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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5648_Библиотеки_им_академика_М_И_Перельмана.pdf
312 Pharmaceutical Chemistry
47. In which of the following drugs the pharmacological activity of the drug is associated
with a specific optical isomer:
(a) Aspirin (b) Adrenaline
(c) Caffeine (d) Phenobarbitone
48. Capsules normally fall into two main categories. These are:
(a) Hard gelatin capsules and soft gelatin capsules
(b) Hard gelatin capsules and layered capsules
(c) Soft gelatin capsules and compressed capsules
(d) Compressed and layered capsules
49. Intravenous, intramuscular and subcutaneous are all examples of which routes of
administration?
(a) Pulmonary administration (b) Parenteral administration
(c) Otic administration (d) Ocular administration
50. What is the term used for small molecules that bind different regions of a binding
site?
(a) Epimers (b) Isomers
(c) Isotopes (d) Epitopes
51. Which of the following values for contact angle with water corresponds to a
hydrophobic drug particle?
(a) 45° (b) 120°
(c) 0° (d) None of the above
52. The Freundlich adsorption isotherm can be used to model:
(a) Multilayer adsorption (b) Monolayer adsorption
(c) Both (d) None of the above
53. The term antibiotic was coined by:
(a) Florey and Chain (b) S A Waksman
(c) Alexander Flemming (d) Abraham
54. Chloramphenicol is obtained from:
(a) Streptomyces griseus (b) Streptomyces venezuelae
(c) Streptomyces pyrogenes (d) None of these
55. Therapeutic activity of penicillin was first experimented by:
(a) Chain et al. (b) Abraham et al.
(c) Fleming et al. (d) All of the above
56. Penicillins inhibit the bacterial growth by:
(a) Blocking the DNA synthesis (b) Blocking the cell wall synthesis
(c) Blocking protein synthesis (d) All of the above
Multiple-Choice Questions and Answers 313
57. Bactericidal activity of penicillins is due to:
(a) Inhibition of nucleic acid biosynthesis
(b) Inhibition of the first stage of the peptidoglycan synthesis
(c) Inhibition of protein synthesis
(d) Inhibition of the third stage of the peptidoglycan synthesis
58. Streptomycin is obtained from:
(a) Streptococcus species (b) Streptomyces griseus
(c) Straphylococcus aureus (d) None of these
59. Dry heat kills the microbes by:
(a) Dehydration of cell materials
(b) Disruption of cell membrane and cell walls
(c) Coagulation of proteins
(d) Inactivation of nucleic acids
60. Sulfonamides kill bacteria by:
(a) Blocking protein synthesis (b) Inhibition of folic acid synthesis
(c) Blocking RNA synthesis (d) Inhibition of tetrahydrofolate synthesis
61. True about macrolides is that:
(a) They bind to a large subunit of bacterial ribosome and inhibit protein synthesis.
(b) They bind to pentapeptides of peptidoglycan and inhibit the cell wall synthesis.
(c) They bind to a small subunit of bacterial ribosome and inhibit protein synthesis.
(d) They bind to DNA and change the base sequence that is lethal to bacteria.
62. Microbicidal activity of chloramphenicol is:
(a) Similar to that of amino glycoside antibiotics.
(b) Similar to that of macrolide antibiotics.
(c) Similar to that of penicillin-G.
(d) Similar to that of Cephalosporin-C.
63. Cephalosporin mechanism of action may include:
(a) Inhibiting protein synthesis
(b) Inhibiting cell wall synthesis
(c) Inhibiting synthesis of essential metabolites
(d) Inhibiting translation of genetic information
64. Drug resistance to sulphonamides is due to:
(a) Production of PABA
(b) Folic acid synthetase
(c) Drug alteration
(d) Low affinity for drug synthesis by bacteria
314 Pharmaceutical Chemistry
65. Penicillins are usually inactivated by:
(a) E-Lactamase (b) Penicillins
(c) Gastric acids (d) (a) and (b)
66. The bacteriostatic effect of sulfametoxazole may be increased by:
(a) Penicillin (b) Sulbactam
(c) Trimetroprim (d) Tarzobactam
67. Folic acid has tetrahydrofolate coenzyme activity which is based on the:
(a) Pyrimidine ring (b) Purine ring
(c) Pyridine ring (d) Pteridine ring
68. Both isoxazole and oxazole rings are found as substituents in some bacteriostatic
sulfanilamides. They are present in these structures specifically because of their:
(a) Size and shapes (b) Electron-withdrawing effects
(c) Enzymatic activities (d) Electron-donating effects.
69. Correct statements regarding Penicillin V includes which of the following?
I. E-lactamase sensitive antibiotic–acid stable
II. Has a short half-life because it is rapidly excreted by glomerular filtration
III. Probenecid increases penicillin’s activity
(a) I (b) III
(c) I & II (d) All are correct
70. Chloramphenicol:
(a) Inhibits cell wall synthesis in sensitive organisms.
