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Flashcards in THE MOTHERLOAD OF QUESTIONS Deck (82)
1

A 38-year-old female complains of 5 days of nasal congestion, sinus pressure, and postnasal drip. On examination her vitals are stable with a temp of 100F. Nasal discharge is yellow and the posterior pharynx is slightly erythematous. Tapping over the maxillary sinuses elicits mild pain. Which of the following is the most appropriate treatment for this patient?

(A) treatment of symptoms (analgesics,antipyretics, decongestants)
(B) 7-day course of amoxicillin
(C) 10-day course of amoxicillin clavulanic acid
(D) 14-day course of clarithromycin

(A) treatment of symptoms (analgesics,antipyretics, decongestants)

2

A 32-year-old male is evaluated for acute low back pain that started yesterday afternoon. He states he was playing tennis when he hyper-extended his upper body with immediate pain in his low back. The pain does not radiate and he feels well otherwise. He denies any chronic illnesses and does not take any medications.
Which of the following is the most appropriate next step?
A. CT of the lumbar spine
B. Exercise therapy
C. Narcotic pain medication on an as needed basis
D. Spinal manipulation using Osteopathic manipulative treatment
E. X-ray of lumbar spin

D. Spinal manipulation using Osteopathic manipulative treatment*

3

A 44-year-old male presents to the clinic with complaints of a popping noise when he sneezes. He denies pain, but localizes the popping by pointing to his sternal angle (of Louis), which is located __________ to the manubrium and __________ to the body of the sternum.
A. dorsal / caudal
B. inferior / superior
C. lateral/ medial
D. medial / lateral
E. superior / inferior

B. inferior / superior *

4


Medical humanities should be considered ______ to clinical medicine.
A. additive
B. complementary
C. equal
D. inferior
E. superior

B. complementary *

5

To increase a patient’s adherence to medical advice which of the following factors are most important?
A. Acute illness, peer support and verbal instructions
B. Chronic illness, verbal instruction and complex treatment schedule
C. Complex treatment schedule, peer support and acute illness
D. Good physician/patient relationship, recommending multiple behavior changes and written instructions
E. Good physician/patient relationship, acute illness and peer support

E. Good physician/patient relationship, acute illness and peer support ***

6

What is a major barrier to rapport building during the medical encounter?
A. Cultural Competency
B. Language barriers
C. Miscommunication
D. Patient non-adherence
E. Time constraints

E. Time constraints ***

7

Which procedure is of historical interest and is no longer used today?
A. Barium enema
B. Cholangiography
C. Fluoroscopy
D. HIDA Scanning
E. Pneumoencephalography

E. Pneumoencephalography*

8

A 77-year-old male presents to the clinic for a routine physical exam. His only complaint is feeling dizzy when he stands up too quickly getting out of bed. His blood pressure lying down was 140/80. After two minutes of quiet standing his blood pressure was 115/65. He has not changed his fluid intake and maintains a good diet. His medical history is significant for an enlarged prostate but he has no urinary changes. His only medication is a baby aspirin. He denies any smoking, alcohol, or illegal drugs. Given the above information what is this patient’s diagnosis and probable cause?

E. Orthostatic hypotension, impaired baroreceptors

9

The activity of alpha-ketoglutarate dehydrogenase is expected to produce which high energy compound?

E. NADH

10

Triose phosphate isomerase converts dihydroxyacetone phosphate to glyceraldehyde-3-phosphate. The energy of dihydroxyacetone phosphate is expected to be _________________ that of glyceraldehyde-3-phosphate:

A. significantly higher than
B. similar to
C. significantly lower than

B. similar to

11

The cell bodies for the post-synaptic sympathetic neurons are located in the
A. cerebellum.
B. dorsal (posterior) root ganglia.
C. medulla oblongata.
D. piloerector muscles.
E. sympathetic chain ganglia.

E. sympathetic chain ganglia.

12

Which of the following substances provided by the endothelium have a role in blood pressure regulation?

A. Angiotensin II
B. Interleukin 6 and 8
C. Prostacyclin
D. TNF alpha (tumor necrosis factor)

A. Angiotensin II

13

Through which messengers does the endothelium and the immune system communicate?

A. Nitric oxide
B. Prostacyclin
C. Thromboxane A2
D. TNF-alpha and Interleukin 6 and 8

D. TNF-alpha and Interleukin 6 and 8

14

Name the components of Virchow’s triad.

