QuestionSBA
QuestionChoice
This patient has suspected meningitis with meningococcal septicaemia. Intramuscular Benzylpenicillin is the most appropriate treatment in a pre-hospital environment, i.e. general practice, community, or ambulance. As this patient is already at A&E, IV treatments would be available and more appropriate.
50092
b
Benzylpenicillin 600mg IM
QuestionChoice
This patient has suspected meningitis with meningococcal septicaemia. IV Cefotaxime or Ceftriaxone would be the most appropriate initial treatment in a hospital setting.
50091
a
Cefotaxime 650mg IV
QuestionChoice
Phenoxymethylpenicillin is the chosen antibiotic to treat tonsillitis, oral infections and otitis media. This patient has suspected meningitis with meningococcal septicaemia.
50095
e
Phenoxymethylpenicillin 125mg PO (Oral)
QuestionChoice
Flucloxacillin is the chosen antibiotic to treat infections such as otitis externa and severe pneumonia in children. This patient has suspected meningitis with meningococcal septicaemia.
50094
d
Flucloxacillin 325mg IM
QuestionChoice
IV Amoxicillin is the treatment for meningitis caused by listeria. This patient has suspected meningitis with meningococcal septicaemia.
50093
c
Amoxicillin 650mg IV
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
3598
Suspected Meningitis Management
Topic
91
Paediatrics
10066
Case Presentation: A 2-year-old girl is brought into A&E by her father. She has been unwell for 24 hours. She is drowsy and disinterested in playing. She has recently developed a non-blanching rash over her torso. **PH** None **DH**  NKDA


**On examination**
The patient is drowsy with her eyes closed.

Non-blanching erythematous rash seen over her torso.

HR 134, RR 32, Capillary Refill 3 seconds

Weight: 13kg

**Investigations**

None performed yet

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