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What is the common name for Enterobius vermicularis, and where does it primarily reside in the human body?
Threadworm or pinworm (Enterobius vermicularis) primarily resides in the upper part of the colon.
Who is most commonly affected by threadworm infections, and what are the factors contributing to its prevalence in children?
Threadworm infections most commonly affect children due to their poor attention to personal hygiene. High rates of infection can occur in residential homes.
What symptoms are caused by the irritant mucus and eggs laid by female threadworms, and how does reinfection typically occur?
Symptoms include intense itching and scratching caused by the irritant mucus and eggs laid by female threadworms. Reinfection occurs when eggs are ingested from contaminated hands.
How can confirmatory diagnosis of threadworm infection be made, and what are the danger symptoms associated with heavy infestation?
Confirmatory diagnosis is usually made by sighting the worms around the perianal area, most easily seen at night. Danger symptoms include secondary bacterial infection, appetite loss, weight loss, insomnia, irritability, and enuresis.
What are the differential diagnoses for perianal itching in adults, and when might referral be necessary?
In adults, perianal itching may be due to haemorrhoids, eczema, or irritants such as deodorants. Referral might be necessary if other parasitic worm infections are suspected.
What is the recommended treatment of choice for threadworm infections in adults and children older than two years, and how does it act on the worms?
Mebendazole (Ovex®) is the treatment of choice for threadworm infections in adults and children older than two years. It acts by inhibiting the uptake of glucose by the worms, causing immobilization and death.
What hygiene measures can be taken as an alternative to drug treatment, and what precautions should be followed when using anthelmintics in a household?
Hygiene measures alone can be considered when drug treatment is not wanted or recommended. If followed for six weeks, these measures can eliminate worms from the intestine. When using anthelmintics, all household members should be treated simultaneously.
What is the primary action of Mebendazole in treating threadworm infections, and what potential side effects may occur during its use?
Mebendazole acts by inhibiting the uptake of glucose by the worms, causing immobilization and death. Transient abdominal pain or diarrhea can occasionally occur, especially in people with heavy infestations.
What practical tips are provided in the extract to prevent and manage threadworm infections at home?
Practical tips include wearing closefitting pyjama bottoms, bathing or showering first thing in the morning, emphasizing good hygiene, cutting fingernails short, and daily laundering of bedding and towels to avoid spreading eggs.
What is the size and color of the head louse (Pediculus capitis)?
The head louse is grey/brown and about 3 mm long.
How do head lice feed?
Head lice feed by sucking blood from the scalp of their host.
Where do female lice lay their eggs, and how are they attached?
Female lice lay eggs on the hair shaft near the scalp surface, and the egg’s shell is firmly attached to the hair.
How long does it take for lice eggs to hatch, and what are the empty shells called?
Eggs hatch in about seven days, and the empty shells are called nits.
Can eggs, whether hatched or unhatched, be proof of an active infection?
No, eggs attached to hairs are not proof of active infection, as they may retain a viable appearance for weeks after death.
How is a conclusive diagnosis of head lice made?
A conclusive diagnosis is made by finding live lice.
Who is more likely to get head lice, and what factors increase the risk?
Infestation is more likely in school children, with increased risks in those with more siblings, longer hair, and lower socioeconomic status.
How are lice transmitted?
Lice are transmitted through close headtohead contact.
What are the potential differential diagnoses for head lice?
Seborrhoeic scales, hair casts, and hair spray may be confused with nits.
What are the recommended treatment options for head lice?
Two applications of insecticide seven days apart, each left on the hair for 2 hours, and examination after 4 days to determine cure.
Why might treatment failure occur, and how much insecticide is needed for an average head of hair?
Treatment failure may occur with one application or insufficient product. An average head of hair needs 50ml of insecticide.
What should be done if treatment failure is suspected?
If treatment failure is suspected, a different insecticide should be used at least three weeks after the last application.
How can observation of lice samples on plain white paper with sticky tape provide useful information?
It helps identify lice resistance if lice of all ages are seen after insecticide treatment.
What is the preferred type of lotion for head lice treatment, and why should caution be taken during application?
Alcoholic lotions are preferred; caution is needed as they are flammable.
What is the preferred strategy if reinfestation occurs?
If reinfestation occurs, a different insecticide should be used in a mosaic strategy.
How does wet combing differ from insecticide treatments, and when is it a useful option?
Wet combing involves using a plastic detection comb plus conditioner every four days; it is useful for pregnant or breastfeeding individuals or children under two.
How does Hedrin® lotion act, and what is its recommended application process?
Hedrin® lotion disrupts lice by covering them physically and must be left on for eight hours, with treatment repeated after seven days.
- Are head lice repellents effective for treating existing infestation?