A. Genetic predisposition, stasis, endothelial damage
B. Hypercoagulable state, genetic etiology, stasis
C. Hypercoagulable state, stasis, endothelial damage
D. Hypercoagulable state, stasis, genetic etiology

C. Hypercoagulable state, stasis, endothelial damage

15

Which of the following factors will increase the diffusive clearance of solutes across the semipermeable dialysis membrane?

A. Area of the membrane increases
B. Concentration gradient for the solute decreases
C. Lipid solubility of the solute decreases
D. Size of the solute molecules increase
E. Thickness of the membrane increases

A. Area of the membrane increases

16

Layers of the arterial and venous anatomy listed from inside to outside include:

A. tunica interna, smooth muscle cells, external elastic lamina, tunica media, tunica externa
B. tunica interna, tunica media, external elastic lamina, tunica adventitia
C. tunica intima, internal elastic lamina, tunica media, external elastic lamina, tunica externa
D. tunica intima, smooth muscle cells, internal elastic lamina, tunica media, external elastic lamina, tunica adventitia

C. tunica intima, internal elastic lamina, tunica media, external elastic lamina, tunica externa **

17

Which of the following transporters are the greatest contributors to the electrochemical gradient across the membrane?

A. Ca++/Mg++ ATPase
B. Cl-/HCO3- exchanger
C. GLUT 4 transporter
D. Na+/K+ ATPase

D. Na+/K+ ATPase **

18

The resting membrane potential is normally -70 to -80 mV because, at rest, the
A. equilibrium potential for K+ is approximately +70 mV.
B. equilibrium potential for Na+ is approximately +70 mV.
C. equilibrium potential for Na+ is approximately -70 mV.
D. neuronal membrane is permeable to K+ and Cl-.
E. neuronal membrane is permeable to Na+ and Ca2+.

D. neuronal membrane is permeable to K+ and Cl-. *

19

In both hypokalemia and hyperkalemia, action potential frequency ______ because in hypokalemia the resting membrane potential _____ and in hyperkalemia the inactivation gates of the voltage-gated Na+ channels are _____.
A. decreases ; depolarizes ; closed
B. decreases ; depolarizes ; open
C. decreases ; hyperpolarizes ; closed
D. decreases ; hyperpolarizes ; open
E. increases ; depolarizes ; closed
F. increases ; depolarizes ; open
G. increases ; hyperpolarizes ; closed
H. increases ; hyperpolarizes ; open

C. decreases ; hyperpolarizes ; closed *

20

A drug that binds to a G-protein coupled receptor and that prevents binding of hormone, but has no other effect on the receptor would be called a/an
A. antagonist.
B. full agonist.
C. inverse agonist.
D. partial agonist.

A. antagonist. *

21

An experimental beauty aid relaxes specific striated skeletal facial muscles by interfering with the process of excitation-contraction coupling in the muscles. The most likely mechanism of action would be
A. binding Ca2+ in the sarcoplasmic reticulum.
B. closing voltage-gated Ca2+ channels in the sarcolemmal membrane.
C. depolarization of the sarcolemmal membrane.
D. inhibiting the sarcoplasmic endoplasmic reticulum Ca2+ ATPase (SERCA) pumps.
E. opening voltage-gated Ca2+ channels in the sarcolemmal membrane.

A. binding Ca2+ in the sarcoplasmic reticulum. *

22

A motorcyclist experiences a severe fright as he narrowly avoids being cut off by a unattentative driver. What change in autonomic nervous system functioning would occur as a result of this event?

A. Alpha-1-adrenergic receptor activation would dilate the pupils through stimulation of adenylyl cyclase.
B. Beta-1-adrenergic receptor activation would depolarize cardiac pacemaker cells by stimulating production of intracellular cAMP.
C. Beta-2-adrenergic receptor activation would cause bronchodilation by increasing intracellular calcium in smooth muscle cells.
D. Beta-2-adrenergic receptor activation would contract arteriolar smooth muscle by decreasing intracellular inositol triphosphate and diacylglycerol.
E. Muscarinic cholinergic receptor activation would depolarize cardiac pacemaker cells by stimulating production of intracellular cAMP.

