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Antibiotics By Alaina Darby
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Cephalosporins, vanc, etc.
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Which of the following would not be an alternative for use in the presence of cephalosporinases?
cefepime aztreonam fluoroquinolone carbapenem b
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Which of the following is a first generation cephalosporin? Cefoxitin
Cefepime Cefotaxine Cefazolin d
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Which of the following has the least gram- positive coverage?
Cefoxitin Cefepime Cefotaxine Cefazolin c
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Which of the following has the least gram- negative coverage?
Cefoxitin Cefepime Cefotaxine Cefazolin d
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Which of the following is a second generation cephalosporin with B
Which of the following is a second generation cephalosporin with B. fragilis coverage? Cefaclor Cefotetan Cefotaxine Cefazolin b
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Which of the following is a third generation cephalosporin with coverage of Pseudomonas?
Cefataroline Cefepime Ceftazidime Cefotaxime c
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Which of the following is FDA approved for CABP and ABSSSI? Cefaroline
Cefotaxime Cefoxitin Cefazolin a
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Increased gram-negative bacterial susceptibility
Which of the following is not true of first to third generation progression? Increased gram-negative bacterial susceptibility Increased gram-positive bacterial susceptibility Increased beta-latamase inactivation Increased capability to enter CSF b
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Which of the following can be used for meningitis? First generation
Second generation Third generation Fourth generation c
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The dosage of which of the following would not have to be adjusted when taking probenecid?
Ceftazidime Cefepime Cefazolin Cefoxitin a
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Which of the following exhibits significant hemodialysis and is also partially hepatically excreted?
Cefotaxime Ceftriaxone Ceftazidime Cefpodoxime b
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Nephrotoxicity at high dosage Phlebitis with IV administration
Which of the following adverse reactions is not common with cephalosporins? Nephrotoxicity at high dosage Phlebitis with IV administration Superinfections Diarrhea and GI disturbance c
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Nephrotoxicity at high dosage Phlebitis with IV administration
Which of the following adverse reactions is most common with ceftriaxone? Nephrotoxicity at high dosage Phlebitis with IV administration Superinfections Diarrhea and GI disturbance d
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Disulfiram-like effects Anticholinergic effects
The N-methylthiotetrazole side chain in some cephalosporins can cause what? Neurotoxicity Nephrotoxicity Disulfiram-like effects Anticholinergic effects c
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Which of the following gives the broadest spectrum of any beta-lactam antibiotic?
Vancomycin Methicillin Imipenem Cefuroxime c
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Which is true of Imipenem? Well absorbed when given orally
Good distribution to body tissues and into the CSF Administered with cilastatin to inhibit beta-lactamases Excreted by both glomerular filtration and active secretion d
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The hospital has run out of cilastatin but needs an effective treatment for P. aeruginosa. Which of the following would be chosen? Cephalexin Meropenem Ertapenem Imipenem b
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Which of the following has the longest serum half-life? Doripenem
Meropenem Ertapenem Imipenem c
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Which of the following would be used for intra-abdominal and pelvic infections?
Doripenem Meropenem Ertapenem Imipenem c
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Which of the following describes the spectrum of aztreonam?
Broad and useful for gram negative and positives Narrow and useful for gram negative anaerobes Narrow and useful for gram negative aerobes Narrow and useful for gram positive anaerobes c
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Which of the following is not given primarily by parenteral administration?
Bacitracin Vancomycin Aztreonam Imipenem a
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Which of the following would be most targeted to Staphylococcus endocarditis?
Bacitracin Vancomycin Aztreonam Imipenem b
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Which of the following is useful for its CSF distribution? Bacitracin
Vancomycin Aztreonam Imipenem c
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Which of the following is used topically? Bacitracin Vancomycin
Aztreonam Imipenem a
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For which of the following would renal function be most important for excretion?
Bacitracin Vancomycin Aztreonam Imipenem b
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Which of the following is most selective for P. aeruginosa? Bacitracin
Vancomycin Aztreonam Imipenem c
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Which of the following has been found to be resistant to vancomycin?
