Antimicrobial Drugs Chapter 14 Complete Test Bank

Chapter 14: Antimicrobial Drugs

= Correct answer

Multiple Choice

1. Which was the first antimicrobial agent discovered to treat syphilis?

A. chloramphenicol

B. compound 606

C. penicillin

D. sulfonamide

Difficulty: Easy

ASM Standard: 14, 23

1. Who is credited for first finding an antimicrobial agent?

A. Paul Ehrlich

B. Alexander Fleming

C. Edward Jenner

D. Joseph Lister

Difficulty: Moderate

ASM Standard: 14

1. Who is credited for first finding a naturally occurring antimicrobial agent?

A. Paul Ehrlich

B. Alexander Fleming

C. Edward Jenner

D. Joseph Lister

Difficulty: Moderate

ASM Standard: 14, 26

1. Alexander Fleming first observed a mold (now known as Penicillium notatum) that was able to inhibit which organism?

A. Escherichia

B. Listeria

C. Staphylococcus

D. Streptococcus

Difficulty: Easy

ASM Standard: 14, 26

1. Which of the following is a semisynthetic antimicrobial agent?

A. actinomycin

B. ampicillin

C. streptomycin

D. neomycin

Difficulty: Moderate

ASM Standard: 14

1. Which describes the difference between a secondary infection and a superinfection?

A. A secondary infection is a type of superinfection that develops when antibiotics are not given.

B. A superinfection is a type of secondary infection that can develop when antibiotics kill much of the patient’s normal flora.

C. A superinfection is a type of secondary infection that develops when antibiotics taken to treat a particular pathogen do not completely kill all of that original pathogen.

D. A secondary infection is a type of superinfection that develops when the pathogen mutates in response to the antimicrobial agent.

Difficulty: Difficult

ASM Standard: 14, 23

1. Life-threatening diseases caused by bacterial pathogens should be treated with which of the following?

A. bactericidal agents only

B. bacteriostatic agents only

C. both bacteriostatic and bactericidal agents

D. neither bacteriostatic nor bactericidal agents

Difficulty: Moderate

ASM Standard: 14, 23

1. Which of the following is a -lactam antibiotic?

A.

B.

C.

D.

Difficulty: Moderate

ASM Standard: 14, 26

1. Which of the following is not a -lactam antibiotic?

A. carbapenem

B. cephalosporin

C. penicillin

D. tetracycline

Difficulty: Easy

ASM Standard: 14, 26

1. How does penicillin work?

A. Penicillin binds to penicillin-binding proteins, thus inhibiting the transglycosylation reaction during cell wall synthesis.

B. Penicillin binds to penicillin-binding proteins, thus inhibiting the transpeptidation reaction during cell wall synthesis.

C. Penicillin blocks the movement of peptidoglycan subunits from the cytoplasm to the exterior of the cell.

D. Penicillin inserts into the plasma membrane, causing cell lysis.

Difficulty: Moderate

ASM Standard: 7, 14, 26

1. How does bacitracin work?

A. Bacitracin binds to penicillin-binding proteins, thus inhibiting the transglycosylation reaction during cell wall synthesis.

B. Bacitracin binds to penicillin-binding proteins, thus inhibiting the transpeptidation reaction during cell wall synthesis.

