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Chapter 12

Drugs, Microbes, Host-The Elements of Chemotherapy

Multiple Choice Questions


1. Substances that are naturally produced by certain microorganisms that can inhibit or
destroy bacteria are called
A. antibiotics.
B. narrow-spectrum drugs.
C. semisynthetic drugs.
D. synthetic drugs.
E. broad-spectrum drugs.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.02 Identify sources of the most commonly used antimicrobial drugs.
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

2. Antimicrobials 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.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.08 Distinguish between broad-spectrum and narrow-spectrum antimicrobials, and explain the significance of the
distinction.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

3. Antibiotics are derived from all of the following except


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

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.02 Identify sources of the most commonly used antimicrobial drugs.
Learning Outcome: 12.14 Identify the cellular target of quinolones, and provide two examples of these drugs.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

4. Important characteristics of antimicrobial drugs include


A. low toxicity for human tissues.
B. high toxicity against microbial cells.
C. do not cause serious side effects in humans.
D. stable and soluble in body tissues and fluids.
E. All of the choices are correct.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.01 State the main goal of antimicrobial treatment.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

5. An ideal antimicrobial therapeutic drug exhibits all of the following characteristics except
A. nontoxic to host.
B. easily broken down by host.
C. easily administered.
D. limited capacity to elicit resistance.
E. nonallergenic.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.01 State the main goal of antimicrobial treatment.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

6. The use of a drug to prevent imminent infection is called


A. competitive inhibition.
B. synergism.
C. prebiotics.
D. prophylaxis.
E. lantibiotics.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.01 State the main goal of antimicrobial treatment.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

7. The use of any chemical in the treatment, relief, or prophylaxis of a disease is called
A. prophylaxis.
B. chemotherapy.
C. selective toxicity.
D. nephrotoxicity.
E. synergism.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.01 State the main goal of antimicrobial treatment.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

8. Penicillins and cephalosporins


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.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.09 Trace the development of penicillin antimicrobials, and identify which microbes they are effective against.
Section Number: 12.03
Topic: Antibacterials

9. Selective toxicity refers to damage to


A. pathogenic organisms.
B. prokaryotic cell membranes.
C. the target organisms but not vertebrate cells.
D. nucleic acids.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.03 Summarize two methods for testing antimicrobial susceptibility.
Section Number: 12.02
Topic: Principles of Antimicrobial Therapy

10. Each of the following effect cell walls except


A. penicillin.
B. cycloserine.
C. vancomycin.
D. erythromycin.
E. cephalosporin.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.09 Trace the development of penicillin antimicrobials, and identify which microbes they are effective against.
Learning Outcome: 12.11 List examples of other beta-lactam antibiotics.
Learning Outcome: 12.12 Describe common cell wall antibiotics that are not in the beta-lactum class of drugs.
Section Number: 12.03
Topic: Antibacterials

11. 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.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

12. Each of the following target prokaryotic ribosomes except


A. streptomycin.
B. gentamycin.
C. polymyxins.
D. tetracycline.
E. erythromycin.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

13. Antibiotics which disrupt prokaryotic ribosomes can also affect


A. eukaryotic large ribosomal subunit.
B. eukaryotic small ribosomal subunit.
C. ribosomal RNA.
D. eukaryotic mitochondrial ribosomes.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

14. Drugs that insert on the _____ ribosomal subunit prevent peptide bond formation or
inhibit translocation of the subunit during translation.

A. 30S
B. 40S
C. 50S
D. 60S
E. 70S
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

15. Which of the following microbials does not inhibit DNA synthesis?
A. chloroquine
B. quinolone
C. penicillin
D. azidothymidine
E. acyclovir

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.10 Describe the action of beta-lactamases, and explain their importance in drug resistance.
Learning Outcome: 12.14 Identify the cellular target of quinolones, and provide two examples of these drugs.
Section Number: 12.03
Topic: Antibacterials

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.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Section Number: 12.03
Topic: Antibacterials

17. Sulfa drugs work on


A. nucleic acid biosynthesis.
B. ribosome biosynthesis.
C. peptidoglycan biosynthesis.
D. folic acid biosynthesis.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Section Number: 12.03
Topic: Antibacterials

18. Sulfonamides are analogs of PABA and, as a result, they inhibit _____ synthesis.
A. protein
B. DNA
C. RNA
D. folic acid
E. phospholipid

