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full file at http://testbankcorner.eu Microbiology with Diseases by Body System, 3e (Bauman) Chapter 10 Controlling Microbial Growth in the Body: Antimicrobial Drugs 10.1 Multiple-Choice Questions 1) A large percentage of antibiotics and semisynthetic drugs are produced by members of the genus A) Cephalosporium. B) Penicillium. C) Bacillus. D) Mycobacterium. E) Streptomyces. Answer: E Bloom's Rank: Comprehension Section: The History of Antimicrobial Agents 2) An antimicrobial that inhibits cell wall synthesis will result in which of the following? A) Cells become more susceptible to osmotic pressure. B) Cells cannot attach to their hosts. C) Ribosomes lose their function. D) The sterols in the cell wall become nonfunctional. E) The replication of cells, including cancer cells, slows down. Answer: A Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 3) Beta-lactam antibiotics have an effect on which of the following types of cells? A) animal cells B) bacterial cells C) fungal cells D) virus-infected cells E) both animal and fungal cells Answer: B Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 4) Which of the following is a primary advantage of semisynthetic drugs? A) They are less stable and consequently have fewer side effects. B) They work faster. C) They have a broader spectrum of action. D) They must be administered intravenously. E) They are not readily absorbed, so they persist longer. Answer: C Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action full file at http://testbankcorner.eu full file at http://testbankcorner.eu 5) Which of the following drugs specifically targets cell walls that contain arabinogalactan-mycolic acid? A) vancomycin B) penicillin C) methicillin D) isoniazid E) bacitracin Answer: D Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 6) Which of the following antibiotics disrupts cytoplasmic membrane function? A) streptomycin B) erythromycin C) tetracycline D) penicillin E) amphotericin B Answer: E Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 7) Which of the following is NOT a target of drugs that inhibit protein synthesis? A) the shape of the 30S ribosomal subunit B) interference with alanine-alanine bridges C) the enzymatic site of the 50S ribosomal subunit D) movement of the ribosome from one codon to the next E) the tRNA docking site Answer: B Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 8) Which scientist coined the term antibiotic? A) Fleming B) Domagk C) Kirby D) Ehrlich E) Waksman Answer: E Bloom's Rank: Knowledge Section: The History of Antimicrobial Agents full file at http://testbankcorner.eu full file at http://testbankcorner.eu 9) The most limited group of antimicrobial agents is the __________ drugs. A) antibacterial B) antifungal C) anthelmintic D) antiviral E) antiprotozoan Answer: D Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 10) Another term for the Kirby-Bauer test is the A) minimum inhibitory concentration test. B) E test. C) diffusion susceptibility test. D) minimum bactericidal concentration test. E) broth dilution test. Answer: C Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 11) Which of the following statements about the zone of inhibition is FALSE? A) It is measured as a diameter. B) The larger the zone, the more resistant the organism is. C) It is a clearing zone with no growth. D) It is a result of diffusion of the drug out of the paper disk. E) It is measured after incubation. Answer: B Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 12) Which of the following groups of drugs can become incorporated into the bones and teeth of a fetus? A) beta-lactams B) aminoglycosides C) quinolones D) tetracyclines E) sulfonamides Answer: D Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs full file at http://testbankcorner.eu full file at http://testbankcorner.eu 13) Which of the following can result when antibiotic therapy disrupts the normal microbiota? A) anaphylactic shock B) black hairy tongue C) pseudomembranous colitis D) thrush E) both pseudomembranous colitis and thrush Answer: E Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 14) Which of the following statements concerning development of antibiotic resistance is FALSE? A) It is often mediated by R-plasmids. B) Resistant cells are normally in the minority in a bacterial population. C) Resistant cells grow more efficiently and quickly than susceptible cells. D) New resistance genes can be gained through transformation, transduction, or conjugation. E) Resistance can occur through mutation of existing bacterial genes. Answer: C Bloom's Rank: Comprehension Section: Resistance to Antimicrobial Drugs 15) β-lactamase production is an example of which of the following types of resistance? A) alteration of the target of the drug B) inactivation of the drug C) change in the permeability of the drug D) overproduction of an enzyme in a key metabolic pathway E) removal of the drug via a pump Answer: B Bloom's Rank: Comprehension Section: Resistance to Antimicrobial Drugs 16) Probiotics A) involve microbial antagonism. B) are an alternative to the use of chemotherapy. C) involve the use of extracts from microorganisms. D) is