Red flags

Question 1

Eyes

Answer 1

Redflags: Pain, Photophobia, vision disturbances, blunt trauma, chemical exposure, foreign body, heat exposure, eye protrusion, contact wearers

Question 2

Ears

Answer 2

Redflags: Ear surgery <6W ago, ruptured TM, Tympanostomy tubes, tinnitus, acute pain onset, foreign body in ear, ear drainage, diving or flying, otitis media, Q-tip use

Risk factors: URTI, Anatomical defects

Question 3

Haemorrhoids

Answer 3

Risk factors: and red flags
Constipation, diarrhea, pregnancy, age (<12, >50), spinal cord injury, heavy lifting, toilet time/straining, low fibre, family history, Dark red blood (should be bright), Rectal mass, abdominal pain, >=7d Tx with no improvement.

Question 4

Gi gas

Answer 4

Red Flags: Moderate to severe abdominal pain, blood in stool, weight loss, nausea or vomiting, dysphagia or odynophagia, Regurgitation, Fever or chills, Tenesmus, Sudden change to BM

Question 5

Dyspepsia and GERD

Answer 5

Red flags: Pat >50 with new or worsening Sx, abdominal mass, anemia, chest pain, GI bleed, odynophagia, vomiting
Ask for Exacerbating factors
Anticholinergics, Benzos, beta-agonists ,nicotine ,opioid , smoking ,chocolate ,coffee ,alcohol ,carbonated drinks

Question 6

Acne

Answer 6

Redflags: <12yo or new acne at <30, severe acne, widespread, hyperandrogenism, systemic fever/ muscle pain

Question 7

Bites

Answer 7

Red flags: <2yo (although not for mosquito bites), >10cm, multiple bites, tongue or mouth, history of allergy, >7d of Sx

Question 8

Burns

Answer 8

Red flags: loss of epidermis, <5 >60, face or large area, chemical/electrical/inhalation burn, immunocompromised

Question 9

Cuts

Answer 9

Red flags: Continuous bleeding, large wounds, deep puncture, severe pain, chronic wound, infection

Question 10

Teething

Answer 10

Red Flags: Rule out URTI or GI cause of Sx, fever, diarrhea, vomiting, cysts (if they interfere with feeding), abscesses

Question 11

Canker sores

Answer 11

Red Flags: >1cm, major pain, Sx >14d, >5 ulcers, reoccurring history, affected gums/soft palate, immunocompromised, >30yo, affecting ability to eat/drink

Check for large white thickened patches from smoking as cancer, fever, vesicles/lesions elsewhere on body

Question 12

Halitosis

Answer 12

Red Flags: Use of antibacterial or alcohol mouthwashes can increase growth, decreased salivation, poor dental hygiene, EtOH/smoking,

Question 13

Xerostomia

Answer 13

Complications: food avoidance if pain, impaired speech, lipstick sticking to teeth, cavities

Red flags: Candidiasis (white patches), symptoms described as burning, cheilitis (cracks in corner of mouth) Refer

Question 14

Seb Derm, dandruff

Answer 14

Risk factors: Family history of psoriasis, immunocompromised, parkinsons, age, cold/dry, stress, Drugs (lithium, haloperidol), watch for alopecia
Cradle cap in babies is common and lasts 3m

Question 15

OM risk factors (watchful waiting)

Answer 15

Daycare, pacifier, cigarette exposure, bottle feeding while laying down

Question 16

Dermatitis

Answer 16

skin infection, large area, open wounds, fever, psychological distress, doubt

Question 17

AR

Answer 17

can’t find allergen after 2 weeks, unilateral Sx, fever, purulent discharge, nosebleed >20min, Tx not effective after 1-2 weeks

Question 18

cold

Answer 18

high breathing rate, dysphonia, confusion, SOB (worsening of asthma or COPD), dehydration, high fever, neck pain, severe throat pain, chest pain, barking like coughs

Question 19

Fever

Answer 19

stiff neck, chemo, high fever, confused, recent medical procedure, recent travel, >72h

Question 20

heat exposure

Answer 20

very young or old, outdoor work, anticholinergics or MAOIs, altered mental state, confusion, ataxia

Question 21

Asthma exacerbations

Answer 21

life stress, low FEV1 <60%, high bronchodilator response 20-30%, high eosinophils, ever intubated, >1 hospitalization in the last year

Question 22

COPD exacerbation

Answer 22

increased mucus purulence
dyspnea severity
increased mucus volume