A 76-Year-Old Hospitalized Woman Is Evaluated for Persistent Fevers

question 238

Multiple Choice

A 76-year-old hospitalized woman is evaluated for persistent fevers.  Four days ago, she was admitted to the hospital for sepsis, for which she has received broad-spectrum empiric intravenous antibiotic therapy.  Her temperature is 38.9 C (102 F) , blood pressure is 110/80 mm Hg, pulse is 98/min, and respirations are 18/min.  Cardiac examination reveals a new diastolic murmur.  Multiple blood cultures drawn at different times grow Enterococcus.  Echocardiogram reveals mitral valve vegetation suggestive of endocarditis.  An intravenous antibiotic is added to the patient's treatment regimen for synergy.  Several days later, she develops tinnitus and hearing loss attributed to this antibiotic.  The additional antibiotic most directly affects which of the following processes?

• A)Cell wall cross-linking
• B)DNA unwinding
• C)Folic acid synthesis
• D)Maintenance of transmembrane potential
• E)mRNA genetic code reading
• F)tRNA charging

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