Deck 12: Drugs, Microbes, Host--The Elements of Chemotherapy

Question 1

Which antimicrobic does not interfere with protein synthesis?

A)aminoglycosides
B)tetracyclines
C)erythromycin
D)trimethroprim
E)chloramphenicol

Answer 1

D

Question 2

Substances that are naturally produced by certain microorganisms that can inhibit or destroy other microorganisms are called

A)antibiotics.
B)narrow-spectrum drugs.
C)semisynthetic drugs.
D)synthetic drugs.
E)broad-spectrum drugs.

Answer 2

A

Question 3

Antimicrobics effective against a wide variety of microbial types are termed

A)antibiotics.
B)narrow-spectrum drugs.
C)semisynthetic drugs.
D)synthetic drugs.
E)broad-spectrum drugs.

Answer 3

E

Question 4

Aminoglycosides

A)interfere with elongation of peptidoglycan.
B)are metabolic analogs of PABA and block folic acid synthesis.
C)attach to the 30S ribosomal subunit and disrupt protein synthesis.
D)damage cell membranes.
E)block peptidases that cross-link glycan molecules.

Question 5

Broad-spectrum drugs that disrupt the body's normal flora often cause

A)nephrotoxicity.
B)superinfections.
C)allergic reactions.
D)drug toxicity.
E)All of these choices are correct.

Question 6

Gram-negative bacilli are often treated with

A)penicillin G.
B)vancomycin.
C)aminoglycosides.
D)synercid.
E)isoniazid.

Question 7

Which antimicrobic does not inhibit cell wall synthesis?

A)gentamicin
B)vancomycin
C)cephalosporins
D)penicllins
E)clavamox

Question 8

A chemical that inhibits beta-lactamase enzymes is

A)synercid.
B)penicillinase.
C)aztreonam.
D)clavulanic acid.
E)imipenem.

Question 9

Antimicrobics that are macrolides

A)disrupt cell membrane function.
B)include tetracyclines.
C)include azithromycin, clarithromcyin, and erythromycin.
D)are very narrow-spectrum drugs.
E)are hepatotoxic.

Question 10

All of the following pertain to cephalosporins except

A)they have a beta-lactam ring.
B)greater resistance to beta-lactamases.
C)newer generations have activity against gram negatives.
D)many administered by injection not orally.
E)they are synthetic drugs.

Question 11

Antibiotics are derived from all the following except

A)Penicillium.
B)Bacillus.
C)Staphylococcus.
D)Streptomyces.
E)Cephalosporium.

Question 12

Ampicillin, amoxicillin, mezlocillin, and penicillin G all have

A)a beta-lactam ring.
B)resistance to the action of penicillinase.
C)a semisynthetic nature.
D)an expanded spectrum of activity.
E)All of the choices are correct.

Question 13

Salvarsan was

A)discovered in the mid 1900s.
B)used to treat syphilis.
C)formulated from the red dye prontosil.
D)first discovered as a product of Penicillium notatum.
E)discovered by Robert Koch.

Question 14

Important characteristics of antimicrobic drugs include

A)readily delivered to the site of infection.
B)high toxicity against microbial cells.
C)do not cause serious side effects in humans.
D)remains active in body tissues and fluids.
E)All of these choices are correct.

Question 15

All of the following pertain to fluoroquinolones except

A)they are broad spectrum.
B)they include ciprofloxacin and levofloxacin.
C)they are nephrotoxic.
D)they are used to treat respiratory, urinary, and sexually-transmitted infections.
E)they work by inhibiting bacterial DNA replication.

Question 16

Sulfonamides

A)interfere with elongation of peptidoglycan.
B)are metabolic analogs of PABA and block folic acid synthesis.
C)attach to the 30S ribosomal subunit and disrupt protein synthesis.
D)damage cell membranes.
E)block peptidases that cross-link glycan molecules.

Question 17

Which of these drugs is useful in treating infections by methicillin-resistant S.aureus and vancomycin-resistant Enterococcus?

A)tetracycline
B)isoniazid
C)linezolid
D)aminoglycosides
E)cephalosporins

Question 18

Which is mismatched?

