EMQs in Clinical Medicine.pdf - Peshawar Medical College

Treatment of infection – answers 231
86 Antibiotics
Answers: L B I D E
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B
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A 24-year-old woman complains of a yellow offensive vaginal
discharge. Motile flagellate organisms are seen on wet film
microscopy.
This is a typical presentation of an infection with Trichomonas vaginalis.
This protozoan pathogen is sexually transmitted, causing a vaginitis in
women and a non-gonococcal urethritis in men. Successful management
involves treating both the patient and the partner.
A 29-year-old man requires treatment for a severe communityacquired
pneumonia.
An intravenous combination of a broad-spectrum -lactamase antibiotic,
e.g. co-amoxiclav or a second-/third-generation cephalosporin, together
with a macrolide, e.g. clarithromycin or erythromycin is the preferred
empirical antibiotic choice for adults hospitalized with severe communityacquired
pneumonia.
A 25-year-old camper presents with fever, dehydration and severe
bloody diarrhoea. Stool culture reveals salmonella infection.
Ciprofloxacin is indicated because this is a severe salmonella infection
and the patient is systemically unwell.
An 18-year-old girl presents with fever, neck stiffness and photophobia.
Intravenous benzylpenicillin can be used for meningococcal (Neisseria
meningitidis) infections.
A 24-year-old man presents with widespread impetigo over the face.
Impetigo is a highly infectious skin disease that is caused by
Staphylococcus aureus infection in most cases. The typical lesion is a
weeping, exudative area with a characteristic honey-coloured crusting
on the surface. Topical fusidic acid can be used for small areas, but
flucloxacillin is indicated if there is widespread impetigo.
87 Treatment of infection
Answers: G C K J F
A 25-year-old man suffering from itchiness of hands and wrists. On
examination burrows can be seen in the digital web spaces.
G This is scabies infection and is treated topically with malathion. Topical 1
per cent lindane is also used to treat this condition. Both treatments are
contraindicated in pregnancy.
A 28-year-old man requires treatment for invasive aspergillosis.