Clinical Course of Chickenpox and Measles

Time between exposure and appearance of symptoms, usually 1-3 weeks.

Time before the rash appears, marked by common flu-like symptoms like fever, malaise, etc.

Time when the patient can spread the virus, usually starts 1-2 days before rash and until all vesicles dry or crust.

Time between exposure and appearance of symptoms, often 10 days.

Includes fever, URTI symptoms and conjunctivitis (red eyes).

Severe complications can arise, from pneumonia to encephalitis.

Indications to seek immediate medical attention (e.g., bacterial superinfection, dehydration).

Chickenpox: tiny blisters (vesicles), Measles: Koplik spots (white spots in the mouth).

Vaccination is the most important preventive measure.

Typically given at 12 months, then again at 4 years old, subcutaneously.

Use ibuprofen, avoid aspirin, monitor for severe itching and consider promethazine.

Cold sores (HSV) have a prodrome of itching and burning, impetigo has golden crusts on the face/extremities.

Indications of severe infection or complications requiring immediate medical attention (e.g., fever, malaise, skin ulceration).

Use Aciclovir 5% cream as soon as symptoms appear, do not use for more than 7-10 days without consulting physician.

Threadworm: nighttime perianal itching, Roundworm: abdominal pain, diarrhea, cough.

Take as directed, often in two doses separated by two weeks, to ensure complete eradication.

Short-term treatment with NSAIDs or opiates, depending on severity.

Various types of pain (visceral, neuropathic, superficial/deep somatic) affecting different body parts.

Ibuprofen is typically the first choice, but use naproxen for certain conditions as needed.

Constipation is a well-known side effect.

Capsaicin is a strong topical option for certain chronic pain conditions.

Abrupt onset of pain around the eye.

Stiff neck and skin rash may be present along with a severe headache, especially in children.

Sumatriptan is a strong consideration for managing migraine.

The consultation process follows a specific sequence; asking about the habits first.

NRT (Nicotine Replacement Therapy) is suitable for most smokers, including light or heavy smokers, with exceptions.

Oral NRT carries potential risks and is not well-suited for everyone.

Insomnia can be transient, chronic, and short term.

Ibuprofen is a suitable pain reliever for children and adults with chickenpox.

Aciclovir cream is usually the recommended treatment for cold sores. It is most effective if started as soon as symptoms appear. It should be be used for no more than 7-10 days without consulting a physician.

Visceral pain originates from internal organs or cavities. It's usually described as deep, throbbing, or cramping.

Neuropathic pain is caused by damage or dysfunction of the nerves. It is often described as burning, tingling, or shooting pain.

Superficial somatic pain comes from skin, muscles, or connective tissues. It's typically sharp or localized.

Deep somatic pain originates from deep tissues like bones, tendons, or ligaments. It's often described as dull or aching.

Ibuprofen is often the first-line analgesic for a variety of conditions, including back pain, tension headaches, and dysmenorrhea (menstrual cramps). It is important to consult a physician about the appropriate dosage and duration of use.

Constipation is a common side effect of codeine-containing analgesics. This is due to codeine's action on the gastrointestinal tract.

Capsaicin, the active ingredient in chili peppers, is a strong topical analgesic used for chronic pain conditions, such as osteoarthritis and nerve pain. It works by depleting substance P, a neurotransmitter involved pain signaling.

Sumatriptan is a medication used to treat acute migraine attacks. It works by narrowing blood vessels in the brain, which reduces pain and other migraine symptoms.

The first step in a smoking cessation consultation is to ask the patient about their tobacco use history and current habits.

Transient insomnia is short-term sleep disturbance, lasting only a few days or weeks. It is often caused by stress, travel, or a change in environment.

Chronic insomnia is persistent sleep disturbance that lasts three months or longer. It can be due to underlying medical conditions, mental health issues, or unhealthy sleep habits.

CBTI is a highly effective, non-drug treatment for insomnia. It helps people identify and change unhealthy sleep habits to improve sleep quality.

Digoxin, a medication used to treat heart failure, is a common cause of medicine-induced nausea and vomiting.

Domperidone, a medication used to relieve nausea and vomiting, should be taken before meals to help prevent or reduce these symptoms.

Acupressure can be used to help prevent motion sickness. The P6 point is located on the inner side of the wrist, about two fingers' width below the wrist crease. Apply pressure to this point with a wristband or your fingers to help reduce nausea and vomiting.

Meclizine is an antihistamine that can be used to prevent or reduce motion sickness. It typically has longer-lasting effects compared to other antihistamines and is often preferred for longer journeys.

Antihistamines for motion sickness should be taken before exposure to motion, such as a plane or car trip, to be most effective in preventing symptoms.

Cauda equina syndrome is a serious condition that requires immediate medical attention. It is characterized by severe low back pain, numbness, and bowel or bladder dysfunction. This suggests compression of the nerve roots in the lower spinal canal.

Exercise programs, tailored to the individual's needs and pain levels, can help strengthen muscles, improve flexibility, and reduce pain in acute low back pain.

