Year 3 OTC Notes Flashcards

Question

What OTC treatment can be given for oral thrush?

Answer 1

Daktarin oral gel (miconazole)

Answer 2

Adults and Children over 2 years: 2.5 ml (half a 5ml spoonful) of gel Applied four times a day after food. Infants 4 months - 2 years: 1.25 ml (one quarter of a 5 ml spoonful) of gel applied four times a day after food. Each application should be divided into smaller portions. Keep the gel in the mouth as long as possible apply directly to the affected area with a clean finger

Answer 3

Its sticky; choking hazard by making sure you place the gel at the front of the mouth

Answer 4

Minimum 4 months and over, should not be used for any babies younger than this.

Answer 5

• pain, cracked, flaky or sensitive nipples and areolas (the darker area around your nipple) and changed colour

Answer 6

* sterilise dummies regularly, as well as any toys that your baby puts in their mouth * sterilise bottles and other feeding equipment regularly, especially the teats

Answer 7

Pain in the chest and upper abdomen to lower abdominal symptoms.

Answer 8

When there is a reflux of gastric contents, particularly acid, into the esophagus, which irritates the sensitive mucosal surface.

Answer 9

Yes, within 1 week.

Answer 10

Burning discomfort is experienced in the upper part of the stomach The pain may be felt only in the lower retrosternal area or on occasion right up to the throat, Causing an acid taste in the mouth. Heart- burn is often brought on by bending or lying down. This causes discomfort which is relieved by belching but which in turn can be associated with acid reflux. Difficult swallowing Regurgitation- medicine sticks in oesophagus

Answer 11

- • Persistent symptoms (>5 days) • ADRs • Treatment has failed - Pregnancy - Injury in the abdominal area - Rigid abdomen but tender when touch - Fever - Difficulty to empty bowels * >45 years with symptoms for the first time * Blood in the vomit or stools * Pain worsens on effort * Pain is severe * Pain radiating to arms * Difficulty swallowing * Regurgitation * Children * Unintentional Weight Loss

Answer 12

- Obesity - if patient is overweight then weight reduction should be advised. - Eat smaller meals more frequently than large meals, as reducing the amount of food in the stomach reduces gastric distention, which helps to prevent reflux. - High fat meals delay gastric emptying, - the evening meal is best taken several hours before going to bed - Posture Bending, stooping and even slumping in an armchair can provoke symptoms and should be avoided where possible. It is better to squat rather than bend down - raising the head of the bed can reduce both acid clearance and the number of reflux episodes. - Tight, constricting clothing, especially waistbands and belts, can be an aggravating factor and should be avoided. - Other aggravating factors Smoking, alcohol, caffeine and chocolate

Answer 13

Nausea is the queasy feeling a person gets before being sick or throwing up.

Answer 14

``` Feeling sick Being sick Pale in colour Headache Finding it hard to eat ```

Answer 15

- Duration of more than 48 hours in adults - Refer if child is under 2 years old - dehydration - blood in the vomit or stools - migraine/ head injury - Pregnant or breastfeeding

Answer 16

infection or feeding problems or, or an obstruction. An obstruction typically occurs in the ﬁrst few weeks of life in a ﬁrst-born male. The vomiting is frequently projectile in that the vomit is forcibly expelled a considerable distance. The condition can be cured by an operation under general anaesthetic lasting about half an hour called a pyloromyotomy. The pharmacist must distinguish, by questioning, between vomiting (the forced expulsion of gastric contents through the mouth) and regurgitation (where food is effortlessly brought up from the throat and stomach).

Answer 17

- keep hydrated (rehydration sachets) | - Try eating small amounts of food, snack which are high in sugar

Answer 18

48 hours for adults - --- children under 2 should be referred to their GP

Answer 19

Thought to be caused by a conflict of messaged to the brain where the vomiting centre receives information from the eyes, the GI tract and the vestibular system in the ear.

Answer 20

Yes, within a couple of days

Answer 21

Nausea and sometimes vomiting, pale skin and cold sweats. Headache, rapid breathing, tired etc.

Answer 22

- driver - length of journey - pregnant - Migraine - Symptoms continue after travelling - Glaucoma - Failed treatment

Answer 23

* Keep still – if possible, choose a cabin or seat in the middle of a boat or plane, because this is where you'll experience the least movement. Use a pillow or headrest to help keep your head as still as possible. * Look at a stable object – for example, the horizon. Reading or playing games may make your symptoms worse. Closing your eyes may help relieve symptoms. * Fresh air – open windows or move to the top deck of a ship to avoid getting too hot and to get a good supply of fresh air. * Relax – by listening to music while focusing on your breathing or carrying out a mental activity, such as counting backwards from 100. * Stay calm – keep calm about the journey. You’re more likely to get motion sickness if you worry about it. * Water bottle

Answer 24

Cinnaraine 15mg, Hyoscine hydrobromide, Promethazine (phenergan elixir), Meclozine (sea legs)

Answer 25

Cinnarizine 15mg = sturgeon | Boots version is the blue pack

Answer 26

Joyrides, | Kwells

Answer 27

cinnarizine = 5 years and over | Hyoscine hydrobromide = 3 years and over

Answer 28

Drowsiness, dry mouth, headache and stomach upset.

Answer 29

Should be taken 2 hours before and lasts 8 hours

Answer 30

Should be taken 20 mins before travelling and lasts 6 hours

Answer 31

* Content of large intestine move slowly & more water is absorbed from the faecal matter * Stool becomes harder & more compacted which slows down their movement through the GI tract

Answer 32

- Not enough fibre in diet - Not enough liquids - lack of exercise - medication (side effect) - IBS - Pregnancy - Old age - Laxative abuse - Cancer

Answer 33

Feeling nausea, loss of appetite, straining when passing, - not passing stools as often as they normally would do - atleast for 3 days, - bloating - pain when passing - can't empty bowels completely, - stomach cramps - stool is dry, hard, abnormally large/ smal

Answer 34

- Change in bowel habit of 2 weeks or longer - Failure of OTC medication - ADRs - Blood in stools - presence of abdominal pain, vomiting - recurrent problem - unintentional weight loss - severe pain when passing stools

Answer 35

* Content of large intestine move slowly & more water is absorbed from the faecal matter * Stool becomes harder & more compacted which slows down their movement through the GI tract

Answer 36

Dietary changes - allow to settle for atleast 2-3 weeks

Answer 37

Avoid stimulant laxatives.

Answer 38

Bulk-forming laxative - fybogel

Answer 39

Bulk forming laxatives but should be advised to maintain fluid intake to prevent development of intestinal obstruction.

Answer 40

If no improvements after a 1 week then refer to GP.

Answer 41

Promotes movement of the faeces.

Answer 42

``` Dulcolax tablet (bisacodyl) Senokot tablet - senna ```

Answer 43

2 tablets at night time

Answer 44

increases the mass of faeces

Answer 45

Fybogel Hi-fibre - ispaghula husk | lemon/orange flavour/ plain

Answer 46

Make sure you drink plenty of fluid when taking this medicine don't take shortly before bed can be used in pregnancy

Answer 47

Lubricates the faeces

Answer 48

DulcoEase - docusate sodium | Glycerin suppositories in infants

Answer 49

Lactulose | Macragol compound

Answer 50

Has sugar - not suitable for diabetics | Takes 2 days to be effective

Answer 51

Is defined as an increased frequency of bowel evacuation, with the passage of abnormally soft or watery faeces.

