MTAP 2 Flashcards by GERVELYN O. GABON

A bulldozer operator became ill while working on a new highway in the San
Joaquin Valley. He developed chest pain, anorexia, headache and general malaise, and myalgia with fever. Chest X-ray showed pneumonic infiltrate and a single, well-defined nodule in the left lower lobe. His leukocyte count and sedimentation rate were slightly elevated. Although no fungus was seen in direct examination of a sputum specimen, processing included a culture on Sabouraud dextrose agar with chloramphenicol and cycloheximide. Within 3 days at 30°C, this culture produced moist, grayish growth, and white aerial mycelia began to develop (see Color Plate 30B). A lactophenol cotton blue wet mount of this organism is seen in Color Plate 31

What is the most likely identification of this fungus?

A. Asperigillus fumigatus
B. Blastomyces dermatitidis
C. Coccidioides immitis
D. Histoplasma capsulatum

C. Coccidioides immitis

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A 38-year-old male from Ohio presented to his physician with a mild influenza like illness that included headache and malaise. His chest X-ray showed no infiltrates. His past medical history was unremarkable. He had no history of travel but reported recently cleaning the bell tower at his church, which was littered with bird excrement. The most likely agent causing his disease is

A. Aspergillus fumigatus
B. Coccidioides immitis
C. Candida albicans
D. Histoplasma capsulatum

D. Histoplasma capsulatum

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A 44-year-old gardener pricked herself with a rose thorn. A subcutaneous fungal
infection characterized by the development of necrotic ulcers followed this
direct inoculation of fungal spores into the skin. The causative fungus was
cultured as a small yeast form at 35°C (see Color Plate 32 •) and as a mould at room temperature with delicate hyphae and conidia. This disease is

A. Blastomycosis
B. Chromomycosis
C. Mycetoma
D. Sporotrichosis

D. Sporotrichosis

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A yeastlike fungus was isolated from a sputum sample. No hyphae were produced on cornmeal agar with Tween 80. The isolate was negative for nitrate assimilation and positive for inositol assimilation and produced urease at 37°C. These findings are typical of

A. Candida krusei
B. Cryptococcus terreus
C. Cryptococcus neoformans
D. Trichospown beigelii

C. Cryptococcus neoformans

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A 24-year-old Vietnamese refugee was seen at a clinic in Houston. His chief
complaints were weight loss and fever. A complete blood count confirmed he was suffering from anemia as well. Multiple skin lesions were present on his arms, some of them draining pus. Gram stain of the pus revealed what appeared to be yeastlike cells. A culture of the pus grew a green mould at 22°C, which produced a red soluble pigment (see Color Plate 33). A lactophenol cotton blue wet mount of
this organism is seen in Color Plate 34. The causative agent in this case is

A. Aspergillus fumigatus
B. Fusarium sp.
C. Trichoderma sp.
D. Penicillium marneffei

D. Penicillium marneffei

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A section of a lymph node stained with the Gomori silver and hematoxylin and eosin stains is shown in Color Plate 35. A lactophenol cotton blue wet mount of a mould that grew from this specimen is shown in Color Plate 36. Large, one celled, smooth to tuberculate macroconidia and smooth or echinulate microconidia are typical of mycelial phase growth of

A. Blastomyces dermatitidis
B. Coccidioides immitis
C. Histoplasma capsulatum
D. Paracoccidioides brasiliensis

C. Histoplasma capsulatum

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Which of the following types of Candida albicans infection is commonly acquired from an exogenous source?

