DEPARTMENT OF ORAL AND

MAXILLOFACIAL SURGERY
GOVERMENT DENTAL COLLEGE &
HOSPITAL, AHMEDABAD.

Antibiotics

Presented by:- Hitesha K. Rawal

Krupesh H. Patel
Intern Batch :- 2014 15.

Antibiotics

Que:-1. Most common side effect of the oral administration of ampicillin is:
2

A.
B.
C.
D.

Anaphylactic shock
Diarrhea
Oral candidisis
Renal failure

Ans:- B. Diarrhea
Exp:- Diarrhea is the most common side effect of oral administration of ampicillin.
After oral administration, ampicillin is incompletely absorabed and the
unabsorbed drug irritates lower intestine causing diarrhea.
Other side effects of ampicillin are
- Alteration of intestinal bacterial flora, (Super infection) due to irritant action
of unabsorbed drug.
- Rashes due to hyper sensitivity.
Ref :- Satoskar 19th Edition, Page no.661/ KDT 5th Edition, Page no. 660.
Que:-2. Which of the following drugs is likely to damage the eighth cranial
nerve when administered for a long period of time?
A.
B.
C.
D.

Ethambutol
Isoniazid
Rifampicin
Streptomycin

Ans:- D . Streptomycin
Exp:- Nephrotoxicity, ototoxicity, and contact sensitization ( due to this, topical
application is not indicated) are common side effects of Streptomycin. 8th
nerve is usually affected. Vestibular involvement is more common and
cochlear involvement is less common.
Ref :- Satoskar 19th Edition, Page no.672.

Que:- 3. Which of the following is primarily a bactericidal drug?

3

A.
B.
C.
D.

Chloramphenicol
Gentamicin
Sulphadiazine
Tetracycline

Ans:- B . Gentamicin
Exp:- All aminoglycosides and hence gentamicin are bactericidal drugs.
Options A, C and D are bacteriostatic drugs.
Ref :- Satoskar 19th Edition, Page no.673.
Que:- 4. Penicillin is effective against
A.
B.
C.
D.

Neisseria meningitis
Neisseria gonorrhoeae
Treponema pallidum
All of the above

Ans :- D . All of the above

Ref :- KDT 5th Edition, Page no. 654.
Que:- 5. The therapeutic advantage that penicillin V has over penicillin G is:
A.
B.
C.
D.

More reliable oral absorption

Greater resistance to pencillinase
Slower renal excretion
Border antibacterial spectrum

Ans:- A . More reliable oral absorption

Exp :- Penicillin V or Phenoxy Methyl penicillin is semi synthetic and differs
from penciling G ( Benzyl penicillin), only in that, it is acid stable. When
given orally, it produes higher plasma concentration than the same amount
of penicillin G given orally.
Ref :- KDT 5th Edition, Page no. 658.
Que:-6. Concurrent administration of tetracyclines is most likely to impair the
4

action of:
A.
B.
C.
D.

Lincomycin
Chloramphenicol
Erythromycin
Penicillin

Ans:-D . Penicillin
Exp :- Inactivation occurs, if injectable form of tetracyclines are mixed with
penicillin.
Ref :- Satoskar 19th Edition, Page no.690.
Que:- 7. Chloramphenicol can cause:
A.
B.
C.
D.

Staining of teeth
Aplastic anaemia
Bone marrow suppression
B&C

Ans:- D . B & C
Exp :- Previosly, chloramphenicol is the drug of choice in treatment of typhoid.
The main disadvantages of Chloramphenicol are
- Bone marrow depression and aplastic anemia.
- Gray baby syndrome.
- Hypersensitivity reactions.
- Super infection.
Ref :- Satoskar 19th Edition, Page no.693.

Que :- 8. Which drug causes photosensitivity

5

A.
B.
C.
D.

Tetracycline
Aminoglycoside
Penicillin
Cephalosporin

Ans:- A . Tetracycline
Exp :- Important Adverse effects of tetracycline are:
- Hepatotoxicity.
- Renal toxicity and fanconi syndrome.
- Phototoxicity.
- Staining of teeth due to formation of chelates with Ca+2 ions
- Suppression of bone narrow growth.
Ref :- Satoskar 19th Edition, Page no.687.
Que:- 9. The antibiotic of choice in patients sensitive to penicillin is:
A.
B.
C.
D.

