>>>Part 4
49.1 The beta lactam antibiotics include the following:
A. Cephalosporins
B. Monobactams
C. Carbapenems
D. All of the above
49.2 The most likely explanation of differing sensitivities
of different bacteria to various penicillins is:
A. Differing susceptibilities of the various penicillins to β-lactamases produced by different bacteria
B. Differing affinities of penicillin binding proteins present in different bacteria towards various penicillins
C. Differing penetrability of various penicillins into different bacteria
D. Differing rates of cell wall synthesis by different bacteria
49.3 Penicillins interfere with bacterial cell wall synthesis by:
A. Inhibiting synthesis of N-acetyl muramic acid pentapeptide
B. Inhibiting conjugation between N-acetyl muramic acid and N-acetyl glucosamine
C. Inhibiting transpeptidases and carboxypeptidases which cross link the peptidoglycan
residues
D. Counterfeiting for D-alanine in the bacterial cell wall
49.4 The characteristic feature(s) of penicillin G is/are:
A. It is unstable in aqueous solution
B. Its antibacterial action is unaffected by pus and tissue fluids
C. It is equally active against resting and multiplying bacteria
D. Both ‘A’ and ‘B’ are correct
49.5 Gram negative organisms are largely insensitive to benzyl penicillin because:
A. They produce large quantities of penicillinase
B. They do not utilise D-alanine whose incorporation in the cell wall is inhibited by benzylpenicillin
C. Benzyl penicillin is not able to penetrate deeper into the lipoprotein-peptidoglycan
multilayer cell wall of gram negative bacteria
D. Both ‘A’ and ‘B’ are correct
49.6 The dominant pharmacokinetic feature of penicillin G is:
A. It is equally distributed extra- and intracellularly
B. It is rapidly secreted by proximal renal tubules
C. It has low oral bioavailability due to high first pass metabolism in liver
D. It does not cross blood–CSF barrier even when meninges are inflamed
49.7 The penicillin G preparation with the longest duration of action is:
A. Benzathine penicillin
B. Sodium penicillin
C. Potassium penicillin
D. Procaine penicillin
49.8 If a patient gives history of urticaria, itching and swelling
of lips following injection of penicillin G, then:
A. He will develop similar reaction whenever penicillin is injected
B. He can be given ampicillin safely
C. He can be given oral phenoxymethyl penicillin safely
D. All natural and semisynthetic penicillins are contraindicated for him
49.9 The most important reason for highly restricted use
of penicillin G injections in present day therapeutics is its:
A. Narrow spectrum of activity
B. Potential to cause hypersensitivity reaction
C. Short duration of action
D. Neurotoxicity
49.10 Intradermal test for penicillin sensitivity should be
performed by injecting the following quantity of
sodium benzyl penicillin:
A. 10 U
B. 100 U
C. 1000 U
D. 5000 U
49.11 An intradermal penicillin sensitivity test has been
performed on a patient and found to be negative. This indicates that:
A. Penicillin antibodies are not present in his body
B. He will not develop any reaction when full dose of penicillin is injected
C. He will not develop anaphylactic reaction when full dose of penicillin is injected
D. He is unlikely to develop immediate type of hypersensitivity reaction when full dose of
penicillin is injected
49.12 Indicate the disease in which penicillin G continues
to be used as first line treatment in all cases (unless
contraindicated), because the causative organism
has not developed resistance so far:
A. Gonorrhoea
B. Syphilis
C. Staphylococcal abscess
D. Haemophillus influenzae meningitis
49.13 Though penicillin G kills the causative organism, it
is only of adjuvant value to other measures in:
A. Diphtheria
B. Subacute bacterial endocarditis
C. Syphilis
D. Anthrax
49.14 Benzathine penicillin injected once every 4 weeks
for 5 years or more is the drug of choice for:
A. Agranulocytosis patients
B. Prophylaxis of bacterial endocarditis in patients with valvular defects
C. Prophylaxis of rheumatic fever
D. Treatment of anthrax
49.15 Which of the following is not a semisynthetic penicillin:
A. Procaine penicillin
B. Ampicillin
C. Cloxacillin
D. Carbenicillin
49.16 Semisynthetic penicillins developed so far have overcome
the following drawbacks of benzylpenicillin except:
A. Lack of efficacy against gram negative bacilli
B. Susceptibility to bacterial penicillinase
C. Inactivation by gastric acid
D. Potential to cause hypersensitivity reactions
49.17 Choose the semisynthetic penicillin which has an
extended spectrum of activity against many gram
negative bacilli, is acid resistant but not penicillinase
resistant:
A. Cloxacillin
B. Amoxicillin
C. Phenoxymethyl penicillin
D. Piperacillin
49.18 Features of phenoxymethyl penicillin include the following:
A. It is acid stable and orally active
B. Its antibacterial spectrum is similar to that of benzyl penicillin
