M6: Microbiology, Parasitology, and Public Health - Bacteriology - Part 7 - Antibacterials

Antibacterial mechanism except:

a. Cell wall synthesis inhibition

b. Protein synthesis inhibition

c. Folic acid synthesis inhibition

d. Topoisomerase inhibition

e. None

e. None

Cell wall synthesis inhibitor:

I. Penicillin

II. Cephalosporin

III. Carbapenems

IV. Monobactam

V. Glycopeptides

a. I, II, III, IV, V

b. I, II

c. III, IV, V

d. I, II, III

a. I, II, III, IV, V

Has time dependent killing through binding to protein binding protein inhibiting transpeptidation which is important for cross linking.

a. Penicillin

b. Cephalosporin

c. Carbapenems

d. Monobactam

e. Glycopeptides

a. Penicillin

All penicillins have similar mechanism of action and most common adverse effects include allergy and GI disturbance.

a. True

b. False

a. True

Narrow spectrum penicillin which are natural include:

a. Pen G

b. Pen V

c. Benzathine Penicillin

d. a and b

e. All

e. All

Can be given IM/IV.

a. Pen G

b. Pen V

c. Benzathine Penicillin

d. a and b

e. All

a. Pen G

Can be given PO.

a. Pen G

b. Pen V

c. Benzathine Penicillin

d. a and b

e. All

b. Pen V

Can be given IM.

a. Pen G

b. Pen V

c. Benzathine Penicillin

d. a and b

e. All

c. Benzathine Penicillin

Benzylpenicillin.

a. Pen G

b. Pen V

c. Benzathine Penicillin

d. a and b

e. All

a. Pen G

Phenoxybenzylpenicillin.

a. Pen G

b. Pen V

c. Benzathine Penicillin

d. a and b

e. All

b. Pen V

Conjugated, longer half life, repository form of penicillin.

a. Pen G

b. Pen V

c. Benzathine Penicillin

d. a and b

e. All

e. All

Only effective for methicillin susceptible S. aureus (MSSA)

a. Natural penicillin

b. Penicillinase resistant

c. Broad spectrum

d. Beta lactamase inhibitor

b. Penicillinase resistant - or Antistaphylococcal penicillin

Penicillinase resistant or antistaphylococcal penicillin.

a. Methicillin

b. Nafcillin

c. Oxacillin

d. a and b

e. b and c

f. All

f. All

Not used because it is nephrotoxic.

a. Methicillin

b. Nafcillin

c. Oxacillin

d. a and b

e. b and c

f. All

a. Methicillin

Not used because it causes rash.

a. Methicillin

b. Nafcillin

c. Oxacillin

d. a and b

e. b and c

f. All

b. Nafcillin

Mostly used.

a. Methicillin

b. Nafcillin

c. Oxacillin

d. a and b

e. b and c

f. All

c. Oxacillin - with derivatives such as cloxacillin, dicloxacillin

Broad spectrum penicillin:

a. Aminopenicillin

b. Antipseudomonal

c. Both

d. None of these

c. Both

Broad spectrum penicillin:

I. Amoxicillin

II. Ampicillin

III. Ticarcillin

IV. Carbenicillin

V. Piperacillin

VI. Azlocillin

VII. Mezlocillin

a. I, II, III, IV, V, VI, VII

b. III, IV, V, VI, VI

c. I, II

d. III, IV

e. V, VI, VII

a. I, II, III, IV, V, VI, VII

Broad spectrum aminopenicillin.

I. Amoxicillin

II. Ampicillin

III. Ticarcillin

IV. Carbenicillin

V. Piperacillin

VI. Azlocillin

VII. Mezlocillin

a. I, II, III, IV, V, VI, VII

b. III, IV, V, VI, VI

c. I, II

d. III, IV

e. V, VI, VII

c. I, II

Aminopenicillin

• Amoxicillin

• Ampicillin

Most stable oral aminopenicillin that can be given with or without food.

a. Amoxicillin

b. Ampicillin

c. Ticarcillin

d. Carbenicillin

a. Amoxicillin

Parenteral aminopenicillin that is one of the antibiotics that can cause pseudomembranous colitis.

a. Amoxicillin

b. Ampicillin

c. Ticarcillin

d. Carbenicillin

b. Ampicillin

Antipseudomonal penicillin:

I. Amoxicillin

II. Ampicillin

III. Ticarcillin

IV. Carbenicillin

V. Piperacillin

VI. Azlocillin

VII. Mezlocillin

a. I, II, III, IV, V, VI, VII

b. III, IV, V, VI, VI

c. I, II

d. III, IV

e. V, VI, VII

b. III, IV, V, VI, VI

Antipseudomonal

• Ticarcillin

• Carbenicillin

• Piperacillin

• Azlocillin

• Mezlocillin

Antipseudomonal carboxypenicillin:

I. Amoxicillin

II. Ampicillin

III. Ticarcillin

IV. Carbenicillin

V. Piperacillin

VI. Azlocillin

VII. Mezlocillin

a. I, II, III, IV, V, VI, VII

b. III, IV, V, VI, VI

c. I, II

d. III, IV

e. V, VI, VII

d. III, IV

Ticarcillin

Carbecillin

Antipseudomonal ureidopenicillin:

I. Amoxicillin

II. Ampicillin

III. Ticarcillin

IV. Carbenicillin

V. Piperacillin

VI. Azlocillin

VII. Mezlocillin

a. I, II, III, IV, V, VI, VII

b. III, IV, V, VI, VI

c. I, II

d. III, IV

e. V, VI, VII

e. V, VI, VII

Piperacillin

Azlocillin

Mezlocillin

Beta lactamase inhibitor:

a. Clavulanic acid

b. Sulbactam

c. Tazobactam

d. a and b

e. All

e. All

Combined with Amoxicillin.

a. Clavulanic acid

b. Sulbactam

c. Tazobactam

a. Clavulanic acid

Combined with Ampicillin.

a. Clavulanic acid

b. Sulbactam

c. Tazobactam

b. Sulbactam

Combined with Piperacillin

a. Clavulanic acid

b. Sulbactam

c. Tazobactam

c. Tazobactam

Very broad spectrum only limited by ESBL.

a. Clavulanic acid + Amoxicillin

b. Sulbactam + Ampicillin

c. Tazobactam + Piperacillin

c. Tazobactam + Piperacillin

Gram negative spectrum increases as generation increases.

a. Penicillin

b. Cephalosporin

c. Carbapenems

d. Monobactam

e. Glycopeptides

b. Cephalosporin

Cephalosporin is pregnancy category what?

a. A

b. B

c. C

d. X

b. B

For Proteus, E. coli, Klebsiella, Staphylococcus, and Streptococcus.

a. 1st gen Cephalosporin

b. 2nd gen Cephalosporin

c. 3rd gen Cephalosporin

d. 4th gen Cephalosporin

e. 5th gen Cephalosporin

a. 1st gen Cephalosporin

1st gen Cephalosporins except:

a. Cephalotin

b. Cephapirin

c. Cephalexin

d. Cefazolin

e. Cefadroxil

f. None

f. None

1st gen Cephalosporin: "Cepha" except

• Cefazoline

• Cefadroxil

DOC for surgical prophylaxis.

a. Cephalotin

b. Cephapirin

c. Cephalexin

d. Cefazolin

e. Cefadroxil

d. Cefazolin

Only parenteral 1st gen Cephalosporin.

a. Cephalotin

b. Cephapirin

c. Cephalexin

d. Cefazolin

e. Cefadroxil

d. Cefazolin

For Haemophilus, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Staphylococcus, and Streptococcus.

a. 1st gen Cephalosporin

b. 2nd gen Cephalosporin

c. 3rd gen Cephalosporin

d. 4th gen Cephalosporin

e. 5th gen Cephalosporin

b. 2nd gen Cephalosporin

2nd gen Cephalosporin except:

a. Cefamandole

b. Cefprozil

c. Cefuroxime

d. Cefmetazole

e. Loracarbef

f. None

f. None

2nd gen Cephalosporin are the "Cef + vowel" except:

• Cefprozil

• Cefmetazole

• Loracarbef

2nd gen Cephalosporin that causes tan man's money.

a. Cefotetan

b. Cefoxitin

c. Cefuroxime

d. Cefamandole

e. a and b

f. a and d

f. a and d

Has Disulfiram like reaction or tan man's money

• Cefamandole

• Cefotetan

2nd gen Cephalosporin effective for anaerobes.

a. Cefotetan

b. Cefoxitin

c. Cefuroxime

d. Cefamandole

e. a and b

f. a and d

e. a and b

Effective for anaerobe

• Cefotetan

• Cefoxitin

2nd gen Cephalosporin mainly used for CAP which can pass the BBB.

a. Cefotetan

b. Cefoxitin

c. Cefuroxime

d. Cefamandole

e. a and b

f. a and d

c. Cefuroxime

3rd gen cephalosporin except:

a. Cefotaxime

b. Ceftriaxone

c. Cefoperazone

d. Moxalactam

e. Cefixime

f. None

f. None

3rd gen cephalosporin are the "Cef + consonant" except:

• Cefotaxime

• Cefoperazone

• Cefixime

• Moxalactam

Only 3rd gen cephalosporin that cannot pass the BBB.

a. Cefotaxime

b. Ceftriaxone

c. Cefoperazone

d. Moxalactam

e. Cefixime

c. Cefoperazone

3rd gen cephalosporin for CAP.

