Katzung Pharmacology Review
questions
. Currently, what is the most likely principal pathogen in non-bullous and bullous
impetigo AND the most appropriate antibiotic? - correct answerS. aureus; Topical
Mupirocin for patients with limited skin involvement
A 22yo man w/ gonorrhea is to be treated with cefixime and will req another drug to
provide possible urethritis caused by C trachomatis. Which drug is least likely to be
effective in nongonoccoal urethritis? - correct answernitrofurantoin
A 36-year-old woman recently treated for leukemia 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 parenteral antibiotics are
indicated. The records of the patient reveal that she had a severe urticarial rash,
hypotension, and respiratory difficulty
after oral penicillin V about 6 mo ago. The most appropriate drug regimen for empiric
treatment is
(A) Aztreonam
(B) Cefazolin
(C) Imipenem
(D) Nafcillin
(E) Ticarcillin plus clavulanic acid - correct answerA (Each of the drugs listed has
activity against some gram-negative bacilli. All penicillins should be avoided in patients
with a history of allergic reactions to any individual penicillin drug. Cephalosporins
should also be avoided in patients who
have had anaphylaxis or other severe hypersensitivity reactions after use of a penicillin.
There is partial cross-reactivity
between penicillins and the carbapenems such as imipenem and meropenem, but no
cross-reactivity between the penicillins and aztreonam. The answer is A.)
A 45 year old male patient with PUD was recently appropriately diagnosed with H.
pylori. He is interested in naturopathic treatments to eradicate the infection. Which of
the following is the most appropriate recommendation?
A. You assure the patient that the infection is easily treatable with botanical medicine
and antibiotics are not needed.
B. The success of treatment can be monitored by symptom improvement, therefore no
follow up testing is needed.
C. You recommend that the patient take the recommended antibiotic therapy including a
proton-pump-inhibitor, clarithromycin, and amoxicillin.
D. You recommend that the patient take the recommended antibiotic therapy including a
proton-pump-inhibitor, tetracycline, and metronidazole.
E. You inform the patient that while conventional medicine recommends a combination
of antibiotics, you can likely treat this infection with a single antibiotic. - correct
,answerYou recommend that the patient take the recommended antibiotic therapy
including a proton-pump-inhibitor, clarithromycin, and amoxicillin.
A patient needs antibiotic treatment for native valve, culture-positive infective
enterococcal endocarditis. His medical history includes a severe anaphylactic reaction
to penicillin G during the last year. The best approach would be treatment with
(A) Amoxicillin-clavulanate
(B) Aztreonam
(C) Cefazolin plus gentamicin
(D) Meropenem
(E) Vancomycin - correct answerE (In patients who have had a severe reaction to a
penicillin, it is inadvisable to administer a cephalosporin or a carbapenem such as
meropenem. Aztreonam has no significant activity against gram-positive cocci, so the
logical treatment in this case is vancomycin, often with an aminoglycoside (eg,
gentamicin)
for synergistic activity against enterococci. The answer is E.)
amikacin has - correct answernarrow therapeutic drug window
Antimicroibal txmt in AIDS pt on antiretroviral drugs who has sepsis with fever from
suspected gram (-) bacillus: - correct answerspecimens must be taken to lab for tests
and examination before antimicrobial txmt
combo of drugs might be given to pt to provide coverage against multiple organisms or
to obtain synergistic axn. examples of drug synergism include: - correct
answercryptococcal meningitis w/ amphotericin B and flucytosine
coliform infections with sulfamethoxazole & trimethoprim
enterococcal infections with rifampin and vancomycin
pseudomonal infections with carbenicillin and gentamicin
if ampicillin and piperacillin are used in combo in txmt of infxns from Pseudomonas
aeruginosa, antagonism may occur. Why? - correct answerampicillin induces beta
lactamase production
If pt had been scheduled for elective colonic surgery, optimal prophylaxis against
infection would be achieve by mechanical bowel preparation and use of - correct
answeroral erythromycin & neomycin
in pt suffering from pseudomembranous colitis due to C difficile w/ established
hypersensitivity to metronidazole, most likely drug to be of clinical value is - correct
answervancomycin
Methenamine salts are used as urinary antiseptics. Reason they lack systemic
antibacterial action is that they are - correct answerconverted to formaldehyde only at
low pH
,Neuropathies much more likely to occur w/ this agent when it is used in pts with renal
dysfunction. The drug may cause acute hemolysis in pts with G6PD deficiency - correct
answerNitrofurantoin
Question 1:
A 30-year-old hospitalized patient with AIDS has a CD4 cell count of 50/μL. He is being
treated with a highly active antiretroviral therapy (HAART) regimen consisting of
zidovudine (ZDV), lamivudine (3TC), and indinavir. Other drugs being administered to
this patient include ganciclovir, clarithromycin, rifabutin, and trimethoprim-
sulfamethoxazole.
