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my own pre reg notes > infection > Flashcards

infection Flashcards

1
Q

patient group most at risk of c.diff?

A

women and elderly

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2
Q

which antibiotics cause c.diff the most

A

clindamycin most

penicillins and quinolones can

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3
Q

treatment of c.diff

A

1st: oral metronidazole
2nd: oral vancomycin/ oral fidoxamicin

10-14 days

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4
Q

what is contraindicated in c.diff?

A

no, loperamide is contraindicated as we want to get rid of the bacteria

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5
Q

how to treat endocarditis

A

amoxicillin, flucloxacillin (staphylococcus), benzylpenicillin (strep), vancomycin if MRSA
can add low dose gentamicin

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6
Q

treatment of mild CAP?

A

7 days:
amoxicillin
pen allergy: clarithromycin or doxycycline

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7
Q

treatment of moderate CAP?

A

amoxicillin+ clarithromycin or doxycycline

7 days

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8
Q

treatment of HAP?

A

7 days
early: <5 days
co-amox or cefurox

severe/ >5 days : piperacillin or broad spectrum quinolone

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9
Q

what would you add into the treatment of HAP if you suspected pseudomonas aeruginosa?

A

aminoglycoside

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10
Q

meningitis treatment?

A

empirical benzylpenicillin or cefotaxime
pen allergy: chloramphenicol

meningococcal: 7 days
pneumococcal: 14 days
h. influenzae: 10 days

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11
Q

osteomyelitis treatment

A

clindamycin: concentrates in the bones
flucloxicillin
if MRSA: +Vancomycin

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12
Q

conjunctivitis drops/ ointment dose?

A

chloramphenicol: 1 drop every 2 hours for the first day then 1 drop every 4 hours till day 5

Oint: TDS-QDS for 5 days

refer if no improvement in >48 hours

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13
Q

impetigo treatment?

A

Fusidic acid for 7 days

Flucloxicillin oral for 7 days if wide spread

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14
Q

cellulitis treatment?

A

Flucloxicillin 250-500mg QDS

Clindamycin

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15
Q

animal bites treatment:

A

co-amoxiclav 1-2 TDS for 7 days

doxycycline+ metro

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16
Q

MRSA treatment

A

Glycopeptide (vancomycin or teicoplanin which is better on the kidneys)

can give a tetracycline or linezolid as well

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17
Q

oral infection treatment and dose? and alternative

A

metronidazole 200mg TDS for 3 days

amoxicillin or doxy if allergic
can combine pen/ macrolide with metronidazole if needed

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18
Q

what should you do if theres no response to treatment of dental infection within 48 hours

A

switch to an alternative

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19
Q

sore throat treatment?

treatment if severe?

A

phenoxymethylpenicillin
benzylpenicillin

clarithromycin if pen allergic

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20
Q

what are sore throats caused by commonly

A

strep

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21
Q

otitis externa treatment and why

A

fluclox or clarithromycin as usually caused by staph

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22
Q

if youre going to treat otitis media what would you give treatment
when wouldn’t you treat it?

A

amoxicillin or Clari if allergic

only treat if it doesnt improve after 3 days or there are systemic symptoms

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23
Q

when should you not give amoxicillin?

A

in glandular fever: mapupapular rash

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24
Q

TB treatment:

A 
initial phase for 2 months: 
Rifampicin
Isonazid 
Pyrazinamide 
Ethambutol

continuous phase for 4 months:
RI

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25
Q

Cautions of TB treatment

A

all hepatotoxic

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26
Q

what should you report with ethambutol

A

visual changes

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27
Q

two things to monitor with linezolid

A

report any visual changes: ocular neuropathy

monitor bloods every week especially with treatment over 10-14 days
anaemia and thrombocyopenia

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28
Q

antibiotics effecting vision

A

linezolid: optic neuropathy

quinolones

ethambutol

Rifampicin can colour contacts red

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29
Q

which anti fungal should be avoided in HF

A

Itraconazole can cause HF

increased risk if with CCB

30
Q

hepatotoxic antibiotics/ antifungals

A 
itraconazole, 
ketoconazole 
fluconazole 
terbinafine 
voriconazole: supply with alert card
co-amox
flucloxacillin
erythromycin
co-trimoxazole 
RI
31
Q

drugs causing cholestatic jaundice

A

flucloxicillin
co-amoxiclav
nitrofurantoin

32
Q

MHRA Ketoconazole

A

fatal hepatotoxity: do not use for anything except cushings

send back Rx if you see it

33
Q

Voriconazole side effects

A

hepatotoxic and phototoxic

alert card for liver
SPF and avoid the sun

34
Q

amphotericin side effects

A

nephrotoxicity

35
Q

how to administer amphotericin

A

IV but monitor for 30 minutes as can cause anaphylaxis

not brand interchangeable

36
Q

oral thrush treatment

A

POM nystatin
OTC metronidazole gel

if severe can give oral fluconazole

37
Q

vulvovaginal thrush treatment

A

oral fluconazole

topical imidazole

38
Q

what is tinea capatis

A

scalp ringworm

39
Q

what is tinea cruris

A

jock itch

40
Q

what is tinea pedis

A

athletes foot

41
Q

what is terbinafine

A

treatment for athletes food ONLY

tinea pedis

42
Q

treatment of tineas?

