Review 5 - Medical Micro

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1

The instillation antibiotics in newborn's eyes will prevent ophthalmia neonatorum in newborns. This disease is caused by:

  1. Neisseria meningitidis.
  2. Streptococcus pyogenes.
  3. Neisseria gonorrhoeae.
  4. Branhamella (Moraxella) catarrhalis.
  5. Staphylococcus aureus.

Neisseria gonorrhoeae

2

All of the following pertain to Neisseria meningitidis EXCEPT:

  1. the reservoir is the nasopharynx of human carriers.
  2. it causes serious meningitis
  3. it is a common cause of bacterial pneumonia
  4. virulent factors include a capsule, pili, endotoxin, and IgA protease
  5. it is more easily transmitted in daycare facilities, dorms, and military barracks.

it is a common cause of bacterial pneumonia

3

All of the following pertain to gonorrhea, EXCEPT:

  1. pelvic inflammatory disease (PID) and infertility are complications
  2. symptoms include painful urination and discharge
  3. it is a reportable infectious disease
  4. a chancre-type lesions develops at the portal of entry
  5. females can have asymptomatic infection

a chancre-type lesions develops at the portal of entry

4

Neisseria gonorrhoeae is:

  1. virulent due to fimbriae and a protease that inactivates IgA
  2. the cause of ophthalmia neonatorum
  3. called the gonoccus
  4. the cause of gonorrhea
  5. All of the choices are correct
  • All of the choices are correct:
  • virulent due to fimbriae and a protease that inactivates IgA
  • the cause of ophthalmia neonatorum
  • called the gonoccus
  • the cause of gonorrhea
5

Meningococcemia is:

  1. caused by a gram positive diplococcus.
  2. associated with vascular hemorrhage and petechiae.
  3. frequently seen in elderly.
  4. common during gonorrhea
  5. All of the choices are correct.

associated with vascular hemorrhage and petechiae

6

People at greatest risk for pneumococcal infections include all the following EXCEPT:

  1. young infants
  2. elderly
  3. those with underlying lung disease and viral infections
  4. adolescents and young adults
  5. patients without a spleen

adolescents and young adults

7

Disease/s caused by Streptococcus pneumoniae include:

  1. lobar pneumonia.
  2. otitis media.
  3. bronchial pneumonia.
  4. meningitis.
  5. All of the choices are correct.

All of the choices are correct.

  • lobar pneumonia.
  • otitis media.
  • bronchial pneumonia.
  • meningitis.
8

Streptococcus pneumoniae is:

  • called the meningococcus.
  • in the viridans group.
  • a gram positive diplococcus with a capsule.
  • a pathogen with endotoxin.
  • All of the choices are correct.

a gram positive diplococcus with a capsule.

9

all of the following are associated with subacute endocarditis EXCEPT:

  1. it occurs in patients that have prior heart damage
  2. it is caused by immune system autoantibodies that attacke hear and valve tissue
  3. bacteria colonize previously damaged heart tissue resulting in vegetation
  4. signs and symptoms include fever, heat murmur, and possible emboli
  5. oral bacteria get introduced by dental procedures to the blood.

it is caused by immune system autoantibodies that attacke hear and valve tissue

10

The viridans streptococci are:

  1. opportunists that can cause subacute endocarditis.
  2. the most numerous residents of the oral cavity.
  3. introduced to deeper body tissues by dental or surgical procedures.
  4. not entirely groupable by Lancefield serology.
  5. All of the choices are correct.

All of the choices are correct:

  • opportunists that can cause subacute endocarditis.
  • the most numerous residents of the oral cavity.
  • introduced to deeper body tissues by dental or surgical procedures.
  • not entirely groupable by Lancefield serology.
11

All of the following pertain to Enterococcus faecalis, EXCEPT:

  1. can cause endocarditis
  2. belong to Lancefield Group B streptococci
  3. increasingly resistant to many antimicrobics
  4. cause nosocomial wound infections, urinary tract infections, and septicemias.
  5. normal flour of the human large intestine

belong to Lancefield Group B streptococci

12

Long-term sequelae of Group A streptococcal infections include all the following, EXCEPT:

  1. development of acute glomerulonephritis
  2. appearance of sequelae within a few weeks after an initial infection
  3. risk decreased with prompt treatment of skin infections and pharyngitis
  4. transmission of sequalae via respiratory secretions from a patient with streptococcal sore throat
  5. development of rheumatic fever

transmission of sequalae via respiratory secretions from a patient with streptococcal sore throat

13

Necrotizing fasciitis is:

  1. not treatable with antimicrobic drugs.
  2. associated with strains of Streptococcus pyogenes producing destructive enzymes and toxins.
  3. typically a sequelae of streptococcal pharyngitis.
  4. also called impetigo.
  5. possibly caused by antibodies to Group A streptococci that cross-react with body tissues.

associated with strains of Streptococcus pyogenes producing destructive enzymes and toxins.

14

Scarlet fever involves:

  1. bright red rash on face, trunk, inner arms and legs, and tongue.
  2. high fever.
  3. eventual desquamation of epidermis.
  4. septicemia as a complication.
  5. All of the choices are correct.

All of the choices are correct.

  • bright red rash on face, trunk, inner arms and legs, and tongue.
  • high fever.
  • eventual desquamation of epidermis.
  • septicemia as a complication.
15

Streptococcal pharyngitis involves all the following, EXCEPT:

  1. can lead to scarlet fever if it is an erythrogenic toxin-producing strain.
  2. a purulent exudate over the tonsils
  3. can lead to serious sequlae
  4. is usually caused by the viridans streptococci
  5. causes redness, difficulty in swallowing, and fever.

is usually caused by the viridans streptococci

16

Streptococcus pyogenes causes all the following EXCEPT:

  1. necrotizing fasciitis
  2. scarlet fever
  3. impetigo
  4. erysipelas
  5. scalded skin syndrome

scalded skin syndrome

17

The M protein of Streptococcus pyogenes:

  1. is also called streptokinase.
  2. gives rise to a zone of b hemolysis on blood agar.
  3. protects against phagocytosis and enhances adherence.
  4. is the basis for the organism belonging to Lancefield
  5. protects against lysozyme damage.

protects against phagocytosis and enhances adherence.

18

Staphylococci can be differentiated from streptococci by the:

  1. Gram stain.
  2. coagulase test.
  3. catalase test.
  4. fermentation of mannitol.
  5. None of the choices are correct.

catalase test.

19

Symptoms of Toxic Shock Syndrome include all the following, EXCEPT :

  1. kidney and liver failure
  2. appearance of flesh being "eaten" down to the muscle
  3. fever and muscle pain
  4. nausea, vomiting, diarrhea
  5. sunburn-like rash

appearance of flesh being "eaten" down to the muscle

20

All the following pertain to Staphylococcus epidermidis infections, EXCEPT:

  1. catheterization can introduce the organism and lead to urinary tract infection
  2. the organism produce a large number of tissue damaging enzymes and toxins
  3. the often from an endogenous source
  4. they typically occur after insertion of shunts and prosthetic devices
  5. the organism is coagulase negative

the organism produce a large number of tissue damaging enzymes and toxins

21

Which is incorrect about Staphylococcus aureus food intoxication?

  1. Symptoms come on quickly, and include nausea, vomiting, diarrhea.
  2. Food becomes contaminated by a human carrier.
  3. Ingestion of the pathogen allows it to multiply and damage the GI tract lining.
  4. Common associated foods include custards, ham, cream
  5. After contamination, food must be left unrefrigerated for a few hours.

Ingestion of the pathogen allows it to multiply and damage the GI tract lining.

22

the most common site where carriers of Staphylococcus aureus carry this pathogen is:

  1. under the fingernails.
  2. mouth.
  3. intestines.
  4. anterior nares (nostrils).
  5. all over the skin.

anterior nares (nostrils).

23

which pathogen has drug resistant strains called MRSA?

  1. Staphylococcus aureus
  2. Staphylococcus epidermidis
  3. Staphylococcus saprophyticus
  4. Streptococcus pyogenes
  5. Streptococcus agalactiae

Staphylococcus aureus

24

Which pathogen is the most common cause of neonatal pneumonia, sepsis, and meningitis in the United States?

