YEAR 5 FINALS

Question 1

Treatment of C-DIFF?

Answer 1

1st-line therapy is ORAL vancomycin for 10 days
2-line therapy: ORAL fidaxomicin
3-line therapy: ORAL vancomycin +/- IV metronidazole

Question 2

Life-threatening Clostridium difficile infection tx?

Answer 2

oral vancomycin AND IV metronidazole

specialist advice - surgery may be considered

Question 3

Lower UTI (non pregnant & pregnant)

Answer 3

trimethoprim or nitrofurantoin for 3 days

1st-line: nitrofurantoin (should be avoided near term)

Question 4

when is trimethoprim CI in Pregnant women?

Answer 4

trimethoprim is teratogenic in the FIRSTT trimester and should be avoided during pregnancy

Question 5

asymptomatic bacteriuria in pregnant women

what do u do after they finish their course of antibiotics?

Answer 5

an immediate antibiotic prescription of either
nitrofurantoin (should be avoided near term),
amoxicillin or cefalexin.
7-day course

further URINE CULTURE should be sent following completion of treatment as a TEST OF CUREEEEE

Question 6

Dx of C-Diff

Answer 6

is made by detecting Clostridium difficile TOXXXINNN (CDT) in the stool

Clostridium difficile antigen positivity only shows exposure to the bacteria, rather than current infection…

Question 7

Men with lower UTI

Answer 7

trimethoprim or nitrofurantoin 7 days

Question 8

how do u treat asymptomatic bacateruria in Catherised patients?

Answer 8

DO NOT TREAT its normal

Question 9

COPD infective excerbation
Treatment?
Prophylaxis

Answer 9

Oral prednisone for 5 days

Amoxicillin/Clarithromycin

Question 10

CAP Pneumonia Tx

depending on different curbs

Answer 10

Curb 0–> Amoxicillin for 5 days

Curb 1-2–> amoxicillin & Doxy

Curb 3 or more–> admission to ITU

Question 11

Pneumonia possibly caused by atypical pathogens

Answer 11

Clarithromycin

Question 12

HAP tx

Answer 12

Within 5 days of admission–> co-amoxiclav or cefuroxime

More than 5 days after admission: piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)

Question 13

Pyelonephritis Tx? women and men?

pregnant?

Answer 13

1st line–> ORAL Cefalexin, or Ciprofloxacin

Pregnant:

Question 14

impetigo Tx
Cellulitis Tx (what if near eyes or nose)

Answer 14

impetigo–> topical fusidic acid (hydrogen peroxide)

cellulitits–> Flucloxacillin
near eyes or nose (co-amoxiclav)

Question 15

Tx and organisms for:
Otitis Media
Otitis Externa (severe)
Necrotizing otitis Externa

Answer 15

OM–> (HSM)–> Amoxicillin 5-7 days
OE–> strep epidermis, staph aureus–> Flucloxacillin
NOE–> pseudomonas–> IV ciprofloxacin

Question 16

Prophylaxis for meningitis

Prophylaxis for Ascites

Answer 16

oral rifampicin or ciprofloxacin

oral ciprofloxacin or norfloxacin

Question 17

Chlamydia
Gonorrhoea
Syphilis
Bacterial Vaginosis
PID
Candida
H. pylori

Answer 17

Oral Doxy or Azithromycin
IM ceftriaxone
Benzathine benzylpenicillin
Oral or topical metronidazole or topical clindamycin
Clarythromycin, Doxycycline, Metriniadzole
Clotrimazole pessary or ORAL fluconazole
2 antibiotics and PPI

Question 18

Latent TB tx

Active TB tx

Answer 18

Latent
R & I for 3 months
OR
Isonaziad for 6 mnths

active
RIPE–> 2 months
RI–> another 4 months

Question 19

Gold standard Ix
C-diff
TB
infectious mononucleosis
Lyme disease

Answer 19

Cdif–> CDT (stool c diff TOXIN)
TB–> sputum culture
IM–> mono spot test
ELISA

Question 20

GI Mx
Campylobacter
Shigella
Salmonella
Giardia
E.coli

Answer 20

Clare is camping –> clarythromycin
shigella–> ciprofloxacin
sipping on some salmon soup–> Ciprofloxacin
Giardia–> metronidazole

Question 21

Most common cause in
COPD infective exacerbation
OM
OE
infective endocarditis
meningits
encephalitis

Answer 21

1. HSM
2. HSM
3. strep epidermis & staph aureus
6. coxsackie ( enterovirus)

Question 22

Mx 
meningitis
Encephalitis
listeria
Pneumocystis jiroveci pneumonia (HIV)
MRSA
Prostitis 
Legionella

Answer 22

M-->
E-->
L--> ampicillin for one month
PJP--> co-trimoxazole
MRSA--> vancomycin
Prostitis--> 4-day course of ciprofloxacin 500mg BD
Macrolides  as clarithromycin

Question 23

Mx in non-falciparum malaria

Answer 23

Primaquine

Question 24

HIV infection, when to repeat second test?

Answer 24

offer a repeat test at 12 weeks