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PHRM865 Exam 2

Total questions: 77

Worksheet time: 49mins

Name
Class
Date
1.

Which of the following antibiotic - adverse effect combinations is incorrect?

a)

Trimethoprim-sulfamethoxazole and rash

b)

Clindamycin and Clostridioides difficile colitis

c)

Minocycline and acute interstitial nephritis

d)

Metronidazole and peripheral neuropathy

e)

Colistin and nephrotoxicity

2.

Which of the following antibiotics should not be used in patients who are pregnant or breastfeeding?

a)

Trimethoprim - sulfamethoxazole

b)

Doxycycline

c)

Clindamycin

d)

Noneyah

3.

Which of the following antibiotics has in vitro activity against penicillin-resistant Streptococcus pneumoniae (PRSP)?

a)

Penicillin

b)

Metronidazole

c)

Vancomycin

d)

Colistin

e)

Clindamycin

4.

Which of the following antibiotics requires dose adjustment in the presence of renal insufficiency?

a)

Clindamycin

b)

Trimethoprim-sulfamethoxazole

c)

Metronidazole

d)

Polymyxin B

e)

Doxycycline

5.

Which of the following antibiotics has in vitro activity against Pseudomonas aeruginosa?

a)

Tigecycline

b)

Colistin

c)

Clindamycin

d)

Cefepime

e)

Piperacillin-Tazobactam

6.

Which of the following antibiotics has in vitro activity against atypical bacteria (e.g., Legionella)?

a)

Trimethoprim-sulfamethoxazole

b)

Levofloxacin

c)

Doxycycline

d)

Clindamycin

7.

Which of the following antibiotics has in vitro activity against methicillin-resistant Staphylococcus aureus (MRSA)?

a)

Clindamycin

b)

Polymyxin B

c)

Metronidazole

d)

Trimethoprim-sulfamethoxazole

e)

Vancomycin

8.

Which of the following antibiotics interacts with warfarin?

a)

Clarithromycin

b)

Bactrim

c)

Ciprofloxacin

d)

Levofloxacin

9.

Which of the following antibiotics does not match up with the corresponding mechanism of action?

a)

Clindamycin – inhibition of protein synthesis by binding to 50S ribosomal subunits

b)

Metronidazole – damage bacterial DNA (inhibit nucleic acid synthesis)

c)

Omadacycline– inhibition of protein synthesis by binding to 30S ribosomal subunits

d)

Polymyxin B – inhibition of DNA synthesis by binding to and inhibiting bacterial topoisomerases

10.

Which of the following antibiotics can be used safely in a patient who experienced anaphylaxis to penicillin?

a)

Metronidazole

b)

Colistin

c)

Vancomycin

d)

Linezolid

11.

Which of the following antibiotics does not interact with warfarin?

a)

Levofloxacin

b)

Gentamicin

c)

Erythromycin

d)

Clarithromycin

12.

Which of the following antibiotics require dose adjustment in the presence of renal insufficiency?

a)

Tobramycin

b)

Azithromycin

c)

Levofloxacin

d)

Clarithromycin

13.

Which of the following antibiotic - adverse effect combinations is incorrect?

a)

Azithromycin IV and phlebitis/venous irritation

b)

Gentamicin and ototoxicity

c)

Erythromycin and seizures

d)

Levofloxacin and tendon rupture

e)

Tobramycin and nephrotoxicity

14.

Which of the following antibiotics does not have in vitro activity against Pseudomonas aeruginosa?

a)

Amikacin

b)

Ciprofloxacin

c)

Tobramycin

d)

Moxifloxacin

e)

Levofloxacin

15.

Which of the following antibiotics should not be used in patients who are pregnant or breastfeeding?

a)

Moxifloxacin

b)

Azithromycin

c)

Amoxicillin

d)

Cephalexin

16.

What is the mechanism of action of Clarithromycin?

a)

inhibition of protein synthesis by binding to 50S ribosomal subunits

b)

inhibition of DNA synthesis by binding to and inhibiting bacterial topoisomerases

c)

inhibition of protein synthesis by binding to 30S ribosomal subunits

d)

inhibits synthesis and assembly during the second stage of cell wall synthesis by firmly binding to the D-alanyl-D-alanine portion of cell wall precursors

17.

What is the mechanism of action of Moxifloxacin?

a)

inhibition of protein synthesis by binding to 50S ribosomal subunits

b)

inhibition of DNA synthesis by binding to and inhibiting bacterial topoisomerases

c)

inhibition of protein synthesis by binding to 30S ribosomal subunits

d)

inhibits synthesis and assembly during the second stage of cell wall synthesis by firmly binding to the D-alanyl-D-alanine portion of cell wall precursors

18.

