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Full Microbiology Fundamentals A Clinical Approach 1St Edition Cowan Test Bank Online PDF All Chapter
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Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
Chapter 10
Drugs, Microbes, Host: The Elements of Chemotherapy
1. Substances that are naturally produced by certain microorganisms that can inhibit or
destroy other microorganisms are called
A. antibiotics.
B. narrow-spectrum drugs.
C. semi-synthetic drugs.
D. synthetic drugs.
E. broad-spectrum drugs.
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.02 Identify the sources for most currently used antimicrobials.
Section: 10.01
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.08 Distinguish between broad-spectrum and narrow-spectrum antimicrobials, and explain the significance of the
distinction.
Section: 10.02
Topic: Antimicrobial Medications
10-1
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.02 Identify the sources for most currently used antimicrobials.
Section: 10.01
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Bloom's Level: 03. Apply
Learning Objective: 10.05 Explain the concept of selective toxicity.
Section: 10.02
Topic: Antimicrobial Medications
10-2
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.01 State the main goal of antimicrobial treatment.
Section: 10.01
Topic: Antimicrobial Medications
Topic: Infection and Disease
6. 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.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.01 State the main goal of antimicrobial treatment.
Section: 10.01
Topic: Antimicrobial Medications
10-3
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.06 List the five major targets of antimicrobial agents.
Section: 10.02
Topic: Antimicrobial Medications
Topic: Prokaryotes
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.05 Explain the concept of selective toxicity.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.06 List the five major targets of antimicrobial agents.
Section: 10.02
Topic: Antimicrobial Medications
10-4
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
10. Aminoglycosides
A. interfere with elongation of peptidoglycan.
B. 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.
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis.
Section: 10.02
Topic: Antimicrobial Medications
Topic: Prokaryotes
10-5
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
12. 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
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis.
Section: 10.02
Topic: Antimicrobial Medications
13. Sulfonamides
A. interfere with elongation of peptidoglycan.
B. 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.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Section: 10.02
Topic: Antimicrobial Medications
10-6
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
15. Sulfonamides are analogs of PABA and, as a result, they inhibit _____ synthesis.
A. protein
B. DNA
C. RNA
D. folic acid
E. phospholipid
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 02. Understand
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Section: 10.02
Topic: Antimicrobial Medications
16. 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.
E. None of the choices is correct.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.09 Identify the microbes against which the various penicillins are effective.
Section: 10.02
Topic: Antimicrobial Medications
10-7
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.10 Explain the significance of beta-lactamases.
Section: 10.02
Topic: Antimicrobial Medications
19. 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
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.20 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section: 10.03
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.10 Explain the significance of beta-lactamases.
Section: 10.02
Topic: Antimicrobial Medications
10-8
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.06 List the five major targets of antimicrobial agents.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.06 List the five major targets of antimicrobial agents.
Section: 10.02
Topic: Antimicrobial Medications
23. 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
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.09 Identify the microbes against which the various penicillins are effective.
Section: 10.02
Topic: Antimicrobial Medications
10-9
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.10 Explain the significance of beta-lactamases.
Section: 10.02
Topic: Antimicrobial Medications
25. All _____ consist of a thiazolidine ring, a beta-lactam ring, and an R group.
A. penicillins
B. tetracyclins
C. macrolides
D. cephalosporins
E. aminoglycosides
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.09 Identify the microbes against which the various penicillins are effective.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.02 Identify the sources for most currently used antimicrobials.
Section: 10.01
Topic: Antimicrobial Medications
10-10
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.08 Distinguish between broad-spectrum and narrow-spectrum antimicrobials, and explain the significance of the
distinction.
Section: 10.02
Topic: Antimicrobial Medications
10-11
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis.
Section: 10.02
Topic: Antimicrobial Medications
31. The drug that can cause injury to red blood cells and white blood cells is
A. chloramphenicol.
B. clindamycin.
C. ciprofloxacin.
D. bacitracin.
E. gentamicin.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.04
Topic: Antimicrobial Medications
32. Which of the following antibacterial drug groups does not target protein synthesis?
A. clindamycin
B. erythromycin
C. aminoglycosides
D. sulfonamides
E. tetracycline
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis.
