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1

1. The process used for identifying the different carbohydrates of streptococci is called
A. Lancefield grouping.
B. CHO typing.
C. streptococci.
D. fermentation testing.

A. Lancefield grouping.

2

2. Rebecca Lancefield showed that almost all the strains of b-hemolytic streptococci from human infections
A. could cause rheumatic fever.
B. had the same cell wall carbohydrate "A."

C. had variable cell wall carbohydrates.
D. responded to penicillin.

B. had the same cell wall carbohydrate "A."

3

3. The scientist who developed a system of identifying the variety of strains of streptococci was
A. Hans Zimmer.
B. Donald Sutherland.
C. O. T. Avery.
D. Rebecca Lancefield.

D. Rebecca Lancefield.

4

4. Enlargement of which of the following structures may contribute to ear infections by interfering with normal drainage from eustachian tubes?
A. Nasal chamber

B. Nasal conchae

C. Epiglottis

D. Adenoids

D. Adenoids

5

5. The conjuctivae
A. have few resident bacteria.

B. are often covered with bacteria.
C. are populated with S. aureus.
D. are populated with S. pyogenes.

A. have few resident bacteria.

6

6. The eyes are protected from infection by
A. the washing action of the tears and eyelids.
B. the chemical action of lysozyme.
C. the use of contact lenses.
D. the dryness of the eye surface.
E. the washing action of the tears and eyelids AND the chemical action of lysozyme.

E. the washing action of the tears and eyelids AND the chemical action of lysozyme.

7

7. The cause of strep throat is
A. Staphylococcus aureus.

B. Streptococcus pyogenes- beta-hemolytic, group A.

C. Staphylococcus pyogenes- alpha-hemolytic, group B.

D. Streptococcus pneumoniae.

B. Streptococcus pyogenes- beta-hemolytic, group A.

8

8. Which of the following is associated with the upper respiratory system?
A. Humidifying inhaled air

B. Warming inhaled air

C. Cooling inhaled air

D. Drying inhaled air

E. Humidifying inhaled air AND warming inhaled air

E. Humidifying inhaled air AND warming inhaled air

9

9. Rapid diagnostic tests for streptococcal infections may utilize
A. blood agar.
B. antibodies.
C. DNA probes.
D. the Kirby-Bauer test.
E. antibodies AND DNA probes.

E. antibodies AND DNA probes.

10

10. Virulence factors used by S. pyogenes may be
A. Protein F.
B. M Protein.
C. a capsule.
D. Protein G.
E. All of the choices are correct.

E. All of the choices are correct.

11

11. The disease characterized by the appearance of a toxin-mediated rash that spares the area around the mouth and causes the tongue to look like the surface of a ripe strawberry is
A. measles.
B. chickenpox.
C. strep throat.
D. scarlet fever.

D. scarlet fever.

12

12. A bacteriophage is necessary for toxin production in
A. E. coli.
B. Staphylococcus aureus.
C. Streptococcus pyogenes.
D. C. diphtheriae.

D. C. diphtheriae.

13

13. Diphtheria toxin works on
A. lysosomes.
B. mitochondria.
C. chloroplasts.
D. elongation factor 2.

D. elongation factor 2.

14

14. Which is used in the vaccination for C. diphtheriae?
A. Protein A

B. M protein
C. Toxoid

D. Red blood cells

C. Toxoid

15

15. The most common bacterial pathogen(s) involved with sinusitis, otitis media, and conjunctivitis is/are

A. S. aureus.

B. H. influenzae.

C. S. pneumoniae.

D. S. epidermidis.

E. H. influenzae AND S. pneumoniae.

E. H. influenzae AND S. pneumoniae.

16

16. Otitis media and sinusitis are usually preceded by a(n)
A. middle ear infection.
B. pseudomonal infection.
C. oropharyngeal infection.
D. nasopharyngeal infection.

D. nasopharyngeal infection.

17

17. Otitis media probably develops from an infection that spread
A. from the outer ear to the middle ear.
B. from the sensory neurons of the middle ear.
C. through the tympanic membrane.
D. upward through the eustachian tube.

D. upward through the eustachian tube.

18

18. Most colds are probably caused by
A. rhinovirus.
B. S. aureus.
C. Pseudomonas sp.
D. E. coli.

A. rhinovirus.

19

19. Rhinoviruses need to be grown
A. in living cells.
B. in synthetic media.
C. on blood agar.
D. at 33C.
E. in living cells AND at 33C.