B. Beta-1-adrenergic receptor activation would depolarize cardiac pacemaker cells by stimulating production of intracellular cAMP. **

23

____ bones that form the longitudinal axis of the body

A. appendicular skeleton
B. axial skeleton
C. cancellous bone
D. capitulum
E. cortical bone
F. diaphysis
G. epiphysis
H. facet
I. malleolus
J. trochlea

B. axial skeleton

24

____ compact bone that provides strength for weight-bearing

A. appendicular skeleton
B. axial skeleton
C. cancellous bone
D. capitulum
E. cortical bone
F. diaphysis
G. epiphysis
H. facet
I. malleolus
J. trochlea

E. cortical bone

25

____ shaft of a long bone

A. appendicular skeleton
B. axial skeleton
C. cancellous bone
D. capitulum
E. cortical bone
F. diaphysis
G. epiphysis
H. facet
I. malleolus
J. trochlea

F. diaphysis

26

____ spool-like articular process or process that acts as a pulley

A. appendicular skeleton
B. axial skeleton
C. cancellous bone
D. capitulum
E. cortical bone
F. diaphysis
G. epiphysis
H. facet
I. malleolus
J. trochlea

J. Trochlea

27

____ smooth flat area, usually covered with cartilage, where two bones articulate

A. appendicular skeleton
B. axial skeleton
C. cancellous bone
D. capitulum
E. cortical bone
F. diaphysis
G. epiphysis
H. facet
I. malleolus
J. trochlea

H. facet

28

An 11-year-old gymnast reports to the emergency room after a fall from the parallel bars. She complains of pain localized to the proximal left femur, and refuses to bear weight through the affected lower extremity. Based on her age and the location of her pain, the most likely diagnosis is
A. avulsion of the tibial tuberosity.
B. fracture through her medial femoral condyle.
C. inversion sprain at her lateral malleolus.
D. patellar dislocation.
E. slipped capital femoral epiphysis .

E. slipped capital femoral epiphysis .*

29

An 80-year-old male presents with shoulder pain and asymmetry following a stroke. Radiographic studies confirm shoulder subluxation. The patient’s loss of shoulder stability can most likely be attributed to which of the following?
A. Change in the proportion of articulating surfaces over time
B. Loose joint ligaments
C. Loosening of the joint capsule
D. Poor posture
E. Weakened rotator cuff musculature

D. Weakened rotator cuff musculature *

30

Which of the following best describes motion that occurs in the transverse plane, around a longitudinal axis through the femur?
A. Abduction of the thigh at the hip joint
B. Circumduction of the thigh at the hip joint
C. Dorsiflexion
D. Flexion of the thigh at the hip joint
E. Medial rotation of the thigh at the hip joint

E. Medial rotation of the thigh at the hip joint *

31

A 47-year-old male steps on a nail in the middle of his foot at a construction site. The nail pierces through his skin, superficial fascia, and ___________ fascia.
A. crural
B. gluteal
C. palmar
D. plantar
E. popliteal

D. plantar *

32

A 3-year-old male is in a persistent vegetative state. The parents request that you discontinue life support for the child. Under the ruling in the Nancy Cruzan case,

A. it is never permissible to discontinue life support.
B. the hospital ethics committee may authorize discontinuing the life support.
C. the ruling does not apply to this situation.
D. the state may require clear and convincing evidence of the child’s wishes.
E. you may discontinue life support in accord with the parent’s wishes.

C. the ruling does not apply to this situation. **

33

A 3-year-old male is in a persistent vegetative state. The parents request that you discontinue nutrition and hydration for the child. Under the ruling in the Nancy Cruzan case,

A. it is never permissible to discontinue life support.
B. the hospital ethics committee may authorize discontinuing the life support.
C. the liberty interest is balanced against the state’s interest in protecting life.
D. the state may require clear and convincing evidence of the child’s wishes.
E. you may discontinue life support in accord with the parent’s wishes.

C. the liberty interest is balanced against the state’s interest in protecting life. **

34

Michael Dulce is a 45-year old male, new to your office. His history, including family history, medical examination and mental status examination are normal, but he presents with previously completed laboratory studies that are unremarkable except for the following: He had Apolipoprotein E testing, the results shows that his alleles are Apo E 3 and Apo E 4. What’s your next step?
A. You arrange for a meeting with patient and spouse and suggest they avoid pregnancy due to this unfortunate abnormal genetic finding.
B. You offer additional genetic testing, including assessment for E 280A gene, a cause of an aggressive dementing illness.
C. You provide your accurate interpretation of his result, offer reassurance and do not suggest treatment presently.
D. You suggest he get his life in order as he will unfortunately eventually succumb to Alzheimer Disease.
E. You tell Mr. Dulce that he will probably develop Alzheimer Disease, and that there is no effective treatment currently.

