Week 19- GP2 Flashcards
Acne rosacea
Chronic rash of centre face with mild-severe papules, pustules and erythema. Telangiectasia. Advanced = rhinophyma/thickening. May be transient or persistent.
Related to UV damage, aggravated by temp and spice.
Inflammatory reaction due to high cathelicidins, neutrophils, nitric oxide, matrix metalloproteinases collagenase and elastase (latter two also thickens).
Yellow brown papules and nodules indicates granulomatous rosacea.
Metronidazole gel and/or azelaic cream 3-4 months, if bad or ineffective: ivermectin cream or doxycycline oral 40mg for 6-8 weeks.
Nasal vestibulitis
Infection of nasal vestibule. Symptoms include fever, painful + swollen nose, furuncles, dry nose, crusting nostrils, nosebleeds, bumps filled with pus.
If reoccurring, might be bcc or scc. Caused by staph aureus, herpes simplex or zoster. Diabetic, immunocompromised. Risk of cellulitis, cavernous sinus thrombosis.
Give mucopiricin 2 wks if essential bc risk of mrsa transformation. If there’s boils or reoccurs add oral antibiotic cephalexin.
Furunculosis
Deep infection of hair follicle from staph aureus. Painful, swollen bumps with pus. Warm, red and vary in size. If several abscesses/boils form in a cluster = carbuncle. Can become chronic.
Severe infections can give enflamed nodes, fever and fatigue. On eyes = stye, on gums = gum boil.
Treat with warm compresses 3-4 times a day. Incision + drainage, topical fusidic acid or mupirocin (note risk resistance). Oral abx includes flucloxacillin or dicloxacillin. Can refer and give rifampicin and clindamycin. Associated with B12 and vit C deficiencies.
Hidradenitis suppurativa
long term abscesses and scarring with inflammation in armpits, groin, buttocks or breast. Inflamed, painful, pus-filed and itchy. Bad odour when leaking.
Give rifampicin and clindamycin. May need cortisone injection. Isotretinoin can be given for follicle repair.
Not seen out of reproductive age range. Linked to crohns and comorbid infections.
Post-nasal drip
drainage of mucous from nose or paranasal sinuses into the pharnyx. Often chronic with repeated episodes of cold and flu. Accumilation of mucus in post nasal space indicates dec mucocilliary clearance. One cause in triad of chronic cough - with asthma and gord.
Also called rhinosinusitis. treat with steroid spray beclomethasone.
Pneumococcal disease
Can be pneumonia, ear, RTI, sinus infection, meningitis, septicaemia.
Chest infection types
Pneumonia, bronchitis, colds, flu, RTIs, bronchiolitis.
Pneumonia (signs, sounds, treatment)
Produces mucus, cough with phlegm. High grade fever with chills, fast breathing, sob, chest pain on coughing, tachycardia, fatigue, D+V, cyanosis, haemoptysis.
Hear crackles, rumbling, consolidation, dull percussion, rhonchi, effusion, empyema (if so, sweating/night sweats).
Give levofloxacin or azithromycin. If viral = oseltamivir or zanamivir.
RTI
Infection of sinus, throat, airway or lungs. Often self-resolving.
Has cough +/- phlegm, sneezing, runny nose, sore throat, headache, muscle ache, breathless, tight chest or wheezing, fever.
Bronchitis
Larger airway infection than pneumonia. Has cough +/- mucus, mild fever/chills, chest discomfort, sob, myalgia, headache, blocked nose. Can lead to pneumonia.
Sounds include low pitched wheeze or rhonchi.
If risk factor positive for pneumonia- treat same- levofloxacin or azithromycin (+100bpm, RR >24, >38C, age 75+, decr O2 sat, signs of consolidation: rales, tactile fremitus, egophony).
Causes of Atypical/walking pneumonia
Mycoplasma, chlamydophila pneumoniae, legionella pneumophilia.
Has headache, low grade fever or malaise.
