Deck 12: Antimicrobial Agents

Question 1

Selective toxicity is the use of antimicrobial agents to ________.

A) kill a pathogen without harming the host
B) kill only some pathogens without harming other pathogens
C) inhibit some pathogens without inhibiting other pathogens
D) antimicrobial agent s to kill or inhibit the growth of a pathogen in vitro only

Answer 1

A

Question 2

What are the primary groups of microbes that produce natural antibiotics?

A) Yeasts like Saccharomyces cerevisiae and some species of Gram positive bacteria
B) Some gram negative bacteria and Actinomycetes bacteria
C) Molds like Penicillium and Actinomycetes bacteria
D) Yeasts and molds as well as some species of Gram negative bacteria

Answer 2

C

Question 3

Which is an example of an antibiotic?

A) Penicillin
B) Ceftriaxone, a third generation cephalosporin
C) Naladixic acid
D) Acyclovir

Answer 3

A

Question 4

Which of the following scientists first developed the concept of selective toxicity?

A) German physician Paul Ehrlich
B) Scottish biologist Alexander Fleming
C) English chemists Howard Florey and Ernest Chain
D) German physician Robert Koch

Question 5

What was the antimicrobial agent that Dr. Ehrlich developed as a less toxic treatment for syphilis?

A) Mercury
B) Sulfanilamides
C) Arsphenamine
D) Streptomycin

Question 6

In the 1930s, which antimicrobial agent was developed to treat Streptococcus infections?

A) Penicillin
B) Sulfanilamides
C) Tetracycline
D) Streptomycin

Question 7

Which is the correct term that describes the relationship in the product of one microbe harms another microbe?

A) Antimicrobial
B) Antibiotic
C) Anti-microorganism
D) Antibiosis

Question 8

Name the scientists who clinically purified penicillin and developed ways to produce it on a large scale as an antibiotic: ________.

A) Chain and Florey
B) Fleming and Koch
C) Koch and Pasteur
D) Pasteur and Fleming

Question 9

Streptomycin was developed to treat ________ infections before the development of widespread antibiotic resistance.

A) Streptococcus pneumoniae
B) Mycobacterium tuberculosis
C) Staphylococcus aureus
D) Klebsiella pneumoniae

Question 10

Penicillin was developed to treat ________ infections before the development of widespread antibiotic resistance.

A) Streptococcus pneumoniae
B) Neisseria gonorrhoeae
C) Staphylococcus aureus
D) Klebsiella pneumoniae

Question 11

________ was developed to treat penicillin-resistant Staphylococcus aureus infections before the development of widespread antibacterial agent resistance.

A) Methecillin
B) Tetracycline
C) Streptomycin
D) Sulfanilamide

Question 12

The process of choosing the best antimicrobial agent to fight an infection relies on these factors. (Select all that apply)

A) Agent must inhibit growth of or kill identified pathogen
B) Agent should be allergenic
C) Agent should not cause adverse reactions when used with other medications
D) Agent should be maintained at a therapeutic level in the body for a long period of time

Question 13

What are the potential side effects of an antimicrobial agent when it interacts with the human body? (Select all that apply)

A) effects on the Nervous System including seizures, dizziness, muscle weakness and/or deafness
B) effects on the Gastrointestinal System including discomfort and upset from killing of residential enteric bacteria
C) effects on the immune system including Type I Hypersensitivity and allergic reactions
D) effects on the adult skeletal system including fractures

Question 14

What is the most frequently cited side effect when looking at antibacterial agents?

A) headache and dizziness
B) gastrointestinal discomfort
C) jaundice
D) rapid heartbeat

Question 15

It is important to determine an identified pathogen's sensitivity or resistance to different antimicrobial agents before an antimicrobial agent can be prescribed to treat it. Which of the following lab tests will demonstrate the MBC (minimum bacteriocidal concentration) of the antimicrobial agent s tested?

A) Kirby-Bauer Disk Diffusion Test
B) E-strip
C) Broth dilution test
D) ELISA

Question 16

The illustration depicts the procedure for ________.

A) an E-test
B) a broth dilution test
C) determining an antibiogram
D) the Kirby-Bauer test

Question 17

Antibiograms are summaries of a bacterium's sensitivity to specific antimicrobial drugs. How are these used? (Select all that apply)

A) used by physicians and pharmacists to choose appropriate antibacterial therapies for a patient
B) used by public health workers to monitor development of resistance trends within a hospital
C) used to compare trends between facilities nationwide
D) used by patients to decide on which antimicrobial agent to take

Question 18

Spectrum of Activity is defined as ________.

