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Finals > Symptoms In Comm Pharm > Flashcards

Symptoms In Comm Pharm Flashcards

1
Q

most coughs are acute, what are some differential diagnoses for acute coughs below 3 weeks

A

upper resp tract infection
acute exacerbation copd or asthma
acute bronchitis
pe if pain

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2
Q

what period in weeks is a subacute cough and could be post viral infection

A

3-8

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3
Q

coughs over what duration suggest a repetitive cause such as smoking or due to medication

A

8 weeks

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4
Q

what 3 conditions may cause long term cough

A

Indigestion/ HF/ lung cancer

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5
Q

why does clear sputum suggest that the cause of a cough is unlikely to be infectious

A

not bacterial

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6
Q

for infection what colour sputum would you expect to see

A

green, yellow maybe dark brown

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7
Q

what colour sputum indicates cancer

A

dark red- blood

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8
Q

what can a rust colour sputum sometimes be a sign of

A

pneumonia

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9
Q

what colour sputum might be indicative of left ventricular failure

A

pink

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10
Q

what professions make px more exposured to cough triggers

A

builders, dust workers

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11
Q

why should people presenting with a cough be asked about recent travel abroad

A

could be malaria

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12
Q

when a cough that is related to asthma be worse

A

night or early morning
cold weather

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13
Q

what qs would you ask px complaining of a ‘nasty cough’

A
  • Duration and severity
  • other symptoms: fever, chest pain, difficulty breathing
  • recent exposure to sick individuals or irritants
  • underlying health conditions or medications taken
  • Tried remedies/ treatment? If not improving after bottle of cough mixture, seek further treatment
  • other/ associated pain?
    Qs to ask
  • Chesty/dry cough
  • Smoker?
  • Current meds
  • Ongoing symptom from recent chest infection?
  • Any allergies? Related to that maybe
  • Sore throat alongside may indicate viral infection. Also may have fever
  • Is it better or worse with/ after food? May indicate heartburn
  • Shortness of breath, wheezing? More concerning
  • Time cough occurs, worse at night? Or early morning? May indicate asthma- refer for assessment and diagnosis - post nasal drip/ chronic bronchitis?
  • Onset
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14
Q

what drug class may cause dry cough

A

ACEi

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15
Q

what alongside cough may indicate viral infection

A

sore throat

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16
Q

with cough why ask Is it better or worse with/ after food?

A

May indicate heartburn

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17
Q

name some non-pharmacological tx for cough

A

hydration
rest
steam inhalation

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18
Q

a syrup would be soothing for a cough for providing relief, what active ingredient may be useful for a chesty cough

A

guaifenesin

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19
Q

what are the two groups that cough mixtures can be broken into

A

expectants and suppressants

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20
Q

expectants are well used and tolerated and available in several different brands, how do they work

A

eg guaifenesin
increase airways secretions by increasing water content of secretions and decreasing viscosity of mucus

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21
Q

what cough suppressant may be useful for use in dry coughs

A

dextromethorphan

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22
Q

what is the usual dose of dextromethorphan qds

A

100-200mg

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23
Q

a cough should be assessed if it exceeds x weeks

A

3

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24
Q

what different aspects of medication advice should you give to patients

A

take per dosing instructions
side effects
storage conditions

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25
Q

what temperature are cough mixtures usually stored at

A

room temp

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26
Q

what should px take for pain w cough if not asthmatic

A

paracetamol/ ibu

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27
Q

list some different red flags that could be associated with coughs

A

fever over 3 days
unexplained weight loss
sob
swelling of face and neck
repeated chest infections
over 3 weeks
coughing up blood

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28
Q

if px complians of intermittent leg pain, what else would you ask

A

duration
on calf/ further up
any trauma/ fall
character (SOCRATES)
swelling/ warts skin changes at site
traveled revently dvt
meds
recent surgery in risk clots
bruising
antihypers new can suggest fall
allergies

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29
Q

what drug class increases risk of muscular pain

A

statin

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30
Q

what is the main differential that you might think of with leg pain

A

dvt

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31
Q

dvt usually affects the calfs, is it usually one leg that is affected or both

A

one

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32
Q

list some symptoms of dvt in the leg

A

throbbing pain
warmth
redness
swollen veins

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33
Q

why might a patient want to choose 2.32% voltarol 12 hrly instead of 1.16% tds

A

pt doesnt have to apply as often but is more expensive

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34
Q

what acronym would be used for the management of a sprain or sporting injury

A

RICE
rest ice compression elevation

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35
Q

what could px take for pain, is it licensed for this indication

A

Ibuprofen 400mg, up tds PRN, with food,
(Naproxen only indicated for menstrual pain)

Reommended to use ibu for shortest time, lowest dose, few days 5 days… still not better need for help

36
Q

what pain med switched from P to POM as more cardiovascular risk, so ibu safer

A

diclofenac

37
Q

what px group is ibuprofen NOT given to

A

asthmatics- intolerant to NSAIDs, but if had it before and no problems, then fine to give

also dont give to
-warfarin px DDI
-SSRI DDI
-GI bleeds/ ulcer hx

38
Q

why may ibu be betetr than paracetamol

A

anti-inflamm properties

39
Q

what red flags symptoms can you list for leg pain

A

systemically unwell
fever
significant swelling or bruising
pain worsening
pain at rest
deformities

40
Q

a patient that is having trouble bearing weight for x steps requires assessment

A

4

41
Q

true or false, with shingles you expect the rash to be localised and affect one side of the body

A

true

42
Q

what qs would you ask px with rash on lower back, to determine if shingles?

