GI Antibiotics PANCE-Style Questions PDF

**GI Antibiotics PANCE-Style Questions** **1.**\ **Question**: Which of the following pathogens is most commonly associated with intra-abdominal infections?\ **Choices**:\ A. Escherichia coli\ B. Streptococcus pyogenes\ C. Staphylococcus aureus\ D. Haemophilus influenzae\ **Correct Answer**: A\ **E...

**GI Antibiotics PANCE-Style Questions** **1.**\ **Question**: Which of the following pathogens is most commonly associated with intra-abdominal infections?\ **Choices**:\ A. Escherichia coli\ B. Streptococcus pyogenes\ C. Staphylococcus aureus\ D. Haemophilus influenzae\ **Correct Answer**: A\ **Explanation**: Escherichia coli is a common gram-negative pathogen implicated in intra-abdominal infections. **2.**\ **Question**: Which of the following antibiotics is recommended as part of triple therapy for Helicobacter pylori infection?\ **Choices**:\ A. Vancomycin\ B. Metronidazole\ C. Azithromycin\ D. Levofloxacin\ **Correct Answer**: B\ **Explanation**: Metronidazole is part of triple or quadruple therapy regimens for H. pylori infection. **3.**\ **Question**: What is the mechanism of action of metronidazole?\ **Choices**:\ A. Inhibits bacterial cell wall synthesis\ B. Disrupts bacterial DNA synthesis\ C. Inhibits protein synthesis at the 50S ribosomal subunit\ D. Inhibits dihydrofolate reductase\ **Correct Answer**: B\ **Explanation**: Metronidazole disrupts bacterial DNA synthesis, making it effective against anaerobic bacteria and protozoa. **4.**\ **Question**: A patient is diagnosed with a dental abscess. What is the most appropriate first-line antibiotic?\ **Choices**:\ A. Amoxicillin\ B. Ciprofloxacin\ C. Vancomycin\ D. Metronidazole\ **Correct Answer**: A\ **Explanation**: Amoxicillin is the first-line therapy for dental abscesses due to its efficacy against oral flora. **5.**\ **Question**: What is a common adverse effect of clindamycin therapy?\ **Choices**:\ A. Hyperkalemia\ B. C. difficile infection\ C. Nephrotoxicity\ D. QT prolongation\ **Correct Answer**: B\ **Explanation**: Clindamycin is associated with a high risk of C. difficile infection due to its disruption of normal gut flora. **6.**\ **Question**: Which antibiotic is associated with a disulfiram-like reaction when taken with alcohol?\ **Choices**:\ A. Metronidazole\ B. Amoxicillin\ C. Azithromycin\ D. Vancomycin\ **Correct Answer**: A\ **Explanation**: Metronidazole can cause a disulfiram-like reaction, leading to nausea and flushing when consumed with alcohol. **7.**\ **Question**: A patient presents with diarrhea after recent clindamycin use. What is the most appropriate initial diagnostic step?\ **Choices**:\ A. Stool culture\ B. Stool toxin assay for C. difficile\ C. Abdominal CT scan\ D. Colonoscopy\ **Correct Answer**: B\ **Explanation**: Stool toxin assay for C. difficile is the diagnostic test of choice in patients with diarrhea following antibiotic use. **8.**\ **Question**: Which of the following is first-line treatment for mild C. difficile colitis?\ **Choices**:\ A. Metronidazole\ B. Oral vancomycin\ C. Fidaxomicin\ D. Intravenous vancomycin\ **Correct Answer**: B\ **Explanation**: Oral vancomycin is recommended as first-line therapy for mild to moderate C. difficile colitis. **9.**\ **Question**: What is the mechanism of action of fidaxomicin?\ **Choices**:\ A. Inhibits RNA polymerase\ B. Disrupts DNA synthesis\ C. Inhibits the 50S ribosomal subunit\ D. Inhibits bacterial cell wall synthesis\ **Correct Answer**: A\ **Explanation**: Fidaxomicin inhibits bacterial RNA polymerase, making it effective against C. difficile. **10.**\ **Question**: Which gram-negative pathogen is commonly associated with severe intra-abdominal infections and often requires antipseudomonal coverage?