What is the mechanism of action of Gentamicin?

a)

inhibition of protein synthesis by binding to 50S ribosomal subunits

b)

inhibition of DNA synthesis by binding to and inhibiting bacterial topoisomerases

c)

inhibition of protein synthesis by binding to 30S ribosomal subunits

d)

inhibits synthesis and assembly during the second stage of cell wall synthesis by firmly binding to the D-alanyl-D-alanine portion of cell wall precursors

19.

What is the mechanism of action of Vancomycin?

a)

inhibition of protein synthesis by binding to 50S ribosomal subunits

b)

inhibition of DNA synthesis by binding to and inhibiting bacterial topoisomerases

c)

inhibition of protein synthesis by binding to 30S ribosomal subunits

d)

inhibits synthesis and assembly during the second stage of cell wall synthesis by firmly binding to the D-alanyl-D-alanine portion of cell wall precursors

20.

Which of the following antibiotics has in vitro activity against penicillin-resistant Streptococcus pneumoniae (PRSP)?

a)

Levofloxacin

b)

Ceftaroline

c)

Vancomycin

d)

Daptomycin

21.

Which of the following antibiotics has in vitro activity against methicillin-resistant Staphylococcus aureus (MRSA)?

a)

Nafcillin

b)

Delafloxacin

c)

Ceftaroline

d)

Gentamicin w/ Beta Lactam

22.

Which of the following antibiotics does not have in vitro activity against atypical bacteria (e.g., Legionella)?

a)

Amikacin

b)

Metronidazole

c)

Clindamycin

d)

Ciprofloxacin

23.

Which of the following antibiotics can be used safely in a patient who experienced anaphylaxis to penicillin?

a)

Gentamicin

b)

Azithromycin

c)

Delafloxacin

d)

Metronidazole

24.

Which of the following antibiotics has in vitro activity against vancomycin-resistant Enterococcus faecium (VREF)?

a)

Synercid

b)

Daptomycin

c)

Oritavancin

d)

Linezolid

25.

Which of the following antibiotics does not have in vitro activity against vancomycin-resistant Enterococcus faecalis (VREF)?

a)

Linezolid

b)

Synercid

c)

Daptomycin

d)

Tedezolid

26.

What is the primary mechanism of resistance to penicillin and cephalosporins in Streptococcus pneumoniae?

a)

Altered penicillin binding proteins

b)

Efflux pump

c)

Decreased outer membrane permeability

d)

β-lactamase production

27.

Which of the following antibiotic - adverse effect combinations is incorrect?

a)

Quinupristin-dalfopristin and phlebitis/venous irritation

b)

Linezolid and thrombocytopenia

c)

Dalbavancin and ototoxicity

d)

Daptomycin and myopathy

28.

Which of the following antibiotics has in vitro activity against methicillin-susceptible Staphylococcus aureus?

a)

Nafcillin

b)

Cefazolin

c)

Ampicillin

d)

Daptomycin

29.

Which of the following antibiotics does not have in vitro activity against methicillin-resistant Staphylococcus aureus (MRSA)?

a)

Linezolid

b)

Amoxicillin

c)

Penicillin VK

d)

Daptomycin

30.

Which of the following Beta-lactams does not have in vitro activity against Pseudomonas aeruginosa

a)

Cefepime

b)

Zosyn

c)

Ceftazidime/ avibactam

d)

Ertapenem

31.

Which B-lactamase inhibitor is commercially available with meropenem and is useful for the treatment of serious infections caused by a KPC (carbapenemase)-producing Klebsiella pneumoniae?

a)

Tazobactam

b)

Sulbactam

c)

Clavulonic Acid

d)

Vaborbactam

32.

Which of the following antibiotics does not require dose adjustment in the presence of renal insufficiency?

a)

Televancin

b)

Vancomycin

c)

Daptomycin

d)

Linezolid

e)

Cefazolin

33.

Which of the following antibiotics does require dose adjustment in the presence of renal insufficiency?

a)

Televancin

b)

Vancomycin

c)

Daptomycin

d)

SMX-TMP

e)

Cefazolin

34.

Which of the following is not a characteristic of B-lactams?

a)

Short half life

b)

Bacteriostatic

c)

Renally Eliminated

d)

Time-dependent

35.

Which of the following β-lactam antibiotics does not achieve therapeutic concentrations in the central nervous system so that it cannot be used for the treatment of meningitis?

a)

Meropenem

b)

Piperacillin

c)

Aztreonam

d)

Cefazolin

36.

