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Pharmacy Exercise Exam, Exams of Pharmacy

Centro Escolar University (CEU)Pharmacy

pharmacy module example example

Typology: Exams

2021/2022

Available from 10/04/2024

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KEEP GOING BANGON KA,SELF!
1
PREVIOUS BOARDEXAM QUESTIONS
(Module 4)
1. Monoamine oxidase inhibitors combined with
tyramine rich food will lead to_______.
I. Accumulation of precursor amines
II. Increased in BP
III. Non-metabolism of Tyramine
Answer: ALL
*cheese effect
2. What is the advantage of Triotropium over
Ipratropium?
a. It doest not cause xerostomia
b. It is available as an oral preparation
c. It is suitable for acute attacks of wheezing
d. It has a longer duration of action
*anti cholinergics cause xerostomia
*they are DRY POWDER preparation
*both of them are suitable for acute attacks of
wheezing
*advantage of Tiotropium
-more selective in the lungs
- has longer duration of action
3. In the classification of drugs in the formulary,
which of the following will NOT be included in
the list under “anti-cancer drugs”
a. Goserelin
b. Bevacizumab
c. Sirolimus - immunosupressant
d. Asparaginase
4. What is the superscription?
a. Rx
b. Information about the patient
c. Give 10mL 3x a day for 7 days
d. Metronidazole 25mg/mL
5. What is the patient’s condition if he is
prescribed with the drug?
a. Ascariasis - Albendazole, Mebendazole
b. Viral gastroenteritis - No treatment,
c. Amoebiasis
d. Bronchial asthma
*Metronidazole - Amoebiasis, Giardiasis,
Trichomonas infection
6. Which of the following is needed to produce a
positive inotropic effect?
a. Actilyse -alteplase
b. Isoproterenol - mixed beta agonist
c. Plavix - antiplatelet
d. Lanoxin - digoxin
7. Which of the following dosage form of sodium
nitroprusside?
a. Injectable - I.V
b. Oral, sustained release tablet -Isosorbide
mononitrate
c. SL tablet -isosorbide dinitrate
d. Transdermal
8. Which of the following is not a diuretic?
a. Acetazolamide
b. Mannitol
c. Spironolactone
d. Desmopressin - analogue of antidiuretic
hormone
CASE: Px JCE
List of Medications:
Al MG Hydroxide ipratropium bromide
Dextromethorphan montelukast
Ferrous sulfate nitroglycerin
Simvastatin vitamin C
Warfarin
9. Which of the following medications was
prescribed for the immediate release of DOB
(difficulty in breathing)
a. Dextromethorphan - antitussive
b. Nitroglycerin - vasodilator
c. Ipratropium bromide
d. Montelukast -leukotriene receptor antagonist
*BRONCHODILATORS
SABA (B2 agonist)
Antocholinergics (ipratropium)
Phosphodiesterase inhibitors (Theophylline)
10. Upon admission, the doctor prescibed
Doxycycline. Which of the following will affect
the absorption of the drug?
I. Warfarin
II. Aluminum Mg Hydroxide
III. Ferrous sulfate
IV. Vitamin C
Answer: Aluminum Mg Hydroxide
*Doxycline, Tetracylcines should not be combined
with Divalent (Calcium containing milk) and
Trivalent cations
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PREVIOUS BOARDEXAM QUESTIONS

(Module 4)

