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micro final Flashcards

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1
Q

All of the following are characteristics or components of innate immunity except _____.
Toll-like receptors
nonspecific
mucociliary escalator
mechanical barriers
memory

A

memory

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2
Q

The cells of the epidermis contain _____, a waterproofing protein that provides strength to the outer layer of skin.

A

keratin

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3
Q

All of the following contain lysozyme except_____.
saliva
stomach acid
perspiration
tears
urine

A

stomach acid

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4
Q

All of the following are examples of granulocytes except _____.
B lymphocytes
mast cells
neutrophils
eosinophils
basophils

A

B lymphocytes

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5
Q

During parasitic infections and allergy, the number of circulating _____ increases significantly.

A

eosinophils

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5
Q

_____ differentiate into macrophages at sites of inflammation.

A

monocytes

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6
Q

Which of the following is a mismatched pair?
lung: alveolar macrophages
liver: Kupffer cells
epidermis: dendritic cells
microglial cells: spleen
blood: monocytes

A

microglial cells: spleen

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7
Q

Dendritic cells located in the skin are referred to as _____.

A

Langerhans cells

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8
Q

Which of the following is not a outcome of complement activation?
membrane attack complex
inflammation
histamine release
opsonization
iron depletion

A

iron depletion

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9
Q

Which of the following is not a trigger of vasodilation?
kinin
histamine
leukotriene
prostaglandin
leukocyte endogenous mediator

A

leukocyte endogenous mediator

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10
Q

The combination of complement proteins C5 to C9 is known as

A

the membrane attack complex

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11
Q

The classical pathway for activation of the complement cascade requires

A

antigen-antibody complexes

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12
Q

Which are the first to arrive at an infection site?

A

neutrophils

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13
Q

The characteristics of cytokines include all of the following except

A

phagocytic activity

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14
Q

Tears contain…
lysozyme
all of the answers are correct
lipocalin
none of the answers are correct
IgA

A

all

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15
Q

The function of the mucocilliary escalator is to

A

remove microorganisms from the upper respiratory tract

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16
Q

Non-specific defense is…
The bodies lack of resistance to infection
The body’s defenses against all pathogens
The body’s defense against a particular pathogen
None of the choices

A

The bodies defenses against all pathogens

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16
Q

Neutrophils attach to the blood capillary linings and move out of the blood and into tissues in a process known as

A

diapedesis

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16
Q

The innate response includes all of the following except
A. Phagocytosis
B. Inflammation
C. Production of antibody
D. Production of interferon
E. Activation of complement

A

C

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17
Q

Which of the following is not a mechanical barrier to
protect the skin and mucous membranes from infection?
A. Lysozyme
B. Tears
C. Layers of cells
D. Saliva
E. Gastric juice

A

A

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18
Q

The function of the mucociliary escalator is to
A. Kill microorganisms
B. Remove microorganisms from the upper respiratory
tract
C. Remove microorganisms from body cavities
D. Remove microorganisms from the lower respiratory
tract
E. All of the above

A

B

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19
Q

Tears contain
A. Lipocalin
B. Lysozyme
C. IgA
D. All of the above
E. None of the above

A

D

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20
Q

Perspiration inhibits bacteria because
A. It contains mucus
B. It contains IgA
C. It contains lysozyme
D. It flushes them away
E. Both C and D are correct

A

E

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21
Q

Toll-like receptors are used by the immune system to distinguish between

viruses and bacteria
self and nonself
alive and dead cells
toxins and nutrients
eukaryotic and prokaryotic cells

A

self and nonself

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22
Q

All of the following cells are involved in the innate
response except
A. Neutrophils
B. Eosinophils
C. Basophils
D. Monocytes
E. Lymphocytes

A

E

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23
Q

Neutrophils attach to the vascular linings and move out
of the blood and into the tissues in a process known as
A. Intravascular clotting
B. Selection
C. Diapedesis
D. Margination
E. None of the above

A

C

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24
Q

The primary phagocytes in the blood are
A. Basophils
B. Eosinophils
C. Lymphocytes
D. Monocytes
E. Neutrophils

A

E

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25
Q

Margination is the process in which white blood cells
A. Separate from red blood cells
B. Leave the blood vessels
C. Produce selectin
D. Slow down, stop, and attach to vessel walls
E. Speed up and attach to vessel walls

A

D

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26
Q

The most phagocytic white blood cells are
A. Neutrophils
B. Macrophages
C. Basophils
D. Monocytes
E. Lymphocytes

A

D

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27
Q

Macrophages located in the liver are called
A. Alveolar macrophages
B. Dendrites
C. Microglial cells
D. Kupffer cells
E. None of the above

A

D

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28
Q

Macrophages located in the central nervous system are
called
A. Alveolar macrophages
B. Dendritic macrophages
C. Microglial cells
D. Kupffer cells
E. None of the above

A

C

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29
Q

The characteristics of cytokines include all of the
following except
A. Regulation of inflammation response
B. Secretion from white blood cells
C. Reaction with specific receptors on target cells
D. Phagocytic activity
E. Having overlapping functions with other cytokines

A

D

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30
Q

Mediators released by mast cells include
A. Histamine
B. Serotonin
C. Cytokines
D. Proteases
E. All of the above

A

E

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31
Q

Dendritic cells found in the skin are called
A. Langerhans cells
B. Kupffer cells
C. Microglial cells
D. None of the above

A

A

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32
Q

Natural killer cells are
A. Restricted to immune surveillance of tumors
B. Part of the adaptive immune response
C. Involved in both surveillance of tumors and response to
pathogens
D. Restricted to destruction of pathogens

A

C

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33
Q

The sequence of phases in phagocytosis is
A. Ingestion, chemotaxis, adherence, digestion,
excretion
B. Digestion, adherence, chemotaxis, ingestion,
excretion
C. Chemotaxis, ingestion, adherence, digestion,
excretion
D. Chemotaxis, adherence, digestion, ingestion,
excretion
E. Chemotaxis, adherence, ingestion, digestion,
excretion

