GP exam Medication practice

Question 1

ABx for periorbital cellulitis?

Answer 1

1) Flucloxacillin (12.5mg/kg) 500mg QID 7 days
2) Cefalexin 500mg (12.5mg/kg) QID 7 days (in kids for flavour)
3) Clindamycin 450mg TDS 7 days (for penicillin hypersensitivity)

Question 2

Shingles antiviral?

Answer 2

Valaciclovir 1g TDS 7 days

Famciclovir 500mg TDS for 7 days

Question 3

Acute migraine treatment?

Answer 3

1) metoclopramide 10mg stat
2) aspirin 600 - 1000mg stat
3) if no resolution Eletriptan 40mg

Question 4

Steroid cream options? (low, moderate, high)

Answer 4

hydrocortisone 1%
triamcinolone 0.02%
Betamethasone diproprionate 0.05%

Question 5

Strep throat PO Abx?

Answer 5

Phenoxymethyl penicillin 15mg/kg Max 500mg BD 10 days

Question 6

CAP Abx?

Answer 6

1) Amoxicillin 1g TDS 5 days or Cefuroxime 500mg BD

2) Doxycycline 100mg BD for duration or Clarithromycin 500mg BD

Question 7

ABx for otitis media?

Answer 7

1) Amoxicillin15mg/kg max 500mg 8 hourly for 5 days (or 30mg/kg BD)

if not improving after 3 days use augmentin Duo Forte

if chronic otorhoea add ciprfloxacin 0.3% drops 5 drops BD until no discharge for 3 days

If penicillin sensitive
cefuroxime 15mg/kg max 500mg BD for 5 days

Question 8

ABx for UTI?

Answer 8

Women:

1) Trimethoprim 300mg nocte for 3 days
2) Nitrofurantoin 100mg QID for 5 days
3) Cefalexin 500mg BD for 5 days

Men:
Same as above but for 7 days instead

Question 9

ABx for sinusitis?

Answer 9

1) Amoxicillin 500mg TDS for 5 days
if not improving after 5 days
2) Augmentin duo forte 875/125mg BD for 5 days

Question 10

Clostiridium Difficile management?

Answer 10

1) Metronidazole 400mg TDS for 10 days
if no improvement after 5 days
change to
2) Vancomycin 125mg QID for 10 days

Question 11

Odontogenic infections Abx?

Answer 11

Avoid Abx until after dental intervention ideally.
1) Augmentin duo forte 875/125mg BD for 5 days
or
2) Metronidazole 400mg TDS for 5 days AND phenoxymethylpenicillin 500mg QID for 5 days

*clindamycin 300mg TDS as penicillin alternative

Question 12

Cellultis ABx?

Answer 12

Erysepelas
Phenoxymethylpenicillin 500mg QID 5 days

Cellulitis
No purulent - Phenoxymethylpenicillin 500mg QID 5 days
purulent or suspected MSSA 
1) Flucloxacillin 500mg QID 5 days
2) Cefalexin 500mg QID 5 days

if MRSA
Bactrim BD for 5 days

Question 13

COPD infective exacerbation ABx?

Answer 13

1) Amoxicillin 1g BD for 5 days OR 500mg TDS (lower doses required than pneumonia)
2) Doxycycline 100mg daily for 5 days
NEVER augmentin duo forte

Question 14

Fungal treatment?

Answer 14

Tinea
1) Topical
Terbinafine 1% BD for 2 weeks
Clotrimazole 1% BD for 2 weeks (vaginal candida)
Nystatin 100000 unit/g cream BD for 2 weeks (vaginal candida)

Pityriasis versicolour
Ketoconazole 2% shampoo - topically to wet skin leaving for 10minutes then wash off - for 5 days

2) Oral
Terbinafine 250mg daily 
-skin 4 weeks
-scalp 6 weeks
-fingernails 6 weeks
-toenails 12 weeks
-monitor LFT 4 weekly

Fluconazole

• skin 150mg weekly for 6 weeks
• nails 150 - 300mg weekly for 3 - 6 months
• monitor LFT 4 weekly
• pityriasis versicolour 400mg single dose

Oral Candida
Nystatin 100000 unit/ml 1ml QID after meals or 2 weeks
Amphoteracin B lozenge 1 QID after meals for 2 weeks

Question 15

Helicobacter Pylori initial Treatment?

Answer 15

PPI BD
Amoxicillin 1g BD
Clarithromycin 500mg BD
for 7 days

• if penicillin allergy then use Metronidazole 400mg BD instead of amoxicillin