Bacterial

Question 1

What are the “Four C’s” (antibiotics) that increase the risk of C. diff infection ?

Answer 1

Co-amoxiclav (and other broad spectrum penicillins e.g. amoxicillin and ampicillin)

Cephalosporins

Clindamycin

Ciprofloxacin (and other Quinolones)

Question 2

True or false: food poisoning is a notifiable disease

Answer 2

TRUE

Other notifiable diseases include anthrax, measles, cholera and small pox

See BNF for full list

Question 3

Which class of antibiotics are usually used in patients allergic to penicillin as an alternative

Answer 3

Macrolides e.g. erythromycin

Question 4

Choice of antibiotic for animal/human bites in patients allergic to penicillin ?

Answer 4

Doxycycline + metronidazole

Question 5

Which group of antibiotic(s) are used to treat septicaemia

Answer 5

Broad spectrum antipseudomonal penicillin e.g. Tazocin

Piperacillin with Tazobactam

Question 6

Which antibiotic is used in meningococcal septicaemia

Answer 6

Benzylpenicillin

Cefotaxime in penicillin allergy

Question 7

First line for skin and soft tissue infections

Answer 7

Flucloxacillin

Question 8

True or false: flucloxacillin is first line for both otitis externa and otitis media

Answer 8

False

Otitis media: Amoxicillin first line

Otitis externa: Flucloxacillin first line

Question 9

Antibiotic of choice for C diff infection

Answer 9

Metronidazole

Question 10

Antibiotic(s) of choice for genital chlamydia

2 points

Answer 10

Azithromycin (single dose)

Doxycycline (2 stat then 1 OD. 7 day course)

Question 11

Antibiotic choice for osteomyelitis

Answer 11

Flucloxacillin

Clindamycin if penicillin allergy

Question 12

Which 3 antibiotics can be used first line for an infective exacerbation of COPD

Answer 12

Amoxicillin

Doxycycline

Clarithromycin

Question 13

Imipenem and and Ertapenem are examples of which class of antibiotics

Answer 13

Carbapenems

Broad spectrum Beta lactams
Activity against many Gram +ves, -ves and anaerobes

Question 14

Which macrolide is generally preferred in pregnancy

Answer 14

Erythromycin

Question 15

First line treatment for genital chlamydia (2 options)

Answer 15

Doxycycline (7 day course)

Or Azithromycin (single dose)

Question 16

Which antibiotic is first line for osteomyelitis in penicillin allergy

Answer 16

Clindamycin

Question 17

True or false: antibacterials should be given for acute sinusitis

Answer 17

FALSE

It is usually self limiting. Antibiotics are rarely indicated unless the patient is systemically unwell and symptoms have been present for > 10 days

Question 18

Which tool is used to assess the severity of community acquired pneumonia?

Answer 18

CRB-65

In hospital, CURB-65 used (as they have facilities to monitor urea)

Question 19

Antibiotic of choice for Lyme disease ?

Answer 19

Doxycycline is 1st line

Question 20

Treatment with gentamicin should ideally not exceed ______ in length

Answer 20

7 days

Question 21

Which penicillin is used to treat syphilis

Answer 21

Benzathine Benzylpenicillin

Question 22

Are penicillins bacteriostatic or bactericidal

Answer 22

Bactericidal

Question 23

Which class of antibiotic is known to cause QT prolongation and tendon damage ?

Answer 23

(Fluoro) Quinolones

Question 24

True or false: tetracyclines are safe for use in pregnancy

Answer 24

FALSE
They should be avoided as they effect skeletal development and cause tooth discolouration

Avoid in under 12s due

May cause maternal hepatotoxicityn

Question 25

What is the most common bacterial cause of UTI

Answer 25

E. Coli

Question 26

True or false: UTIs are considered recurrent if a patient has 2 in the last 6 months

Answer 26

TRUE Also if the patient has had 3 or more in the last 12 months

Question 27

Antibiotic of choice for UTI in a pregnant woman ?

