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1
Q

Which hepatitis types are faeco-oral spread rather than blood?

A

A+E

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2
Q

Which hepatitis is most likely to be asymptomatic?

A

C

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3
Q

Which hepatitis types have vaccines against them?

A

A and B

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4
Q

Hep A and B might cause what syndrome?

A

Immunological- rash, fever, polyarthritis, rarely glomerulonephritis

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5
Q

Rarely, hepatitis is caused by which viruses?

A

CMV, EBV, HSV

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6
Q

What can you give in Hep C to prevent it becoming chronic?

A

Interferon

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7
Q

Which types of hepatitis do not develop into chronic infection?

A

A and E

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8
Q

What is the treatment for uncomplicated hepatitis?

A

Symptomatic

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9
Q

What is a marker of acute Hep B infection

A

Surface antigen

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10
Q

What does an IgG core hep b antibody show?

A

Past infection

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11
Q

What does an IgM core hep b antibody show?

A

Acute infection

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12
Q

What is a marker of being vaccinated against hep b?

A

Surface antibody

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13
Q

What is a marker of being infectious with hep b?

A

HbeAg infectivity marker

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14
Q

Which drugs are metabolised by the p450 system?

A 
Carbamezapine
OCP
Warfarin
Phenytoin
Theophyline
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15
Q

Which drugs induce the p450 system?

A 
Carbamezapine
Rifampicin
Alcohol (chronic)
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas and St John's Wort
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16
Q

Which drugs inhibit the P450 system?

A 
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol (binge)
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole, Miconazole
Grapefruit and Cranberry juice
Clarithromycin
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17
Q

What is isoniazid?

A

Antibiotic used for TB

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18
Q

What is cimetidine?

A

H2 antagonist (like ranitidine)

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19
Q

What is chloramphenicol?

A

Antibiotic eye drop

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20
Q

What are sulphonamides?

A

Antimicrobials that start with ‘sulf-‘
Diuretics that end in ‘-amide’/-‘emide’
Anticonvulsants
Antiretrovirals

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21
Q

What drugs do you give for secondary prevention following an MI?

A 
Aspirin 75mg OD
Clopidogrel 75mg OD
Beta blocker – Bisoprolol 10mg OD
ACE Inhibitor – Ramipril 10mg OD
Statin – Atorvastatin 80mg OD
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22
Q

What is a side effect of amlodipine?

A

Swollen ankles

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23
Q

Where in the body are lipophilic drugs distributed?

A

Whole body

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24
Q

Where in the body are hydrophilic drugs distributed?

A

Stay in plasma

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25
Q

Which of lipophilic and hydrophilic drugs need to be metabolised before excretion?

A

Lipophilic only, they are metabolised into a hydrophilic substance

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26
Q

Where does metabolism of lipophilic drugs occur?

A

Liver

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27
Q

What are the stages of lipophilic drug metabolism?

A

Phase I- oxidation/reduction/hydrolysis
Phase II- conjugation with glucuronide/sulphate
→ hydrophilic drug.

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28
Q

How are hydrophilic drugs metabolised?

A

Unchanged

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29
Q

When lipophilic drugs have been metabolised into hydrophilic drugs, where are they excreted?

A

Kidneys, gall bladder

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30
Q

Some lipophilic drugs are metabolised into active metabolites e.g. opioids. When might this be a problem?

A

Accumulate in renal failure

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31
Q

What is ‘steady state’ of a drug?

A

When you give several doses, the plasma conc rises and falls but doesn’t fall back to 0 so a small increase with every dose. Steady state is when it is in equilibrium with its elimination. Normally 4 to 5 times the drug’s half-life. So may need a loading dose.

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32
Q

What is meant by the prescribing cascade?

A

When a medication is given to counteract the side-effects of another medication

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33
Q

What can drug reactions be sub-divided into?

A

ABCDE:
A- predictable from the way the drug works
B- bizzare- cannot be predicted from how the drug works
C- chronic- only after long term use
D- delayed- years later
E- end of treatment effects e.g. withdrawal

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34
Q

Can you give augmentin in penicillin allergy?

A

No- it is co-amoxiclav which contains amoxicillin

35
Q

Can you give ceftriaxone in penicillin allergy?

A

With caution- it is a cephalosporin which 10% are also allergic to

36
Q

Can you give Magnapen in penicillin allergy?

