f a patient is on a drug that reduces bacterial growth, then it would be (competitive/beneficial/synergistic/antagonistic) to penicillin treatment of an infection. SubmitMy AnswersGive Up
f a patient is on a drug that reduces bacterial growth, then it would be (competitive/beneficial/synergistic/antagonistic) to penicillin treatment of an infection. SubmitMy AnswersGive Up
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Considering the details of this case, what is the patient likely suffering from?
A. | A brand new type of bacterium, made by combining Gram-positive and Gram-negative bacteria | |
B. | Lung cancer | |
C. | Mycoplasma pneumoniae | |
D. | A multi drug resistant Streptococcus pneumoniae |
A 47 year old female patient presents herself to you with symptoms of pneumonia. All indications are that the patient is suffering from an infection of Streptococcus pneumoniae, a Gram-positive bacterium. Since the patient is not allergic to penicillin, you prescribe a dose of amoxicillin, a semi-synthetic penicillin. This drug works by blocking the peptide cross-links, between the muramic acid subunits, of peptidoglycan chains. This leads to a destabilization of the bacterial cell, leading to its rupture. However, after the patient finished her course of amoxicillin, no improvement in symptoms were reported. Perplexed, you decide to culture and examine the bacteria infecting her lungs. The test you order is a Gram stain test, which comes back as Gram-negative. You feel like a failure as a health care provider due to your misdiagnosis of this bacterium. The same day, you put the patient on an aminoglycoside class antibiotic. This antibiotic is Gram-negative specific and works by shutting down ribosomes. You are dismayed and confused when this treatment also fails. To get a full read on the disease, you have a barcoding DNA test done on the causative bacterium. The test comes back and it clearly shows that the bacterium is within the group of Gram-positive bacteria. With the results of this test, you come up with the theory that the patient is infected with a strain of Drug Resistant Streptococcus pneumoniae (DRSP), resistant to amoxicillin. You decide to treat the DRSP by administering intravenous vancomycin, which is indicated for the treatment of serious, life-threatening infections by Gram-positive bacteria. This treatment also fails. In the end, you figure out that you were wrong about everything, and that there was a simple solution to the treatment of the patient.
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Part A
The ultimate problem with cholera that can lead to death is __________.
The ultimate problem with cholera that can lead to death is __________.
only water loss |
fluid loss with electrolyte concentrations remaining normal |
severe dehydration and electrolyte imbalance |
only electrolyte loss |
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Part B
The loss of chloride ions is occurring as a result of an continuously open __________, found in certain intestinal epithelial cells.
The loss of chloride ions is occurring as a result of an continuously open __________, found in certain intestinal epithelial cells.
chloride channel protein |
sodium pump |
ATP dependent sodium/potassium pump |
potassium pump |
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Part C
The main purpose of the chloride channel proteins on the apical surface of the intestinal epithelial cells is to create an osmotic gradient that ultimately causes __________ to move through the intestinal epithelium and into the intestinal lumen to assist in the formation of mucus. These are the same chloride channel proteins, adversely affected in cystic fibrosis.
The main purpose of the chloride channel proteins on the apical surface of the intestinal epithelial cells is to create an osmotic gradient that ultimately causes __________ to move through the intestinal epithelium and into the intestinal lumen to assist in the formation of mucus. These are the same chloride channel proteins, adversely affected in cystic fibrosis.
potassium |
calcium |
water |
sodium |
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Part D
The main physiologic mechanism used to control the opening of the chloride channel protein is through the use of __________.
The main physiologic mechanism used to control the opening of the chloride channel protein is through the use of __________.
G proteinâlinked receptors |
potassium pump |
enzyme-linked receptors |
sodium pump |
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Part E
The main factor that causes cholera is the overstimulation of __________ by the __________.
The main factor that causes cholera is the overstimulation of __________ by the __________.
guanylate cyclase; the bacterium Vibrio cholerae |
adenylate cyclase; the bacterium Vibrio cholerae |
guanylate cyclase; cholera toxin |
adenylate cyclase; cholera toxin |
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Part F
The normal physiologic mechanism used by G proteinâlinked receptors is for a ligand to bind to the G proteinâlinked receptor; this in turn activates __________ located in the intracellular side of the plasma membrane, which eventually leads to the physiologic effector action.
The normal physiologic mechanism used by G proteinâlinked receptors is for a ligand to bind to the G proteinâlinked receptor; this in turn activates __________ located in the intracellular side of the plasma membrane, which eventually leads to the physiologic effector action.
diacylglycerol |
inositol triphosphate |
G protein |
cyclic AMP |
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Part G
Cholera toxin bypasses the normal sequential cascade of events involving G protein activation. The __________subunit of cholera toxin enters into the cell and directly activates __________. This leads to a non-physiologic (non-homeostatic) action of inappropriately maintaining the chloride channel proteins open. This causes excessive __________, sodium, and water to leave the intestinal epithelial cells.
Cholera toxin bypasses the normal sequential cascade of events involving G protein activation. The __________subunit of cholera toxin enters into the cell and directly activates __________. This leads to a non-physiologic (non-homeostatic) action of inappropriately maintaining the chloride channel proteins open. This causes excessive __________, sodium, and water to leave the intestinal epithelial cells.
A; G protein; chloride |
B; G protein; chloride |
B; inositol triphosphate; calcium |
A; diacylglycerol; chloride |
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Part H
A defect in the chloride channel protein, causing it to not open, will _________ the chloride, sodium, and water loss in cholera. However, it will also cause the individual to have __________ mucus.
A defect in the chloride channel protein, causing it to not open, will _________ the chloride, sodium, and water loss in cholera. However, it will also cause the individual to have __________ mucus.
allow; thick |
allow; thin |
prevent, thin |
prevent; thick |
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Part I
A drug that prevents the cholera toxin from attaching to the __________ in the intestinal epithelial cell could be a useful treatment.
A drug that prevents the cholera toxin from attaching to the __________ in the intestinal epithelial cell could be a useful treatment.
ganglioside |
protein |
phospholipid |
AMP |
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Part J
The best method to reduce the spread of cholera is to __________.
The best method to reduce the spread of cholera is to __________.
never travel to underdeveloped countries |
provide properly treated water supplies |
give everyone antibiotics |
give everyone antacids |