Staphylococci Enterococci Streptococci Clostridium b
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Which of the following would be given for a Chlostridium difficile infection?
IV vancomycin Oral vancomycin IV imipenem Oral imipenem b
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Which of the following is not an adverse effect of vancomycin?
Ototoxicity Hepatotoxicity Nephrotoxicity Red man syndrome b
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Which of the following drugs would not precipitate adverse effects when given in conjunction with vancomycin? Rifampin Furosemide Aminoglycoside Cyclosporine a
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When would vancomycin be considered a first line therapy?
Antibiotic associated colitis Empiric prophylaxis when MSSA is suspected Pseudomembranous colitis caused by C. difficile Oxacillin resistant Staphylococcus aureus d
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Protein Synthesis inhibitors
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Which of the following is not true of aminoglycosides?
They are basic compounds An aminocyclitol is part of their structure They can be combined with acids They can be used with beta-lactams c
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Their movement through the inner membrane is passive
Which of the following is true of the aminoglycoside mechanism of action? Their movement through the inner membrane is passive Their movement through the cytoplasmic membrane is passive Their movement through the inner membrane is energy dependent Their movement through the outer membrane is energy dependent c
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Diffusion through porin channel of outer membrane
Which of the following is the rate limiting step to aminoglycoside action? Diffusion through porin channel of outer membrane Diffusion through porin channel of cytoplasmic membrane Energy dependent transportation across outer membrane Energy dependent transportation across cytoplasmic membrane d
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They displace Mg++ on the membrane They displace Ca++ on the membrane
Which of the following is true of aminoglycoside movement in the electron transport system? They displace Mg++ on the membrane They displace Ca++ on the membrane Transport is blocked by increased pH Transport is blocked by hypoosmolarity a
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Which of the following binds reversibly to the 30S ribosomal subunit?
Tetracyclines Aminoglycosides Microlides Chloramphenicol a
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Which of the following is considered bactericidal as a sole agent in growing cells?
Aminoglycosides Tetracyclines Streptogramins Erythromycin a
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How can aminoglycoside activity be increased?
Increased membrane permeability due to inhibition of aerobic pathways Increased membrane permeability due to aberrant protein production Decreased efflux due to inhibition of bacterial mRNA translation Decreased efflux due to adenylase and acetylase activity b
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Inactivation by microbial enzymes
Which of the following is not a mechanism of aminoglycoside resistance? Inactivation by microbial enzymes Reduced transport of drug into the cell Increased drug efflux from the cell Alteration of target site c
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Which of the following aminoglycosides is most resistant to inactivation?
Gentamicin Netilmicin Tobramycin Amikacin d
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Plasma concentration decreases with fever
Which of the following does not describe the distribution of aminoglycosides? Hair cells of the ear and tubular cells of the renal cortex exhibit higher concentrations Plasma concentration decreases with fever It rapidly distributes and crosses into the CNS Apparent Vd is decreased in obese patients c
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Which of the following is a type of toxicity resulting from aminoglycoside treatment that is not reversible? Ototoxicity Hepatotoxicity Nephrotoxicity Neurotoxicity a
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Which of the following is a type of toxicity resulting from aminoglycoside treatment that is reversible with calcium administration? Ototoxicity Hepatotoxicity Nephrotoxicity Neurotoxicity d
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Enterococcus endocarditis Pseudomonas aeruginosa
Which of the following would be least likely to be treated with gentamicin in combination with a cell wall inhibitor? Enterococcus endocarditis Pseudomonas aeruginosa Staphylococcus epidermidis Methicillin resistant Staphylococcus aureus b
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Which of the following has the best activity against P. aeruginosa?
Gentamycin Tobramycin Amikacin Streptomycin b
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Which of the following would not be treated with an aminoglycoside?
Pseudomonas Eneterobacter Clostridium Serratia c
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For which of the following would aminoglycosides not be a first line agent?
Plague Tularemia MRSA MDR tuberculosis c
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For which of the following would a tetracycline not be considered as the drug of choice?