A

No it is aka co-fluampicil

37
Q

Can you give tazocin in penicillin allergy?

38
Q

Can you give Selexid in penicillin allergy?

A

No it is pivmecillinam

39
Q

Can you give Timentin in penicillin allergy?

40
Q

Can you give co-amoxiclav in penicillin allergy?

41
Q

Can you give meropenem in penicillin allergy?

A

With caution- it is a carbapenem which 10% are also allergic to

42
Q

Can you give aztreoman or other monobactams in penicillin allergy?

A

With caution 10% are also allergic

43
Q

Can you give co-fluampicil in penicillin allergy?

44
Q

For staph aureus you give which antibiotic?

A

Flucloxacillin

45
Q

For strep pyogenes you give which antibiotic?

A

Benzylpenicillin

46
Q

For gram -ve you give which antibiotic?

A

Cephalosporins (not in elderly though)

47
Q

For anaerobes you give which antibiotic?

A

Metronidazole

48
Q

For gram +ve (e.g. MRSA) you give which antibiotic?

A

Vancomycin

49
Q

UTI normally caused by which bacteria?

A

Gram -ve rods

Enterococci

50
Q

UTI antibiotics?

A

Trimethoprim
Nitrofurantoin (lower UTI only)
Pivmecillinam (lower only)

51
Q

Bacteria causing sinusitis?

A

Mixed- strep pneumoniae, staph aureus, H. Influenzae

52
Q

Abx for severe/prolonged sinusitis?

A

Amoxicillin

Clarithromycin

53
Q

Bacteria causing CAP?

A

Strep pneumoniae

54
Q

Antibiotics for CAP?

A

Co-amox and clarithromycin

or levofloxacin

55
Q

Causative organism of HAP?

A

Enterobacteriaceae

56
Q

Causative organism VAP?

A

Pseudomonas ssp

57
Q

Aspiration pneumonia causative organism

58
Q

Endocarditis pathogen?

A

Strep (esp strep viridans)

Staph aureus

59
Q

Endocarditis additional pathogen in prosthetic valve?

A

Coagulase negative staph

60
Q

what is duke’s criteria used in?

A

Infective endocarditis diagnosis

61
Q

What bloods do you do in endocarditis?

A

3x blood cultures separated in time over 24hrs

62
Q

Antibiotics for endocarditis?

A

Vancomycin + rifampicin + ciprofloxacin (native) or gentamicin (prosthetic)

63
Q

Causative organisms of surgical site infection?

A

Staph aureus

Group A beta-haemolytic strep (strep pyogenes)

64
Q

Trimethoprim should be avoided in…

A

first trimester of pregnancy

65
Q

Trimethoprim interferes with ____ _____ synthesis

A

Folic acid

66
Q

Strep pneumoniae is a…..?

A

alpha haemolytic streptococcus (gram +ve)

67
Q

Strep pyogenes is a?

A

Group A beta haemolytic strep (gram +ve)

68
Q

Staph aureus is a?

A

Coagulase positive staphylococcus (gram +ve)

69
Q

Staph epidermis is a?

A

Coagulase negative staphylococcus (gram +ve)

70
Q

are coagulase negative staphs problematic?

A

Only with prostheses

71
Q

Clostridium ssp. are?

A

Spore forming gram positive bacilli

72
Q

Listeria ssp are?

A

Non-spore forming gram positive bacilli

73
Q

Are mycobacteria gram positive or negative?

A

Weakly positive, but better to use an acid fast stain

74
Q

What are enterococci?

A

Streptococci (gram positive catalase negative cocci)

75
Q

What is neisseria meningitidis?

A

Gram negative (diplo)coccus

76
Q

What is haemophilus ssp?

A

Gram negative cocco-bacillus

77
Q

What are enterobactericaea?

A

Gram negative bacillus

78
Q

what is coombs test for?

A

Haemolytic anaemia

79
Q

SACDC is caused by?

A

B12 deficiency

80
Q

Which type of lymphoma might present with a single enlarged lymph node?

81
Q

What organomegaly is present in lymphoma?

A

Hepatomegaly

Splenomegaly

82
Q

Ramsey Hunt is

A

Bells palsy plus ear symptoms

83
Q

Ramsey Hunt is caused by

Y3 hist and exam (17 decks)

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