E. in living cells AND at 33C.

20

20. The rhinovirus contains
A. single-stranded RNA and is an enveloped virus.

B. double-stranded RNA and is an enveloped virus.

C. single-stranded RNA and and is a non-enveloped virus.

D. double-stranded RNA and is a non-enveloped virus.

C. single-stranded RNA and and is a non-enveloped virus.

21

21. The reservoir of the common cold is the
A. family pet.
B. human.
C. infected fomite.
D. fruit.

B. human.

22

22. A vaccine for the common cold is not feasible because
A. the surface antigens of rhinovirus mutate frequently.
B. the cause is unknown.
C. the rhinovirus cannot be grown in sufficient quantities.
D. there are more than 100 types of rhinovirus.

D. there are more than 100 types of rhinovirus.

23

23. Colds are effectively treated with
A. antibiotics.
B. aspirin and acetaminophen.
C. proteases.
D. nucleotide analogs.
E. None of the choices is correct.

E. None of the choices is correct.

24

24. Effective preventive methods for avoiding the common cold is/are
A. hand washing.
B. avoiding crowds.
C. not touching one's face.
D. avoiding close contact with people with colds.
E. All of the choices are correct.

E. All of the choices are correct.

25

25. The disease that closely resembles "strep throat" but is of viral origin is
A. the common cold.
B. otitis media.
C. tonsilitis.
D. adenoviral pharyngitis.

D. adenoviral pharyngitis.

26

26. Adenoviral pharyngitis is effectively treated with
A. antibiotics.
B. lysozyme.
C. proteases.
D. nucleotide analogs.
E. None of the choices is correct.

E. None of the choices is correct.

27

27. Which of the following are considered diseases of the lower respiratory tract?
A. Diphtheria and pneumonia

B. Influenza and diphtheria

C. Tuberculosis and pneumonia

D. Common cold and tuberculosis

C. Tuberculosis and pneumonia

28

28. About 60% of the bacterial pneumonias that require hospitalization of adults are caused by
A. S. pyogenes.
B. S. pneumoniae.
C. S. aureus.
D. K. pneumonia.

B. S. pneumoniae.

29

29. The characteristic virulence factor of S. pneumoniae is
A. a capsule.
B. flagella.
C. pili.
D. cilia.

A. a capsule.

30

30. The key virulence factor of S. pneumoniae interferes with

A. the action of C3.
B. the action of C3b.
C. the action of C5a.
D. interferon.

B. the action of C3b.

31

31. The pneumococcal vaccine is directed against the
A. flagella.
B. pili.
C. cilia.
D. capsule.

D. capsule.

32

32. Both S. pneumoniae and K. pneumoniae use this as a virulence factor.
A. Pili

B. Flagella

C. Capsules

D. Cilia

C. Capsules

33

The causative agent of the pneumonia that results in permanent lung damage, may be nosocomial, and has a high mortality if untreated is

A. S. pneumoniae.
B. K. pneumoniae.
C. S. pyogenes.
D. S. aureus.

B. K. pneumoniae.

34

34. The virulence of Klebsiella is due partly to the
A. motility of the organism.
B. exotoxin produced.
C. engorgement of blood vessels.
D. antiphagocytic properties of their capsules.
E. exotoxin produced AND antiphagocytic properties of their capsules.

D. antiphagocytic properties of their capsules.

35

35. The resistance of Klebsiella to antibiotics may be
A. chromosomal mediated.
B. plasmid mediated.
C. lysosomal mediated.
D. capsule mediated.
E. chromosomal mediated AND plasmid mediated.

E. chromosomal mediated AND plasmid mediated.

36

36. Mycoplasmal and klebsiellal pneumonias
A. have similar incubation periods.
B. have causative agents that lack cell walls.
C. are serious diseases often requiring hospitalization.
D. are both relatively mild diseases.
E. None of the choices is correct.

E. None of the choices is correct.

37

37. The spread of mycoplasma is through
A. inhalation of infected droplets.
B. the fecal-oral route.
C. an insect vector.
D. a fomite.