  1. Staphylococcus aureus
  2. Staphylococcus epidermidis
  3. Staphylococcus saprophyticus
  4. Streptococcus pyogenes
  5. Streptococcus agalactiae

Staphylococcus agalactiae

25

Scarlet fever is caused by strains of:

  1. Staphylococcus aureus
  2. Staphylococcus epidermidis
  3. Staphylococcus saprophyticus
  4. Streptococcus pyogenes
  5. Streptococcus agalactiae

Staphylococcus pyogenes

26

The bright red rash and fever of scarlet fever is due to:

  1. enterotoxins
  2. exfoliative toxin
  3. hemolysins
  4. erythrogenic
  5. toxins toxic shock syndrome toxin.

erythrogenic toxins

27

The enzyme that coagulates plasma is:

  1. hyaluronidase
  2. coagulase
  3. staphylokinase
  4. catalase
  5. Dnase

coagulase

28

Normal skin microbiota are able to grow on the skin because they can thrive in the presence of:

  1. keratin
  2. sebum
  3. salt
  4. sebum and salt
  5. sebum, salt, and keratin

sebum and salt

29

Virulent strains of Staphylococcus aureus can resist penicillin because they produce:

  1. a slime layer
  2. staphylokinase
  3. lipase
  4. coagulase
  5. beta-lactamase

beta-lactamase

30

Impetigo can be caused by:

  1. Streptococcus pyogenes
  2. Staphylococcus epidermidis
  3. Staphylococcus aureus
  4. both Staphylococcus aureus and Streptococcus pyogenes
  5. both Staphylococcus epidermidis and Streptococcus pyogenes

both Staphylococcus aureus and Streptococcus pyogenes

31

Necrotizing fasciitis is caused by:

  1. Rickettsia ricketsii
  2. Streptococcus pyogenes
  3. Pseudomonas aeruginosa
  4. Staphylococcus aureus
  5. both Streptococcus pyogenes and Staphylococcus aureus

both Streptococcus pyogenes and Staphylococcus aureus

32

Localized swelling of a scratch accompanied by fever, malaise, and swollen lymph nodes may result from infection with:

  1. Bartonella henselae
  2. Propionibacterium acnes
  3. Rickettsia rickettsii
  4. Mycroporum canis
  5. Pseudomonas aeruginosa

Bartonella henselae

33

A specific wavelength of UVA can be used to treat:

  1. acne
  2. RMSF
  3. bacteremia
  4. swimmer's ear
  5. cat scratch disease

acne

34

Anthrax derives its name from which of the following aspects of the disease?

  1. the shape of its endospores
  2. the shape of B. anthracis colonies on agar
  3. the necessity of burning animals killed by the disease
  4. the appearance of eschars on the skin
  5. the microscopic appearance of its cells

the appearance of eschars on the skin

35

The resistance of Pseudomonas to a wide variety of antimicrobial drugs is due, in part, to its:

  1. ability to grow in almost any moist environment
  2. ability to utilize a wide range of carbon and nitrogen sources
  3. production of pyocyanin
  4. production of exoenzymes
  5. ability to pump drugs out of the cell

ability to pump drugs out of the cell

36

Rickettsias are obligate intracellular parasites because they:

  1. cannot metabolize lipids
  2. cannot synthesize amino acids
  3. lack the glycolytic pathway
  4. lack a cell wall
  5. lack ribosomes

lack the glycolytic pathway

37

What is the pathogenic process underlying Rocky Mountain spotted fever?

  1. interference with host cell metabolism
  2. formation of biofilms in host tissue
  3. cellular damage via potent exotoxins
  4. stimulation of a strong immune response
  5. damage to blood vessels

damage to blood vessels

38

Smallpox was the first human disease to be:

  1. treated with antiviral drugs
  2. analyzed and studied on the genetic level
  3. globally eradicated
  4. identified as a viral disease
  5. re-created in an experimental animal

globally eradicated

39

A herpetic lesion on the finger or hand is known as a:

  1. furuncle
  2. pox
  3. fever blister
  4. macule
  5. whitlow

whitlow

40

Some strains of Papillomavirus are oncogenic due their ability to:

  1. integrate into the host cell DNA
  2. lie dormant in cells for years
  3. cause extensive damage to blood vessels
  4. produce deoxyribonucleases
  5. escape the phagosome before lysosome fusion

integrate into the host cell DNA

41

A reddening of the skin of the face that intensifies when exposed to the sun is characteristic of:

  1. herpes
  2. rubeola
  3. chickenpox
  4. rubella
  5. erythema infectiosum

erythema infectiosum

42

A rash characterized by macules which swell, fill with fluid and then pus, then rupture and become crusty lesions, is characteristic of:

  1. poxvirus infection.
  2. chickenpox virus reactivation.
  3. papillomavirus infection.
  4. human herpes virus 2 primary infection.
  5. roseola virus

poxvirus infection.

43

"Ringworm" is caused by:

  1. dermatophytes that have invaded deep into the living tissue.
    skin.
  2. dermatophytes growing in the upper dead tissue layers of the
  3. parasitic worms that infect the skin.
  4. immunosuppresion due to HIV.
  5. a hypersensitivity caused by superficial contact with dermatophytes.

dermatophytes growing in the upper dead tissue layers of the

44

Which of the following is becoming rarer as a result of childhood vaccination?

  1. roseola
  2. warts
  3. subacute sclerosing panencephalitis
  4. neonatal herpes
  5. impetigo

subacute sclerosing panencephalitis

45

A series of nodular lesions on an arm that fill with pus and ulcerate through the skin is characteristic of infections with the fungus:

  1. Sporothrix schenckii
  2. Micrococcus
  3. Trichophyton
  4. Microsporum
  5. Epidermophyton

Sporothrix schenckii

46

A man is suffering severe foot pain in the area of what looks like a large wart. He reports he has had the wart for some time, and the pain and swelling have developed slowly. A sample from the lesion shows that the pus contains large cells that stain a golden brown color. The man is likely suffering from:

  1. chromblasomyosis
  2. chromblasomyosis
  3. phaeohyphomycosis
  4. necrotizing fasciitis
  5. mycetoma

chromblasomyosis

47

A child complains of intensely itchy "pimples" on the hands and wrists. The lesions are small inflamed streaks, but do not appear to contain pus. The child's condition may be the result of infection with:

  1. Sarcoptes scabiei
  2. Staphylococcus epidermidis
  3. Clostridium perfringens
  4. Sporothrix schenkii
  5. Pseudomonas aeruginosa

Sarcoptes scabiei

48

A small puncture wound on a woman's are has become swollen, hot to the touch, and intensely painful. There is tissue necrosis but it is not "gassy", and under the microscope Gram-positive cocci in chains are present. which of the following microbes is likely to be responsible?

  1. Clostridium perfringens
  2. Pseudomonas aeruginosa
  3. Streptococcus pyogenes
  4. Staphylococcus aureus
  5. Sporothrix schenckii

Streptococcus pyogenes

49

A pigment produce by an opportunistic pathogen that contributes to tissue damage is:

  1. pyocyanin
  2. lipase
  3. streptokinase
  4. hyaluronidase
  5. M protein

pyocyanin

50

Under some circumstances, _____ is beneficial, but under other conditions that bacteria become overabundant leading to inflammation of the hair follicles.

  1. Propionibacterium acnes
  2. Bacillus anthracis
  3. Pseudomonas aeruginosa
  4. Streptococcus pyogenes
  5. Microsporum

Propionibacterium acnes

51

A child has a rash on the face, arms, upper legs, and torso. It is splotchy and intensifies after being in the sun. The child does not complain of fever or itchiness. The signs and symptoms are consistent with:

  1. roseola
  2. cat scratch disease
  3. chickenpox
  4. scabies
  5. fifth disease

fifth disease

52

A sample from an abscess is stained and examined under the microscope. A Gram stain appears uniformly pink, but a GMS (Gomori methenamine silver) stain reveals brownish filaments in the sample. These findings suggest:

  1. dermatophytosis
  2. necrotizing fasciitis
  3. phaeohyphomycosis
  4. leishmaniasis
  5. sporotrichosis

phaeohyphomycosis

53

One summer, bird watchers and zookeepers in a major city notice that more birds than usual are dying. At the same time reports of human encephalitis cases increase sharply. The cerebrospinal fluid of human patients is clear. Similar enveloped RNA virus particles are detected in samples from both birds and humans. Which of the following might be responsible for this outbreak?

