Minor illnesses SLA 3

Question 1

Describe the pathophysiology of scabies

Answer 1

This is when there are mites which burrow under the skin where they lay their eggs which then resurface.
Transmission is usually skin-to -skin contact

Question 2

Symptoms of scabies

Answer 2

Intense itching
pimple- like rash

Question 3

Treatment of scabies

Answer 3

1. Insecticide -premethrin cream- avoid eyes and mouth- wash off after 8-12 hours- creams have a risk of ignition
   THE WHOLE HOUSEHOLD AND ANYONE IN CONTACT HAS TO BE TREATED

Question 4

What is the pathophysiology of chicken pox?

Answer 4

This is when you get the varicella zoster virus- usually spread through coughing or sneezing- sometimes the VSV can remain in the dorsal root ganglion

Question 5

Why is VSV dangerous in pregnancy?

Answer 5

because it can cause maternal mortality and can also cause neonatal varicella.

Question 6

What is the treatment of shingles?

Answer 6

Aciclovir- oral antiviral for 7 days =
get them on pain management

Question 7

What are some serious complications of Shingles?

Answer 7

-meningitis, encephalitis
-Hutchinsons sign- which is when the patient has vesicles on the side of the nose which in turn means that they have shingles in the eye- (any unexplained red eye with shingles indicates opthalmic shingles) m

Question 8

What is ramsay hunt syndrome?

Answer 8

This is when there is shingles which affects the facial nerve causing the facial paralysis and hearing loss.

Question 9

What is the treatment for chicken pox?

Answer 9

Keep the nails short
Anti-histamine- piritone
Cooling gel- calamine lotion

Question 10

What is the Fifth disease?

Answer 10

This is also known as parvo-virus or slapped cheek syndrome- it is a viral illness that spreads across the whole body- in children it starkly presents with bright red cheeks

Question 11

What is the management of parvovirus in children?

Answer 11

it is managed by analgesics- supportive treatment

Question 12

What is childhood exanthem?

Answer 12

This is when there is a skin rash associated with a fever

Question 13

What are the numbered diseases 1-6?

Answer 13

first disease- measles
second disease-scarlet fever
third-rubella
fourth- filatow-dukes disease
fifth-erythema infectiosum
sixth-exanthem subitum

Question 14

What are the three types of conjunctivitis?

Answer 14

-VIRAL- this is the most common - this has a clear exudate
-BACTERIAL- staph and strep - more contagious - has a more purulent secretion
-ALLERGIC - this usually is associated with a trigger- like hayfever- dust, pet fur
-secondary to gonorrhea or syphillis

Question 15

What is the treatment of conjunctivitis?

Answer 15

Viral conjunctivitis- usually resolves in two weeks- by itself- cool compresses
using seperate towels
good hand hygiene
Bacterial- self-limiting should resolve by itself in 5-7 days
but can be treated with chloramphenicol- 0.5% drops or ointment - 3-4 times a day

Question 16

What are the two types of styes?

Answer 16

External- develops along the edge of eyelid
internal stye- this develops on the inside of the eyelid and is less painful
HOT COMPRESS should bring out the pus
or if incredibly painful and not resolving- surgical popping is also a possibility

Question 17

What is the cause of a stye?

Answer 17

It is a blocked sebaceous gland- it swells and becomes bigger

Question 18

What are the types of orbital cellulitis?

Answer 18

Periorbital cellulitis - this doesn’t impair the vision - but does present with swelling
Orbital (postseptal) cellulitis- this is more dangerous as the orbital veins drain into the cavernous sinus- therefore infection can spread intracranially

Question 19

What is blepharitis?

Answer 19

This is when there is inflammation along the eyelid margin
- crusting dry eyes

Question 20

What are the symptomatic differences and similarities between post and pre septal infection?

