1. A 25 years old boy having oropharyngeal infection for one week. He is taking penicillins.

Which statement about the bio disposition of penicillins and cephlosporins is not accurate? a) Oral bioavailability is affected by liability in gastric acid b) Most third generation cephlosporins cross the blood brain barrier c) Nafcillin and ceftriaxone are eliminated by mainly via biliary secreation d) Procaine penicillin G is used via intra muscular injection e) Renal tubular reabsorption of beta- Lactams is inhibited by probenecid 2. A young female having a urinary tract infection on urine C/S there is E.Coli sensitive to cephalosporin. The primary mechanism of antibacterial action of cephlosporins involves a) Production of Beta- Lactamases b) Inhibition of Cell membrane synthesis c) Inhibition of Reaction involving transpeptidation d) Decreasing Synthesis of N- acetyl muramic acid e) Preventing Trans glycosylation 3. A 40years old man having an infection involving enterobacter spp. Which of the drug is drug of choice now a days? a) Penicillin b) Cephalosporin c) Tetracycline d) Imipenem e) Clavilanic acid 4. An elderly male has a fever believed to be due to an infection. He has skin lesions scrapings of which reveal the presence of large number of gram positive cocci. The drug to use for the treatment of this patient is? a) Amoxicillin b) Aztreonam c) Cefoxitin d) Nafcillin e) Penicillin G 5. A 40 years old female treated for Leukemia two month back. She is admitted to the hospital with malaise, chills and high fever. Gram stain of blood reveals the presence of gram negative bacilli. The initial diagnosis is bacteremia and the parenteral antibiotics are indicated. The records of the patients reveal that she had a severe urticarial rash, hypotension and respiratory difficulty after oral penicillin V about 6 month ago. The drug regimen for empiric treatment is? a) Ampicillin plus sulbactam b) Aztreonam c) Cefazolin d) Imipenem plus cilastatio e) Ticarcillin plus clavulanic

6. A female patient needs antibiotic treatment prophylaxis before going for a tooth extraction. Her medical history includes a severe anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with: a) Amoxicillin clavcilanate b) Aztreonam c) Cefazolin plus gentamycin d) Meropenem e) vancomycin 7. A man is on vancomycin for one week. Which statement about vancomycin is accurate a) It is bacteriostatic b) It is binds to PBPs c) It is not susceptible to penicillinase d) It has good oral bioavailability e) Staphylococcal enterocolitis occurs commonly with its use 8. A 10 years old child is taking Ampicillin for upper respiratory tract infection. Which of the following statements about ampicillin is not accurate? a) Antibacterial activity is Enhanced by sulbactam b) Causes maculopapular rashes c) Drug of choice for L monocytogenes infection d) Eradicates most strains of MRSA e) May cause pseudomembranous colitis 9. A 25 years old female has primary syphilis. She has a history of penicillin hypersensitivity, so tetracycline will be used to treat the infection. Which statement about the proposed drug treatment of this patient is accurate? a) Antacids will not affect absorption of the drug b) Azithromycin would not be effective in treatment of this patient c) For full effectiveness tetracycline must be taken for 15 days d) She should eat plenty of yogurt to prevent vaginal candidiasis e) Tetracycline is potent inhibitor of hepatic drug metabolizing enzymes 10. A patient having culture positive enterococcal bacteremia. Who has failed to respond to vancomycin because of resistance, the treatment most likely to be effective is? a) Claritheomycin b) Erythromycin c) Linezolid d) Minocycline e) Ticarcillin