A. inhalation of infected droplets.

38

38. Which is/are true of coccidioidomycosis and histoplasmosis?
A. They are both soil fungi.
B. They are both dimorphic fungi.
C. They are both life-threatening.
D. They may be treated with antibiotics.
E. They are both soil fungi AND they are both dimorphic fungi.

E. They are both soil fungi AND they are both dimorphic fungi.

39

39. Which antibiotics may be completely ineffective in treating a mycoplasmal infection?
A. Penicillin

B. Cephalosporin

C. Tetracycline

D. Erythromycin

E. Penicillin AND cephalosporin

E. Penicillin AND cephalosporin

40

40. The sudden, violent, uncontrollable cough of pertussis is described as

A. productive.
B. contagious.
C. infective.
D. paroxysmal.

D. paroxysmal.

41

41. The causative agent of whooping cough is
A. parvovirus.
B. M. pneumoniae.
C. B. pertussis.
D. S. aureus.

C. B. pertussis.

42

42. Pertussis toxin
A. uses part B to attach to receptors on the host cell.
B. uses part A to inactivate G protein.
C. affects the level of cAMP in a cell.
D. affects the level of mucus secretion.
E. All of the choices are correct.

E. All of the choices are correct.

43

43. Although unusually resistant to many control factors, the tubercle bacillus is easily killed by
A. strong acids.
B. disinfectants.
C. pasteurization.
D. strong alkalis.

C. pasteurization.

44

44. The resistance of the tubercle bacillus to various factors is probably due to its
A. capsule.
B. larger ribosomes.
C. ability to adhere tightly.
D. cell wall.

D. cell wall.

45

45. The virulence of the tubercle bacillus is due to its
A. toxin.
B. lysogenic conversion.
C. resistance to antibiotics.
D. survival within macrophages.
E. lysogenic conversion AND resistance to antibiotics.

D. survival within macrophages.

46

46. The destructive nature of tuberculosis can be characterized as a(n)
A. endotoxin pyrogenic response.
B. immune complex reaction.
C. inflammatory response.
D. delayed hypersensitivity reaction.

D. delayed hypersensitivity reaction.

47

47. Influenza is caused by
A. orthomyxovirus.
B. H. influenza.
C. cytomegalovirus.
D. adenovirus.

A. orthomyxovirus.

48

48. Projecting from the outer envelope of the influenza virus are two glycoproteins called
A. leukocidin and hemolysin.
B. hyaluronidase and coagulase.
C. hemagglutinin and neuraminidase.
D. lysozyme and coagulase.

C. hemagglutinin and neuraminidase.

49

49. Antigenic shifts may be the result of
A. two different viruses infecting a cell at the same time.
B. the lysogenic conversion of two viruses.
C. conjugation of two viruses.
D. blending of a bacterial and a viral genome.
E. the lysogenic conversion of two viruses AND blending of a bacterial and viral genome.

A. two different viruses infecting a cell at the same time.

50

50. Which is true of hantavirus?
A. It is a zoonosis involving mice.
B. It has three segments of single-stranded RNA.
C. The primary effect is to flood the lungs with fluid.
D. Shock and death occurs in 30% of the cases.

E. All of the choices are correct.

E. All of the choices are correct.

51

51. Two relatively widespread North American lung mycoses are
A. candidiasis and coccidioidomycosis.
B. candidiasis and aspergillosis.
C. apergillosis and Reyes syndrome.
D. coccidioidomycosis and histoplasmosis.

D. coccidioidomycosis and histoplasmosis.

52

62. What is the most likely reason why smokers are more at risk for respiratory system infections?
A. Cigarette smoke is carcinogenic (cancer-causing), leading to a much higher incidence of lung cancer.
B. They aren't-this is just a rumor used to get people to stop smoking.
C. Chemicals in cigarette smoke can impair the mucociliary escalator, preventing natural cleansing of the respiratory tract.
D. Smokers take in microbes from their hands into their lungs as they handle cigarettes and inhale the smoke.

C. Chemicals in cigarette smoke can impair the mucociliary escalator, preventing natural cleansing of the respiratory tract.