  1. Monoamine oxidase inhibitors combined with tyramine rich food will lead to_______. I. Accumulation of precursor amines II. Increased in BP III. Non-metabolism of Tyramine Answer: ALL
  • cheese effect
  1. What is the advantage of Triotropium over Ipratropium? a. It doest not cause xerostomia b. It is available as an oral preparation c. It is suitable for acute attacks of wheezing d. It has a longer duration of action
  • anti cholinergics cause xerostomia *they are DRY POWDER preparation
  • both of them are suitable for acute attacks of wheezing *advantage of Tiotropium -more selective in the lungs - has longer duration of action
  1. In the classification of drugs in the formulary, which of the following will NOT be included in the list under “anti-cancer drugs” a. Goserelin b. Bevacizumab c. Sirolimus - immunosupressant d. Asparaginase
  2. What is the superscription? a. Rx b. Information about the patient c. Give 10mL 3x a day for 7 days d. Metronidazole 25mg/mL
  3. What is the patient’s condition if he is prescribed with the drug? a. Ascariasis - Albendazole, Mebendazole b. Viral gastroenteritis - No treatment, c. Amoebiasis d. Bronchial asthma * Metronidazole - Amoebiasis, Giardiasis, Trichomonas infection
  4. Which of the following is needed to produce a positive inotropic effect? a. Actilyse - alteplase b. Isoproterenol - mixed beta agonist c. Plavix - antiplatelet d. Lanoxin - digoxin
    1. Which of the following dosage form of sodium nitroprusside? a. Injectable - I.V b. Oral, sustained release tablet - Isosorbide mononitrate c. SL tablet - isosorbide dinitrate d. Transdermal
    2. Which of the following is not a diuretic? a. Acetazolamide b. Mannitol c. Spironolactone d. Desmopressin - analogue of antidiuretic hormone CASE: Px JCE List of Medications: Al MG Hydroxide ipratropium bromide Dextromethorphan montelukast Ferrous sulfate nitroglycerin Simvastatin vitamin C Warfarin
    3. Which of the following medications was prescribed for the immediate release of DOB (difficulty in breathing) a. Dextromethorphan - antitussive b. Nitroglycerin - vasodilator c. Ipratropium bromide d. Montelukast -leukotriene receptor antagonist _BRONCHODILATORS_*  SABA (B2 agonist)Antocholinergics (ipratropium)Phosphodiesterase inhibitors (Theophylline)
    4. Upon admission, the doctor prescibed Doxycycline. Which of the following will affect the absorption of the drug? I. Warfarin II. Aluminum Mg Hydroxide III. Ferrous sulfate IV. Vitamin C Answer: Aluminum Mg Hydroxide *Doxycline, Tetracylcines should not be combined with Divalent (Calcium containing milk) and Trivalent cations
  1. Upon discharge, the physician added the drug Lipitor to the regimen a. Refer to the physician for possible changes in the discharge medications since there is a therapeutic duplication of the 2 drugs b. Medication counseling should be performed since the patient should be informed that Simvastatin and Lipitor need to be taken in the morning for best results * Lipitor is atorvastatin and meron na si px ng simvastatin = therapeutic duplication
  2. Which of the following drugs is classified as Urinary antiseptic? a. Povidone-iodine b. Sodium bicarbonate c. Nitrofurantoin d. Hexatidine
  3. Which of the following drugs when taken with food such as aged cheese and cured meats may cause dangerous increase in blood pressure? a. Buspirone b. Isosorbide mononitrate c. Imipramine d. Phenelzine * MAOIs :MoclobemidePhenelzineIsocarboxazidTranylcypramineSelegiline
  4. Senolytic drugs are intented to a. Alter the aging process b. Improve fertility c. Treat autoimmune diseases d. Prevent cancer
  5. Which of the following is the correct Tall- Man lettering for Dopamine and Dobutamine a. DOPamine, DOBUTamine b. Dopamine, dobutAMINE c. DOPAMINE, DOBUTAMINE d. Dopamine, dobutamine
  6. Which of the following is/are TRUE about celecoxib? I. It is a sulfonamide II. Is a selective COX1-inhibitor III. It is associated with higher incidence of cardiovascular thrombotic events * Celecoxib - NSAID - selective COX2-inhibitor
    1. Which of the following is/are considered as “Error-prone abbreviations” bu the institute for Safer medication practices? I. mcg II. IU III. cc IV. mL Answer: IU and cc
    2. Which of the following macronutrients are found in TPN? a. Fats, vitamins, carbohydrates and Trace elements b. Carbohydrates, proteins and fats c. Carbohydrates, Proteins and vitamins d. Proteins, fats and electrolytes
    • Micronutrients - vitamins, electrolytes
    1. The serum creatinine of a 65yrs old female weighing 150lb was 1.5mg/dl. What is the creatinine clearance in mL/minute? a. 94. b. 104. c. 40. d. 27. *FORMULA (140-age)(weight in Kg) (72) (serum creatinine) x 0.85 (kapag female)
    2. Which of the following is important in monitoring the effects of Warfarin? a. INR b. Hemoglobin time c. Platelet count d. AST,ALT * PT-INR - warfarin
    3. What adverse effect may result in the intake of HMG-CoA reductase inhibitors? a. Bleeding b. Hypoglycemia c. Rhabdomyolysis d. Hypertensive crisis

