(19) Micro 3 SLO Flashcards Preview

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Flashcards in (19) Micro 3 SLO Deck (39):
1

A female patient is complaining of an abnormally smelly vaginal discharge. She has just completed a course of Keflex. What is the most likely cause?
A. Hypersensitivity reaction
B. Clostridium difficile
C. Kidney failure
D. Superinfection
E. Pseudomembranous colitis

Superinfection

2

Beta lactamases are enzymes produced by almost all __?__ bacteria
A. known (All bacteria produce lots of beta lactamase)
B. Gram +
C. Mycobacterium
D. None of the above is correct
E. Gram –

Gram –

3

Cell walls are NOT present in __?__ bacteria
A. Gram +
B. Gram –
C. Mycobacterium
D. Spirochete
E. Mycoplasma

Mycoplasma

4

Cephalosporin antibiotics are associated with __?__.
A. Causing a false positive Coomb’s test and false positive urine glucose tests
B. Blood dyscrasias including anemia and pancytopenia.
C. Peripheral neuropathies and fatal hepatitis, as well as seizures, psychosis, blood dyscrasias, hyperglycemia and because of MAOI activity, hypertensive crisis.
D. All the above
E. A & B only

A & B only

5

Dapsone and the sulfonamides work by:
A. Inhibition of cell wall synthesis
B. Inhibition of transcription
C. Inhibition of protein synthesis
D. Anti-metabolite which leads to the inhibition of nucleic acid synthesis
E. Other mechanism

Anti-metabolite which leads to the inhibition of nucleic acid synthesis

6

INH has a boxed warning regarding:
A. Cancer
B. Kidney failure
C. Peliosis
D. Liver failure
E. Blood dyscrasias

Liver failure

7

INH is metabolized mostly by acetylation. 50% of blacks and whites are slow acetylators; 80% of Asians and Eskimos are fast acetylators - who is more likely to experience treatment failure?
A. Blacks and/or Whites
B. Eskimos and/or Whites
C. Asians and/or Eskimos
D. Blacks
E. Whites

Asians and/or Eskimos

8

Inhibition of cell wall synthesis is caused by:
A. Beta lactams
B. Vancomycin
C. Isoniazid
D. Penicillins
E. All of the above

All of the above

9

Isoniazid associated with __?__.
A. Allergy, but only 1/10 th of the patients reporting a penicillin allergy probably actually are allergic to the antibiotic.
B. 8th cranial nerve damage
C. Causing a false positive Coomb’s test and false positive urine glucose tests
D. Peripheral neuropathies and fatal hepatitis, as well as seizures, psychosis, blood dyscrasias, hyperglycemia and because of MAOI activity, hypertensive crisis.
E. Turning secretions bright orange.

Peripheral neuropathies and fatal hepatitis, as well as seizures, psychosis, blood dyscrasias, hyperglycemia and because of MAOI activity, hypertensive crisis.

10

Isoniazid is primarily metabolized by __?__
A. Phase 2 acetylation
B. Phase 2 glucuronidation
C. P450 CYP 3A4
D. Monoamine oxidase
E. Phase 1 enzymes

Phase 2 acetylation

11

Penicillin antibiotics are associated with __?__.
A. Blood dyscrasias including anemia and pancytopenia.
B. Peripheral neuropathies and fatal hepatitis, as well as seizures, psychosis, blood dyscrasias, hyperglycemia and because of MAOI activity, hypertensive crisis
C. Turning secretions bright orange.
D. Causing a false positive Coomb’s test and false positive urine glucose tests
E. Allergy, but only 1/10 th of the patients reporting a penicillin allergy probably actually are allergic to the antibiotic.

Allergy, but only 1/10 th of the patients reporting a penicillin allergy probably actually are allergic to the antibiotic.

12

Rifampin is associated with __?__.
A. Allergy, but only 1/10 th of the patients reporting a penicillin allergy probably actually are allergic to the antibiotic.
B. Turning secretions bright orange
C. Blood dyscrasias including anemia and pancytopenia.
D. Causing a false positive Coomb’s test and false positive urine glucose tests
E. Peripheral neuropathies and fatal hepatitis, as well as seizures, psychosis, blood dyscrasias, hyperglycemia and because of MAOI activity, hypertensive crisis.