53

63. Pleurisy and pneumonia are different. Why?
A. Pleurisy is inflammation of the lungs, while pneumonia is infection of the linings that surround the lungs. One is inflammation (not necessarily due to a microbe!), while the other is active infection with a microbe.
B. Pneumonia is infection of the lungs, while pleurisy is inflammation of the linings that surround the lungs. One is inflammation (not necessarily due to a microbe!), while the other is active infection with a microbe.
C. Pleurisy is caused by viruses, while pneumonia is caused by bacteria.
D. Pneumonia is caused by viruses, while pleurisy is caused by bacteria.

B. Pneumonia is infection of the lungs, while pleurisy is inflammation of the linings that surround the lungs. One is inflammation (not necessarily due to a microbe!), while the other is active infection with a microbe.

54

64. Why would it be reasonable to treat strep throat with antibacterial antibiotics, but not diphtheria?
A. The illness in diphtheria is largely from the exotoxin produced. An antibiotic won't clear out the exotoxin.
B. The illness in strep throat is largely from the exotoxin produced. An antibiotic effectively eliminates exotoxins.
C. The causative agent of diphtheria is a virus, not a bacterium. The drug would have no effect.
D. There are no antibiotics that have proven effective against the bacterium that causes diphtheria.

A. The illness in diphtheria is largely from the exotoxin produced. An antibiotic won't clear out the exotoxin.

55

65. The best way to speed up recovery from a common cold is
A. to dose the patient with ibuprofen to keep the fever down.
B. to take decongestants as a means of alleviating the symptoms of the cold.
C. to take 1,000 mg of vitamin C every day during the illness.
D. None of the above-in fact, the only way to clear out a cold is to let your immune system do its job. Several of the treatments above may actually INCREASE the time needed to get over the illness.

D. None of the above-in fact, the only way to clear out a cold is to let your immune system do its job. Several of the treatments above may actually INCREASE the time needed to get over the illness.

56

66. If you are a 20-year-old healthy young adult and you have to CHOOSE a type of pneumonia to become infected with (and you will NOT get treatment for it), which would be the "best," and why?

A. Pneumococcal pneumonia-it doesn't destroy lung tissue and can be completely recovered from.
B. Klebsiella pneumonia-it has the shortest recovery time.
C. Mycoplasmal pneumonia-it has the mildest symptoms and is generally easily cleared out.
D. Viral pneumonia-there are many antiviral medications you can take for this version with very few side effects.

C. Mycoplasmal pneumonia-it has the mildest symptoms and is generally easily cleared out.

57

67. Why are pneumococcal pneumonia infections so dangerous in nursing homes?
A. There is no vaccine available for protection.
B. There is no longer an antibiotic effective against the infection.
C. This type of pneumonia causes permanent lung damage, and old people often have impaired lung function in the first place.
D. While this type of pneumonia does NOT cause permanent lung damage, the immune system of older people is usually impaired, leaving them predisposed to more serious and potentially life-threatening pneumonia infections.

D. While this type of pneumonia does NOT cause permanent lung damage, the immune system of older people is usually impaired, leaving them predisposed to more serious and potentially life-threatening pneumonia infections.

58

68. People infected with M. tuberculosis are always highly infectious to everyone around them-true or false, and why?
A. True-they are constantly shedding bacteria to the environment around them in high numbers, facilitating transmission.
B. False-while in the early stages of the illness, their tissues are not irritated and damaged to induce the cough required to spread the organism in respiratory droplets very easily.
C. True-as the mode of transmission is direct contact, anyone or anything they touch can be infected.
D. False-since TB requires a very high infectious dose, in the early stages of the disease, the patients aren't producing enough bacteria in their respiratory secretions to be infectious.

B. False-while in the early stages of the illness, their tissues are not irritated and damaged to induce the cough required to spread the organism in respiratory droplets very easily.

59

69. Which is more likely to happen-antigenic DRIFT, or antigenic SHIFT-and why?
A. Antigenic DRIFT-since infection with only a single virus is required, and the random mutations happen as the virus replicates in the infected person's cells.
B. Antigenic SHIFT-since infection with only a single virus is required, and the random mutations happen as the virus replicates in the infected person's cells.
C.

Antigenic DRIFT-since random mutations occur more readily when only one virus is infecting a cell at a given time.

D. Antigenic SHIFT-since multiple viruses in a cell at once means more RNA polymerase to copy the RNA, and therefore more possibilities for much larger mistakes to be made in the copying (leading to mutations).

A. Antigenic DRIFT-since infection with only a single virus is required, and the random mutations happen as the virus replicates in the infected person's cells.