  1. Neisseria meningitidis
  2. an arbovirus
  3. coxsackie A virus
  4. rabies virus
  5. Cryptococcus neoformans

an arbovirus

54

A young man is experiencing fever and severe headaches, and is having difficulty staying awake. He reports having spent time in Africa on a missionary trip several months ago. Recently he spent time in a park where he went swimming in the lake and was bitten by a bat he attempted to catch. His cerebrospinal fluid is nearly clear, and contains long, slender, mobile cells. This description indicates infections with:

  1. Acanthamoeba
  2. Trypanosoma brucei
  3. rabies virus
  4. Neisseria meningitidis
  5. an enterovirus

Trypanosoma brucei

55

A child is brought to the hospital with a high fever, nausea and vomiting, and complaining of headache. The cerebrospinal fluid collected by spinal tap is cloudy and contains spherical cells which stain Gram-positive. These signs and symptoms are consistent with:

  1. bacterial meningitis probably due to Streptococcus
  2. aseptic meningitis from infection with Neisseria meningitidis
  3. cryptococcal meningitis due to infection with Cryptococcus neoformans
  4. tetanus resulting from infection with Clostridium botulinum
  5. primary amebic encephalitis caused by Naegleria

bacterial meningitis probably due to Streptococcus

56

Which of the following causes of meningitis can be spread by the fecal-oral route?

  1. coxsackie A virus
  2. West Nile virus
  3. Haemophilus influenzae
  4. Streptococcus agalactine
  5. Streptococcus pneumoniae

coxsackie A virus

57

Nasal or ocular contact with water containing ____ may result in primary amoebic meningoencephalitis.

  1. Naegleria
  2. Trypanosoma brucei
  3. Acanthamoeba
  4. both Acanthamoeba and Naegleria
  5. Acanthamoeba, Naegleria, and Trypanosoma brucei

both Acanthamoeba and Naegleria

58

Variant Creutzfeldt-Jakob disease can be prevented by avoiding:

  1. contaminated waterways
  2. contact with bird droppings
  3. contact with mosquitoes
  4. consumption of undercooked meat
  5. consumption of contaminated meat

consumption of contaminated meat

59

An intracellular parasite primarily transmitted as an STD is the agent of _____, which may cause enough damage to result in blindness.

  1. trachoma
  2. cryptococcal meningitis
  3. rabies
  4. primary amebic menigoencephalopathy
  5. tetanus

trachoma

60

African sleeping sickness is fatal if not treated because the parasite:

  1. evades destruction by the immune system by changing surface antigens
  2. produces a non-immunogenic toxin the immune system cannot neutralize
  3. produces a toxin which binds irreversibly to neurons
  4. is an intracellular parasite in RBC's, where they are not detected by the immune system
  5. reproduces so fast there is no time for an immune response to develop

evades destruction by the immune system by changing surface antigens produces a toxin which binds irreversibly to neurons

61

The disease know as cryptococcal meningitis:

  1. begins as a lung infection
  2. results from exposure to bird droppings
  3. is caused by a Gram-negative coccus
  4. is transmitted in respiratory aerosols
  5. results from exposure to bird droppings and begins as a lung infection

results from exposure to bird droppings and begins as a lung infection

62

Which of the following nervous system diseases is treated with both passive and active immunization?

  1. rabies
  2. botulism
  3. West Nile encephalitis
  4. primary amebic meningoencephalopathy
  5. arboviral encephalitis

rabies

63

Poliovirus is most often transmitted via:

  1. household pets.
  2. mosquitoes.
  3. contaminated water.
  4. droplets.
  5. endospores.

contaminated water

64

Listeria monocytogenes pathogenesis is directly related to its ability to:

  1. live and reproduce inside its host's cells
  2. produce a powerful toxin
  3. resist most antimicrobial agents
  4. form endospores
  5. produce a polysaccharide capsule

live and reproduce inside its host's cells

65

The highly destructive form of Hansen's disease is the result of:

  1. autoimmune disease triggered by Myobacteria leprae.
  2. intracellular infection with Clostridium botulinum.
  3. infection with rabies virus.
  4. poor immune response to Mycobacterium leprae.
  5. poor immune response to Streptococcus agalactiae.

poor immune response to Mycobacterium leprae.

66

Tetanus vaccine contains:

  1. antibodies against Clostridium tetani
  2. antibodies against Clostridium tetani endospores
  3. fragments of Clostridium tetani cell walls
  4. inactivated Clostridium tetani endospores
  5. inactivated tetanospasmin

inactivated tetanospasmin

67

A baby arrives at an emergency room suffering from violent muscle spasms and difficulty breathing. The baby's body is so rigid a proper exam is difficult, but staff note the baby is only a few weeks old and the umbilicus has not healed properly. The signs are consistent with which of the following diseases?

  1. listeriosis
  2. infant botulism
  3. rabies
  4. acute bacterial meningitis
  5. tetanus

tetanus

68

How does tetanospasmin affect motor control?

  1. it blocks the release of inhibitory neurotransmitters in the CNS
  2. it blocks the secretion of acetylcholine into the synaptic cleft
  3. it triggers the endocytosis of skeletal muscle cells
  4. it is a pyrogenic toxin
  5. it induces nervous system proteins to fold into abnormal shapes

it blocks the release of inhibitory neurotransmitters in the CNS

69

Which of the following is TRUE of foodborne botulism?

  1. large amounts of bacteria must be consumed to produce disease
  2. it is an intoxication disorder
  3. Normal food preparation methods can prevent it
  4. an effective vaccine is available
  5. it is not a life-threatening infection even when left untreated

it is an intoxication disorder

70

The type of bacterial meningitis that becomes epidemic among young adults is caused by:

  1. Streptococcus pneumoniae
  2. Streptococcus agalactiae
  3. Listeria monocytogenes
  4. Neisseria meningitidis
  5. Haemophilus influenzae

Neisseria meningitidis

71

Contaminated food is the source of _____, which causes meningitis in the elderly and susceptible persons.

  1. Haemophilus influenzae
  2. Neisseria meningitidis
  3. Streptococcus pneumoniae
  4. Listeria monocytogene
  5. Streptococcus agalactiae

Listeria monocytogene

72

Newborns exposed to the Gram-positive bacterium _____ during vaginal birth are at risk of developing neonatal meningitis.

  1. Streptococcus pneumoniae
  2. Streptococcus agalactiae
  3. Neisseria meningitidis
  4. Haemophilus influenzae
  5. Listeria monocytogenes

Streptococcus agalactiae

73

The Gram-negative diplococcus _____ is resistant to phagocytosis and releases Lipid A to cause inflammation.

  1. Streptococcus agalactiae
  2. Clostridium botulinum
  3. Listeria monocytogenes
  4. Haemophilus influenza
  5. Neisseria meningitidis

Neisseria meningitidis

74

Functions of the meninges include:

  1. protection from external shock.
  2. support for the brain and spinal cord and protection from external shock.
  3. support for the brain and spinal cord.
  4. production of neurotransmitters.
  5. transmission of signals from the peripheral nervous system.

support for the brain and spinal cord and protection from external shock.

75
card image

A person reports to a clinic complaining of fever and abdominal pain. The abdomen is swollen, and blood test indicate kidney damage. A stool sample is examined under a microscope and found to contain the egg shown in the figure. The indications are consistent with infection with:

  1. Anaplasma phagocytophilim
  2. Trypanosoma cruzi
  3. Plasmodium falciparum
  4. Schistosoma mansoni
  5. Toxoplasma gondii

Schistosoma mansoni

76

A young man who is an avid outdoorsman goes to see his doctor complaining of fever with chills, headache nausea, and diarrhea. Blood tests show that he has low levels of leukocytes and platelets. He may have contracted:

  1. Chagas disease
  2. Lyme disease
  3. tularemia
  4. brucellosis
  5. ehrlichiosis

ehrlichiosis

77

Which of the following disease is currently vaccine-preventable in humans?