Mycoplasma Protozoa Chlamydia Spirochetes b
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Reduced transport into the cell Increased efflux from the cell
Which of the following is not a mechanism of resistance to tetracycline? Reduced transport into the cell Increased efflux from the cell Production of ribosomal protection protein Alteration of ribosomal drug target site d
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When counseling, which of the following would not cause an interaction with tetracycline that you would want to warn your patient about? Milk Pepto-Bismol Grapefruit juice Rolaids c
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Into which of the following does tetracycline not cross or enter in significant amounts?
Placenta CSF Liver Tumors b
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Which of the following is most likely to cause vestibular toxicity?
Minocycline Chlortetracycline Demeclocycline Tetracycline a
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Which of the following is most likely to cause photosensitivity?
Minocycline Chlortetracycline Demeclocycline Tetracycline c
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Which of the following is useful for meningococcal prophylaxis but may cause vomiting and vertigo?
Minocycline Chlortetracycline Demeclocycline Tetracycline a
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Reduced transport into the cell Increased efflux from the cell
Which of the following mechanisms of resistance to tetracyclines does tigecycline overcome with high affinity binding? Reduced transport into the cell Increased efflux from the cell Production of ribosomal protection protein Enzymatic inactivation c
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Which of the following would not be treated with tigecycline?
Staphylococcus aureus Streptococcus epidermidis Pseudomonas aeruginosa Streptococcus pyrogenes c
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Alteration in cell wall permeability Alteration in ribosomal protein
Which of the following mechanisms of resistance is the most frequently displayed in chloramphenicol due to acquisition of a plasmid resistance gene in gram negative bacteria? Alteration in cell wall permeability Alteration in ribosomal protein Increased drug efflux Inactivation by enzymatic acetylation d
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Which of the following is a form of toxicity that is common in chloramphenicol?
Ototoxicity Hepatotoxicity Bone marrow toxicity Neurotoxicity c
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Which of the following drugs has good distribution into the CSF?
Gentamicin Doxycycline Chloramphenicol Tigecycline c
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Which of the following groups of antimicrobials is only given parenterally?
Tetracyclines Chloramphenicol Macrolides Aminoglycosides d
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Jordan experiences a neuromuscular blockade after administration of an antimicrobial into a serosal cavity. Which of the following antimicrobials most likely caused this reaction? Gentamicin Doxycycline Chloramphenicol Daptomycin a
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Which of the following would be used to treat serious VRE infections?
Minocycline Doxycycline Chloramphenicol Tigecycline c
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Which of the following drugs requires dosage modification with renal failure?
Tobramycin Minocycline Tigecycline Linezolid a
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Which of the following drugs is associated with gray baby syndrome?
Minocycline Doxycycline Chloramphenicol Tigecycline c
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Which of the following drugs exhibits biliary excretion? Gentamicin
Tigecycline Chloramphenicol Daptomycin b
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Which of the following is least likely to cause superinfections due to broad spectrum effects?
Minocycline Doxycycline Chloramphenicol Tigecycline b
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Which of the following is not included in the cross-resistance conferred by erm gene?
Erythromycin Clindamycin Linezolid Streptogramin B c
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Modification of ribosomal target by methylases
Which of the following is not a mechanism of resistance to erythromycin? Decreased transport Modification of ribosomal target by methylases Chromosomal alteration of 30S ribosomal protein Hydrolysis of drug by esterases c
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Which of the following is true of erythromycin?
Broad spectrum of activity Gastric acidity increases absorption Metabolized in the liver Excreted primarily in bile and feces d
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Which of the following is not true of erythromycin?
Used in patients allergic to penicillins The estolate formulation causes fewer adverse effects Drug interactions due to CYP3A are common Very safe with few adverse effects b
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Which of the following is not true of clarithromycin?