Erythromycin
Streptomycin
Tetracycline
Chloramphenicol

Ans:- A . Erythromycin
Ref :- Satoskar 19th Edition, Page no.664.

Que:- 10. Which of the following penicillins can be given by IV route?

6

A.
B.
C.
D.

Benzathine
Procaine
Crystalline
benzathamine

Ans:- C . Procaine
Exp.:Type of penicillin
- Procaine penicillin
- Benzathine penicillin
- ( long acting)
Crystalline penicilline
Phenoxy methyl penicillin or Penicillin V

Route of administration
Deep I.M.
IM/IV
Oral

Drugs, which should not be given by I.V. route are

- Paracetamol
- Diclofenac
- Chloroquine
- Adrenaline
Ref :- KDT 5th Edition, Page no. 665.
Que :- 11. Tetracycline is contraindicated in:
A.
B.
C.
D.

Children
Pregnancy
Renal failure
All of the above

Ans:- D . All of the above

Ref :- Satoskar 19th Edition, Page no.689.

Que:-12 . Fluconazole is used for the treatment of:

7

A.
B.
C.
D.

Pemphigus
Herpes simplex
Candidiasis
Syphilis

Ans:- C . Candidiasis
Exp.:Antibiotics
Antimetabolites
Imidazoles
Trialzoles

Classification of antifungal drugs

- Amphotericin B
- Nystatin
- Griseofulvin
Flucytosine
Clotrimazole
Fluconazole

Ref :- Satoskar 19th Edition, Page no.702.

Que:- 13. Mechanism of action of quinolones is:
A.
B.
C.
D.

Inhibits DNA gyrase

Inhibitits bacterial protein synthesis
Inhibits bacterial cell wall synthesis
Inhibits intake of folic acid

Ans:- A . Inhibits DNA gyrase

Exp :- Flouroguinolones inhibit the bacterial enzyme DNA gyrase. In place of
DNA gyrase, the mammalian cells contains an enzyme topoisoMerase II,
which has very low affinity for flouroquinolones; hence low toxicity to the
host cells.
Ref :- Satoskar 19th Edition, Page no.645.

Que:-14. A child with peramanently stained teeth reports. He was most

8

probably administered
A.
B.
C.
D.

Disphenyl hydantoin
Diphenhydramine
Digoxin
Doxycycline

Ans:- D. Doxycycline
Exp:- Compared to tetracycline, dxycycline or oxytetracycline will cause less
tooth discolouration.
Gingival hyperplasia and megaloblastic anemia are the side effects of option
Ai.e./Disphenyl hydantion
Ref :- Satoskar 19th Edition, Page no.689.
Que:-15. The bacterial resistance to tetracycline is due to:
A.
B.
C.
D.

Alteration of drug binding sites

Alteration of dehydrofolate reductase
Inactivation uptake of drug by bacteria
Decreased uptake of drug by bacteria

Ans:- C . Inactivation uptake of drug by bacteria

Exp:-Mechanisum of bacterial resistance to tetracyclines are:
- Decrease in tetracycline concentrating mechanism.
- Plasmid mediated synthesis of a protection protein that protects the
ribosomal bonding site from tetracycline.
- Elaboration of tetracycline inactivating enzymes.
Ref :- Satoskar 19th Edition, Page no.687.

Que:- 16. A Patient suffering from syphilis is given penicillin. He may develop
9

A.
B.
C.
D.

Cholestatic Jaundice
Grey syndrome
Fanconi Syndrome
Jarish Heexheimer reaction

Ans:- D . Jarish Heexheimer reaction

Exp.:- Jerisch- Herxheimer reaction occurs when pencilin is injected in syphilitic
patient, due to sudden release ofsprocheatal lytic products. Thisreaction last
for 12-72 hours, characterized by shivering, fever, myalgia, and
exacerbation of lesion. It does not recur and does not need interruption of
therapy.
Option A cholestatic jaundice is a side of effect of chlorpromazine.
Option B Grey baby syndrome is caused by chloramphenicol, when high
doses are given to neonates.
Option c fanconi syndrome like condition is caused due to administration
of outdated tetracyclines.
Ref :- Satoskar 19th Edition, Page no.654.
Que:- 17. The drug of choice for treatment of typhoid is:
A.
B.
C.
D.