  1. yellow fever
  2. schistosomiasis
  3. Lyme disease
  4. plague
  5. malaria

yellow fever

78

The normal hosts for Ebola viruses are probably:

  1. birds
  2. cats
  3. humans
  4. bats
  5. rodents

bats

79

Lyme disease becomes chronic because:

  1. Borrelia is an intracellular parasite of erythrocytes
  2. the bacterium resists phagocytosis
  3. Borrelia can lie dormant in liver cells
  4. Borrelia changes its surface antigens frequently
  5. the bacterium resists phagocytosis and "hides" erythrocytes

Borrelia changes its surface antigens frequently

80

Which of the following statements concerning Toxoplasma infection is CORRECT?

  1. Freshwater snails are intermediate hosts
  2. It is transmitted by biting insects
  3. It is typically contracted by eating undercooked meat
  4. It is a rare infection
  5. In most individuals, the infection results in lasting damage to the heart

It is typically contracted by eating undercooked meat

81

Plasmodium species reproduce sexually in:

  1. Anopheles mosquitoes
  2. humans
  3. birds
  4. Aedes mosquitoes
  5. Ixodes ticks

Anopheles mosquitoes

82

A large number of people experience a high fever with a rash during the summer months in a small country. Epidemiologists suspect an emerging disease. Both Aedes and Anopheles mosquitos are endemic to the country. Researchers are able to detect +ssRNA in the blood of fever victims and in some mosquitoes. What type of pathogen might be responsible for the epidemic?

  1. a flavivirus
  2. Plasmodium
  3. a filovirus
  4. plague bacteria
  5. a herpesvirus

a flavivirus

83

Dengue hemorrhagic fever is the result of:

  1. a hyperimmune response to reinfection with dengue virus
  2. an antibody- antigen complex reaction
  3. the chronic carrier state associated with dengue virus infection
  4. an immediate immune reaction to the initial infection with dengue virus
  5. an autoimmune disease

a hyperimmune response to reinfection with dengue virus

84

Schizogony is an important aspect of which of the following pathogens?

  1. Trypanosoma cruzi
  2. Plasmodium species
  3. Schistosoma mansoni
  4. Yersinia pestis
  5. Toxoplasma gondii

Plasmodium species

85

Primary infection with Epstein-Barr virus is known as:

  1. oral hairy leukoplakia
  2. Hodgkin's lymphoma
  3. Burkitt's lymphoma
  4. infectious mononucleosis
  5. chronic fatigue syndrome

infectious mononucleosis

86

How does Borrelia burgdorferi evade the body's defenses?

  1. It has a polysaccharide capsule
  2. It is capable of antigenic variation
  3. It has manganese-containing enzymes
  4. It has a polysaccharide capsule and is antiphagocytic proteins
  5. It is capable of antigenic variation and has manganese-containing enzymes

It is capable of antigenic variation and has manganese-containing enzymes

87

Which of the following statements is CORRECT concerning tularemia?

  1. The causative agent is an intracellular bacterial parasite
  2. The disease is easily treated
  3. The signs include a distinctive pattern of mild but recurring fever
  4. The disease is transmitted from person to person
  5. Infection occurs by inhalation only

The causative agent is an intracellular bacterial parasite

88

Unprotected contact with the bodily fluids of an infected animal may result in:

  1. brucellosis
  2. toxoplasmosis
  3. African sleeping sickness
  4. Lyme disease
  5. blackwater fever

brucellosis

89

Entamoeba histolytica is acquired by:

  1. contaminated food.
  2. contaminated water.
  3. sexual contact.
  4. ingestion of cysts of the pathogen.
  5. All of the choices are correct.

All of the choices are correct.

  • contaminated food.
  • contaminated water.
  • sexual contact.
  • ingestion of cysts of the pathogen.
90

Pregnant women should never change cat litter due to risk of contracting:

  1. malaria
  2. toxoplasmosis
  3. amebic dysentery
  4. trypanosomiasis
  5. Chagas disease

toxoplasmosis

91

Schistosomiasis involves:

  1. eggs from humans enter water and develop into miracidium.
  2. snails allow development into cercaria.
  3. cercariae enter hair follicles and pass to the blood and then the liver.
  4. a blood fluke.
  5. All of the choices are correct.

All of the choices are correct.

  • eggs from humans enter water and develop into miracidium.
  • snails allow development into cercaria.
  • cercariae enter hair follicles and pass to the blood and then the liver.
  • a blood fluke.
92

Trichinosis includes all the following, EXCEPT:

  1. associated with undercooked pork or bear meat
  2. the first symptoms are diarrhea, nausea, fever, and pain
  3. migrate from intestines to blood an various body tissues
  4. All of the choices are correct

All of the choices are correct

93

Strongyloides stercoralis:

  1. chronic infection is very rare
  2. is a tapeworm
  3. immunosuppressed patients can die from disseminated disease
  4. is ingested with food and does not migrate out of the intestine
  5. All of the choices are correct

immunosuppressed patients can die from disseminated disease

94

Toxoplasmosis includes all the following, EXCEPT :

  1. immunocompromised patients often develop a fatal, disseminated infection.
  2. tachyzoites can cross the placenta
  3. ingesting or inhaling oocysts from infected cats or cat feces
  4. intrauterine infection are generally mild with very little damage to fetal tissues.
  5. ingesting pseudocysts from contaiminated raw or undercooked meat.

intrauterine infection are generally mild with very little damage to fetal tissues.

95

The symptoms that occur in cyclic 48 to 72 episodes in a malaria patient are:

  1. chills, fever, and sweating
  2. sore throat, low grade fever, and swollen lymph nodes
  3. bloody, mucus-filled stools, fever, diarrhea, and weight loss
  4. fever, swollen lymph nodes, and joint pain.
  5. urinary frequency and pain, and vaginal discharge.

chills, fever, and sweating

96

Which of the following are likely to predispose patients to fungal infections?

  1. tuberculosis
  2. AIDS
  3. cancer
  4. malnutrition
  5. All of the choices are correct

All of the choices are correct

  • tuberculosis
  • AIDS
  • cancer
  • malnutrition
97

Which antifungal drug inhibits division of the fungus?

  1. ketoconazole (Nizaral)
  2. fluconazole
  3. terbinafine (Lamisil)
  4. griseofulvin
  5. amphtericin B

griseofulvin

98

All of the following are fungal allergies, except:

  1. teapicker's lung
  2. thrush
  3. bark strippers disease
  4. farmer's lung
  5. all of the above

thrush

99

Which of the following is a rare mycosis caused by a mold commonly found in soil, in dairy products, and on the human body?

  1. geotrichosis
  2. bark stripper's disease
  3. sporotrichosis
  4. Valley fever
  5. Pneumocystis pneumonia

geotrichosis

100

Pneumocystis (carinii) jiroveci:

  1. has protozoan and fungal characteristics
  2. causes serious infection in elderly, premature infants, and AIDS patients
  3. is an obligate parasite
  4. lacks ergosterol in its plasma membrane
  5. All of the choices are correct

All of the choices are correct

  • has protozoan and fungal characteristics
  • causes serious infection in elderly, premature infants, and AIDS patients
  • is an obligate parasite
  • lacks ergosterol in its plasma membrane
101

Decaying vegetation, such as piles of leaves and compost matter, allows growth and transmission of:

  1. Dermatophytes
  2. Pneumocystis
  3. Aspergillus
  4. Cryptococcus
  5. Candida

Aspergillus

102

Serious mycoses treated with amphotericin B include all the following, except :

  1. invasive aspergillosis
  2. histoplasmosis
  3. Pneumocystis pneumonia
  4. coccidioidomycosis
  5. zygomycosis

Pneumocystis pneumonia

103

Aspergillosis includes all the following, except:

  1. most cases are due to A. fumigatus
  2. noninvasive infections of the eyelids, sinuses, conjunctiva, and ear canals
  3. a pneumonia that disseminates to the brain.
  4. life-threatening infections in AIDS, leukemia, and transplant patients
  5. there are no effective drugs to treat the infection

there are no effective drugs to treat the infection

104

This opportunist is the most frequent cause of life-threatening pneumonia is AIDS patients:

  1. Pneumocystis (carinii) jiroveci
  2. Malassezia furfur
  3. Candida albicans
  4. Cryptococcus neoformans
  5. None of the choices are correct

Pneumocystis (carinii) jiroveci

105

Cryptococcus neoformans has the following characteristics, except:

  1. in high numbers in soil containing pigeon droppings
  2. primarily infects patients with AIDS, cancer, and diabetes
  3. usually enters body by inhalation
  4. commonly found in the human mouth, intestines, and genitalia
  5. a capsulated yeast

commonly found in the human mouth, intestines, and genitalia

106

All of the following pertain to Candida albicans, except:

  1. has a large capsule
  2. infections often arise from an endogenous source
  3. persistent moist skin influences infection
  4. opportunistic yeast
  5. low numbers found in the mouth, intestines, genitalia, and skin

has a large capsule

107

Which is mismatched?