Answer 52

Yes within a couple of days

Answer 53

``` Abdominal cramps, flatulence, weakness or malaise, nausea and vomiting, fever ```

Answer 54

* Lasting ≥1 day in children <1yr * Lasting ≥2 days in children <3yrs and the elderly * Lasting ≥3 days in older children and adults * History of change in bowel habit * Suspected drug induced reaction * Recent travel abroad * Presence of blood or mucus in stools * Pregnancy * Change in diet * Drugs

Answer 55

Diarrhoea is often caused by an infection. You can reduce your risk by making sure you maintain high standards of hygiene. For example, you should • wash your hands thoroughly with soap and warm water after going to the toilet and before eating or preparing food • clean the toilet, including the handle and the seat, with disinfectant after each bout of diarrhoea • avoid sharing towels, flannels, cutlery or utensils with other household members It's also important to practise good food and water hygiene while travelling abroad, such as avoiding potentially unsafe tap water and undercooked food.

Answer 56

1 day in children, otherwise 2 days

Answer 57

Loperamide | Dioralyte

Answer 58

Two capsules to start with. After that, take one capsule after each loose bowel movement. Don’t take more than 6 capsules in any 24 hours. Don’t take for more than 24 hours.

Answer 59

Irritable bowel syndrome (IBS) is deﬁned as a chronic, functional bowel disorder in which abdominal pain is associated with intermittent diarrhoea, sometimes alternating with constipation, and a feeling of abdominal distension.

Answer 60

Nope it isn't, can go on for months or years.

Answer 61

Abdominal pain- anywhere in abdomen, relived by defecating Bloating Bowel habit change- can be either diarrhoea or constipation, incomplete emptying, semi formed stools, can have mucus in it NOT blood Other symptoms- nausea, lethargic, urinary symptoms

Answer 62

* Unexplained weight loss * Child under 16 presenting symptoms * Blood in stools * Patient with no previous history of IBS and no precipitating factors * Failed treatment * Nausea and/or vomiting

Answer 63

Low fat, low sugar and high fiber diet Fiber food oats, barely, rye, fruits, root vegetables, wholegrain bread, bran, cereal, nuts and seeds If diarrhea- eat less fiber If constipated - eat more fiber Bloating- insoluble fiber e.g. bran Exclude food that can exacerbate IBS like sweeteners (sorbitol and fructose), caffeine, and dairy products

Answer 64

Mebeverine hydrochloride (Colofac) - not under 18 years old - Peppermint Oil (Colpermin IBS Relief) - Alverine Citrate 60mg (Spasmadol) - Buscopan - Hyoscine butylbromide

Answer 65

• Threadworms are small, thin, white, thread-like worms between 2 and 13 mm long. • They infect human guts (intestines). • They are common in children, but anyone of any age can be affected

Answer 66

- Itchy around the anus (worse at night) - white-cream threadlike objects in faeces/on anus - Vaginal itch (girls) - Diarrhoea may also be present in severe cases - tiredness/ irritability during the day )due to loss of sleep)

Answer 67

- medication failure - Signs of bacterial infection )perianal skin broken/ weeping (secondary infection) - recent travel abroad (if the patient has travelled abroad they may have become infected with a different worm infection (e.g. tapeworm, roundowrm).

Answer 68

Treat ALL FAMILY members – even if they do not present the symptoms. Reassure (parents in particular) that it is extremely COMMON • Prevent transmission/reinfection by: -CUT FINGERNAILS SHORT -WASH HANDS and BRUSH FINGERNAILS after using the bathroom/ preparing food • This is to prevent the transmission of eggs (can remain viable for up to 1 week) • Children – wear PYJAMAS to reduce itching of bare skin during the night. Underpants can be worn under pyjama bottoms. • Affected family members- have a BATH/SHOWER each MORNING to wash away eggs laid during previous night. • Bed linen should be wash frequently

Answer 69

After 2 weeks

Answer 70

Mebendazole

Answer 71

2 years and over

Answer 72

Commonly known as piles, this is when veins in the anal pop out from the anal canal (internal) or pop out of the anus (external)

Answer 73

- Pain - irritation - bleeding - constipation - change in bowel habits

Answer 74

- Duration longer than 3 weeks ADRs presence of blood in the stools persistent change in bowel habit

Answer 75

Hygiene with warm water no soap Pat with tissue rather than rubbing Increase dietary fibre

Answer 76

- Garmoloid cream (lidocaine and Zn) - Anusol supositories (Zn, bismuth) - Anusol HC ointment (with hydrocortisone)

Answer 77

A cold is a contagious viral disease which infects the soft lining (mucous membrane) of the nose (thus antibiotics don’t work against this) - usually occurs anytime during the year - symptoms gradually come on, not to severe

Answer 78

- Flu virus affects the upper airways - Usually occurs during the winter months - Has a more sudden onset than cold, more severe, affect people’s daily activities

Answer 79

-you can catch a cold/flu by inhaling drops of mucus infected with a cold virus. Cold viruses can also survive on objects such as handles, keyboards etc. Spread by coughing, sneezing, talking

Answer 80

``` First signs: - scratch feeling in their throat -Tickling sensation in nose Runny/stuffy nose Sneezing Sore throat , coughs Sinus congestion Water eyes Mild muscular aches/ headache Symptoms can last for up to 2-14 day Mild fever temp 37-38.3ᴼC ```

Answer 81

One respiratory symptom (cough, sore throat, nasal congestion, or rhinorrhoea) Fever/high temperature (>38ᴼC) One constitutional symptom (headache, sweat/chills, prostration) Bedbound, unable to do daily activities Loss of appetite Weakness Symptoms last for 1 week

Answer 82

- Persistent high temperature | - Difficulty breathing/ wheezing

Answer 83

If green (getting worse), yellow (getting better)/ blood may be secondary infection - refer

Answer 84

o Wash hands frequently to prevent the spread of germs o Get plenty of rest. Keep warm, but don’t let the room get to stuffy-a little fresh air may help you feel better o Drink plenty of fluids –around 8-10 glasses a day. Hot drinks containing lemon juice or honey may help soothe the sore throat o Inhale steam to help loosen & bring up phlegm o Increase Vitamin C & zinc levels to boost the immune systems o If possible, stay away from people with colds o Avoid smoking – it irritates the mucus membrane of the nose o Always sneeze and cough into tissues. Throw away used tissues immediately and then wash your hands, o Don’t share cups or kitchen utensils with others. Use your own cup, plates and cutlery

Answer 85

Flu vaccination | elderly and also those with certain medical conditions such as diabetes, asthma, heart conditions

Answer 86

Helps with absoprtion

Answer 87

Coughing is a reflex action caused when the airway is being irritated or obstructed Can be due to an infection in the upper respiratory tract or just a common cold

Answer 88

Yes within a few days, if longer than 2 weeks then refer to GP

Answer 89

Dry tickly cough Chesty, loose cough with sputum Sore throat

Answer 90

- Long duration (2-3 weeks) - • Difficulty breathing/shortness of breath • Coloured sputum (yellow/green/rusty or blood stained) • Persistent nocturnal cough in children • Croup/whooping cough/ TB • Bronchitis, asthma, CVD, gastro-osephagus

Answer 91

- Maintain fluid intake - catch it bin it and wash - stop smoking  Drink plenty of fluids - thin mucous in throat help to cough it up. Rest Suck on hard candy – can ease dry, tickly cough Cut down / try to quit smoking / stay away from second hand smoke. If cough made worse by dry air then make air humid  HUMIDIFIER If cough made worse at night then use something that causes drowsiness

Answer 92

Used for dry cough, go to GP if it doesn't work within 5 days. It also contains high amounts of sucrose.

