Infection questions Flashcards
Master K 2 years old, has come into the practice to visit the nurse. He has been diagnosed as having widespread non-bullous impetigo. The practice nurse prescribes some treatment to help treat the impetigo for Master K. Master K has a severe allergy to Penicillin.
Which from below would be most suitable treatment?
A-Amoxicillin 125mg/5mL – 5mL TDS for 7 days
B-Flucloxacillin 125mg/5mL – 5mL TDS for 10 days
C-Clarithromycin 125mg/5mL – 2.5mL BD for 5 days
D-Clarithromycin 125mg/5mL – 10mL BD for 10 days
C- Clarithromycin 125mg/5ml: 2.5ml BD for 5 days
Mr DP presents in the pharmacy with a script for Doxycycline 100mg capsules 2 on the first day then 1 thereafter for 4 days (5 days in total) to treat his acute bronchitis. Upon checking his PMR you note that he takes a medication which could potentially interact with Doxycycline. You advise him to space out the administration of the Doxycycline and this particular medication by at least 2-3 hours.
Which medication from below should the administration be space out when taking Doxycycline?
A- Ferrous Sulphate
B- Sildenafil
C- Loperamide
D-Atorvastatin
A- Ferrous sulphate
Iron impact absorption when taken closely
Master G, 8 years old has presented to the practice with symptoms of Acute Otitis Media. The practice nurse has decided to issue a prescription for a course of antibiotics. Master G is on no other medication and has no allergies.
What antibiotic would you expect to be prescribed for the first line treatment of acute otitis media for Master G?
A- Amoxicillin 500mg TDS for 5 days
B- Lymecycline 408mg BD for 14 days
C- Co-Amoxiclav 250/125mg TDS for 9 days
D- Metronidazole 400mg TDS for 7 days
A- Amoxicillin 500mg TDS for 5 days
Special directions for Phenoxymethylpenicillin
Take this medication when you stomach is empty. This means an hour before food or 2 hours after food.
The practice nurse has got in touch asking for some advice. She wishes to prescribe an antibiotic for a 42-year-old women who is presenting with a UTI. You look at the drug record for the women and note she has an extreme allergy to penicillin. She is also taking the following medication.
-Folic Acid 5mg – 3 days per week (not on same day as MTX)
-Methotrexate 20mg – 20mg ONCE weekly
-Paracetamol 500mg – 1-2 QDS PRN
Which of the antibiotics below would be most appropriate to prescribe to treat her UTI?
A- Nitrofurantoin
B- Co-amoxiclav
C- Cefalexin
D- Trimethoprim
A- Nitrofurantoin
Methotrexate and Trimethoprim are folate antagonists so they work by inhibiting the same enzyme- involved in folate metabolism.
When used together their effects add up, significantly increasing the risk of toxicity
Which of the following antibiotics is most likely to be associated with causing C.Difficile infection?
A- Clindamycin
B- Doxycycline
C- Lymecycline
D- Metronidazole
A- Clindamycin
Mr Moss Keto, has come to your travel clinic at the pharmacy. He believes he needs some anti-malaria tablets, before his travel to a country which has a high prevalence of malaria. Mr Moss Keto gives you a list of the medications he is currently taking as listed below:
-Sertraline 200mg OD for severe anxiety
-Propranolol 40mg TDS for severe anxiety
Which of the following anti-malarial medications would be the LEAST suitable for Mr Moss Keto based on his medication and clinical history?
A- Chloroquine
B- Chloroquine with proguanil
C-Mefloquine
D-Proguanil
C- Mefloquine
Mefloquine is contraindicated in people with a previous history of psychiatric illnesses (also convulsions)
What drug would you expect to see prescribed alongside Isoniazid for the treatment of Tuberculosis to prevent peripheral neuropathy?
A- Folic Acid 5mg Daily
B- Folic Acid 400mcg Daily
C- Pyridoxine 10-20mg Daily
D- Pyridoxine 50mg TDS
C- Pyridoxine 10-20mg daily
Pyridoxine is essential for nerve function
Isoniazid interferes with pyridoxine by blocking its activation and deactivating it = deficiency
This can cause peripheral neuropathy, so you need supplemental pyridoxine
Mrs Staph 38-years-old, has presented to you a prescription for Flucloxacillin 500mg TDS for 5 days. Upon dispensing the prescription, you note on her records she has a severe penicillin allergy, and confirm this with Mrs Staph, who also tells you she is also 12 weeks pregnant. Speaking to Mrs Staph, you find out that the reasoning why the Flucloxacillin was prescribed is due to a bite which the ANP believes is infected. You proceed to ring the ANP who wrote the prescription to inform them and suggest an alternative ABX to prescribe.
Which would be the most suitable Flucloxacillin alternative to suggest?
A- Clarithromycin
B- Doxycycline
C- Erythromycin
D- Co-amoxiclav
Erythromycin
Safe in pregnancy
Mr R Hagrid 62-years-old presents a prescription after visiting the ANP at the local practice, due to being bitten by his dog Fluffy. The ANP has assessed the bite and believes it to be infected. Mr Hagrid has a severe penicillin allergy.
Which of the following is most likely to be prescribed by the ANP for the treatment of the infected bite?
A- Doxycycline
B- Amoxicillin
C- Doxycycline + Metronidazole
D- Clarithromycin
C- Doxycycline and Metronidazole
Mrs S, a 36-year-old lady who is 1 month pregnant suffers from morning sickness. She has been experiencing a burning sensation upon urination and has a slightly elevated temperature. The doctor has decided to start her on antibiotics while waiting for her urine specimen culture testing results. Mrs S has no regular medication and is otherwise healthy.
