Worksheets527 ME 25-26 Tutorial RTI
Total questions: 10
Worksheet time: 5mins
A 19-year-old university student presents to the community pharmacy with a 2-day history of a sore throat, fever, and general malaise. On examination, you note inflamed tonsils with white exudate and tender anterior cervical lymph nodes. She is otherwise fit and well with no drug allergies. Her FeverPAIN score is calculated as 4. What is the most appropriate management?
Advise self-care with paracetamol and medicated lozenges only.
Recommend an immediate prescription for phenoxymethylpenicillin.
Recommend a back-up prescription for clarithromycin.
Advise a "wait and see" approach for 5 days.
Recommend an immediate prescription for co-amoxiclav.
A 3-year-old child is brought in by his mother. He has been irritable, has a fever (38.5°C), and is tugging at his ear. The GP has diagnosed acute otitis media. The tympanic membrane is bulging and red. He has no known allergies. The mother is keen for treatment to help him recover quickly. What is the most appropriate initial advice and management?
Immediate prescription of amoxicillin.
Recommend regular paracetamol or ibuprofen for pain and advise no antibiotic at this time.
Immediate prescription of co-amoxiclav.
Recommend eardrops containing an anaesthetic/analgesic and an immediate oral antibiotic.
Immediate prescription of clarithromycin.
A 40-year-old man presents with a 12-day history of facial pain, purulent nasal discharge, and congestion following a cold. He has tried paracetamol and a nasal decongestant with no improvement. He has no drug allergies. What is the most appropriate management?
Reassure him that it is viral and continue with simple analgesia.
Recommend an immediate prescription for phenoxymethylpenicillin.
Recommend a back-up prescription for doxycycline.
Recommend an immediate prescription for co-amoxiclav.
Advise a high-dose nasal corticosteroid and recommend no antibiotic.
A previously healthy 25-year-old woman has had a persistent cough for 10 days, productive of green sputum. She feels generally unwell but is not feverish. She has no significant past medical history and no allergies. What is the most appropriate management?
Immediate prescription of amoxicillin 500mg TDS for 5 days.
Immediate prescription of doxycycline 200mg stat then 100mg OD for 5 days.
Advise self-care (e.g., honey, pelargonium) and a no-antibiotic prescribing strategy.
Immediate prescription of co-amoxiclav 500/125mg TDS for 5 days.
Send a sputum sample for culture before deciding on treatment.
A 68-year-old man with a history of COPD presents to his GP with an increase in shortness of breath and a change in his sputum from white to green over the past 2 days. He requires his salbutamol inhaler more frequently. He is not severely unwell and can be managed at home. He has no penicillin allergy. What is the most appropriate first-choice antibiotic?
Levofloxacin 500mg OD for 5 days.
Doxycycline 200mg on day 1, then 100mg OD for 5 days.
Co-amoxiclav 500/125mg TDS for 5 days.
Amoxicillin 500mg TDS for 5 days.
Co-trimoxazole 960mg BD for 5 days.
A 55-year-old woman presents with a 4-day history of productive cough, fever, and pleuritic chest pain. On assessment, her CRB65 score is 0 (low severity). She has no known allergies. What is the most appropriate first-line antibiotic treatment?
No antibiotic is needed.
Amoxicillin 500mg TDS for 5 days.
Co-amoxiclav 500/125mg TDS for 5 days.
Clarithromycin 500mg BD for 5 days.
Levofloxacin 500mg BD for 5 days.
A 70-year-old man presents with symptoms suggestive of moderate severity pneumonia (CRB65 score of 2). He has a documented anaphylactic allergy to penicillin. What is the most appropriate antibiotic regimen?
Amoxicillin and clarithromycin.
Trimethoprim alone.
Co-amoxiclav alone.
Clarithromycin alone.
Levofloxacin alone.
A 75-year-old patient develops a cough and fever 3 days after admission for elective hip surgery. A diagnosis of hospital-acquired pneumonia (HAP) is made. He is not severely unwell and is not at a higher risk of resistance (no recent antibiotics, not in ICU). What is the most appropriate first-choice antibiotic?
Piperacillin/tazobactam IV.
Co-amoxiclav orally.
Levofloxacin orally.
Vancomycin IV.
Meropenem IV.
A 50-year-old woman with known bronchiectasis presents with a sustained increase in cough and purulent sputum volume for one week. She is afebrile and manages at home. She has no penicillin allergy. What is the most appropriate first-choice antibiotic?
Amoxicillin orally.
Wait for sputum culture results before initiating treatment.
Doxycycline orally.
Co-amoxiclav orally.
Levofloxacin alone.
A 5-year-old child with acute otitis media is not improving with analgesia after 72 hours. The decision is made to start an antibiotic. The child has a confirmed penicillin allergy. What is the most appropriate antibiotic choice?
Amoxicillin.
Phenoxymethylpenicillin.
Clarithromycin.
Co-amoxiclav.
Cefalexin.
