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PHRM4012 Questions with Detailed Verified Answers
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Quiz: Bee Sting Background
Ans: Most insect bites and stings result in a localised itch and swelling that
settles within a few days.
Severe allergic reactions (anaphylaxis) to insects are usually due to bees,
wasps or the Australian Jack Jumper ant.
Insect stings are the second most common cause of anaphylactic reactions,
with the majority of them associated with hymenoptera venoms (wasps,
bees, ants, and saw flies) and fire ant stings.
Insect bites are a less common cause of anaphylaxis than insect stings.
Allergies to venoms from stinging insects (bees, wasps and ants) are one of
the most common causes of severe allergic reactions (anaphylaxis) in
Australia. Allergy to one type of stinging insect does not usually increase the
risk of an allergic reaction to another.
The Honey Bee is the most common cause of allergic reactions to insects in
Australia.
Quiz: Bee Sting Symptoms
Ans: Instant, sharp burning pain at the sting site.
A red welt at the sting area.
Slight swelling around the sting area.
Quiz: Bee Sting Differential Diagnosis
Ans: Scabies
Allergic contact dermatitis
18:36:59
,Quiz: Bee Sting Referral Points
Ans: Signs of anaphylaxis include:
Difficult/noisy breathing
Swelling of tongue
Swelling/tightness in throat
Wheeze/persistent cough
Difficulty talking and/or hoarse voice
Persistent diiness or collapse
Pale and floppy (young children)
Abdominal pain and vomiting are normally symptoms of mild allergic
reaction though for insect bites/stings these are a sign of anaphylaxis.
(see ASCIA action plan)zz
Quiz: Bee Sting Pharmacological Management
Ans: Treat the itch with:
Corticosteroid cream - hydrocortisone 1% suitable choice
Clobetasone available OTC but not for children under 12 years
Pinetarsol solution or Soov (lignocaine , cetrimide), Eurax (crotamiton)
Oral non-sedating antihistamine (e.g. fexofenadine, loratadine) to reduce
the severity and duration of the reaction
Very large and uncomfortable local reactions may sometimes need
cortisone tablets to settle the swelling - Refer
Quiz: Bee Sting Non- Pharmacological Management
Ans: Review for signs of severe reaction
Remove the sting as it will continue to discharge venom until it is empty, DO
NOT SQUEEZE as this will release more venom.
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,Place the edge of a knife, credit card or a fingernail next to the embedded
sting and scrape across the skin surface to remove the sting
Treat as per any other insect sting
Clean the area (soap and water or disinfectant)
Apply ice pack (no more than 15minutes at a time) to relieve pain and
swelling
Quiz: Bee Sting Prevention
Ans: Food and flavoured drinks in cans, bottles, and straws can be an
unsuspected source of a sting to the tongue or throat.
Use an effective insect repellent, preferably containing DEET
Avoid times when insects are out
Avoidance of wearing brightly coloured clothes is of uncertain benefit.
Quiz: Chicken Pox Background
Ans: A highly contagious viral disease spread by respiratory secretions,
including aerosol transmission, or from the vesicle fluid of the skin lesions
Outbreaks more common in winter and early spring
The average incubation period is 14 to 16 days (range 10 to 20 days)
The period of infectivity is from 48 hours before the onset of rash until crusting
of all lesions has occurred
Children usually immunised at 18 months
Quiz: Chicken Pox Complications
Ans: Complications of chickenpox:
Scarring - chickenpox can leave pockmark scars on the skin
Avoid scratching, use cotton gloves
Cellulitis - a type of bacterial infection of the skin
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, Pneumonia - infection and inflammation of the lung can occur in adults and
can be fatal
Encephalitis - inflammation of the brain, usually mild, but sometimes severe
Bleeding disorders - rare, but can be fatal
Quiz: Chicken Pox Symptoms
Ans: Malaise, low grade fever, headache, runny nose and cough
Rash with small blisters, usually starts on the body progressing to head and
limbs
Rash is very itchy
Rash appears as small blisters surrounded by irregularly-shaped patches of
inflamed skin known as 'dew drop on a rose petal'
The blisters may burst and develop crusts
Blisters or ulcers may develop in mouth
Quiz: Chicken Pox Differential Diagnosis
Ans: Measles - Rash appears around ears and face and progresses to trunk
and limbs; fever; No swollen glands and cold-like symptoms
German Measles (Rubella) - Rash starts on face and quickly progresses to
trunk; No fever; swollen glands; cold-like symptoms
Meningitis - Rash on trunk and limbs; Fever; Lethargy; stiff neck; No swollen
glands; No cold-like symptoms
Glandular Fever - Rash on trunk; Fever; Swollen glands; Malaise; Headache;
No cold-like symptoms
Molluscum Contagiosum - Rash on face and axillae; No other symptoms
Impetigo - Rash on facial area especially around nose and mouth; No other
symptoms
Erythema infectiosum - Rash on face before moving to arms and legs; Cold-
like symptoms
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