front 1 A patient is prescribed Bactrim for a urinary tract infection. Which two drugs are in this combination? A) Ciprofloxacin and levofloxacin B) Trimethoprim and sulfamethoxazole C) Sulfadiazine and pyrimethamine D) Moxifloxacin and delafloxacin | back 1 B. Trimethoprim and sulfamethoxazole |
front 2 TMP-SMX is also commonly known by which drug name? A) Bactrim B) Leucovorin C) Pyrimethamine D) Delafloxacin | back 2 A. Bactrim |
front 3 Trimethoprim-sulfamethoxazole works by blocking which bacterial pathway? A) DNA gyrase pathway B) Folate pathway C) Protein synthesis pathway D) Cell wall pathway | back 3 B. Folate pathway |
front 4 Why does blocking bacterial folate impair bacterial growth? A) Bacteria cannot make DNA well B) Bacteria cannot make capsules C) Bacteria cannot make flagella D) Bacteria cannot make ribosomes | back 4 A. Bacteria cannot make DNA well |
front 5 Bacteria need folate mainly to synthesize which molecule? A) RNA polymerase B) Cell membrane C) DNA D) Peptidoglycan | back 5 C. DNA |
front 6 TMP-SMX prevents bacterial survival mainly by disrupting which process? A) Calcium entry B) DNA production C) Beta-lactamase release D) Protein folding | back 6 B. DNA production |
front 7 Which infection is a clinical use of TMP-SMX? A) UTIs B) Influenza C) Malaria only D) Syphilis | back 7 A. UTIs |
front 8 A patient has a soft tissue infection treated with Bactrim. Which drug class is being used? A) Fluoroquinolone B) Folate antagonist C) Macrolide D) Aminoglycoside | back 8 B. Folate antagonist |
front 9 TMP-SMX is used for Pneumocystis jirovecii pneumonia because it blocks which process? A) DNA replication via gyrase B) Folate-dependent DNA synthesis C) Cell wall crosslinking D) Viral genome release | back 9 B. Folate-dependent DNA synthesis |
front 10 Which opportunistic pneumonia can be treated with TMP-SMX? A) Pneumocystis jirovecii pneumonia B) Streptococcus pneumoniae pneumonia C) Mycoplasma pneumoniae pneumonia D) Klebsiella pneumoniae pneumonia | back 10 A. Pneumocystis jirovecii pneumonia |
front 11 Which parasitic infection is listed as a use for TMP-SMX? A) Giardiasis B) Toxoplasmosis C) Malaria D) Schistosomiasis | back 11 B. Toxoplasmosis |
front 12 TMP-SMX is used for which branching filamentous bacterial infection? A) Nocardiosis B) Anthrax C) Tetanus D) Botulism | back 12 A. Nocardiosis |
front 13 Which clinical use belongs to TMP-SMX? A) Osteomyelitis only B) Digitalis toxicity C) Nocardiosis D) Torsades | back 13 C. Nocardiosis |
front 14 Which side effect is associated with TMP-SMX? A) Tendon rupture B) Rash C) Ototoxicity D) Lupus-like syndrome | back 14 B. Rash |
front 15 Bacrtrim adverse effect? A) Fever B) Constipation C) Cyanide toxicity D) Visual brightness | back 15 A. Fever |
front 16 TMP-SMX can suppress which body system? A) Bone marrow B) Adrenal cortex C) Thyroid gland D) Pancreatic islets | back 16 A. Bone marrow |
front 17 A patient taking TMP-SMX develops low blood cell counts. Which adverse effect best explains this? A) Neurotoxicity B) Tendon rupture C) Bone marrow suppression D) Calcium binding | back 17 C. Bone marrow suppression |
front 18 Which electrolyte abnormality is associated with TMP-SMX? A) Hypocalcemia B) Hyperkalemia C) Hypernatremia D) Hypokalemia | back 18 B. Hyperkalemia |