Section: 10.02
Topic: Antimicrobial Medications
10-12
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.14 Name a drug that targets the cellular membrane.
Section: 10.02
Topic: Antimicrobial Medications
35. The antifungal drug that can be used to treat serious systemic fungal infections is
A. nystatin.
B. griseofulvin.
C. amphotericin B.
D. sulfa drugs.
E. metronidazole.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.16 Name the four main categories of antifungal agents.
Section: 10.02
Topic: Antimicrobial Medications
10-13
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.16 Name the four main categories of antifungal agents.
Section: 10.02
Topic: Antimicrobial Medications
37. Which of the following is not a drug group used to treat fungal infections?
A. quinolones
B. macrolide polyene antibiotics
C. griseofulvins
D. synthetic azoles
E. flucytosines
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.16 Name the four main categories of antifungal agents.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.17 Explain why antiprotozoal and antihelminthic drugs are likely to be more toxic than antibacterial drugs.
Section: 10.02
Topic: Antimicrobial Medications
10-14
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.17 Explain why antiprotozoal and antihelminthic drugs are likely to be more toxic than antibacterial drugs.
Section: 10.02
Topic: Antimicrobial Medications
40. There are fewer antifungal, anti-protozoan, and anti-helminth 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.
D. are parasites found inside human cells.
E. because their cells have fewer target sites compared to bacteria.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.17 Explain why antiprotozoal and antihelminthic drugs are likely to be more toxic than antibacterial drugs.
Section: 10.02
Topic: Antimicrobial Medications
Topic: Eukaryotes
Topic: Prokaryotes
10-15
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.17 Explain why antiprotozoal and antihelminthic drugs are likely to be more toxic than antibacterial drugs.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.18 List the three major targets of action of antiviral drugs.
Section: 10.02
Topic: Antimicrobial Medications
Topic: Viruses
10-16
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
43. 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.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.18 List the three major targets of action of antiviral drugs.
Section: 10.02
Topic: Antimicrobial Medications
Topic: Viruses
44. Antiviral drugs that target reverse transcriptase would be used to treat
A. influenza A virus.
B. HIV.
C. herpes zoster virus.
D. respiratory syncytial virus.
E. hepatitis C virus.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 02. Understand
Learning Objective: 10.18 List the three major targets of action of antiviral drugs.
Section: 10.02
Topic: Antimicrobial Medications
Topic: Viruses
10-17
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.18 List the three major targets of action of antiviral drugs.
Section: 10.02
Topic: Antimicrobial Medications
Topic: Viruses
46. Which of the following block HIV binding to host cell receptors?
A. AZT
B. acyclovir
C. nevirapine
D. fuzeon
E. amantidine
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.18 List the three major targets of action of antiviral drugs.
Section: 10.02
Topic: Antimicrobial Medications
Topic: Viruses
10-18
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.20 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section: 10.03
Topic: Antimicrobial Medications
Topic: Prokaryotes
48. 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.
D. alteration of drug receptors on cell targets.
E. All of the choices are correct.
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.20 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section: 10.03
Topic: Antimicrobial Medications
Topic: Prokaryotes
10-19
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.19 Discuss two possible ways that microbes acquire antimicrobial resistance.
Section: 10.03
Topic: Antimicrobial Medications
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.20 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section: 10.03
Topic: Antimicrobial Medications
51. Each of the following is a mechanism for drug resistance transfer between
microorganisms except
A. transposons.
B. R-plasmids.
C. conjugation.
D. mutation.
E. All of the choices provide for transfer of drug resistance.
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.19 Discuss two possible ways that microbes acquire antimicrobial resistance.
Section: 10.03
Topic: Antimicrobial Medications
10-20
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 01.03 Human impact on the environment influences the evolution of microorganisms (e.g, emerging diseases and the
selection of antibiotic resistance).
ASM Topic: Module 01 Evolution
Bloom's Level: 01. Remember
Learning Objective: 10.19 Discuss two possible ways that microbes acquire antimicrobial resistance.
