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Antimicrobial resistence

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Entry Tests / Final Microbiologoy - PUM Quiz on Antimicrobial resistence, created by Leon Schwarze on 21/02/2024.
Leon Schwarze
Quiz by Leon Schwarze, updated 9 months ago
Leon Schwarze
Created by Leon Schwarze 9 months ago
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Resource summary

Question 1

Question
Definition KPC Klebsiella Pneumoniae carbapenemase
Answer
  • True
  • False

Question 2

Question
Beta-lactams don’t work on atypical bacteria, because: Atypical bacteria lack cell walls and thus are naturally resistant against all beta-lactams & because beta-lactams act by preventing the synthesis of the bacterial cell wall.
Answer
  • True
  • False

Question 3

Question
Which bacteriaare intrinsically resistant to vancomycin (glycopeptide)
Answer
  • a) Lactobacillus
  • b) Erysipelothrix
  • c) a+b

Question 4

Question
Resistance to [blank_start]Quinolones[blank_end]. is caused by chromosomal mutation in structural genes of DNA gyrase and topoisomerase IV
Answer
  • Quinolones

Question 5

Question
Which Bacteria can become resistant to Macrolides
Answer
  • Staphylococcus
  • Streptococcus

Question 6

Question
In gentamicin active efflux of drug in bactericides
Answer
  • True
  • False

Question 7

Question
Chloramphenicol is the enzymatic modifcation of acetyltransferase-
Answer
  • True
  • False

Question 8

Question
Which resistant bacterias are enzymatic
Answer
  • PRSA
  • HLAR
  • MRSA
  • ESBL
  • KPC

Question 9

Question
Resistant bacterias witch are NOT enzymatic but have an altered target site
Answer
  • MLSb
  • PRSP
  • MBL
  • MRSA
  • VRE

Question 10

Question
MRSA ? [blank_start]methicillin[blank_end] [blank_start]resistant[blank_end] [blank_start]staphylococcus[blank_end] [blank_start]aureus[blank_end] resistant against all beta-lactams and inhibitors, excluding 5th generation of cephalosporins
Answer
  • methicillin
  • resistant
  • staphylococcus
  • aureus

Question 11

Question
Which Bacteria are resistant against Beta Lactams
Answer
  • MBL - Metallobetalactamases
  • KPC - Klebisella pneumonia carbapanemase / CPE - Carbapanemase producing Enterobacteriaceae
  • MRSA (with exception to 5th gen cephalosporin)
  • Mycoplasma and Chlamydia
  • Chlamydia + VRE - Vancomyocinr resistant enterococcus

Question 12

Question
Which of the following phenotypes relate to the enzyme production
Answer
  • VRE
  • ESBL - positive
  • HLAR
  • PRSP
  • MBL - positive
  • NDM - positive

Question 13

Question
Which of the following phenotypes relate to the enzyme production
Answer
  • VRE
  • ESBL
  • HLAR
  • PRSP
  • MBL
  • Ch-

Question 14

Question
[blank_start]PRSP[blank_end]: Resistant to narrow penicillin & possibly 3rd gen cephalosporin
Answer
  • PRSP
  • MRSA
  • HLAR

Question 15

Question
Which Bacteria are resistant to narrow penicillin
Answer
  • a) E.coli
  • b) PRSP
  • c) MRSA
  • d) b+c
  • e) All of the mentionend

Question 16

Question
Which of the following may become resistent (aquired) to tigecycline 1) E.coli 2) P.aeruginosa 3) Acinetobacter baumannii 4) proteus mirabilis 5) K. pneumoniae
Answer
  • a) 1,2,3,5
  • b) 1,3,5
  • c) 2,3
  • d) 3,4
  • e) 4,5

Question 17

Question
Modification of an existing PBP´s through recombination indicates
Answer
  • a) MRSA
  • b) VRE
  • c) NDM+
  • d) PRSP
  • e) PRSA