A

topical imidazoles: miconazole, clotrimazole

daktacort 10+ BD for 7 days

43
Q

daktacort age restriction OTC

A

10+

44
Q

DAKTACORT dose regimen for tinea treatment

A

BD for 7 days

45
Q

OTC treatment of herpes simplex? +dose

A

aciclovir 5 times a day for 4 days with 4 hour intervals

Penciclovir: 12+ 8 times daily for 4 days with 2 hour intervals

46
Q

what can be used as influenza prophylaxis? who would use this?

A

oseltamivir

> 65
diabetes
immunocompromised

47
Q

ABCD acronym in malaria?

A

aware of risk
bite prevention
chemoprophylaxis
Diagnose promptly

48
Q

strength of DEET?
age restriction
what must you wear with it

A

20-50%
>2 months old

suncream 35-40 SPF put on before DEET. DEET reduces the SPF of suncream

49
Q

macaroni contains?

A

atorvaquone and proguanil

50
Q

different regimens for malaria chemoprophylaxis?

A
  1. Malarone
  2. Chloroquine only
  3. Chloroquine and proguanil
  4. Mefloquine
  5. Doxycycline
51
Q

before giving chloroquine what should be checked

A

the area for chloroquine resistance

52
Q

doxycycline for malaria treatment regimen

A

1-2 days before and 4 weeks after

53
Q

doxycycline CA labels

A

not to be given with CA, FE, ZN antacids 2 h before or after

photosensitivity

with a whole glass of water

54
Q

if someone wants a quick get away holiday which malaria regimen should they take

A

doxycycline or macaroni as only 1-2 days before

55
Q

MHRA for mefloquine

+ a counselling point

A

C/I if history of psychiatric disorders or convulsions

care when driving as can cause dizziness
stop and seek immediate medical attention if neuropsychiatric effects occur- replace with alternative anti-malarial

56
Q

when can the side effects of mefloquine occur

A

months after stopping as long half life

57
Q

Flucloxicillin safety?

A

hepatitis and liver toxicity

can occur 2weeks-2 months after stopping

58
Q

length of treatment for chemoprophylaxis on malaria before and after travel

A

Usually 1 week before EXCEPT:
Mefloquine is 2-3 weeks to see if they tolerate
malarone and doxycycline are 1-2 days

after: usually 4 weeks
EXCEPT: Malarone which is 1 week after

59
Q

malaria long term prophylaxis?

A

> 5 years: chloroquine and proguanil
2 years: doxy
1 year: mefloquine and malarone but if tolerated mefloquine can be used for up to 3 years

60
Q

which malaria prophylaxis can be used for up to 5 years

A

chloroquine and proquanil

61
Q

which malaria prophylaxis can be used for up to 2 years

A

doxycycline

62
Q

which malaria prophylaxis can be used for up to 1 years

A

malarone and mefloquine but mefloquine can be used for up to 3 years

63
Q

which anti malarials should be avoided in epilepsy

A

mefloquine and chloroquine

can give malarone

64
Q

which anti malarials should be given in renal impairment

which should be avoided

A

give doxycycline or mefloquine

avoid: proguanil, malarone and chloroquine (if eGFR <30)

65
Q

which anti malarials can be given in pregnancy

which cannot be given

A

chloroquine and proguanil
give proguanil with folic acid 5mg
mefloquine in the second/ third trimester if no alternative
dont give doxycycline or mefloquine

66
Q

which patient group require different malaria chemoprophylaxis?

A

warfarin patients- start 1-2 weeks before to stabilise INR before

67
Q

malaria treatment?

A
  1. falciparum: quinine, malarone, raiment

2. non-falciparum: chloroquine

68
Q

what can be given as malaria stand by treatment. when would this be provided?

A

quinine if cant reach medical care within 24 hours

69
Q

treatment of chlamydia and dose

alternative?

A

doxycycline 100mg BD 7 days

azithromycin if pregnant, allergies or breast feeding

70
Q

when would you give azithromycin instead of doxycycline for treatment of chlamydia

A

pregnant, allergies or breast feeding

my own pre reg notes (5 decks)

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