Antibacterial Ant i my cob ac t cria Is Antifungals
DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question
37, A 19-year-old male being treated for leukemia develops fever. You give agents that will cover bacterial, viral and fungal infections. Two days later, he develops acute renal failure. Which drug was most likely responsible?
a Vancomycin b Ceftazidime c. Amphotericin B
38, A 26-year-old female with acquired immunodeficiency syndrome (AIDS) develops cryptococcal meningitis. She refuses all intravenous medication. Which antifungal agent can be given orally to treat the meningeal infection?
a Ketoconazole b. Amphotericin B
c. Fluconazole d. Nystatin
39, Why is vitamin B6 usually prescribed with isoniazid (INI I)?
a. Lt acts as a cofactor for LNH
b Lt prevents some adverse effects of LNH therapy c. Like 1NH, it has tub ere ulostati c ac Li vi ty d. Lt prevents metabolism of LNH
40. The quinolone derivative that is most effective against Pseudomonas aeruginosa is a. Norfloxacin b. Ciprofloxacin c. Ofloxacin d. Enoxacin e. Lomefloxacin
41. A 19-year-old woman is diagnosed with tuberculosis (TB)t Before prescribing a drug regimen, you take a careful medication history because one of the drugs commonly used to treat TB induces microsomal cytochrome P450 enzymes in the liver. Which drug is this?
a. lsoniazid b. Rifampin c. Pyrazinamidc d. Ethambutol e. Vitamin B^
42. The elimination hal f-li fe of which of the fo 1 lowing tetracy c Ii nes r etnai ns unchanged when the drug is administered to an anuric patient?
a. Methacydine b. Oxytetracycline c. Doxy eye line d. Tetracycline e. None of the above
43. In the treatment of bacterial meningitis in children, the drug of choice is a. Penicillin G
b. Penicillin V
c. Erythromycin d. Procaine penicillin e. Ceftriaxone
44. Inpatients with hepatic coma, decreases in the production and absorption of ammonia from the gastrointestinal (Gl) tract will be beneficial. The antibiotic of choice in this situation would be a. Neomycin b. Tetracycline c. Penicillin G
d. Chloramphenicol e. Cephalothin
45, Indicate from the diagram below the site of action of penicillinase.
46. Clavulanic acid is important because it a Easily penetfates Gram-negative microorgani5m_s b. Is specific for Gram-positive microorganisms c. Is a potent inhibitor of cell-wall transpeptidase d. Inactivates bacterial fi-lactam ases e. Has a spectrum of activity similar to that of penicillin G
47, In the treatment o\ infections causeel by P. aeruginosetf the antimicrobial agent that has proved to be effective is a. Penicillin G
b. Piperacillin c. Nafcillin d. Erythromycin e. Tetracycline
48, Ethambutol is administered concurrently with other antitubercular drugs in the treatment of TB in order to a. Reduce the pain of injection b. Faci I it at e pene tra tion o f the b 1 ood-brain b am er c. Retard the development of organism resistance d. Delay excretion of other antitubercular drugs by the kidney e. Retard absor pt ion a ft er i ntramu scular injection
49, The most active aminoglycoside against Mycobacterium tuberculosis is a. Streptomycin b Amikacin c. Neomycin d. Tobramycin e Kanamycin
50, The drug used in all types of TB is a. Ethambutol b. Cycloserine c. Streptomycin d. INH
51, Chronic candidiasis infections of the GI tract and oral cavity are treated with which agent in pill form a. Amphotericin B
b Nystatin c. Miconazole d. Fluconazole e. Clotrimazole
52, Drug X is an antimycobacterial agent that inhibits other bacteria as well as poxviruses. However it should not be used as a single agent because resistant mutants frequently form. The responsible mutation may alter the site of action of drug X [i.e., the deoxyribonucleic acid (DNA)—dependent ribonucleic acid (RNA) polymerase]. What is drugX?
b. Rifampin c. Pyraz in amide d. Ethambutol
53, For the treatment of a patient with Legionella pneumophila, the drug of choice would be a. Penicillin G
b. Chloramphenicol c. Erythromycin d. Streptomycin e. Li neomycin
54, The most effective agent in the treatment of Rickettsia, My capias ma, and Chlamydia infections is a. Penicillin G
b. Tetracycline c. Vancomycin d. Gentamicin e. Bacitracin
55, The mechanism of action by which pyrantel pamoate is effective for the treatment of Necator americ.anus (hookworm) disease is a. Interference with cell-wall synthesis b. Interference with cell division c. I nhi bi ti on o f neu romusen bi transm i s si o n d. Ln ter fere nc e wi L h p ro t.e i n syn thesis e. Depletion of membrane lipoproteins
56, Vertigo, inability to perceive termination of movement, and difficulty in sitting or standing without visual clues are some of the toxic reactions that are likely to occur in about 75% of patients treated with a. Penicillin G
b. Doxycycline c. Amphotericin B
d. Streptomycin e. INH
57, Amantadine, a synthetic antiviral agent used prophylactically against influenza A2, is thought to act by a. Prevent itig pro due lion of viral e ap sid p rote i n b. Prevent i tig virion re Ieas e c. Preventing penetration of the virus into the host cell d. Prevent i tig unc o a ti ng o f vi red D N A
e. Causing lysis of infected host ee 1 Is by release of intracellular Lysosoma 1 enzymes
58, Streptomycin and other aminoglycosides inhibit bacterial protein synthesis by binding a. Peptidoglycan units in the eel J wall b. Messenger RNA f.mRNA)
d. 30S ribosomal panicles e. RNA p olyme ras e
59, A patient with AIDS is treated with a combination of agents, which includes zidovudine. What is the mechanism of action of zidovudine?
