Investigation of infections in general practice

Question 1

What test is done for possible urinary infection in clinic?

Answer 1

Dipstix

Question 2

What is a sign of urinary infection?

Answer 2

Cloudy urine - means white blood cells present

Question 3

What do vaginal swabs test for?

Answer 3

Thrush
Bacterial vaginosis
Chlamydia
Gonorrhoea

Question 4

What test is used for streptococcus?

Answer 4

Throats swabs

Question 5

What test is used for persistent conjunctivitis in babies?

Answer 5

Eye swabs

Question 6

What test is used for mouth thrush?

Answer 6

Mouth swab

Question 7

What is needed to test for fungal nail infections?

Answer 7

Nail clippings

Question 8

What do you test for in people with gastritis symptoms?

Answer 8

Helicobacter pylori

Question 9

What does overuse of antibiotics cause?

Answer 9

Encourages growth of harmful superbugs

Question 10

What bugs cause chest infections?

Answer 10

Strep pneumoniae
Haemophilus
Mycoplasma pneumoniae

Question 11

How can you tell if a patient is ill?

Answer 11

Temperature - high
Pulse rate - high
Respiratory rate - high
Capillary refill time > 2sec

Question 12

What antibiotics are recommended for community acquired pneumonia?

Answer 12

Streps - amoxicillin
General - doxycycline

Question 13

What influences prescription of antibiotics of community acquired pneumonia?

Answer 13

Diabetes
Frailty
HIV
Immunosuppression

Question 14

When would you consider sending a patient for a chest xray?

Answer 14

Wheezing
Coughing up blood (check for lung cancer if they are a smoker)

Question 15

What are impetigo and cellulitis?

Answer 15

Impetigo = little pustules on the skin
Cellulitis = common in elderly, red and swollen areas of skin

Question 16

What causes impetigo?

Answer 16

Staphylococcus or Streptococcus

Question 17

What causes cellulitis?

Answer 17

Streptococcus

Question 18

What antibiotics are used for impetigo and cellulitis?

Answer 18

Staphylococcus = flucloxicillin
Streptococcus = penicillin V or amoxicillin

Question 19

How is impetigo spread?

Answer 19

Close contact to infected children or by using towels, wash cloths etc.

Question 20

What is conjunctivitis?

Answer 20

Sticky eyes
Common in babies
Viral or occasionally strep or staph

Question 21

What is used to treat conjunctivitis?

Answer 21

Chloramphenicol

Question 22

What happens if the conjunctivitis is severe 24-48hrs post delivery?

Answer 22

May be chlamydia caught during delivery
Do a swab

Question 23

Describe UTIs

Answer 23

Very common in women
Often associated with sexual intercourse

Question 24

What are symptoms of UTIs?

Answer 24

Burning on passing urine
Urine looks cloudy due to pus cells

Question 25

What do dipstix test check for?

Answer 25

Leucocyte esterase Protein Blood Nitrites Also glucose if they are diabetic

Question 26

What is the most common bug for UTI?

Answer 26

E coli

Question 27

What are symptoms of chlamydia?

Answer 27

Usually asymptomatic Symptoms include dysuria, pain in testicles (men), vaginal discharge, spotting or pelvic pain (women)

Question 28

What can chlamydia lead to?

Answer 28

Pelvic inflammatory disease Infertility Ectopic pregnancy

Question 29

What should be done for vaginal discharge?

Answer 29

Take swabs for candida/thrush and bacterial vaginosis, chlamydia and gonorrhoea

Question 30

What treatment is given for candida and BV?

Answer 30

Usually oral Topical treatment for thrush during pregnancy because fluconazole is teratogenic (causes developmental malformations)

Question 31

What causes diarrhoea?

Answer 31

Often food poisoning eg. campylobacter Can be viral and resolve within 5 days

Question 32

Describe tonsilitis/sore throat

Answer 32

Mostly viral Can sometimes get scarlet fever with tonsilitis, strawberry tongue and rash

Question 33

What should be tested for if antibiotics are not being given in tonsilitis?

Answer 33

Throat swab for beta haemolytic streptococcus

Question 34

What antibiotic can be used to treat tonsilitis?

Answer 34

Penicillin

Question 35

What are shingles?

Answer 35

Painful rash on one side Known as Herpes zoster virus

Question 36

What can shingles lead to?

Answer 36

Post herpetic neuralgia, especially in old people and those who are immunosuppressed

Question 37

What causes fungal infections eg. athletes foot?

Answer 37

Fungi like warm, wet places In the case of athletes foot, maybe not changing socks, sweaty shoes/socks

Question 38

What should be done to treat athlete's foot?

Answer 38

Keep clean and dry and open to air, e.g wear flip flops Topical treatment first line = clotrimazole or miconazole cream If not responsive then consider oral treatment eg. fluconazole

Question 39

What are likely causes of skin infections?

Answer 39

Staph or strep

Question 40

What are possible treatments for skin infections?

Answer 40

Flucloxacillin Clarithromycin if allergic to penicillin Topical fucidic acid if mild

Question 41

What are likely causes of conjunctivitis?

Answer 41

Staph or strep

Question 42

What are possible treatments for conjunctivitis?

Answer 42

Chloramphenicol eye drops

Question 43

What are likely causes of ear, nose and throat (ENT) infections?

Answer 43

Strep or haemophilus influenzae

Question 44

What are possible treatments for ENT infections?

Answer 44

Amoxicillin or clarithromycin

Question 45

What are likely causes of lung infections?

Answer 45

Strep pneumoniae, mycoplasma

Question 46

What are possible treatments for lung infections?

Answer 46

Doxycycline

Question 47

What are likely causes of UTIs?

Answer 47

E.coli if straight forward Otherwise proteus, pseudomonas etc. depends on sensitivities

Question 48

What are possible treatments of UTIs?

Answer 48

Nitrofurantoin