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Section Number: 12.03
Topic: Antibacterials

19. Drugs that act by mimicking the normal substrate of an enzyme, thereby blocking its
active site, are called
A. inhibitors.
B. blockers.
C. competitive inhibitors.
D. noncompetitive inhibitors

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Section Number: 12.03
Topic: Antibacterials

20. 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.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.09 Trace the development of penicillin antimicrobials, and identify which microbes they are effective against.
Learning Outcome: 12.11 List examples of other beta-lactam antibiotics.
Section Number: 12.03
Topic: Antibacterials

21. A chemical that inhibits beta-lactamase enzymes is


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

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.10 Describe the action of beta-lactamases, and explain their importance in drug resistance.
Section Number: 12.03
Topic: Antibacterials

22. What type of chemical will allow some bacteria to be resistant to many penicillins?
A. synercid
B. penicillinase
C. aztreonam
D. clavulanic acid
E. imipenem

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.10 Describe the action of beta-lactamases, and explain their importance in drug resistance.
Section Number: 12.03
Topic: Antibacterials

23. All of the following pertain to cephalosporins except


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

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Section Number: 12.03
Topic: Antibacterials

24. Which antimicrobial does not inhibit cell wall synthesis?


A. gentamicin
B. vancomycin
C. cephalosporins
D. penicillins
E. carbapenems

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

25. Which drug is used to treat cases of tuberculosis?


A. penicillin G
B. vancomycin
C. tetracycline
D. synercid
E. isoniazid

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Section Number: 12.03
Topic: Antibacterials

26. What drug is used in cases of penicillin and methicillin resistance and also used to treat
endocarditis?
A. penicillin G
B. vancomycin
C. tetracycline
D. erythromycin
E. isoniazid

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.11 List examples of other beta-lactam antibiotics.
Learning Outcome: 12.14 Identify the cellular target of quinolones, and provide two examples of these drugs.
Section Number: 12.03
Topic: Antibacterials

27. Clavulanic acid inhibits


A. beta-lactamase activity.
B. peptidoglycan synthesis.
C. formation of peptidoglycan cross linkages.
D. cell membrane synthesis.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.10 Describe the action of beta-lactamases, and explain their importance in drug resistance.
Section Number: 12.03
Topic: Antibacterials

28. All _____ consist of a thiazolidine ring, a beta-lactam ring, and an R group.
A. penicillins
B. tetracyclines
C. macrolides
D. cephalosporins
E. aminoglycosides

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.11 List examples of other beta-lactam antibiotics.
Section Number: 12.03
Topic: Antibacterials

29. The major source of naturally produced penicillin is the mold


A. Penicillium notatum.
B. Penicilium chrysogenum.
C. Penicilium familiaris.
D. Naturally produced penicillin is no longer used.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.11 List examples of other beta-lactam antibiotics.
Section Number: 12.01
Topic: Antibacterials

30. What antibiotic is mixed with neomycin and polymyxin to make an antibiotic ointment
(Neosporin) for superficial skin infections?
A. vancomycin
B. bacitracin
C. chloramphenicol
D. streptomycin
E. clindamycin

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.12 Describe common cell wall antibiotics that are not in the beta-lactum class of drugs.
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

31. Infections caused by gram-negative bacilli are often treated with


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

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

32. Which antimicrobial does not interfere with protein synthesis?


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

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

33. Which of these drugs has the most narrow-spectrum activity?


A. tetracycline
B. isoniazid
C. erythromycin
D. aminoglycosides
E. cephalosporins

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.07 Identify which categories of drugs are most selectively toxic, and explain why they exhibit this effect.
Learning Outcome: 12.08 Distinguish between broad-spectrum and narrow-spectrum antimicrobials, and explain the significance of the
distinction.
Section Number: 12.03
Topic: Antibacterials

34. Antimicrobials 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.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

35. The drug that is used to treat typhoid fever and brain abscesses, but can cause aplastic
anemia, is:
A. chloramphenicol.
B. clindamycin.
C. ciprofloxacin.
D. bacitracin.
E. gentamicin.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 05 Systems
Blooms Level: 1. Remember
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Learning Outcome: 12.23 Distinguish between drug toxicity and allergic reactions to drugs.
Section Number: 12.03
Topic: Antibacterials