(b) Is suitable for empirical therapy in common infections.
(c) Has a wide distribution but less concentration in brain.
(d) Recommended for serious rickettsial infection.
71. Which of the following is true of tetracycline?
(a) It binds to 30s unit of ribosome and inhibits protein synthesis.
(b) It inhibits cell wall synthesis.
(c) It binds 50s subunit of ribosome and inhibits protein synthesis.
(d) It inhibits DNA replication by blocking DNA gyrase.
72. Phagocytosis can be suppressed by
(a) Iron and alcohol (b) Sulfonamide
(c) Chloramphenicol (d) All of the above
73. Which of the following is correct for warfarin and sulfonamide?
(a) They are not bound to plasma proteins.
(b) Warfarin will displace sulfonamide from plasma protein.
(c) Sulfonamide will displace warfarin from plasma proteins and cause blood clotting.
(d) Warfarin has more potent action if taken with sulfonamide and can lead to
haemorrhage.
Multiple-Choice Questions and Answers 315
74. Which of the following is a wrong statement about antimicrobial drugs?
(a) Penicillins inhibit cell wall synthesis.
(b) Chloramphenicol blocks translation step.
(c) Bacterium blocks the synthesis of bacterial peptidoglycan.
(d) Erythromycin interferes with DNA replication.
75. Pencillin has small t
due to:
1/2
(a) Great protein binding (b) Active tubule secretion
(c) Hydrolysis (d) (b) and (c)
76. Erythroped A:
(a) Is a macrolide antibiotic (b) Is effective against Gram-positive cocci
(c) Can increase GIT motility (e) All of the above
77. The only antibiotic available as chewable tablet includes:
(a) Penicillin (b) Amoxicillin
(c) Ampicillin (d) Erythromycin
78. A patient with allergy to sulphonamides (i.e., Sulphametoxazole) can take all of the
(a) Penicillin (b) Tetracycline
(c) Celecoxib (d) Clindamycin
79. Correct statements regarding erythromycin estolate may include:
I. Primarily effective against Gram-positive bacteria and also have activity against
some Gram-negative bacteria.
II. It is a macrolid antibiotic, very useful as alternative to penicillin for those that are
allergic to penicillin antibiotics.
III. Regular erythromycin is better absorbed by GIT than erythromycin estolate.
(a) I (b) III
(c) I & II (d) II & III
80. All of the following penicillins are acid label penicillins, except:
(a) Penicillin V (b) Penicillin G
(c) Methicillin (d) Nafcillin
81. Which of the following describes the mechanism of action of sulfametoxazole?
(a) Inhibits protein synthesis
(b) Inhibits cell growth by competitive antagonism with folic acid synthesis
(c) Inhibits synthesis of essential metabolites
(d) Inhibits translation of genetic information
82. Mechanism of inhibiting protein synthesis is characteristic of all the following
antibiotics, except
(a) Aminoglycosides (b) Tetracycline
(c) Cephalexin (d) Chloramphenicol
316 Pharmaceutical Chemistry
83. Which of the following is not an anti-fungal drug?
(a) Amphotericin B (b) Metronidazole
(c) Clotrimazole (d) Nystatin
84. Which of the following statement(s) is/are correct regarding Gray baby syndrome?
I. Occurs in premature and newborn infants when chloramphenicol is administrated
during the first few days of life.
II. Due to the inability of the infant to metabolize the drug because of glucoronyl
transferase deficiency.
III. Glucoronyl transferase is required to detoxify chloramphenicol.
(a) I (b) III
(c) II & III (d) All are correct
85. Which of the following statements is not true?
(a) A bacterial cell is prokaryotic whereas an animal cell is eukaryotic.
(b) A bacterial cell has a cell wall whereas an animal cell does not.
(c) Bacterial and animal cells both have a well-defined nucleus.
(d) Bacteria may contain enzymes that are not present in animal cells.
86. Which of the following is the general mechanism of action for erythromycin?
(a) Inhibition of a metabolic enzyme
(b) Inhibition of cell wall synthesis
(c) Disruption of protein synthesis
(d) Inhibition of nucleic acid transcription and replication
87. The following general structure is representative of sulphonamides. Which of the
following statements is true for active sulphonamides?
O
SR1HN
O
NHR
2
(a) R1 can be H or an alkyl group
2
(b) R
must be hydrogen
(c) The aromatic ring is essential.
(d) The sulphonamide functional group can be replaced with an ester.
88. Which of the following statements is true regarding the properties of benzylpenicillin?
(a) It is a bacteriostatic agent.
(b) It is active over a wide range of bacterial species.
(c) It is resistant to E-lactamases.