Section: 10.03
Topic: Antimicrobial Medications
53. Nutrients that encourage the growth of beneficial microbes in the intestines are
known as
A. prebiotics.
B. probiotics.
C. lantibiotics.
D. phytobiotics.
E. riboswitches.
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.21 Discuss at least two novel antimicrobial strategies that are under investigation.
Section: 10.03
Topic: Antimicrobial Medications
Topic: Prokaryotes
10-21
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
54. 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.
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 05 Systems
Bloom's Level: 02. Understand
Learning Objective: 10.21 Discuss at least two novel antimicrobial strategies that are under investigation.
Section: 10.03
Topic: Antimicrobial Medications
Topic: Prokaryotes
55. Broad-spectrum drugs that disrupt the body's normal flora often cause
A. nephrotoxicity.
B. superinfections.
C. allergic reactions.
D. drug toxicity.
E. All of the choices are correct.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.23 Explain what a superinfection is and how it occurs.
Section: 10.04
Topic: Antimicrobial Medications
10-22
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
56. Side effects that occur in patient's tissues while on antimicrobial drugs include all
the following except
A. development of resistance to the drug.
B. hepatotoxicity.
C. nephrotoxicity.
D. diarrhea.
E. deafness.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.04
Topic: Antimicrobial Medications
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.23 Explain what a superinfection is and how it occurs.
Section: 10.04
Topic: Antimicrobial Medications
10-23
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
58. The _____ are drugs that deposit in developing teeth and cause a permanent brown
discoloration.
A. streptomycins
B. cephalosporins
C. macrolides
D. tetracyclins
E. penicillins
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.04
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Section: 10.01
Topic: Antimicrobial Medications
10-24
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 07.01b Ability to apply the process of science: Analyze and interpret results from a variety of microbiological methods, and
apply these methods to analogous situations.
ASM Topic: Module 07 Scientific Thinking
Bloom's Level: 01. Remember
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Section: 10.01
Topic: Antimicrobial Medications
61. 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.
B. antibiogram.
C. E-test.
D. MIC.
E. therapeutic index (TI).
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Section: 10.01
Topic: Antimicrobial Medications
10-25
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 07.01b Ability to apply the process of science: Analyze and interpret results from a variety of microbiological methods, and
apply these methods to analogous situations.
ASM Topic: Module 07 Scientific Thinking
Bloom's Level: 01. Remember
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Section: 10.01
Topic: Antimicrobial Medications
ASM Objective: 07.01b Ability to apply the process of science: Analyze and interpret results from a variety of microbiological methods, and
apply these methods to analogous situations.
ASM Topic: Module 07 Scientific Thinking
Bloom's Level: 01. Remember
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Section: 10.01
Topic: Antimicrobial Medications
10-26
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
64. Which two antibiotics affect the DNA and RNA of bacteria?
A. tetracycline and amphotericin B
B. trimethoprim and sulfonamides
C. Rifampin and quinolones
D. tetracycline and bacitracin
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.06 List the five major targets of antimicrobial agents.
Section: 10.02
Topic: Antimicrobial Medications
65. Antimicrobial drugs that inhibit folic acid synthesis work with no side effects
because mammals must get folic acid from their diet.
TRUE
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Bloom's Level: 01. Remember
Learning Objective: 10.05 Explain the concept of selective toxicity.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.02 Identify the sources for most currently used antimicrobials.
Section: 10.01
Topic: Antimicrobial Medications
10-27
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.09 Identify the microbes against which the various penicillins are effective.
Section: 10.03
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Section: 10.02
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.13 Identify one example of a fluoroquinolone.
Section: 10.02
Topic: Antimicrobial Medications
70. Resistance factor plasmids are transferred to other bacterial cells during
transformation, transduction, and conjugation.
TRUE
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.19 Discuss two possible ways that microbes acquire antimicrobial resistance.
Section: 10.03
Topic: Antimicrobial Medications
10-28
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
71. Bacteria can have a natural resistance to a drug that it has never been exposed to.
TRUE
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.19 Discuss two possible ways that microbes acquire antimicrobial resistance.