C. You provide your accurate interpretation of his result, offer reassurance and do not suggest treatment presently. **

35

A 70-year-old female is noted to have poor posture and reports back pain. In order to assess possible muscle weakness, the patient is asked to lift her shoulders and head against resistance while lying in the prone position. This test most likely assesses the function of
A. erector spinae.
B. latissimus dorsi.
C. rhomboid major.
D. serratus anterior.
E. serratus posterior inferior.

A. erector spinae.

36

Cells differentiate to become specialized. Differentiated cells differ because different cell types
A. have different DNA content.
B. have different DNA expression patterns.
C. have different genomes.
D. have different organelles.

B. have different DNA expression patterns

37

The 22 human somatic chromosomes contain
A. all genes for all human structures, with the sex chromosomes only influencing the production of gonads.
B. only one functional copy for each gene on each chromosome.
C. relatively the same number of genes per chromosome, though “junk” DNA causes the chromosomes to differ in size.
D. vastly different number of active genes per chromosome.

D. vastly different number of active genes per chromosome.*

38

Contains oxygenated blood
A. Pulmonary artery
B. Pulmonary veins
C. Right ventricle
D. Superior vena cava

B. Pulmonary veins*

39

The umbilicus marks the
A. Division of the aorta into left and right common iliac arteries.
B. Entrance of the ureters into the bladder.
C. Esophageal hiatus.
D. Origin of the celiac axis.
E. Separation of retroperitoneum from the peritoneum

A. Division of the aorta into left and right common iliac arteries.*

40

His patient lived 18 days after this first “successful” operation:
A. Akutsu; artificial heart
B. Barnard; heart transplant
C. Blalock; Tetralogy of Fallot
D. Cooley; heart transplant
E. Kolff; kidney transplant

B. Barnard; heart transplant*

41

A 40-year-old male is evaluated in the emergency department for a 3-day history of fever, fatigue, abdominal pain, and loose stools. He does not speak English and the history is obtained by a telephone translator for Korean. His medical history is significant for a heart transplant 1 month ago for cardiomyopathy. At the time of transplantation, he was seronegative for cytomegalovirus (CMV) with a seropositive donor. The patient’s health insurance lapsed possibly through his not understanding that he needed to follow up with social services. He has been taking his immunosuppressive medications, but not prophylactic medications for cytomegalovirus.
Which of the following is the most appropriate next step in management?

A. Ask the patient to bring a family member with him at his next visit
B. Remind the patient to schedule an appointment with social services
C. Start cytomegalovirus prophylaxis
D. Start treatment patient for CMV infection

D. Start treatment patient for CMV infection *

42

Tissue macrophages differentiate from peripheral blood

A. lymphocytes.
B. monocytes.
C. neutrophils.
D. platelets.
E. red blood cells.

B. monocytes. *

43

Lymphocytes destined to produce antibodies differentiate and mature in the

A. blood.
B. bone marrow.
C. lymph nodes.
D. spleen.
E. thymus.

B. bone marrow. *

44

The most effective treatment for symptomatic lymphedema is
A. antibiotics.
B. complete decongestive therapy.
C. positional elevation of the affected region.
D. surgical reconstruction of lymphatics.

B. complete decongestive therapy.**

45

A 30-year-old single mother presents at the clinic. She states she has recently become homeless due to being laid off at her job. She and her children are living out of their car. The woman has an infection and needs antibiotics. What is the best question can you ask to determine the social determinants of health for this woman in this situation?
A. Can you drive to a drugstore?
B. How much will your insurance pay towards your bill?
C. How will you get your medications?
D. There is a free clinic about 5 miles away. Do you have enough gas to get there?
E. Would you prefer a generic brand of antibiotics?

C. How will you get your medications? ***

46

When people congratulate fully capable disabled people for performing routine and normal activities this is a good an example of
A. being polite to the disabled person.
B. building rapport with the disabled person.
C. objectifying the disabled person.
D. romanticizing the disability.
E. teaching tolerance towards disabled people.

C. objectifying the disabled person. ***

47

Which of the following tissues would contain the most collagen?