a. Creatine kinase MB b. Lactate dehydrogenase c. Creatinine d. Neutrophil

  • CK MB and Troponin I
  1. Quinidine sulfate 200mg capsule and Quinidine 200 mg tablet are _______ products. a. Therapeutic alternative - diff drugs, same effect (e.g quinidine sulfate and amodiaquine) b. Therapeutic equivalent - same EVERYTHING and bioequivalent studies (seen in orange book) c. Pharmaceutically equivalent - same EVERYTHING except brand name d. Pharmaceutical alternative - diff dosage forms, different salt used and different amount
  2. Which of the following refers to the drug distribution system in which peripheral facility determines the drug quantities to be requisition from the procurement unit or warehouse? a. UDDS b. Pull system c. Direct purchase from suppliers d. Push system
  • Push system - the procurment unit or warehouse determines what drug quantities are to be issued to the peripheral facilities * UDDS/Unit Dose distribution system - most ideal distribution system; medications are ordered, packaged, handled, administered and charge in multiples of single dose units.
  1. Drugs with names ending with “-sartan” belong to what classification? a. Angiotensin-2 receptor blocker b. CCB - “dipine” c. H2 blocker - “tidine” d. ACE inhibitors - “pril”
  2. What is the interaction between Warfarin and Vitamin K a. Additive b. Antagonistic c. Potentation d. Synergistic
  • Warfarin inhibits vitamin K dependent clotting factors (10, 9, 7,3) *green leafy vegetables are rich in vitamin K
    1. A patient who is planning to travel is inquiring on when to take Meclizine tablet. Which of the following is correct? a. Take 30mins after reaching the destination b. Take during travel c. Take 1hr before travel d. Take 24hrs before travel
    2. Which of the following are considered Pharmaceutical alternatives? a. Paracetamol 500mg tablet (Biogesic) and Paracetamol 500 mg tablet (Tempra) b. Mefenamic acid tablet and ibuprofen tablet c. Paracetamol 500mg tablet x50’s and paracetamol 500mg tablet x100’s d. Verapamil SR tablet and Verapamil sugar coated tablet *a- Pharmaceutical equivalence : same everything except brand name b - Therapeutic alternative : different drugs but same effect d - Pharmaceutical alternative : diff dosage forms, diff salt used and different amount
    3. Which of the following statements about drug interactions are TRUE I. Drug interaction may result to different responses of the patient for what the drug is primarily intended II. Drug interactions may be beneficial III. Drug interactions may be intentional Answer: I, II and III *drug interactions may be intentional; e.g Amoxicillin + clavulanic acid
    4. Which of the following should be included in the auxiliary label of Omeprazole? a. Refrigerate b. Do not chew or crush c. Must be taken with food d. B and C * omeprazole is enteric coated and must be taken WITHOUT food. (30mins before breakfast)
    5. What type of adverse reaction is exemplified by Serotonin syndrome due to the administration of SSRI? a. Therapeutic failure b. Augmented - type A ADR c. Teratogenic

d. Bizarre

  1. Physico-chemical incompatibilities can be detected by: I. Change in color II. Formation of precipitate III. Evolution of gas Answer: All
  2. Which of the following best described endorphins? a. Endogenous opioid peptides b. Antidiabetic c. Biogenic amines believes to cause schizophrenia d. Andrenergic neurotransmitters * Endorphins - endogenous morphine - natural pain killers Case: A prescription is presented to the pharmacist contains 4 medications for a patient: Drug A: Protease inhibitor Drug B: Non-selective beta blocker Drug C: Calcium channel blocker Drug D: ACE inhibitor
  3. Which of the ff is/are indicated for hypertension? a. Drug A b. Drug B c. Drugs C and D d. Drugs B, C, D _Protease inhibitors_* - antiviral drugs
  4. If the patient has asthma, which of the drugs may potentially aggrevate this condition? a. Drug D b. Drug B c. Drug C d. Drug A *Non selective beta blocker are CI with asthma because it can cause bronchoconstriction
  5. Aside from hypertension, given the drugs prescribed, what co-morbidity maybe present in the patient? a. Allergy b. Diabetes c. Malaria d. Viral infection
    1. Which of the following is/are TRUE regarding sildenafil? I. Causes priapism II. Used for erectile dysfunction III. Phosphodiesterase inhibitor Answer: All
    2. The drug affected by the interaction is____ a. Inactive drug b. Precipitant drug - causes the interaction c. Active drug d. Object drug
    3. Cystatin C is a biomarker in ____disease a. Pulmonary b. Renal c. Hepatic d. Cardiac *Cystatin c - when you have renal failure , DECREASE GFR = INCREASE Cystatin C (like creatinine)
    4. Which of the following medications is most likely to cause endocrine side effects? a. Ranitidine b. Omeprazole c. Cimetidine d. Lansoprazole * Cimetidine (Tagamet) - s/E: Alopecia, Gynecomastia, Erectile dysfunction (not prescribed anymore!)
    5. In a drug interaction scenario, what would best describe the result if Drug A induces the metabolism of Drug B? a. Decrease in blood level of Drug B b. Increase in blood level of Drug A c. Decrease in blood level if Drug a d. Increase in blood level of Drug B * Enzyme inducers = INC metabolism = INC excretion!
    6. Which of the following medications can increase the likelihood of patient falls? I. Zolpidem II. Loratidine III. Olanzapine Answer: I and III