Answer 93

Dry tickly cough, not to be taken for under 12. contains alcohol. do not give id breastfeeding.

Answer 94

chesty coughs

Answer 95

Dextromethorphan

Answer 96

promote sputum used for chesty coughs- guaifenesin and ipecucanhua

Answer 97

codeine, pholcodiene, dextromethorphan

Answer 98

Contain soothing substances such as syrup or glycerol and some patients believe that such preparations relieve a dry irritating coughsimple linctus, glycerine, lemon, honey- sooth effect

Answer 99

lasting less than 3 weeks

Answer 100

Lasting more than 3 weeks - may be related to smoking, asthma/ bronchitis

Answer 101

FOR DIABETICS USE ROBOTUSSIN (SUGAR-FREE) - | tell patient to monitor blood glucose as control can get worse when ill

Answer 102

- Often mark the start of a cold/flu - also be due to localised infection or irritation caused by coughing or mucus running down the back throat - Can be caused by viruses / bacteria – infection - Can also be brought on from following treatment with antibiotics or steroids o Can be spread from one person to another by airborne droplets, hand contact / kissing o If sever sore throat could be- Tonsillitis which is inflammation of the tonsils (found at the back of the throat)

Answer 103

Vary from localised, mild discomfort, to intense pain when swallowing, Pain may spread to ears Dry throat, swollen tonsils Difficulty swallowing Hoarseness / croakiness Redness & swelling of the back of the throat Tenderness around the jaw & ear or around the front of the throat Associated symptoms: headache, aching, temp, tiredness

Answer 104

* Long duration (2-3 weeks) * ADRs (agranulocytosis) * Unable to swallow * White exudate on tonsils * Recurrent infection

Answer 105

extremely painful sore throat, along with a fever, headache & general feeling of being unwell.

Answer 106

- Drink plenty of fluids. Warm drinks containing lemon juice & honey can be soothing - Gargle with salty water / aspirin (adults only, not if you’re taking other aspirin medication/ <16 yrs) - Don’t smoke or avoid smoky environment - Don’t share cups, cutlery - -Avoid food or drink that is too hot as this could irritate your throat – and sometimes triggers such as spicy food - Can be contagious especially if it is glandular fever

Answer 107

Should improve within 1 week then refer

Answer 108

Pastilles and lozenges - strepsils, beechams lozenges Antiseptic lozenges - Beecham lozenges Local anaesthetics - Ultra chloraseptic anaesthetic throat spray (benzocaine) Strepsil extra Difflam Spray Painkillers/ anti-inflammatory - ease the pain - covonia throat spray Salt water - gargling with salty water - relieves sore throat - add teaspoon of salt to a glass of warm water

Answer 109

Fungal - Candida albicans

Answer 110

Yes - usually within 1-2 weeks.

Answer 111

- itching - soreness - Discharge (colourless/watery/white)

Answer 112

 OTC medication failure  Diabetics – high blood sugars favourable environment  Under 16ys – not usually fungus  Over 60 yrs – not usually fungus • More than two attacks in the last 6 months - recurrent • Pregnancy or suspected pregnancy • Blood stained or strong smelling discharge – could be signs of STIs would need referral

Answer 113

* Avoid tight, close fitting clothes since these create a warm, moist environment which can be a trigger for thrush * Avoid the use of soaps, bubble baths and douches which may affect the pH balance of the vagina and encourage infection * The application of live yogurt not only has a soothing action but can restore the balance between bacterial and fungal cells, making fungal overgrowth less likely

Answer 114

If symptoms do not improve within 1 week of treatment, refer to GP

Answer 115

clotrimazole 2% cream - canestan - apply thinly 2-3 times a day until it has cleared clotrimazole 500mg pessary fluconazole oral capsule 150mg

Answer 116

A urinary tract infection where there is some inflammation of the urethra and the bladder (sometimes not through infection but also through bruising can be prevented through urinating after intercourse). Most commonly occurs in women, rare in men.

Answer 117

Mild cases will resolve themselves within a few days

Answer 118

* Pain, burning or stinging when you pee (it’s a bit more acidic) * Needing to pee more often and urgently than normal * Urine that's dark, cloudy or strong smelling * Pain low down in your tummy * Feeling generally unwell, achy, sick and tired * Possible symptoms in young children include a high temperature (fever) of 38C (100.4F) or above, weakness, irritability, reduced appetite and vomiting.

Answer 119

 Failed medication  Diabetics – sugar in the urine more risk at infection  Blood in urine • All men (longer urinary tract) and children (not as common so needs referring) • Fever, nausea/vomiting – systemic effects of infection • Loin pain/tenderness – bacteria going from the bladder to the kidneys • Haematuria • Pregnancy – women who get cystitis while pregnant are more likely to have complications during birth • Recurrent cystitis • Discharge

Answer 120

* Staying well hydrated – drinking plenty of fluids may help to stop bacteria multiplying in your bladder * Emptying your bladder as soon as possible after having sex * Drinking cranberry juice has traditionally been recommended as a way of reducing your chances of getting cystitis. * Wipe front to back

Answer 121

2 days - if symptoms are still persistent then see GP.

Answer 122

Cystitis relief sachets - 1 TDS for 2 days

Answer 123

Allergic reaction to tree pollen, grass pollen, fungal spores.

Answer 124

Allergy to house dust mite, animal dander, feathers - symptoms are present all year round

Answer 125

``` Itchy eyes Watery eyes Itchy nose Runny nose Blocked nose Sneezing ```

Answer 126

``` Wheezing/shortness of breath Tightness of chest Painful ear Painful sinuses Purulent conjunctivitis Failed medication ```

Answer 127

Sleep with windows closed. Avoid being outside when pollen count is high (mid morning/early evening) Get someone else to cut the lawn. Avoid stroking animals. Drive the car with windows and vents closed. Vacuum regularly

Answer 128

If no improvement of symptoms after 5 days of treatment, refer to GP.

Answer 129

Headache is defined as pain in the head that is located above the eyes or the ears, behind the head, or the back of the upper neck

Answer 130

The most common type of headache. Muscles in the head and neck tighten up to cause pain Can be caused by tension or stress, not enough sleep, smoking, too much alcohol, eye strain, part of a cold or a side effect of some medication.

Answer 131

Caused by a build-up of pressure in the sinus, often during or after a cold

Answer 132

Pounding headache that occurs after drinking too much alcohol. Alcohol causes dehydration, which leads to swelling of the blood vessels in the brain.

Answer 133

Caused by the overuse of painkiller, any nitrate e.g. GTN can cause headaches. Someone who has just started a COC who has a headache needs to be referred as it can cause an embolism (stroke).

Answer 134

– Caused by the swollen blood vessels and the reduction of certain chemical substances in the brain.

Answer 135

Tension headache – felt as dull, aching pain in the forehead, temples or at the back of the neck. Sometimes described as a tight bound around the head or a heavy weight pressing down on top of the head – BOTH SIDES OF THE HEAD – Last 30min – 7 days. If migraine, will have sensitivity to light, numbness, loss of sensation

Answer 136

Felt as deep, dull ache, on the sides of the nose and around the eyes, which is worse when the head is moved.

Answer 137

feels like a dull pounding ache, often with nausea and vomiting

Answer 138

Often described as oppressive and worse in the morning or after exercise.

Answer 139

``` • Severe and >4 hrs duration • ADRs • Children <12 yrs • Associated with head injury/trauma • Location and type of pain (severe occipital and raised intracranial pressure) • Nausea and vomiting • Neck stiffness • Frequently recurring - sudden, severe headache - blurred vision - recent head injury - high fever with stiff neck - meningitis - numbness, tingling, weakness in arms and legs (stroke - symptoms) ```

Answer 140

* Get plenty of rest, take regular breaks when on a computer/concentrating for a long period * Regular exercise or warm baths can help relieve tension * Apply ice pack to painful areas * If trigger is known, try to avoid * Massage * Drink plenty of water or non-alcoholic drinks in between alcohol

Answer 141

1 day treatment timescale.

Answer 142

Dispersible dosage achieve peak in 30 minutes compared to traditional drugs which peak in 2 hours

Answer 143

16 years and over

Answer 144

No cannot be used - they will have a blue book (lithium and NSAIDs compete for the same site of action but NSAIDs are more ‘powerful’ so will displace lithium and therefore lithium plasma conc increases leading to toxicity)

Answer 145

- A severe throbbing, intense, recurring headache - usually affects only one side of the head. - accompanied by nausea, vomiting and visual disturbances. - Caused by swollen blood vessels & the reduction of certain chemical substances in the brain - There are also certain ‘trigger’ factors that can set off a migraine such as: certain foods (cheese, chocolate), bright lights, menstruation and some drugs. - Not just pain – increase sensitivity to light and other sensations - Certain foods and alcohol can cause It/ flashing lights/tiredness

Answer 146

``` Headache - ON ONE SIDE Blurred vision Flashing/ coloured lights Nausea and/or vomiting tingling in the hands or arms Lasts 4min to 60mins ```

Answer 147

``` • Severe and >4 hrs duration • ADRs • Children <12 yrs • Associated with head injury/trauma • Location and type of pain (severe occipital and raised intracranial pressure • Neck stiffness - medication not relieving symptoms - oral contraceptive/headache- if they start combined oral contraceptive there is a risk of stroke(any headaches) ```

Answer 148

* Keep a diary of everyday life so when a migraine occurs, can help pinpoint a trigger such as certain foods, smoking or certain drugs * During the attack, lie down and rest (preferably sleep) in a dark, quiet room * Try to lead a healthy lifestyle with good nutrition, plenty of water, sufficient sleep and exercise

Answer 149

1 day - if no improvement then see GP

Answer 150

Sumatriptan - only to be used with clear diagnosis of migraine. Age 18 and over to 65

Answer 151

14 years and over

Answer 152

2P at onset, if needed, 2Y every 4hrs | MAX: 2P, 6Y

Answer 153

GUT motility slows down in migrane – so you recommend effervescent instead of oral tablets

Answer 154

Painful periods or menstrual cramps

Answer 155

Yes - usually lasts less than 3 days

Answer 156

* Painful cramps * Headache, backache * Nausea, vomiting constipation * Faintness, dizziness, fatigue * Premenstrual syndrome (PMS)

Answer 157

 Abnormal discharge (of unusual colour) or (abnormal/heavy) bleeding (continuous bleeding) • Severe intermenstrual pain – period pain when you are expecting your period • Medication failure – don’t refer if one OTC didn’t work, if different combinations don’t work • Presence of fever – signs of infection

Answer 158

17-25 years old

Answer 159

25 years +

Answer 160

Secondary = underlying cause

Answer 161

* Exercise during menstruation is not harmful and may be beneficial - some evidence that moderate aerobic exercise can improve symptoms of PMS * Some evidence that a low-fat, high-carbohydrate diet reduces breast pain and tenderness * Some doctors suggest starting painkillers the day before the period is due – may prevent pain from building up * Use hot water bottle

Answer 162

If the pain of primary dysmenorrhea is not improved after two cycles of treatment, referral to the doctor would be advisable.

Answer 163

Naproxen 250mg Suitable for only women aged 15-50 years. Should not be used for longer than 3 days treatment

Answer 164

Ibuprofen lysine

Answer 165

Two tablets taken initially, then a further tablet 6-8h later if needed. Max. 3 tablets in 24 hours. Max. treatment duration is 3 days.

Answer 166

Difficulty sleeping or waking up and not being able to go back to sleep

Answer 167

* Difficulty falling asleep at night. * Awakening during the night. * Awakening too early. * Not feeling well rested after a night's sleep. * Daytime tiredness or sleepiness. * Irritability, depression or anxiety. * Difficulty paying attention, focusing on tasks or remembering. * Increased errors or accidents.

Answer 168

* Suspected depression – can’t say are you feeling depressed/ so say is there anything you think might have caused this, How you feeling in yourself?/ How are you feeling in the moment? * Insomnia lasting more than 3 weeks * Children under 16 * Medication failure

Answer 169

* Set a specific time for getting up each day. Try to stick to this time, seven days a week, even if you feel you haven't had enough sleep. This should help you sleep better at night. * Don't take a nap during the day. * Take daily exercise, such as 30 minutes walking or cycling. But don't exercise for at least four hours before going to bed, because this may make it more difficult to fall asleep. * Stop drinking tea and coffee for a few hours before bedtime. * Avoid drinking alcohol and smoking, particularly shortly before going to bed. * Don't eat a big meal just before bedtime. * Only go to bed when you're feeling tired. If necessary, go to bed later than usual if it means you might be able to fall asleep more quickly. * Don't use back-lit devices shortly before going to bed, including televisions, phones, tablets and computers. * Try to create a relaxing bedtime routine, such as taking a bath, listening to soft music, and drinking a warm, milky drink every night. These activities will be associated with sleep and will cause drowsiness. * Avoid regularly using over-the-counter sleeping tablets. It is not clear how effective these are, they don't tackle the underlying problem, and have potential side effects. Read more abouttreatments for insomnia. * Don't lie in bed feeling anxious about lack of sleep. Instead, get up, go to another room for about 20 minutes and do something else, such as reading or listening to soft music, before trying again. * Avoid watching the clock because it will only make you anxious about how long it's taking you to fall asleep. * Write a list of your worries and any ideas to solve them before going to bed. This may help you forget about them until the morning. * Use thick blinds or curtains or wear an eye mask if the early morning sunlight or bright street lamps affect your sleep. * Make sure your bedroom is at a comfortable temperature for sleeping. * Wear ear plugs if noise is a problem. * Don't use your bedroom for anything other than sleeping or sex. Avoid watching television, making phone calls, eating or working while you're in bed. * Make sure your mattress is comfortable and that you have a pillow you like, as well as adequate bedding for the time of year.

Answer 170

Diphenhydramine (Nytol) Promethazine (Phenargan) Valerian (Nytol Herbal)

Answer 171

Sedating antihistamines

Answer 172

- Mild-severe inflammation - redness - itching - blistering, bleeding or cracking - if becomes chronic, dry, inflamed, scaly and thickened

Answer 173

Starts as itchy, red rash at site of contact - may be swelling or blistering - if allergen persisits, skin becomes thicker, drier and scaly, - reaction confined to site of contact but may spread

Answer 174

• Infection – weeping, crusting, spreading - broken skin • Symptoms don’t subside after 1 week of treatment • Severe condition – cracked skin, bleeding • Duration of longer than 2 weeks

Answer 175

• Avoid known substances that cause irritation or wear protective clothing e.g. gloves • Avoid itching or scratching or rubbing the skin • If exposed to known allergen, wash skin immediately with cool water and soap (to remove allergen • Moisturise hands to prevent dry, cracked skin • Avoid skin contact with substances that may worsen the condition:  Hot water  Soaps  Chemicals  Acidic substances  Creams and lotions

Answer 176

onset of the skin reaction is usually within 48 hours of coming into contact with the irritant

Answer 177

often a delay of many hours to several days before symptoms develop following contact with the allergen

Answer 178

IF SYMPTOMS NOT IMPROVED IN 1 WEEK THEN REFER TO GP

Answer 179

Acne vulgaris – inflammation of hair follicles and sebaceous glands  Most common on face but also on arms and back  Triggered around puberty to due hormonal changes  Starts at the age of 10-13 yrs

Answer 180

* Occur on face, chest and upper back * Greasy skin * Small, tender, red papules (=small, solid elevation of skin) * Open and closed white heads and blackheads * Deep inflamed lesions

Answer 181

Signs of infection – weeping, crusting, pus - Moderate-Severe acne - Failed medication - Suspected drug-induced acne - Not responded to treatment after 8 weeks - If the suffer is an adult with spots for the first time - Failed medication - Severe case

Answer 182

• Wash skin gently with a mild cleanser morning and night, plus after any heavy exercise.  Avoid very hot water, strong detergents, rough scrubbing pads or harsh astringents. Pat skin dry with a clean towel. Gentle toners or skin freshener can be used. • Use acne treatment regularly and give them time to work. • Wash hair regularly, especially if the person has a hair style with a fringe, or other hair which falls over the face • Resist the temptation to squeeze, pinch or pick spots. • Natural sunlight helps • Choose cosmetics which are water-based rather than oil-based. • A healthy, balanced diet with plenty of water, and regular exercise • Water-based make up rather than oil based • No evidence to say diet can make acne worse • Takes at least two months for symptoms to clear – so need to be patient • Skin may become dry

Answer 183

Athlete’s foot is a very common, highly contagious fungal infection.  Occurs between the toes and on the soles of the feet.  Thrives in warm, damp environments so sweaty skin encourages infection.  Passed from person to person by direct contact or by contact with clothing and floors.  Itchy and flaky

Answer 184

Itching between the toes and sometimes on the soles or sides of the feet - Soggy white skin between the toes, smelly - Flaking and Peeling or cracked skin - Red and inflamed skin - Small blisters between the toes - Thickened, yellow toenails if the infection has spread to the nails

Answer 185

- Signs of bacterial infection - Diabetics – poor blood glucose management - Affecting parts of the foot other than in-between toes - No toenails affected

Answer 186

o Wash feet every day and dry thoroughly especially between the toes using separate towel. o Avoid sharing towels to reduce risk of passing the infection on. o Wear socks made of cotton or wool (natural materials) and change them at least twice a day or when they have become damp. o Avoid wearing shoes made of synthetic materials. Wear sandals or leather shoes instead. o Powder the feet and inside of shoes with an antifungal powder o Finish course of treatment, stopping early can lead to re-infection o Wear plastic shoes or flip-flops in communal showers, changing rooms and around pools. o Spend time bare foot allowing feet to breathe when possible. o Antifungal powders to put in shoes – t o Normal HbA1c should be around 48 – can also be about 53 if on different medications – for diabetics – risk of neuropathy

Answer 187

• Continue treatment for up to 2 weeks after the infection has cleared

Answer 188

Daktarin (miconazole) - cream or powder (Avoid in people who are on warfarin serious interaction). Lamisil AT 1% cream

Answer 189

Caused by a strain of the herpes simplex virus which is caught I childhood or early adulthood, probably from being kissed by someone with the virus.

Answer 190

- Physical or emotional stress - Illness such as cold or flu - Strong sunlight or other sources of ultraviolet light such as sun beds - Mouth Injuries - Menstruation - Fatigue or mental exhaustion - Cold weather

Answer 191

* Discomfort, tingling or irritation in skin 6-24 hours before appearance * Weeping and crusting about 4th day after appearance * Extremely painful * Total length of an episode is usually 1-2 weeks * Length of an episode is 10-20 days

Answer 192

- Babies and young children - Signs of bacterial infection - History of frequent cold sores - Painless sores - Patients with atopic eczema - Eye affected - Immuno-compromised patient

Answer 193

* If the sore has developed, try to avoid touching it and if so, wash hands thoroughly to avoid spreading it to other parts of body – especially the EYE * Don’t kiss someone when you have a sore * Don’t share a towel, flannel, lipstick etc * Never touch the eyes or genital area before washing your hands if you have touched the cold sore

Answer 194

Zovirax - acyclovir 5% antiviral cream | Blistex relief cream

Answer 195

Apply ever 4hrs/5 times a day for 5-10 days | Start treatment at first sign of cold sore-when skins tingles

Answer 196

NO KNOWN CURE FOR COLD SORES

Answer 197

Viral infection of the skin. high incidence in school children.

Answer 198

o Rough, scaly, pink or skin- coloured papules with roughened surface o Normally Painless

Answer 199

o Areas of flat, thickened skin with a harder edge around a softer centre (warts grow inwards) o Weight bearing areas (sole & heel), painful when pressure applied o Often sore to touch and to stand or walk on

Answer 200

* Cracked skin or weeping – may be secondary bacterial infection * Change in appearance of lesions (size and colour) * Bleeding or Itching * Genital Warts * Facial Warts * Immuno-compromised patients - Diabetes

Answer 201

* Avoid direct contact with another person's wart * Don't share towels with a person who has warts or shoes or socks with someone who has a verucca * Keeping feet dry and changing socks daily * Don't scratch or pick at a wart, this may encourage it to spread * Wear flip-flops in communal showers * Veruccas are covered with a plaster or special swimming socks (no bare feet) * People with hand warts should wear gloves if they are using communal equipment (for example, in a gym).

Answer 202

Bazuka Gel

Answer 203

1. Soak the affected area with warm water and towel dry 2. Rub the surface of the verruca with a pumice stone or emery board to remove any hard skin 3. Cover the surrounding healthy skin with Vaseline to protect it 4. Carefully apply the salicylic acid making sure it does not cover any healthy skin around the verucca. 5. Repeat the procedure daily, remember it can take up to 12 weeks – 3 months

Answer 204

Scabies is an intensely itchy skin infestation caused a human  Mites burrow into skin on the abdomen, armpits, genital area, hands and feet. The neck and hands are not usually affected.  It is highly contagious and spread by close personal contact especially in overcrowded living conditions – schools, nursing homes. It can be passed on by sexual contact.  Itching is due to an allergic reaction to the itch mites and their body fluid

Answer 205

* Small, thread like grey-line burrows can be seen * Lines are raised, wavy and about 5-10mm long * Intense itching which is worse at night

Answer 206

* Babies and children * Infected skin – weeping yellow discharge or yellow crusts (signs of bacterial infection) * Treatment failure * If diabetic or immunocompromised

Answer 207

Symptoms of scabies begin to appear 2-6 weeks after infestation but after previous experience can appear a few hrs later

Answer 208

* All bed linen, clothing and towels should be machine washed after the treatment has been applied to prevent re-infection * Any items that can’t be washed e.g. cushions, sofa etc should be covered in plastic for 72 hrs to contain the mites until they die * If you wash your hands during period of treatment then product will need to be re-applied * Itching may continue after 3 weeks of successful treatment – eurax cream needed * All household members should be treated on the same day as symptoms may take up to 8 weeks to develop therefore risk of reinfestation

Answer 209

* Treatment is applied to entire body from neck down in adults * Children under 2 and elderly the treatment should be applied thinly to entire body including ears unless contra-indicted (avoid eyes and mouth) * Use malathion when permathrin is not suitable

Answer 210

