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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor=[[User:Gonzalo Romero|Gonzalo A. Romero, M.D.]] {{Alison}}
|QuestionAuthor=[[User:Gonzalo Romero|Gonzalo A. Romero, M.D.]] {{Alison}}(Reviewed by Serge Korjian)
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Embryology, Microbiology, Pharmacology
|MainCategory=Embryology, Microbiology, Pharmacology
Line 8: Line 8:
|MainCategory=Embryology, Microbiology, Pharmacology
|MainCategory=Embryology, Microbiology, Pharmacology
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|MainCategory=Embryology, Microbiology, Pharmacology
|MainCategory=Embryology, Microbiology, Pharmacology
|MainCategory=Embryology, Microbiology, Pharmacology
|MainCategory=Embryology, Microbiology, Pharmacology
|MainCategory=Embryology, Microbiology, Pharmacology
Line 20: Line 21:
|MainCategory=Embryology, Microbiology, Pharmacology
|MainCategory=Embryology, Microbiology, Pharmacology
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|Prompt=A 2-year-old girl is brought to the pediatrician because her mother is concerned about her teeth appear abnormally dark. She states that her daughter developed a ring-like rash on her leg after a nature walk, which appeared to be similar to a rash that her 17-year-old son developed following a camping trip. The mother administered her daughter the leftover antibiotics that had been prescribed to her teenage son for his rash.  Which of the following mechanisms of action corresponds to the antibiotic most likely provided to the young girl?
|Prompt=A 2-year-old girl is brought to the pediatrician because her mother is concerned that her teeth have turned a dark shade of grey  since her last check-up. The mother explains that her daughter has been developing normally, but she recently she started refusing formula. She also reports that approximately 1 month ago, the child had an episode of cough and sore throat for which she gave    Which of the following mechanisms of action corresponds to the antibiotic most likely provided to the young girl?
|Explanation=In this scenario a 2-year-old patient presents with discolored teeth. Her mother had previously administered her with an antibiotic treat a rash, which was indicative of Lyme’s disease.  [[Tetracycline]], used to treat [[Lyme disease]], is not prescribed to young children due to the high risk of bone and teeth malformation.  [[Tetracycline]], specifically [[doxycycline]], inhibits protein synthesis by binding to the 30S ribosomal subunit and preventing the attachment of aminoacyl-tRNA.
|Explanation=In this scenario a 2-year-old patient presents with discolored teeth. Her mother had previously administered her with an antibiotic treat a rash, which was indicative of Lyme’s disease.  [[Tetracycline]], used to treat [[Lyme disease]], is not prescribed to young children due to the high risk of bone and teeth malformation.  [[Tetracycline]], specifically [[doxycycline]], inhibits protein synthesis by binding to the 30S ribosomal subunit and preventing the attachment of aminoacyl-tRNA.
[[File:BullseyeLymeDiseaseRash.jpg|center|400px|]]
[[File:BullseyeLymeDiseaseRash.jpg|center|400px|]]
This image above depicts a "bull's eye" rash, often associated with Lyme disease.
This image above depicts a "bull's eye" rash, often associated with Lyme disease.
|EducationalObjectives= When tetracycline is administered to young children, it is often associated with teeth discoloration (teratogenic)
|References= First Aid 2013 Microbiology-Pharmacology chapter.
|AnswerA=Prevents attachment of aminoacyl-tRNA
|AnswerA=Prevents attachment of aminoacyl-tRNA
|AnswerAExp=See overall explanation
|AnswerAExp=See overall explanation
|AnswerB=Inhibits the formation of initiation complex
|AnswerB=Inhibits the formation of initiation complex
|AnswerBExp=This is the mechanism of action of [[aminoglycosides]] used for gram negative rod infections.
|AnswerBExp=This is the mechanism of action of [[aminoglycosides]] used for gram negative rod infections.
