Antibacterial Quiz Flashcards
A 31 year old white intravenous drug user was admitted to the hospital with a four week history of cough and fever. A chest radiograph showed left upper lobe cavitary infiltrate. Culturres of sputum yielded M. tberculosis susceptible to all antimycobacterial drugs. The patient received isoniazid, rifampin, and pyrazinamide. The patient’s sputum remianded culture-positive for the subsequent four months. Which one of the following is the most likely cause of treatment failure?
A. False-positive cultures
B. Drug resistance
C. Noncompliance by the patient
D. Malabsorption of the medications
E. Concomitant infection with HIV
C. Noncompliance by the patient Unverified
Verified by KEY
A 45 year old man presents to the emergency department with severe pneumonia. He recently returned from a business trip, and has a history of smoking and alcohol abuse. An x-ray film shows extensive consolidation affecting portions of each lung lobe. Culture on charcoal yeast extract medium grows out a small gram-negative bacterium Legionella. Which of the following antibiotics is the most appropriate treatment for this patient?
A. Ceftriaxone
B. Chloramphenicol
C. Clindamycin
D. Erythromycin
E. Sufonamides
D. Erythromycin Unverfied
Your 23 year old female is pregnant and has gonorrhea. The medical history includes anaphylaxis following exposure to amoxicillin. Worried about compliance, you would like to treat patient with single does, so you choose
A. Cefixime
B. Ceftriaxone
C. Spectinomycin
D. Tetracycline
E. Ciprofloxacin
C. Spectinomycin
Verified by KEY
An 18-month- old boy is taken to the emergency department because he has a fever and is irritable and lethargic. The mother says the boy was fine when he went to bed the night before. In response to questioning about drug allergies, she says that the boy recently had a severe hypersensitivity reaction to amoxicillin. Neurologic examination shows the obtunded infant to have marked nuchal rigidity. Cerebrospinal fluid (CSF) samples indicate an elevated white blood cell count with 85% polymorphonuclear leukocytes and a decreased level of glucose. Gram stain of the CSF shows numerous gram-negative encapsulated rods. Empiric therapy is begun. When culture and sensitivity results are available, the causative organism is found to be a β-lactamase–producing strain of Haemophilus influenzae. At this point, the most appropriate therapy for the patient would be a) ampicillin
b) ceftriaxone
c) chloramphenicol
d) clindamycin
e) vancomycin
f) sulfasoxazole
c) chloramphenicol Unverified
A 35 year old Indian woman presented with a 6 year history of a hypopigmented patch on her left thigh and tender red bumps on her shins. The physical examination revealed erythematous nodules on anterior aspects of her legs, bilateral madarosis, and multiple nonhealing ulcrous lesion on the upper and lower extremities. The neurologic examination revealed glove and stocking anesthesia. The lepromin test was negative. The histopathologic examination of skin biopsy showed atrophic epidrmia and numerous acid-fast bacilli in globi and within macrophages. What is the best form of therapy of this patient?
A. Rifampin
B. Dapsone
C. Clofazimine
D. Triple Combination therapy
D. Triple Combination therapy Unverified
A 43-year-old woman is recovering from major surgery, following discharge from the hospital, in an assisted-care facility. She develops fever, rales, dyspnea, cough, and purulent sputum. Results of a chest radiograph indicate bilateral pulmonary infiltrates. We send blood and sputum sam- ples to the clinical pathology lab for culturing, but now must turn our attention to what we believe is community-acquired pneumonia caused by antibiotic-resistant pneumococci. We want to start empiric antibiotic ther- apy until culture results are available. Which of the following drugs would be best for this initial therapy?
a. Amoxicillin
b. Cefazolin
c. Erythromycin
d. Levofloxacin
e. Penicillin G
f. Vancomycin
g. Aztreonam
d. Levofloxacin or another Quinolone analog Unverified
Despite its short elimination half-life, gentamicin may be administered once daily at high dose in the treatment of hospitalized patients with infections caused by aerobic gram-negative rods. Once daily dosing regimens with gentamicin are likely to result in
A. The rapid emergence of resistance
B. A higher incidence of deafness
C. Higher cost
D. Less Nephrotoxicity
E. A decrease in cure rate
D. Less Nephrotoxicity Unverified
A patient with degenerative joint disease is to undergo insertion of a hip prosthesis. To avoid com- plications due to postoperative infection, the surgeon will pretreat this patient with an antibiotic. This hospi- tal has a significant problem with methicillin-resistant Staphylococcus aureus. Which of the following antibi- otics should the surgeon select?
