Aminoglycosides (6 - 10)

5 Questions | By Medicinemcq | Updated: Mar 22, 2022 | Attempts: 484

Questions and Answers

1.

A 76-year-old man is seen in a hospital emergency department complaining of pain in and behind the right ear. Physical examination shows edema of the external otic canal with purulent exudate and weakness of the muscles on the right side of the face. The patient informs the physician that he is a diabetic. Gram stain of the exudate from the ear shows many polymorphonucleocytes and gram-negative rods, and samples are sent to the microbiology laboratory for culture and drug susceptibility testing. A preliminary diagnosis is made of external otitis. At this point, which of the following is most appropriate?
- A.
  
  Amikacin should be injected intramuscularly, and the patient should be sent home
- B.
  
  Analgesics should be prescribed, but antibiotics should be withheld pending microbiological results
- C.
  
  Oral cefaclor should be prescribed together with analgesics, and the patient should be sent home
- D.
  
  The patient should be hospitalized, and treatment started with imipenem-cystatin
- E.
  
  The patient should be hospitalized, and treatment started with gentamicin plus ticarcillin
2.

Regarding the toxicity of aminoglycosides which statement is accurate?
- A.
  
  Gentamicin and tobramycin are the least likely to cause renal damage
- B.
  
  Ototoxicity due to amikacin and gentamicin includes vestibular dysfunction, which is often irreversible
- C.
  
  Ototoxicity is reduced if loop diuretics are used to facilitate the renal excretion of aminoglycoside antibiotics
- D.
  
  Reduced blood creatinine is an early sign of aminoglycoside nephrotoxicity
- E.
  
  Skin reactions are very rare following topical use of neomycin
3.

This drug has characteristics almost identical to those of gentamicin but has much weaker activity in combination with penicillin against enterococci.
- A.
  
  Amikacin
- B.
  
  Erythromycin
- C.
  
  Netilmicin
- D.
  
  Spectinomycin
- E.
  
  Tobramycin
4.

Your 23-year-old female patient is pregnant and has gonorrhea. The medical history includes anaphylaxis following exposure to amoxicillin. The most appropriate drug to use is
- A.
  
  Azithromycin
- B.
  
  Cefixime
- C.
  
  Ceftriaxone
- D.
  
  Ciprofloxacin
- E.
  
  Doxycycline
5.

Which statement about “once-daily” dosing with aminoglycosides is not accurate?
- A.
  
  Dose adjustment is less important in renal dysfunction
- B.
  
  It is convenient for outpatient treatment
- C.
  
  Less nursing time is required for drug administration
- D.
  
  Often fewer side effects than multiple (conventional) dosing regimens
- E.
  
  Underdoing is less of a problem