Chapter·PharmacologyAntibiotics

Tetracyclines and glycylcyclinesDownloads

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1

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

2

A 37-year-old woman with a history of anorectal abscesses complains of pain in the perianal region. Physical examination reveals mild swelling, tenderness, and erythema of the perianal skin. She is prescribed oral ampicillin and asked to return for follow-up. Two days later, the patient presents with a high-grade fever, syncope, and increased swelling. Which of the following would be the most common mechanism of resistance leading to the failure of antibiotic therapy in this patient?

AIntrinsic absence of a target site for the drug

BUse of an altered metabolic pathway

CProduction of beta-lactamase enzyme

DAltered structural target for the drug

EDrug efflux pump

3

A 39-year-old man presents to his primary care physician with a high fever, cough, and malaise. One week ago, he returned from a vacation to Hawaii where he went waterskiing with his family. Three days before presentation, he started experiencing intermittent abdominal pain, which was followed by flu-like symptoms, itchiness in his eyes, and photosensitivity. On presentation, his temperature is 103°F (39.4°C), blood pressure is 114/72 mmHg, pulse is 105/min, and respirations are 18/min. Physical exam reveals conjunctivitis and mild jaundice. Which of the following treatments could be used to treat this patient's condition?

AGanciclovir

BMetronidazole

CDoxycycline

DVancomycin

EAzithromycin

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