  1. Tinea pedis - ringworm of the foot
  2. Tinea unguium - ringworm of the nails
  3. Tinea corporis - ringworm of the body
  4. Tinea capitis - ringworm of the beard
  5. Tinea cruis - ringworm of the groin

Tinea capitis - ringworm of the beard

108

Paracoccidioides is:

  1. also known as Valley fever
  2. only seen in immunocompromised patients
  3. endemic to regions of Central and South America
  4. a superficial mycosis
  5. all of the choices are correct

endemic to regions of Central and South America

109

The highest incidence of histoplasmosis in the United States occurs in the:

  1. Northeast
  2. Rocky Mountains
  3. Southeast
  4. East and Midwest
  5. Southeast

East and Midwest

110

Characteristics of Histoplasma capsulatum include:

  1. it is a dermatophyte
  2. it grows in dry, arid soil
  3. it grows in moist soil, rich in nitrogen from bird and bat guano
  4. it is a yeast with a capsule
  5. None of the choices are correct

it grows in moist soil, rich in nitrogen from bird and bat guano

111

The routes of entry for most fungi into the body are:

  1. digestive and respiratory.
  2. urinary and reproductive.
  3. respiratory and cutaneous.
  4. blood and wounds.
  5. None of the choices are correct.

respiratory and cutaneous.

112

Pseudomonas aeruginosa causes all the following, except

  1. severe nosocomial infection in burn patients
  2. diarrheal illness
  3. skin rashes from contaminated hot tubs and bath sponges
  4. external ear infection
  5. serious infection in lung tissue of cystic fibrosis patients
  1. skin rashes from contaminated hot tubs and bath sponges
113

Which of the following is not correct concerning the plague?

It is transmitted by flea vectors.

Mice, voles, and other rodents are primary long-term reservoirs.

Less than 10 cases per year occur in the US.

Strains of the plague bacillus are less virulent today as they were in the Middle Ages.

The etiological agent is Yersinia pestis.

Strains of the plague bacillus are less virulent today as they were in the Middle Ages

114

Which of the following is not correct concerning Legionnaires disease?

  1. L. pneumophila lives in close associations with free-living amoebas.
  2. Symptoms include cough, diarrhea, and abdominal pain.
  3. Cases have been traced to the fallout of Mount Saint Helen's volcano.
  4. It is more common in males over 50 years of age.
  5. The disease is communicable from person to person.

The disease is communicable from person to person.

115

Which bacteria could be responsible for hemolytic uremic syndrome (HUS)?

  1. Salmonella
  2. Enterotoxigeic strains of E. coli
  3. Enteroinvasive E. coli
  4. Shigella dysenteriae
  5. E. coli 0157:H7

E. coli 0157:H7

116

Up to 70% of travel-associated gastrointestinal diseases are caused by:

  1. Enteroinvasive E. coli
  2. E. coli 0157:H7
  3. Enterotoxigeic strains of E. coli
  4. Salmonella
  5. Shigella dysenteriae

Enterotoxigeic strains of E. coli

117

All of the following are correct about salmonelloses except

  1. drug resistance of salmonella is on the rise
  2. outbreaks have been caused by eggs
  3. non-typhoidal strains of salmonella are zoonotic in origin
  4. strains of normal flora in dogs and cats
  5. food contaminated by rodent feces may cause outbreaks

strains of normal flora in dogs and cats

118

All of the following are associated with bubonic plague, except

  1. it is caused by Yersinia pestis
  2. it can progress to a septicemia
  3. it is transmitted by human feces
  4. the patient has fever, headache, nausea, weakness
  5. the patient often has enlarged inguinal lymph nodes

it is transmitted by human feces

119

Yersinia pestis:

  1. does not respond to antimicrobic drugs.
  2. is usually transmitted by a flea vector.
  3. was virulent in the Middle Ages but is not longer virulent
  4. has humans as an endemic reservoir.
  5. all of the choices are correct

is usually transmitted by a flea vector.

120

Typhoid fever has the following characteristics, except:

  1. it can cause chronic carriers to have pathogens in their gallbladder
  2. it can infect the small intestine with fever, diarrhea, and abdominal pain.
  3. it is spread by handling reptiles
  4. it can become a septicemia, spread to lymph nodes and spleen, and cause liver abscesses
  5. it is transmitted by ingesting fecal contaminated food.

it is transmitted by ingesting fecal contaminated food.

121

All of the following are coliforms that cause opportunistic and nosocomial infections, except:

  1. Citrobacter
  2. Enterobacter
  3. Serratia
  4. Shigella
  5. Klebsiella

Shigella

122

Characteristics of all the members of the family Enterobacteriaceae include:

  1. ferment glucose
  2. produce enterotoxins
  3. are normal flora of the human intestines
  4. ferment lactose
  5. All of the choices are correct

All of the choices are correct:

  • ferment glucose
  • produce enterotoxins
  • are normal flora of the human intestines
  • ferment lactose
123

Pertussis has the following characteristics, except:

  1. transmission is by respiratory droplets
  2. DTaP immunization will prevent it
  3. catarrhal stage has persistent, hacking coughs with "whoops"
  4. early stage resembles a cold with nasal discharge and sneezing
  5. pathogen has virulence factors to destroy the action respiratory cilia

catarrhal stage has persistent, hacking coughs with "whoops"

124

Which of the following may be recommended for treating gangrene?

  1. rigorous cleansing of deep wounds
  2. amputation of affected limb
  3. debridement of the wound
  4. hyperbaric chamber
  5. All of the choices are correct

All of the choices are correct

  • rigorous cleansing of deep wounds
  • amputation of affected limb
  • debridement of the wound
  • hyperbaric chamber
125

What is the usual caused of pseudo-membranous colitis?

  1. living in dose contact with someone infected with C. perfringens
  2. improperly home-preserved foods containing botulin toxin
  3. eating unpasteurized dairy containing Listeria monocytogenes
  4. therapy with broad-spectrum antibiotics leading to superinfection by C. difficile
  5. handling infected animals contaminated with E. rhusiopathiae

therapy with broad-spectrum antibiotics leading to superinfection by C. difficile

126

Generally, what must healthy adults consume in order to contract botulism?

  1. C. botulin toxin on contaminated food
  2. botulin toxoid on contaminated food
  3. botulin antitoxin on contaminated food
  4. vegetative cells of C. botulinum
  5. spores of C. botulinum

spores of C. botulinum

127

All of the following are true about diphtheria toxin, except:

  1. it primarily targets the heart and nerves
  2. it must be neutralized with antitoxin
  3. it inhibits cellular protein synthesis
  4. antitoxin (DAT) comes from immunized human plasma donors
  5. it is an exotoxin

it primarily targets the heart and nerves

128

Lepromatous leprosy:

  1. is the most disfiguring.
  2. pathogen grows extensively in cooler body areas, such as nose, ears, testes.
  3. complications include secondary infections, kidney, or respiratory failure.
  4. can cause lepromas.
  5. includes all of these choices.

includes all of these choices.

  • is the most disfiguring.
  • pathogen grows extensively in cooler body areas, such as nose, ears, testes.
  • complications include secondary infections, kidney, or respiratory failure.
  • can cause lepromas.
129

Actinomyces israelii:

  1. causes most cases in the immunocompromised.
  2. can cause pneumonia with symptoms similar to tuberculosis.
  3. lives in the soil.
  4. can be transmitted by respiratory droplets.
  5. are filamentous rods that grow in clusters called sulfur granules in infected tissue.

are filamentous rods that grow in clusters called sulfur granules in infected tissue.

130

Which is not a characteristic of Nocardia?

  1. are filamentous rods that grow in clusters called sulfur granules in infected tissue.
  2. causes most cases in the immunocompromised.
  3. can cause pneumonia with symptoms similar to tuberculosis.
  4. lives in the soil.
  5. can be transmitted by respiratory droplets.

are filamentous rods that grow in clusters called sulfur granules in infected tissue.

