Chapter 186- Systemic and Topical Antibiotics

Question 1

First line options for empiric therapy for mild and moderate nonpurulent SSTIs (2)

Answer 1

B lactam antibiotics (penicillin &;; cephalosporins)

Clindamycin

Question 2

Empiric therapy for moderate and severe purulent SSTIs should cover

Answer 2

MRSA

Question 3

Inhibits 50s protein synthesis (4)

Answer 3

Lincosamides (clindamycine)
Macrolides
Streptogramins
Oxazolidinones

Question 4

Mainstay of therapy for SSTIs

Answer 4

B lactams

Question 5

Matching type

1. Francisella tularensis
2. HA-MRSA
3. Bartonella sp.
4. Pseudomonas aeroginosa
5. Actinomyces israelii

A. Amino glycosides 
B. Ciprofloxacin
C. Penicillin
D. Streptomycin
E. Vancomycin

Answer 5

D
E
A
B
C

Question 6

Doxycycline can be used for (6)

Answer 6

Borrelia burgdorferi, recurrentis
Coxiella burnetti
Ehrlichiosis
Rickettsia
Bacillus anthracis
Chlamydia trachomatis

Question 7

Azithromycin can be used for (4)

Answer 7

Bartonella
Chlamydia trachomatis
Haemophilus ducreyi
Klebsiella granulomatis

Question 8

Treatment for CA MRSA (5)

Answer 8

TMP-SMX
Clindamycin
Doxycyline
Minocycline
Rifampin

Question 9

Treatment for HA MRSA (9)

Answer 9

Vancomycin
Linezolid/Tedizolid
Tigacycline
Daptomycin
Quinopristin + Dalfopristin
Ceftarolinr
Ontovancin/Dalbovancin

Question 10

Pencillin can be used for (5)

Answer 10

Erysipelothrix rhusiopathiae
Pasteurella multocida
Streptococcus pyogenes
Treponema pallidum
Actinomyces israelli

Question 11

Treatment for Vibrio vulnificus

Answer 11

Doxycycline + Ceftazidime

Question 12

Treatment for Clostridum perfringens

Answer 12

Penicillin + clindamycin

Question 13

Matching type

1. Natural
2. Extended spectrum
3. Aminopenicillin
4. B lactamase resistant penicillin

A. Broad spectrum, for URTI infection
B. All form of syphilis
C. Uncomplicated SSTIs
D. Pseudomonas

Answer 13

B
D
A
C

Question 14

Penicillin wherein absorption is unaffected by food

Answer 14

Amoxicillin

Question 15

Penicillin cannot enter BBB/ CSF, prostate, and intraocular fluid hence not effective for meningitis.
True or False

Answer 15

False, effective for meningitis

Question 16

Added to penicillin to allow slower relase and prolonged drug delivery (2)

Answer 16

Procaine

Benazathine

Question 17

Penicillins safe for patients with renal failure (3)

Answer 17

Nafcillin
Oxacillin
Ureidopenicillin

Question 18

Most common ADE associated with penicillin use

Answer 18

Type 1 hypersensitive reaction

Question 19

The ___ ring of cephalosporins provides resistance to some B lactamases

Answer 19

Dihydrothiazine

Question 20

Cephalsoporin which crosses blood brain barrier and effective treatment for meningitis (2)

Answer 20

Ceftriaxone, cefotaxime

Question 21

Cephalosporin active against Pseudomonas aeruginosa

Answer 21

Ceftazidime

Question 22

Cephalosporin used for empiric therapy of severe purulent SSTIs

Answer 22

Ceftaroline

Question 23

Most oral cephalosporins can be taken without food except (3)

Answer 23

Cefaclor
Cefuroxime
Cefpodoxime

Question 24

Cephalosporins safe for usage in patients with allergy to penicillin (3)

Answer 24

Cefdinir
Cefpodoxime
Cefuroxime

Question 25

Treatment for Lyme disease

Answer 25

Early: Cefuroxime Late: Ceftriaxone

Question 26

Tetracyclines have greater activity than doxycyline and minocycline against S. aureus as they are less lipophilic. True or False

Answer 26

False, less activity

Question 27

In patient allergic to penicillin, ___ is an alternative for animal bites and syphilis

Answer 27

Doxycycline

Question 28

For tetracyclines, avoid concurrent ingestion with (5)

Answer 28

``` Iron preparations Aluminum hydroxide gels Calcium salts Magnesium salts Milk products ```

Question 29

Facilitates opsonization and phagocytosis amd decreases bacterial adhesion to host cells and production of staphylococcal exotoxin

Answer 29

Clindamycin

Question 30

Clindamycin has antiparasitic activity that targets protein synthesis of ___ organelle essential for survival

Answer 30

Apicoplast

Question 31

Protozoal spectrum of clindamycin

Answer 31

Toxoplasma gondii Babesia Plasmodium falciparum

Question 32

Clindamycin has its impact on abscesses due to its preferential accumulation in ___

Answer 32

Polymorphonuclear leukocytes

Question 33

Contraindication of clindamycin therapy

Answer 33

Hepatic failure Colitis Enhancement of neuromuscular blockade with tubocurarine and pancuronium Antagonism with erythromycin

Question 34

ADE of clindamycin

Answer 34

C. Difficile associated bacteria and pseudomembranous colitis

Question 35

Activity of macrolides to Gram positive pathogens from best to least Azithromycin Clarithromycin Erythromycin

Answer 35

Clarithromycin Erythromycin Azithromycin

Question 36

Azithromycin has good activity against (2)

Answer 36

Pasteurella multocida | Eikinella corrodens

Question 37

Clarithromycin is the most active macrolide against (3)

Answer 37

Mycobacterium chenolae Mycobacterium abscessus Mycobacterium fortuitum

Question 38

Macrolide are associated with increased risk of

Answer 38

Sudden cardiac death or ventricular tachyarrythmias

Question 39

Inhibits the action of bacterial topoisomerase II (DNA gyrase) and topoisomerase IV

Answer 39

Fluoroquinolones

Question 40

Fluoroquinolone most active against P. Aeruginosa

Answer 40

Ciprofloxacin

Question 41

Effective for STIs

Answer 41

Levofloxacin | Ciprofloxacin

Question 42

Adverse effects of quinolones in the immature

Answer 42

Tendon rupture, arthropathy

Question 43

For SSTIs, levofloxacin should be given ____ if uncomplicated; and ____ if complicated

Answer 43

Levofloxacin 500mg q 24h | Levofloxacin 750mg q 24h

Question 44

MOA of TMP SMX

Answer 44

``` Inhibit DHFR (TMP) Inhibit dihydropteroate synthetase (SMX) ```

Question 45

Contraindications of TMP SMX

Answer 45

MTX | HIV/AIDS

Question 46

TMP SMX is avoided for breastfeeding women, esp during the first ___ weeks of the newborn’s life

Answer 46

6

Question 47

Glycopeptide antibiotic, 1st line for HA MRSA

Answer 47

Vancomycin

Question 48

Red man syndrome is due to ___ release caused by drug impurities and fast infusions of vancomycin

Answer 48

Histamine

Question 49

Lipoglycopeptides with an increased risk of osteomyelitis

Answer 49

Oritavancin

Question 50

Lipoglycopeptides with increased risk of taste disturbances, nephrotoxicity, and QT prolongation

Answer 50

Telavancin

Question 51

First line option for empiric treatment of severe purulent SSTIs

Answer 51

Linezolid