A) the range of pathogens sensitive to an antimicrobial agent
B) the administration of 2 or 3 broad-spectrum antimicrobial agent s to begin treatment before receiving ID of the pathogen
C) a method to determine most effective, safe antimicrobial agent dosage for treating an infection
D) the high risk of acquiring an infection if given a broad-spectrum antimicrobial agent without any signs or symptoms

Question 19

Empiric Antimicrobial Therapy is defined as the ________.

A) range of pathogens sensitive to an antimicrobial agent
B) administration of 2 or 3 broad-spectrum antimicrobial agent s to begin treatment before receiving ID of the pathogen
C) determination of the most effective, safe antimicrobial agent dosage for treating an infection
D) patient at high risk of acquiring an infection if given a broad-spectrum antimicrobial agent without any signs or symptoms

Question 20

Therapeutic Index (TI) is defined as: ________.

A) range of pathogens sensitive to an antimicrobial agent
B) administration of 2 or 3 broad-spectrum antimicrobial agent s to begin treatment before receiving ID of the pathogen
C) determination of the most effective, safe antimicrobial agent dosage for treating an infection
D) patient at high risk of acquiring an infection is given a broad-spectrum antimicrobial agent without any signs or symptoms

Question 21

Prophylaxis is defined as: ________.

A) range of pathogens sensitive to an antimicrobial agent
B) administration of 2 or 3 broad-spectrum antimicrobial agent s to begin treatment before receiving ID of the pathogen
C) determination of the most effective, safe antimicrobial agent dosage for treating an infection
D) providing a patient at high risk of acquiring an infection with a broad-spectrum antimicrobial agent without any signs or symptoms

Question 22

The procedure shown below is used to determine ________.

A) the minimum bacteriocidal concentration of an antibacterial agent
B) the minimum inhibitory concentration of an antibacterial agent
C) the therapeutic index of an antibacterial agent
D) the toxic dose of an antibacterial agent

Question 23

If the undiluted concentration of drug E is 640 μg/ml, the minimum bacteriocidal concentration of drug E (μg/ml) is: ________.

A) 5
B) 10
C) 20
D) 40

Question 24

If the undiluted concentration of drug E is 640 μg/ml, the minimum inhibitory concentration of drug E (μg/ml) is: ________.

A) 10
B) 20
C) 40
D) 80

Question 25

Why is the cell wall a major target for antibacterial therapy?

A) it is critical for cells living in a hypotonic environment
B) it prevents osmotic lysis for cells living in an isotonic environment
C) it determines the shape of the cell
D) it anchors flagella

Question 26

Which of the following is a correct match between inhibitors and their effect on cell wall synthesis? (Select all that apply)

A) Carbapenems: inhibit formation of peptide crossbridges during synthesis of the cell wall
B) Glycopeptides: bind to amino acids on the side chain of the peptidoglycan precursor
C) Bacitracin: inhibits release of peptidoglycan precursor from membrane's lipid carrier
D) Penicillins: degrade peptidoglycan

Question 27

What is a Beta-lactam antibacterial agent?

A) an antibacterial agent that contains a Beta-lactam ring as the key structural component responsible for inhibiting the penicillin-binding protein
B) an antibacterial agent that contains four fused Beta-lactam rings as the key structural component
C) an antibacterial agent that contains a Beta-lactam moiety that serves a competitive enzyme inhibitor
D) an antibacterial agent that contains an enzyme that breaks down Beta-lactam in the cell wall

Question 28

Penicillin G is ________.

A) penicillinase-resistant drug that is resistant to degradation by Beta-lactamases
B) a natural penicillin that is not acid-stable and therefore has to be administered IV
C) semisynthetic penicillins that are acid-stable, broad-spectrum and can be taken orally
D) extended-spectrum penicillin used to treat Pseudomonas infections

Question 29

Ampicillin and Amoxicillin are ________.

A) penicillinase-resistant drug that is resistant to degradation by Beta-lactamases
B) a natural penicillin that is not acid-stable and therefore has to be administered IV
C) semisynthetic penicillins that are acid-stable, broad-spectrum and can be taken orally
D) extended-spectrum penicillin used to treat Pseudomonas infections

Question 30

Methicillin is a(n) ________.

A) penicillinase-resistant drug that is resistant to degradation by Beta-lactamases
B) natural penicillin that is not acid-stable and therefore has to be administered IV
C) natural penicillin that is acid-stable, broad-spectrum and can be taken orally
D) extended-spectrum penicillin used to treat Pseudomonas infections

Question 31

Carbenicillin is a(n) ________.