c. Myasthenia gravis d. Cosmetic purposes *Botox - flaccid paralysis

  1. Drug disposition commences with which of the following pharmacokinetic processes? a. Absorpton b. Distribution c. Metabolism d. Excretion ***** Drug dispositionDistributionMetabolismExcretion
  2. Drug elimination commences with which of the following pharmacokinetic processes? a. Absorption b. Distribution c. Metabolism d. Excretion _Drug elimination_*  MetabolismExcretion
  3. TRUE of Bioavailability a. Rate and extent of drug distribution b. Refers to the amount of drug in the bloodstream c. Rate and extent of drug clearance d. 10% only for IM administered drugs * Bioavailability - rate and extent of drug ABSORPTION from a dosage form. _Drug Absorption_* - refers to transfer of the drug from SITE OF ADMINISTRATION going to the BLOOD/SYSTEMIC circulation
  4. TRUE of Bioavailability a. Applicable only to IV administered drugs b. Reflects the fraction of drugs metabolized c. Always poor in orally administered drugs d. Greatly affected by drug absorption * Bioavailability - rate and extent of drug ABSORPTION from a dosage form.
    1. Intravenous route of administration is the only route that can give you 100% bioavailability? a. True b. False *both intraVENOUS and intra-ARTERIAL gives off 100% bioavailability PLASMA CONCENTRATION TIME CURVE OF IV, IM, SUBCUTANEOUS AND ORAL.
    2. Which of the ff statements is CORRECT? a. In IV route, drugs are not absorbed but have 100% bioavailability b. In ORAL route, drugs are poorly absorbed but have 100% bioavailability c. In IV route, drugs have good absorption and have 100% bioavailability d. In IV route, a “depot effect” can be achieved * IV route - NO absorption kasi directly sa blood na sya naadminister kaya 100% bioavailability _depot effect_* - for IM route
    3. What is the basis why acidic drugs are best absorbed in the stomach? a. Fick’s law of diffusion b. Henderson-hasselbalch equation c. Boyle’s law d. Young’s rule _henderson-hasselbalch equation:_*  Acidic drug in Acidid medium = NON-IONIZED will predominate over ionizedAcidic drug in Basic medium = IONIZEDFormula: pH=pKa + log [A]/[HA]
  1. A 47 y/o patient ingested 24 tablets of Aspirin and presents with hepatic encephalopathy. One of the management is to alkalinize the blood thry IV NaHCO3. What is the basis of this management? a. NaHCO3 traps the aspirin in the ionized form b. NaHCO3 will neutralize the free aspirin in the systemic circulation c. NaHCO3 increases the fraction of protein- bound aspirin thus decreasing its toxicity d. NaHCO3 induces the CYP450 enzyme in the hepatocytes thus accelerating the elimination of toxin.
  • remember Henderson-hasselbalch equation concept
  • Aspirin - acidic drug, so we need a basic medium so the excretable form (IONIZED) will predominate.
  1. In case of a Sepsis, prompt antibiotic administration is needed. In theses cases, a loading dose would be warranted. What is the basis of the computation of the loading dose? a. Drug plasma concentration b. eGFR and serum creatinine c. Drug clearance d. Volume of distribution of a drug *the basis for the computation of the loading dose is Volume of distribution *formula: Vd = dose(mg)/drug plasma conc (mg/L)
  2. After how many half lives, it would reach for a drug to its steady state concentration? Answer: 3-4 half-life
  3. Phenobarbital when given to a patient on chronic warfarin is classified as? a. Pharmacodynamic antagonist b. Pharmacokinetic antagonist c. Physiologic antagonist d. Chemical antagonist * Phenobarbital is an enzyme inducer. It induced the metabolism of warfarin.. *metabolism is part of Pharmacokinetics (A.D.M.E)
    1. A target plasma theophylline concentration of 10mg/L is desired to relieve acute bronchial asthma in a patient. If the patient is a non- smoker and otherwise normal except for the asthma, mean clearance is 2.8L/hr. The drug is to be given as an IV infusion; dosing interval is 12hrs. Determine the dosing rate and maintenance dose. Answer: DR = 28mg/hr MD = 336mg * Maintenance dose formula: MD = Dosing rate x Dosing interval * Dosing rate formula: DR= Target conc x Clearance
    2. Fast acting drug used in the management of bronchial asthma is _______ a. Montelukast - inhibit LTD4 receptor b. Cromolyn c. Methylprednisolone d. Salbutamol
    • Reliever - bronchodilators; management of acute asthma Controller - anti-inflammatory; prevent future exacerbation
    • Montelukast - controller; inhibit LTD4 receptor/ LTRA (Leukotriene receptor antagonist) - has NEUROPSYCHIATRIC effect * Cromolyn - inhaled mast cell stabilizer (“crom”) Ketotifen - ORAL mast cell stabilizer * Methylprednisolone - steroid; controller (IV form; Reliever) * Salbutamol - reliever; beta agonist
    1. Which drug facilitates the body’s mechanism for clearing mucus from the respiratory tract making phlegm thinner and less viscous a. Butamirate - CNS antitussives b. Bromhexine - mucoregulator c. Dextrometorphan - CNS antitussives d. Phenylephrine - Alpha1 agonist
    • Anti-tussives - suppressed cough reflex; for DRY cough * Mucoregulators - break the disulfide bonds of mucus (mucolytic) and facilitate mucociliary clearanceAmbroxolBromhexineCarbocysteine * Alpha1 agonist - vasoconstrictor; nasal decongestant