131

Tuberculin skin testing:

  1. will be positive if person has had previous exposure.
  2. uses a purified protein filtrate of Mycobacterium tuberculosis.
  3. injects PPD intradermally.
  4. will be positive in active TB.
  5. All of the choices are correct.

All of the choices are correct.

  • will be positive if person has had previous exposure.
  • uses a purified protein filtrate of Mycobacterium tuberculosis.
  • injects PPD intradermally.
  • will be positive in active TB.
132

All of the following pertain to tuberculosis, except:

  1. live bacilli can remain dormant in the lungs and reactivate later in life
  2. the BCG vaccine is used in other countries
  3. symptons of active TB include low-grade fever, coughing, fatigue, weight loss, and night sweats
  4. lung infection can disseminate to many other organs in extrapulmonary TB
  5. antimicrobials cannot treat and cure tuberculosis.

antimicrobials cannot treat and cure tuberculosis.

133

Erysipeloid is transmitted by:

  1. contaminated soil entering deep puncture wounds.
  2. inhalation of spores from hides and wool of animals.
  3. ingestion of improperly cooked hot dogs.
  4. an abrasion on skin coming in contact with infected swine or other animals.
  5. respiratory secretions.

an abrasion on skin coming in contact with infected swine or other animals.

134

All of the following pertain to Clostridium difficile infection, except:

  1. it is a colitis that is a superinfection
  2. it often has an endogenous source
  3. it is due to the ingestion of contaminated, improperly stored, cooked meats and gravies
  4. it may be on the rise due to the increased use of gastric acid inhibitors
  5. it is a major caused of diarrhea in hospitals

it is due to the ingestion of contaminated, improperly stored, cooked meats and gravies

135

Which form of anthrax involves a black eschar on the skin?

  1. cutaneous
  2. gastrointestinal
  3. pulmonary
  4. All of the choices are correct.
  5. None of the choices are correct.

cutaneous

136

A woman goes to her gynecologist and reports that she is experiencing pain during intercourse and frequently has an unusual vaginal discharge that is increased in quantity and sort of foamy. A vaginal smear shows normal appearing epithelial cells along with small leaf-shaped cells with prominent oval nuclei. What disease is this woman experiencing?

  1. herpes
  2. syphilis
  3. chancroid
  4. cervical cancer
  5. trichomoniasis

trichomoniasis

137

Which of the following statements is TRUE regarding genital herpes?

  1. Herpes can be prevented using vaginal spermicidal creams.
  2. Acyclovir is effective in reducing the occurrence of lesions, but is not a cure.
  3. There is an effective vaccine to prevent infection
  4. Re-appearance of lesions is the result of new infections.
  5. It can only be transmitted when lesions are evident.

Acyclovir is effective in reducing the occurrence of lesions, but is not a cure.

138

A diagnosis of genital herpes is confirmed by the:

  1. appearance and size of herpetic lesions
  2. binding of fluorescent antibodies
  3. location of herpetic lesions
  4. detection of herpesvirus DNA by PCR
  5. appearance of stained tissue specimens

detection of herpesvirus DNA by PCR

139

A young adult shows up at a free clinic complaining of painful swellings in the groin. The young woman has a history of occasional casual sex, but denies noticing any genital sores or experiencing painful urination. The young woman is most likely infected with:

  1. Neisseria gonorrhoeae
  2. Treponema pallidum
  3. Haemophilus ducreyi
  4. Trichomonas vaginalis
  5. Chlamydia trachomatis

Chlamydia trachomatis

140

Which of the following statements is CORRECT regarding the incidence of STDs?

  1. Bacterial STDs are declining worldwide as a result of the availability of antibiotics.
  2. viruses transmitted by sexual contact are not widespread.
  3. The incidence of STDs is known with a high degree of accuracy.
  4. The incidence of most STDs could be reduced by vaccination.
  5. Viral STDs in the U.S. are considered epidemic.

Viral STDs in the U.S. are considered epidemic.

141

A distinctive feature of secondary syphilis is:

  1. rubbery, painful lesions.
  2. a widespread rash that can include the palms and soles.
  3. hard, red, painless bumps.
  4. soft, painful ulcers.a widespread rash that can include the palms and soles
  5. blister-like lesions which ulcerate.

a widespread rash that can include the palms and soles.

142

The presence of Gram-negative dipplocci in pus from an inflamed penis is diagnostic for infection by:

  1. Neisseria gonorrhoeae.
  2. Treponema pallidum.
  3. Chlamydia trachomatis.
  4. Mycoplasma hominis,
  5. human herpesvirus 2.

Neisseria gonorrhoeae.

143

Neisseria gonorrhoeae of the reproductive tract in women:

  1. results in the formation of curd-like discharge
  2. is usually initially asymptomatic
  3. produces painful ulcerations produces severe inflammation of the vagina and cervis
  4. results in the production of a yellow-greenish frothy discharge

is usually initially asymptomatic

144

During the spring calving season, a ranch hand begins to run a fever and feel nauseous and achy. After he develops a headache and vomiting, he goes to a clinic. A microscopic exam of a urine sample reveals long thin microbes which move very rapidly in a corkscrewing patter. The man may have contracted:

  1. thrichomoniasis
  2. glomerulonephritis
  3. leptospirosis
  4. chancroid
  5. staphylococcal toxic shock syndrome

leptospirosis

145

Accessory organ infections are caused by:

  1. norovirus
  2. rotavirus
  3. enterovirus
  4. human herpesvirus 1
  5. mumps virus

mumps virus

146

What member of the human intestinal microbiota occasionally causes life-threatening disease?

  1. Escherichia coli O157:H7
  2. Giardia intestinalis
  3. Clostridium difficile
  4. Salmonella enterica
  5. Lactobacilus

Clostridium difficile

147

Care in the handling and disposal of diapers in day care centers may prevent the spread of which of the following?

  1. Salmonella enterica
  2. Cryptosporidium parvum
  3. norovirus
  4. hepatitis A virus
  5. Giardia intestinalis

Giardia intestinalis

148

A large number of people in a community experience diarrhea with fever. Public health authorities investigate and find that the people are passing dark urine, and some have yellowish skin. Furthermore, all of the affected individuals recently ate at a new restaurant in town known for its wide variety of fresh imported vegetables. Which of the following is the most likely causative agent?

  1. Salmonella enterica
  2. Escherichia coli 0157:H7
  3. norovirus
  4. hepatitis E virus
  5. hepatitis A virus

Salmonella enterica

149

Where in a tapeworm would you expect to find fertilized eggs?

  1. outside the cuticle
  2. in all proglottids
  3. the neck region of the strobila
  4. inside the scolex
  5. at the end of the strobila

at the end of the strobila

150

A man reports to his doctor that he is tired all the time and his urine has become darker in color. He has not experienced fever or vomiting recently. The physician notes that his eyes are yellowish and his abdomen is swollen. The man has a history of kidney transplant and recently returned from an overseas trip. Then man may be infected with:

  1. hepatitis C virus
  2. Shigella
  3. norovirus
  4. hepatitis E virus
  5. Entamoeba histolytica

hepatitis E virus

151

Which of the following conditions usually results in severe acute liver damage?

  1. co-infection with hepatitis B and hepatitis delta viruses
  2. co-infection with hepatitis A and hepatitis B viruses
  3. superinfection with hepatitis A and hepatitis E viruses
  4. co-infection with hepatitis B and hepatitis C viruses
  5. superinfection with hepatitis B and hepatitis delta viruses

co-infection with hepatitis B and hepatitis delta viruses

152

Which of the following statements is TRUE with regard to oral herpes?

  1. Lesions become more severe with each recurrence.
  2. There is an effective cure for oral herpes
  3. Ninety percent of all cases are caused by human herpesvirus 2 (HHV-2)
  4. Primary infections are usually characterized by severe lesions.
  5. Lesions can be triggered by emotional stress or physiologic changes.

Lesions can be triggered by emotional stress or physiologic changes.