Tetracycline
Metronidazole
Ciprofloxacin
Cefotaxim

Ans:- C . Ciprofloxacin
Ref :- Satoskar 19th Edition, Page no.695.

Que:-18.peripheral neuritis is a complication of

10

A.
B.
C.
D.

Isoniazid
Ethambutol
Rifampicin
Pirazinamide

Ans:- A . Isoniazid
Exp :- Peripheral neuritis caused by isoniazide can be prevented by taking
pyridoxine 10 mg/day prophylactically and treated by taking pyridoxine 100
mg/day. Other drugs that cause peripheral neuritis are.
- Griseofulvin.
- Nitrofurantoin.
- Vincristine.
Ref :- Satoskar 19th Edition, Page no.737.
Que:-19. When broad- spectrum antibiotics are administered withcoumarin
anticoagulants, the anticoagulant action may be:
A.
B.
C.
D.

Reduced because of enhanced hepatic drug methabolism

Reduced because of increased protein-binding
Increased because of reduction of vitamin K sources
Increased because of decreased renal excretion of the anticoagulant

Ans:- C . Increased because of reduction of vitamin K sources

Exp:- When broad-spectrum antibiotics are administered with coumarin
derivatives, they inhibit gut flora and reduce vitamin K absorption and thus
enhance the anticoagulant action.
Ref :- Satoskar 19th Edition, Page no.690.

Que:-20. Antifungal drug not used in the treatment of imtestinal candidiasis.

11

A.
B.
C.
D.

Amphotericin
Nystatin
Ketoconazole
Clotrimazole

Ans:- D . Clotrimazole
Exp:Amphotericin B
Nystatin

Used topically as well as systematically

It is used locally, because of its higher
systemic toxixity.
Given orally, it is not absorbed; so used for
monilial darrhoea.
Also used against
- Monilial vaginitis.
- Oral thrush
- Corneal, conjuctival and cutaneous
candidiasis.
Ketoconazole
Used systemically
Clotrimazole
Used for topical application only.
So it is not used in treatment of intestinal condidiasis.
th
Ref :- Satoskar 19 Edition, Page no.737.
Que:-21. A patient has seasonal allergic rhinitis and is on terfenadine. He
develops cardiac arrhythmias after a course of antibiotics. Which of
the following antibiotic could have been given:
A.
B.
C.
D.

Ampicillin
Tetracycline
Erythromycin
Co-trimoxazole

Ans:- C . Erythromycin
Exp:- Terfenadine in overdoses blocks cardiac K+ channels and occasionally
produces arrhythmias. The druge, which precipitates this toxicity, are
erythromycin, clarithromycin, ketoconazole, etc.,
Ref :- Satoskar 19th Edition, Page no.323.
Que:-22. Granesetron, has antiemetic properties because of:
12

A.
B.
C.
D.

Dopaminergic receptor blocking actions

Gabamimetic actions
Gaba-inhibitory actions
Serotonin receptor-blocking action

Ans:- D . Serotonin receptor-blocking action

Exp:- Granisetron is selective 5-HT3 antagonist. These drugs are highly effective
in controlling nausea and vomiting following administration of highly emetic
anti cancer drugs.
Ref :- KDT 5th Edition, Page no. 150.
Que:-23. Desfuroxamide is a drug used for:
A.
B.
C.
D.

Kala-azar
Pernicious anaemia
Pain control
Thalassemia

Ans:- D . Pain control

Exp:- Desferrioxamine is chelating agent for iron. It is used in
- Acute Iron poisoning cases.
- Transfusion siderosis, which occurs in thalassemia patients receiving
repeated blood transfusions.
Important Chelating Agents Are
-

BAL (British Antileusite ) for heavy metal poisoning ( mercury poisoning).

DMSA ( Dimercapto succinic acid ) for lead poisoning.
EDTA- for heavy metal poisoning.
Pencillanamine (copper poisoning)

Ref :- Satoskar 19th Edition, Page no.1047.