36. Which of the following is not an aminoglycoside?


A. streptomycin
B. gentamicin
C. tetracycline
D. amikacin
E. tobramycin

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

37. Which of the following antibacterial drug groups does not target protein synthesis?
A. oxazolidinones
B. macrolides
C. aminoglycosides
D. sulfonamides
E. tetracyclines

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.04 Define therapeutic index, and identify whether a high or a low index is preferable in a drug.
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.03
Topic: Antibacterials

38. Which antibiotic is used to treat MRSA and VRE infections?


A. synercid
B. clindamycin
C. linezolid
D. azithromycin
E. clarithromycin

ASM Objective: 04.02 Although the central dogma is universal in all cells, the processes of replication, transcription, and translation differ
in Bacteria, Archaea, and Eukaryotes.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.13 Identify the ribosomal targets of several antibiotics that inhibit protein synthesis.
Section Number: 12.04
Topic: Drug Resistance

39. Which group are the key drugs used to treat Hansen's disease (leprosy)?
A. sulfonamides
B. sulfones
C. fluoroquinolones
D. polymyxins
E. streptomyces

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 3. Apply
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Section Number: 12.03
Topic: Antibacterials

40. All of the following pertain to fluoroquinolones except


A. broad spectrum.
B. include ciprofloxacin and levofloxacin.
C. are nephrotoxic.
D. used to treat respiratory, urinary, and sexually transmitted infections.
E. readily absorbed from intestines.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.14 Identify the cellular target of quinolones, and provide two examples of these drugs.
Learning Outcome: 12.17 Name the four main categories of antifungal agents, and provide one example of each.
Section Number: 12.03
Topic: Antibacterials

41. Which of the following is not true of polymyxins?


A. source is Bacillus polymyxa
B. narrow spectrum
C. toxic to kidneys
D. target cell walls
E. can treat severe urinary tract infections caused by gram-negative bacilli

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.15 Name two drugs that target the cellular membrane.
Learning Outcome: 12.18 List four antiprotozoal drugs and three antihelminthic drugs used today.
Section Number: 12.03
Topic: Antibacterials

42. The antifungal drug that can be used to treat serious systemic fungal infections is
A. nystatin.
B. griseofulvin.
C. amphotericin B.
D. sulfa drugs.
E. metronidazole.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.18 List four antiprotozoal drugs and three antihelminthic drugs used today.
Section Number: 12.03
Topic: Antimicrobials for Eukaryotic Infections

43. Ketoconazole, fluconazole, clotrimazole, and miconazole are broad-spectrum azoles used
to treat _____ infections.
A. bacterial
B. fungal
C. protozoan
D. helminthic
E. viral

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.18 List four antiprotozoal drugs and three antihelminthic drugs used today.
Section Number: 12.03
Topic: Antimicrobials for Eukaryotic Infections

44. Which of the following is not a drug group used to treat fungal infections?
A. quinolones
B. macrolide polyene antibiotics
C. griseofulvin
D. synthetic azoles
E. flucytosine

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.14 Identify the cellular target of quinolones, and provide two examples of these drugs.
Learning Outcome: 12.17 Name the four main categories of antifungal agents, and provide one example of each.
Learning Outcome: 12.18 List four antiprotozoal drugs and three antihelminthic drugs used today.
Section Number: 12.03
Topic: Antimicrobials for Eukaryotic Infections

45. The drug used for several protozoan infections is


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

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.18 List four antiprotozoal drugs and three antihelminthic drugs used today.
Learning Outcome: 12.21 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section Number: 12.03
Topic: Antimicrobials for Eukaryotic Infections

46. Mebendazole, thiabendazole, and ivermectin are drugs used to treat _____ infections.
A. bacterial
B. fungal
C. protozoan
D. helminthic
E. viral

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.18 List four antiprotozoal drugs and three antihelminthic drugs used today.
Learning Outcome: 12.21 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section Number: 12.03
Topic: Antimicrobials for Eukaryotic Infections

47. There are fewer antifungal, antiprotozoan, and antihelminthic drugs compared to
antibacterial drugs because fungi, protozoa, and helminths
A. do not cause many human infections.
B. are not affected by antimicrobials.
C. are so similar to human cells that drug selective toxicity is difficult to achieve.
D. are parasites found inside human cells.
E. fewer target sites in their cells compared to bacteria.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.18 List four antiprotozoal drugs and three antihelminthic drugs used today.
Learning Outcome: 12.21 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section Number: 12.03
Topic: Antimicrobials for Eukaryotic Infections