A)Fleming-penicillin
B)Domagk-sulfonamide
C)Ehrlich-tetracycline
D)Florey and Chain-penicillin

Question 19

Penicillins and cephalosporins

A)interfere with DNA synthesis.
B)are metabolic analogs of PABA and block folic acid synthesis.
C)attach to the 30S ribosomal subunit and disrupt protein synthesis.
D)damage cell membranes.
E)block the peptidases that cross-link glycan molecules.

Question 20

Which of these drugs is used to treat cases of tuberculosis?

A)penicillin G.
B)vancomycin.
C)aminoglycosides.
D)synercid.
E)isoniazid.

Question 21

Acyclovir is used to treat

A)influenza A virus.
B)HIV.
C)shingles, chickenpox, and genital herpes.
D)respiratory syncytial virus.
E)hepatitis C virus.

Question 22

The multidrug resistant pumps in many bacterial cell membranes cause

A)bacterial chromosomal mutations.
B)synthesis of enzymes that alter drug structure.
C)removal of drugs from the cell.
D)alteration of drug receptors on cell targets.
E)All of these choices are correct.

Question 23

A clinical microbiologist makes serial dilutions of several antimicrobics in broth, and then incubates each drug dilution series with a standard amount of a patient's isolated pathogen.What is this microbiologist setting up?

A)Kirby-Bauer test
B)antibiogram
C)E-test
D)minimum inhibitory concentration (MIC)
E)therapeutic index (TI)

Question 24

There are fewer antifungal, antiprotozoan, and antihelminth drugs compared to antibacterial drugs because these organisms

A)do not cause many human infections.
B)are not affected by antimicrobics.
C)are so similar to human cells that selective drug toxicity is difficult to achieve.
D)are parasites found inside human cells.
E)have fewer target sites compared to bacteria.

Question 25

Antimicrobics effective against only gram-positive bacteria would be termed

A)antibiotics.
B)narrow-spectrum drugs.
C)semisynthetic drugs.
D)synthetic drugs.
E)broad-spectrum drugs.

Question 26

Side effects that occur in patient tissues while they are on antimicrobic drugs include all the following except

A)development of resistance to the drug.
B)hepatotoxicity.
C)nephrotoxicity.
D)diarrhea.
E)deafness.

Question 27

Antivirals that target reverse transcriptase would be used to treat

A)influenza A virus.
B)HIV.
C)herpes zoster virus.
D)respiratory syncytial virus.
E)hepatitis C virus.

Question 28

Which of the following is not a mode of action of an antiviral?

A)Block viral entry into a host cell
B)Block transcription and translation
C)Inhibit DNA synthesis
D)Block maturation
E)Bond to ergosterol in the cell membrane

Question 29

The drug that can cause aplastic anemia, and is used to treat typhoid fever and brain abscesses is

A)chloramphenicol.
B)clindamycin.
C)ciprofloxacin.
D)bacitracin.
E)gentamicin.

Question 30

The most versatile and useful antifungal drug that is used to treat serious systemic fungal infections is

A)nystatin.
B)griseofulvin.
C)amphotericin B.
D)sulfa drugs.
E)metronidazole.

Question 31

A ratio of the dose of the drug that is toxic to humans versus the minimum effective dose for that pathogen is assessed to predict the potential for toxic drug reactions.This is called the

A)Kirby-Bauer technique.
B)antibiogram.
C)E-test.
D)minimum inhibitory concentration (MIC).
E)therapeutic index (TI).

Question 32

An antiviral that is a guanine analog would have an antiviral mode of action that

A)blocks penetration.
B)blocks DNA replication.
C)inhibits peptidoglycan cross-linking.
D)blocks maturation.
E)bonds to ergosterol in the cell membrane.

Question 33

The drug used for several protozoan infections is

A)nystatin.
B)griseofulvin.
C)amphotericin B.
D)sulfa drugs.
E)metronidazole.

Question 34

Ketoconazole, fluconazole, clotrimazole, and miconazole are broad-spectrum azoles used to treat _____ infections.

A)bacterial
B)fungal
C)protozoan
D)helminthic
E)virus

Question 35

Mebendazole, niclosamide, and ivermectin are drugs used to treat _____ infections.

