Pharm Antimicrobial Systemic Infxn

21 Questions | Total Attempts: 198

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Pharm Antimicrobial Systemic Infxn

Antimicrobials and treatment of systemic infections


Questions and Answers
  • 1. 
    Which of the following penicillins is effective against infections caused by methicillin-sensitive beta-lactamase producing staphylococci?
    • A. 

      Ticarcillin

    • B. 

      Amoxicillin

    • C. 

      Penicillin V

    • D. 

      Nafcillin

    • E. 

      Piperacillin

  • 2. 
    Which of the following bacterium is resistant to all the beta-lactam antibiotics?
    • A. 

      Listeria monocytogenes

    • B. 

      Methicillin-resistant Staphylococcus aureus

    • C. 

      Escherichia coli

    • D. 

      Pseudomonas aeruginosa

    • E. 

      Enterococcus faecalis

    • F. 

      Clostridium tetani

  • 3. 
    A 50-year-old woman has developed a nosocomial urinary tract infection. Gram-stain showed gram-negative bacilli, later confirmed to be Pseudomonas aeruginosa. Which of the following antibiotics would most likely show activity against this bacterium?
    • A. 

      Aztreonam

    • B. 

      Linezolid

    • C. 

      Vancomycin

    • D. 

      Quinupristin-dalfopristin

    • E. 

      Tigecycline

  • 4. 
    A 50-year-old man who was admitted to the ICU has developed septicemia on his 5th day of admission. Blood culture report comes positive for Enterobacter aerogenes. A therapy with an antibiotic in combination with cilastatin is started. Which of the following is the most likely antibiotic given to him?
    • A. 

      Aztreonam

    • B. 

      Imipenem

    • C. 

      Nafcillin

    • D. 

      Ceftazidime

    • E. 

      Amoxicillin

    • F. 

      Meropenem

  • 5. 
    A 72-year-old man was prescribed antibiotic therapy for the treatment of streptococcal pharyngitis. Four days later her general conditions deteriorated, and physical examination showed abdominal distension and absent bowel sounds. Colonoscopy revealed diffuse ulcerations and exudative plaques lining the colonic mucosa. Which of the following antibiotics most likely caused the patient’s symptoms?
    • A. 

      Gentamicin

    • B. 

      Metronidazole

    • C. 

      Vancomycin

    • D. 

      Dicloxacillin

    • E. 

      Ampicillin

  • 6. 
    A 5-year-old boy with recurrent pulmonary infections is brought to the hospital by his mother because of respiratory difficulties. Gram stain of the sputum reveals Gram-positive cocci in grape-like clusters. Which of the following drugs would be the best empiric treatment at this early stage?
    • A. 

      Penicillin G

    • B. 

      Ampicillin

    • C. 

      Piperacillin

    • D. 

      Dicloxacillin

    • E. 

      Amoxicillin

  • 7. 
    A 56-year-old farmer presented to the hospital with a small, flat, hard swelling under the oral mucosa which formed a fistula discharging yellow granules. One month before he had several teeth extracted because of periodontal abscess. Anaerobic cultures of the biopsy material showed small spidery colonies containing gram positive, non-acid fast rods and branching filaments. Which of the following antibacterial drugs would be most appropriate for the patient’s disease?
    • A. 

      Penicillin G

    • B. 

      Aztreonam

    • C. 

      Metronidazole

    • D. 

      Gentamicin

    • E. 

      Ciprofloxacin

  • 8. 
    A 65-year- old woman was admitted to the emergency room febrile and unresponsive. Vital signs on admission were: blood pressure 90/50 mm Hg, pulse 115 bpm, fever 104 F. Pupils were equal and poorly reactive to light. Papilledema was present. A Gram stain of the CSF showed many Gram negative rods. An antibiotic was given IV. Which of the following statements best explains the most likely mechanism of action of the given drug?
    • A. 

      Misreading of the code on the mRNA template

    • B. 

      Inhibition of the synthesis of tetrahydrofolate

    • C. 

      Inhibition of polymerization of RNA

    • D. 

      Blockade of translocation of newly synthesized peptidyl-tRNA

    • E. 

      Inhibition of the synthesis of peptidoglycan

  • 9. 
    A 28 weeks pregnant woman develops a urinary tract infection during her hospitalization. She was admitted to the hospital 3 days ago because of suspected threatened abortion. Culture sensitivity report indicates that the infection is due to Pseudomonas aeruginosa that is sensitive to gentamicin and piperacillin, and resistant to most other antibiotics. Which of the following adverse effects is a likely risk to the fetus in response to gentamicin?
    • A. 

      Skeletal deformity

    • B. 

      Hearing loss

    • C. 

      Blindness

    • D. 

      Mental retardation

    • E. 

      Neural tube defects

  • 10. 
    Which of the following microorganisms is most sensitive to aminoglycoside antibiotics?
    • A. 

      Clostridium difficile

    • B. 

      Pseudomonas aeruginosa

    • C. 

      Bacteroides fragilis

    • D. 

      Borrelia recurrentis

    • E. 

      Methicillin-resistant staph aureus

    • F. 

      Chlamydia pneumoniae

    • G. 

      Mycoplasma pneumoniae

    • H. 

      Neisseria gonorrhoeae

    • I. 