153

A young woman being treated for serious burns develops severe diarrhea accompanied by intense abdominal pain. She passes several water, foul-smelling, bloody stools a day. A colonoscopy reveals patches of yellowish lesions in the large intestine. The probable causative agent is:

  1. Vibrio cholerae
  2. Campylobacter
  3. Giardia intestinalis
  4. Salmonella enterica serotype Typhi
  5. Clostridium difficile

Clostridium difficile

154

Infection with some Salmonella enterica serotypes can progress to typhoid fever when the bacteria:

  1. reproduce within cells of the small intestine.
  2. produce type III secretion system proteins.
  3. enter the blood and are engulfed by phagocytes.
  4. attach to cells of the small intestine.
  5. induce endocytosis by intestinal cells.

enter the blood and are engulfed by phagocytes.

155

The virulence factor of Vibrio cholera, which is primarily responsible for the signs and symptoms of cholera, is:

  1. its ability to survive in freshwater
  2. its activation of certain genes within the human body
  3. its ability to produce a potent exotoxin
  4. the presence of polar flagella
  5. its ability to form biofilms in saltwater

its ability to produce a potent exotoxin

156

A woman who breeds parrots develops a fever and cough, and begins to have difficulty breathing. Small Gram-negative bacteria are detected inside cells of a sputum sample. Which of the following diseases is she likely to have contracted?

  1. influenza
  2. primary atypical pneumonia
  3. histoplasmosis
  4. ornithosis
  5. inhalation anthrax

ornithosis

157

A young man who works on a ranch and lives in the log bunkhouse experiences sudden fever with muscle aches. A few days later he begins to cough and have difficulty breathing, and goes to an urgent care clinic. A blood sample reveals a high leukocyte count and low platelets. A Gram stain of a sputum sample shows only a few small bacteria present. Which of the following is the most likely infecting agent?

  1. Bacillus anthracis
  2. influenza
  3. Hantavirus
  4. Mycoplasma pneumonia
  5. Histoplasma capsulatum

Hantavirus

158

Legionella pneumophila is an opportunistic pathogen that:

  1. is a disease of birds transmissible to humans
  2. is capable of forming endospores
  3. survives in the environment as an intracellular parasite of a protozoan
  4. is part of the microbiota of the nasal cavity which occasionally invades the lungs
  5. is part of the microbiota of the lower respiratory system

survives in the environment as an intracellular parasite of a protozoan

159

A nursing student develops a positive reaction to the tuberculin skin test. A history reveals possible exposure to patients with tuberculosis. A sputum sample is acid-fast negative. When asked for vaccination records, the student reports that childhood vaccination records were lost when the family emigrated from a Southeast Asian country. What is the best explanation for the test results?

  1. The student has been exposed to Mycobacterium tuberculosis
  2. The student is not infected
  3. The student has been infected with Mycobacterium tuberculosis
  4. The student has been exposed to Mycobacterium tuberculosis or was vaccinated with BCG vaccine
  5. No conclusion is possible with the information provided

The student has been exposed to Mycobacterium tuberculosis or was vaccinated with BCG vaccine

160

A new vaccine for the upcoming flu season is developed from an influenza isolate designated A/Shanghai/2/2013/(H7N9). This nomenclature means the isolate is:

  1. the second type A strain with HA 7 and NA 9 antigens isolated in Shanghai in 2013
  2. a type A with antigens HA 7 and NA 9 isolated in Shanghai in February 2013
  3. a hybrid of 2 type As combining 7 HA and 9 NA antigens, created in February 2013
  4. a type A with 7 HA antigens and 9 NA antigens isolated in Shanghai in February 2013
  5. a type B strain with antigens HA 7 and NA 9, first isolated in February 2013

a type A with antigens HA 7 and NA 9 isolated in Shanghai in February 2013

161

Why are nearly all AIDS patients at risk of developing Pneumocystis pneumonia?

  1. Pneumocystis jiroveci is zoonotic in a wide range of vertebrates and exposure is unavoidable.
  2. Pneumocystis jiroveci is becoming a wide-spread contaminant in health care environments.
  3. Pneumocystis jiroveci is a common member of the respiratory microbiota in humans and opportunistic pathogen.
  4. Pneumocystis jiroveci is commonly found in a wide variety of soils.
  5. The pathogen is easily transmitted from infected persons to others.

Pneumocystis jiroveci is a common member of the respiratory microbiota in humans and opportunistic pathogen.

162

Exposure to large accumulations of bird dropping may result in which of the following mycoses?

  1. histoplasmosis
  2. valley fever
  3. coccidioidomycosis
  4. blastomycosis
  5. Pneumocystis pneumonia

histoplasmosis

163

Which of the following factors is primarily responsible for the ability of Mycobacterium tuberculosis to survive long periods of time in dried droplets of respiratory aerosols?

  1. the presence of LPS in the outer membrane
  2. formation of tubercles
  3. production of cord factor
  4. pyrogenic toxin
  5. the presence of mycolic acid in the cell wall

the presence of mycolic acid in the cell wall

164

Which of the following statements is TRUE regarding infection with Mycoplasma pneumoniae?

  1. It is diagnosed by the appearance of typical "fried egg" colonies on agar
  2. It is extremely difficult to treat
  3. the causative agent is a fast-growing GRAM positive bacillus
  4. It causes disease which is usually severe enough to require hospitalization
  5. The causative agent attaches to ciliated cells in the respiratory tract

The causative agent attaches to ciliated cells in the respiratory tract

165

Bordetella pertussis causes whooping cough by:

  1. forming a pseudomembrane that obstructs the respiratory passages
  2. interfering with the activity of ciliated epithelial cells in the trachea
  3. the development of pneumonia
  4. irritating the diaphragm, which leads to severe coughing attacks
  5. suppressing mucus production

interfering with the activity of ciliated epithelial cells in the trachea

166

Which of the following statements is TRUE regarding tuberculosis?

  1. It remains viable in dried aerosol droplets for up to eight months
  2. Only virulent strains of Mycobacterium tuberculosis produce mycolic acid?
  3. The immune system is not affected by the infection
  4. Several hundred cells are required for infection
  5. It occurs only in the lungs

It remains viable in dried aerosol droplets for up to eight months

167

Which of the following statements is TRUE regarding the common cold?

  1. The viruses can infect both upper and lower respiratory tracts
  2. The immune system cannot develop an effective response to cold viruses
  3. Cold viruses are frequently spread by contaminated fomites
  4. Only coronaviruses cause the common cold
  5. Cold viruses reproduce most effectively at 37 degrees celsius

Cold viruses are frequently spread by contaminated fomites

168

Pathogenic streptococci of the upper respiratory tract (such as Streptococcus pyogenes) are distinguished from non-pathogenic streptococci by:

  1. beta hemolytic activity
  2. the presence of a lysogenic phage
  3. the absence of a capsule
  4. alpha hemolytic activity
  5. no hemolytic activity

beta hemolytic activity

169

Which of the following Streptococcus pyogenes virulence factors kills leukocytes and erythrocytes?

  1. pyrogenic toxins
  2. C5a peptidase
  3. streptokinases
  4. streptolysins
  5. the hyaluronic acid capsule

streptolysins

170

A common source of antibiotics is:

  1. Lactoccocus cremoris
  2. Aspergillus oryzae and Lactobacillus
  3. Acetobacter
  4. Streptomyces
  5. Streptococcus thermophilus

Streptomyces

171

Which of the following bacteria is a common soil bacterium that may cause disease in humans?

  1. Aspergillus oryzae
  2. Lactoccocus cremoris
  3. Streptomyces scabies
  4. Cyanobacteria
  5. Bacillus anthracis

Bacillus anthracis

172

Why are "fortified" foods more likely to spoil than are unfortified foods?

  1. Vitamins are added to "fortified" foods by adding the microbes that produce the vitamins to the food item.
  2. The addition of nutrients creates an osmotic environment suitable for a wide range of microbes.
  3. Every step of modification or manipulation of food increases the chance for contamination.
  4. The addition of vitamins or minerals makes the food more nutritious for microbes as well as humans.
  5. The vitamins require a neutral pH environment, which is suitable for many microbes.

The addition of nutrients creates an osmotic environment suitable for a wide range of microbes.

173

A patient has a serious lung infection. A sputum sample was taken. The lab technician state that the lab isolated a bacterium that did not have any peptidoglycan. You hypothesize that the identity of this microbe could possibly be _____.