A. Diaper rash
B. Neonatal thrush
C. Perianal infection
D. Urinary tract infection

B. Neonatal thrush

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In a direct examination of a KOH wet mount of a nail specimen, Epidermophyton floccosum could be detected as

A. Arthroconidia
B. Blastoconidia
C. Macroconidia
D. Microconidia

A. Arthroconidia

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The mould phase of the systemic fungus Blastomyces dermatitidis can be confused with

A. Scedosporium apiospermum
B. Sporothrix schenckii
C. Aspergillus sp.
D. Penicillium notatum

A. Scedosporium apiospermum

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It is usually difficult or impossible to identify a fungal culture before it is
mature. However, hyaline, septate hyphae, and a young conidiophore with a foot cell (see Color Plate 37B) and a swollen vesicle are excellent clues to the identification of

A. Acremonium
B. Aspergillus
C. Paecilomyces
D. Penicillium

B. Aspergillus

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Zygomycetes are rapidly growing, airborne saprobes. In clinical specimens
they

A. Are common as normal, human microflora
B. Are found only as contaminants
C. May be seen in a dimorphic tissue phase
D. May be found as a cause of rapidly fatal infection

D. May be found as a cause of rapidly fatal infection

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Trichophyton rubrum and T. mentagrophytes may be differentiated by the

A. Consistently different appearance of their colonies
B. Endothrix hair infection produced by T. rubrum
C. Fluorescence of hairs infected with T. rubrum
D. In vitro hair penetration by T. mentagrophytes

D. In vitro hair penetration by T. mentagrophytes

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Broad, coenocytic hyphae found in tissue would be most typical of infection with

A. Aspergillus
B. Blastomyces
C. Microsporum
D. Rhizopus

D. Rhizopus

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A fungus infecting only skin and nails typically produces in culture

A. Spindle-shaped, hyaline, echinulate macroconidia and microconidia
B. Cylindrical or club-shaped, smooth, thin-walled macroconidia and microconidia
C. Many microconidia in clusters or along the hyphae
D. Large, thin-walled, club-shaped macroconidia without microconidia

D. Large, thin-walled, club-shaped macroconidia without microconidia

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The most useful finding for prompt, presumptive identification of C. albicans
is its

A. Failure to assimilate sucrose
B. “Feathering” on EMB
C. Production of chlamydospores
D. Production of germ tubes

D. Production of germ tubes

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Identify the dimorphic fungus that typically has a tissue phase in which the
large mother cells have one to a dozen narrow-necked buds and a slowly growing
mycelial form with intercalary chlamydoconidia and coiled hyphae.

A. Blastomyces dermatitidis
B. Coccidioides immitis
C. Histoplasma capsulatum
D. Paracoccidioides brasiliensis

D. Paracoccidioides brasiliensis

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Which of the following stains greatly enhances the visibility of fungi by binding
to the cell walls, causing the fungi to fluoresce blue-white or apple green?

A. Rhodamine-auramine
B. Warthin-Starry
C. Calcofluor white
D. Periodic acid-Schiff

C. Calcofluor white

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The formation of arthroconidia is not an important characteristic in the identification of

A. Coccidioides
B. Geotrichum
C. Trichosporon
D. Sporothrix

D. Sporothrix

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A black pigment produced by colonies growing on bird seed agar is due to

A. Urease
B. Phenol oxidase
C. Sucrose assimilation
D. Arthroconidia production

B. Phenol oxidase

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Which of the following fungi is not considered an opportunistic pathogen?

A. Absidia
B. Aspergillus
C. Coccidioides
D. Fusarium

C. Coccidioides

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Observation of hyaline or dematiaceous hyphae is an early clue in the identification of common, airborne fungi. Which of the following genera contains species found as dematiaceous contaminants?

A. Alternaria
B. Aspergillus
C. Fusarium
D. Penicillium

A. Alternaria

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Which of the following fungi is most likely to be found as a common saprobe
and as an agent of keratitis?

A. Exophiala
B. Phialophora
C. Fusarium
D. Wamgiella

C. Fusarium

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The microscopic identification of Pneumocystis jirovecii is based on the
detection of

A. Arthroconidia in subcutaneous tissue biopsies
B. Cysts and trophozoites in respiratory specimens
C. Yeasts in respiratory specimens
D. Tuberculate macroconidia in lung biopsies

B. Cysts and trophozoites in respiratory specimens

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Fungi that undergo asexual reproduction
are termed

A. Imperfect
B. Perfect
C. Aseptate
D. Septate

A. Imperfect

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Hyaline septate hyphae, branched or unbranched conidiophores, and multicelled banana-shaped conidia are characteristic of which of the following? A. Fusarium B. Curvularia C. Acremonium D. Trichophyton

A. Fusarium

Which of the following does not correctly describe the yeast Rhodotorula rubra? A. It has been isolated from dairy products, soil, and water. B. It is the most common fungal cause of diaper rash. C. It has been identified as a nosocomial pathogen. D. It has been found as a contaminant or commensal in specimens of urine, sputum, and feces.