a term for resistance to antibiotics. E) are an alternative to the use of chemotherapy involving microbial antagonism. Answer: E Bloom's Rank: Comprehension Section: Resistance to Antimicrobial Drugs full file at http://testbankcorner.eu full file at http://testbankcorner.eu 17) Most drugs that inhibit the synthesis of the cell wall act by A) preventing the cross-linkage of NAM subunits. B) blocking the secretion of cell wall molecules from the cytoplasm. C) preventing the formation of alanine-alanine bridges. D) disrupting the formation of the mycolic acid layer of the cell wall. E) preventing the formation of β-lactamases. Answer: A Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 18) Most broad-spectrum antibiotics act by A) inhibiting the synthesis of the cell wall. B) inhibiting protein synthesis. C) inhibiting nucleic acid synthesis. D) inhibiting metabolic pathways. E) disrupting the cytoplasmic membrane. Answer: B Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 19) Which of the following antifungals works by inhibiting ergosterol synthesis? A) fluconazole B) turbinafine C) amphotericin B D) nystatin E) both fluconazole and turbinafine Answer: E Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 20) Sulfonamides A) are antimetabolic drugs. B) were the first widely used antimicrobial drugs. C) indirectly inhibit the synthesis of nucleic acids. D) are no longer widely used. E) were the first widely used antimetabolic antimicrobial and indirectly inhibit nucleic acid synthesis. Answer: E Bloom's Rank: Comprehension Section: History of Antimicrobial Agents full file at http://testbankcorner.eu full file at http://testbankcorner.eu 21) Which of the following pathways is specifically inhibited by sulfonamides? A) the conversion of tetrahydrofolic acid to PABA B) the conversion of PABA to dihydrofolic acid C) the conversion of dihydrofolic acid to tetrahydrofolic acid D) the conversion of PABA to tetrahydrofolic acid E) the conversion of dihydrofolic acid to PABA Answer: B Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 22) Which of the following drugs inhibits nucleic acid synthesis specifically in prokaryotes? A) quinolones B) actinomycin C) rifampin D) tetracycline E) 5-fluorocytosine Answer: A Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 23) The cooperative activity of drugs such as beta-lactam antibiotics and clavulanic acid, a β-lactamase inhibitor, is known as A) cross resistance. B) antimetabolism. C) synergism. D) selective toxicity. E) chemotherapy. Answer: C Bloom's Rank: Knowledge Section: Resistance to Antimicrobial Drugs 24) Alterations in the structure of which of the following are an important aspect of Gram-negative bacterial resistance to antimicrobial drugs? A) plasmids B) porins C) mitochondria D) cytoplasmic membrane E) ribosomes Answer: B Bloom's Rank: Knowledge Section: Resistance to Antimicrobial Drugs full file at http://testbankcorner.eu full file at http://testbankcorner.eu 25) It is inappropriate to prescribe antibacterial agents to treat colds or flu because A) the microbes involved can develop resistance rapidly. B) these diseases are transmitted by endospores, which are hard to kill. C) these diseases exhibit cross resistance. D) these diseases are caused by viruses. E) these diseases can act synergistically with each other. Answer: D Bloom's Rank: Knowledge Section: Resistance to Antimicrobial Drugs 26) Who discovered the first widely available antibiotic? A) Domagk B) Ehrlich C) Fleming D) Waksman E) Ehrlich and Waksman Answer: A Bloom's Rank: Knowledge Section: The History of Antimicrobial Agents 27) Which of the following statements is true of selective toxicity? A) Selective toxicity takes advantage of structural differences between host and pathogen. B) To be effective, an antimicrobial agent must be more toxic to the patient than the pathogen. C) Selective toxicity takes advantage of metabolic differences between host and pathogen. D) Antimicrobial agents must target structural differences between host and pathogen and be more toxic to the patient than the pathogen. E) Selective toxicity takes advantage of structural and/or metabolic differences between host and pathogen. Answer: E Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 28) Antimicrobials that block protein synthesis by binding to the mRNA are A) aminoglycosides. B) antisense nucleic acids. C) macrolides. D) beta-lactams. E) nucleic acid analogs. Answer: B Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action full file at http://testbankcorner.eu full file at http://testbankcorner.eu 29) The Etest determines which of the following? A) susceptibility B) MBC C) MIC D) both susceptibility and MIC E) both MBC and MIC Answer: D Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 30) Which of the following is NOT a criterion by which all antimicrobial agents can be evaluated? A) their spectrum of action B) their efficacy C) their activity against cell walls D) their route of administration E) their safety Answer: C Bloom's Rank: Knowledge Section: Clinical Considerations in Prescribing Antimicrobial Drugs 31) Which of the following interferes with cell wall synthesis by blocking alanine bridge formation? A) beta-lactams B) cycloserine C) bacitracin D) vancomycin E) both cycloserine and vancomycin Answer: E Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 32) Antimicrobial sugar analogs are effective for A) preventing bacterial protein synthesis. B) preventing cell membrane synthesis. C) preventing virus attachment. D) preventing nucleic acid synthesis. E) blocking a metabolic pathway. Answer: C Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action full file at http://testbankcorner.eu full file at http://testbankcorner.eu 33) Which of the following is a measurement associated with the broth dilution test? A) the zone of inhibition B) lack of turbidity C) cell lysis D) lack of turbidity and zone of inhibition E) presence of turbidity and cell lysis Answer: B Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 34) Infection of the __________ would be the hardest to treat with antimicrobial drugs. A) heart B) kidneys C) liver D) brain E) colon Answer: D Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 35) Disruption of the normal microbiota can result in infections caused by which of the following microbes? A) Mycobacterium B) Candida albicans C) Clostridium difficile D) both Mycobacterium and Clostridium difficile E) Candida albicans, Mycobacterium, and Clostridium difficile Answer: E Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 36) The antimicrobials called quinolones act by A) disrupting cytoplasmic membranes. B) inhibiting cell wall synthesis. C) inhibiting nucleic acid synthesis. D) inhibiting a metabolic pathway. E) inhibiting protein synthesis. Answer: C Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action full file at http://testbankcorner.eu full file at http://testbankcorner.eu 37) Amphotericin B is an antifungal drug that A) inhibits protein synthesis. B) inhibits nucleic acid synthesis. C) blocks a metabolic pathway. D) disrupts cytoplasmic membranes. E) inhibits cell wall synthesis. Answer: D Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action 38) The mechanism of action of the antibiotic vancomycin is A) inhibition of protein synthesis. B) inhibition of cell wall synthesis. C) inhibition of nucleic acid synthesis. D) inhibition of a metabolic pathway. E) disruption of cytoplasmic membranes. Answer: B Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action 39) The tetracyclines interfere with A) protein synthesis. B) cell wall synthesis. C) cell membrane component synthesis. D) nucleic acid synthesis. E) folic acid synthesis. Answer: A Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action 40) Trimethoprim is an example of antimicrobials that A) disrupt cytoplasmic membranes. B) inhibit cell wall synthesis. C) inhibit nucleic acid synthesis. D) inhibit metabolic pathways. E) inhibit protein synthesis. Answer: D Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action full file at http://testbankcorner.eu full file at http://testbankcorner.eu 41) The mechanism of action of erythromycin is A) inhibition of protein synthesis. B) inhibition of cell wall synthesis. C) inhibition of nucleic acid synthesis. D) inhibition of a metabolic pathway. E) disruption of cytoplasmic membranes. Answer: A Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action 42) Methicillin is an example of the beta-lactam class of drugs that A) disrupt cytoplasmic membranes. B) inhibit cell wall synthesis. C) inhibit nucleic acid synthesis. D) inhibit metabolic pathways. E) inhibit protein synthesis. Answer: B Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action 43) Ribavirin is an antiviral that interferes with A) protein synthesis. B) cell wall synthesis. C) cell membrane component synthesis. D) nucleic acid synthesis. E) viral attachment. Answer: D Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action 44) The antimicrobial polymyxin A) inhibits protein synthesis. B) inhibits nucleic acid synthesis. C) blocks a metabolic pathway. D) disrupts cytoplasmic membranes. E) inhibits cell wall synthesis. Answer: D Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action full file at http://testbankcorner.eu full file at http://testbankcorner.eu 45) The mechanism of action of sulfonamides is A) inhibition of metabolic pathways. B) inhibition of cell wall synthesis. C) inhibition of nucleic acid synthesis. D) disruption of cytoplasmic membranes. E) inhibition of protein synthesis. Answer: A Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action 10.2 True/False Questions 1) Paul Erhlich coined the term antibiotics for the "magic bullet" antimicrobials he pursued. Answer: FALSE Bloom's Rank: Knowledge Section: The History of Antimicrobial Agents 2) Antisense nucleic acids are designed to have no side effects against humans. Answer: TRUE Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 3) Beta-lactam drugs act by inhibiting formation of the cytoplasmic membrane. Answer: FALSE Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 4) Because all cells engage in protein synthesis, there are few antimicrobial drugs that selectively inhibit this process. Answer: FALSE Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 5) Many antimicrobial drugs that affect the cytoplasmic