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Flashcards in Referral Criteria Deck (36):
1

What is the referral criteria for colds and flu?

- Earache not settling with analgesic

- In the very young

- in the very old

- in those with heart and lung disease (COPD, kidney disease, diabetes, compromised immune system)

- persisting fever and productive cough

- delirium

- Asthma

- Pleuritic type chest pain

2

What is the referral criteria for cough?

- Cough lasting 2 weeks or more and not improving

- Sputum (yellow, green, rusty, or blood stained)

- Chest pain

- SOB/ wheezing

- whooping cough or croup

- Recurrent nocturnal cough

- Suspected adverse drug reaction

- Failed medication

3

What is the referral criteria for sore throat?

- Sore throat lasting more than 1 week

- Recurrent bouts of infection

- Hoarseness of more than 3 weeks duration

- dysphagia

- failed medication

4

What is the referral criteria for hayfever

- Wheezing

- SOB

- Tightness of chest

- Painful ear

- Painful sinuses

- Purulent conjunctivitis

5

What is the referral criteria for mouth ulcers?

- Duration of longer than 3 weeks

- Associated weight loss

- Involvement of other mucous membranes

- Rash

- Suspected ADR

- Diarrhoea

6

What is the referral criteria for heart burn?

- Failure to respond to antacids

- Pain radiating to arms

- Difficulty swallowing

- Regurgitation

- Long duration

- increasing severity

- Children

7

What is the referral criteria for indigestion

- Age 45+ and presenting for the first time

- Persistent symptoms (longer than 5 days) or recurrent

- Pain is severe

- Blood in vomit or stool

- Pain worsens on effort

- Persistent vomiting

- Failed treatment

- ADR suspected

- Associated weight loss

- Children

8

What is the referral criteria for nausea and vomiting

- vomiting in children under 2

- vomting for longer than 2 days

- suspected gastroenteritis

- any vomiting should be referred - hydration therapy in mean time by pharmacists

- blood in vomit

9

What is the referral criteria for motion sickness?

None (it's preventative treatment)

10

What is the referral criteria for constipation?

- Change in bowel habit of 2 weeks or longer

- Presence of abdominal pain, vomiting, bloating

- Blood in stools

- Prescribed medication suspected as cause

- Failure of OTC medication (for 1 weeks use)

11

What is the referral criteria for diarrhoea?

- Diarrhoea greater than 1 days duration in children younger than 1

- Diarrhoea greater than 2 days duration in children under 3 years and the elderly

- Diarrhoea greater than 3 days in older children and adults

- Association with severe vomiting and fever

- Recent travel abroad

- Suspected drug induced reaction to prescribed medication

- History of change in bowel habit

- Presence of blood or mucus in the stools

- Pregnancy

12

What are the referral criteria for IBS?

- Children

- Older person with no previous history of IBS

- Pregnant woman

- Blood in stools

- Unexplained weight loss

- Caution in patients aged 45 plus with changed bowel habit

- Signs of bowel obstruction

- Unresponsive to appropriate treatment

13

What is the referral criteria for haemorrhoids / piles?

- Duration of longer than 3 weeks

- Presence of blood in the stools

- Change in bowel habit (persisting alteration from normal bowel habit)

- Suspected drug induced constipation

- Associated abdominal pain/vomiting

14

What are the referral criteria for eczema/contact dermatitis

- Evidence of infection (weeping, crusting, spreading)

- Severe: badly fissured, cracked skin, bleeding

- Failed medication

- Non-identifiable cause (unless previously diagnosed as eczema)

- Duration of longer than 2 weeks

15

What is the referral criteria for Acne?

- Failed medication

- Severe acne

- Suspected drug-induced acne

- If patient has not responded to treatment within 8 weeks warrants referral to doctor

16

What is the referral criteria for athetes foot?

- Diabetic patients

- Severe, affecting other parts of the foot

- Unresponsive to appropriate treatment

- Signs of bacterial infection (crusting, pus, weeping)

- Involvement of toenails

17

What is the referral criteria for cold sores?

- Babies and young children

- Failure of an established sore to resolve

- Severe or worsening sore

- History of frequent cold sores

- Sore lasting longer than 2 weeks

- Painless sore

- Patients with actopic eczema

- Eye affected

- Uncertain diagnosis

- immunocompromised patient (e.g on chemotherapy)

18

What are the referral criteria for warts/verrucae?

