 1.

Which of the following statements correctly pair the antifungal drugs with
their likely mechanisms of action?

o A. 

Amphotericin B - inhibits thymidylate synthetase

o B. 

Griseofulvin - interferes with microtubule function

o C. 

Flucytosine - inhibits fungal mycolic acid synthesis

o D. 

Miconazole - inhibits DNA dependent RNA polymerase

o E. 

Nystatin - inhibits ergosterol synthesis

o F. 

Terbinafine - inhibits squalene epoxidase

 

 2. 

Which of the following statements correctly pairs the antifungal drug with its
typical adverse effect?

o A. 

Amphotericin B - normocytic anemia

o B. 

Griseofulvin - photosensitivity

o C. 

Flucytosine - myelosuppression
 o D. 

Ketoconazole - menstrual irregularities

o E. 

Nystatin - mental confusion

 

 3. 

Which of the following statements best explain the mechanism of antifungal

action of amphotericin B?

o A. 

Inhibition of topoisomerase II

o B. 

Impairment of the normal permeability of fungal cell membrane

o C. 

Inhibition of reverse transcriptase

o D. 

Blockade of fungal mitosis

o E. 

Inhibition of fungal cytochrome P450 enzymes

 

 4. 

Which of the following statements regarding the toxicity of amphotericin B

are correct?

o A. 

Metabolic alkalosis is frequent and may be pronounced

o B. 

A shock-like fall in blood pressure may occur during IV infusion

 o C. 

A sudden decrease of body temperature may occur during IV infusion

o D. 

Renal toxicity is common, is dose-dependent and may be severe

o E. 

Amphotericin B toxicity seems to be lower with the use of lipid formulations the
drug
 

 5. 

Which of the following is an antifungal drug that acts by inhibiting fungal

DNA synthesis?

o A. 

Fluorouracil

o B. 

Cytarabine

o C. 

Flucytosine

o D. 

Griseofulvin

o E. 

Ketoconazole

o F. 

Terbinafine
 

 6. 

Which of the following statements best explains the mechanism of antifungal

action of azoles?
 o A. 

Inhibition of conversion of squalene to lanosterol

o B. 

Formation of artificial pores in the fungal membrane

o C. 

Inhibition of fungal mitosis

o D. 

Inhibition of squalene synthesis

o E. 

Inhibition of conversion of lanosterol to ergosterol

 

 7. 

Which of the following fungal disease is resistant to azole treatment?

o A. 

Coccidioidomycosis

o B. 

Histoplasmosis

o C. 

Aspergillosis

o D. 

Cryptococcosis

o E. 

Mucormycosis
 

 8. 
 Which of the following fungi are sensitive to Griseofulvin?

o A. 

Candida albicans

o B. 

Malassezia furfur

o C. 

Trichophyton rubrum

o D. 

Epidermophyton floccosum

o E. 

Microsporum gypseum

o F. 

Pseudomonas aeruginosa

o G. 

Histoplasma capsulatum
 

 9. 

Recognized clinical indications for the use of terbinafine include which of the
following diseases?

o A. 

Actinomycosis

o B. 

Brucellosis

o C. 

Toxoplasmosis
 o D. 

Onychomycosis

o E. 

Histoplasmosis
 

 10. 

A 31-year-old man presented to his physician with an annular lesion with

raised borders in his left hand. Microscopic examination of skin scrapings
revealed branching hyphae. The diagnosis of tinea manus was made and the
patient has prescribed appropriate oral treatment. Which of the following
skin structures was most likely the site of action of the prescribed drug?

o A. 

Stratum basale

o B. 

Stratum spinosum

o C. 

Stratum corneum

o D. 

Pigment layer

o E. 

Hair follicle

o F. 

Hair shaft
 

 11. 

A 37-year-old man complained of anorexia, nausea, enlargement of his

breast, and impotence. The man, recently diagnosed with pulmonary
coccidioidomycosis, has been receiving an antifungal treatment for two
 weeks. Which of the following drugs most likely caused these adverse
effects?

o A. 

Amphotericin B

o B. 

Nystatin

o C. 

Ketoconazole

o D. 

Flucytosine

o E. 

Griseofulvin

o F. 

Terbinafine
 

 12. 

A 37-year-old woman with AIDS has been recently diagnosed with systemic
candidiasis due to  Candida cruzii, and an IV antifungal treatment has been
prescribed. Four days later the following lab results were obtained: serum
creatinine 5.9 mg/dL(normal: 0.6-1.5), blood urea nitrogen 53 mg/dL (normal
7-30), plasma potassium 2.3mmol/L (normal 3.5-5.3). Which of the following
drugs was most likely prescribed?

o A. 

Amphotericin B

o B. 

Fluconazole

o C. 
 Griseofulvin

o D. 

Flucytosine

o E. 

Cyclosporine

o F. 