Question 18

Question
Which phenotype refers to MSSA
Answer
  • a) resistant to all beta-lactams excluding Vth generation of cephalosporin
  • b) resistant to all beta lactams including Vth generation of cephalosporin
  • c) resistant to methicillin, susceptible to oxacillin and carbapenems
  • d) susceptible to all beta lactams, excluding narrow spectrum penicillins
  • e) susceptible to all beta lactams including narrow spectrum penicillins

Question 19

Question
Which of the drugs are pumped out by efflux
Answer
  • a) Tetrayclines
  • b) Vancomycin
  • c) Tigecycline
  • d) a+c
  • e) all of the mentionend

Question 20

Question
Choose correct Statement
Answer
  • The class C beta-lactamases are primarily cephalosporinases and are encoded on bacterial chromosomes
  • Class B carbapenemases are i.A. New Delhi metallo-beta-lactamases
  • Colistin binds to the membrane instead of penetrating it
  • Tigecycline may be affected by efflux or enzymatic modification
  • Active efflux of gentamycin is commonly observed in Bacteroides fragilis

Question 21

Question
Which of the following phenotypes relate to the enzyme production: 1. VRE 2. ESBL-positive 3. HLAR 4. PRSP 5. MBL-positive 6. NDM-positive
Answer
  • a) 1,2,3,5
  • b) 2,4
  • c) 2,5
  • d) Only 4
  • e) 2,3,5,6

Question 22

Question
What is an “intrinsic resistance” [blank_start]Natural resistance[blank_end] definition they want us to write: Bacteria is born with such a resistance, “comes into the world”
Answer
  • Natural resistance

Question 23

Question
Explain the abbreviation “NDM”: [blank_start]New Delhi[blank_end] [blank_start]Metallo-beta lactamase[blank_end]
Answer
  • New Delhi
  • Metallo-beta lactamase

Question 24

Question
Resistance to this drug results from [blank_start]acetyltransferase[blank_end] which catalyzes its acetylation. This characteristic indicates: Chloramphenicol
Answer
  • acetyltransferase

Question 25

Question
Class B ß-Lactamases:
Answer
  • a.) Are Zinc dependent Metalloenzymes
  • b.) Have Broad spectrum of action
  • c.) SHV-1 and TEM-1 are Major examples
  • d.) a+b
  • e.) None of the above

Question 26

Question
Tetracycline resistance develops with which of the following mechanisms?
Answer
  • a) Decreased penetration into the bacterial cell
  • b) Active efflux of the drug
  • c) Alteration of the ribosomal target site
  • d) a+c
  • e) all of the above

Question 27

Question
Natural resistance is observed in:
Answer
  • a) Pediococcus, Leuconostonc, Erysipelothrix, Lactobacillus
  • b) E.Coli, Klebsilla
  • c) Staphylococci
  • d) a+b
  • e) none of the above

Question 28

Question
Pseudomonoas aeruginosa is intrinsically resistant to:
Answer
  • a) Tigecycline
  • b) Tobramycin
  • c) Meropenem
  • d) Ceftazidime
  • e) Sulphonamides
  • f) d+e

Question 29

Question
Resistance through enzymatic modification of the drug is observed in:
Answer
  • a. Clindamycin – Str. Pyogenes
  • b. ß-Lactams – chlamydia
  • c. E. coli – glycopeptides
  • d. Isoniazid – mycobacteria
  • e. None of the above

Question 30

Question
Strict anaerobic bacteria have an intrinsic resistance to:
Answer
  • d. Clindamycin
  • e. None of the above
  • c. Metronidazole
  • b. Ampicillin
  • a. Gentamicin

Question 31

Question
Which of the following phenotypes (resistance) matches the description for MRSA
Answer
  • a. Penicillin G, ureidopenicillin, imipenem, vancomycin – susceptible
  • b. Vancomycin, imipenem – susceptible; penicillin, 1st and 2nd Generation cephalosporins – resistant
  • c. Vancomycin – susceptible; penicillin, Cephalosporin, carbapenem – resistant d. Penicillin – susceptible; vancomycin, carbapenem, cephalosporin – resistant
  • d) a+b
  • e) none

