Week 2: Minor illness 1/3 Flashcards

1
Q

influenza

A

Contagious respiratory illness caused by influenza virus that infect the nose, throat and sometimes the lungs. Can cause mild to severe illness and can lead to death

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2
Q

causes of influenza

A
  • Spread mainly by tiny droplets made when people with flu cough, sneeze or talk
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3
Q

presentation of influenza

A
  • fever* or feeling feverish/chills
  • cough
  • sore throat
  • runny or stuffy nose
  • muscle or body aches
  • headaches
  • fatigue (tiredness)
  • some people may have vomiting and diarrhoea, though this is more common in children than adults.
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4
Q

complications of flu

A
  • bacterial pneumonia
  • ear infections
  • sinus infections
  • worsening of chronic medical conditions e.g. CHF, asthma or diabetes
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5
Q

prophylaxis of influenza

A

flu vaccine

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6
Q

diagnosis of influenza

A
  • presentation
  • rapid influenzas diagnostic test
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7
Q

management of influenza

A
  • antipyretic
  • anti-viral – oseltamivir (Tamiflu)
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8
Q

common cold

A

A mild self-limiting upper respiratory tract infection characterised by nasal stuffiness and discharge, sneezing, sore throat and cough.

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9
Q

causes of cold

A
  • Wide range of virus’ inc rhinovirus, coronavirus, influenza
  • Can be transmitted in a variety of ways including
    • Direct contact
    • Small-particle aerosols
    • Large-particle aerosols
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10
Q

presentation of common cold

A

The onset of symptoms is usually rapid, over 1–2 days.

  • Sore or irritated throat — often the first symptom, typically has a sudden onset and resolves rapidly.
  • Nasal irritation, congestion, nasal discharge (rhinorrhoea), and sneezing — nasal discharge is often profuse and clear, but may become thicker and darker as the infection progresses (although this does not usually indicate that bacterial infection is present).
  • Cough develops in about 30% of people, typically after nasal symptoms have cleared.
  • Hoarse voice caused by associated laryngitis.
  • General malaise.
  • Other symptoms are less common and may include:
    • Fever — this is unusual in adults and is typically low grade.
    • Headache and myalgia — more often associated with influenza rather than the common cold.
    • Loss of taste and smell, eye irritability, and a feeling of pressure in the ears or sinuses (due to obstruction or mucosal swelling).
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11
Q

diagnosis of common cold

A

history

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12
Q

management of common cold

A
  • No know treatment improves the time course of infection
  • Symptom relief and rest
    • Adequate fluid
    • Healthy food
    • Adequate rest
    • Paracetamol or ibuprofen
    • Steam inhalation
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13
Q

management of common cold

A
  • No know treatment improves the time course of infection
  • Symptom relief and rest
    • Adequate fluid
    • Healthy food
    • Adequate rest
    • Paracetamol or ibuprofen
    • Steam inhalation
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14
Q

sore throat can be caused by

A
  • Acute pharyngitis- inflammation of the pharynx
  • Tonsilitis- inflammation of the tonsils
  • Common cold
  • Glandular fever
  • Flu
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15
Q

non-infectious causes of sore throat

A
  • GORD
  • Drug induced e.g. Carbimazole
  • Smoking
  • Hayfever
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16
Q

infectious causes of sore throat

A
  • Rhinovirus
  • Coronavirus
  • Influenza type A and B
  • Streptococcal infection e.g. strep pyogenes
  • Adenovirus
  • Haemophilus influenza
17
Q

How to different between pharyngitis and tonsilitis?

A
  • Pharyngitis  exudate and erythema on pharyx
  • Tonsilitis- exudate and erythema on tonsils
    • Higher temp
18
Q

in a person with a sore throat when should 999 be called

A
  • epiglottitis
    • high pitched stridor
    • haemophilus type B
    • high fever
    • sore throat
    • sitting up and leaning forward
    • drooling due to difficulty swallowing
    • dont examine childs throat- dont want to distress
19
Q

in which patients should specialist advice be soert if they present with a sore throat

A

If person is on chemo, or has known suspected leukaemia (can be caused by carbimazole), asplenia, aplastic anaemia or HIV/AIDs or taking immunosuppressive therapy seek immediate specialist advice.

