microguide testing

Question 1

severity markers for c.difficile

Answer 1

temperature >38.5
suspicion of PMC, toxic megacolon and ileus
-evidence of severe colitis in CT scan and x-ray
-wbc >15 cells
-acute rising serum creatinine >1.5 x baseline

Question 2

treatment of c.difficile with no severity marker

Answer 2

metronidazole oral

Question 3

treatment of c.diff with one severity marker

Answer 3

vancomycin oral

Question 4

treatment of c.diff with one severity marker but oral route is not available or an ileus is detected

Answer 4

metronidazole iv and vancomycin

Question 5

treatment of intra-abdominal infection eg peritonitis and diverticulitis

Answer 5

amoxicillin iv
and
gentamicin
and metronidazole oral

Question 6

acute cholecystitis and cholangitis treament

Answer 6

amoxicillin iv
and 
gentamicin
and 
metronidazole oral

Question 7

treatment of penicillin allergy intra abdo infection

Answer 7

vancomycin 
and 
gentamicin
and
metronidazole oral

Question 8

spontaneous bacterial peritonitis treatment

Answer 8

amoxicillin iv
and 
temocillin 
and 
metronidazole oral

Question 9

sbp treatment with penicillin allergy

Answer 9

ciprofloxacin oral 
and 
vancomycin 
and 
metronidazole oral

Question 10

h.pylori treatment

Answer 10

amoxicillin oral 
and 
clarithromycin oral or metronidaolze oral
and 
omeprazole oral

Question 11

h.pylori treatment if penicillin allergy

Answer 11

omeprazole
and
clarithromycin oral
and 
metronidazole oral

Question 12

CAP severity scoring

Answer 12

confusion >8  altered mental state
urea >7
rr>30
bp <90 or <60
>65

Question 13

pathogens that cause cap

Answer 13

typicals: s.pneum and h.influezae and s.aureus and m.catarhalis
atypicals: m.pneumonia, legionella, chlamydia, coxiella

Question 14

cap 0-1 treatment

Answer 14

amoxicillin oral

Question 15

cap 0-1 treatment with pen allergy

Answer 15

doxycycline oral

Question 16

cap 2 treatment

Answer 16

amoxicillin and clarithromycin oral

Question 17

cap 2 with pen allergy

Answer 17

doxycylin or clarithromycin

Question 18

cap 3-5 treatment

Answer 18

co-amoxiclav iv
and
clarithromycin iv

Question 19

treatment cap 3-5 with pen allergy

Answer 19

ciprofloxacin oral
and
vancomycin

Question 20

HAP severity scoring

Answer 20

sepsis
temp <36 or >38
wcc <4 or >12 
hr >90
rr>20
organ dysfunction

Question 21

early onset hap <5 days

Answer 21

treat as CAP

Question 22

hap >5 day onset with 1 severity marker

Answer 22

doxycycline oral

Question 23

hap >5 days with 2 severity markers

Answer 23

amoxicillin and gentamicin iv

Question 24

pathogens of hap

Answer 24

gram positive: s.aureus , s.pneumoniae

gram negatives: h.influenzae

Question 25

treatment of hap >5 days 2 severity markers with a pen allergy

Answer 25

gentamicin and vancomycin iv

Question 26

treatment of aspiration pneumonia

Answer 26

-metronidazole and amoxicillin oral

Question 27

pen allergy for aspiration pneumonia

Answer 27

doxycycline
or
co-trimoxazole
and metronidazole

Question 28

pneumocystis jiroveci treatment

Answer 28

co-trimoxaozole

Question 29

bacterial meningitis treatment

Answer 29

ceftriaxone iv
and dexamethasone iv

and if >50 immunocomp or pregnant or on steroids then give amoxi iv

Question 30

bacterial meningitis pathogens

Answer 30

strep pneum and Neisseria meningitidis

Question 31

cerebral abscess treatment

Answer 31

ceftriaxone iv and metronidazole oral

Question 32

viral encephalitis treatment

Answer 32

aciclovir iv

Question 33

cellulitis treatment

Answer 33

flucoxacillin oral/ iv if severe

vanc if mrsa severe

Question 34

pen allergy treatment of cellulitis or mild mrsa

Answer 34

doxycycline or clarithromycin

Question 35

treatment of human and animal bites

Answer 35

co-amoxiclav oral

Question 36

treatment of human and animal bites in elderly and pen allergy

Answer 36

doxycycline oral and metronidazole oral

Question 37

necrotising fasciitis

Answer 37

ben pen
flucox
clinda
metro
genta
all iv

Question 38

necrotising fasciitis pen allergy not severe

Answer 38

ceftriaxone
clinda
genta
metro 
all iv

Question 39

necrotising fasciitis pen allergy severe

Answer 39

van
clinda
ciprofloxacin
metro

Question 40

septic arthritis treatment

Answer 40

flucox iv

Question 41

septic arthritis and risk of gram negative treatment

Answer 41

flucox iv and ciprofloxacin oral

Question 42

osteomyelitis treament

Answer 42

fluxoc iv or vanc if mrsa