``` Derbac M (malathion) Lyclear Dermal cream (Permethrin) ```

Answer 211

Eurax cream | Piriton

Answer 212

may continue up to 3 weeks

Answer 213

Check if the patient is asthmatic and don't give anything with alcohol

Answer 214

Apply head to toe leave it on over night and then shower the next day – then apply again in one week. Wash bed sheets and clothes – at 50oC

Answer 215

 Increased cell renewal leads to greater shedding of skin – build up of dead skin cells  Noticeable when brushing etc  Can occur either due to : - Not brushing the hair regularly - An over growth of tiny fungal - Nutritional deficiencies, such as lack of vitamin B or essential fatty acids - A diet that is high in sugar & refined carbohydrates.

Answer 216

* Greyish white flakes of skin visible on the hair & shoulders * Itching of the scalp * Soreness of the scalp (can also feel tight) * Hair loss

Answer 217

* OTC treatment failure * Suspected psoriasis – will see more pink scales * Signs of bacterial infection – is it weeping

Answer 218

* Brushing hair on a regular daily basis * Washing hair at least 3 times per week * Rinsing hair thoroughly after washing * Using specially medicated shampoo every 1-2 weeks to prevent reoccurrence * Avoid using chemical hair dyes * Ensuring a well balanced diet to include vitamins such as zinc, beta-carotene, B6, B12 and selenium. * Avoid using hair products that may irritate the scalp, switch to a different product that may cause less irritation. * Avoid scratching the scalp. When washing the hair use the tips of your fingers, NOT the nails. * For mild dandruff use a shampoo used for dry hair, this will remove the flakes shed and the moisturiser in the shampoo will protect the scalp. * Use an anti-dandruff shampoo & conditioner.

Answer 219

SYMTPOMS SHOULD IMPROVE WITHIN 12 WEEKS OF BEGINNING TREATMENT

Answer 220

Capasal therapeutic shampoo (salicylic acid) selsun shampoo meted anti-dandruff (salicyclic acid) Nizoral anti-dandruff shampoo (ketoconazole)

Answer 221

Two types - localized patch hair loss (alopecia arieta) and common baldness (alopecia androgenetica)

Answer 222

Men – hair line decreases Women- parting increases Hair thinning Gradual decrease

Answer 223

* Alopecia areata (sudden patchy hair loss) * Suspected drug induced hair loss * Suspected hypothyroidism * Suspected anaemia * Levodopa, warfarin, lithium, chemotherapy drugs, sodium valproate, carbamazepine – could be a side effects of these

Answer 224

stress, smoking and reduce alcohol

Answer 225

6-12 month Will take 4 months to see results – then 6 to 8 months later will see normal hair, however not meant to use it for longer than 12 months

Answer 226

Minoxidil (there is a 2% and 5% available) – don’t give to patients who are already on hypertensives or some cardiac issues – don’t give as it induces hypotension and increases risk of falls

Answer 227

* Chronic recurring skin condition, where skin cells reproduce too quickly * This is a skin condition in which skin cells reproduce too quickly causing red, flaky, crusty patches covered with silvery scales. These scales are then shed easily. * Most commonly occur on elbows, knees, lower back and scalp. Can also cause intense itching and burning.

Answer 228

* Red, scaly patches (silvery scales when scraped or scratched) * Itchy patches (feel painful or sore) * Thickening and reddening of patches of skin * Usually on extensor surfaces of knees and elbows * Can affect your scalp - where it can cause redness and flaking * Can affect your fingernails - which can become pitted and discolored

Answer 229

Evidence of infection – pus, weeping, crusting, cracked skin No visible improvement after 1 week of treatment No previous diagnosis

Answer 230

Keep the skin lubricated – oils, creams, Vaseline • Mild soaps or soap-free cleaners are recommended such as Nivea and dove • Exposure to the sun can help • Bathing in hot water can help reduce scaling • Avoid skin injuries and infections • Try to drink at least 8 glasses of water a day • Increase your fruit/veg intake • Limit alcohol intake

Answer 231

• An irritant dermatitis confined to the nappy area  Caused by prolonged contact of skin with urine and faeces, human waste produce turns into ammonia-which eats the baby’s skin & irritates the skin

Answer 232

• Small, red dots present suggest fungal infection

Answer 233

* OTC treatment failure * Broken skin * Signs of bacterial infection * Other body areas affected * Very severe rash

Answer 234

* Increase frequency of nappy changes * Use warm water and cotton to clean the bottom thoroughly, rather than baby wipes. (contain alcohol that can irritate skin) * Make sure the nappy area is dried thoroughly – pat rather than rub dry * Leave the nappy off for as long as possible as air will encourage healing * If cloth nappies are used, they should be machine washed using a non-biological washing powder, using an extra rinse if possible * Avoid the use of talc this can cause irritation * Apple a barrier cream (Vaseline) to protect the skin * Avoid soaps as they dry out skin * Find out how often the nappy is changed – ask how frequently it is being changed

Answer 235

* have a stiff neck * are bothered by light * seem confused * are shaking uncontrollably * have a fever you can't control * have unusually cold hands and feet * have a rash that doesn't fade when you press a glass against it * unwell * does not go with treatment * long time * spreading * have an allergy

Answer 236

• This is an inflammation of the conjunctiva, which is the thin membrane covering the white of the eye & inside of the eyelids.

