Practice questions pharm

Question 1

which is the answer

A 45-year-old male presented to the hospital ED with severe cellulitis and a large abscess on his left leg. Incision and drainage were performed on the abscess, and cultures revealed methicillin-resistant Staphylococcus aureus. All of the following antibiotics would be appropriate for this infection EXCEPT:

A.Vancomycin

B.Doxycycline

C.Clindamycin

D.Piperacillin-tazobactam

E.Sulfamethoxazole-trimethoprim

F.All would be appropriate

Answer 1

D. Pipercillin Tazo

Question 2

A 30-year-old pregnant female has cellulitis caused by MRSA. Which of the following would be the most appropriate option for outpatient therapy?

A.Amoxicillin-clavulanate

B.Cephalexin (1st C)

C.Clindamycin

D.Doxycycline

E.Piperacillin-tazobactam

F.Vancomycin

Answer 2

C. Clindamycin

Question 3

5. The regimen of choice for treatment of urogenital gonorrhea is:

A.IM ceftriaxone and oral azithromycin

B.Oral cephalexin and oral azithromycin

C.Oral moxifloxacin and oral azithromycin

D.IM ceftriaxone and oral doxycycline

Answer 3

A. IM Ceftriaxone

Question 4

A 22-year-old man with gonorrhea is to be treated with ceftriaxone and will need another drug to provide coverage for urethitis caused by C. trachomatis. Which of the following drugs is LEAST likely to be effective in nongonococcal urethitis?

A.Azithromycin

B.Clarithromycin

C.Nitrofurantoin

D.SMX-TMP

E.Doxycycline

Answer 4

C. Nitrofurontin

Question 5

A 68-year-old man presents to the emergency department because of fever, abdominal pain, and rapidly progressive distension of the abdomen. His appendix was removed for an abscess 3 days ago. The complete blood count showed leukocytosis. Anaerobic culture of the peritoneal fluid needle aspirate showed a gram-negative pathogen identified as Bacteroides fragilis. Which of the following antibiotics should be used in the treatment of this infection?

A.IV clindamycin

B.IV vancomycin

C.Oral vancomycin

D.Oral piperacillin-tazobactam

Answer 5

A. IV clindamycin

Question 6

An aspirate from a peritoneal abscess grows two organisms. One is Escherichia coli while the other has the following characteristics: Gram-negative bacillus, obligate anaerobe, catalase-positive, and possesses a polysaccharide capsule. From your recommended training in microbiology you recognize this organism is most likely Bacteroides fragilis. From your required training in pharmacology you know that antibiotics with activity against such an anaerobe include all of the following EXCEPT:

A.Clindamycin

B.Metronidazole

C.Gentamicin, an aminoglycoside

D.Piperacillin-Tazobactam

Answer 6

C. Gentamicin, an aminoglycoside

Question 7

A 22-year-old female 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. All of the following would be considered appropriate initial therapy for this patient EXCEPT:

A.Amoxicillin-clavulanate

B.Sulfamethoxazole-Trimethoprim

C.Nitrofurantoin

D.Ciprofloxacin

E.Cephalexin

Answer 7

D. Cirpofloxacin

Question 8

A 24-year-old pregnant woman (8 weeks gestation) presents to the urgent care clinic with fever, urinary frequency and urgency. She is diagnosed with an uncomplicated UTI. Based on potential harm to the fetus, which of the following medications should generally be avoided in treating her UTI?

A.Nitrofurantoin

B.Amoxicillin

C.Cephalexin

D.Ampicillin

E.Trimethoprim-sulfamethoxazole

Answer 8

E.

Question 9

11. A 35-year-old, otherwise healthy man is complaining of purulent nasal discharge, fever and facial pain. He says his symptoms began about 2 weeks ago and have gotten worse over the past 2 days despite using a nasal steroid. He has no known drug allergies. Which antibiotic would you recommend for treatment of acute bacterial sinusitis in this patient?

A.Amoxicillin-clavulanate

B.Azithromycin

C.Trimethoprim-sulfamethoxazole

D.Levofloxacin

E.None - symptomatic treatment only

Answer 9

A. amoxi/clauv

Question 10

A 24-year-old woman has returned from a vacation abroad suffering from traveler’s diarrhea and her problem has not responded to antidiarrheal drugs. A pathogenic gram-negative bacillus is suspected. Which one of the following drugs can be given orally for outpatient management of this patient’s infection?

