Responding To Symptoms IPM

Question 1

What is the ASMETHOD

Answer 1

Adult or Child?
Self or Someone Else
Medication (regularly taken or Rx or OTC)
Extra Medicines
Time Persisting
History 
Other Symptoms
Danger Symptoms

Question 2

Ear infections symptoms include..

Answer 2

Pain, Discharge, Fever, Itch, Hearing loss, Dizziness/Imbalance

Question 3

List some Ear Specific questions

Answer 3

• Any history of ear injury? (can occur with inserting cotton bud)
• History of ear problems?
• Are you suffering form any other illness e.g cough, cold, sore throat.

Question 4

What conditions do we need to eliminate with earache?

Answer 4

Earache with fever, vomit, severe deafness, children below 6 with ear pain.

Question 5

Whats easy to be infected after ear is infected? What age group is most affected from getting ear infections?

Answer 5

Throat. Most common in children before age 3

Question 6

Whats the name of the tube leading to the back of the throat from the ear?

Answer 6

eustachian tube

Question 7

OTC Treatment available

Answer 7

• Cerumenolytics (soften the cerumen, wax)
• Docusate Sodium (e.g Waxol - it softents te cerumen)
• Olive/Almond oil
• Irrigation/syringe: use warm water
• Peroxide-based (e.g Otex, breaks up hardened wax)

Question 8

Where can bacterial/fungal ear infections be acquired

Answer 8

Caught through swimming

Question 9

OTC Treatment for ear infection other than the common ones given to soften ear wax?

Answer 9

Analgesics!
Ear Calm Spay (Contains Acetic acid which has antimicrobial effects, by making the environment acidic and difficult to survive)

Question 10

Self Care advice after Ear OTC treatment?

Answer 10

Swim ear plugs, ear drops, shower, use swim cap, dry your ears after a swim

Question 11

Prescription Ear Treament

Answer 11

Chloramphenicol ear drops.
Antifungal Ear drops e.g Clomitrazole Solution
Aluminium Acetate + ribbon gauze dressing

Question 12

Counselling on administering ear drops?

Answer 12

Wash hands, ten shake the bottle and remove the cap
Tilt head to one side so affected ear is upwards
Pull ear lobe to straighten ear canal
Instil required number + keep tilted for 5-10 min
Discard after 28 days. Write date of opening

Question 13

Conjunctivitis has 3 stypes. These are..

Answer 13

Irritant - Allergic - Infective

Question 14

State two key eye complications (not conjunctivitis)

Answer 14

• Styes

- Blepharitis

Question 15

Important Eye questions are:

Answer 15

Do you wear contact lenses?
Are there any visual disturbances?
Are you Diabetic?
Are you unwell?
Pain?
PMH

Question 16

Infective Conjunctivitis can be either

Answer 16

Bacterial or viral

Question 17

Presenting features of Bacterial Conjunctivitis

Answer 17

muco-purulent sticky discharge, eyelashes have crusty discharge

Question 18

Presenting Features of Viral Conjunctivitis

Answer 18

Watery, Red eye, Very intensive and photophobia

Question 19

Other broad features of both viral and bacterial conjunctivitis

Answer 19

sore, burning, swollen, irritated and contagious (infects both eyes)

Question 20

Features of Allergic detmatitis

Answer 20

Seasonal

Question 21

when to refer a patient with suspected conjunctivitis

Answer 21

Pain in eyes/ Disturbed vision, Acute glaucoma, eye surgery (lasts 6 months)

Children below age of 2 years

OTC treatment failure

Question 22

Conjunctivitis at risk groups include

Answer 22

Children/Elderly/Newborn
Immunosuppressed Px
Diabetic

Question 23

Treatment of bacterial conjunctivitis and viral conjunctivitis

Answer 23

NO Treatment for viral OTC

10mL Chloramphenicol 0.5% eye drops. Store in fridge at 2-8°C

or 4g Chloramphenicol 1% eye ointment..

Question 24

Treatment of Allergic Conjunctivitis

Answer 24

Antihistamines/Sodium Chromoglycate/ Intra ocular eye drops/ nasal spray

Question 25

Irritant Conjunctivitis Tx

Answer 25

Witch Hazel (Optrex sore eyes)

Question 26

Self care for infective conjunctivitis

Answer 26

• contact work or school (for adult or child)
• avoid contact lenses
• avoid rubbing in eyes, wash hands regularly
• Cold compress and avoid sharing towels. Wash with high temperatures.

Question 27

Self care for irritant conjunctivitis

Answer 27

Sunglasses to avoid the glare.

Computer rest breaks

Question 28

Key points for all eye drops and ear products when opened

Answer 28

• Discard after 28 days
• Check for compatibility with contact lenses
• Write ‘date of opening’ on label to remember

Question 29

What do styles look like?

Answer 29

small pimple/boil in or on outside of eyelid

painful lump

pus

self limiting 1-3 weeks

Question 30

Stye Treatment?

Answer 30

Warm Compress and Analgesics