a. lnhib iti on o f RN A synthes i s b. lnhi bi t i on o f vi ral p ar tic le assembly c. I nhi bi t i on o f vi ra II prote ase s d. lnhi bi 1 i on of nuc Ieos i de re ve rs e t ran sc ti p lase e. Inhibition of nonnucleoside reverse transcriptase
60, A 39-year-old male with aortic insufficiency and a history of no drug allergies is given an intravenous dose of antibiotic as a prophylaxis preceding the insertion of a valve prosthesis. As the antibiotic is being infused, the patient becomes flushed over most of his body. What antibiotic was given?
a Vancomycin b. Gentamicin c. Erythromycin d. Penicillin G
61, Which of the following cephalosporins would have increased activity against anaerobic bacteria such as Bacteroides fragilis?
a. Cefaclor b. Cephalothin c. Cephalexin d. Cefuroxime e. Cefoxitin
62, Which one of the following antimicrobial agents is primarily administered topically?
a. Polymyxin B b Penicillin G
c. Dicloxacilliti d. Carbenicillin e. Streptomycin
63, A 75-year-old woman is hospitalized for pneumonia and treated with an intravenous antibiotic. On day threet she develops severe diarrhea. Stool is positive for Clostridium difficile toxin. What is the best treatment?
a. Clindamycin b Cefaclor c. Metronidazole d. Erythromycin e. Doxy eye line
64, A jaundiced one-day-old premature infant with an elevated free bilirubin is seen in the premature-baby nursery The mother received an antibiotic combination preparation containing sulfamethizole for a urinary tract infection (UTL) one week before delivery You suspect that the infant's findings are caused by the sulfonamide because of the following mechanism:
a. Enhanced synthesis of bilirubin b. Co mpe ti ti on b ct ween th e ^ ul fana mi de and b i liru b i n f o r b i ndi ng sites o n al bu m in c. Lnhi bi ti on o f bi I irub i ti de grad ati an d. Inhibition of urinary excretion of bilirubin
65, A 27-year-old female has just returned from a trip to Southeast Asia. In the past 24 hours, she has developed shaking, chills, and a temperature of 104°E A blood smear reveals Plasmodium vivax. Which of the following agents should be used to eradicate the extraerythrocytic phase of the organism?
a. Primaquine b Pvvimethamine c. Qu mac nne d. Chloroqutne e. Chloroguanide
66, An 86-year-old male complains of cough and blood in his sputum for the past two days. On admission, his temperature is 103=H Physical examination reveals rales in his right lung, and x-ray examination shows increased density in the right middle lobe. A sputum smear shows many Gram-positive cocci, confirmed by sputum, culture as penicillinase-producing Staphylococcus aureus. Which of the following agents should be given?
a. Ampicillin b. Oxacillin c. Carbenicillin d. Ticarcillin e. Mezlocillin
67. A 40-year-old male is HIV-positive with a cluster-of-differentiation^ (CD4) count of 200/mm\ Within two months, he develops a peripheral white blood cell count of 1000/mm' and a hemoglobin of 9.0 mg/dL Which drug has most likely caused lite adverse effect?
a. Acyclovir b. Dideoxycytidine c. Foscarnet d. Rimantadine e. Zidovudine
68, Thiabendazole, a benzimidazole derivative, is an antihelminthic drug used primarily to treat infections caused by a. A solris J umbrkt des (roundwo r m) b V American us (hookworm)
c. Stringyioiiics d. tnterobins vermicularis e. Tac n \ a sag i n a ta (f I at wo r m)
69. A 30-year-old male with a two-year history of chronic renal failure requiring dialysis consents to transplantation. A donor kidney becomes available He is given cyclosporine to prevent transplant rejection just before surgery. What is the most likely adverse effect of this drug?
a. Bone marrow depression b Nephrotoxicity c. Oral and GI ulceration d. Pancreatitis e. Seizures
70, The mechanism of action of chloroquine in Plasmodium falciparum malaria is elimination of a. Secondary tissue ^chizonts b Exoerythrocytic schlzonts c. Erythrocytic stage d. Asexual forms e. Sporozoites
71, The use of chloramphenicol may result in a. Bone marrow si i m ulat i on b Phototoxicity c. Aplastic anemia d. Staining of teeth e. Alopecia
72, A drug primarily used in pneumonia caused by Pneumocyssti.s carinii is a. Nifurtimox b. Penicillin G
c. Metronidazole d. Pentamidine e. CarbeniciJlin
DIRECTIONS: Each group of questions below consists of lettered options followed by a set of numbered items. For each numbered item, select the one lettered option with which it is most closely associated. Each lettered option may be used once, more than once, or not at all.