Threadworm and Pinworm Treatment Guide

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Questions and Answers

Why are the nape of the neck and behind the ears preferred areas for lice?

  • They are shielded from insecticide sprays.
  • They are easier to access for feeding.
  • They are cooler and more ventilated.
  • They are warm and sheltered. (correct)

Bedding and clothes need specific laundering to eliminate lice.

False (B)

What is the best way to control lice infestation?

Regular detection combing

If wet combing is insufficient, __________ can be given.

<p>insecticides</p> Signup and view all the answers

Which type of insecticide is considered more effective and less likely to cause resistance?

<p>Physical insecticides (C)</p> Signup and view all the answers

Permethrin is generally recommended for lice treatment in the UK.

<p>False (B)</p> Signup and view all the answers

How does dimethicone work to kill lice?

<p>Suffocates lice by interrupting their oxygen supply</p> Signup and view all the answers

Match the insecticide with its application instructions:

<p>Dimethicone = Apply to dry hair, leave on for 8 hours (or overnight), repeat 7 days later Cyclomethicone = Apply to dry hair, leave on for 1 hour, inspect for 10 days Malathion = Apply to dry hair, leave on for 12 hours (or overnight), repeat after 7 days</p> Signup and view all the answers

What is a common symptom of threadworm/pinworm infection in children?

<p>Scratching the bottom at night (B)</p> Signup and view all the answers

Finding nits (eggs) attached to hair always confirms an active head lice infection.

<p>False (B)</p> Signup and view all the answers

Which antiviral agent is considered the first-line treatment for shingles?

<p>Acyclovir 800mg (D)</p> Signup and view all the answers

What anthelmintic medication is mentioned for the treatment of threadworm infections?

<p>Mebendazole</p> Signup and view all the answers

For head lice, applying wet hair plus ______ renders lice motionless.

<p>conditioner</p> Signup and view all the answers

Antiviral treatment for shingles is always required for patients under 50 years old, regardless of symptoms.

<p>False (B)</p> Signup and view all the answers

What is the recommended timeframe for initiating oral antiviral agents in order to reduce the severity and duration of acute pain associated with shingles?

<p>Within 72 hours of onset</p> Signup and view all the answers

Match the preventative measure with the infestation it helps prevent:

<p>Cutting fingernails short = Threadworm/Pinworm Damp dusting surfaces = Threadworm/Pinworm Wet Combing = Head Lice</p> Signup and view all the answers

To minimize spreading, the shingles rash should be kept ______.

<p>covered</p> Signup and view all the answers

Why is it recommended to treat all household members simultaneously when one person is diagnosed with threadworms?

<p>To ensure complete eradication of the worms and prevent re-infection (C)</p> Signup and view all the answers

Wet combing is ineffective for head lice if insecticide resistance is high.

<p>False (B)</p> Signup and view all the answers

Besides antiviral agents, what other medication can be used for pain relief associated with shingles?

<p>Paracetamol and ibuprofen (D)</p> Signup and view all the answers

Shingles always appears as a rash on both sides of the body.

<p>False (B)</p> Signup and view all the answers

How often should wet combing be performed to treat head lice?

<p>Every 4 days</p> Signup and view all the answers

How long should cold, wet compresses be applied to weeping blisters?

<p>Up to 20 minutes</p> Signup and view all the answers

Threadworm eggs can remain viable for up to ______ weeks.

<p>2</p> Signup and view all the answers

Which of the following is a practical tip to manage threadworm infections?

<p>Wearing close fitting pyjama bottoms at night (D)</p> Signup and view all the answers

Match the following shingles recommendations to the action:

<p>Keep affected area clean and dry = Prevents secondary infection Change cloths and towels regularly and don’t share = Minimizes the spread of the virus Loose-fitting clothes = Minimizes pressure on affected area Calamine lotion = Soothes unbroken itching skin</p> Signup and view all the answers

Which of the following is a common symptom of scabies?

<p>Extremely itchy skin, especially at night (C)</p> Signup and view all the answers

Scabies is primarily transmitted through contaminated food and water.

<p>False (B)</p> Signup and view all the answers

What is a 'burrow' in the context of scabies, and how might it appear on the skin?