|AnswerC=Inhibits protein synthesis by binding to the 50S ribosomal subunit  
|AnswerC=Inhibits protein synthesis by binding to the 50S ribosomal subunit
|AnswerCExp=This is the mechanism of action of [[macrolides]], used to treat atypical pneumonias (Mycoplasma, Chlamydia, Legionella), URiI, STDs, gram-positive cocci (streptococcal infections in patients allergic to penicillin), and Neisseria.
|AnswerCExp=This is the mechanism of action of [[macrolides]], used to treat atypical pneumonias (Mycoplasma, Chlamydia, Legionella), URiI, STDs, gram-positive cocci (streptococcal infections in patients allergic to penicillin), and Neisseria.
|AnswerD= Inhibits the translocation of the peptidyl-tRNA
|AnswerD=Inhibits the translocation of the peptidyl-tRNA
|AnswerDExp=This often corresponds with [[aminoglycosides]] use.
|AnswerDExp=This often corresponds with [[aminoglycosides]] use.
|AnswerE=Inhibits protein elongation by blocking peptidyl-transferase  
|AnswerE=Inhibits protein elongation by blocking peptidyl-transferase
|AnswerEExp=This is the mechanism of action associated with [[chloramphenicol]].
|AnswerEExp=This is the mechanism of action associated with [[chloramphenicol]].
|EducationalObjectives=When tetracycline is administered to young children, it is often associated with teeth discoloration (teratogenic)
|References=First Aid 2013 Microbiology-Pharmacology chapter.
|RightAnswer=A
|RightAnswer=A
|WBRKeyword=
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 19:59, 27 August 2014
Author [[PageAuthor::Gonzalo A. Romero, M.D. (Reviewed by Alison Leibowitz)(Reviewed by Serge Korjian)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Embryology, MainCategory::Microbiology, MainCategory::Pharmacology
Sub Category SubCategory::Infectious Disease
Prompt [[Prompt::A 2-year-old girl is brought to the pediatrician because her mother is concerned that her teeth have turned a dark shade of grey since her last check-up. The mother explains that her daughter has been developing normally, but she recently she started refusing formula. She also reports that approximately 1 month ago, the child had an episode of cough and sore throat for which she gave Which of the following mechanisms of action corresponds to the antibiotic most likely provided to the young girl?]]
Answer A AnswerA::Prevents attachment of aminoacyl-tRNA
Answer A Explanation AnswerAExp::See overall explanation
Answer B AnswerB::Inhibits the formation of initiation complex
Answer B Explanation [[AnswerBExp::This is the mechanism of action of aminoglycosides used for gram negative rod infections.]]
Answer C AnswerC::Inhibits protein synthesis by binding to the 50S ribosomal subunit
Answer C Explanation [[AnswerCExp::This is the mechanism of action of macrolides, used to treat atypical pneumonias (Mycoplasma, Chlamydia, Legionella), URiI, STDs, gram-positive cocci (streptococcal infections in patients allergic to penicillin), and Neisseria.]]
Answer D AnswerD::Inhibits the translocation of the peptidyl-tRNA
Answer D Explanation [[AnswerDExp::This often corresponds with aminoglycosides use.]]
Answer E AnswerE::Inhibits protein elongation by blocking peptidyl-transferase
Answer E Explanation [[AnswerEExp::This is the mechanism of action associated with chloramphenicol.]]
Right Answer RightAnswer::A
Explanation [[Explanation::In this scenario a 2-year-old patient presents with discolored teeth. Her mother had previously administered her with an antibiotic treat a rash, which was indicative of Lyme’s disease. Tetracycline, used to treat Lyme disease, is not prescribed to young children due to the high risk of bone and teeth malformation. Tetracycline, specifically doxycycline, inhibits protein synthesis by binding to the 30S ribosomal subunit and preventing the attachment of aminoacyl-tRNA.

This image above depicts a "bull's eye" rash, often associated with Lyme disease.
Educational Objective: When tetracycline is administered to young children, it is often associated with teeth discoloration (teratogenic)
References: First Aid 2013 Microbiology-Pharmacology chapter.]]

Approved Approved::Yes
Keyword
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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