C. It is used for less serious penicillin G sensitive infections
D. All of the above are correct
49.19 Cloxacillin is indicated in infections caused by the following organism(s):
A. Staphylococci
B. Streptococci
C. Gonococci
D. All of the above
49.20 The most frequent side effect of oral ampicillin is:
A. Nausea and vomiting
B. Loose motions
C. Constipation
D. Urticaria
49.21 Amoxicillin is inferior to ampicillin for the treatment
of the following infection:
A. Typhoid
B. Shigella enteritis
C. Subacute bacterial endocarditis
D. Gonorrhoea
49.22 Select the semisynthetic penicillin which is not acid resistant:
A. Phenoxymethyl penicillin
B. Ampicillin
C. Carbenicillin
D. Cloxacillin
49.23 Piperacillin differs from carbenicillin in the following respect(s):
A. It is more active against Pseudomonas aeruginosa
B. It is active against Klebsiella as well
C. It is acid resistant
D. Both ‘A’ and ‘B’ are correct
49.24 Clavulanic acid is combined with amoxicillin because:
A. It kills bacteria that are not killed by amoxicillin
B. It retards renal excretion of amoxicillin
C. It counteracts the adverse effects of amoxicillin
D. It inhibits beta lactamases that destroy amoxicillin
49.25 Amoxicillin + Clavulanic acid is active against the
following organisms except:
A. Methicillin resistant Staph. aureus
B. Penicillinase producing Staph. aureus
C. Penicillinase producing N.gonorrhoeae
D. β-lactamase producing E.coli
49.26 The following statement is not true of sulbactam:
A. It is a broad spectrum β-lactamase inhibitor
B. It does not augment the activity of ampicillin against bacteria that are sensitive to the
latter
C. It induces chromosomal β-lactamases
D. Combined with ampicillin, it is highly effective against penicillinase producing N.
gonorrhoeae
49.27 Sulbactam differs from clavulanic acid in that:
A. It is not a progressive inhibitor of β-lactamase
B. It does not inhibit β-lactamase produced by gram negative bacilli
C. It is quantitatively more potent
D. It per se inhibits N.gonorrhoeae
49.28 Which of the following is a second generation cephalosporin
that is highly resistant to gram negative
β-lactamases, and cures penicillinase positive as
well as negative gonococcal infection by a single
intramuscular dose:
A. Cephalexin
B. Cefuroxime
C. Cefoperazone
D. Ceftazidime
49.29 Cefotaxime has the following properties except:
A. It is highly active against aerobic gram negative bacteria
B. It is the most active cephalosporin against Pseudomonas aeruginosa
C. It produces an active metabolite
D. It has achieved high cure rates in serious hospital acquired infections
49.30 Choose the orally active third generation cephalosporin
having good activity against gram positive cocci as well:
A. Cefdinir
B. Ceftazidime
C. Cefoperazone
D. Ceftizoxime (p. 665)
49.31 Select the 3rd generation cephalosporin that can be
used only by parenteral route:
A. Cefpodoxime proxetil
B. Ceftizoxime
C. Ceftibuten
D. Cefixime
49.32 Select the fourth generation cephalosporin among the following:
A. Cefpirome
B. Ceftizoxime
C. Ceftazidime
D. Cefuroxime
49.33 Ceftriaxone has all the following attributes except:
A. It has a long plasma half life of 8 hours
B. It can cause bleeding by prolonging prothrombin time
C. It has attained high cure rates in multiresistant typhoid infection
D. It penetrates CSF poorly and therefore not
effective in meningitis
49.34 The third generation cephalosporins differ from the
first generation cephalosporins in that they are:
A. More active against gram positive cocci
B. More active against gram negative enterobacteriaceae
C. Nonimmunogenic
D. Not excreted by tubular secretion
49.35 Choose the correct statement(s) about cefepime:
A. It is a 4th generation cephalosporin
B. It is active against many bacteria resistant to 3rd generation celphalosporins
C. It is active by the oral route
D. Both 'A' and 'B' are correct
49.36 What is true of cefpirome:
A. It is a fourth generation cephalosporin
B. It easily penetrates porin channels of gram negative bacteria
C. It inhibits type I β-lactamase producing enterobacteriaceae
D. All of the above
49.37 The β-lactam antibiotic(s) that prolong(s) bleeding
time by altering surface receptors on platelets is/are:
A. Carbenicillin
B. Piperacillin
C. Cefotaxime
D. Both `A’ and `B’ are correct
49.38 The following statements are true about imipenem except:
A. It is a β-lactam antibiotic, but neither a penicillin nor a cephalosporin
B. It is rapidly degraded in the kidney
C. It is safe in epileptics
D. It is always given in combination with cilastatin
Ans:
49.1D 49.2 B 49.3 C 49.4D 49.5 C 49.6 B 49.7 A 49.8D 49.9 B 49.10 A 49.11D 49.12 B 49.13 A 49.14 C 49.15 A 49.16D 49.17 B 49.18D 49.19 A 49.20 B 49.21 B 49.22 C 49.23D 49.24D 49.25 A 49.26 C 49.27D 49.28 B 49.29 B 49.30 A 49.31 B 49.32 A 49.33D 49.34 B 49.35D 49.36D 49.37 A 49.38 C
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