium sulphide 2.5% twice weekly for first 2 weeks then once weekly. Massage the scalp and leave for 2 to 3 mins

Should remove jewellers as it selenium discolour and should not use within the first 48h of dying hair.

34
Q

What is the management of psoriasis?

A

1) Topical D preparation ( calciptriol 50mcg) ointment OTC for plaque psoriasis over 18yrs . Can cause odeam, irritation. If overused risk of hypercalcemia. It is OD for max of 12 weeks. Max size is 60g. Avoid it if the patient is taking anything with ca or vitamins D.

Refer when nail involvement
Less than 50% improve within 12 weeks.

Good to use vitamin D and ICS.

Coal tar with salicylic acid.

Dithranol for 30 min ( causes and stain yellow-brown skin).

Second line ( methotrexate or ciclosporin)

35
Q

What is tension headache?

A

1) affect both sides ( tender to touch, like a band around the head) Bilateral
2) sometimes associated with musculoskeletal neck problems.
3) not aggravated by physical like walking.

You need to refer if it worse when lying down or worse in morning and gets better at night ( intracranial pressure).

36
Q

Chronic daily headaches?

A

1) occurs 15 days or more a month and last for more than 3 months.

37
Q

Cluster headaches?

A

1) pain comes very quickly
2) Wakes the person from sleep
3) last from 15min to 3h
4) affect one side of head, eye, cheeks. Watery eyes. Blocked nose on same side.

Refer when children under 12 yrs
More than 4 h pain
Temperature

38
Q

Treatment of headaches?

A

1) ibuprofen ( daily otc max is 1200mg) over 12 yrs. Avoid in renal impairment or in peptic ulcers.
2) should not prescribe NSAIDs for someone who is allergic or has hypersensitivity to Aspirin. Avoid in HF becoz of fluid retention. Asprin avoid in gout. Aspirin avoid in pregnancy and asthmatics.
3) Dihydrocodeine 7.46mg over 12 yrs
4) Doxylamine over 12 yrs

Buclizine otc for migraine contains antiemteics.

39
Q

What is the difference between sprains or strains?

A

1) sprains is over stretching example is ankle ligament. Joint pain and swollen
2) Strains ( muscle fibres are damaged and ruptures).

40
Q

What is Rhamatoid arthritis?

A

Come on quickly
Symmetrical
Swelling and pain
Stiffness most in the morning last more than 30 mins

41
Q

What is acute back pain?

Chronic back pain?

A

Lasts less than 6 weeks.

Chronic >12 weeks (give NSAIDS).

Bed rest is not recommend to be active.

If they cannt carry weight then refer

Rubefacients ( warm the skin)
Counterirritsns ( methyl salicylate)
Nicotinates ( methyl nicotinate)

Menthol has cooling effect

Capsiaicn makes it warm.

Topical ICS

Heparinoid and hyaluronidase reduction in swelling.

42
Q

sprains or strains?

A

Heat can be used only after 1 - 2 days.

Avoid activity for first 48-72 h following injury

43
Q

Symptoms of Cyctitis?

A

Pass urine frequent and pain when passing
Itching
Burning

Vaginal discharge would indicate local fungal.

Cyclophosphamide causes cystitis.

Refer if fever, N&V, men, longer than 2 days of beginning treatment.

Treatment: potassium or sodium citrate ( contraindicated in hypertension, HD, HTN). Cranberry juice

44
Q

What are practical points of cyctits?

A

1) Drink large quantities of fluids
2) wait for 20 seconds after passing urine
3) wipe from front to back.

45
Q

What is dysmenorrhoea?

A

It is painful periods.

46
Q

Does aspirin cause more GI problems than NSAIDs?

A

Yes but soluble ones are less

47
Q

What is menorrhagi

A

Heavy periods ( if not improved after 3 cycles of treatment then refer).

Tranexamic acid ( Pass into milk)

48
Q

Symptoms of vagina thrush?

A

Itch ( vag deodorants can lead to itching)
Discharge cream coloured, thick appearance.

Treatment: imidazoles cream BD for 7 days. Oral fluconazole

Avoid nylon underwear and tights

49
Q

What is management of ear wax?

A

1) eye drops for 3-5 days
2) olive oil or almond oil 3 times a day for 3-5 days.
3) sodium bicarbonate 5%

50
Q

What is otitis externa?

A

1) inflammation of the ear or sever pain.
2) itching, hearing loss and discharge.

Managment: refer, antibiotics

For pain just give para or ibuprofen.

Use hairdryer to dry it
Can use Earcalm TDS

51
Q

What is otitis media?

A

1) infection of the middle ear common in children).

Symptoms: pain and pressure

Paracetamol or ibuprofen.

If there is a discharge then refer.

52
Q

What is glue ear?

A

Is also known as serous otitis media.
Becoz of fluid in ear doesn’t drain out completely.
It may cause deafness.

Refer.

NHS (8 decks)

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