OTC

Question 1

define colic and common cause of colic in infants

Answer 1

• colic - infant difficulty to digest lactose in milk.
• common in infants until the age of 4-6 months

Question 2

symptoms of colic and describe the rule of 3’s

Answer 2

• excessive and high pitched crying = red face
• excessive gas/constipation
• pulling knees to stomach
• clenched fists

Rule of 3’s
1. every 3 hours/day
2. occurs 3 days per week
3. started at 3 weeks +

Question 3

referral criteria of colic

Answer 3

1. failure to gain weight
2. inconsolable crying

referral to GP

Question 4

OTC products for colic

Answer 4

Only 1 week trial

1. Infacol = contains simeticone
   - relieve gripping pain, colic and flatulence
2. Colief = contains lactulose enzymes
   - breaks down lactose found in breast milk/bottle fed milk.
   - apply to breast or bottle directly - NOT to infant

Question 5

advice for colic

Answer 5

• breast fed = mothers to take a week trial of stopping cow’s milk/diary
• bottle fed= switch to hypoallergenic formula
• burp baby after feeds
• massage baby stomach
• hold them upright during feeds to avoid swallowing air.

Question 6

a mother shows you the scalp of her 2 month old baby. There are large, greasy yellow-brown scales which crusted over from weeping. The skin appears to be inflamed and is extending beyond the forehead.
What is the best course of action?
a. Refer to the GP for fluclox
b. baby has fungal ringworm infection: sell clotrimazole cream and chloramphenamine for itching
c. sell olive oil BP
d. sell cradle cap shampoo
e. sell hydrocortisone to tx the inflammation; it is most likely an allergic rection

Answer 6

a. Refer to the GP for fluclox
most likely to be bacterial skin infection as indicated by weeping, inflamed scalp

Question 7

referral symptoms of cradle cap

Answer 7

1. severe cradle cap on the face/body
2. swelling, scratching or bleeding = atopic eczema
3. weeping/ inflamed = may be infected, may need abx or antifungal prescribed

Question 8

what is cradle cap?

Answer 8

-infantile seborrhoeic derm
- affects before 6 months of age
- usually self-limiting = disappear after a few weeks/months
- caused: lack of hygiene or allergies

Question 9

otc products for cradle cap

Answer 9

1. baby shampoo overnight & comp with soft brush
2. olive oil BP
3. capasal shampoo : salicyclic acid, coconut oil = all ages
4. nizoral dandruff shampoo: ketoconazole = 12 yrs+

Question 10

advice for cradle cap

Answer 10

• common and harmless
• do NOT pick on the scales = may cx infection
• not contagious

Question 11

what ages are children given vaccines for MMR?

Answer 11

• at 1 year
• at 3 yrs 4 months old

Question 12

what are the early signs for measles

Answer 12

• koplik spots = white spots in the inner cheeks (buccal mucosa)
• conjunctivitis
• fever

Question 13

symptoms of measles

Answer 13

• red-brown blotching rash that starts behind ear to the face, body, trunk and limbs

Question 14

how long is measles contagious for and potential complications?

Answer 14

• 4 days
• dangerous for children illness; otitis media, pneumonia, encephalopathy

Question 15

what are the early signs of mumps

Answer 15

• fever
• headaches
• malaise

Question 16

what are the symptoms of mumps

Answer 16

• swelling of the face one side or both
  (cx: inflammation of the parotid glands)

Question 17

how long is mumps contagious for and potential complications?

Answer 17

• 5 days
• in adults risk of meningitis and sterility

Question 18

what are the early signs of rubella

Answer 18

• swollen lymph nodes

Question 19

symptoms of rubella

Answer 19

• pink macular rash - that starts on the face then spreads to the body, trunk

Question 20

how long is rubella contagious for and potential complications?

Answer 20

• 6 days
• stay away pregnant women = foetal damage

Question 21

treatment for MMR

Answer 21

• referral to urgent medical attention

Question 22

advice for MMR

Answer 22

• rest
• hydration
• avoid acidic drugs = irritate parotid glands = mumps

Question 23

what is meningitis

Answer 23

bacterial/viral infection

• meningococal bacterial infection = most dangerous = blood poisoning

Question 24

The main symptoms of meningitis

Answer 24

• stiff neck
• severe headaches
• non-blanching rash
• photophobia
• seizures

Question 25

key features of meningitis in infants

Answer 25

- refuse to feed - not responsive / floppiness - rapid breathing - difficult to wake

Question 26

referral for meningitis

Answer 26

all suspected cases require immediate hospital admission

Question 27

72 year old woman seeks treatment for white plaques located on her inner cheeks, towards the back of her throat. She has tried to scrape it off which has left a sore and red surface underneath. She also complains of a hoarse voice. She is taking the following medications QVAR inhaler and Warfarin What is the best course of action? a. sell miconazole (daktarin oral gel) b. refer to GP for nystatin c. refer to GP. She is suffering from a medication ADR d. Sell vocalzone lozenges e. Sell miconazole. encourage patient to use spacer and to rinse her mouth out after using the inhaler

Answer 27

b. refer to GP for nystatin. Pt is taking warfarin = cannot offer miconazole = increases risk of severe bleeding therefore refer to GP for nystatin

Question 28

Moses is 5yrs and has a bright red rash on his cheeks and a light pink, itchy rash on his chest, thighs and arms. His mother believes it to be allergic reaction. She mentions that he has a slight fever and been feeling poorly for a while. She believes it might be something he had eaten at a friend's baby shower a few days ago What is the best course of action? a. Sell hydrocortisone b. Sell paracetamol. Advice the mother to inform her pregnant friend to see the GP urgently c. Sell paracetamol and chlorphenamine. Advice the mother to inform her pregnant friend to see her GP urgently. d. Refer to the GP. The child is contagious e. Sell chlorphenamine

Answer 28

c. Sell paracetamol and chlorphenamine. Advice the mother to inform her pregnant friend to see her GP urgently. - Moses has an itchy rash which also requires symptomatic treatment

Question 29

differentiate between cold sores and impetigo

Answer 29

Cold sores usually occur around your mouth and consist of small blisters. Impetigo can form around your mouth but also on other parts of your face and body. It causes larger blisters