Chapter 30
Which of the following adverse effects is often employed as a therapeutic use for erythromycin?
A. QTc prolongation
B. Increased gastrointestinal motility
C. Photosensitivity
D. Deposition in bone
Increased gastrointestinal motility
A 32-year-old man presents to an outpatient clinic with a 5-day history of productive cough, purulent sputum, and shortness of breath. He is diagnosed with community-acquired pneumonia (CAP). It is noted that this patient has a severe ampicillin allergy (anaphylaxis). Which would be an acceptable treatment for this patient?
A. Levofloxacin
B. Ciprofloxacin
C. Penicillin VK
D. Nitrofurantoin
Levofloxacin
Which is a common adverse effect of cotrimoxazole?
A.Hyperkalemia
B. Pulmonary fibrosis
C. Tendon rupture
D. Blood glucose disturbances
Hyperkalemia
A 22-year-old female intravenous drug user was admitted to the hospital with a 4-week history of cough and fever. A chest radiograph showed left upper lobe cavitary infiltrate. Cultures of sputum yielded M. tuberculosis susceptible to all antimycobacterial drugs. The patient received self-administered isoniazid, rifampin, pyrazinamide, and ethambutol. Two weeks following initiation of therapy, the patient is concerned that her urine is a “funny-looking reddish color.” Which drug is the most likely cause?
A. Isoniazid
B. Rifampin
C. Pyrazinamide
D. Ethambutol
Rifampin
Which of the following describes the mechanism of action of tetracycline antibiotics?
A. Bind the 30S subunit of the bacterial ribosome, preventing binding of tRNA to the mRNA–ribosome complex.
B. Bind the 30S ribosomal subunit, interfering with assembly of the functional ribosomal apparatus.
C. Bind irreversibly to a site on the 50S subunit of the bacterial ribosome, inhibiting translocation steps of protein synthesis.
D. Bind the bacterial 23S ribosomal RNA of the 50S subunit, inhibiting the formation of the 70S initiation complex.
Bind the 30S subunit of the bacterial ribosome, preventing binding of tRNA to the mRNA–ribosome complex.
A 22-year-old woman presents with a 2-day history of dysuria with increased urinary frequency and urgency. A urine culture and urinalysis are done. She is diagnosed with a urinary tract infection caused by E. coli. Which agent should be avoided in the treatment of her UTI?
A. Levofloxacin
B. Cotrimoxazole
C. Moxifloxacin
D. Nitrofurantoin
Moxifloxacin
A 21-year-old marathon runner reports to the clinic with acute Achilles tendon rupture. The nurse noted that the patient recently took an antibiotic for community-acquired pneumonia. Which antibiotic may have contributed to tendon rupture?
A. Amoxicillin/clavulanate
B. Cefdinir
C. Levofloxacin
D. Minocycline
Levofloxacin
A 32-year-old man has been on standard four-drug therapy for active pulmonary tuberculosis for the past 2 months. He has no other comorbid conditions. At his regular clinic visit, he complains of a “pins and needles” sensation in his feet. Which drug is most likely causing this?
A. Isoniazid
B. Rifampin
C. Pyrazinamide
D. Ethambutol
Isoniazid
Linezolid would be a good choice for antibiotic treatment in which of the following patient scenarios?
A. Bacteremia caused by Staphylococcus aureus
B. Urinary tract infection caused by Escherichia coli
C. Pneumonia caused by drug-resistant Streptococcus pneumoniae
D. Diabetic foot infection caused by Pseudomonas aeruginosa
Pneumonia caused by drug-resistant Streptococcus pneumoniae
Which drug is correctly matched with the appropriate adverse effect?
A.Levofloxacin—hyperkalemia
B. Nitrofurantoin—pulmonary fibrosis
C. Cotrimoxazole—hepatic encephalopathy
D. Methenamine—nystagmus
Nitrofurantoin—pulmonary fibrosis
A 70-year-old woman with acute cystitis presents to the Family Medicine clinic for assessment. She has a past medical history of hypertension and chronic kidney disease. The team recommends initiation of nitrofurantoin for cystitis. After reviewing her antimicrobial therapy, which actions should be taken prior to clinic discharge?
A. Continue current therapy and counsel on gastrointestinal effects of nitrofurantoin.
B. Change nitrofurantoin to alternative agent due to chronic kidney disease.
C. Reduce nitrofurantoin dose due to impaired renal function.
D. Counsel patient regarding neuropathy associated with short-term therapy.
Change nitrofurantoin to alternative agent due to chronic kidney disease.
After 5 days of clindamycin treatment for a skin infection, a patient develops diarrhea (10 watery stools/day), severe abdominal pain, and fever. Which of the following organisms would you be concerned about as the causative pathogen of diarrhea?
A. Escherichia coli
B. Bacteroides fragilis
C. Staphylococcus aureus
D. Clostridium difficile
Clostridium difficile
Cotrimoxazole provides activity against which organism?
A. MRSA
B. Pseudomonas aeruginosa
C. Anaerobes
D. Mycoplasma
MRSA
Which of the following statements accurately describes the difference in spectrum of activity between erythromycin and azithromycin?
A. Azithromycin has better activity against respiratory pathogens such as Haemophilusinfluenzae and Moraxella catarrhalis but less potent activity against staphylococci and streptococci.
B. Erythromycin has the same activity as azithromycin against gram-positives and gram-negatives.
C. Azithromycin has better activity against staphylococci and streptococci compared to erythromycin.
D. Erythromycin has better activity against gram-negatives such as H. influenza.
Azithromycin has better activity against respiratory pathogens such as Haemophilus influenzae and Moraxella catarrhalis but less potent activity against staphylococci and streptococci.
A 55-year-old man presents to primary care clinic with an erythematous and tender abscess on his left thigh. He has a history of MRSA skin infections. Which is an appropriate antibiotic for empiric treatment?
A. Ciprofloxacin
B. Cotrimoxazole
C. Pyrimethamine
D. Cephalexin
Cotrimoxazole