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Headache

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Tension headache

Tightness on both sides of the head

Stress-related

A trial of Tylenol or Ibuprofen

Migraine

Often affect just 1 side of the head, pounding or throbbing

Nausea, vomit, sensitive to light and sound

Recommend to lie down in a cool, dark, quiet room

Cluster

Male dominant, tearing

See a doctor immediately

1. "the worst headache of your life"

2. Fever with neck stiffness

3. Weakness, numbness, or trouble seeing

Doctors may ask:

duration, severity, quality of the headache, unilateral or bilateral, nausea/vomit, sensitive to light, etc

Dizziness

image333

Vertigo

1. With the room spinning

2. If positional related, the patient could try maneuver supervised by a doctor

3. If associated with ear symptoms, check with an ENT doctor

4. If not able to point precisely to the target, check with a neurologist

Cardiogenic

1. If associated with low BP, check for black/bloody stool, get adequate hydration and re-check BP

2. 

Others

others

Pink eye

image334

Conjunctivitis

1. No vision loss

2. Can be virus, allergy or bacterial

3. Check with family doctor for differential

Cornea infection

1. Vision loss, pain, fear of light

2. Check with an eye doctor for treatment ASAP

Eyeball infection

1. Vision loss, pain, fear of light

2. Check with an eye doctor for treatment ASAP

3. May need to check immune disease

Foreign body

1. Adequate saline/Tap water irrigation

2. Check with an eye doctor for treatment ASAP

Nose bleeding

image335

1. Lean forward, not back

2. Pinch the patient's nose for 5-10 min, below the bony bridge but not nostrils. Make sure you can still breathe while holding the nose.

3. Cold pack over the bridge of the nose can constrict the blood vessels

4. Don’t blow nose after successfully stop bleeding

Rhinitis

image336

Non-allergic Rhinitis

  • Nasal congestion (stuffiness), rhinorrhea, and postnasal drainage
  • Onset at a later age
  • Triggers including irritant odors and strong fragrances, air pollution or temperature changes
  • Absence of nasal and ocular itching and prominent sneezing
  • Treatment, an intranasal spray of antihistamine or steroid (Afrin, Flonase, etc) or pseudoephedrine. Daily nasal saline irrigation is a helpful adjunctive therapy

Allergic Rhinitis

  • in development

Ear pain

image337

Otitis Media (Eardrum infection)

1. Affect the hearing

2. Need to check if any perforation

3. Usually needs antibiotic

Otitis Externa (Ear Canal Infection)

1.  Normal hearing but tender to touch

2. Mild: try ear drop of antibiotic

3. Severe: oral antibiotic 

Hearing damage

image338

Cerumen Impaction

1. A trial of Debrox at home

2. Ear lavage if no improvement

Sudden deafness

1. Some are self-limited

2. Check with ENT doctor ASAP

Dental pain

image339

Cavity

Try ibuprofen and make appointment with dentist

Dental abscess

Need antibiotics together with ibuprofen

Sore throat

image340

1. Tell the doctor if you have a fever, neck pain and cough

2. Having cough lower to risk to have a strep throat

3. Do a rapid strep test, taking antibiotics if strep positive

4. Adequate hydration and good rest if negative



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