48. Primaquine and chloroquine are drugs used in the treatment of ___ infections.
A. gram-positive bacterial
B. gram-negative bacterial
C. fungal
D. protozoan
E. viral

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.18 List four antiprotozoal drugs and three antihelminthic drugs used today.
Section Number: 12.03
Topic: Antimicrobials for Eukaryotic Infections

49. Which of the following is not used to treat malaria?


A. quinine
B. chloroquine
C. metronidazole
D. primaquine
E. meflaquine

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.18 List four antiprotozoal drugs and three antihelminthic drugs used today.
Learning Outcome: 12.21 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section Number: 12.03
Topic: Antimicrobials for Eukaryotic Infections

50. Which of the following is not a mode of action of antiviral drugs?


A. block penetration
B. block transcription and translation
C. inhibit DNA synthesis
D. block maturation
E. bond to ergosterol in the cell membrane

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.19 Describe two major modes of action of antiviral drugs.
Learning Outcome: 12.22 Discuss at least three novel antimicrobial strategies that are under investigation.
Section Number: 12.03
Topic: Antivirals

51. An antiviral that is a guanine analog would have an antiviral mode of action that
A. blocks penetration.
B. blocks transcription and translation.
C. inhibits DNA synthesis.
D. blocks maturation.
E. bonds to ergosterol in the cell membrane.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.19 Describe two major modes of action of antiviral drugs.
Learning Outcome: 12.22 Discuss at least three novel antimicrobial strategies that are under investigation.
Section Number: 12.03
Topic: Antivirals

52. Antiviral drugs that target reverse transcriptase would be used to treat infections caused
by:
A. influenza A virus.
B. HIV.
C. herpes zoster virus.
D. respiratory syncytial virus.
E. hepatitis C virus.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.19 Describe two major modes of action of antiviral drugs.
Section Number: 12.03
Topic: Antivirals

53. Acyclovir is used to treat infections caused by:


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

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.19 Describe two major modes of action of antiviral drugs.
Section Number: 12.03
Topic: Antivirals

54. Which of the following blocks HIV binding to host cell receptors?
A. AZT
B. acyclovir
C. nevirapine
D. Fuzeon
E. amantidine

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.19 Describe two major modes of action of antiviral drugs.
Learning Outcome: 12.22 Discuss at least three novel antimicrobial strategies that are under investigation.
Section Number: 12.03
Topic: Antivirals

55. Which of the following is not a therapeutic benefit of interferon?


A. reduces healing time
B. increases white blood cell count
C. prevents or reduces some cold symptoms
D. slows progress of some cancers
E. treats hepatitis C

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.19 Describe two major modes of action of antiviral drugs.
Learning Outcome: 12.22 Discuss at least three novel antimicrobial strategies that are under investigation.
Section Number: 12.03
Topic: Antivirals

56. The cellular basis for bacterial resistance to antimicrobials 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 the choices are correct.

ASM Objective: 01.02 Mutations and horizontal gene transfer, with the immense variety of microenvironments, have selected for a huge
diversity of microorganisms.
ASM Topic: Module 01 Evolution
Blooms Level: 2. Understand
Learning Outcome: 12.20 Discuss two possible ways that microbes acquire antimicrobial resistance.
Section Number: 12.04
Topic: Drug Resistance

57. The multidrug resistant pumps in many bacterial cell membranes function by
A. bacterial chromosomal mutations.
B. synthesis of enzymes that alter drug structure.
C. removing the drug from the cell when it enters.

ASM Objective: 02.02 Bacteria have unique cell structures that can be targets for antibiotics, immunity, and phage infection.
ASM Topic: Module 02 Structure and Function
Blooms Level: 2. Understand
Learning Outcome: 12.21 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section Number: 12.04
Topic: Drug Resistance

58. Microbial resistance resulting from mutation occurs because


A. prokaryotic genomes undergo mutation rapidly.
B. prokaryotic genomes undergo mutation often.
C. short generation times accumulate mutations in populations.
D. mutations are passed between organisms.
E. All of the choices are correct.

