week 2 Flashcards
who does the NHS offer cholesterol testing for?
all patients 40-74 years can have a CVD risk check
6 components to CVD risk check
1) alcohol consumption
2) FH
3) physical activity
4) smoking
5) diet
6) ethnicity
physical activity recommendations for adults in UK
- 75 mins vigorous aerobic activity + strength exercises on 2 or morE days a week
- 150 mins mod activity OR 75 mins of vigorous activity every week
physical activity recommendations to over 65 year olds
balance + co-ordination activities
units =
ABV x ml / 1000
current alcohol guidelines
< 14 units a week, spread throughout the week, ideally with some alcohol free days.
BMI =
(kg) / (metres squared)
BMI obese
BMI > 30
BMI overweight
25-30
normal BMI
18.5 - 25
malignant HTN value is
> 180/110
useful NHS guide for dietary advice
The Eatwell Guide
what does a QRISK2 score of 12.4% mean?
of every 100 people the same age as you, with the same risk factors; about 12 of them are likely to have a heart attack or stroke within the next 10 years
when on statins which blood tests are needed?
@ 3 months: total cholesterol, HDL, non-HDL cholesterol
LFT @ 3 months + 12 months
symptoms patients should look out for when on statins
- muscle aches + pains
- pain, tenderness, weakness of muscles
seek medical advice + CK levels may be tested
definition of HTN
clinic reading >/= 140/90
or
24 hour BP average reading >/= 135/85
trx HTN for < 55 year olds
Ace inhibitor
trx HTN for either above 55 or Africo caribbean origin
Calcium channel blocker
step 2 and step 3 management of HTN
step 2: Ace inhibitor + Calcium channel blocker
step 3: Ace inhibitor + calcium channel blocker + Thiazide diuretic
symptoms of HTN if >200/120
- headaches
- visual disturbances
- seizures
normal temperature is
36.5 - 37.5
non blanching rash, particularly with one or more of the following
- ill looking child
- lesions larger than 2 mm in diameter
- CRT > 3 seconds
- neck stiffness
MENINGOCOCCAL DISEASE
- neck stiffness
- bulging fontanelle
- decreased level of consciousness
- convulsive status epilepticus
BACTERIAL MENINGITIS
- focal neurological signs
- focal seizures
- decreased level of consciousness
HERPES SIMPLEX ENCEPHALITIS
- tachypnoea
- chest crackles
- nasal flaring
- chest indrawing
- cyanosis
- oxygen sats = 95%
PNEUMONIA
- vomiting
- poor feeding
- lethargy
- irritability
- abdo pain/tenderness
- urinary freq/dysuria
- any infant under 3 months with a fever
URINARY TRACT INFECTION
- swelling of limb or joint
- not using an extremity
- non weight bearing
SEPTIC ARTHRITIS
Fever for more than 5 days at and least 4 of the following
- bilateral conjunctival injection
- change in mucous membranes
- change in the extremities
- polymorphous rash
- cervical lymphadenopathy
KAWASAKI DISEASE
Barking cough
croup
signs of increased work of breathing
- tracheal tug
- recession
- increased respiratory rate
- abdominal breathing
- cyanosis
what is EPIGLOTTITIS
inflammation of the epiglottis (flap at base of tongue
typical age for epiglottitis
2-4 year old child
cause of Epiglottitis
Haemophilus influenzae type b
why is epiglottitis more common in adults than children
because of the increase in use of haemophilus influenzae type b conjugated vaccine
importance of considering epiglottitis prior to throat examination?
risk of causing abrupt + complete airway obstruction due to rapidly progressive cellulitis of the epiglottis and adjacent structures
- sore throat
- enlarged tonsils
- fever
Tonsillitis/Pharyngitis
clinical presentation of epiglottitis
- difficulty swallowing
- dyspnoea
- dysphonia
- irritability
- fever
- drooling of oral secretions
clinical presentation of tonsilitis?
- sore throat
- enlarged tonsils
- fever
- malaise
appearance of tonsils in tonsilitis
Tonsils are oedematous + yellow
white pustules may be present
treatment of tonsilitis
Penicillin
causative bacteria of tonsilitis
Streptococcus pyogenes
guidance to help decide if abx are helpful?
Centor criteria
Other than the centor criteria, when else may a GP give abx
- immunocompromise
- systemic upset
- valvular heart disease
what is the centor criteria for?
developed to predict bacterial infection in people with acute sore throat
Centor criteria (4)
1) presence of tonsillar exudate
2) presence of tender anterior cervical lymphadenopathy
3) history of fever
4) absence of cough
results of centor criteria
Centor score 3 or 4 indicates the person may have a bacterial infection and would benefit from antibiotics
where are vaccinations recorded?
In the red book which parents look after.
They are given it at the time of the baby’s birth
red book aka personal child health record
how can a patient seek medical help
contact GP surgery
or
NHS 111
safety netting symptoms for treatment of viral tonsilitis
- any new symptoms develop
- seems unwell in himself
- unable to swallow
- noisy breathing
- reduced oral intake
3 good reasons to vaccinate your child
1) they are quick, safe, effective
2) once your child has been vaccinated against a disease, their body can fight it off better
3) if they are not vaccinated they are at higher risk of catching and becoming very ill from the illness
