Questions 8081

For each patient, select the drug that most likely caused the adverse effect.

a. Acyclovir b. Amantadine c. Did e o xycy tidi n e d. Foscarnet e. Ganciclovir 1. Idoxuridine g. Interferon a h. Ribavirin i. Vidarabine j Zidovudine

80, A 27-year-old male with a three-year history of AIDS complains of progressive blurring of vision for two days. Eye examination reveals evidence of retinitis consistent with cytomegalic virus inclusion disease. Intravenous treatment is started, and within five days the patient complains of muscular weakness and cramping. Blood chemistries show a creatinine of mEq/L and a Ca of 6.9 mEq/L.

81, A 22-year-old female with a two-year history of AIDS treated with one of these agents develops epigastric pain that radiates to the chest. Endoscopic examination reveals an esophageal ulceration.

82, The mechanism of action of chloramphenicol as an antibiotic is that it a. Binds to the 30S ribosome subimit b Reversibly binds to the ^OS ribosome subunit c. Prevents cell membrane development d. Inhibits cell-wall synthesis e. Inhibits RNA polymerase

83, The drug of choice for the treatment of I saginata (tapeworm) is a. Mebendazole b Ceftriaxone c. Primaquine d. Niclosamide e. Chloroquine

84, The drug of choice for the treatment of Schistosoma haematobium is a. Praziquantel b. Ceftriaxone c. Metronidazole d. Mebendazole e. Die thy! carbamaz i ne

85, Ampicillin and amoxicillin art! in the same group of penicillins. Which of the following statements best characterizes amoxicillin?

a. It has better oral absorption than does ampicillin b It c an be used in penicillinase -p ro d uc i ng organ isms c. It is classified as a broad-spectrum penicillin d. It does not cause hypersensitivity reactions e. It is effective against Pstiudomonas

86, A 60-year-old male with AIDS develops a systemic fungal infection that is treated with fluconazole. What is the mechanism of action of fluconazole?

a. It inhibits ergoste ro I syn ihe si s b It inhibits DNA synthesis c. It inh i bi Ls p e pt idoglyean synt hesis d. It inhibits protein synthesis

87, A 50-year-old male diabetic develops an external otitis from which Pseudomonas organisms are cultured. Topical therapy with polymyxin is effective. What is the mechanism of action of polymyxin?

a. lnhi bi ti on o f cell - wal J synth es i s b. Formation of reactive cytotoxic products that interfere with DNA synthesis c. Disrup ti on o f me mbr a ne pe rme abi lity d. Inac ti vati on o f p ro le i ti su 1 fhydryl gro up s e. Inhibition of protein synthesis by binding to transfer RNA (tRNA)

88, A 75-year-old male develops a cough that produces blood-tinged sputum. I le has a fever of 104°n Gram-positive cocci in clusters are found in a sputum smear. A chest x-ray shows increased density in the right upper lobe. Of the following penicillins, which is most likely to be ineffective?

a. Oxacillin b. Cloxacillin c. Heard Jlin d. Mafcillin e. Dicloxacillin

89, A 40-year-old female with a history of AIDS develops a herpes simplex keratitis of the eye. Which of the following antiviral agents should be administered in this case?

a. Zanamivir b Infi uridine c. Zidovudine d. Amantadine e. Indinavir

90, A 45-year-old female being treated for a chronic UTI develops acute alcohol intolerance. Which of the following agents could have caused this intolerance?

a. Cefcperazone b Amoxicillin c. Su 1 fame thoxaz ol e -tri me thopri m d. Norfloxacin e. Tetracycline

91, A 60-year-old male with a temperature of 104CF and a productive cough is diagnosed as having staphylococcal pneumonia After several days on nafnllin, he develops truncal urticaria and pruritis. Which of the following agents is best avoided in this patient?

a. Cefazolin b. Clarithromycin c. Sparfloxacin d. Clindamycin e. Tetracycline

92, A 65-year-old male with a pneumonia has a sputum culture that is positive for a staphylococcal strain that is p-lactamase-positive. Which is the best choice of penicillin therapy in this patient?

a. Ampicillin b. Oxacillin c. Heard Jlin d. Penicillin G

e. Carbenicillin

93, A 35-year-old female complains of itching in the vulval area. Hangingdrop examination of the urine reveals trichomonads. What is the preferred treatment for trichomoniasis?

a. Doxy eye line b. Pyrimeth amine c. Pentamidine d. Emetine e. Metronidazole

94, A 40-year-old female with duodenal ulcers is treated with a combination of agents that includes clarithromycin. Of the following enzymes, which is inactivated by clarithromycin?

a. Dihydrofolate reductase b. Glucose-G-phosphate dehydrogenase c. Cytochrome P45Q

d. Na\K -ATPase e. Na^K^Cl" co-transporter

95, A 30-year-old type 1 diabetic with renal complications develops acute pyelonephritis. P aeruginosa is found in urine cultures and blood cultures. Combined therapy is instituted with an aminoglycoside and which of the following?

a. Clavulanic acid b Vancomycin c. A second-generation cephalosporin d. Azithromycin e. Piperacillin

96, A 35-year-old male is diagnosed with primary syphilis. Which of the following agents is the best choice for treating this patient?

a. A first-generation cephalosporin b. Oxacillin c. lmipenen d. Benzathine penicillin G

e. Vancomycin

97, A 20-year-old male has a urethral discharge. Culture of the discharge shows Neisseria gonorrhoeae. Which of the following agents is the best choice for treating this patient?

a. Ceftriaxone b Benzathine penicillin G

c. lmipenen d. Amikacin e. SulE ame thoxaz ole-t ri me th o pri m

98, Which of the following best describes ampicillins effect on therapeutically administered estrogens?

a. It decreases estrogen metabolism b. It decreases the enterohepatic circulation of estrogen c. It decreases the plasma protein binding of estrogen d. It decreases the renal excretion of estrogen e. It decreases the sensitivity of estrogen at its site of action

99, A 36-year-old female with a chronic UTI treated with ciprofloxacin is not responsive to the antibiotic. Which of the following agents that she might have been taking for other reasons would decrease the effectiveness of ciprofloxacin?

a. An antacid b. An antihistamine c. A nonsteroidal anti-inflammatory d. An anxiolytic e. A multivitamin noi containing iron

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.

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