60

70. Which is more dangerous to human beings-antigenic DRIFT or antigenic SHIFT-and why?
A. Antigenic DRIFT-since this produces the quickest and largest degree of changes in the virus structure and we may not have immunity against it.

B. Antigenic SHIFT-since this produces the quickest and largest degree of changes in the virus structure and we may not have immunity against it.

C. Antigenic DRIFT-the small changes make the virus look like something we already have an immune response in place for, but we actually don't. This lets the virus hide from the immune responses needed to clear it out for a longer period of time.
D. Antigenic SHIFT-the process completely changes the virus 100%, allowing it to jump into different species (i.e., from birds into humans). As such, we have no responses in place for the new virus.

B. Antigenic SHIFT-since this produces the quickest and largest degree of changes in the virus structure and we may not have immunity against it.

61

1. The Rickettsial disease that killed Howard Ricketts and Stanislaus Prowazek was
A. louse-borne typhus.
B. tick-borne typhus.
C. yellow fever.
D. bubonic plague.

A. louse-borne typhus.

62

2. Which of the following is considered an important function of the skin?
A. Hold muscle to bone

B. Manufacture blood cells

C. Produce antibodies

D. Control body temperature

D. Control body temperature

63

3. Which of the following is considered a function of the skin?
A. Regulation of body temperature

B. Prevention of fluid loss

C. Synthesis of vitamin D

D. Produces cytokines

E. All of the choices are correct.

E. All of the choices are correct.

64

4. The surface layer of the skin is the
A. cutaneous.
B. keratin.
C. dermis.
D. epidermis.

D. epidermis.

65

5. The oily secretion that lubricates the hair follicles of the skin is
A. sebum.
B. eczema.
C. suder.
D. acne.

A. sebum.

66

6. The secretions of the sweat and sebaceous glands provide ________ to the microbiota.
A. water
B. amino acids
C. lipids
D. All of the choices are correct.

D. All of the choices are correct.

67

7. The antimicrobial aspect(s) of the skin is/are
A. dryness.
B. saltiness.
C. acidity.
D. toxicity.
E. All of the choices are correct.

E. All of the choices are correct.

68

8. Which of the following organisms is not normally found on the skin?
A. Staphylococci

B. Diptheroids

C. Candida spp.
D. Malassezia spp.

C. Candida spp.

69

9. Diphtheroids
A. are part of the normal microbiota of the skin.

B. are responsible for body odor.
C. include P. acnes.
D. include Malassezia spp.
E. are part of the normal microbiota of the skin, are responsible for body odor, AND include P. acnes.

E. are part of the normal microbiota of the skin, are responsible for body odor, AND include P. acnes.

70

10. Which of the following normal skin microbiota is a small yeast?

A. Staphylococci

B. Diphtheroids

C. Candida spp.
D. Malassezia spp.

D. Malassezia spp.

71

11. The growth of P. acnes within hair follicles, in many individuals, leads to
A. eczema.
B. carbuncles.
C. boils.
D. acne.

D. acne.

72

12. The principal species of Staphylococcus found on the skin is
A. aureus.
B. acnes.
C. pyogenes.
D. epidermidis.

D. epidermidis.

73

The bacteria that appear to maintain balance between the members of the normal microbiota and play a vital role in limiting colonization by pathogens are

A. staphylococci.
B. diptheroids.
C. Candida spp.
D. Malassezia spp.

A. staphylococci.

74

14. Which of the following may be added to normal media to make it more selective for staphylococci?
A. 7.5% salt
B. 0.5% HCl
C. 1.0% glucose
D. 5.0% mannose

A. 7.5% salt

75

The member of the normal microbiota sometimes considered responsible for tinea versicolor is

A. staphylococci.
B. diptheroids.
C. Candida spp.
D. Malassezia spp.

D. Malassezia spp.

76

16. Which is deemed the most serious staphylococcal skin infection?
A. Tinea versicolor

B. Folliculitis

C. Furuncles

D. Carbuncles

D. Carbuncles

77

17. A protein associated with a more virulent form of Staphylococcus is
A. leukocidin.
B. mannose.
C. streptokinase.
D. coagulase.

D. coagulase.

78

18. The protein produced by S. aureus that interferes with phagocytosis is
A. protein M.
B. collagen.
C. protein A.
D. capsular protein.