Que:- 24. The mechanism of action of chloramphenicol is inhibition of
synthesis of:
13

A.
B.
C.
D.

Cell wall
Cell membrane
Protein
DNA

Ans:- C . Protein
Ref :- Satoskar 19th Edition, Page no.693.
Que:-25.which one of following is penicillinase resistant penicillin:
A.
B.
C.
D.

Amoxicillin
Cloxacillin
Ampicillin
Penicillin G

Ans:- B . Cloxacillin
Exp:- Methicillin, cloxacillin are examples of pencillinase resistant penicillins.
Ref :- Satoskar 19th Edition, Page no.659.
Que:- 26. A patient taking which of the following is penicillinase resistant
penicillin:
A.
B.
C.
D.

Tetracycline
Amoxicillin
Doxycyline
Triamterene

Ans:- A . Tetracycline
Exp.:- Tetracyclines have chelating property; they from insoluble and
unabsorbable complexs with calcium and other metals. Hence, milk, iron
preparations, non- systemic antacids and sucralfate should not be given
with them.
Ref :- Satoskar 19th Edition, Page no.687.
Que:-27. Erythromycin is
14

A.
B.
C.
D.

Cidal in action
Cidal in high concentration
Static in action
All of the these

Ans:- B . Cidal in high concentration

Exp:- Erythromycin is bacteriostatic at loconcentrations but acts like a bactericidal
drug at higher constrations.
Ref :- Satoskar 19th Edition, Page no.664.
Que:-28. Prolonged administration of streptomycin may result in damage to
the:
A.
B.
C.
D.

Optic nerve
Facial nerve
Auditory nerve
Trigeminal nerve

Ans:- C . Auditory nerve

Ref :- Satoskar 19th Edition, Page no.672.
Que:- 29. Which of the following antibiotics is most frequently associated with
pseudomembranouscolitis?
A.
B.
C.
D.

Ampicilin
Penicillin
Clindamycin
Cephalosporin

Ans:- C . Clindamycin
Exp:- Clindamycin causes pseudomembranous enterocolitis due to clostridium
difficile superinfection, which is fatal. Diarrhea is the main side effect of
option A ampicillin.
The order drug, which causes pseudomembranous colitis, is tetracycline.
Ref :- Satoskar 19th Edition, Page no.667.
Que:-30. In the treatment of intestinal and extraintestinal amoebiasis which of
the following drug is useful:
15

A.
B.
C.
D.

Diloxane
Metronidazole
Chloroquine
Cefaclor

Ans:- B . Metronidazole
Exp:- Classification of antiamoebic Drugs:
i.

Drugs used in intestinal amoebiasis.

Eg.:Emetine bismuth iodide
Drugs used in extraintestinal amoebiasis.
Eg.: Chloroquine (also used in malaria, lepra reaction and arthritis (cases).
Drugs used in both intestinal and extra intestinal cases.
Eg.: Metronidazole, Tinidazole.

ii.
iii.

Ref :- Satoskar 19th Edition, Page no.779.

Que:-31. Cephalosporins have all of the following interactions except:
A.
B.
C.
D.

Show cross sensitivity with penicillins

Are penicillinase resistant
Have a broad spectrum but are inactive against anaerobes
Are used in upper respiratory tract infections

Ans:- B . Are penicillinase resistant

Exp:- About 10% of patients allergic to penicillin show, hypersensitivity to
cephalosporins. Those with a history of immediate type of reaction to
penicillin should better not given a cephalosporin.
Ref :- Satoskar 19th Edition, Page no.679.

Que:-32. A distinct advantage that tetracyclines have over penicillins is that

tetracyclines:
16

A.
B.
C.
D.

Have no side effects

Do not causwe superinfections
Are safer to use during pregnancy
Have a wider range of antibacterial activity

Ans:- D . Do not causwe superinfections

Ref :- Satoskar 19th Edition, Page no.686.
Que:-33. Clavulanic acid added to ampicillin causes:
A.
B.
C.
D.

Increase effectivity against gram-negative organisms

Inhibition of B-lactamases
Increases the effectiveness against delta lactamase producing organism
Increase effectivity againstgram-positive organisms

Ans:- B . Inhibition of B-lactamases

Exp.:- B- lactamases are family of enzymes produced by many gram positive and
gram negative bacteria. They inactivate B-lactam antibiotics by opening Blactam ring.
Clavuanic acid and sulbactum are examples of B-lactamase inhibitors.
They inhibit the B-lactamase enzymes and thus increase the efficiency of
antibiotics.
Ref :- Satoskar 19th Edition, Page no.663.

