Term
[image]
Name this Condition |
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Definition
| Axial Chilitis (angular stomatitis) |
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Term
| How would you describe Axial Chilitis (angular stomatitis)? |
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Definition
More moisture is lost through the lips than through any other part of the face or body.
When the lips lose moisture, the skin covering them can become tight and start to split. |
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Term
| What advise would you give to patients presenting with Angular stomatitis? |
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Definition
Do not pick and bite off flakes of dried skin, this will only make your lips bleed and heal more slowly.
Do not keep licking dry or cracked lips. This will only dry your lips more.
The best thing to do if you have dry or sore lips is to regularly apply a lip balm containing petroleum or beeswax.
Choose a lip balm with a sun protection factor (SPF) of at least 15 if out in the sun. |
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Term
| What patient group is susceptible to Angular stomatitis? |
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Definition
| It is often seen in the elderly where it is predisposed to by sagging facial muscles and ill-fitting dentures which produce a fold in the angle of the mouth. |
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Term
[image]
If a candida infection is suspected for Angular stomatitis, it is often called Angular cheilitis. What treatment would a GP prescribe in this case? |
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Definition
Miconazole-Hydrocortisone cream (daktacort) for 7 days
This combination will reduce inflammation and treat candida infection; also many gram positive bacteria including streptococci and staphylococci are sensitive to miconazole. |
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Term
[image]
Identify the condition and name the causative micro-organism |
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Definition
| Cold sore - Herpes simplex virus type 1 |
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Term
| If untreated how long will it take for a Cold Sore to heal? |
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Definition
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Term
| What are the symptoms of a cold sore? |
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Definition
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Term
| What self-care advice can you give for Cold Sore? |
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Definition
eat cool, soft foods
use an antiseptic mouthwash if it hurts to brush your teeth
wash your hands with soap and water before and after applying cream
avoid anything that triggers your cold sores
use sunblock lip balm (SPF 15 or above) if sunshine is the trigger
take paracetamol or ibuprofen to ease pain and swelling (liquid paracetamol is available for children) – don't give aspirin to children under 16
drink plenty of fluids to avoid dehydration
wash your hands with soap and water before and after applying cream |
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Term
| What should you avoid doing if you have a Cold Sore? |
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Definition
eat acidic or salty food
touch your cold sore (apart from applying cream)
rub cream into the cold sore – dab it on instead
kiss anyone while you have a cold sore
share anything that comes into contact with a cold sore (such as cold sore creams, cutlery or lipstick)
have oral sex until your cold sore completely heals – the cold sore virus also causes genital herpes |
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Term
| For how long will a Cold Sore remain infectious and can spread to other people? |
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Definition
| Until the cold sores have 'scabbed over' and are completely dry, the cold sore is very infectious and can be spread to other people. |
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Term
| What treatments can you buy in a pharmacy to treat Cold Sores? |
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Definition
Painkilling gels - Choline salicylate gel(Bonjela), Lidocaine gels(Lypsyl)
Antiviral cream - Aciclovir (Zovirax®), Penciclovir (Fenistil) |
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Term
| What is the posology and method of administration for Bonjela to treat Cold Sores? |
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Definition
Adults and children over the age of 16: Using a clean finger massage approximately half an inch of the gel onto the sore area, not more than once every 3hours.
There is no indication that dosage need be modified in the elderly. |
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Term
| What is the posology and method of administration for Lypsyl to treat Cold Sores? |
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Definition
| Adults and children over 12 years: Apply a small amount to the affected area with your fingertips 3-4 times daily. |
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Term
| What is the posology and method of administration for Zovirax cream to treat Cold Sores? |
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Definition
Adults and children: Apply to the affected area FIVE times a day at approximately four hourly.
Treatment should be continued for at least 4 days. If healing has not occurred, treatment may be continued for up to 10 days |
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Term
| What is the posology and method of administration for Fenistil cream to treat Cold Sores? |
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Definition
Adults (including older people) and children over 12 years of age: Apply at approximately two hourly intervals during waking hours, (approximately EIGHT times a day).
Treatment should be continued for 4 days. If the condition gets worse or does not improve after 4 days treatment, seek medical advice. |
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Term
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Definition
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Term
[image]
[image]
[image]
Identify the condition and name the causative micro-organism |
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Definition
Top 2 images: Non-bullous impetigo (most common type)
Bottom image: Bullous impetigo
Causes:
Staphylococcus aureus (the most common cause).
