The document discusses various statements about the bioavailability, mechanisms of action, and appropriate uses of different antibiotics including penicillins, cephalosporins, vancomycin, tetracycline, and others. It provides scenarios involving patients with various infections and asks which antibiotic statement is accurate or drug would be most appropriate for treatment.

2. Oral bioavailability is affected by liability in gastric acid

3. Most third generation cephlosporins cross the blood brain barrier

4. Nafcillin and ceftriaxone are eliminated by mainly via biliary secreation

5. Procaine penicillin G is used via intra muscular injection

6. Renal tubular reabsorption of beta- Lactams is inhibited by probenecid

7. A young female having a urinary tract infection on urine C/S there is E.Coli sensitive to cephalosporin. The primary mechanism of antibacterial action of cephlosporins involves

8. Production of Beta- Lactamases

9. Inhibition of Cell membrane synthesis

10. Inhibition of Reaction involving transpeptidation

11. Decreasing Synthesis of N- acetyl muramic acid

12. Preventing Trans glycosylation

13. A 40years old man having an infection involving enterobacter spp. Which of the drug is drug of choice now a days?

14. Penicillin

15. Cephalosporin

16. Tetracycline

17. Imipenem

18. Clavilanic acid

19. An elderly male has a fever believed to be due to an infection. He has skin lesions scrapings of which reveal the presence of large number of gram positive cocci. The drug to use for the treatment of this patient is?

20. Amoxicillin

21. Aztreonam

22. Cefoxitin

23. Nafcillin

24. Penicillin G

25. A 40 years old female treated for Leukemia two month back. She is admitted to the hospital with malaise, chills and high fever. Gram stain of blood reveals the presence of gram negative bacilli. The initial diagnosis is bacteremia and the parenteral antibiotics are indicated. The records of the patients reveal that she had a severe urticarial rash, hypotension and respiratory difficulty after oral penicillin V about 6 month ago. The drug regimen for empiric treatment is?

26. Ampicillin plus sulbactam

27. Aztreonam

28. Cefazolin

29. Imipenem plus cilastatio

30. Ticarcillin plus clavulanic

31. A female patient needs antibiotic treatment prophylaxis before going for a tooth extraction. Her medical history includes a severe anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with:

32. Amoxicillin clavcilanate

33. Aztreonam

34. Cefazolin plus gentamycin

35. Meropenem

36. vancomycin

37. A man is on vancomycin for one week. Which statement about vancomycin is accurate

38. It is bacteriostatic

39. It is binds to PBPs

40. It is not susceptible to penicillinase

41. It has good oral bioavailability

42. Staphylococcal enterocolitis occurs commonly with its use

43. A 10 years old child is taking Ampicillin for upper respiratory tract infection. Which of the following statements about ampicillin is not accurate?

44. Antibacterial activity is Enhanced by sulbactam

45. Causes maculopapular rashes

46. Drug of choice for L monocytogenes infection

47. Eradicates most strains of MRSA

48. May cause pseudomembranous colitis

49. A 25 years old female has primary syphilis. She has a history of penicillin hypersensitivity, so tetracycline will be used to treat the infection. Which statement about the proposed drug treatment of this patient is accurate?

50. Antacids will not affect absorption of the drug

51. Azithromycin would not be effective in treatment of this patient

52. For full effectiveness tetracycline must be taken for 15 days

53. She should eat plenty of yogurt to prevent vaginal candidiasis

54. Tetracycline is potent inhibitor of hepatic drug metabolizing enzymes

55. A patient having culture positive enterococcal bacteremia. Who has failed to respond to vancomycin because of resistance, the treatment most likely to be effective is?

56. Claritheomycin

57. Erythromycin

58. Linezolid

59. Minocycline

60. Ticarcillin

61. A 28 years old man having a degenerative joint disease is to undergo insertion of hip prosthesis. To avoid complication due to postoperative infection, the surgeon will pretreat this patient with an antibiotic. This hospital has a significant problem with methicillin resistant staphylococcus aureus. Which of the following antibiotics should the surgeon select?

62. Ampicillin

63. Imipenem

64. Gentamycin

65. Vancomycin

66. Cefazolin

67. A 28 years old male returns home from a holiday in the far days east and complains of three days of dysuria and a purulent urethral discharge. You diagnose this to gonorrhea. Which of the following is appropriate treatment?

