Micro Questions

Question 1

A 48 year old farmer attends the emergency department 7 days after cutting his arm from falling on barbed wire in his field. He complaints of fever, headache and painful spasms in his neck and back which last several minutes.

You suspect tetanus and he tells you he has completed a course of tetanus vaccination previously.

What is the most appropriate treatment?

tetanus booster
IM tetanus Ig
flucloaxicillin
ciprofloxacin

Answer 1

IM tetanus Ig

A tetanus booster is not recommended in the UK if the patient is already immunized.

Question 2

can you give pregnant lady HEP C therapy during pregnancy (i.e. ribavirin)?

Answer 2

NO

Hepatitis C drug therapy: CI in pregnancy due to concerns of teratogenicity

Question 3

A 65-year-old female presents to the emergency department with a rising fever. After a full examination, no focal point for an infection can be localised. Which of the following features may cause you to start antibiotics even though no source of infection could be found?

chemo 2 weeks ago
THR 4 wks ago
HR 110 bpm
RR >22

Answer 3

Recent chemotherapy is a red flag in a suspected septic patient

Question 4

if they have just been away - foreign travel - what type of bacteria will cause pneumonia/

Answer 4

legionella pneumophila

Question 5

What is the latest time that HIV post-exposure prophylaxis may be given? (hours)

6
12
24
48
72

Answer 5

72

Question 6

first line for severe C difficile infection?

Answer 6

Vancomycin

Question 7

first line for gram -ve dipplococci ?

Answer 7

azithromycin + ceftriaxone