\ **Choices**:\ A. Pseudomonas aeruginosa\ B. Enterococcus faecalis\ C. Escherichia coli\ D. Streptococcus pneumoniae\ **Correct Answer**: A\ **Explanation**: Pseudomonas aeruginosa is a gram-negative pathogen that often requires broad-spectrum antipseudomonal coverage. **11.**\ **Question**: Which antibiotic is commonly used to treat traveler\'s diarrhea caused by Escherichia coli?\ **Choices**:\ A. Azithromycin\ B. Vancomycin\ C. Rifaximin\ D. Ciprofloxacin\ **Correct Answer**: C\ **Explanation**: Rifaximin is often used to treat traveler\'s diarrhea caused by non-invasive strains of Escherichia coli. **12.**\ **Question**: A patient with an intra-abdominal infection is started on piperacillin-tazobactam. What is the primary mechanism of action of this antibiotic combination?\ **Choices**:\ A. Inhibits bacterial cell wall synthesis\ B. Disrupts DNA synthesis\ C. Inhibits the 30S ribosomal subunit\ D. Inhibits folate synthesis\ **Correct Answer**: A\ **Explanation**: Piperacillin-tazobactam inhibits bacterial cell wall synthesis, with tazobactam providing beta-lactamase inhibition. **13.**\ **Question**: Which antibiotic class is commonly used as monotherapy for mild to moderate intra-abdominal infections?\ **Choices**:\ A. Carbapenems\ B. Macrolides\ C. Cephalosporins\ D. Fluoroquinolones\ **Correct Answer**: A\ **Explanation**: Carbapenems provide broad-spectrum coverage, including gram-positive, gram-negative, and anaerobic pathogens, making them effective for intra-abdominal infections. **14.**\ **Question**: A patient with infectious diarrhea has bloody stools and fever. Which pathogen should be suspected?\ **Choices**:\ A. Giardia lamblia\ B. Norovirus\ C. Shigella species\ D. Vibrio cholerae\ **Correct Answer**: C\ **Explanation**: Shigella species are common causes of bloody diarrhea and fever, requiring antimicrobial therapy in severe cases. **15.**\ **Question**: What is a contraindication for the use of fluoroquinolones in treating GI infections?\ **Choices**:\ A. Pregnancy\ B. Diabetes\ C. Mild renal impairment\ D. Mild hepatic impairment\ **Correct Answer**: A\ **Explanation**: Fluoroquinolones are contraindicated in pregnancy due to potential teratogenic effects on cartilage development. **16.**\ **Question**: Which of the following antibiotics requires monitoring for nephrotoxicity?\ **Choices**:\ A. Ciprofloxacin\ B. Vancomycin\ C. Amoxicillin\ D. Azithromycin\ **Correct Answer**: B\ **Explanation**: Vancomycin requires monitoring for nephrotoxicity, especially in patients with renal impairment. **17.**\ **Question**: Which antibiotic regimen is recommended for severe C. difficile colitis?\ **Choices**:\ A. Intravenous metronidazole and oral vancomycin\ B. Oral fidaxomicin\ C. Intravenous vancomycin\ D. Oral metronidazole\ **Correct Answer**: A\ **Explanation**: Severe C. difficile colitis is treated with oral vancomycin and intravenous metronidazole. **18.**\ **Question**: What is a major adverse effect of aminoglycosides in the treatment of GI infections?\ **Choices**:\ A. Ototoxicity\ B. Neutropenia\ C. QT prolongation\ D. Photosensitivity\ **Correct Answer**: A\ **Explanation**: Aminoglycosides, such as gentamicin, can cause ototoxicity, necessitating close monitoring. **19.**\ **Question**: Which antibiotic is often prescribed for anaerobic coverage in intra-abdominal infections?\ **Choices**:\ A. Metronidazole\ B. Ciprofloxacin\ C. Amoxicillin\ D. Vancomycin\ **Correct Answer**: A\ **Explanation**: Metronidazole is effective against anaerobic bacteria, making it a key component in treating intra-abdominal infections. **20.**\ **Question**: Which antibiotic combination is commonly used to treat H. pylori-associated peptic ulcer disease?