Answer 237

• Infective Conjunctivitis (bacterial & viral) -Caused by a virus (mainly in adults) or bacteria (mainly in children) -Very contagious • Allergic conjunctivitis -Caused by an allergy (e.g. pollen, animal, fur, smoke, pollution, etc) • Irritant conjunctivitis -Caused by pollution, smoke, chlorine in swimming pool & low humidity Glare & bright lights Concentrating for long periods (eye strain), driving, using a computer

Answer 238

- starts in one eye then quickly spreads to the other - easily spreads from one person to another - whites of the eye look pink - eyelids- red and swollen - sticky discharge - eyelash stick together (morning) - eyes feel gritty/ irritated

Answer 239

- both eye develop symptoms at the same time - accompanied with sneezing and runny nose - watery eyes - itchy eyes - May occur at particular

Answer 240

- red eyes - eyes feel tired - eyes feel sore/irritated - dry eyes

Answer 241

``` younger than 2 years old pain recent eye surgery visual disturbances if patient has glaucoma pregnant or breastfeeding abnormal pupil ```

Answer 242

 Good hygiene of hands & face (don’t share face towels)  Don’t rub eyes, as you may spread the condition  Pus & crust can be removed by using lukewarm salty water  Use disposable tissues when you dry your eyes  Dispose of antibiotic eye drops after the treatment is over

Answer 243

 Wear sunglasses to avoid glare  Place a bowl of water any a radiator to prevent the eye from drying out  Take regular breaks from the computer  Keep the eyes clean by continuing to bathe them with boiled and cooled water and using separate swabs for each eye to prevent re-infection.  Use separate face flannels and towels to the rest of the family to prevent passing on the infection.  Only use the treatments during waking hours.  Try not to rub your eyes.  If doing the gardening again in the wind try to protect the eyes with goggles or glasses.

Answer 244

IF SYMPTOMS DON’T IMPROVE WITHIN 48 HOURS OF STARTING THEN REFER TO GP** **USE TREATMENT FOR 5 DAYS EVEN IF SYMPTOMS DISAPPEAR

Answer 245

* When using the eye drops or ointment you should take care to not touch the dropper or tube tip to any surface, or to your eye, in order to avoid contaminating the medicine. * The eye drops and ointment may cause your vision to blur temporarily after you have applied them into your eye. Do not drive or operate machinery until this has worn off. * Don’t wear contact lenses, as product can affect the contact lenses (may absorb preservatives) or it may aggravate the condition * Must not be taken by mouth

Answer 246

Ear wax - may be produce at a faster rate than normal–leads to a build up of excess wax -In extreme cases the wax may block the ear canal Otitis Media -an infection amongst the middle ear -Common amongst children (can affect adults) Glue ear -type of chronic otitis media. -Long term build up of thick/ stick fluid in the middle ear Otitis externa -bacterial/fungal infection -occurs when too much water in ear

Answer 247

Difficulty in hearing, - pain in the ear, - tinnitus (noise / ringing in the ear), - blocked feeling in the ear, - temporary deafness after swimming/ showers

Answer 248

Pus, fluid, inflammation inside middle ear - Sever earache, hearing loss, fever & tinnitus - Treatment – antibiotic

Answer 249

hearing loss | -commonly occurs in children

Answer 250

common in children - pain & itching, dulled hearing & ear discharge - usually caused by a cold

Answer 251

Signs of infection (discharge) • Perforated ear drum • Pain - under 12 years old

Answer 252

Never insert anything into the ear -Don’t use COTTON BUDS/FINGERS / SMALL OBJECTS to clean ear as this will simply push the ear wax deeper – increase the build up -Swimming – the use of EAR PLUGS can help prevent water from getting into the ear. -For ear glue – avoid SMOKY ENVIRONMENT • Avoid doing anything before travelling that may cause your ears to get blocked e.g. swimming, diving. • Have ears checked before travelling for infection. • Have ears checked before travelling for excess wax.

Answer 253

IF SYMPTOMS DON’T IMPROVE WITHIN 1 to 2 weeks THEN REFER TO | GP

Answer 254

* Suck sweets to relieve the pressure. * Swallow regularly to relieve the pressure. * Try Valsalva’s manoeuvre- hold the nose closed between the finger and thumb and with the mouth closed try and breathe out through the nose. This may relieve the pressure. * Yawning

Answer 255

* Use a decongestant spray just before descent. E.g. Sudafed decongestant nasal spray- one spray into each nostril three times a day when required, Otrivine nasal spray- one spray in each nostril 2-3 times a day. * Use nasal drops e.g. otrivine drops- 2-3 drops in each nostril 2-3 times a day. * Oral decongestant one hour before descent e.g. Sudafed one tablet 3-4 times a day

Answer 256

A baby's first teeth usually develop while the child is growing in the womb. These teeth then start to emerge through the gums when a child is 6-9 months old. This process is known as teething. -A baby's bottom front teeth usually come through first, followed by their top front teeth and then the top and bottom incisors either side

Answer 257

* Pain and discomfort * Swollen gums * Red, hot cheeks * Nappy rash * Increased tendency to chew objects * Changes in sleep pattern and/or appetite * Heavy drooling

Answer 258

* Failed medication * Signs of lactose intolerance * Infant failing to gain or is losing weight * Excessive diarrhoea (leads to excessive fluid loss therefore dehydration) * Temperature above 38 oC may suggest infection on top of teething

Answer 259

- It can be helpful to give the child something hard to chew on. - Teething rings that can be cooled in the fridge can be particularly soothing. - Teething gels containing local anaesthetics can provide some pain relief from sore gums. - Brush the teeth as soon as they appear - Do not rub whiskey on the gums

Answer 260

IF SYMPTOMS HAVE NOT IMPROVED IN 7 DAYS/ 1 week THEN REFER TO GP

Answer 261

Anbesol liquid/ teething gel dentinox teething gel bonjela teething gel

Answer 262

Head lice are small, blood sucking insects that live and feed on the scalp.  After hatching the empty egg case turns white and is carried up to the surface by hair growth, where it becomes visible (‘nits’)  They take 6-14 days to become fully grown, and after this time they are capable of reproducing. They need to maintain contact with the host in order to survive.  More common in young children ( 4-11 years old are more susceptible due to prolonged head-to-head contact)

Answer 263

* Common in young children * Small greyish-white or brown-coloured specks comb out of hair (Live and dead lice) * Small blackish specks on pillows and collars (Insect faeces) * Itching may occur after several weeks of infestation * Nits are creamy-coloured empty egg cases that remain firmly attached to hair shafts as they grow outwards (if present is a sign of previous or current infection)

Answer 264

* Bacterial infection from scratching - Weeping and pus from too much scratching– evidence of secondary infection * Treatment failure (two applications of insecticide seven days apart – to kill any eggs not killed by first treatment

Answer 265

avoid those that contain alcohol as this can trigger asthma attacks

Answer 266

* Avoid direct head to head contact. * Minimise itching of scalp/behind ears. * Carry out regular checks using the wet combing method. Every week, and also check behind the ears and neck * Protect eyes and face when treating, with a towel * Comb the hair every night * Check hair clothes regularly for black specks * Inform all close contacts if lice are found

Answer 267

