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Flashcards in Chap 21 Deck (80)
1

Which of the following is not part of the upper respiratory tract?


A. Mouth

B. Nasal cavity

C. Trachea

D. Pharynx

E. Larynx

C

2

Which of the following is not part of the lower respiratory system?


A. Alveoli

B. Bronchi

C. Bronchioles

D. Trachea

E. Sinuses

E

3

What features of the respiratory system protect is from infection?


A. Nasal hairs

B. Cilia

C. Mucus

D. Macrophages

E. All of the choices are correct

E

4

Which antibody is concentrated in the respiratory tract?


A. IgA

B. IgE

C. IgG

D. IgM

E. All of the choices are correct

A

5

Normal biota of the upper respiratory tract include


A. Corynebacterium

B. Candida albicans

C. Haemophilus influenzae

D. Staphlococcus aureus

E. All of the choices are correct

E

6

Normal biota of the upper respiratory tract include


A. Streptococcus pyogenes

B. Streptococcus pneumoniae

C. Neisseria meningitides

D. Alpha-hemolytic streptococci

E. All of the choices are correct

E

7

Normal biota of the lower respiratory tract include


A. Corynebacterium

B. Candida albicans

C. Haemophilus influenzae

D. Staphlococcus aureus

E. None of the choices are correct

E

8

What is the function of normal biota of the respiratory tract?


A. Competes with pathogens for resources and space

B. Microbial antagonism

C. Provide antibodies

D. Both A and B are correct

E. A, B and C are correct

D

9

The most common type of virus leading to rhinitis is


A. Coronavirus

B. Adenovirus

C. Rhinovirus

D. Herpes simplex virus

E. Retrovirus

C

10

Cold viruses are transmitted by


A. Droplet contact and indirect contact

B. Endogenous

C. Direct contact

D. None of the choices are correct

E. All of the choices are correct

A

11

The most common mode of transmission for sinusitis is


A. Exotoxin

B. Direct contact

C. Indirect contact

D. Endogenous

E. Droplet contact

D

12

Which of the following is true about sinusitis caused by allergy?


A. Greenish or yellowish mucous discharge

B. Caused by Streptococcus pneumoniae

C. Introduced by trauma

D. Clear, watery discharge

E. Preceded by viral rhinitis

D

13

The most common causative agent in fungal sinusitis is


A. Aspergillus fumigatus

B. Haemophilus influenzae

C. Candida albicans

D. Corynebacterium

E. Streptococcus pneumoniae

A

14

Infection travels to the middle ear by way of the


A. Auditory canal

B. Sinuses

C. Nasal cavity

D. Eustachian (auditory) tubes

E. Subarachnoid space

D

15

The most common causative agent of otitis media is


A. Aspergillus fumigatus

B. Haemophilus influenzae

C. Candida albicans

D. Corynebacterium

E. Streptococcus pneumoniae

E

16

Streptococcal pharyngitis involves all the following except


A. A purulent exudate over the tonsils

B. Can lead to scarlet fever if it is an erythrogenic toxin-producing strain

C. Can lead to serious sequelae

D. Is usually caused by the viridans streptococci

E. Causes redness, difficulty in swallowing and fever

D

17

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


A. Enterotoxins

B. Hemolysins

C. Toxic shock syndrome toxin

D. Exfoliative toxin

E. Erythrogenic toxin

E

18

Rheumatic fever is caused by


A. A primary streptococcal infection

B. A primary viral infection

C. A secondary streptococcal infection

D. Both a primary streptococcal infection and a primary viral infection

E. Both a primary viral infection and a secondary streptococcal infection

C

19

Superantigens


A. Include streptolysin O

B. Include Erythrogenic toxin

C. Induce production of tumor necrosis factor

D. Include only streptolysin and Erythrogenic toxin

E. All of the choices are correct

E

20

Streptococcus pyogenes infection may affect


A. The tricuspid valve

B. The aortic semilunar valve

C. The biscupid valve

D. Both the tricuspid valve and the aortic semilunar valve

E. Both the aortic semilunar valve and bicuspid valve

A

21

Which of the following is/are the main causative agent/s of pharyngitis?


