Cell Wall Inhibitors

Front 1

A drug for which dressing loss might be increased for food animals

Back 1

Procaine or benzathine penicillin

Front 2

A drug, which combined with beta-lactams, will express antagonistic effects

Back 2

Any drug which slows the growth of the organism (ribosomal inhibitors)

Front 3

A drug, which combined with beta-lactams, will express synergistic effects

Back 3

Aminoglycosides, Fluoroquionolones, Potentiated Sulfonamides

Front 4

A first generation cephalosporine often used for surgical prophlylaxis

Back 4

cefazolin

Front 5

A host factor which may decrease the efficacy of beta-lactams more so than other drugs

Back 5

Marked inflammatory debris (hyperosmotic environment)

Front 6

A potential toxicity associated with the potassium penicillin salt

Back 6

hyperkalemia

Front 7

A reason that a large inoculum will decrease therapeutic success with a beta-lactam more so than other drug classes

Back 7

More beta-lactamases; if gram negative, endotoxin release

Front 8

An isolate is susceptible to cefovecin on culture but not in the patient. What might explain this?

Back 8

Extended-spectrum beta-lactamases tend to be inducible and thus often occur only in the patient

Front 9

An isolate will be most susceptible to the effects of beta-lactams if rapidy growing: T or F

Back 9

TRUE

Front 10

A 3rd generation cephalosporin approved for use in horses, dogs and beef cattle

Back 10

Ceftiofur

Front 11

Beta-lactams are nephrotoxic: T or F

Back 11

FALSE

Front 12

Beta-lactams in general can achieve effective concentrations in the brain: T or F

Back 12

False

Front 13

Ceftiofur labeled for use in beef cattle can be legally used to treat mastitis in dairy cattle: T or F

Back 13

FALSE

Front 14

Clavulanic acid is susceptible to extended spectrum beta-lactamases: T or F?

Back 14

FALSE; indeed, that is how ESBL are detected: the MIC of cefovecin will be much lower if combined with clavulanic acid

Front 15

CLSI has set two breakpoints for Staphylococcus and cephalosporins: T or F

Back 15

FALSE (cephalosporins are relatively more resistant to cephalosporinases)

Front 16

In general, beta-lactams should be effective for treatment of mycooplasma

Back 16

False (cell wall deficient)

Front 17

In general, cefovecin is more susceptible to beta-lactamase destruction compared to cefazolin

Back 17

FALSE (until ESBL are formed)

Front 18

Indicated for methicillin resistant staphylococcus aureus

Back 18

Vancomycin

Front 19

Intrauterine penicllin will not be systemically absorbed: T or F

Back 19

FALSE

Front 20

Meropenem is generally susceptible to beta-lactamase destruction :Tor F?

Back 20

FALSE

Front 21

Meropenem will still be effective in a Staphylococcus isolate that has acquired the mec gene. T or F?

Back 21

FALSE

Front 22

More than 400 Beta-lactamses have been identified: T or F

Back 22

TRUE

Front 23

Most common mechanism of resistance of Staphylococcus to penicillins

Back 23

penicillinases (a beta-lactamase)

Front 24

Name a first tier cephalosporin

Back 24

Cephalexin (possible cefazolin)

Front 25

Name a first tier penicillin

Back 25

Penicillin, ampicillin or amoxicillin

Front 26

Natural penicillin

Back 26

penicillin (procaine or benzathine)

Front 27

Orally administered beta-lactams

Back 27

penicillin V, Ampicillin, amoxicillin (clavulanic acid), cephalexin, (cefpodoxime)

Front 28

Penicillin expresses excellent activity toward gram negatives:Tor F?

Back 28

False (only "whimpy" ones)

Front 29

Penicillins express excellent activity toward anaerobes: Tor F?

Back 29

TRUE

Front 30

The "downside" of slow release penicillins

Back 30

Peak plasma drug concentrations may not reach MIC

Front 31

The "upside" of slow release penicillins

Back 31

As time dependent drugs, T>MIC will be longer

Front 32

The active site of penicillins and cephalosporins

Back 32

the beta lactam ring

Front 33

The amine added to penicillin allows for oral absorption:Tor F?

Back 33

TRUE

Front 34

The amine added to penicillin improves the Gram negative spectrum: Tor F?

