Pharm Antifungal Drugs

20 Questions | By Chachelly | Last updated: Nov 6, 2018 | Total Attempts: 1346

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A person is more likely to get a fungal infection if they have a weakened immune system or take antibiotics. Antifungal medicines work by either killing the fungal cells or by affecting a substance in the cell walls. Take up this quiz and see how much you know about antifungal drugs.

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Questions and Answers

1.

Which of the following statements correctly pair the antifungal drugs with their likely mechanism of action? (Check all that apply)

Discuss
- A.
  
  Amphotericin B - inhibits thymidylate synthetase
- B.
  
  Griseofulvin - interferes with microtubule function
- C.
  
  Flucytosine - inhibits fungal mycolic acid synthesis
- D.
  
  Miconazole - inhibits DNA dependent RNA polymerase
- E.
  
  Nystatin - inhibits ergosterol synthesis
- F.
  
  Terbinafine - inhibits squalene epoxidase
2.

Which of the following statements correctly pairs the antifungal drug with its typical adverse effect? (Check all that apply)

Discuss
- A.
  
  Amphotericin B - normocytic anemia
- B.
  
  Griseofulvin - photosensitivity
- C.
  
  Flucytosine - myelosuppression
- D.
  
  Ketoconazole - menstrual irregularities
- E.
  
  Nystatin - mental confusion
3.

Which of the following statements best explain the mechanism of antifungal action of amphotericin B?
- A.
  
  Inhibition of topoisomerase II
- B.
  
  Impairment of the normal permeability of fungal cell membrane
- C.
  
  Inhibition of reverse transcriptase
- D.
  
  Blockade of fungal mitosis
- E.
  
  Inhibition of fungal cytochrome P450 enzymes
4.

Which of the following statements regarding the toxicity of amphotericin B are correct? (Check all that apply)

Discuss
- A.
  
  Metabolic alkalosis is frequent and may be pronounced
- B.
  
  A shock-like fall in blood pressure may occur during IV infusion
- C.
  
  A sudden decrease of body temperature may occur during IV infusion
- D.
  
  Renal toxicity is common, is dose-dependent and may be severe
- E.
  
  Amphotericin B toxicity seems to be lower with the use of lipid formulations the drug
5.

Which of the following is an antifungal drug that acts by inhibiting fungal DNA synthesis?
- A.
  
  Fluorouracil
- B.
  
  Cytarabine
- C.
  
  Flucytosine
- D.
  
  Griseofulvin
- E.
  
  Ketoconazole
- F.
  
  Terbinafine
6.

Which of the following statements best explains the mechanism of antifungal action of azoles?

Discuss
- A.
  
  Inhibition of conversion of squalene to lanosterol
- B.
  
  Formation of artificial pores in the fungal membrane
- C.
  
  Inhibition of fungal mitosis
- D.
  
  Inhibition of squalene synthesis
- E.
  
  Inhibition of conversion of lanosterol to ergosterol
7.

Which of the following fungal disease is resistant to azole treatment?
- A.
  
  Coccidioidomycosis
- B.
  
  Histoplasmosis
- C.
  
  Aspergillosis
- D.
  
  Cryptococcosis
- E.
  
  Mucormycosis
8.

Which of the following fungi are sensitive to Griseofulvin? (Check all that apply)
- A.
  
  Candida albicans
- B.
  
  Malassezia furfur
- C.
  
  Trichophyton rubrum
- D.
  
  Epidermophyton floccosum
- E.
  
  Microsporum gypseum
- F.
  
  Pseudomonas aeruginosa
- G.
  
  Histoplasma capsulatum
9.

Recognized clinical indications for the use of terbinafine include which of the following diseases?
- A.
  
  Actinomycosis
- B.
  
  Brucellosis
- C.
  
  Toxoplasmosis
- D.
  
  Onychomycosis
- E.
  
  Histoplasmosis
10.

A 31-year-old man presented to his physician with a annular lesion with raised borders in his left hand. Microscopic examination of skin scrapings revealed branching hyphae. The diagnosis of tinea manus was made and the patient was prescribed an appropriated oral treatment. Which of the following skin structures was most likely the site of action of the prescribed drug?

Discuss
- A.
  
  Stratum basale
- B.
  
  Stratum spinosum
- C.
  
  Stratum corneum
- D.
  
  Pigment layer
- E.
  
  Hair follicle
- F.
  
  Hair shaft
11.

A 37-year-old man complained of anorexia, nausea, enlargement of his breast and impotence. The man, recently diagnosed with pulmonary coccidioidomycosis, has been receiving an antifungal treatment for two weeks. Which of the following drugs most likely caused these adverse effects?

Discuss
- A.
  
  Amphotericin B
- B.
  
  Nystatin
- C.
  
  Ketoconazole
- D.
  
  Flucytosine
- E.
  
  Griseofulvin
- F.
  
  Terbinafine
12.

A 37-year-old woman with AIDS has been recently diagnosed with systemic candidiasis due to Candida cruzii, and an IV antifungal treatment has been prescribed. Four days later the following lab results were obtained: serum creatinine 5.9 mg/dL (normal: 0.6-1.5), blood urea nitrogen 53 mg/dL (normal 7-30), plasma potassium 2.3 mmol/L (normal 3.5-5.3). Which of the following drugs was most likely prescribed?
- A.
  