A
  • Vaccination history, any recent vaccine – could it be adverse reaction to that
  • Rash anywhere else on body?
  • SOCRATES for pain, severity, radiation
  • Ask to look at rash, take to consultation room, get consent
  • Localised, widespread…
  • immunocompromised? More at risk of getting viral infections etc, ask what medication she’s on- immunosuppressants- corticosteroids prednisolone, long term use
  • RA, asthma, CKD = more at risk of shingles, undergoing chemotherapy, check allergies before recommending treatment
  • Fever, refer on
43
Q

what meds may mean px more at risk of getting viral infections in case of shingles etc

A

immunosuppressants- corticosteroids prednisolone, long term use

44
Q

list some different conditions that put patients at more risk of developing shingles

A

ra, asthma, ckd

45
Q

what infection causes shingles

A

herpes zoster

46
Q

shingles is a viral infection of ?

A

individual nerve over its surface area

47
Q

if you have x condition in childhood it is possible that is may reactivate and cause shingles in the future

A

chickenpox

48
Q

what is the firstline treatment for shingles that is covered in the pharmacy first scheme and can be supplied under a pgd

A

acyclovir

49
Q

the treatment for shingles first line is acyclovir 800mg 5 times a day for x days

A

7/7

50
Q

the pgd for shingles treatment allows you to give what 2 strengths of acyclovir tabs to make up the required dose

A

200 and 400mg

51
Q

why is it important that treatment for shingles is started within 72 hrs

A

thats when antiviral is most effective to reduce complications

52
Q

name a common complication post shingles that can continue for months after but if treatment is well managed and early patients are less likely to get symptoms such as severe nerve pain

A

hepatic neuralgia

53
Q

what drug should be offered for shingles in immunocompromised patients

A

valacyclovir

54
Q

what is the treatment regimen for valacyclovir when used to treat shingles

A

1g tds for 7 days

55
Q

how many weeks does it usually take for shingles to resolve

A

4 weeks

56
Q

what are some common side effects of shingles treatment

A

vomiting
diarrhoea
nausea
abdominal pain

57
Q

it is important that patients on acyclovir or valacyclovir complete the course for the full 7 days and space doses out in regular intervals, what advice should you give regarding missed doses

A

take as soon as possible unless time is close to next dose

58
Q

what different safety netting is associated with shingles treatment

A

changes
gets worse
minimise contact with babies below 1 month, immunocompromised, pregnant

59
Q

shingles is contagious until blisters have crusted over, how many days does this usually take

A

5-7

60
Q

what is some general management advice for someone with shingles

A

avoid sharing towels and clothes
wash hands often
keep rash clean and dry
wear loose clothing
if rash cant be covered stay off work and indoors

61
Q

true or false, if a patient has been treated for shingles and blisters have not crusted over/ new blisters have formed this is a red flag and they should be referred for a longer course of an alternative antiviral

A

true

62
Q

can you treat pregnant women with shingles under the pgd pharmacy first scheme yes or no

A

no

63
Q

true or false, even a second shingle infection requires referring as patients tend to be in severe pain and may require something stronger eg Gabapentin

A

true
if doesnt work see GP

64
Q

shingles usually affects the trunk, back and flanks, what should you do if there is any involvement of the eye and why

A

refer GP due to risk of losing vision

65
Q

Shingrix vaccine is available for shingles for patients that are aged x due to being most at risk of complications, however any patient who is above 50 and immunocompromised may also receive it

A

60-79

66
Q

how is widespread impetigo defined

A

4 or more lesions or clusters

67
Q

list some different causes of impetigo

A

previous skin conditions
flare ups
insect bites
trauma
abrasions

68
Q

it is important to ensure that children that present with rashes do not have neck pain or photosensitivity to rule out

A

meningitis

69
Q

how does bullous impetigo present

A

blisters

70
Q

how does non bullous impetigo present

A

sores

71
Q

what is the causative agent of impetigo

A

staph aureus

72
Q

impetigo is common in younger children 0-4, where are some common sites for lesions

A

face
mouth
limbs and joints like elbow creases sometimes

73
Q

the pharmacy first scheme only allows for the treatment of what type of impetigo and therefore the other type must be referred

A

non bullous

74
Q

what is the first line treatment for non bullous impetigo if it is localised

A

hydrogen peroxide crystacide

75
Q

when using hydrogen peroxide to treat impetigo a thin layer should be applied to the affected areas tds for x days

A

3

76
Q

name an alternative localised treatment for impetigo instead of hydrogen peroxide that can be used tds for 5 days

A

fusidic acid

77
Q

t/f impetigo with any blisters suggesting bullous, would refer

A

true
cant treat under pharm first

78
Q

what is the treatment regimen of fluclox for impetigo

A

250mg qds 5 days

78
Q

if impetigo is widespread a localised treatment will not be sufficient, in this case what oral abx would be appropriate

A

flucloxacillin

79
Q

alternative drug to fluclox in the case of penicillin allergy

A

clarithromycin

80
Q

if a patient is pregnant or suspected to pregnant what abx is appropriate to treat non bullous widespread impetigo

A

erythromycin

81
Q

general advice for impetigo management

A

avoid school till lesions healed
reinforce dose and side effects
missed dose advice
complete course
storage

82
Q

prevention measures for impetigo as it is contagious

A

avoid sharing towels
wash bed sheets
clean toys
avoid scratching

83
Q

for people with impetigo they should keep off school/work for at least x hrs after starting treatment or until lesions have healed

A

48

84
Q

what safetynetting is associated with impetigo

A

if it doesnt improve seek further help

85
Q

impetigo red flags

A

systemically unwell
lethargic
bullous
recurrent infections
severely immunocompromised

86
Q

true or false, if a rash crosses the spine it is less likely to be shingles

A

true

Finals (30 decks)

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