A. Hyaline cartilage
B. Loose areolar connective tissue
C. Neural tissue
D. Osseous tissue
E. Simple squamous epithelia

D. Osseous tissue**

48

Intraperitoneal
A. Aorta
B. Duodenum
C. Kidney
D. Pancreas
E. Transverse colon
F. Uterus

E. Transverse colon*

49

Most numerous taste bud of the tongue
A. Circumvallate
B. Filiform
C. Foliate
D. Fungiform

B. Filiform*

50

Cells active in antibody dependent cell-mediated cytotoxicity require ___ receptors on their surface

A. antibody
B. B cell
C. complement
D. Fc
E. T cell

D. Fc *

51

HIV infects cells that express ___ on their surface.

A. CD4
B. CD8
C. CD20
D. CD56
E. CD80

A. CD4 *

52

A 6-year-old male presents with measles despite having received the measles vaccine as an infant. The most likely explanation for this is a deficiency of ____________ immunity.
A. active
B. artificial
C. innate
D. passive

A. active *

53

You're watching a television program that is discussing viruses called bacteriophages that can kill bacteria. Your roommate says "Wow, maybe viruses can be used to kill the bacteria that infect people! You're taking the Microbiology course now; what's the difference between virus and bacteria?" Which of the following would be the most accurate statement to make?

A) Viruses do not have mitochondria, whereas bacteria do
B) Viruses do not have a nucleolus, whereas bacteria do.
C) Viruses do not have ribosomes, whereas bacteria do.
D) Viruses replicate by binary fission, whereas bacteria replicate by mitosis.
E) Viruses are prokaryotic, whereas bacteria replicate by mitosis

C) Viruses do not have ribosomes, whereas bacteria do.

54

Bacteria, fungi, viruses, and protozoa are important causes of human disease. Which one of the following microbes contains either DNA or RNA but not both?

D) Viruses

55

Which one of the following contains DNA that is not surrounded by a nuclear membrane?
A) Bacteria
B) Molds
C) Protozoa
D) Yeasts

A) Bacteria

56

The initial step in the process of many bacterial infections is adherence of the organism to mucous membrane. The bacterial component that mediates adherence is the:

A) Lipid A
B) Nucleoid
C) Peptidoglycan
D) Pilus
E) Plasmid

D) Pilus

57

In the Gram stain procedure, bacteria are exposed to 95% alcohol or to an acetone/alcohol mixture. The purpose of this step is:

A) To adhere the cells to the slide
B) To retain the purple dye within all the bacteria
C) To disrupt the outer cell membrane so the purple dye can leave the bacteria
D) To facilitate the entry of the purple dye into the gram negative cells
E) To form a complex with the iodine solution

C) To disrupt the outer cell membrane so the purple dye can leave the bacteria

58

In the process of studying how bacteria cause disease, it was found that a rare mutant of a pathogenic strain failed to form a capsule. Which one of the following statements is the most accurate in regard to this unencapsulated mutant strain?

A) It was nonpathogenic primarily because it was easily phagocytized
B) It was nonpathogenic primarily because it could not invade tissue.
C) It was nonpathogenic primarily because it could only grow anaerobically
D) It was highly pathogenic because it could secrete large amounts of exotoxin.
E) It was highly pathogenic because it could secrete larger amounts of endotoxin.

A) It was nonpathogenic primarily because it was easily phagocytized

59

Mycobacterium tuberculosis stains well with the acid-fast stain, but not with the gram stain. Which one of the following is the most likely resin for this observation?

A) It has a large number of pili that absorb the purple dye
B) It has a large amount of lipid that prevents entry of the purple dye.
C) It has a very thin cell wall that does not retain the purple dye.
D) It is to thin to be seen in the Gram stain
E) It has histones that are highly negatively charged.

B) It has a large amount of lipid that prevents entry of the purple dye.

60

Of the following bacterial components, which one exhibits the most antigenic variation?

A) Capsule
B) Lipid A of endotoxin
C) Peptidoglycan
D) Ribosome
E) Spore

A) Capsule

61

Beta-Lactamases are an important cause of antibiotic resistance. Which one of the following is the most common site where Beta-lacamases are located?

A) Attached to DNA in the nucleoid
B) Attached to pili on the bacterial surface
C) Free in the cytoplasm
D) Within the capsule
E) Within the periplasmic space

E) Within the periplasmic space

62

Which one of the following is the most accurate description of the structural differences between gram-positive bacteria and gram-negitive bacteria?