A

E

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34
Q

Phagolysosomes are formed during which phase of
phagocytosis?
A. Ingestion
B. Chemotaxis
C. Digestion
D. Adherence
E. Excretion

A

A

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35
Q

Redness, pain, heat, and swelling are hallmarks of
A. Phagocytosis
B. Vasoconstriction
C. An anti-inflammatory response
D. An inflammatory response
E. Intravascular clotting

A

D

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36
Q

The acute-phase response is seen only in
A. Recovering patients
B. Patients with no visible signs of infection
C. Acutely ill patients
D. Patients who are immune
E. Patients who are immunodeficient

A

C (sudden)

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37
Q

Fever is caused by chemicals known as
A. Pyretics
B. Intravascular clotting factors
C. Pyrogens
D. Pyrotechnics
E. None of the above

A

C

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38
Q

The complement system is activated by
A. The alternative pathway
B. The restriction pathway
C. The lectin-binding pathway
D. A and C
E. None of the above

A

D

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39
Q

The classical pathway for activation of the complement
system requires
A. A phagocytic response
B. Mannose-binding ligands
C. Factor D
D. Antigen–antibody complexes
E. Properdin

A

D

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40
Q

The combination of complement proteins C5 to C9 is
known as
A. The terminal complex
B. The defense complex
C. The membrane defense complex
D. The membrane attack complex
E. None of the above

A

D

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40
Q

The alternative pathway for activation of the
complement system is initiated at protein
A. C1
B. C2
C. C6
D. C3
E. C1–C2–C4 complex

A

D

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41
Q

the loss of which barrier makes burns victims most vulnerable to infection
skin
lysozyme
mucocilliary escalator
saliva

A

skin

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42
Q

Gamma interferon is produced by
A. T lymphocytes
B. T lymphocytes and NK cells
C. T lymphocytes, NK cells, and neutrophils
D. NK cells
E. NK cells and neutrophils

A

B

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43
Q

Which are the first cells to arrive at an infection site
A. Neutrophils
B. Macrophages
C. Basophils
D. Monocytes
E. Lymphocytes

A

neutrophils

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44
Q

Mannose binding protein is involved in complement activation in
A The classical pathway
B The alternative pathway
C Neither the classical or alternative pathway
D Both the classical and alternative pathway

A

C

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45
Q

Factors B and D are involved in complement activation in
A The classical pathway
B The alternative pathway
C Neither the classical or alternative pathway
D Both the classical and alternative pathway

A

B

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46
Q

C3 is involved in complement activation in
A The classical pathway
B The alternative pathway
C Neither the classical or alternative pathway
D Both the classical and alternative pathway

A

D

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47
Q

C2 and C4 is involved in complement activation in
A The classical pathway
B The alternative pathway
C Neither the classical or alternative pathway
D Both the classical and alternative pathway

A

A

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48
Q

Derived from myeloid stem cell is true for
A) neutrophils
B) basophils
C) both
D) neither

A

C

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49
Q

Directly involved in inflammation is true for
A) neutrophils
B) basophils
C) both
D) neither

A

B

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50
Q

Directly involved in phagocytosis is true for
A) neutrophils
B) basophils
C) both
D) neither

A

A

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51
Q

Directly involved in an adaptive immune response is true for
A) neutrophils
B) basophils
C) both
D) neither

A

D

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52
Q

Expression of antiviral protein genes is true for
A) only cells infected with virus
B) only cells not infected with virus
C) both cells infected and not infected with virus
D) none of the choices

A

B

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53
Q

Expression of interferon genes is true for
A) only cells infected with virus
B) only cells not infected with virus
C) both cells infected and not infected with virus
D) none of the choices

A

A

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54
Q

Contain interferon receptors is true for
A) only cells infected with virus
B) only cells not infected with virus
C) both cells infected and not infected with virus
D) none of the choices

A

C

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55
Q

The concentration of antibody in the serum generated in response to an infectious pathogen is called the _____.

A

titer

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56
Q

T-cell receptors have _____ of antigen-binding sites in comparison with B-cell receptors.

A

half the number

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56
Q

The B-cell antigen receptor is called a(n) _____.

A

immunoglobin

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57
Q

T lymphocytes mature in the _____.

A

thymus

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58
Q

Lymphocytes bearing antigen receptors that have a high degree of affinity for self antigen undergo _____ during B-cell development.

A

clonal deletion

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59
Q

Long-lived lymphocytes that respond more rapidly and effectively to an antigen encountered at a later time are known as _____ cells.

A

memory

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60
Q

The isotype of an antibody is determined by the _____.

A

constant region of the heavy chain

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61
Q

The location on the immunoglobulin that contributes to the unique antigen-binding site is referred to as the _____.

A

hypervariable region

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62
Q

All of the following are examples of chemical interactions used to facilitate the binding of antigen to antibody except_____.
hydrophobic forces
hydrogen bonds
electrostatic forces
peptide bonds

A

peptide bonds

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63
Q

Which of the following is nota function of the immunoglobulin constant region?
binds non-covalently to foreign antigens during infection
enhances opsonization of encapsulated bacteria
enables antibody transport out of the bloodstream to other anatomical locations
binds to specialized receptors on phagocytic cells
activates the classical pathway of complement

A

binds non-covalently to foreign antigens during infection

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64
Q

The movement of antibodies across epithelial barriers is called _____.

A

transcytosis

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65
Q

Babies who breast feed are afforded passive immune protection of their gastrointestinal tracts by the presence of _____ in colostrum.

A

IgA

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66
Q

When antigen binds to _____ on the surface of mast cells, inflammatory mediators are released, provoking vomiting, coughing, and sneezing.

A

IgE

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67
Q

_____ control antibody synthesis and isotype switching.

A

CD4 T cells

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67
Q

Circulating T lymphocytes that have never before encountered antigen to which they are specific are referred to as _____ cells.

