In a patient with culture-positive enterococcal endocarditis who has failed to respond to vancomycin because of resistance, the treatment most likely to be effective is (a) Clarithromycin (b) Erythromycin (c) Linezolid (d) Minocycline (e) Ticarcillin

In a patient with culture-positive enterococcal endocarditis who has failed to respond to vancomycin because of resistance, the treatment most likely to be effective is (a) Clarithromycin (b) Erythromycin (c) Linezolid (d) Minocycline (e) Ticarcillin
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A patient needs antibiotic treatment for native valve, culture-positive infective enterococcal endocarditis. His medical history includes a severe anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with (a) Amoxicillin/clavulanate (b) Aztreonam (c) Cefazolin plus genatamicin (d) Meropenem (e) Vancomycin

Description : A patient needs antibiotic treatment for native valve, culture-positive infective enterococcal endocarditis. His medical history includes a severe anaphylactic reaction to penicillin G during the past year. ... /clavulanate (b) Aztreonam (c) Cefazolin plus genatamicin (d) Meropenem (e) Vancomycin

Last Answer : Ans: E

The following is true of linezolid except: A. It inhibits bacterial protein synthesis at an early step B. It is active against vancomycin resistant enterococci C. It is the drug of choice for enterococcal endocarditis D. It can be administered orally as well as by i.v. infusion

Description : The following is true of linezolid except: A. It inhibits bacterial protein synthesis at an early step B. It is active against vancomycin resistant enterococci C. It is the drug of choice for enterococcal endocarditis D. It can be administered orally as well as by i.v. infusion

Last Answer : C. It is the drug of choice for enterococcal endocarditis

Which of the following drugs has demonstrated in vitro activity against Mycobacterium avium-intracellular(MAI)? (a) Vancomycin (b) Clarithromycin (c) Erythromycin base (d) Troleandomycin (e) Erythromycin estolate

Description : Which of the following drugs has demonstrated in vitro activity against Mycobacterium avium-intracellular(MAI)? (a) Vancomycin (b) Clarithromycin (c) Erythromycin base (d) Troleandomycin (e) Erythromycin estolate

Last Answer : Ans: B

The following antibiotic is a first line drug for treatment of Mycobacterium avium complex infection in AIDS patients (a) Clindamycin (b) Clarithromycin (c) Roxithromycin (d) Erythromycin

Description : The following antibiotic is a first line drug for treatment of Mycobacterium avium complex infection in AIDS patients (a) Clindamycin (b) Clarithromycin (c) Roxithromycin (d) Erythromycin

Last Answer : Ans: B

The following is true of vancomycin except: A. It is a bactericidal antibiotic active primarily against gram positive bacteria B. It acts by inhibiting bacterial protein synthesis C. It is an alternative to penicillin for enterococcal endocarditis D. It can cause deafness as a dose related toxicity

Description : The following is true of vancomycin except: A. It is a bactericidal antibiotic active primarily against gram positive bacteria B. It acts by inhibiting bacterial protein synthesis C. It is an alternative to penicillin for enterococcal endocarditis D. It can cause deafness as a dose related toxicity

Last Answer : B. It acts by inhibiting bacterial protein synthesis

The drug of choice for treatment of methicillin resistant Staphylococcus aureus infection is (a) Cloxacillin (b) Vancomycin (c) Erythromycin (d) Amikacin

Description : The drug of choice for treatment of methicillin resistant Staphylococcus aureus infection is (a) Cloxacillin (b) Vancomycin (c) Erythromycin (d) Amikacin

Last Answer : Ans: B

Clarithromycin and erythromycin have very similar spectrums of antimicrobial activity. The major advantage of clarithromytcin is that it (a) Eradicates mycoplasmal infections in a single dose (b) Is active against strains of streptococci that are resistant to erythromycin (c) Is more active against Mycobacterium avium complex (d) Does not inhibit live drug-metabolizing enzymes (e) Acts on methicillin-resistant strains of staphylococci

Description : Clarithromycin and erythromycin have very similar spectrums of antimicrobial activity. The major advantage of clarithromytcin is that it (a) Eradicates mycoplasmal infections in a single dose (b ... not inhibit live drug-metabolizing enzymes (e) Acts on methicillin-resistant strains of staphylococci

