Question 1 - Single Best Answer
Which of the following diseases does Staphylococcus aureus NOT cause?
impetigo follicultis scalded skin syndrome furuncles S. aureus DOES cause all of the above diseases.
Question 2 - Single Best Answer
A young man is in a car accident and is thrown from his car, experiencing a severe, deep wound on his arm that is contaminated with dirt. Four days later, the wound becomes extremely swollen, foul smelling, hemorrhagic, with extensive necrosis of tissues. The most likely causative agent is:
a spore-forming, obligately anaerobic, gram-positive rod. a gram-positive coccus in chains a gram-positive coccus in clumps a gram-negative rod a spore-forming, aerobic, gram-positive rod.
Question 3 - Single Best Answer
A major difference between toxic shock syndrome and septic shock is that:
symptoms of toxic shock are directly caused by toxins, while symptoms of septic shock are directly caused by cytokines. toxic shock is self-limiting, while septic shock is almost always lethal. toxic shock can be caused by a local infection, while septic shock involves systemic infection. toxic shock is only caused by gram-positives, while septic shock is only caused by gram-negatives. toxic shock involves macrophages, while septic shock involves T cells.
Question 4 - Single Best Answer
Performing a blood gas analysis is helpful in diagnosing sepsis because:
pre-sepsis presents with metabolic acidosis, while late septic shock presents with respiratory alkalosis blood gasses are metabolically linked to oxidative burst by neutrophils, as well as clotting reactions blood gas levels help differentiate between aerobic and anaerobic infections pre-sepsis presents with respiratory alkalosis, while late septic shock presents with metabolic acidosis blood gasses are directly related to complement consumption and platelet aggregation
Question 5 - Single Best Answer
The drug recently approved by the FDA for treatment of sepsis is:
activated complement protein activated TNF-alpha platelet aggregating factor (PAF) C-reactive protein activated protein C
Question 6 - Single Best Answer
Meningeal symptoms include each of the following EXCEPT:
fever headache stiff neck lethargy confusion
Question 7 - Single Best Answer
In some recent studies, the most predominant cause of all cases of meningitis was gram-negative rods. This is best explained by:
antibiotic resistant Haemophilus influenzae type b (this question was thrown out because of a formatting error) antigenic variation in the type b capsule of Haemophilus influenzae increased cases caused by Listeria monocytogenes increased cases caused by Neisseria meningitidis nosocomial infections
Question 8 - Single Best Answer
A CSF profile that consists of polymorphonuclear leukocytes, depressed glucose, and elevated protein suggests:
untreated bacterial meningitis encephalitis viral meningitis brain abscess fungal meningitis
Question 9 - Single Best Answer
If a suspected meningitis patient has focal neurological deficits, the proper order of action is:
lumbar puncture, blood culture, antibiotics, CT scan blood culture, antibiotics, CT scan, lumbar puncture (if appropriate) antibiotics, blood culture, lumbar puncture, CT scan (if appropriate) neurosurgery consult, lumbar puncture, blood culture, antibiotics if cultures are positive None of the above is correct.
Question 10 - Single Best Answer
The blood brain barrier affects antibiotic treatment of meningitis by:
making treatment of intermediately resistant pneumococcus nearly impossible with beta-lactams making first generation cephalosporins useless causing recurrence of symptoms as healing occurs and CSF antibiotic levels decline making combined treatment with vancomycin and corticosteroids less effective All of the above. (10)
Question 11 - Single Best Answer
The seasonal variation in incidence of viral encephalitis is primarily due to:
crowding of people during the winter. consumption of improperly cooked foods during the summer mosquitoes in the summer and early fall decreased mucociliary escalator function during the winter None of the above - there is no seasonal variation for viral encephalitis.
Question 12 - Single Best Answer
Excessive cleaning of the exterior ear canal most often leads to:
acute otitis externa malignant otitis externa chronic otitis externa acute otitis media None of the above - regular cleaning of the ear canal should be encouraged to prevent the above diseases.
Question 13 - Single Best Answer
Major differences in symptoms between acute otitis media (AOM) and otitis media with effusion (OME) are:
AOM presents with more purulent effusion and more otalgia AOM has no effusion, while OME has an effusion AOM usually involves the mastoid air cells, while OME does not. AOM never presents with otorrhea (drainage from the ear canal), while OEM almost always does. The symptoms are the same, it is only the length of time the symptoms persist that differs.
