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PRP Mock Papers Questions > Infection > Flashcards

Infection Flashcards

1
Q

Tetracycline can be used in children under 12 years old - TRUE/FALSE

A

FALSE - C/I in Children under 12 years (deposition in growing bone and teeth, by binding to calcium, causes staining and occasionally dental hypoplasia)

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2
Q

Abx broad spectrum and has resistance to strains in pneumonia

A

Co-amoxiclav

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3
Q

Treatment C.Diff

A

mild-moderate: PO Metronidazole 400-500mg TDS for 10-14 days.
Severe: PO Vancomycin 500mg QDS 10-14 days.

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4
Q

Drugs that can cause Diarrhoea

A 
Abx
Acarbose
Biguanides
Bile salts
Colchicine
Cytotoxics
Dipyridamole
Iron preparations
Laxataives
Leflunomide
magnesium preparations
Metoclopramide
Misoprostol
NSAIDs
Olsalazine
Orlistat
PPI
Ticlopinide
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5
Q

Treatment UTI - non-pregnant pt

A

Ibuprofen and paracetamol for pain
1st line:
- Nitrofurantoin 50mg QDS or 100mg M/R BD for 3 days if eGFR above 45
- OR Trimethoprim 200mg BD for 3 days
2nd line: No improvement after 48 hrs or unavailable 1st line
- Nitrofurantoin 100mg M/R BD (or 50mg QDS) for 3 days if eGFR above 45
- Pivmecillinam 400mg STAT then 200mg BD for 3 days
- Fosfomycin 3g STAT

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6
Q

Treatment UTI - pregnant pt

A

1st line:
- Nitrofurantoin 100mg M/R BD (or 50 mg QDS) for 7 days if eGFR above 45 - avoid at term
2nd line: failure 1st line after 48 hrs or unavailable
- Amoxicillin 500mg TDS for 7 days (only if culture av and susceptible)
- Cefalexin 500mg BD for 7 days

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7
Q

treatment oral candidiasis

A
  1. miconazole oral gel 2.5ml QDS 7 days then 7 days after resolved
  2. Nystatin suspension 1ml 7 days, continue 2 days after resolved
  3. fluconazole capsule 50/100 mg OD 7-14 days
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8
Q

isoniazid in renal impairment

A

increased risk of ototoxicity and peripheral neuropathy - pyridoxine hydrochloride (B6) recommended

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9
Q

Notifiable diseases

A 
Antrax
Cholera
Diarrhoea (infectious bloody)
Diphteria
encephalitis (acute)
food poisonning
hepatitis viral 
legionnaire's disease
leprosy
malaria
measles
meningitis
meningococcal speticaemia 
mumps
paratyphoid fever
plague
rabies
rubella
SARS
scarlet fever
smallpox
streptococcal disease (grp A invasive) 
tetanus 
tuberculosis
typhoid fever
typhus
whooping cough
yellow fever
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10
Q

Mefloquine BNF

A

for treatment/prophylaxis of malaria
AVOID if hx of psychiatric disorder - associated with potential serious psychiatric disorders(inc suicidal ideation and suicide) - continues for month after cessation due to long half-life - if s+s DISCONTINUE IMMEDIATELY
S/E: psychiatric and GI upset
X in pt allergic to quinine
avoid mosquito bites, take regularly, visit dr if ill within 1 year or 3 mths of coming back from country with malaria

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11
Q

causative agent for community-acquired pneumonia

A

s. pneumoniae

h. influenza are 2 most common

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12
Q

treatment CAP

A

1st: amoxicillin 500mg TDS 5 days
2nd: doxycycline, clarithromycin, erythromycin

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13
Q

Upper resp Infections

A

1 - phenoxymethylpenicillin 500mg QDS or 1000 mg BD for 5-10 days
2- PEN ALL: Clarithromycin 250mg to 500mg BD 5 days
OR
PREGOS: Erythromycin 250mg to 500mg QDS or 500mg to 1000 mg BD 5 days

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14
Q

Scarlet fever

A

1- phenoxymethylpenicillin 500mg QDS 10 days
2- PEN ALL: Clarithromycin 250-500mg BD

Optimise analgesia + safety netting advice

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15
Q

Acute otitis media

A

IF SYSTEMICALLY UNWELL -give according to age, for 18+:
1- Amoxicillin 500mg TDS 5-7 DAYS
PEN ALL: CLARITHROMYCIN 250-500MG BD 5-7 days
PREGO: Erythromycin 250-500mg QDS or 500-1000mg BD 5-7 days
2nd line if first line after 2-3 days of no improvement:
Co-amoxiclav: 625mg TDS 5-7 days

GIVE APPROPRIATE ANALGESIA

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16
Q

Acute otitis externa

A

1st: Analgesia and apply localised heat (hot flannel)
2nd: topical acetic acid 2% 1 spray TDS 7 days
OR
Topical neomycin suplhate with corticosteroids 3 drops TDS 7-14 days

IF CELLULITIS: REFER + Flucloxacillin 250mg QDS 7 days or 500 mg QDS if severe

17
Q

Sinusitis

A

Symptoms 10 days or less: no ABX
No improvement >10 days: consider use of high doss nasal corticosteroids (X IN UNDER 12)

