1. A 30 years old patient was admitted to UMMC for pneumonia.

He developed fever 2 days later

and methicillin-resistant staphylococcus aureus (MRSA) was isolated from his blood culture.
Which of the following antibiotic is the most likely to be resistant to and should not be used to
treat this patient’s infection?
a. Vancomycin
b. Ceftaroline
c. Daptomycin
d. Linezolid
e. Cloxacillin

2. A 30 years old patient was admitted to UMMC for pneumonia. He developed fever 2 days later
and methicillin-resistant staphylococcus aureus (MRSA) was isolated from his blood culture. How
does staphylococcus aureus become resistant to methicillin?
a. It produces altered porins that prevent the access of the antibiotic into the bacterial skin
b. It produces an enzyme that destroys the antibiotic
c. It modifies the target site of the antibiotic in the bacterial cell
d. It causes a mutation in the antibiotic that causes it to self-destroy
e. It produces efflux pumps that pump the antibiotic out of the bacterial cell.

3. A 30 years old man presented to A&E, UMMC with fever. The following was his blood culture
report.
Blood culture: ESBL producing Escherichia coli isolated.

Which of the following antibiotic is this bacteria most likely to be sensitive to and may be used to
treat his infection?
a. Penicillin
b. Ampicillin
c. Imipenem
d. Ceftriaxone
e. Amoxicillin clavulanate

4. A male patient was admitted to UMMC for a surgical procedure. 2 days post-op, he developed
SOB and a temperature of 38°C. He was prescribed piperacillin-tazobactam for 7 days. MSSA was
isolated from his blood culture 2 days later. You are the HO on call and the nurse calls you to
review the blood culture results. You examine the patient and finds that he is not complaining of
anymore respiratory symptoms. His temperature is now 37°C. How would you manage this
patient and why?
a. Stop piperacillin-tazobactam and discharge the patient
b. Continue the patient on piperacillin-tazobactam
c. Switch the patient to vancomycin
d. Switch the patient to cloxacillin
e. Switch the patient to a cephalosporins