Antimicrobials and Resistance · USMLE Step 1

A 25-year-old woman with UTI is prescribed TMP-SMX. Which pathway does this drug combination inhibit?

  1. DNA gyrase and cell wall synthesis
  2. Folate synthesis at two sequential steps
  3. Protein synthesis at 50S and 30S
  4. Bacterial peptidoglycan cross-linking
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Correct answer: Folate synthesis at two sequential steps

TMP-SMX blocks folate synthesis at sequential steps, providing synergistic bactericidal action.

Difficulty: Medium Question 5 of 20

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