Chapter·PharmacologyAntibiotics

FluoroquinolonesDownloads

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1

A 64-year-old woman with a past medical history of poorly managed diabetes presents to the emergency department with nausea and vomiting. Her symptoms started yesterday and have been progressively worsening. She is unable to eat given her symptoms. Her temperature is 102°F (38.9°C), blood pressure is 115/68 mmHg, pulse is 120/min, respirations are 17/min, and oxygen saturation is 98% on room air. Physical exam is notable for left-sided costovertebral angle tenderness, and urinalysis demonstrates bacteriuria and pyuria. The patient is admitted to the hospital and started on IV ceftriaxone. On day 3 of her hospital stay she is afebrile, able to eat and drink, and feels better. Which of the following antibiotic regimens should be started or continued as an outpatient upon discharge?

AAmoxicillin

BNitrofurantoin

CCiprofloxacin

DCeftriaxone

ETrimethoprim-sulfamethoxazole

2

An 8-year-old girl is brought to the emergency room for a 6-hour history of fever, sore throat, and difficulty swallowing. Physical examination shows pooling of oral secretions and inspiratory stridor. Lateral x-ray of the neck shows thickening of the epiglottis and aryepiglottic folds. Throat culture with chocolate agar shows small, gram-negative coccobacilli. The patient's brother is started on the recommended antibiotic for chemoprophylaxis. Which of the following is the primary mechanism of action of this drug?

AInhibition of the 50S ribosomal subunit

BInhibition of prokaryotic topoisomerase II

CInhibition of DNA-dependent RNA-polymerase

DInhibition of the 30S ribosomal subunit

EInhibition of peptidoglycan crosslinking

3

A 61-year-old woman is brought to the emergency department because of fever, chills, and flank pain for 8 hours. Her temperature is 39.1°C (102.4°F). Physical examination shows right costovertebral angle tenderness. Urine dipstick is positive for nitrites. Urinalysis shows gram-negative rods. The patient is admitted to the hospital and treatment with a drug that directly inhibits bacterial DNA replication is begun. This drug inhibits a protein that is normally responsible for which of the following steps of DNA replication?

AExcising RNA fragments in 5' to 3' direction

BCleaving DNA to relieve supercoils

CBinding to single-stranded DNA to prevent reannealing

DUnwinding DNA at replication fork

EJoining of short DNA fragments

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