A 28-year-old woman presents with a 3-day history of dysuria, urinary frequency, and suprapubic pain. She is otherwise well with no fever. Urine dipstick shows nitrites positive, leucocytes positive. What is the most appropriate first-line antibiotic treatment?
AAmoxicillin 500mg TDS for 7 days
BTrimethoprim 200mg BD for 3 days
CCiprofloxacin 500mg BD for 7 days
DNitrofurantoin 50mg QDS for 3 days
ECo-amoxiclav 625mg TDS for 7 days
A 59-year-old man with type 1 diabetes for 25 years is admitted with acute pancreatitis. His usual insulin regimen is insulin glargine 32 units at bedtime and insulin lispro 8 units with meals. He is kept nil by mouth and started on intravenous fluids. His admission glucose is 16.2 mmol/L. According to best practice for managing insulin in acute illness with nil-by-mouth status, what is the most appropriate insulin management?
AContinue insulin glargine at usual dose; omit insulin lispro while nil by mouth
BContinue insulin glargine; give insulin lispro based on blood glucose readings every 4 hours
CStop all insulin until he is eating and drinking again
DConvert to variable-rate intravenous insulin infusion at 0.05 units/kg/hour
EGive half the usual total daily insulin dose as basal insulin only
A 68-year-old woman with non-valvular atrial fibrillation (CHA₂DS₂-VASc score 4) is on apixaban 5mg twice daily. She is diagnosed with intermediate-risk myelodysplastic syndrome requiring treatment with azacitidine chemotherapy, which carries significant thrombocytopenia risk (expected platelet nadir 20-50 × 10⁹/L). What is the most appropriate anticoagulation strategy during chemotherapy?
AContinue apixaban 5mg twice daily throughout chemotherapy; monitor platelets weekly
BReduce apixaban to 2.5mg twice daily during chemotherapy cycles
CSwitch to prophylactic-dose LMWH during chemotherapy cycles
DSwitch to warfarin with target INR 2-3 as it can be more easily reversed
ETemporarily stop all anticoagulation during chemotherapy cycles; restart when platelets >50 × 10⁹/L
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