Section: 10.03
Topic: Antimicrobial Medications
72. When a patient's immune system reacts adversely to a drug, this serious side effect
is called a superinfection.
FALSE
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.23 Explain what a superinfection is and how it occurs.
Section: 10.04
Topic: Antimicrobial Medications
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.04
Topic: Antimicrobial Medications
74. The MIC is the smallest concentration of an antimicrobial required to inhibit the
growth of the microbe.
TRUE
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Section: 10.01
Topic: Antimicrobial Medications
10-29
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
75. The Kirby-Bauer test uses an agar surface, seeded with the test bacterium, to
which small discs containing a specific concentration of several drugs are placed on
the surface.
TRUE
ASM Objective: 08.05 Use appropriate microbiological and molecular lab equipment.
ASM Topic: Module 08 Microbiology Skills
Bloom's Level: 01. Remember
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Section: 10.01
Topic: Antimicrobial Medications
76. An antimicrobial with a low therapeutic index is a safer choice compared to a drug
with a high therapeutic index.
FALSE
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Section: 10.01
Topic: Antimicrobial Medications
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Bloom's Level: 01. Remember
Learning Objective: 10.08 Distinguish between broad-spectrum and narrow-spectrum antimicrobials, and explain the significance of the
distinction.
Section: 10.02
Topic: Antimicrobial Medications
10-30
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
78. Newer, more expensive antimicrobials are always better to use than cheaper, older
drugs.
FALSE
ASM Objective: 01.03 Human impact on the environment influences the evolution of microorganisms (e.g, emerging diseases and the
selection of antibiotic resistance).
ASM Topic: Module 01 Evolution
Bloom's Level: 01. Remember
Learning Objective: 10.06 List the five major targets of antimicrobial agents.
Section: 10.02
Topic: Antimicrobial Medications
79. Indwelling catheter biofilm infections are more resistant to antibiotics than non-
biofilm infections.
TRUE
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Bloom's Level: 01. Remember
Learning Objective: 10.15 Discuss how treatment of biofilm infections differs from that of nonbiofilm infections.
Section: 10.02
Topic: Antimicrobial Medications
80. Drug toxicity occurs when an antimicrobial drug acts as antigen and stimulates an
allergic response.
FALSE
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 01. Remember
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.04
Topic: Antimicrobial Medications
10-31
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
NCLEX Prep - Test Bank Question: Please read the clinical scenario, and then
answer the questions that follow to become familiar with the traditional NCLEX
question format.
A 76-year-old male visits his primary care physician with complaints of burning with
urination and a frequent urge to void. As the RN, you aid the patient in collecting a
urine specimen to be sent for analysis. While awaiting the final results of drug
susceptibility testing in the lab, the patient is prescribed oral sulfasoxazole.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.01
Section: 10.02
Section: 10.04
Topic: Antimicrobial Medications
81. In the lab, the urine specimen is spread on an agar plate with antibiotic discs
placed to determine antimicrobial susceptibility. Following incubation, the clear area
around each disc is measured. What term describes the observed area of antimicrobial
action around each disc?
A. zone of inhibition
B. zone of susceptibility
C. zone of resistance
D. antibiogram
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.01
Section: 10.02
Topic: Antimicrobial Medications
10-32
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
82. You provide education to the patient regarding sulfasoxazole, a sulfonamide that
targets folic acid synthesis. The synthesis of which of the following products is
affected by inhibition of folate metabolism?
A. DNA
B. RNA
C. DNA and RNA
D. DNA, RNA, and amino acids
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.01
Section: 10.02
Section: 10.04
Topic: Antimicrobial Medications
83. Which of the following reactions by the patient would demonstrate an allergic
response?
A. anaphylaxis
B. rash
C. difficulty breathing
D. Anaphylaxis, rash development, and difficulty breathing could all indicate allergic
response in a patient.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.01
Section: 10.02
Section: 10.04
Topic: Antimicrobial Medications
10-33
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
84. The in vitro susceptibility of the pathogen is established, and the patient is
maintained on sulfasoxazole. If no in vivo effect of the drug is observed by the patient
following the first 7 days of antibiotics, what is the most appropriate action by the
medical team?
