ENT + genito-urinary + blood + TB + fungal infections

Question 1

What are the different types of ENT infections?

Answer 1

Otitis externa

Otitis media

Sinusitis

Sore throat

Question 2

What is the treatment for otitis externa?

Answer 2

Flucoxacillin

Pen allergy: clarith, eryth (pregnant) OR azith

Pseudomonas suspected: ciprofloxacin OR aminoglycoside

Question 3

What is the treatment for otitis media?

Answer 3

First line: amox

Symptoms worsen after 2/3 days: co-amox

Pen allergy: clarith OR eryth (pregnant)

Question 4

What is the treatment for sinusitis?

Answer 4

First line: Phenoxymethylpenicillin

Symptoms worsen after 2/3 days: co-amox (also first line if systemically unwell)

Pen allergy: clarith OR eryth (pregnant) OR doxy

Question 5

What is the treatment for sore throat?

Answer 5

First line: Phenoxymethylpenicillin 5-10 days
Pen allergy: clarith OR eryth (pregnant) - 5 days

Question 6

Give examples of genitourinary infections

Answer 6

Chlamydia (Chlamydia trachomatis)
Bacterial vaginosis
UTI (E coli)

Question 7

What is the treatment for chlamydia?

Answer 7

First line: doxycycline

Alt: azith 1g 1 day and 500mg 2 days

Question 8

What is the treatment for bacterial vaginosis?

Answer 8

First line: metronidazole 2g - single dose OR 400 to 500mg BD - 5 to 7 days

Alt: topical clindamycin - 7 days or metronidazole - 5 days

Question 9

What is the treatment for lower UTI?

Answer 9

Female: 3 days, Male: 7 days

First line: trimethoprim OR nitrofurantoin

Second line in females (no improvement >48H): nitrofurantoin, fosfomycin, pivmecillinam

No improvement for men: consider alt diagnosis (kidney infection/prostatitis)

Question 10

What is the treatment for lower UTI for pregnant women?

Answer 10

pregnant: 7 days

• First line: nitrofurantoin
• Alt: amox OR cefalexin

Question 11

What are the symptoms for septicaemia?

Answer 11

Slurred speech
Extreme shivering
Passing no urine
Severe breathlessness
It feels like you going to die
Skin mottled

Question 12

What is the treatment for community septicaemia?

Answer 12

Antipseudomonal penicillin (ticarcillin/piperacillin)
OR cephalosporin

Question 13

What is the treatment for hospital septicaemia?

Answer 13

Antipseudomonal beta lactam

• MRSA suspected ADD vancomycin
• Anaerobic bacteria ADD metronidazole

Question 14

What are the symptoms of TB?

Answer 14

Cough 3+ weeks
Weight loss
Night sweats or fever
Loss of appetite
Neck swelling

Question 15

What is the treatment for TB?

Answer 15

2RIPE 4RI

→ Initial: 2M
→ Continuation: 4M

Rifampicin

Isoniazid

Pyrazinamide

Ethambutol

Question 16

Rifampicin

Answer 16

Enzyme inducers interacts w hormonal contraceptives

Counselling: report signs of liver disorder

Colour bodily fluids orange

Question 17

Isoniazid

Answer 17

Peripheral neuropathy: take with pyridoxine

Counselling: report signs of liver disorder, avoid tyramine + histamine rich food

Question 18

Pyrazinamide

Answer 18

Report signs of liver disorder

Question 19

Ethambutol

Answer 19

Stop med + Report any visual deterioration

Question 20

Examples of triazoles

Answer 20

Fluconazole (rash, enzyme inhibitor)

Itraconazole (enzyme inhibitor, HF, hepatotoxicity, interacts w antacids - RED absorption)

Voriconazole (phototoxicity; hepatotoxicity)

Question 21

Examples of imidazole

Answer 21

Clotrimazole (thrush)

Ketoconazole (hepatotoxicity, enzyme inhibitor)

Miconazole (enzyme inhibitor)

Question 22

Terbinafine

Answer 22

choice of oral drug in nail, hepatotoxicity, rash