A. Streptococcus pyogenes

B. Aspergillus fumigatus

C. Viruses

D. Both B and C are correct

E. Both A and C are correct

E

22

Untreated streptococcal pharyngitis can lead to all of the following except


A. Scarlet fever

B. Otitis media

C. Rheumatic fever

D. Glomerulonephritis

E. Scarlatina

B

23

Virulence factors of S. pyogenes include


A. Polysaccharides on the cell wall

B. Lipoteichoic acid

C. Spiky M-proteins

D. Hyaluronic acid capsule

E. All of the choices are correct

E

24

Which of the following is not true of S. pyogenes?


A. Group A streptococcus

B. Gram-positive

C. Forms spores

D. Sensitive to bacitracin

E. Beta-hemolytic

C

25

Formation of a pseudomembrane in the back of the throat is seen in


A. Diphtheria

B. Pharyngitis

C. Tuberculosis

D. Pertussis

E. SARS

A

26

Which of the following pertains to diphtheria?


A. Results in meningitis

B. Symptoms include vomiting and diarrhea

C. Can be transmitted from mother's birthcanal to neonate

D. Prevented by the DTaP immunization

E. All of the choices are correct

D

27

The major virulence factor of Corynebacterium diphtheriae that causes serious systemic effects is


A. Its capsule

B. Metachromatic granules

C. Exotoxin

D. Endospores

E. Endotoxin

C

28

Diphtherotoxin targets cells in the


A. Pharynx and lungs

B. Lungs and heart

C. Heart and brain

D. Heart and nerves

E. Lungs and nerves

D

29

In addition to antimicrobials, patients with diphtheria are treated with


A. Antitoxin

B. Tracheostomy

C. Heart medication

D. Bronchoscopy

E. All of the choices are correct

E

30

Pertussis has the following characteristics except


A. Pathogen has virulence factors to destroy the action of respiratory cilia

B. Catarrhal stage has persistent, hacking coughs with "whoops"

C. Early stage resembles a cold with nasal discharge and sneezing

D. DTaP immunization will prevent it

E. Transmission is by respiratory droplets

E

31

The causative organism of Whooping cough is


A. Bordetella pertussis

B. Streptococcus pneumoniae

C. Haemophilus influenzae

D. Streptococcus pyogenes

E. Cornyebacterium diphtheriae

A

32

Which of the following is not a virulence factor of Bordetella pertussis?


A. Endotoxin

B. Tracheal cytotoxin

C. M-protein

D. Pertussis toxin

E. Filamentous hemagglutinin

C

33

Which of the following is not true of whooping cough?


A. Secondary infections can occur during the convalescent phase

B. Caused by a small aerobic gram-negative rod

C. Incubation period is 3 – 21 days

D. Coldlike symptoms are common for the paroxysmal stage

E. An uncontrollable cough occurs during the paroxysmal stage

D

34

Respiratory syncytial virus


A. Causes serious disease in infants 6 months old or younger

B. Uses the nasopharynx as its main replication site

C. Can be treated with the antiviral aerosol Ribavirin

D. Has symptoms of dyspnea and rales

E. All of the choices are correct

E

35

The enzyme associated with the influenza virus that hydrolyzes the protective mucous coating of the respiratory tract is


A. Catalase

B. Reverse transcriptase

C. Hyaluronidase

D. Neuraminidase

E. Kinase

D

36

Symptoms of influenza include


A. Nasal discharge, mild fever, absence of cough

B. Fever, diarrhea, vomiting

C. Fever, myalgia, sore throat, cough, nasal discharge

D. Fever, sore throat, rash, cough

E. Fever and pneumonia

C

37

Influenza vaccines include all the following except


A. Inactivated intramuscular vaccine

B. Usually incorporates three different strains

C. Attenuated, nasal drops vaccine

D. Provides lifelong immunity

E. Has an overall effectiveness of 70% - 90%

D

38

Which of the following is not true of influenza?


