Infection extra Flashcards
A patient has come in for their check-up at 24 weeks of pregnancy and the nurse prescriber has noticed that they have some cellulitis present on their leg. The nurse would like to prescribe an antibiotic but is aware that they also have a penicillin allergy. Which of the following antibiotics would be most appropriate to prescribe?
Choose only ONE best answer.
A
Flucloxacillin
B
Clarithromycin
C
Erythromycin
D
Doxycycline
E
Metronidazole
C – Due to the penicillin allergy, the first line treatment of flucloxacillin could not be used. The second line treatment would usually be doxycycline, clarithromycin or erythromycin. Doxycycline and clarithromycin should not be used in pregnancy. Metronidazole is not licensed for cellulitis on the legs. This leaves erythromycin as the correct option.
an 83-year-old patient, has been staying in hospital for the last week after a COPD exacerbation and has been diagnosed with a mild pneumonia. Given that the first line treatment is not suitable for this patient, which of the following medications would not be a suitable alternative?
Choose only ONE best answer.
A
Clarithromycin
B
Cefalexin
C
Co-trimoxazole
D
Doxycycline
E
Levofloxacin
A – As the patient has been in the hospital for longer than 48 hours, this pneumonia would be classed as hospital acquired. First line would be co-amoxiclav, with alternatives being cefalexin, co-trimoxazole, doxycycline or levofloxacin.
Clarithromycin is generally avoided in elderly patients, especially those with comorbid conditions such as COPD, due to its potential for drug interactions, particularly with medications that are commonly prescribed to elderly patients. Additionally, clarithromycin has a higher risk of causing QT prolongation, which can be particularly concerning in older adults who may have existing cardiac issues or who are taking other medications that affect the QT interva
A patient has come into the pharmacy with a prescription for an antibiotic due to being bitten by a cat. The patient does not show any signs of infection at the location of the bite but still needs to take some antibiotics. Which medication regimen would be most likely prescribed to the patient?
Choose only ONE best answer.
A
Flucloxacillin 500mg four times a day for three days
B
Flucloxacillin 500mg four times a day for five days
C
Co-amoxiclav 500/125mg three times a day for three days
D
Co-amoxiclav 500/125mg three times a day for five days
E
Metronidazole 400mg three times a day for three days
C – Co-amoxiclav is the first line treatment in animal bites. Though the patient has been bitten, they do not show signs of infection meaning that a prophylactic regimen of three days is needed and not five days.
A patient has come into the general practice with shortness of breath and green sputum. The advanced practitioner pharmacist would like to test them for community acquired pneumonia using the CURB65 test. Which of the following parameters is not measured in the CURB65 score?
Choose only ONE best answer.
A
Blood urea nitrogen
B
Age
C
Blood pressure
D
Weight
E
Respiratory rate
D – The following parameters are measured in the CURB65 score: Confusion, blood urea nitrogen, respiratory rate, blood pressure, and age.
she will go and travel around South America for 6 months. Before setting off, she would like some advice on what to do and avoid in order to prevent herself from getting traveller’s diarrhoea. Which of the following points would be the most appropriate point to tell her?
Choose only ONE best answer.
A
You only need to wash your hands after touching an animal if it is dead
B
If eating seafood, it is best to eat it raw
C
Unpasteurised cheese is safe to eat
D
Tap water should be avoided even for brushing teeth
E
Fruits with no outer skin would be preferrable to eat
D – You would need to wash your hands after touching live animals. Raw fish, seafood and meats should be avoided. Unpasteurised milk and cheese should be avoided. Tap water should be avoided for drinking, preparing food, making ice, cooking and brushing teeth unless it is certain to be safe. Fruits and vegetables which can be peeled by the end-user are more suitable for consumption.
complaining of really bad dyspepsia, even though they were put on a proton pump inhibitor for the last 4 weeks. The pharmacist advises him to go to their doctor and request a test for H. pylori. Which of the following tests can they be expected to undergo?
Choose only ONE best answer.
A
Saliva antigen test
B
13C Urea breath test
C
Mantoux test
D
D-Dimer test
E
TPMT test
B – The tests for H. pylori would typically be a stool antigen test, a 13C urea breath test, or an antibody blood test. A Mantoux test is for tuberculosis, D-Dimer for thromboembolisms and TPMT for the use of thiopurines.
A patient has been rushed to hospital after they were diagnosed with severe osteomyelitis in the doctor’s practice. The patient needs to be initiated on antibiotics immediately, but has a penicillin allergy. Which of the following treatment plans could you expect to see?
Choose only ONE best answer.
A
Co-amoxiclav + metronidazole
B
Co-trimoxazole + gentamicin
C
Clarithromycin + metronidazole
D
Doxycycline + metronidazole
E
Co-amoxiclav + gentamicin
B – Treatment in severe osteomyelitis in patients with penicillin allergy would be co-trimoxazole +/- gentamicin and/or metronidazole
A patient has been to their doctor after a recurring outer ear infection which hurts too much to even apply creams onto to help it settle down. After doing a swab test of the infection, results showed that it is a staphylococcus aureus variant of otitis externa. Which of the following antibiotics should be prescribed?
Choose only ONE best answer.
A
Ciprofloxacin
B
Vancomycin
C
Flucloxacillin
D
Amoxicillin
E
Clarithromycin
C – otitis externa is usually caused by Pseudomonas aeruginosa or Staphylococcus aureus. If pseudomonas is suspected, we would use an aminoglycoside or ciprofloxacin, but as this is a staphylococcus infection, flucloxacillin should be used. If the patient had a penicillin allergy, we would then use a macrolide.
A patient has been admitted to an out-patient clinic in a hospital after having a CURB65 assessment which gave them a score of 2. The patient does not have any atypical pathogens suspected. Which of the following treatments would be recommended?
Choose only ONE best answer.
A
Amoxicillin 500mg three times a day
B
Amoxicillin 500mg three times a day + clarithromycin 500mg twice a day
C
Doxycycline 200mg two times a day
D
Co-amoxiclav 500/125mg three times a day
E
Levofloxacin 500mg twice a day
A – The patient has not shown any atypical pathogens, so would not need the addition of clarithromycin or erythromycin. The patient can be treated with amoxicillin on its own.
A patient has come into the pharmacy thinking that they had a stye underneath their right eye. The pharmacist, after taking a look thought that it might be cellulitis instead and would need a prescription to help treat it. Which of the following medications would most likely be prescribed?
Choose only ONE best answer.
A
Chloramphenicol
B
Co-amoxiclav
C
Clarithromycin + metronidazole
D
Doxycycline
E
Flucloxacillin
B – When the cellulitis is near the eyes or nose, a course of co-amoxiclav would be used as first line therapy. Clarithromycin and metronidazole would be used if there is a penicillin allergy.