  1. Select the drug that can loosen phlegm and make respiratory mucus thinner, improving expectoration. a. Butamirate - CNS anti-tussive b. Bromhexine c. Potassium iodide d. Dextrometorphan - CNS anti-tussive
  • Anti-tussives - suppressed cough reflex; for DRY cough * Mucoregulators - break the disulfide bonds of mucus (mucolytic) and facilitate mucociliary clearanceAmbroxolBromhexineCarbocysteine * Expectorant - for productive cough; reduce the thickness of mucus
  1. Cheryl is sick with flu complaining of nasal congestion and rhinorrhea. Select the drug you will prescribe to address the patient’s complaint. a. Dextrometorphan - anti tussive b. Phentolamine - alpha 1,2 antagonist c. Phenylephrine - alpha1 agonist d. Paracetamol - analgesic
  • Anti-tussives - suppressed cough reflex; for DRY cough * Mucoregulators - break the disulfide bonds of mucus (mucolytic) and facilitate mucociliary clearanceAmbroxolBromhexineCarbocysteine * Alpha1 agonist - vasoconstrictor; nasal decongestant _Phentolamine & Phenoxybenzamine_* - treat pheocromocytoma _Analgesics_* - inhibit COX
  1. Select the antibiotic regimen NOT approved by the Center for Disease control in the management of Pelvic inflammatory disease a. Clindamycin + Gentamicin b. Co-amoxiclav + doxycyline c. Ceftriaxone + doxycycline d. Cefoxitin + doxycycline * Pelvic inflammatory disease - cause more on Gram negative and atypical organisms - DOC is tetracycline * Co-amoxiclav - covers more on Gram positive and no coverage for atypical organisms
    1. Jun jun is diagnosed with multiple sexually transmitted diseases namely; syphilis, gonorrhea and chlamydia. Select the antibiotic that can cure all three infections. a. Trimetoprim/ sulfamethoxazole b. Streptomycin c. Ceftriaxone d. Doxycycline - BEST answer
    • Streptomycin covers gram positive (except Strep. Pneuomoniae), gram negative, pseudomonas aeroginosa but NOT atypical organism (Chlamydia) * Ceftriaxone - a cephalosphorin; cover gram postive and gram negative but NO coverage for atypical organism (Chlamydia) * Cotrimoxazole - can cover all three it is not mainly use because: Resistance and several drug reactions
    1. Identify the penicillinase-resistant antibiotic a. Carbenicillin - CARboxypenicillin b. Bacampicillin - AMinopenicillin c. Methicillin d. Piperacillin - ureidopenicillin * Penicillinase- resistant antibiotic (CONDoM)CloxacillinOxacillinNafcillinDicloxacillinMethicillin _Carboxypenicillin_* - pseudo aeroginosa _Aminopenicillin -_* broad spectrum penicillin _Ureidopenicillin (P.A.M)_* - Pseudo aeroginosa
  1. Septic arthritis is generally treated with analgesia, draining the joint and intravenous antibiotic. Empiric antibiotics should be started based on the gram stain of the synovial fluid. Gram negative bacilli should be treated with____. a. Ampicillin b. Ceftriaxone c. Vancomycin d. Gentamicin
  • Empiric treatment for septic arthritisVancomycinCefotaximeCeftriaxone
  1. The patient was complaining of extreme knee pain associated with erythema, swelling of the knee. Your diagnosis is septic arthritis. Gram stain of the synovial fluid secured through arthrocentesis revealed gram positive cocci. The empiric treatment should be a. Streptomycin b. Azithromycin c. Vancomycin d. Ceftriaxone *Vancomycin is combined with cefotaxime *see image above
  2. Which of the following conditions is resistant to Sulfamethoxazole + Trimethoprim combinataion? a. Escherichia coli b. Pneumocystis carinii c. Mycobacterium tubercolosis d. Shigella pp. * Co-trimoxazole _- covers gram positive and gram negative bacteria and atypical organisms.
  • DOC for Pneumocystis carinii_
    1. First line drug for the treatment of typhoid fever is a. Co-trimoxazole b. Chloramphenicol c. Ampicillin - DOC for uncomplicated typhoid fever d. Fluoroquinolone - DOC for complicated typhoid fever * Typhoid fever - salmonella typhi * Ceftriaxone - DOC for typhoid fever
    2. Culture studies showed klebsiella spp. Select drug that will NOT be effective for the patient. a. Ceftazidime - 3 rd^ gen cephalosphorin b. Aztreonam - Monobactam c. Clindamycin d. Imipinem
    • Klebsiella - gram (-) * Monobactam - covers gram (-) and pseudomonas * Clindamycin - covers only gram (+), anaerobic and community acquired MRSA * Imipinem - covers gram (+), gram (-) and anaerobes. DOC for ESBL infection (extended spectrum betalactamase infxn)
    1. Select the DOC for cholera a. Streptomycin b. Doxycycline c. Penicillin G d. Imipinem *Cholera - Vibrio cholerae
    2. Select the INCORRECT statement regarding beta lactamase inhibitors a. Adjustment in patient with CRF is based on the penicillin component b. The new anti-bacterial spectrum of the combination is determined by the beta- lactamase inhibitor c. They have similar appearance to penicillin but with limited antibacterial activity d. Beta-lactamase inhibitors are compounds that irreversible in activate bacterial beta-lactamase
    • Beta-lactamase inhibitor + betalactam drug = covers Bacteroides fragilis and anaerobes - they have NO ANTIBACTERIAL activity