- changed appearance of lesion -size or colour

- Bleeding

- itching

- Genital warts

- Facial warts

- Diabetic patient

- Immunocompromised patient

19

What are the referral criteria in scabies?

- Babies and young

- Secondary infection

- Immunocompromised

- treatment failure

- unclear diagnosis

20

What is the referral criteria for head lice?

- suspected psoriasis

- signs of infection

- unresponsive to appropriate treatment

21

What are the referral criteria for headaches?

- Severe headache of more than 4h duration

- Suspected ADR

- Headache in children under 12

- Headache is worse in morning then improves

- Severe occipital headache (across back of head)

- Associated drowsiness, unsteadiness, visual disturbances, vomiting

- neck stiffness

- Frequent migraines requiring prophylactic treatment

- Frequent and persistent headaches

- women on COC and presenting with headaches

- Recent head injury or trauma

22

What are the referral criteria for musculoskeletal conditions?

- Suspected fracture

- Possible ADR: falls or bruising

- Head injury

- Medication failure

- Arthritis

- Severe back pain

- Back pain (and/or pins and needles/numbness) radiating to leg

- Back pain in the middle upper back

- Brusing without apparent injury

23

What is the referral criteria for cystitis? (UTI)

All men

All children

Fever/nausea/vomiting (indicative of upper urinary tract problems which can be more serious)

Duration of longer than 2 days

Haematuria

Vaginal discharge

Pregnancy

Recurrent

Failed medication

24

What is the referral criteria for dysmenorrhoea?

Presence of abnormal vaginal discharge

Abnormal bleeding

Symptoms suggest secondary dysmenorrhoea

Severe intermenstrual pain (mittelschmerz) and bleeding

25

What is the referral criteria for menorrhagia?

Presence of abnormal vaginal discharge

Intermenstrual and/or postcoital bleeding

Pelvic pain

Pain on intercourse

Dysmenorrhoea

Presence of fever

(treat with tranexamic acid OTC)

26

What is the referral criteria for vaginal thrush?

First occurrence of symptoms

Known hypersensitivity to imidazole or other vaginal anti-fungal products

Pregnancy or suspected pregnancy

More than 2 attacks in previous 6 months

Previous history of STD/ exposure to partner with STD

Under 16 or over 60

Abnormal or irregular vaginal bleeding

Any blood staining of vaginal discharge

Vulval or vaginal sores, ulcers or blisters

Associated lower abdominal pain or dysuria

Adverse effects associated with treatment

No improvement within 7 days of treatment

27

What are the referral criteria for emergency hormonal contraception?

Under the age of 16

Unprotected sex over 72 hours ago

Taking a medicine that interacts with EHC

Requests for future use

28

What are the referral criteria for benign prostatic hyperplasia?

Pain or urination

Fever that might be related to a UTI

Bloody or cloudy urine in the last 3 months (could indicate possible UTI)

Urinary incontinence

29

What is the referral criteria for alopecia?

Suspected drug induced hair loss

Suspected hyperthyroidism

menstrual disorders

Suspected anaemia

30

What are there referral criteria for eye problems?

Painful red eye

Loss of vision

Double vision

31

What are the referral criteria for ear problems?

Pain

Discharge

Deafness

Irritation

Tinnitus

Vertigo

32

What is the referral criteria for rashes in children

Suspected meningitis:

- Flu-like symptoms

- Headache

- Neck stiffness

- Rash

- Small widespread pots or bruises that do not blanch when pressed

- Rashes that do not blanch when pressed

33

What is the referral criteria for nappy rash

Broken skin, severe rash

signs of infection

Other body areas affected

34

What are the referral criteria for thread worm?

Recen travel abroad

Alternative infection to threadworm suspected

Medication failure

Secondary bacterial infection suspected (weeping, crusting)

35

What are the referral criteria for oral thrush?

- Recurrent infection

- Anyone who isn't a baby

- Failed medication (if symptoms haven't cleared up in 1 week)

36

What are the referral criteria in insomnia?

- Suspected depression

- Chronic problem (over 3 weeks)

- Children under 16

- Snoring, apnoea, restless legs - indicators of CV risk

- Associated physical condition

- Suspected alcohol dependency