No, head lice repellents are not intended for treating existing infestations.
- Is there evidence supporting the use of herbal and essential oils or electric combs for head lice?
No, there is no evidence supporting their use; electric combs may kill lice but not eggs, and oils have no proven efficacy.
2 . What is the effectiveness of wet combing compared to malathion and permethrin in cases of high insecticide resistance?
In cases of high insecticide resistance, wet combing was found to be more effective than malathion or permethrin in one trial.
- How does wet combing with conditioner render lice motionless, and how often should it be performed?
Wet combing with conditioner renders lice motionless; it should be performed every four days over at least a twoweek period until no lice are seen on three consecutive sessions.
- What is the mechanism of action for Hedrin® lotion, and how does it disrupt lice?
Hedrin® lotion disrupts lice by covering them physically and disrupting their ability to manage water balance.
- What caution should be taken during the application of alcoholic lotions for head lice treatment?
Patients should be warned not to use a hair dryer, as alcoholic lotions are flammable.
- In head lice treatment, what is the recommended strategy if resistance is suspected after using one insecticide?
A different insecticide should be used at least three weeks after the last application if treatment failure is suspected.
- Why is malathion lotion preferred over permethrin in some studies, and what is a common misconception about treatment failure?
Malathion may increase lice eradication compared with permethrin. Treatment failure is commonly mistaken by patients as treatment resistance.
How does hedrin lotion work?
Physically works to cover the lice and disrupt their ability to manage water balance. Must be left on for eight hours and repeated after 7 days.
- What is the suggested interval for using a different insecticide if treatment failure is suspected?
A different insecticide should be used at least three weeks after the last application if treatment failure is suspected.
- Are head lice repellents intended for routine prophylactic use, and do they treat existing infestations?
Head lice repellents are not intended for routine prophylactic use, and they do not treat existing infestations.
What are some practical tips for headlouse
• Regular detection combing is the best way to control head lice infestation, so that treatment can be initiated as soon as infestation is detected.
• Long hair should be worn tied up and fringes tucked away when there is an outbreak at a school or nursery.
•Bedding and clothes do not need specific laundering since lice cannot live for very long away from the heat and blood of the head.
- What causes scabies, and what is the main symptom?
Scabies is caused by the mite Sarcoptes scabiei. the main symptom is extreme itching, especially at night, accompanied by a rash.
- Where does the scabies rash commonly appear, and what are secondary lesions?
the rash appears between fingers and toes, on wrists, ankles, around nipples, buttocks, and genitals. Secondary lesions can occur due to excoriation.
- What are scabies burrows, and how are they identified?
Burrows are fine, silvery lines, 2 5 mm in length, often with the mite at the closed end. They may appear as dark points.
- How is the rash caused, and what is the average life span of the mite?
The rash is caused by the female mite burrowing into the skin and laying eggs. The mite dies after 46 weeks.
- How is scabies transmitted, and why is it important to treat all close contacts?
Scabies is transmitted by close physical contact. Treating all close contacts is crucial, as symptoms may not appear until two weeks after infestation.
- When should children under two years of age with scabies symptoms be referred for treatment?
Children under two years of age should be referred for treatment under medical supervision.
- What are the possible differential diagnoses for scabies?
Eczema, contact dermatitis, or insect bites may have a similar appearance.
- How should scabies be treated, and why is it important to treat all household members simultaneously?
Permethrin 5% w/w cream is a firstline option. All household members and close contacts should be treated simultaneously to prevent reinfestation.
- Why is malathion 0.5% aqueous liquid recommended for pregnant or breastfeeding women?
Malathion is recommended for pregnant or breastfeeding women as it is poorly absorbed and eliminated rapidly.
- What are practical tips for preventing reinfestation and managing scabies at home?
Wash clothes, towels, and bed linen at a temperature of at least 50°C. Treat the whole household.
- What is Norwegian (crusted) scabies, and who is particularly susceptible to it?
Norwegian Scabies is characterized by crusted lesions and scaly plaques. Immunocompromised patients are particularly susceptible.
- How is Norwegian scabies different from typical scabies, and why is it more resistant to standard treatment?
Norwegian Scabies has crusted lesions and scaly plaques, making it more resistant to standard treatment. it may have hundreds to thousands of female mites, making it easily transmitted.
- What additional considerations are important for immunocompromised patients with scabies?
Immunocompromised patients are particularly susceptible to Norwegian Scabies, a rare and more resistant form of the condition.
- What are danger symptoms in scabies, and when should children under two be referred for treatment?
Danger symptoms include extreme itching, especially at night, and a rash. Children under two should be referred for treatment under medical supervision.
- What are the potential differential diagnoses for scabies?
