Tutorial 2: Case 2

Question 1

21-year-old student, is requesting ‘miracle’ cure for her horrible flu as she has two oral exams in the coming days

A) Who is it for?

B) What are the symptoms?

C) How long have you had these symptoms?

D) Action taken

E) Medications being taken?

F) Medical conditions

G) Allergies

H) P/BF (female asking…)

Answer 1

A) Myself

B) I can’t breathe out my nose, it is so congested and a bit snotty

C) They came on quickly yesterday morning, bad timing with my exams

D) I toom a big dose of vitamin C this morning hoping to get rid of this

E) None

F) None

G) Cats, though no recent exposure

H) NO

Question 2

Appropriate extended questions

1. Are there any other symptoms
2. Have you had this before
3. Can you describe the discharge from your nose i.e. clear/watery or thick/colored
4. Do you have any fever or significant facial pain
5. Do you prefer oral or intranasal products
6. Has anything changed recently? Any activities

Answer 2

1. light dull headache in my eyebrow area on and off, especially when the congestion is bad
2. Maybe this time I last year I had similar symptoms
3. Sometimes it is runny and clear, sometimes it is thick and whitish, mostly it is blocked up
4. Only the slight headache at times, nothing serious
5. I find those cold and flu tablets can make me feel a bit ‘high’ and ‘awake’ and I need to slep well with my exams so maybe not something oral
6. No, jsut studying for exams

Question 3

What is the diagnosis? Explain reasoning to patient.

Answer 3

Based on the signs and symptoms you have told me, I believe you have the common cold. The slight headache. runny/blocked nose are common symptoms of the cold. Most likely a viral infection that you contracted from somewhere. Extremely common.

Question 4

What product would you recommend for this patient? Provide IDARL.

Answer 4

Xylometazoline (intranasal decongestant)

• Indication: reduce swelling and nasal congestion of the nose and therefore reduces the symptoms of the runny nose, nasal treatment preferred over oral
• Dosage and directions: 1 spray per nostril, use 2-3 times daily. Block one nostril, cross arms and aim spray at the corner of the nose, keep heat tilted down, clean nozzle after each use.
• Adverse effects: may cause local irritation and rebound congestion with prolonged used
• Duration of treatment, time to recovery, when to refer: Don’t use for longer than 5 days in a row, refer if >7 days, if there is middle ear pain, chest pain or fever
• Lifestyle/self care: drink plenty of fluids, avoid exposure to cigarette smoke, have good hygiene

I will give you a self care-card for the common cold and a consumer medication information leaflet. Do you have any questions for me?