<p>A burrow is a tunnel created by the scabies mite under the skin. It often appears as a small, threadlike, raised, wavy grey line.</p> Signup and view all the answers

__________ scabies, also known as Norwegian scabies, typically affects immunocompromised individuals.

<p>Crusted</p> Signup and view all the answers

Match the following treatments for scabies with their description:

<p>Permethrin 5% cream = First-line treatment option; apply over the whole body and wash off after 8-12 hours. Malathion 0.5% aqueous liquid = First-line treatment for pregnant and breastfeeding women. Lindane 1% lotion = Used for patients who cannot tolerate or failed first-line treatment; use with caution due to potential neurotoxicity. Sedative antihistamine = Used at night to relieve itching and prevent excoriation.</p> Signup and view all the answers

Which of the following is NOT a danger symptom that warrants seeking medical attention for scabies?

<p>Mild itching that subsides during the day. (C)</p> Signup and view all the answers

Itching that persists for several weeks after treatment for scabies automatically indicates treatment failure.

<p>False (B)</p> Signup and view all the answers

Why is Permethrin cream not recommended immediately after a hot bath?

<p>A hot bath can increase systemic absorption of permethrin, potentially leading to adverse effects.</p> Signup and view all the answers

Lindane 1% lotion is contraindicated in __________ infants and individuals with known uncontrolled __________ disorders.

<p>premature, seizure</p> Signup and view all the answers

Which of the following is the application of Malathion 0.5% aqueous liquid?

<p>Apply over the whole body including scalp, neck, face and ears and wash off after 8 to 12 hours (A)</p> Signup and view all the answers

What is the most common symptom of impetigo in children?

<p>Red, itchy sore around mouth and nose (A)</p> Signup and view all the answers

Scaling of skin is a primary symptom of non-bullous impetigo.

<p>False (B)</p> Signup and view all the answers

What antibiotic ointment is commonly used to treat impetigo?

<p>Mupirocin</p> Signup and view all the answers

To prevent the spread of impetigo, children should not attend __________.

<p>nursery or school</p> Signup and view all the answers

Match the treatment option with its application frequency:

<p>Mupirocin = 2-3 times a day for up to 10 days Fusidic acid = 3 times a day until resolved Warm water soak = A few minutes before applying treatment</p> Signup and view all the answers

Which of the following is a common symptom of athlete's foot?

<p>Itchy, scaly rash between the toes (C)</p> Signup and view all the answers

Talcum powder is a first-line treatment for athlete's foot.

<p>False (B)</p> Signup and view all the answers

What type of footwear is recommended to prevent recurrence of athlete's foot?

<p>Open, non-occlusive shoes</p> Signup and view all the answers

Accumulation of ______ under the nail is a symptom of fungal nail infections.

<p>debris</p> Signup and view all the answers

Which of the following is considered a first-line treatment for confirmed cases of fungal nail infections?

<p>Oral antifungal (terbinafine) (D)</p> Signup and view all the answers

Topical treatments for fungal nail infections are most effective when more than 50% of the nail plate is affected.

<p>False (B)</p> Signup and view all the answers

How often should fingernails be monitored during treatment for fungal nail infections?

<p>Every 3 months</p> Signup and view all the answers

Tinea cruris, also known as ______, is a fungal infection of the groin.

<p>jock itch</p> Signup and view all the answers

A circular, red, scaly lesion with less scaling and erythema in the center is characteristic of which fungal infection?

<p>Tinea corporis (B)</p> Signup and view all the answers

Topical antifungals are usually effective in treating ringworm of the scalp.

<p>False (B)</p> Signup and view all the answers

What should be done with items that may spread fungal spores in cases of ringworm of the scalp?

<p>Discard or disinfect them</p> Signup and view all the answers

Match the following symptoms with the corresponding fungal infection:

<p>Itchy, scaly rash between toes = Athlete's foot Thickened, discolored nails = Fungal nail infection Scaly, erythematous lesions in groin = Tinea cruris (jock itch) Circular, red, scaly lesion on body = Tinea corporis (ringworm)</p> Signup and view all the answers

Which of the following is a danger symptom associated with athlete's foot?

<p>Secondary bacterial infection (cellulitis) (D)</p> Signup and view all the answers

Clotrimazole and Miconazole are unsafe for pregnant and breastfeeding women.

<p>False (B)</p> Signup and view all the answers

Pityriasis versicolor is caused by the yeast ______.

