Hospital adult Flashcards

1
Q

how do you treat meningitis?

A
  1. Ceftriaxone IV 2g bd + Dexamethasone IV 10mg qds
  2. Aciclovir IV (10mg/kg tds) if encephalitis suspected
  3. Add Amoxicillin IV 2g 4 hourly if ≥ 60 years or immunocompromised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how do you treat epiglottitis/ supraglottitis?

A

Ceftriaxone IV 2g od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how do you treat community acquired pneumonia?

0-2 curb 65 score

A

0-2 Mild/Mod

Amoxicillin 1g tds IV/PO (5 days)

(If penicillin allergic:Doxycycline PO 200mg on day 1 then 100mg od or IV Clarithromycin* if NBM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how do you manage hospital acquired pneumonia?

non severe

A

Non severe: PO Amoxicillin (If penicillin allergic: Doxycycline 100mg bd) TOTAL 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how do you manage aspiration pneumonia?

non severe

A

Non severe:

PO Amoxicillin + Metronidazole (If penicillin allergic: PO Doxycycline 100mg bd + Metronidazole) TOTAL 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how do you manage acute exacerbation of COPD?

A

1ST LINE Amoxicillin 500mg tds

2ND LINE Doxycycline 200mg on day 1 then 100mg od (5days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how do you manage acute bronchitis?

A

1ST LINE Amoxicillin 500mg tds

2ND LINE Doxycycline 200mg on day 1 then 100mg od (5days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how do you manage endocarditis?

A

Native valve indolent (Subacute): Amoxicillin IV 2g 4 hourly + Gentamicin

Native valve severe sepsis (Acute): Flucloxacillin IV 2g 6 hourly (4 hourly if >85kg)

Prosthetic valve or Suspected MRSA: Vancomycin IV + Gentamicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how do you manage c.difficle infection?

A

Severe/Non severe: Vancomycin 125mg qds (10 days)

Recurrent: positive CDI in previous 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how do you manage peritonitis/biliary tract/ intra-abdominal?

A

IV amoxicillin+ metronidazole+ gentamicin

step down: PO co-trimoxazole + metronidazole

if penicillin allergic : IV vancomycin + metronidazole + gentamicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what must you consider when treating catherterised patients?

A

do not use urinalysis

do not treat unless clinical signs/ symptoms of infection

if confirmed treat as complicated UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how do you manage complicated UTI/ pyelonephritis/urosepsis?

A

IV amoxicillin + gentamicin ( penicillin allergic: IV Co-trimoxazole + Gentamicin)

Step down: PO Co-trimoxazole or as per sensitivities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how do you manage uncomplicated Female lower UTI?

A

Nitrofurantoin 100mg MR bd or 50mg qds or Trimethoprim 200mg bd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you manage uncatherterised male UTI?

A

Nitrofurantoin 100mg MR bd or 50mg qds or Trimethoprim 200mg bd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how do you manage cellulitis?

A

Flucloxacillin 1g qds (If penicillin allergic: Doxycycline 100mg bd PO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do you manage open fracture prophylaxis?

A

Cefuroxime 1.5g IV every 8 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how do you manage diabetic foot infection?

A

Mild: Flucloxacillin 1g qds or Doxycycline 100mg bd

Moderate: Flucloxacillin 1g qds + Metronidazole 400mg tds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how do you manage acute septic arthritis osteomyelitis?

A

IV flucloxacilin 2g qds

19
Q

how do you manage severe systemic infection source unknown?

A

IV Amoxicillin + Metronidazole + Gentamicin (If PWID add S. aureus cover IV Flucloxacillin 2g qds or if penicillin allergic use regime below)

Penicillin allergy: IV Vancomycin + Metronidazole + Gentamicin

20
Q

what causes meningitis?

A

pneumococcus

meningicoccus

if >60: listeria

21
Q

what causes encephalitis?

A

herpes simplex

22
Q

what causes epiglottis?

A

haemophilius influenzae

streptococci

23
Q

what causes tonsilitis?

A

group A streptococci

24
Q

what causes sinusitis?

A

pneumococcus

25
Q

what causes acute otitis media?

A

pneumococcus

haemophilius influenzae

26
Q

what causes mild/moderate Community acquired pneumonia?

A

pneumococcus

haemophilius influenzae

27
Q

what causes severe CAP?

A

same as mild/moderate

as well as legionella

mycoplasma

chlamydia pneumoniae

coxiella

28
Q

what are the causes of acute exacerbation of COPD?

A

pneumococcus

haemophilius influenzae

29
Q

what are the causes of HAP?

A

pneumococcus

haemophilius influenzae

coliforms

30
Q

what are the causes of endocarditis?

A

native valve acute: staph aureus

native valve sub acute: viridans streptococci ,enterococci

prosthetic valve: MRSA ( resistant to flucloxacillin and beta lactams, coagulase negative staphylococci

31
Q

what are the causes of peritonitis/biliary tract sepsis?

A

polymicrobial coliforms, anaerobes and enterococci

32
Q

what are the causes of spontaneous bacterial peritonitis?

A

coliforms

sometimes strep pneumonia

33
Q

what are the causes of female uncomplicated UTIs?

A

coliforms

enterococci

34
Q

what are the causes of male (no catheter) UTIs?

A

coliforms

enterococci

35
Q

what are the causes of complicated infections such as pyelonephritis,urosepsis ?

A

coliforms

pseudomonas aeruginosa

enterococci

36
Q

what are the causes of cellulitis?

A

staph aureus

group A & other beta haemolytic streptococci

37
Q

what are the causes of diabetic foot acute infections?

A

staph aureus

38
Q

what are the causes of septic arthritis/osteomyelitis?

A

staph aureus

39
Q

what is the CURB 65 score?

A

C Confusion (abbreviated mental test score <= 8/10)
R Respiration rate >= 30/min
B Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg
65 Aged >= 65 years

CRB 65 for primary care

UREA ( >7mmol) for hospital

40
Q

how do you manage CAP?

Curb 3-5 score (severe)

A

3-5 Severe
Co-amoxiclav IV 1.2g tds + Doxycycline PO 100mg bd (If penicillin allergic: IV Levofloxacin 500mg bd monotherapy)

Step down to Doxycycline 100mg bd for ALL patients with severe CAP TOTAL IV/PO 5 days

41
Q

how do you treat CAP?

ICU

A

ICU/HDU or NBM

Co-amoxiclav IV 1.2g tds + Clarithromycin* IV 500mg bd (If penicillin allergic: IV Levofloxacin 500mg bd monotherapy)

42
Q

how do you treat severe HAP?

A

Severe: IV Amoxicillin + Gentamicin

(If penicillin allergic:IV Co-trimoxazole + Gentamicin)

Step down: PO Co-trimoxazole TOTAL IV/PO 7 days

43
Q

how do you manage severe aspiration pneumonia?

A

Severe:
IV Amoxicillin + Metronidazole + Gentamicin

(If penicillin allergic: replace amoxicillin with PO
Doxycycline or IV Clarithromycin*)

Step down: PO Amoxicillin + Metronidazole (If penicillin allergic: Doxycycline 100mg bd + Metronidazole) TOTAL IV/PO 7 days