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Master Specialist Public Health & General Preventive Medicine (SPH6022)
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Sample Practice Questions

Question 1 FULLY WORKED EXAMPLE

A 34-year-old woman presents to the emergency department at 30 weeks' gestation with a 6-hour history of fever (38.9?C), rigors, and a spreading erythematous rash on her left leg. She is hypotensive with a blood pressure of 82/48 mmHg and a heart rate of 128/min. She has no known drug allergies. The obstetric team requests immediate empiric antibiotics. Which of the following is the most appropriate initial antibiotic regimen?

A) Intravenous ceftriaxone 2 g once daily
B) Intravenous vancomycin 1 g twice daily
C) Intravenous piperacillin-tazobactam 4.5 g three times daily ✓ Correct
D) Intravenous gentamicin 5 mg/kg once daily
Explanation:
The deciding finding is pregnancy at 30 weeks with septic shock from a likely soft-tissue infection; ceftriaxone monotherapy is inadequate for broad gram-negative and anaerobic cover in this scenario, and gentamicin is contraindicated due to fetal ototoxicity and nephrotoxicity. Piperacillin-tazobactam provides broad-spectrum coverage including Pseudomonas and anaerobes, which is the standard empiric choice for sepsis of unknown source in pregnancy per Surviving Sepsis Campaign and RCOG guidance. Ceftriaxone fails because it lacks reliable anaerobic and Pseudomonas coverage in a patient with a spreading leg rash and shock. Vancomycin monotherapy is inadequate because it does not cover gram-negative organisms. Gentamicin is unsafe in pregnancy due to fetal harm and is not a first-line monotherapy for septic shock.
References: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock, 2021.
Question 2 TRY IT — TAP AN ANSWER

A 28-year-old woman presents to a sexual health clinic with a 2-day history of purulent vaginal discharge and dysuria. She is 10 weeks pregnant. She has no allergies. A nucleic acid amplification test is pending, but the clinic decides to start empiric treatment for presumed gonorrhoea based on her symptoms and a recent partner with confirmed infection. Which of the following is the most appropriate empiric regimen?

A) Intramuscular ceftriaxone 500 mg plus oral azithromycin 1 g
B) Oral ciprofloxacin 500 mg twice daily for 7 days
C) Intramuscular benzathine penicillin G 2.4 million units
D) Oral doxycycline 100 mg twice daily for 7 days
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Question 3 TRY IT — TAP AN ANSWER

A 45-year-old man with a history of alcohol-related cirrhosis (Child-Pugh B) presents with a 1-day history of fever, abdominal pain, and distension. Paracentesis reveals a neutrophil count of 400 cells/mm?. He has no allergies. The team plans to start antibiotics and albumin. Which of the following is the most appropriate initial antibiotic regimen?

A) Intravenous cefotaxime 2 g every 8 hours
B) Oral ciprofloxacin 500 mg twice daily
C) Intravenous vancomycin 1 g twice daily
D) Intravenous metronidazole 500 mg three times daily
💡 Pick an answer above to see if you're right — the full explanation unlocks instantly.
Question 4 TRY IT — TAP AN ANSWER

A 62-year-old woman with type 2 diabetes and a history of heart failure with reduced ejection fraction (EF 35%) presents with a 2-day history of dysuria and frequency. She is afebrile, haemodynamically stable, and urinalysis shows nitrites and leukocytes. She has no allergies. Which of the following is the most appropriate oral antibiotic?

A) Ciprofloxacin 500 mg twice daily for 7 days
B) Trimethoprim 200 mg twice daily for 7 days
C) Nitrofurantoin 100 mg twice daily for 5 days
D) Amoxicillin 500 mg three times daily for 7 days
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Question 5 TRY IT — TAP AN ANSWER

A 55-year-old man with a history of asthma presents with a 3-day history of fever, cough, and pleuritic chest pain. He is tachypneic at 24/min, SpO2 92% on room air, and chest X-ray shows left lower lobe consolidation. He has no allergies. The team plans to start antibiotics. Which of the following is the most appropriate empiric antibiotic regimen?

A) Oral amoxicillin 500 mg three times daily
B) Oral levofloxacin 500 mg once daily
C) Oral doxycycline 100 mg twice daily
D) Intravenous ceftriaxone 2 g once daily
💡 Pick an answer above to see if you're right — the full explanation unlocks instantly.

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Specialist Public Health & General Preventive Medicine (SPH6022) Questions for DHA Speciality — FAQ

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