Which of the following antibiotic - adverse effect combinations is incorrect?

a)

Nafcillin and interstitial nephritis

b)

Imipenem and seizures

c)

Cefotetan and hypoprothrombinemia

d)

Meropenem and myopathy

37.

Which of the following drugs must be used in caution for patients with CHF or renal insufficiency due to SODIUM LOAD?

a)

Sodium Penicillin G

b)

Nafcillin

c)

Ticarcillin

d)

Piperacillin

e)

Ampicillin

38.

What is the main use that penicillin are still used for today?

a)

CAP

b)

MRSA

c)

Syphils

d)

Salpingitis

39.

Which of the following drugs could be used for Pseudomonas infection?

a)

Meropenem

b)

Cefepime

c)

Zosyn

d)

Ertapenem

e)

Aztreonam

40.

Which of the following β-lactam antibiotics requires dose adjustment in the presence of renal insufficiency?

a)

Ampicillin

b)

Cefepime

c)

Imipenem

d)

Aztreonam

41.

Which of the following β-lactam antibiotics has activity against methicillin-resistant Staphylococcus aureus (MRSA)?

a)

Ampicillin

b)

Doxycycline

c)

Unasyn

d)

Ceftaroline

42.

Which of the following β-lactam antibiotics has activity against below the diaphragm anaerobes such as Bacteroides fragilis?

a)

Ceftriaxone

b)

Aztreonam

c)

Zosyn

d)

Meropenem

43.

Which of the following β-lactam antibiotics can be used safely in a patient who experienced anaphylaxis to penicillin?

a)

Cafazolin

b)

Ceftriaxone

c)

Piperacillin

d)

Aztreonam

44.

Which of the following β-lactam antibiotics does not have activity against Pseudomonas aeruginosa?

a)

Ticarcillin

b)

Piperacillin

c)

Cefuroxime

d)

Meropenem

45.

Which of the following β-lactam antibiotics is co-formulated with cilastatin to prevent dihydropeptidase degradation in the renal brush border and subsequent nephrotoxicity?

a)

Ertapenem

b)

Ceftazidime

c)

Imipenem

d)

Ticarcillin

46.

Which drugs can be used to treat C. Diff colitis?

a)

Vancomycin (IV)

b)

Metronidazole

c)

Vancomycin (PO)

d)

SMX-TMP

47.

How can resistance occur with Penicillin?

a)

β-lactamase production

b)

Altered PBPs

c)

Decreased penetration through outer cell membrane (GNO)

d)

it don't

48.

How can resistance occur with Cephalosporins?

a)

β-lactamase production

b)

Altered PBPs

c)

Decreased penetration through outer cell membrane (GNO)

d)

it don't

49.

How can resistance occur with Carbapenems?

a)

β-lactamase production

b)

Altered PBPs

c)

Decreased penetration through outer cell membrane (GNO)

d)

it don't

50.

How can resistance occur with Aztreonam?

a)

β-lactamase production

b)

Altered PBPs

c)

Decreased penetration through outer cell membrane (GNO)

d)

it don't

51.

How can resistance occur with Flouroquinolones?

a)

Mutation in genes that code for DNA gyrase or topoisomerase IV

b)

Efflux pumps

c)

Decreased penetration through outer cell membrane (GNO)

d)

it don't

52.

How can resistance occur with Macrolides?

a)

Mutation in genes that code for DNA gyrase or topoisomerase IV

b)

Efflux pumps (mef)

c)

Change in ribosomal binding site (erm)

d)

it don't

53.

How can resistance occur with Aminoglycosides?

a)

Alteration in ribosomal binding sites (strepto)

b)

Altered uptake into cells

c)

Synthesis of aminoglycoside-modifying  enzymes

d)

it don't

54.

How can resistance occur with Vancomycin & Dalbavancin?

a)

Modification of the D-alanyl-D-alanine

b)

Altered uptake into cells

c)

Synthesis of aminoglycoside-modifying  enzymes

d)

it don't

55.

How can resistance occur with Quinupristin-dalfopristin?

a)

Modification of the D-alanyl-D-alanine

b)

Alteration in ribosomal binding site

c)

Synthesis of aminoglycoside-modifying  enzymes

d)

it don't

56.

How can resistance occur with Tetracyclines?

a)

Efflux pumps

b)

Ribosomal protection proteins

c)

Inactivation through enzymes

d)

it don't

57.

