1.

A patient is taken to the emergency room with respiratory failure and has to be put on a
ventilator. An aspiration of the respiratory airway (BAL) is performed. The serum and BAL
galactomannan are positive for Aspergillus. Which of the following is the preferred treatment
option?1.Amphotericin 2. Itraconazole 3. Voriconazole 4. Caspofungin 5. None of the above
2. Which side effects of amphotericin B are NOT infusion-related?
1. Fever 2. Muscle 3. Rigor 4. Hypotension 5. NephrotoxicityChills
3. Which is NOT an imidazole antifungical agent?
1. Ketoconazole 2. Miconazole 3. Tioconazole 4. Clotrimazole 5.Fluconazole
4. Which antifungal agent is NOT from the triazole family?
1. Fluconazole 2.Voriconazole 3. Ketoconazole 4. Terconazole 5.Voriconazole
5. Which is the treatment for moderately severe to severe acute pulmonary histoplasmosis? 1.
Ampicillin 2. Amphotericin 3. Vancomycin 4. Benznidazole 5.Doxycycline
6. What is NOT a standard treatment for urethritis due to infection with Chlamydia?
1.Doxycycline 2. Azithromycin 3.Erythromycin 4.Tetracyclines 5.Cefixime
7. What is a standard treatment for genital Neisseria gonorrhoeae infection?
1. Azithromycin 2. Cefixime 3.Spectinomycin 4.CeftriaxoneAll of the above
8. Indicate a known adverse effect of fluoroquinolones:
1. QT prolongation 2. Hepatotoxicity3. Tendon rupture 4.Peripheral neuropathy 5.All of the
above
9. A patient is diagnosed with Helicobacter pylori and needs to start eradication treatment, but
she is allergic to penicillin. Which antibiotics are preferred in her regimen treatment?
1.Amoxicillin plus Clarithromycin 2.Clarithromycin plus Metronidazole 3. Metronidazole plus
Oxacillin 4.Levofloxacin plus Amoxicillin 5.Tetracycline plus Ampicillin
10. A patient that is allergic to penicillin and has had macrolide exposure, what is the best
eradication treatment for H. pylori: 1.Clarithromycin + Amoxicillin + Nitroimidazole
2.Clarithromycin + Amoxicillin 3.Amoxicillin + Clarithromycin + NitroimidazoleTetracycline +
Metronidazole 4.Levofloxacin + Amoxicillin
11. A patient diagnosed with an infectious endocarditis is in treatment with intravenous antibiotics,
during the rapid administration of one of the antibiotics the patient experienced a mild pruritic
erythematous rash to the face, neck, and upper torso. Which drug is more likely associated
with 1.Amoxicillin 2.Vancomycin 3.Fosfomycin 4.Amikacin 5.Ampicillin
12. What is the ideal timing for drawing plasma concentrations for drug therapeutic monitoring
(DTM) of vancomycin? 1.Peak 1 hour after infusion 2. Peak 30 minutes after infusionTrough
just before next dose
13. A patient in the ICU with a diagnosis of sepsis due to an infection with pseudomonas, which
of the following antibiotics would you recommend? 1. Imipenem 2. Ceftazidime 3.Cefepime
4.Amikacin 5.All of the above
14. A pseudomembranous enterocolitis (PE) is a Clostridium difficile overgrowth producing
diarrhea. Which of the following antibiotics have been associated with PE?
1. Clindamycin 2. Vancomycin 3. Metronidazole
A and B are correctA and C are correct
15. What are the treatment options for pseudomembranous enterocolitis caused by Clostridium
difficile infection?1.Vancomycin 2. Metronidazole 3.Fidaxomicin 4.Fecal transplantation 5.All
of the above
16. In a patient who has had a hypersensitivity to metronidazole, which is the most appropriate
drug as treatment of pseudomembranous enterocolitis caused by Clostridium difficile
infection? 1.Ampicillin 2.Clindamycin 3.Vancomycin 4.Clarithromycin 5.Erythromycin
17. When acute infection with Influenza is diagnosed in an adult patient, treatment with
oseltamivir is needed. What is the standard dose for treatment?1.75 mg twice a day for 5
 days 2.75 mg twice a day for 7 days 3.75 mg once a day for 5 days 4.50 mg twice a day for 5
days 5. 50 mg twice a day for 7 days
18. When acute infection with Influenza is diagnosed in an adult patient, treatment with
oseltamivir is needed. What is the standard dose renally impaired adults (creatinine clearance
10-30 mL/min)? 1.75 mg twice a day for 5 days 2.75 mg twice a day for 7 days 3.75 mg once
a day for 5 days 4.50 mg twice a day for 5 days 5.50 mg twice a day for 7 days
19. What is the mechanism of action of the influenza treatment oseltamivir?
1. Reverse transcriptase inhibitor 2.Neuraminidase inhibitor 3.Non-nucleoside polymerase
inhibitor 4.Integrase inhibitorM2 inhibitor
20. Indicate which are adverse reactions to treatment with oseltamivir?
1.Toxic epidermal necrolysis 2.Hallucinations 3.Delirium 4.Nausea, vomiting 5.All of the
above
21. What is the mechanism of action of the antiviral amantadine?
1.Reverse transcriptase inhibitor 2. Neuraminidase inhibitor 3. Non-nucleoside polymerase
inhibitor 4. Integrase inhibitor 5. M2 inhibitor
22. Amantadine is an antiviral drug used to treat influenza A, but it is also indicated in what
disease?
1.Alzheimer´s Disease 2. Parkinson´s Disease 3. Huntington’s Disease 4. Crohn's
Disease5.Graves’Disease
23. Which antiviral does NOT inhibit viral reverse transcriptase?
1. Amantadine 2. Zidovudine 3. Didanosine 4. Stavudine 5. Zalcitabine
24. Which antiviral does NOT inhibit the viral aspartate protease?
1.Indinavir2.Ritonavir3.Saquinavir4.Nelfinavir5.Oseltamivir
25. Which of the following is most likely to be associated with elevation of amylase and
lipase?1.Isoniazid 2.Zidovudine 3. Didanosine 4. Pyrazinamide 5.Erythromycin

