RTS- Respiratory Conditions Flashcards
List the common respiratory conditions you may come across in community pharmacy (8)
1) the common cold
2) influenza
3) coughs
4) Hayfever
5) asthma and COPD
6) pneumonia and other bacterial and viral infections
7) drug induced cough
8) more serious diseases :TB , lung cancer etc
outline the difference between the common causes for cold and influenza, explain the transmission of the disease and state whether there is a vaccine.(4, 3)
colds:
1) viral infection by over 100 causative viruses (40% rhino-viruses, 10% coronaviruses)
2) affects nose, nasopharynx and upper respiratory tract
3) immunity specific to each virus so no vaccine
4) transmission: droplet inhalation or touching surfaces where droplets have landed.
influenza:
1) viral infection of the whole respiratory tract by 3 types of myxovirus
2) vaccine is available - reformulated each year
3) transmission by droplet inhalation- highly contagious
Describe the symptoms of a cold (5)
1) gradual onset
2) initial discomfort of eyes, nose, throat
3) sneezing, rhinorrhoea, congestion, sore throat , dry tickly cough, headache
4) mild fever in children , although uncommon in adults
5) colds last 4-7 days
- common - average adult has 2-4 a year , all year
Describe the symptoms of influenza (4)
1) rapid onset
2) initially fever, shivering , headache , myalgia, vertigo, nausea, back pain
3) may also get symptoms of cold
4) anorexia and depression for up to few weeks after
- can affect up to 15% population and causes epidemics and pandemics periodically, usually in winter.
Outline when you would refer a cold or influenza (10)
1) asthmatics -not always
2) night time cough in children
3) persistent cough
4) dyspnoea (SOB) /wheezing
5) stiff neck and/or non-blanching rash
6) severe pain on coughing
7) earache
8) facial pain
9) treatment failure
10) nasty sputum
Describe the Non-pharmacological counselling advice given to patients suffering from cold and influenza (7)
1) caused by virus so no paint going to GP!
2) rest, keep warm, plenty of fluids
3) eat plenty of fresh fruits and vegetables to help maintain body’s vitamins and minerals and therefore immune system
4) should improve within 7-10 days
5) influenza vaccine advice to at risk groups
6) steam inhalation, inhalants etc.
7) sweets to ease throat
List the complementary medicine for colds and influenza (6)
1) zinc
2) menthol
3) vitamin c
4) vitamin E
5) echinacea
6) garlic
Describe the possible likely and unlikely diagnosis of a sore throat (4)
1) most likely :viral infections and self limiting (7-10 days )
2) likely: streptococcal infection “strep throat” may require referral
3) unlikely: glandular fever, thrush, herpes simplex
4) very unlikely - carcinoma, medicines
Explain how the choice of treatment for a person with a sore throat is influenced by who the person is. (5)
Who: age affects choice of medicine and the likely cause of symptoms, especially in children so you may need to refer
- babies or infants- croup, difficulty breathing
- children
Outline the symptoms of a sore throat and state when you need to refer (5, 5)
1) runny/ blocked nose
2) runny eyes
3) cough
4) temperature
5) severity of pain
Referral:
1) observation: ulceration, redness, white patches, exudate, inflammation
2) swollen lymph glands - if very painful/ not improving for 5-7 days
3) difficulty swallowing (dysphagia) /drinking / breathing
4) over one week consider referral , over 2 weeks refer
5) severe pain with no other symptoms and no improvement 24-48 hours should be referred
Explain why it is important to check if a patient is on any medication before recommending a product for a sore throat (5)
1) some medication can cause sore throats e.g. Inhaled steroids - advice
2) for others it is a sign of immunosuppression as a result of taking: carbimazole, carbamazepine, sodium valproate, azathioprine, oral steroids, cytotoxic drugs including chemotherapy- refer
3) interactions with recommended products
4) allergies to medication
5) other conditions they have not shared? Asthma, diabetes , heart problems?
Describe when you would refer a patient suffering from a sore throat (10)
1) babies or infants, especially if associated with difficulty breathing
2) bacterial infections
3) suspected glandular fever
4) difficulty swallowing and/or breathing
5) ulceration
6) white patches/ plaques in throat and/or mouth and tongue
8) patient is immunosuppressed , especially if sore throat is associated with a fever
9) extreme pain with no other symptoms and no improvement after 24- 48 hours
10) treatment failure
What is tonsillitis and outline the treatment options (6)
1) tonsillitis is the inflammation of the tonsils and often the cause of a sore throat
2) can be viral
3) if bacterial, often streptococcal and known as “strep throat”
4) signs of streptococcal infection include white patches on tonsils, fever and malaise
5) if recurrent may consider having them removed
6) drinking can be difficult, cannot swallow saliva
Explain what glandular fever is and list the symptoms (4)
1) a viral infection usually affecting adolescents and young adults
2) sore throat, swollen lymph glands, fever
3) recovery from symptoms usually in 6 weeks
4) patient may be tired or become depressed for several months
Explain what oral truth is and list the symptoms and treatment (7)
1) a fungal infection caused by candida (yeast)
2) mouth and throat may be very sore
3) presence of white patches/ plaques on mucosal surfaces that cannot be wiped/ brushed off
4) common in babies and asthmatics using steroid inhalers
5) diabetics (undiagnosed/uncontrolled)
6) refer if patient is/ could be immunocompromised
7) if simple cause - Tx OTC with oral miconazole gel