Which of the following is a correct description of Ludwig's Angina?
Caused by anaerobe infection
It occurs in children with concomitant dental infections
It is not life-threatneing
Caused by infection from bacteroids, staphylococci, and streptococci
Choose all the following that are mechanisms of select toxicity?
Inhibition of cell wall synthesis
Selective Inhibition
Suppression of DNA synthesis
Common targets
Unique drug targets
Alteration of cell membrane permeability
Which of the following is the correct definition of Anti-infective agents?
Natural or synthetic substances used to suppress growth or kill bacteria/ single cell organisms
Substances that act against or destroy infections (Fungal/Viral/Bacteria)
Substances that destroy or supress the growth or multiplcation of bacteria
Substances produced by bacteria that can destroy or suppress the growth or multiplication of bacteria or prevent the action of bacteria
What antibacterial is given for emergency treatment of Ludwig's Angina?
Penicillin V
Ampicillin
Penicillin G
Augmentin
Which of the following is the correct mechanism for how Polymyxins act as antibiotics?
Binds to ribosome 30s to prohibit protein synthesis
Disrupts the integrity of the baceterial cell wall by displacing calcium and magnesium
Inhibits the cross-linkages between the peptidoglycan polymer strands
Disrupts the integrity of the cell membrane by displacing calcium and magnesium
Antibiotics that bind to bacterial ribosomes inhibit what enzyme?
Transpeptidase
Peptidyl transferase
Beta lactamase
Transcriptase
How do sulfonamides prevent the further growth of bacteria?
They block conversion of PABA into dihydrofolic acid
They inhibit DNA gyrase and Topoismerase enzymes, preventing supercoiling
They inhibit peptidyl transferase, inhibiting binding of tRNA to mRNA
They bind to the dihydroflate reductase (DHFR) enzyme, thus preventing production of folic acid
Acquired resistance is when the bacteria has always been resistant due to inherent properties of the bacteria
Which bacteria are susceptible to enzyme inactivation by beta lactamases?
Cephalosporins
Macrolides
Metronidazole
Tetracyclines
Which of the following is defines as a mobile genetic element which may be transferred from one organism to the other?
Bacteriophages
Integrons
Transposons
Plasmid
An integron is a genetic element that captures and disseminates genes through a gene cassette
Which of the following is NOT an example of microbial resistance?
Enzymatic inactvation
Antibiotic antagonism or interactions
Insensitivity to apoptosis
Overproduction of target sites
Which of the following cancers do NOT have a high incidence of p53 mutations
Ovarian
Lung
Colon
Pancreatic
Which of the following is correct regarding superinfections?
More likely to occur with narrow spectrum antibiotics
Occurs with transfer of plasmids and transposons
They are easy to treat
May be opportunistic infections with viruses such as Candidda albicans and Histoplasmosis
When would chemoprophylaxis be used?
Used after surgery to prevent wound infections
Used after a potential expsoure
To prevent an oral infection after having a dental procedure
In immunocompromised patients to prevent reactivation of latent reactions
Penicillins are narrow spectrum drugs
Select all of the bactericidal antibiotics
Pencillin
Tetracycline
Cefadroxil
Cephalexin
Aminoglycosides
Ciprofloxacin
Clindamycin
Which of the following is NOT a cause for antibiotic failure?
Limited vascularity or blood flow to tissue
Blood concentration too low
Impaired host to immune system
Failure to activate the antibiotics
Which of the following antibacterials can cause a long QT syndrome?
Fluroquinolones
Sulfonamides
Penicillins
Cephalsporins
Which of the following antibacterials cause agranulocytosis?
C. diff
Which of the following is NOT a concern of antibiotic use?
Stevens Johnsons
Superinfection
Teratology
Increased effects of oral contraceptives
Which of the following is incorrect regarding Penicillin G/Penicillin V?
One of these two can be used for treatment of Ludwig's Angina
Used for mixed aerobic-anerobic infections
Used for head, neck, and dental infections
These are all correct
Which of the following is the correct use of antistaphylococcal penicillins?
Skin and soft tissue infections
Broad spectrum Enterobacter
Klebsiella and enterocci
Ear, nose and throat, H. pylori
Which of the following is not an antistaphylococcal penicillin?
Amoxicillin
Methicillin
Nafcillin
These are all antistaphylococcal penicilllins
Augmentin contains an antistaphylococcal penicillin
Penicillins work by inhibiting which enzyme?
Integrase
Penicillin V is administered IV only?
Which of the following is NOT a possible adverse effect from peniciilins?