A.Penicillin V K

B.Levofloxacin

C.Gentamicin-aminoglycoside

D.Clindamycin

E.Ceftriaxone

Answer 10

B. Levofloxacin

Question 11

Which of the following is an advantage of using bactericidal agents rather than bacteriostatic agents to treat infectious disease?

A.Their effects are often irreversible.

B.They act more quickly to resolve infections.

C.They can compensate for impaired host defense mechanisms.

D.They retain efficacy against infections located at sites inaccessible to the immune system.

E.All are advantages of bactericidal agents.

Answer 11

E

Question 12

14. Which of the following antibiotics are considered to exert bacteriostatic actions against most organisms in their spectrum at readily attained clinical levels?

A.Tobramycin

B.Vancomycin

C.Ceftriaxone

D.Clindamycin

E.Levofloxacin

Answer 12

D. Clindamycin

Question 13

15. A 58-year-old male with a history of hepatitis C, cirrhosis, and ascites presents with spontaneous bacterial peritonitis. Which of the following antibiotics might require cautious consideration of use in this patient given his liver disease?

A.Erythromycin

B.Amoxicillin-clavulanate

C.Levofloxacin

D.Cephalexin

Answer 13

A. Eryhtromycin

Question 14

17. Which of the following drugs is INcorrectly matched with the mechanism of resistance to the organism?

A.Amoxicillin

B.Azithromycin

C.Penicillins

D.Dicloxacillin

E.Ceftriaxone

F. Piperacillin

Answer 14

E. Ceftriaxone

Question 15

A 45-year-old male presented to the hospital ED with severe cellulitis and a large abscess on his left leg. Incision and drainage were performed on the abscess, and cultures revealed methicillin-resistant Staphylococcus aureus. All of the following antibiotics would be appropriate for this infection EXCEPT:

A.Vancomycin

B.Doxycycline

C.Clindamycin

D.Piperacillin-tazobactam

E.Sulfamethoxazole-trimethoprim

F.All would be appropriate

Answer 15

D. Pipercillin tazo

Question 16

19. A 22-year-old man with gonorrhea is to be treated with ceftriaxone and will need another drug to provide coverage for urethitis caused by C. trachomatis. Which of the following drugs is LEAST likely to be effective in nongonococcal urethitis?

A.Azithromycin

B.Clarithromycin

C.Nitrofurantoin

D.SMX-TMP

E.Doxycycline

Answer 16

C. Nitrofurontin

Question 17

20. Select the antibacterial agent that rapidly accumulates in bladder and urine resulting in its clinical utility as a urinary tract antiseptic in the treatment of cystitis:

A.Ampicillin

B.Gentamicin (an aminoglycoside)

C.Levofloxacin

D.Nitrofurantoin

E.Amoxicillin

Answer 17

D. Nitrofurantoin

Question 18

21. All of the following statements about the clinical uses of the aminoglycosides are accurate EXCEPT:

A.Owing to their polar nature, aminoglycosides are not absorbed after oral administration

B.Trough plasma levels are monitored to reduce the risk of hepatotoxicity

C.Aminoglycoside-induced ototoxicity can be irreversible if not identified early

D.They lack activity against infections caused by anaerobic organisms

Answer 18

B.Trough plasma levels are monitored to reduce the risk of hepatotoxicity

Question 19

Select the FALSE statement about clinical use of sulfamethoxazole-trimethoprim?

A.No cross-allergenicity occurs between sulfonamides and penicillins

B.No activity against MRSA skin infections

C.Kernicterus may occur if sulfonamides are given late in pregnancy or in first 2 months after birth

D.Exerts bactericidal action against susceptible organisms

E.Trimethoprim inhibits bacterial dihydrofolate reductase and has less selective toxicity than sulfamethoxazole

Answer 19

B.No activity against MRSA skin infections

Question 20

23. A 24-year-old pregnant woman (8 weeks gestation) presents to the urgent care clinic with fever, urinary frequency and urgency. She is diagnosed with an uncomplicated UTI. Based on potential harm to the fetus, which of the following medications should generally be avoided in treating her UTI?