20
Q

which tool is used to decide whether sore throat is viral or bacterial in origin

A
  • Viral if more systemic symptoms e.g. fever and cough
  • Bacterial if localised to tonsils
21
Q

antibiotic of choice for tonsillitis

A

penicillin (5-10 days, QDS)or erythromycin

22
Q

common ear infections

A
  • Otitis externa
  • Otitis media
  • Otitis media with effusion
23
Q

Signs and symptoms of ear disease (can be varied!)

A
  • Otalgia (ear pain)
  • Discharge
  • Hearing loss (conductive vs sensorineural)
    • Tuning forks
  • Tinnitus
  • Vertigo
  • Facial nerve palsy
    • Through the petrous bone (middle ear)
    • Disease involving the ear may manifest as facial palsy
24
Q

otitis externa

A
  • Inflammation of the external ear esp EAM
  • Known as swimmer ear
  • Rare complication of otitis externa= malignant otitis externa
    • Rare and very serious potential life threatening esp in immunocompromised e.g. diabetics
25
Q

presentation of otitis externa

A
  • Presents with ear pain and itchiness
  • Discharge
26
Q

management of otitis externa

A
  • Advice on self-care measures e.g. avoid swimming for 7 days, use hairdryer to dry ear out after swim, over counter ear drops
  • Topic antibiotics e.g. amoxicillin with or without steroids e.g. hydrocortisone
  • Oral if immunosuppressive
27
Q

otitis media

A
  • Middle ear infection
    • More common in infants/ children than in adults
28
Q

causes of otitis media

A
  • Mostly viral aetiology
  • Occasionally bacterial
    • S. pneumonia
    • H. influenza
29
Q

presentation of otitis media

A
  • Otalgia  infants may pull or tug at ear
  • Other non-specific symptoms e.g. temp
  • Red +/- bulging TM and loss of normal landmarks middle ear cavity full of puss
30
Q

why are children more susceptible to otitis media

A

Why are children more susceptible?

  • Pharyngotympanic tube is shorter and more horizontal in infants
31
Q

management of otitis media

A

amoxicillin

paracetamol and ibuprofen

32
Q

presentation of Otitis media with effusion “glue ear”

A
  • Looks retracted and TM looks straw coloured
  • May see evidence of fluid
33
Q

MOA of otitis media

A
  • Not an actual infection- can predispose to infection
  • Due to eustachian tube dysfunction
  • Fluid and negative pressure in middle ear
    • Decreases mobility of TM and ossicles  affecting hearing
    • Also draws fluid from across the mucous membrane in the middle ear
  • Most resolve spontaneously without Abx in 2/3 months
  • If persists or impede speech and language development/ school performance
    • Require grommets (tympanostomy tube)
    • Act to maintain equilibration of pressure
34
Q

sinusitis is

A

Symptomatic inflammation of the paranasal sinuses.

35
Q

sinusitis causes

A
  • Viral upper resp tract infection, followed by bacterial infection
  • Sinus mucosa oedema, obstruction of the sinus ostia, and reduction in mucociliary action allow secretions to stagnate and give bacteria a suitable environment in which to grow
  • Allergic rhinitis
  • Smoking
  • Impaired ciliary motility
36
Q

presentation of sinusitis

A
  • Usually follows a common cold
  • Nasal blockage/ discharge
  • Facial pain/ pressure
  • Reduction in smell
  • Tenderness, swelling or redness over cheekbone
  • Cough
  • Bacterial sinusitis when symptoms
    • >10 days
    • Discoloured or purulent nsala discharge
37
Q

Management of sinusitis

A
  • If less than <10 days – do not offer antibiotics
  • >10 day
    • High-dose nasal corticosteroid
    • Antibiotics- penicillin