ID

Question 1

gram positive anaerobes

Answer 1

CLAP

clostridium
lactobacillus
actinomyces
propionibacterium

Question 2

MRSA is trested with

Answer 2

doxycycline
clindamycin
vancomycin
teicoplanin
linezolid

Question 3

what are ESBL

Answer 3

extended spectrum beta lactamase bacteria- they have become resistant to beta lactams

usually e coli or klebsiella

Question 4

difference between gram pos and neg

Answer 4

pos= have a peptidoglycan cell wall

neg= no cell wall

Question 5

gram positive rods

Answer 5

corny mikes list of basic cars

cornybacteria
mycobacteria
listeria
bacillus
nocardia

Question 6

general escalation of hospital abx

Answer 6

amoxicillin- covers strep, listeria and enterococcus
co amoxiclav- covers staph, haem and e coli
piptaz- covers pseudomonas
meropenem- covers ESBLs
teicoplanin/vanc- covers MRSA
clarith/doxy- covers atypicals

Question 7

what is septic shock

Answer 7

when blood pressure remains low despite fluid resus

this causes hypoperfusion and anaerobic respiration so lactate rises

Question 8

how is septic shock diagnosed

Answer 8

low MAP despite fluid resus
raised lactate

Question 9

NEWS2 components

Answer 9

blood pressure
heart rate
temp
o2 sats
resp rate
consciousness level

Question 10

pyelonephritis triad

Answer 10

fever
loin pain
nausea/vomitting

Question 11

urine dip UTI results

Answer 11

nirates or leukocytes plus RBC= likely UTI

only leukocytes= send to lab

only nitrates= treat as UTI

Question 12

what type of bacteria is e coli

Answer 12

gram negative anaerobic rod

Question 13

avoid nitrofurantoin in

Answer 13

patients with an eGFR <45
pregnant women near term

Question 14

abx for pyelonephritis in community

Answer 14

cefalexin 7-10 days

Question 15

what does use of nitrofurantoin in the 3rd trimester cause

Answer 15

neonatal haemolysis

Question 16

what dopes use of trimethoprim in the 1st trimester cause

Answer 16

NTDs

Question 17

in cellulitis what indicates a staph aureus infection

Answer 17

a golden yellow crust

Question 18

common bacteria associated with cellulitis

Answer 18

staph aureus
group A strep
group C strep

Question 19

abx for cellulitis near eyes or nose

Answer 19

co amoxiclav

Question 20

bacterial tonsillitis common bacteria

Answer 20

group A strep (strep pyogenes)

if not then usually strep pnuemoniae

Question 21

what centor score warrants use of abx

Answer 21

3 or more

Question 22

centor score components

Answer 22

fever over 38 degrees
tender cervical lymphadenopathy
tonsillar exudates
absence of cough

Question 23

first line abx tonsillitis

Answer 23

penicillin V for 10 days
clarithromycin if allergic to penicillin

Question 24

complications of tonsillitis

Answer 24

quinsy
otitis media
scarlet fever
rheumatic fever
post strep glomerulonephritis

Question 25

otitis media abx

Answer 25

amoxicillin 5-7 days 1st line clarithromycin if allergic erythromycin if pregnant and allergic

Question 26

sinusitis mx

Answer 26

10 days conservative mx high dose steroid nasal spray 14 days back up abx if not improving

Question 27

chronic sinusitis mx

Answer 27

saline nasal irrigation steroid nasal spray

Question 28

septic arthritis most common organism

Answer 28

staph aureus nisseria gonorrhoea if young

Question 29

pseudogout crystals are made of

Answer 29

calcium pyrophosphate

Question 30

septic arthritis abx

Answer 30

empirical IV abx for 4-6 weeks fluclox usually 1st line

Question 31

what type of virus is influenza

Answer 31

RNA

Question 32

medications for flu

Answer 32

olsetamivir zanamivir

Question 33

what medication increases risk of HUS

Answer 33

antibiotics- avoid use if e coli gastroenteritis is suspected

Question 34

gastroentertitis stay off work/school rules

Answer 34

till 48 hrs after sx resolve

Question 35

abx that cause c diff

Answer 35

clindamycin cipro cephalosporins carbapenams

Question 36

c diff recurrence rate

Answer 36

high

Question 37

complications of c diff

Answer 37

toxic megacolon pseudomembranous colitis bowel perforation sepsis

Question 38

what type of bacteria is nisseria meningitis

Answer 38

gram negative diplococcus

Question 39

most common cause of viral meningitis

Answer 39

enterovirus

Question 40

how to test for kernigs sign

Answer 40

flex the hip and knee to 90 degrees while keeping the hip flexed straighten the knee pain or resistance to movement indicates meningitis

