ID

Question 1

Mycoplasma pneumonia features

Answer 1

Dry cough after flu-like period
B/l consolidation CXR
Erythema multiforme/erythema nodosum

Question 2

Mycoplasma complications

Answer 2

Bullous myringitis - painful TM vesicles
Cold agglutinins -> thrombocytopenia/haemolytic anaemia
Meningoencephalitis/Guillain Barre
Peri/myocarditis
Hepatitis/pancreatitis
Acute GN

Question 3

Mycoplasma Ix

Answer 3

Serology
Blood film may show RBC agglutination

Question 4

Mycoplasma Rx

Answer 4

Macrolide/doxy

Question 5

Chlamydia Rx

Answer 5

Doxy 7d
Azithromycin/Erythromycin/Amoxicillin 2nd line

Question 6

When to delay LP meningitis

Answer 6

Septic shock/rapid rash evolution
Significant bleeding risk
Raised ICP signs (focal neuro, papilloedema, seizures, GCS<10)

Question 7

When to avoid steroids meningitis

Answer 7

Septic shock
Meningococcal septicaemia
Immunocompromised
Post-surgery

Question 8

When to add listeria cover in meningitis

Answer 8

<3mths or >59yrs

Question 9

Meningococcus contacts prophylaxis

Answer 9

Close contacts from past 7d
Cipro or rifampicin

Question 10

Gonorrhoea Rx

Answer 10

IM cef 1g
Cefixime + azithromycin if needle-phobic
Re-test after 2wks to ensure Rx

Question 11

Giardia Ix

Answer 11

Stool microscopy shows protozoa/trophozoite + cysts

Question 12

Giarda Rx

Answer 12

Metronidazole

Question 13

Diarrhoea bugs at different periods

Answer 13

1-6 hrs: Staphylococcus aureus, Bacillus cereus (for vomiting, diarrhoea takes 6-14hrs)
12-48 hrs: Salmonella, Escherichia coli
48-72 hrs: Shigella, Campylobacter
> 7 days: Giardiasis, Amoebiasis

Question 14

Active TB Rx

Answer 14

2mths:
Rifampicin
Isoniazide
Pyrazinamide
Ethambutol

Next 4mths just R+I

12mth Rx if meningeal

Question 15

Latent TB Rx

Answer 15

Isoniazid (+pyridoxine) for 6mths, add rifampicin to shorten to 3mths

Question 16

Rifampicin SEs

Answer 16

Orange secretions
Hepatitis
Flu-like sx
Potent inducer

Question 17

Isoniazid SEs

Answer 17

Peripheral neuropathy (mitigate with pyridoxine)
Hepatitis
Agranulocytosis
Liver enzyme inhibitor

Question 18

Pyrazindamide SEs

Answer 18

Hyperuricaemia
Arthralgia/myalgia
Hepatitis

Question 19

Ethambutol SEs

Answer 19

Optic neuritis

Question 20

Metronidazole SEs

Answer 20

Disulfiram-like reaction with alcohol
Increases anticoag effect of warfarin

Question 21

Campylobacter presentation

Answer 21

Bloody stool
Headache/malaise prodrome
1-6d incubation
Abdo pain mimicking appendicitis

Question 22

Campylobacter Rx

Answer 22

Only if severe/immunocomp
Clari
Cipro 2nd line

Question 23

High risk tetanus wounds

Answer 23

Contaminated by soil/manure
Extensive devitalised tissue
Wounds requiring surgical intervention

Question 24

Tetanus prone wounds

Answer 24

Puncture with possibly contaminated e.g. garden
Compound fracture
Animal bites
Wound/burn with systemic sepsis
Wound with foreign bodies

Question 26

Erythema migrans

Answer 26

Bullseye rash in tick bite