A)bacterial
B)fungal
C)protozoan
D)helminthic
E)virus

Question 36

A superinfection results from

A)build up of a drug to toxic levels in the patient.
B)the wrong drug administered to the patient.
C)an immune system reaction to the drug.
D)decrease in most normal flora with overgrowth of an unaffected species.
E)All of these choices are correct.

Question 37

The cellular basis for bacterial resistance to antimicrobics include

A)bacterial chromosomal mutations.
B)synthesis of enzymes that alter drug structure.
C)prevention of drug entry into the cell.
D)alteration of drug receptors on cell targets.
E)All of these choices are correct.

Question 38

A "shotgun" approach to antimicrobial therapy involves

A)giving a narrow-spectrum drug.
B)culturing the pathogen and identifying it.
C)performing the disk diffusion assay.
D)using a broad-spectrum drug so that the chance of killing the pathogen is greater.
E)using antiviral and antibiotic drugs in combination.

Question 39

The drug used against intestinal anaerobic bacteria, that can also alter normal flora causing antibiotic-associated colitis is

A)chloramphenicol.
B)clindamycin.
C)ciprofloxacin.
D)bacitracin.
E)gentamicin.

Question 40

Drug susceptibility testing

A)determines the patient's response to various antimicrobics.
B)determines the pathogen's response to various antimicrobics.
C)determines if normal flora will be affected by antimicrobics.
D)determines if the drug is increasing to toxic levels in a patient.
E)determines the pathogen's identity.

Question 41

Why has the United States and Europe banned the use of human drugs in animal feeds?

A)Because it makes the animals grow too large.
B)Because it causes infections in the cows and poultry fed them.
C)Because it raises the price of the meat too high.
D)Because it contributes to the growing drug resistance problem.
E)All of these choices are correct.

Question 42

An antimicrobic with a low therapeutic index is a safer choice compared to a drug with a high therapeutic index.

Question 43

Which of the following describes the mechanism of action for zidovudine?

A)It is a thymine analog that interferes with the synthesis of DNA from the HIV RNA template.
B)It directly binds to reverse transcriptase and prevents reverse transcription of HIV RNA.
C)It inhibits the assembly of HIV particles.
D)It inhibits fusion of the viral envelope and host cell envelope.
E)It prevents the viral DNA from integrating in the host chromosome.

Question 44

A semisynthetic antibiotic is a drug which is chemically modified in the laboratory after being isolated from natural sources.

Question 45

Drugs that are hepatotoxic cause damage to a patient's kidneys.

Question 46

Which organ is responsible for metabolizing and detoxifying foreign chemicals in the blood, including drugs?

A)liver
B)kidneys
C)gallbladder
D)spleen
E)stomach

Question 47

_____ are plasmids that contain genes for resistance to a drug.

Question 48

The Kirby-Bauer test uses an agar surface, seeded with the test bacterium, to which small discs containing a specific concentration of several drugs are placed on the surface.

Question 49

Ciprofloxacin is used to treat viral respiratory infections.

Question 50

Which of the following antimicrobials is contraindicated for children due to permanent tooth discoloration?

A)penicillin G
B)tetracycline
C)gentamicin
D)vancomycin
E)erythromycin

Question 51

All of the following are correct about allergic reactions to drugs except

A)the drug acts as an antigen.
B)the greatest number of antimicrobic allergies are to the penicillins.
C)hives may be the result after the drug is taken.
D)anaphylaxis can occur.
E)allergic reactions generally will occur the first time a person takes the drug.

Question 52

When a patient's immune system reacts adversely to a drug, this serious side effect is called a superinfection.

Question 53

Resistance factor plasmids are transferred to other bacterial cells during transformation, transduction, and conjugation.

Question 54

Levaquin, a fluoroquinolone, kills viruses.

Question 55

All of the following are correct about Tamiflu and Relenza except

A)they should be given early in an infection.
B)they prevent assembly and release of the virus.
C)they are used to treat infections by influenza A and B.
D)they inhibit fusion and uncoating of the virus.
E)they are effective prophylactics for influenza

Question 56

What is vancomycin most often used to treat?

A)methicillin-resistant Staphylococcus aureus
B)Clostridium difficile
C)Streptococcus pyogenes
D)Escherichia coli
E)methicillin-resistant Staphylococcus aureus and Clostridium difficile

Question 57

The MIC is the smallest concentration of an antimicrobic required to inhibit the growth of the microbe.