Back 34

TRUE

Front 35

The beta-lactam least likey to relase endotoxin

Back 35

Any Carbapenem

Front 36

The beta-lactam ring substitutes for this their mechanisn of action)

Back 36

d-ala-d-ala pentapeptide

Front 37

The cause of susceptible microbial death following treatment with beta lactams

Back 37

Osmotic lysis

Front 38

The Cmax of amoxicillin is 4 mcg/ml. The half-life is 1 hr. The MIC of the target oranism is 0.5 mcg/ml. What is the maximum dosing interval that should be considered?

Back 38

6 hours

Front 39

The enzyme inhibited by beta-lactams

Back 39

transpeptidases (penicillin binding proteins)

Front 40

The half-life of cefovecin

Back 40

Greater than 125 hours

Front 41

The half-life of penicillins (in general)

Back 41

1-2 hours

Front 42

The impact of gastric acidity on beta lactams in general

Back 42

Destruction of beta -lactam ring

Front 43

The impact of gastric acidity on orally stable beta lactams

Back 43

As weak acids, they should be better absorbed in an acid environment

Front 44

The model drug for cephalexin and cefazolin on culture and susceptibility reports

Back 44

Cephalothin

Front 45

The pH at which beta-lactams will be more effective: 6 or 8?

Back 45

6 (weak acids)

Front 46

The pharmacokinetic-pharmacodynamic target of beta-lactams

Back 46

Time over MIC of at least 50% of the dosing interval

Front 47

The reason that CLSI has provided two breakpoints for Staphylococcus sp and penicillins

Back 47

penicillinases reduce the concentration of penicillins at the site of infection

Front 48

The reason that withdrawal times/discard times must be strictly adhered to

Back 48

Penicillin hypersensitivity (allergy) in humans

Front 49

The route of elimination of most beta-latams

Back 49

Renal

Front 50

The withdrawal time for ceftiofur regular release is the same as the withdrawal time for ceftiofur extended release: T or F?

Back 50

FALSE

Front 51

This activity may reduce the presence of a beta-lactam that has passed the blood brain barrier

Back 51

efflux by p-glycoprotein

Front 52

Ticarcillin has an excellent spectrum toward Gram negative organisms: T or F

Back 52

TRUE

Front 53

Ticarcillin is not susceptible to beta-lactamase destruction: Tor F?

Back 53

FALSE

Front 54

Ticarcillin with clavulanic acid and meropenem are similar in spectrum: Tor F?

Back 54

TRUE

Front 55

True or False: A microbe surrounded by hypertonic fluid is less susceptible to beta lactams.

Back 55

TRUE

Front 56

Vancomycin is orally bioavailable: T or F

Back 56

FALSE

Front 57

What is, in general, the volume of distribution of beta lactams?

Back 57

< 0.3 L/kg (30% of body weight: water soluble = ECF distribution)

Front 58

Which has the longer elimination half-life: procaine or benzathine penicillin?

Back 58

The elimination half-life is the same

Front 59

Which is longer acting: procaine or benzathine penicillin?

Back 59

Benzathine

Front 60

Which is longer withdrawal time: procaine or benzathine penicillin?

Back 60

Benzathine

Front 61

Which MODEL beta-lactams should be effective against anaerobes?

Back 61

Any of the penicillins, ceftiofur, cefovecin

Front 62

Which MODEL beta-lactams should be effective against Pseudomonas aeurginosa?

Back 62

Ticarcillin, Meropenem

Front 63

Which would be better for treatment of E. coli: Amoxi-Clav or Cephalexin?

Back 63

Amoxi-Clav

Front 64

Which would be better for treatment of Enterococcus: Amoxicillin or cephalexin?

Back 64

Amoxicillin (enterococci are resistant to cephalosporins)

Front 65

Which would be better for treatment of Staphylococcus pseudintermedius: Amoxi or Cephalexin?

Back 65

Cephalexin

Front 66

Which would be better for treatment of Staphylococcus pseudintermedius: Amoxi-clav or Cephalexin?

Back 66

Cephalexin, but only because the half-life is longer

Front 67

The model drug for amoxicillin on culture and susceptibility reports

Back 67

ampicillin

Front 68

The model drug for ampicillin-sulbactam on culture and susceptibility reports

Back 68

amoxicilliln-sulbactam

Front 69

The model drug for methicillin on culture and susceptibility reports

Back 69

oxacillin

Front 70

A Staph isolate is resistant to all beta-lactams on the report. Oxacillin is not on the report. Is this isolate MRS?

Back 70

Yes