Introduction to Antimicrobials

Question 1

Mordant for Gram staining

Answer 1

Iodine

Question 2

Class of antimicrobials that has no effect on anaerobes since it needs to enter the cell wall via an oxygen dependent process

Answer 2

Aminoglycoside

Question 3

Space between the outer envelope and peptidoglycan

Answer 3

periplasmic space

Question 4

Which of the following is the target of aminoglycosides?
A. Bacterial cell wall synthesizing enzymes
B. Bacterial ribosomes
C. Enzymes for nucleotide synthesis and DNA replication
D. Viral replication machinery

Answer 4

B. Aminoglycosides and tetracycline targets the 30s subunit

Question 5

Which of the following targets enzymes required for nucleotide synthesis and DNA replication?
A. Streptomycin
B. Lincosamides
C. Streptogramin
D. Quinolones

Answer 5

D. Quinolones and Sulfa drugs target enzymes for nucleotide synthesis and DNA replication

Streptomycin, Macrolides, Lincosamides, Streptogramin all target the 50s subunit ribosome

Question 6

Which of the following is the target of Beta-lactams?
A. Bacterial cell wall synthesizing enzymes
B. Bacterial ribosomes
C. Enzymes for nucleotide synthesis and DNA replication
D. Viral replication machinery

Answer 6

A. Beta-lactams penetrate peptidoglycan layer of gram-positive organisms

Question 7

Better choice of antimicrobial for life-threatening infections in immunocompromised patients
(Bactericidal or bacteriostatic)

Answer 7

bactericidal

Question 8

Which antimicrobial has more chances of developing ADRs?
(Absorbable or non-absorbable)

Answer 8

absorbable

Question 9

Concentration of drug required to kill the organism

Answer 9

Minimal bactericidal concentration

Question 10

Increasing the concentration drug increases the extent and rate of microbial killing

Answer 10

Concentration-dependent antibiotics

Question 11

Concentration of drug required to inhibit growth of the organism

Answer 11

Minimal inhibitory concentration

Question 12

Bactericidal activity continues as long as serum concentrations are greater than the MBC

Answer 12

Time-dependent antibiotics

Question 13

Persistent suppression of bacterial growth after limited exposure to an antimicrobial agent

Answer 13

Postantibiotic effect

Question 14

Macrolides were found to have increased the susceptibility of bacteria to activity of leukocytes. This is known as:

Answer 14

Postantibiotic leukocyte enhancing effect (PALE)

Question 15

T>MIC is expressed in what unit?

Answer 15

percentage

Question 16

Which of the following is T>MIC at least 40-50% of dosing interval but with minimal or no PAE effects?
A. Beta-lactams
B. Macrolides
C. Clindamycin
D. AOTA

Answer 16

D. AOTA

Question 17

T/F: IV drugs usually have 100% bioavailability

Answer 17

true

Question 18

This reflects the actual body exposure to drug after administration of a dose of the drug and is expressed in mg*h/L.

Answer 18

Area under the curve (AUC)

Question 19

AUC is dependent on (2):

Answer 19

Rate of elimination and Dose administered

Question 20

This pertains to medical treatment based on possible etiology of infection without direct evidence of what type of bacteria is present

Answer 20

Empiric therapy

Question 21

T/F:
Azalides and Oxazolidenons follows a time-dependent killing with a moderate to persistent PAE

Answer 21

True
Azalides (azithromycin)
Oxazolidinons (linezolid)

Question 22

Which of the two has activity against anaerobes as it needs a reduced, devoid of oxygen, environment to gain access to bacterial cell?
(Metronidazole or Aminoglycoside)

Answer 22

Metronidazole

Question 23

T/F:
Nafcillin, a pencillinase-resistant penicillin, is frequently used for treatment of staphylococcal infections in hemodialysis patients.

Answer 23

T: Unlike other penicillins, nafcillin exhibits primarily hepatic clearance rather than renal clearance.

Question 24

Which among the third generation cephalosporins has a dual route of elimination?
A. Ceftriaxone
B. Ceftazidime
C. Cefotaxime

Answer 24

A. Ceftriaxone

Question 25

T/F: Monotherapy is preferred in patients with Pulmonary TB

Answer 25

False

Question 26

T/F: Vancomycin level are expected to be decreased in hemodialysis patients

Answer 26

T

Question 27

Conversion of IV medication to a PO equivalent within the same class and has the same level of potency, but of a different compound
A. Oral switch
B. Step-down
C. Sequential therapy

Answer 27

A. Oral switch

Question 28

Conversion from an injectable medication to an oral agent in another class
A. Oral switch
B. Step-down
C. Sequential therapy

Answer 28

B. Step-down

Question 29

Act of replacing a parenteral version of a medication with its oral counterpart of the same compound
A. Oral switch
B. Step-down
C. Sequential therapy

Answer 29

C. Sequential therapy

Question 30

T/F:
If procalcitonin starts to go up, antibiotics can be stopped

Answer 30

F:
procalcitonin should decrease to warrant discontinuation of antibiotics

Question 31

T/F:
Antifungals target ergosterol or ergosterol synthesis

Answer 31

T

Question 32

Pattern of antimicrobial activity of Carbapenems
A. Type I
B. Type II
C. Type III

Answer 32

B. Type II: T>MIC (Time-dependent killing with minimal PAE)
CCELP (Carbapenem, Cephalosporin, Erythromycin, Penicillin)

Question 33

Pattern of antimicrobial activity of Ketolides
A. Type I
B. Type II
C. Type III

Answer 33

A. Type I: Concentration-dependent killing
ADFK (aminoglycoside, daptomycin, fluoroquinolones, ketoldies)

Question 34

Pattern of antimicrobial activity of Carbapenems
A. Type I
B. Type II
C. Type III

Answer 34

C. Type III: 24h-AUC/MIC (Time-dependent killing with moderate to prolonged PAE)
OCTAV (Oxazolidinone, Clindamycin, Tetracycline, Azithromycin, Vancomycin)

Question 35

The goal of therapy for 24h-AUC/MIC is to maximize the:

Answer 35

amount of drug