Chap24, Chapter 24

Multiple Choice

1. Alexander Fleming is credited with the discovery of which of the following

antimicrobial agents?
A. Quinine
B. Penicillin
C. Cephalosporin
D. Erythromycin

Ans: B

2. Which of the following is the best definition of an antibiotic?

A. A chemical that is made in the pharmaceutical laboratory that kills or inhibits other
microorganisms
B. A product produced by living microorganisms that kills or inhibits other
microorganisms
C. Any chemotherapeutic agent that harms an infectious organism
D. The concentration of the drug that destroys the pathogen

Ans: B

3. A semisynthetic antibiotic is one that is

A. made in a pharmaceutical laboratory.
B. produced by a species of mold or bacteria.
C. partly of microbial origin and partly of laboratory origin.
D. partly functionally.

Ans: B

4. A broad spectrum antibiotic would be expected to be effective against

A. Gram positive bacteria only.
B. Gram negative bacteria only.
C. both Gram positive and Gram negative bacteria.
D. both bacteria and viruses.
Ans: C

5. Ideally, an antimicrobial agent should exhibit selective toxicity, meaning that

A. it should harm the infectious agent but not the host.
B. it should have very low toxic dose.
C. it should have a very high therapeutic dose.
D. it should be toxic to a wide variety of infectious agents.

Ans: A

6. Sulfanilamide is active against those bacteria that

A. form granular lesions in the body.
B. synthesize folic acid.
C. induce allergic reaction.
D. are commonly found in polluted water.

Ans: B

7. Sulfonamide is a competitive inhibitor which interferes with the ability of a bacteriujm

to
A. resist the effect of tetracycline.
B. synthesize PABA.
C. undergo transformation to a resistant form.
D. form folic acid.

Ans: D

8. Isoniazid is a narrow spectrum antibiotic that is useful for treatment of

A. viral infections.
B. pneumonia.
C. tuberculosis.
D. strep throat.

Ans: C
9. Isoniazid inhibits the synthesis of
A. peptidoglycan.
B. folic acid.
C. mycolic acid.
D. viral RNA.

Ans: C

10. Which group of antibiotics block DNA synthesis in bacteria?

A. Quinolones
B. Penicillins
C. Aminoglycosides
D. Tetracyclines

Ans: A

11. The two major drawbacks to the use of penicillin are

A. kidney damage and immune complex formation.
B. allergic reactions and development of drug-resistant bacteria.
C. aplastic anemia and anaphylactic hypersensitivity.
D. loss of hearing and cytotoxic hypersensitivity.

Ans: B

12. A person who is allergic to penicillin allergy may be treated with

A. bacitracin but not cephalosporin.
B. erythromycin but not ampicillin.
C. amoxicillin but not erythromycin.
D. ampicillin but not amoxicillin.

Ans: B

13. The beta lactam nucleus is the basic structure of

A. penicillin.
B. tetracycline.
C. chloramphenicol.
D. aminoglycosides.
Ans: A

14. Penicillin is most effective against

A. log phase gram (-) bacteria.
B. stationary phase gram (-) bacteria.
C. log phase gram (+) bacteria.
D. stationary phase gram (+) bacteria.

Ans: C

15. Both the cephalosporin and penicillin antibiotics

A. are produced by mold-like bacteria.
B. are used primarily for gram-negative bacteria.
C. act on the cell wall of bacteria.
D. are related to sulfanilamide.

Ans: C

16. Cephalosporins act by

A. inhibiting protein synthesis.
B. interfering with cell-wall biosynthesis.
C. competitively inhibiting folic acid biosynthesis.
D. inhibiting RNA synthesis.

Ans: B

17. Members of the genus Streptomyces

A. produce sulfanilamide.
B. are commonly found in the urinary tract.
C. produce many well-known antibiotics.
D. are used to test the MIC of an antibiotic.

Ans: C

18. A common feature of bacitracin and polymyxin B is that both antibiotics

A. are effective against fungi.
B. contain four benzene rings and several carbohydrate side-groups.
C. are only used topically.
D. lead to anaphylaxis reactions.

Ans: C

19. All aminoglycoside antibiotics function by

A. interfering with cell wall synthesis.
B. attaching irreversibility to bacterial ribosomes.
C. blocking absorption at the cell membrane.
D. blocking DNA transcription.

Ans: B

20. The tubercle bacillus is usually susceptible to

A. erythromycin but not streptomycin.
B. streptomycin but not penicillin.
C. penicillin but not nystatin.
D. cephalothin but not isoniazid.

Ans: B

21. Chloramphenicol
A. inhibits RNA synthesis.
B. cannot be absorbed from the intestine.
C. interferes with protein synthesis in microorganisms.
D. is effective only against gram (-) infections.