C. protein A.

79

19. The preferred habitat of S. aureus is the
A. throat.
B. urethra.
C. bladder.
D. nasal chamber.

D. nasal chamber.

80

20. Which of the following is a fairly reliable method of characterizing strains of S. aureus?
A. Complement fixation

B. Protein fingerprint

C. Genome typing

C. Genome typing

81

21. Which of the following may aid Staphylococcus in resisting phagocytosis?
A. Leukocidin

B. Hemolysin

C. Granulation enzyme

D. Coagulase

D. Coagulase

82

22. Which of the following virulence factors used by Staphylococcus puts holes in host cells?
A. Protein A

B. Alpha toxin

C. Leukocidin

D. Clumping factor

B. Alpha toxin

83

23. S. aureus clumping factor
A. causes fibrinogen to clump together.
B. causes bacteria to clump together in plasma.
C. reacts with prothrombin.
D. produces staphylothrombin.

B. causes bacteria to clump together in plasma.

84

24. The S. aureus product that causes scalded skin syndrome is/are
A. exfoliation toxin.
B. lipases.
C. leukocidins.
D. protein M.
E. All of the choices are correct.

A. exfoliation toxin.

85

25. Which is true of MRSA strains?

A. They are all resistant to vancomycin.

B. They carry the R plasmid.

C. They may be susceptible to linezolid.

D. The carry the R plasmid AND they may be susceptible to linezolid.

D. The carry the R plasmid AND they may be susceptible to linezolid.

86

26. A frequent complication of scalded skin syndrome is a secondary infection caused by
A. M. luteus.
B. S. pyogenes.
C. S. epidermidis.
D. Pseudomonas spp.

D. Pseudomonas spp.

87

27. In addition to S. aureus, impetigo may also involve
A. M. luteus.
B. S. pyogenes.
C. S. epidermidis.
D. Pseudomonas spp.

B. S. pyogenes.

88

28. In S. pyogenes, which of the following interferes with phagocytosis?
A. M protein
B. Protein A

C. Collagen

D. Pilin

A. M protein

89

29. In which of the following does a rash start on the palms and soles and progress toward the trunk?
A. Epidemic typhus
B. Typhoid
C. Lyme disease
D. Impetigo
E. Rocky Mountain spotted fever

E. Rocky Mountain spotted fever

90

The major vector of Rocky Mountain spotted fever in the western United States is

A. Rickettsia rickettsi.
B. Rickettsia prowazeki.
C. Borrelia burgdorferi.
D. Dermacentor andersoni.

D. Dermacentor andersoni.

91

31. Rocky Mountain spotted fever is an example of a(n)
A. animalosis.
B. tickonosis.
C. plantonosis.
D. zoonosis.

D. zoonosis.

92

32. After being bitten by an infected tick, transfer of the rickettsial organism occurs
A. immediately.
B. within 5 minutes.
C. within 20 minutes.
D. within 4-10 hours.

D. within 4-10 hours.

93

33. Which of the following is an obligate intracellular parasite?
A. M. luteus
B. S. pyogenes
C. Rickettsia rickettsi
D. Pseudomonas spp.

C. Rickettsia rickettsi

94

34. The causative agent of Lyme disease is
A. Rickettsia rickettsi.
B. Rickettsia prowazeki.
C. Borrelia burgdorferi.
D. Dermacentor andersoni.

C. Borrelia burgdorferi.

95

35. The unique characteristic of Lyme disease is
A. erythema migrans.
B. induration.
C. carbuncle.
D. furuncle.

A. erythema migrans.

96

36. The stage of Lyme disease that is characterized by arthritis is the
A. primary.
B. third.
C. second.
D. fourth.

B. third.

97

The most important vector of Lyme disease in the eastern United States is

A. Dermacentor virabilis.
B. Dermacentor andersoni.
C. Staphylococcus aureus.
D. Ixodes scapularis.

D. Ixodes scapularis.

98

38. Which of the following pertains to Borrelia burgdorferi?
A. Coccus

B. Bacillus

C. Spirochete

D. Filament

C. Spirochete

99

39. The preferred host of Ixodes scapularis is the

A. wood rat.
B. white-footed mouse.
C. moose.
D. human.

B. white-footed mouse.

100

40. The growth stage of the vector that is mainly responsible for transmitting Lyme disease is the
A. nymph stage.
B. egg.
C. moulter.
D. adult.