Last Answer : Ans: C

In which of the following groups do all four drugs warrant careful monitoring for drugrelated seizures in high-risk patients? (a) Penicillin G, imipenem, amphotericin B, metronidazol (b) Penicillin G, chlormphenicol, tetracycline, vancomycin (c) Imipenem, tetracycline, vancomycin, sulfadiazine (d) Cycloserine, metronidazole, vancomycin, sulfadiazine (e) Metronidazole, imipenem, doxycycline, erythromycin

Description : In which of the following groups do all four drugs warrant careful monitoring for drugrelated seizures in high-risk patients? (a) Penicillin G, imipenem, amphotericin B, metronidazol ... (d) Cycloserine, metronidazole, vancomycin, sulfadiazine (e) Metronidazole, imipenem, doxycycline, erythromycin

Last Answer : Ans: A

Select the antimicrobial agent that can be used to treat with both methicillin resistant and vancomycin resistant Staphylococcus aureus infection: A. Clarithromycin B. Clindamycin C. Linezolid D. Lincomycin

Description : Select the antimicrobial agent that can be used to treat with both methicillin resistant and vancomycin resistant Staphylococcus aureus infection: A. Clarithromycin B. Clindamycin C. Linezolid D. Lincomycin

Last Answer : C. Linezolid

Which one of the following drugs is most likely to be effective against multidrug – resistant strains of M tuberculosis, including those resistant to streptomycin? (a) Amikacin (b) Clarithromycin (c) Gentamicin (d) Meropenem (e) Spectinomycin

Description : Which one of the following drugs is most likely to be effective against multidrug – resistant strains of M tuberculosis, including those resistant to streptomycin? (a) Amikacin (b) Clarithromycin (c) Gentamicin (d) Meropenem (e) Spectinomycin

Last Answer : Ans: A

A high school student presents with headache, fever, and cough of 2 day’s duration. Sputum is scant and nonpurulent and a Gram stain reveals many white cells but no organisms. Since this patient appears to have atypical pneumonia. You should initiate treatment with (a) Cefazolin (b) Clindamycin (c) Erythromycin (d) Gentamicin (e) Trovafloxacin

Description : A high school student presents with headache, fever, and cough of 2 day's duration. Sputum is scant and nonpurulent and a Gram stain reveals many white cells but no organisms. Since this ... initiate treatment with (a) Cefazolin (b) Clindamycin (c) Erythromycin (d) Gentamicin (e) Trovafloxacin

Last Answer : Ans: C

This drug has activity against many strains of Pseudomomas aeruginosa. However, when it is used alone, resistance has emerged during the course of treatment. The drug should not be used in penicillinallergic patients. Its activity against gramnegative rods is enhanced if it is given in combination with tazobactam (a) Amoxicillin (b) Aztreonam (c) Imipenem (d) Piperacillin (e) Vancomycin

Description : This drug has activity against many strains of Pseudomomas aeruginosa. However, when it is used alone, resistance has emerged during the course of treatment. The drug should not be used in ... with tazobactam (a) Amoxicillin (b) Aztreonam (c) Imipenem (d) Piperacillin (e) Vancomycin

Last Answer : Ans: D

Amoxicillin is inferior to ampicillin for the treatment of the following infection (a) Typhoid (b) Shigella enteritis (c) Subacute bacterial endocarditis (d) Gonorrhoea

Description : Amoxicillin is inferior to ampicillin for the treatment of the following infection (a) Typhoid (b) Shigella enteritis (c) Subacute bacterial endocarditis (d) Gonorrhoea

Last Answer : Ans: B

Benzathine penicillin injected once every 4 weeks for 5 years or more is the drug of choice for (a) Agranulocytosis patients (b) Prophylaxis of bacterial endocarditis in patients with valvular defects (c) Prophylaxis of rheumatic fever (d) Treatment of anthrax

Description : Benzathine penicillin injected once every 4 weeks for 5 years or more is the drug of choice for (a) Agranulocytosis patients (b) Prophylaxis of bacterial endocarditis in patients with valvular defects (c) Prophylaxis of rheumatic fever (d) Treatment of anthrax

Last Answer : Ans: C

The appearance of markedly vacuolated, nucleated red cells in the marrow, anemia, and reticulocytopenia are characteristic dose-dependent side effects of (a) Azithromycin (b) Chloramphenicol (c) Clindamycin (d) Doxycycline (e) Linezolid