A) Gram positive bacteria have a thick peptidoglycan layer, whereas gram-negitive bacteria
B) Gram-positive bacteria have an outer lipid rich membrane whereas gram-negitive bacteria do not.
C) Gram-positive bacteria from a sex pills that mediates conjugation, whereas gram-negitive bacteria do not.
D) Gram-positive bacteria have plasmids, where as gram negative do not.
E) Gram positive bacteria have capsules, whereas gram-negative bacteria do not.

A) Gram positive bacteria have a thick peptidoglycan layer, whereas gram-negitive bacteria

63

Bacteria that cause nosocomial infections often produce extracellular substances that allow them to stick firmly to medical devices, such as intravenous catheters. Which one of the following is the name of this extracellular substance?

A) Axial filament
B) Endotoxin
C) Flagella
D) Glycocalyx
E) Porin

D) Glycocalyx

64

Lysozyme in tears is an effective mechanism for preventing bacterial conjunctivitis. Which one of the following bacterial structures does lysozyme degrade?

A) Endotoxin
B) Nucleoid DNA
C) Peptidoglycan
D) Pilus
E) Plasmid DNA

C) Peptidoglycan

65

Several bacteria that form spores are important human pathogens. Which one of the following is the most accurate statement about bacterial spores?

A) They are killed by boiling for 15 minutes
B) They produce primarily by gram negative cocci
C) They are formed primarily when the bacterium is exposed to antibiotics
D) They are produced by anaerobes only in the presence of oxygen
E) They are metabolically inactive yet can survive for years in that inactive state.

E) They are metabolically inactive yet can survive for years in that inactive state.

66

In the bacterial growth cure which of the phases are antibiotics such as PCN most likely to kill bacteria?

A) Lag
B) Log
C) Stationary
D) Death

B) LOG

67

Some bacteria are obligate anaerobes. Which of the following statements best explains this phenomenon?

A) They can produce energy both by fermentation and by respiration using the Krebs cycle and cytochromes.
B) They cannot produce their own ATP
C) They do not form spores
D) They lack superoxide dismutase and catalase
E) They do not have capsule

D) They lack superoxide dismutase and catalase

68

The emergence of antibiotic-resistant bacteria especially in enteric gram-negative rods, is medically important phenomenon. This most commonly occurs y a process that involves a sex pills and the subsequent transfer of plasmids carrying one or more transposons. Which one of the following is the name that best describes this process?

A) Conjugation
B) Transduction
C)Transformation
D) Translocation
E) Transposition

A) Conjugation

69

-Several important pathogenic bacteria have the ability to translocate pieces of their DNA in a process called programmed rearrangements. Which one of the following is the most important known consequence of this ability?

A) The number of plasmids increases significantly, which greatly enhances antibiotic resistance
B) The amount of endotoxin increases significantly, which greatly enhances the ability to cause septic shock
C) The surface antigens of the bacteria vary significantly, which greatly enhances the ability to avoid opsonization by the antibody
D) The ability of the bacterium to be lysogenized is increased, which greatly enhances the ability to produce increased amounts of exotoxins.
E) The ability of the bacterium to survive intracellularly is greatly increased.

C) The surface antigens of the bacteria vary significantly, which greatly enhances the ability to avoid opsonization by the antibody

70

Which statement is the most accurate regarding transposons?
A) They encode enzymes that degrade the ends of the bacterial chromosomes.
B) They are short sequences of DNA that often encode enzymes that mediate antibiotic resistance
C) They are short sequence of RNA that silence specific regulatory genes.
D) They are a family of transfer RNAs that enhance mutations at "hot spots" in the bacterial genome.

B) They are short sequences of DNA that often encode enzymes that mediate antibiotic resistance

71

Corynebacterium diphtheria causes stye disease diphtheria by producing diphtheria toxin. The gene encoding the toxin is integrated into bacterial genome during lysogenic conversion. The toxin gene was acquired by which process?

A) Conjugation
B) Transduction
C) Transformation
D) Translocation
E) Transposition

B) Transduction

72

The colon is the site of the largest number of normal flora bacteria. Which one of the following bacteria is found in the greatest number in the colon?