\ **Choices**:\ A. Amoxicillin and metronidazole\ B. Amoxicillin and clarithromycin\ C. Ciprofloxacin and rifaximin\ D. Vancomycin and azithromycin\ **Correct Answer**: B\ **Explanation**: Amoxicillin and clarithromycin, combined with a PPI, are part of triple therapy for H. pylori eradication. **21.**\ **Question**: A patient with a known penicillin allergy presents with a dental abscess. What is the most appropriate antibiotic alternative?\ **Choices**:\ A. Metronidazole\ B. Clindamycin\ C. Ceftriaxone\ D. Vancomycin\ **Correct Answer**: B\ **Explanation**: Clindamycin is an effective alternative for treating dental abscesses in patients with penicillin allergy. **22.**\ **Question**: Which of the following antibiotics is preferred for treating severe traveler\'s diarrhea caused by Campylobacter jejuni?\ **Choices**:\ A. Ciprofloxacin\ B. Azithromycin\ C. Metronidazole\ D. Rifaximin\ **Correct Answer**: B\ **Explanation**: Azithromycin is preferred for Campylobacter species due to increasing resistance to fluoroquinolones. **23.**\ **Question**: Which anaerobic pathogen is a common cause of intra-abdominal infections?\ **Choices**:\ A. Bacteroides fragilis\ B. Escherichia coli\ C. Clostridium tetani\ D. Shigella flexneri\ **Correct Answer**: A\ **Explanation**: Bacteroides fragilis is a key anaerobic pathogen often implicated in intra-abdominal infections. **24.**\ **Question**: Which medication is commonly used for prophylaxis in hepatic encephalopathy?\ **Choices**:\ A. Rifaximin\ B. Vancomycin\ C. Ciprofloxacin\ D. Amoxicillin\ **Correct Answer**: A\ **Explanation**: Rifaximin reduces ammonia-producing gut bacteria, making it effective for hepatic encephalopathy prophylaxis. **25.**\ **Question**: Which of the following antibiotics can cause Achilles tendon rupture as a side effect?\ **Choices**:\ A. Ciprofloxacin\ B. Vancomycin\ C. Amoxicillin\ D. Azithromycin\ **Correct Answer**: A\ **Explanation**: Fluoroquinolones, including ciprofloxacin, are associated with tendonitis and Achilles tendon rupture. **26.**\ **Question**: A patient with C. difficile infection is started on fidaxomicin. What is a major advantage of fidaxomicin compared to other therapies?\ **Choices**:\ A. Broad-spectrum antimicrobial activity\ B. Reduced recurrence rates\ C. Intravenous formulation availability\ D. Rapid bactericidal action\ **Correct Answer**: B\ **Explanation**: Fidaxomicin has been shown to reduce recurrence rates of C. difficile infection compared to other therapies. **27.**\ **Question**: Which antibiotic is recommended as monotherapy for mild diverticulitis?\ **Choices**:\ A. Amoxicillin\ B. Ciprofloxacin\ C. Metronidazole\ D. Augmentin (Amoxicillin/Clavulanate)\ **Correct Answer**: D\ **Explanation**: Amoxicillin/clavulanate provides sufficient broad-spectrum coverage for mild cases of diverticulitis. **28.**\ **Question**: What is the most common side effect of oral vancomycin?\ **Choices**:\ A. Nephrotoxicity\ B. Ototoxicity\ C. GI upset\ D. Hypokalemia\ **Correct Answer**: C\ **Explanation**: Oral vancomycin is associated with gastrointestinal upset as the most common side effect. **29.**\ **Question**: A patient with typhoid fever is being treated with ciprofloxacin. What is the mechanism of action of this antibiotic?\ **Choices**:\ A. Inhibits DNA gyrase\ B. Disrupts bacterial protein synthesis\ C. Inhibits cell wall synthesis\ D. Blocks RNA polymerase\ **Correct Answer**: A\ **Explanation**: Ciprofloxacin inhibits bacterial DNA gyrase, preventing DNA replication. **30.**\ **Question**: Which of the following is an appropriate initial therapy for an intra-abdominal infection caused by a multidrug-resistant gram-negative pathogen?\ **Choices**:\ A. Piperacillin/tazobactam\ B. Ceftriaxone\ C. Ertapenem\ D. Meropenem\ **Correct Answer**: D\ **Explanation**: Meropenem is a broad-spectrum carbapenem effective against multidrug-resistant gram-negative pathogens. **31.