NAPLEX Questions: ID 1 with 100%
Correct Solutions Latest Update 2024
Gram positive organisms have a thick cell wall and stain ____. - ANS-Purple or bluish
Gram negative organisms have a thin cell wall and result in a ___ color. - ANS-Pink or
reddish
Identify the bug: gram-positive clusters (1) - ANS-Staphylococcus species
Identify the bug: gram-positive cocci in pairs and chains (3) - ANS-Strep. pneumoniae
(pairs), Streptococcus species, Enterococcus species
Identify the bug: gram-positive rods (1) - ANS-Listeria monocytogenes
Identify the bug: gram-positive anaerobes (3) - ANS-Peptostreptococcus, Actinomyces,
Clostridium
Identify the bug: gram-negative cocci (1) - ANS-Neisseria
Identify the bug: gram-negative anaerobes (2) - ANS-Bacteroides fragilis, Prevotella
Identify the bug: gram-negative coccobacilli (3) - ANS-Acinetobacter baumannii,
Bordetella pertussis, Moraxella catarrhalis
Identify the bug: gram-negative rods that colonize the gut, aka enteric GNRs (5) - ANS-
Proteus mirabilis, E. coli, Klebsiella, Serratia, Enterobacter, Citrobacter
Identify the bug: gram-negative rods that do not colonize the gut (3) - ANS-
Pseudomonas aeruginosa, Haemophilus influenzae, Providencia
,Identify the bug: curved or spiral-shaped gram-negative rods (4) - ANS-H. pylori,
Campylobacter, Treponema, Borrelia
What is an MIC? - ANS-Minimum inhibitory concentration; the minimum concentration of
an antibiotic necessary to kill a bug in 24 hours
If the MIC is ___ than the breakpoint, the antibiotic CAN be used to treat the bacterial
infection - ANS-Less than or equal to
Antibiograms aid in selecting ___ drug therapy and are used to monitor ___ trends over
time - ANS-Empiric; resistance
Name the six common resistant pathogens - ANS-MRSA
VRE (E. faecalis, faecium)
ESBL, CRE E. coli and K. pneumoniae
Acinetobacter baumannii
Pseudomonas aeruginosa
What is intrinsic drug resistance? - ANS-When an antibiotic won't work for a pathogen
purely because of the molecule; vancomycin can't treat E. coli because it's too big to
penetrate the cell wall
What is selection pressure? - ANS-Antibiotics kill off the susceptible bacteria, leaving
behind the more resistant strains to multiply
Name the four beta-lactamase inhibitors - ANS-Clavulanate, sulbactam, tazobactam,
avibactam
Even though all antibiotics are associated with C. diff, this one has a black boxed
warning for it. - ANS-Clindamycin
, Hydrophilic agents have small/large Vds, hepatic/renal elimination, do/do not achieve
intracellular concentrations, increased/decreased clearance and/or distribution in
sepsis, and poor-moderate/excellent PO bioavailability. - ANS-Hydrophilic agents have
small Vds, are renally eliminated, do not achieve intracellular concentrations (not good
against atypicals), increased clearance and/or distribution in sepsis (may need a loading
dose), and poor-moderate bioavailability
Lipophilic agents have small/large Vds, hepatic/renal elimination, do/do not achieve
intracellular concentrations, increased/decreased clearance and/or distribution in
sepsis, and poor-moderate/excellent PO bioavailability. - ANS-Lipophilic agents have
large Vds, hepatic metabolism, achieve intracellular concentrations (active against
atypicals), can be used without dose adjustment in sepsis, and have excellent PO
bioavailability, so PO to IV ratio is often 1:1
Beta-lactams exhibit time-dependent killing, so they are dosed more frequently or at
greater doses - ANS-More frequently. Can also extend infusion time or administer as
continuous infusion.
Aminoglcosides, quinolones, and daptomycin exhibit concentration dependent killing, so
they are dosed more frequently or at greater doses - ANS-At greater doses
What are the three classes of antibiotics that are beta-lactams? - ANS-Penicillins,
cephalosporins, and carbapenems
What is the MOA of beta-lactams? - ANS-Inhibit bacterial cell wall synthesis
Are beta-lactams time-dependent or concentration-dependent killers? - ANS-Time-
dependent
Natural penicillins are mainly active against gram ___ like ___ with little activity against
gram ___. - ANS-Positives like Streptococci and other mouth flora; little activity against
gram negatives.
Amoxicillin and ampicillin cover gram positives like __ and __, plus gram-negative bacilli
HNPEK and gram-negative anaerobes (B. Fragilis). What are those anyway? - ANS-
Streptococci and enterococci