front 19 A patient on TMP-SMX can have what adverse effect? A) Nephrotoxicity B) Tendonitis C) Bronchoconstriction D) Cyanosis | back 19 A. Nephrotoxicity |
front 20 Which side effect set best matches TMP-SMX? A) GI upset, tendon rupture, neurotoxicity B) Rash, fever, bone marrow suppression C) QT prolongation, constipation, dizziness D) Cough, angioedema, hyperkalemia | back 20 B. Rash, fever, bone marrow suppression |
front 21 Which adverse effect is shared by TMP-SMX and sulfadiazine plus pyrimethamine? A) Bone marrow toxicity B) Tendon rupture C) Calcium chelation D) Neurotoxicity | back 21 A. Bone marrow toxicity |
front 22 A patient with sulfa allergy needs treatment for a lower UTI. Which drug from the notes may be used alone? A) Sulfamethoxazole B) Trimethoprim C) Pyrimethamine D) Sulfadiazine | back 22 B. Trimethoprim |
front 23 Trimethoprim alone treats lower UTIs by blocking which pathway? A) DNA gyrase pathway B) Bacterial folate pathway C) Topoisomerase IV pathway D) Cell membrane pathway | back 23 B. Bacterial folate pathway |
front 24 Trimethoprim alone is especially useful when a patient has which issue? A) Beta blocker allergy B) Sulfa allergy C) Calcium deficiency D) Tendon injury | back 24 B. Sulfa allergy |
front 25 Which infection is listed as a use for trimethoprim alone? A) Lower UTIs B) Anthrax C) Osteomyelitis D) Toxoplasmosis only | back 25 A. Lower UTIs |
front 26 Which drug blocks bacterial folate without the sulfa component? A) Ciprofloxacin B) Trimethoprim C) Sulfadiazine D) Moxifloxacin | back 26 B. Trimethoprim |
front 27 Sulfadiazine plus pyrimethamine produces what type of antimicrobial blockade? A) Strong folate pathway blockade B) Strong DNA gyrase blockade C) Strong ribosomal blockade D) Strong cell wall blockade | back 27 A. Strong folate pathway blockade |
front 28 Sulfadiazine plus pyrimethamine is used clinically for which infection? A) Anthrax B) Nocardiosis C) Toxoplasmosis D) Gastroenteritis | back 28 C. Toxoplasmosis |
front 29 A patient with toxoplasmosis receives sulfadiazine plus pyrimethamine. What pathway is targeted? A) Topoisomerase pathway B) Folate pathway C) Calcium transport pathway D) Beta receptor pathway | back 29 B. Folate pathway |
front 30 Sulfadiazine plus pyrimethamine prevents organisms from making which molecule properly? A) DNA B) Capsule C) Flagella D) Toxin | back 30 A. DNA |
front 31 Which adverse effect is especially associated with sulfadiazine plus pyrimethamine? A) Bone marrow toxicity B) Tendon rupture C) GI upset only D) Neurotoxicity | back 31 A. Bone marrow toxicity |
front 32 Leucovorin is given with sulfadiazine plus pyrimethamine to protect which tissue? A) Bone marrow B) Tendon C) Kidney tubules D) Gastric mucosa | back 32 A. Bone marrow |
front 33 Which drug combination requires leucovorin protection in the notes? A) TMP-SMX B) Sulfadiazine plus pyrimethamine C) Ciprofloxacin plus calcium D) Levofloxacin plus magnesium | back 33 B. Sulfadiazine plus pyrimethamine |
front 34 Which drug is a fluoroquinolone? A) Ciprofloxacin B) Trimethoprim C) Sulfadiazine D) Pyrimethamine | back 34 A. Ciprofloxacin |
front 35 Which drug is a fluoroquinolone? A) Bactrim B) Levofloxacin C) Leucovorin D) Sulfamethoxazole | back 35 B. Levofloxacin |
front 36 Which drug is a fluoroquinolone? A) Pyrimethamine B) Trimethoprim C) Moxifloxacin D) Sulfadiazine | back 36 C. Moxifloxacin |