Description : The appearance of markedly vacuolated, nucleated red cells in the marrow, anemia, and reticulocytopenia are characteristic dose-dependent side effects of (a) Azithromycin (b) Chloramphenicol (c) Clindamycin (d) Doxycycline (e) Linezolid

Last Answer : Ans: C

A woman has an upper respiratory infection. Six years ago, she experienced an episode of bronchospasm follwing penicillin V therapy. The cultures now reveal a strain of streptococcus pneumoniae that is sensitive to all of the following drugs. Which of these drugs would be the best choice for this patient? (a) Amoxicillin/clavulanate (b) Erythromycin (c) Ampicillin (d) cefaclor (e) Cyclacillin

Description : A woman has an upper respiratory infection. Six years ago, she experienced an episode of bronchospasm follwing penicillin V therapy. The cultures now reveal a strain of streptococcus pneumoniae that is ... ? (a) Amoxicillin/clavulanate (b) Erythromycin (c) Ampicillin (d) cefaclor (e) Cyclacillin

Last Answer : Ans: B

In the empiric treatment of severe bacterial infections of unidentified entiology, this drug, often used in combination with an aminoglycoside, provides coverage against many staphylococci (a) Amoxicillin (b) Clavulanic acid (c) Erythromycin (d) Nafcillin (e) Tetracycline

Description : In the empiric treatment of severe bacterial infections of unidentified entiology, this drug, often used in combination with an aminoglycoside, provides coverage against many staphylococci (a) Amoxicillin (b) Clavulanic acid (c) Erythromycin (d) Nafcillin (e) Tetracycline

Last Answer : Ans: D

If a multibacillary leprosy patient treated with standard fixed duration multidrug therapy relapses, he should be treated with: A. The same rifampin + dapsone + clofazimine regimen B. Clofazimine + ofloxacin + minocycline C. Clofazimine + ofloxacin + clarithromycin D. Ofloxacin + minocycline + clarithromycin

Description : If a multibacillary leprosy patient treated with standard fixed duration multidrug therapy relapses, he should be treated with: A. The same rifampin + dapsone + clofazimine regimen B. ... + minocycline C. Clofazimine + ofloxacin + clarithromycin D. Ofloxacin + minocycline + clarithromycin

Last Answer : . The same rifampin + dapsone + clofazimine regimen

Roxithromycin has the following advantages over erythromycin except (a) It is more effective in whooping cough (b) It causes less gastric irritation (c) It has longer plasma half-life (d) It is unlikely to precipitate theophylline toxicity

Description : Roxithromycin has the following advantages over erythromycin except (a) It is more effective in whooping cough (b) It causes less gastric irritation (c) It has longer plasma half-life (d) It is unlikely to precipitate theophylline toxicity

Last Answer : Ans: A

Select the most potent tetracycline antibiotic (a) Demeclocycline (b) Methacycline (c) Minocycline (d) Doxycycline

Description : Select the most potent tetracycline antibiotic (a) Demeclocycline (b) Methacycline (c) Minocycline (d) Doxycycline

Last Answer : Ans: C

Which one of the following antibiotics is likely to be most effective agent in the treatment of an infection due to enterococci if used in conjuction with penicillin G? (a) Amikacin (b) Gentamicin (c) Netilmicin (d) Streptomycin (e) Tobramycin

Description : Which one of the following antibiotics is likely to be most effective agent in the treatment of an infection due to enterococci if used in conjuction with penicillin G? (a) Amikacin (b) Gentamicin (c) Netilmicin (d) Streptomycin (e) Tobramycin

Last Answer : Ans: D

Beta – lactamase production by strains of Haemophilus influenzae, Moraxella catarrhalis, and Neissera gonorrhoeae confers resistance against penicillin G.which one of the following antibiotics is most likely to be effective against all strains of each of the above organisms? (a) Ampicillin (b) Ceftriaxone (c) Clindamycin (d) Gentamicin (e) Piperacillin

Description : Beta - lactamase production by strains of Haemophilus influenzae, Moraxella catarrhalis, and Neissera gonorrhoeae confers resistance against penicillin G.which one of the following antibiotics is most likely to be ... ? (a) Ampicillin (b) Ceftriaxone (c) Clindamycin (d) Gentamicin (e) Piperacillin