(d) Certain individuals may have an allergic response to it.
Multiple-Choice Questions and Answers 317
89. Which of the following is released by bacterial infection? (…. by bacterial cell wall
during their growth)
(a) Endotoxin (b) Exotoxin
(c) Antibiotics (d) Cytotoxin
90. What crucial feature of penicillin is involved in its mechanism of action?
(a) Carboxylic acid (b)
E-lactam ring
(c) Acyl side chain (d) Thiazolidine ring
91. :KDWUHDFWLRQLVFDWDO\VHGE\DǃODFWDPDVHHQ]\PH"
(a) The final cross-linking reaction to form the bacterial cell wall.
(b) The hydrolysis of the acyl side chain from penicillin structures.
(c) The hydrolysis of the four-membered ring present in penicillins.
(d) The biosynthesis of the penicillin structure from the amino acids—valine and
cysteine.
92. Which of the following statements is accurate in explaining why Gram-negative
bacteria are generally more resistant to penicillins than Gram-positive bacteria?
(a) Gram-negative bacteria have a thicker cell wall.
(b) Gram-negative bacteria have an outer hydrophilic membrane that acts as an
extra barrier.
(c) *UDPQHJDWLYHEDFWHULDFDQFRQFHQWUDWHǃODFWDPDVHHQ]\PHVLQWKHSHULSODVPLF
space.
(d) Gram-negative bacteria produce smaller quantities of transpeptidase enzyme.
93. What role does the acetoxy group at the 3-position of Cephalosporins have in
enhancing antibacterial activity?
(a) It acts as a steric shield and masks enzymatic attack at the E-lactam ring.
(b) It acts as a good leaving group when the
E-lactam ring is opened.
(c) It takes part in a transesterification reaction with the carboxylic acid group at
position.
(d) It increases the reactivity of the E-lactam ring by neighbouring group participation.
94. Which of the following antibiotics is a macrolide?
(a) Chloramphenicol (b) Doxycycline
(c) Erythromycin (d) Streptomycin
95. Which of the following antibiotics is a tetracycline?
(a) Chloramphenicol (b) Doxycycline
(c) Erythromycin (d) Streptomycin
96. Which of the following antibiotics is responsible for Gray baby syndrome?
(a) Chloramphenicol (b) Doxycycline
(c) Erythromycin (d) Streptomycin
318 Pharmaceutical Chemistry
97. Which of the following agents is NOT associated with the toxic effect of Stevens-
Johnson syndrome?
(a) Warfarin (b) Clotrimoxazole
(c) Amoxicillin (d) Phenobarbital
98. Example of drug(s) used to treat pneumonia includes
I. Ampicillin combined with aminoglycosides
II. Clarithromycin
III. Levofloxacin
(a) I (b) III
(c) I & II (d) All are correct
99. Erythromycin
I. Is effective against Gram-positive cocci.
II. Is a macrolide antibiotic.
III. Can increase gastrointestinal tract motility.
(a) I (b) III
(c) I & II (d) I, II & III
100. Otitis media is an ear infection normally caused by S. pneumoniae and may be best
treated by
(a) Amoxicillin (b) Penicillin V
(c) Ampicillin (d) Amoxicillin clavulanate
101. First line treatment for urinary tract infection may include
(a) Sulfametoxazole + Trimetoprim
(b) Amoxicillin clavulanate
(c) Penicillin procaine
(d) Erythromycin
102. Which of the following agents would be used in the treatment of infections caused
by Helicobacter pylori as combination therapy?
(a) Penicillin, amoxicillin, ampicillin and metronidazole
(b) Clarithromycin, amoxicillin, omeprazole and metronidazole
(c) Clarithromycin, azithromycin and lansoprazole
(d) Combinations of antibiotic should not be used due to resistance.
103. Treatment of large intestine infection mainly caused by food intoxication may
include:
I. Lots of fluids
II. Ciprofloxacin
III. Metronidazole
(a) I (b) III
(c) I & II (d) All are correct
Multiple-Choice Questions and Answers 319
104. Colitis associated with antibiotic use can best be treated by:
(a) Cephalosporins (b) Macrolides
(c) Aminoglycosides (d) Vancomycin
105. Antibiotics that often cause colitis (acute inflammation of colon) as side effect
include:
I. Broad-spectrum penicillins
II. Cephalosporins
III. Clindamycin
(a) I (b) III
(c) I & II (d) All are correct
106. Correct statements regarding antibiotics may include:
(a) Drugs derived from synthetic substances that can kill or inhibit bacterial growth.
(b) Drugs derived from natural sources that can kill or inhibit bacterial growth.
(c) Drug with ability only to kill bacteria.
(d) Drug with ability only to inhibit bacterial growth.