Question 32

Question
Partial modification of a PBP through recombination in:
Answer
  • e. All of the above
  • d. Klebsiella pneumoniae
  • c. MRSA-acquisition of new pbp
  • b. Streptococcus pneumoniae
  • a. Escherichia Coli

Question 33

Question
Which of the following haven an aquired resistance to ß-Lactams
Answer
  • a) MRSA
  • b) PRSP
  • c) ESBL
  • d) a+b
  • e) All of the above

Question 34

Question
Strict anaerobic bacteria are resistant to:
Answer
  • a) Gentamicin
  • b) Penicillin
  • c) Metronidazole

Question 35

Question
Which of the following resistance phenotypes are associated with PBP modification
Answer
  • a) NDM
  • b) ESBL
  • c) PRSP
  • d) KPC
  • e) MRSA
  • f) c+e

Question 36

Question
Choose true Statement
Answer
  • a) Efflux of aminoglycosides occurs rarely in gram negative bacteria
  • b) Penicillin G is inactivated with gastric acid
  • c) Gram negative bacteria rapidly develop resistance against beta lactams by production
  • d) all of the above

Question 37

Question
Intrinsic Resistance to sulphonamides
Answer
  • a) Pseudomonas aeruginosa
  • b) Nocardia
  • c) Chlamydia
  • d) B+c

Question 38

Question
HLAR - [blank_start]high level[blank_end] [blank_start]aminoglycoside[blank_end] [blank_start]resistance[blank_end]
Answer
  • high level
  • aminoglycoside
  • resistance

Question 39

Question
MRSA - [blank_start]methicillin[blank_end] [blank_start]resistant[blank_end] [blank_start]staphylococcus[blank_end] [blank_start]aureus[blank_end]
Answer
  • methicillin
  • resistant
  • staphylococcus
  • aureus

Question 40

Question
Choose true combination of drugs resistance against
Answer
  • a) Rifampin – rna polymerase
  • b) Levofloxacin – mosaic PBP
  • c) Erythromycin – enzyme modification
  • d) Penicillin G- enzyme modification
  • e) a+c+d

Question 41

Question
Resistance to this drug with protein production similar to elongation factor that protects 30S ribosomal subunit indicates the resistance to?
Answer
  • a) Penicillin
  • b) Azithromycin
  • c) Tetracyclines
  • d) Rifampin

Question 42

Question
Acquired resistance to penicillin G is observed in
Answer
  • a) Streptococcus pyogenes
  • b) E.coli
  • c) Streptococcus pneumonia
  • d) a+c

Question 43

Question
Give two examples of mechanisms of resistance with change of target site?
Answer
  • PRSP
  • MRSA

Question 44

Question
Give 2 groups of drugs that are elimanted by efflux group
Answer
  • Quinolones
  • Tetracycline

Question 45

Question
Resistance to aminoglycosides
Answer
  • Decreased permeability
  • Enzymatic modification

Question 46

Question
Erythomyocin is not active against K.Pneumoniae
Answer
  • True
  • False

Question 47

Question
Which of the following resistant phenotypes are associated with aminoglycosides modyfying enzyme production HLAR
Answer
  • True
  • False

Question 48

Question
Choose True sentence
Answer
  • a) Bacteria can become resistant to β-lactam antibiotics hydrolysis of the antibiotic by bacterial enzymes
  • b) Exclusion of B-lactamases in treatment of infection caused by non fermented process also due to decreased permeability of membrane
  • c) Enterobacteriaceae develop resistance to cephalosporins also due to the enzymes production
  • d) a+c

Question 49

Question
Intrinsic resistance to Linezolid - Escheria
Answer
  • True
  • False

Question 50

Question
Resistance to Metronidauole due to
Answer
  • Rescreased uptake of antibiotic
  • Elimination of cytotoxic compound before they reach DNA

Question 51

Question
Intrinsic resistance to Penicillin G - S pyogenes - Chlamydia
Answer
  • True
  • False

