Anti-Microbial

Question 1

Acute cellulitis

Answer 1

s
Rx
1. Tab. AMOXICILLIN + CLAVULANIC ACID (500 mg+125 mg) per oral after
food three times a day for 7 days
2. Tab. PARACETAMOL 500 mg per oral after food three times a day till fever
subsides, after that one tablet SOS
ADVICE:
➢ Regular Cleaning and Dressing
➢ Drink Plenty of water
➢ Keep the Limb elevated

Question 2

Varicella zoster infection

Answer 2

Rx
1. Tab. ACYCLOVIR 800 mg per oral after food five times a day for 7 days
2. Tab. PARACETAMOL 500mg per oral after food when required

Question 3

Bilateral enlarged and congested tonsils

Answer 3

1. Tab. AMOXICILLIN + CLAVULANIC ACID (500 mg +125 mg) per oral after food
   three times a day for 7 days
2. Tab. PARACETAMOL 500mg per oral after food three times a day for 3days
   ADVICE:
   ➢ Saline gargle
   ➢ Review after one week

Question 4

Community acquired pneumonia

Answer 4

1. Tab. CEFPODOXIME 200 mg per oral after food two times a day for 7 days
2. Tab. CLARITHROMYCIN 500mg per oral after food two times a day for 7 days
   ADVICE:
   ➢ Monitor vital signs – RR, HR, BP, and O2 saturation
   ➢ Maintain good hydration, review after 5 days

Question 5

28. ENTERIC FEVER IN 36-YEAR-OLD PREGNANT LADY

Answer 5

1. Inj. CEFTRIAXONE 2 g IV twice daily for 2 days followed by 1 g IV twice daily
   till 2 days after fever subsides
2. Tab. PARACETAMOL 500mg SOS till fever subsides
   ADVICE:
   ➢ Plenty of fluid intake
   ➢ Avoid drinking untreated water
   ➢ Avoid stray foods
   ➢ Prefer to eat hot foods
   ➢ Tepid sponging

Question 6

29. A 6-YEAR-OLD CHILD WITH TYPHOID FEVER

Answer 6

Inj. CEFTRIAXONE 75mg/kg/day (maximally 2 g/day two times a day until defervescence)
and continued 75 mg/kg per day for 5 days.
2. Tab. PARACETAMOL 250mg SOS till the fever subsides
ADVICE:
➢ Plenty of fluid intake
➢ Avoid drinking untreated water
➢ Avoid stray foods
➢ Prefer to eat hot foods
➢ Tepid sponging

Question 7

30. AMOEBIC DYSENTERY.

Answer 7

Rx:
1.Tab. METRONIDAZOLE 800 mg per oral after food three times a day for 10 days
2. Tab. DILOXANIDE FUROATE 500 mg per oral after food three times a day for 10 days
ADVICE:
 Follow adequate hand hygiene/ sanitation measures
 Maintain hydration
 Maintain good food hygiene

Question 8

31. ACUTE ATTACK OF PLASMODIUM VIVAX MALARIA.

Answer 8

1.Tab. CHLOROQUINE 150 mg 4 tabs stat followed by 2 tablets (300mg) after 8 hours,
2 tablets (300mg) for next 2 days
2. Tab. PRIMAQUINE 15mg once daily for 14 days
ADVICE:
Review after 2 weeks

Question 9

ACUTE ATTACK OF CHLOROQUINE RESISTANT FALCIPARUM MALARIA

Answer 9

Rx
1.Tab. ARTESUNATE 100 mg twice daily for 3 days
2. Tab. SULFADOXINE 1500mg + PYRIMETHAMINE 75 mg single dose after food on
day 1
3. Tab. PRIMAQUINE 45mg single dose on day 2 after food

Question 10

33.Mr. Joseph Varghese, planning a travel to an area which is endemic for Malaria,
has come seeking medical advice. What will you prescribe?

