Corrections

Question 1

How long should post-exposure prophylaxis for HIV be continued?

Answer 1

4 weeks

Question 2

What is Q fever caused by?

Answer 2

Coxiella burnetti

Question 3

Who is Q fever typically seen in?

Answer 3

Farmers (typically from sheep/cattle)

Question 4

Features of Q fever?

Answer 4

1) Fever

2) Transaminitis (deranged LFTs)

3) Atypical pneumonia

4) Endocarditis (culture-negative)

Question 5

Mx of Q fever?

Answer 5

Doxycycline

Question 6

Mx of trichomonas vaginalis?

Answer 6

Metronidazole

Question 7

Severe hepatitis in a pregnant woman?

Answer 7

Think hep E

Question 8

In what 3 scenarios are prophylactic abx given for bites?

Answer 8

1) A human bite that has drawn blood or broken the skin in a high-risk individual

2) A cat bite that has drawn blood or appears to be deep

3) A dog bite that has caused considerable tissue damage or is contaminated

Question 9

What is used for propyalxis of animal bites?

Answer 9

3d course of co-amoxiclav

Question 10

What bacteria causes typhoid?

Answer 10

Salmonella typhi

Question 11

Features of typhoid?

Answer 11

1) initially systemic upset: headache, fever, arthralgia

2) relative bradycardia

3) abdominal pain, distension

4) constipation: although Salmonella is a recognised cause of diarrhoea, constipation is more common in typhoid

5) rose spots: present on the trunk

Question 12

Can legionella pneumonia cause deranged LFTs?

Answer 12

Yes

Question 13

What can be used to treat Chlamydia in pregnancy?

Answer 13

Azithromycin, erythromycin or amoxicillin

Question 14

Mx of tetanus?

Answer 14

1) supportive therapy including ventilatory support and muscle relaxants

2) IM human tetanus immunoglobulin for high-risk wounds

3) metronidazole is abx of choice

Question 15

Mx of women with a suspected UTI if associated with visible or non-visible haematuria?

Answer 15

Abx plus send an MSU

Question 16

Mx of rabies post-exposure?

Answer 16

give immunglobulin + vaccination

Question 17

Mx of legionella?

Answer 17

Macrolides e.g. clarithromycin

Question 18

Mx of mastitis?

Answer 18

1) Continue breastfeeding

2) Simple measures:
- analgesia
- warm compresses

3) Abx if no improvement (flucloxacillin)

Question 19

Length of abx course in mastitis?

Answer 19

10-14d

Question 20

Can breast feeding continue duriing abx treatment in mastitis?

Answer 20

Yes

Question 21

What Abx are indicated in non-lactational mastitis?

Answer 21

Broad spectrum e.g. co-amoxiclav or erythromycin/clarithromycin + metronidazole

Question 22

Most commonly implicated bacteria in breast abscess?

Answer 22

Staph. aureus

Question 23

Can a breast abscess cause systemic features?

Answer 23

Yes e.g. fever, chills, tachycardia, malaise, fatigue

Question 24

Though commonly seen in lactating women, abscesses can also present in non-lactating women.

What are some predisposing factors?

Answer 24

Nipple piercings, diabetes, immunosuppression

Question 25

Diagnostic investigation for breast abscess?

Answer 25

Culture of needle aspirate (can help guide abx)

Question 26

Give a key differential for a breast abscess?

Answer 26

Galactocele

Question 27

1st line mx of a breast abscess?

Answer 27

1) Smaller abscess (<5cm) –> Needle aspiration of the abscess

2) Larger abscess –> Surgical incision & drainage w/ washout

3) Adjuvant abx treatment (flucloxacillin)

Question 28

Which anti-TB drug is an indiciation for visual monitoring?

Answer 28

Ethambutol –> can cause optic neuritis

Question 29

What feature of C. diff makes it particularly hard to kill?

Answer 29

Spore formation

C. difficile spores are resistant to many environmental stresses, including heat, disinfectants, and antibiotics, which makes them particularly difficult to eliminate. These spores can persist on surfaces for months, making them a significant source of transmission in healthcare settings.

Question 30

What is leptospirosis?

Answer 30

Leptospirosis is caused by the spirochaete Leptospira interrogans, classically being spread by contact with infected rat urine.

Question 31

Who is at risk of leptospirosis?

Answer 31

sewage workers, farmers, vets or people who work in an abattoir

Question 32

1st line mx of erysipelas?

Answer 32

Flucloxacillin

Question 33

What causative organism of meningitis stains with India ink?

Answer 33

Cryptococcus neoformans

Question 34

Mx of a tetanus prone wound in patients with an uncertain tetanus vaccination history?

Answer 34

Booster vaccine + immunoglobulin

Question 35

Which cause of pneumonia can cause immune-mediated neurological diseases?

Answer 35

Mycoplasma

Question 36

Mx of patients who are immunosuppressed 2ary to long-term steroids or methotrexate if they are exposed to chickenpox and have no antibodies to varicella?

Answer 36

Test for varicella antibodies and give VZIG if no antibodies

Question 37

What vaccines should patients with hyposplenism have?

Answer 37

1) pneumococcal
2) Hib
3) meningococcal type C

Question 38

Discharge in gonorrhoea vs chlamydia?

Answer 38

Discharge from chlamydia is usually clear or milky, while discharge from gonorrhoea tends to be thicker and can be yellow, white, or green

Question 39

Mx of immunocompromised patients with toxoplasmosis?

Answer 39

Pyrimethamine + sulphadiazine

Question 40

What are 2 options for prophylaxis of meningococcal meningitis for contacts of patients?

Answer 40

Oral ciprofloxacin or oral rifampicin

Question 41

When may oral rifampicin be used instead of ciprofloxacin in prophylaxis of meningococcal meningitis?

Answer 41

E.g. history of tendon rupture

Question 42

Mx of human bites?

Answer 42

Co-amoxiclav (like animal bites)

Question 43

Mx of pneumonia caused by atypical pathogens?

Answer 43

Clarithromycin

Question 44

Mx of exacerbation of chronic bronchitis?

Answer 44

Amoxicillin or clarithromycin