MOSLER Revision

Question 1

What pathogen does doxycycline cover for suspected LRTI that isn’t necessarily covered by amoxicillin?

Answer 1

Moraxella Catarrhalis

Question 2

What 2 Abs are not recommended for empirical treatment of suspected LRTIs?

Answer 2

Co-amoxiclav or ciprofloxacin

Question 3

Rx for CAP with CURB65

Answer 3

Amoxicillin +/- clarithromycin dependent on suspicion of atypical pathogen

Question 4

If treating for atypical pneumonia, particularly with relevant history, what else should be sent for besides sputum culture and usual stuff?

Answer 4

Urine for legionella antigen

Acute and convalescent sera for serology

Question 5

Rx for CAP with CURB65 3 or more but not suspected sepsis?

Answer 5

Amoxicillin + clarithromycin IV

Question 6

Rx for CAP with CURB65 3 or more and signs of sepsis?

Answer 6

Tazocin + clarithromycin IV

Question 7

Alternative to tazocin + clarithromycin for high-scoring CURB65 in patient with penicillin allergy?

Answer 7

Tigecycline

Question 8

What important microbes does tazocin cover over co-amoxiclav?

Answer 8

Pseudomonas

Anaerobes e.g. Coliforms

Question 9

What pathogen is linked with COPD exacerbation and also HAP?

Answer 9

Moraxella Catarrhalis

Question 10

What is it important to cover for in suspected aspiration pneumonia?

Answer 10

Anaerobes - add metronidazole to amoxicillin

Question 11

First line Rx for suspected hospital acquired pneumonia?

Answer 11

Co-amoxiclav

Question 12

Recommended empirical treatment of suspected LRTI?

Answer 12

Amoxicillin

Or doxycycline in penicillin allergy

Question 13

What type of bacteria is C diff?

Answer 13

Gram positive anaerobic rod

Question 14

SIGHT management of C Diff?

Answer 14

Suspected case of infectious diarrhoea, no other likely cause
Isolate patient + investigate
Gloves and aprons (PPE)
Hand washing w/ soap and water
Test stools

Question 15

Outline testing routine for suspected C Diff?

Answer 15

Glutamate dehydrogenase GDH test - if positive indicates presence of c diff; may or may not be causing problem
If positive GDH, then do stool toxin test (A+/-B). If toxin also positive = infection

Question 16

What is the next investigative line if someone with suspected C Diff tests positive for GDH but negative for toxin and has persistent diarrhoea?

Answer 16

Isolate patient anyway and retest stools

Question 17

2 patients, one with MRSA one with C Diff. Which one do you isolate first and why?

Answer 17

C diff - spore formation in the environment which can be spectacularly difficult to eradicate

Question 18

Most common bacteria responsible for UTIs?

Answer 18

E. coli + other coliforms
Enterococci
Staph saprophyticus

Question 19

Rx for pyelonephritis? Common pathogens?

Answer 19

E. coli or s aureus

Ciprofloxacin