C. Bacitracin blocks the movement of peptidoglycan subunits from the cytoplasm to the exterior of the cell.

D. Bacitracin inserts into the plasma membrane, causing cell lysis.

Difficulty: Moderate

ASM Standard: 7, 14, 26

1. The penicillins act on which type of bacteria?

A. gram-negative bacteria only

B. gram-positive bacteria only

C. mostly gram-negative bacteria and some gram-positive bacteria

D. mostly gram-positive bacteria and some gram-negative bacteria

Difficulty: Moderate

ASM Standard: 7, 14, 26

1. The aminoglycosides directly target which structure of the bacterial cell?

A. 30S ribosomal subunit

B. 50S ribosomal subunit

C. cell wall

D. plasma membrane

Difficulty: Easy

ASM Standard: 7, 14, 26

1. The macrolides target which feature of the bacterial cell?

A. 30S ribosomal subunit

B. 50S ribosomal subunit

C. cell wall

D. plasma membrane

Difficulty: Easy

ASM Standard: 7, 14, 26

1. Which of the following was the first broad-spectrum antibiotic to be approved by the FDA?

A. chloramphenicol

B. compound 606

C. penicillin

D. tetracycline

Difficulty: Easy

ASM Standard: 7, 14, 26

1. Which of the following commonly results from most antibiotic classes that bind to the 50S ribosomal subunit?

A. Peptide bond formation is inhibited.

B. Proteins made from this ribosome insert into the plasma membrane.

C. The proofreading mechanism of the ribosome is inhibited.

D. tRNAs charged with an amino acid cannot enter the ribosome.

Difficulty: Difficult

ASM Standard: 7, 14, 26

1. Congratulations! You have discovered a new antibiotic. It is lipophilic and detergent-like. On the basis of this information, its target is most likely which of the following?

A. peptidoglycan

B. the bacterial ribosome

C. the plasma membrane

D. nucleic acid synthesis machinery

Difficulty: Moderate

ASM Standard: 7, 14

1. Which is the target of the antimicrobial drug known as rifampin?

A. DNA gyrase

B. DNA polymerase

C. helicase

D. RNA polymerase

Difficulty: Easy

ASM Standard: 7, 14, 26

1. Which is the target of the class of antimicrobial drugs known as fluoroquinolones?

A. DNA gyrase

B. DNA polymerase

C. helicase

D. RNA polymerase

Difficulty: Moderate

ASM Standard: 7, 14, 26

1. Sulfa drugs (sulfonamides) inhibit which metabolic pathway?

A. dihydrofolic acid synthesis pathway

B. Embden-Meyerhof pathway

C. Entner–Doudoroff pathway

D. pentose-phosphate pathway

Difficulty: Moderate

ASM Standard: 7, 14

1. Metronidazole and pentamidine are used to treat which type of infection?

A. bacterial

B. fungal

C. helminth

D. protozoan

Difficulty: Difficult

ASM Standard: 7, 14, 23

1. Benzimidazoles and avermectins are used to treat which type of infection?

A. bacterial

B. fungal

C. helminth

D. protozoan

Difficulty: Difficult

ASM Standard: 7, 14, 23

1. Reverse transcriptase inhibitors, such as AZT, can be used to target which virus?

A. herpes

B. HIV

C. influenza

D. rabies

Difficulty: Easy

ASM Standard: 7, 10, 14, 23

1. Which of the following antiviral drugs is not a nucleoside analog?

A. acyclovir

B. etravirine

C. sofosbuvir

D. vidarabine

Difficulty: Moderate

ASM Standard: 7, 14

1. What mechanism of resistance is used by both MRSA and VRSA?

A. blocked/reduced penetration

B. efflux pump

C. inactivation of enzyme

D. target modification

Difficulty: Moderate

ASM Standard: 3, 7, 14, 22

1. Which of the following contributes to the development of antibiotic resistance?

A. blocked/reduced penetration

B. efflux pump

C. inactivation of enzyme

D. target modification

Difficulty: Easy

ASM Standard: 2, 3, 7, 14, 22

1. Examine the results of the disk diffusion assay shown below. Which antimicrobial agent is the most effective?

A. A

B. B

C. C

D. D

Difficulty: Moderate

ASM Standard: 14, 28b, 38

1. A macrobroth dilution assay to determine the MIC of amoxicillin on E. coli is shown below. What is the MIC?

(credit: modification of work by Brian Forster)

A. 0.01 µg/mL

B. 0.05 µg/mL

C. 0.10 µg/mL

D. 5.00 µg/mL

Difficulty: Moderate

ASM Standard: 14, 28b, 38

1. Using the Etest shown below, determine the approximate MIC of this antibiotic against the bacterium plated.

(credit: Nathan Reading)

A. 0.12 µg/mL

B. 0.5 µg/mL

C. 8 µg/mL

D. 256 µg/mL

Difficulty: Moderate

ASM Standard: 14, 28b, 38

1. Which of the following describes an antibiogram?

A. a compilation of all known antibiotic resistant bacteria found in the United States

B. a compilation of local antibiotic susceptibility data broken down by bacterial pathogen

C. a sterile disk infused with antibiotic and used in a Kirby-Bauer disk diffusion assay

D. a synthetic antibiotic

Difficulty: Easy

ASM Standard: 14

True/False

1. Antimicrobial agents may be the metabolites of microorganisms or synthetically made.

Difficulty: Easy

ASM Standard: 14, 26

1. If antibiotic treatment is needed for immunocompromised individuals who develop infections, the medications should be bactericidal rather than bacteriostatic.