IF SYSTEMICALLY V.UNWELL:
1- Phenoxymethylpenicillin 500mg QDS 5 days
2nd line: co-amox 625mg TDS 5 days

PEN ALL: DOXYCYCLINE 200mg STAT then 100mg OD next day for 5 days (X UNDER 12)
OR
Clarithromycin 500mg BD 5 DAYS
or
PREGGO: Erythromycin 250-500mg QDS or 500-1000mg BD 5 days

18
Q

Acute exacerbation COPD

A

1st choice:
1- Amoxicillin 500mg TDS for 5 days
2- Doxycycline 200mg STAT then 100mg OD thereafter 5 days
3- Clarithromycin 500mg BD 5 days

If treatment failure swap to diff 1st line abx

2nd choice: IF PERSON AT HIGHER RISK OF TREATMENT FAILURE
1- Co-amoxicalv 625mg TDS 5 days
2- Co-trimaxozole 960mg BD
3- Levofloxacin (NEED SPE ADVICE) 500 mg OD
IF V.SEVERE - IV ABX

19
Q

acute exacerbation of bronchiectasis

A

1st choice empirical treatment:
1- Amoxicillin 500 mg TDS 7-14 days (1st IF PREGGO)
2- Doxycycline 200 mg STAT and 100mg OD thereafter for 7-14 days (NOT IN UNDER 12)
3- Clarithromycin 500mg BD 7-14 days

2nd choice empirical treatment for pt at higher risk of severity:
1- co-amox 625mg TDS 7-14 days
2nd line:
ADULTS ONLY: Levofloxacin 500 mg OD or BD 7-14 days
CHILDREN ONLY: Ciprofloxacin 7-14 days

POSSIBILITY IV ABX

20
Q

Acute cough higher risk pop factors

A 
people with pre-existing co-morbidity 
premature babies and babies born premie 
Aged >65+ with 2 of OR aged >80+ with 1 of:
- hospitalisation in previous year
- T1DM OR T2DM
- Hx congestive HF 
- current use of oral corticosteroids
21
Q

Acute cough treatment

A

For pt at high risk or pt that are systemically unwell:

ADULTS:
1- Doxycycline 200mg STAT then 100mg OD for 5 days
2 - Amoxicillin 500 mg TDS 5 days (PREF IF PREGGO)
OR
Clarithromycin 250-500 mg BD 5 days
OR
Erythromycin 250-500mg QDS or 500-1000 mg BD for 5 days (PREF IF PREGGO)

CHILDREN: 
1- AMOXICILLIN 5 days 
OR 
Clarithromycin 5 days 
OR
Erythromycin 5 days 
OR 
Doxycycline 5 days (X UNDER 12s)
22
Q

CAP low severity (non-severe in kids)

A

CURB 0-1 - START TREATMENT WITHIN 4 HRS

1st: Amoxicillin 500mg TDS 5 days

IF PEN ALL: Doxycycline 200mg STAT then 100mg OD thereafter 5 days  (NOT IN UNDER 12s) 
OR 
Clarithromycin 500 mg BD 5 days
OR 
2ND IF PREGGO: 500 mg QDS 5 days
23
Q

CAP moderate severity

A

CURB 2 - START TREATMENT WITHIN 4 HOURS

1st: Amoxicillin 500 mg TDS 5 days
AND (IF ATYPICAL PATHOGEN)
Clarithromycin 500mg BD 5 days
OR Erythromycin (PREF IF PREGGO) 500 mg QDS 5 days

alternative choice 1st line:
PEN ALL:
1ST: Doxycycline 200mg STAT then 100 mg OD thereafter 5 days
2nd: Clarithromycin 500mg BD 5 days (give with erythromycin if atypical suspected)

24
Q

CAP severe

A

CURB 3-5 - TREAT WITHIN 4 HOUSR DIAGNOSIS

1st: Co-amoxiclav 625mg TDS 5 days
AND (IF ATYPICAL PATHOGEN):
Clarithromcin 500 mg BD 5 days
OR (PREF IF PREGGO) Erythromycin 500mg QDS 5 days

Alternative 1st line:
Levofloxacin (consider safety issues) 500 mg BD 5 days

25
Q

CURB SCORE

A 
1 pt per parameter: 
Confusion 
Urea (> 7 mmol)
Reps rate (30+ breath/min)
Blood Pressure: Low systolic (<90 mmHg) OR diastolic (<60 mmHg)
Age 65+
26
Q

HAP

A

Start within 48 hours of hospital admin
TREAT WITHIN 4 HOURS OF DIAGNOSIS

Non-SEVERE and NOT HIGH RISK RESISTANCE:
1st - Co-amox 625 mg TDS 5 days then R/W
PEN ALL:
1- Doxyxycline 200 mg STAT then 100mg OD thereafter 5 days then R/W
2- Cefalexin (care in pen allergy) 500 mg BD or TDS (can increase to 1g to 1.5g TDS or QDS) 5 days then r/w
3- Co-trimaxozole 960 mg BD 5 days then R/W
4- Levofloxacin (only if switching from IV) 500 mg OD or BD for 5 days then R/W

CHILDREN ALTERNATIVE:
Clarithromycin

IF SEVER OR RESISTANCE: IV Abx + micro input

PRP Mock Papers Questions (15 decks)

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