107. Drug derived from synthetic substances that can kill bacteria is normally called
(a) Bacteriostatic antibiotic
(b) Bactericidal antibiotic
(c) Bactericidal antimicrobial
(d) Bacteriostatic antimicrobial
108. Correct statements regarding cephalosporins include:
I. Bactericidal antimicrobial
II. Derived from natural source: Cephalosporium acremonium
III. Broad-spectrum agent
(a) I (b) III
(c) I & II (d) II & III
109. Example of fourth generation cephalosporin includes
(a) Ceftriaxone (b) Cefipime
(c) Cefixime (d) Cefoxitin
110. Which of the following is not a side effect of tetracycline?
(a) Alteration in gut flora (b) Disulfiram like reactions
(c) Permanent discoloration of teeth (d) Hyperchloremic metabolic acidosis
111. Which of the following agents can be classified as macrolide antibiotics?
I. Azithromycin
II. Clarithromycin
III. Erythromycin
(a) I (b) III
(c) I & II (d) All are correct
320 Pharmaceutical Chemistry
112. Wrong statement regarding macrolides antibiotics include:
(a) Used in both Gram-positive and Gram-negative infections.
(b) Used as an alternative to penicillin when patient has allergy to penicillins.
(c) Inhibit cell wall synthesis of microorganisms.
(d) Increase gastric motility causing cramps and diarrhoea as major side effect.
113. Which of the following is considered a polyene antifungal agent?
(a) Miconazole (b) Clotrimazole
(c) Amphotericin (d) Itraconazole
114. In which of the following conditions are quinolone antimicrobial drugs mainly used?
(a) Respiratory tract infections (b) Urinary tract infections
(c) Gastrointestinal tract infections (d) Cerebral infections
115. In which of the following statements best describes the action of the antitubercular
agent isoniazid?
(a) Inhibits cell wall synthesis of mycobacterium.
(b) Inhibits the DNA duplication of mycobacterium.
(c) Inhibits protein synthesis of mycobacterium.
(d) Inhibits mycolic acids that are unique for mycobacterium.
116. Bacterial resistance to an antibiotic may occur due to:
I. Mutation
II. Adaptation
III. Gene transfer
(a) I (b) III
(c) II & III (d) All are correct
117. Which one of the following was Gram-negative, chemolithotrophic bacteria?
(a) Siderococcus (b) E. coli
(c) Spirellum (d) Mycoplasms
118. Staining material of Gram-positive bacterium is
(a) Fast green (b) Haematoxylon
(c) Crystal violet (d) Safranin
119. Broad-spectrum antibiotics that may cause severe impairment of bone marrow
include which of the following agents?
(a) Tetracycline (b) Aminoglycosides
(c) Vancomycin (d) Chloramphenicol
120. Which of the following agent is classified as a lincosamide antibiotic?
(a) Tetracycline (b) Aminoglycosides
(c) Clindamycin (d) Chloramphenicol
Multiple-Choice Questions and Answers 321
121. Sulfonamides are metabolised by humans principally by:
(a) Acetylation (b) Deamination
(c) Conjugation (d) Methylation
122. What kind of antibacterial agent is erythromycin?
(a) Macromolecule (b) Macrolide
(c) Lactone ring (d) (b) and (c)
123. Sulfonamide metabolism in the human body is carried out by:
(a) Oxidation (b) Conjugation
(c) Methylation (d) Acetylation
124. Which of the following cephalosporins can be used to treat H. influenza meningitis?
(a) Cefaclor (b) Cephalexin
(c) Ceftriaxone (d) Cefoxitin
125. Which one of the following penicillins is resistant to Staphylococcus aureus
ǃODFWDPDVHV"
(a) Benzathine penicillin (b) Methicillin
(c) Amoxicillin (d) Piperacillin
126. Amoxicillin is least effective against Shigellosis because of:
(a) Introduction of E-lactamase in the organism.
(b) Complete absorption from the upper GIT.
(c) Modification of penicillin binding proteins on the bacteria.
(d) Chelation of drug with bile salts to make it inactive.
127. Urine culture of a patient has shown growth of Pseudomonas aeruginosa. Which one
of the following cephalosporins should be used in the treatment of this case?
(a) Ceftizoxime (b) Ceftazidime
(c) Cefuroxime (d) Cefotetan
128. Which one of the following sulphonamides is used in the treatment of ulcerative
colitis?
(a) Sulphacetamide (b) Sulphadiazine
(c) Sulphasalazine (d) Sulphadimidine
129. Bacteroides fragilis infection is preferably treated with
(a) Azithromycin (b) Tetracyclines
(c) Metronidazole (d) Carbenicillin
130. Which one of the following penicillins is not stable in the presence of gastric HCI?
(a) Amoxicillin (b) Piperacillin
(c) Nafcillin (d) Phenoxymethyl penicillin