Continuous Assessment PHCL L3S5 (General Principles and Anti-microbials): 12nov 2010 Section A: MCQ (QCM): Choose the

ONE best answer (60mins)

8. Which of these anti-fungal agents will act by destabilising microbial microtubules

during mitosis? [a] Clotrimazole [b] Ketoconazole [c] Nystatine [d] Griseiofulvine [e] Amphotericine

1. A 45 year old man who develops gynecomastia is likely to have received which of the
following antimicrobial agents? [a] Amoxicilline [b] Doxycycline [c] Chloramphenicol [d] Ketoconazole [e] Azithromycine Which of the following anti-microbial agent has a very broad spectrum of antimicrobial activity? [a] Doxycycline [b] Isoniazid [c] Penicilline V [d] Streptomycine [e] Penicilline G Which of the following cephaloporines is best indicated for the treatment of infections due to Pseudomonas aeruginosa? [a] Ceftazidime [b] Cephalexin [c] Carbenicillin [d] Ceftriaxone [e] Cefoxitin Which of the following classes of anti-microbial agents could cause prolongation of QTc interval on ECG thereby predisposing to arrhythmias? [a] Penicillin A [b] Macrolides [c] Cephalosporines [d] Cyclines [e] None of the Above Which of the following cephalosporins could be administered through the oral route? [a] Ceftriazone [b] Cefoxitin [c] Cefotaxime [d] Ceftazidime [e] None of the above The following antimicrobials could be used as prophylactic medication for cholera control? [a] Albendazole [b] Chloramphenicol [c] Streptomycin [d] Trimethoprim [e] Doxycycline The following drug is effective against Methicilin Sensitive Staphylococcal Infection (MSSA) [a] Ampicillin [b] Penicilline G [c] Penicillin V [d] Flucloxacillin [e] Clavulanic Acid

9. A dose-dependent adverse effect of amphotericine B is

[a] Fever [b] Hypotension [c] Nephrotoxicity [d] Hepatoxicity [e] Anaphylaxis 10. Which of the following is a broad spectrum anti-helminthic drug? [a] Mebendazole [b] Praziquantel [c] Pyrantel pamoate [d] Niclosamide [e] Diethylcarbamazine 11. Why are flouroquinolones contraindicated in breast-feeding mothers? [a] They are teratogenic [b] They block the secretion of breast milk [c] They are very costly [d] They result in discoloration of dental structures (teeth) [e] They might result in arthropathy in babies The statement below applies to questions 12-14. The use of anti-microbial or anti-parasitic drugs has become a very important tool for the control of highly endemic tropical infectious diseases in the world. The Ministry of Public Health has requested you to recommend anti-infective drugs for mass drug treatment of populations living in endemic zones of the following diseases: [a] Onchocerciasis [b] Soil transmitted Helmintic infections (nematodes) [c] Schistosomiasis [d] Ocular Trachoma [e] Druncunculosis For questions 12-14, select the disease from the above list that the drug below is

2.

3.

4.

5.

6.

the best choice to recommend.

12. Albendazole: ____

13.

Praziquantel: ____

14.

Azithromycine: ____

15. Ivermectine is effective for the treatment of which of the following conditions?

7.

[a] Norwegian Scabies (la gale norvgienne) [b] Body lice [c] Nematodes infections [d] Larva migrans [e] All of the above 16. What is the relative dosage (weight : weight) of standard pharmaceutical preparations of Trimethoprim-Sulfamethoxazole (Bactrim or Cotrimoxazole) ? [a] 1:5 [b] 2:5 [c] 1:4
1

[d] 1:3 [e] 2:3

____________________________________________________________________________
Section B: (14pts). Open Questions (Short answers)

17. Give a concise description of 3 molecular or biochemical mechanisms of resistance of bacteria to antimicrobial agents. (3pts) 18. How could you apply the pharmacokinetic and phamacodynamic properties of gentamicine to optimise it antimicrobial effects while minimising it toxicity. (4pts) 19. As concerns the use of anti-microbial agents in the treatment of of the lower respiratory tract bacteria infections in children, compare amoxicilline and erythromycine in terms of their spectrum of action and adverse effects (3pts). 20. What is the justification or rational of antimicrobial combination therapy (4pts).