A) penicillinase-resistant drug that is resistant to degradation by Beta-lactamases
B) a natural penicillin that is not acid-stable and therefore has to be administered IV
C) semisynthetic penicillins that are acid-stable, broad-spectrum and can be taken orally
D) extended-spectrum penicillin used to treat Pseudomonas infections

Question 32

Which of the following is a correct match of an antibacterial drug that inhibits cell wall synthesis with its description? (Select all that apply)

A) Carbenicillin/extended-spectrum penicillin used to treat Pseudomonas infections
B) Cephalosporins/Beta-lactams that can be taken orally and have low toxicity
C) Carbapenems/Beta-lactams with narrowest spectrum of activity
D) Vancomycin/Highly effective glycopeptide antibacterial agent that works against Gram positive bacteria

Question 33

Vancomycin causes: ________.

A) discoloration of teeth in children
B) red rash from rapid IV infusion
C) headaches and dizziness
D) gastrointestinal discomfort

Question 34

The item marked "x" is the site of action of which antibacterial agent?

A) Beta-lactams
B) Glycopeptides
C) Bacitracin
D) Aminoglycosides

Question 35

The item marked "y" is the site of action of which antibacterial agent?

A) Beta-lactams
B) Glycopeptides
C) Bacitracin
D) Lincosamides

Question 36

The item marked "z" is the site of action of which antibacterial agent?

A) Penicillin G
B) Vancomycin
C) Bacitracin
D) Ceftriaxone

Question 37

Antibacterial drugs that cause inhibition of protein synthesis include all of these mechanisms ________. (Select all that apply)

A) blockage of formation of 30S initiation complex
B) stimulating peptidyl-tRNA dissociation
C) prevention of tRNAs from binding to ribosome A site
D) inhibition of THFA synthesis

Question 38

This antibacterial agent inhibits formation of peptide bond during elongation stage ________.

A) aminoglycosides
B) oxazolidinones
C) tetracyclines
D) chloramphenicol

Question 39

This antibacterial agent binds to ribosome A site blocking binding of aminoacyl-tRNA ________.

A) aminoglycosides
B) oxazolidinones
C) tetracyclines
D) chloramphenicol

Question 40

This antibacterial agent blocks the start of protein synthesis by preventing formation of 30S initiation complex ________.

A) aminoglycosides
B) oxazolidinones
C) tetracyclines
D) chloramphenicol

Question 41

This antibacterial agent blocks the start of protein synthesis by inhibiting binding of 50S subunit to 30S initiation complex ________.

A) aminoglycosides
B) oxazolidinones
C) tetracyclines
D) chloramphenicol

Question 42

Which of the following antibiotics that inhibit protein synthesis is bacteriostatic rather than bacteriocidal?

A) Streptomycin
B) Tetracycline
C) Chloramphenicol
D) Azithromycin

Question 43

Which of the following antimicrobial agents that inhibit protein synthesis by stimulating the dissociation of peptidyl-tRNA has to be used carefully because it has been found to encourage the overgrowth of Clostridium difficile in the intestines?

A) Clindamycin
B) Erythromycin
C) Azithromycin
D) Ketolides

Question 44

Tetracyclines may cause: ________.

A) discoloration of teeth in children
B) photosensitivity
C) headaches and dizziness
D) gastrointestinal discomfort

Question 45

Aminoglycosides may cause: ________.

A) discoloration of teeth in children
B) photosensitivity
C) red rash from rapid IV infusion
D) headaches and dizziness

Question 46

Amoxicillin may cause: ________.

A) discoloration of teeth in children
B) photosensitivity
C) red rash from rapid IV infusion
D) gastrointestinal discomfort

Question 47

The arrow marked "z" is the site of action of which antibacterial agent? (Select all that apply)

A) Macrolides
B) Lincosamides
C) Ketolides
D) Aminoglycosides

Question 48

The arrow marked "y" is the site of action of which antibacterial agent?

A) Erythromycin
B) Clindamycin
C) Streptomycin
D) Chloramphenicol

Question 49

The arrow marked "x" is the site of action of which antibacterial agent?

A) Doxycycline
B) Linzolid
C) Streptomycin
D) Chloramphenicol

Question 50

The Arrow marked "v" is the site of action of which antibacterial agent?

A) Erythromycin
B) Linzolid
C) Streptomycin
D) Chloramphenicol

Question 51

The item marked "u" is the site of action of which antibacterial agent?

A) Tetracycline
B) Clindamycin
C) Streptomycin
D) Chloramphenicol

Question 52

Sulfonamides may cause: ________.

A) photosensitivity
B) red rash from rapid IV infusion
C) headaches and dizziness
D) gastrointestinal discomfort

Question 53

Trimethoprim ________.