How can resistance occur with polymyxins?

a)

Efflux pumps

b)

Alteration in outer cell membrane

c)

Inactivation through enzymes

d)

it don't

58.

How can resistance occur with Clindamycin?

a)

Efflux pumps

b)

Alteration in ribosomal binding sites (erm)

c)

Inactivation through enzymes

d)

it don't

59.

How can resistance occur with Metronidazole?

a)

Altered growth requirements

b)

Reduced transcription of ferredoxin gene

c)

Inactivation through enzymes

d)

it don't

60.

MSSA Coverage

a)

Nafcillin

b)

Dicloxacillin

c)

Cefazolin

d)

Vancomycin

e)

Cefepime

61.

MRSA Coverage

a)

Nafcillin

b)

Linezolid

c)

Daptomycin

d)

Vancomycin

e)

Cefepime

62.

Enterococcus spp. (Susceptible) coverage

a)

Ampicillin

b)

Vancomycin

c)

Meropenem

d)

Zosyn

63.

Vancomycin-Resistant Enterococcus spp. coverage

a)

Linezolid

b)

Vancomycin

c)

Meropenem

d)

Zosyn

e)

Daptomycin

64.

A patient has been diagnosed with an infection caused by VRE. The patient is currently taking Lexapro. What is the drug that you should recommend for this patient?

a)

Linezolid

b)

Ampicilliln

c)

Daptomycin

d)

Quinupristin-dalfopristin

65.

A patient has been diagnosed with an infection caused by VRE. The patient is immunocompromised and is receiving chemotherapy that causes him to have thrombocytopenia. What is the drug that you should recommend for this patient?

a)

Linezolid

b)

Ampicilliln

c)

Daptomycin

d)

Quinupristin-dalfopristin

66.

Pseudomonas Drugs of choice?

a)

Piperacillin

b)

Aminoglycosides (alone)

c)

Cefepime

d)

Ceftriaxone

e)

Meropenem

67.

A patient with a severe penicillin allergy with a h/o anaphylaxis. He is septic and is in critical condition, worsening rapidly. What empiric therapy should be initiated?

a)

Zosyn + Vanco

b)

Vanco + Metronidazole

c)

Vancomycin + Meropenem

d)

Draw cultures now and treat based on results.

68.

Atypical Bacteria coverage, drugs of choice:

a)

Meropenem

b)

Azithromycin

c)

FQs

d)

Doxycycline

69.

Which of these macrolides forms a cyclic ketal acid?

a)
b)
c)
d)

Erythromycin

70.

The methyl groups on alternatives carbons of erythromycin are the result of being formed by:

a)

Acetate Biosynthesis

b)

Aminosugar biosynthesis

c)

Polyketide Biosynthesis

d)

Alkaloid Biosynthesis

e)

Gluconeogenesis

71.

Which of the following is NOT a macrolide resistance mechanism?

a)

Lactone Hydrolysis

b)

Methylation of adenine A2058 of the 23S ribosomal RNA

c)

Mutation of adenine A2058 to guanine

d)

Induction of drug efflux pumps

e)

methylation of the desosamine amino group

72.

A patient states that the only liquid he has at home for his oral meds is Tito's vodka. Which of the following medications should be avoided?

a)

Metronidazole

b)

x

c)

x

d)

x

73.

A patient just recently was discharged from the Emergency Room following intense seizures. The patient is requiring a cephalosporin to treat an infection. Which of the following medications should be avoided?

a)

cefepime

b)

ceftazidime

c)

cefiderocol

d)

tell the patient to kick rocks

74.

A patient presents to the ED with a severe infection and long-term uncontrolled T2DM. The patient has a h/o peripheral neuropathy. Which medications should we avoid due to the neuropathy risk?

a)

Flouroquinolones

b)

Macrolides

c)

Aminoglycosides

d)

Penicillin

75.

A male patient presents to the emergency room with newly diagnosed Atrial Fibrillation. The patient is taking amiodarone and the last QTc reading showed 460ms (long). Which medications would we want to avoid in this patient when treating an infection?

a)

Levofloxacin

b)

Linezolid

c)

Neosporin

d)

Cefazolin

76.

Which of the following elements would affect the absorption of fluoroquinolones if taken PO?

a)

Zinc

b)

Mg

c)

Iron

d)

Ca

e)

Al

77.

A patient presents to the clinic complaining of pain in his right knee. His medication list includes: Percocet, Warfarin, Lisinopril, and atorvastatin. Which of the following medications should be avoided to treat an infection?

a)

Levofloxacin

b)

Clarithromycin

c)

Daptomycin

d)

Vancomycin

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