Allergy
Fungal overgrowth
Pseudomembraneous colitis
Oral lesions
Which of the following is a known drug reaction with use of penicillin?
Increase renal tubular secretion with use of probenecid
Inactivation with use of aminoglycosides
Disulfram-like reaction
Inhibits metabolism of anticoagulants, increasing risk of bleeding
Which of the following is true regarding aminopenicillins?
Resistant to beta lactamases
Narrow spectrum
Ampicillin has less side effects than amoxicillin
Effective against Neissseria gonorrhea and meningitidis
Select the following that are ineffective against beta lactamases:
Cloxacillin
Which of the following can be used to overcome resistant bacteria?
Amoxacillin
Clavulanic acid
Which of the following is true regarding penicillins and beta-lactamase inhibitors?
Amoxicillin has a molecular structure similar to beta lactam, thus prevents inactivation by beta lactamase
They are ineffective against Salmonella related infections
They are used in immunocompromised patients with mixed infections
They are effective against Klebsiella bacteria
Which of the following best represents first generation cephalosporins?
Includes Cefotaxime and Ceftriaxone
Used for UTI and soft tissue abscesses
Effective against Klebsiella and H influenza
Used for treatment of community-acquired pneumonia
Which of the following best describes generation 2 cephalosporins
Drug of choice for surgical prophylaxis
Used to treat Meningitis
Includes the drug Cefuroxime
Includes the drug Cefepime
Which of the following best describes generation 3 cephalosporins?
They have resistance to beta lacmases
Hightly active against P aeruginosa
Not approved for treatment of meningitis
Best for any H influenza infection
Which of the following best describes fourth generation cephalosporins?
It is used for meningitis
It includes the drug ceftaroline
It is active against Neisseria
Can be used for MRSA
Ceftaroline is active against MDR staph aureus, MRSA, and VRSA
Protein synthesis inhibitors are considered narrow spectrum antibiotics
Tetracyclines are broad spectrum antibiotics
Which of the following best matches the mechanism of tetracyclines?
Inhibition of beta 1-3 glycan of bacterial cell wall, preventing cross-linkages
Becomes mechanically reduced to a toxic metabolite, interacting with DNA
Binds to 50s subunit, preventing binding of tRNA to mRNA
Binds to 30s subunit, preventing binding of tRNA to mRNA
Which of the following are targeted by tetracyclines
Rickettsia
Chlamydia
Gram positive bacteria
All are targeted by tetracyclines
Which of the following is NOT a concern of tetracyclines?
Kills flora
Neutropenia
Impairs absorption of antacids
Damages development of bones and teeth
Which of the following is incorrect regarding macrolides?
Broad spectrum
Kills Treponema pallidum
Used as an alternative for patients allergic penicillins
Can be bacteriostatic or bacteriocidal, depending on dose
What makes Telithromycin so special?
It can be used for MRSA
It can cause Fanconi's syndrome if taken when it is expired
It can bind to ribosome 23s, which makes it unique
Can be used in cases when other macrolides cause fulminant hepatic necrosis
Which of the following is incorrect regarding Chloramphenicol?
It is bacteriostatic
Binds to 23s ribosome
Can be toxic due to inhibiting mitochondrial protein synthesis
Can be used for Neisseria gonorrhea
Chloramphenicol can cause gray baby syndrome
Which of the following is NOT a use for Clindamycin?
Pseudomembranous colitis
Skina nd soft tissue infections
Septic abrotion
Prophylaxis of infective endocarditis
Which of the following is NOT a concern for use of Clindamycin?
Thrombocytopenia
Fulminant hepatic necrosis
Which of the following is NOT a risk factor for pseudomembranous colitis?
Elderly
Erhythromycin
Choose all of the following that are part of treatment of pseudomembranous colitis?
Start on Vancomycin IV
Hydration
Start on clotrimazole
Start of Metronidazole
Stop all antibiotics
Start on Vancomycin oral
What is the clinical use of sulfonamides?
Skin infections
UTI
Alternative for patients allergic to Penicillins
Sulfonamide is a structural analog of DFHR
Which of the following causes Steven-Johnson syndrome?
Sulfonamides can cause which of the following adverse effects?
Renal damage from crystalluria
Prolonged QT syndrome
Pseudomembranous Colitis
Which of the following is NOT another name for trimethoprim?
Co-trimoxazole
Bactrim
Clotrimazole
Septra
Which best describes the mechanism of trimethoprim?
