Others

Question 1

Microbes involved in cholecystitis

Answer 1

Cryptosporidium or cytomegalovirus in immunosupressed

E Colo, kleb and strepro

Question 2

Most common org in asicitc fluid culture

Answer 2

E coli

Question 3

Management of SBP

Answer 3

Cefotaxime

Question 4

Abx prophylaxis for pts with ascites

Answer 4

Give oral cipro or norfloxacin

Prev SBO
Fluid protein <15g
Hepatorenal sx

Question 5

Where is diverticulitis pain usually located

Answer 5

LLQ`

Question 6

Ix for diverticulitis

Answer 6

CT abd and pelvis - can help identify perf, abscess,fistula or obstruction

Question 7

Mx for diverticulitis

Answer 7

First choice co-amox, cefalexin or trim + metro if allergic

Question 8

Dx for appendicitis

Answer 8

Usually just need high inflammatory markers with compatible history- periumbillical pain radiating to RIF, mild pyrexia, anorexia, nausea

Question 9

Mx of appendicitis

Answer 9

Appendicectomy- open or lapraroscopically
Can give prophylactic IV abx

Question 10

Abx tx for appendicitis

Answer 10

Amox, gent, metro

Question 11

Osteomyelitis common org

Answer 11

S.aureus

Question 12

Sx of osteomyelitis

Answer 12

Fever with joint pain

Question 13

Ix for osteomyelitis and Mx

Answer 13

MRI
Fluclox or clinda if pen allergic

Question 14

Most common cause of septic arthritis

Answer 14

Staph also LOL

Question 15

Fx of bacterial vs viral conjunctivitis

Answer 15

Purulent discharge vs serous discharge, recurrent URTI, prearuricular lymphh nodes

Question 16

How to mx infective conjunctivitis

Answer 16

Chloramphenicol eye drops to pts , fusidic acid for pregnant women. Don’t need school exclusion, don’t share towels

Question 17

Causes of infectious mononucleosis

Answer 17

HSV, EBV, CMV, HIV

Question 18

Sx of IM

Answer 18

The classic triad of sore throat, pyrexia and lymphadenopathy :
sore throat
lymphadenopathy
pyrexia

May also have malaise, anorexia, headache, hepatits, MACULOPAPULAR RASH

Question 19

How to diagnosis mononucleoiss

Answer 19

Heterophil antibody test (Monospot test)
NICE guidelines suggest FBC and Monospot in the 2nd week of the illness to confirm a diagnosis of glandular fever.

Question 20

Mx of mononucleosis

Answer 20

Rest, fluids, avoid alcohol
Simple analgesia
Avoid playing contact sports for 4 weeks to reduce risk of splenic rupture

Question 21

Which pts are most likely to benefi from Abx for sore throat

Answer 21

Feverpain 4/5 or centor 3/4

Question 22

Sx of chlamydia

Answer 22

asymptomatic in around 70% of women and 50% of men
women: cervicitis (discharge, bleeding), dysuria
men: urethral discharge, dysuria

Question 23

Ix for chlaymidia

Answer 23

Vulvovaginal swab for women, urine test for men

Question 24

Mx of chlamydis

Answer 24

Doxy , or azithro, eryhtro or amox if pregnant

Question 25

Fx of trichomonas vaginalis

Answer 25

vaginal discharge: offensive, yellow/green, frothy vulvovaginitis strawberry cervix pH > 4.5 in men is usually asymptomatic but may cause urethritis

Question 26

Ix of trichomonas vaginalis

Answer 26

Microscopy will show motile trophozites

Question 27

mx of tricho

Answer 27

oral metronidazole for 5-7 days,

Question 28

Common causes of Otitis media

Answer 28

Strep pneuumonia, HI, MC

Question 29

Comon sx of Otitis Media

Answer 29

Otalgia, fever, hearing loss, ear discharge if tympanic membrane perforates, viral URTI

Question 30

Dx of Otitis media

Answer 30

acute onset of symptoms otalgia or ear tugging presence of a middle ear effusion bulging of the tympanic membrane, or otorrhoea decreased mobility on pneumatic otoscopy inflammation of the tympanic membrane i.e. erythema