Eczema, contact dermatitis, or insect bites may have a similar appearance.
- How long does it take for scabies symptoms to appear after infestation, and why is simultaneous treatment for all close contacts important?
symptoms may not appear until two weeks after infestation. Simultaneous treatment for all close contacts is crucial to prevent reinfestation.
- What is the firstline option for scabies treatment, and how should it be applied?
Permethrin 5% w/w cream is generally the firstline option. Apply over the whole body (including scalp, neck, face, and ears) and wash off after 8 to 2 hours.
- Why is malathion 0.5% aqueous liquid recommended for pregnant or breastfeeding women?
Malathion is recommended for pregnant or breastfeeding women as it is poorly absorbed and eliminated rapidly. it should be removed from the nipple before feeds and reapplied afterward.
- What additional treatment options are available for relieving skin irritation in scabies?
Crotamiton cream or liquid (Eurax®) may help soothe and relieve skin irritation. A sedative antihistamine for nighttime use may be helpful to relieve itching.
- How long does itching often persist after scabies treatment, and why is it important to continue preventive measures?
itching often persists for up to three weeks after treatment. Preventive measures, such as washing clothes and bedding at a high temperature, are crucial to avoid reinfestation.
2 . What is Norwegian (crusted) scabies, and why is it more resistant to standard treatment?
Norwegian Scabies is characterized by crusted lesions and scaly plaques. it may have hundreds to thousands of female mites, making it more resistant to standard treatment.
- What special considerations are important for immunocompromised patients with scabies?
Immunocompromised patients are particularly susceptible to Norwegian Scabies, a rare and more resistant form of the condition. crusted lesions and scaly plaques are prominent, and transmission is more likely.
- What is the importance of treating all close contacts simultaneously in scabies?
Treating all close contacts simultaneously is crucial to prevent reinfestation, even if they are asymptomatic. symptoms may not appear until two weeks after infestation.
- Why is it important not to apply scabies treatment after a hot bath?
Applications should not take place after a hot bath, as this increases the likelihood of systemic absorption of the treatment.
- What are the recommended intervals for reapplying scabies treatment after the initial application?
the application should be repeated after seven days to ensure complete treatment.
- How can crotamiton cream or liquid (Eurax®) contribute to scabies management?
Crotamiton may help soothe and relieve skin irritation, although it has poorer efficacy compared to Permethrin for Scabies treatment.
- What are practical tips for preventing reinfestation and managing scabies at home?
Wash clothes, towels, and bed linen at a temperature of at least 50°C to kill all mites and prevent reinfestation. It is necessary to treat the whole household.
- What is the role of a sedative antihistamine in scabies management?
a sedative antihistamine for nighttime use may be helpful to relieve itching, especially if the skin is becoming excoriated. itching often persists for up to three weeks after treatment.
What is the association between Herpes Simplex Type and Type 2?
Type is associated with cold sores, while Type 2 is associated with genital herpes.
What triggers the reactivation of the herpes simplex virus after a primary infection?
Possible triggers include sunlight, stress, colds, and menstruation.
Describe the prodromal signs of cold sores (herpes labialis).
Early signs include tingling, itching, or numb feelings, followed by the development of small red fluidfilled vesicles that may burst and crust over.
How long does the recovery from cold sores typically take?
Recovery usually takes 1014 days.
What are the differential diagnoses for lesions inside the mouth resembling cold sores?
Lesions may be confused with aphthous ulcers. Axial cheilitis, with similar appearance, is more common in the very young and the elderly.
What are the treatment options for cold sores?
Topical antiviral agents like aciclovir and penciclovir can speed up healing if applied during the prodromal phase.
How should aciclovir be applied for cold sores treatment?
Aciclovir should be applied five times daily for five days.
What danger symptoms indicate a potential bacterial infection in cold sores?
Weeping pustules may indicate a secondary bacterial infection, requiring antibiotic treatment.
What practical tips can help manage cold sores?
Use lip balm to limit drying and cracking. Wash hands after touching lesions, avoid sharing face cloths, and apply sunscreen to prevent sun exposure.
0 Why should immunocompromised patients be referred for routine appointments?
0 They may need additional care due to the risk of complications from herpes simplex infections.
1 What is the most common secondary infection associated with cold sores?
1 Impetigo is the most common, identifiable by spreading golden crusting or erythema.
2 When are oral antiviral treatments indicated for cold sores?
2 Oral antivirals are indicated in exceptional circumstances, where recurrence is frequent and severe.
3 How can the spread of herpes simplex infection be prevented?
3 Wash hands after touching lesions, avoid touching the eyes, and do not share face cloths or towels. Avoid oral sex to prevent genital herpes.