Streptococcus pyogenes.
Meticillin-resistant Staphylococcus aureus (MRSA). |
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Term
Impetigo can easily spread to other parts of your body or to other people until it stops being contagious.
When does it STOP being contagious? |
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Definition
48 hours after you start using the medicine your GP prescribed
when the patches dry out and crust over – if you don't get treatment |
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Term
| Should your child stay away from school if they have impetigo? |
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Definition
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Term
| What self care advice can you give to patients with Impetigo? |
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Definition
keep sores, blisters and crusty patches clean and dry
cover them with loose clothing or gauze bandages
wash your hands frequently
wash your flannels, sheets and towels at a high temperature
wash or wipe down toys with detergent and warm water if your children have impetigo |
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Term
| What should you avoid doing if you have impetigo? |
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Definition
touch or scratch sores, blisters or crusty patches – this also helps stop scarring
have close contact with children, or people with diabetes or a weakened immune system (if they're having chemotherapy, for example)
share flannels, sheets or towels
prepare food for other people
go to the gym
play contact sports like football |
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Term
| What are the symptoms of Impetigo? |
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Definition
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Term
| Impetigo cannot be treated in the pharmacy. What will a GP prescribe for a Non-bullous infection? |
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Definition
For localized infection, treat with topical fusidic acid (three to four times daily, for 7 days).
For extensive infection: Oral flucloxacillin (four times daily for 7 days) is recommended first-line.
Oral clarithromycin (twice daily for 7 days) or erythromycin (four times daily for 7 days) are alternatives if the person is allergic to penicillins. |
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Term
| Impetigo cannot be treated in the pharmacy. What will a GP prescribe for a Bullous infection? |
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Definition
Bullous infection usually requires treatment with an oral antibiotic (flucloxacillin or clarithromycin/erythromycin).
Oral flucloxacillin (four times daily for 7 days) is recommended first-line.
Oral clarithromycin (twice daily for 7 days) or erythromycin (four times daily for 7 days) are alternatives if the person is allergic to penicillins. |
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Term
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Definition
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Term
[image]
[image]
[image]
Identify the condition and name the causative micro-organism |
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Definition
| Scabies is an itchy, highly contagious skin disease caused by an infestation by the itch mite Sarcoptes scabiei |
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Term
| What are the symptoms of scabies? |
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Definition
| Itching is the main symptom of scabies, usually starting about a month after the mites are picked up. The itch often gets worse at night. It is common for several people in the same family, and their friends, to become itchy at roughly the same time. |
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Term
| What should be prescribed for children over the age of two months, and adults with non-crusted scabies? |
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Definition
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Term
| In scabies itching can persist for 3 weeks after treatment. What can be given to control itching? |
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Definition
Crotamiton 10% cream or, if the scabies mites have definitely been eradicated, with topical hydrocortisone 1%.
Night time use of a sedative antihistamine (e.g. chlorphenamine or hydroxyzine) may help with sleep and reduce scratching. |
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Term
| What advice would you give to people with Scabies? |
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Definition
wash all bedding and clothing in the house at 50C or higher on the first day of treatment
put clothing that can't be washed in a sealed bag for 3 days until the mites die
stop babies and children sucking treatment from their hands by putting socks or mittens on them |
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Term
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Definition
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Term
[image]
[image]
[image]
Name the condition |
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Definition
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Term
| What are the symptoms of Athlete's foot? |
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Definition
| Itching & scaling on one foot which can become macerated and soggy, usually between 4th & 5th toe, > common in adults then kids, white/red in appearance |
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Term
| How would you treat Athlete's foot? |
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Definition
Clotrimazole: apply 2-3 times a day for at least four weeks.
Miconazole: apply twice a day and continue for 10 days after the skin is back to normal.
Econazole: apply twice a day until the skin is back to normal.
Ketoconazole. apply twice a day for seven days. Continue for a further few days if more severe. Not suitable for children.
Terbinafine: apply once or twice a day for seven days. Not suitable for children. |
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Term
| How do you avoid Athlete's foot? |
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Definition
Keep your feet dry. The athlete's foot fungus loves warm and moist conditions.
Avoid sharing towels and communal bathing.
Change your socks daily. Different shoes every 2-3 days to allow each pair to dry out fully after being worn.