A. Ampicillin
B. Imipenem/cilastatin
C. Gentamicin/piperacillin
D. Vancomycin
E. Cefazolin
D. Vancomycin Unverified
A seventy-year-old alcoholic male with poor dental hygiene is to have his remaining teeth extracted for subsequent dentures. He has mitral valve stenosis with mild cardiac insufficiency and is being treated with captopril, digoxin, and furosemide. The dentist decides that his medical history warrants prophylactic antibiotic therapy prior to the procedure and pre- scribes which of the following drugs?
A. Vancomycin
B. Amoxicillin
C. Tetracycline
D. Cotrimoxazole
E. Imipenem
B. Amoxicillin
Verified by KEY
A 33 y/o man has dysuria, meatla erythema and pain, and a purulent urethral discharge. Gram stain of the urethral exudate shows intracellular gram negative diplococci. The medical records indicate that the patient recently had a severe type 1 allergic reaction to penicillin. The most appropriate therapy for this patient would be
A. Ceftriaxone
B. Metronidazole
C. Gentamicin
D. Vancomycin
E. Ciprofloxacin
E. Ciprofloxacin
Verified by KEY
A patient presents to the emergency room with a progressive fever, cough, and general malaise. History determines that he works with sheep on a farm and had just been involved in wool harvesting. Which of the following antibiotics is most appropriate as part of your immediate treatment?
A. Vancomycin
B. Ceftazidne
C. Penicillin
D. Streptomycin
E. Ceftriaxone
C. Penicillin
Verified by Ashley
Verified by KEY
A 29 y/o man who has AIDS and is on retroviral therapy reports for a regular check up and complains of headaches and difficulty with eye-hand coordination. He is found to have cerebral toxoplasmosis. Which of the following drugs is most appropriate for treating this patient?
A. Pyrimethamine plus Sulfadiazine
B. Fluconazole
C. Rifabutin
D. Azithromycin
E. Clofazamine plus Sulfamethoxazole
A. Pyrimethamine plus Sulfadiazine
Verified with KEY
A 21 y/o man was seen in a clinic with a complain of dysuria and urethral discharge of yellow pus. He had a painless clean-based ulcer on the penis and contender enlargement of the regional lymph nodes. Gram stain of the urethral exudate showed gram negative diplococci with polymorphonucleocytes. The patient informed the clinic staff that he was unemployed and had not eaten a meal for 2 days. Immunofluorescent microscopic examination of fluid express ed from the pencil chancre of this patient revealed treponemes. Because he appears to be infected with Treponema palladium, the best course of action would be to
A.Give a single oral dose of fosfomycin
B. Treat with vancomycin
C. Give no other antibiotics because drug treatment of gonorrhea provides coverage for incubating sympathies
D. Treat with oral tetracycline for 7 day
E. Inject Intramuscular benzathine penicillin G
E. Inject IM benzathine penicillin G Verified by Ashley
A patient with a gunshot would to the abdomen, which has resulted in spillage of intestinal contents, is brought to the emergency room. Which antibiotic would you select to effectively treat an infection due to Bacteroides fragilis?
A. Aztreonam
B. Clindamycin
C. Gentamicin
D. Azithromycin
E. Doxycycline
B. Clindamycin
Verified by KEY
A 31 y/o woman with a very light complexion visits her PCP because she has a severe sunburn. Examination shows first degree burns over all of the exposed surfaces of her body and some second degree burns on her extremities. She is taking multiple medications for several health issues. She says that she has not been sunbathing or had any unusual exposure to sunshine. Which of the following drugs is most likely to have causes this patients photosensitivity reaction.
A. Acetaminophen
B. Alprazolam
C. Amoxicillin plus clavulanic acid
D. Sulfamethoxazole plus Trimethoprim
E. Erythromycin
D.Sulfamethoxazole plus Trimethoprim
Verified by KEY
