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ENT & Skin (low weighted) Flashcards

(103 cards)

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1
Q

If using 2 different eye drops, how long would you separate them out by?

A

5 minutes, longer if using a gel

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2
Q

Would you apply drops or ointment first?

A

Drops first, ointment last

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3
Q

When would you ideally apply an ointment?

A

At night

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4
Q

What is the expiry dates for eye drops at home, on hospital/ward use and in outpatient/surgery?

A

28 days for home,

hospital ward use= 1 week,

outpatient/surgery= single application

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5
Q

How would you reduce nasolacrimal drainage?

A

Pressure on lacrimal punctum for a minute

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6
Q

Which lenses do can you wear eye drops with?

A

Hard lenses- you can still use eye drops whilst wearing lenses but not soft lenses (silicone hydrogel) as you will need to remove the lenses before using eye drops

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7
Q

What colour does rifampicin and sulfasalazine colour lenses?

A

Orange

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8
Q

What is an ectropion?

A

where the lower lid droops out and turns outward

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9
Q

What is keratitis?

A

Inflammation of the cornea due to trauma, photophobia, severe pain, watery discharge or contact lenses

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10
Q

What is episcleritis?

A

Painless eye redness and treat with lubrication.

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11
Q

What drugs can affect blink rate?

A

Anxiolytics, antihistamines, muscle relaxants, TCAs and diuretics reduce blink rate

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12
Q

What do we use for allergic eyes?

A

Sodium cromoglicate (mast cell stabiliser), can use azelastine (antihistamine) or xylometazoline (vasoconstrictor)

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13
Q

What are the three main dangers associated with topical corticosteroids on eyes?

A

Red eye- corticosteroids can aggravate certain infections possibly leading to corneal ulceration. Steroid glaucoma. Steroid cataract.

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14
Q

Age for sodium cromoglicate?

A

> 6 years (QDS)

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15
Q

How does dry eye present?

A

Chronic soreness and inflammation of ocular surface associated with reduced or abnormal tear secretion

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16
Q

What is normally used in dry eye?

A

1st line- Hypromellose, instil hourly, then reduce.

2nd – carbomers and polyvinyl alcohol (they have higher viscosity so QDS)

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17
Q

What drugs can cause dry eye?

A

TCAs, diuretics, isotretinoin, HRT, BB, SSRI

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18
Q

What is the condition with the symptoms of inflammation of the eyelids, sticky, sore, sticky, crusty, gritty, photophobia and worse in the morning

A

Blepharitis

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19
Q

Treatment of Blepharitis (inflammation of eyelids)

A

Hot compress or OTC propamidine (golden eye 0.1% or brolene)

NB: blepharitis is often caused by staphylococci.

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20
Q

What is bacterial or viral conjunctivitis normally caused by?

A

Streptococcus pneumoniae, staph aureus or haemophilus influenzae

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21
Q

What is first line for glaucoma?

A

1st line- Beta blocker eye drops or prostaglandin eye drops.

2nd line- sympathomimetic eye drops (brimodine) or carbonic anhydrase inhibitors (brinzolamide, dorzolamide)

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22
Q

Side effects of prostaglandin eye drops

A

Cause longer eye lashes and darker iris colour

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23
Q

What is used in chronic open angle glaucoma?

A

Topical prostaglandin analogue (latanoprost)

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24
Q

Give an example of
A) beta blocker
B) Sympathomimetic
C) carbonic anhydrase inhibitor
D) mitotic
E) Prostaglandin analogue