The drug in this patient's regimen that inhibits posttranslational modification of viral
proteins is
A
Acyclovir
B
Indinavir
C
Lamivudine
D
Rifabutin
E
Zidovudine - correct answer• indinavir
The correct answer is (B).
Explanation:
Protease inhibitors such as indinavir act at the posttranslational step of HIV at which the
viral enzyme cleaves precursor molecules to form the final structural proteins of the
mature virion core.
Question 10:
A 29-year-old G1P1 (gravida-1, para-1) woman presents with infertility of 12 months'
duration. Questioning reveals that the patient has had only 4 menstrual periods in the
last year and that she sometimes notices breast nipple discharge. She has not been
taking any prescription medications during the last year. A serum prolactin
measurement reveals a concentration of 90 ng/mL (normal for a nonpregnant woman is
<25 ng/mL). Based on these findings, which of the following drugs is most likely to help
make this woman's ovulation more regular and restore her fertility?
A
Bromocriptine
B
Desmopressin
C
Leuprolide
D
Prochlorperazine
E
Spironolactone - correct answer• 2-bromoergocryptine mesylate
, The correct answer is (A).
Explanation:
This patient has signs and symptoms of hyperprolactinemia, which is caused by
prolactin-secreting pituitary adenomas. Dopamine D2 receptor agonists such as
bromocriptine can be used to suppress the excessive prolactin secretion.
Question 100:
A 55-year-old woman with type 2 diabetes was going to be started on metformin. Before
initiating therapy, it is important to confirm that the patient has normal renal function
because patients with unrecognized renal insufficiency who take normal doses of
metformin are at increased risk of which of the following?
A
Hypoglycemia
B
Interstitial nephritis
C
Lactic acidosis
D
Liver failure
E
Torsades de pointes cardiac arrhythmia - correct answer• metformin
The correct answer is (C)
Explanation:
Metformin carries a black box warning for lactic acidosis. Note that metformin is a
"euglycemic agent" (ie, it does not cause hypoglycemia).
Question 11:
A 26-year-old woman comes to the outpatient clinic with a complaint of rapid heart rate
and easy fatigability. Laboratory workup reveals low hemoglobin and microcytic red cell
size. Which of the following is the most suitable therapy?
A
Ferrous sulfate
B
Folic acid
C
Iron dextran
D
Pyridoxine
E
Vitamin B12 - correct answer• ferrous sulfate
The correct answer is (A).
Explanation:
The most common cause of microcytic anemia is iron deficiency, which can be treated
in most patients with an oral iron supplement such as ferrous sulfate.
Question 12:
questions
. Currently, what is the most likely principal pathogen in non-bullous and bullous
impetigo AND the most appropriate antibiotic? - correct answerS. aureus; Topical
Mupirocin for patients with limited skin involvement
A 22yo man w/ gonorrhea is to be treated with cefixime and will req another drug to
provide possible urethritis caused by C trachomatis. Which drug is least likely to be
effective in nongonoccoal urethritis? - correct answernitrofurantoin
A 36-year-old woman recently treated for leukemia 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 parenteral antibiotics are
indicated. The records of the patient reveal that she had a severe urticarial rash,
hypotension, and respiratory difficulty
after oral penicillin V about 6 mo ago. The most appropriate drug regimen for empiric
treatment is
(A) Aztreonam
(B) Cefazolin
(C) Imipenem
(D) Nafcillin
(E) Ticarcillin plus clavulanic acid - correct answerA (Each of the drugs listed has
activity against some gram-negative bacilli. All penicillins should be avoided in patients
with a history of allergic reactions to any individual penicillin drug. Cephalosporins
should also be avoided in patients who
have had anaphylaxis or other severe hypersensitivity reactions after use of a penicillin.
There is partial cross-reactivity
between penicillins and the carbapenems such as imipenem and meropenem, but no
cross-reactivity between the penicillins and aztreonam. The answer is A.)
A 45 year old male patient with PUD was recently appropriately diagnosed with H.
pylori. He is interested in naturopathic treatments to eradicate the infection. Which of
the following is the most appropriate recommendation?
A. You assure the patient that the infection is easily treatable with botanical medicine
and antibiotics are not needed.
B. The success of treatment can be monitored by symptom improvement, therefore no
follow up testing is needed.
C. You recommend that the patient take the recommended antibiotic therapy including a
proton-pump-inhibitor, clarithromycin, and amoxicillin.
D. You recommend that the patient take the recommended antibiotic therapy including a
proton-pump-inhibitor, tetracycline, and metronidazole.
E. You inform the patient that while conventional medicine recommends a combination
of antibiotics, you can likely treat this infection with a single antibiotic. - correct
,answerYou recommend that the patient take the recommended antibiotic therapy
including a proton-pump-inhibitor, clarithromycin, and amoxicillin.
