old exam 4

Sprenkle EXAM 4 Spring 2006

Name_____________________________________________________________________

Directions: choose the best answer for the multiple choice or matching problems and enter the letter on the scantron sheet. Read the entire question and all the answers before making your choice!

1. Antimicrobial chemotherapy can include many different kinds of drugs that control or prevent microbial infection. Subsets of antimicrobial drugs are: 1) antibiotics and 2) synthetic antimicrobials. These two groups differ in that antibiotics are defined as ________________________, while synthetic antimicrobials are__________________.

a. potent…toxic

b. metabolic product from one microbe that is toxic to another…microbistatic

c. microbicidal… metabolic products from one microbe that is toxic to another

d. metabolic product from one microbe that is toxic to another…compounds similar to antibiotics that are chemically modified to provide new pharmaceutical properties

2. Selective toxicity is the characteristic of an ideal antimicrobial drug that is defined as:

a. being microbicidal rather than microbistatic

b. not affected by antimicrobial resistance

c. functioning at low concentrations and soluble in body fluids

d. toxic to microbe but not to host

e. toxic to host but not to microbe

3. A broad spectrum drug might work against:

a. bacteria

b. Mycobacterium species

c. malaria protozoan

d. fungi

e. all of the above

4. The action of penicillin on Staphylococcal species is _______, since it’s mechanism of action is _________.

a. microbistatic…to inhibit translation

b. microbicidal…weaken the peptidoglycan cell wall

c. microbistatic…disrupt membranes

d. microbicidal…bind to DNA gyrase

5. Choose the statement which best describes the action of sulfa drugs on bacteria.

a. the beta-lactam ring binds to the ribosomal subunit to block translation

b. the beta-lactam ring is cleaved by beta-lactamase and is inactivated

c. sulfa drugs prevent peptide cross-bridge formation in the peptidoglycan layer

d. sulfa drugs prevent the conversion of PABA to DHF

6. Antimicrobials which act to inhibit nucleic acid synthesis can act by:

a. inhibiting the synthesis of nucleotides

b. binding to DNA gyrase

c. binding to RNA polymerase

d. all of the above

e. none of the above

7. Beta lactams are one of the components in the drug cocktail used in the treatment of HIV-infected patients.

a. True

b. False

8. Natural penicillin is most effective against Gram positive bacteria. To make drugs of a similar function that have a more broad spectrum of activity, _______________________ are created by modifying the _______________ of the drug

a. chimeras / beta lactam ring

b. synthetic antimicrobials / R-group

c. antibiotics / N-group

d. amino acids / codon

9. Non-beneficial host-drug interactions resulting from antimicrobial treatment may include:

a. allergy

b. superinfection

c. organ toxicity

d. all of the above

e. none of the above

10. Common mechanisms or strategies of drug resistance in bacteria include all of the following except:

a. bypassing DNA replication

b. acquisition of a beta-lactamase

c. mutated growth factor receptor

d. activation of a drug pump

e. use of alternate metabolic pathways

11. The most common antiviral drug is a(an):

a. aminoglycoside

b. surfactant

c. nucleotide analog

d. beta-lactam

12. The choice of the use of a mycolic acid inhibitor in the treatment of Mycobacterium tuberculosis is a good example of using a drug with:

a. modified R groups

b. selective toxicity

c. a beta lactam ring

d. none of the above

13. Gram negative enteric bacteria are typically found as normal flora residents of the:

a. upper respiratory tract

b. GI tract

c. skin

d. external female genitalia

14. Strategies to reduce antimicrobial drug resistance include:

a. accurate diagnoses

b. responsible prescription of antimicrobials

c. ensuring patient compliance

d. combined therapy

e. all of the above

15. Microbes tolerant drying and high salt conditions are often found as normal flora of the:

a. upper respiratory tract

b. GI tract

c. skin

d. external female genitalia

16. The normal flora of the stomach is _______ diverse than that of the large intestine

a. more

b. less

17. Virulence factors of microorganisms include all of the following except:

a. exotoxins

b. capsule

c. exoenzymes

d. interferon

e. antiphagocytic mechanisms

18. A virulence factor that helps a bacterium avoid phagocytosis by killing the phagocyte outright might be called a:

a. hyaluronidase

b. hemolysin

c. leukocidin

d. protease

e. beta-lactamase

19. A disease outbreak that spans continents is referred to as:

a. endemic

b. epidemic

c. sporadic

d. pandemic

20. A low-level disease occurrence that is located in a region of a particular climate, like a desert or rainforest is referred to as:

a. endemic

b. epidemic

c. sporadic

d. pandemic

21. These types of organisms would probably be more sensitive to an antimicrobial with surfactant action:

a. Gram positive

b. Gram negative

c. Naked viruses

Matching: match the metabolic target on the right to the antimicrobial on the left.