Que:- 34. The administration of penicillin G along with probenicid results in:
17

A.
B.
C.
D.

Increased excretion of probenacid in the feaces and perspiration

Increased excretion of probenacid in urine
Increased metabolism of penciling G
Decreased renal excretion of penciling G

Ans:- D . Decreased renal excretion of penciling G

Exp:- The plasma half-life of penicillin G is low because of its rapid renal
excretion. Tubular secretion of penicillin G can be blocked by probenecid
and this results in higher and longer lasting plasma concentrations.
Ref :- Satoskar 19th Edition, Page no.652.
Que:- 35. Which of the following drugs are components of the MOPP cancer
Chemotherapy regimen EXCEPT:
A.
B.
C.
D.

Norfloxacin
Streptomycin
Doxycycline
Cefotaxime

Ans:- B . Streptomycin
Exp:- Use of streptomycin with compective docker ( d-tubocurarine) causes
prolonged apnoea.
Ref :- KDT 5th Edition, Page no. 315.

Que:-36. Which one of the following drugs is an antipseudomonal penicillin?

18

A.
B.
C.
D.

Cephalexin
Cloxacillin
Piperacillin
Dicloxacillin

Ans:- C . Piperacillin
Exp:- Carboxypenicillins ( carbenicillin, Ticarcilin )
- Ureido penicillins (Piperacillin ) are the penicillins which are
antipseudomonal in action.
Ref :- KDT 5th Edition, Page no. 66.
Que:- 37. Clavulanic acid is given in combination with amoxicillin in order to
A.
B.
C.
D.

Reduce the risk allergic reactions

Prolong amoxicillins half-life
Reduce the severity of diarrhea
Extend amoxicillins antibacterial spectrum

Ans:- D. Extend amoxicillins antibacterial spectrum

Exp:- Addition of clavulanic acid reestablishes the activity of amoxicillin against
B-lactamase producing bacteria and extends the anti-bacterial spectrum.
Ref :- KDT 5th Edition, Page no. 661.
Que:-38. The oropharyngeal and oesophageal candidiasis following long-term
therapy with a broad spectrum antibiotic can be best treated with:
A.
B.
C.
D.

Griseofulvin
Amphotericin
Fluconazole
Sulfonates

Ans:- C . Fluconazole
Exp:- Fluconazole is most effective orally for all types of fungal infections.
Ref :- KDT 5th Edition, Page no. 719.
Que:- 39. One of the below mentioned penicillin is NOT given orally:
19

A.
B.
C.
D.

Amoxicillin
Carbenicillin
Cloxacillin
phenoxymethy penicillin

Ans:- B. Carbenicillin
Exp:- Carbenicillin is neither penicillinase resistant nor acid resistant. It is inactive
orally and is rapidly excreted in urine. The special feature of carbenicillin is
its activity against pseudomonas aeruginosa and indole positive proteus,
that are not inhibited by pencillin G or aminopencillins.
Ref :- Satoskar 19th Edition, Page no.662.
Que:-40. The drug for choice for treatment of infection involving nonpenicillinase producing staphylococcus is:
A.
B.
C.
D.

Ampicillin
Erythromycin
Penicillin G
Methicillin sodium

Ans:- C . Penicillin G
Ref :- Satoskar 19th Edition, Page no.656.
Que:-41. Ototoxicity and nephrotoxicity is caused by:
A.
B.
C.
D.

Antiemetic
Antiviral
Antifungal
Antibiotic

Ans:- D . Antibiotic
Exp:- Aminoglycosides are the antibiotics that cause ototoxicity and
nephrotoxicity.
Ref :- Satoskar 19th Edition, Page no.672.
Que:-42. INH induced neuropathy is treated with
20

A.
B.
C.
D.

Thiamine
Pyridoxine
Niacin
Riboflavin

Ans:- B . Pyridoxine
Exp:- The peripheral neuritis due to INH is due to interference with utilization of
pyrodixine and its increased excretion in urine. Pyridoxine given
prophylactically ( 10mg/day) prevents this neurotoxicity.
Ref :- KDT 5th Edition, Page no. 700.
Que:- 43. Which of the following penicillins is given by oral route?
A.
B.
C.
D.