<p>Malassezia furfur</p> Signup and view all the answers

Flashcards

Wet Combing

A method of lice detection using a comb on wet hair, section by section.

Dimethicone

A physical insecticide that suffocates lice by coating them and interrupting oxygen supply.

Cyclomethicone

A physical insecticide applied to hair that disrupts lice water balance.

Malathion

A chemical insecticide used as a second-line treatment for lice.

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Permethrin

A chemical insecticide that is generally not recommended due to resistance issues.

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Resistance in Lice

The ability of lice to survive chemical insecticides after prolonged exposure.

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Practical Tips for Infestation

Effective measures to control lice, including regular combing and tying hair up.

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Laundering Bedding and Clothes

Not essential for lice control since they don’t survive long away from the scalp.

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Scabies

A skin condition caused by the Sarcoptes scabiei mite, leading to intense itching.

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Symptoms of Scabies

Includes extreme itching, red papules, rash, and secondary lesions.

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Transmission method

Scabies spreads easily through close physical contact.

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Danger symptoms

Include effects on children under 2 and immunocompromised individuals.

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Lindane

Used when first-line treatments fail; can be toxic with caution needed.

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Secondary lesions

Result from scratching and excoriation in scabies sufferers.

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Itch persistence

Itching may continue for weeks even after treatment is successful.

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Burrows

Small threadlike, raised grey lines caused by scabies mites under the skin.

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Threadworm Symptoms

Child scratching bottom at night; sighting of worms around perianal area.

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Confirmatory Diagnosis for Threadworm

Sightings of worms in perianal area or on feces, especially at night.

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Danger Symptoms of Threadworm

Secondary infections from scratching; potential symptoms include weight loss, insomnia, and irritability.

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Threadworm Treatment

Anthelmintics like Mebendazole for those over 2 years; all household members treated.

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Mebendazole Mechanism

Inhibits glucose uptake, immobilizing and causing death of worms.

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Head Lice Diagnosis

Finding live lice and eggs (nits) attached to hair confirms infection.

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Wet Combing Technique

Effective method where wet hair makes lice motionless; performed every 4 days.

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Comb Lice Check

Comb hair over white paper; damp hair eases the process.

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Nit Persistence

Nits can appear viable for weeks even after lice are dead, causing confusion about treatment success.

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Threadworm Practical Tips

Good hygiene practices like washing hands and laundering bedding to prevent reinfestation.

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Impetigo

A contagious skin infection caused by Staphylococcus aureus or Streptococci, common in young children.

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Symptoms of Impetigo

Itchy sores typically around the mouth and nose, may worsen existing skin conditions.

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Non-bullous vs Bullous Impetigo

Non-bullous is itchy; bullous is painful and contains blisters.

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Treatment for Impetigo

Use topical antibiotics like Mupirocin or Fusidic acid for 2-10 days.

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Personal Hygiene Tips for Impetigo

Wash hands after contact, avoid sharing towels, and keep nails short.

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Shingles Symptoms

Pain, itching, and a red rash that forms blisters.

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Rash Location

Shingles rash appears in a single stripe on one side of the body.

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Oral Antiviral Agents

Medications like acyclovir that reduce the severity of shingles if taken promptly.

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First Line Treatment

Acyclovir 800mg is the primary medication prescribed.

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Pain Relief Options

Paracetamol and ibuprofen can help alleviate pain from shingles.

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Practical Tips for Care

Keep the affected area clean, dry, and covered to avoid spreading.

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Cold Compress Method

Applying a cold, wet compress can reduce inflammation and soothe blisters.

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Athlete’s Foot

A fungal infection causing an itchy, scaly rash, mostly between toes.

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Symptoms of Athlete’s Foot

Starts between toes, presents as itchy rash; worsens with time.

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Local Antifungal Treatments

Topical creams and powders like clotrimazole for fungal infections.

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Imidazoles

First-line antifungal agents used for treating athlete’s foot.

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Fungal Nail Infections

Involves thickened, discolored nails often preceded by skin infections.

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Candazole Lotion

Topical treatment applied to affected nails sparingly, twice daily.

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Danger Symptoms in Nail Infection

Immunosuppressed patients need caution due to potential complications.

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Ringworm Symptoms

Includes scaly lesions on groin, body, scalp, and white spots on skin.

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Tinea Cruris

Fungal infection causing red, scaly lesions in the groin area.