Structural analog of PABA
Binds to mammalian DHFR
Structural analog of bacterial DHFR
Binds to bacterial DHFR
Which of the following antibiotics are best known to be used for acne?
Clotrimazole can be used for UTI?
Metronidazole is used for the treatment of amoebic liver abscesss
How do fluoroquinolones kill bacteria?
They are chemically reduced to a toxic metabolite which interacts with DNA, resulting in loss of helical structure and essentially cell death
They bind to bacterial ribosomes 30s
They inhibit transpeptidases
They compromise the integrity of the bacterial cell membrane
Which of the following do metronidazoles NOT attack?
Gram positive
Anaerobes
Gram negative
Aerobes
Which of the following is not a drug interaction of metronidazole?
Phenytoin toxicity
Disulfram reactions
Failure of oral contraceptives
Inhibition of anticoagulant metabolism
Sharp metallic taste is one of many adverse effects of sulfonamides
Which best describes the mechanism of action of fluroquinolones?
Binding to bacterial ribosome 50s
Inhibits DNA gyrase, preventing supercoiling and stopping DNA replication
Inhibits transcriptase, preventing supercoiling and stopping DNA replication
Chemically reduced to a toxic metabolite, interacting with DNA and essentially causing cell death
The causes of resistance in fluoroquinolones are alteration in DNA gyrase and decreased permeability
Which of the following bacteria could cause cartilage damage in children?
Cefepime
Ciprofloxacin is an extended spectrum drug
Which of the following is true about vancomycin?
Given by quick infusion for serious systemic infections
May be used where resistance to macrolides has developed in bacterial strains
Inhibits transpeptidase
It is not absorbed by the GI
Which of the following can cause Red Man Syndrome?
Penicillin
Erythromycin
Vancomycin
Sulfamethoxazole
Which of the following is NOT true regarding aminoglycosides?
Can be used for the treatment of sepsis
Same spectrum as fluroquinolones
Given only PO
Drug monitoring is required
Which of the following is NOT side effect of drugs such as gentamicin, tobramycin, and amikacin?
Reversible renal toxicity
Irreversible vestibular toxicity
Neuromuscular blockade
Adding furoseminde can decrease risk of renal damage
Which of the following would you want to avoid giving prior to a surgical procedure?
Tobramycin
You would want to give Vancomycin PO q12h for MRSA
VRE infects immunocompromised patients
Which of the following cannot be used for treatment of MRSA?
Linezolid
Ceftaroline
Streptogramins
MRSA is resistant to ALL penicillins and cephalosporins
What are mechanisms of genetic transfer that are related to superinfections?
Transposon
Which of the following best describes amphotericin B?
Used only as topical therapy
Dose adjustment required and dose limited to 6 months
A polyene antifungal that binds to ergosterol in fungal cell membranes
Binds to bacterial RNA polymerase enzyme and inhibits RNA synthesis
Amphotericin B is used to only treat progressive and potentially fatal systemic infections due to its severe adverse effects
Which of the following is NOT an adverse effect of Amphotericin B?
Infusion-related reactions
Fever
Mild elevation in liver enzymes
Nephrotoxicity
Which of the following does NOT increase risk of nephrotoxicity
Amphoterecin B
Cisplatin
Nystatin is not related to Amphoterecin B and can therefore be used systemically
What type of fungal infection does nystatin treat?
Cryptococcal meningitis
Candida infections
Histoplasmosis
Asperillosis
What do you want to avoid taking with azole antifungals?
Antacids
Echinocandins
Calcium
Milk
Fluconazole is a prodrug
Choose all of the traizoles
Ketoconazole
Itraconazole
Fluconazole
Voriconazole
Miconazole
Which is the correct mechanism of azoles?
Disrupts microtubule function and inhibits dermatophyte growth
Binds to membrane Ergosterol
Inhibits viral DNA polymerase
Inhibits the lanosterol 14 alpha enzyme, preventing the conversion of lanosterol to ergosterol and disrupts the struction of fungal membrane
Which of the following is NOT an adverse effect of Azoles?
Steven Johnson
Increased levels of warfarin
Decreased fluconazole levels wiht isoniazid
Which of the following are used in hematopoietic stem cell transplatation patients?
Isoniazid
Which of the following antifungals are used to disrupt microtubule function?
Terbinafine
Griseofulvin
Which of the following antifungals is used for onychomychosis and tinea?
What is the difference between NRTIs and NNRTIs?
