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  • Question 1 - Regarding macrolide antibiotics, which of the following statements is CORRECT: ...

    Correct

    • Regarding macrolide antibiotics, which of the following statements is CORRECT:

      Your Answer: Macrolides are first line for treatment of whooping cough.

      Explanation:

      A macrolide antibiotic is recommended first line for whooping cough (if onset of cough is within the previous 21 days)
      Prescribe clarithromycin for infants less than 1 month of age.
      Prescribe azithromycin or clarithromycin for children aged 1 month or older, and non-pregnant adults.
      Prescribe erythromycin for pregnant women.
      Macrolides interfere with bacterial protein synthesis and are mainly active against Gram-positive organisms. They have a similar antibacterial spectrum to penicillin and are thus a useful alternative in penicillin-allergic patients. Erythromycin is commonly associated with gastrointestinal upset.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      11.7
      Seconds

  • Question 2 - A 30-year-old woman presents with a history of fever and sore throat. On...

    Correct

    • A 30-year-old woman presents with a history of fever and sore throat. On examination, there is tonsillar exudate and cervical lymphadenopathy and a diagnosis of tonsillitis is made. A course of penicillin is prescribed.

      What is the mechanism of action of penicillin?

      Your Answer: Inhibition of cell wall synthesis

      Explanation:

      Penicillin is bactericidal and produces its antimicrobial action by preventing cross-linkage between the linear peptidoglycan polymer chains that make up the bacterial cell wall. This action inhibits cell wall synthesis.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      17.2
      Seconds

  • Question 3 - In a ward round, you come across a patient's treatment chart prescribed an...

    Correct

    • In a ward round, you come across a patient's treatment chart prescribed an antibiotic to fight his infection. This antibiotic is a protein synthesis inhibitor.

      Which of the following antimicrobial drugs is prescribed to this patient?

      Your Answer: Gentamicin

      Explanation:

      Gentamicin, an aminoglycoside antibiotic, acts by binding to the 30S subunit of the bacterial ribosome inhibiting the binding of aminoacyl-tRNA and thus preventing initiation of protein synthesis.

      Vancomycin inhibits cell wall peptidoglycan formation by binding the D-Ala-D-Ala portion of cell wall precursors.

      Penicillins and cephalosporins are the major antibiotics that inhibit bacterial cell wall synthesis. They inactivate transpeptidases that help cross-link peptidoglycans in cell walls.

      Metronidazole and the other 5-nitroimidazole agents inhibit nucleic acid synthesis by forming toxic free radical metabolites in the bacterial cell that damage DNA.

      Ciprofloxacin inhibits prokaryotic enzymes topoisomerase II (DNA gyrase) and topoisomerase IV.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      11
      Seconds

  • Question 4 - Regarding drug interactions with erythromycin, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding drug interactions with erythromycin, which of the following statements is INCORRECT:

      Your Answer: Erythromycin increases the risk of QT-interval prolongation in patients taking drugs that increase the QT interval.

      Correct Answer: Erythromycin decreases plasma levels of warfarin.

      Explanation:

      Erythromycin and clarithromycin inhibit cytochrome P450-mediated metabolism of warfarin, phenytoin and carbamazepine and may lead to accumulation of these drugs. There is an increased risk of myopathy (due to cytochrome P450 enzyme CYP3A4 inhibition) if erythromycin or clarithromycin is taken with atorvastatin or simvastatin. Erythromycin increases plasma concentrations of theophylline, and theophylline may also reduce absorption of oral erythromycin. All macrolides can prolong the QT-interval and concomitant use of drugs that prolong the QT interval is not recommended.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      21.6
      Seconds

  • Question 5 - A 6-year-old child with a few itchy honey crusted sores on her left...

    Incorrect

    • A 6-year-old child with a few itchy honey crusted sores on her left cheek is brought in by her mother. Following a thorough examination of the child, you diagnose impetigo and recommend a course of topical fusidic acid.

      Fusidic acid's mode of action is which of the following?

      Your Answer: Inhibition of cell wall synthesis

      Correct Answer: Inhibition of protein synthesis

      Explanation:

      By binding EF-G-GDP, fusidic acid prevents both peptide translocation and ribosome disassembly, which slows protein synthesis. Because it has a novel structure and mechanism of action, it is unlikely to cause cross-resistance with existing antibiotics.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      38.5
      Seconds

  • Question 6 - A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a...