* All members of the family should be treated at the same time to prevent re-infection * Lotions allow for longer contact periods of insectides with hair than shampoos therefore several applications may be required or treatment failure may occur * After treatment comb the hair wet with nit comb * Use hand protection when applying * Use fine tooth comb on wet hair to reduce pain and static electricity, over white paper. First brush the hair, then comb the hair and then use the fine tooth comb to prevent pain when the comb catches on knots in the hair * Lice shells are yellowish colour. * Live lice are grey/white or brown specs. * Louse faeces are black specs on pillow or collar. * Check hair at nape of neck and behind the ears.-warm and sheltered. * Check weekly by wet combing to spot signs of infestation. * Empty shells and no live lice probably means there is no current infestation. * Only the comb and not the lotion removes the shells. * Protect the eyes and face from the lotion. * Residual effect of malathion reduced by chlorine in swimming pools and hair driers. * AVOID ALCOHOL BASED TREATMENTs IN ASTHMATICS

Answer 268

REFER TO GP IF SYMPTOMS HAVEN’T IMPROVED WITHIN ~ 14 DAYS

Answer 269

Dimeticone

Answer 270

A sprain involves an injury to a ligament that supports a joint, Knee and ankle joints are particularly vulnerable. The pain will be considerable and instant when the damage occurs. The area will look swollen and bruised, and little movement of the affected joint will be possible. Grade I – Mild stretching of ligament Grade II- Partial rupture of ligament Grade III- Complete rupture with joint instability

Answer 271

A strain involves injury to the muscles and tendons that move the bones of a joint. There is a sharp and sudden pain on movement, although movement is possible. The area will be tender and swollen.

Answer 272

Some soreness – caused by a repeating movement

Answer 273

* ADRs causing falls/bruising * Medication failure * Suspected fracture

Answer 274

* Immediate treatment should lead to PRICE (in first 24-48hr period, avoid HARM (heat, alcohol, running and massage, can do HARM after 48hrs of the strain) * Protection * Rest – joint should be rested for 48 hrs after injury to avoid further damage * Ice – apply ice asap after injury for 10-30mins max. e.g. bag of frozen peas * Compression – gentle compression such as tubigrip can be used * Elevation – by elevating the affected area, it helps reduce the swelling and bruising * After the first 48hrs and inflammation has gone down, can apply heat for pain by using hot water bottle, warm bath or a counter-irritant (heat rub cream)

Answer 275

- Backache is mild to severe pain or discomfort in the area of the lower back. - The pain can be acute (sudden and severe) or chronic if it has lasted more than three months. - It can be caused by awkward bending, pregnancy or sitting for a long period of time e.g. when driving.

Answer 276

- fever, nausea/ vomiting - weight loss - inflammation/ swelling - pain that travels to chest, at high up the back - pins and needles in the legs below the knee - constant pain - under 20 or over 55 Pain felt on either side of middle part of back -just below ribcage associated with abnormality in passing urine – KIDNEY PAIN -SEVERE pain radiating down back onto both legs - SCIATICA

Answer 277

* continuing with your normal activities wherever possible, * the use of a muscle relaxant may be prescribed but only for a few days, * if you are in severe pain, keep any bed rest as short as possible, as complete rest does not help recovery, * doing exercises to strengthen your muscles and improve your posture, * applying a cold compress (bag of frozen peas wrapped in a tea towel) to reduce the initial inflammation, applying heat (heating pad, hot water bottle or hot shower) after a few days to ease muscular pain * Good posture, lifting correctly

Answer 278

IF SYMPTOMS HAVE NOT IMPROVED IN 5 DAYS THEN REFER TO GP

Answer 279

Tennis, Golfer’s elbow: affects the elbow muscles, tendons and the bony knobble (epicondyle) on the inside of the elbow where the muscles that flex the forearm attach to the upper arm – it will be a strain

Answer 280

swelling around the outer edge of the elbow, tenderness around the elbow and pain during movement

Answer 281

swelling appears on the inside of the elbow, tenderness around the elbow and pain during movement & when quickly flexing the arm and hand Picking things up may be difficult because of pain or weakness, and it is usually due to inflammation around the area due to repetitive movement

Answer 282

* PRICE to be used immediately * Protection * Rest – joint should be rested for 48 hrs after injury to avoid further damage * Ice – apply ice asap after injury for 10-30mins max. e.g. bag of frozen peas * Compression – gentle compression such as tubigrip can be used * Elevation – by elevating the affected area, it helps reduce the swelling and bruising * After the first 48hrs and inflammation has gone down, can apply heat for pain by using hot water bottle, warm bath or a counter-irritant (heat rub cream

Answer 283

It is a condition that affects your ability to move your shoulder around. - There is stiffness and pain in the shoulder joint, which reduces normal movement in this area. – - Recovery can be slow and symptoms usually last for two to three years, although for some people it is much faster than this.

Answer 284

Stage 1: -the shoulder starts to ache and feel stiff, before becoming very painful. - the pain is often worse at night and when you lie on the affected side. - This stage lasts between 2-9 months. Stage 2: -this is known as the adhesive stage. -The shoulder typically becomes more and more stiff, although the pain does not normally get worse. -The muscles may start to waste slightly as they are not being used. -This stage lasts between 4-12 months. Stage 3: -this is the recovery stage in which you gradually regain movement of the shoulder. -The pain also fades, although it may recur from time to time as the stiffness eases. -Although you may not regain full movement of your shoulder, you will be able to do many more tasks. -This stage lasts five to twelve months.

Answer 285

Rheumatoid arthritis is an autoimmune disease. - Your immune system, which usually fights infection, attacks the lining of your joints, causing them to become inflamed. - Over time, your joints may become permanently damaged and stop working properly. - pain, soreness or stiffness in the muscle, joints or tendons that is long-term

Answer 286

Joint pain and swelling - this is usually worst in the morning and tends to improve as you move around. Joint stiffness - again this often improves once you start moving around. Warmth and redness - the lining of the affected joint becomes inflamed, leaving the skin over the joint warm, red and swollen Loss of appetite. Generally feeling unwell. Skin nodules - one in four people with rheumatoid arthritis develop lumps under their skin, known as rheumatoid nodules. These commonly occur on the skin over the elbows, and forearms, and are usually painless. Anaemia -is a condition where the blood is unable to carry enough oxygen, due to a low number

Answer 287

You should try and get plenty of rest during a flare-up, as this is when your joints can be particularly painful and inflamed. - Putting further strain on very swollen and painful joints can often make pain and inflammation worse. - Exercise is very important for maintaining your general health and mobility. A gentle form of exercise that does not put too much strain on your joints is best. Swimming, for example

Year 3 OTC Notes Flashcards

(325 cards)