Practice Paper 2: Answers
Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar in Get ahead! Medicine, 2016
Cystitis usually presents with dysuria, frequency of urine, suprapubic discomfort and fever. Cystitis is much more common in women than in men due to the shorter urethra in women. Escherichia coli, usually found in the bowel, is the most common pathogen responsible for uncomplicated cystitis in the UK. Cystitis can be confirmed by the presence of leucocytes, nitrites and blood in the urine. A midstream urine (MSU) sample should be sent to microbiology for microscopy, culture and sensitivity. A positive culture is when more than 105 of a single organism are grown per millilitre of urine. The growth of mixed bacterial species usually indicates contamination of the sample. Antibiotic treatment should be guided by local patterns of bacterial resistance and MSU sensitivity results. Uncomplicated cystitis is usually treated with a 3- to 5-day course of trimethoprim. Other antibiotics that are used to treat cystitis include amoxicillin, ciprofloxacin, cefradine and nitrofurantoin. Patients who are susceptible to recurrent UTI can be prescribed prophylactic antibiotics (e.g. 100 mg of trimethoprim once nightly). Patients should be advised to drink lots of fluids and avoid dehydration. UTIs in men and children require further investigation.
Information on level of drugs into breastmilk
Wendy Jones in Breastfeeding and Medication, 2013
Cefradine is less protein bound than the other cephalosporins (8 to 12%) but still has low levels in breastmilk with an average milk level of 1 mg per litre compared with a licensed paediatric dose of 25 to 50 mg per day so is compatible with breastfeeding (Kafetzis et al. 1981; Mischler et al. 1972; Mischler et al. 1978). The BNF states that it is present in breastmilk in low concentrations but that it is appropriate to use in breastfeeding mothers. Compatible with use during breastfeeding.
DRCOG MCQs for Circuit C Answers
Una F. Coales in DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Chorio-amnionitis is caused by multiple organisms ascending from the cervix and vagina. Prolonged rupture of membranes is a risk factor. The clinical presentation is one of high maternal fever, fetal tachycardia and uterine irritability. A high vaginal swab should be taken and the mother should be started on systemic broad-spectrum antibiotics such as cefradine and metronidazole. Labour should be induced.
Hybrid Reconstruction of the Aortic Arch Using a Double-Branched Stent-Graft in a Canine Model
Published in Journal of Investigative Surgery, 2019
Fan Qiao, Cunhua Su, Qingqi Han, Mengwei Tan, Jun Wang, Yang Liu, Fanglin Lu, Lin Han, Zhiyun Xu
The canines were sedated with an intramuscular injection of atropine sulphate (0.5 mg/mL dog), and ketamine hydrochloride (10 mg/kg). Endotracheal intubation was performed after anesthetic induction with intravenous propofol (2 mg/kg), fentanyl citrate (2 µg/kg), and rocuronium bromide (0.6 mg/kg), followed by mechanical ventilation with oxygen at an appropriate concentration. Anesthesia was maintained with intravenous administration of propofol (6 mg/kg/h), fentanyl citrate (1 µg/kg/h), and rocuronium bromide (0.1 mg/kg/h). Arterial blood pressure was monitored via a catheter placed in the aperture of the right femoral artery, and electrocardiography was performed via limb leads. Cerebral perfusion was monitored using an INVOS cerebral oximeter (Somanetics Corporation, USA). Each dog received an appropriate amount of intravenous fluid with electrolytes during the surgery. One gram of cefradine antibiotic prophylaxis was administered perioperatively to prevent infection.
Effects of shuanghuanglian injection on the activities of CYP1A2, 2C11, 2D1 and 3A1/2 in rats in vivo and in vitro
Published in Xenobiotica, 2019
Yuan Shi, Juan Xu, Yan Qiao, Wenlong Zhang, Duo Liu, Mengnan Qin, Gaofeng Liu, Mei Dong
SHLI is one of the most popular herbal prescription in China, and have been shown inhibitory effect on bacterium, such as Staphylococcus aureus, Streptococcus pneumoniae, Hemolytic streptococcus and Shigella (Yuan, 2007). It has been reported that SHLI could also enhance immune function, reduce blood pressure, relieve fever and antagonize arrhythmia (Gao & Miao, 2010). Clinically, SHLI has been used for the treatment of various respiratory diseases such as respiratory tract infection, pharyngitis, pneumonia and often combined with antibiotics or other medicine. The literature reports that SHLI, co-administered with cefoperazone sodium/sulbactam sodium for lower respiratory tract infection (Chen, 2012), with Zhuli capsules or clindamycin phosphate injection for acute and chronic pharyngitis (Gao et al., 2017; Guo et al., 2014), and with antibiotics or antivirals for pneumonia (Wu et al., 2017). A retrospective study of 4382 medical records about SHLI has shown that SHLI was commonly used in the form of combination, and only 1.03% used independently. However, it is also reported that the combination of SHLI with other drugs had caused adverse drug reactions in the application, such as SHLI co-administered with cefepime had lead to renal toxicity increased (Chen et al., 2012, 2016), with ceftriaxone sodium and ribavirin had lead to one death (Zhang & Zhang, 2017), and with cefradine also had lead to one death (Dong & Shen, 2010). It has been reported that 80% patients of death who used SHLI also co-administered other 1–4 kinds of drugs (Zhang & Zhang, 2017). However, up to now, whether SHLI could influence the effects of CYP and cause metabolic interactions is still unknown, so the finding of this paper is of great importance for predicting possible herb-drug interactions between SHLI and other drugs, which are substrates of CYP.
Prophylactic antibiotics to prevent surgical site infections in Botswana: findings and implications
Published in Hospital Practice, 2018
Julius C. Mwita, Sajini Souda, Mgaywa G. M. D. Magafu, Amos Massele, Brian Godman, Michael Mwandri
In this study, we found that approximately three quarters (73%) of the patients received antibiotics perioperatively, mostly after surgery. In addition, the majority of patients who had preoperative antibiotics continued them postoperatively. The most frequently prescribed antibiotics were intravenous cefotaxime, cefradine, and metronidazole. The incidence of SSIs was 9%, and about half (48.6%) of the patients with SSI had culture-positive pus swabs.
Related Knowledge Centers
- Antibiotic
- Cephalosporin
- Pharyngitis
- Tonsillitis
- Streptococcus Pneumoniae
- Streptococcus
- Lobar Pneumonia
- British Approved Name
- Haemophilus Influenzae
- Staphylococcus