Ans: C

22. All the following apply to the tetracycline antibiotics except

A. they are associated with discoloration of the teeth.
B. they are used for rickettsial and chlamydial diseases.
C. they are broad-spectrum antibiotics.
D. they may cause aplastic anemia or the gray syndrome.

Ans: D
23. The spectrum of activity of tetracycline antibiotics
A. includes the viruses.
B. is limited to the fungi.
C. includes viruses, protozoa, and fungi.
D. includes Rickettsia and Chlamydia.

Ans: D

24. Pseudomembranous colitis is a condition of the intestine that may be related to

A. the anaphylaxis associated with penicillin.
B. aplastic anemia.
C. overuse of lincomycin and clindamycin.
D. cell-wall inhibition caused by vancomycin.

Ans: C

25. Penicillins interfere with the synthesis of

A. folic acid.
B. peptidoglycan.
C. DNA.
D. mRNA.

Ans: B

26. Some bacteria produce beta-lactamases, which break down and inactivate
A. penicillins.
B. macrolides.
C. fluoroquinolones.
D. tetracyclines.

Ans: A

27. Nystatin is the recommended drug for

A. infections of the intestine due to gram-negative bacteria.
B. viral infections of the skin.
C. malaria and tuberculosis.
D. Candida albicans infections of the intestine or oral cavity.

Ans: D

28. Flucytosine, clotrimazole, and ketoconazole are all

A. drugs for treating leprosy.
B. modern sulfonamide drugs.
C. antifungal agents.
D. cell wall inhibitors.

Ans: C

29. Chloroquine, primaquine, and quinine are of value for the treatment of
A. urinary tract infections.
B. cases of malaria.
C. infections caused by bacteria of the intestinal tract.
D. fungal diseases.

Ans: B

30. Which of the following is not a type of chemotherapeutic agent used to treat viral
infections?
A. Agents which inhibit reverse transcriptase
B. Agents which inhibit proteases
C. Agents which are base analogs
D. Agents which interfere with ergosterol

Ans: D

31. The Kirby-Bauer test is useful for determining

A. the minimum inhibitory concentration of an antibiotic.
B. whether side effects will result from use of an antibiotic.
C. which antibiotic may be employed to treat an infection.
D. the origin of an antibiotic.

Ans: C
32. Which of the following factors contribute to the selection of antibiotic resistant
bacteria?
A. Using antibiotics when they are not needed
B. Failing to complete a course of treatment
C. Antibiotics given to livestock
D. All of the above.

Ans: D

True/False

33. True or false? Antibiotic abuse and misuse encourages the emergence of resistant
species of microorganisms.

Ans: True

34. True or false? After Fleming noticed the antibacterial effect of Penicillin he isolated
it and used it on several patients as World War II was beginning and was able to make it
available for therapy.

Ans: False
Response: After Fleming noticed the antibacterial effect of Penicillin he isolated it and
tried to use it unsuccessfully. Only later as World War II was beginning was it purified
and made available for therapy.

35. True or false? Sulfanilamide can interfere with the metabolism of bacteria because it
is so similar to the PABA.

Ans: True

36. True or false? Vancomycin interferes with aspects of folic acid metabolism in
bacteria that cause urinary tract infections.

Ans: False
Response: Sulfamethoxazole interferes with aspects of folic acid metabolism in bacteria
that cause urinary tract infections.

37. True or false? The antituberculosis drug isoniazid interferes with cell wall synthesis
in Mycobacterium by inhibiting production of sulfanilic acid.

Ans: False
Response: The antituberculosis drug isoniazid interferes with cell wall synthesis in
Mycobacterium by inhibiting production of mycolic acid.

38. True or false? The quinolones are synthetic drugs which block DNA synthesis and
are used to treat urinary tract infections, gonorrhea and chlamydia, and intestinal tract
infections.

Ans: True

39. True or false? Penicillinase-producing bacteria convert penicillin to penicilloic acid,

which has no effect on the bacterial cell wall.

Ans: True

40. True or false? Penicillin antibiotics are used primarily against gram-positive bacteria,
but in high concentrations they are also inhibitory to some gram-negative bacteria.

Ans: True

41. True or false? Both bacitracin and polymyxin B are synthesized by Bacillus species.
They are quite toxic internally and can cause kidney damage. Therefore, they generally
are restricted to topical use, such as on the skin.

Ans: True

42. True or false? Vancomycin has emerged as a key treatment in therapy for gram
positive organisms that are resistant to other antibiotics; it is often is referred to as the
“drug of last resort.”
Ans: True

43. True or false? All antibiotics and chemotherapeutic agents are produced by species of
Streptomyces.

Ans: False
Response: Not all antibiotics and chemotherapeutic agents are produced by species of
Streptomyces.

