Common infections

Question 1

What parasite most commonly causes threadworms in the UK

Answer 1

Enterobius vermicularis

Question 2

Eggs of threadworms can live in house for ________

Answer 2

Up to 2 weeks

Question 3

Investigation for threadworms

Answer 3

Sellotape glass slide

- Place on anus in the morning

Question 4

______ (brandname) is first line treatment for threadworms

Answer 4

Mebendazole (Vermox)

Question 5

Mebendazole is contraindicated in the ______ trimester of pregnancy

Answer 5

First

Question 6

Treatment for threadworms is repeated after _____ days/weeks

Answer 6

2 weeks

Question 7

Hygiene advice for threadworms on the first day.

Answer 7

Washing clothes/ bedding/ towels/ nightwear in warm water. Dry properly

Hovering carpet/ matress

Thorough cleaning of bathroom

Question 8

Hygiene advice for threadworms for week 2

Answer 8

Closely fitted underpants at night. Change every morning

Wash anus thorough in morning, scrub nails

Clip nails

Discourage finger sucking/ nail biting.

Question 9

First line medication for headlice is ______ (brandname)

Answer 9

Dimeticone (Hedrin)

Question 10

Second line medication for headlice is ______ (brandname)

Answer 10

Malathion (Derbac M)

Question 11

Wet combin advise for headlice

Answer 11

4 sessions over 2 weeks

• Every 4 days from day 1.
• At least 10 mins for short hair.

Question 12

First line management of chest infection CURB 65= 0

Answer 12

Self-care
- Hydrate, rest, simple analgesia

Antibiotics

• Amoxicillin/ clarithromycin 500mg TDS 5/7
• Doxycycline 200mg then 100mg 5/7

Question 13

First line management of chest infection CURB 65= 1-2

Answer 13

Consider hospital admission

Self care

Antibiotics

• Amoxicillin + clarithromycin (atypical infection)
• Doxycycline

Question 14

Management of pneumonia CURB 65 =/> 3

Answer 14

Urgent hospital assessment.

Question 15

Safety netting for chest infections

Answer 15

• Symptoms worsen rapidly
• Symptoms do not improve significantly after 3 days
• Become systemically unwell
• Antibiotics does not improve symptoms significantly

Question 16

X-ray is indicated as a follow up for chest infection when…

Answer 16

Symptoms persist despite antibiotics

high risk of malignancy (i.e. >50, smoker)

Question 17

1 week after starting antibiotics for pneumonia, ____ should have resolved

Answer 17

Fever

Question 18

4 week after starting antibiotics for pneumonia, ____ should have improved significantly

Answer 18

Chest pain and sputum production

Question 19

6 week after starting antibiotics for pneumonia, ____ should have resolved

Answer 19

Breathlessness and cough

Question 20

3 months after starting antibiotics for pneumonia, ____ may persist

Answer 20

Fatigue

Question 21

Symptoms of pneumonia may not take until _____ to fully resolve

Answer 21

6 months

Question 22

Features of Centor criteria

Answer 22

tender Cervical lymphadenopathy

Exudative tonsils

No Cough

Temperature >38

Age

• 3-14 = 1
• 15-44 = 0
• > 45= -1

Question 23

Antibiotic prescription for tonsillitis

Answer 23

Pen V (phenoxymethylpenicillin) QDS / clarithromycin

Question 24

Saftey net for sore throat

Answer 24

Fever >38

Rash

Unable to eat/ drink

Drowsy

Question 25

Lifestyle advice for UTI

Answer 25

Frequent hydration Sodium citrate sachets Peeing after sex

Question 26

Medical management of UTI (women, uncomplicated)

Answer 26

Pain + fever= Paracetamol 1. Nitrofurantoin 100mg BD 3 days 1. Trimethoprim 200 BD 3/7 2. Pivmecillinam 400mg, then 200mg TDS 3/7 3. Fosfomycin 3g satchet

Question 27

Management of haematuria in UTI

Answer 27

Treat with antibiotics and retest urine. If still present - Refer for cancer as appropriate: urological, gynae. - Consider CKD- refer to secondary care

Question 28

Management of recurrent UTI in women

Answer 28

Treat acute UTI, send cultures Advice on behavioural practices Vaginal oestrogen - If underlying cause is investigated and behavioural methods don't work - Review in 12 months Consider antibiotic prophylaxis (single dose)

Question 29

Antibiotic choice in pregnancy for UTI

Answer 29

1. Nitrofurantoin (avoid at term) 100mg MR BD, 7/7 2. Amoxicillin 500mg TDS 7/7 (if sensitive) 2. Cefalexin 500mg BD 7.7

Question 30

Asymptomatic bacteruria management in pregnancy

Answer 30

Nitrofurantoin 100mg MR BD, 7/7 Amoxicillin TDS 500mg, 7/7 Cefalexin 500mg BD 7/7

Question 31

Catheter UTI in women is treated for...

Answer 31

7 days

Question 32

Lower UTI in men should be managed for...

Answer 32

7 Days

Question 33

Who should be avoided when infected with chickenpox

Answer 33

Pregnant women Babies <4 weeks Nursery/ school until lesions have crusted Immuncompromised people

Question 34

Complications of chickenpox

Answer 34

Bacterial superinfection Neurological - Reye's syndrome - Cerebellar ataxia - Encephalitis Systemic - All the itis

Question 35

First line antibiotic for AOM

Answer 35

Amoxicillin PO Clarithromycin for pen allergy