I. Cefotaxime

II. Ceftriaxone

III. Cefoperazone

IV. Ceftadizime

a. I, II

b. II, III

c. III, IV

d. I, IV

a. I, II

3rd gen cephalosporin for CAP

• Cefotaxime

• Ceftriaxone

3rd gen cephalosporin active against anaerobe.

I. Cefotaxime

II. Ceftriaxone

III. Cefoperazone

IV. Ceftadizime

a. I, II

b. II, III

c. III, IV

d. I, IV

a. I, II

3rd gen cephalosporin for CAP

• Cefotaxime

• Ceftriaxone

3rd gen cephalosporin biliary excreted.

I. Cefotaxime

II. Ceftriaxone

III. Cefoperazone

IV. Ceftadizime

a. I, II

b. II, III

c. III, IV

d. I, IV

b. II, III

3rd gen cephalosporin biliary excreted

• Ceftriaxone

• Cefoperazone

3rd gen cephalosporin that has anti-pseudomonal activity.

I. Cefotaxime

II. Ceftriaxone

III. Cefoperazone

IV. Ceftadizime

a. I, II

b. II, III

c. III, IV

d. I, IV

c. III, IV

3rd gen cephalosporin that has anti-pseudomonal activity.

• Cefoperazone

• Ceftadizime

3rd gen cephalosporin that is the DOC for Neisseria species.

a. Cefotaxime

b. Ceftriaxone

c. Cefoperazone

d. Ceftadizime

b. Ceftriaxone

3rd gen cephalosporin that is the DOC for pseudomonal infection.

a. Cefotaxime

b. Ceftriaxone

c. Cefoperazone

d. Ceftadizime

d. Ceftadizime

Has activity against beta-lactamase producing organisms.

a. 1st gen Cephalosporin

b. 2nd gen Cephalosporin

c. 3rd gen Cephalosporin

d. 4th gen Cephalosporin

e. 5th gen Cephalosporin

d. 4th gen Cephalosporin

Cefepime

Cefpirome

a. 1st gen Cephalosporin

b. 2nd gen Cephalosporin

c. 3rd gen Cephalosporin

d. 4th gen Cephalosporin

e. 5th gen Cephalosporin

d. 4th gen Cephalosporin

Very broad activity but not effective against anaerobe.

a. Cefotaxime

b. Ceftriaxone

c. Cefoperazone

d. Ceftadizime

e. Cefepime

e. Cefepime

For MRSA.

a. 1st gen Cephalosporin

b. 2nd gen Cephalosporin

c. 3rd gen Cephalosporin

d. 4th gen Cephalosporin

e. 5th gen Cephalosporin

e. 5th gen Cephalosporin

Ceftaroline

Ceftobiprole

a. 1st gen Cephalosporin

b. 2nd gen Cephalosporin

c. 3rd gen Cephalosporin

d. 4th gen Cephalosporin

e. 5th gen Cephalosporin

e. 5th gen Cephalosporin

For gram(+) cocci, gram(-) bacilli, pseudomonas, and anaerobes.

a. Penicillin

b. Cephalosporin

c. Carbapenems

d. Monobactam

e. Glycopeptides

c. Carbapenems

DOC for organism with extended-spectrum beta-lactamases such as Klebsiella.

a. Penicillin

b. Cephalosporin

c. Carbapenems

d. Monobactam

e. Glycopeptides

c. Carbapenems

Carbapenem include:

a. Imipinem

b. Meropenem

c. Ertapenem

d. a and b

e. b and c

f. All

f. All

Most neurotoxic carbapenem that is combined with cilastatin.

a. Imipinem

b. Meropenem

c. Ertapenem

a. Imipinem

Has very broad spectrum and has no limitation.

a. Imipinem

b. Meropenem

c. Ertapenem

b. Meropenem

Antibacterial with the broadest spectrum

a. Piperacillin + Tazobactam

b. Meropenem

c. Cefepime

d. a and b

e. All

e. All

Antibacterial with the broadest spectrum but not effective against ESBL.

a. Piperacillin + Tazobactam

b. Meropenem

c. Cefepime

d. a and b

e. All

a. Piperacillin + Tazobactam

Antibacterial with the broadest spectrum but not effective against anaerobes.