Question 14 - Single Best Answer
In diagnosing acute sinusitis, the most important finding on radiographic analysis is:
destruction of the nasal septa. inflammation of the sinuses inflammation of roots of teeth effusion in the sinuses observation of foreign bodies
Question 15 - Single Best Answer
Which of the following is NOT a source of enteric infections?
human only soil animals water All of the above ARE sources of enteric infection.
Question 16 - Single Best Answer
Vomiting after ingestion of contaminated food is usually caused by:
ingestion of a toxin secreted by bacteria. invasion of the gastric mucosa by intracellular bacteria inflammation of the gastric mucosa caused by adherent bacteria attaching-effacing lesions necrosis of the gastric epithelium
Question 17 - Single Best Answer
Treating hemorrhagic colitis caused by Enterohemorrhagic E. coli (EHEC) with the wrong antibiotic can lead to serious complications because:
when the bacteria lyse in the bloodstream, they may cause shock. the lysogenic phage could be stimulated to produce shiga-like toxin. the bacteria could mutate and become resistant. the antibiotic selection could stimulate virulence gene expression from the antibiotic resistance plasmid. None of the above - as long as the EHEC bacteria are susceptible to the antibiotic, there are no serious problems.
Question 18 - Single Best Answer
How does the Venturi effect affect bacterial endocarditis?
It determines the antibiotic resistance of the bacteria. It prevents the formation of nonbacterial thrombotic endocarditis (NBTE). It causes bacteria to settle and colonize particular surfaces. It is responsible for Janeway lesions and Osler nodes. None of the above - the Venturi effect is not related to endocarditis, it predicts the lobe of aspiration pneumonia.
Question 19 - Single Best Answer
Which of the following is NOT a major clinical manifestation or physical finding of bacterial endocarditis?
fever chills weakness manifestations of septic emboli chest pain
Question 20 - Single Best Answer
How should blood cultures be taken to diagnose endocarditis and what is the rationale?
Once a day for a week because the number of bacteria can be low. Three times over the first 24 hours because the number of bacteria can be low. Ten times over the first 24 hours to catch the peak or spike release of bacteria. 100 milliliters needs to be drawn because the numbers of bacteria are so low. None of the above - endocarditis cannot be diagnosed with blood cultures, so they are useless. (20)
Question 21 - Single Best Answer
A 45 year old alcoholic ate fresh, raw oysters harvested from the Gulf of Mexico. Two days later she experiences fever of 39C, malaise, hypotension, and blood-blister (bullous) lesions on her legs. Which statement describes the most likely causative agent and its relationship to this disease process?
Gram-negative rods contaminated the oysters from improperly treated human sewage. Viruses that infected the liver contaminated the oysters from improperly treated human sewage. Gram-negative rods naturally present in the water contaminated the oysters. Gram-positive cocci contaminated the oysters from a wound on an infected food handler. None of the above - this is most likely a case of chemical food poisoning.
Question 22 - Single Best Answer
In the United States, a child is most likely going to experience hemolytic uremic syndrome from:
Enterotoxinogenic E. coli Shigella dysenteriae Enteroinvasive E. coli Shigella flexneri Enterohemorrhagic E. coli
Question 23 - Single Best Answer
Salmonella enterica serovar Typhimurium (S. typhimurium) infection occurs:
only in the intestines and lamina propria almost anywhere in the body. only in immunocompromised patients. only from foods contaminated with human feces only from naturally contaminated food, humans are dead-end hosts.
Question 24 - Single Best Answer
In the United States the current standard of care for acute otitis media is:
watchful waiting tympanocentesis myringotomy tubes topical antibiotics and anesthetics antibiotics
Question 25 - Single Best Answer
The reason that botulism in adults is frequently associated with rural areas where food is home grown and preserved is that:
the food preparer spread the bacteria from an infected wound on the hand. well water is usually contaminated. home-canned foods are not processed correctly honey is frequently used as a sweetener None of the above - the vaccine has all but eliminated botulism in the United States.
Question 26 - Single Best Answer
One of the most notable and unique aspects of bacterial-host interaction in attaching-effacing pathogenesis is:
the bacteria inject their own receptor into the host cell. the bacteria invade the host cell and emerge on the opposite side. the bacteria kill the host cell and parasitize nutrients from the surface. the bacteria invade the cell and thrive in the nucleus like a virus normally would. the bacteria cause the host cell to release ATP for use by the bacteria.