A) is a structural analog of PABA that are competitive inhibitors of first enzyme in pathway for microbial THFA synthesis
B) causes breaks in DNA during separation of daughter chromosomes during semi-conservative replication
C) inhibits bacterial RNA polymerase
D) inhibits DHFA reductase enzyme in bacteria

Question 54

Sulfonamides ________.

A) are structural analogs of PABA that are competitive inhibitors of first enzyme in pathway for microbial THFA synthesis
B) cause breaks in DNA during separation of daughter chromosomes during semi-conservative replication
C) inhibits bacterial RNA polymerase
D) inhibits DHFA reductase enzyme in bacteria

Question 55

Quinolones ________.

A) are structural analogs of PABA that are competitive inhibitors of first enzyme in pathway for microbial THFA synthesis
B) cause breaks in DNA during separation of daughter chromosomes during semi-conservative replication
C) inhibits bacterial RNA polymerase
D) inhibits DHFA reductase enzyme in bacteria

Question 56

Rifamycins ________.

A) are structural analogs of PABA that are competitive inhibitors of first enzyme in pathway for microbial THFA synthesis
B) cause breaks in DNA during separation of daughter chromosomes during semi-conservative replication
C) inhibits bacterial RNA polymerase
D) inhibits DHFA reductase enzyme in bacteria

Question 57

The arrow marked "y" is the site of action of which antibacterial agent?

A) Trimethoprim
B) Sulfamethoxazole
C) Metronidazole
D) Tetracycline

Question 58

The arrow marked "z" is the site of action of which antibacterial agent?

A) Trimethoprim
B) Sulfamethoxazole
C) Metronidazole
D) Tetracycline

Question 59

This antibacterial agent binds to the plasma membrane of gram-positive bacteria and disrupts the membrane's electrical potential. It is used to treat complicated skin and soft-tissue infections caused by vancomycin-resistant bacteria.

A) Polymyxin
B) Daptomycin
C) Isoniazid
D) Ciprofloxacin

Question 60

This cyclic peptide with a hydrophobic tail binds to the lipopolysaccharide of gram-negative bacteria and disrupts the membrane. It is now used to treat emerging multidrug resistant Pseudomonas infections.

A) Polymyxin
B) Daptomycin
C) Pyrazinamide
D) Clindamycin

Question 61

Why are the Mycobacterial infections difficult to treat with antibiotics? (Select all that apply)

A) The waxy cell wall created by the inclusion of mycolic acids is difficult for most antibacterial agent to permeate.
B) Members of this genus grow very slowly requiring long-term therapy that leads to potential antimicrobial agent toxicity.
C) Because appropriate antibiotics have to be taken for long periods of time patients are less likely to keep taking them.
D) The outer membrane has small porins that restrict the diffusion of antibacterial agents into the cell.

Question 62

An active case of tuberculosis has to be treated with a multidrug approach. Which of the following list of antimycobacterial agents commonly prescribed is matched with its mechanism of action? (Select all that apply)

A) Rifampicin/inhibit RNA polymerase
B) Isoniazid/ inhibits mycolic acid synthesis leading to cell wall damage and cell death
C) Pyrazinamide/converted to a base inside the cell causing pH to rise to 10 thereby inhibiting growth
D) Ethambutol/inhibits mycolic acid synthesis leading to cell wall damage and cell death

Question 63

Which of the following is a major target for antiviral therapy? (Select all that apply)

A) Inhibition of viral entry
B) Inhibition of viral nucleic acid synthesis
C) Inhibition of ribosome assembly
D) Inhibition of viral assembly and release

Question 64

Understanding the steps in a viral infection of a host cell are important in the design of effective antiviral antimicrobial agents. What are these steps? (Select all that apply)

A) Fusion of viral envelope with host cell membrane
B) Capsid uncoating to release nucleic acid into cell
C) Attachment of an adhesin on the viral surface to a receptor on the host cell
D) Expression of viral genetic information to produce viral genomes and proteins

Question 65

Integrase inhibitors are ________.

A) anti-herpes simplex I and II viruses
B) anti-HIV agents used to treat all states of HIV disease
C) anti-HBV agent used to treat multidrug-resistant infections
D) treatment of chronic HBV and HBC infections

Question 66

3-thiocytidine (3TC) is ________.

A) used in combination therapy to treat Hepatitis B virus (HBV)
B) a nucleoside analog that causes termination of DNA synthesis by reverse transcriptase
C) used in combination with fuzeon to treat all stages of HIV infection
D) used to prevent maternal-to-fetal transmission of HIV

Question 67

Azidothymidine (AZT) ________.