B. It is the most common fungal cause of diaper rash.

A 21-year-old male member of a university track team presents to student health services with a light brown circular lesion on his upper back. The agent most likely responsible for this condition is A. Candida albicans B. Fusarium spp. C. Geotrichum candidum D. Malassezia furfur

D. Malassezia furfur

Which of the following is likely to be found in clinical specimens as normal microflora and as clinically significant isolates? A. Aspergillus niger B. Paracoccidioides brasiliensis C. Penicillium marneffei D. Candida albicans

D. Candida albicans

A 4-year-old child's hair is falling out in patches. The hair fluoresces when subjected to the UV light from a Wood's lamp. When the hair is cultured, a white cottony mould grows at 25°C on potato dextrose agar. Microscopically, rare microconidia, septate hyphae, and terminal chlamydospores are seen. Macroconidia are absent. The mould fails to grow on polished rice grains. The causative agent is A. Microsporum audouinii B. Microsporum gypseum C. Trichophyton mentagrophytes D. Trichophyton rubrum

A. Microsporum audouinii

In tissues infected with Histoplasma capsulatum A. The hyphae usually invade blood vessels B. Encapsulated yeast cells are typical C. Tuberculate macroconidia are typical D. The fungus is usually intracellular

D. The fungus is usually intracellular

For each numbered mycosis below, choose the letter of the environment most commonly associated with an increased incidence of that infection. 31. Blastomycosis 32. Coccidioidomycosis 33. Cryptococcosis A. Lower Sonoran Life Zone B. Mississippi and Ohio River basins C. Pigeon roosts D. Bat roosts

31. Blastomycosis - B. Mississippi and Ohio River basins 32. Coccidioidomycosis - A. Lower Sonoran Life Zone 33. Cryptococcosis - C. Pigeon roosts

For each numbered mycosis below, choose the letter of the environment most commonly associated with an increased incidence of that infection. 34. Histoplasmosis 35. Sporotrichosis A. Sphagnum moss B. Starling roosts C. Stagnant fresh water D. Colorado River Valley

34. Histoplasmosis - B. Starling roosts | 35. Sporotrichosis - A. Sphagnum moss

For each numbered incomplete statement, select the letter of the most appropriate species. 36. The cause of white piedra 37. The cause of black piedra 38. The cause of tinea nigra A. Hortaea werneckii B. Trichosporon sp. C. Piedraia hortae D. Fonsecaea compacta

36. The cause of white piedra - B. Trichosporon sp. 37. The cause of black piedra - C. Piedraia hortae 38. The cause of tinea nigra - A. Hortaea werneckii

For each numbered incomplete statement, select the letter of the most appropriate species. 39. The cause of tinea versicolor 40. A keratinophilic saprophyte 41 A cause of otomycosis A. Aspergillus niger B. Malassesia furfur C. Microsporum gypseum D. Geotrichum Candid

39. The cause of tinea versicolor - B. Malassesia furfur 40. A keratinophilic saprophyte - C. Microsporum gypseum 41 A cause of otomycosis - A. Aspergillus niger

The incomplete statements below describe the appearance of growth of yeast or yeastlike fungi in morphology agar, such as rice agar or cornmeal agar with Tween 80, a finding helpful in the presumptive identification of these organisms. For each numbered description, select the letter of the most appropriate species. 42. True hyphae and arthroconidia only 43. True hyphae, arthroconidia, and blastoconidia 44. Pseudohyphae, blastoconidia, and chlamydospores A. Candida albicans B. Geotrichum C. Trichosporon D. Aspergillus fumigatus

42. True hyphae and arthroconidia only - B. Geotrichum 43. True hyphae, arthroconidia, and blastoconidia - C. Trichosporon 44. Pseudohyphae, blastoconidia, and chlamydospores - A. Candida albicans

