BFI Flashcards
Very common
Sudden onset
Sticky discharge
One eye spread to another
Gritty feeling in eye
Trigger:
Cold - rub nose in eye
Poor hygiene (contact lenses)
CONJUNCTIVITIS
When to refer CONJUNCTIVITIS
Vomiting / Diarrhoea
Pain
Photophobia
Foreign body
Symptoms more than 2 weeks
Baby <28 days
Treatment of CONJUNCTIVITIS
Nothing! Resolve in 5-7 days
Bathe with freshly boiled, cooled water
Chloramphenicol
0.5% eye drops - 2hrs for 48 hrs, then every 4 hrs for 3 days
1% eye ointment - 3-4 times daily (ON if used with drops)
Wash hand before & after using
Better in 2 days
Contact lenses (avoid / discard), wear after 1 week
Storage: Discard after 28 days opening
Advice for CONJUCTIVITIS
Hand hygiene
Wash pillow cases & face cloth
Don’t share towels
Don’t rub eyes
Bacterial infection of oropharynx
Common in neonates / debilitated elderly
Babies do not want to feed
Mouth pain / soreness
Creamy white, soft patches, underlying redness
Taste disturbances, malaise, loss of appetite
Trigger:
Medicine-induced / Wrong technique (inhaler)
Denture
Medical conditions (immunocompromised)
ORAL THRUSH
When to refer ORAL THRUSH
> 3 weeks
Diabetes, Immunocompromised
Patches cannot wipe off
Denture with GOOD hygiene
Treatment of ORAL THRUSH
Topical Imidazoles (Daktarin)
Hold gel in the mouth for as long as possible QDS
Finish the course of 1 week
Continue 2 days after clear up
Remove dentures at night and brush them with the gel
Babies >4mths
Avoid in patients taking warfarin
Advice of ORAL THRUSH
Good oral hygiene (brush & floss regularly)
Denture hygiene
Gargle with salt water
Itchy, flaky skin
Fissures
White, soggy maceration
Web space of toe
ATHLETES FOOT
When to refer ATHLETES FOOT
Diabetes
Very painful
How to treat ATHLETES FOOT
Terbinafine 1% (Lamisil)
Cream - OD
Lamisil Once - both feet
Do not wash off for 24 hrs
Imidazoles (Daktarin, Canesten)
Cream - apply BD or TDS
Powder / Sprays - apply to socks
Steroids - unbroken skin, max 7 days (Daktacort)
Tolnaftate (Mycil)
Undecenoates (Mycota)
Advice for ATHLETES FOOT
Good hygiene (change socks regularly)
Drying foot
Wear slippers to avoid spreading
Groin area
Red, itchy, not painful
JOCK ITCH
Treatment for JOCK ITCH
Imidazoles (Daktarin, Canesten)
Cream - apply BD or TDS
Refer if no improve in 7 days
Advice for JOCK ITCH
Keep affected area clean and dry
Avoid sharing personal items
Avoid tight clothes, wear breathable clothing
Itching
Irritation
Swelling
Pain during sex
Stinging when urinating
Vaginal discharge - thin, watery, thick like cottage cheese
Triggers:
Antibiotics
Hormonal changes
VAGINAL THRUSH
When to refer VAGINAL THRUSH
Diabetic
Discharge with strong smell
OTC fail
Pre-disposed thrush
Pregnancy
2 or more attacks in 6 mths
<16 and >60
Prev history of STI
Signs of additional infection (fever / lower abdominal pain)
Unusual vaginal bleeding
Only sell if previously diagnosed
Treatment for VAGINAL THRUSH
Topical imidazoles
Canesten / Daktarin
1% cream - BD or TDS (not for watery discharge)
2% cream
500mg pessary - 1 ON
200mg pessary - 1 ON for 3 nights
100mg pessary - 1 ON for 6 nights
10% vaginal cream as 500mg pessary
Advice for VAGINAL THRUSH
Advice partner to get treated - cream
Avoid soaps, use emollients (E45)
Avoid sex until thrush clear up
Wear cotton underwear, do not wear tight underwear
Why be aware of Fluconazole?
Interactions (CYP450 inhibitor)
Warfarin, terfendine, cisapride
Drugs increase metabolism of fluconazole
Carbamazepine
Phenytoin
Phenobarbital
Sulfonylureas
Discolouration (white, yellow, brown)
Debris (under nail)
Distortion
Scaliness
Thickening
Brittleness
NAIL INFECTION
Discolouration (white, yellow, brown)
Debris (under nail)
Distortion
Scaliness
Thickening
Brittleness
NAIL INFECTION
When to refer NAIL INFECTION
Severe infection
>2 nails
<18 yrs old
Pregnancy / Breast feeding
Diabetics
Treatment of NAIL INFECTION
5% amorolfine nail lacquer (Curanail)
Fingernail - 6mths
Toenail - 9~12 mths
Apply once weekly
How to use:
File down infected nails
Clean nail with supplied swab
Apply lacquer
Clean the applicator with swab
Repeat weekly