Answer 27

Nitrofurantoin AVOID TRIMETHOPRIM

Question 28

This class of antibiotic is not known to increase the anticoagulant effect of warfarin

Answer 28

Cephalosporins

Question 29

True or false Tetracyclines need to be stopped if the patient develops headaches or visual disturbances

Answer 29

TRUE Seek medical attention. This could be a sign of benign intracranial hypertension

Question 30

True or false: Clindamycin is safe to continue if the patient develops diarrhoea

Answer 30

FALSE This could indicate antibiotic associated colitis. Clindamycin is one of the 4 Cs

Question 31

Counselling points for doxycycline? | 4 points

Answer 31

1. Swallowed whole with plenty of fluid, while sitting or standing. 2. Taken during meals. 3. Do not take indigestion remedies, Ca or Zn products within 2 hours of doxycycline. 4. May cause photosensitivity - avoid sunlight. Wear broad spec sunscreen

Question 32

Which drugs increase the risk of tendon rupture with Quinolones

Answer 32

Corticosteroids

Question 33

How to beta lactam antibiotics work

Answer 33

They inhibit the enzymes that cross link peptidoglycan which weakens cell walls Causes swelling, lysis and death Bactericidal

Question 34

Which group of beta lactam antibiotics are only available IV

Answer 34

Carbapenems eg meropenem

Question 35

True or false Carbapenems are cautioned in epilepsy

Answer 35

TRUE They are known to cause CNS toxicity (including seizures) at high doses or in renally impaired patients

Question 36

Which antibiotics may cause cholestatic jaundice | 3 points

Answer 36

Macrolides Co-amoxiclav Flucloxacillin

Question 37

True or false: Macrolides are enzyme inhibitors

Answer 37

FALSE All except azithromycin are enzyme inhibitors

Question 38

Is metronidazole bactericidal or bacteriostatic

Answer 38

Bactericidal

Question 39

Which antibiotic should be taken with food or milk to minimise the GI effects

Answer 39

Nitrofurantoin

Question 40

Which classes of antibiotics increase the anticoagulant effect of warfarin (3 points) How?

Answer 40

Penicillins Tetracyclines Trimethoprim Kill vitamin K producing flora

Question 41

Which class of antibiotics increase the risk of methotrexate toxicity

Answer 41

Penicillins They reduce the renal excretion of methotrexate = increased risk of toxicity

Question 42

Which quinolone can be used for pseudomonas infections

Answer 42

Ciprofloxacin

Question 43

Is trimethoprim bactericidal or bacteriostatic

Answer 43

Bacteriostatic

Question 44

Which drug used in the treatment of TB is not known to be hepatotoxic

Answer 44

Ethambutol Associated with ocular toxicity though !

Question 45

Therapeutic levels for gentamicin: a) peak b) trough Also values in endocarditis

Answer 45

A) Peak 5-10 mg/L 3-5 mg/L in endocarditis B) Trough <2 mg/L < 1 mg/L in endocarditis

Question 46

Which antibiotic is known to cause taste disturbances?

Answer 46

Metronidazole | Causes a metallic taste in the mouth

Question 47

Which antibiotics are treatment options in pyelonephritis ? Include duration of treatment (4 points)

Answer 47

Cefalexin for 7 - 10 days [preferred in pregnancy] Co-amoxiclav for 7 - 10 days Trimethoprim for 14 days Ciprofloxacin for 7 days

Question 48

Antibiotic for meningococcal septicaemia in penicillin allergy?

Answer 48

Cefotaxime

Question 49

What does CURB-65 stand for ? What is it used for

Answer 49

Pneumonia severity score in hospital (CRB-65 in community as can't measure urea) ``` C = (new onset) Confusion U = Urea > 7 R = Respiratory rate > 30 breaths/min B = (low) Blood pressure < 90 sys or < 60 dia 65 = Age 65 or older ```