A

A) beta blocker – timolol

B) Sympathomimetic - brimonidine

C) carbonic anhydrase inhibitor -brinzolamide, dorzolamide, acetazolamide

D) mitotoic- pilocarpine

E) Prostaglandin analogue- latanoprost, bimatoprost, travoprost

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25
Treatments for ocular hypertension?
1st line- topical prostaglandin, 2nd – alternative prostaglandin 3rd – BB 4th- carbonic anhydrase inhibitor (brinzolamide)
26
EAR: What is swimmer’s ear?
Otitis externa – inflammation of the external ear canal. Primarily caused by bacterial infection.
27
When would you consider antibiotics for otitis externa?
After 72 hours of any red flags
28
What is otitis media?
Acute otitis media Is a self limiting conditions which mainly affects children and it is characterised by inflammation in the middle ear associate with pain, irritability, crying, cough, poor feeding, restlessness.
29
When would symptoms of otitis media usually resolve?
Within 3-7 days
30
What do you do if someone comes in with otitis media in the pharmacy?
Self-help measures for patients over 3 days for 72 hours, then pharmacy first
31
Do you refer with hearing loss if infected with otitis media?
No as this is normal
32
What is the referral criteria for otitis media/externa/ears?
Tinnitus (generally associated with inner ear), pain, vertigo, dizziness, bleeding, discharge, N/V etc
33
How do you treat ear wax?
First line olive oil/almond oil, then can use sodium bicarb but can cause dryness. Then, docusate sodium or urea, then ear irrigation
34
What is used for irrigation in allergic rhinitis?
Sodium chloride 0.9%
35
What is added to allergic rhinitis treatment (of antihistamines or nasal corticosteroids) when watery rhinorrhoea persists despite treatment?
nasal ipratropium bromide
36
What is first line in nasal decongestion?
sodium chloride 0.9% nasal drops, spray or irrigation
37
How long can you use topical decongestants (xylometazoline) for in nasal decongestion?
max 7 days as cause rebound congestion
38
How long should you use antihistamines for before the hay fever season?
2-3 weeks
39
When do you refer for bacterial sinusitis?
>10 days (NB: worse when bending down, usually dull and unilateral)
40
How long can you generally use an intranasal corticosteroid for?
Max 3 months
41
Why do you have to wait for 30 minutes between using chlorhexidine mouthwash and toothpaste?
Because chlorhexidine is incompatible with anionic agents present in some toothpastes
42
OTC age for Corsodyl (Chlorhexidine)?
12
43
When do you refer for sore throat?
Duration >2 weeks, skin rash, dysphagia, meds causing agranulocytosis
44
What meds would you refer with a sore throat?
Captopril, carbimazole, cytotoxics, neuroleptics i.e. clozapine, penicillamine, sulfasalazine, sulfur containing antibiotics and immunosuppressants
45
Age for lidocaine otc?
12
46
Age for benzocaine otc?
3 but 6 for spray
47
Benzydamine age?
12 for rinse but 6 for spray
48
Age for flurbiprofen?
12 (avoid in pregnancy)
49
When do you refer for mouth ulcers?
> 3 weeks, >1cm, <10 years, more than 5 at once, weight loss, persistent diarrhea, if taking NSAIDs, sulfasalazine or cytotoxic drugs
50
Age for bonjela?
16
51
Treatment for mouth ulcers?
Saline mouthwash, antiseptic mouthwash (Chlorhexidine), corticosteroids (hydrocortisone tab to dissolve next to ulcer or spray inhaler onto ulcer), lidocaine
52
How do you apply emollients?
In direction of the hair growth to prevent folliculitis, after washing or bathing to maximise hydration and as often as possible
53
What is the MHRA alter with emollients?
Fire risk with paraffin-based emollients. Note clothes and dressings are easily ignitable. Do not smoke.
54
What do you endorse on a prescription when it has a borderline substance (foods and toiletry for medical purpose)?
ACBS (Advisory Committee on Borderline Substances)
55
Which medicines can exacerbate psoriasis?
Lithium, chloroquine, hydroxychloroquine, ACE + ARBS, BBs and NSAIDs
56
How do you treat psoriasis?
Topical corticosteroids, vitamin D analogues, retinoids, methotrexate
57
When using corticosteroids for nappy rash, which is applied first the barrier cream or corticosteroid cream?
Apply barrier AFTER corticosteroid
58
What is the max use of corticosteroid?
1 week.
59
How do you treat cellulitis?
Flucloxacillin
60
How do you treat acute impetigo?
Fusidic acid (max 10 days), mupirocin (max 10 days), severe= fluclox/clari for penicillin allergy
61