Question 27 - Single Best Answer
What is the treatment and rationale for most gastric ulcers?
Anti-viral agents to inhibit cytomegalovirus Antacids and beta-blockers Prozac to relieve stress Antibiotics to kill infecting bacteria Change in diet to reduce acid production.
Question 28 - Single Best Answer
What do Listeria and Shigella have in common?
They are both gram-negative rods. They both cause dysentery They both cause meningitis in adults. They both adhere to, but do not invade into, host cells. They both move in the host cell cytoplasm by causing actin polymerization.
Question 29 - Single Best Answer
What is the relationship between E. coli and the different diseases it causes?
The bacteria are the same, it is the immune status of the host that differs. The bacteria are the same, it is the route of entry that differs. The bacteria possess different sets of virulence genes. The same bacteria express different sets of virulence genes depending on environmental conditions of the host. None of the above - E. coli is normal flora, hence cannot cause disease by definition.
Question 30 - Single Best Answer
A 35 year old male presents with a one day history of headache, stiff neck, and fever of 102F. There is no papilledema or focal neurological deficits. He claims he has been under a lot of stress, and he usually gets headaches and is prone to infections then. There is debate among the emergency room staff over whether to perform a lumbar puncture. The best course of action is:
perform a CT scan. perform an MRI. give the man aspirin, ibuprofen, or acetaminophen and see if his headache goes away. begin oral antibiotics and send him home. do a lumbar puncture.
Question 31 - Single Best Answer
Salmonella diarhhea is best explained by:
inflammation and cytokines produced by macrophages in the lamina propria production of an attaching-effacing lesion invasion of host cells, escape from the phagosome, and lysis of the cell production of a potent exotoxin that stimulates fluid secretion All of the above
Question 32 - Single Best Answer
Most of the extra-cardiac symptoms of bacterial endocarditis are caused by:
damage caused by bacterial exotoxins immune complexes and septic emboli lipopolysaccharide (endotoxin) hypo-perfusion cytotoxicity caused by intracellular bacteria
Question 33 - Single Best Answer
The skin lesions of secondary syphilis are:
non-infectious because they are of immune complex origin. contagious because of high numbers of bacteria not contagious because the bacteria are under the skin identical in appearance to the primary chancre, they are just in different locations a very good prognostic sign that the infection and disease will be self-limiting.
Question 34 - Single Best Answer
Coupled with an appropriate clinical workup, which of the following statements describes the interpretation of the VDRL or RPR (non-treponemal) serology test?
A positive result definitely means that the patient has syphillis. A positive result definitely means the patient has AIDS. A negative result means the patient does not have syphilis, barring severe immune deficiency. A negative result must be followed by a treponemal specific test. None of the above - non-treponemal tests are no longer used to diagnose syphilis.
Question 35 - Single Best Answer
Tertiary syphilis is manifested primarily by:
antibody-antigen complexes throughout the body. high numbers of treponemes throughout the circulatory system, necrotic lesions on the genitals and throughout the reproductive system. granulomatous lesions in the vasculature and central nervous system. All of the above.
Question 36 - Single Best Answer
Which pair of organisms has the most similar symptoms?
Shigella and Enteropathogenic E. coli (EPEC) Streptococcus pneumoniae and Staphylococcus aureus Neisseria gonorrhoeae and Chlamydia trachomatis Nontypeable Haemophilus influenzae and Neisseria meningitidis Clostridium difficile and Clostrifium perfringens
Question 37 - Single Best Answer
Reticulate/reticular bodies are associated with which organism?
Treponema pallidum Gardernella vaginalis Listeria monocytogenes Herpes simplex 2 virus None of the above
Question 38 - Single Best Answer
Which of the following would NOT likely contribute to decreasing use of antibiotics in treating acute otitis media?
watchful waiting upon initial diagnosis adherence to strict guidelines for diagnosis use of the new conjugated pneumococcal vaccine frequent cleaning of the external ear canal increased use of diagnostic typmanocentesis
Question 39 - Single Best Answer
How does the biology of Toxoplasma gondii affect treatment of congenital toxoplasmosis?
The outer membrane precludes use of vancomycin and bacitracin. Its peptidoglycan is resistant to beta-lactams. It is a protozoan, so anti-protozoal drugs are used. It is a fungus, so anti-mycotic drugs are used. None of the above - there is no effective treatment for toxoplasmosis.