Glucosamine is a naturally occurring substance found in cartilage. It is often used as an adjuvant therapy for osteoarthritis, as it may help protect cartilage and reduce pain.

Achilles tendon injuries involve the large tendon at the back of the ankle. Signs include pain behind the heel, tenderness, swelling, and difficulty with walking. The severity can range from small tears to complete ruptures.

Rotator cuff syndrome involves the muscles and tendons that surround the shoulder joint. It is often caused by overuse, injury, or degeneration. Symptoms include pain, weakness, and limited range of motion of the shoulder.

Compression helps to reduce swelling and promote blood flow to the injured area. It can be achieved using a bandage or compression garment.

A BMI of 23.5 for a Filipino patient falls within the normal range according to the WHO BMI classification for Asians.

For obese patients, it is crucial to combine healthy dietary changes with regular exercise to achieve sustainable weight loss. This approach is often the most effective and long-term solution.

Orlistat is a medication that blocks the absorption of fat in the diet. It is most effective when used in combination with a low-fat, hypocaloric diet.

To assess visual acuity, ask the patient to read small print from a distance. This test determines how clearly the patient can see details at a specific distance.

Bacterial conjunctivitis, also known as pink eye, is characterized by a purulent (thick, yellow) discharge from the eye. It is highly contagious and can spread quickly.

Allergic conjunctivitis is caused by an allergic reaction to substances like pollen, dust mites, or pet dander. It presents with itching of the eye, redness that is generally diffused (spread out), and watery discharge. It can also be associated with a family history of atopy (tendency to develop allergies).

If a patient experiences true eye pain, it is important to refer them to a physician. It is crucial to rule out serious conditions such as scleritis, keratitis, or acute glaucoma.

It is important to avoid wearing contact lenses until the symptoms of conjunctivitis have resolved to prevent further irritation and possible worsening of the infection.

Chloramphenicol eye drops are a common and effective treatment for bacterial conjunctivitis. They help reduce bacterial growth and relieve associated symptoms.

Intraocular sodium cromoglycate eye drops are a helpful prophylactic measure for allergic conjunctivitis. They help to lessen the allergic reaction and reduce the symptoms.

Beta-blockers, a class of medication commonly used to treat hypertension and other cardiovascular conditions, can sometimes lead to dry eyes as a side effect.

The choice of artificial tears should be tailored to the patient's individual preferences. This includes considerations such as the type of solution, the drop size, the viscosity, and the preservation system.

Hypromellose 2% eye drops are a common type of artificial tears. They provide lubrication and moisture, which can help to alleviate symptoms of dry eyes. They are also generally well-tolerated.

Orbital cellulitis is a serious infection of the tissue surrounding the eye. It is characterized by swelling of the eyelids, redness, pain, fever, and sometimes difficulty moving the eye. It requires prompt medical attention.

Blepharitis and styes, both involving inflammation of the eyelid, are often treated with conservative measures, which include warm compresses and good lid hygiene practices to help reduce inflammation and promote healing.

It is important to avoid squeezing or picking at a stye. Squeezing can trap infected material within the eyelid, increasing the risk of further inflammation and infection.

Tinnitus (ringing in the ears) and deafness (hearing loss) are typically associated with problems in the inner ear.

For most adults, earache is a self-limiting condition that can be managed with over-the-counter oral analgesics, such as paracetamol or ibuprofen, for a maximum of two days. If the symptoms persist or worsen, a physician should be consulted.

In children, especially young children, earache accompanied by fever and general malaise is often a sign of a middle ear infection (otitis media). This requires referral to a physician for further evaluation and treatment.

Hydrogen peroxide can be used as a cerumenolytic (earwax softener) to help remove excess earwax. However, it should be used with caution and only as directed by a healthcare professional. Applying a cotton wool plug after instillation is not recommended.

Using cotton buds to clean the ear canal should be avoided as it can push earwax further in and increase the risk of otitis externa (inflammation of the ear canal).

Teething infants can experience discomfort, swelling, and pain in their gums. A cool washcloth is a safe and effective method to help reduce the discomfort.

Trauma-induced mouth ulcers are caused by injury to the oral mucosa (lining of the mouth). These ulcers are often painful and may be irregular in shape.

Minor aphthous ulcers are small, shallow ulcers that usually occur inside the mouth, often on the soft palate or inside the cheeks. They are painful and typically last about 7-10 days.

Benzydamine is a medication used to treat minor aphthous ulcers. It is available as a mouthwash or gel and has analgesic and anti-inflammatory properties.

Certain medications, like inhaled corticosteroids used for asthma, immunosuppressants, and antibiotics, can increase the risk of developing oral thrush (candidiasis) by disrupting the natural balance of fungi in the mouth.

To prevent relapse or reinfection with oral thrush, treatment with miconazole should be continued for at least two days after the symptoms have cleared to ensure that the infection is completely eradicated.

Regular and proper flossing, along with brushing, is essential for removing plaque and food debris, which can accumulate between teeth and contribute to gingivitis (gum inflammation).