A.Nitrofurantoin

B.Amoxicillin

C.Cephalexin

D.Ampicillin

E.Trimethoprim-sulfamethoxazole

Answer 20

E.Trimethoprim-sulfamethoxazole

Question 21

A 52-year-old male with diabetes presents with a diabetic foot infection. Cultures from the wound are growing Streptococcus pneumoniae and Escherichia coli. Of the following antibiotics, which one would most likely provide the best coverage for these two pathogens?

A.Clindamycin

B.Ceftriaxone

C.Vancomycin

D.Azithromycin

Answer 21

B.Ceftriaxone

Question 22

Amoxicillin and first-generation cephalosporins share all of the following properties EXCEPT:

A.Inhibit cell wall synthesis

B.Activity against gram negative organisms

C.Elimination primarily by the kidneys

D.Contain beta-lactam ring in structure

E.Inactivation by penicillinase (NSBL)

Answer 22

E.Inactivation by penicillinase (NSBL)

Question 23

26. An important distinction between 1st and 3rd generation cephalosporins is:

A.1st generation agents have greater activity against methicillin-resistant Staphylococcus aureus

B.3rd generation agents have less activity against Pseudomonas

C.3rd generation agents have increased activity against chlamydia

D.1st generation agents have increased penetration into the CNS

E.3rd generation agents have increased activity against resistant gram-negative organisms

Answer 23

E.3rd generation agents have increased activity against resistant gram-negative organisms

Question 24

27. A 68-year-old man presents to the emergency department because of fever, abdominal pain, and rapidly progressive distension of the abdomen. His appendix was removed for an abscess 3 days ago. The complete blood count showed leukocytosis. Anaerobic culture of the peritoneal fluid needle aspirate showed a gram-negative pathogen identified as Bacteroides fragilis. Which of the following antibiotics should be used in the treatment of this infection?

A.IV clindamycin

B.IV vancomycin

C.Oral vancomycin

D.Oral piperacillin-tazobactam

Answer 24

A.IV clindamycin

Question 25

28. A patient is being discharged from the hospital on a 2-week course of clindamycin. Which of the following potential adverse effects should be discussed with her? A.Nephrotoxicity B.Drug interactions due to enzyme induction C.Severe diarrhea D.Skin rash E.Ototoxicity

Answer 25

C.Severe diarrhea

Question 26

A 30-year-old pregnant female has cellulitis caused by MRSA. Which of the following would be the most appropriate option for outpatient therapy? A.Amoxicillin-clavulanate B.Cephalexin (1st C) C.Clindamycin D.Doxycycline E.Piperacillin-tazobactam F.Vancomycin

Answer 26

C.Clindamycin

Question 27

30. A 28-year-old man presents with a complaint of penile discharge. He says that he noticed a yellowish watery discharge from his penis since last week. He adds that he has painful urination only in the mornings, but he sometimes feels a lingering pain in his genital region throughout the day. He denies any fever, body aches, or joint pains. Physical examination is unremarkable. The penile discharge is collected and sent for analysis. Ceftriaxone IM is administered, after which the patient is sent home with a prescription for an oral medication. Which of the following oral drugs was most likely prescribed to this patient? A.Azithromycin B.Doxycycline C.Gentamicin D.Clindamycin

Answer 27

A.Azithromycin

Question 28

You notice that an otherwise healthy patient has developed a mild case of oral candidiasis (thrush) while receiving antibiotic treatment for a respiratory infection. Which of these drugs is a broad-spectrum antibacterial agent that would be most likely have caused this fungal superinfection? A.Penicillin V B.Dicloxacillin C.Doxycycline D.Clindamycin (CleocinÒ) E.Clarithromycin

Answer 28

C.Doxycycline

Question 29

32. Doxycycline is: A.Bactericidal B.Eliminated slowly and can be dosed 1-2 times a day C.Preferred over macrolides for use in small children D.Given in lower doses to patients with renal dysfunction E.Can be used to treat pseudomonas UTIs