A) is used in combination therapy to treat Hepatitis B virus (HBV)
B) is a noncompetitive inhibitor of HBV reverse transcriptase
C) is used in combination with entecavir to treat all stages of HIV infection
D) used to prevent maternal-to-fetal transmission of HIV

Question 68

A membrane fusion inhibitor is ________.

A) an anti-HIV agent use to treat all states of HIV disease
B) an anti-influenza A and B virus agent
C) an anti-HIV agent used to treat multidrug-resistant infections
D) used to treat chronic HBV and HBC infections

Question 69

Which of the following statements about Fuzeon is true? (Select all that apply)

A) It is an anti-HIV drug that is used to treat patients with resistance to usually prescribed antiviral agents.
B) It is a peptide that prevents the 3-dimensional change required for fusion of the HIV envelop to the host cytoplasmic membrane
C) It is an enzyme that promotes a 3-dimensional change required for a new shape to the host cell receptor
D) It is part of the recommended combination of three antiviral agents that are used to treat all stages of HIV disease

Question 70

This antiviral agent is a monoclonal antibody that binds the primary host cell receptor for HIV and is used for the treatment of multidrug-resistant HIV-1 infection in patients that have previously received several anti-HIV-1 regimens and are failing their current antiretroviral therapy.

A) Ibalizumab
B) Maraviroc
C) Dideoxy-3′-thiacytidine (3TC)
D) Efavirenz

Question 71

This antiviral agent is an inhibitor that binds to one of the co-receptors which is found on the surface of macrophages or T cells. and blocks an HIV envelope protein from fusing the viral envelope with the host cell membrane. It is indicated for use in treatment-experienced adult patients infected with a susceptible HIV-1 strain who have evidence of infection by a virus with resistance to multiple anti-HIV agents.

A) Maraviroc
B) Azidothymidine (AZT)
C) Bictegravir
D) Darunavir

Question 72

Which of the following are nucleoside analogs are anti-HIV agents used in combination therapy to treat all stages of HIV. (Select all that apply)

A) Carbovir (prodrug abacavir)
B) Dideoxy-3′-thiacytidine (3TC)
C) Dideoxyfluorothiacytidine (FTC)
D) Acyclovir

Question 73

This antiviral agent was the first agent developed to treat AIDS. It is a nucleoside analog of deoxythymidine and has a high affinity for HIV reverse transcriptase. After incorporation into the DNA, it acts as a terminator of DNA synthesis.

A) Azidothymidine (AZT)
B) Efavirenz
C) Darunavir
D) Tenofovir

Question 74

This antiviral agent is a nonnucleoside drug that is a noncompetitive inhibitor of HIV reverse transcriptase It is used in combination therapy to treat patients with varying stages of HIV infections. It is effective against HIV-1 virus infections, but not HIV-2 infections.

A) Efavirenz
B) Tenofovir
C) Dolutegravir
D) Bictegravir

Question 75

This antiviral agent is an inhibitor of the HIV integrase enzyme. It is used in combination therapy to treat patients with varying stages of HIV infections.

A) Dolutegravir
B) Darunavir
C) Tenofovir
D) Efavirenz

Question 76

This antiviral agent is an inhibitor of the HIV protease enzyme. It binds to the active site of HIV protease ~100X more tightly than other protease inhibitors. It is used in combination therapy to treat individuals for whom dolutegravir-based therapies are failing.

A) Dolutegravir
B) Darunavir
C) Tenofovir
D) Efavirenz

Question 77

HIV PrEP (pre-exposure prophylaxis) is recommended for ________. (Select all that apply)

A) Men who have sex with men
B) people who engage in injection drug use
C) persons whose sexual partner is HIV⁺
D) anyone who is HIV⁺

Question 78

These antiviral agents are the current recommendations for PrEP (pre-exposure prophylaxis) for HIV/AIDS.

A) Tenofovir
B) 3TC (or FTC) and dolutegravir
C) tenofovir and efavirenz
D) bictegravir and Darunavir

Question 79

This combination of antiHIV agents generally result in higher viral suppression, higher CD4 cell count recovery rates, a higher genetic barrier to developing drug resistance, a lower risk of treatment discontinuation and clinical activity against HIV-2 infection relative to treatment with tenofovir and 3TC (or FTC) plus efavirenz.

A) tenofovir and 3TC (or FTC) plus dolutegravir
B) Tenofovir
C) azidothymidine (AZT) and bictegravir plus Darunavir
D) AZT and 3TC (or FTC) plus darunavir

Question 80

The item marked "s" is the site of action of which antiviral agent?

A) Ibalizumab
B) Maraviroc
C) Dideoxy-3′-thiacytidine (3TC)
D) Efavirenz