Question 40 - Single Best Answer
The treatment for hydrops in a fetus is:
intravenous antibiotics of the mother vaccination of the mother administration of intrauterine immune globulin to the fetus intrauterine blood transfusion of the fetus administration of immune globulin to the mother
Question 41 - Single Best Answer
The three major bacterial sexually transmitted diseases are caused by:
exotoxin-producing bacteria obligate intracellular bacteria normal flora bacteria with only human reservoirs bacteria that cannot be cultured in vitro.
Question 42 - Single Best Answer
Potassium hydroxide (KOH) is used in a wet prep of a vaginal sample to:
hydrolize cotton fibers from the swab sterilize the slide make the Candida structure more obvious make Clue cells easier to identify stimulate Trichomonas to move and be seen more easily
Question 43 - Single Best Answer
Disseminated Gonococcal Infection usually manifests itself as all of the following EXCEPT:
arthritis dermatitis meningitis pneumonia perihepatitis
Question 44 - Single Best Answer
Routine bladder catheterization prevents lower tract urinary tract infection by:
flushing the urethra of contaminating bacteria keeping the bladder empty enabling antibiotics to be instilled directly into the bladder enabling patients to remain in bed and get plenty of rest None of the above - routine bladder catheterization does not prevent UTI
Question 45 - Single Best Answer
Major symptoms that distinguish upper versus lower tract UTI include all of the following EXCEPT:
fever suprapubic pain costovertebral angle (CVA) pain hypotension nausea and vomiting
Question 46 - Single Best Answer
Which of the following is part of standard, appropriate action for patients with lower urinary tract infection (as determined by urinalysis, urine gram-stain, and symptoms)?
urine culture - if positive, then return visit for antibiotics suprapubic sonography - if positive, antibiotics given in office needle aspirate of bladder - culture intravenous pyelogram - if positive ñ antibiotics oral antibiotics - culture if treatment failure
Question 47 - Single Best Answer
The significance of 100,000 CFU/ml of bacteria in a midstream urine is:
it differentiates upper versus lower tract disease it is the level of bacteria in the bladder that is required to cause symptoms it is greater than the level of typical contamination of a midstream urine it differentiates infection by E. coli from Proteus that it is never seen in asymptomatic patients.
Question 48 - Single Best Answer
A woman 8 months pregnant presents at the Emergency Room because of a slight fever and malaise. In addition, she is worried as she has felt the fetal movements decline over the past several days. She is hospitalized, and two days later delivers a stillborn infant. A gram-positive rod is isolated from the placenta. The most likely disease-causing organism:
was likely acquired from sexual activity. was a member of her normal vaginal flora. was likely acquired by ingestion of cheese from a friend's goat farm. was likely acquired by inhalation and secondary transmission to the uterus through the macrophages. was a virus with the bacteria seen being normal placenta flora.
Question 49 - Single Best Answer
A sixty-four-year-old Caucasian female presents at the University Hospital clinic with a complaint of fatigue, lack of appetite, and weight loss during the last two weeks. She has not been coughing. About a month ago she had been in a farm accident in which a cow had kicked her in the jaw and knocked out a tooth. Her medical history includes rheumatic fever as a child. Her physical and laboratory examination would most likely include which elements?