Answer 20

Pre-septal- this is when there is swelling usually from a superficial cut/ infection
post-septal- this is when there is swelling however- there is also pain on eye movement and reduced visual acuity- the spread of infection here is from the paranasal sinuses - there is also EXOPTHALAMOUS

Question 21

What is the treatment for orbital cellulitis?

Answer 21

flucloaxicillin 4 times a day for 5-7 days

Question 22

What are the ottawa rules for X-RAYS

Answer 22

-Bony tenderness on 6cm of the tip of the dital fibula or lateral malleolus
-Bony tenderness on 6cm of the tip of the distal tibia or medial malleolus
-Bony tenderness on the the base of the 5th metatarsal
-bony tenderness at the navicular
-cannot bear weight initially after injury- but also first four steps on evaluation

Question 23

What is the treatment for ankle sprain?

Answer 23

-analgesics
-rest
-elevation
-ice
-consider x-ray if OTTAWA ankle rules apply

Question 24

What is otitis media?

Answer 24

This is an infection in the middle ear- which causes bulging of the tympanic membrane - which can lose its landmarks and can look very red
- sometimes it can be accompanied with an effusion- in this case- it can cause hearing problems-and can require a grommet- the ear discharge can be offensive smelling

Question 25

What is one thing you must always check for in a patient who comes in with an ear ache?

Answer 25

you should always check the mastoid process- to check for mastoiditis.

Question 26

What is the treatment for otitis media?

Answer 26

First line- clarithromycin 5-7 day course- amoxicillin tastes worse
co-amoxiclav- is not a first choice because it is broad spectrum therefore increases resistance and can cause c.diff

Question 27

What are the causes of ulcers?

Answer 27

-smoking, alcohol usage and male-on-male sex, tobacco- paan, betel leaves- these can increase risk of oral cancer
- could be an STD
- can have associated cervical lymphadenopathy

Question 28

What is the management advice for headlice?

Answer 28

wet combing- comb hair root to tip to remove all the lice and repeat every couple of days
- check everyone in the house
-washing laundry
medicated shampoo - dimeticone products

Question 29

What is the management for nappy rash?

Answer 29

-self-management- using bigger more breathable nappies
-99% water wipes- alcohol free wipes
-topical steroid if the rash is inflamed or looks uncomfortable

Question 30

What is plantar fasciitis?

Answer 30

This is when there is a thickening of the band that goes from the ball of the toes to the heel of the foot- usually more common in flat-feeted patients

Question 31

What are the symptoms of plantar fasciitis?

Answer 31

Pain around the bottom of the foot-and around heel and arch
-usually patients will have a job which requires them to walk a lot- causing thickening

Question 32

What is impetigo?

Answer 32

This is a contagious skin rash-that looks golden brown- and crusty- it is caused by strep/staph

Question 33

What are the two types of impetigo

Answer 33

Non-bullous- where there are no blisters
Bullous- in which there are blisters present

Question 34

What is the treatment of impetigo

Answer 34

hydrogen peroxide -2-3 times a day or fusidic acid 3 times a day

for adults with non-bullous impetigo give oral flucloxacillin

Question 35

What is the management for insect bites?

Answer 35

usually if there is no sign of infection then just give supportive treatment
if there is infection signs then treat with flucloxacillin

Question 36

What is the treatment for otitis media with effusion?

Answer 36

place a grommet - usually with otitis media with effusion its not infectious

Question 37

What are the symptoms of otitis media with effusion?

Answer 37

-Painless ear otorrhea

Question 38

What is the treatment for Influenza?

Answer 38

healthy patients with influenza do not require any treatment
patients who are at risk should be on oseltamivir or zanamivir

Question 39

What are the two broad categories of influenza?

Answer 39

Uncomplicated - urtI, COLD and fever, GI symptoms
complicated- this is when there is involvement of the CNS and LRTI

Question 40

What is the treatment of thrush?

Answer 40

Metronidazole- fluconazole, clotrimazole - intravaginally if orally is contraindicated