ASM Objective: 01.02 Mutations and horizontal gene transfer, with the immense variety of microenvironments, have selected for a huge
diversity of microorganisms.
ASM Topic: Module 01 Evolution
Blooms Level: 2. Understand
Learning Outcome: 12.20 Discuss two possible ways that microbes acquire antimicrobial resistance.
Section Number: 12.04
Topic: Drug Resistance

59. Each of the following results in drug resistance except a drug


A. being pumped out of the cell.
B. being used as a nutrient by the cell.
C. binding site being altered.
D. being inactivated.
E. being blocked from entering the cell.

ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Blooms Level: 5. Evaluate
Learning Outcome: 12.20 Discuss two possible ways that microbes acquire antimicrobial resistance.
Learning Outcome: 12.24 Define the term superinfection, and summarize how it develops in a patient.
Section Number: 12.04
Topic: Drug Resistance

60. Each of the following is a mechanism for drug resistance transfer between
microorganisms except
A. transposons.
B. R-plasmids.
C. conjugation.
D. mutation.

ASM Objective: 01.02 Mutations and horizontal gene transfer, with the immense variety of microenvironments, have selected for a huge
diversity of microorganisms.
ASM Topic: Module 01 Evolution
Blooms Level: 1. Remember
Learning Outcome: 12.20 Discuss two possible ways that microbes acquire antimicrobial resistance.
Learning Outcome: 12.23 Distinguish between drug toxicity and allergic reactions to drugs.
Section Number: 12.04
Topic: Drug Resistance

61. Each of the following contributes to emerging drug resistance except


A. overuse of antibiotics.
B. improper use of antibiotics.
C. multiple drug therapy.
D. ingestion of antibiotics with animal feed.
E. addition of antibiotics to common household products.

ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Blooms Level: 1. Remember
Learning Outcome: 12.21 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section Number: 12.04
Topic: Drug Resistance

62. Nutrients that encourage the growth of beneficial microbes in the intestines are known as
A. prebiotics.
B. probiotics.
C. lantibiotics.
D. phytobiotics.
E. riboswitches.

ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Objective: 06.03 Humans utilize and harness microorganisms and their products.
ASM Topic: Module 05 Systems
ASM Topic: Module 06 Impact of Microorganisms
Blooms Level: 1. Remember
Learning Outcome: 12.22 Discuss at least three novel antimicrobial strategies that are under investigation.
Section Number: 12.04
Topic: Principles of Antimicrobial Therapy

63. The use of vaginal inserts of Lactobacillus to restore a healthy acidic environment is an
example of
A. prebiotics.
B. probiotics.
C. lantibiotics.
D. phytobiotics.
E. riboswitches.

ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Objective: 06.03 Humans utilize and harness microorganisms and their products.
ASM Topic: Module 05 Systems
ASM Topic: Module 06 Impact of Microorganisms
Blooms Level: 1. Remember
Learning Outcome: 12.22 Discuss at least three novel antimicrobial strategies that are under investigation.
Section Number: 12.04
Topic: Principles of Antimicrobial Therapy

64. Broad-spectrum drugs that disrupt the body's normal biota often cause
A. nephrotoxicity.
B. superinfections.
C. allergic reactions.
D. drug toxicity.

ASM Objective: 05.01 Microorganisms are ubiquitous and live in diverse and dynamic ecosystems.
ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Blooms Level: 1. Remember
Learning Outcome: 12.24 Define the term superinfection, and summarize how it develops in a patient.
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

65. The drug used against intestinal anaerobic bacteria, that can also alter normal biota
leading to antibiotic-associated colitis, is
A. chloramphenicol.
B. clindamycin.
C. ciprofloxacin.
D. bacitracin.
E. gentamicin.