Question 41

how to test for brudzinskis sign

Answer 41

lift head and neck off bed when patient is lying flat involuntary flexion of hip and knees is positive

Question 42

CSF protein in bacterial meningitis

Answer 42

high

Question 43

CSF protein in viral meningitis

Answer 43

slightly raised or normal

Question 44

high neutrophils in CSF indicates

Answer 44

bacterial cause

Question 45

high lymphocytes in CSF indicates

Answer 45

viral cause

Question 46

benzylpenicillin dosing in meningitis

Answer 46

under 1 yr- 300mg 1-9yrs- 600mg over 10yrs- 1200mg

Question 47

what test should be done if meningococcus is suspected in meningitis

Answer 47

meningococal PCR

Question 48

what tests can be done when examining a patient with suspected meningitis

Answer 48

brudzinski kernigs

Question 49

meningitis abx

Answer 49

under 3 months- cefotaxime plus amoxicillin over 3 months- ceftriaxone

Question 50

what can reduce neurological complications and hearing loss in meningitis

Answer 50

steroids

Question 51

post exposure prophylaxis for meningitis contacts

Answer 51

single dose cipro

Question 52

complications of meningitis

Answer 52

hearing loss seizures/epilpesy cognitive impairment focal neurological deficit eg limb weakness/spasticity

Question 53

TB stain and result

Answer 53

zeihl neelsen turns bright red on a blue background

Question 54

are people with latent tuberculosis infectious

Answer 54

no

Question 55

what is potts disease

Answer 55

spinal tuberculosis

Question 56

tests for immune response to TB

Answer 56

mantoux test IGRA (interferon gamma release assay)

Question 57

mantoux test method and result

Answer 57

tuberculin is injected after 72hrs the induration is measured >5mm= positive

Question 58

IGRA method and result

Answer 58

pt blood is mixed with TB antigens release of interferon gamma is positive- leukocytes that have been sensitised will release it

Question 59

miliary TB on CXR

Answer 59

millet seed appearance- small nodules disseminated through the lung field

Question 60

latent TB mx

Answer 60

isoniazid 6 months rifampicin and isoniazid for 3 months

Question 61

what should be prescribed with isoniazid

Answer 61

pyroxidine/vitamin b6 this reduces peripheral neuropathy

Question 62

what ventilation is used in rooms where patients are isolated with infectious disease that are aiborne

Answer 62

negative pressure

Question 63

what enzyme does rifampicin affect and how

Answer 63

induces cytochrome p450 this enzyme metabolises medications like COCP so these become less effective

Question 64

pyrazinamide side effects

Answer 64

gout kidney stones

Question 65

what cells does HIV destroy

Answer 65

CD4 T helper cells

Question 66

AIDS defining illnesses

Answer 66

kaposi sarcoma PCP cytomegalovirus candidiasis lymphoma TB

Question 67

HIV blood test consent rules

Answer 67

in emergency departments there is assumed consent unless patients choose to opt out

Question 68

lab test for HIV tests for

Answer 68

HIV antibodies p24 antigen

Question 69

lab test for HIV has a reliable result after how many days

Answer 69

45

Question 70

what CD4 count in HIV is high risk

Answer 70

<200 cells/mm3

Question 71

what is given to high risk HIV pts

Answer 71

prophylactic co trimox for PCP

Question 72

cervical smear frequency in HIV pts

Answer 72

yearly

Question 73

delivery plan for HIV pts

Answer 73

viral load <50= normal vaginal possible viral load >400= c section recommended 50-400= consider c section IV zidovudine during labour and delivery and to babies

Question 74

PEP drugs and duration

Answer 74

truvada and raltegravir for 28 days

Question 75

PrEP drugs

Answer 75

truvada

Question 76

most common malaria type

Answer 76

plasmodium falciparum

Question 77

most severe malaria type

Answer 77

plasmodium falciparum

Question 78

what is tertian fever

Answer 78

fever every 48 hrs associated w p vivax and o ovale