winter illnesses and treating kids

Question 1

definition of a sore throat

Answer 1

when an acute upper respiratory tract infection affects the mucosa of the throat

Question 2

clinical descriptions of sore throat:

Answer 2

acute pharyngitis: inflammation of the part of the throat behind the soft palate (oropharynx)

tonsilitis (inflammation of the tonsils)

Question 3

common infectious causes of acute sore throat:

Answer 3

• • rhinovirus, coronavirius, adenovirus
• influenza types a and b
• streptoccal infection

Question 4

how does the bacteria cause a sore throat

Answer 4

infects upper respiratory tract mucosa causing inflammation.

Question 5

how common are sore throats?

Answer 5

sore throat = a common conditions, highest indicidence in 5-24 year olds, and has rare/little complications

Question 6

prognosis (development): sore throat due to a viral or bacterial condition is a self limiting condition which generally resolves within …

Answer 6

2 weeks . by week 1, people = normally substance free

Question 7

advice for sore throats

Answer 7

• take adequate fluid
• salt water gargling, medicated lozenges, and anaesthetic sprays may provide temporary relief
• hot drinks should be avoided

Question 8

people with sore throats should seek follow up if:

Answer 8

• symptoms = no improvement after 3/4 days of antibiotic therapy (e.g. for altenative diagnoses)
• pain doesn’t improve after 3 days / fever over 38.3 degrees
• becomes difficult to swallow saliva or liquids, any difficulty in breathing, any one sided neck or throat swelling

Question 9

what is a major trigger of asthma symptoms

Answer 9

cold air

Question 10

examples of asthma symptoms

Answer 10

wheezing and shortness of breath

Question 11

people with asthma should be advised to monitor their symptoms in what season

Answer 11

winter

Question 12

top tips for asthma patients

Answer 12

Stay indoors on very cold, windy days. If patients go out, advise them to wear a scarf over their nose and mouth. Also advise patients to be extra vigilant about taking regular medications, and to keep rescue inhalers close by.

Question 13

arthritis flare-ups

• many people report their joints become more painful in what season

Answer 13

winter, tho why is unclear

Question 14

what arthritis symptoms are affected by the weather

Answer 14

Only joint symptoms such as pain and stiffness are affected by the weather (no evidence that changes in the weather cause joint damage).

Question 15

top tips for arthritis patients

Answer 15

Advise patients that many people get a little depressed during the winter months, and this can make them perceive pain more acutely. Explain that for many patients, everything feels worse, including medical conditions. Advise daily exercise as it can boost both mental and physical states. Swimming is ideal as it is easy on the joints.

Question 16

heart attacks are morre common in the winter. why?

Answer 16

this may be because cold weather increases blood pressure and puts more strain on the heart. The heart also has to work harder to maintain body heat in cold temperatures.

Question 17

top tip for patients - heart attacks

Answer 17

Advise patients to stay warm in their homes. Keep the main rooms used at 18⁰C and tell them to use a hot water bottle or electric blanket to keep warm in bed. Advise them to wrap up warm when outside and wear a hat, scarf and gloves

Question 18

cold hands:

• what is raynauds phenomenon

Answer 18

a common condition that makes fingers and toes change colour and become very painful in cold weather. Fingers can go white, then blue, then red, and throb and tingle; signalling poor circulation.

Question 19

what happens to the small blood vessels of the hands and feet

Answer 19

they go into spasm, temporarily reducing blood flow to these areas. In severe cases, medication can help, but most people manage their symptoms without treatment.

Question 20

what are chillblains

Answer 20

Chilblains are small, itchy swellings on the skin that occur as a delayed reaction to cold temperatures. They most often affect the body’s extremities and typically cause a burning/itching sensation, which can become more intense on entering a warm room.

Question 21

top tip for patients with raynauds

Answer 21

Don’t smoke or drink caffeine (they can both worsen symptoms) and advise them to wear warm gloves, socks and shoes when going out in cold weather.

Question 22

dry skin:

• Dry skin is often worse when

Answer 22

during the winter, when environmental humidity is low.