    Correct

    • A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a course of antibiotics

      Which of the antibiotics listed below is MOST likely to be the cause? 

      Your Answer: Ciprofloxacin

      Explanation:

      Tendinopathy and spontaneous tendon rupture are caused by fluoroquinolones, which are an uncommon but well-known cause. Tendon problems caused by fluoroquinolones are expected to affect 15 to 20 people per 100,000. Patients over the age of 60 are most likely to develop them.

      It usually affects the Achilles tendon, but it has also been described in cases involving the quadriceps, peroneus brevis, extensor pollicis longus, long head of biceps brachii, and rotator cuff tendons. The exact aetiology is uncertain, although the fluoroquinolone medication is thought to obstruct collagen activity and/or cut off blood supply to the tendon.

      Other factors linked to tendon rupture spontaneously include:
      Gout
      Treatment with corticosteroids
      Hypercholesterolaemia
      Long-term dialysis
      Kidney transplant
      Rheumatoid arthritis 

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      4.4
      Seconds

  • Question 7 - Fusidic acid is primarily indicated for infections caused by which of the following...

    Correct

    • Fusidic acid is primarily indicated for infections caused by which of the following microorganisms:

      Your Answer: Staphylococcal infections

      Explanation:

      Fusidic acid is a narrow spectrum antibiotic used for staphylococcal infections, primarily topically for minor staphylococcal skin (impetigo) or eye infection. It is sometimes used orally for penicillin-resistant staphylococcal infection, including osteomyelitis or endocarditis, in combination with other antibacterials.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      5.8
      Seconds

  • Question 8 - Flucloxacillin is used first line for all of the following infections EXCEPT for:...

    Correct

    • Flucloxacillin is used first line for all of the following infections EXCEPT for:

      Your Answer: Otitis media

      Explanation:

      Flucloxacillin is used first line for treatment of widespread impetigo infection, cellulitis, mastitis, osteomyelitis, septic arthritis, severe erysipelas, severe/spreading otitis externa and infective endocarditis caused by staphylococci. Amoxicillin is first line for acute otitis media.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      4.4
      Seconds

  • Question 9 - You review a patient with urinary sepsis and decide to start her...

    Correct

    • You review a patient with urinary sepsis and decide to start her on gentamicin.

      Which statement about gentamicin is true?

      Your Answer: Ototoxicity is a dose-related effect

      Explanation:

      Gentamicin, an aminoglycoside antibiotic, acts by binding to the 30S subunit of the bacterial ribosome inhibiting the binding of aminoacyl-tRNA, and thus prevents initiation of protein synthesis.

      Gentamicin is given by injection because it is NOT absorbed orally.

      It is excreted in the kidneys by glomerular filtration

      Gentamicin is not to be used for the treatment of Neisseria meningitidis, Neisseria gonorrhoea, or Legionella pneumophila.There is a risk of patient going into shock from lipid A endotoxin release.

      Two of its most notable side effects are hearing loss reversible nephrotoxicity and which are both dose-related and levels should be monitored in patients.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      8.4
      Seconds

  • Question 10 - You need to give your patient antibiotics, so you call microbiology for some advice.

    Of...

    Incorrect

    • You need to give your patient antibiotics, so you call microbiology for some advice.

      Of the following antibacterial drugs, which of them is a protein synthesis inhibitor?

      Your Answer: Metronidazole

      Correct Answer: Erythromycin

      Explanation:

      Bacteriostatic antibiotics include erythromycin and other macrolides. They work by attaching to the bacterial ribosome’s 50S subunit, preventing translocation and, as a result, inhibit protein synthesis. Macrolide antibiotics are actively concentrated inside leukocytes and delivered into the infection site as a result.

      Action Mechanisms- Examples:

      Cell wall production is inhibited
      Vancomycin
      Vancomycin
      Cephalosporins

      The function of the cell membrane is disrupted
      Nystatin
      Polymyxins
      Amphotericin B

      Inhibition of protein synthesis
      Chloramphenicol
      Macrolides
      Aminoglycosides
      Tetracyclines

      Nucleic acid synthesis inhibition
      Quinolones
      Trimethoprim
      Rifampicin
      5-nitroimidazoles
      Sulphonamides
      Anti-metabolic activity
      Isoniazid

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      10.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Infections (7/10) 70%
Pharmacology (7/10) 70%
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