What is used to treat infective burns?
Silver sulfadiazine
62
How do you treat rosacea (butterfly shape on face, redness)?
Topical brimonidine, or oral metronidazole (DO NOT USE ACNE PRODUCTS)
63
When using antifungals on the skin, how long should they be continued for to prevent relapse?
1-2 weeks after all appearance has gone
64
What is tinea cruris?
Jock itch- isolated to inner thigh and groin area
65
Age for amorolfine 2%?
18
66
You can’t use amorolfine is you have a fungal nail infection on more than how many toes?
2 toenails
67
How many times do you apply the amorolfine?
Use weekly, use for 6-12 months
68
What treatment do you avoid in athlete’s foot?
Hydrocortisone. But can use topical imidazole (3 days) or terbinafine (16 and over) or miconazole (10 days)
69
What is the referral criteria for ringworm?
When it is on the scalp (tinea capitis)- as requires oral and topical antifungal
70
What are the different types of tinea?
scalp (tine capitis), body (tinea corporis), groin (tinea cruris), hand (tinea manuum), foot (tinea pedis- athlete’s foot).
71
Med used for scabies
Permethrin leave on for 8-12 hours, repeat a week after. Malathion leave on for 24 hours. All household members should be treated, and entire body should be covered in cream. Pay particular attention to the webs of the fingers and toes and lotion brushed under the ends of nails. Malathion and permethrin should be applied twice, one week apart.
72
Age for permethrin
2
73
Age for malathion
6 months
74
First line for headlice
Dimeticone 4% lotion- reapply one week later. Leave for 8 hours and let dry naturally
75
What is the MHRA alert for headlice eradication products?
Risk of severe burns when head/hair exposed to open flames or other sources of ignition
76
Age for salicylic acid?
>6 years (max use for 12 weeks)
77
Age for bazuka?
>2 years
78
Age for wart freeze remover?
4 years
79
What does molloscum contagiosum look like?
Pinkish or pearly white papules with a central dimple and are up to 5 mm diameter (resembles small sea shells stuck on skin)
80
Is molloscum contagiosum harmless or severe?
harmless and usually self resolve in a few months without scarring itchy but not painful
81
What do you use to treat a cold sore
Aciclovir 4 hourly for 5 days
82
What is the symptoms of scarlett fever?
Fever Sore throat Scarlet rash Strawberry tongue (beefy red when uncovered with white coating) Sandpaper like rash (turn white when pressed)
83
What is measles and what is the incubation period?
7-14 days
84
Glandular fever is indicative of what virus?
Epstein Barr Virus
85
What drug do you NOT give to people with chicken pox?
Ibuprofen
86
How do you treat chicken pox?
Calamine lotion, paracetmol
87
What virus causes chicken pox?
Varicella Zoster
88
What is the symptoms of shingles?
blotches one side of the body (painful tingly and numb) develops into itchy blister looks like chickenpox
89
Mumps - symptoms
swollen salivary glands, fever, headache, joint pain, pain on opening mouth, earache NB: avoid citrus juices and stay away from school for 5 days
90
slapped cheek disease - symptoms
cheeks are inflamed and look like they've been slapped
91
What does lyme disease look like?
dartboard Treat with tetracyclines
92
How do you treat subconjunctival haemorrhage?
No treatment, will clear up on own
93
How do you treat rosacea?
brimonidine 6-12 week course
94
What is the MHRA alert with brimonidine?
risk of systemic cv effects and risk of exacerbation in rosacea
95
What strength do you start at with benzoyl peroxide?
2.5% to 5% to 10%
96
What do you use if there has been no improvement in 2 months of benzoyl peroxide or azelaic acid on acne?
topical abx i.e. clindamycin or erythromycin, then topical retinoid, then oral abx, then isotretinoin
97
Can you use repeats in isotretinoin?
No
98
What is the caution in isotretinoin?
depression and diabetes
99
What are the side effects with isotretinoin?
Hyperglycaemia, hypertriglyceridaemia, high cholesterol, pancreatitis, hepatoxicity, visual disturbances skin peeling, redness, severe dryness of skin and mucous membranes
100
What do you monitor with isotretinoin?
PPP (Contraception): Rx valid for only 7 days (max 30 days supply)
101
How long do you avoid waxing or epilation for with isotretinoin?
6 months
102
What steroid creams can be sold OTC?
Clobetasone and hydrocortisone
103
How long do you wait to apply steroids after an emollient?
30 minutes

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