Treatment for epiglottitis
Cefotaxime
Surfer’s ear/exostosis
Bone of ear canal develops multiple bony growths/exostoses leading to partial or complete blockage of ear canal from cold wind or water exposure.
Swimmer’s ear = otitis externa
Sciatica causes and treatments
Causes: spinal disc herniation, spinal stenosis, piriformis syndrome, endometriosis, pregnancy, pelvic tumour, epidural abscess/tumour, cauda equina syndrome.
Treatments-
anti-inflammatory: celecoxib, diclofenac.
Narcotics: codeine, hydrocodone, oxycodone.
Muscle relaxants: carisoprodol, chlorzoxazone, thiocolonicoside and tricyclics.
Beclomethasone
Nasal steroid. Anti-inflammatory. Local use can give irritation, sneezing, nausea and light-headedness.
Ozempic/semaglutide
Antidiabetic medication and long term weight management. Taken once per month. Glucagon-like peptide. Can have reduced appetite, burping, cholelithiasis, GI interruption.
Levetiracetam
Antiepileptic. Can cause drowsiness, headaches, vertigo, ENT signs. For myoclonic or tonic-clonic seizures. (ethosuximide for absence).
Loperamide
Antimotility drug to treat acute diarrhoea, side effects include constipation, flatulence, headache, nausea.
Lansoprazole
An alternative to omeprazole. For ulcers, gord, H.pylori/ Side effects can include stomach upset, dizzy, headache, oral dryness or itchy skin.
Lamotrigine
Anticonvulsant for epilepsy or bipolar. Can get rash, headache, aches, stomach upset.
Chlorphenamine maleate
For allergies- itching, hayfever, food, drugs, anaphylaxis. Antihistamine- feels dizzy, tired, blurred vision.
Rigevidon
For contraception and menstrual issues. Combined oral contraceptive- sickness, headache, inc weight, breast tenderness, mood change, menstrual change.
Pregabalin
For epilepsy, neuropathic pain, GAD, dizzy, headache, dry mouth, GI issues.
Amitriptyline
For depression, migrane, nerve pain, nocturnal enuresis. A TCA.
Quetiapine
Schizophrenia and bipolar- incr weight, dry mouth, shaky, blurred vision, stomach upset, neuroleptic malignant syndrome.
Sulfasalazine
For ulcerative colitis, crohns, rheumatoid arthritis. An aminosalicylate. Can make dizzy and stain contact lenses.
Zopiclone
For insomnia rather than benzos. Can leave bitter metallic taste and fatigue.
Venlafaxine
SNRI- serotonin and noradrenaline reuptake inhibitor. For depression, gad, social anx, panic disorder or menopausal symptoms in those with breast cancer.
Midazolam
Benzodiazepine for status epilepticus, agitation, anxiety, anaesthesia. Often used in palliative care.
Cyanocobalamin
Vitamin B12 eg for tapeworm, bowel cancer, MS, neuropathy, pernicious anaemia, gord, alcoholism.
Triptorelin
used with tamoxifen or aromatase inhibitor for breast cancer, endometriosis, fibroid reduction, central precocious puberty. Also treats advanced prostate cancer and male sexual deviation.
Side effects allergy, arthralgia, asthenia, asthma.
Clopixol/depixol/zuclopenthixol
Drug for schizophrenia
Rhonchi
Rhonchi, or “large airway sounds,” are continuous gurgling or bubbling sounds typically heard during both inhalation and exhalation. These sounds are caused by movement of fluid and secretions in larger airways (asthma, viral URI).
cauda equina syndrome
Rare and severe type of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed.
Symptoms include: sciatica on both sides. weakness or numbness in both legs that is severe or getting worse. numbness around or under your genitals, or around your anus.
Give decompression by a lumbar laminectomy.
piriformis syndrome
The piriformis muscle, located in the buttock region, spasms from exercise, pressure or strain and causes buttock pain. The piriformis muscle also can irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).
Treatment is physical therapy, exercise, and stretching.
