General ID Knowledge

Question 1

Is ceftriaxone a 4C antibiotic?

Answer 1

Yes

Question 2

Is co-amoxiclav a 4C antibiotic?

Answer 2

Yes

Question 3

Is clarithromycin a 4C antibiotic?

Answer 3

No

Question 4

Is co-trimoxazole a 4C antibiotic?

Answer 4

No

Question 5

Is ciprofloxacin a 4C antibiotic?

Answer 5

Yes

Question 6

Is clindamycin a 4C antibiotic?

Answer 6

Yes

Question 7

Gram negative ‘coliforms’ and pseudomonas aeruginosa and sensitive to which commonly used antibiotic?

Answer 7

Gentamicin

Question 8

Anaerobes are sensitive to which commonly used antibiotic?

Answer 8

Metronidazole

Question 9

MRSA is sensitive to which commonly used antibiotic?

Answer 9

Vancomycin

Question 10

Beta-haemolytic streps (groups A C G) are sensitive to which 2 common antibiotics that are both in the same family?

Answer 10

Penicillin and flucloxacillin

Question 11

Is chloramphenicol a 4C antibiotic?

Answer 11

No

Question 12

Which antibiotic is used against coliforms if gentamicin has already been used for 3 days?

Answer 12

Aztreonam

Question 13

When should you notify public health about a notifiable disease?

Answer 13

As soon as you have a reasonable clinical suspicion - DO NOT wait for lab confirmation

Question 14

Name some of the most common notifiable diseases you may encounter

Answer 14

• E.coli O157
• Haemolytic Uraemic Syndrome (HUS)
• Meningococcal disease
• Necrotizing fasciitis
• TB
• Tetanus / diptheria / polio
• Measles / Mumps / Rubella
• Pertussis
• Haemophilus influenzae type b (Hib)
• etc

Question 15

What are the exclusion criteria that determine a patient needs to wait for confirmation of stool clear or E.coli rather than just wait 48hrs like everyone else?

Answer 15

• Doubtful personal hygiene or unsatisfactory access to sanitary facilities
• Pre-school attending child
• Food worker
• Clinical/social care staff of vulnerable people

Question 16

Does Legionnaire’s disease need contact tracing?

Answer 16

No - there is no human to human transmission but you do need to do case finding and try to discover the source

Question 17

What are the exclusion criteria for gentamicin treatment?

Answer 17

• < 16 years old
• Ascites > 20% body weight
• Major burns > 20% body surface
• Decompensated Liver Disease
• Myasthenia Gravis
• Renal Transplant
• Acute Kidney Injury (AKI 3) on dialysis or eGFR <20ml/min
• End stage renal failure on dialysis with residual kidney function

Question 18

What is the maximum course length of gentamicin?

Answer 18

72hrs (3 days)

Question 19

What are the indications for vancomycin use?

Answer 19

• Serious proven or suspected MRSA or coagulase negative staphylococcal infections
• Infections due to other resistant gram positive organisms
• Native (with severe sepsis or where MRSA suspected) or prosthetic valve endocarditis
• Other infections – after consultation with ID Physician or Microbiologist

Question 20

How long can a PVC be left in before you have to consider taking it out?

Answer 20

72 hrs (3 days)

Question 21

The bottom of a blood culture bottle should be greenish in colour. An orange/red colour indicates what?

Answer 21

Contamination

Question 22

What is the optimum volume of blood to draw for a blood culture?

Answer 22

8-10ml - overfilling can lead to false positives

Question 23

If the patient has an arteriovenous fistula/graft in place in their arm can you cannulate them?

Answer 23

You must use the other arm

Question 24

Can you take blood cultures from a PVC?

Answer 24

No

Question 25

If a patient has an existing PVC, where should you not draw blood cultures from?

Answer 25

Sites on the arm above the PVC

Question 26

A patient has been started on intravenous antibiotics due to severe sepsis. There was not the opportunity to take a blood culture sample prior to commencement of antibiotics. When should a blood culture be taken or is it even necessary now?

Answer 26

Yes. It is necessary and a blood culture sample should be taken immediately before the next dose of antibiotics

Question 27

What are the components of SIRS

Answer 27

≥2 of the following: - Temp >38 or <36 - HR >90 - RR >20 - WBC count >12,000/mm3 or <4,000/mm3 or >10% immature neutrophils

Question 28

What are the side effects of gentamicin?

Answer 28

Kidney damage and deafness/dizziness

Question 29

What organs can vancomycin damage?

Answer 29

Kidneys

Question 30

What side effect can tetracyclines (eg doxycyline) have in children <12?

Answer 30

Permanent staining of teeth and bones

Question 31

What can you not do while taking metronidazole?

Answer 31

Drink alcohol

Question 32

What classes of antibiotics are all generally safe in pregnancy?

Answer 32

Penicillins and cephalosporins

Question 33

What antibiotics should be avoided in the first 3 months of pregnancy?

Answer 33

Trimethoprim and metronidazole

Question 34

What antibiotics shouldn't be given to pregnant women?

Answer 34

Gentamicin, tetracyclines (eg doxycycline) and fluoroquinolones (eg ciprofloxacin)

Question 35

What is co-amoxiclav made up of?

Answer 35

Amoxicillin + clavulanic acid

Question 36

What is the treatment of TB?

Answer 36

Rifampicin, Isoniazid, Pyrazinamide, Ethambutol orally