Which of the following antibiotics would be the most suitable or Mrs S to start taking while doctor awaits the results of the culture?
A- Trimethoprim
B- Cefalexin
C- Methenamine hippurate
D-Doxycycline
E- Ciprofloxacin
B- Cefalexin
Uncomplicated lower UTIs often respond to trimethoprim or nitrofurantoin or alternatively amoxici;;in, ampicillin or cephalosporin.
Trimethoprim would be appropriate but it is teratogenic in first trimester
Miss T, a 56-year-old present at your pharmacy complaining of pain behind her right ankle. She is unable to weight bear on her right leg. She would like you to suggest some analgesics for her and you check her PMR for any existing medication before proceeding. You notice that she was dispensed a course of ciprofloxacin 500mg twice daily three days ago and confirms she has been taking them as prescribed since then. You suspect that she may have ruptured her tendon.
Which of the following factors would increase the risk of tendon damage in Miss T while taking ciprofloxacin?
A- Taking oral prednisone daily for the management of rheumatoid arthritis
B- A history of gout
C- Taking oral diclofenac daily for the management of osteoarthritis
D- Age over 55 years
E- A history of osteoporosis
A - Taking oral prednisolone daily for the management of RA
Ciprofloxacin : risk of tendon damage is increased by the concomitant use of corticosteroids
Mr T has come for his travel clinic appointment in your pharmacy. He states that he is travelling to a small village in a western province of Cambodia bordering Thailand. He asks your advice about which antimalarial he should take. He has a past medical history of chronic kidney disease stage 4 (eGFR 24mL/min).
Which of the following anti-malarials would be the most appropriate for this patient? Hint: Use the table in the BNF for risk of malaria in each country?
A- Chemoprophylaxis is not recommended
B- Mefloquine
C- Doxycycline
D- Atovaquone with proguanil hydrochloride
E- Chloroquine
A- Chemoprophylaxis not recommended
Low risk area
What is cross sensitivity?
Cross sensitivity in terms of antibiotics and allergies mean that someone who is allergic to one antibiotic may also react to another structurally similar antibiotic
Penicillins and Cephalosporins
Penicillins and Carbapenems
A patient receives Amikacin 60mg by IM injection TDS for a soft tissue infection (target range for amikacin; peak 5-10mg/L, trough <2mg/L). Three days later a peak gentamicin level 9mg/L is reported, with a trough concentration 4mg/L.
Which of the following is an appropriate method of dose rationalisation?
A- Decrease the dose and decrease the dosage interval
B- Increase the dose and increase the dosage interval
C- Increase the dose and maintain same dosage interval
D- Maintain the same dose and increase the dosage interval
E- Maintain the same dose and decrease the dosage interval
D- Maintain the same dose and increase the dosage interval
If the trough conc is high, the interval between doses must be increased
If peak concentration is high, the dose must be decreased
Trough = pre dose
Peak = post dose
An 8-year-old boy with a confirmed penicillin allergy has developed a chest infection and requires antibacterial treatment. His GP phones you to discuss which antibiotic would be most appropriate.
Which of the following antibiotics would be the most appropriate?
A- Co-amoxiclav
B- Doxycycline
C- Azithromycin
D- Ciprofloxacin
E- Ofloxacin
C- Azithromycin
Alternatives that can be used are doxycycline or azithromycin
Doxycycline cannot be used in children under the age of 12
Mrs U has been diagnosed with a urinary tract infection. Her medical history shows rheumatoid arthritis, hypothyroidism and severe allergy to Flucloxacillin. She is taking levothyroxine 125mcg with 100mcg on alternate days, folic acid 5mg once weekly methotrexate 20mg injection.
What would be the most suitable therapy to treat Mrs K’s symptoms?
A- Cefuroxime
B- Amoxicillin
C- Co-amoxiclav
D- Trimethoprim
E- Nitrofurantoin
E- Nitrofurantoin
Penicillin allergic: cannot have amoxicillin or co-amoxiclav
Trimethoprim and Nitrofurantoin are first line
But as she uses methotrexate she cannot have trimethoprim
Which antibiotic is least likely to have its absorption and / or efficacy impaired if taken after a meal with an antacid?
A- Ciprofloxacin
B- Co-amoxiclav
C- Flucloxacillin
D- Phenoxymethylpenicillin
E- Tetracycline
B- Co-amoxiclav
Can be taken with antacids without affecting the absorption of the antibiotic
Which antibiotic can change the colour of your urine orange/red?
A- Amoxicillin
B- Ciprofloxacin
C- Metronidazole
D- Oxytetracycline
E-Rifampicin
E- Rifampicin
Which is the single most appropriate antibiotic to treat C.diff ?
A- Co-amoxiclav tablets
B- Co-trimoxazole tablets
C- Doxycycline capsules
D- Erythromycin tablets
E- Vancomycin capsules
E- Vancomycin
Miss S is a 22-year-old woman who comes into the pharmacy with a prescription for Ketoconazole 200mg tablets TDS. Your pre-registration pharmacist asks you what this is most likely for?
Which of the following conditions is Miss S most likely to be suffering from?
A- Aspergillosis
B- Acne
C- Cushing’s Syndrome
D- Candidiasis
E- Tinea Pedis
C- Cushings syndrome
Specialist use only
What is the most appropriate treatment for a 9- year-old with a widespread impetigo infection?
A- Clindamycin
B- Flucloxacillin
C- Fusidic acid
D- Ciprofloxacin
E- Amoxicillin
B - Flucloxacillin
Oral flucloxacillin is most appropriate for widespread impetigo
If penicillin allergic, oral clarithomycin / azithromycin / erythromycin
What is the likely organism that could cause chicken pox?
Varicella Zoster