Answer 10

Rx:
1. TAB. CHLOROQUINE PHOSPHATE, loading dose of 600 mg base (4 tablets) to be
started one week before journey and 300 mg base (2 tablets) per week until one month after
return from endemic area

Question 11

URINARY TRACT INFECTION DUE TO PSEUDOMONAS

Answer 11

Rx:
1. Tab. CIPROFLOXACIN 500 mg per oral after food two times a day for 7 days
2. Tab. PARACETAMOL 500 mg per oral after food three times a day for 3 days
3. Syrup. DISODIUM HYDROGEN CITRATE 30 ml diluted with 250 ml of
water after food four times a day for 3 days
ADVICE:
➢ Drink Plenty of water
➢ Review after one week

Question 12

35. A 22 YEAR OLD 20 WEEKS ANTENATAL FEMALE WITH UTI

Answer 12

Rx:
1. Tab. CEPHALEXIN 500 mg per oral after food four times a day for 7 days
2. Tab. PARACETAMOL 500 mg per oral after food three times a day till fever
subsides, after that one tablet SOS
ADVICE:
➢ Plenty of fluid intake
➢ Review after one week

Question 13

36. HOOKWORM INFESTATION

Answer 13

Rx:
1. Tab. ALBENDAZOLE 400mg one tablet as a single dose per oral after food at
bedtime
2. Tab. FERROUS SULPHATE 200mg per oral two hours after food two times a
day for 30 days (Check Hb level, Iron is needed if there is anemia)
ADVICE:
 Avoid walking on barefoot
 Follow adequate hand hygiene/ sanitation measures
 Consume iron, vitamin, and protein-rich food
 Review after one month
Follow up
If symptoms persist:
i) Check Hb Level
ii) PCV
iii) Stool examination - If positive for hookworm ova repeat another dose of albendazole

Question 14

37. ORAL CANDIDIASIS

Answer 14

Rx:
1. CLOTRIMAZOLE mouth paint 1% locally 2-3 times a day for 7-10days
If not resolving,
2. Tab. FLUCONAZOLE 200 mg orally once, then 100 mg orally once daily for 7 to 14 days

Question 15

38. MUCORMYCOSIS

Answer 15

After assessing the extent of the disease, do surgical debridement
2. 0.9% NORMAL SALINE 500ml IV infusion, before starting amphotericin B
3. Inj. LIPOSOMAL AMPHOTERICIN B 5 mg/kg/day, dilute in 200 cc 5% dextrose over
2-3 hours infusion (avoid slow escalation) for 3 to 6 weeks
4. Tab. POSOCONAZOLE delayed-release tablet 300mg twice a day on the first day
followed by 300mg once a day for 3 to 6 months
General measures:
 Maintain hydration
 Control underlying diseases such as DM
 Monitor renal function and k level
 Monitor patients clinically, microbiologically, and radio imaging for response/ disease

Question 16

39.COVID -19 INFECTION WITHOUT CT CHANGES IN LUNG

Answer 16

Rx:
1. Tab. PARACETAMOL 500mg per oral SOS
2. Inj. TOCILIZUMAB 4-6mg/kg in 100ml NS over 1 hour (single dose)
ADVICE:
 Hydration
 Salt water gargling
 Mask use
 Isolation, and quarantine for 17days

Question 17

40.COVID -19 INFECTION WITH CT CHANGES IN LUNG

Answer 17

G
Rx
1.Oxygen 3L/min
2. Tab. PARACETAMOL 500mg per oral SOS
3. Inj. DEXAMETHASONE 6mg/ day IV for 5 to 10 days or until discharge, whichever is
earlier
4.Inj.REMDESIVIR 200 mg diluted in 100 ml of Normal saline IV for 30 minutes on day 1
followed by 100 mg IV Once daily for next 4 days
5. Inj. ENOXAPARIN 0.5mg/kg/dose Subcutaneously twice daily for 14 days
6. Inj. TOCILIZUMAB 4-6mg/kg in 100ml Normal saline over 1hour (single dose)
General measures:
 Clinical Monitoring: Work of breathing, Hemodynamic instability, Change in oxygen
requirement
 Serial CXR; HRCT chest to be done only if there is worsening of symptoms
 Lab monitoring: CRP, D-dimer, blood sugar 48 to 72 hrly; CBC, KFT, LFT 24 to 48