A. nymph stage.

101

41. Many childhood diseases caused by viral infections of the upper respiratory tract can usually be diagnosed by
A. inspection of the rash.
B. the type of cough.
C. the type of fever.
D. the incubation period.

A. inspection of the rash.

102

A common viral rash of childhood with the popular name chickenpox is also known as

A. bariola.
B. rubella.
C. rubeola.
D. varicella.

D. varicella.

103

43. The varicella virus is a member of which virus family?
A. Paramyxo

B. Toga

C. Papilloma

D. Herpes

D. Herpes

104

44. Reactivation of chickenpox is called
A. shingles.
B. herpes zoster.
C. pneumonia.
D. exanthems.
E. shingles AND herpes zoster.

E. shingles AND herpes zoster.

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45. The childhood disease that damages the body defenses and is frequently complicated by secondary infections involving, primarily, Gram-positive cocci is
A. German measles.
B. measles.
C. mumps.
D. chickenpox.

B. measles.

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46. The rubeola virus contains
A. double-stranded RNA.
B. single-stranded DNA.
C. double-stranded DNA.

D. single-stranded RNA.

D. single-stranded RNA.

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Rubella, rubeola, and varicella-zoster are all only acquired via

A. the gastrointestinal route.
B. the respiratory route.
C. wounds.
D. blood transfusions.

B. the respiratory route.

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48. An important diagnostic sign of measles is
A. Koplik's spots.
B. giant cells.
C. fever.
D. swollen lymph nodes.

A. Koplik's spots.

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49. The MMR vaccine is used to protect against
A. mononucleosis, mange, rubeola.
B. measles, mange, rubeola.
C. mononucleosis, mumps, rubella.
D. measles, mumps, rubella.

D. measles, mumps, rubella.

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50. The most serious consequence of rubella is
A. encephalitis.
B. meningitis.
C. deafness.
D. birth defects.

D. birth defects.

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51. Rubella is a member of which virus family?
A. Paramyxo virus

B. Herpes

C. Togavirus

C. Togavirus

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52. Warts are caused by
A. papillomavirus.
B. parvovirus.
C. adenoviruses.

A. papillomavirus.

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53. The skin-invading molds belong to the genera
A. Epidermophyton.
B. Microsporum.
C. Trichophyton.
D. Ixodes.
E. Epidermophyton, Microsporum, AND Trichophyton.

E. Epidermophyton, Microsporum, AND Trichophyton.

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63. Who would have larger numbers of bacteria living on the surface of their skin, a person living in the tropics or in the desert, and why?

A. The tropics would provide more shade, so the surface of the skin wouldn't be exposed to high levels of ultraviolet radiation. This would protect the bacteria on the skin, and they would have higher numbers due to this shading effect.
B. The very low humidity of the desert would lead to rapid evaporation of sweat and sebum from an individual's skin. Bacteria need these secretions for a nutrient source. Without them, bacteria would be found in much lower numbers on the skin of a person in the desert than the skin of the person in the tropics.
C. The constant secretion (and lack of evaporation) of high amounts of sweat would produce a highly salty environment on the skin of a person in the tropics. This would provide a local environment that would be too hostile for microbes to survive, so the number of microbes on the skin of the person in the tropics would be lower than that of the person in the desert.
D. The constant secretion of large amounts of sweat would wash bacteria off of the skin of the person in the tropics. As such, the person in the desert should have much more bacteria on their skin than the person in the tropics would.

B. The very low humidity of the desert would lead to rapid evaporation of sweat and sebum from an individual's skin. Bacteria need these secretions for a nutrient source. Without them, bacteria would be found in much lower numbers on the skin of a person in the desert than the skin of the person in the tropics.

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64. The existence of extensive scalded skin syndrome does not indicate that Staphylococcus is growing in all the affected areas. Why not?
A. This condition is caused by an exotoxin produced by certain strains of this microbe, and NOT directly by the microbe itself.
B. This condition is caused by an endotoxin produced by certain strains of this microbe, and NOT directly by the microbe itself.
C. This condition isn't caused by Staphylococcus at all.
D. This microbe doesn't grow in the skin-but the toxins it releases are transported by the blood vessels into the skin, where it achieves the observed effect.

