SEPSIS/Infections

Question 1

Mild CAP (CURB 0-2)

Answer 1

Amoxicillin

Doxycycline if allergic

Question 2

Severe CAP (CURB 3-5)

Answer 2

Co-amoxiclav + doxycycline

IV levofloxacin if allergic

Question 3

Severe CAP in ICU/HDU

Answer 3

Co-amoxiclav + clarithromycin

IV Levofloxacin if allergic

Question 4

Non-severe HAP

Answer 4

PO Amoxicillin + Metronidazole

Co-trimoxazole + metronidazole if pen allergic

Question 5

Severe HAP

Answer 5

Amox + Met + Gent
Step down to PO co-trimoxazole + doxycycline

Co-trimoxazole + metronidazole +/- gentamicin if pen allergic

Question 6

Native valve indolent endocarditis

Answer 6

Amox + gent

Question 7

Native valve acute endocarditis

Answer 7

Flucloxacillin

Question 8

Step down for all patients with severe CAP

Answer 8

Doxycycline

Question 9

Prosthetic valve/suspected MRSA endocarditis

Answer 9

Vancomycin + Rifampicin + Gent

Question 10

Native valve severe sepsis + risk factor for resistant pathogens

Answer 10

Vancomycin + Meropenem

Question 11

Peritonitis/Biliary tract/Intra-abdo

Answer 11

Amox + met + gent
(vanc + met + gent if pen allergic)

Step down to Co-trimoxazole + metronidazole

Question 12

Cellulitis

Answer 12

Flucloxacillin

Doxycycline if pen allergic

Question 13

Diabetic foot ulcer

Answer 13

Mild: Flucloxacillin (or doxycycline)

Mod: Flucloxacillin + Metronidazole
or dox + metronidazole

Question 14

Meningitis < 3 months old

Answer 14

Cefotaxime + amoxicillin

Question 15

Meningitis > 3 months old

Answer 15

1st dose Cefotaxime
Then ceftriaxone
+/- dexamethasone
(chloramphenicol if pen allergic)

Question 16

Orbital cellulitis

Answer 16

Flucloxacillin + ceftriaxone +/- metronidazole

Question 17

Tonsillitis

Answer 17

Penicillin V

Clarithromycin if pen allergic

Question 18

Acute otitis media

Answer 18

Penicillin V

Clarithromycin if pen allergic

Question 19

Mastoiditis

Answer 19

Co-amoxiclav

Question 20

Epiglottitis

Answer 20

Ceftriaxone

Chloramphenicol if pen allergic

Question 21

Cellulitis in kids

Answer 21

Flucloxacillin

Clarithromycin if pen allergic

Question 22

Septic Arthritis/Osteomyelitis in kids

Answer 22

Flucloxacillin
(clindamycin if pen allergic)

If <5y/o and not HiB immunised add Ceftriaxone

Question 23

UTI in pregnancy

Answer 23

1st/2nd trimester - nitrofurantoin
3rd trimester - trimethoprim

2nd line - cefalexin

Question 24

Prostatitis

Answer 24

Ofloxacin/Ciprofloxacin

Question 25

Epidydimo-orchitis

Answer 25

If STI likely (<35, new partner) - Doxycycline

If STI unlikely (>35, no new partner) - Ofloxacin

Question 26

Athlete’s foot

Answer 26

Topical terbinafine

Question 27

Dermatophyte nail infection

Answer 27

Confirm with clippings first

finger - oral terbinafine 6-12 weeks
toe - oral terbinafine 3-6 months

Question 28

Impetigo

Answer 28

localised - fusidic acid

Spread - flucloxacillin
clarithromycin if pen allergic

Question 29

Shingles

Answer 29

Aciclovir if present within 72 hours of rash onset

Question 30

Chickenpox

Answer 30

Aciclovir if present within 24 hours of rash onset

Question 31

Staph pneumonia

Answer 31

Flucloxacillin +/- rifampicin

Question 32

Chlamydia psittaci?

Answer 32

Tetracycline/Clarithromycin

Question 33

Legionella

Answer 33

Clarithromycin (+rifampicin?)

OR ciprofloxacin

Question 34

SIRS criteria

Answer 34

temp >38 OR <36
HR > 90
RR > 20
WCC >12,000 OR <4,000 OR >10% neutrophils

Question 35

qSOFA criteria

Answer 35

RR 22+
Change in mental status
Systolic BP 100 or below