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Antibiotics that inhibit cell wall synthesis include:
A.
Tetracyclines
B.
Cephalosporins
C.
Sulfonamides
D.
Aminoglycosides
Correct Answer
B. CepHalosporins
Explanation In addition to cephalosporins, penicillins and vancomycin also inhibit cell wall synthesis.
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2.
Antibiotics that inhibit nucleic acid synthesis include:
A.
Tetracyclines
B.
Aminoglycosides
C.
Quinolones
D.
Penicillins
Correct Answer
C. Quinolones
Explanation In addition to quinolines (DNA gyrase), sulfonamides/trimethoprim (folate synthesis) and rifampin (RNA polymerase).
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3.
Antibiotics that inhibit protein synthesis include:
A.
Tetracyclines
B.
Cephalosporins
C.
Quinolones
D.
Penicillins
Correct Answer
A. Tetracyclines
Explanation In addition to tetracyclines, macrolides, and clindamycin also inhibit protein synthesis.
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4.
What is the best choice of antibiotic for a patient with NKDA presenting with streptococcal pharyngitis?
A.
Doxycycline
B.
Azithromycin
C.
Ciprofloxacin
D.
Amoxicillin
Correct Answer
D. Amoxicillin
Explanation Amoxicillin is also effective against AOM, streptococcus pneumoniae, syphilis (treponema pallidum), and Lyme disease (b. burgdorferi).
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5.
Penicillin was discovered by __________ in 1928.
Correct Answer Alexander Fleming
Explanation Penicillin, the first widely used antibiotic, was discovered by Alexander Fleming in 1928. He observed that the mold Penicillium notatum produced a substance that killed a wide range of bacteria.
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6.
Which of the following is a serious side effect of amoxicillin?
A.
Elevated LFTs
B.
Seizures
C.
Thrombophlebitis
D.
Tendon rupture
Correct Answer
B. Seizures
Explanation Thrombocytopenia and pseudomembranous colitis are also serious side effects of amoxicillin.
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7.
Amoxicillin does not undergo renal excretion.
A.
True
B.
False
Correct Answer
B. False
Explanation Amoxicillin is renally excreted and also may decrease the efficacy of OCP.
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8.
Which of the following antibiotics should be prescribed for an infection resulting from a dog bite?
A.
Amoxicillin/clavulanate
B.
Doxycycline
C.
Trimethoprim/sulfamethoxazole
D.
Clindamycin
Correct Answer
A. Amoxicillin/clavulanate
Explanation The most likely pathogen is pasteurella.
Amoxicillin/clavulanate is also best for treating AOM, resistant sinus infections, diabetic ulcers, aspiration pneumonia, and animal and human bites.
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9.
Which of the following microorganisms is the most likely cause of an infected diabetic ulcer?
A.
Streptococcus
B.
Eikenella
C.
MRSA
D.
Pseudomonas
Correct Answer
D. Pseudomonas
Explanation treat with amoxicillin/clavulanate
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10.
Which of the following is a common side effect of amoxicillin/clavulanate?
A.
Elevated LFTs
B.
Neutropenia
C.
GI upset
D.
Headache
Correct Answer
C. GI upset
Explanation Other common side effects include hypersensitivity reaction and candidiasis.
Instruct patients to take with food or milk to decrease GI effects.
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11.
A patient presents with an infection in their cuticle area due to biting their nails. What do you prescribe?
A.
Amoxicillin
B.
Cephalexin
C.
Trimethoprim/sulfamethoxazole
D.
Ceftriaxone
Correct Answer
B. CepHalexin
Explanation Cephalexin is also used for surgical prophylaxis, staphylococcal endocarditis, and skin infections (ex: impetigo).
Explanation more serious side effects include neutropenia and pseudomembranous colitis.
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13.
Which antibiotic is best to prescribe for a patient presenting with gonorrhea?
A.
Vancomycin
B.
Nitrofurantoin
C.
Ceftriaxone
D.
Ciprofloxacin
Correct Answer
C. Ceftriaxone
Explanation Ceftriaxone is also effective against lower respiratory tract infections, pyelonephritis, Lyme disease, PID, and skin infections.
It covers gram + and has strong gram - coverage.
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14.
Which of the following antibiotics has a serious side effect of pseudomembranous colitis and has the strongest association with C. diff diarrhea?
A.
Vancomycin
B.
Azithromycin
C.
Metronidazole
D.
Ceftriaxone
Correct Answer
D. Ceftriaxone
Explanation Ceftriaxone is the correct answer because it has a serious side effect of pseudomembranous colitis, which is an inflammation of the colon caused by the bacteria Clostridium difficile (C. diff). This antibiotic is strongly associated with C. diff diarrhea, making it the most likely choice in this scenario. Vancomycin is also used to treat C. diff infections, but it does not have the same strong association as ceftriaxone. Azithromycin and metronidazole are not typically associated with pseudomembranous colitis or C. diff diarrhea.
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15.
Which of the following is consistent with the use of ceftriaxone?