Should not be taken with food Better tissue penetration than erythromycin Undergoes first pass metabolism Dosage adjusted for creatinine clearance a
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Legionella pneumophila Helicobacter pylori Chlamydia trachomatis
For which of the following is would clarithromycin be considered the drug of choice? Legionella pneumophila Helicobacter pylori Chlamydia trachomatis Mycobacterium avium complex d
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Fewer drug interactions Wider range of therapeutic uses
Which of the following is a benefit of clarithromycin over erythromycin? Fewer drug interactions Wider range of therapeutic uses Greater acid-stability No adjustment for renal impairment c
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Fewer drug interactions Longer half life
What is not a reason that a doctor might choose to treat with azithromycin over erythromycin? Less GI toxicity Fewer drug interactions Longer half life Decreased oral absorption with food d
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For which of the following is azithromycin not the drug of choice?
Campylobacter Legionella Lyme disease Mycobacterium avium complex c
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Higher affinity binding Less susceptible to resistance
Which of the following is not a characteristic of telithromycin that is also a characteristic of an ideal antimicrobial drug? Higher affinity binding Less susceptible to resistance Metabolized in the liver Absorption not affected by food c
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Which of the following is not an adverse effect associated with telithromycin?
Tachycardia GI intolerance Hepatic toxicity QT prolongation a
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Currently taking procainamide Hyperkalemia
Which of the following patients would not have a contraindication to taking telithromycin? Bradycardia Myastenia gravis Currently taking procainamide Hyperkalemia d
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Community acquired pneumonia Hospital acquired pneumonia
Based on telithromycin’s spectrum, what is a therapeutic use of the antimicrobial? Community acquired pneumonia Hospital acquired pneumonia Community acquired skin infections Hospital acquired skin infections a
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Which of the following is especially effective for anaerobes?
Erythromycin Clarithromycin Clindamycin Streptogramins c
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Does not penetrate to CSF Biliary excretion Acid stability
Which of the following is a difference in clindamycin from erythromycin? Does not penetrate to CSF Biliary excretion Acid stability Can be administered orally c
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In which of the following situations would clindamycin not be used?
Clostridium difficile Bacteroides fragilis Pneumocystis jiroveci Staphylococcus aureus a
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Which of the following is the composition of streptogramins?
30% dalfopristin, 70% quinupristin 70% dalfopristin, 30% quinupristin 70% daptomycin, 30% quinolone 30% daptomycin, 70% quinolone b
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Where do streptogramins bind on the ribosome?
Peptidyltransferase domain 23S RNA on ribosomal subunit tRNA binding domain 30S ribosomal subunit a
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Streptogramins are not used to treat which of the following?
Vancomycin-resistant Enterococcus faecium Vancomycin-resistant Enterococcus faecalis Methicillin-resistant Staphylococcus aureus Streptococcus pyrogenes b
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Which of the following is not a common side effect of streptogramins?
Thrombophlebitis Gastrointestinal upset Increased conjugated bilirubin Arthralgias and myalgias b
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For which of the following is linezolid bacteriocidal?
Enterococcus faecium Enterococcus faecalis Staphylococcus aureus Streptococcus pyrogenes d
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For which of the following resistant infections is linezolic reserved?
Methicillin-resistant Staphylococcus aureus Methicillin-resistant Staphylococcus epidermidis Vancomycin-resistant Enterococcus faecium Penicillin resistant Staphylococcus aureus c
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Which of the following is not true of linezolid? Good oral absorption
No food effect on absorption Does not induce CYP450 enzymes Undergoes non-enzymatic oxidation b
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Which of the following have a possible drug interaction with linezolid due to drug metabolism?
Erythromycin Cabenzapine Phenylpropanolamine Rifampin c
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Congestive heart failure Renal failure
Someone with which of the following conditions would be least likely to take linezolid as an oral suspension? Phenylketonuria Diabetes mellitus Congestive heart failure Renal failure a
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Which of the following is not a characteristic of an ideal drug that is also a characteristic of daptomycin? Bactericidal No resistance No CYP450 interactions Orally administered d
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For which of the following is daptomycin not a therapeutic use?
Methicillin-resistant Staphylococcus aureus Vancomycin-susceptible Enterococcus faecalis Vancomycin-resistant Enterococcus faecium Streptococcus pyrogenes c
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