**\ **Question**: A patient develops severe diarrhea after hospitalization. Which is the most likely causative agent?\ **Choices**:\ A. Giardia lamblia\ B. Escherichia coli\ C. Clostridium difficile\ D. Campylobacter jejuni\ **Correct Answer**: C\ **Explanation**: C. difficile is the most common cause of nosocomial diarrhea, particularly following antibiotic use. **32.**\ **Question**: What is the recommended treatment for a first episode of mild to moderate C. difficile infection?\ **Choices**:\ A. Intravenous metronidazole\ B. Oral fidaxomicin\ C. Intravenous vancomycin\ D. Oral vancomycin\ **Correct Answer**: D\ **Explanation**: Oral vancomycin is the first-line treatment for mild to moderate C. difficile infection. **33.**\ **Question**: Which antibiotic used for GI infections carries a risk of QT prolongation?\ **Choices**:\ A. Ciprofloxacin\ B. Metronidazole\ C. Azithromycin\ D. Vancomycin\ **Correct Answer**: C\ **Explanation**: Azithromycin, a macrolide, is associated with QT prolongation and potential arrhythmias. **34.**\ **Question**: What is a potential adverse effect of long-term metronidazole use?\ **Choices**:\ A. Hepatic toxicity\ B. Peripheral neuropathy\ C. QT prolongation\ D. Hyperkalemia\ **Correct Answer**: B\ **Explanation**: Long-term use of metronidazole can cause peripheral neuropathy due to neurotoxicity. **35.**\ **Question**: Which antibiotic is most appropriate for empiric treatment of intra-abdominal infections in critically ill patients?\ **Choices**:\ A. Cefazolin\ B. Levofloxacin\ C. Piperacillin/tazobactam\ D. Amoxicillin\ **Correct Answer**: C\ **Explanation**: Piperacillin/tazobactam provides broad-spectrum coverage and is commonly used in critically ill patients with intra-abdominal infections. **36.**\ **Question**: A patient with a penicillin allergy requires treatment for H. pylori. What is an alternative regimen?\ **Choices**:\ A. Bismuth, tetracycline, and metronidazole\ B. Amoxicillin and clarithromycin\ C. Ciprofloxacin and rifaximin\ D. Vancomycin and azithromycin\ **Correct Answer**: A\ **Explanation**: A bismuth-based quadruple therapy is an alternative for patients with penicillin allergy. **37.**\ **Question**: What is the recommended duration of antibiotic therapy for uncomplicated diverticulitis?\ **Choices**:\ A. 3-5 days\ B. 5-7 days\ C. 7-10 days\ D. 10-14 days\ **Correct Answer**: B\ **Explanation**: A 5-7 day course of antibiotics is recommended for uncomplicated diverticulitis to minimize resistance and adverse effects. **38.**\ **Question**: Which antibiotic is effective for treating gram-positive, gram-negative, and anaerobic pathogens?\ **Choices**:\ A. Ciprofloxacin\ B. Piperacillin/tazobactam\ C. Azithromycin\ D. Vancomycin\ **Correct Answer**: B\ **Explanation**: Piperacillin/tazobactam provides broad-spectrum coverage, including gram-positive, gram-negative, and anaerobic bacteria. **39.**\ **Question**: A patient with hepatic encephalopathy is prescribed rifaximin. What is a key benefit of this antibiotic?\ **Choices**:\ A. Systemic absorption\ B. Selective gut activity\ C. Rapid bactericidal action\ D. Broad-spectrum coverage\ **Correct Answer**: B\ **Explanation**: Rifaximin works selectively in the gut to reduce ammonia-producing bacteria with minimal systemic absorption. **40.**\ **Question**: Which antibiotic is considered first-line therapy for typhoid fever in areas with no fluoroquinolone resistance?\ **Choices**:\ A. Ciprofloxacin\ B. Vancomycin\ C. Azithromycin\ D. Doxycycline\ **Correct Answer**: A\ **Explanation**: Ciprofloxacin is a first-line therapy for typhoid fever in areas without significant fluoroquinolone resistance.