Question 23

top tips for patients with dry skin

Answer 23

moisturising is essential during winter. Contrary to popular belief, moisturising lotions and creams aren’t absorbed by the skin. Instead, they act as a sealant to stop the skin’s natural moisture from evaporating away.
– The best time to apply a moisturiser is after a bath or shower while skin is still moist, and again at bedtime.
– Have warm, rather than hot, showers. Water that is too hot makes skin feel more dry and itchy.

Question 24

norovirus

• this presents with what symptoms

Answer 24

symptoms of gastroenteritis (vomiting and diarrhoea)

Question 25

norovirus - rec treatment:

Answer 25

Plenty of fluid, paracetamol, and rehydration sachets

Question 26

Immediately after the norovirus symptoms have subsided, the advice is to

Answer 26

NOT go back to school work etc. Personal hygiene is of paramount importance, as it can prevent the spread of norovirus - no vaccination available for it - not every patient that has norovirus needs to see their GP

Question 27

colds: - what is a cold

Answer 27

a mild viral infection of the nose, throat, sinuses and upper airways.

Question 28

what can a cold cause

Answer 28

It can cause a blocked nose followed by a runny nose, sneezing, a sore throat and a cough.

Question 29

how longs do colds last in adults vs kids

Answer 29

In adults and older children, the cold will usually last for about a week. Colds in younger children can last up to two weeks.

Question 30

top tips for patients with colds

Answer 30

there is no cure for a cold, although symptoms of a cold can be relieved by taking over-the-counter medication (such as paracetamol), and drinking plenty of fluids.

Question 31

flu (influenza) - what is the flu?

Answer 31

influenza or ‘flu’ is a respiratory virus which causes symptoms such as a sore throat, headache, fever, and a dry unproductive cough.

Question 32

when does the flu usually occur

Answer 32

* Usually occurs in the UK during the winter months, from October to May.

Question 33

how is the flu usually spread

Answer 33

* The flu virus is spread mainly through tiny droplets produced when people with the infection cough, sneeze, or talk. - These droplets can land in the mouths/noses of people who are nearby or can be inhaled into the lungs, thereby spreading the infection.

Question 34

how long does the flu vaccine last

Answer 34

one year

Question 35

top tips for patients suffering from the flu

Answer 35

the flu jab (or flu nasal spray for children aged 2-18) is recommended to prevent catching the flu.

Question 36

Flu is a major killer of vulnerable people. which people are particularly at risk.

Answer 36

People aged ≥ 65 years, pregnant women, children, and people with long-term health conditions (such as diabetes)

Question 37

In England, when was the largest excess all-cause mortality since 2008/09, which coincided with the circulation of influenza and respiratory syncytial virus.

Answer 37

2012/2013 winter

Question 38

scarlet fever: - this is contagious and mainly affects what group

Answer 38

mostly affects young children

Question 39

first signs of scarlet fever include what types of symptoms

Answer 39

First signs include flu-like symptoms inc. sore throat andvswollen neck glands

Question 40

what shows 12-48 hours later: scarlet fever

Answer 40

appearance of a rash 12-48 hours later – red/sandpapervlike – can cause cheeks to appear red

Question 41

what is a strawberry tongue that patients might get: should it be referred?

Answer 41

* White coating on the tongue – red, swollen and little bumps called “strawberry tongue” all cases should be referred

Question 42

complications can arise esp if scarlet fever patients suffering from what at the same time?

Answer 42

chickenpox

Question 43

scarlet fever treatment

Answer 43

after a swab of the throat and possibloy a blood test - antibiotics – reduces chances of serious illnesses such as pneumonia

Question 44

Transmission risks and how to avoid spreads:

Answer 44

avoid close contact with someone you know is infected/wash your hands often with soap and water/cover your mouth and nose with a tissue when you cough or sneeze/bin used tissues as quickly as possible

Question 45

strep A: common in

Answer 45

children - Common type of bacteria – mostly mild and easily treated

Question 46

what are the symptoms of strep A infection:

Answer 46

high temp, swollen glands, sore throat, rash, scabs and sores, pain and swelling

Question 47

whats the strep A referral criteria

Answer 47

children unwell/getting worse, not eating as much, baby under 3 months has a fever of 38 degrees, 3-6 month olds 39 degrees or higher etc, trouble breathing, blue r grey skin, child is floppy and won’t stay awake

Question 48

what are the treatments for strep A

Answer 48

antibiotics, and stay away from nursery and stuff

Question 49

coronaviruses (CoVs) - what are these?