front 37 Which drug is a fluoroquinolone? A) Delafloxacin B) Leucovorin C) Pyrimethamine D) Sulfamethoxazole | back 37 A. Delafloxacin |
front 38 Fluoroquinolones inhibit which bacterial enzymes? A) ACE and renin B) DNA gyrase and topoisomerase IV C) Na/K ATPase and PDE-3 D) Transpeptidase and beta-lactamase | back 38 B. DNA gyrase and topoisomerase IV |
front 39 DNA gyrase and topoisomerase IV help bacteria do what? A) Unwind and replicate DNA B) Build fungal cell walls C) Produce viral envelopes D) Secrete histamine | back 39 A. Unwind and replicate DNA |
front 40 Fluoroquinolones kill bacteria by preventing which process? A) DNA copying B) Folate absorption C) Calcium binding D) Capsule staining | back 40 A. DNA copying |
front 41 A patient receives ciprofloxacin. Which mechanism explains bacterial death? A) Blocks beta receptors B) Inhibits DNA gyrase C) Blocks folate only D) Activates leucovorin | back 41 B. Inhibits DNA gyrase |
front 42 A drug blocks topoisomerase IV and DNA gyrase. Which class is it? A) Sulfonamide B) Folate antagonist C) Fluoroquinolone D) Antimetabolite | back 42 C. Fluoroquinolone |
front 43 Which clinical use belongs to fluoroquinolones? A) UTIs B) Torsades C) Asthma D) Angina | back 43 A. UTIs |
front 44 Which gastrointestinal infection category is listed for fluoroquinolone use? A) Gastroenteritis B) Toxoplasmosis C) Pneumocystis pneumonia D) Nocardiosis | back 44 A. Gastroenteritis |
front 45 Which bone infection is listed as a fluoroquinolone clinical use? A) Osteomyelitis B) Cellulitis only C) Septic arthritis only D) Endocarditis | back 45 A. Osteomyelitis |
front 46 Which bioterrorism-associated infection is listed as a fluoroquinolone use? A) Anthrax B) Botulism C) Tetanus D) Diphtheria | back 46 A. Anthrax |
front 47 A patient with anthrax is treated with an antibiotic ending in “floxacin.” Which class is this? A) Fluoroquinolone B) Folate antagonist C) Sulfonamide D) Pyrimidine analog | back 47 A. Fluoroquinolone |
front 48 A patient with osteomyelitis receives ciprofloxacin. Which bacterial process is inhibited? A) DNA replication B) Folate rescue C) Peptidoglycan crosslinking D) Ribosomal translocation | back 48 A. DNA replication |
front 49 Which side effect set best matches fluoroquinolones? A) GI upset, neurotoxicity, tendon rupture B) Rash, fever, hyperkalemia C) Bone marrow toxicity only D) Cough, angioedema, nephrotoxicity | back 49 A. GI upset, neurotoxicity, tendon rupture |
front 50 Why should fluoroquinolones not be taken with calcium, magnesium, iron, or aluminum? A) They bind drug and decrease absorption B) They increase folate synthesis C) They worsen bacterial DNA copying D) They activate topoisomerase IV | back 50 A. They bind drug and decrease absorption |
front 51 A patient takes ciprofloxacin with calcium supplements. What is the likely result? A) Decreased drug absorption B) Increased drug absorption C) Increased folate blockade D) Increased leucovorin activity | back 51 A. Decreased drug absorption |
front 52 Which medication should be separated from iron supplements because absorption can decrease? A) Ciprofloxacin B) Trimethoprim C) Pyrimethamine D) Leucovorin | back 52 A. Ciprofloxacin |