NRTIs inhibit viral DNA relication by binding to reverse transcriptase and inhibit DNA polymerase and NNRTIs act as chain terminators and imtate nucleotides
NNRTIs inhibit viral DNA relication by binding to reverse transcriptase and inhibit DNA polymerase and NRTIs act as chain terminators and imtate nucleotides
NRTIs interact with ohter drugs metabolized by CYP450 enzyme
NRTIs cause Stevens Johnson syndrome
NRTIs have mitochondrial toxicity
Which of the following is an adverse effect of NRTIs?
Steven Johnson Syndrome
Cushing-like syndrome
Local injection site reactions
Lactic acidosis
NRTIs cause Steven Johnson syndrome
Which of the following is not a protease inhibitor?
Saquinavir
Retrovir
Ritonavir
Indinavir
Which of the following is the correct drug regimen for post-exposure prophylaxis?
Retrovir + Epivir + Kaletra
Ritonavir + Epivir
2 NNTis with an NNRTI or a Ritonavir or Integrase
Raltegravir + Integrase
How do enfuvirtides work?
They incorporate into the growing DNA and inhibit chain formation
Blocks protease
Inhibit DNA polymerase
Blocks entry of the virus into the cell by preventing conformational change
Which of the following is an integrase inhibitor?
Raltegravir
Lopinavir
TNX-355 is used to prevent virus maturation
When should Antiretroviral therapy be started?
When CD4 count is less than 200
In HIV patient who is pregnant
With Hepatits B virus coinfection
These are all reasons to start therapy
Efavirenz is the recommended drug for HIV therapy in pregnant women
Choose the drugs that are part of HAART?
2NRTIs
NNRTIs
Enfuvirtide
Befirimat
TNX-355
Acyclovir
Famciclovir
Which antiviral drug prevents formation of DNA chain by inhibiting viral DNA synthesis?
Ganciclovir
Ganciclovir causes myelosuppression
Which of the following is used for prophylaxis of TB
Rifampin
Streptomycin
Ethambutol
Which of the following is true about isoniazid?
It is not readily absorbed by the GIT
It is metabolized by CYP450 enzyme, therefore having many drug interactions
Inhibits synthesis of Mycolic acid
Structurally distinct from pyridoxine, therefore causing peripheral neuropathy
Choose which of the following drugs are administered with isoniazid for treatment?
Rifampin is a "true" antibiotic
Which of the following is NOT true regarding Rifampin?
Gives a harmless orange color to all bodilly secretions
Can cause cholestatic jaundice
Used for prophylaxis
Mr. Smith works as an airline pilot and was found to have TB. Which drug would you NOT want to give him, due to its effects on visual acuity and color discrimination?
Which of the following drugs is given for prophylaxis and cure of malaria?
Fluoroquinolones
Quinolones
Albendazole
Chloroquine
Which of the following are concerns with the use of Antimalarials?
Hemolysis in G6Pd deficient individuals
Orange color of bodily secretions
Hepatitis
Which of the following is NOT a concern of antimalrials with long term drug dosing?
Retinopathy
Ototoxicity
Irreversible neuropathy
Epstein-Barr virus can cause nasopharyngeal cancer
Which of the following cause Hodgkins/Non-Hodgkins?
Hepatitis B
HIV
HPV
Epstein-Barr virus
Which of the following is part of treatment for advanced disease?
Surgery
Radiation
Chemotherapy
All of these are part of advanced disease treatment
Which of the following NOT consistent with primary resistance in regards to cancer drugs?
No response with drug therapy
Blamed on loss of p53 tumor suppressor gene
Common in malignant melanoma
Increased expression of MDR1 gene
How do alkylating agents cause cell death in cancer drugs?
They transfer their alkyl groups to DNA within the nucleus
They can inhibit protein chains and DNA strand breakage by carbamoylation
React chemically with sulfydryl, amino,hydroxyl and phosphate groups
All of the above
Which of the following causes hemorrhagic cystitis?
Cyclophosphamide
Vincristine
Mitomycin
Which of the following causes myelosuppression?
Methotrexate
Vinblastine
Which of the following cause mucositis?
Chlorambucil
Vinorelbine
5-flurouracil
None of the above
Which of the following cause neutropenia?
Which of the following causes SIADH?
Cyclophospamide
Methotrexate has a similar mechanism to what other drug?
Trimethoprim
Which of the following drugs does NOT inhibit renal excretion of methotrexate?
Aspirin
All of these inhibit renal excretion of methotrexate
Imatinib prevents phosphorylation of the cell kinase substrates by ATP
Cetuximab works against which enzyme to suppress cancer growth?
EGFR
DNA polymerase
Retinoic acid is used to treat childhood ALL