A. increase the dose of sulfasoxazole
B. discontinue antibiotic therapy
C. discontinue sulfasoxazole and initiate a new antibiotic
D. initiate antiviral therapy
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 03 Metabolic Pathways
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.01
Section: 10.02
Section: 10.04
Topic: Antimicrobial Medications
NCLEX Prep - Test Bank Question: Please read the clinical scenario, and then
answer the questions that follow to become familiar with the traditional NCLEX
question format.
A 12-year-old male is admitted to the pediatric unit due to persistent upper respiratory
symptoms and respiratory distress. The patient has a history of developmental delay,
chronic lung disease, and frequent respiratory infections. Upon assessment, as the RN,
you note the patient to have a fever, moderate respiratory rate, productive cough, and
large amount of nasal secretions. Upon report from the patient’s mother, the patient
has been on a 3-week course of antibiotics with no improvement in symptoms. Upon
further work-up, the patient is diagnosed with bacterial pneumonia and methicillin-
resistant Staphylococcus aureus (MRSA) superinfection.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.23 Explain what a superinfection is and how it occurs.
Section: 10.04
Topic: Antimicrobial Medications
10-34
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
85. You provide education to the patient and his mother regarding the diagnosis.
Which of the following statements, by the mother, demonstrates an understanding of
the teaching?
A. "My son has an extremely resistant form of MRSA causing his prolonged illness."
B. "My son developed simultaneous bacterial infections."
C. "My son developed a MRSA superinfection, following suppression of normal
resident species in his lungs due to his initial infection."
D. "My son has pneumonia caused by a virus."
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.23 Explain what a superinfection is and how it occurs.
Section: 10.04
Topic: Antimicrobial Medications
86. Based upon the patient’s history, what is the most likely cause of the
superinfection?
A. poor hygiene
B. long-term antibiotic therapy
C. fecal-oral contamination
D. community-acquired MRSA
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.23 Explain what a superinfection is and how it occurs.
Section: 10.04
Topic: Antimicrobial Medications
10-35
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
87. The use of which of the following drugs results in the highest risk of
superinfection in a treated patient?
A. broad-spectrum antibiotics
B. narrow-spectrum antibiotics
C. topical antibiotics
D. antivirals
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.23 Explain what a superinfection is and how it occurs.
Section: 10.04
Topic: Antimicrobial Medications
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.23 Explain what a superinfection is and how it occurs.
Section: 10.04
Topic: Antimicrobial Medications
10-36
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
NCLEX Prep - Test Bank Question: Please read the clinical scenario, and then
answer the questions that follow to become familiar with the traditional NCLEX
question format.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.21 Discuss at least two novel antimicrobial strategies that are under investigation.
Section: 10.03
Topic: Antimicrobial Medications
89. Following the teaching to patients and families, you assess understanding of the
teaching prior to obtaining consent. All of the following are accurate statements by a
patient regarding probiotics, except probiotics
A. are live microorganisms.
B. are nutrients to encourage microbe growth.
C. augment the microbes in the intestine.
D. can replace microbes killed during antibiotic therapy.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.21 Discuss at least two novel antimicrobial strategies that are under investigation.
Section: 10.03
Topic: Antimicrobial Medications
10-37
Chapter 10 - Drugs, Microbes, Host: The Elements of Chemotherapy
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.21 Discuss at least two novel antimicrobial strategies that are under investigation.
Section: 10.03
Topic: Antimicrobial Medications
91. You indicate to the patient that research has demonstrated that probiotics may also
be useful in the management of allergies caused by
A. animal dander.
B. pollen.
C. food.
D. detergents.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Bloom's Level: 03. Apply
Learning Objective: 10.21 Discuss at least two novel antimicrobial strategies that are under investigation.
Section: 10.03
Topic: Antimicrobial Medications
10-38
Another random document with
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„Nee, vergeven.… ten minste als je daaronder verstaat: doen alsof
er niets gebeurd is, en verder weer gewoon doorleven.…”
„O, zoo.”