Difficulty: Easy

ASM Standard: 14, 26

1. Both vancomycin and penicillin target the bacterial cell wall and have the same mode of action.

Difficulty: Moderate

ASM Standard: 7, 14

1. Chloramphenicol should be used sparingly because it also inhibits the large subunit of mitochondrial ribosomes.

Difficulty: Moderate

ASM Standard: 7, 26

1. Continued use of quinolones can lead to hallucinations, cardiac complications, and, potentially, anemia.

Difficulty: Easy

ASM Standard: 14

1. Tamiflu is a hemagglutinin inhibitor commonly used against influenza virus.

Difficulty: Easy

ASM Standard: 14

1. Isoniazid is an antimetabolite that can be used to treat mycobacterial infections.

Difficulty: Moderate

ASM Standard: 14

1. Individuals cannot have MRSA as part of their normal flora or microbiota.

Difficulty: Moderate

ASM Standard: 14, 23

1. The Kirby-Bauer disk diffusion assay can distinguish between bacteriostatic and bactericidal agents.

Difficulty: Easy

ASM Standard: 36

1. The Etest combines both the Kirby-Bauer disk diffusion assay and the minimum inhibitory concentration dilution assay to determine the effectiveness of an antimicrobial compound.

Difficulty: Easy

ASM Standard: 36

1. Due to concern of antimicrobial resistance, the number of antimicrobial drugs approved by the FDA has increased since the 1980s.

Difficulty: Easy

ASM Standard: 3, 14, 26

Matching

1. Match the antimicrobial agent to its mode of action.

Answers: A. v., B. i., C. iii., D. ii., E. iv.

Difficulty: Easy

ASM Standard: 7, 14

1. Match the antimicrobial agent to its mode of action.

Answers: A. i., B. iv., C. v., D. iii., E. ii.

Difficulty: Moderate

ASM Standard: 7, 14

1. Match the antimicrobial agent to its mode of action.

Answers: A. iii., B. i., C. iv., D. v., E. ii.

Difficulty: Moderate

ASM Standard: 14

1. Match the antiviral to the virus it is used to treat.

Answers: A. iv., B. ii., C. i., D. iii.

Difficulty: Moderate

ASM Standard: 14

Fill in the Blank

1. The microbial environment that has been investigated most thoroughly for the production of antimicrobial compounds is ________?

Difficulty: difficult

ASM Standard: 7, 14, 22

1. At the hospital, the fist antimicrobial drug given, especially when the pathogen is not yet known, is often a ________-spectrum drug.

Difficulty: Easy

ASM Standard: 14, 26

1. Ampicillin and amoxicillin are ________ penicillins.

Difficulty: Easy

ASM Standard: 14, 26

1. Penicillin inhibits the ________ reaction of cell wall synthesis.

Difficulty: Difficult

ASM Standard: 7, 14

1. Most antifungal agents target ________, which is found in the fungal cell membrane.

Difficulty: Easy

ASM Standard: 7, 14

1. Artemisinin and quinolines are antimicrobials used against ________.

Difficulty: Easy

ASM Standard: 14

1. Carbapenem-resistant gram-negative bacteria are common in ________.

Difficulty: Moderate

ASM Standard: 3, 14, 23

1. The ________ is the lowest concentration of a drug that inhibits visible growth in culture.

Difficulty: Easy

ASM Standard: 36

1. The ________ is the lowest concentration of a drug that kills at least 99.9% of the starting inoculum.

Difficulty: Easy

ASM Standard: 36

1. A group of pathogens called ________ pathogens are multidrug resistant microbes that demonstrate cross-resistance.

Difficulty: Moderate

ASM Standard: 3, 14, 22, 23

Short Answer

1. Examine the two growth curves shown below. Identify which drug is the bactericidal agent and which is the bacteriostatic agent. Briefly state how you arrived at your answer.