44. True or false? Aplastic anemia sometimes occurs as a serious side effect of
chloramphenicol therapy.

Ans: True

45. True or false? Most systemic fungal infections are treated with gentamicin, an
antifungal antibiotic that changes the permeability of the membranes of cells.

Ans: False
Response: Most systemic fungal infections are treated with amphotericin B, an antifungal
antibiotic that changes the permeability of the membranes of cells

46. True or false? Griseofulvin and nystatin are valuable drugs where resistance to
tetracycline drugs has developed in bacteria.

Ans: False
Response: Griseofulvin and nystatin are valuable drugs for fungal infections.

47. True or false? Quinine, chloroquine, and primaquine are all drugs used for the
treatment of malaria.

Ans: True
48. True or false? Artemisia annua (sweet wormwood) is used to treat multi-drug
resistant strains of P. falciparum. In red blood cells, the drug releases “free radicals” that
destroy the malarial parasites.

Ans: True

49. True or false? 40 percent of all the antibiotics produced in the United States are in
animal feeds to check disease and promote growth. By killing off less hardy bacteria,
chronic low doses of antibiotics create ideal growth environments for resistant strains that
can be transferred to humans.

Ans: True

Matching

Reference: List of modes of action

Match each antimicrobial agent with its mode of action.
A. Competitive inhibition
B. Inhibits RNA synthesis
C. Inhibits protein synthesis
D. Inhibits function of cell membrane
E. Inhibits cell wall synthesis
F. Affects protozoal metabolism
G. Interferes with mitosis

50. ___ Penicillin

Ans: E
Refer to: List of modes of action

51. ___ Sulfanilamide

Ans: A
Refer to: List of modes of action
52. ___ Erythromycin

Ans: C
Refer to: List of modes of action

53. ___ Chloramphenicol

Ans: C
Refer to: List of modes of action

54. ___ Rifampin

Ans: B
Refer to: List of modes of action

55. ___ Cephalosporin

Ans: E
Refer to: List of modes of action

56. ___ Polymyxin

Ans: D, E
Refer to: List of modes of action

57. ___ Griseofulvin

Ans: G, E
Refer to: List of modes of action

58. ___ Chloroquine

Ans: F, E
Refer to: List of modes of action

Essay

59. Explain why some microbes produce antibiotics in the environment.

Ans: Answers will vary.

Page: 772-773

60. Identify and describe each of the four major mechanisms used by bacteria to resist of
antibiotics.

Ans: Answers will vary.

Page: 794

61. Illustrate how antibiotic misuse and abuse can lead to the emergence of resistant
forms.

Ans: Answers will vary.

Page: 795-796

62. Identify three elements of the viral replication cycle that are targets of antiviral drugs
and describe how each may be interfered with by antiviral drugs.

Ans: Answers will vary.

Page: 784-785

63. Compare and contrast the tube dilution method and Kirby-Bauer method of
antibioticl susceptibility assays.

Ans: Answers will vary.

Page: 789-790
64. What are the four main strategies the CDC has proposed for the prevention of
microbial resistance? Explain each.

Ans: Answers will vary.

Page: 798-799

65. Assess the importance of the discoveries made by Ehrlich and Fleming to the
discovery and advancement of chemotherapeutic agents to fight disease.

Ans: Answers will vary.

Page: 769-770

66. Illustrate the mechanism of competitive inhibition by showing how it operates in

bacteria treated with sulfanilamide.

Ans: Answers will vary.

Page: 772

67. Discuss the penicillin antibiotics according to discovery, derivatives, mode of

activity, synthesis, and two major side effects.

Ans: Answers will vary.

Page: 776-777

68. Identify two semisynthetic penicillins and explain how they differ functionally from
Penicillin.

Ans: Answers will vary.

Page: 777

69. Identify two antibacterial agents that target each of the following bacterial structures
or activities:
Cell membrane
Folic acid synthesis
Cell wall synthesis
DNA replication
Translation

Ans: Answers will vary.

Page: 783

70. Discuss the reasons why there are so many more antimicrobial drugs to treat bacterial
infections than there are drugs to treat fungal, viral, or parasitics.

Ans: Answers will vary.

Page: 784-788

71. Explain what is meant by the acronym “MRSA”, and discuss its role as a public
health concern.

Ans: Answers will vary.

Page: 784-788

72. State two modes of action for antifungal drugs and state an example of each.

Ans: Answers will vary.

Page: 785-786

73. State two modes of action for antiprotozoal drugs and state an example of each.

Ans: Answers will vary.

Page: 786-787