Answer 29

B.Eliminated slowly and can be dosed 1-2 times a day

Question 30

33. Which statement about the fluoroquinolones is FALSE? A.Antacids decrease the bioavailability of fluoroquinolones B.Modification of ciprofloxacin dose may be necessary in patients with a CrCl less than 30 ml/min C.A fluoroquinolone is the drug of choice for treatment of an uncomplicated UTI in a 7-year-old girl D.Most “first-time” urinary tract infections are sensitive to ciprofloxacin E.Rapidly bactericidal via inhibition of bacterial DNA gyrase

Answer 30

C.A fluoroquinolone is the drug of choice for treatment of an uncomplicated UTI in a 7-year-old girl

Question 31

34. A 29-year-old woman presents to a physician at 16 weeks gestation with fevers and a cough for 2 days. Physical and laboratory evaluations suggest a diagnosis of community-acquired pneumonia. The physician explains to her that she needs to be treated with antibiotic therapy. She asks the physician if she can take levofloxacin because she tolerates levofloxacin. The physician explains that levofloxacin should be avoided during pregnancy because fetal exposure may increase the risk of a specific medical condition. Which of the following medical conditions is the physician referring to? A.Arthropathy B.Congenital heart defect C.Deafness D.Neural tube defect E.Ocular anomalies

Answer 31

A.Arthropathy

Question 32

36. Select the FALSE statement concerning penicillin V: A.It is eliminated from the body primarily by renal excretion. B.It has reliable antimicrobial activity against most gram positive cocci. C.It has excellent oral bioavailabilty D.It is effective in treating infections caused by penicillinase-producing organisms.

Answer 32

D.It is effective in treating infections caused by penicillinase-producing organisms

Question 33

. A 20-year-old female presents to the emergency department with headache, stiff neck, and fever of 2 days duration and is diagnosed with meningitis. Which of the following agents is the best choice for empiric coverage of Strep. pneumoniae? A.Acyclovir B.Piperacillin-tazobactam C.Ceftriaxone D.Gentamycin (aminoglycoside) E.Cefazolin

Answer 33

C.Ceftriaxone

Question 34

38. A 13-year-old girl presents with a right infected ingrown toenail. On examination, the skin on the lateral side of the toe is red, warm, swollen, and severely tender to touch. When gentle pressure is applied, pus oozes out. Culture and sensitivity analysis of the pus shows methicillin-resistant Staphylococcus aureus (MRSA). Which of the following antibiotics is most effective against this organism? A.Piperacillin-tazobactam B.Oral vancomycin C.Clindamycin D. Cefuroxime (2nd gen ceph

Answer 34

C.Clindamycin

Question 35

39. A 42-year-old man presents to the emergency department complaining of pain in his right knee and fever. The patient is having difficulty walking and looks visibly uncomfortable. On examination, he is disheveled, but his behavior is not erratic. The patient’s right knee is erythematous, edematous, and warm, with evidence of a 3 cm wound that is weeping purulent fluid. The wound is cultured, and empiric antibiotic therapy is initiated. Four minutes into the patient’s antibiotic therapy, he develops a red, pruritic rash on his face and neck. What is the most likely antibiotic this patient is being treated with? A.Penicillin G B.Vancomycin C.Sulfamethoxazole D.Erythromycin

Answer 35

B.Vancomycin

Question 36

40. Vancomycin: A.Can elevate plasma levels of co-administered drugs that are CYP450 substrates B.Binds to penicillin-binding proteins C.Is active against MRSA D.Has advantage of oral bioavailability E.Requires dosage reduction in renal impairment F.Is inactivated by beta-lactamases G.Acts at stage 3 of bacterial cell wall synthesis

Answer 36

C.Is active against MRSA

Question 37

41. A 27-year-old woman seeks evaluation by her general physician with complaints of an odorous yellow vaginal discharge and vaginal irritation for the past 3 days. She also complains of itching and soreness. The medical history is unremarkable. She is not diabetic. She has been sexually active with a single partner for the last 3 years. A vaginal swab is sent to the lab for microscopic evaluation, the results of which are shown in the exhibit, and the culture yields heavy growth of protozoa. A pregnancy test was negative. What is the most appropriate treatment for this patient? A.Metronidazole B.Nystatin C.Amoxicillin D.Fluconazole E.Acyclovir