A.
Caution with use in neonates
B.
Caution with use in the elderly
C.
Caution with use in those who take MVIs
D.
Not to be used in patients with severe renal dysfunction
Correct Answer
A. Caution with use in neonates
Explanation Ceftriaxone is a medication commonly used to treat bacterial infections. Neonates, or newborn babies, have immature liver and kidney function, which can affect the metabolism and excretion of drugs. Therefore, caution is advised when using ceftriaxone in neonates to avoid potential adverse effects or complications.
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16.
A patient admitted to the hospital is experiencing well demarcated erythema over their cheeks and nose. What do you prescribe for this condition?
A.
Penicillin
B.
Trimethoprim/sulfamethoxazole
C.
Vancomycin
D.
Doxycycline
Correct Answer
C. Vancomycin
Explanation This condition is known as erysipelas, a type of cellulitis.
Vancomycin is also effective for hospitalized patients being treated for MRSA pneumonia and bacteremia and C. diff associated diarrhea.
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17.
Which of the following antibiotics is known to cause "red man syndrome" after rapid IV infusion?
A.
Azithromycin
B.
Vancomycin
C.
Doxycycline
D.
Cephalexin
Correct Answer
B. Vancomycin
Explanation Other side effects of vancomycin include hypotension, fever, nephrotoxicity and thrombophlebitis.
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18.
A pediatric patient presents with what your preceptor describes as a "strawberry tongue" and a "sandpaper rash" on their forehead. What should you suggest be prescribed for this condition?
A.
Azithromycin
B.
Amoxicillin
C.
Ceftriaxone
D.
Vancomycin
Correct Answer
A. Azithromycin
Explanation The likely condition is scarlet fever.
Azithromycin is also used to treat walking pneumonia (M. pnumoniae), other CAPs (Chlamydia pnumoniae and Legionella pneumophilia), COPD exacerbations, bacterial bronchitis, pharyngitis (strep), sinusitis, AOM, pertussis (b. pertussis), PID, PUD
Azithromycin is also effective against M. catarrhalis, M. avium, Chlamydia, H. pylori and H. flu
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19.
Antibiotics are ineffective against __________ infections.
Correct Answer viral
Explanation Antibiotics are designed to target bacterial infections and are ineffective against viral infections, such as the common cold or influenza. Antiviral medications are required to treat viral infections.
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20.
A patient presents with a dental abscess. What is the best choice of antibiotic for this patient?
A.
Ciprofloxacin
B.
Trimethoprim/sulfamethoxazole
C.
Azithromycin
D.
Clindamycin
Correct Answer
D. Clindamycin
Explanation Clindamycin is also indicated for AOM, erysipelas, mastoiditis, skin and soft tissue infections, topical use for acne, and malaria (plasmodium)
*strep and staph infections
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21.
Name a serious side effect of clindamycin?
A.
Prolonged QT interval
B.
C. diff diarrhea
C.
Nephrotoxicity
D.
Hepatotoxicity
Correct Answer
B. C. diff diarrhea
Explanation Clindamycin may also cause thrombocytopenia.
More commonly Clindamycin causes N/V/D and rash.
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22.
A patient has just returned from a vacation to Cancun, Mexico. They are complaining of diarrhea that began after they drank a soda with ice cubes a restaurant the night before they boarded their flight home. What is the best antibiotic to prescribe for this patient?
A.
Ceftriaxone
B.
Vancomycin
C.
Metronidazole
D.
Ciprofloxacin
Correct Answer
D. Ciprofloxacin
Explanation In addition to most enteric GNRs (E.coli, proteus, klebsiella), ciprofloxacin is also effective against H. flu, pseudomonas, mycoplasma, chlamydia, and legionella and can be used to treat UTI, prostatitis, pyelonephritis, anthrax, CAP, chronic bronchitis, sinusitis, and epididymitis.
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23.
Which of the following antibiotics may cause a mental status change in the elderly?
A.
Vancomycin
B.
Ciprofloxacin
C.
Metronidazole
D.
Ceftriaxone
Correct Answer
B. Ciprofloxacin
Explanation Ciprofloxacin may also cause insomnia in younger patients, photosensitivity, tendon rupture, and prolonged QT interval
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24.
You have a patient who is leaving for a missions trip in Africa to treat patients with malaria and they would like antibiotic prophylaxis for their trip. What is the best antibiotic to prescribe for them?
A.
Clindamycin
B.
Trimethoprim/sulfamethoxazole
C.
Doxycycline
D.
Amoxicillin/clavulanate
Correct Answer
C. Doxycycline
Explanation Doxycycline is also used for acne vulgaris (P. acnes), syphilis (T. pallidum), urethritis, PID, epididymitis, atypical CAP, bacterial bronchitis, Lyme disease (B. burgdorferi), Rocky mountain spotted fever (rickettsia)
*other organisms include H. pylori, Chlamydia
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25.
What pregnancy category is doxycycline?
A.
A
B.
B
C.
C
D.