22. ____Polymixin B	A. peptidoglycan cross bridge formation
23. ____actinomycin	B. protein translation
24. ____cloxacillin	C. cell membrane disruption
25. ____levaquin	D. inhibition of DNA replication
26. ____nucleotide analogs (AZT)	E. inhibit transcription of RNA

27. Superinfection by Candida or C. difficile may follow use of an antibiotic due to

a. disruption of normal flora

b. drug resistance

c. nephrotoxicity

d. all of the above

e. none of the above

28. Influenza is an example of a(an) __________ disease, while tetanus is an example of a _________.

a. epidemic / zoonose

b. non-communicable / communicable

c. communicable / non-communicable

d. viral / fungal

29. To control the spread of a disease, if one is directed to control fomites, one should:

a. isolate the infected individual

b. destroy or decontaminate all inanimate objects with which the infected individual has come into contact.

c. keep the patient hydrated

d. none of the above

30. Bacteria are __ apt to acquire antimicrobial drug resistance in the presence of __ antibiotic usage.

a. more / heavy

b. less / frequent

c. more / infrequent

d. less / heavy

31. All of the following are celluar targets of antimicrobial drugs except:

a. inhibiting protein synthesis

b. nucleic acid synthesis inhibition

c. inhibiting conjugation via pili

d. cell wall synthesis inhibition

32. Penicillin and cephalosporin inhibit cell wall synthesis by:

a. depleting the pool of peptidoglycan building blocks

b. breaking the link between the ‘G’ (N-acetylglucosamine )and ‘M’ (N-acetyl muramic acid) glycans or sugars in peptidoglycan

c. binding to enzymes that repair the peptide crossbridge links between the sugar chains

d. all of the above

e. none of the above

33. The immediate cause of death of bacteria susceptible to beta-lactam agents is:

a. hypotonic lysis

b. cell membrane stretching

c. peptidase inhibition

d. hypertonic dehydration

34. Chemotherapy of mycoses is complicated by two factors. First, unlike bacteria, fungi are __ as are humans, thus there are fewer differences for selective toxicity that may be exploited for microbial control. What is toxic to fungi is likely to be __ to humans as well.

a. eukaryotes, toxic

b. prokaryotes, tolerable

c. eukaryotes, beneficial

d. prokaryotes, toxic

35. In the creation of synthetic antimicrobials using the beta-lactam nucleus, but changing the R groups, or side chains is to:

a. change the spectrum of activity

b. make the drug resistant to penicillinase

c. make the drug more acid resistant

d. make the drug more effective against Gram negative organisms

e. all of the above are possible outcomes of the change in an R-group

36. The Kirby-Bauer technique is an agar __ method comprised of applying impregnated discs of known antimicrobic dosages to a __ of isolated bacteria and, after incubation, evaluating zones of inhibition.

a. dilution, colony

b. diffusion, lawn

c. dilution, lawn

d. diffusion, colony

37. During a natural birth, the first opportunity for a newborn to have contact with microflora is via:

a. touching with delivery forceps

b. feeding by breast or bottle

c. bedding, wrapping, diapers

d. handling of newborn

e. contact with birth canal

38. If you isolated E. coli from a hand-washing sample along with some other microbes, what epidermal flora population does it represent?

a. resident

b. transient

39. In the digestive tract, the least hospitable site for the growth of resident microbiota is the:

a. oral cavity

b. esophagus

c. colon

d. stomach

e. small intestines

40. Assorted microflora like Streptococcus, Staphylococcus, Haemophilus, Klebsiella, and Neisseria reside in all respiratory sites except in the __ and __.

a. bronchioles, alveoli

b. bronchi, trachea

41. In both sexes, the kidney and __ are normally microbe-free but the lower __ is subject to encroachment of resident microflora.

a. bladder, urethra

b. urethra, genitalia

42. A pathogen adapted to enter, multiply, and spread in its host is biologically successful but requires ________in order to go on to infect the next individual.

a. pathogenesis

b. virulence

c. a portal of entry

d. a portal of exit

43. While microbial slime or capsule coating helps microbes __ phagocytic engulfment, __ actually destroy phagocytic white blood cells.

a. promotes, streptokinase

b. resist, leukocidins

c. stimulates, endotoxins

d. none of the above

44. Normal flora can be found in all of the following locations except:

a. mucous membranes

b. gastrointestinal tract

c. bladder

d. vagina

45. The population of transient flora on an individual’s hands at any given time is most affected by:

a. hygiene

b. genetics

c. temperature

d. amount of oxygen in the atmosphere

46. An organism that can only cause disease when the host’s defenses are compromised are known as

a. true pathogens

b. opportunistic pathogens

c. mycogens

d. aminoglycosides

e. funky pathogens

47. A positive antibody test for HIV would be a _______ of infection

a. sign

b. symptom

c. syndrome

d. sequela

48. Virulence factors include

a. toxins

b. enzymes

c. capsules

d. all of the above

e. none of the above

Matching: Match the definition on the right to the term on the left

49. ____sign	a. subjective evidence sensed and communicated by the patient (nausea, headache)
50. ____symptom	b. permanent damage to tissue or organ as a result of an infection
51. ____sequele	c. an animal that transmits a pathogen from one host to another
52. ____zoonose	d. evidence of disease as noted by an observer (rash, fever)
53. ____living vector	e. an infection indigenous to animals, but is transmitted to humans (rabies)

Matching: Match the definition on the right to the term on the left

54. ____reservoir	a. an organism that transmits a pathogen, and is also required in the life cycle of the pathogen
55. ____biological vector	b. the primary habitat of a pathogen
56. ____nosocomial	c. a disease which by law must be communicated to public health officials
57. ____community acquired	d. an infection acquired ONLY as a result of a hospital stay
58. ____reportable disease	e. an infection acquired outside of a hospital