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Most acute cases caused by respiratory virus.
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-
Rest at home including voice rest (best treatment).
-
Avoid talking, use voice sparingly (hoarseness lasts 3–14 d).
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Use warm sialogogues (e.g. hot lemon drinks).
-
Avoid whispering.
-
Drink ample fluids, especially water.
-
Avoid smoking and passive smoke.
-
Use steam inhalations (5 mins tds).
-
Humidity helps, esp. hot steamy showers.
-
Use cough suppressants, esp. mucolytic agents.
-
Use simple analgesics, e.g. paracetamol or aspirin.
++
All Australians should have a blood level <10 mcg/dL. Levels above this are associated with adverse nevrocognitive defects.
++
Children at risk of elevated blood lead:
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aged 9–48 mths living in or visiting older houses with peeling paint
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those with pica
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those living in lead-contaminated areas (e.g. heavy traffic, battery breaking yards)
++
++
++
Consider lead toxicity in children presenting with developmental delay or behaviour problems and in those with unexplained iron-deficiency anaemia. Active management needed if blood level is >40 mcg/dL (15 g/dL). Treatment involves chelation with Calcium Disodium Edetate, succimer or dimercaprol in hospital. Penicillamine or succimer are oral preparations which can be used.
++
+++
Spinal causes of leg pain
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Problems originating from the spine are an important, yet at times complex, cause of pain in the leg. Important causes are:
++
-
nerve root (radicular) pain from direct pressure, esp. sciatica (L4–S3)
-
referred pain from:
-
spinal canal stenosis causing claudication
+++
Vascular causes of leg pain
+++
Occlusive arterial disease
+++
Acute lower limb ischaemia
++
Sudden occlusion whether by embolism or thrombosis is a dramatic event which requires immediate diagnosis and management to save the limb.
+++
Signs and symptoms—the 6 Ps
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-
Pain
-
Pulselessness
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Pallor
-
Paralysis
-
Paraesthesia or numbness
-
‘Perishing’ cold