11. A 28 years old man having a degenerative joint disease is to undergo insertion of hip prosthesis. To avoid complication due to postoperative infection, the surgeon will pretreat this patient with an antibiotic. This hospital has a significant problem with methicillin resistant staphylococcus aureus. Which of the following antibiotics should the surgeon select? a) Ampicillin b) Imipenem c) Gentamycin d) Vancomycin e) Cefazolin 12. A 28 years old male returns home from a holiday in the far days east and complains of three days of dysuria and a purulent urethral discharge. You diagnose this to gonorrhea. Which of the following is appropriate treatment? a) Ceftriaxone intra muscular b) Penicillin G intra muscular c) Gentamycin intra muscular d) Piperacillin intra Venus e) Vancomycin intra Venus 13. 19 years old beautiful, fair skinned girl visits her dermatologist at a local clinic because of a rash that appeared after she spent the sunny weekend kite flying with her friends. She was put on a drug for two months to prevent acne flare ups. The drug responsible for her recent concerns may be: a) Amoxicillin b) Cepheradine c) Minocycline d) Oxacillin e) Erythromycin 14. 40 years old bus driver presents to the clinic with severe headache and tinnitus. Upon investigations he is found to have an increased intracranial pressure but the CSF composition is normal. No hydrocephalus, mass, or structural or vascular lesion. No obvious cause is identified except a history of antibiotic therapy. Which of the following drug may be responsible for this condition? a) Azithromycin b) Imipenem c) Mezlocillin d) Tetracycline e) Methicillin 15. a) b) c) d) e) Drug of first choice for MRSA is: Clindamycin Erythromycin Vancomycin Oxytetracycline Meropenem

16. Medical students are discussing the clinical uses of antimicrobials when they come across a beta lactam antibiotic named methacillin. After considerable arguments they approach their instructor. The instructor wouyld tell: a) It is used to treat gram positive infection b) It is used to treat Methacillin Sensitive Staphylococcus Aureus (MSSA) c) It is used to treat Vancomycin Resistant Staphylococcus Aureus (VRSA) d) It is used to treat Vancomycin Resistant Enterococci (VRE) e) It is not used therapeutically 17. After taking a macrolide the girl develops severe diarrhea and colitis, which of the following drugs may be of use in antimicrobial associated diarrhea? a) Apmicillin b) Vancomycin c) Ceftriaxone d) Cefamendol e) Oxytetracycline 18. 49 years school teacher has been regularly taking warfarin, an anti-coagulant for his long standing coagulation disorder. He develops upper respiratory tract infection and goes to a quack who prescribes an antibacterial without bothering about his drug history. After a couple of doses he develops frank bleeding from gums. Which antimicrobial may have been wrongly prescribed? a) Gentamycin b) Clarithromycin c) Linezolid d) Amoxicillin e) Cephradine 19. Drug of choice for treatment of mycobacterium avium complex in AIDS patient is: a) a) Tetracycline b) b) Azithromycine c) c) Penicillin G d) d) Amoxicillin e) e) Chloramphenicol 20. Which of the following groups of antibiotics demonstrates a bacteriostatic effect? a) Carbapenems b) Erythromycin c) Penicillin G d) Cephradine e) Amoxicillin

21. Mr. Smith is a patient of chronic renal failure and has regular dialysis. The tetracycline antibiotic that does not require dose reduction to treat his skin lesions is: a) Doxycycline b) Demeclocycline c) Minocycline d) Oxytetracycline e) Chlortetracycline 22. A 61 years old male smoker presents with headache, weakness, fatigue and decreased urinary output, he has hyponateremia and urine osmolality is markedly increased. He might be suffering from a condition that may be treated with: a) Doxycycline b) Demeclocycline c) Minocycline d) Oxytetracycline e) Chlortetracycline 23. Vancomycin resistant staphylococci may be given a trail of: a) Aztreonam b) A thirg generation cephalosporin c) Streptogramins d) Rifampin e) Azithromycin 24. The term MIC refers to: a) Minimum Inhibitory Concentration of an anti microbial in blood b) Minimum Inhibitory Concentration of an anti microbial in a confined medium c) Minimum Inhibitory Concentration of an anti microbial in a diseased tissue or organ d) Minimum Inhibitory Concentration of an anti microbial against bacterial in a population e) Minimum concentration required to kill the bacteria in the body 25. After an antimicrobial overdosage little Johnny developed irregular and rapid respiration, abdominal distention, periods of cyanosis, and passage of loose, green stools occur. He was severely ill by the end of the first day. Over the next 24 hours, he turned an ashen-gray color and became flaccid and hypothermic. The most likely antimicrobial he has taken is: a) Amoxicillin b) Chloramphenicol c) Erythromycin d) Doxicycline e) Bacitracin

1 2 3 4 5 6 7 8 9

e c d d b e c d c

10 c 11 d 12 a 13 c 14 d 15 c 16 e 17 b 18 b 19 b 20 b 21 a 22 b 23 c 24 b 25 b