Benzyl penicillin
Benzathine penicillin
Procaine penicillin
Penicillin V / Phenoxymenthyl penicillin

Ans:- D . Penicillin V / Phenoxymenthyl penicillin

Exp:- phenoxy methyl penicillin is acid restant and is alternative to penicillin G.
Ref :- Satoskar 19th Edition, Page no.654.

Que:- 44. A diabetic patient developed cellulitis due to Staphylococcus aureus,

which was found was to be Methicillin resistant on the antibiotic
21

sensitivity testing. All the following antibiotics will be appropriate

except:
A.
B.
C.
D.

Vancomycin
Imipenem
Teichoplanin
Linezolid

Ans:- B . Imipenem
Exp:- Methicillin resistant Staph-aureus ( MRSA ) are insensitive to all
penicillinase resistant pencillins and erythromycin, aminoglycosides,
tetracyclines, etc.
The drug of choice for these organisms is vancomycin, linezolid.
Ref :- KDT 5th Edition, Page no. 659, 691.
Que:- 45. Oral infection by penicillinase producing organisms should be
treated with:
A.
B.
C.
D.

Ampicillin
Dicloxacillin
Erythromycin
Any of the above

Ans:- B. Dicloxacillin
Exp:- Methicillin, cloxacillin and oxacillin are penicillinase resistant penicillinis.
Ref :- Satoskar 19th Edition, Page no.660.

Que:-46. Which of the following drug does not show renal toxicity
22

A. Gentamycin
B. Streptomycin
C. Methoxyprenalin
D. Isoflurane
Ans:- D . Isoflurane
Exp:- Isofurane ( inhalation anaesthetic) does not cause nephrotoxicity while
option A, B, C cause nephrotoxicity.
Ref :- KDT 5th Edition, Page no. 341.
Que:- 47. Among thedrugs given below, which is LEAST likely to be
implicated in drug induced hepatitis?
A.
B.
C.
D.

Isoniazid
Streptomycin
Ripampicin
Pyrazinamide

Ans:- B . Streptomycin
Exp:- Hepatitis is a major adverse effect of antitubercular drugs like isoniazid,
rifampicin and pyrazinamide. Streptomycin and ethambutol are less likely
implicated in drug induced hepatitis.
Ref :- KDT 5th Edition, Page no. 753, 754,755.

Que:-48. Tetracycline acts on:

23

A.
B.
C.
D.

30S ribosomes
50S ribosomes
Cell membrane
Inhibiting DNA gyrase

Ans:- A . 30S ribosomes

Exp:- The tetracylines are primarily bacteriostatic. They inhibit protein synthesis
by binding to 30S ribosomes in susceptible organism. Because of this,
attachment of amino acyl-t-RNA to the mRNA ribosome complex is
interfered. As a result the peptide chaine fails to grow.
Ref :- KDT 5th Edition, Page no. 710.
Que:-49. Which of the following drug control lepramin reaction:
A.
B.
C.
D.

Dapsone
Streptomycin
Clofazimine
Ethambutol

Ans:- C . Clofazimine
Exp:- Lepra reaction is seen in lepromatous chemotherapy and/ or intercurrent
infection. It is a Jarish Herxheimer type of reaction due to release of
antigens from killed bacilli. The reaction, which develops 4-6 weeks after
dapsone treatment, is called Sulfone syndrome.
Ref :- Satoskar 19th Edition, Page no.759.

Que:- 50. Oral Contraceptive failure occurs in a patient on Rifampicin

because of:
24

A.
B.
C.
D.

Rifampicin induce the metabolism of contra- captive

Rifampicin simulates gonadotropin release from pituitary
Rifamicin decrease the secretion of progestin
Rifampicin antagonize the action of oral contraceptive

Ans:- A . Rifampicin induce the metabolism of contra- captive

Exp:- Contraceptive failures can be minimized by using an oral contraceptive
containing higher dose of estrogen or by using alternative method of
contraception.
Ref :- Satoskar 19th Edition, Page no.738.

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25