Use antifungal sprays to beat stubborn cases. |
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Term
| Which patients would you refer with Athlete's foot? |
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Definition
| Diabetics, Immunocomprised, your foot is red, hot and painful |
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Term
[image]
Name the condition |
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Definition
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Term
| Which patients would you refer with fungal nail infections? |
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Definition
| Diabetics & immunocompromised patients & >2 nails affected |
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Term
| What are the treatment options for Fungal nail infections? |
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Definition
1) Not treating is an option
2) Antifungal tablets
Terbinafine tablets. The usual adult dose is 250 mg once a day; for between six weeks and three months for fingernails, and for three to six months for toenails.
Itraconazole tablets. This is usually given as pulsed treatment. That is, for an adult: 200 mg twice a day for one week, with subsequent courses repeated after a further 21 days.
3) Amorolfine nail lacquer (Loceryl/Loceryl Curanail, Omicur) |
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Term
| What is the posology and method of administration for Amorolfine nail lacquer cream to treat Fungal nail infection? |
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Definition
Limited to a maximum of 2 infected nails at one time for adults over 18 years of age.
Duration of treatment is six months (fingernails) and nine to twelve months (toenails).
Pharmacist to monitor every 3 months
File down the nail before applying. Apply the nail lacquer to the entire surface of the affected nails and allow it to dry |
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Term
[image]
[image]
[image]
Name this condition and causative agent |
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Definition
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Term
| What are the symptoms of Measles? |
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Definition
Starts off with flu like symptoms that develop 10 days after being infected. (illness lasts 7-10 days), small grey/white spots may appear (kopliks spots) in the mouth, so after this a rash may occur .
Small red/brown flat or raised spots that join together to for blotchy patches, start on the neck or head 1st itchy |
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Term
[image]
Name the condition |
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Definition
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Term
| What are the symptoms of Mumps? |
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Definition
| Mumps usually develops 14 to 25 days after becoming infected with the mumps virus (this delay is known as the incubation period). The average incubation period is around 17 days |
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Term
[image]
Name this condition |
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Definition
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Term
| What are the symptoms of Rubella? |
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Definition
Red/pink rash, swollen lymph glands, temperature & cold like symptoms.
It's usually a mild condition that gets better without treatment in 7 to 10 days. |
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Term
| What is the vaccination schedule for MMR? |
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Definition
First - 12-13 MONTHS
Second - 3 YEARS 4 MONTHS |
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Term
[image]
Name this condition |
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Definition
Molluscum contagiosum - viral
Can take up to 18 months or more for the condition to clear completely. |
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Term
| Symptoms of molluscum contagiosum |
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Definition
Usually, the only symptom of MC is a number of small, firm, raised papules (spots) on the skin with a characteristic small dimple in the middle. The spots aren't painful, but can be itchy.
The spots may develop in small clusters and can be spread across different parts of the body. They're most often found in the armpit, behind the knees or on the groin. |
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Term
| Do you need to stay away from work, school or nursery, or to stop doing activities such as swimming if you have molluscum contagiosum |
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Definition
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Term
| How infectious is molluscum contagiosum? |
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Definition
This virus can be spread through:
close direct contact – such as touching the skin of an infected person
touching contaminated objects – such as towels, flannels, toys and clothes
sexual contact – this includes intimate physical contact as well as sexual intercourse |
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Term
| How do you treat molluscum contagiosum? |
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Definition
Routine treatment for MC, particularly in children, is generally not recommended.
If needed for older children where spots affect quality of life:
1) liquids, gels or creams that are applied directly to the skin
2) minor procedures such as cryotherapy (where the spots are removed by freezing them) |
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Term
[image]
Name the condition |
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Definition
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Term
| What are the complications of Cellulitis? |
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Definition
Call 999 or go to A&E now if you have cellulitis with:
a very high temperature, or you feel hot and shivery
a fast heartbeat or fast breathing
purple patches on the skin
feeling dizzy or faint
confusion or disorientation
cold, clammy, pale skin
unresponsiveness or loss of consciousness
These are symptoms of sepsis, which can be very serious and potentially life threatening. |
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Term
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Definition
Flucloxacillin 500 mg four times daily (in adults) is usually given as first-line in uncomplicated infection for a WEEK.
Erythromycin 500 mg four times daily can be used if the patient is penicillin-allergic and clarithromycin (500 mg twice daily) if the patient is intolerant to erythromycin.