A) Bacteroids fragilis
B) Clostridium perfringens
C) Enterococcus faecalis
D) Escherichia coli
E) Lactobacillus species

A) Bacteroids fragilis

73

A 76 year old woman with a prosthetic hip comes to you complaining of fever and pain in that joint. You are concerned about an infection by S. epidermis. Using your knowledge of normal flora, what is the most likely source of this organism?

A) Skin
B) Mouth
C) Skin
D) Stomach
E) Vagina

C) Skin

74

An outbreak of post surgical wound infections caused y S. aureus has occurred in the hospital. This infection control team was asked to determine whether the organism could be carried by one of the operating room personnel. Using your knowledge of normal flora, which one of the following body sites is the most likely location for this organism?

A) Colon
B) Gingival crevice
C) Mouth
D) Nose
E) Throat

D) Nose

75

Which one of the following sets of properties of exotoxins and endotoxins is correctly matched?

A) Exotoxins- Polypeptides; Endotoxins- lipopolysaccharide
B) Exotoxins- Weakly antigenic endotoxins- highly antigenic
C) Exotoxins-produced only by gram negative bacteria; endotoxins produced only by gram positive bacteria.
D) Exotoxins- weakly toxic per microgram; endotoxins-highly toxic per microgram.
E) Exotoxins-Toxoid vaccines are ineffective; endotoxins- toxoid vaccines are effective.

A) Exotoxins- Polypeptides; Endotoxins- lipopolysaccharide

76

Regarding endotoxin, which one of the following is the most accurate?

A) Endotoxin is polypeptide, the toxic portion of which consists of two D-alanines.
B) Endotoxin is produced by both gram-positive cocci as well as gram-negative cocci.
C) Endotoxin acts by binding to class II MHC proteins and the variable portion of the beta chain of the T-cell receptor.
D) Endotoxin causes fever and hypotension by inducing the release of interleukins such as interleukin-1 and tumor necrosis factor.
E) the antigenicity of endotoxin resides in its fatty acid side chains.

D) Endotoxin causes fever and hypotension by inducing the release of interleukins such as interleukin-1 and tumor necrosis factor.

77

Which one of the following host defense processes is the most important in preventing the action of exotoxins?

A) Binding of cytokines to exotoxin-specific receptors inhibits the attachment of exotoxins.
B) Degradation of exotoxins by the membrane attack complex of complement
C) Lysis of exotoxins by performs produced by cytotoxic T cells
D) Neutralization of exotoxins by antibody prevents binding to target cell membrane.
E) Phagocytosis of exotoxins by neutrophils and subsequent destruction by hypochlorite.

D) Neutralization of exotoxins by antibody prevents binding to target cell membrane.

78

An inflammatory response in the skin is characterized by erythema (redness). Which one of the following is the most important cause of this erythema?

A) C3b component of complement
B) Gamma interferon
C) Histamine
D) Hypochlorite
E) Superoxide

C) Histamine

79

Opsonization is the process by which:

A) Bacteria are made more easily phagocytized
B) Chemokines attract neutrophils to the site of infection.
C) Neutrophils migrate from the blood through the endothelium to reach this site of infection
D) The acute-phase response is induced
E) The alternate pathway of complement is activated.

A) Bacteria are made more easily phagocytized

80

If the venipuncture site is inadequately disinfected, blood cultures are most often contaminated with which one of the following bacteria?

A) Escherichia coli
B) Haemophilus influenzae
C) Pseudomonas aeruginosa
D) Staphylococcus epidermidis
E) Streptococcus pneumoniae

D) Staphylococcus epidermidis

81

The spread of antibiotic resistance from one bacterium to another is a well-recognized and clinically important phenomenon. Which one of the following mechanisms is most likely to be involved with the spread of resistance?

A) Acetylation
B) Conjugation
C) Programmed rearrangement
D) Protoplast mobility
E) Translation

B) Conjugation

82

Regarding the structure and reproduction of fungi, which one of the following is the most accurate?

A) Peptidoglycan is an important component of the cell wall of fungi.
B) Molds are fungi that grow as single cells and reproduce by budding.
C) Some fungi are dimorphic
D) The fungal cell membrane contains ergosterol, whereas the human cell membrane contains cholesterol.
E) As most fungi are anaerobic, they should be cultured under anaerobic conditions in the lab.

D) The fungal cell membrane contains ergosterol, whereas the human cell membrane contains cholesterol.