AMR Fundamentals
Antibiotics should only be used to treat infections caused by:
A. Viruses
B. Bacteria
C. Parasites
D. Allergies
Which mechanism allows bacteria to survive antibiotic exposure?
A. Freezing temperatures
B. Developing or acquiring resistance genes that neutralize or evade the antibiotic’s action
C. Becoming dormant viruses
D. Producing vitamins
B. Developing or acquiring resistance genes that neutralize or evade the antibiotic’s action
“Superbugs” in hospitals are dangerous because they:
A. Are visible to the naked eye
B. Cause allergies
C. Resist multiple antibiotics, making infections harder to treat
D. Only infect animals
C. Resist multiple antibiotics, making infections harder to treat
Which everyday practice reduces infection and antibiotic need?
A. Skipping meals
B. Handwashing with soap and water regularly
C. Drinking more coffee
D. Using leftover antibiotics
B. Handwashing with soap and water regularly
In which environmental hotspot do resistant bacteria and antibiotic residues often accumulate?
A. Frozen mountain lakes
B. Properly chlorinated pools
C. Wastewater from hospitals, farms, and pharmaceutical factories
D. Sealed bottled water
C. Wastewater from hospitals, farms, and pharmaceutical factories
Using antibiotics to treat viral illnesses like the flu is considered a misuse. What negative consequence does this practice have on public health?
A. It strengthens the virus, making the illness last longer.
B. It leads to the unnecessary exposure of bacteria (both good and bad) to the drug, accelerating the development of antimicrobial resistance (AMR).
C. It causes immediate and severe allergic reactions in the majority of patients.
D. It delays the production of new antiviral medications by pharmaceutical companies.
B. It leads to the unnecessary exposure of bacteria (both good and bad) to the drug, accelerating the development of antimicrobial resistance (AMR).
Which process enables rapid spread of AMR genes between different bacterial species?
A. Vertical transmission only
B. Slow chromosomal mutation
C. Horizontal gene transfer via plasmids, transposons, and phages
D. Host immunity
C. Horizontal gene transfer via plasmids, transposons, and phages
Which patient population is MOST vulnerable to AMR complications?
A. Healthy athletes
B. Children with viral fevers
C. ICU patients requiring invasive devices (ventilators, catheters) and immunocompromised individuals
D. People with minor injuries
C. ICU patients requiring invasive devices (ventilators, catheters) and immunocompromised individuals
What is the MAIN benefit of wastewater treatment for AMR control?
A. Enhancing natural bacteria
B. Removing resistant bacteria and antibiotic residues to prevent environmental spread of resistance genes
C. Creating stronger antibiotics
D. Purifying water for antibiotic production
B. Removing resistant bacteria and antibiotic residues to prevent environmental spread of resistance genes
In One Health surveillance, the principal advantage of integrating human, animal, and environmental AMR data is:
A. Lowering laboratory costs by merging budgets
B. Enabling detection of shared resistance determinants and transmission pathways across sectors
C. Eliminating the need for clinical diagnostics
D. Ensuring identical treatment guidelines for humans and animals
Answer: B.
Explanation: Integrated surveillance helps identify cross-sector transmission and shared resistance mechanisms for coordinated interventions.
What is the primary risk to public and individual health when a patient discontinues their prescribed antibiotic course prematurely?
A. The immune system is weakened, making future infections harder to fight.
B. The remaining, less susceptible bacteria survive and have a chance to develop and spread resistance.
C. The body develops a tolerance, requiring higher future doses of the same drug.
D. The infection immediately resolves, but side effects are unnecessarily prolonged.
B. The remaining, less susceptible bacteria survive and have a chance to develop and spread resistance.
A bacterium produces β-lactamase enzymes. This is an example of which resistance strategy?
A. Altering host immunity
B. Enzymatic degradation of antibiotics before they reach their target site
C. Viral transformation
D. Mutating the human immune cells
B. Enzymatic degradation of antibiotics before they reach their target site
Which bacteria commonly cause high-burden, drug-resistant hospital infections?
A. MRSA and Carbapenem-resistant Enterobacteriaceae (CRE)
B. Lactobacillus and Bifidobacterium
C. Common cold viruses
D. Fungi only
A. MRSA and Carbapenem-resistant Enterobacteriaceae (CRE)
What is the purpose of antimicrobial stewardship?
