QuestionSBA
QuestionChoice
This patient has a lower UTI. As she is pregnant she should NOT be prescribed trimethoprim which leaves nitrofurantoin as the first line medication she should be prescribed.
50319
a
Nitrofurantoin MR 100mg PO BD
QuestionChoice
Cefalexin can be used to treat lower UTIs however it is a second line option. Nitrofurantoin should be trialled first.
50322
d
Cefalexin 500mg PO BD
QuestionChoice
This patient has a lower UTI. If she was not pregnant then this treatment option would be okay however it is contraindicated during pregnancy due to its anti-folate properties.
50320
b
Trimethoprim 200mg PO BD
QuestionChoice
Amoxicillin can be used to treat lower UTIs however it is a second line option. Nitrofurantoin should be trialled first.
50321
c
Amoxicillin 500mg PO TDS
QuestionChoice
Clarithromycin isn't typically prescribed to treat lower UTIs. This particular dose of clarithromycin is used to treat cellulitis.
50323
e
Clarithromycin 500mg PO BD
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3647
Prescribing antibiotics in a pregnant woman in her first trimester
Topic
131
Obstetrics & Gynaecology/Paediatrics
10118
Case Presentation: A 24 year old pregnant woman attends her GP due to dysuria. She is 12 weeks pregnant.


**PH** Nil.

**DH** Nil. NKDA

**Investigations**

Urine dip:

* Blood: -
* Nitrates: ++
* White blood cells: ++
* Red blood cells: -

Question: Select the most appropriate management at this stage.
a