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MT 6314 (3rd Shifting) > BLCWI Rationale > Flashcards

BLCWI Rationale Flashcards

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1
Q

Dicloxacillin is active against:

a. Staphylococci
b. Enterococci
c. Both
d. Neither

A

a. Staphylococci

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2
Q

Acid stable penicillin

a. Dicloxacillin
b. Penicillin G
c. Both
d. Neither

A

a. Dicloxacillin

Acid-stable penicillin:

  • Dicloxacillin
  • Ampicillin
  • Amoxicillin
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3
Q

Adverse effect of hypoprothrombinemia is associated with:

a. Cefotetan
b. Cefepime
c. Cefuroxime
d. Ceftriaxone

A

a. Cefotetan

Bleeding disorders/Hypoprothrombinemia:

  • Cefamandole
  • Cefmetadole
  • Cefoperazone
  • Cefotetan
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4
Q

Which can be used to treat metallo beta-lactamase producing bacteria?

a. Ceftolozane-tazobactam
b. Ceftazidime-avibactam
c. Both
d. Neither

A

d. Neither

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5
Q

True or False:

Beta-lactamase inhibitors can be combined with penicillins or cephalosporins.

A

True

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6
Q

This may cause myopathy prompting creatine phosphokinase monitoring:

a. Daptomycin
b. Cycloserine
c. Clindamycin
d. Vancomycin
e. Flucytosine

A

a. Daptomycin

Cycloserine - TB
Clindamycin - Skin and soft-tissue infection against Streptococci & Staphylococci
Vancomycin - Red Man syndrome
Flucytosine - Thrombocytopenia

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7
Q

Aztreonam has activity against:

a. Aerobic gram-negative bacteria
b. P. aeruginosa
c. both
d. neither

A

c. both

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8
Q

True or False:

Penicillins are excreted into sputum.

A

True

Penicillin is also excreted into sputum and breast milk to levels 3–15% of those in the serum.

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9
Q

Oxacillin is active against:

a. Streptococci
b. Staphylococci
c. Both
d. Neither

A

b. Staphylococci

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10
Q

The only first generation parenteral cephalosporin:

a. Cefazolin
b. Cefotetan
c. Ceftaroline
d. Cefuroxime

A

a. Cefazolin

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11
Q

Acid stable penicillin:

a. Oxacillin
b. Ampicillin
c. Both
d. Neither

A

b. Ampicillin

Acid-stable penicillin:

  • Dicloxacillin
  • Ampicillin
  • Amoxicillin
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12
Q

This may cause allergic pneumonitis in prolonged treatment:

a. Daptomycin
b. Amoxicillin
c. Both
d. Neither

A

a. Daptomycin

Daptomycin cause an allergic pneumonitis in patients receiving prolonged therapy (>2 weeks)

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13
Q

Drug active against Pseudomonas:

a. Ampicillin
b. Vancomycin
c. Both
d. Neither

A

d. Neither

Ampicillin - DOC for Shigella
Vancomycin - Creatinine clearance

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14
Q

Which can cross the Blood Brain Barrier:
a. Tetracycline
b. Vancomycin
c. Both
d. Neither

A

b. Vancomycin

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15
Q

The only fourth generation parenteral drug:

a. Cefepime
b. Cefotetan
c. Ceftaroline
d. Cefuroxime

A

a. Cefepime

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16
Q

Which can be used to treat extended spectrum Beta-lactamase producing Enterobacteriaceae:

a. Ceftolozane-tazobactam
b. Ceftazidime-avibactam
c. Both
d. Neither

A

c. Both

Their coverage are:

  • Gr(-)
  • P. aeruginosa
  • Extended spectrum Beta-lactamase producing Enterobacteriaceae:
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17
Q

Which is resisted by Listeria monocytogenes infection:
a. Penicillin G
b. Ivermectin
c. Diethylcarbamazine
d. Bithionol
e. Praziquantel

A

a. Penicillin G

Bacteria Resistant to Penicillins Resistant to Staphylococcal Beta-Lactamase:

● Listeria monocytogenes
● Enterococci
● Methicillin-resistant strains of staphylococci

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18
Q

Second generation cephalosporin which crosses the Blood Brain barrier:

a. Cefuroxime
b. Cefotetan
c. Ceftaroline
d. Cefepime

A

a. Cefuroxime

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19
Q

Glycopeptide which associated with the adverse reaction of infusion related flushing:

a. Vancomycin
b. Teicoplanin
c. Telavancin
d. Dalbavancin
e. Oritavancin

A

a. Vancomycin

Among the more common reactions to vancomycin is the so-called “red man” syndrome. This infusion-related flushing is caused by release of histamine.

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20
Q

Nafcillin is active against:

a. Staphylococci
b. Enterococci
c. Both
d. Neither

A

a. Staphylococci

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21
Q

This may cause psychosis and convulsion at high doses:

a. Cycloserine
b. Bacitracin
c. Daptomycin
d. Fosfomycin

A

a. Cycloserine

Bacitracin - Nephrotoxic
Daptomycin - Allergic pneumonitis
Fosfomycin - UTI

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22
Q

Which can be used to treat anaerobic infection:

a. Ceftolozane-tazobactam
b. Ceftazidime-avibactam
c. Cefepime
d. Ceftaroline

A

d. Ceftaroline

Ceftaroline has increased binding to penicillin-binding protein 2a,which mediates methicillin resistance in staphylococci (anaerobic bacteria, resultingin bactericidal activity against these strains).

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23
Q

True or False:

Antistaphylococcal penicillins are resistant to Beta-lactamases.

A

True

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24
Q

Drug of choice for surgical prophylaxis:

a. Cefazolin
b. Cefoxitin
c. Cefofetan
d. Ceftriaxone

A

a. Cefazolin

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25
# True or False: Penicillin can be used to treat meningococcal meningitis.
True
26
What is the second line anti-TB drug which is a structural analog of D-alanine?
Cycloserine
27
Antimetabolite inhibitor of cystosolic enolpyruvate transferase:
Fosfomycin
28
# Identify what generation of cephalosporins: Cefazolin
1st-generation cephalosporins
29
# Identify what generation of cephalosporins: Cefixime
3rd-generation cephalosporins
30
# Identify what generation of cephalosporins: Cefoperazone
3rd-generation cephalosporins
31
# Identify what generation of cephalosporins: Cefotetan
2nd-generation cephalosporins
32
# Identify if Narrow, Very Narrow, and Wider: Amoxicillin
Wider spectrum penicillinase-susceptible agent
33
Adverse effects of interstitial nephritis is associated with:
Methicillin
34
# Identify if Narrow, Very Narrow, and Wider: Penicillin G
Narrow-spectrum penicillinase-susceptible agent
35
Interferes with a late stage in cell wall synthesis in gram (+) organisms. What drug is this?
Bacitracin
36
# Identify this drug based on the mechanism of action: Binds to the D-ala-D-ala Terminal of the nascent peptidoglycan pentapeptide side chain
Vancomycin
37
What is the third generation cephalosporins that do not penetrate the blood-brain barrier?
Cefixime Cefoperazone
38
What is the drug of choice for **gonorrhea?**
Cefixime (IV)
39
# Identify what generation of cephalosporins: Cefadroxil
1st-generation cephalosporins
40
# Identify if Narrow, Very Narrow, and Wider: Penicillin V
Narrow-spectrum penicillinase-susceptible agent
41
# Identify what generation of cephalosporins: Ceftazidime
3rd-generation cephalosporins
42
# Identify what generation of cephalosporins: Cefazolin
1st generation cephalosporin
43
What are the Beta-lactamase inhibitor?
* Sulbactam * Clavulanic Acid * Avibactam * Tazobactam
44
# Identify if Narrow, Very Narrow, and Wider: Nafcillin
Very narrow spectrum penicillinase-resistant agent
45
# Identify this drug based on its mechanism of action: Blocks the incorporation of D-Ala into the pentapeptide side chain of the peptidoglycan.
Cycloserine
46
# Identify if Narrow, Very Narrow, and Wider: Piperacillin
Wider-spectrum penicillinase-susceptible agent
47
# Identify this drug based on its mechanism of action: Prevents the formation of N-acetylmuramic acid which is essential in peptidoglycan chain formation.
Fosfomycin
48
What is the Penicillin used for oropharyngeal infections?
Penicillin V
49
Which can be used to treat MRSA infection: a. Ceftriaxone b. Cefotaxime c. Cefepime d. Ceftaroline
d. Ceftaroline
50
Drug of choice against *Treponema pallidum:* a. Penicillin G b. Penicillin V c. Oxacillin d. Ampicillin
a. Penicillin G
51
Dicloxacillin is active against: a. Enterococci b. Anaerobes c. Both d. Neither
d. Neither ## Footnote Staphylococci
52
Excretion of Penicillin is mainly thru: a. Renal b. Billiary c. Both d. Neither
a. Renal ## Footnote Billiary - Nafcillin
53
This used to treat UTI even in pregnant women: a. Cycloserine b. Bacitracin c. Daptomycin d. Fosfomycin
d. Fosfomycin
54
Acid stable penicillin: a. Penicillin V b. Benzathine Penicillin c. Both d. Neither
a. Penicillin V
55
Component of peptidoglycan bacterial cell wall: a. N-acetylglucosamine b. N-acetylmuramic acid c. Both d. Neither
c. Both
56
Which has activity against anaerobes: a. Cefotetan b. Cefaclor c. Cefuroxime d. Cefprozil
a. Cefotetan
57
Which can be used to treat Enterobacter infection: a. Ceftriaxone b. Cefotaxime c. Ceftazidime d. Cefepime
d. Cefepime
58
MOA is a cell wall synthesis inhibitor: a. Ethionamide b. Capreomycin c. Cycloserine d. Aminosalicylic acid e. Bedaquiline
c. Cycloserine
59
Carbapanem inhibited by renal dehydropeptidase: a. Doripenem b. Ertapenem c. Imipenem d. Metropenem
c. Imipenem
60
# True or False: All beta lactam antibiotics inhibit bacterial cell growth by interfering with transpeptidation reaction.
True
61