  1. Borrelia burgdorferi
  2. Mycobacterium tuberculosis
  3. Mycoplasma pneumoniae
  4. Haemophilus influenzae
  5. Streptococcus pneumoniae

Mycoplasma pneumoniae

174

Which is incorrect about Leptospirosis?

  1. It is a zoonosis
  2. Weil's syndrome occurs during the second phase of the disease
  3. A vaccine is not available
  4. Its principle targets are the kidneys, liver, brain, and eyes
  5. It can be avoided by not swimming in livestock watering ponds

A vaccine is not available

175

Ureaplasma urealytictum is implicated in which of the following?

  1. Rocky Mountain Spotted Fever
  2. nongonococcal urethritis
  3. Q fever
  4. periodontal disease
  5. endemic typhus

nongonococcal urethritis

176

Oral flora bacteria on the tooth surface:

  1. use fimbriae and slime layers to adhere
  2. lactobacilli and streptococci ferment carbohydrates and produce acids that cause caries
  3. include streptococci that metabolize sucrose, produce sticky glucans, and form plaque
  4. develop a biofilm
  5. all of the choices are correct

all of the choices are correct

  • use fimbriae and slime layers to adhere
  • lactobacilli and streptococci ferment carbohydrates and produce acids that cause caries
  • include streptococci that metabolize sucrose, produce sticky glucans, and form plaque
  • develop a biofilm
177

The following are characteristics of Chlamydias, except:

  1. gram negative
  2. obligate parasites that need host cells for growth
  3. elementary bodies are the infectious form
  4. reticulate bodies differentiate into elementary bodies
  5. elementary bodes lack enzyme systems for making ATP

elementary bodes lack enzyme systems for making ATP

178

Which is incorrect regarding Q fever?

  1. pathogen produces resistant spores
  2. is a zoonosis
  3. causes fever, muscle aches, rash, and sometimes pneumonia
  4. humans infected from unpasteurized milk and airborne spread
  5. transmitted by lice

transmitted by lice

179

Rocky Mountain spotted fever:

  1. symptoms include fever, headache, and rash.
  2. is seen in highest numbers along the west coast.
  3. is transmitted by Ixodes ticks.
  4. never has severe complications.
  5. All of the choices are correct.

symptoms include fever, headache, and rash.

180

All of the following are characteristics of Campylobacter jejuni, except:

  1. it is transmitted through ingestion of contaminated chicken, meat, milk, and water.
  2. it has gram negative curved rods with darting motility
  3. it infects the stomach
  4. it causes fever and watery bloody diarrhea
  5. it produces an enterotoxin called CJT that stimulates diarrhea

it infects the stomach

181

The causative agent of Lyme disease is:

  1. Ixodes pacificus.
  2. Leptospira interrogans.
  3. Borrelia burgdorferi.
  4. Borrelia hermsii.
  5. Ixodes scapularis.

Borrelia burgdorferi.

182

Treponema, Borrelia, and Leptospira are all:

  1. spirochetes
  2. obligate parasites requiring host cells
  3. bacteria without cell walls
  4. curved rods
  5. transmitted by arthropod vectors

spirochetes

183

The chancre of syphilis:

  1. is very painful
  2. develops into a lesion with firm margins and an ulcerated central crater
  3. occurs during the tertiary stage
  4. occurs due to small hemorrhaging of capillaries
  5. All of the choices are correct

develops into a lesion with firm margins and an ulcerated central crater

184

Which is not correct about genital warts?

  1. It is the most common STD in the United States.
  2. They are strongly associated with cancer of the penis.
  3. The etiological agent is the human polyoma virus JC.
  4. They are strongly associated with cancer of the cervix.
  5. Treatment can involve laser surgery.

The etiological agent is the human polyoma virus JC.

185

All of the following are similarities between HAV, HBV, and HCV, except:

  1. There are diagnostic tests available to distinguish between them.
  2. They are all RNA viruses
  3. They all have an incubation period of one month.
  4. They are all endemic in the U.S.
  5. They all cause hepatitis

They are all RNA viruses

186

Which of the following viruses is an RNA virus that causes many cases of transfusion hepatitis?

  1. Adenovirus
  2. Cytomegalovirus (CMV)
  3. Epstein Barr Virus (EBV)
  4. Hepatitis C virus (HCV)
  5. Hepatitis B virus (HBV)

Hepatitis C virus (HCV)

187

Fifth disease:

  1. is a childhood febrile disease with a bright red rash on the cheeks.
  2. in immunodeficient children, destroys red blood cell stem cells.
  3. involves pathogen capable of crossing the placenta.
  4. is caused by Parvovirus B19.
  5. All of the choices are correct.

All of the choices are correct.

188

Hepatitis B infection:

  1. can be transmitted by the fecal-oral route.
  2. is due to a flavivirus.
  3. has an incubation of 1 to 3 weeks.
  4. increases risk for hepatocellular cancer.
  5. All of the choices are correct.

increases risk for hepatocellular cancer.

189

The hepadnaviruses:

  1. are nonenveloped, double-stranded DNA viruses.
  2. are transmitted by respiratory secretions.
  3. show tropism for the liver.
  4. include the adenoviruses.
  5. All of the choices are correct.

show tropism for the liver.

190

If a person who has never been infected with the varicella-zoster virus comes in contact with a person who has shingles, they will come down with:

  1. herpes labialis.
  2. infectious mononucleosis.
  3. chickenpox.
  4. herpes keratitis.
  5. shingles.

chickenpox.

191

Which of the following antivirals is not used for treatment of HSV-1 and HSV-2?

  1. Valacyclovir
  2. Famciclovir
  3. Acyclovir
  4. Interferon
  5. All of the choices are correct.

Interferon

192

Viruses with single-stranded DNA are the:

  1. Parvoviruses.
  2. Herpesviruses.
  3. Poxviruses.
  4. Papovaviruses.
  5. Adenoviruses.

Parvoviruses

193

Which is incorrect about viral diseases?

  1. Diagnosis of some diseases involves antigen detection with monoclonal antibodies.
  2. Some DNA viruses can become permanent residents of host cells.
  3. Some viruses are teratogenic.
  4. Viral diseases can be zoonoses.
  5. Most DNA viruses multiply in and are released from the cytoplasm.

Most DNA viruses multiply in and are released from the cytoplasm.

194

Which infection are you likely looking at if you view a direct smear of a cervical scraping and seen enlarged (multinucleate giant) cells and intranuclear inclusions?

  1. VZV
  2. EBV
  3. HPV
  4. HSV-2
  5. HCV

HSV-2

195

Which virus may play a role in multiple sclerosis?

  1. Smallpox
  2. Herpes simplex virus-2
  3. Epstein Barr Virus
  4. Human herpesvirus 6 (HHV-6)
  5. Cytomegalovirus (CMV)

Human herpesvirus 6 (HHV-6)

196

Human herpesvirus 6 (HHV-6) has the following characteristics, except:

  1. it is transmitted by saliva
  2. it appears as a mononucleosis-like illness in adults
  3. it causes Kaposi's sarcoma
  4. it replicates in T lymphocytes, macrophages, and salivary gland tissue.
  5. it causes roseola in infants.

it causes Kaposi's sarcoma

197

All of the following are correct about the indirect ELISA, except:

  1. a known antigen is adsorbed to the surface of a well
  2. it can detect antibodies in a serum sample
  3. color development indicates that antibody was not present in the patient's serum
  4. it is the common screening test for antibodies to Hepatitis A
  5. it is the common screening test for antibodies to Helicobacter.

color development indicates that antibody was not present in the patient's serum

198

A rising antibody titer a few days apart indicates:

  1. The patient has a current infection
  2. All of the above mentioned choices are possible
  3. Nothing, people always have antibodies in their serum
  4. The patient had a past case of the disease
  5. None of the above mentioned choices are possible

The patient has a current infection

199

Maggie was told she has a positive titer to measles. Which of the following could explain this?

  1. She was vaccinated against measles
  2. She has measles now
  3. She had measles sometime in her life
  4. The test was a false positive
  5. All of the choices are correct

All of the choices are correct

200

Precipitation tests involve all the following, except:

  1. a cloudy or opaque zone developing where the antigen and antibody react
  2. the rely on formation of visible clumps for detection
  3. they include VDRL test syphilis
  4. they can be done in a test tube by carefully adding antiserum over antigen solution
  5. they are often performed in agar gels.

they are often performed in agar gels.