ASM Objective: 05.01 Microorganisms are ubiquitous and live in diverse and dynamic ecosystems.
ASM Objective: 05.02 Most bacteria in nature live in biofilm communities.
ASM Topic: Module 05 Systems
Blooms Level: 1. Remember
Learning Outcome: 12.24 Define the term superinfection, and summarize how it develops in a patient.
Section Number: 12.04
Topic: Principles of Antimicrobial Therapy

66. Side effects that occur in patient tissues while they are on antimicrobial drugs include all
of the following except
A. development of resistance to the drug.
B. hepatotoxicity.
C. nephrotoxicity.
D. diarrhea.
E. deafness.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.23 Distinguish between drug toxicity and allergic reactions to drugs.
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

67. 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. a decrease in most normal biota resulting in the overgrowth of an unaffected species.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.24 Define the term superinfection, and summarize how it develops in a patient.
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

68. The _____ are drugs that deposit in developing teeth and cause a permanent brown
discoloration.
A. streptomycins
B. cephalosporins
C. macrolides
D. tetracyclines
E. penicillins

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.08 Distinguish between broad-spectrum and narrow-spectrum antimicrobials, and explain the significance of the
distinction.
Learning Outcome: 12.23 Distinguish between drug toxicity and allergic reactions to drugs.
Section Number: 12.03
Topic: Antibacterials

69. Drug susceptibility testing determines


A. the patient's response to various antimicrobials.
B. the pathogen's response to various antimicrobials.
C. if normal biota will be affected by antimicrobials.
D. if the drug is increasing to toxic levels in a patient.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.03 Summarize two methods for testing antimicrobial susceptibility.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

70. A clinical microbiologist makes serial dilutions of several antimicrobials 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 technique
B. antibiogram
C. E-test
D. minimum inhibitory concentration (MIC) test
E. therapeutic index (TI)

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Objective: 08.05 Use appropriate microbiological and molecular lab equipment and methods.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 08 Microbiology Skills
Blooms Level: 3. Apply
Learning Outcome: 12.03 Summarize two methods for testing antimicrobial susceptibility.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

71. 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).

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 08 Microbiology Skills
Blooms Level: 1. Remember
Learning Outcome: 12.03 Summarize two methods for testing antimicrobial susceptibility.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

72. 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/n _____ zone of inhibition compared to pathogen
B.
A. smaller
B. equal
C. larger

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Objective: 08.07 Document and report on experimental protocols, results and conclusions.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 08 Microbiology Skills
Blooms Level: 3. Apply
Learning Outcome: 12.03 Summarize two methods for testing antimicrobial susceptibility.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

73. A drug exhibiting which therapeutic index value would be the safest, most effective to use
on a patient?
A. 20
B. 10
C. 1
D. 0.1
E. Any choice would be equally effective.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 3. Apply
Learning Outcome: 12.03 Summarize two methods for testing antimicrobial susceptibility.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

74. Who is considered to be the father of modern antibiotics?


A. Fleming
B. Chargaff
C. Watson
D. Crick
E. Domagk

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.09 Trace the development of penicillin antimicrobials, and identify which microbes they are effective against.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

75. Which two antibiotics affect nucleic acids of bacteria?


A. tetracycline and amphotericin B
B. trimethoprim and sulfonamides
C. rifampin and quinolones
D. tetracycline and bacitracin
E. penicillin and vancomycin

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.14 Identify the cellular target of quinolones, and provide two examples of these drugs.
Section Number: 12.03
Topic: Antibacterials

True / False Questions


76. Antimicrobial drugs that inhibit folic acid synthesis work with no side effects because
mammals must get folic acid from their diet.
TRUE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

77. Species of Bacillus produce bacitracin and the polymyxin drugs.


TRUE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.14 Identify the cellular target of quinolones, and provide two examples of these drugs.
Learning Outcome: 12.15 Name two drugs that target the cellular membrane.
Section Number: 12.03
Topic: Antibacterials

78. An antibiotic of the penicillin family is penicillin G.


TRUE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.09 Trace the development of penicillin antimicrobials, and identify which microbes they are effective against.
Section Number: 12.03
Topic: Antibacterials

79. The first modern antimicrobial drugs were sulfa drugs.


TRUE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.06 Describe the five major targets of antimicrobial agents, and list major drugs associated with each.
Section Number: 12.03
Topic: Antibacterials

80. Ciprofloxacin is used to treat viral respiratory infections.


FALSE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.14 Identify the cellular target of quinolones, and provide two examples of these drugs.
Section Number: 12.03
Topic: Antibacterials

81. Resistance genes can be transferred to other bacterial cells during transformation,
transduction, and conjugation.
TRUE

ASM Objective: 01.02 Mutations and horizontal gene transfer, with the immense variety of microenvironments, have selected for a huge
diversity of microorganisms.
ASM Topic: Module 01 Evolution
Blooms Level: 1. Remember
Learning Outcome: 12.20 Discuss two possible ways that microbes acquire antimicrobial resistance.
Learning Outcome: 12.23 Distinguish between drug toxicity and allergic reactions to drugs.
Section Number: 12.04
Topic: Drug Resistance

82. Bacteria can have a natural resistance to a drug which they have never been exposed.
TRUE

ASM Objective: 01.02 Mutations and horizontal gene transfer, with the immense variety of microenvironments, have selected for a huge
diversity of microorganisms.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.20 Discuss two possible ways that microbes acquire antimicrobial resistance.
Learning Outcome: 12.23 Distinguish between drug toxicity and allergic reactions to drugs.
Section Number: 12.04
Topic: Drug Resistance

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

ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Blooms Level: 2. Understand
Learning Outcome: 12.24 Define the term superinfection, and summarize how it develops in a patient.
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

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


FALSE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 1. Remember
Learning Outcome: 12.07 Identify which categories of drugs are most selectively toxic, and explain why they exhibit this effect.
Learning Outcome: 12.23 Distinguish between drug toxicity and allergic reactions to drugs.
Section Number: 12.01
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

85. The MIC is the smallest concentration of an antimicrobial required to inhibit the growth of
the microbe.
TRUE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Objective: 08.05 Use appropriate microbiological and molecular lab equipment and methods.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 08 Microbiology Skills
Blooms Level: 2. Understand
Learning Outcome: 12.03 Summarize two methods for testing antimicrobial susceptibility.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

86. 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.
TRUE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Objective: 08.05 Use appropriate microbiological and molecular lab equipment and methods.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 08 Microbiology Skills
Blooms Level: 1. Remember
Learning Outcome: 12.03 Summarize two methods for testing antimicrobial susceptibility.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

87. An antimicrobial with a low therapeutic index is a safer choice compared to a drug with a
high therapeutic index.
FALSE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
Blooms Level: 2. Understand
Blooms Level: 3. Apply
Learning Outcome: 12.04 Define therapeutic index, and identify whether a high or a low index is preferable in a drug.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

88. It is better to use a broad-spectrum drug instead of a more specific, narrow-spectrum


drug.
FALSE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.08 Distinguish between broad-spectrum and narrow-spectrum antimicrobials, and explain the significance of the
distinction.
Section Number: 12.03
Topic: Principles of Antimicrobial Therapy

89. Newer, more expensive antimicrobials are always better to use than cheaper, older drugs.
FALSE

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 3. Apply
Learning Outcome: 12.01 State the main goal of antimicrobial treatment.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

90. Indwelling catheter biofilm infections are more resistant to antibiotics than nonbiofilm
infections.
TRUE

ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Blooms Level: 2. Understand
Learning Outcome: 12.16 Describe the unique methods used to treat biofilm infections.
Learning Outcome: 12.19 Describe two major modes of action of antiviral drugs.
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

91. The use of antibiotics in cattle feed leads to the development of antibiotic-resistant
bacteria.
TRUE

ASM Topic: Module 03 Metabolic Pathways


Blooms Level: 2. Understand
Learning Outcome: 12.23 Distinguish between drug toxicity and allergic reactions to drugs.
Learning Outcome: 12.24 Define the term superinfection, and summarize how it develops in a patient.
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

92. Drug toxicity occurs when an antimicrobial drug acts as antigen and stimulates an allergic
response.
FALSE

ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 2. Understand
Learning Outcome: 12.23 Distinguish between drug toxicity and allergic reactions to drugs.
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

Multiple Choice Questions


93. The patient has a staphylococcal infection of the blood, a septicemia--very serious and
possibly deadly. As the doctor, you would like to prescribe a relatively non-toxic and
inexpensive drug out of the cephalosporin family. However, if the patient harbors a strain of
Staphylococcus that is resistant to a variety of antibiotics, you would prefer to use
vancomycin-- which is highly effective against Staphylococcus. Which of the following
explains why the cephalosporin drug is preferred for use over the vancomycin?
A. You would rather give an inexpensive drug to save the family money.
B. You really do not know that much about vancomycin, so you would rather go with a drug
that you can find out more about.
C. Vancomycin is very toxic, and the Staphylococcus strain could become resistant leaving no
back-up drugs with which to treat the infection.
D. Vancomycin is one of the most selectively toxic drugs there is, so you would prefer one
that has a more broad-spectrum effect.

ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Blooms Level: 4. Analyze
Learning Outcome: 12.21 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section Number: 12.03
Topic: Drug Resistance

94. You have given a dosage of an antibiotic to a patient for his infection, but the patient is not
getting any better. The MIC tests shows that the drug that you prescribed, at the dosage that
was given, should work against this particular strain of bacterium. What do you think might
be the problem?
A. The drug might be broken down in the patient's body before it can have its full effect on
the bacterium.
B. The patient is resistant to the drug.
C. The bacterium is immune to the chemical effects of the drug.
D. The drug was improperly made at the pharmaceutical company, so is no longer effective.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 3. Apply
Learning Outcome: 12.01 State the main goal of antimicrobial treatment.
Section Number: 12.01
Topic: Principles of Antimicrobial Therapy

95. Alexander Fleming had been running tests using Staphylococcus, and left some plates out
to incubate. Evidently, after returning to his lab after the weekend, he found that Penicillium
mold was growing on his agar plates containing the growth of Staphylococcus. Looking more
closely, he found a large, clear area around the mold colony where Staphylococcus colonies
did not grow. Given this situation, a valid hypothesis would be that:
A. The Staphylococcus was being inhibited by the Penicillium mold.
B. The Penicillium mold was being killed by the Staphylococcus.
C. The bacteriological medium being used in the plates was somehow inhibitory to the
Staphylococcus growth.
D. The room temperature incubation was inhibitory to the growth of Staphylococcus.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Topic: Module 03 Metabolic Pathways
Blooms Level: 4. Analyze
Learning Outcome: 12.09 Trace the development of penicillin antimicrobials, and identify which microbes they are effective against.
Section Number: 12.01
Topic: Antibacterials

96. Your patient has been on antibiotics for 6 weeks after a case of streptococcal
endocarditis, an infection of the inner heart wall. The infection clears up. However, the
patient just visited you about a urinary tract infection, and the lab verified that the culprit was
E. coli. What do you hypothesize happened in this situation?
A. The lab has made a mistake in identifying the cause, and, in fact, the UTI was caused by
the original Streptococcus.
B. The lab has made a mistake in identifying the cause, and, in fact, the endocarditis was
caused by the E. coli.
C. Her normal microbiota in the genitourinary tract were killed, allowing E. coli (not killed
by the antibiotics) to establish an infection.
D. The antibiotics damaged her immune system, making her very susceptible to
environmental bacteria.

ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Blooms Level: 4. Analyze
Learning Outcome: 12.24 Define the term superinfection, and summarize how it develops in a patient.
Section Number: 12.05
Topic: Principles of Antimicrobial Therapy

97. In a conversation with your friends from microbiology class, you are talking about drug
resistance. The three of you disagree about the definition of the term so each of you state his
or her definition and give a justification. Compare the various definitions and justifications
below and pick the one that is most accurate.
A. The bacterium becomes immune to the drug: the drug no longer kills or inhibits the
bacterium.
B. The person becomes resistant to the drug: The body adjusts to the dosage of the chemical
and no longer responds to its action.
C. The drug is changed in the body and is inactivated physically and chemically so it no
longer works properly against the bacterium.
D. The bacterium has changed physically or chemically in some way to be able to destroy the
drug or avoid its action, allowing it to grow unimpeded by the drug.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 05 Systems
Blooms Level: 4. Analyze
Learning Outcome: 12.20 Discuss two possible ways that microbes acquire antimicrobial resistance.
Section Number: 12.04
Topic: Drug Resistance

98. Over 50 percent of all sales of medically important antibiotics in the United States are for
livestock use. Why is this problematic for humans?
A. The livestock will become resistant to the antibiotics and not respond to treatment when
they have infections.
B. Resistant bacteria grow in the animals and may then be passed to humans.
C. The use of antibiotics for livestock means that there are not enough for use in the human
population.
D. The animals may become sick from the antibiotic ingestion.

ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, or biological means.
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 05 Systems
Blooms Level: 3. Apply
Learning Outcome: 12.20 Discuss two possible ways that microbes acquire antimicrobial resistance.
Learning Outcome: 12.21 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section Number: 12.04
Topic: Drug Resistance