A 19-year-old man presents asking for advice. His girlfriend has recently been diagnosed with meningococcal meningitis. He is worried he may have 'caught it'.
What is the recommended antibiotic prophylaxis for close contacts such as this man?
Correct Answer C: The BNF recommends a twice a day dose of rifampicin for two days, based on the patients weight.
Meningitis: management:
Investigations suggested by NICE:
Management: All patients should be transferred to hospital urgently. If patients are in a pre-hospital setting (for example a GP surgery) and meningococcal disease is suspected then intramuscular benzylpenicillin may be given, as long as this doesn't delay transit to hospital. BNF recommendations on antibiotics:
If the patient has a history of immediate hypersensitivity reaction to penicillin or to cephalosporins the BNFrecommends using chloramphenicol.
Management of contacts:
A baby is born to a mother who is known to have chronic hepatitis B. The mothers latest results are as follows:
What is the most appropriate strategy for reducing the vertical transmission rate?
Correct Answer A: HBeAg is a marker of infectivity. If the mother was anti-HBe positive only the vaccine would need to be administered.
Hepatitis B and pregnancy:
Basics:
Which of the following infections usually has the longest incubation period?
Correct Answer E:
Incubation periods: Questions may either ask directly about incubation periods or they may be used to provide a clue in a differential diagnosis.
Less than 1 week:
1 - 2 weeks:
2 - 3 weeks:
Longer than 3 weeks:
What is the mechanism of action of rifampicin?
Correct Answer C:
Antibiotics: mechanisms of action:
The lists below summarize the site of action of the commonly used antibiotics.
Inhibit cell wall formation:
Inhibit protein synthesis:
Inhibit DNA synthesis:
Inhibit RNA synthesis:
A 31-year-old female presents to the genitourinary medicine clinic due to four fleshy, protuberant lesions on her vulva which are slightly pigmented. She has recently started a relationship with a new partner.
What is the most appropriate initial management?
Correct Answer B:
Genital wart treatment:
Cryotherapy is also acceptable as an initial treatment for genital warts.
Genital warts:
Genital warts (also known as condylomata accuminata) are a common cause of attendance at genitourinary clinics. They are caused by the many varieties of the human papilloma virus HPV, especially types 6 & 11. It is now well established that HPV (primarily types 16,18 & 33) predisposes to cervical cancer.
Features:
Management:
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