A. This condition is caused by an exotoxin produced by certain strains of this microbe, and NOT directly by the microbe itself.

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65. Why is it a good idea to immunize little boys against rubella?
A. As this is a sexually-transmitted disease, vaccinating girls AND boys early in their lives prevents the spread of the disease in adulthood.
B. We want to achieve herd immunity, and there's no reason why only girls would be infected by this virus. By vaccinating the entire population, we achieve a higher degree of herd immunity than is possible by vaccinating only girls.
C. Only boys get this disease, and one of the common complications is sterility.
D. While this disease is quite strikingly symptomatic in girls, it is completely asymptomatic in boys. Boys can be carriers and transmit it easily to girls they are in close proximity to without realizing it through respiratory secretions. This can lead to large-scale and dangerous outbreaks in the female population.

B. We want to achieve herd immunity, and there's no reason why only girls would be infected by this virus. By vaccinating the entire population, we achieve a higher degree of herd immunity than is possible by vaccinating only girls.

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66. What is the epidemiological significance of shingles?
A. It shows that, as a latent viral infection, there is always a possible reservoir available to reinfect new susceptible individuals.
B. It shows that we must always be vigilant against this deadly and highly infectious secondary infection in elderly and immunocompromised individuals.
C. It shows that, as a chronic viral infection, individuals infected are always infectious to others around them, even when they do not show outward symptoms.
D.

It shows that our fight for long-term eradication of varicella zoster virus will be a very long fight, depending on immunizing all newly born individuals until all the people who had ever had contracted the illness have died

E. It shows that, as a latent viral infection, there is always a possible reservoir available to reinfect new susceptible individuals AND it shows that our fight for long-term eradication of varicella zoster virus will be a very long fight, depending on immunizing all newly born individuals until all the people who had ever contracted the illness have died

E. It shows that, as a latent viral infection, there is always a possible reservoir available to reinfect new susceptible individuals AND it shows that our fight for long-term eradication of varicella zoster virus will be a very long fight, depending on immunizing all newly born individuals until all the people who had ever contracted the illness have died

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67. A public health official was asked to speak about immunizations during a civic group luncheon. One parent asked if rubella was still a problem. In answering the question, the official cautioned women planning to have another child to have their present children immunized against rubella. Why did the official make this statement to the group?
A. Rubella is spread very easily by respiratory secretions and is largely asymptomatic. However, it can cause birth defects/stillbirth in pregnant women. Women with other children would want to prevent these children from acquiring the virus before attempting to conceive a new child in order to protect the fetus.
B. Rubella is passed very easily between children, so the official was trying to protect the child that would soon be born from this infection that might be brought in by its siblings after it was born.
C. The official is getting kickbacks and bribes from the companies making the vaccines, and he's trying to pad his pockets by getting as many people immunized as possible, regardless of whether they need it or not.
D. Rubella infections often lead to very serious and potentially fatal complications. While a woman is pregnant, she may not be able to take care of a sick child as easily. The vaccine will prevent the child already in the family from falling ill and potentially dying due to these possible complications.

A. Rubella is spread very easily by respiratory secretions and is largely asymptomatic. However, it can cause birth defects/stillbirth in pregnant women. Women with other children would want to prevent these children from acquiring the virus before attempting to conceive a new child in order to protect the fetus.

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When Lyme disease was first being investigated, the observation that frequently only one person in a household was infected was a clue leading to the discovery that the disease was spread by arthropod bites. Why was this so?

A. Mosquitoes (an example of arthropods) are never inside a house. They are strictly outdoor animals, so they couldn't spread the infection inside the household.
B. Mosquitoes (an example of arthropods) only bite once in their life cycle. As such, they can only transmit the illness once before they die. Even if an infected mosquito was inside a house, it could therefore only infect one human.
C. If the infection is spread by the bite of an arthropod, it wouldn't spread easily by respiratory secretions, direct contact, or sexual contact between individuals within the family.
D. Arthropods lose their mechanical ability to bite a human after a single bite, much like certain bees that lose their stinger after a single sting. This prevents them from transmitting the infection to more than one individual in a household.

C. If the infection is spread by the bite of an arthropod, it wouldn't spread easily by respiratory secretions, direct contact, or sexual contact between individuals within the family.