Minor Illnesses Flashcards
(65 cards)
1
Q
for how long can a cough be considered acute?
A
less than 3 weeks
2
Q
what are the common causes of an acute cough?
A
- URTI
- croup
- LRTI
- exacerbation of asthma
3
Q
what are the common symptoms of an URTI?
A
- acute cough
- +/- productive with sputum
- +/- fever
- feeling unwell
- +/- wheeze
4
Q
what are the common signs of an URTI?
A
- pyrexia
- irritated throat
- no focal chest sounds on auscultation
5
Q
how would you manage a URTI?
A
- explain to patient this is likely a viral infection and therefore does not require antibiotic treatment.
- advise on OTC medication, rest, and fluids
- advise to come back if issue does not resolve or get worse
6
Q
when would you refer a patient for a chest xray?
A
- focal chest signs
- suspected inhalation of a foreign body
- suspected lung cancer
7
Q
if a patient presents with signs of a LRTI, what would you prescribe them?
A
amoxicillin 500mg TDS
doxycycline 100mg OD
8
Q
what is the most common organism causing a UTI?
A
e. coli
9
Q
what are the risk factors for a UTI?
A
- prior infection
- DM
- stones
- dehydration
- sex
- urinary stasis
10
Q
what are the common presentations of a lower UTI?
A
- urinary symptoms: frequency, dysuria, urgency, cloudy, smelly urine
- lower abdominal pain
11
Q
what are the common presentations of pyelonephritis?
A
- loin pain
- fever
- feeling unwell
- haematuria
12
Q
what are the differentials for a patient presenting with dysuria?
A
- UTI
- interstitial cystitis
- menopause
- tumour/ stone
13
Q
what are the differentials for a patient presenting with frequency?
A
- UTI
- detrusor instability
- external pressure (e.g. pregnancy)
- enlarged prostate
- drugs (diuretics)
- fluid intake
- DM
14
Q
what initial investigation would you do in a patient presenting with an uncomplicated UTI?
A
urine dip
15
Q
when would you send an MSU sample for cultures and consider further investigations?
A
- infection unresolved post abx
- recurrent UTI
- man with a UTI
- pregnant woman
- child
- haematuria (frank or not)
16
Q
how would you manage a patient with an uncomplicated UTI?
A
- increase fluid intake
- nitrofurantoin 100mg BD/3days
17
Q
what is blepharitis?
A
chronic, low-grade inflammation of the meibomian glands and lid margins
18
Q
how does blepharitis present?
A
long history of irritable, dry, burning, red eyes
eyelids will have red margins +/- scales on the eyelashes
19
Q
how do you manage blepharitis?
A
long term treatment (2-3 months)
- warm compress to open up meibomian glands
- massage with cotton buds to move glands secretions
- clean with tea tree oil
- treat dry eyes with liquid tears
20
Q
what are the red flag symptoms for a patient presenting with red eye?
A
- decreased visual acuity
- pain deep in the eye
- absent or slow pupil response
- history of trauma
21
Q
what would you do if a patient has red flag red eye symptoms?
A
refer the patient immediately to be seen on the same day
22
Q
how does conjunctivitis present?
A
- unilateral/ bilateral red eye with surface irritation
- eye discharge
- sticking of eyelids
23
Q
how do you manage acute conjunctivitis?
A
most are self limiting and settle within a few days
- bathe eye in warm and cold water
- maintain good eye hygiene (no contact lenses)
- if not resolved give OTC chloramphenicol qds/5days
24
Q
what is considered acute lower back pain?
A
a new episode of lower back pain <6 weeks in duration
25
what is considered chronic lower back pain?
back pain lasting >3 months
26
what are important associated symptoms to investigate in lower back pain?
numbness, weakness, bowel/bladder symptoms
27
what is important to look out for in an examination of the lower back?
- any deformity (kyphosis, loss of lumbar lordosis, scoliosis)
- check lower limbs for neurological changes and sciatica
28
what does a kyphosis deformity look like and what can it indicate?
concaved thoracic spine indicating ankylosing spondylitis
29
what does a loss of lumbar lordosis indicate?
acute mechanical back pain
30
how do you manage a patient presenting with acute back pain?
- prescribe analgesia
- advise for bed rest
- if not resolved in 4 weeks come back and request physio
31
what are common causes of back pain in people <30 years old?
- trauma
- ankylosing spondylosis
- prolapsed disc
32
what are the common causes of back pain in people 30-50 years old?
- prolapsed disc
- discitis
- degenerative joint disease
33
what are the common causes of back pain in people >50 years old?
- degenerative
- malignancy
- osteoporotic collapse
34
what are some other common causes of back pain in people of all ages?