68. Ceftriaxone intra muscular

69. Penicillin G intra muscular

70. Gentamycin intra muscular

71. Piperacillin intra Venus

72. Vancomycin intra Venus

73. 19 years old beautiful, fair skinned girl visits her dermatologist at a local clinic because of a rash that appeared after she spent the sunny weekend kite flying with her friends. She was put on a drug for two months to prevent acne flare ups. The drug responsible for her recent concerns may be:

74. Amoxicillin

75. Cepheradine

76. Minocycline

77. Oxacillin

78. Erythromycin

79. 40 years old bus driver presents to the clinic with severe headache and tinnitus. Upon investigations he is found to have an increased intracranial pressure but the CSF composition is normal. No hydrocephalus, mass, or structural or vascular lesion. No obvious cause is identified except a history of antibiotic therapy. Which of the following drug may be responsible for this condition?

80. Azithromycin

81. Imipenem

82. Mezlocillin

83. Tetracycline

84. Methicillin

85. Drug of first choice for MRSA is:

86. Clindamycin

87. Erythromycin

88. Vancomycin

89. Oxytetracycline

90. Meropenem

91. Medical students are discussing the clinical uses of antimicrobials when they come across a beta lactam antibiotic named methacillin. After considerable arguments they approach their instructor. The instructor wouyld tell:

92. It is used to treat gram positive infection

93. It is used to treat Methacillin Sensitive Staphylococcus Aureus (MSSA)

94. It is used to treat Vancomycin Resistant Staphylococcus Aureus (VRSA)

95. It is used to treat Vancomycin Resistant Enterococci (VRE)

96. It is not used therapeutically

97. After taking a macrolide the girl develops severe diarrhea and colitis, which of the following drugs may be of use in antimicrobial associated diarrhea?

98. Apmicillin

99. Vancomycin

100. Ceftriaxone

101. Cefamendol

102. Oxytetracycline

103. 49 years school teacher has been regularly taking warfarin, an anti-coagulant for his long standing coagulation disorder. He develops upper respiratory tract infection and goes to a quack who prescribes an antibacterial without bothering about his drug history. After a couple of doses he develops frank bleeding from gums. Which antimicrobial may have been wrongly prescribed?

104. Gentamycin

105. Clarithromycin

106. Linezolid

107. Amoxicillin

108. Cephradine

109. Drug of choice for treatment of mycobacterium avium complex in AIDS patient is:

110. a) Tetracycline

111. b) Azithromycine

112. c) Penicillin G

113. d) Amoxicillin

114. e) Chloramphenicol

115. Which of the following groups of antibiotics demonstrates a bacteriostatic effect?

116. a) Carbapenems

117. b) Erythromycin

118. c) Penicillin G

119. d) Cephradine

120. e) Amoxicillin

121. Mr. Smith is a patient of chronic renal failure and has regular dialysis. The tetracycline antibiotic that does not require dose reduction to treat his skin lesions is:

122. Doxycycline

123. Demeclocycline

124. Minocycline

125. Oxytetracycline

126. Chlortetracycline

127. A 61 years old male smoker presents with headache, weakness, fatigue and decreased urinary output, he has hyponateremia and urine osmolality is markedly increased. He might be suffering from a condition that may be treated with:

128. Doxycycline

129. Demeclocycline

130. Minocycline

131. Oxytetracycline

132. Chlortetracycline

133. Vancomycin resistant staphylococci may be given a trail of:

134. Aztreonam

135. A thirg generation cephalosporin

136. Streptogramins

137. Rifampin

138. Azithromycin

139. The term MIC refers to:

140. Minimum Inhibitory Concentration of an anti microbial in blood

141. Minimum Inhibitory Concentration of an anti microbial in a confined medium

142. Minimum Inhibitory Concentration of an anti microbial in a diseased tissue or organ

143. Minimum Inhibitory Concentration of an anti microbial against bacterial in a population

144. Minimum concentration required to kill the bacteria in the body

145. After an antimicrobial overdosage little Johnny developed irregular and rapid respiration, abdominal distention, periods of cyanosis, and passage of loose, green stools occur. He was severely ill by the end of the first day. Over the next 24 hours, he turned an ashen-gray color and became flaccid and hypothermic. The most likely antimicrobial he has taken is:

146. Amoxicillin

147. Chloramphenicol

148. Erythromycin

149. Doxicycline

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