membrane are used only externally because they can be toxic to humans. Answer: TRUE Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 6) Some bacterial cells are resistant to a variety of antimicrobials because they actively pump the drugs out of the cell. Answer: TRUE Bloom's Rank: Comprehension Section: Resistance to Antimicrobial Drugs full file at http://testbankcorner.eu full file at http://testbankcorner.eu 7) The outer membrane of Gram-negative bacteria enables many antimicrobial drugs to enter the cell more easily. Answer: FALSE Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 8) If a subculture of an MIC test grows in an MBC test, the concentration of the drug was bactericidal. Answer: FALSE Bloom's Rank: Application Section: Clinical Considerations in Prescribing Antimicrobial Drugs 9) Brain and spinal cord infections are difficult to treat because most antimicrobial drugs cannot diffuse out of the blood into these organs. Answer: TRUE Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 10) Organs that are commonly affected by drug toxicity include the kidneys and the liver. Answer: TRUE Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 10.3 Short Answer Questions 1) Any drug that acts against a disease is called a(n) __________ agent. Answer: chemotherapeutic Bloom's Rank: Knowledge Section: The History of Antimicrobial Agents 2) Selective __________ means that a given antimicrobial agent is more toxic to a pathogen than to the host being treated. Answer: toxicity Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 3) Nucleotide or nucleoside __________are antimicrobial agents that mimic the chemical structure of DNA building blocks. Answer: analogs Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 4) A broad-spectrum __________ is effective against a wide variety of pathogens. Answer: drug Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs full file at http://testbankcorner.eu full file at http://testbankcorner.eu 5) Secondary infections that result from the killing of the normal microbiota are called __________. Answer: Superinfections Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 6) Competition between beneficial microbes and potential pathogens is called microbial __________. Answer: antagonism Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 7) A(n) __________ concentration of a drug is one at which microbes survive but are not able to grow and reproduce. Answer: bacteriostatic Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs 8) R-plasmids are __________ pieces of DNA that promote horizontal transfer of genes among bacteria and contribute to the spread of antimicrobial resistance. Answer: extrachromosomal Bloom's Rank: Knowledge Section: Resistance to Antimicrobial Drugs 9) Some bacteria develop resistance to groups of drugs because the drugs are all structurally similar to each other; this is a phenomenon known as __________ resistance. Answer: cross Bloom's Rank: Comprehension Section: Resistance to Antimicrobial Drugs 10) Second-generation drugs are semisynthetic drugs developed to combat __________ against an existing drug. Answer: resistance Bloom's Rank: Comprehension Section: Resistance to Antimicrobial Drugs 11) Drugs that slow down bacterial growth would be __________ to penicillin. Answer: antagonistic Bloom's Rank: Comprehension Section: Resistance to Antimicrobial Drugs 12) External infections can be treated by __________ administration, in which a drug is applied directly to the site of infection. Answer: topical Bloom's Rank: Comprehension Section: Clinical Considerations in Prescribing Antimicrobial Drugs full file at http://testbankcorner.eu full file at http://testbankcorner.eu 13) The abbreviation __________ stands for the smallest amount of a drug that will inhibit the growth and reproduction of a pathogen. (Be sure to use all capital letters.) Answer: MIC Bloom's Rank: Knowledge Section: Clinical Considerations in Prescribing Antimicrobial Drugs 14) Antiviral medications frequently block unique __________ to prevent production of new virus. Answer: enzymes Bloom's Rank: Comprehension Section: Mechanisms of Antimicrobial Action 15) Praziquantel alters the cytoplasmic membrane permeability of __________ worms. Answer: parasitic Bloom's Rank: Knowledge Section: Mechanisms of Antimicrobial Action 10.4 Essay Questions 1) Why can microbial resistance to antibiotics and other drugs be considered a primarily genetic phenomenon? Answer: Microbial resistance is considered a genetic phenomenon because there are two major ways that bacteria acquire resistance: through mutations of chromosomal genes or through acquisition of new genes carried on R-plasmids. In both cases, the cell gains the ability to resist the activity of a particular drug through the modified structure or activity of proteins that are coded for by the genes in question. For example, some of these altered proteins can be cytoplasmic membrane proteins or porin proteins that no longer allow a drug such as penicillin to enter the cell. Also, some of the proteins coded for by these genes may be enzymes of various sorts that serve to inactivate a particular drug, such as the inactivation of beta-lactam antibiotics by β-lactamases. Furthermore, these altered genes and proteins are then heritable by the offspring of the cell that acquired the resistance, leading quickly to entire populations of bacteria or other microbes that are resistant to a drug. When selective pressure is then brought to bear (through the administration of a particular drug) on a population that contains both susceptible and resistant cells, the result is that the susceptible cells die off, leaving the resistant cells to grow and flourish. Bloom's Rank: Application Section: Resistance to Antimicrobial Drugs full file at http://testbankcorner.eu full file at http://testbankcorner.eu 2) Discuss the cellular factors that might make a drug's spectrum of action narrow rather than broad. Answer: When a drug is labeled "narrow-spectrum," meaning that it has activity against only a limited number of microbes, generally the reason is that many microbes possess some form of natural resistance against the drug. For example, many drugs work better against Gram-positive organisms than Gram-negative ones because Gram-negative cells possess an outer membrane that does not allow these drugs to enter the cell as readily as they enter Gram-positive cells. Other cellular factors that can have an effect on the spectrum of action of a particular drug include the presence of R-plasmids in the cell that carries resistance genes, the presence of altered cytoplasmic membrane or cell wall proteins that prevent the passage of some types of drugs, and alterations in a cell's metabolic pathways, which can make the cell more resistant to certain types of drugs. Other antimicrobials have a narrow spectrum of action because they target a metabolic or structural feature unique to a single pathogen or small group of pathogens. One example of this type of narrow-spectrum antimicrobial is antisense RNA, which complements a specific nucleotide sequence that may be present in only one pathogen. Another example is isonizid which blocks the synthesis of a cell wall component unique to the Mycoplasmas. Bloom's Rank: Application Section: Clinical Considerations in Prescribing Antimicrobial Drugs 3) Explain the concept of selective toxicity. Answer: Selective toxicity is the underlying principle supporting Ehrlich's idea of the "magic bullet." This simply means that the most effective antimicrobial drugs are those that target some difference in a cellular structure or metabolic process between the host/patient cell and the target microbe. Conversely, the more similar the host cell and the microbe are, the harder it is to selectively attack just the microbe. Drugs that do not differentiate very well between types of cells are generally more toxic to the host than those that are more selective. This is most striking in the case of antiviral drugs, which are generally poor magic bullets because the virus is dependent on the host cell for all aspects of its growth. Those drugs that successfully inactivate the virus sometimes also end up damaging or even killing the cell. Bloom's Rank: Application Section: Mechanisms of Antimicrobial Action 4) Examine the diffusion susceptibility plate results shown in Figure 10.9. Propose an explanation for the appearance of the zone around the AM/10 disk, and discuss the implications for therapeutic use of this antibiotic for the pathogen tested. Answer: The ring of colonies within the outermost limit of the zone of inhibition indicates that there are some cells in the population that are less susceptible to the antibiotic than the rest. If this antibiotic were used to treat an infection with this population, the growth of bacteria with some resistance would be promoted at the expense of the more susceptible cells, potentially giving rise to a new variant that is fully resistant. If this were to occur in a patient being treated, the antibiotic therapy would fail, putting the patient's health at risk. Therefore drug AM would be a poor choice, perhaps the poorest choice, for chemotherapy against this bacterial species. Bloom's Rank: Application Section: Clinical Considerations in Prescribing Antimicrobial Drugs full file at http://testbankcorner.eu full file at http://testbankcorner.eu 5) Explain why many antibiotics are effective only against cells that are actively growing and reproducing. Answer: When cells are not actively growing and reproducing, they are not synthesizing many of their component molecules or structures. Because many antimicrobial drugs inhibit the synthesis of structures such as the cell wall or interfere with various metabolic pathways, cells that are not actively doing one or both of these activities will be naturally more resistant to these drugs. For example, as bacterial cells age or become dormant, they cease to synthesize molecules such as peptidoglycan; therefore, drugs such as penicillin, which act by inhibiting peptidoglycan synthesis, have no effect on these cells. Additionally, as cells age, they may modify or cease certain metabolic pathways. Drugs that target these pathways will thus lose their effectiveness. Bloom's Rank: Application Section: Mechanisms of Antimicrobial Action full file at http://testbankcorner.eu