- postural
- cauda equina
- referred pain
35
what are the common causes of heartburn?
- GORD
- peptic ulcer disease
- stomach cancer
- functional dyspepsia
36
true or false: functional dyspepsia is the most common cause of dyspepsia
true
37
what are some differential diagnoses for heart burn?
- cardiac pain
- gall stone disease
- pancreatitis
38
how does a patient with heart burn commonly present?
- epigastric/retrosternal pain
- fullness, bloating
- nausea and vomiting
- burning sensation up the oesophagus
39
what should you look at in a patient history before treating heart burn?
- drugs (NSAIDs, Ca2+ blockers)
| - any palpable masses (2 week wait referral)
40
what do you prescribe to treat heart burn?
PPI - omeprazole 20mg OD for a month
41
what is the next step one month PPI treatment has not helped the heartburn?
test for H. pylori
42
what is the test for H. pylori?
urease breath test
43
what is the treatment for H. pylori?
PPI - omeprazole 20mg BD
| amoxicillin 1g BD and clarithromycin 500mg BD for 1 wk
44
what other drugs can be given to treat heart burn?
H2 receptor antagonist rantidine 150mg BD
45
what lifestyle advice should be given to a patient with heartburn?
- smoking cessation
- decrease fatty/spicy foods
- decrease alcohol consumption
- eating earlier
46
what should you examine in a patient presenting with a headache?
- signs of infection (fever, skin rash)
- BP
- neurological exam (vision, sensation, gait)
- neck stiffness or tenderness
47
what are red flags in a headache history?
- fever with meningism and rash = meningitis
- thunderclap headache = subarachnoid haemorrhage
- recent head injury < 3months
- papilloedema = raised ICP
- change in cognition or personality
48
what are common causes for an acute new episode headache?
- meningitis
- encephalitis
- subarachnoid haemorrhage
- head injury
49
what are common causes for an acute recurrent headache?
- migraine
- cluster headache
- exertional headache
- trigeminal neuralgia
- glaucoma
50
what is the most common cause for a subacute headache?
giant cell arteritis
51
what are common causes for a chronic headache?
- tension headache
- medication overuse
- raised ICP
52
how does a headache caused by meningitis present and how should it be treated?
- fever, photophobia, stiff neck, rash
| - IV/IM penicillin V and admission
53
how does a headache cause by encephalitis present and how should it be treated?
- fever, confusion, low GCS
| - immediate admission
54
how does a SAH headache present and how should it be treated?
- thunder clap headache, stiff neck "worst headache ever"
| - immediate admission
55
how does a head injury headache present and how should it be treated?
- bruising/injury, low GCS, lucid periods, amnesia
| - consider admission
56
how does a migraine present and how should it be treated?
- aura, visual disturbances, nausea vomiting, triggers
- acute attack: sumatriptan 50mg
- prophylaxis: propranolol 80mg OD
57
how does a cluster headache present and how should it be treated?
- nightly pain in 1 eye, tearing, redness around the eye
- refer for specialist advice and imaging
- acute attack: sumatriptan 6mg SC and high flow O2
- prophylaxis: verapamil 80mg TDS if attacks are frequen
58
how does a exertional headache present and how should it be treated?
- suggested by history of association
| - NSAIDs or propranolol before attacks
59
how does a trigeminal neuralgia present and how should it be treated?
- intense stabbing pain lasting seconds in the trigeminal nerve distribution
- refer to neurology if <50y and treat with carbamazepine
60
how does a glaucoma headache present and how should it be treated?
- red eye, haloes, loss of visual acuity, pupil abnormality
| - requires regular optometry check ups to check intraocular pressures
61
how does a giant cell arteritis headache present and how should it be treated?
- >50y, scalp tenderness, raised ESR, decrease in visual acuity
- prednisolone 40-60mg OD and refer to opthalmology or rheumatology for temporal artery biopsy
62
how does a tension type headache present and how should it be treated?
- band around the head, stress, low mood
- reassure no underlying pathology and to alleviate stress
- treat with paracetamol PRN
63
how does a medication overuse headache present and how should it be treated?
- rebound headache on stopping analgesia
- advise to stop overused medication abruptly for 1month
- consider specialist referral if taking strong opioids or failed recurrent attempts to stop meds
64
how does a raised ICP headache present and how should it be treated?
- worse on waking/ coughing, low pulse, high BP, neurological signs
- refer to specialist
65
what are common triggers of headaches?
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CHOCOLATE
Chocolate
Hangovers
Orgasms
Cheese/Caffeine
Oral contraception
Lie-ins
Alcohol
Tumult
Exercise
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