D
Correct Answer
D. D
Explanation Doxycycline is classified as pregnancy category D. This means that there is evidence of risk to the fetus based on human data, but the potential benefits of using the medication during pregnancy may outweigh the risks in certain situations. It is important to consult with a healthcare professional before taking doxycycline during pregnancy to weigh the potential risks and benefits.
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26.
Name a side effect of doxycycline.
Correct Answer headache, nausea, phototoxicity, C. diff diarrhea, hepatotoxicity
Explanation Doxycycline is a commonly used antibiotic that can have several side effects. Headache and nausea are common side effects that may occur during treatment. Phototoxicity is another potential side effect, where the skin becomes more sensitive to sunlight and can lead to sunburn or rash. C. diff diarrhea is a severe side effect that can occur when the normal balance of bacteria in the gut is disrupted, leading to an overgrowth of Clostridium difficile bacteria. Hepatotoxicity refers to liver damage that can occur with the use of doxycycline.
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27.
You should always take your doxy with calcium, iron, antacids and multivitamins.
A.
True
B.
False
Correct Answer
B. False
Explanation It is not recommended to take doxy with calcium, iron, antacids, and multivitamins because they can decrease the effectiveness of the medication. These substances can bind to doxy in the stomach and prevent its absorption into the bloodstream. It is best to take doxy on an empty stomach, at least 1-2 hours before or after consuming these products.
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28.
Which of the following antibiotics should be prescribed for treatment of an outpatient MRSA skin infection?
A.
Doxycycline
B.
Amoxicillin/clavulanate
C.
Metronidazole
D.
Trimethoprim/sulfamethoxazole
Correct Answer
D. Trimethoprim/sulfamethoxazole
Explanation Trimethoprim/sulfamethoxazole is also effective against UTI, traveler's diarrhea (E. coli, klebsiella, legionella), pneumocystis pneumonia (P. jirovecii)
*other organisms: H. flu, S. pneumoniae
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29.
Which of the following is a serious side effect of trimethoprim/sulfamethoxazole?
A.
Hepatotoxicity
B.
Bone marrow supression
C.
Leukopenia
D.
Insomnia
Correct Answer
B. Bone marrow supression
Explanation especially when treating pneumocystis infections
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30.
What is something important to consider when treating with trimethoprim/sulfamethoxazole?
A.
Renal excretion
B.
Caution with coumadin
C.
Caution with alcohol use
D.
Don't take with multivitamins
Correct Answer
B. Caution with coumadin
Explanation When treating with trimethoprim/sulfamethoxazole, it is important to exercise caution if the patient is also taking coumadin. This is because trimethoprim/sulfamethoxazole can increase the effects of coumadin, which is a blood thinner. Therefore, close monitoring of the patient's blood clotting time is necessary to prevent excessive bleeding.
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31.
What is the best choice of antibiotic for bacterial vaginosis (gardenerella)?
A.
Metronidazole
B.
Nitrofurantoin
C.
Amoxicillin/clavulanate
D.
Ciprofloxacin
Correct Answer
A. Metronidazole
Explanation Metronidazole is also effective for PID, amebiasis (giardiasis), trichomoniasis, C. diff, H. pylori, diverticulitis/appendicitis (mixed gram + and - anaerobes in the gut)
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32.
Which of the following antibiotics has a metallic taste and should not be taken with alcohol?
A.
Nitrofurantoin
B.
Ciprofloxacin
C.
Vancomycin
D.
Metronidazole
Correct Answer
D. Metronidazole
Explanation Metronidazole is the correct answer because it is known to cause a metallic taste in the mouth, which can be unpleasant. Additionally, metronidazole should not be taken with alcohol as it can cause a severe reaction known as the "disulfiram reaction," which includes symptoms such as flushing, nausea, vomiting, and increased heart rate. Therefore, it is important to avoid alcohol consumption while taking metronidazole to prevent these adverse effects.
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33.
The first line treatment for a pregnant patient with a UTI is:
A.
Metronidazole
B.
Nitrofurantoin
C.
Clindamycin
D.
Amoxicillin
Correct Answer
B. Nitrofurantoin
Explanation Uncomplicated UTIs are best treated and prevented with nitrofurantoin. It treats E. coli and Staphylococcus saprophyticus.
Explanation Metronidazole is an antibiotic commonly used to treat various infections. One serious side effect associated with its use is dose-related, reversible peripheral neuropathy. This means that the risk of developing nerve damage increases with higher doses of the medication. However, the good news is that this side effect is reversible, meaning that it can be resolved once the medication is discontinued or the dose is adjusted. It is important for healthcare providers to monitor patients closely when prescribing metronidazole to minimize the risk of this potential side effect.
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35.
Which of the following are side effects of nitrofurantoin?
A.
Fever
B.
C. diff diarrhea
C.
N/V/D
D.
All of the above
Correct Answer
D. All of the above
Explanation Nitrofurantoin may also cause rash and pneumonitis. Additionally, It should not be used in patients with significant renal dysfunction.
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