A

naive T

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68
Q

The production of armed effector T cells is made possible by all of the following except _____.
mast cells
B cells
dendritic cells
macrophages

A

mast cells

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69
Q

All of the following are consequences of macrophage activation except _____.
the release of perforin
increased expression of cytokine receptors
the enhancement of phagosome to lysosome fusion
the production of oxygen free radicals
the induction of co-stimulatory molecule expression
elevated levels of class II MHC

A

the release of perforin

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70
Q

All of the following are characteristics of memory cells except _____.
they are generated after antigen encounter
they are maintained with the assistance of interleukins
they are formed in both B and T cell responses
they are more sensitive to re-stimulation and produce cytokines more effectively than naive cells
once generated they do not undergo cell division

A

once generated they do not undergo cell division

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71
Q

A(n) _____ is any foreign substance that provokes an immune response.

A

antigen

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71
Q

Chemicals included in vaccines to enhance their efficacy are called _____.

A

adjuvants

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72
Q

Superantigens

A

are recognized by T cells without being bound to MHC molecules

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72
Q

Vaccination, such as the MMR vaccine, is an example of

A

artifically acquired active immunity

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73
Q

Antibody molecules are bivalent because they have

A

two identical binding sites

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74
Q

Which of the following statements is not true of the B-cell receptor?
It is an immunoglobulin
Its stucture is Y-shaped
It can only recognize antigen bound to MHC molecules
It has constant and variable regions
It has two antigen binding sites

A

It can only recognize antigen bound to MHC molecules

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75
Q

The antibody response is part of the
A. Humoral response
B. The cellular response
C. The phagocytic response
D. The propagation response
E. None of the above

A

A

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76
Q

The amount of antibody to a specific pathogen found in
serum is referred to as the
A. Level of antibody
B. Antibody concentration
C. Antibody titer
D. Antibody minimum
E. Antibody maximum

A

C

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77
Q

Specificity is seen in each of the following except
A. The humoral response
B. The cellular response
C. The adaptive immune response
D. The innate response
E. Antigen–antibody complexes

A

D

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78
Q

The adaptive response relies upon distinguishing
A. Complete from incomplete antigens
B. Proteins from lipid antigens
C. Carbohydrates from protein antigens
D. Self from nonself antigens
E. Carbohydrates from lipids

A

C

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79
Q

Presentation of antigen is done by
A. Macrophages
B. Dendritic cells
C. Monocytes
D. Macrophages and dendritic cells
E. All of the above

A

D

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80
Q

Antibody is produced by
A. T cells
B. B cells
C. Plasma cells
D. Macrophages
E. Dendritic cells

A

C

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81
Q

T cells mature in the
A. Bone marrow
B. Liver
C. Lymph nodes
D. Thymus
E. Thyroid

A

D

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82
Q

B cells mature in the
A. Bone marrow
B. Liver
C. Lymph nodes
D. Thymus
E. Thyroid

A

A

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83
Q

There are two classes of T cells called
A. Antigen presenting and suppressor
B. Suppressor and killer
C. Cytotoxic and helper
D. Suppressor and cytotoxic
E. None of these pairs is correct

A

C

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84
Q

Clonal selection involves all of the following except
A. Rearrangement of gene segments
B. Specific antigen receptors
C. Reversible genetic rearrangement
D. Irreversible genetic rearrangement
E. Passage of genetic rearrangement to progeny

A

c

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84
Q

M cells are found in all of the following except
A. The intestine
B. The Peyer’s patches
C. The GALT
D. The MALT
E. Lymph nodes

A

E

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85
Q

A mature antigen-presenting cell
A. Is older than other cells
B. Has recognized antigens
C. Is able to phagocytose proteins
D. Has recognized and processed antigens
E. Is able to recognize antigens better than an imma
ture cell

A

d

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86
Q

After antigen presentation, T cells in the lymph nodes
A. Immediately leave the node
B. Become activated and leave the node
C. Become activated and remain in the node
D. Become inactivated and remain in the node
E. Become inactivated and leave the node

A

c

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87
Q

Anergy is
A. Lymphocyte activation by B cells
B. Lymphocyte inactivation by B cells
C. Lymphocyte inactivation due to increased
co-stimulatory signals
D. Lymphocyte inactivation due to lack of
co-stimulatory signals
E. Another name for apoptosis

A

d

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88
Q

The thymus
A. Grows larger when puberty is reached
B. Becomes populated with dendritic cells when
puberty is reached
C. Atrophies when puberty is reached
D. Becomes filled with activated T cells when puberty
is reached
E. None of the above

A

C

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89
Q

T cells are found in which part of the lymph node?
A. Stroma
B. Follicles
C. Paracortical areas
D. Capsular areas
E. Both A and B

A

C

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90
Q

Interaction of T cells with self-antigen–MHC causes
A. Maintenance of the T-cell population
B. Apoptosis of T cells
C. Activation of T cells
D. Inactivation of T cells
E. None of the above

A

B

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91
Q

which of these statements is not true of the B-cell receptor
A) its structure is Y-shaped
B) it has two antigen binding sites
C) it can only recognize antigen bound to MHC molecules
D) it has constant and variable regions
E) it is an immunoglobin

A

C

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92
Q

The T-cell receptor
A. Recognizes antigens
B. Recognizes antigens linked to MHC molecules
C. Recognizes MHC molecules only
D. Recognizes small pieces of antigen associated with
MHC molecules
E. None of the above

A

B

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93
Q

Class I MHC molecules present antigen to
A. Phagocytic cells
B. B cells
C. Helper T cells
D. Cytotoxic T cells
E. All of the above

A

D

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94
Q

Class II MHC molecules present antigen to
A. Phagocytic cells
B. B cells
C. Helper T cells
D. Cytotoxic T cells
E. All of the above

A

C

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94
Q

Superantigens are
A. Extra-large proteins
B. Recognized by T cells after being bound to MHC
molecules
C. Recognized by T cells without being bound to MHC
molecules
D. Presented by special antigen-presenting cells
E. Presented only by dendrites

A

C

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95
Q

Antibody molecules are bivalent because they have
A. One binding site
B. One attachment site for macrophages
C. Two identical binding sites
D. Two binding sites that recognize different antigens
E. Four identical binding sites

A

B

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96
Q

Antibody generally recognizes a specific
A. Receptor
B. T cell
C. Antigen
D. Epitope
E. B cell

A

C

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97
Q

The antibody molecule that is found in colostrum
(mother’s milk) is
A. IgG
B. IgA
C. IgD
D. IgE
E. All of the above

A

B

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98
Q

T cells that have not been presented with antigen are
referred to as
A. Armed
B. Effector
C. Cytotoxic
D. Primed
E. Naive

A

E

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99
Q

Immunological memory
A. Allows protection on re-exposure to a previous
pathogen
B. Is associated with both T and B cells
C. Is the responsibility of long-lived T cells
D. Is the responsibility of bone marrow B cells
E. All of the above

A

E

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100
Q

Vaccines were first administered by
A. Pasteur
B. Salk
C. Jenner
D. Sabin
E. None of the above

A

C

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101
Q

Which antibody is produced first
A) IgA
B) IgD
C) IgE
D) IgG
E) IgM

A

E

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102
Q

vaccination is an example of
A) naturally acquired passive immunity
B) naturally acquired active immunity
C) artificially acquired passive immunity
D) artificially acquired active immunity

A

D

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103
Q

Which of the following is a mismatched pair?
sterilization: destruction of all forms of microbes
pasteurization: heat without boiling to kill pathogens
bacteriocidal: kills bacteria
aseptic: pathogen-free environment
antisepsis: inanimate objects disinfected

A

antisepsis: inanimate objects disinfected

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104
Q

De-germing is best described as _____.

A

a mechanical process for removing microbes

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105
Q

Which of the following is not susceptible to the effects of surfactants?

A

non-enveloped viruses

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106
Q

Microbial death has occurred if _____.

A

reproductive capability is lost even when microbe is placed in optimal conditions

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106
Q

The microbial death rate associated with antimicrobial agents is _____.

A

logarithmic

107
Q

Of the following, the most effective method of nucleic acid disruption is _____.
freeze-drying
surfactants
filtration
radiation
pasteurization

A

radiation

108
Q

A _____ is a solution made by combining alcohol with another antimicrobial compound.

A

tincture

109
Q

Which of the following is used to destroy endospores in a liquid medium that will subsequently be used to culture bacteria?

A

pressurized steam

110
Q

Which of the following is a mismatched pair?
food preservation: hypotonic medium
non-ionizing radiation: ultraviolet rays
pressurized steam: autoclave
freeze-drying: lyophilization
pasteurization: flash method

A

food preservation: hypotonic medium

111
Q

The effectiveness of all chemical disinfectants increases with the following except
length of exposure
higher concentration
None; they all increase the effectiveness of all chemical disinfectants
increasing temperature

A

higher concentration

112
Q

Which of the following substances is the least effective antimicrobial agent?
soap
phenol
alcohol
iodine
hydrogen peroxide

A

soap

113
Q

Oxidizing agents target

A

metabolic pathways

114
Q

QUATS target

A

plasma membrane

115
Q

Which of the following can sterilize?
autoclaving
pasteurization
boiling
UV irradiation
freeze drying

A

autoclaving

116
Q

Which of the following best describes microbial death rate
A. All the cells in a culture die at once.
B. The cells in a population die at a constant rate.
C. All of the cells in a culture are never killed.
D. The pattern varies depending on the antimicrobial
agent.
E. The pattern varies depending on the species.

A

The cells in a population die at a constant rate.

117
Q

Bacterial death will result from damage to which of the following structures
A. Plasma membrane
B. Proteins
C. Nucleic acids
D. Cell wall
E. All of the above

A

E

118
Q

Sterilization involves
A. Removal of all microbes and endospores
B. Removal of all microbes but not endospores
C. Killing only pathogens
D. Bacteriostatic agents
E. All of the above

A

A

119
Q

Which of the following is a direct result of heat?
A. Breaking hydrogen bonds
B. Cell lysis
C. Denaturing enzymes
D. Breaking sulfhydryl bonds
E. All of the above

A

D

120
Q

Which of these factors affect the rate of bacterial cell
death
A. The number of organisms present
B. The time of exposure
C. The environment
D. Endospore formation
E. All of the above

A

E

120
Q

The bacteriocidal versus the bacteriostatic nature of
a disinfectant can be determined with which of the
following test methods?
A. The phenol coefficient
B. The disk method
C. The thermal death point
D. The use dilution method
E. The thermal death time

A

D

121
Q

The effectiveness of chemical disinfectants increases with
each of the following except
A. Length of exposure
B. Temperature
C. higher concentration
E. None of the above

A

C

122
Q

Which of the following substances is the least effective
antimicrobial agent?
A. Phenol
B. Cationic detergents
C. Soap
D. Alcohol
E. Iodine

A

C

123
Q

Which of the following are unaffected by alcohol?
A. Bacteria
B. Viruses
C. Fungi
D. Endospores
E. None of the above

A

D

124
Q

Oxidizing agents target
A. Cell membranes
B. Metabolic pathways
C. The cell wall
D. Protein synthesis
E. None of the above

A

B

125
Q

QUATS target
A. Metabolic pathways
B. The cell wall
C. The plasma membrane
D. Protein synthesis
E. Endospores

A

C

126
Q

Which one of the following is the best advertisement
for a disinfectant?
A. Kills Staphylococcus aureus
B. Kills lipophilic viruses
C. Kills E. coli
D. Kills Pseudomonas
E. All are equal

A

D

127
Q

All of the following are involved in the control of
microbial growth except
A. Disinfection
B. Antisepsis
C. Neutralization
D. Pasteurization
E. Sanitization

A

C

128
Q

All of the following are chemicals used in disinfection
except
A. Aldehydes
B. Ultraviolet irradiation
C. Phenolic compounds
D. Halogens
E. Surfactants

A

B

129
Q

Pasteurization kills
A. All microorganisms
B. Only endospores
C. Only pathogens
D. Gram-positive organisms preferentially
E. Gram-negative organisms preferentially

A

C

130
Q

Refrigeration at –20°C
A. Sterilizes food
B. Preserves food for a period of time
C. Causes bacterial cell death through changes in
osmotic pressure
D. Has no effect on microbial growth

A

B

131
Q

Which of the following can sterilize?
A. Pasteurization
B. Autoclaving
C. Refrigeration
D. Freezing
E. None of the above

A

B

132
Q

Compare pasteurization with sterilization. Which is the best option for killing endospores?
A) pasteurization
B) sterilization
C) both
D) neither

A

B

133
Q

Compare pasteurization with sterilization. Which is the best option for killing bacteria?
A) pasteurization
B) sterilization
C) both
D) neither

A

c

134
Q

Compare pasteurization with sterilization. Which option is a milder treatment?
A) pasteurization
B) sterilization
C) both
D) neither

A

a

134
Q

Compare pasteurization with sterilization. Which is the best option for destroying prions?
A) pasteurization
B) sterilization
C) both
D) neither

A

d

135
Q

compare ionizing with non-ionizing radiation. Which uses ultraviolet light?
A) Ionizing radiation
B) non-ionizing radiation
C) both
D) neither

A

b

136
Q

compare ionizing with non-ionizing radiation. Which uses gamma rays?
A) Ionizing radiation
B) non-ionizing radiation
C) both
D) neither

A

a

137
Q

compare ionizing with non-ionizing radiation. Which alters DNA?
A) Ionizing radiation
B) non-ionizing radiation
C) both
D) neither

A

C

138
Q

compare ionizing with non-ionizing radiation. Which uses X-rays?
A) Ionizing radiation
B) non-ionizing radiation
C) both
D) neither

A

A

139
Q

By incorporating antibiotics into animal feed, farmers _____.

A

increase the weight gain of their livestock

139
Q

Penicillin resistance in bacteria is conferred by the production of _____.

A

beta-lactamase

140
Q

Augmentin combines amoxicillin with _____ to overcome enzymatic resistance to the antibiotic by the microbe

A

potassium clavulanate

141
Q

The efficacy of penicillin is highest during the _____ phase of the bacterial life cycle.

A

log

141
Q

Which of the following antibiotics contains a double bond in the beta-lactam ring that protects against beta-lactamase cleavage?

A

carbapenems

142
Q

Disruption of DNA synthesis occurs if _____ is targeted by antibiotics.

A

bacterial topoisomerase

143
Q

A _____ is a antimicrobial compound that is activated enzymatically after its introduction into the body.

A

prodrug

144
Q

Which of the following is not a drug used for viral infections?
rimantadine
flucytosine
ganciclovir
3TC (lamivudine)
ritonavir

A

flucytosine

145
Q

All of the following target the 30S ribosomal subunit except ____.
spectinomycin
ampicillin
kanamycin
tetracycline

A

ampicillin

146
Q

All of the following target the 50S ribosomal subunit except _____.
azithromycin
chloramphenicol
clindamycin
vancomycin

A

vancomycin

147
Q

Which of the following is used in treating protozoan infections?
bacitracin
none of the answers are correct
polyenes
all of the answers are correct
griseofulvin

A

none

148
Q

All of the following are antifungal drugs except
griseofulvin
bacitracin
polyenes
azoles
flucytosine

A

bacitracin

149
Q

Acyclovir

A

is administered to patients as a prodrug

150
Q

All of the following target the bacterial ribosome except
tetracycline
vancomycin
erythromycin
streptomycin
chloramphenical

A

vancomycin

151
Q

A bacteriostatic antibiotic

A

inhibits bacterial growth but does not kill the organism

152
Q

Which of the following organisms would most probably be sensitive to natural penicillin?
Mycoplasma
penicillinase-producing Neisseria gonorrhea
Histoplasma
Penicillium
Streptococcus pyogenes

A

Streptococcus pyogenes

153
Q

Which of the following antimicrobial agents is recommended for use against fungal infections?
a cephalosporin
amphotericin B
a penicillin
polymyxin B
bacitracin

A

amphotericin B

154
Q

Which of these antibiotics has the fewest side effects?
amoxicillin
neomycin
tetracycline
chloramphenicol
streptomycin

A

amoxicillin

155
Q

Which of the following does not target the same component as the others?
vancomycin
aminoglycosides
cephalosporins
monbactams
carbapemens

A

aminoglycosides

156
Q

Which of the following drugs is not used primarily to treat tuberculosis?
sulfonamide
ethambutol
rifampin
None, all these drugs are used to treat TB
isoniazid

A

sulfonamide

157
Q

The first antibiotic discovered was
A. Streptomycin
B. Quinine
C. Sulfa drugs
D. Penicillin

A

penicillin

158
Q

Most of the available antimicrobial agents are effective
against
A. Viruses
B. Fungi
C. Bacteria
D. Protozoa
E. All of the above

A

bacteria

159
Q

Which of the following does not target the same bacterial component as the others?
Monobactam
Cephalosporin
Bacitracin
Streptomycin
Penicillin

A

Streptomycin

160
Q

Which of these antibiotics has the fewest side effects? Penicillin
chloramphenicol
tetracycline
erythromycin
streptomycin

A

Penicillin

161
Q

Which of the following methods of action would be
bacteriostatic?
A. Inhibition of cell wall synthesis
B. Inhibition of RNA synthesis
C. Competitive inhibition with folic acid synthesis
D. Injury to plasma membrane
E. None of the above

A

E

162
Q

Which of the following antimicrobial agents is
recommended for use against fungal infections?
A. Amphotericin B
B. Penicillin
C. Bacitracin
D. Cephalosporin
E. Polymyxin

A

A

162
Q

More than half of our antibiotics are
A. Produced by Fleming
B. Produced by bacteria
C. Produced by fungi
D. Synthesized in laboratories
E. None of the above

A

B

163
Q

Which of the following drugs is NOT used primarily to
treat tuberculosis?
A. Sulfonamide
B. Rifampin
C. Isoniazid
D. Ethambutol
E. None of the above

A

A

164
Q

The antimicrobial drugs with the broadest spectrum of
activity are
A. Aminoglycosides
B. Macrolides
C. Chloramphenicol
D. Lincomycin
E. Tetracyclines

A

A

164
Q

Which of the following organisms would most probably
be sensitive to natural penicillin?
A. Streptococcus pyogenes
B. Penicillium
C. Penicillinase-producing Neisseria gonorrhoeae
D. Mycoplasma

A

A

165
Q

Streptomyces bacteria produce all of the following
antibiotics except
A. Erythromycin
B. Nystatin
C. Kanamycin
D. Rifampin
E. Bacitracin

A

E

166
Q

A bacteriostatic antibiotic
A. Inhibits bacterial growth by killing the organism
B. Increases the electrical charge of the organism
C. Damages the bacterial plasma membrane
D. Inhibits bacterial growth but does not kill the
organism
E. None of the above

A

D

166
Q

Broad-spectrum antibiotics
A. React only with Gram-positive bacteria
B. React only with Gram-negative bacteria
C. React only with Pseudomonas
D. React with Gram-positive bacteria, Gram-negative
bacteria and Pseudomonas
E. React only with large bacteria

A

D

166
Q

The difference between penicillin and ampicillin is
A. The b-lactam ring
B. The type of carbohydrates associated with the drug
C. The side chains affixed to the core ring structure
D. All of the above

A

C

166
Q

b-Lactamase is
A. A ring structure seen in semi-synthetic penicillin
B. Found only on cephalosporin
C. A chemical that enhances the effect of antibiotics
D. An enzyme that cleaves the ring structure of
penicillin
E. None of the above

A

D

166
Q

Carbapenem antibiotics have
A. The same structure as penicillin
B. Different side chains from penicillin’s
C. The same ring structure as penicillin
D. A different ring structure from penicillin’s
E. Three rings in the core

A

d

166
Q

The antibiotic isoniazid is
A. Similar to ethambutol
B. Never used with ethambutol
C. Used with rifampin
D. Used with ethambutol and rifampin for the
treatment of tuberculosis
E. None of the above

A

D

166
Q

All of the following are targets for antibiotics except
A. The cell wall
B. Bacterial ribosomes
C. The glycocalyx
D. The plasma membrane of the bacteria
E. Nucleic acids

A

C

167
Q

Protein synthesis is
A. Not a target for antibiotics
B. Not a selectively toxic target
C. A selective target
D. A target of last resort for antibiotic therapy
E. Used only for viral infections

A

c

168
Q

All of the following target the ribosome except
A. Streptomycin
B. Tetracycline
C. Penicillin
D. Chloramphenicol
E. Erythromycin

A

C

169
Q

Sulfa drugs target
A. folate
B. The cell wall
C. The bacterial plasma membrane
D. Ribosomes
E. DNA

A

A

170
Q

Acyclovir
A. Is effective against herpes infections
B. Is selectively toxic
C. Blockades viral DNA replication
D. All of the above
E. Only A and C above

A

C

170
Q

Antiviral drugs
A. Are all selectively toxic
B. Only affect infected cells
C. Only affect free viral particles
D. Must eliminate all viral particles to be effective
E. Only effect uncoating of viral particles

A

D

171
Q

Which of the following is used for protozoan infections?
A. Griseofulvin
B. Bacitracin
C. Polyenes
D. All of the above
E. None of the above

A

D

171
Q

Which of the following antimicrobial peptides is
naturally produced by frogs?
A. Lantibiotics
B. Defensins
C. Marginins
D. Drosocin

A

B

172
Q

All of the following are antifungal drugs except
A. Polyenes
B. Bacitracin
C. Azoles
D. Griseofulvin
E. Flucytosine

A

B

173
Q

Which of the following tests gives the MBC?
A. The Kirby–Bauer test
B. The E test
C. The broth dilution test
D. B and C above
E. A above only

A

C

174
Q

Monobactam antibiotics have
A) different side chains from penicillin
B) the same ring structure as penicillin
C) A different ring structure to penicillin
D) no core structure

A

D

175
Q

T/F
The activity of penicillin is most effective during cell growth because penicillin prevents the cross-linking of the NAG and NAM units and thereby prevents the formation of an intact cell wall.

A

T

176
Q

T/F
The plasma membrane in bacteria is a prime target for antibiotics because any disruption of this membrane will destroy the bacteria’s ability to survive.

A

T

177
Q

T/F
Isoniazid is very effective against mycobacteria because it inhibits the synthesis of protein

A

F

178
Q

T/F
The synthetic forms of erythromycin known as azithromycin and clarithromycin have expanded spectra and are used for respiratory infections because they are more potent.

A

F

179
Q

T/F
Rifampin is used only in combination therapy because resistance develops rapidly if the antibiotic is used alone.

A

T

180
Q

Which of the following antibiotics destroys red blood cells as its mechanism of action?
A) azoles
B) Chloroquine
C) Flucytosine
D) Mebendazole

A

B

181
Q

Which of the following antibiotics inhibits the production of sterols as its mechanism of action?
A) azoles
B) Chloroquine
C) Flucytosine
D) Mebendazole

A

A

182
Q

Inhibition of microtubule formation is the mechanism of action for which of the following antibiotics?
A) azoles
B) Chloroquine
C) Flucytosine
D) Mebendazole

A

D

183
Q

Which of the following antibiotics interferes with nucleic acid synthesis as its mechanism of action?
A) azoles
B) Chloroquine
C) Flucytosine
D) Mebendazole

A

C

184
Q

_____ are locations in the bacterial genome where antibiotic resistance genes integrate and accumulate.

A

resistance islands

185
Q

Which of the following is not an example of an autoprotective mechanism used by microbes producing antibiotics?

A

producing antibody only during the log phase of growth

186
Q

Which of the following is not a mechanism for acquiring resistance to antibiotics?

A

increasing the growth rate to decrease inhibitory concentrations

187
Q

Potassium clavulanate is a(n) _____.

A

beta-lactamase inhibitor

188
Q

Which of the following is not a characteristic of an efflux pump?

A

Some are energy-independent.

189
Q

Resistance to antibiotics seen at the level of the ribosome is caused by

A

changes in the shape of the ribosome

190
Q

The best way to slow the development and higher levels of bacterial resistance is to

A

use antibiotics as sparingly and precisely as possible

190
Q

The useful life of antibiotics may be increased by

A

using combinations of antibiotics

191
Q

The adaptive immune system is a __________ response.

A

lymphocyte (B, T, and NK cells)

191
Q

Why is the innate immune response important?

A

A: Innate immunity mechanisms (Ch15) are immediately available, while the Adaptive immune response (Ch 16) has a delay of 7-10 days. Only the adaptive immune response can clear an infection. You need Innate immunity or you don’t survive long enough from the Adaptive immunity to kick in. With only Innate immunity, an infection would not be cleared and you would still succumb.

191
Q

Why is a complement regulation system a cascade?

A

A: Systems that need to be carefully regulated often use a cascade (not a simple on/off switch)

192
Q

3 ways to activate complement and 3 consequences

A

classical, alternative, and lectin-binding
cytosis, inflammation, and opsonization

193
Q

T cells are made in the ___ and mature in the ___.

A

bone marrow; thymus

194
Q

What is the humoral and cellular parts of the adaptive response?

A

Humoral- production of antibodies
Cellular- killing and regulation of infected cells

195
Q

What makes a good (nonself) antigen?

A

good antigens are proteins and large molecular weight polysaccharides (such as found in cells walls)

196
Q

Where do B and T cells originate from?

A

bone marrow

197
Q

What makes a bad (nonself) antigen?

A

poor antigens are lipids, nucleic acids (DNA and RNA) and small molecules (metabolites). The fact that small molecules are poor antigens that do not evoke an immune response is what makes the entire field of pharmacology possible. Most drugs are low molecular weight so as not to stimulate an immune response

198
Q

What does GALT, BALT, and MALT stand for?

A

gut-associated lymphoid tissue, bronchial associated lymphoid tissue, and mucosal-associated lymphoid tissue

199
Q

What is the first antibody to be made?

A

IgM

199
Q

What are Peyer’s patches in the GALT?

A
  • contain M cells
  • M cells are antigen-collecting cells
  • under M cells are germinal centers filled with B cells.
199
Q

What is MHC?

A

major histocompatibility complex; marker for what is self; two classe

199
Q

What is clonal selection?

A

It is both the concept that the lymphocyte response is selected from a diversity of cells with different receptors to antigen AND that selected lymphocyte undergoes division to create an entire population (or clones) of lymphocytes with that identical receptor

200
Q

Why have so many genes that are unique in MHC?

A

The MHC must undergo randomization in sexually reproducing hosts, such as humans to generate diversity. If all human hosts had the same MHC, a pathogen with that same molecule would be “invisible “ to the immune system. It would be presumed to be self and therefore would avoid the host immune response.
The MHC is different in all of us in the same way that combination locks all have different combinations.

201
Q

Why is breastfeeding for one year recommended?

A

There is NO substitute for the passive transfer of antibody in human breast milk to a nursing infant. Cow milk, goat milk, powdered formula may satisfy the nutritional needs , but do NOT provide immune protection. Breast-fed babies have fewer digestive and respiratory infections than bottle-fed infants. “Breast is Best” The gut microbiome in breast-fed infants benefit from pre-biotics in human beast milk.

202
Q

Define sterile

A

Absence of all living microorganisms including spores

203
Q

Define disinfectant

A

reduction in the # of potential pathogens; associated with inanimate objects

204
Q

Define antiseptics

A

destroying microbial life associated with human skin and tissue

205
Q

Define aseptic

A

an environment or procedure free from contamination

206
Q

define de-germing

A

the removal of microbes from skin surface by antiseptic and mechanical means

207
Q

define sanitization

A

used to reduce the number of pathogens to meet acceptable public health standards

208
Q

Define pasteurization

A

using heat to kill pathogens

209
Q

What defines microbial death?

A

permanent loss of reproductive capabilities

210
Q

What are the 4 principles of microbial killing?

A

1) Microbes are killed at a log rate
2) The more microbes you have to start, the longer it takes to achieve sterility
3) Numerous conditions affect rate of microbial killing
4) Microbes vary widely in their susceptibility to killing
Know this:
the most resistant forms are endospores and that the most resistant vegetative cell are the Mycobacterium (acid-fast ).
Gram negatives are more resistant than Gram positives
Naked viruses are more resistant than enveloped viruses

211
Q

What is the best disinfectant?

A

there is no ideal disinfectant

212
Q

for most chemical agents, _____ in concentration = increase in potency

A

increase (except for alcohol)

213
Q

The active ingredient in Clearasil is benzoyl peroxide. Why does it work so well against anaerobic bacteria?

A

the bacteria are obligate anaerobes without SOD, peroxidase and catalase (enzymes that detoxify oxygen), so oxidizing agents work well against them

214
Q

Soap is a poor at microbial killing, so why is it so useful for handwashing?

A

It works by solubilizing microbes and washing them down the drain

215
Q

Should you use 10% bleach or a QUAT disinfectant in a nursery school?

A

Not bleach, it would harm the children and put holes in their clothes. Quats are very nontoxic, so if they put a toy in their mouths, they will not be poisoned or harmed (but may taste terrible?)

215
Q

Coins are inherently safer than bills. Why?

A

Coins are alloys of metals that create ions that disrupt protein structure. Bills can get wet and soiled, even food stained, and hold plenty of food from microbes.

216
Q

Two types of heat and examples

A

Moist heat (boiling, autoclave)
Dry heat (hot air with low moisture like from ovens)

216
Q

The bacterial cell wall peptidoglycan is assembled by enzymes _______ of the bacterial plasma membrane

A

outside

216
Q

What are PCPs?

A

Penicillin-binding proteins; bacterial enzymes that synthesize peptidoglycan

216
Q

Organisms that produce _________ are resistant to penicillin.