Turning secretions bright orange

13

Rifampin works as a(n):
A. Inhibitor of cell wall synthesis
B. Anti-metabolite or inhibitor of nucleic acid synthesis
C. Other mechanism
D. Inhibitor of fatty acid synthesis
E. Inhibitor of transcription

Inhibitor of transcription

14

The acronym, CRE, stands for:
A. Carbapenem-Resistant Enterobacteria
B. Carbapenem Restricted Escherichia
C. Crush and Reconstitute Enterics
D. Carry Resilient Enteric-tubing
E. Could Result in Emergency

Carbapenem-Resistant Enterobacteria

15

The acronym, CRKP, stands for:
A. Carbapenem Resistant Kidney Pathogen
B. Carries Resistance, Keep Private
C. Caring Really Kind People
D. Carbapenem-Resistant Klebsiella pneumonia
E. Carbohydrate Resistant Klebsiella pneumonia

Carbapenem-Resistant Klebsiella pneumonia

16

The acronym, MDRO, stands for:
A. Many Drugs Result in Overkill
B. Mortality and Death Result from Overuse
C. Most Drugs Resist Organization
D. Multi-Drug Resistant Organism
E. Many Doctors Really Obsess

Multi-Drug Resistant Organism

17

The acronym, MRSA, stands for:
A. Methicillin-Resistant Staphylococcus aureus
B. Medication-Resistant and Something Awful
C. Methicillin-Resistant Streptococcus pyrogenes
D. Medically Restricted Standard Application
E. Multi Resistant and Smelling Awful

Methicillin-Resistant Staphylococcus aureus

18

The acronym, VRE, stands for:
A. Vanquish Resistant Enterobacteria
B. Vancomycin Relishing Episode
C. Vancomycin-Resistant Enterococcus spp.
D. Vancomycin Resistant Escherichia coli
E. Virtually Resistant Enterobacteria

Vancomycin-Resistant Enterococcus spp.

19

The acronym, VREF, stands for:
A. Vancomycin-Resistant Enterococcus faecium
B. Vancomycin Resistant Escherichia coli
C. Vancomycin Resistant Enterobacteria
D. Very Red Edematous Face
E. Vanguard Retirement Emergency Fund

Vancomycin-Resistant Enterococcus faecium

20

The Coombs test measures antibodies that bind to:
A. Red Blood cells
B. Platelets
C. Liver cells
D. White blood cells
E. Thyroid cells

Red Blood cells

21

The nurse should realize that a PABA allergy may cause which adverse effect in a patient given Penicillin G Procaine?
A. Paresthesias
B. Resistance
C. Procaine reaction
D. Acute kidney failure
E. Hepatitis

Procaine reaction

22

The patient is taking INH, which adverse effect(s) does the nurse include in the plan of care to monitor the client’s status?
A. Liver function (serum transaminase concentrations)
B. Peripheral nervous function (in alcoholics, malnurished or patients with previous neuropathies)
C. Kidney function (in kidney disfunction patients)
D. Vision
E. Any or all of the above may be part of a monitoring program

Any or all of the above may be part of a monitoring program

23

The Procaine reaction (a PABA allergy) that may occur in 1 in 500 susceptible people given penicillin G procaine may be described as:
A. Stevens Johnson Syndrome
B. Kidney failure
C. Headache, orthostatic hypotension
D. Mental confusion, anxiety, combativeness, fear of impending death
E. Jaundice

Mental confusion, anxiety, combativeness, fear of impending death

24

The t ½ of some Penicillin antibiotics may be extended by:
A. Beta lactamase inhibitors
B. Clavulanic acid
C. Sulbactam
D. Tazobactam
E. All the above

All the above

25

Which of the following can be given PO or by IV infusion as a bactericidal against TB & Neisseria meningitides?
A. Dapsone
B. Augmentin
C. Isoniazid (INH, Nydrazid)
D. Cephalexin (Keflex)
E. Rifampin (Cavidin, Mycostat)

Rifampin (Cavidin, Mycostat)

26

Which of the following can inhibit tubular secretion and therefore be used to increase the t ½ of a penicillin antibiotic?
A. Procaine
B. Tazobactam
C. Probenecid
D. Clavulanic acid
E. Sulbactam