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Topical Antifungal for Ringworm

Includes imidazoles and terbinafine to treat skin infections.

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Oral Antifungal

Used for systemic infections, includes fluconazole and terbinafine.

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Preventive Tips for Fungal Infections

Maintain hygiene, don't share towels or footwear to prevent infection spread.

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Practical Care for Nails

Avoid nail polish and tight shoes to promote healthy nail growth.

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Study Notes

THREADWORM/PINWORM (Enterobius vermicularis)

  • Symptoms: Child scratching their bottom at night, sighting of worms around the perianal area at night or on faeces (rare).
  • Danger symptoms: Secondary bacterial infection due to scratching, persistent or heavy infestation, appetite loss, weight loss, insomnia, irritability and enuresis. Refer to a physician if pregnant/breastfeeding or a child under 2 years old for treatment differences.
  • Treatment options: Anthelmintics (Mebendazole) for children and adults over 2 years old. All household members should be treated simultaneously, given as a single oral dose, repeated in 2-3 weeks if needed to address reinfection. Works by inhibiting glucose uptake for immobilisation and death.
  • Practical tips: Wear close-fitting pyjamas at night, bathe first thing in the morning attending to the anal area, emphasize good hygiene (wash hands after toilet and before eating). Cut fingernails short. Launder bedding and towels daily, avoid shaking linen. Damp dust and vacuum surfaces daily.

HEAD LICE (Pediculus capitis)

  • Symptoms: Conclusive diagnosis of live lice, eggs (nits) attached to hair (proof of active infection). Nits may retain a viable appearance for weeks after death. Some parents think treatment has failed if nits are still visible.
  • Treatment methods: Check by combing damp hair with a fine-toothed comb over a white paper.

SCABIES (Sarcoptes scabiei mite)

  • Symptoms: Extremely itchy, especially at night, accompanied by rash. Red papules between fingers, toes, wrists, ankles, armpits, around nipples, buttocks, and genitals. Secondary lesions due to excoriation. Other family members often experience similar symptoms.
  • Treatment options: Sedative antihistamine for night time use (prevent excoriation, secondary infection), Permethrin 5% w/w cream (first-line, applied over whole body). Malathion 0.5% or Lindane 1% (as second/third options, for pregnant/breastfeeding women, or those who can't tolerate others) to treat.

HERPES

  • Symptoms (Cold Sore/Herpes Labialis): Occurrence on face (around mouth and nose), tendency to reoccur in same place, early signs of tingling, itchy, numb feeling, development of small red fluid-filled vesicles (may coalesce, burst, and crust). Painful and itchy.
  • Danger symptoms: Weeping pustules (potential secondary bacterial infection). May require antibiotic treatment.
  • Treatment options: Topical antiviral agents (Acyclovir, famciclovir, valcyclovir) to speed up healing when started at the first stage. Topical anaesthetics or oral analgesics for pain relief, symptomatic medication (anti-inflammatory, antipyretic, analgesic drugs).
  • Practical Tips: Wash hands after touching lesions, avoid touching eyes, don't share face cloths or towels, avoid oral sex.

FUNGAL SKIN INFECTIONS

  • Athlete's foot (Tinea pedis): Symptoms begin between toes, in people with sweaty feet confined to tight-fitting shoes. Itchy, scaly rash, secondary bacterial infection (cellulitis), immunocompromised/diabetic patients, fever. Symptoms worsen over 2 weeks, and excessive discomfort, redness, and swelling may be evident.
  • Treatment options: Antifungal creams to be used in damp areas between toes. Ointments may also be beneficial.

IMPETIGO

  • Symptoms: Common in children (2-5 years) and those with scabies. Appears as red sores, initially itchy in the mouth and nose area, then painful; weeping, golden, crusted eruptions appear, becoming golden and crusted with an erythematous (red) base as they heal.
  • Danger symptoms: More serious bacterial infections (cellulitis/septicaemia), Scalded skin syndrome.
  • Treatment options: Antibiotic cream/ointment (Mupirocin / Fusidic acid). Soaking affected areas and/or using compression cloths for a few minutes. 2-3 times a day for up to 10 days or until healing.
  • Practical tips: Personal hygiene (washing hands after contact, not sharing towels or clothing), keep fingernails short, avoiding scratching.

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