The incomplete statements below describe the appearance of growth of yeast or yeastlike fungi on morphology agar, such as rice agar or cornmeal agar with Tween 80, a finding helpful in the presumptive identification of these organisms. For each numbered description, select the letter of the most appropriate species. 45. Pseudohyphae and blastospores only 46. Blastospores only, without hyphae or pseudohyphae A. Mucor sp. B. Candida tropicalis C. Cryptococcus neoformans D. Candida albicans

45. Pseudohyphae and blastospores only - B. Candida tropicalis 46. Blastospores only, without hyphae or pseudohyphae - C. Cryptococcus neoformans

Select the letter of the most appropriate specimen source for isolation of each numbered species description. 47. Cryptococcus neoformans 48. Histoplasma capsulatum 49. Pseudallescheria boydii 50. Trichophyton mentagrophytes A. Bone marrow B. Cerebrospinal fluid C. Chronic draining sinus tract of foot D. Chronic interdigital lesion of foot

47. Cryptococcus neoformans - B. Cerebrospinal fluid 48. Histoplasma capsulatum - A. Bone marrow 49. Pseudallescheria boydii - C. Chronic draining sinus tract of foot 50. Trichophyton mentagrophytes - D. Chronic interdigital lesion of foot

The retrovirus responsible for causing acquired immune deficiency syndrome is a member of the family A. Orthomyxoviridae B. Paramyxoviridae C. Retroviridae D. Flaviviridae

C. Retroviridae

The appearance of Koplik spots in the oral mucosa of patients is characteristic of infection with what viral agent? A. Hepatitis B. Measles C. Rabies D. Smallpox

B. Measles

Characteristics of this DNA hepatitis virus include infections spread by contaminated body fluids, 50- to 180-day incubation period, and chronic infections. A. HAV B. HBV C. HCV D. HEV

B. HBV

Which of the following has been declared eradicated by the World Health Organization? A. Smallpox B. Human T cell lymphotropic virus C. Hepatitis G virus D. Eastern equine encephalitis

A. Smallpox

Rotavirus is the most common etiologic agent of A. Acute nonbacterial encephalitis in children B. Acute nonbacterial gastroenteritis in infants and young children C. Chronic nonbacterial pharyngitis in children and young adults D. Chronic nonbacterial retinitis in children

B. Acute nonbacterial gastroenteritis in infants and young children

Kaposi sarcoma is associated with infection by A. Adenovirus B. Cytomegalovirus C. Hepatitis E vims D. Human herpes virus 8

D. Human herpes virus 8

``` The molecular receptor of the virus causing acquired immune deficiency syndrome is A. CD 4 B. CDS C. Fc receptor D. Complement receptor ```

A. CD 4

``` The type of cell culture that best supports the growth of cytomegalovirus is A. HeLa cells B. HEp-2 cells C. Human fibroblast cells D. Primary monkey kidney (PMK) cells ```

C. Human fibroblast cells

Which of the following viruses is predominantly associated with respiratory disease and epidemics of keratoconjunctivitis? A. Adenovirus B. Molluscum contagiosum virus C. Norwalk virus D. Rotavirus

A. Adenovirus

A 25-year-old patient presented with multiple vesicles around the mouth. Material from the lesions was obtained by needle aspiration and inoculated to MRC-5 cells. After 1 day, the cytopathic effect included foci of "ballooned" and lysed cells. These observations suggest infection with A. Adenovirus B. Cytomegalovirus C. Epstein-Barr virus D. Herpes simplex virus

D. Herpes simplex virus

The Sabin polio vaccine uses which of the following? A. Formalin-inactivated viruses B. Attenuated viruses C. Recombinant viral antigens D. DNA

