Antimicrobials: streptomycin and neomycin: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antimicrobials: streptomycin and neomycin

Sample item

A patient on prolonged streptomycin complains of vertigo, ataxia and oscillopsia. Which statement describes the toxicity?

AIt causes neuromuscular paralysis onlyBIt causes hepatic necrosisCStreptomycin is predominantly vestibulotoxic, whereas amikacin and kanamycin mostly affect hearingDStreptomycin predominantly causes hearing loss

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Streptomycin is predominantly vestibulotoxic, whereas amikacin and kanamycin mostly affect hearing

Streptomycin and gentamicin mainly damage the vestibular apparatus, while amikacin, kanamycin and neomycin are more cochleotoxic. Neomycin, unabsorbed orally, is used for hepatic coma and bowel preparation.

Option by option

A. It causes neuromuscular paralysis only
Neuromuscular block is a rarer effect.
B. It causes hepatic necrosis
Hepatotoxicity is not typical.
C. Streptomycin is predominantly vestibulotoxic, whereas amikacin and kanamycin mostly affect hearing (correct)
Correct. Streptomycin is mainly vestibulotoxic.
D. Streptomycin predominantly causes hearing loss
Hearing loss is more typical of amikacin and kanamycin.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Streptomycin is predominantly vestibulotoxic, whereas amikacin and kanamycin mostly affect hearing. Streptomycin and gentamicin mainly damage the vestibular apparatus, while amikacin, kanamycin and neomycin are more cochleotoxic.

Why is "It causes neuromuscular paralysis only" not the answer?

Neuromuscular block is a rarer effect.

Why is "It causes hepatic necrosis" not the answer?

Hepatotoxicity is not typical.

Why is "Streptomycin predominantly causes hearing loss" not the answer?

Hearing loss is more typical of amikacin and kanamycin.

What concept does this question test?

It tests Antimicrobials: streptomycin and neomycin in Pharmacology. Neomycin, unabsorbed orally, is used for hepatic coma and bowel preparation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antimicrobials: streptomycin and neomycin?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.