Last Answer : Ans: B

A woman’s neglected hangnail has developed into a mild staphylococcal cellulites. Which of the following regimens would be appropriate oral therapy? (a) Dicloxacillin 125 mg q6h (b) Vancomycin 250 mg q6h (c) Methicillin 500 mg q6h (d) Cefazolin 1 g q8h (e) Penicillin V 500 mg q6h

Description : A woman’s neglected hangnail has developed into a mild staphylococcal cellulites. Which of the following regimens would be appropriate oral therapy? (a) Dicloxacillin 125 mg q6h (b) Vancomycin 250 mg q6h (c) Methicillin 500 mg q6h (d) Cefazolin 1 g q8h (e) Penicillin V 500 mg q6h

Last Answer : Ans: A

Which one of the following antimicrobial drugs does not require supplementation of dosage following hemodialysis? (a) Ampicillin (b) Cefazolin (c) Ganciclovir (d) Tobramycin (e) Vancomycin

Description : Which one of the following antimicrobial drugs does not require supplementation of dosage following hemodialysis? (a) Ampicillin (b) Cefazolin (c) Ganciclovir (d) Tobramycin (e) Vancomycin

Last Answer : Ans: E

Which of the following statements about vancomycin is accurate? (a) It is bacteriostatic (b) It binds to PBPs (c) It is not susceptible to penicillinase (d) It has the advantage of oral bioavailability (e) Staphylococcal enterocolitis occurs commonly with its use

Description : Which of the following statements about vancomycin is accurate? (a) It is bacteriostatic (b) It binds to PBPs (c) It is not susceptible to penicillinase (d) It has the advantage of oral bioavailability (e) Staphylococcal enterocolitis occurs commonly with its use

Last Answer : Ans: C

In the treatment of typhoid fever, ciprofloxacin has the following advantage(s) (a) It is effective in nearly all cases (b) Early abetment of fever and other symptoms (c) Development of carrier state is less likely (d) All of the above

Description : In the treatment of typhoid fever, ciprofloxacin has the following advantage(s) (a) It is effective in nearly all cases (b) Early abetment of fever and other symptoms (c) Development of carrier state is less likely (d) All of the above

Last Answer : Ans: D

Highest incidence of antibiotic associated pseudo membranous enterocolitis has been noted with the use of (a) Ampicillin (b) Chloramphenicol (c) Vancomycin (d) Clindamycin

Description : Highest incidence of antibiotic associated pseudo membranous enterocolitis has been noted with the use of (a) Ampicillin (b) Chloramphenicol (c) Vancomycin (d) Clindamycin

Last Answer : Ans: D

An aminoglycoside antibiotic should not be used concurrently with the following drug (a) Ampicillin (b) Vancomycin (c) Ciprofloxacin (d) Rifampin

Description : An aminoglycoside antibiotic should not be used concurrently with the following drug (a) Ampicillin (b) Vancomycin (c) Ciprofloxacin (d) Rifampin

Last Answer : Ans: B

Which one of the following antibiotics is a potent inducer of hepatic drug-metabolizing enzymes? (a) Ciprofloxacin (b) Cyclosporine (c) Erythromycin (d) Rifampin (e) Tetracycline

Description : Which one of the following antibiotics is a potent inducer of hepatic drug-metabolizing enzymes? (a) Ciprofloxacin (b) Cyclosporine (c) Erythromycin (d) Rifampin (e) Tetracycline

Last Answer : Ans: D

Hepatitits with cholestatic jaundice occurs most frequently as an adverse reaction to the following preparation of erythromycin (a) Erythromycin base (b) Erythromycin stearate (c) Erythromycin estolate (d) Erythromycin ethylsuccinate

Description : Hepatitits with cholestatic jaundice occurs most frequently as an adverse reaction to the following preparation of erythromycin (a) Erythromycin base (b) Erythromycin stearate (c) Erythromycin estolate (d) Erythromycin ethylsuccinate

Last Answer : Ans: C

Which out of the following antibiotics penetrates blood-CSF barrier the best (a) Erythromycin (b) Gentamicin (c) Tetracycline (d) Chloramphenicol

Description : Which out of the following antibiotics penetrates blood-CSF barrier the best (a) Erythromycin (b) Gentamicin (c) Tetracycline (d) Chloramphenicol