„Daarom vind ik de moraal van „la Petite Paroisse” van Daudet ook
misselijk.”
„Als een vrij geborneerd, dom wezen. Maar,” hervatte Van Thiemen,
„we hebben nog niet gelet op een andere omstandigheid, die ’t
verschil in schuld bij man en vrouw zoo enorm groot maakt. En die
omstandigheid zal blijven zoolang we het patriarchaat in ons
familieleven erkennen. De tijd dat de moeder ’t hoofd van ’t gezin
wordt zal wel nooit komen. Dat zoo iets niet rijmbaar is met hooge
beschaving bewijst wel het feit dat nog maar bij zeer enkele volken
het matriarchaat voorkomt. Bij de d i e r e n is ’t matriarchaat
algemeen! Tsh!”
Hij keek op zijn horloge: „Half twaalf! Wat dunkt je, blijf je
koffiedrinken? Dan kunnen we straks op ons gemak verder praten.”
De tafel was keurig van servies, kristal en spijzen. Ook in dit opzicht
was de gastheer epicurist en man van smaak. Hij rekende zich niet
tot hen die eten en drinken onder de bijzaken in ’t leven brengen: hij
kwam er rond voor uit dat een goede maaltijd zijn waarde heeft, en
dat hij er gaarne meer tijd aan besteedde dan de meeste andere
harde werkers. Een hard werker wàs hij er niet minder om. Volgens
hem kon geen frisch brein boven een verwaarloosde of met
onverschilligheid verzorgde maag zetelen. „Men leeft ook om te
eten” was een van zijn stelregels. Veel van ’t ongezonde in
denkuitingen, die hij hoorde of las, schreef hij toe aan minachting
voor maageischen, een hebbelijkheid die vooral bij „intellectueelen”
nog al eens voorkomt.
„Maar,” zei Larsen, terwijl hij zijn kopje droomerig neerzette, „we
moeten even terugkomen op die kwestie van zooeven.…”
„Best. Ga je gang.”
Van Thiemen had willen vragen hoe ’t kwam dat nu op eens die
onvereenigbaarheid van karakters tusschen Larsen en zijn vrouw
ontdekt was, na zooveel jaren van „best opschieten”; maar hij hield
zich in: als Larsen voor den dag woû komen met zijn reden, dan zou
hij ’t wel uit zichzelf doen.…
„In dat geval kan jij je laten beschuldigen van overspel,” zei Van
Thiemen kalmpjes, en keek zijn vriend leuk aan.
„Ja?”
„Tenzij anders bepaald. Bijvoorbeeld zou je vrouw kunnen vragen
het kind aan jou te laten.”
„Ik zeg je immers dat zoo iets onmogelijk is.…” viel Larsen kregelig
in. „Als die overspel-komedie niet gaat, schiet ik me voor m’n kop.…
Of.…”
’t Beeld der kleine Didi kwam hem vóor de geest in al zijn zoete
bekoring. De vader voelde een schok van zelfverwijt. Hij boog ’t
hoofd met vochtige oogen. [89]
Van Thiemen zag ’t: zijn mooie trekken namen een bizonder
sympathieke plooi aan. Hij besefte volkomen hoe daar in dat
vaderhart gestreden en geleden werd.
Larsen keek op, zwijgend vragend, met iets hulpeloos in zijn blik.
„Er blijft je dan nog éen ding: niet wettelijke, maar feitelijke
scheiding.…”
„Zeg ’s, amice,” begon Van Thiemen op eens, na over veel anders
gesproken te hebben, „dat gaat zoo niet. We komen zoo geen stap
verder. Je komt hier om raad, en ’t lijkt wel of ik je aanraad
ervandoor te gaan als een roover.… Wil ik je ’s wat zeggen? Maar
dan niet boos worden, hoor.…”
„Nee.…”
„Kom, wees oprecht! Kom er maar voor uit. Dacht je dan dat ik niet
al lang begrepen had hoe de vork in de steel zit?”
„Zoo, nee.…” stamelde de ander ongemakkelijk.
„Ik vin’ dat je in een geval als ’t joue,” begon Van Thiemen weer,
„handelend moet optreden.… tegen je vrouw.”