d. It requires addressing the cause of the complication _Complicated UTI_* - common to males, pregnant woman, immunocompromised pxs, metabolic disorders (Diabetes) and Urologic abnormalities *treatment should be 7 to 14 days! * Uncomplicated UTI - tx is 5 to 7 days only

  1. Infections complicated by the presence of atypical organisms can be addressed by giving________ a. Rifampicin b. Ciprofloxacin c. Linezolid d. Azithromycin
  • Ciprofloxacin - increasing resistance to atypical organisms. Iwasan na dapat ang pag prescribed.
  1. Which of the following drug is effective for the treatment of soft chancre? a. Penicillin V b. Ceftriaxone c. Trimethoprim d. Doxycycline * Soft chancre - caused by Haemophilus ducreyi (gram (-) organism)CeftriaxoneAzithromycinCiprofloxacinErythromycin
  2. Giardiasis is best treated with a. Azithromycin b. Itraconazole c. Metronidazole d. Co-amoxiclav * Metronidazole - Amoebiasis, Giardiasis, Trichomonas infection
  3. Mang jojo 42/M s/p Hartmann’s procedure developed fever and chills 2 days post-op. Upon abdominal imaging, anechoic to hypoechoic spherical collections of echogenic fluid with poorly defined border were noted. If you are to start him with antibiotic which of the following is the best choice? a. Metronidazole- s/e: Metallic taste b. Vancomycin c. Clindamycin d. Ampicillin-Gentamicin *Px case is Intraabdominal abscess (anaerobic org) *RULE: for any anaerobic infection below the respiratory diaphragm and the brain, METRONIDAZOLE is given. *anaerobic infection above respiratory diaphragm = CLINDAMYCIN
  4. Select the treatment not suitable for uncomplicated syphilis a. Oral doxycyline b. Intramuscular benzathine pencillin c. Oral amikacin d. Intramuscular ceftriaxone check syphilis guideline _NO oral aminoglycoside, only in parenteral form_ except NEOMYCIN and TOBRAMYCIN
  5. Serious life threatening infections caused by Pseudomonas spp can be addressed by using__________ a. Cefamandole b. Cefazolin c. Cefoperazone d. Cefoxitin
* **_1,2nd_**^ **_gen cepha_** _- NO coverage for Pseudomonas_ **_*3rd_**^ **_gen cepha -_** _NO coverage for Pseudomonas_ _except Ceftazidime and Cefoperazone_ 106. Mario is suffering from Chronic kidney disease and is on dialysis. Identify the drug that should be least used a. Doxycycline b. Aztreonam c. Netilmicin d. Linezolid * _Netilmicin - aminoglycosides are nephrotoxic!_ 107. A patient with ESRD undergoing renal replacement therapy has shown you a list of his

medications. Identify the drug that is most likey not given daily. a. Erythropoietin b. Calcium carbonate c. Ferrous sulfate + folic acid d. Sevelamer * eryhtropoietin - given every dialysis session only

  1. Chloe, 30 yrd old, consulted for yellow- green, itchy, frothy, foul smelling vaginal discharge accompanied by a burning sensation with urination and dyspareunia. Saline microscopy showed trichomonads. The DOC is