A patient needs antibiotic treatment for native valve, culture-positive infective
enterococcal endocarditis. His medical history includes a severe anaphylactic reaction
to penicillin G during the last year. The best approach would be treatment with
(A) Amoxicillin-clavulanate
(B) Aztreonam
(C) Cefazolin plus gentamicin
(D) Meropenem
(E) Vancomycin - correct answerE (In patients who have had a severe reaction to a
penicillin, it is inadvisable to administer a cephalosporin or a carbapenem such as
meropenem. Aztreonam has no significant activity against gram-positive cocci, so the
logical treatment in this case is vancomycin, often with an aminoglycoside (eg,
gentamicin)
for synergistic activity against enterococci. The answer is E.)
amikacin has - correct answernarrow therapeutic drug window
Antimicroibal txmt in AIDS pt on antiretroviral drugs who has sepsis with fever from
suspected gram (-) bacillus: - correct answerspecimens must be taken to lab for tests
and examination before antimicrobial txmt
combo of drugs might be given to pt to provide coverage against multiple organisms or
to obtain synergistic axn. examples of drug synergism include: - correct
answercryptococcal meningitis w/ amphotericin B and flucytosine
coliform infections with sulfamethoxazole & trimethoprim
enterococcal infections with rifampin and vancomycin
pseudomonal infections with carbenicillin and gentamicin
if ampicillin and piperacillin are used in combo in txmt of infxns from Pseudomonas
aeruginosa, antagonism may occur. Why? - correct answerampicillin induces beta
lactamase production
If pt had been scheduled for elective colonic surgery, optimal prophylaxis against
infection would be achieve by mechanical bowel preparation and use of - correct
answeroral erythromycin & neomycin
in pt suffering from pseudomembranous colitis due to C difficile w/ established
hypersensitivity to metronidazole, most likely drug to be of clinical value is - correct
answervancomycin
Methenamine salts are used as urinary antiseptics. Reason they lack systemic
antibacterial action is that they are - correct answerconverted to formaldehyde only at
low pH
,Neuropathies much more likely to occur w/ this agent when it is used in pts with renal
dysfunction. The drug may cause acute hemolysis in pts with G6PD deficiency - correct
answerNitrofurantoin
Question 1:
A 30-year-old hospitalized patient with AIDS has a CD4 cell count of 50/μL. He is being
treated with a highly active antiretroviral therapy (HAART) regimen consisting of
zidovudine (ZDV), lamivudine (3TC), and indinavir. Other drugs being administered to
this patient include ganciclovir, clarithromycin, rifabutin, and trimethoprim-
sulfamethoxazole.
The drug in this patient's regimen that inhibits posttranslational modification of viral
proteins is
A
Acyclovir
B
Indinavir
C
Lamivudine
D
Rifabutin
E
Zidovudine - correct answer• indinavir
The correct answer is (B).
Explanation:
Protease inhibitors such as indinavir act at the posttranslational step of HIV at which the
viral enzyme cleaves precursor molecules to form the final structural proteins of the
mature virion core.
Question 10:
A 29-year-old G1P1 (gravida-1, para-1) woman presents with infertility of 12 months'
duration. Questioning reveals that the patient has had only 4 menstrual periods in the
last year and that she sometimes notices breast nipple discharge. She has not been
taking any prescription medications during the last year. A serum prolactin
measurement reveals a concentration of 90 ng/mL (normal for a nonpregnant woman is
<25 ng/mL). Based on these findings, which of the following drugs is most likely to help
make this woman's ovulation more regular and restore her fertility?
A
Bromocriptine
B
Desmopressin
C
Leuprolide
D
Prochlorperazine
E
Spironolactone - correct answer• 2-bromoergocryptine mesylate
, The correct answer is (A).
Explanation:
This patient has signs and symptoms of hyperprolactinemia, which is caused by
prolactin-secreting pituitary adenomas. Dopamine D2 receptor agonists such as
bromocriptine can be used to suppress the excessive prolactin secretion.
Question 100:
A 55-year-old woman with type 2 diabetes was going to be started on metformin. Before
initiating therapy, it is important to confirm that the patient has normal renal function
because patients with unrecognized renal insufficiency who take normal doses of
metformin are at increased risk of which of the following?
A
Hypoglycemia
B
Interstitial nephritis
C
Lactic acidosis
D
Liver failure
E
Torsades de pointes cardiac arrhythmia - correct answer• metformin
The correct answer is (C)
Explanation:
Metformin carries a black box warning for lactic acidosis. Note that metformin is a
"euglycemic agent" (ie, it does not cause hypoglycemia).
Question 11:
A 26-year-old woman comes to the outpatient clinic with a complaint of rapid heart rate
and easy fatigability. Laboratory workup reveals low hemoglobin and microcytic red cell
size. Which of the following is the most suitable therapy?
A
Ferrous sulfate
B
Folic acid
C
Iron dextran
D
Pyridoxine
E
Vitamin B12 - correct answer• ferrous sulfate
The correct answer is (A).
Explanation:
The most common cause of microcytic anemia is iron deficiency, which can be treated
in most patients with an oral iron supplement such as ferrous sulfate.
Question 12:
