Deck 12: Drugs, Microbes, host-The Elements of Chemotherapy
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Deck 12: Drugs, Microbes, host-The Elements of Chemotherapy
1
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.
A)prophylaxis.
B)chemotherapy.
C)selective toxicity.
D)nephrotoxicity.
E)synergism.
B
2
Each of the following target prokaryotic ribosomes except
A)streptomycin.
B)gentamycin.
C)polymyxins.
D)tetracycline.
E)erythromycin.
A)streptomycin.
B)gentamycin.
C)polymyxins.
D)tetracycline.
E)erythromycin.
C
3
Sulfonamides are analogs of PABA and,as a result,they inhibit _____ synthesis.
A)protein
B)DNA
C)RNA
D)folic acid
E)phospholipid
A)protein
B)DNA
C)RNA
D)folic acid
E)phospholipid
D
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.
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.
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5
Which of the following microbials does not inhibit DNA synthesis?
A)chloroquine
B)quinolone
C)penicillin
D)azidothymidine
E)acyclovir
A)chloroquine
B)quinolone
C)penicillin
D)azidothymidine
E)acyclovir
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6
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.
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.
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7
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.
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.
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8
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
A)inhibitors.
B)blockers.
C)competitive inhibitors.
D)noncompetitive inhibitors
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9
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.
A)a beta-lactam ring.
B)resistance to the action of penicillinase.
C)a semisynthetic nature.
D)an expanded spectrum of activity.
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10
Sulfa drugs work on
A)nucleic acid biosynthesis.
B)ribosome biosynthesis.
C)peptidoglycan biosynthesis.
D)folic acid biosynthesis.
A)nucleic acid biosynthesis.
B)ribosome biosynthesis.
C)peptidoglycan biosynthesis.
D)folic acid biosynthesis.
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11
Antibiotics are derived from all of the following except
A)Penicillium.
B)Bacillus.
C)Staphylococcus.
D)Streptomyces.
E)Cephalosporium.
A)Penicillium.
B)Bacillus.
C)Staphylococcus.
D)Streptomyces.
E)Cephalosporium.
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12
The use of a drug to prevent imminent infection is called
A)competitive inhibition.
B)synergism.
C)prebiotics.
D)prophylaxis.
E)lantibiotics.
A)competitive inhibition.
B)synergism.
C)prebiotics.
D)prophylaxis.
E)lantibiotics.
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13
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.
A)antibiotics.
B)narrow-spectrum drugs.
C)semisynthetic drugs.
D)synthetic drugs.
E)broad-spectrum drugs.
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14
Selective toxicity refers to damage to
A)pathogenic organisms.
B)prokaryotic cell membranes.
C)the target organisms but not vertebrate cells.
D)nucleic acids.
A)pathogenic organisms.
B)prokaryotic cell membranes.
C)the target organisms but not vertebrate cells.
D)nucleic acids.
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15
Each of the following affect cell walls except
A)penicillin.
B)cycloserine.
C)vancomycin.
D)erythromycin.
E)cephalosporin.
A)penicillin.
B)cycloserine.
C)vancomycin.
D)erythromycin.
E)cephalosporin.
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16
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.
A)eukaryotic large ribosomal subunit.
B)eukaryotic small ribosomal subunit.
C)ribosomal RNA.
D)eukaryotic mitochondrial ribosomes.
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17
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.
A)nontoxic to host.
B)easily broken down by host.
C)easily administered.
D)limited capacity to elicit resistance.
E)nonallergenic.
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18
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.
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.
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19
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
A)30S
B)40S
C)50S
D)60S
E)70S
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20
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.
A)antibiotics.
B)narrow-spectrum drugs.
C)semisynthetic drugs.
D)synthetic drugs.
E)broad-spectrum drugs.
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21
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.
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.
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22
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.
A)Penicillium notatum.
B)Penicilium chrysogenum.
C)Penicilium familiaris.
D)Naturally produced penicillin is no longer used.
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23
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
A)vancomycin
B)bacitracin
C)chloramphenicol
D)streptomycin
E)clindamycin
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24
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.
A)chloramphenicol.
B)clindamycin.
C)ciprofloxacin.
D)bacitracin.
E)gentamicin.
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25
A chemical that inhibits beta-lactamase enzymes is
A)synercid.
B)penicillinase.
C)aztreonam.
D)clavulanic acid.
E)imipenem.
A)synercid.
B)penicillinase.
C)aztreonam.
D)clavulanic acid.
E)imipenem.
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26
Which antibiotic is used to treat MRSA and VRE infections?
A)synercid
B)clindamycin
C)linezolid
D)azithromycin
E)clarithromycin
A)synercid
B)clindamycin
C)linezolid
D)azithromycin
E)clarithromycin
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27
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
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
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28
Which antimicrobial does not inhibit cell wall synthesis?
A)gentamicin
B)vancomycin
C)cephalosporins
D)penicillins
E)carbapenems
A)gentamicin
B)vancomycin
C)cephalosporins
D)penicillins
E)carbapenems
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29
Which group are the key drugs used to treat Hansen's disease (leprosy)?
A)sulfonamides
B)sulfones
C)fluoroquinolones
D)polymyxins
E)streptomyces
A)sulfonamides
B)sulfones
C)fluoroquinolones
D)polymyxins
E)streptomyces
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30
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.
A)disrupt cell membrane function.
B)include tetracyclines.
C)include azithromycin,clarithromcyin,and erythromycin.
D)are very narrow-spectrum drugs.
E)are hepatotoxic.
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31
Which drug is used to treat cases of tuberculosis?
A)penicillin G
B)vancomycin
C)tetracycline
D)synercid
E)isoniazid
A)penicillin G
B)vancomycin
C)tetracycline
D)synercid
E)isoniazid
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32
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
A)penicillin G
B)vancomycin
C)tetracycline
D)erythromycin
E)isoniazid
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33
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.
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.
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34
Clavulanic acid inhibits
A)beta-lactamase activity.
B)peptidoglycan synthesis.
C)formation of peptidoglycan cross linkages.
D)cell membrane synthesis.
A)beta-lactamase activity.
B)peptidoglycan synthesis.
C)formation of peptidoglycan cross linkages.
D)cell membrane synthesis.
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35
Which of these drugs has the most narrow-spectrum activity?
A)tetracycline
B)isoniazid
C)erythromycin
D)aminoglycosides
E)cephalosporins
A)tetracycline
B)isoniazid
C)erythromycin
D)aminoglycosides
E)cephalosporins
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36
Which antimicrobial does not interfere with protein synthesis?
A)aminoglycosides
B)tetracyclines
C)erythromycin
D)trimethroprim
E)chloramphenicol
A)aminoglycosides
B)tetracyclines
C)erythromycin
D)trimethroprim
E)chloramphenicol
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37
Which of the following antibacterial drug groups does not target protein synthesis?
A)oxazolidinones
B)macrolides
C)aminoglycosides
D)sulfonamides
E)tetracyclines
A)oxazolidinones
B)macrolides
C)aminoglycosides
D)sulfonamides
E)tetracyclines
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38
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
A)synercid
B)penicillinase
C)aztreonam
D)clavulanic acid
E)imipenem
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39
Which of the following is not an aminoglycoside?
A)streptomycin
B)gentamicin
C)tetracycline
D)amikacin
E)tobramycin
A)streptomycin
B)gentamicin
C)tetracycline
D)amikacin
E)tobramycin
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40
All _____ consist of a thiazolidine ring,a beta-lactam ring,and an R group.
A)penicillins
B)tetracyclines
C)macrolides
D)cephalosporins
E)aminoglycosides
A)penicillins
B)tetracyclines
C)macrolides
D)cephalosporins
E)aminoglycosides
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41
Each of the following is a mechanism for drug resistance transfer between microorganisms except
A)transposons.
B)R-plasmids.
C)conjugation.
D)mutation.
A)transposons.
B)R-plasmids.
C)conjugation.
D)mutation.
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42
Which of the following is not used to treat malaria?
A)quinine
B)chloroquine
C)metronidazole
D)primaquine
E)meflaquine
A)quinine
B)chloroquine
C)metronidazole
D)primaquine
E)meflaquine
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43
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
A)block penetration
B)block transcription and translation
C)inhibit DNA synthesis
D)block maturation
E)bond to ergosterol in the cell membrane
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44
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.
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.
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45
Nutrients that encourage the growth of beneficial microbes in the intestines are known as
A)prebiotics.
B)probiotics.
C)lantibiotics.
D)phytobiotics.
E)riboswitches.
A)prebiotics.
B)probiotics.
C)lantibiotics.
D)phytobiotics.
E)riboswitches.
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46
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.
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.
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47
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.
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.