a. Ceftriaxone b. Metronidazole c. Itraconazole d. Doxycycline

  1. The treatment of uncomplicated UTI can be shortened to 3 days for the ff antibiotics EXCEPT a. Co-trimoxazole b. Nitrofurantoin c. Norfloxacin d. Trimethorpim
  2. The first line DOC for streptococcus pharyngitis is______ a. Ciprofloxacin b. Amoxicillin c. Fluconazole d. Chloramphenicol *Amoxicillin is given 10-14 days
  3. Arnold, while vising overseas, develops an infection with shigella bacteria. Select the inappropriate treatment. a. Ciprofloxacin b. Amoxicillin c. Fluconazole - anti-fungal d. Chloramphenicol
  4. Which of the ff statements regarding Mebendazole is incorrect? a. It is usually given w piperazine to prevent migration of the worms during treatment b. It kills parasites slowly and in patients with heavy infestations, can cause the worms to migrate out digestive tract c. It is effective in tx of anaerobic infections d. It is a broad spectrum anthelmintic agent * Mebendazole - is anthelmintic; inhibits microtubule synthesis
  5. Albendazole is the DOC for the ff parasitic infections EXCEPT a. Whipworm b. Liver fluke c. Pinworm d. Tapeworm
  1. Which of the ff falls under the class of Cephalosphorins? a. Gentamicin - aminoglycosid e b. Loracarbef- 2 nd^ gen cephalosphorins c. Ampicillin - aminopenicillin d. Ticarcillin - carboxypenicillin
  2. Which of the ff drugs LEAST likely to cover for Legionella pneumophila infection? a. Ampicillin b. Erythromycin c. Ciprofloxacin d. Doxycycline * Legionella pneumophila - atypical organism _Atypical organisms_*  LegionellaChlamydophilaMycoplasmaChlamydia, vibrio, bordetella (behaves as atypical) * Ampicillin - covers gram (+) and gram (-) * Erythromycin - Macrolides; covers gram (+), gram(-) and atypical _Ciprofloxacin_* - fluoroquinolone; gram (+) , gram (-), atypical and pseudomonas (MOXYFLOXACIN - only fluoroquinolone that covers anaerobic org) * Doxycycline - gram (+), gram (-), atypical and anaerobic. No coverage for pseudomonas
  3. Which of the ff drugs can be used for the treatment of anaerobic infection (non-healing wound of the foot) a. Ceftriaxone - 3 rd^ gen b. Cefepime - 4 th^ gen c. Ceftaroline - 5 th^ gen d. Cefoxitin - 2 nd^ gen
  4. Identify the penicillinase resistance antibiotic? a. Ureidopenicillin b. Methicillin c. Bacampicillin d. carboxypenicillin * Penicillinase- resistant antibiotic (CONDoM)CloxacillinOxacillinNafcillinDicloxacillinMethicillin
* **_Methicillin_** _- is phased out bec it causes_ _intersitial nephritis_ 125. Maricel is suffering from PID. Which of the ff is the most effective treatment? a. Ciprofloxacin b. Amoxicillin c. Minocycline d. Co-trimoxazole **_*Pelvic inflammatory disease_** _- cause more on_ _Gram negative and atypical organisms_ _- DOC is tetracycline_ 126. In a patient presenting with pneumonia with CXR (+) of hazy infiltrates and pneumatocoeles, which