1. A 30 year old female patient presents to her primary care physician with recurrent bacterial cystitis, cultured for proteus sp, from the bladder, the physician starts her on amikacin (aminoglycoside) which of the following best describes the mechanism of action of the drug.
A. Inhibition of cell wall synthesis by blocking transpeptidation of peptidoglycan.
B. Disruption of bacterial cell wall by pore formation.
C. Binding of bacterial 30 S ribosomal subunit and blocking bacterial protein synthesis.
D. Binding of bacterial 50 S ribosomal subunit and blocking bacterial protein synthesis.
2. A 32 year old Caucasian male patient suffering from HIV is on acyclovir for a herpes simplex infection, the patient develops toxicity, hence what be the clinical signs seen and what adjustments are to be made to the current regime.
A. Acute Hepatotoxicity, stop acyclovir administration and start supportive care.
B. Acute renal disease, administer probenecid concomitantly with acyclovir.
C. neurologic disorders, stop acyclovir administration and start anticonvulsant therapy as needed.
D. Hepatoencephalopathy, stop acyclovir administration and start anticonvulsant therapy and antiemetics as needed.
3. A 46 year old immigrant from india comes to office after noting hypopigmented anesthetic patch on his back. On further examination the physician discover bilaterally thickened ulnar nerves. Skin biopsy reveals numerous acid fast bacilli and negative lepromin test. What combination of drugs is best recommended for the patient.
A. Isoniazid, rifampin, dapsone
B. ethambutol, Isoniazid, clofazimine
C. pyrazinamide, Isoniazid, rifampin
D. ethambutol, Dapsone, clofazimine
E. Dapsone, clofazimine, rifampin.
4. A 28 year old immmuno compromised patient presents to the physician with cryptococcal meningitis, which of the following antifungal agents can be used safely in this patient despite hepatic failure.
A. miconazole
B. ketoconazole
C. Amphotericin B
D. flucytosine
E. itraconazole
5. A 40 year old patient presents in the emergency room with intense ocular itching and increased sensitivity, he reports he has been using a topical preparation for an eye infection prescribed by his ophthalmologist for keratitis. Which of the following drug was he most likely using.
A. Amphotericin B
B. Amantadine
C. Zidovudine
D. idoxuridine
E. acyclovir
6. A 24 year old man presents with painful blisters at right angle of his mouth for 2 days. He has had tingling and burning sensations at the site for 4-5 days. Has no significant past history. On examination the physician finds the temperature to be 99.5F and other vital signs to be normal multiple small vesicles are found at right angle of his mouth and no such lesions elsewhere what would be the drug of choice for the treatment for this condition.
A. Zidovudine
B. Amantadine
C. acyclovir
D. interferon
7. The physician explains to 40 year old patient that one of the drugs he is going to take is cephalosporin A. The physician explains that cephalosporin A is a useful drug for patients with organ transplants because
A. the drug acts as an immunosuppressant
B. it is an anti fungal agent
C. the drug increases antigen in circulation
D. it is a powerful antibiotic
E. increases the level of interleukin-2
8. A 26 year old sexually active woman was diagnosed to have tuberculosis and was put on therapy immediately, the physician advises her to use another form of contraceptive in addition to oral contraceptive pills that she taking then this is because
A. streptomycin is teratogenic
B. rifampin stimulates the liver microsomal enzymes
C. INH stimulates ovulation
D. INH is hepatotoxic
E. ethambutol potentiates side effects of OCP
9. Tetracyclines display broad-spectrum activity and are Effective against both gram-positive and gram-negative bacteria, including atypical microorganisms , the antimicrobial activity of tetracyclines involve which of the following mechanisms
A. inhibition of DNA gyrase.
B. Block the attachment of aminoacyl tRNA to acceptor site.
C. inhibition of bacterial cell synthesis
D. inhibition of microbial protein synthesis
E. both B and D.
10. A 32 year old Caucasian male patient suffering from HIV is on acyclovir for a herpes simplex infection, the patient does not respond to acyclovir which of the following is best likely reason.
A. the defective expression of cellular kinase
B. the herpes virus encoded DNA polymerase is inhibited by acyclovir
C. The herpes virus strain is defective for thymidine kinase expression
D. the HIV patients with genital herpes do not respond to acyclovir
Answers: 1. C, 2. B, 3. E, 4. D, 5. D, 6. C, 7. A, 8. B, 9. E, 10. C
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