Carbapanem which may cause seizure in patients with renal failure: a. Doripenem b. Ertapenem c. Imipenem d. Meropenem
c. Imipenem
62
Adverse effect of skin rashes in the setting of viral illness associated with: a. Ampicillin b. Oxacillin c. Nafcillin d. Piperacillin
a. Ampicillin
63
Adverse effect of hepatitis is associated with: a. Nafcillin b. Oxacillin c. Ampicillin d. Piperacillin
b. Oxacillin ## Footnote Nafcillin - neutropenia Ampicillin - rash Piperacillin - *K. pneumoniae, P. aeruginosa*
64
# Identify what generation of cephalosporins: Cefepime
4th-generation cephalosporins
65
# Identify what generation of cephalosporins: Ceftriaxone
3rd-generation cephalosporins
66
# Identify what generation of cephalosporins: Cefuroxime
2nd-generation cephalosporins
67
The patient has renal failure. Which of the following will not cause any problems for the patient? a. Methicillin b. Amoxicillin c. Ampicillin d. Nafcillin
d. Nafcillin
68
If you will give Ampicillin to your patient which of the following should be your instruction to your patient? a. Take the drug while standing up. b. Take the drug 1 hour before eating food c. Take the drug in the afternoon. d. Take the drug at nighttime.
b. Take the drug 1 hour before eating food
69
Resistance of the bacteria to Methicillin is largely due to: a. Alteration of penicillin binding proteins. b. Efflux c. Impaired drug penetration d. Beta-lactamase production
a. Alteration of penicillin binding proteins.
70
The half life of Penicillin G in patients with renal failure is: a. 8 hours b. 15 hours c. 20 hours d. 10 hours
d. 10 hours
71
Which of the following needs dose adjustment for renal failure? a. Oxacillin b. Nafcillin c. Cloxacillin d. Ampicillin
d. Ampicillin
72
The most common adverse reaction of penicillins: a. Renal Failure b. Nausea c. Hypersensitivity d. Vomiting
c. Hypersensitivity
73
Which among the following has the best coverage for Gram-positive bacteria? a. Cefazolin 1 gen b. Cefoxitin 2 gen c. Ceftriaxone 3 gen d. Cefepime 4 gen
a. Cefazolin 1 gen
74
Which among these 2nd generationcephalosporins have coverage for anaerobic bacteria? a. Cefuroxime b. Cefoxitin c. Cefamandole d. Cefaclor
b. Cefoxitin
75
The following are third generation cephalosporins except? a. Ceftriaxone b. Cefprozil c. Cefixime d. Moxalactam
b. Cefprozil ## Footnote 2nd-generation drug.
76
What is the main basis of grouping the cephalosporins by generations? a. Ability to cross the blood-brain barrier b. Gram-negative bacteria coverage c. Price d. Penicillinase resistance
b. Gram-negative bacteria coverage ## Footnote Higher generations have more enhanced gram-negative coverage.
77
Which of the following drugs has no activity against Gram-positive organisms? a. Aztreonam b. Amoxicillin c. Ceftriaxone d. Cefazolin
a. Aztreonam
78
The main problem for beta-lactamase inhibitors would be? a. Unique beta-lactamases b. Heat resistance c. Induction of nephrotoxicity d. Hypersensitivity reactions
a. Unique beta-lactamases
79
Which of the following carbapenems has poor entry to the cerebrospinal fluid? a. Meropenem b. Doripenem c. Ertapenem d. Imipenem
c. Ertapenem ## Footnote All carbapenems can penetrates well into CSF except for Ertapenem.
80
Which of the following carbapenems have the longest half-life? a. Meropenem b. Ertapenem c. Doripenem d. Imipenem
b. Ertapenem
81
True about Vancomycin: a. Active against Gram-positive anaerobes. b. Kills staphylococci slowly and only if they are actively dividing. c. All of these. d. Poorly absorbed into the gastrointestinal tract.
c. All of these.
82
Proposed mechanism of action of Daptomycin: a. Inhibition of cell wall transpeptidases b. Binds to cell membrane causing depolarization c. Inhibits cell wall synthesis as a D Ala-D-Ala analog. d. Binds to penicillin binding proteins to disrupt peptidoglycan synthesis
b. Binds to cell membrane causing depolarization ## Footnote a. Bacitracin c. Vancomycin d. Cycloserine (?)
83
Bacitracin is only administered topically because of: a. Weak intravenous bioavailability b. Poor intestinal absorption c. Bile solubility d. Nephrotoxicity