Last Answer : Ans: D

An 8-year-old child presented with brownish discoloured and deformed anterior teeth. History of having received an antibiotic about 4 years earlier was obtained. Which antibiotic could be responsible for the condition ? (a) Chloramphenicol (b) Tetracycline (c) Erythromycin (d) Genetamicin

Description : An 8-year-old child presented with brownish discoloured and deformed anterior teeth. History of having received an antibiotic about 4 years earlier was obtained. Which antibiotic could be responsible for the condition ? (a) Chloramphenicol (b) Tetracycline (c) Erythromycin (d) Genetamicin

Last Answer : Ans: B

Select the antibiotic whose dose must be reduced in patients with renal insufficiency (a) Ampicillin (b) Chloramphenicol (c) Tobramycin (d) Erythromycin

Description : Select the antibiotic whose dose must be reduced in patients with renal insufficiency (a) Ampicillin (b) Chloramphenicol (c) Tobramycin (d) Erythromycin

Last Answer : Ans: C

Select the macrolide antibiotic that can be given once daily for 3 days for empirical treatment of ear-nosethroat, respiratory and genital infections: A. Erythromycin B. Azithromycin C. Roxithromycin D. Clarithromycin

Description : Select the macrolide antibiotic that can be given once daily for 3 days for empirical treatment of ear-nosethroat, respiratory and genital infections: A. Erythromycin B. Azithromycin C. Roxithromycin D. Clarithromycin

Last Answer : B. Azithromycin

The following antibiotic is a first line drug for treatment of Mycobacterium avium complex infection in AIDS patients: A. Clindamycin B. Clarithromycin C. Roxithromycin D. Erythromycin

Description : The following antibiotic is a first line drug for treatment of Mycobacterium avium complex infection in AIDS patients: A. Clindamycin B. Clarithromycin C. Roxithromycin D. Erythromycin

Last Answer : B. Clarithromycin

Methicillin resistant staphylococci do not respond to ß-lactam antibiotics because (a) They produce a ß-lactamase which destroys methicillin and related drugs (b) They elaborate an amidase which destroys methicillin and related drugs (c) They have acquired a penicillin binding protein which has low affinity for ß-lactam antibiotics (d) They are less permeable to ß-lactam antibiotics

Description : Methicillin resistant staphylococci do not respond to ß-lactam antibiotics because (a) They produce a ß-lactamase which destroys methicillin and related drugs (b) They elaborate an amidase which destroys ... low affinity for ß-lactam antibiotics (d) They are less permeable to ß-lactam antibiotics

Last Answer : Ans: C

Chloramphenicol is particularly effective in the treatment of (a) Diphtheria (b) Tuberculosis (c) Emphysema (d) Rickettsial diseases (e) Streptomyces pyogenes infections

Description : Chloramphenicol is particularly effective in the treatment of (a) Diphtheria (b) Tuberculosis (c) Emphysema (d) Rickettsial diseases (e) Streptomyces pyogenes infections

Last Answer : Ans: D

The primary mechanism underlying the resistance of gram-positive organisms to macrolide antibiotics is (a) Methylation of binding sites on the 50S ribosomal subunit (b) Formation of esterases that hydrolyze the lactone ring (c) Increased activity of efflux mechanisms (d) Formation of drug-inactivating acetyltranferases (e) Decreased drug permeability of the cytoplasmic membrane

Description : The primary mechanism underlying the resistance of gram-positive organisms to macrolide antibiotics is (a) Methylation of binding sites on the 50S ribosomal subunit (b) Formation of ... ) Formation of drug-inactivating acetyltranferases (e) Decreased drug permeability of the cytoplasmic membrane

Last Answer : Ans: A

All of the following statements regarding pentamidine isethionate are true except (a) it is indicated for treatment or prophylaxis of infection due to Pneumocystis carinii (b) it may be administered intramuscularly, intravenously or by inhalation (c) it has no clinically significant effect on serum glucose (d) it is effective in the treatment of leishmaniasis

Description : All of the following statements regarding pentamidine isethionate are true except (a) it is indicated for treatment or prophylaxis of infection due to Pneumocystis carinii (b) it may be ... clinically significant effect on serum glucose (d) it is effective in the treatment of leishmaniasis

