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M103 > W20 Respiratory conditions > Flashcards

W20 Respiratory conditions Flashcards

1
Q

Who can access the Common Ailment Scheme (CAS)?
Exclusions?

A
  • Any patient who lives in Wales or who is registered to a Welsh GP is eligible to access the Choose Pharmacy Service.
  • Temporary residents whose usual address is not in Wales
  • Care Home residents
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2
Q

What are the 26 conditions that can be treated under the Common Ailment Scheme (CAS)

A
  1. Acne
  2. Athletes Foot
  3. Backache (acute)
  4. Chickenpox
  5. Cold sores*
  6. Colic*
  7. Conjunctivitis (bacterial)
  8. Constipation
  9. Dermatitis (acute)
  10. Diarrhoea*
  11. Dry eyes
  12. Haemorrhoids
  13. Hayfever
  14. Head Lice
  15. Indigestion/reflux
  16. Ingrowing toenail*
  17. Intertrigo/ringworm
  18. Mouth Ulcers
  19. Nappy rash
  20. Oral thrush
  21. Scabies
  22. Sore throat/tonsillitis
  23. Teething
  24. Threadworm
  25. Vaginal thrush
  26. Verruca

*Advice only conditions - no treatment available on NHS

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3
Q
A

Acne
Cold sores
Headline
Ringworm
Mouth ulcers
Athletes foot
Nappy rash
Oral thrush
Verruca
Headache

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4
Q

What is Choose Pharmacy?

A

Choose Pharmacy is a confidential NHS electronic records system, which community pharmacists use to record details of NHS services they provide to you.

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5
Q

Cold symptoms vs Flu symptoms

A

Cold:
- Congestion
- Itchy/watery eyes
- Feeling tired

Flu:
- Fever
- Body aches
- Extreme fatigue

Both:
- Cough
- Runny/stuffy nose
- Sore throat
- Headache

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6
Q

Common Cold:
What are the general symptoms?
When is the onset of symptoms?

A
  • Mild, self-limiting, viral (rhinovirus), upper respiratory tract infection
  • General symptoms: nasal stuffiness and discharge, sneezing, sore throat, and cough. No known treatment improves the time course of infection.
  • Transmitted by either direct contact or aerosol transmission.
  • People can remain infectious for several weeks.
  • The most common complications are sinusitis, lower respiratory tract infections (LRTI), and acute otitis media.
  • Onset of symptoms after infection is sudden, reaching a peak at day 2–3, then decreasing in intensity.
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7
Q

How long does a common cold last?
Adults?
Children?
Smokers?

A
  • In adults and older children, symptoms tend to last about a week, although cough can persist for up to 3 weeks.
  • In younger children, symptoms typically last 10–14 days.
  • Smokers tend to have more severe respiratory symptoms (including cough), and the infection is more prolonged.
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8
Q

What do the common cold symptoms or signs in adults and older children include:

A
  • Sore or irritated throat.
  • Nasal irritation, congestion, nasal discharge (rhinorrhoea), and sneezing.
  • Nasal discharge is often profuse and clear at first but becomes thicker and darker as the infection progresses.
  • Cough, which typically develops after nasal symptoms clear.
  • Hoarse voice caused by associated laryngitis.
  • General malaise.
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9
Q

What is Seasonal Influenza?
What are the complications?

A
  • Acute respiratory illness caused by RNA viruses of the family Orthomyxoviridae (influenza viruses).
  • Most complications of influenza in adults are respiratory in nature and include:
  • Acute bronchitis.
  • Pneumonia.
  • Exacerbations of asthma and chronic obstructive
    pulmonary disease (COPD).
  • Otitis media.
  • Sinusitis.
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10
Q

What is Uncomplicated influenza?

A

oryza (inflammation), nasal discharge, cough, fever, gastrointestinal (GI) symptoms, headache, malaise, myalgia, arthralgia, ocular symptoms, and sore throat.

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11
Q

What is Complicated influenza?

A

Requires hospital admission, involve the lower respiratory tract, central nervous system (CNS), or cause significant exacerbation of an underlying medical condition.

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12
Q

Influenza symptoms appear when?

A

Influenza presents with symptoms appearing around 2 days after exposure.

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13
Q

Seasonal Influenza:
Who do the ‘At risk’ group include?

A
  • Those with chronic respiratory, heart, kidney, liver, or neurological disease; diabetes mellitus (DM); or those who are obese or immunosuppressed.
  • Those > 65 years.
  • Women who are pregnant (or women up to two weeks post partum).
  • Children aged < 6 months.
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14
Q

What is the management of seasonal influenza?

A
  • Drink adequate fluid
  • Take paracetamol or ibuprofen to relieve symptoms, rest
  • Stay off work or school until the worst symptoms have resolved (usually ~1 week)
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15
Q

Seasonal Influenza
Urgent admission to hospital should be
considered if?

A
  • A complication such as pneumonia occurs.
  • The person has a concomitant disease that may be affected by influenza (for example, type 1 diabetes).
  • There is suspicion of a serious illness other than influenza (for example, meningitis).
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16
Q

What is a Cough?
How long can it last?
What are the causes?

A
  • It is a reflex response to airway irritation.
  • It is triggered by stimulation of airway cough receptors, either by irritants or by conditions that cause airway distortion.
  • Cough can be acute (lasting < 3 weeks), sub-acute (lasting 3–8 weeks), or chronic (lasting > 8 weeks).
  • Commonly caused by a viral upper respiratory tract infection (URTI).
  • Other causes include:
  • Acute bronchitis.
  • Pneumonia.
  • Acute exacerbations of asthma
  • Environmental or occupational causes.
  • Foreign body aspiration.
17
Q

What are the Managements of a cough?

