Primary Care Adult

Question 1

Meningitis

Answer 1

Transfer to hospital + Benzylpenicillin 1.2g IV/ IM if there is time

Question 2

Orbital Cellulitis

Answer 2

Transfer to hospital

Question 3

Conjunctivitis

Answer 3

Self limiting

Chloramphenicol 2 hourly for 2 days then 4 times daily

Question 4

Ophthalmic shingles

Answer 4

Refer to ophthalmology

aciclovir 800mg 5 times daily or valaciclovir 1g tds 7 days

Question 5

Tonsilitis / pharyngitis/ sore throat

Answer 5

Most are viral!
Penicillin V 1g bd or 500mg qds 10 days
2nd line:
Clarithromycin 500mg bd 5 days

Question 6

Sinusitis

Answer 6

Reserve antibiotics for severe / deteriorating cases of >7-10 days duration
Penicillin V 500mg qds or 1g bd - 7 days
2nd Line:
Doxycycline 200mg day 1 then 100mg daily 7 days)

Question 7

Epiglottitis

Answer 7

Medical emergency - transfer to hospital immediately

Question 8

Otitis Media

Answer 8

Most cases will resolve without antibiotics
if otorrhoea:
1st line: amoxicillin: 500mg tds
2nd line: Clarithromycin 500mg bd

Question 9

Otitis Externa

Answer 9

Provide info on aural care

Acetic acid 2% for 2 days after resolution

Question 10

Oral thrush

Answer 10

Nystatin liquid 1 ml qds (7 days)

2nd line: Fluconazole 50mg daily

Question 11

Cellulitis

Answer 11

Flucloxacillin 1g was or doxycycline 100mg bd

Question 12

Athlete’s foot

Answer 12

Topical 1% terbinafine 7 days

Question 13

Dermatophyte nail infection

Answer 13

Terbinafine 250mg od for 6-12 weeks (fingers) or 3-6 months (toes)

Question 14

Diabetic foot

Answer 14

Flucloxacillin 1g qds for mild to moderate disease
doxycycline 100mg bd for mild
Cotrimoxazole 960mg bd for moderate
Consider addition of metronidazole for anaerobes

Question 15

Impetigo

Answer 15

Localised lesions - topical fusidic acid
Flucloxacillin 500mg qds
clarithromycin 500mg bd
7 days

Question 16

Chickenpox

Answer 16

Antiviral

If

Question 17

Shingles

Answer 17

Must present within 72 hours of onset of rash

Aciclovir 500mg 5 times daily (7 days)

Question 18

Bites

Answer 18

Co-amoxiclav 625mg tds

Metronidazole 400mg tds + doxycycline 100mg bd (7 days)

Question 19

Catheterised patients

Answer 19

Coamoxiclav 625mg yds or co-trimoxazole 960mg bd (7days)

Change catheter

Question 20

Uncomplicated Female Lower UTI

Answer 20

Trimethoprim 200mg bd OR
Nitrofurantoin 50mg qds or 100mg MR bd
3 days

Question 21

Pyelonephritis

Answer 21

Send MSSU
co amoxiclav 625mg tds or cotrimoxaxole 960mg bd
7 days

Question 22

Uncatheterised male UTI

Answer 22

send MSSU
trimethorprim 200mg bd or nitrofurantoin MR 100mg bd or 50mg qds
7 days

Question 23

UTI or bacteriuria in pregnancy

Answer 23

send MSSU
1st or 2nd trimester - nitrofurantoin MR 100mg bd or 50mg wds
3rd trimester - trimethoprim 200mg bd

2nd line and trimesteris cefalexin 500mg tads

all 7 days
sampe for test o fcure

Question 24

Recurrent UTI women

Answer 24

Trimethoprim 100mg or nitrofurantoin 50-100mg nightly dose

Review after 6-12 months