Tobramycin
 

 13. 

A 32-year-old woman presents to her gynecologist with a 4 days history of

perineal pruritus and a non-malodorous, thick, cheesy vaginal discharge. The
only medication the woman is taking is an oral contraceptive. A wet
preparation of vaginal secretion shows budding yeast cells and
pseudohyphae. Which of the following drugs, given locally, would be
appropriate for this patient?

o A. 

Mebendazole

o B. 

Metronidazole

o C. 

Miconazole

o D. 

Zidovudine

o E. 

Griseofulvin

o F. 
 Saquinavir
 

 14. 

A 68-year-old man is in the hospital because of a prostatectomy performed 4

days before. He is wearing a urinary catheter and is currently treated with a
combination of broad-spectrum antibiotics. The patient has been suffering
from chronic renal insufficiency for the past two years. Two recent urinalysis
show many budding yeasts and cultures were positive for Candida albicans.
Which of the following drugs would be appropriate for systemic antifungal
treatment of this patient?

o A. 

Amphotericin B

o B. 

Fluconazole

o C. 

Piperacillin

o D. 

Metronidazole

o E. 

Griseofulvin

o F. 

Nystatin
 

 15. 

A 30-year-old Filipino man, who is a lifelong resident in the San Joaquin

Valley, California, presented to the hospital with a 4-day history of low-grade
fever (99.8 F°), severe headache, irritability, and fatigue. Physical
examination showed a stiff neck and Kerning’s sign. Microscopic analysis of
the spinal fluid revealed spherules filled with endospores. Which of the
following drugs would be appropriate for this patient?
 o A. 

Flucytosine

o B. 

Penicillin G

o C. 

Gancyclovir

o D. 

Amphotericin B

o E. 

Gentamicin

o F. 

Zidovudine
 

 16. 

A 31-year-old homosexual male with AIDS presents to the emergency room

with fever(102.3 F°), headache, confusion, muddled thinking, and vomiting.
Physical examination reveals nuchal rigidity, diplopia, and loss of vision. An
agglutination test of the spinal fluid for capsular polysaccharide antigen is
positive. Which of the following drugs would be an appropriate treatment for
this patient?

o A. 

Ampicillin and erythromycin

o B. 

Saquinavir and foscarnet

o C. 

Pyrimethamine and sulfadiazine

 o D. 

Amphotericin B and flucytosine

o E. 

Tolnaftate and nystatin

o F. 

Terbinafine and griseofulvin

 

 17. 

A 7-year-old girl is brought to the physician by her mother because she has
several small hairless patches on her scalp. Upon close physical
examination, patches look like black dots on the skin surface. Microscopic
examination reveals a dense sheath of spores around the hair. Which of the
following drugs given orally would be an appropriate treatment for this
patient?

o A. 

Acyclovir

o B. 

Metronidazole

o C. 

Griseofulvin

o D. 

Vancomycin

o E. 

Amphotericin B

o F. 

Flucytosine
 
 18. 

A 32-year-old man suffering from a non-Hodgkin’s lymphoma presented with

fever, cough, increasing dyspnea, and hemoptysis. The man was in the
hospital for the second cycle of chemotherapy. Chest radiograph disclosed
diffuse alveolar infiltrates on the right lobe and multiple small cavitary
lesions on the left lobe. Bronchoalveolar lavage revealed fungal forms are
typical of the Aspergillus genus. Which of the following drug was mostlikely
given IV to this patient?

o A. 

Flucytosine

o B. 

Terbinafine

o C. 

Griseofulvin

o D. 

Amphotericin B

o E. 

Nystatin
 

 19. 

A 33-year-old, HIV positive homosexual man living near the Mississippi River,
was admitted to the hospital with a 3-week history of cough, productive yellow
sputum, progressive dyspnea of exertion, and 14-pound weight loss. Pertinent
lab results on admission were: CD4+ lymphocyte counts 320 cells/mm, lactate
dehydrogenase 5000 IU/L (normal < 600). A bloodstain showed neutrophils
containing small, uninucleated, and encapsulated microorganisms. Which of
the following statements correctly pairs the most likely disease of the patient
with the appropriate treatment?

o A. 

Progressive disseminate histoplasmosis - amphotericin B

 o B. 

Progressive disseminate coccidioidomycosis - fluconazole

o C. 

Pulmonary blastomycosis - fluconazole

o D. 

Meningeal cryptococcosis- amphotericin B

o E. 

Disseminate sporotrichosis - amphotericin B

 

 20. 

Which of the following microorganisms are sensitive to amphotericin B?

o A. 

Coccidioides immitis

o B. 

Mycoplasma pneumoniae

o C. 

Histoplasma capsulatum

o D. 

Aspergillus fumigatus

o E. 

Cryptococcus neoformans

o F. 

Chlamydia psittaci

o G. 
Nocardia asteroides