CDW 06

Question 1

Cold sores are caused by?

Answer 1

re-activation of a dormant HSV infection in the TRIGEMINAL nerve

Question 2

What is the typical time to resolution of a cold sore without treatment?

Answer 2

7-10 days

Question 3

The statement is FALSE?

Answer 3

Minor aphthous ulcers are common in children under 10 years

Question 4

Some TRUE statement?

Answer 4

Persistent, painless ulcers should be referred
Minor aphthous ulcers are usually painful
Minor aphthous ulcers will usually heal in 1-2 weeks

Question 5

Oral thrush is caused by infection with a?

Answer 5

yeast

Question 6

Which situation (in community pharmacy) would warrant referral for further investigation?

Answer 6

Recurrent oral thrush, (Because it might be some other underlying cause, may be a sign of underlying disease.Nutritional deficiency or dry mouth.)

Question 7

Recognise the symptoms and causes of the cold sores

Answer 7

(Herpes Simplex Type 1 (HSV1) virus) as they present in community pharmacy

Small fluid-filled blisters: that appear on the skin, usually on the lips, chin, cheeks, or nostrils.

Burning/tingling sensation: often felt just prior to skin lesions developing.

Some people develop no infection and others develop painful cold sores that can last a week or more.

Question 8

Differentiate symptoms between cold sores and impetigo?

Answer 8

Cold sores is: an itchy, burning feeling just prior to the skin lesions forming.
Its complications inside the mouth such as ulcers, swollen glands, fever associated
Impetigo is: Blistering on any area other than the face such as hands and feet.
Impetigo skin lesions have a honey coloured crust over top of them.

Question 9

Pharmacological and non-pharmacological treatment options of Cold sores, pharmacist-only, over-the-counter (OTC) medicines and lifestyle modifications?

Answer 9

Pharmacological options: Aciclovir cream Topical(G)5x day for 10 days. Famciclovir tablets ® 3 tab at once that’s all for over 18, Cold sore patches(G), Idoxuridine & lignocaine cream (aesthetic & antiviral) every hour for day 1 and 4 times a day.
Non pharmacological: Aloe vera, Lemon balm, petroleum jelly.
Lifestyle modification: Wash hands before and after touching cold sore.avoid patients close contact or clothes. Drinking in the same cup.

Question 10

Symptoms and causes of minor Aphthous ulcers (mouth ulcers)?

Answer 10

Causes can be Bacterial, viral or fungal infection
One of more painful sores located on the interior lining of the mouth, swollen skin around the sores, reluctance to eat due to tenderness in the mouth
Common amongst all age groups.

Question 11

Causes of Minor Aphthous mouth ulcer:

Answer 11

May be due to irritation, injury, drugs, radiation, infection, inflammatory disorders or unknown causes.

Question 12

Pharmacological option to treat mouth ulcer?

Answer 12

Pharmacist only option: Triamcinolone dental paste (Corticosteroid). 4 x daily.
OTC - NSAID mouthwash, choline salicylate gel (adults only) anti inflammatory & antiseptic. Rub well to the affected area not more than every 3 hours. People with peptic ulcers avoid use. Don’t use dentures.
Topical corticosteroid (can be G, P, R or Rx).- Bonjela (G) and Lignocaine gel(G) can apply every 20 min. Avoid sucrose allergy.
Tetracycline mouthwash if infection.

Advice:3 Apply to affected areas only for the shortest possible period.

Question 13

What is the lifestyle advice for mouth ulcer?

Answer 13

Lifestyle: Avoid spicy, hard, salty or acidic food, avoiding toothpaste with sodium lauryl sulfate.

Question 14

Non pharmacological option to treating Mouth ulcer:

Answer 14

use a soft toothbrush to reduce further damage.
rinse your mouth with a warm salt-water mouthwash.
avoid foods that make the pain worse, such as spicy or acidic food.
choose softer foods that are less likely to make the ulcer feel worse.

Question 15

What are the Possible triggers for these three condition(s) ?

Answer 15

Mouth ulcer:Ibuprofen,Denture,Stress, Immunocompromised
Candida or oral Thrush:Oral amoxicillin, Corticosteroids inhaler for asthma,Immunocompromised
Cold sore: Stress,Immunocompromised,Sunshine

Question 16

Symptoms and causes of oral thrush (oral candidiasis)

Answer 16

Causes: Predispose infancy, injury to mouth, broad spectrum antibiotics may cause OC.
Symptoms: Redness in mouth and throat, loss of taste, painful, burning sensation.

Question 17

Pharmacological and non-pharmacological treatment of oral thrush (oral candidiasis), including pharmacist only, over-the-counter (OTC) medicines and lifestyle modifications.

Answer 17

Pharmacological option:
Miconazole oral gel (Pharmacist Only)
Over-the-counter (OTC):
Chlorhexidine gluconate

Question 18

Non pharmacological Option of treating oral thrush?

Answer 18

Brush teeth twice a day and floss daily.
Rinse mouth after meals or use inhaled medications.
Ensure that any dentures are well-fitted in the mouth.
Remove any dentures at night and clean them regularly.
Consume a healthy diet with low intake of sugary foods

Question 19

Lifestyle changes for oral thrush?

Answer 19

Sterilize your baby’s pacifiers, teething rings, bottle nipples, and any other items they put in their mouth. If you use a breast pump, sterilize all of its pieces as well.
Keep your nipples clean and dry between feedings. If you use nursing pads, avoid those that have a plastic liner, which may trap moisture and create favorable conditions for fungus to grow.
Certain probiotic foods or taking probiotic supplements might help limit the growth of C. albicans (more research is needed)
limiting refined carbohydrates and sugars can help treat or prevent oral thrush and other yeast infections