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CHAPTER 23

front 1

Which of the following statements about sepsis is FALSE?
A. Lymphangitis may occur.
B. It most always is self-limiting
C. It usually is caused by gram-positive bacteria.
D. Symptoms include fever and decreased blood pressure.
E. It may be aggravated by antibiotics.

back 1

B. It most always is self-limiting

front 2

Which of the following pairs is mismatched?
A. Burkitt's lymphoma – Epstein-Barr virus
B. rheumatic fever– Streptococcus pyogenes
C. subacute bacterial endocarditis – alpha-hemolytic streptococci
D. acute bacterial endocarditis – Staphylococcus aureus
E. puerperal sepsis – Staphylococcus aureus

back 2

E. puerperal sepsis – Staphylococcus aureus

front 3

Which of the following is NOT a recognized form of anthrax?
A. cutaneous
B. gastrointestinal
C. septic
D. inhalationial
E. None of the answers are correct; all of these are recognized forms of anthrax.

back 3

C. septic

front 4

Which of the following is NOT typically treated with penicillin?
A. puerperal sepsis
B. rat-bite fever
C. serious wounds at risk for gas gangrene
D. patients at risk for rheumatic fever
E. tularemia

back 4

E. tularemia

front 5

Which of the following statements about tularemia is FALSE?
A. It may be transmitted by arthropods.
B. It occurs only in California.
C. It is caused by Francisella tularensis.
D. It may be transmitted by direct contact.
E. The most common reservoir is rabbits.

back 5

B. It occurs only in California.

front 6

Which of the following is a symptom of brucellosis?
A. undulant fever
B. pneumonia
C. relapsing fever
D. gastroenteritis
E. jaundice

back 6

A. undulant fever

front 7

Which of the following is NOT transmitted in raw milk?
A. listeriosis
B. brucellosis
C. toxoplasmosis
D. anthrax
E. All of these can be transmitted in raw milk.

back 7

C. toxoplasmosis

front 8

Which of the following is NOT a characteristic of Bacillus anthracis?
A. is gram-positive
B. is aerobic
C. found in soil
D. produces endotoxins
E. forms endospores

back 8

D. produces endotoxins

front 9

The symptoms of gas gangrene are due to all of the following EXCEPT
A. hyaluronidase.
B. microbial fermentation.
C. proteolytic enzymes.
D. endocarditis
E. necrotizing exotoxins.

back 9

D. endocarditis

front 10

Which of the following is NOT a bacterial pathogen transmitted by the bite of an animal?
A. Bartonella henselae
B. Streptobacillus
C. Pasteurella multocida
D. Plasmodium vivax
E. None of the answers is correct; all of these bacterial infections can be transmitted by dog or cat bites.

back 10

D. Plasmodium vivax

front 11

Which of the following pairs is mismatched?
A. encephalitis – Ixodes (tick)
B. epidemic typhus – Pediculus (louse)
C. Rocky Mountain spotted fever – Dermacentor (tick)
D. malaria – Anopheles (mosquito)
E. dengue – Aedes (mosquito)

back 11

A. encephalitis – Ixodes (tick)

front 12

Unsanitary and crowded conditions increase the incidence of all of the following diseases EXCEPT
A. plague.
B. relapsing fever.
C. endemic murine typhus.
E. epidemic typhus.
D. Rocky Mountain spotted fever.

back 12

D. Rocky Mountain spotted fever.

front 13

Which of the following statements about toxoplasmosis is FALSE?
A. The reservoir is cats.
B. It is transmitted by the gastrointestinal route.
C. It can be congenital.
D. It typically is a severe illness in adults.
E. It is caused by a protozoan.

back 13

D. It typically is a severe illness in adults.

front 14

Which of the following pairs does NOT apply to Chagas' disease?
A. diagnosis of acute phase – serological tests for antibodies
B. reservoir – rodents
C. causative agent – Trypanosoma cruzi
D. treatment – nifurtimox
E. vector – kissing bug

back 14

A. diagnosis of acute phase – serological tests for antibodies

front 15

Which of the following is NOT caused by a bacterium?
A. epidemic typhus
B. tickborne typhus
C. relapsing fever
D. plague
E. malaria

back 15

E. malaria

front 16

Which is NOT considered a potential agent of bioterrorism?
A. Brucella melitensis
B. Bacillus anthracis
C. Anaplasma phagocytophilium
D. Franciella tularensis
E. All of these agents are potential bioterrorism agents.

back 16

C. Anaplasma phagocytophilium

front 17

Which of the following statements about puerperal sepsis is FALSE?
A. It is caused by health care personnel.
B. Its frequency of occurrence has decreased because of antibiotics and aseptic techniques.
C. It is a complication of abortion or childbirth.
D. It begins as a focal infection.
E. It is transmitted from mother to fetus.

back 17

E. It is transmitted from mother to fetus.

front 18

Which of the following statements about schistosomiasis is FALSE?
A. The cercariae penetrate human skin.
B. It is caused by a roundworm.
C. The intermediate host is an aquatic snail.
D. The female lives in a groove that runs down the body of the male.
E. The symptoms are caused by immune reactions to the eggs shed in the human host.

back 18

B. It is caused by a roundworm.

front 19

Which of the following statements about rheumatic fever is FALSE?
A. Once resolved, a patient rarely experiences a reoccurrence.
B. It is an inflammation of the heart.
C. It is an inflammation of the joints.
D. It is a complication of a group A beta-hemolytic streptococcal infection.
E. The incidence has declined in the last ten years.

back 19

A. Once resolved, a patient rarely experiences a reoccurrence.

front 20

Which of the following pairs is mismatched?
A. Francisella – gram-positive facultatively anaerobic pleomorphic bacillus
B. Rickettsia – intracellular parasite
C. Brucella – gram-negative aerobic rods
D. Bacillus – gram-positive endospore-forming rods
E. None of the pairs is mismatched.

back 20

A. Francisella – gram-positive facultatively anaerobic pleomorphic bacillus

front 21

Which of the following can be transmitted from an infected mother to her fetus across the placenta?
A. Yersinia
B. Spirillum
C. Borrelia
D. cytomegalovirus
E. anthrax

back 21

D. cytomegalovirus

front 22

Which of the following pairs is mismatched?
A. Pasteurella – cat-scratch disease
B. Streptobacillus – rat-bite fever
C. Borrelia – relapsing fever
D. Rickettsia- typhus.
E. Yersinia – plague

back 22

A. Pasteurella – cat-scratch disease

front 23

A patient returning from an extended trip into Mexico has an ulcerating papule at the site of a previous bug bite. Microscopic examination of the papule reveals nucleated amastigotes in white blood cells. The patient most likely has
A. malaria.
B. anthrax.
C. brucellosis.
D. schistosomiasis.
E. leishmaniasis.

back 23

E. leishmaniasis.

front 24

Human-to-human transmission of plague is usually by
A. rat flea.
B. dog flea.
C. the respiratory route.
D. unsanitary conditions.
E. wounds.

back 24

C. the respiratory route.

front 25

A characteristic symptom of plague is
A. nausea and vomiting.
B. swollen lymph nodes.
C. rose-colored spots.
D. small red spots on the skin.
E. recurrent fever.

back 25

B. swollen lymph nodes.

front 26

Which of the following pairs regarding the epidemiology of malaria is mismatched?
A. treatment – chloroquine when possible
B. diagnosis – presence of merozoites
C. etiology – Plasmodium
D. enter liver cells – sporozoites
E. vector – Ixodes

back 26

E. vector – Ixodes

front 27

A predisposing factor for infection by Clostridium perfringens is
A. debridement.
B. gangrene.
C. hyperbaric treatment.
D. an infected finger.
E. burns.

back 27

B. gangrene.

front 28

Which of the following is NOT a zoonosis?
A. anthrax
B. Hantavirus infection
C. brucellosis
D. puerperal sepsis
E. tularemia

back 28

D. puerperal sepsis

front 29

Arthropods can serve as a reservoir for all of the following diseases EXCEPT
A. epidemic typhus.
B. yellow fever.
C. malaria.
D. brucellosis.
E. plague.

back 29

D. brucellosis.

front 30

Which of the following pairs is mismatched?
A. brucellosis – a temperature of 40°C each evening
B. tularemia – a localized infection appearing as a small ulcer
C. toxoplasmosis – congenital brain damage
D. cat-scratch disease – malignant pustule developing into septicemia
E. Borrelia – rash and flulike

back 30

D. cat-scratch disease – malignant pustule developing into septicemia

front 31

Which of the following CANNOT be transmitted to humans from domestic cats?
A. Chagas' disease
B. toxoplasmosis
C. Bartonella
D. plague
E. None of the answers is correct; all of these diseases can be transmitted to humans from domestic cats.

back 31

A. Chagas' disease

front 32

Which of the following is the same for both relapsing fever and undulant fever?
A. rodent reservoir
B. presence of rash
C. mode of transmission
D. rising and falling body temperature
E. treatment with tetracycline

back 32

D. rising and falling body temperature

front 33

Which of the following is NOT treated with antibiotics?
A. anthrax
B. Ebola
C. plague
D. tularemia
E. Lyme disease

back 33

B. Ebola

front 34

Which of the following produces a permanent carrier state following infection?
A. Borrelia
B. cytomegalovirus
C. Toxoplasma
E. Spirillum
D. Yersinia

back 34

B. cytomegalovirus

front 35

Epstein-Barr virus has been implicated in all of the following EXCEPT
A. endocarditis.
B. Hodgkin's disease.
C. nasopharyngeal carcinoma.
D. Burkitt's lymphoma.
E. infectious mononucleosis.

