2011 I&I exam Flashcards by geeky medical

Which of the following has the greatest chance of developing catheter-related infections?

a. peripheral venous catheter
b. central venous catheter
c. catheter with a transparent dressing
d. catheter placed for 2 days
e. non-impregnated catheter

b. central venous catheter

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A 60-year-old man has colon cancer. He underwent surgery to excise the tumor and developed a yeast infection. It was identified as candida that was intrinsically resistant to fluconazole. Which of the following could it be?

a. Candida albicans
b. Candida tropicalis
c. Candida krusei

a. Candida krusei

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What is the reservoir for brucella suis?

a. Dogs
b. Pigs
c. Cows
d. Rats

b. Pigs

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What is the reservoir for Yersinia pestis?

a. Dogs
b. Pigs
c. Cows
d. Rats

d. Rats

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What do Th-1 cells do?

a. Activate macrophages
b. Activate humoral immunity
c. Stimulate eosinophils

a. Activate macrophages

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How does Caspofungin work?

a. disrupts the mitotic spindle & inhibits mitosis
b. Inhibits the enzyme squalene epoxidase
c. Inhibits the synthesis of 1,3 β-glucan

c. Inhibits the synthesis of 1,3 β-glucan

its an Echinocandin

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A patient has esophageal candidiasis and is neutropenic. What would be the first choice to treat this condition?

a. Terbinafine
b. Ketoconazole
c. Flucytosine
d. Fluconazole

d. Fluconazole

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Which antifungal makes pores in the cell membrane of fungi?

a. Nystatin
b. Ketoconazole
c. Flucytosine
d. Terbinafine

a. Nystatin

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Which of these work in synergy with amphotericin B?

a. Nystatin
b. Ketoconazole
c. Flucytosine
d. Terbinafine

c. Flucytosine

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How does fluconazole affect amphotericin B action?

a. it inhibits the synthesis of amphotericin B site of action
b. it enhances its function & they’re always used together

a. it inhibits the synthesis of amphotericin B site of action

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Which of the following contains an anti-folate component?

a. Ciprofloxacin
b. Co-trimoxazole
c. Tetracycline

b. Co-trimoxazole

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Which of these drugs bind reversibly to the 30S subunit of ribosomes?

a. Ciprofloxacin
b. Co-trimoxazole
c. Tetracycline
d. Macrolide

c. Tetracycline

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Which of these is an anti-staphylococcal drug?

a. Cephalexin
b. Ceftazidime
c. Cefuroxime
d. Cloxacillin

d. Cloxacillin

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Khalid, a 20-year old college student, is a sensation seeker and engages in physical and social challenges associated with health-related behaviors that may put him at risk of acquiring an STD. What is the characteristic associated with Khalid’s behavior?
A. He underestimates the risk involved
B. Has siblings with a “sensation seeker” personality
C. He’s an idiot

A. He underestimates the risk involved

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A child presented with recurrent infections. He suffered from eczema and had bloody diarrhea. A blood count revealed thrombocytopenia. What immune defect is this?

a. Hyper IgM syndrome
b. Wiskott Aldrich syndrome
c. Catch 22 anomaly
d. Chédiak Higashi syndrome

b. Wiskott Aldrich syndrome

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An infant has a severely infected navel and an unhealed umbilical cord stump. What immune defect is this?

Leukocyte adhesion deficiency type 1 (LAD-1) affects the separation of the umbilical cord

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What is the mechanism of action of tigycycline?

a. Inhibits folic acid from cell entry
b. Inhibits DNA synthesis
c. Inhibits protein synthesis
d. inhibit the cell wall synthesis

c. Inhibits protein synthesis

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Which of these inhibit the cell wall synthesis?

a. penicillin
b. gentamycin
c. clindamycin

a. penicillin

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Which of these drugs might cause lipodystrophy?

a. Raltegravir
b. Zanamivir
c. Maraviroc
d. Saquinavir

d. Saquinavir

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What is the mechanism of action of fomiversin?

a. binds to tRNA to inhibit translation
b. binds to mRNA to inhibit translation
c. binds to cRNA to inhibit translation

b. Binds to the virus mRNA and inhibits translation

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What is the mechanism of action of maraviroc?