Larsen zweeg.
„Natuurlijk, beste kerels als jij gelooven zoo iets nooit, als ze veel
van hun vrouw houen! En er zijn er die nog blinder zijn dan jij. De
buitenwereld ziet beter en merkt meer op.…”
„Och, larie! Jou rust en geluk gaan voor. Nog eens: je vrouw is niet
waard dat je haar zoo ontziet …”
„Och, Van Thiemen, je weet niet wat ’t is! Jij kent dat zoo niet.… Een
vrouw met wie je dertien jaar samen bent geweest is een deel van
jezelf geworden.… je eigen vleesch en bloed.… je eigen hart.…”
„Arme bl.…” mompelde Van Thiemen. „En toch.… je moet van haar
af. Die brief.… heb je die behoorlijk weggesloten?”
„Wel, m’n waarde, die vrouw van je is slim, slim genoeg om.… je de
bewijzen afhandig te maken.… Tsh!”
„Kom.”
„Nou, pas maar op. Maar ter zake. Jij produceert eenvoudig je
bewijs, en deelt haar mee wat je doen zult. Dan raad je haar in
gemoede toe te geven, en [93]eenvoudig niet te verschijnen. Dan
wordt zij bij verstek veroordeeld, en jij blijft vrij man.…”
„Vijf jaar.…”
„Je moet dat document bij mij deponeeren: hier is ’t veiliger. Dan kan
ik ’t ook ’s inzien.…”
„Och, zeg haar maar dat ik haar goeie raad zal geven.… in haar
eigen belang.…”
„Ik begrijp niet hoe jij zoo spreken kunt.…” viel Larsen ontwijkend in.
„Jij behoorde tot onze [95]intiemen, en scheen toch altijd sympathie
voor mijn vrouw te hebben.”
„Nee, ’t was geen sympathie.… Ik heb die wel vroeger voor haar
gehad. Ze was jou vrouw. Ik wist dat jij haar lief hadt.… en.…”
„O, kerel.…”
„Ja, dat was voor mij al veel. Later toen ik haar begon te doorzien.…
veranderde dat. Eindelijk had ik vrij wel zekerheid.… en toen.…”
„Ik kòn niet anders! Die zekerheid was m ij n zekerheid, niet die van
een jurist in mij, maar van de mensch, van een vriend ook.…”
„Ja, ik wist het al lang.… En, zooals ik zei: i k geloof meer dan eens,
en.… met verschillenden.…”
„Hm.”
„Jij, omdat je me toch niet gelooven zoudt. Niemand die een vrouw
waarlijk liefheeft—en dat deedt jij, dat wist ik—gelooft zoo iets maar
voetstoots. [96]En.… liefde gaat boven vriendschap. Wij hadden de
hevigste onaangenaamheden gekregen, en ’t had toch niets
gegeven. Je hadt mij afgezworen—en wat nog erger is—je hadt je
rust en daarmee je geluk verloren.…”
„Een schijngeluk!”
„Nou ja, alle geluk is schijn, verbeelding. Voelde jij je eergisteren—
laten we zeggen eergisteren—volkomen gelukkig, of soms niet?”
„Volkomen.…”
Haastig liep hij zijn gang door, de trap op. Hij wilde Paula spreken,
zoo spoedig mogelijk. Er moest een beslissing komen, hoe dan ook,
zoo mogelijk vandaag nog. Paula moest weten waar ’t op stond. Ja,
Van Thiemen’s raad was wel goed: hij zou haar zeggen vandaag
nog bij hem aan te gaan, om raad en inlichting. Dat was beter zoo
dan lange uitleggingen van hemzelf—hij deugde er niet voor,
trouwens; en ’t was hem zoo pijnlijk. Hij zou niet meer dan ’t
allernoodigste zeggen; haar naar zijn vriend verwijzen—die was te
vertrouwen, volkomen, die kende beide goed, die meende ’t goed
met beiden.… [98]
Nu ja, humaan wàs Van Thiemen, al.… had hij geen sympathie meer
voor haar. De oppervlakkige beleefdheid en aangename manieren
waarmee de jurist haar steeds bejegend had, zijn bizondere takt om
met vrouwen om te gaan, zijn innemend uiterlijk en oprechte
bewondering voor haar uiterlijke verschijning namen immers
voldoende de plaats in van die.… sympathie.…
Hij stiet de deur van ’t vertrek open, en trad binnen. Paula was er
niet. De piano stond open. Een muziekboek stond opengeslagen op
de lezenaar. Onwillekeurig wierp hij een blik op de noten: de
Washington post van d e S o u z a .… Dat had ze gisterenavond niet
gespeeld.
