Multiple Choice Questions (MCQ)

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Category: Emergency Medicine--->Infectious Diseases
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Question 1# Print Question

A 15-year-old girl was brought to the emergency department (ED) by friends; she was at a party and began to feel unwell with a headache and fever. By the time she arrived she had deteriorated significantly and was obtunded, requiring intubation and aggressive fluid resuscitation. She has been transferred to the intensive care unit (ICU) with a working diagnosis of meningococcaemia. You contact public health authorities to initiate contact tracing.

Who of the following should receive clearance antibiotics?

A. The staff member who intubated the patient if a mask was not worn
B. The patient’s classmates
C. All staff who came within 1 m of the patient
D. The friends who brought the patient to the ED when she was symptomatic

Question 2# Print Question

An 18-year-old male has presented to the ED with a rapid-onset febrile illness associated with myalgia. You consider meningococcaemia as a potential diagnosis.

Which ONE of the following is INCORRECT regarding meningococcaemia?

A. The rash of meningococcaemia may be urticarial, macular or maculopapular
B. Carriers have some immunity against invasive disease
C. Serogroup C causes the most disease in Australia
D. The mortality of a patient with meningococcal meningitis is higher than that of patients with invasive meningococcal disease

Question 3# Print Question

A 42-year-old female presents to the ED with a cough and a fever of 38.9°C; she is found to have mild community-acquired pneumonia.

Which ONE of the following is correct regarding blood cultures in this patient?

A. Aerobic and anaerobic cultures are indicated
B. If multiple bacteria are isolated on culture, these are likely to be pathogenic
C. The most likely organism to be cultured is Chlamydia pneumoniae
D. The primary determinant in detecting bacteraemia is the volume of blood collected

Question 4# Print Question

A 57-year-old woman presents to the ED in Cairns with symptoms of pneumonia. She has no medical history, medications or allergies. She is a non-smoker and drinks 35 standard drinks per week. Her observations are: respiratory rate 32, heart rate 122, blood pressure (BP) 100/56 mmHg, SaO2 90% on 15l O2/min, temperature 38.2°C, Glasgow Coma Scale (GCS) 14. Chest X-ray (CXR) confirms a right middle lobe (RML) and right lower lobe (RLL) pneumonia.

What is the most appropriate initial regime of antibiotics for this patient?

A. Benzylpenicillin 1.2 g IV 4-hourly plus azithromycin 500 mg IV daily plus gentamicin 4–6 mg/kg IV daily
B. Ceftriaxone 1 g IV daily plus azithromycin 500 mg IV daily
C. Moxifloxacin 400 mg IV daily plus azithromycin 500mg IV daily
D. Meropenem 1 g IV 8-hourly plus azithromycin 500 mg IV daily

Question 5# Print Question

A 26-year-old female who is 39 weeks pregnant presents to a rural ED with an itchy vesicular rash of 24 hours’ duration. She has no past history and this is her first pregnancy, which has, so far, been uncomplicated. You diagnose chickenpox and find that this patient has not been immunised or exposed to varicella in the past.

What should you do prior to discharging her?

A. Give her a dose of varicella zoster immunoglobulin
B. Counsel her regarding the risk of congenital varicella syndrome
C. Commence a course of oral acyclovir
D. Arrange in utero transfer to a larger centre for caesarean section to reduce transmission at delivery

Category: Emergency Medicine--->Infectious Diseases
Page: 1 of 5