Clindamycin is often given as a second-line treatment, if needed
Consider co-amoxiclav if there is facial involvement. However, facial involvement is one of the possible criteria for hospital admission. |
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Term
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Definition
Cellulitis and erysipelas are infections of the skin and the tissues just below the skin surface. Erysipelas is a less serious version of cellulitis that often affects the face.
Any area of the skin can be affected but the leg is the most common site. |
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Term
[image]
Name the condition |
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Definition
| psoriasis - red, flaky, crusty patches of skin covered with silvery scales |
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Term
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Definition
| Skin cells are normally made and replaced every 3 to 4 weeks, but in psoriasis this process only takes about 3 to 7 days. The resulting build-up of skin cells is what creates the patches associated with psoriasis. |
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Term
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Definition
| The condition isn't contagious, so it can't be spread from person to person. |
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Term
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Definition
topical – creams and ointments applied to your skin
phototherapy – your skin is exposed to certain types of ultraviolet light
systemic – oral and injected medications that work throughout the entire body |
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Term
| What are the OTC treatment options for psoriasis? |
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Definition
Coal tar
GSL - Neutrogena T/Gel Therapeutic Shampoo, Alphosyl '2 in 1' Shampoo, Cocois (Coconut Oil Compound Ointment), Exorex Lotion 5% v/w
P - Capasal Therapeutic Shampoo, Psoriderm Cream, Bath Additive & Lotion Shampoo
Salicylic Acid - Capasal Therapeutic Shampoo, Cocois (Coconut Oil Compound Ointment)
Dithranol - P - Dithrocream |
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Term
| What is the age limit for Neutrogena T/Gel Therapeutic Shampoo, Alphosyl '2 in 1' Shampoo |
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Definition
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Term
| What is the age limit for Cocois? |
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Definition
12+
Children 6-12 years - To be used under medical supervision only |
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Term
| What are the complications with Dithranol use in psoriasis? |
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Definition
| The main complications of this treatment are burning and red/purple staining which is permanent on baths, bedding and clothes. Burns can be unpleasant, especially near the eyes, and expert advice is required on application. |
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Term
| Which corticosteroids can be sold OTC to treat psoriasis? |
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Definition
| None - Hydrocortisone and clobetasone are not licensed for OTC treatment of psoriasis and must not be sold for this purpose. |
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Term
| Where do corticosteroids fit into the treatment of psoriasis? |
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Definition
| Corticosteroids are not generally used for chronic psoriasis as they can cause deterioration in the condition. They may be used on prescription for scalp and flexure (creases around joints) psoriasis. |
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Term
[image]
[image]
[image]
Name the condition |
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Definition
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Term
| How is the rash in Scarlet fever usually described as? |
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Definition
| A pink-red rash comes out, which feels like sandpaper and looks like sunburn. It starts on the chest and tummy |
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Term
| What are the referral criteria for Scarlet fever? |
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Definition
Can't treat in pharmacy, must refer all patients with suspected SF.
doesn't get better in a week (after seeing the GP), especially if your child has recently had chickenpox
is ill again weeks after scarlet fever has cleared up – this can be a sign of a complication, such as pneumonia |
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Term
| How long does scarlet fever last? |
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Definition
Scarlet fever lasts for around a week
You're infectious from up to 7 days before the symptoms start and until:
24 hours after you take the first antibiotic tablet
2 weeks after symptoms start, if you don't take antibiotics |
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Term
| What are the complications of Scarlet fever? |
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Definition
Complications are rare but can include:
ear infection
throat abscess
pneumonia
meningitis
rheumatic fever |
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Term
| Is scarlet fever infectious and does the child need to stay away from school/work? |
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Definition
| Scarlet fever is very infectious and can easily spread to other people. Stay away from nursery, school, or work for 24 hours after starting antibiotic treatment. |
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Term
| What are the treatment options for scarlet fever? |
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Definition
Phenoxymethylpenicillin (penicillin V) four times a day for 10 days first line.
Amoxicillin can be prescribed for children who are unable to swallow tablets or where compliance is a concern - 50 mg/kg once a day (max 1000 mg) or 25 mg/kg (max 500 mg) twice a day for 10 days.