  Amphotericin B
- B.
  
  Fluconazole
- C.
  
  Griseofulvin
- D.
  
  Flucytosine
- E.
  
  Cyclosporine
- F.
  
  Tobramycin
13.

A 32-year-old woman presents to her gynecologist with a 4 days history of perineal pruritus and a non-malodorous, thick, cheesy vaginal discharge. The only medication the woman is taking is an oral contraceptive. A wet preparation of vaginal secretion shows budding yeast cells and pseudohyphae. Which of the following drugs, given locally, would be appropriate for this patient?

Discuss
- A.
  
  Mebendazole
- B.
  
  Metronidazole
- C.
  
  Miconazole
- D.
  
  Zidovudine
- E.
  
  Griseofulvin
- F.
  
  Saquinavir
14.

A 68-year-old man is in the hospital because of a prostatectomy performed 4 days before. He is wearing a urinary catheter and is currently treated with a combination of broad spectrum antibiotics. The patient has being suffering from chronic renal insufficiency for the past two years. Two recent urinalysis show many budding yeasts and cultures were positive for Candida albicans. Which of the following drugs would be appropriate for a systemic antifungal treatment of this patient?

Discuss
- A.
  
  Amphotericin B
- B.
  
  Fluconazole
- C.
  
  Piperacillin
- D.
  
  Metronidazole
- E.
  
  Griseofulvin
- F.
  
  Nystatin
15.

A 30-year-old filipino man, who is a life long resident in the San Joaquin valley, California, presented to the hospital with a 4 day history low grade fever (99.8 F°), severe headache, irritability and fatigue. Physical examination showed stiff neck and Kerning’s sign. Microscopic analysis of the spinal fluid revealed spherules filled with endospores. Which of the following drugs would be appropriate for this patient?

Discuss
- A.
  
  Flucytosine
- B.
  
  Penicillin G
- C.
  
  Gancyclovir
- D.
  
  Amphotericin B
- E.
  
  Gentamicin
- F.
  
  Zidovudine
16.

A 31-year-old homosexual male with AIDS presents to the emergency room with fever (102.3 F°), headache, confusion, muddled thinking and vomiting. Physical examination reveals nuchal rigidity, diplopia and loss of vision. An agglutination test of the spinal fluid for capsular polysaccharide antigen is positive. Which of the following drugs would be an appropriate treatment for this patient?

Discuss
- A.
  
  Ampicillin and erythromycin
- B.
  
  Saquinavir and foscarnet
- C.
  
  Pyrimethamine and sulfadiazine
- D.
  
  Amphotericin B and flucytosine
- E.
  
  Tolnaftate and nystatin
- F.
  
  Terbinafine and griseofulvin
17.

A 7-year-old girl is brought to the physician by her mother because she has several small hairless patches in her scalp. Upon close physical examination, patches look like black dots in the skin surface. Microscopic examination reveals a dense sheath of spores around the hair. Which of the following drugs given orally would be an appropriate treatment for this patient?

Discuss
- A.
  
  Acyclovir
- B.
  
  Metronidazole
- C.
  
  Griseofulvin
- D.
  
  Vancomycin
- E.
  
  Amphotericin B
- F.
  
  Flucytosine
18.

A 32-year-old man suffering from a non-Hodgkin’s lymphoma presented with fever, cough, increasing dyspnea and hemoptysis. The man was in the hospital for the second cycle of chemotherapy. Chest radiograph disclosed diffuse alveolar infiltrates on the right lobe and multiple small cavitary lesions on the left lobe. A bronchoalveolar lavage revealed fungal forms typical of Aspergillus genus. Which of the following drug was most likely given IV to this patient?

Discuss
- A.
  
  Flucytosine
- B.
  
  Terbinafine
- C.
  
  Griseofulvin
- D.
  
  Amphotericin B
- E.
  
  Nystatin
19.

A 33-year-old, HIV positive homosexual man living near Mississippi river, was admitted to the hospital with a 3 week history of cough, productive yellow sputum, progressive dyspnea of exertion and 14-pound weight loss. Pertinent lab results on admission were: CD4+ lymphocyte counts 320 cells/mm 3, lactate dehydrogenase 5000 IU/L (normal < 600). A blood stain showed neutrophils containing small, uninucleated and encapsulated microorganisms. Which of the following statements correctly pairs the most likely disease of the patient with the appropriate treatment?

Discuss
- A.
  
  Progressive disseminate histoplasmosis - amphotericin B
- B.
  
  Progressive disseminate coccidioidomycosis - fluconazole
- C.
  
  Pulmonary blastomycosis - fluconazole
- D.
  
  Meningeal cryptococcosis- amphotericin B
- E.
  
  Disseminate sporotrichosis - amphotericin B
20.

Which of the following microorganisms are sensitive to amphotericin B ? (Check all that apply)
- A.
  
  Coccidioides immitis
- B.
  
  Mycoplasma pneumoniae
- C.
  
  Histoplasma capsulatum
- D.
  
  Aspergillus fumigatus
- E.
  
  Cryptococcus neoformans
- F.
  
  Chlamydia psittaci
- G.
  
  Nocardia asteroides

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