Last Answer : Ans: C

The drug of choice for treatment of methicillin resistant Staphylococcus aureus infection is: A. Cloxacillin B. Vancomycin C. Erythromycin D. Amikacin

Description : The drug of choice for treatment of methicillin resistant Staphylococcus aureus infection is: A. Cloxacillin B. Vancomycin C. Erythromycin D. Amikacin

Last Answer : B. Vancomycin

Your 23-year-old female patient is pregnant and has gonorrhea. The past medical history includes anaphylaxis following exposure to amoxicillin. Worried about compliance, you would like to treat this patient with a singly dose, so you chose (a) Cefixime (b) Ceftriaxone (c) Ciprofloxacin (d) Spectinomycin (e) Tetracycline

Description : Your 23-year-old female patient is pregnant and has gonorrhea. The past medical history includes anaphylaxis following exposure to amoxicillin. Worried about compliance, you would like to treat this patient ... chose (a) Cefixime (b) Ceftriaxone (c) Ciprofloxacin (d) Spectinomycin (e) Tetracycline

Last Answer : Ans: D

Select the macrolide antibiotic having clinically useful antileprotic activity: A. Azithromycin B. Clarithromycin C. Erythromycin D. Roxithromycin

Description : Select the macrolide antibiotic having clinically useful antileprotic activity: A. Azithromycin B. Clarithromycin C. Erythromycin D. Roxithromycin

Last Answer : B. Clarithromycin

The following is true of clarithromycin except: A. It produces less gastric irritation and pain than erythromycin B. It is the most active macrolide antibiotic against Helicobacter pylori C. It does not interact with terfenadine or cisapride to cause cardiac arrhythmias D. It exhibits dose dependent elimination kinetics

Description : The following is true of clarithromycin except: A. It produces less gastric irritation and pain than erythromycin B. It is the most active macrolide antibiotic against Helicobacter pylori ... terfenadine or cisapride to cause cardiac arrhythmias D. It exhibits dose dependent elimination kinetics

Last Answer : C. It does not interact with terfenadine or cisapride to cause cardiac arrhythmias

The most suitable tetracycline for use in a patient with impaired renal function is (a) Chlortetracycline (b) Demeclocycline (c) oxytetracycine (d) Doxycycline

Description : The most suitable tetracycline for use in a patient with impaired renal function is (a) Chlortetracycline (b) Demeclocycline (c) oxytetracycine (d) Doxycycline

Last Answer : Ans: D

If a patient gives history of urticaria, itching and swelling of lips following injection of penicillin G, then (a) He will develop similar reaction whenever penicillin is injected (b) He can be given ampicillin safely (c) He can be given oral phenoxymethyl penicillin safely (d) All natural and semisynthetic penicillins are contraindicated for him

Description : If a patient gives history of urticaria, itching and swelling of lips following injection of penicillin G, then (a) He will develop similar reaction whenever penicillin is injected ( ... oral phenoxymethyl penicillin safely (d) All natural and semisynthetic penicillins are contraindicated for him

Last Answer : Ans: D

Bleomycin is used in most effective drug combination regiment for the chemotherapy of testicular carcinoma. Which one of the following statements about the drug is accurate? (a) Acts mainly in the M phase of the cell cycle (b) Derived from the bark of yew trees (c) Myelosuppression is dose-limiting (d) Peripheral neuropathy occurs in more than 50% of patients (e) Pulmonary infiltrates and fibrosis may occur

Description : Bleomycin is used in most effective drug combination regiment for the chemotherapy of testicular carcinoma. Which one of the following statements about the drug is accurate? (a) Acts mainly in the ... neuropathy occurs in more than 50% of patients (e) Pulmonary infiltrates and fibrosis may occur

Last Answer : Ans: E

Spectinomycin is an aminoglycoside-like antibiotic indicated for the treatment of (a) Gram-negative bacillary septicemia (b) Tuberculosis (c) Penicillin-resistant gonococcal infections (d) Syphilis (e) Gram-negative meningitis due to susceptible organisms

Description : Spectinomycin is an aminoglycoside-like antibiotic indicated for the treatment of (a) Gram-negative bacillary septicemia (b) Tuberculosis (c) Penicillin-resistant gonococcal infections (d) Syphilis (e) Gram-negative meningitis due to susceptible organisms

Last Answer : Ans: C