Syllabus · Historical · V4 (2023) · Microbiology
T2 · Antimicrobial Pharmacology
T2.i · Antimicrobial Pharmacology
Describe the classification and pharmacology of antibacterial agents.
Written examination
SAQ history
Antibacterials — Aminoglycosides
1 exam appearance
Describe the mechanism of action, antibacterial spectrum and pharmacokinetics of aminoglycosides.
50%
Antibacterials — Anti-staphylococcal Drugs
1 exam appearance
List any five classes of antibiotics with anti-staphylococcal activity and provide one example of each class. Outline the mechanism of action and side effects of the five drugs.
82%
Antibacterials — Benzylpenicillin–Metronidazole–Clindamycin
1 exam appearance
Compare and contrast the mechanism of action, spectrum of activity and adverse effects of benzyl penicillin, metronidazole and clindamycin.
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Antibacterials — Ceftriaxone
1 exam appearance
Describe the mechanism of action, dose, pharmacokinetics and pharmacodynamics of ceftriaxone.
39%
Antibacterials — Flucloxacillin vs Vancomycin
2 exam appearances
Compare and contrast the mechanism of action (25% of marks), antimicrobial profile (25% of marks), pharmacokinetics (25% of marks) and adverse effects (25% of marks) of Flucloxacillin and Vancomycin.
83%
Antibacterials — Gentamicin
1 exam appearance
Antibacterials — Piperacillin-Tazobactam vs Ciprofloxacin
1 exam appearance
Antibacterials — Piperacillin–Tazobactam
1 exam appearance
Antibacterials — Vancomycin
2 exam appearances
Antibiotics — Mechanisms & Resistance
1 exam appearance
Outline the mechanism of action of ampicillin, gentamicin, vancomycin and ciprofloxacin. How does resistance develop to each of these antibiotics?
36%
Ceftriaxone vs Meropenem
1 exam appearance
Compare and contrast Ceftriaxone and Meropenem with respect to the following:
a. Mechanism of action and spectrum (40% of marks)
b. Pharmacokinetics (30% of marks)
c. Effect of critical illness on pharmacokinetics and subsequent dosing. (30% of marks)
33%
Penicillins — Spectrum & Resistance
1 exam appearance
Compare and contrast the spectrum of activity and the mechanisms of microbial resistance for the following penicillins: benzyl penicillin, flucloxacillin and ampicillin.
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Antibacterials — Ciprofloxacin & Resistance
1 exam appearance
Outline the mechanisms of antimicrobial resistance (50% of marks). Briefly outline the pharmacology of ciprofloxacin (50% of marks).
71%
Antibacterials — Gram+ & Vancomycin
1 exam appearance
Classify gram positive bacteria with examples (20% of marks). Outline the pharmacology of vancomycin (80% of marks).
75%
Antibacterials — Mechanisms & Resistance
1 exam appearance
Classify antibiotics with respect to their mechanism of action (50% of marks). Outline the mechanisms of antimicrobial resistance (50% of marks). Give specific examples of each.
70%
Oral examination
VIVA history
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2026A · VIVA 8
Relevant examiner prompts
Explain why a continuous infusion of meropenem may be more effective than regular intermittent dosing?
In critical illness we risk underdosing meropenem. Explain what patient and drug factors lead to this.
Why don’t we give gentamicin as a continuous infusion?
How are the spectrums of activity different between gentamicin and meropenem?
This organism is resistant to amoxicillin but is sensitive to meropenem. How is meropenem active over a broader range of bacteria in comparison to amoxicillin?
How does the addition of clavulanic acid change the spectrum of amoxicillin?
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2025A · Day 1 · VIVA 3
This VIVA will examine pharmacokinetics and antimicrobial pharmacology. You are treating a patient in the ICU with intravenous vancomycin. The measured level is high. Why might the level be high?
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2023B · Day 1 · VIVA 5
This viva will examine antibiotic pharmacology and hepatic physiology. Describe the mechanisms of action of antibiotics with examples.
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2023A · Day 2 · VIVA 8
This VIVA will examine anti-bacterial pharmacology. What factors determine the ability of an intravenously administered anti-bacterial to treat a localised infection?
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2022A · Day 1 · VIVA 2
This viva will explore your understanding of gentamicin pharmacology. How does gentamicin work against bacteria?
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2022A · Day 2 · VIVA 8
This viva will explore your understanding of microbiology, antimicrobials and resistance. A patient develops a rash receiving meropenem and a change of antibiotics is required. What pharmacological properties would you need to consider when choosing an alternative option and provide examples.
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2020B · Day 1 · VIVA 8
This viva will explore your knowledge of bacteria and antibiotics. What type of bacteria are demonstrated in the above gram stain? How can bacteria be classified? (Image removed from report.)
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2020B · Day 4 · VIVA 8
This viva will explore your knowledge of the pharmacology of aminoglycoside antibiotics. How does gentamicin work against bacteria?
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2018A · Day 2 · VIVA 6
This viva will explore your understanding of antibiotics and antiarrhythmics. Which classes of antibiotics are effective against Gram positive organisms?
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2016A · Day 1 · VIVA 7
This viva tested knowledge of antibacterial agents, including mechanisms of action and mechanisms of resistance and dosing rationale for aminoglycosides.
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2015B · VIVA 6
This Viva tested knowledge of classification and mechanisms of resistance to antibiotics. It then explored the immunology related to anaphylaxis and immunoglobulins.
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2012A · VIVA 5
This Viva will explore your knowledge of microbiology and antibiotics What do these pictures show? (Candidates were shown pictures of Gram +ve cocci above; Gram –ve bacilli) Subsequent questions explored knowledge of classification of bacteria, examples of medically important bacteria, classification of antibiotics and pharmacology of gentamicin.
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2009A · VIVA 4
This station will explore your knowledge of bacteria and anti-bacterial agents. How do bacteria differ from the majority of normal human cells (eukaryotes)?
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2008A · VIVA 4
Classification of bacteria. Answers included shape, staining, atmosphere and presence and position of spores. Mechanism of antibiotic action. Answers included inhibition of cell wall synthesis and interruption of mRNA/DNA Mechanisms of antibiotic resistance. Answers included production of beta lactamase, impermeable cell wall and developing alternative metabolic pathways. Syllabus M2a Reference: Medical Microbiology and Infection at a Glance; Gillespie and Bamford, pp. 8- 21.
Sources: objective text from the relevant CICM syllabus; historical SAQ and VIVA wording from CICM examiner reports.