A. To reduce drug prices
B. To optimize antibiotic use and prevent resistance while ensuring best patient outcomes
C. To replace doctors
D. To eliminate all microbes
B. To optimize antibiotic use and prevent resistance while ensuring best patient outcomes
Which practice on farms BEST reduces AMR?
A. Increasing antibiotic growth promoters
B. Routine prophylactic antibiotic mixing in feed
C. Strong biosecurity (clean housing, vaccination, hygiene) to reduce infection and antibiotic need
D. Leaving animal waste in open fields
C. Strong biosecurity (clean housing, vaccination, hygiene) to reduce infection and antibiotic need
Which of these is the MOST accurate indicator of inappropriate antibiotic use in a community?
A. Number of pharmacies selling cold medications
B. High vaccination rates
C. High levels of non-prescription antibiotic purchases and incomplete courses among households
D. Increased handwashing behaviour
C. High levels of non-prescription antibiotic purchases and incomplete courses among households
The vast majority of naturally derived antibiotics used in medicine today are produced by members of which microbial group?
A. Cyanobacteria
B. Single-celled Fungi (Yeasts)
C. Actinobacteria
D. Archaea
C. Actinobacteria
If carbapenem-resistant organisms (CROs) increase, what is the major clinical risk?
A. No antibiotics remain effective, leading to high mortality in severe infections
B. More antibiotics become available
C. Viruses mutate faster
D. Hospitals become cleaner
A. No antibiotics remain effective, leading to high mortality in severe infections
What is an example of a stewardship intervention?
A. Prescribing antibiotics for all fevers
B. Pre-authorization for certain high-risk antibiotics before dispensing them
C. Selling antibiotics over-the-counter
D. Doubling antibiotic doses for safety
B. Pre-authorization for certain high-risk antibiotics before dispensing them
What is the biggest challenge in controlling AMR through a One Health approach?
A. Availability of vaccines
B. The lack of connection between sectors, meaning actions in humans may fail if agriculture or environmental controls are weak
C. Limited funding
D. Antibiotic prices
B. The lack of connection between sectors, meaning actions in humans may fail if agriculture or environmental controls are weak
Which of these is the MOST accurate indicator of inappropriate antibiotic use in a community?
A. Number of pharmacies selling cold medications
B. High vaccination rates
C. High levels of non-prescription antibiotic purchases and incomplete courses among households
D. Increased handwashing behaviour
C. High levels of non-prescription antibiotic purchases and incomplete courses among households
What is the “mutant selection window”?
A. The temperature range where microbes mutate
B. The antibiotic concentration range that kills all bacteria quickly
C. The suboptimal drug concentration range that encourages survival of partially resistant mutants
D. A genetic editing tool
C. The suboptimal drug concentration range that encourages survival of partially resistant mutants
In a hospital outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP), whole-genome sequencing (WGS) reveals multiple isolates with identical resistance genes but different plasmid backbones. What does this most strongly suggest about the outbreak dynamics?
A. A single patient is transmitting the same strain to others
B. Resistance arose independently in each patient due to carbapenem use
C. Horizontal transfer of resistance genes across different Klebsiella strains or species via mobile genetic elements, indicating gene-level rather than strain-level transmission within the hospital ecosystem
D. The sequencing results are likely contaminated and unreliable
C. Horizontal transfer of resistance genes across different Klebsiella strains or species via mobile genetic elements, indicating gene-level rather than strain-level transmission within the hospital ecosystem
What does an antibiogram help clinicians do?
A. Increase use of broad-spectrum antibiotics
B. Track medication costs
C. Choose empiric antibiotics based on local susceptibility patterns to reduce treatment failure and resistance selection
D. Replace diagnostic labs
C. Choose empiric antibiotics based on local susceptibility patterns to reduce treatment failure and resistance selection
Which mechanism best explains how environmental bacteria can indirectly accelerate the emergence of clinically significant AMR in humans—even if the environmental species themselves never cause infections?
A. Environmental bacteria compete with pathogens, preventing their growth
B. Environmental microbes act as reservoirs of resistance genes that can be transferred to human and animal pathogens via mobile genetic elements (e.g., integrons, plasmids) under antibiotic selection pressure in soil and water ecosystems
C. Environmental bacteria evolve resistance only when ingested by humans
D. Environmental bacteria neutralise antibiotics and make them ineffective in the human body
B. Environmental microbes act as reservoirs of resistance genes that can be transferred to human and animal pathogens via mobile genetic elements (e.g., integrons, plasmids) under antibiotic selection pressure in soil and water ecosystems