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Round Up Email September 2025

Highlights in this month's Roundup include a new section on paternal perinatal depression, a review of aspirin in primary prevention of cardiovascular disease (CVD); and trial evidence of the use of digitoxin in heart failure with reduced ejection fraction (HFrEF

Question 1
Community acquired pneumonia (CAP) – the updated guidance suggests criterion when more than a standard five-day course of antibiotics in an adult with CAP is indicated. How long should be the course of antibiotic treatment be as a default for children with CAP?: Community acquired pneumonia (CAP)
With respect to NICE guidance for community acquired pneumonia (CAP), which statement is false?
- the default length of antibiotic treatment in an adult with community acquired pneumonia (CAP) is 5 days
- the default length of antibiotic treatment for babies and children aged 3 months (corrected gestational age) to 11 years with non-severe community-acquired pneumonia without complications or underlying disease is 5 days
- for all children and young people with community-acquired pneumonia, stop antibiotic treatment after 5 days unless microbiological results suggest a longer course is needed or the child or young person is not clinically stable
Question 2
Paternal perinatal depression – how common is this condition? What features are stated as more prominent in men with perinatal depression in comparison with women with perinatal depression?: Paternal postpartum depression (PPD)
With respect to paternal perinatal depression, which statement is false?
- paternal perinatal depression is a mental health condition that affects about 10% of fathers worldwide
- paternal perinatal depression is defined as depressive symptoms that develop in fathers during their partner’s pregnancy and/or during the first year of their infant’s life
- evidence suggests that drug and alcohol use is less common in patients with paternal perinatal depression than in maternal perinatal depression
Question 3
Castleman's disease (CD) – This is a is an uncommon benign lymphoproliferative disorder characterized by hyper-vascular lymphoid hyperplasia. Is this condition more common in women? Is the mediastinum the most common site of occurrence? : Castleman's syndrome
With respect to Castleman's disease, which statement is false?
- Castleman's syndrome (Castleman Disease (CD)) is characterised by benign hyperplasia of lymph nodes
- in Castleman's disease, the groin is the most common site of occurrence followed by head-neck region
- preferred management of unicentric Castleman's disease is complete surgical excision, which is curative in approximately 95% of patients
Question 4
Thrombotic microangiopathies (TMAs) - are a group of disorders characterized by thrombocytopaenia, microangiopathic haemolytic anaemia, and ischaemic end-organ damage due to microvascular thrombosis. What is the most affected organ? Can vitamin B12 deficiency cause TMA?: Thrombotic microangiopathies (TMAs)
With respect to thrombotic microangiopathies (TMAs), which statement is false?
- with respect to thrombotic microangiopathies (TMAs), vitamin D deficiency is an established cause
- with respect to thrombotic microangiopathies (TMAs), vitamin B12 deficiency is an established cause
- with respect to thrombotic microangiopathies (TMAs), uncontrolled hypertension is an established cause
Question 5
Tthe recently produced DIGIT-HF Study provides evidence that a cardiac glycoside, in this case digitoxin, reduces the risk of death by 16% compared with placebo in the 36-month trial.: Digitoxin in heart failure with reduced ejection fraction (HFrEF)
With respect to digitoxin in heart failure with reduced ejection fraction (HFrEF), which statement is false?
- in the DIGIT-HF study, treatment with digitoxin led to a lower combined risk of death from any cause or hospital admission for worsening heart failure than placebo among patients with heart failure and reduced ejection fraction who received guideline-directed medical therapy
- digitoxin is a calcium channel blocker
- with respect to digitoxin, concentrations in blood can remain stable without dose adjustments, even among patients with progressive renal dysfunction
Question 6
Aspirin in primary prevention of cardiovascular disease (CVD) – this section has been updated.: Aspirin in people without established vascular disease
With respect to the use of aspirin in the primary prevention of cardiovascular disease, which statement is false?
- a meta-analysis has shown that aspirin use is associated with a significant increased risk of bleeding
- study evidence does not show that aspirin is associated with reduced incidence of colorectal cancer
- a meta-analysis showed that the main risk factors for coronary disease were also risk factors for bleeding

Round Up Email September 2025

Question 1

Question 2

Question 3

Question 4

Question 5

Question 6