Azithromycin once a day for 5 days for people with penicillin allergy:
12 mg/kg (max 500 mg) for children aged 6 months to 11 years 11 months
500 mg for children aged 12 years and over and adults. |
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Term
[image]
[image]
[image]
Name the condition where the rash appears on ONE Side of the body only! |
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Definition
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Term
| What are the first signs of shingles |
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Definition
a tingling or painful feeling in an area of skin
a headache or feeling generally unwell
A rash will appear a few days later. |
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Term
| How long does shingles last? |
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Definition
It can take up to 4 weeks for the rash to heal.
Your skin can be painful for weeks after the rash has gone, but it usually settles over time.
Treatment works best if taken within 3 days of your symptoms starting. |
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Term
| Do you need to stay away from school/work if you have shingles? |
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Definition
Stay off work or school until the rash scabs.
You're only infectious to others while the rash oozes fluid. |
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Term
| What are the complications with Shingles during pregnancy? |
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Definition
If you're pregnant and get shingles, there's no danger to your pregnancy or baby.
But your GP should refer you to a specialist, as you may need antiviral treatment.
There is also no complication with antiviral treatment in pregnancy or breastfeeding. |
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Term
| Can you get shingles from someone with shingles/chickenpox? |
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Definition
You can't get shingles from someone with shingles or chickenpox.
But you can get chickenpox from someone with shingles if you haven't had chickenpox before.
When people get chickenpox, the virus remains in the body. It can be reactivated later and cause shingles if someone's immune system is lowered. |
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Term
| Is there a vaccine for shingles? |
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Definition
A shingles vaccine is available on the NHS for people in their 70s. It helps reduce your risk of getting shingles.
If you get shingles after being vaccinated, the symptoms can be much milder. |
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Term
| What are the treatment options for shingles? |
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Definition
| Antivirals - oral aciclovir, valaciclovir, or famciclovir |
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Term
| Which patient group does not require antivirall treatment for shingles? |
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Definition
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Term
| What are the treatment options for pain in shingles? |
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Definition
Paracetamol alone or with codeine and NSAID
amitriptyline (off-label use), duloxetine (off-label use), gabapentin, or pregabalin for SEVERE pain or if above not effective
Oral corticosteroids in the first 2 weeks following rash onset in immunocompetent adults with localised shingles if pain is severe, but only in combination with antiviral medication. |
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Term
1:[image]
2:[image]
3:[image]
Name the condition |
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Definition
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|
Term
Today is Friday. A mother is planning to travel to Spain this weekend with her son who's just had chickenpox and is wondering if she can use anything to calm his symptoms.
What advice would you offer? |
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Definition
take paracetamol to help with pain and discomfort
check with your airline if you're going on holiday – many airlines won't allow you to fly with chickenpox |
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Term
| Can you give ibuprofen to children with chickenpox? |
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Definition
| DON'T use ibuprofen unless advised to do so by your doctor, as it may cause serious skin infections |
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Term
| When should you refer patients with chickenpox? |
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Definition
An adult with chickenpox
Pregnant lady and haven't had chickenpox before and have been near someone with it
Weakened immune system and have been near someone with chickenpox
Newborn baby has chickenpox |
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Term
| Can chickenpox spread from person to person? |
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Definition
It's easy to catch chickenpox - You can catch chickenpox by being in the same room as someone with it.
It's also spread by touching clothes or bedding that has fluid from the blisters on it. |
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Term
| How long chickenpox is infectious for? |
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Definition
| Chickenpox is infectious from 2 days before the spots appear to until they have crusted over, usually 5 days after they first appeared. |
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Term
| How soon can you get symptoms after coming into contact with chickenpox |
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Definition
| It takes ONE to THREE WEEKS from the time you were exposed to chickenpox for the spots to start appearing |
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Term
| Are there any concerns with chickenpox in pregnancy? |
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Definition
It's rare to get chickenpox when you're pregnant, and the chance of it causing complications is low.
If you do get chickenpox when you're pregnant, there's a small risk of your baby being very ill when it's born.
Speak to your GP if you haven't had chickenpox and have been near someone with it. |
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Term
| When should you get vaccinated against Chickenpox? |
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Definition
You can get the chickenpox vaccine on the NHS if there's a risk of harming someone with a weakened immune system.
For example, a child could be vaccinated if one of their parents was having chemotherapy.
You can pay for the vaccine at some private clinics or travel clinics. It costs between £120 and £200. |
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Term
[image]
[image]
[image]
Name this condition |
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Definition
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Term
What is the name for ringworm when it is:
1) on the Scalp
2) on the Groin |
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Definition
Scalp - tinea capitis
Groin - jock itch |
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Term
| What are the treatment options for ringworm in the pharmacy? |
|
Definition
Antifungal creams
Clotrimazole: apply 2-3 times a day for at least four weeks.