front 53 Which pairing is correct? A) TMP-SMX—folate pathway blockade B) Ciprofloxacin—cell wall blockade C) Trimethoprim—DNA gyrase inhibitor D) Leucovorin—fluoroquinolone | back 53 A. TMP-SMX—folate pathway blockade |
front 54 Which pairing is correct? A) Sulfadiazine/pyrimethamine—toxoplasmosis B) Levofloxacin—bone marrow rescue C) TMP-SMX—tendon rupture D) Leucovorin—DNA gyrase inhibition | back 54 A. Sulfadiazine/pyrimethamine—toxoplasmosis |
front 55 Which pairing is correct? A) Fluoroquinolones—DNA gyrase inhibition B) TMP-SMX—topoisomerase IV inhibition C) Trimethoprim—calcium chelation D) Leucovorin—bacterial DNA unwinding | back 55 A. Fluoroquinolones—DNA gyrase inhibition |
front 56 Which pairing is correct? A) Trimethoprim alone—lower UTIs B) Moxifloxacin—sulfa allergy alternative C) Bactrim—anthrax first only D) Delafloxacin—leucovorin rescue | back 56 A. Trimethoprim alone—lower UTIs |
front 57 Which pairing is correct? A) Fluoroquinolones—avoid calcium coadministration B) TMP-SMX—avoid all folate rescue C) Leucovorin—causes tendon rupture D) Sulfadiazine—blocks DNA gyrase | back 57 A. Fluoroquinolones—avoid calcium coadministration |
front 58 A patient with sulfa allergy has a lower UTI. Which option best avoids the sulfa component? A) Trimethoprim alone B) TMP-SMX C) Sulfadiazine/pyrimethamine D) Sulfamethoxazole alone | back 58 A. Trimethoprim alone |
front 59 A patient with toxoplasmosis receives sulfadiazine and pyrimethamine. Which add-on reduces bone marrow toxicity A) Leucovorin B) Aluminum C) Ciprofloxacin D) Dapagliflozin | back 59 A. Leucovorin |
front 60 A patient with UTI and soft tissue infection is prescribed Bactrim. Which side effect should be monitored? A) Hyperkalemia B) Tendon rupture only C) Constipation D) Bradycardia | back 60 A. Hyperkalemia |
front 61 A patient taking TMP-SMX develops rash, fever, and cytopenias. Which drug caused this? A) Bactrim B) Ciprofloxacin C) Leucovorin D) Moxifloxacin | back 61 A. Bactrim |
front 62 A patient taking moxifloxacin develops GI upset and tendon pain. Which class toxicity is this? A) Fluoroquinolone toxicity B) Folate antagonist toxicity C) Sulfonamide rescue effect D) Leucovorin toxicity | back 62 A. Fluoroquinolone toxicity |
front 63 Trimethoprim-sulfamethoxazole is established to be effective
| back 63 (D) Toxoplasmosis |
front 64 A 65-year-old woman has returned from a vacation abroad
| back 64 (B) Ofloxacin |
front 65 Which statement about the clinical use of sulfonamides is
| back 65 (E) Reduced intracellular uptake is a mechanism of sulfonamide
|
front 66 A 31-year-old man has gonorrhea. He has no drug allergies, | back 66 (E) None of the above |
front 67 Which statement about the fluoroquinolones is accurate? | back 67 (D) Gonococcal resistance to fluoroquinolones may involve
|
front 68 A 40-year-old man complains of periodic bouts of diarrhea | back 68 (D) Sulfasalazine |
front 69 Which adverse effect is most common with sulfonamides? | back 69 (E) Skin rash |
front 70 Which drug is effective in the treatment of nocardiosis and, | back 70 (D) Sulfadiazine |
front 71 Which statement about ciprofloxacin is
accurate? | back 71 (E) Tendinitis may occur during treatment |
front 72 Supplementary folinic acid may prevent anemia in folate-deficient
persons who use this drug; it is a weak base achieving tissue levels
similar to those in plasma. | back 72 (E) Trimethoprim |