Een vreemde gewaarwording trilde door hem heen, deed hem zijn
wenkbrauwen fronsen.
Hij trad weer naar de deur en ging de trap op, onzeker waar hij heen
zou gaan. Misschien zou hij Paula boven vinden, in zijn
studeerkamer. Een naar vermoeden bekroop hem. Och, onzin! Waar
dacht hij aan?
Daar trof hem ’t geluid van zingen. Wie was dat? De meid? Nee,
onmogelijk.… ’t Kwam van boven, van de verdieping waar de
slaapkamers waren, en [99]’t was nu geen bedden-opmaken—anders
de geliefde zang-periode der „kamermeid”. Didi was naar school.
Pietje, de eene gedienstige, kwam net de trap op, uit de keuken op
weg naar boven, een paar badhanddoeken over de eene arm
geslagen.
In zijn verbeelding zag hij haar vóor zich, zooals hij haar dien avond
gezien had, nog kort geleden—nauw een week—frisscher en
begeerlijker dan ooit, de loshangende weelderige zwarte haren over
haar donkerroode k i m ó n o , ’t Japansche kleed, dat ze altijd droeg
als ze uit de badkamer kwam. Hij was haar toen gevolgd naar haar
slaapkamer … Een lichte huivering voer door zijn leden bij de
herinnering aan dat uur. Wat was hij verliefd geweest, en zij
verleidelijk, dartel, beroezender dan ooit!
Hij stond op met een ruk; en ’t was of hij iets van zich af wierp. Zijn
wenkbrauwen waren gefronst, zijn gelaat vertrokken—oud,
wonderoud voor zijn jaren—zijn eene vuist balde zich. Hij deed een
paar schreden. Daar viel zijn oog op Paula’s portret boven zijn
schrijftafel—als bruid. Hij wendde zich om.
Dan zette hij zich weer op de sofa en verzonk in dof gemijmer. [101]
Hij hoefde niet lang te wachten, veel korter dan hij gedacht had.
„Zoo, ben jij hier?” klonk het opeens aan de deur der studeerkamer.
Dadelijk trof hem haar toon. Er was iets kouds, iets gewild brutaals
in, dat hem, als geheel nieuw in haar, met verwondering vervulde.
„Je wil me altijd spreken tegenwoordig. Maar goed, deze keer wil i k
j o u ook wel ’s spreken.…”
„En,” ging ze voort, „je hebt er zeker heel wat afgepraat. Toe, vertel
’s.”
„Ik woû dat je niet zoo suf keek, zeg,” zei Paula weer. „Is er iets
bizonders aan me? Je hebt me zoo wel meer gezien, geloof ik.…”
„O zeker, best. Ik wil ook heel, heel ernstig zijn. Maar, komaan, vertel
’s op. Van Thiemen heeft gezegd dat je van me af moest zien te
komen, niet?”
„Paula, wat scheel je? Waarom sla je zoo’n onverschillige losse toon
aan?”
Larsen haalde de schouders op. Waarom zou hij ook dit maar niet
verdragen—als de zaak maar spoedig tot een eind kwam?
„Ja, en hij acht het wenschelijk dat jij ook ’s met hem spreekt.… of.…
hij wil ook wel hier komen, bij jou.…”
„Hoe kom je dáaraan?” Hij deed een schrede naar haar toe.
„Wel, uit je laadje. Zie ’t goed? Daar gaat het.” Meteen, met vlugge
vingertjes, verscheurde zij ’t document in kleine stukjes—rits, rits,