Infection

Question 1

What does CRB-65 Score stand for?

Answer 1

C= New onset confusion
R= Respiratory rate greater than 30/min
B = Systolic blood pressure less than 90 or diastolic BP below or equal to 60mmHg

Age 65 years or above.

Question 2

Whats the threshold for CRB-65?

Answer 2

CRB-65 Score of:

2 = Consider short stay in hospital or monitor as an outpatient

3 = Requires hospitalisation. Consider ICU

Question 3

If your CRB-65 score is equal or below 2, what is this classed as?

Answer 3

Non-Severe CAP

Question 4

First line Treatment in CAP?

Answer 4

First line = Amoxicillin 500 mg TDS + Doxycyline 200mg od

Question 5

If Amoxicillin is contraindicated in non severe CAP what do you give

Answer 5

Doxycyline 200mg od PO 5-7/7

Question 6

treatment of severe CAP?

Answer 6

Co-amoxiclav 1.2g TDS IV + Doxyxycline 200mg OD PO 5-7 days

Question 7

If your CRB-65 score is equal or below 3, what is this classed as?

Answer 7

Severe CAP

Question 8

In case of penicillin allergy for severe CAP, what do you give?

Answer 8

Vancomycin IV + Ciprofloxacin IV or PO for 5 - 7 days

Question 9

If i have infection exacerbation of COPD what would you give me?

Answer 9

Doxycycline 200mg STAT

Then 100mg PO for 6 days.

Question 10

Treat me for bacterial tonsillitis what if i got allergies?

Answer 10

Penicillin V 500mg QDS if unable to swallow give Benzylpenicillin IV

in case of allergy give Clarithromycin

Question 11

Treatment for Otitis media Sinusitis

Answer 11

Amoxicillin 250mg TDS PO for 7 days Or Clarithromycin

Question 12

Early onset HAP. How to treat? What about allergies?

Answer 12

Co-Amoxiclav PO 5/7

Or in case of allergy
Doxycycline 5/7 days

Question 13

UTI first line Treatment if patient has a penicillin allergy?

Answer 13

Trimethoprim 200mg bd PO for 5/7 days

Question 14

Clostridium Difficile - How to treat? What about severe C Diff?

Answer 14

Metronidazole 400mg PO for 10-14 days

Vancomycin PO for 14 days

Question 15

First line for cellulitis or in case of allergy?

Answer 15

Flucloxicillin oral QDS

in case of allergy give Clarithromycin

Question 16

Human and Animal Bites?

Answer 16

Co-Amoxiclav Oral.

Question 17

how do you treat Diabetic foot infection and how to treat in case of allergy?

Answer 17

Flucloxacillin + Amoxicillin PO for 14 days.

Clarithromycin 500 for 14 days in case of penicillin allergy.

Question 18

SBP Treatment?

Answer 18

Co-Amoxicillin for SBP Treatment.

Question 19

Helicobacter Pylori First line Tx?

Answer 19

H Pylori First line.

Amoxicillin / Clarithromycin / Omeprazole.

Metronidazole can be given as part of the triple therapy if you have allergy to Amoxicillin

Question 20

Important adverse effects of Penicillin?

Answer 20

Skin rash - Anaphylaxis - CNS toxicity

Question 21

Quinolones such as Ciprofloxacin and Levofloxacin are indicated for what?

Answer 21

UTI - Gastrointestinal infections (Shigella) - LRTI - Pseudmonas aerugenosa.

Question 22

What is a major side effect of Quinolones?

Answer 22

QT prolongation

Question 23

What class is Doxycyline in and what SPECIFIC side effects are associated with it?

Answer 23

Doxycycline is a Tetracycline and it has adverse effects of oesophageal irritation, discolouration of teeth, photosensitivity and inter-cranial hypertension

Question 24

State how Macrolides cause interactions and what do they inhibit

Answer 24

Inhibits CYP450 and this increases [drugs] made by this path e.g Statins/ Warfarin/ Amiodarone/ Antipsychotics/ Quinine/ Quinolones/ SSRIs

Question 25

what Gram is vancomycin effective against? and where does it get used generally?

Answer 25

Vancomycin is effective against Gram Positives and ineffective against Gram negatives. It is generally prescribed in severe cases where penicillin is not appropriate.

Question 26

State indication, MOA and ADR and Interactions of Metronidazole

Answer 26

Metronidazole

Indication: Oral Infections
MOA: Only active against Anaerobic Gram Positives. Generates Free radicals that bind to and causes DNA generation.
ADRs: Optic neuropathy, Seizures, GI upset
Interactions: Inhibits CYP450 enzymes and reduces metabolism of warfarin.