Answer 49

A family of viruses that causes illness in human and animals. * Of the 7 different types that have been found in people: – SARS (Severe Acute Respiratory Syndrome) – MERS (Middle East Respiratory Syndrome) – COVID-19

Question 50

what illnesses do coronaviruses cause

Answer 50

Cause respiratory and intestinal illnesses

Question 51

how do coronaviruses usually present

Answer 51

Usually present as mild colds but the above have caused severe disease – epidemics and pandemics

Question 52

what are coronaviruses made from

Answer 52

* Made from RNA genomes – subject to constant change = mutations * COVID-19 – diverse effects that affect multiple organs of the body

Question 53

Current research: new coronavirus has a fatality rate among infected people that is how high

Answer 53

6-16 times higher than common flu (killing 0.6%-1.6%)

Question 54

difference between covid 19 vs influenza

Answer 54

- There may be some cross-protective immunity from other coronaviruses that cause milder diseases that have been in circulation for a while – still unknown for sure

Question 55

True/False: Adults and children are treated with the same remedies when presenting with a cold or the flu -

Answer 55

false

Question 56

The Commission on Human Medicines (CHM) has advised that: * Cough and cold medicines containing the following ingredients should not be used in children under the age of 6:

Answer 56

– nasal decongestants (pseudoephedrine, ephedrine, phenylephrine, oxymetazoline, and xylometazoline) – expectorants (guaifenesin and ipecacuanha) – antitussives (dextromethorphan and pholcodine) – antihistamines (diphenhydramine, chlorphenamine, brompheniramine, promethazine, triprolidine, and doxylamine)

Question 57

For 6-12 year olds, these products should be indicated for “second line” use, and recommended for a max. of how many days

Answer 57

5 days use.

Question 58

which analgesic should I prescribe for children under 16 years of age?

Answer 58

Prescribe either paracetamol or ibuprofen alone. Both are suitable first-line choices for treating mild-to- moderate pain in children. * If the child does not respond to the first analgesic: – Check their compliance, and that an appropriate dose is being taken – If paracetamol has been used, switch to ibuprofen alone – If ibuprofen has been used, switch to paracetamol alone

Question 59

If switching has been tried and the child has not responded sufficiently to appropriate doses of one drug alone, consider

Answer 59

alternating paracetamol and ibuprofen. – Add a dose of the second drug (for example after 2– 3 hours), provided that the parents are confident to do this. – Paracetamol is usually given every 6 hours and ibuprofen every 8 hours. Care needs to be taken not to exceed the maximum dose of each drug in a 24-hour period. – A treatment diary may be useful if the parents or carers find it difficult to remember which was the last drug given and at what time.

Question 60

if the child is still in pain or more than short courses of analgesics are required, consider

Answer 60

referral to a paediatrician for further assessment.

Question 61

the following treatment options are not recommended for children in primary care:

Answer 61

– Combining paracetamol with ibuprofen (administering paracetamol and ibuprofen at the same time) – Naproxen – Diclofenac – Aspirin – Weak opioids

Question 62

Additional good advice for all patients during the winter months (5)

Answer 62

- 1. Eliminate sleep debt 2. Drink more milk 3. Eat more fruits and vegetables 4. Try new activities for the whole family 5. Have a hearty breakfast

Question 63

why might someone with norovirus etc develop a headache after

Answer 63

likely due to dehydration

Question 64

in self care 'further questioning' what can we ask about

Answer 64

Regarding risk factors and potential causes, if they travelled etc , or symptoms e.g. how often , how they feel etc