Answer 37

A.Metronidazole

Question 38

. Azithromycin and clarithromycin have very similar spectra of antimicrobial activity. Advantages of azithromycin include: A.Does not inhibit drug metabolizing enzymes B.Eradicates mycoplasmal infections in a single dose C.Is active against methicillin-resistant strains of staphylococci D.Is metabolized to an active metabolite E.Greater duration of activity

Answer 38

A.Does not inhibit drug metabolizing enzymes

Question 39

43. A 32-year-old pregnant woman presents to the clinic with crampy abdominal pain and severe watery diarrhea for the past 3 days. She was started on a 7-day course of amoxicillin after being admitted to the hospital for pyelonephritis 5 days ago. Physical exam reveals abdominal distention with diffuse tenderness. Laboratory studies show a peripheral white blood cell (WBC) count of 15,000/mm3 and stool guaiac positive for occult blood. A nosocomial C. difficile superinfection is suspected. Which of the following is the most appropriate pharmacotherapy for her condition? A.Metronidazole B.Gentamicin (aminoglycoside) C.IV metronidazole plus oral vancomycin D.Oral vancomycin

Answer 39

D.Oral vancomycin

Question 40

. Consumption of ethanol together with this drug causes nausea, vomiting, abdominal cramps, flushing, and headache in some patients. A.Amoxicillin B.Clindamycin C.Metronidazole D.Doxycycline E.Erythromycin

Answer 40

C.Metronidazole

Question 41

45. A 28-year-old woman presents with an abnormal vaginal discharge for the past week. She is five weeks late for her menstrual cycle. Subsequent testing demonstrates a positive pregnancy test. A wet mount demonstrates motile, pear-shaped organisms consistent with trichomoniasis protozoal infection. Which of the following is the most appropriate treatment for this patient? A.Azithromycin B.Doxycycline C.Metronidazole D.Ceftriaxone

Answer 41

C.Metronidazole

Question 42

46. An 18-year-old woman presents with a dry cough for the past 2 weeks. She also says that she is tired all the time and feels feverish and chilly at times. She is a college student and lives in a dormitory and says that her roommate has a similar cough. The patient denies any smoking history, alcohol or recreational drug use. Her vitals signs include temperature 36.8°C (98.2°F), pulse 72/min, blood pressure 118/63 mm Hg, and respiratory rate 15/min. A chest radiograph reveals interstitial infiltrates that look worse than her symptoms. A nasopharyngeal swab is sent to the lab for a bacterial culture which shows colonies having fried-egg appearance on Eaton’s agar. Cold agglutinins are positive. Which of the following antibiotics would be best to administer to this patient? A.Vancomycin B.Cephalexin C.Ceftriaxone D.Clarithromycin

Answer 42

D.Clarithromycin

Question 43

47. Which drug inhibits the hepatic metabolism of co-administered drugs? A.Azithromycin B.Doxycycline C.Erythromycin D.Amoxicillin E.Tobramycin (aminoglycoside) F.Ceftriaxone

Answer 43

C.Erythromycin

Question 44

48. In a patient suffering from pseudomembranous colitis due to C. difficile with established hypersensitivity to vancomycin, the drug most likely to be of clinical value is: A.Vancomycin B.Clindamycin C.Doxycycline D.Levofloxacin E.Metronidazole

Answer 44

E.Metronidazole

Question 45

49. An aspirate from a peritoneal abscess grows two organisms. One is Escherichia coli while the other has the following characteristics: Gram-negative bacillus, obligate anaerobe, catalase-positive, and possesses a polysaccharide capsule. From your recommended training in microbiology you recognize this organism is most likely Bacteroides fragilis. From your required training in pharmacology you know that antibiotics with activity against such an anaerobe include all of the following EXCEPT: A.Clindamycin B.Metronidazole C.Gentamicin, an aminoglycoside D.Piperacillin-Tazobactam

Answer 45

C.Gentamicin, an aminoglycoside

Question 46

48. The primary reason for the use of drug combinations in the treatment of tuberculosis is to: A.Reduce the incidence of adverse effects B.Enhance activity against metabolically inactive mycobacteria C.Ensure patient compliance with the drug regimen D.Delay of prevent the emergence of resistance E.Provide prophylaxis against other bacterial infections