A

Beta-lactamase; example of antibiotic resistance mechanism

217
Q

Gram-______ (such as mycoplasma) bacteria have less peptidoglycan and are less sensitive to ________.

A

negative; penicillin

218
Q

What sub-structure does a penicillin and a cephalosporin have in common?

A

beta-lactam ring

218
Q

What do you do if a bacteria is resistant to all antibiotics?

A

Tough situation. These days they may try old, toxic antibiotics that are little used. The calculation is the toxic side effects may be less risky than dying from the infection.

219
Q

Neosporin contains _____, ____, and _____. Why?

A

Bacitracin (cell wall synthesis inhibitor)
Polymyxin (disrupts plasma membrane)
Neomycin (an aminoglycoside inhibitor of bacterial protein synthesis)
Using all 3 makes it very unlikely that bacteria will be resistant to all 3

219
Q

“inhibition of bacterial protein synthesis” has _____ different mechanisms

A

many

219
Q

What is synergy?

A

the holy grail of pharmacology: it multiplies rather than adds the effects of two drugs. Lower doses can be used to reduce toxicity to host , and the synergy is more effective that each drug alone.

219
Q

What is the grandaddy of antiviral drugs?

A

acyclovir

220
Q

The problem with treating fungi, protozoans, and helminths is that they are ___________.

A

eukaryotic, like human cells, so they’re harder to target with selective toxicity

221
Q

The golden age of antibiotic discovery is…

A

well behind us

221
Q

Is the patient resistant to the antibiotics that don’t work on them?

A

No, the bacteria inside them is resistant.

222
Q

Why is microbial resistance to a drug inevitable?

A

mutation happens, and evolution via artificial selection

222
Q

Has there ever been a drug that has not induced resistance in bacteria?

A

no, they all have

223
Q

How can you resist the pt. as a “customer” demanding antibiotics?

A

Medical providers are acting unethically if they prescribe worthless or harmful treatments when the patient “customer” demands it. The customer is not always right in the medical setting

223
Q

The ______ of antibiotics has led to widespread resistance.

A

over-prescribing

224
Q

All of the following are involved in the spread of
antibiotic resistance except
A. Travel
B. Overuse of antibiotics
C. Specific prescriptions for antibiotics
D. Improper use of antibiotics
E. Immunocompromised population

A

E

224
Q

Resistance to antibiotics is facilitated by which of the
following?
A. The antibody response
B. Host immunity
C. Frequency of use
D. The inflammatory response

A

C

225
Q

All of the following are mechanisms of resistance except
A. Activation of the antibiotic
B. Efflux pumping
C. Modification of the target structure
D. Inactivation of the antibiotic
E. None of the above

A

A

226
Q

The second most often used mechanism in
development of antibiotic resistance is
A. Target modification
B. Efflux pumping
C. Destruction of the antibiotic
D. Enhancement of antibiotic activity

A

A

227
Q

MRSA stands for which of the following?
A. Microbial-resistant Streptococcus aureus
B. Microbial-resistant Staphylococcus aureus
C. Methicillin-reactive Staphylococcus aureus
D. Methicillin-resistant Staphylococcus aureus

A

C

227
Q

MRSA organisms are resistant to which of the
following?
A. Penicillin
B. Cephalosporins
C. Carbapenems
D. None of the above
E. All of the above

A

E

227
Q

Resistance to antibiotics seen at the level of the
ribosome is caused by
A. Efflux pumping
B. Destruction of anti-ribosomal antibiotics
C. Changes in the shape of the ribosome
D. None of the above

A

C

228
Q

Increased use of antibiotics can be attributed to the
following
A. An increasing number of large cities
B. Emerging infectious diseases
C. Increased levels of immunodeficiency diseases
D. All of the inappropriate prescription, food production, and increased numbers of immunodeficient people

A

D

229
Q

The best way to deal with antibiotic resistance is to use
A. More antibiotics
B. use antibiotics as sparingly and precisely as possible
C. Combinations of antibiotics
D. None of the above

A

B

229
Q

The useful life of antibiotics can be extended by
A. Increasing the doses
B. Using more broad-spectrum antibiotics
C. Using combinations of antibiotics
D. None of the above

A

C

230
Q

VRSA stands for which of the following?
A) very resistant Streptococcus aureus
B) Vancomycin-resistant Streptococcus aureus
C) Variably resistant Staphylococcus aureus
D)Vancomycin-resistant Staphylococcus aureus

A

D

231
Q

T/F
Active transport of penicillin out of the bacterial cell is required because the concentration of antibiotic is lower outside than inside the cell.

A

F

231
Q

T/F
Genes for antibiotic resistance are more of a problem on plasmids because they are expressed at a higher rate.

A

F

232
Q

T/F
Bacteria can resist the action of β-lactam antibiotics by producing penicillin-binding proteins that do not bind penicillin.

A

T

233
Q

T/F
Potassium clavulanate augments the action of antibiotics by inhibiting the action of β-lactamase enzymes.

A

T

234
Q

T/F
Antibiotics promote superinfections because they make the bacteria normally present in the body stronger.

A

F

235
Q

T/F
Because antibiotics are not effective against viruses, taking antibiotics does not prevent or cure viral infections.

A

T

235
Q

T/F
The main cause of viral resistance to antiviral drugs is because they produce many proteins.

A

F

236
Q

T/F
E. coli has become a clinical problem because it has acquired antibiotic resistance and can cause dangerous systemic infections.

A

T

237
Q

T/F
Because metabolic pathways can parallel one another, circumvention of the blockade of an established pathway can occur.

A

T

238
Q

T/F
Mutants that are resistant to antibiotics are selected for in the presence of antibiotics.

A

T

239
Q

T/F
Antibiotic resistance does not spread easily in health care facilities.

A

F

240
Q

T/F
Handwashing is important to combat the spread of antibiotic resistance.

A

F

241
Q

T/F
The time taken for antibiotic resistance to develop can be lengthened by using more broad-spectrum antibiotics.

A

F

242
Q

T/F
Resistance to an antibiotic can only occur through destruction of the antibiotic.

A

Microbiology (6 decks)

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