A. Has glycoprotein spikes of hemagglutinin (H) and neuraminidase (N)

B. Antigenic drift which changes the antigens to reduce immune recognition

C. Antigenic shift causes changes in the RNA strands

D. Influenza B viruses undergo both antigenic drift and antigenic shift

E. H5N1 is the bird flu strain that may cause a pandemic

D

39

Which is not correct about Mycobacterium species?


A. All species are human pathogens

B. Cell walls have waxy lipids

C. Acid fast

D. Usually have a slow growth rate

E. Long, slender rods

A

40

Mycobacterium tuberculosis


A. Produces several virulence factor enzymes and an exotoxin

B. Has a cord factor that can prevent destruction by lysosomes and macrophages

C. Can survive for 8 months in fine aerosol particles

D. Has a capsule

E. Lives in the soil

C

41

All of the following pertain to tuberculosis except


A. Live bacilli can remain dormant in the lungs and reactivate later in life

B. Symptoms of active TB include low-grade fever, coughing, fatigue, weight loss and night sweats

C. Lung infection can disseminate to many other organs in extrapulmonary TB

D. The BCG vaccine is used in other countries

E. Antimicrobials cannot treat and cure tuberculosis

E

42

Tuberculin skin testing


A. Injects PPD intradermally

B. Uses a purified protein filtrate of Mycobacterium tuberculosis

C. Will be positive if person has had previous exposure

D. Will be positive in active TB

E. All of the choices are correct

E

43

A diagnosis of tuberculosis involves


A. Chest X-ray

B. Acid fast stain of sputum

C. Sputum culture

D. Tuberculin skin test

E. All of the choices are correct

E

44

Which of the following causes a non-communicable pulmonary infection that resembles tuberculosis?


A. Mycobacterium avium complex (MAC)

B. Mycobacterium kansasii

C. Mycobacterium scrofulaceum

D. Mycobacterium fortuitum complex

E. Mycobacterium marinum

A

45

The tubercles formed in primary tuberculosis are caused by an influx of


A. Neutrophils

B. Basophils

C. Mononuclear cells

D. Polymorphonuclear leukocytes

E. Antibodies

C

46

Extrapulmonary TB is more common in


A. Young children and immunosuppressed patients

B. Elderly

C. Organ transplant patients

D. AIDS patients

E. All of the choices are correct

A

47

When the centers of tubercles break down into _____ lesions, they gradually heal by calcification that replaces normal lung tissue.


A. Primary

B. Secondary

C. Necrotic caseous

D. Granuloma

E. Tertiary

C

48

Which is incorrect about Mycoplasma pneumoniae?


A. Has birds as a reservoir

B. Common cause of primary atypical pneumonia

C. Initially causes fever, malaise, sore throat, headache

D. After 2 to 3 weeks develops into an unproductive cough and earache

E. Is a bacterial cell without a cell wall

A

49

Streptococcus pneumoniae is


A. Alpha-hemolytic on blood agar

B. Found in up to 50% of people as normal flora

C. A gram positive diplococcus with a capsule

D. A pathogen with endotoxin

E. All of the choices are correct

E

50

Disease/s caused by Streptococcus pneumoniae include


A. Otitis media

B. Meningitis

C. Lobar pneumonia

D. Bronchial pneumonia

E. All of the choices are correct

E

51

People at greatest risk for pneumococcal infections include all the following except


A. The elderly

B. Those with underlying lung disease and viral infections

C. Patients without a spleen

D. Adolescents and young adults

E. Young infants

D

52

Legionella pneumophila


A. Requires special lab growth media

B. Often lives intracellularly in amoebas

C. Causes fever, cough and diarrhea

D. Always causes a severe pneumonia

E. All of the choices are correct

B

53

Which disease involves transmission by aerosolized water from whirlpool spas, air conditioners, cooling towers and supermarket vegetable misters?


A. Legionellosis

B. Pertussis

C. Brucellosis

D. Plague

E. Traveler's diarrhea

A

54

Which of the following is caused by Haemophilus influenzae in the respiratory tract?