a. Piperacillin + Tazobactam

b. Meropenem

c. Cefepime

d. a and b

e. All

c. Cefepime

Carbapenem that is not anti pseudomonal.

a. Imipinem

b. Meropenem

c. Ertapenem

c. Ertapenem

Penicillinase resistant active against gram(-) aerobes such as pseudomonas and the main alternative for penicillin allergic patients.

a. Penicillin

b. Cephalosporin

c. Carbapenems

d. Monobactam

e. Glycopeptides

d. Monobactam

Aztreonam class.

a. Penicillin

b. Cephalosporin

c. Carbapenems

d. Monobactam

e. Glycopeptides

d. Monobactam

Glycopeptide antibiotic except:

a. Vancomycin

b. Televancin

c. Dalbavancin

d. Teicoplanin

e. None

e. None

Binds fo D-Ala-D-Ala terminal of forming peptidoglycan inhibiting transglycosylation thus prevents elongation.

a. Penicillin

b. Cefepime

c. Meropenem

d. Aztreonam

e. Vancomycin

e. Vancomycin

Form of vancomycin that is DOC for MRSA, enterococcus.

a. Oral

b. IV

c. Both

b. IV

Form of vancomycin that is DOC for Pseudomembranous colitis.

a. Oral

b. IV

c. Both

a. Oral

Ototoxic and can cause Red Man Syndrome due to rapid infusion.

a. Penicillin

b. Cefepime

c. Meropenem

d. Aztreonam

e. Vancomycin

e. Vancomycin

Glycopeptide that disrupt cell membrane potential increasing cell membrane permeability.

a. Vancomycin

b. Televancin

c. Dalbavancin

d. Teicoplanin

b. Televancin

Teicoplanin is what type of antibiotic?

a. Penicillin

b. Cephalosporin

c. Carbapenems

d. Monobactam

e. Glycopeptides

e. Glycopeptides

Binds to cell membrane and inserts to ion channels to cause depolarization eventually leading to cell death. It can cause myopathy and contraindicated to respiratory infections.

a. Daptomycin

b. Fosfomycin

c. Bacitracin

d. Cycloserine

a. Daptomycin

Inhibit enolpyruvate transderase (peptidoglycan synthesis).

a. Daptomycin

b. Fosfomycin

c. Bacitracin

d. Cycloserine

b. Fosfomycin

Usually given as single 3g dose to treat UTI specifically acute cystitis.

a. Daptomycin

b. Fosfomycin

c. Bacitracin

d. Cycloserine

b. Fosfomycin

Inhibit lipid carriers important for peptidoglycan synthesis but is highly nephrotoxic so only topically used ro treat gram(+) infection.

a. Daptomycin

b. Fosfomycin

c. Bacitracin

d. Cycloserine

c. Bacitracin

Inhibits conversion of L-alanine to D-alanine with side effects such as headache and seizures.

a. Daptomycin

b. Fosfomycin

c. Bacitracin

d. Cycloserine

d. Cycloserine

2nd line anti Koch's agent.

a. Daptomycin

b. Fosfomycin

c. Bacitracin

d. Cycloserine

d. Cycloserine

All protein synthesis inhibitor are bacteriostatic except:

a. Aminoglycoside

b. Linezolid

c. Streptogramins

d. a and b

e. All

e. All

Protein synthesis inhibitors:

I. Aminoglycoside

II. Tetracycline

III. Chloramphenicol

IV. Erythromycin

V. Lincosamides

VI. Linezolids

VII. Streptogramin

a. I, II, III, IV, V, VI, VII

b. III, IV, V, VI, VII

c. I, II

d. I, VI, VII

e. II, III, IV, V

a. I, II, III, IV, V, VI, VII

Protein synthesis inhibitor specifically 30s inhibitor:

I. Aminoglycoside

II. Tetracycline

III. Chloramphenicol

IV. Erythromycin

V. Lincosamides

VI. Linezolids

VII. Streptogramin

a. I, II, III, IV, V, VI, VII

b. III, IV, V, VI, VII

c. I, II

d. I, VI, VII

e. II, III, IV, V

c. I, II

30s inhibitor

• Aminoglycoside

• Tetracycline

Protein synthesis inhibitor specifically 50s inhibitor:

I. Aminoglycoside

II. Tetracycline

III. Chloramphenicol

IV. Erythromycin

V. Lincosamides

VI. Linezolids

VII. Streptogramin

a. I, II, III, IV, V, VI, VII

b. III, IV, V, VI, VII

c. I, II

d. I, VI, VII

e. II, III, IV, V

b. III, IV, V, VI, VII

50s inhibitor

• Chloramphenicol

• Erythromycin

• Lincosamides

• Linezolids

• Streptogramin

Has concentration dependent killing which is usually given OD at high dose. It also has post antibiotic effect.

a. Aminoglycoside

b. Tetracycline

c. Chloramphenicol

d. Erythromycin

e. Lincosamides

a. Aminoglycoside

Block formation of initiation complex leading to misreading of mRNA template and inhibiting translocation.

a. Aminoglycoside

b. Tetracycline

c. Chloramphenicol

d. Erythromycin

e. Lincosamides

a. Aminoglycoside

Nephrotoxic and ototoxic.

a. Aminoglycoside

b. Tetracycline

c. Chloramphenicol

d. Erythromycin

e. Lincosamides

a. Aminoglycoside

Most ototoxic aminoglycosides:

I. Neomycin

II. Amikacin

III. Kanamycin

IV. Streptomycin

V. Gentamicin

VI. Tobramycin

a. I, II, III

b. IV, V

c. I, V, VI

d. II, IV, V

a. I, II, III

Most ototoxic:

• Neomycin

• Amikacin

• Kanamycin

Most vestibulotoxic aminoglycosides:

I. Neomycin

II. Amikacin

III. Kanamycin

IV. Streptomycin

V. Gentamicin

VI. Tobramycin

a. I, II, III

b. IV, V

c. I, V, VI

d. II, IV, V

b. IV, V

Most vestibulotoxic aminoglycoside:

• Streptomycin

• Gentamicin

Most nephrotoxic aminoglycosides:

I. Neomycin

II. Amikacin

III. Kanamycin

IV. Streptomycin

V. Gentamicin

VI. Tobramycin

a. I, II, III

b. IV, V

c. I, V, VI

d. II, IV, V

c. I, V, VI

Most nephrotoxic aminoglycoside:

• Neomycin

• Gentamicin

• Tobramycin

Block t-RNA attachment.

a. Aminoglycoside

b. Tetracycline

c. Chloramphenicol

d. Erythromycin

e. Lincosamides

b. Tetracycline

Should not be taken with metal cation specially Ca.

a. Aminoglycoside

b. Tetracycline

c. Chloramphenicol

d. Erythromycin

e. Lincosamides

b. Tetracycline

Causes tooth discoloration and impair bone growth this contraindicated to children <8 years old in pregnancy.

a. Aminoglycoside

b. Tetracycline

c. Chloramphenicol

d. Erythromycin

e. Lincosamides

b. Tetracycline

Tetracycline include all of the following except:

a. Tetracylcine

b. Doxycycline

c. Demelocycline

d. Minocycline

e. Tigecycline

f. None

f. None

Absorption is not affected by food as it is biliary excreted.

a. Tetracylcine

b. Doxycycline

c. Demelocycline

d. Minocycline

e. Tigecycline

b. Doxycycline

Usually for mild UTI, Chlamydia, and Lyme disease.

a. Tetracylcine

b. Doxycycline

c. Demelocycline

d. Minocycline

e. Tigecycline

b. Doxycycline

Most phototoxic aminoglycoside.

a. Tetracylcine

b. Doxycycline

c. Demelocycline

d. Minocycline

e. Tigecycline

c. Demelocycline

Has no antibiotic affect so used to treat SIADH instead.

a. Tetracylcine

b. Doxycycline

c. Demelocycline

d. Minocycline

e. Tigecycline

c. Demelocycline

Most vestibulotoxic.

a. Tetracylcine

b. Doxycycline

c. Demelocycline

d. Minocycline

e. Tigecycline

d. Minocycline

Newest tetracycline thus has the broadest spectrum.

a. Tetracylcine

b. Doxycycline

c. Demelocycline

d. Minocycline

e. Tigecycline

e. Tigecycline

Inhibits transpeptidation inhibiting peptide bond formation which is specifically used as alternative for S. typhi infection.

a. Aminoglycoside

b. Tetracycline

c. Chloramphenicol

d. Erythromycin

e. Lincosamides

c. Chloramphenicol

Causes Gray Baby Syndrome and aplastic anemia.

a. Aminoglycoside

b. Tetracycline

c. Chloramphenicol

d. Erythromycin

e. Lincosamides

c. Chloramphenicol

Caused by lack of glucuronidation of chloramphenicol.

a. Gray baby syndrome

b. Aplastic anemia

c. Malignant hyperthermia

d. Red man syndrome

a. Gray baby syndrome