a. CCR5 agonist that inhibits viral entry into the host cell
b. CCR5 antagonist that inhibits viral entry into the host cell
c. CCR7 agonist that inhibits viral entry into the host cell
d. CCR6 antagonist that inhibits viral entry into the host cell

b. CCR5 antagonist that inhibits viral entry into the host cell

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Which virus shows susceptibility to valacyclovir?

a. CMV
b. HSV
c. HPV
d. MCV

b. HSV

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Which virus can develop resistance to nevirapine?

a. MCV
b. HSV
c. HPV
d. HIV

d. HIV

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Which of these drugs is a nucleoside analog reverse transcriptase inhibitor?

a. Zidovudine
b. Nevirapine
c. Tenofovir
d. Efavirenz
e. Adefovir

a. Zidovudine

non-nucloside RTI’s = B&D
nucleotide RTI’s = C&E

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Which of these drugs is metabolized to a substance that inhibits neuraminidase? a. Amantadine b. Maraviroc c. Oseltamivir d. Saquinavir

c. Oseltamivir

Which of these drugs is an M2 blocker? a. Amantadine b. Maraviroc c. Oseltamivir d. Saquinavir

a. Amantadine

Which of these drugs blocks viral release? a. Amantadine b. Maraviroc c. Oseltamivir d. Saquinavir

c. Oseltamivir

Which of the following best describes the thymus? a. It is active during fetal life b. It remains active throughout life c. It attains functional maturity at puberty d. It is most functional during the fifth decade of life

a. It is active during fetal life

What type of cells lines the splenic sinuses? a. Fenestrated cells b. Discontinuous cells c. Elongated cells

c. Elongated cells | which are the cylindrical cells

Which of the following is least likely a function of the lymph nodes? a. production of antibodies b. addition of lymphocytes to the lymph c. differentiation of B-cells d. synthesis of reticulocytes e. filtration of lymph

d. synthesis of reticulocytes

Which one is associated with the central artery? a. White pulp b. Germinal centers c. Lymphatic nodules d. Marginal zone d. Trabeculae

a. White pulp | there's an explanation in the past exams

A fisherman was pricked in his finger while handling fish and developed a skin infection. What is the causative organism? a. Bacillus anthacis b. Brucellosis c. Erysipelothrix rhusiopathiae d. Yersinia pestis

c. Erysipelothrix rhusiopathiae

What virus has both oral live and killed vaccines?

Poliovirus

How can a pregnant woman get toxoplasmosis? a. eating contaminated meat b. drinking cow milk c. looking at a cat from 1 meter

a. eating contaminated meat

An HIV infected patient developed meningoencephalitis. A CSF specimen revealed encapsulated yeast. What is the causative organism? a. Pneumocystic jiroveci b. Cryptococcus neoformans c. Aspergillus fumigatus d. Candida

b. Cryptococcus neoformans

What is the diagnostic marker for invasive aspergillosis? a. ergosterol b. 1,3-beta-glucan c. galactomannan d. beta-D-glucan

c. galactomannan

A diabetic patient developed a rhino-cerebral infection with hemorrhage. A specimen was taken and it revealed non-septate hyphae. What is the causative organism? a. Rhizopus b. Aspergillus fumigatus c. Pneumocystic jiroveci

a. Rhizopus | This is mucormycosis and it can be caused by rhizopus, mucor, absidia

A patient suffered from an infection. Tissue specimens showed cells with owl eye inclusions. What might be the cause?

CMV

A pregnant lady presents with a flu-like illness. Her child presented at birth with micro-abscesses in his liver and an erythematous skin rash with nodules. A culture of the placenta revealed gram-positive bacilli. What is the causative organism? a. Brucelosis b. Listeria monocytogenes c. Toxoplasmosis d. Rubella d. VZV

b. Listeria monocytogenes

In which region is meningococcal meningitis common? a. South America b. Mongolia c. Congo d. North Africa

d. North Africa

Which organism releases its enterotoxin while sporulating in the intestine? a. Clostridium perfringens b. Clostridium botulism

a. Clostridium perfringens | B= the germination of the spore

what causes severe anemia of the fetus & non-immune hydrops fetalis? a. HSV b. Chicken pox c. HIV d. Parvovirus

d. Parvovirus

A man developed genital nodules. The nodules were painless, flesh-coloured, dome shaped, and were 3-5mm in diameter. What is the cause? a. HSV-2 b. Molluscum contagiosum c. Genital herpes

b. Molluscum contagiosum

What is meant by vaccine efficacy? a. The production of a high number of memory cells b. The production of a high number of antibodies

a. The production of a high number of memory cells

What is the most common cause of cellulitis? a. S. aureus b. S. saprophyticus c. S. epidermidis

a. S. aureus

What would you use to sterilize a surgical gown? a. Dry heat b. Autoclave c. Scouring powder

b. Autoclave

What is a virulence factor of Neisseria gonorrhea?