A. Bacterial meningitis

B. Influenza (flu)

C. Otitis media

D. Bronchitis

E. Epiglottitis

C

55

The vaccine for immunity to Haemophilus influenzae serotype b is


A. DTaP

B. Pneumovax

C. MMR

D. Hib

E. None of the choices are correct

D

56

Characteristics of Histoplasma capsulatum include


A. Grows in moist soil, rich in nitrogen from bird and bat droppings

B. Is a yeast with a capsule

C. Is a dermatophyte

D. Grows in dry, arid soil

E. None of the choices are correct

A

57

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


A. Southeast

B. Southwest

C. East and Midwest

D. Northeast

E. Rocky Mountains

C

58

Which is incorrect about histoplasmosis?


A. Pathogen grows inside macrophages

B. Transmitted by inhalation of spores

C. Respiratory infections range from mild to severe

D. Chronic cases have symptoms similar to tuberculosis

E. Never spreads to sites outside the respiratory tract

E

59

Pneumocystis (carinii) jiroveci


A. Has protozoan and fungal characteristics

B. Lacks ergosterol in its plasma membrane

C. Is an obligate parasite

D. Causes serious infection in elderly, premature infants and AIDS patients

E. All of the choices are correct

D

60

Inhalation of respiratory secretions is involved in the transmission of the following except


A. Influenza

B. Rhinitis

C. Legionella

D. Diphtheria

E. SARS

C

61

Hantavirus has all the following characteristics except


A. Reservoir is human carriers

B. Is a zoonosis

C. Symptoms are abrupt fever, lung edema, respiratory distress and hypotension

D. Transmitted by aerosol transmission from rodent excreta

E. The first U.S. outbreak occurred in 1993 in the Southwest

A

62

Sudden acute respiratory syndrome (SARS)


A. Causes high fever, pneumonia and respiratory distress

B. Began with an initial outbreak in the United States and then spread to Canada and China

C. Is caused by the respiratory syncytial virus

D. Is a zoonosis

E. All of the choices are correct

A

63

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


A. Cryptococcus neoformans

B. Candida albicans

C. Malassezia furfur

D. Pneumocystis (carinii) jiroveci

E. None of the choices are correct

D

64

Drug resistant strains of Streptococcus pneumoniae are now treated with


A. Penicillin v

B. Eryrthromycin

C. Tetracyline

D. Vancomycin

E. Ketek

E

65

Of the six Category A diseases listed by the U.S. Public Health Service, which effect the respiratory tract?


A. botulism

B. pneumonic plague

C. tularemia

D. small pox

E. Both B and C

E

66

Influenza virus can exhibit constant mutation of viral glycoproteins, called ________, or __________ , a more serious phenomenon caused by the exchange of a viral gene with that of another influenza virus strain.


A. Antigenic drift, antigenic drift

B. Antigenic shift, antigenic drift

C. Antigenic drift, antigenic shift

D. None of these

C

67

T or F
The primary transmission route for acquiring agents of the common cold is by contact with hands and fomites contaminated with the nasal discharges of an infected person

T

68

T or F
Secondary bacterial infections may occur with the common cold

T

69

T or F
Antibiotic treatment for otitis media is standard procedure today

F

70

T or F
Treatment for diphtheria requires only penicillin or erythromycin

F

71

T or F
Pertussis outbreaks still occur in the United States

T

72

T or F
Respiratory syncytial virus is a major cause of global respiratory infection outbreaks in infants 6 months of age or younger

T

73

T or F
Influenza is predominantly transmitted by the fecal-oral route

F

74

T or F
People who have received the BCG immunization will generally have a negative tuberculin skin test.

F

75

T or F
An induration of less than 5mm in the Mantoux test is negative for TB

T

76

T or F
The major reservoir for the hantavirus is the deer mouse.

F

77

T or F
Legionellosis is a zoonosis

F

78

T or F
The pathogen that causes Legionnaires pneumonia also causes a milder infection called Pontiac fever.

T

79

T or F
A paroxysmal cough is associated with Legionnaires' disease

F

80

T or F
Medical professionals actually observe MDRTB patients take their medicine through a program called DOT

T