Sample

Difficulty: Moderate

ASM Standard: 14

1. What is the definition of dosage?

Sample

Difficulty: Easy

ASM Standard: 26

1. What should be considered when determining dosage?

Sample

Difficulty: Easy

ASM Standard: 26, 27

1. What should be considered when determining a route of administration?

Sample

Difficulty: Easy

ASM Standard: 26

1. Give an example of an antagonistic drug interaction.

Sample

Difficulty: Easy

ASM Standard: 26

1. A culture of E. coli is currently in the exponential phase. It is exposed to penicillin. What will happen to the bacteria as they continue to grow and divide in the presence of this antibiotic? Briefly explain your answer.

Sample

Difficulty: Moderate

ASM Standard: 7, 14

1. What are the three antibiotics typically found in Neosporin?

Sample

Difficulty: Easy

ASM Standard: 14

1. Why is chloramphenicol rarely used on humans?

Sample

Difficulty: Easy

ASM Standard: 26

1. Why are helmiths, fungi, and protozoan pathogens difficult to treat with antimicrobial agents?

Sample

Difficulty: Moderate

ASM Standard: 14

1. Some bacteria have a very low level of resistance to antibiotics, while others have a high level of resistance. (a) In terms of natural selection, explain why scientists believe antibiotics should be given only when necessary. (b) What can be done to prevent the further spread of antibiotic resistance?

Sample

Difficulty: Moderate

ASM Standard: 3, 14, 26

1. What is the resistance mechanism for MRSA?

Sample

Difficulty: Moderate

ASM Standard: 3, 14

1. How do VISA and VRSA differ?

Sample

Difficulty: Difficult

ASM Standard: 3, 14

1. How could bacteria develop resistance to sulfa drugs (sulfonamide)? Be sure to state a possible resistance mechanism.

Sample

Difficulty: Difficult

ASM Standard: 2, 3, 14

1. What is the difference between MIC and MBC?

Sample

Difficulty: Easy

ASM Standard: 36

1. An MIC assay is shown below. Tube A contains vancomycin at a concentration of 25 mg/mL. The serial dilutions performed are shown. Then Staphylococcus aureus was inoculated into each tube. The tubes were then incubated for 24 hours. After 24 hours, growth was observed only in tubes E and F. From this experiment, identify which tube contains the MIC and calculate the MIC of vancomycin for S. aureus.

Sample

Difficulty: Difficult

ASM Standard: 28b, 29a, 36

Brief Essay

Essay Question Rubric

Assume rating/grading scale for the question ranges from 0 to 3 points.

1. (a) State the five general targets of antibacterial compounds and give an example of an antibiotic that acts on each target.
2. Why are viruses not affected by antibacterial compounds?

Difficulty: Easy

ASM Standard: 7, 14, 26

1. (a) State any four mechanisms of antibiotic resistance that bacteria use.
2. For each multidrug-resistant microbe listed below, state specifically the mechanism it uses to resist the action of the antibiotic.

• MRSA
• VISA
• VRSA
• carbapenem resistance in Pseudomonas aeruginosa

Sample

Difficulty: Moderate

ASM Standard: 3, 7, 14, 22, 26

1. Explain the treatment of HIV, answering the following four questions:

• What class of virus is HIV?
• Briefly describe the life cycle of HIV.
• In terms of the viral life cycle, why is it difficult to treat HIV?
• In terms of the viral life cycle, what type of inhibitor drugs could be used to treat HIV?

Sample

Difficulty: Moderate

ASM Standard: 3, 7, 10, 14, 18

1. Lori has a very bad sore throat. She goes to the doctor and is told that it is not a bacterial infection.
2. The doctor then prescribes an antibiotic for her to take. Should the doctor have given Lori this prescription? Why would the doctor give such a treatment?
3. Lori gets well! A week goes by and then the sore throat comes back. This time the doctor suspects strep throat. A culture is taken and sent to the lab to confirm, using blood agar, that she has strep throat. The lab then performs a Kirby-Bauer disk diffusion assay using antibiotics A through D. The results are shown below:

1. Based on the results shown above, which antibiotic worked best?
2. Circle any antibiotic-resistant colonies. If there are any antibiotic-resistant bacteria, how could they have arisen?
3. Lori takes the antibiotic as prescribed and a week later returns to the doctor. Apparently the concentration being used is not working. Should the doctor just give a higher concentration of antibiotic? What problems may arise from this action?

Sample

Difficulty: Difficult

ASM Standard: 2, 3, 14, 22, 26, 28b, 36

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