IgA protease | other exams have different answers

Which virus causes retinitis in HIV patients? a. BK virus b. CMV c. HSV d. HPV

b. CMV

What would you use to disinfect a blood spillage? a. alcohol b. hypochlorite c. scouring powder d. hydrogen peroxide

b. hypochlorite

A patient revealed bi-lateral infiltrates in his lungs. A BAL specimen was taken but no organism could be cultured. He successfully treated with sulfamethoxazole-trimethorprim. What is the causative organism? a. Candida b. Cryptococcus neoformans c. Aspergillus fumigatus d. Pneumocystic jiroveci

d. Pneumocystic jiroveci

A neutropenic patient developed a pulmonary infection. Lung biopsy results revealed branched septate hyphae. What is the causative organism? a. Candida b. Cryptococcus neoformans c. Aspergillus fumigatus d. Pneumocystic jiroveci

c. Aspergillus fumigatus

A patient has primary syphilis. Which test is used to follow-up of the treatment?

RPR/VDRL | non-specific test used to measure progress

A 30-year old woman developed genital blisters with inguinal lymphadenopathy but no anal or perianal lesions. What might be the cause? a. HSV b. chancroid

a. HSV | blisters and not ulcers so its HSV

What cell expresses both HLA-I and HLA-II?

Macrophage

T-lymphocytes undergo a process of positive and negative selection in the thymus. What will be the effect of T-lymphocyte if Positive selection fails? a. Unable to recirculate b. Unable to recognize self-MHC c. Unable to express TCR

not sure about the answer

Which of the following cytokines is involved in the activation, proliferation, and differentiation of B-lymphocytes? a. IL-1 b. IL-2 c. IL-3 d. IL-4

d. IL-4

Which of the following cells mediated the reaction in contact dermatitis? a. Mast cells b. B lymphocytes c. T lymphocytes d. Antibodies

c. T lymphocytes

Which of the following is involved in both humoral and cell-mediated immunity? a. Complement b. Antibodies

a. Complement

Which of the following cells defines granulomas? a. Mast cells b. B lymphocytes c. T lymphocytes

c. T lymphocytes

How can antibodies protect against a viral infection? a. Prevent primary infection b. Prevent re-infection c. Prevent viral spread

b. Prevent re-infection

Which of the following is a characteristic of the immune response in AIDS? a. Impaired delayed-type skin hypersensitivity reaction b. Hyperactive NK cells c. Increased IL-2 production

a. Impaired delayed-type skin hypersensitivity reaction

What do Th-2 cells activate? a. Humoral immunity b. Cell-mediated immunity

a. Humoral immunity

What is a function of Th-1 cytokines? a. B cell proliferation b. Activation of macrophages c. Eosinophil activation

b. Activation of macrophages

Which of the following binds to immunoglobulins? a. MHC b. Fc receptor c. HLA

b. Fc receptor

Which of the following results in the agglutination of bacteria? a. IgM b. IgD

a. IgM | not B since it is only on B-cell surface

What type of molecule presents antigens to T-helper cells? a. HLA-I b. HLA-II

b. HLA-II

How do cytotoxic T-cells defend against virus-infected cells? a. By inducing apoptosis b. By activating cytokines c. By phagocytosis of the cells

a. By inducing apoptosis

What is a characteristic of passive immunization? a. Delayed onset but long-lived b. Rapid in onset but short-lived c. T cell-mediated

b. Rapid in onset but short-lived

Which of the following inhibit the attachment of bacteria to epithelial surfaces? a. IgA b. IgE c. IgM d. IgD

a. IgA

Which of the following is the basis of blood grouping? a. Anaphylactic reaction b. DTH c. Agglutination d. Precipitation

c. Agglutination

What does the T-cytotoxic TCR recognize the surface of infected cells? a. MHC class I and epitope b. MHC class II and antigen