Probenecid

27

Which of the following has no PO bioavailability and must be injected or inhaled?
A. Cefepime (Maxipime)
B. Isoniazid (INH)
C. Aztreonam (Azactam, Cayston)
D. Penicillin G Procaine
E. Dapsone

Aztreonam (Azactam, Cayston)

28

Which of the following increases the risk of liver failure with INH?
A. Old age
B. Alcohol consumption
C. Hepatitis B
D. Caucsian or African American female
E. All the above

All the above

29

Which of the following increases the risk of peripheral neuropathy with INH?
A. Slow acetylation
B. Diabetes
C. Malnourishment and/or low Vitamin B6 levels
D. Alcoholism
E. All the above

All the above

30

Which of the following is a combo product, given PO, that has broad-spectrum bactericidal activity against G+/G- beta lactamase producers?
A. Amoxicillin
B. Zosyn
C. Penicillin G procaine
D. Unasyn
E. Augmentin

Augmentin

31

Which of the following is bactericidal and can be given IM to treat moderate to severe Gram + infections? Use caution when giving to PABA allergic patients, though.
A. Amoxicillin
B. Cefaclor
C. Cephalexin
D. Cefepime
E. Penicillin G procaine

Penicillin G procaine

32

Which of the following is only bactericidal against actively growing TB, but can be given PO or IM?
A. Rifampin (Cavidin, Mycostat)
B. Augmentin
C. Isoniazid (INH, Nydrazid)
D. Dapsone
E. Cephalexin (Keflex)

Isoniazid (INH, Nydrazid)

33

Which of the following is used IV/inhalation as a bactericidal antibiotic against G- aerobes?
A. Aztreonam (Azactam, Cayston)
B. Cefepime
C. Augmentin
D. Amoxicillin (Moxatag)
E. Cephalosporins

Aztreonam (Azactam, Cayston)

34

Which of the following orders would be appropriate in a cystic fibrosis patient with P. aeroginosa pneumonia?
A. Cefepime IM
B. Penicillin G procaine IV
C. Cefaclor PO
D. Keflex PO without regard to meals
E. Azetreonam Inhaled (via nebulizer)

Azetreonam Inhaled (via nebulizer)

35

Which of the following should be part of the plan of care to monitor an HIV-infected patient on INH?
A. Monthly interview concerning appetite, fatigue, nausea, dark urine, icterus or rash.
B. Initial instructions to avoid histamine-containing foods.
C. Monthly interview concerning the presence of persistent “Pins and Needles” sensations in the hands and feet (paresthesias).
D. Initial interview to determine pregnancy status
E. All the above

All the above

36

Which of the following would be an appropriate instruction to a 21-year old female patient taking oral contraceptives (OC) who is given ampicillin?
A. The OC can inactivate the antibiotic
B. There are no interactions between OCs and antibiotics
C. Stop taking the OC immediately
D. Use a secondary method of birth control while on the antibiotic
E. Dangerous adverse effects are possible

Use a secondary method of birth control while on the antibiotic

37

Which of these symptoms would indicate that a patient on IV Vancomycin is experiencing drug-induced ototoxicity?
A. Ocular pain with purulent discharge
B. Erythema of the earlobes and ear canal
C. Acute Otitis media
D. Inner ear pruritus
E. Tinnitus and dizziness when still

Tinnitus and dizziness when still

38

A patient calls to report they are experiencing “very watery diarrhea, sometimes with a lot of mucous.” They have been taking Cefepime for eight days and have been having “explosive diarrhea” episodes repeatedly since yesterday. What is the most likely cause?
A. Drug-induced peptic ulcer
B. GI-associated hypersensitivity reaction
C. Candida albicans superinfection
D. C. diff. associated diarrhea
E. Antibiotic-associated malabsorption

C. diff. associated diarrhea

39

Which of the following statements indicates the patient understands the instructions for taking INH?
A. Take an hour before or 2 hours after eating
B. Non-compliance with regimen may cause treatment failure and the development of drug-resistant TB.
C. Avoid eating tuna or skip-jack
D. Avoid eating kim chee, tofu, processed meats including Spam, and sauerkraut
E. All of the above.

All of the above.