Answer 46

D.Delay of prevent the emergence of resistance

Question 47

49. Which statement about the use of isoniazid (INH) in the treatment of TB is FALSE? A.INH is bactericidal against actively growing tubercle bacilli B.Symptoms of peripheral neuritis may occur during treatment C.INH may induce the metabolism of certain drugs D.Patients should take pyridoxine (vitamin B6) daily

Answer 47

C.INH may induce the metabolism of certain drugs

Question 48

50. Select the FALSE statement concerning rifamycin antibiotics: A.Rifapentine can be given once weekly for treatment of latent TB infections B.Rifabutin is a weaker inducer of CYP450 and is preferred over rifampin for TB treatment in HIV patients on HAART C.Rifamycins are inhibitors of DNA-dependent RNA polymerase D.Rifamycins are bacteriostatic against M. tuberculosis

Answer 48

D.Rifamycins are bacteriostatic against M. tuberculosis

Question 49

51. A 55-year-old man, who was recently diagnosed with tuberculosis, presents to his primary care provider as part of his routine follow-up visit every month. He is currently in the initial phase of anti-tubercular therapy. His personal and medical histories are relevant for multiple trips to southeast Asia as part of volunteer activities and diabetes of 5 years duration, respectively. The physical examination is unremarkable except for a visual abnormality on a color chart; he is unable to differentiate red from green. The physician assistant suspects the visual irregularity as a sign of toxicity to one of the drugs in the treatment regimen. Which of the following drugs is most likely causing this vision abnormality? A.Ganciclovir B.Ethambutol C.Rifabutin D.Pyrazinamide E.Isoniazid

Answer 49

B.Ethambutol

Question 50

52. 26-year-old woman presents to a gynecologist after a missed period. After performing a complete physical examination and a screening test for pregnancy, her gynecologist informs her that she is pregnant. She is very surprised as she has been taking oral contraceptives regularly. When the gynecologist asks her about the consumption of any other medications, she mentions that she was put on treatment for pulmonary tuberculosis (TB) 2 months ago. Her current anti-TB regimen includes rifampin, isoniazid, pyrazinamide, and ethambutol. Which of the following mechanisms best explains the failure of oral contraceptives in this patient? A.Induction of CYP2E1 by isoniazid leading to decreased serum levels of progesterone B.Interference with intestinal absorption of the oral contraceptive by pyrazinamide C.Increased renal elimination of the progesterone component of the oral contraceptive by ethambutol D.Induction of CYP3A4 by rifampin leading to decreased serum levels of ethinyl estradiol and progesterone

Answer 50

D.Induction of CYP3A4 by rifampin leading to decreased serum levels of ethinyl estradiol and progesterone

Question 51

54. Interactions between this drug and cell membrane components can result in the formation of pores lined by hydrophilic groups present in the drug molecule: A.Fluconazole B.Amphotericin B C.Itraconazole D.Nystatin E.Ketoconazole F.Terbinafine

Answer 51

B and D

Question 52

55. Which of the following antifungal agents is most commonly associated with renal insufficiency? A.Fluconazole B.Amphotericin B C.Itraconazole D.Nystatin E.Ketoconazole

Answer 52

B.Amphotericin B

Question 53

56. Which drug is most appropriate for oral (systemic) use in the treatment of vaginal candidiasis? A.Clotrimazole B.Fluconazole C.Flucytosine D.Nystatin E.Amphotericin

Answer 53

B.Fluconazole

Question 54

57. Select the true statement regarding the pharmacology of fluconazole: A.It is an inducer of hepatic drug-metabolizing enzymes B.It does not penetrate the blood-brain barrier C.It is highly effective in the treatment of aspergillosis D.It has the least effect of all azoles of hepatic drug metabolism E.Oral bioavailability is less than that of ketoconazole

Answer 54

D.It has the least effect of all azoles of hepatic drug metabolism

Question 55

58. A 56-year-old female with diabetes presents for routine foot evaluation with her podiatrist. The patient complains of thickening of the nail on the right big toe and a change in the color (yellow). The podiatrist diagnoses the patient with onychomycosis of the toenails. Which of the following is the most appropriate choice for treating this infection? A.Itraconazole B.Ketoconazole C.Nystatin topical D.Terbinafine E.Clotrimazole topical