A
  • Management of people with cough should be based on treating the underlying cause where it has been identified, or sequential trials of treatment to confirm or refute common causes.
  • Offer self care (e.g. paracetamol or ibuprofen for pain and inflammation, if appropriate), and refer to smoking cessation if relevant.
  • Referral to a respiratory physician should be arranged for people with a cough that does NOT respond to trials of treatment, if the diagnosis is uncertain, or if systemically unwell.
  • Emergency referral should be arranged for people with: Clinical features of foreign body aspiration.
18
Q

What is croup?

What are the symptoms?

Who does it commonly affect?

A
  • Croup (laryngotracheobronchitis) is a common childhood disease
  • Usually caused by a virus.
  • Symptoms: sudden onset of a seal-like barking cough usually accompanied by stridor (predominantly inspiratory), hoarse voice, and respiratory distress due to upper-airway obstruction.

Symptoms are usually worse at night. There may be a fever.
* There is often a preceding 12–48 hour history of a non-specific cough, rhinorrhoea, and fever.
* Croup most commonly affects children between 6 months and 6 years of age, with a peak incidence during the second year of life.

19
Q

Croup:
- Mild croup symptoms:
- Moderate croup symptoms:
- Severe croup symptoms:

A
  • Mild croup symptoms include seal-like barking cough but no stridor or sternal/intercostal recession at rest.
  • Moderate croup symptoms include seal-like barking cough with stridor and sternal recession at rest; no agitation or lethargy.
  • Severe croup symptoms include seal-like barking cough with stridor and sternal/intercostal
    recession associated with agitation or lethargy.
  • A child should be immediately admitted when presenting with moderate or severe croup, or impending respiratory failure.
  • stridor- high-pitched sound heard during inspiration
20
Q

What are the different managements of croup?

A
  • Management: All children with mild, moderate, or severe croup should receive a single dose of oral dexamethasone (0.15 mg per kg body weight).
  • If the child is too unwell to receive medication, inhaled budesonide (2 mg nebulised as a single dose) or intramuscular (IM) dexamethasone (0.6 mg/kg as a single dose) are possible alternatives.
  • Mild croup can usually be managed at home.
  • Croup is usually self-limiting and symptoms usually resolve within 48 hours.
  • If the child is being managed at home, the use of paracetamol or ibuprofen to control fever and pain should be advised, and parents should be advised to seek urgent medical advice if there is any deterioration.
21
Q

Why are Steroids given?

A

Suppresses immune system and thus reduces inflammation

22
Q

What is a Whooping Cough?
What is it spread by?
What is the incubation period?
How long does it last?

A
  • Also known as pertussis
  • It is a highly infectious disease caused by the bacterium Bordetella pertussis.
  • It is spread by aerosol droplets released during coughing, and disproportionately affects infants and young children.
  • The incubation period is usually about 7 days, and the person is infectious for 3 weeks after the onset of symptoms.
23
Q

What are the 3 phases of symptoms of whooping cough?

A

-The catarrhal phase lasts ~ a week and is characterised by the development of a dry, unproductive cough.

-The paroxysmal phase may last for a month or more and is characterised by coughing fits, whooping, and post-tussive vomiting. The person may be relatively well between paroxysms.

-The convalescent phase may last an additional 2 months or more, and is characterised by gradual
improvement in the frequency and severity of symptoms.

24
Q

Management of whooping cough

A
  • People who are seriously unwell should be admitted to hospital (a low threshold is required for children aged 6 months or less).
  • An antibiotic (usually a macrolide, such as erythromycin or clarithromycin) should be prescribed to all people with suspected or confirmed whooping cough with onset of cough within the previous 21 days.
  • Advice should be given on rest, adequate fluid intake, and the use of paracetamol or ibuprofen for symptomatic relief.
  • Children and healthcare workers should be advised to stay off nursery, school, or work until 48 hours of appropriate antibiotic treatment has been completed, or 21 days after onset of symptoms if not treated.
  • Close contacts may require antibiotic prophylaxis.
25
Q

Management of whooping cough

A
  • People who are seriously unwell should be admitted to hospital (a low threshold is required for children aged 6 months or less).
  • An antibiotic (usually a macrolide, such as erythromycin or clarithromycin) should be prescribed to all people with suspected or confirmed whooping cough with onset of cough within the previous 21 days.
  • Advice should be given on rest, adequate fluid intake, and the use of paracetamol or ibuprofen for symptomatic relief.
  • Children and healthcare workers should be advised to stay off nursery, school, or work until 48 hours of appropriate antibiotic treatment has been completed, or 21 days after onset of symptoms if not treated.
  • Close contacts may require antibiotic prophylaxis.
26
Q

9 cough types in kids (for info)

A

Croup
Viral cold
Asthma
Flu
Whooping cough
Pneumonia
Bronchitis
Reflux cough
Allergic cough

27
Q

Compare croup and whooping cough

A

Croup- Caused by virus, seal-like barking cough

Whooping cough- Caused by bacteria, highly infectious

Has 3 phases
1. Dry, unproductive cough (1 week)
2. Coughing fits, whooping and post-tussive vomiting (a month)
3. Gradual improvement but symptoms (2 months)

28
Q

Compare cold and flu:

A

Both have symptoms of
Cough, runny nose, sore throat, headache

Ony cold:
Congestion, watery eyes, feeling tired

Only influenza:
Fever
Body aches
Extreme fatigue

M103 (46 decks)

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