a. MHC class I and epitope

Where would you find the greatest uptake of gallium-67 citrate? a. BM b. Mammary glands c. Spleen d. Liver

d. Liver

Where would you find an increased uptake of indium-111 labeled leukocytes? a. BM b. Mammary glands c. Spleen d. Liver

c. Spleen

Which of the following is a mechanism of defense against intracellular bacteria? a. activation of macrophages b. proliferation of plasma cell c. activation of B cells d. activation of antibody production

a. activation of macrophages

What is a function of Th-2 cytokines? a. activation of macrophages b. activation of antibody production c. activation of T lymphocytes

b. activation of antibody production

What is the direct role of IFN-α in innate immunity? a. Inhibits viral release b. Inhibits viral replication c. Mediates antibody synthesis

b. Inhibits viral replication

What are the cells that recirculate between the blood and lymph? a. Dendritic cells b. B-cells c. T-cells

c. T-cells

Which of the following techniques is used for identification and separation of cells? a. Agglutination b. Precipitation c. Flow cytometry d. Radioimmunoassay

c. Flow cytometry

which technique uses enzyme-labeled antibodies for the identification of antigens? a. ELISA b. PCR c. Western blotting d. Flow cytometry

a. ELISA

What is the typical way of identifying B-lymphocytes? a. ELISA b. PCR c. Western blotting d. Flow cytometry

d. Flow cytometry

If there is a defect in negative selection, what would be the consequence? a. Release of unresponsive T-lymphocytes b. Release of auto-reactive T-lymphocytes

b. Release of auto-reactive T-lymphocytes

What is the immune defect in chronic granulomatous disease? a. Neutrophil phagocytosis b. Neutrophil intracellular killing c. T cell apoptotic signals d. Neutrophil intracellular organelle trafficking

b. Neutrophil intracellular killing | failure to produce a functional NADPH oxidase enzyme

Ataxia-telangiectasia is a primary immunodeficiency syndrome caused by a defect in the ATM gene. What is the function of this gene? a. RNA repair b. DNA repair c. Ribosome protein synthesis

b. DNA repair

A child has an apparently normal innate and adaptive immune system. He presented with recurrent bacterial infections and hemolysis. Histology of his tissues showed granulomas. What immune defect is this? a. LAD-1 b. Chédiak-Higashi syndrome c. Wiskott-Aldrich syndrome d. Chronic granulomatous disease

d. Chronic granulomatous disease

A child presented with recurrent infections. He suffered from eczema and had bloody diarrhea. A blood count revealed thrombocytopenia. What immune defect is this? a. LAD-1 b. Chédiak-Higashi syndrome c. Wiskott-Aldrich syndrome d. Chronic granulomatous disease

c. Wiskott-Aldrich syndrome

HIV is a progressive infection characterized by acute, chronic, and critical phases. What is a characteristic of the chronic phase of HIV? a. retroviral state b. persistent generalized lymphadenopathy c. flu-like symptoms d. opportunistic infections

b. persistent generalized lymphadenopathy

A woman with a group B streptococcal bacterial infection of the vagina. She got pregnant. She gave birth after 33 weeks of pregnancy with a foul-smelling liquid during delivery. On histological examination of the placenta, what would you find?

Neutrophils in the chorion and amnion | chorioamnionitis

An infection has a basic reproductive number of 2. Which of the following is true? a. An epidemic would be prevented if 60% of the population is immunized b. The infection would be eradicated if we isolate cases and quarantine the exposed c. It is endemic in nature

a. An epidemic would be prevented if 60% of the population is immunized

Which virus carries the highest risk of parenteral transmission in a healthcare setting? a. HIV b. HBV

b. HBV

What vaccine should not be given to an HIV infected patient? a. BCG b. Intravascular polio

a. BCG

To which drug is mycoplasma pneumoniae intrinsically resistant? a. tetracylins b. penicillin c. trimethoprim

b. penicillin (the lack of a cell wall in mycoplasmas makes them intrinsically resistant to beta-lactams like Penicillins and Cephalosporins)

A child developed meningococcal meningitis. What prophylaxis should be given to his contacts?

Ciprofloxacin

A child with a damaged mitral valve is undergoing a tooth extraction, what is prophylaxis used in this situation?

First generation cephalosporins (EX/cephazolin) | amoxicillin should be given, but he's allergic