Question 52

Question
Pumped out by efflux pump
Answer
  • Tetracyclines
  • Aminoglycosides

Question 53

Question
Which phenotype refers to MRSA?
Answer
  • a.) resistant to all beta lactams including vth generations of cephalosporins
  • b.) resistant to all beta lactams excluding vth generations of cephalosporins
  • c.) resistant to methicillin,susceptible to oxacillin and carbapenem
  • d.) resistant to beta lactams,resistant to vancomycin,susceptible to monobactams
  • e.) none of the mentioned

Question 54

Question
Enterococcus gallinarum and casseliflavus are instrinctly resistant
Answer
  • e)all mentioned
  • d.) a+c
  • c.) vancomycin contain D-alanine-D-serine terminus
  • b.)Linezolid
  • a.) Tigecycline

Question 55

Question
Correct Examples
Answer
  • A class beta- lactamase = SHV-1 penicillinases found in common gram negative rods (and TEM-1)
  • B class beta - lactamase= New Delhi metallo-ß-lactamases

Question 56

Question
Which of the following may become resistant (acquired resistant) to macrolides
Answer
  • S.pyogenes
  • K.pneumoniae
  • S.aureus
  • Acinetobacter baumannii
  • P.aeruginosa
  • E.coli

Question 57

Question
Resistance to Aminoglycosides may result from:-
Answer
  • e.)all mentioned
  • d.)a+c
  • c.)increased expulsion of drug from cell
  • d.)decrease uptake of drug
  • a.)mutation of ribosomal target site

Question 58

Question
Resistance to this drug results from acetyltransferase which catalyse to acetylation:-this characteristics indicate
Answer
  • e.)chloramphenicol
  • d.)imipenem
  • c.)penicillin G
  • b.)ceftriaxone
  • a.)Sulfamethoxazol

Question 59

Question
Intrinsic resistance to tigecyycline is observed in
Answer
  • a) Morganella
  • b) Providencia Proteus and P aeruginosa
  • c) Pseudomonas
  • d) b+c
  • e) all mentioned

Question 60

Question
Which of the following is/are enzyme producers: 1.S.pyogenes 2.ESBL + 3.HLAR + 4.PRSP 5.MBL + 6.chlamydia trachomatis
Answer
  • 1,2,3,5
  • 2,5
  • 2,3,5
  • only 4
  • 2,3,5,6

Question 61

Question
Becomes resistant to aztreonam
Answer
  • e. faecalis
  • p.aeruginosa
  • acinobacter baumanii
  • s.aureus
  • s epidermidis
  • s pygones

Question 62

Question
1. Complete information regarding the 3 ways how bacteria can become resistant to beta-lactam antibiotics:
Answer
  • Decreased concentration of antibiotic at the cell wall from target site
  • Decreased binding of antibiotic to the PBP
  • Enzymatic modification
  • All
  • None

Question 63

Question
a. ESBL - [blank_start]Extended[blank_end] [blank_start]spectrum[blank_end] [blank_start]beta lactamase[blank_end] b. VRE - [blank_start]Vancomycin[blank_end] [blank_start]resistant[blank_end] [blank_start]enterococci[blank_end] c. KPC - [blank_start]Klebsiella[blank_end] [blank_start]Pneumoniae[blank_end] [blank_start]Carbapenemase[blank_end]
Answer
  • Extended
  • spectrum
  • beta lactamase
  • Vancomycin
  • resistant
  • enterococci
  • Klebsiella
  • Pneumoniae
  • Carbapenemase

Question 64

Question
5. Which of the following resistance mechanism phenotypes stem from the enzymatic modification of the drug:
Answer
  • a. PRSA
  • b. VRE
  • c. HLAR
  • d. MBL
  • e. a+c+d

Question 65

Question
7. Which of the following phenotype refers to MBL + P.aeruginosa:
Answer
  • a. Susceptible to carbapenems, resistant to beta lactams and its combinations with inhibitors
  • b. resistant to all beta lactams with exclusion of its combination with inhibitors
  • c. resistant to all beta lactams with possible exception of aztreonam
  • d. resistant to all beta lactams with possible exception of monobactams
  • e. c+d