Answer 55

D.Terbinafine

Question 56

59. A 6-year-old boy presents with high fever, sore throat, and cough for the past day. The patient’s mother also says he is complaining of generalized muscle aches and chills. Past medical history is significant for childhood asthma, managed with the inhaled corticosteroid (ICS) fluticasone. The patient’s temperature is 39.1°C (102.3°F), pulse is 120/min, and respiratory rate is 20/min. On physical examination, his oropharynx is erythematous with mild swelling of the pharyngeal tonsils. Rapid diagnostic testing for influenza B infection in this patient is positive. In addition to symptomatic treatment, which of the following antiviral drugs would most likely benefit this patient? A.Amantadine B.Oseltamivir C.Zanamivir D.Any of the above E.Either B or C

Answer 56

B.Oseltamivir

Question 57

60. A 65-year-old man presents to a clinic after 2 days of pain just below the right nipple. The pain radiates to the scapula. The rash was preceded by a burning and tingling pain in the affected region. The medical history is relevant for hypertension and hypercholesterolemia. He does not recall his vaccination status or childhood illnesses. The physical examination revealed stable vital signs and a maculopapular rash with vesicles distributed along the T4 dermatome. What is the most appropriate therapy to treat his condition and prevent further complications? A.Prednisone B.Acyclovir C.Valganciclovir D.Trimethoprim-Sulfamethoxazole

Answer 57

B.Acyclovir

Question 58

61. After onset of flu symptoms, neuraminidase inhibitors are considerably less effective if not started: A.Within 24 hours B.Within 48 hours C.Within 72 hours D.Within 5 days

Answer 58

B.Within 48 hours

Question 59

62. A 78-year-old man with COPD presents with a 2-day history of fever, cough, and fatigue. You have seen at least 10 patients with positive influenza tests this week and suspect he has the flu, but his test was negative. You should: A.Not treat him because his influenza test was negative B.Ask him to come back in 2 days to be retested C.Begin treatment with a neuraminidase inhibitor D.Begin treatment with rimantadine

Answer 59

C.Begin treatment with a neuraminidase inhibitor

Question 60

63. The preferred drug for treatment of patients with severe or complicated influenza illness is: A.Oral oseltamivir B.Inhaled zanamivir C.IV peramivir D.Oral baloxavir

Answer 60

A.Oral oseltamivir

Question 61

1. An 8-year-old boy is brought to a pediatric clinic by his mother with a complaint of difficulty swallowing for 4 days. He was diagnosed with asthma 3 months ago and has been using an inhaled corticosteroid (ICS) as directed by the pediatrician. The child does not have a fever or a cough and is not short of breath. He denies pain during swallowing. On examination, the vitals are as follows: temperature 35.8℃ (96.5℉), respiratory rate 14/min, blood pressure 90/40 mm Hg, and pulse 80/min. The oral examination reveals a slightly raised white lesion over his tongue and oropharynx. What drug would most likely be used to manage this infection? A.Valacyclovir B.Oseltamivir C.Fluconazole D.Clotrimazole E.Itraconazole

Answer 61

C.Fluconazole

Question 62

64. A patient receives a drug that is converted to acyclovir in the body. Which antiviral action is exerted by this agent? A.Inhibition of viral uncoating B.Inhibition of DNA polymerase C.Inhibition of viral entry D.DNA chain termination E.Prevention of viral maturation

Answer 62

B.Inhibition of DNA polymerase

Question 63

65. Acyclovir would be ineffective against HSV strains with loss of expression of which viral protein? A.M2 proton channel B.DNA polymerase C.Thymidine kinase D.Neuraminidase

Answer 63

C.Thymidine kinase

Question 64

66. Which of the following patient groups may require acyclovir dosage adjustments from the usual recommended mg/kg adult doses? A.Patients undergoing aminoglycoside therapy B.Patients taking cimetidine C.Chronic kidney disease patients D.Pregnant patients

Answer 64

C.Chronic kidney disease patients