drug is LEAST likely to be effective? a. Ampicillin-sulbactam b. Piperacillin c. Cephalexin d. Penicillin G **_*Pneumatocoeles_** _- a fluid collection with air in_ _the lungs; cause by Staphylococcus aureus_ **_*Ureidopenicillin (P.A.M)_** _- Pseudo aeroginosa_  _Piperacillin_  _Azlocillin_  _Mezlocillin_ 127. Which of the ff drugs can precipitate pseudomembranous colitis? a. Clindamycin b. Cephalexin c. Amoxicillin d. All of the above _*ALL_ **_ORAL antibiotics_** _can precipitate_ _pseudomemranous colitis_
  1. What is the DOC in treating pseudomembranous colitis? a. Vancomycin IV b. Vancomycin PO c. Clindamycin - most common cause d. All of the above
  2. What is the DOC in treating pseudomembranous colitis in the local setting? a. Metronidazole b. Vancomycin PO c. Daptomycin d. Any of the above
  • Vancomycin PO is not available here in the PH. So Metronidazole is given Vancomycin - DOC for hospital acquired MRSA Clindamycin - DOC for community acquired MRSA
  1. The ff drugs have coverage for Pseudomonas aeruginosa EXCEPT a. Ciprofloxacin b. Amikacin c. Cefepime d. Tetracycline
  2. Which of the ff drugs can be used for the treatment of anaerobic infection (non-healing wound of the foot) e. Ceftriaxone - 3 rd^ gen f. Cefepime - 4 th^ gen g. Ceftaroline - 5 th^ gen h. Cefoxitin - 2 nd^ gen
  3. A 49/F presented with hearing loss to high frequency sound but not to low frequency sounds after prolonged treatment with this drug. Utircaria is also evident on certain episodes. Identify the drug. a. Ceftaroline b. Doripenem c. Phenoxymethylpenicillin d. Kanamycin * Nephrotoxicity - Neomycin, Tobramycin, Gentamicin * Ototoxicity - Neomycin, amikacin, kanamycin
* **Vestibulotoxicity -** _streptomycin, gentamicin_ 133. 34y/o male presented with EEG changes, seizure, nystagmus, accompanied by vomiting and diarrhea after being infused with an antibiotic for his pneumonia. Which of the ff is the MOST LIKELY cause? a. Streptomycin b. Ceftriaxone c. Imipenem + cilastatin d. Pen G * _all cell wall synthesis inhibitors are epileptogenic_ _*PINAKA nagccause ng seizure is carbapenem_ _*_ **_Imipenem_** _ay nadedegrade ng dehydropeptidase,_ _to prevent its degradation we add Cilastatin_ 134. A 56/F with DM and HTN, s/p exploratory laparotomy present with fever, chills, LUQ pain 2wks post-op. Upon imaging of the abdomen, a well-circumscribed splenic abscess was noted. Which is the most appropriate antibiotic? a. Clindamycin b. Metronidazole c. Penicillin d. All of the above * **Abscess** - anaerobic infection _*RULE: for any anaerobic infection below the_ _respiratory diaphragm and the brain,_ **_METRONIDAZOLE_** _is given._ _*anaerobic infection above respiratory_ _diaphragm =_ **_CLINDAMYCIN_** YOU REACHED THE END! Don’t worry, okay? All your hard work and sacrifices will pay off. Naniniwala ako sayo :) #OWNPACING #OWNTIME - Love, G