B. Attenuated viruses

``` Which of the following is caused by a herpes virus? A. Cold sores B. Hemorrhagic fever C. Polio D. Rabies ```

A. Cold sores

Which of the following is not a general characteristic of a virus? A. Obligate intracellular parasite B. Does not produce ATP C. Genome is surrounded by a protein coat D. Can self-replicate in the appropriate host cell

D. Can self-replicate in the appropriate host cell

The viral disease shingles, which causes extreme tenderness along the dorsal nerve roots and a vesicular eruption, has the same etiologic agent as A. Rubeola B. Vaccinia C. Varicella D. Variola

C. Varicella

The etiologic agents of many common colds are RNA viruses that grow better at 33°C than at 37°C. These viruses are A. Adenoviruses B. Orthomyxoviruses C. Paramyxoviruses D. Rhinoviruses

D. Rhinoviruses

``` Influenza A virus undergoes recombination events that produce new strains; this is referred to as A. Antigenic drift B. Antigenic shift C. Reactivation D. Viral latency ```

B. Antigenic shift

Negri bodies may be found in brain tissue of humans or animals infected with A. Adenovirus B. Filovirus C. Measles virus D. Rabies virus

D. Rabies virus

Molluscum contagiosum virus is a member of the A. Adenoviruses B. Herpes viruses C. Papovaviruses D. Pox viruses

D. Pox viruses

A clinical specimen is received in viral transport medium for viral isolation. The specimen cannot be processed for 72 hours. At what temperature should it be stored? A. -80°C B. -20°C C. 4°C D. 22°C

A. -80°C

``` Arboviruses A. Only infect humans B. Often cause hepatitis C. Typically infect lymphocytes D. Are transmitted by arthropods ```

D. Are transmitted by arthropods

Mumps is characterized by an infection of the A. Central nervous system B. Parotid glands C. Pancreas D. Thymus

B. Parotid glands

Which of the following hepatitis viruses is typically transmitted by the fecal-oral pathway? A. HAV B. HBV C. HCV D. HGV

A. HAV

``` Enteroviruses are most often associated with A. Acute nonspecific febrile syndrome B. Bronchitis and pneumonia C. Lower respiratory tract infections D. Upper respiratory tract infections ```

A. Acute nonspecific febrile syndrome

The "core window" refers to the time A. During hepatitis B virus infection when anti-HBc IgM is the only serologic marker B. During hepatitis B virus infection when HBc is the only serologic marker C. During hepatitis A virus infection when HAc is the only serologic marker D. During hepatitis C virus infection when the virus is latent

A. During hepatitis B virus infection when anti-HBc IgM is the only serologic marker

Human herpesviruses 6 and 7 are associated with a childhood disease called A. Chickenpox B. Measles C. Roseola D. Zoster

C. Roseola

A baby was admitted to the hospital in February for dehydration due to severe diarrhea. Cultures for bacterial pathogens revealed normal fecal flora at 24 hours. Which of the following additional tests would be most appropriate given the case history? A. Heterophile antibody test B. Rotavirus antigen assay of stool specimen C. McCoy cell inoculation for cytomegalovirus (CMV) D. Urine microscopic analysis for presence of CMV cellular inclusion bodies

B. Rotavirus antigen assay of stool specimen

``` Rhabdovirus is most noted for causing infections of the A. Central nervous system B. Gastrointestinal tract C. Lower respiratory tract D. Upper respiratory tract ```

A. Central nervous system

``` Jaundice is a common clinical symptom of which of the following viral diseases? A. Hepatitis A B. Infectious mononucleosis C. Rabies D. Varicella ```

A. Hepatitis A

An 18-year-old male presents to his family physician complaining of sore throat and fatigue. The patient is found to have a fever and swollen cervical lymph nodes. A complete blood count and differential reveal lymphocytosis and many reactive (atypical) lymphocytes. The physician should suspect an infection caused by A. Adenoviruses B. Epstein-Barr virus C. Parainfluenza virus D. Varicella-zoster virus

B. Epstein-Barr virus

The poliovirus, an RNA virus, is a(n) A. Adenovirus B. Coxsackie virus C. Enterovirus D. Rhinovirus

C. Enterovirus

The virus that causes hepatitis B is characterized as a A. Defective DNA virus requiring delta virus to complete its replication cycle B. DNA virus utilizing reverse transcriptase C. Nonenveloped DNA virus D. Single-stranded RNA virus