Question 66

Question
a. A class beta lactamases: [blank_start]KPC, SHV-1, TEM-1[blank_end] b. B class beta lactamases: [blank_start]MBL, NDM, VIM[blank_end]
Answer
  • KPC, SHV-1, TEM-1
  • MBL, NDM, VIM

Question 67

Question
Which of the following may become resistant to Rifampin?
Answer
  • E.Coli
  • P. Aeruginosa
  • Acinebacter Baumanii
  • S. Auereus
  • S. Pneumonia
  • M. Tuberculosis

Question 68

Question
10. which of the following may become resistant (acquire resistance) to rifampin: (1) E.coli (2) P. aeurigonase (3) acinetobacter baumanii (4) S .aureus (5) K .pneumonia (6) M. tuberculosis
Answer
  • 1,2,3,5,6
  • 4,3,5
  • 4,5,6
  • 2,3
  • 4,6

Question 69

Question
Choose Correct Statement
Answer
  • 1. Resistance to amikacin can stem from decreased uptake of drug into bacterial cell
  • 2. Bacteroides fragilis is intrinsically resistant to metronidazole
  • 3. Most of gram (+) bacteria is resistant to macrolides

Question 70

Question
Which of the follwoing resistance phenotypes refers to MBL P+Aeruginosa
Answer
  • 1. Susceptible to carbapenems, resistant to B-lactams and its combinations
  • 2. Resistant to all B-lactams, with exclusion of its combination with inhibitors
  • 3. Resistant to all B-lactams, with possible exception of azteonem
  • 4. Resistant to all B-lactams, with possible exception of macrolides

Question 71

Question
Complete information regarding the ways how bacteria can become resistant to aminoglycosides:
Answer
  • Target site modification
  • Decreased membrane permeability
  • Active efflux
  • : Enzymatic inactivation of antimicrobial agent

Question 72

Question
Choose Correct Statement
Answer
  • a/ Pseudomonas aeruginosa is intrinsically resistant to trimethoprim.
  • b/ Overexpression of efflux pumps determines the resistance to ciprofloxacin
  • c/ Polymyxins are not effective against Gram-positive bacteria due to the lack of outer membrane in these.

Question 73

Question
Explain the abbreviations: PRSP: [blank_start]Penicillin resistant[blank_end] [blank_start]streptococcus pneumoniae[blank_end] HLAR: [blank_start]High level[blank_end] [blank_start]aminoglycoside[blank_end] [blank_start]resistance[blank_end] NDM: [blank_start]New delhi[blank_end] [blank_start]metallo-beta-lactamase[blank_end]
Answer
  • Penicillin resistant
  • streptococcus pneumoniae
  • High level
  • aminoglycoside
  • resistance
  • New delhi
  • metallo-beta-lactamase

Question 74

Question
Intrinsic resistance to glycopeptides is observed in:
Answer
  • a/ Lactobacillus
  • b/ Streptococcus pneumoniae
  • c/Enterococci
  • d/ E coli
  • e/ a+d

Question 75

Question
Which of the following resistance phenotype refers to MRSA:
Answer
  • a/ Resistant to beta-lactams with possible exception of its combinations with inhibitors.
  • b/ Resistant to all beta-lactams, susceptible to Vth generation of cephalosporins
  • c/ Resistant to narrow spectrum penicillins, resistant to macrolides and lincosamides.
  • d/ Resistant to all beta-lactams, with possible exception of monobactams.
  • e/ c+d

Question 76

Question
Resistance to gentamicin in Bacteroides fragilis is due to...[blank_start].lack of aerobic metabolism[blank_end]
Answer
  • .lack of aerobic metabolism

Question 77

Question
Which of the following may become resistant (acquire resistance) to tigecycline:
Answer
  • 1. Proteus mirabilis
  • 2. P. aeruginosa
  • 3. Morganella morganii
  • 4. E. faecalis
  • 5. K. pneumoniae
  • 6. Providencia retgerii
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