Podcast
Questions and Answers
Which of these options are correct? (Select all that apply)
Which of these options are correct? (Select all that apply)
Ibuprofen is an appropriate analgesic for patients with chickenpox.
Ibuprofen is an appropriate analgesic for patients with chickenpox.
False
Aspirin is an appropriate analgesic for adults with chickenpox.
Aspirin is an appropriate analgesic for adults with chickenpox.
False
Promethazine 25mg HS is an appropriate dose for a 3-year-old patient with chickenpox complaining of severe itchiness.
Promethazine 25mg HS is an appropriate dose for a 3-year-old patient with chickenpox complaining of severe itchiness.
Signup and view all the answers
How can impetigo and cold sores be differentiated from each other? (Select all that apply)
How can impetigo and cold sores be differentiated from each other? (Select all that apply)
Signup and view all the answers
Which of the following pharmacy products would you BEST recommend to a patient with a history of cold sores?
Which of the following pharmacy products would you BEST recommend to a patient with a history of cold sores?
Signup and view all the answers
Which of the following would you BEST recommend to a patient with localized non-bullous impetigo?
Which of the following would you BEST recommend to a patient with localized non-bullous impetigo?
Signup and view all the answers
Which of the following is the BEST recommendation for the uptake of measles vaccine?
Which of the following is the BEST recommendation for the uptake of measles vaccine?
Signup and view all the answers
Chronic pain is characterized by pain that persists for extended periods of time (>3 months) that tends to be circular in nature.
Chronic pain is characterized by pain that persists for extended periods of time (>3 months) that tends to be circular in nature.
Signup and view all the answers
Identify the MOST important step when examining the conjunctiva?
Identify the MOST important step when examining the conjunctiva?
Signup and view all the answers
Study Notes
Clinical Course of Chickenpox
- Incubation Period: 1 to 3 weeks
- Prodromal Period: Symptoms like nausea, vomiting, headache, myalgia, loss of appetite, fever, and malaise. Occur 1-2 days before rash appears.
- Infectious Period: 1 to 2 days prior to rash until vesicles crust over.
- Reactivation Period: May present as shingles.
- Complications: Can involve pneumonia, encephalitis, and otitis media.
Chickenpox vs. Measles
- Koplik's Spots: Present with measles but not chickenpox.
- Rash Location: Chickenpox rash is more widespread, appearing on the trunk rather than the face and limbs as in measles.
- Rash Appearance: Chickenpox has small blisters (vesicles) surrounded by reddened area, measles has a flat, erythematous rash
- Symptoms: Measles involves GI and respiratory symptoms, while chickenpox is more focused on skin manifestations.
Red Flags for Referral
- Bacterial Superinfection: High fever, pain, and redness around lesions.
- Measles: Requires immediate referral and notification.
- Dehydration: Reduced urine output, lethargy, reduced skin turgor.
- Cellulitis: Erythematous rash or ulceration on the lower leg or ankles in an elderly person.
Important Lifestyle Advice
- Vaccination: Crucial for preventing chickenpox and measles.
- Exclusion from school or nursery: May be necessary in infected cases but exclusion should follow guidelines.
- Hygiene: Maintain good hygiene to minimize skin irritation.
- Fluid intake: Ensure adequate fluid intake.
Measles Vaccine Recommendations
- Administration: Given at 12 months of age, then a repeat dose at ~4 years of age, subcutaneously.
Appropriate Treatments (for Chickenpox)
- Ibuprofen: Inappropriate for chickenpox.
- Aspirin: Inappropriate for adults with chickenpox.
- Promethazine: Appropriate for severe itchiness in 3-year-olds with chickenpox.
- PPT/Promethazine: Appropriate for patients over 2 years old.
- 1% menthol topical calamine lotion with fever: Inappropriate, use oral antipyretics like paracetamol.
Impetigo vs. Cold Sores
- Appearance: Impetigo presents with vesicles that rupture and form golden crusts. Cold sores present with flaccid fluid-filled bullae that rupture to form crusts on the trunk.
- Location: Cold sores may appear on nerve innervations of the trigeminal nerve, Impetigo appear on face or extremities.
- Symptoms: Cold sores have a prodrome of itching, burning, stinging prior to the blister eruption.
Cold Sores and Impetigo Referral Flags
- Widespread herpetiform eczema: Indicates a possible infection.
- Fever and Malaise: Skin lesions accompanied by fever and malaise indicate a possible bacterial infection.
- Beard area of men with rash: May indicate sycosis barbae.
Impetigo Treatment
- 1% Hydrogen Peroxide Cream: Not best recommendation.
- Antibiotics: Inappropriate, unless secondary infection is occurring, use 5% Aciclovir Cream.
- Aciclovir Cream 5%: Best recommendation.
Threadworms vs. Roundworms
- Possible presentations for different worms may be similar, they need to be differentiated clinically based on symptoms.
Mebendazole for Threadworms
- Mechanism: Inhibits worm glucose uptake, disrupts energy, usually 100mg administered as the initial dose.
- Adjuvant: Personal hygiene is critical for effective treatment of all types of worms.
Acute vs. Chronic Pain
- Acute Pain: Short-term, resulting from injury, resolves when the cause is addressed.
- Chronic Pain: Persistent or recurring, lasts longer than 3 months.
Oral Analgesics for Different Conditions
- Back Pain, Tension Headache: Ibuprofen.
- Pain and Fever in Children: Ibuprofen.
- Dysmenorrhea: Naproxen.
- Dental Pain: Ibuprofen.
Oral Analgesics
- Naproxen vs. Ibuprofen: Naproxen is more potent but Ibuprofen is superior due to fewer side effects.
- Max Daily Dose Ibuprofen: 1200 mg/day.
- Aspirin Side Effects: Aspirin has more side effects vs Ibuprofen.
Different Types of Headache
- Cluster Headache: Unilateral pain around the eye, temple, or the frontotemporal area; sudden onset.
- Tension-Type Headache (TTH): Usually bilateral, may be generalized
- Migraine: Can be unilateral or bilateral, may be generalized or localized (70% unilateral)
Patient with Newly-Diagnosed Migraine
- Recommend lifestyle management first (diet, exercise, stress management) followed by specific medication if needed.
Other Medical Conditions
- Conjunctivitis: Treatment depends on etiology (viral, bacterial, allergic) but typically involves supportive care and, if bacterial, antibiotics or antivirals as necessary.
- Otitis externa: Supportive care, possible topical antibiotics.
- Otitis Media: Referral to doctor is needed, depends on severity of symptoms.
- Sinusitis: Treatment depends on severity of symptoms, if severe referral warranted to a physician.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers the clinical aspects of chickenpox, including its incubation, prodromal, infectious, and reactivation periods. It also compares chickenpox and measles, highlighting key differences in symptoms and rash appearance. Additionally, red flags for referral related to chickenpox complications are discussed.