back 35

A. endocarditis.

front 36

Which of the following leads to all the others?
A. bacterial growth in endothelial cells
B. presence of antirickettsial antibodies
C. subcutaneous hemorrhaging
D. breakage of capillaries
E. blockage of capillaries

back 36

A. bacterial growth in endothelial cells

front 37

A patient complains of fever, severe muscle and joint pain, and a rash. The patient reports returning from a Caribbean vacation one week ago. Which of the following do you suspect?
A. Hantavirus hemorrhagic fever
B. dengue
C. typhus
D. Lassa fever
E. yellow fever

back 37

B. dengue

front 38

Which of the following pairs is NOT correctly matched for Gram reaction?
A. anthrax – gram-positive
B. tularemia – gram-negative
C. Rocky Mountain spotted fever – gram-negative
D. Ehrlichia – gram-positive
E. Lyme disease – gram-negative

back 38

D. Ehrlichia – gram-positive

front 39

Scrapings from a patient's rash reveal cercariae. The disease is most likely
A. Rocky Mountain spotted fever.
B. Chagas' disease.
C. relapsing fever.
D. swimmer's itch.
E. Lyme disease.

back 39

D. swimmer's itch.

front 40

You advise your pregnant friend to not adopt a new kitten from her neighbor because she could contract
A. Burkitt's Lymphoma.
B. toxoplasmosis.
C. plague.
D. infectious mononucleosis.
E. listeriosis.

back 40

B. toxoplasmosis.

front 41

Which of the following is evidence that the arthritis afflicting children in Lyme, Connecticut, was due to bacterial infection?
A. transmitted by ticks
B. accompanied by a rash
C. affected mostly children
D. treatable with penicillin
E. not contagious

back 41

D. treatable with penicillin

front 42

Which of the following is NOT controlled by a mosquito eradication program?
A. malaria
B. chikungunya fever
C. schistosomiasis
D. yellow fever
E. dengue fever

back 42

C. schistosomiasis

front 43

A 62-year-old man was hospitalized with an eight-day history of fever, chills, sweats, and vomiting. His temperature on admission was 40°C (104°F). A routine peripheral blood smear revealed ring-shaped bodies in the RBCs. What treatment would you prescribe?
A. hyperbaric oxygen
B. streptomycin
C. mefloquine
D. penicillin
E. no treatment

back 43

C. mefloquine

front 44

Which of the following statements about group B streptococci is FALSE?
A. They are present in healthy carriers.
B. They cause strep throat.
C. They cause gram-positive sepsis.
D. They cause neonatal sepsis.
E. They are classified as Streptococcus agalactiae

back 44

B. They cause strep throat.

front 45

Brucella bacteria are considered a potential agent of bioterrorism because
A. infection causes a fever.
B. they cause ulcerating lesions of the skin.
C. they are not susceptible to antibiotics.
D. they are endospore-forming bacteria.
E. they easily become airborne.

back 45

E. they easily become airborne.

front 46

What is NOT true about gram-negative sepsis?
A. The progression to lethal stages is rapid.
B. Potent exotoxins cause shock.
C. LPS is released upon death of the cells.
D. The rapid progression is almost impossible to treat effectively.
E. The site of infection itself may not be the bloodstream.

back 46

B. Potent exotoxins cause shock.

front 47

Which is NOT true regarding Rocky Mountain spotted fever?
A. The organism passes from one generation of Dermacentor to the next.
B. It is most common in the Rocky Mountain region.
C. The macular rash is sometimes mistaken for measles.
D. It is caused by Rickettsia rickettsii.
E. It is also known as tick-borne typhus.

back 47

B. It is most common in the Rocky Mountain region

front 48

Yellow fever
A. is transmitted by Anopheles mosquitoes.
B. has a mortality rate of 5%.
C. was eradicated from the U.S. in the early 1900s.
D. has an effective component vaccine available.
E. cannot be transmitted human to human.

back 48

C. was eradicated from the U.S. in the early 1900s.

front 49

Which set of pairs is mismatched?
A. Chikungunya - Anopheles
B. Marburg virus -African monkeys
C. Trypanosoma cruzi - Reduviid bug
D. Dengue - Aedes aegypti
E. Yellow fever - Aedes aegypti

back 49

A. Chikungunya - Anopheles

front 50

Which is NOT true concerning Babesiosis?
A. It has rodent reservoirs.
B. It is sometimes mistaken for malaria.
C. The parasite can be found within red blood cells in patient samples.

D. It is a tickborne disease.

E. It is caused by an obligate intracellular bacterium.

back 50

E. It is caused by an obligate intracellular bacterium.