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48
Ketoconazole,fluconazole,clotrimazole,and miconazole are broad-spectrum azoles used to treat _____ infections.
A)bacterial
B)fungal
C)protozoan
D)helminthic
E)viral
A)bacterial
B)fungal
C)protozoan
D)helminthic
E)viral
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49
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
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
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50
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.
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.
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51
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.
A)prebiotics.
B)probiotics.
C)lantibiotics.
D)phytobiotics.
E)riboswitches.
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52
Mebendazole,thiabendazole,and ivermectin are drugs used to treat _____ infections.
A)bacterial
B)fungal
C)protozoan
D)helminthic
E)viral
A)bacterial
B)fungal
C)protozoan
D)helminthic
E)viral
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53
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
A)quinolones
B)macrolide polyene antibiotics
C)griseofulvin
D)synthetic azoles
E)flucytosine
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54
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.
A)influenza A virus.
B)HIV.
C)herpes zoster virus.
D)respiratory syncytial virus.
E)hepatitis C virus.
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55
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.
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.
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56
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.
A)bacterial chromosomal mutations.
B)synthesis of enzymes that alter drug structure.
C)removing the drug from the cell when it enters.
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57
Which of the following blocks HIV binding to host cell receptors?
A)AZT
B)acyclovir
C)nevirapine
D)Fuzeon
E)amantidine
A)AZT
B)acyclovir
C)nevirapine
D)Fuzeon
E)amantidine
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58
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.
A)influenza A virus.
B)HIV.
C)herpes simplex virus.
D)respiratory syncytial virus.
E)hepatitis C virus.
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59
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.
A)blocks penetration.
B)blocks transcription and translation.
C)inhibits DNA synthesis.
D)blocks maturation.
E)bonds to ergosterol in the cell membrane.
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60
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
A)gram-positive bacterial
B)gram-negative bacterial
C)fungal
D)protozoan
E)viral
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61
An antibiotic of the penicillin family is penicillin
G.
G.
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62
Resistance genes can be transferred to other bacterial cells during transformation,transduction,and conjugation.
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63
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).
A)Kirby-Bauer technique.
B)antibiogram.
C)E-test.
D)minimum inhibitory concentration (MIC).
E)therapeutic index (TI).
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64
Bacteria can have a natural resistance to a drug which they have never been exposed.
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65
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
A)tetracycline and amphotericin B
B)trimethoprim and sulfonamides
C)rifampin and quinolones
D)tetracycline and bacitracin
E)penicillin and vancomycin
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66
Broad-spectrum drugs that disrupt the body's normal biota often cause
A)nephrotoxicity.
B)superinfections.
C)allergic reactions.
D)drug toxicity.
A)nephrotoxicity.
B)superinfections.
C)allergic reactions.
D)drug toxicity.
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67
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)
A)Kirby-Bauer technique
B)antibiogram
C)E-test
D)minimum inhibitory concentration (MIC)test
E)therapeutic index (TI)
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68
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.
A)chloramphenicol.
B)clindamycin.
C)ciprofloxacin.
D)bacitracin.
E)gentamicin.
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69
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.
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.
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70
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.
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.
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71
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.
A)20
B)10
C)1
D)0.1
E)Any choice would be equally effective.
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72
The _____ are drugs that deposit in developing teeth and cause a permanent brown discoloration.
A)streptomycins
B)cephalosporins
C)macrolides
D)tetracyclines
E)penicillins
A)streptomycins
B)cephalosporins
C)macrolides
D)tetracyclines
E)penicillins
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73
Who is considered to be the father of modern antibiotics?
A)Fleming
B)Chargaff
C)Watson
D)Crick
E)Domagk
A)Fleming
B)Chargaff
C)Watson
D)Crick
E)Domagk
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74
The first modern antimicrobial drugs were sulfa drugs.
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75
Ciprofloxacin is used to treat viral respiratory infections.
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76
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.
A)development of resistance to the drug.
B)hepatotoxicity.
C)nephrotoxicity.
D)diarrhea.
E)deafness.
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77
Species of Bacillus produce bacitracin and the polymyxin drugs.
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78
When a patient's immune system reacts adversely to a drug,this serious side effect is called a superinfection.
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79
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
A)smaller
B)
B)equal
C)larger
A)smaller
B)
B)equal
C)larger
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80
Antimicrobial drugs that inhibit folic acid synthesis work with no side effects because mammals must get folic acid from their diet.
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