Answers:

1. Voriconazole is the preferred treatment option for patients with severe aspergillosis.
2. The infusion-related side effect include fever, chills, muscle rigor, hypotension (histamine
release) during the Iv infusion. Can be alleviated partly by pretreatment with NSAIDs and
antihistamines. Nephrotoxicity is a dose dependent side effect.
3. Azole antifungicals can be of the imidazole or triazole family. The Imidazoles are clotrimazole,
econazole, ketoconazole, miconazole and tioconazole. The Triazoles are fluconazole,
itraconazole, terconazole and voriconazole.
4. Azole antifungicals can be of the imidazole or triazole family. The imidazoles are clotrimazole,
econazole, ketoconazole, miconazole and tioconazole. The triazoles are fluconazole,
itraconazole, terconazole and voriconazole.
5. Histoplasmosis is an infection caused by a fungus called Histoplasma. The fungus lives in the
environment, particularly in soil that contains large amounts of bird or bat droppings. In the
United States, Histoplasma mainly lives in the central and eastern states, especially areas
around the Ohio and Mississippi River valley. The treatment for moderately severe to severe
Acute Pulmonary Histoplasmosis includes amphotericin B, itraconazole and prednisone.
6. The two most commonly prescribed antibiotics for chlamydia are: azithromycin and
doxycycline. But other antibiotics may be used, like erythromycin if pregnant or tetracyclines
in children.
7. Treatment recommendations by the WHO for genital and anorectal gonococcal infections are
as follows:
• Ceftriaxone plus azithromycin
• Cefixime plus azithromycin
• Ceftriaxone or Cefixime or Spectinomycin
8. Black box warnings for fluoroquinolones (ciprofloxacin) include tendinitis, tendon rupture,
peripheral neuropathy, central nervous system effects, exacerbation of myasthenia gravis.
Also hepatotoxicity, QT prolongation and Hypersensitivity reactions.
9. The regimen must not include a derivate from penicillin. The classic regimen: PPI +
Clarithromycin + Amoxicillin OR Metronidazole.
10. The preferred treatment option is a tetracycline antibacterial plus metronidazole.
11. Red man syndrome (RMS) is an anaphlylactoid reaction caused by the rapid infusion of the
glycopeptide antibiotic Vancomycin. RMS consists of a pruritic erythematous rash to the face,
neck, and upper torso which may also involve the extremities to a lesser degree. Symptoms
may include weakness, angioedema, and chest or back pain. RMS is caused by Vancomycin
through the direct and nonimmune mediated release of histamine from mast cells and
basophils. The amount of histamine release is generally related to the dose of Vancomycin
infused and the rate of infusion.
12. The correct timing is to draw a peak 1 hour after infusion has completed (because of its
distribution volume) and a through just before the next dose.
13. Antipseudomonal antibiotics: penicillin (mezlocillin, piperacillin, carbenicillin, ticarcillin),
cephalosporin (Ceftazidime, Cefepime), aminoglycoside (amikacin), quinolone, carbapenem
(imipenem)
14. Oral Metronidazole and/or oral vancomycin are the treatment options for PE. Clindamycin is
one of the antibiotics that have been associated with PE.
15. For mild/moderate disease, oral metronidazole (500 mg 3 times daily for 10 days) is
recommended as the initial treatment. In patients for whom oral treatment is inappropriate,
fidaxomicin may be used; specific indications include first-line treatment in patients with
recurrence or at risk for recurrence. For patients with severe CDI, suitable antibiotic regimens
include vancomycin (125 mg 4 times daily for 10 days; may be increased to 500 mg 4 times
daily) or fidaxomicin (200 mg twice daily for 10 days). Fecal transplantation is recommended
for multiple recurrent CDI.
16. Vancomycin is a powerful drug against serious Gram positive infections and is, in this case,
the preferred option.
17. The treatment of influenza with oseltamivir in Adults and adolescents (13 years and older) is
75 mg twice daily for 5 days.
18. The dose recommendations for renally impaired patients is: 75 mg once a day for 5 days
19. Most viruses egress from infected host cells by cell lysis or by budding through the cell
membrane. However, some virions require the additional step of release. For example,
influenza A and B viruses require viral neuraminidase to effect their release from the
extracellular surface of host cell membranes. Oseltamivir a neuraminidase inhibitor prevents
the detachment the new influenza A and B virions from host cells.
20. The adverse reactions of oseltamvivir may include serious skin/hypersensitivity reactions like
TEN, neuropsychiatric events like hallucinations and delirium and gastrointestinal effects like
nausea and vomiting.
21. Amantadine interferes with the release of infectious viral nucleic acid into the host cell through
interaction with the transmembrane domain of the M2 protein of the virus.
22. Amantadine has some effect on the dopaminergic system. It is indicated for the treatment of
dyskinesia in patients with Parkinson’s disease receiving levodopa-based therapy, with or
without concomitant dopaminergic medications.
23. Amantadine interferes with the release of infectious viral nucleic acid into the host cell through
interaction with the transmembrane domain of the M2 protein of the virus.
24. Oseltamivir a neuraminidase inhibitor prevents the detachment the new influenza A and B
virions from host cells.
25. Pancreatic disfunction is associated with the use of several reverse-transcriptase inhibitors
(RTIs), particularly didanosine