      Legionella pneumophila

  • 11. 
    Which of the following statements regarding resistance to aminoglycoside antibiotics is correct?
    • A. 

      It can be due to inactivation of the drug by the bacterial enzymes

    • B. 

      It can be due to a decreased affinity of the drug for the 50S ribosomal subunit

    • C. 

      It appears mostly to amikacin

    • D. 

      It is very rare among enterococci

    • E. 

      It is quite uncommon among strains of Mycobacterium tuberculosis

  • 12. 
    Which of the following statements regarding the toxicity of aminoglycosides is correct?
    • A. 

      Allergic reactions are very common and often serious

    • B. 

      The toxicity of these drugs is mainly dose-dependent

    • C. 

      The risk of ototoxicity and nephrotoxicity decreases with age

    • D. 

      Ototoxicity is always reversible upon the discontinuation of the drug

    • E. 

      Nephrotoxicity is always irreversible

  • 13. 
    Aminoglycosides are contraindicated, or should be used with caution in patients receiving which of the following drugs?
    • A. 

      Penicillin G

    • B. 

      Furosemide

    • C. 

      Lidocaine

    • D. 

      Captopril

    • E. 

      Ceftazidime

    • F. 

      Verapamil

  • 14. 
    A 37-year-old man presents with a high grade fever. He has a history of diabetes and impaired renal function. Clinical picture is suggestive of a severe bacterial infection. Culture sensitivity report of the blood sample shows the causative bacteria to be sensitive to azithromycin, imipenem, levofloxacin, tetracycline, vancomycin, and gentamicin. Which of these antibacterial agents can be administered to him to treat his infection without any dose modification?
    • A. 

      Azithromycin

    • B. 

      Imipenem

    • C. 

      Levofloxacin

    • D. 

      Tetracycline

    • E. 

      Vancomycin

    • F. 

      Gentamicin

  • 15. 
    A 67-year-old man develops signs of septicemia 2 days after undergoing an abdominal surgery. The data from the microbiology lab indicates that there is high prevalence of gentamicin-resistant Gram-negative bacterial infections in the hospital. Blood sample is sent for culture and sensitivity. Which of the following aminoglycosides in combination with a beta-lactam antibiotic would be an appropriate choice to start an empiric therapy for this patient?
    • A. 

      Neomycin

    • B. 

      Streptomycin

    • C. 

      Amikacin

    • D. 

      Tobramycin

    • E. 

      Netilmycin

  • 16. 
    A 33-year-old woman with type I diabetes is admitted to the hospital with fever (102 F), shaking chills, nausea and vomiting, flank pain and hematuria. She has been suffering from chronic lower urinary tract infection for one year. The predominant pathogen of the infection was found to be Pseudomonas aeruginosa. Which of the following pair of antibiotics would be most appropriate therapy of the treatment of this patient’s infection?
    • A. 

      Piperacillin and tobramycin

    • B. 

      Ampicillin and gentamicin

    • C. 

      Imipenem and erythromycin

    • D. 

      Cephalothin and doxycycline

    • E. 

      Ampicillin and doxycycline

  • 17. 
    A 45-year-old homosexual man presents to the clinic complaining of pain on defecation and presence of mucopus on stools. A Gram stain of rectal mucus reveals Gram-negative cocci. Which of the following drugs would be most appropriate for this patient?
    • A. 

      Trimethoprim-sulfamethoxazole

    • B. 

      Ceftriaxone

    • C. 

      Ciprofloxacin

    • D. 

      Tetracycline

    • E. 

      Metronidazole

  • 18. 
    Which of the following statements about tetracyclines is correct?
    • A. 

      They are mainly bactericidal drugs for susceptible bacteria

    • B. 

      They are not active against mycoplasmas, chlamydia and plasmodia

    • C. 

      Most compounds do not cross the blood brain barrier even when meninges are inflamed

    • D. 

      They may cause the “gray-baby syndrome” when given to the newborn

    • E. 

      They are chelating agents that bind to several cations including calcium

  • 19. 
    Which of the following antibiotics is effective against rickettsial infections and is also capable of countering the actions of antidiuretic hormone?
    • A. 

      Erythromycin

    • B. 

      Chloramphenicol

    • C. 

      Ciprofloxacin

    • D. 

      Demeclocycline

  • 20. 
    Bacterial resistance to tetracyclines may be due to which of the following mechanisms?
    • A. 

      Production of an effusion pump that extrudes the drug from the bacterial cell

    • B. 

      Production of acetyl transferase enzymes that inactivate the drug

    • C. 

      Improved permeability of the outer bacterial membrane to the drug

    • D. 

      Production of phosphoryl transferase enzymes that inactivate the drug

  • 21. 
    A 16-year-old girl presented with a 5 days history of vulvar itching and burning and a thick, cheesy vaginal discharge. The girl has been taking an oral antibiotic for two months to cure moderate acne. Microscopic examination of the vaginal smear indicated Candida albicans as the offending pathogen. Which of the following drugs could have contributed to the appearance of the girl’s infection?
    • A. 

      Cycloserine

    • B. 

      Amikacin

    • C. 

      Aztreonam

    • D. 

      Fluconazole

    • E. 

      Doxycycline

    • F. 

      Amphotericin B

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