B. DNA virus utilizing reverse transcriptase

Hepatitis C virus infections A. Are commonly diagnosed during the acute stage B. Are uncommon in the U.S. C. Are most often acquired by contact with blood D. Seldom results in chronic infection

C. Are most often acquired by contact with blood

``` Characteristic cytopathic effect associated with respiratory syncytial virus is A. Giant multinucleated cells B. Basophilic intranuclear inclusions C. Eosinophilic cytoplasmic inclusions D. Shrunken cells with multilobed nuclei ```

A. Giant multinucleated cells

``` The virus associated with warts is A. Flavivirus B. Morbillivirus C. Mumps virus D. Papillomavirus ```

D. Papillomavirus

``` RNA-dependent DNA polymerase is also called A. Gyrase B. Neuraminidase C. Reverse transcriptase D. Transaminase ```

C. Reverse transcriptase

``` Coxsackie viruses are associated with A. Gastrointestinal disease B. Hepatitis C. Myocarditis D. The common cold ```

C. Myocarditis

The tubular cells of the human kidney shed which of the following viruses for prolonged periods? A. Adenovirus B. Cytomegalovirus C. Epstein-Barr virus D. Rubella virus

B. Cytomegalovirus

``` The togavirus known to produce fetal defects is A. Influenza B. Rotavirus C. Rubella D. Varicella ```

C. Rubella

An 8-week-old infant was admitted to the hospital with symptoms of low birth weight, jaundice, and neurologic defects. Intranuclear inclusions were found in epithelial cells from the urine. The most likely diagnosis in this case would be infection by A. Cytomegalovirus B. Epstein-Barr virus C. Herpes simplex virus D. Rubella virus

A. Cytomegalovirus

``` The most common cause of cervical cancer is A. Cytomegalovirus B. Enterovirus C. Molluscum contagiosum D. Papillomavirus ```

D. Papillomavirus

Select the statement that is correct concerning the influenza A viruses. A. Humans are the only animal hosts for influenza A viruses. B. Pandemics are characteristically produced by influenza A. C. The incidence of infection peaks in the summer months. D. They are DNA viruses.

B. Pandemics are characteristically produced by influenza A.

An example of a virus associated with latent infections is A. Influenza B. Rotavirus C. Rubella D. Varicella-zoster

D. Varicella-zoster

The use of cell cultures has enabled virologists to isolate and identify many clinically important viruses. However, because some viruses cannot be grown in cell cultures, these agents are best diagnosed by serologic testing. Such an agent is A. Cytomegalovirus B. Hepatitis C virus C. Herpes simplex virus 2 D. Respiratory syncytial virus

B. Hepatitis C virus

Which of the following is associated with the rubella virus? A. It is a DNA virus. B. It is a member of the same taxonomic family as measles virus. C. It is known to produce defects in fetuses during the early stages of pregnancy. D. It is transmitted by an arthropod vector.

C. It is known to produce defects in fetuses during the early stages of pregnancy.

``` Which of the following is not a step involved in virus replication? A. Attachment B. Mitosis C. Penetration D. Release ```

B. Mitosis

``` Which of the following opportunistic diseases is not closely associated with acquired immune deficiency syndrome? A. Cryptococcosis B. Cryptosporidiosis C. Malaria D. Mycobacteriosis ```

C. Malaria

Although there have been no natural cases of this serious disease in about 30 years, which of the following is considered a potential bioterrorism disease A. Dengue B. Ebola hemorrhagic fever C. Shingles D. Smallpox

D. Smallpox

``` Poliovirus is a member of the family A. Flaviviridae B. Paramyxoviridae C. Picornaviridae D. Reoviridae ```

C. Picornaviridae

Which of the following has not been successfully used to detect viruses in clinical specimens? A. Cytopathic effect B. Enzyme-linked immunosorbent assay C. Growth on selective agar media D. Immunofluorescence

C. Growth on selective agar media

Which of the following diseases is not associated with herpes simplex virus? A. Cold sores B. Encephalitis C. Genital herpes D. Thrush

D. Thrush

MTAP 2 Flashcards

(87 cards)