d. Nephrotoxicity
84
Which of the following is mainly a second-line drug for Tuberculosis? a. Dalvabancin b. Cycloserine c. Fosfomycin d. Bacitracin
b. Cycloserine
85
Fungal origin of Clindamycin: a. Streptomyces erythreus b. Streptomyces lincolnensis c. Streptomyces griseus d. Micromonospora purpurea e. Streptomyces mediterranei
b. Streptomyces lincolnensis
86
# True or False: Pencillin has good penetration into the eye.
False ## Footnote Penicillin penetration into the eye, prostate and CNS is poor.
87
# True or False: Intravenous administration of penicillin G is preferred than intramuscular route.
True ## Footnote IV administration preferred because IM injection of large doses can cause irritation and local pain.
88
Which among the group would be the least likely option as treatment for beta lactamase producing organisms? a. Ertapenem b. Cefazolin c. Ceftazidime-avibactam d. Cefepime
b. Cefazolin ## Footnote All are resistant to beta lactamases except for Cefazolin.
89
Which among the following is not suitable as an empiric treatment for hospital acquired pneumonia? a. Meropenem b. Piperacillin-Tazobactam c. Ertapenem d. Cefepime
c. Ertapenem ## Footnote All are suitable for treatment of *Pseudomonas aeruginosa* (hospital-acquired) except ertapenem.
90
Which among the following would require dose adjustment in renal disease patients? a. Nafcillin b. Oxacillin c. Vancomycin d. Nafcillin
c. Vancomycin
91
The following drugs improve patient compliance because of less frequency of dosing except? a. Benzathine penicillin b. Fosfomycin c. Piperacillin-tazobactam d. Procaine penicillin
c. Piperacillin-tazobactam
92
# Identify the drug based on its mechanism of action: Inhibits formation of N-acetyl-muramic acid
Fosfomycin
93
# Identify the drug based on its mechanism of action: Binds cell membrane via Ca-dependent mechanisms leading to cell death
Daptomycin
94
# Identify the drug based on its mechanism of action: Binds PBP to stop transpeptidation reaction
Amoxicillin
95
# Identify the drug based on its mechanism of action: Binds D-Ala-D-Ala terminus of peptidoglycan
Vancomycin Oritavancin
96
# Identify the drug based on its mechanism of action: Inhibits alanine-racemase and D-Alanyl-D-Alanine ligase
Cycloserine
97
# Identify the drug based on its mechanism of action: Disrupts cell membrane permeability
Oritavancin Telavancin
98
# Identify the drug based on adverse effects: Myopathy
Daptomycin
99
# Identify the drug based on adverse effects: Red man syndrome
Vancomycin
100
# Identify the drug based on adverse effects: Ototoxicity
Vancomycin
101
# Identify the drug based on adverse effects: Seizure
Imipenem
102
# Identify the drug based on adverse effects: Pseudomona colitis
Ampicillin
103
# Identify the drug based on adverse effects: Neutropenia
Nafcillin
104
# Identify the drug based on adverse effects: Congenital deformity
Telavancin
105
# Identify the drug based on adverse effects: Disulfiram like reaction
Cefazolin
106
Adverse effect of bleeding disorder is associated with: a. Cephalosporins b. Avibactam c. Both d. Neither
a. Cephalosporins
107
Oxacillin is active against: a. gram(-) b. anaerobes c. both d. neither
d. neither
108
Drug active against Pseudomonas: a. Ampicillin b. Piperacillin c. Both d. Neither
b. Piperacillin
109
Acid-stable penicillin: a. Ampicillin b. Amoxicillin c. Both d. Neither
c. Both
110
Resistance mechanism to penicillin: a. Alteration of the PBP's b. Production of efflux pump c. Beta-lactamase production d. All of the above e. Neither
d. All of the above
111
Cephalosporins has activity against: a. *E.coli* b. *Listeria monocytogenes* c. Both d. Neither
a. *E. coli*
112
Which can be used to treat meningococcal meningitis: a. Cefotetan b. Cefotaxime c. Both d. Neither
b. Cefotaxime
113
Which can be used to treat carbapenemase-producing bacteria: a. Ceftolozane-tazobactam b. Ceftadizime-avibactam c. Both d. Neither
b. Ceftadizime-avibactam
114
Which cephalosporins is excreted through the bile: a. Cefotaxime b. Ceftriaxone c. Both d. Neither