Miconazole: apply twice a day and continue for 10 days after the skin is back to normal.
Econazole: apply twice a day until the skin is back to normal.
Ketoconazole: apply once or twice a day and continue for a few days after the skin is back to normal. Cannot be used for children.
Terbinafine: apply once or twice a day for one to two weeks. Cannot be used for children. |
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Term
[image]
[image]
Name the condition |
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Definition
| Scalp ringworm - Tinea Capitis |
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Term
| What is the duration of treatment with anti fugal tablets for Ringworm |
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Definition
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Term
[image]
[image]
Name this condition |
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Definition
|
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Term
| How is Lyme disease spread? |
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Definition
| Lyme disease is a bacterial infection that can be spread to humans by infected ticks. |
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Term
| When does a rash usually appear after a tick bite in Lyme disease? |
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Definition
| The rash can appear up to THREE Months after being bitten by a tick and usually lasts for several weeks. Most rashes appear within the first FOUR Weeks. |
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Term
| What points should you know about ticks?[image] |
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Definition
| Ticks don't jump or fly – they attach to the skin of animals or humans that brush past them. Once a tick bites into the skin, it feeds on blood for a few days before dropping off. |
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Term
| How do you remove a Tick safely? |
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Definition
1) Use fine-tipped tweezers or a tick-removal tool – you can buy these from some pharmacies, vets and pet shops.
2) Grasp the tick as close to the skin as possible.
3) Slowly pull upwards, taking care not to squeeze or crush the tick. Dispose of it when you've removed it.
4) Clean the bite with antiseptic or soap and water. |
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Term
| What are the treatment options for Lyme disease? |
|
Definition
For adults and children 12 years of age or older:
First-line — doxycycline 100 mg twice daily (contraindicated in pregnancy and breastfeeding), OR Amoxicillin 500 mg three times daily (off label use).
Second-line — cefuroxime axetil 500 mg twice daily.
For children younger than 12 years of age prescribe:
First line — amoxicillin
Second-line — cefuroxime axetil |
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|
Term
|
Definition
cover your skin while walking outdoors and tuck your trousers into your socks
use insect repellent on your clothes and skin – products containing DEET are best
stick to paths whenever possible
wear light-coloured clothing so ticks are easier to spot and brush off |
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Term
[image]
[image]
[image]
Name the condition |
|
Definition
| Hand, foot and mouth disease - It usually clears up by itself in 7 to 10 days. |
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|
Term
| What are the symptoms of Hand, foot and mouth disease? |
|
Definition
The first signs of hand, foot and mouth disease can be:
a sore throat
a high temperature, above 38C
not wanting to eat
After a few days mouth ulcers and a rash will appear.
Ulcers appear in the mouth and on the tongue. These can be painful and make it difficult to eat or drink
Red spots, which develop into blisters, usually appear on the hands and feet
The blisters are grey in the centre and can be painful |
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Term
| When should you refer Hand, foot and mouth disease? |
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Definition
your symptoms don't improve after 7 to 10 days
you or your child has a very high temperature, or feels hot and shivery
your child is dehydrated – they're not peeing as often as usual
you're pregnant and get hand, foot and mouth disease |
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Term
| How long does your child need to stay off school when they have Hand, foot and mouth disease? |
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Definition
Keep your child off school or nursery while they are feeling unwell.
But as soon as they're feeling better, they can go back to school or nursery. There's NO NEED to wait until all the blisters have healed. Keeping your child off for longer is unlikely to stop the illness spreading. |
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Term
| What are the complications of Hand, foot and mouth disease in pregnancy? |
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Definition
Having a high temperature during the first 3 months of pregnancy can lead to miscarriage, although this is very rare
Getting hand, foot and mouth disease shortly before birth can mean the baby is born with a mild version of it |
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Term
| What are the treatment options for a sore mouth in Hand, foot and mouth disease? |
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Definition
Lidocaine gel.
Benzydamine mouthwash or spray. The spray can be used from 6 years of age, the mouthwash from 12 years of age.
Choline salicylate gel (Bonjela®). This cannot be used in children under the age of 16 years. Pregnant women should also not use it.
Warm salty mouthwashes. |
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