Question 58

All of the following could be reasons why antimicrobic treatment fails except

A)the inability of the drug to diffuse into the infected body compartment.
B)a mixed infection where some of the pathogens are drug resistant.
C)not completing the full course of treatment.
D)a disk diffusion test showing pathogen sensitivity to the antimicrobic.
E)diminished gastrointestinal absorption due to an underlying condition or age.

Question 59

Species of Bacillus produce bacitracin and the polymyxins.

Question 60

Which of the following will influence a physician's decision to prescribe an antimicrobial?

A)patient age
B)pregnancy
C)liver function
D)alcohol use
E)All of these choices are correct.

Question 61

Which of the following is/are true of antibiotic usage and the development of antibiotic resistance?

A)Antibiotics cause mutations (antibiotics are mutagens), thus resulting in increasingly resistant bacterial populations.
B)Antibiotics increase the rate of bacterial transformation, conjugation, and transduction, and thus increase the spread of antibiotic resistance.
C)Antibiotics cause R-plasmids to form and cause their transfer, spreading antibiotic resistance.
D)Antibiotics select for resistant mutants and bacteria possessing R-plasmids, increasing their frequency in the population.
E)All of these choices are correct.

Question 62

Discuss 5 factors that have influenced the increasing development of resistant microbial strains.

Question 63

If pathogen A is more resistant to an erythromycin disc on a Kirby-Bauer plate compared to pathogen B, then pathogen A will have a _____ zone of inhibition compared to pathogen
B.

Question 64

The macrolide, __________, is a useful substitute for dealing with penicillin-resistant Streptococci.

Question 65

Describe how the therapeutic index of a drug is determined and explain its function.

Question 66

One of the greatest challenges in development of antivirals is finding drugs that are

A)administered orally.
B)absorbed by the GI tract.
C)not likely to disrupt the normal microbiota of the patient.
D)selectively toxic for viruses.

Question 67

Which is the best guide for selecting an effective antibiotic?

A)results of antimicrobial susceptibility testing
B)identification of the microbe causing the infection
C)history of prior antibiotics prescribed for the patient
D)location of the patient's infection

Question 68

Polyene drugs bind to fungal _____ and cause loss of selective permeability.

Question 69

Nutrients that encourage the growth of beneficial microbes in the intestines are called ________.

Question 70

The major source of naturally-produced penicillin is the mold _____.

Question 71

________ are preparations of live microorganisms that are fed to animals and humans to modify the intestinal flora.

Question 72

Janice has just had hip replacement surgery and her physician has prescribed antibiotics and directed her to take them every time she has a dental appointment.This is an example of antibiotic

A)synergy.
B)prophylaxis.
C)allergy.
D)abuse.

Question 73

Discuss the problems with development of antifungal, antiprotozoan, antihelminth, and antiviral drugs compared to the antibacterial drugs.Discuss at least 3 different modes of action that have been developed for these drugs.

Question 74

All of the following are problems in the management of antibiotic usage, except

A)the selection of antibiotics based on results of appropriate antibiotic susceptibility testing.
B)the sale of many antibiotics over-the-counter in foreign countries.
C)extensive use of broad-spectrum drugs for minor infections.
D)the use of antibiotics for upper respiratory viral infections.
E)There are no exceptions here.All of these are challenges in the management of antibiotic usage.

Question 75

The development of successful antiviral drugs has been relatively easy because viral structure is so different from the structure of eukaryotic cells.

Question 76

Sulfonamides are analogs of PABA and, as a result, they inhibit _____ synthesis.

Question 77

While trying to start an IV on a patient, Kurt received a needlestick injury and blood exposure involving a patient with AIDS.He was immediately started on three different antiretroviral medications.The advantage of using combined therapy in this circumstance is

A)the duration of treatment is much shorter.
B)the drugs only work if given together.
C)cost savings to the patient.
D)this should prevent the emergence of drug-resistant microbes.

Question 78

All of the following information should be considered in managing antimicrobial drugs for a patient, except

A)possible allergies.
B)liver and/or kidney disease.
C)age of patient.
D)other drugs the patient is taking.
E)There are no exceptions.All of this information is important.