b. Ceftriaxone
115
Which has activity against anaerobes: a. Cefoxitin b. Cefaclor c. Cefuroxime d. Cefprozil
a. Cefoxitin
116
Which can be used to treat meningicoccal meningitis: a. Ceftriaxone b. Cefotaxime c. Both d. Neither
c. Both
117
Hypoprothrombinemia may be caused by this cephalosporins: a. Cefoperazone b. Cephadrine c. Cefoxitin d. Ceftizoxime
a. Cefoperazone
118
Anti-pseudomonal activity is seen with this cephalosporin: a. Ceftizoxime b. Cefotaxime c. Both d. Neither
d. Neither ## Footnote Anti-pseudomonal activity is seen through: * Cefoperazone * Ceftazidime
119
Adverse effect of disulfiram-like reactions is associated with: a. Cefotetan b. Cefepime c. Cefuroxime d. Ceftriaxone
a. Cefotetan
120
This is highly nephrotoxic thus is only used topically: a. Cycloserine b. Bacitracin c. Daptomycin d. Fosfomycin
b. Bacitracin
121
This is cell wall synthesis inhibitor is produced by *Streptomyces orchidaceous:*
Cycloserine
122
Lipopeptide which binds to bacterial cell membrane causing depolarization and rapid cell death: a. Cycloserine b. Bacitracin c. Daptomycin d. Vancomycin
c. Daptomycin
123
Aztreonam has activity against: A. Gr(+) B. Anaerobes c. Both d. Neither
d. Neither
124
# True or False: Penicillins have little activity against Gram-negative rods.
True
125
Which has activity against anaerobes? a. Cefoxitin b. Cefotetan c. Both d. Neither
c. Both
126
Which cephalosporin is excreted thru the urine? a. Cefuroxime b. Cefaclor c. Both d. Neither
c. Both
127
This is cell wall synthesis inhibitor is an analogue of phosphoenolpruvate: a. Cycloserine b. Bacitracin c. Daptomycin d. Vancomycin e. Fosfomycin
e. Fosfomycin
128
Drug active against Pseudomonas: a. Ampicillin b. Amoxicillin c. Ticarcillin d. Penicillin V
c. Ticarcillin
129
Lipoglycopeptide which can disrupt cell membrane potential and inhibit RNA synthesis: a. Vancomycin b. Teicoplanin c. Telavancin d. Dalbavancin e. Oritavancin
e. Oritavancin
130
Anti-pseudomonal activity is seen with this cephalosporin: Select all that apply. a. Cefixime b. Ceftazidime c. Cefepime d. Ceftriaxone e. Cefotaxime
b. Ceftazidime c. Cefepime
131
Excretion of Nafcillin is primarily thru: a. Renal b. Biliary c. Both d. Neither
b. Biliary
132
Cephalosporins has activity against: Select all that apply. a. Enterococci b. Streptococci c. E. coli d. L. monocytogenes (Listeria monocytogenes) e. MRSA (Methicillin-resistant Staphylococcus aureus) f. K. pneumoniae
b. Streptococci c. E. coli f. K. pneumoniae
133
Drug of choice against endocarditis: a. Penicillin G b. Penicillin V c. Nafcillin d. Ampicillin
c. Nafcillin
134
Carbapenem administered with Cilastatin: a. Doripenem b. Ertapenem c. Imipenem d. Meropenem
c. Imipenem
135
Excretion of Oxacillin is thru: a. Renal b. Biliary c. Both d. Neither
c. Both
136
Drug of choice against Beta hemolytic streptococcal pharyngitis: a. Penicillin G b. Penicillin V c. Oxacillin d. Ampicillin
a. Penicillin G
137
Adverse effect of seizure if given at high doses is associated with: a. Penicillin G b. Oxacillin c. Ampicillin d. Piperacillin
a. Penicillin G
138
Adverse effect of bleeding disorder is associated with: a. Cefotetan b. Cefepime c. Cefuroxime d. Ceftriaxone
a. Cefotetan
139
# True or False: Antipseudomonal penicillins are resistant to Beta-lactamase hydrolysis.
False
140
Which can be used to treat Listeria monocytogenes infection: a. Ceftriaxone b. Cefotaxime c. Both d. Neither
d. Neither
141
# True or False: Oral absorption of Amoxicillin is impaired by food intake.
False
142
Adverse effect of acute kidney injury when combined with Vancomycin is associated with: a. Piperacillin b. Oxacillin c. Ampicillin d. Penicillin G
a. Piperacillin
143
# True or False: Antupseudomonal penicillins are susceptible to Beta-lactamase hydrolysis.
True
144
Glycopeptide which can be administered intramuscular: a. Vancomycin b. Teicoplanin c. Telavancin d. Dalbavancin e. Oritavancin
b. Teicoplanin

MT 6314 (3rd Shifting) (7 decks)

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