a very high fever and sterile blood cultures a red throat with with beta-hemolytic colonies isolated a low grade fever, splinter hemorrhages, and beta-hemolytic colonies in the blood a high fever and bloody sputum abnormal echocardiogram and an alpha hemolytic bacterium isolated from her third blood culture
Question 50 - Single Best Answer
A twenty-seven year old African-American male presents at the Emergency Room with a complaint of frequent bloody diarrhea, fever and chills. He says he has been this way for the past day and a half. He owns a small farm in High Springs with chickens and cows. His family eats their own eggs and makes their own cheese from their cows' milk. His temperature is at 101.5 F, and he is perspiring. He shivers occasionally. There is diffuse tenderness over his stomach upon palpation. There is also abdominal distension, and it seems hyper motile upon auscultation. A gram-negative gull-shaped organism was cultured on special media at elevated temperature. Other characteristics of the disease/organism include
growth of the organism at refrigerator temperatures mild, self-limiting disease in immunologically normal individuals Guillain-Barre syndrome a toxin that ADP ribosylates adenyl cyclase lactose positive colonies on MacConkey's agar
Question 51 - Single Best Answer
A young woman is brought to the Emergency room because she had fainted during class. She was found to be menstruating, have a fever of 102F and very low blood pressure. The causative organism was isolated from her vagina and her blood culture was negative. She should not be treated with penicillin because:
the organism causing her problem has no cell wall the causative organism is almost certain to encode beta-lactamase gram-negative organisms are not susceptible to penicillin the causative organism has accumulated point mutations in its penicillin binding proteins that make it resistant to penicillin she has a viral infection
Question 52 - Single Best Answer
A gram-negative organism that can cause periodontal disease, endocarditis, and abscess formation is
Streptococcus mutans Escherischia coli Eikenella corrodens Staphylococcus aureus Haemophilus influenzae
Question 53 - Single Best Answer
Virulence factors/mechanisms for Listeria monocytogenes include
an enzyme that hydrolyses the wall of the endocytic vessicle adherence via its myosin tail a toxin that ADP ribosylates EF2 a superantigen toxin endotoxin
Question 54 - Single Best Answer
Diphtheria and tetanus both increase in incidence in the elderly. The reason for this is they are both:
anaerobes and the oxygen tension in the tissues of the elderly decreases wound infections and elderly individuals are more susceptible to serious wounds unusually sensitive to a decrease in cell-mediated immunity which happens as one gets older toxigenic infections with ADP ribosylating activity and the substrate for ADP ribosylase, NAD, goes up as energy utilization goes down prevented by vaccines that require booster immunizations.
Question 55 - Single Best Answer
Wound botulism differs from tetanus in that:
in wound botulism only the toxin, not the bacteria, get into the wound, while in tetanus the bacteria make the toxin in the wound. in tetanus there is spastic paralysis while in wound botulism there is flaccid paralysis. in botulism the organism makes the toxin when it sporulates while in tetanus the vegetative cells makes the toxin. in tetanus the spores infect the wound while in wound botulism vegetative cells are the source of the infection. only babies get wound botulism, but anyone can get tetanus.
Question 56 - Single Best Answer
Organisms that can be transmitted through the placenta to a fetus include
Toxoplasma, B19 virus, Listeria Treponema pallidum, Neisseria gonorrhoea, Chlamydia trachomatis Rubella virus, CMV, E. coli 0157 B19 virus, Neisseria gonorrhoea, Streptococcus agalactiae Neisseria gonorrhea, Haemophilus ducreyi, E. coli K1
Question 57 - Single Best Answer
To prevent tetanus during the neonatal period, one should:
make sure the baby is vaccinated as soon as it is born make sure the umbilical stump is kept clean and aerobic give silver nitrate drops to the baby deliver the baby by Caesarean section if the mother is symptomatic give the mother high doses of penicillin during the birth process
Question 58 - Single Best Answer
The role of antibodies produced as a result of vaccination in the prevention of bacterial meningitis is to:
bind to the adhesin and prevent the bacteria from crossing the blood brain barrier bind to the capsule so as to allow phagocytosis inactivate the endotoxin inactivate the toxin that is lysing the neurons prevent colonization of the nasopharynx
Question 59 - Single Best Answer
A 30-month-old female from a commune opposed to vaccination was brought to the emergency room by her parents with a fever of 39.7 C. She had come home with a "cold" from the day care center several days ago, but yesterday was extremely fussy, crying almost all the time she was awake, and screaming if she was picked up. Today she was very lethargic, and, in fact, her parents report that it was hard to rouse her at all. You note that she is responsive only to deep pain, and that it is very difficult to bend her neck forward. The first thing that must be done for this child is
intravenous antibiotics a CAT scan a blood culture a Gram stain of spinal fluid treatment of her symptoms is the only possible thing to do as she has viral encephalitis
Question 60 - Single Best Answer
Chlamydia trachomatis can cause sterility in the female by scarring and occluding the Fallopian tubes. It does this by
persistant inflammation causing cell-mediated autoimmunity a toxin that ADP ribosylates EF2 and causes cell death stimulating the growth of Neisseria gonorrhoea which then causes the scarring by endotoxic damage predisposing to Herpes Simplex 2 infection.
Question 61 - Single Best Answer
Jane (not her real name) Smith, a 19 year old white female, went to the County Health Department because she had noted multiple "sores" on her vagina that were very painful. They had developed the previous day. She had recently had her first sexual encounter with another student. He told her that he had had several STD's but that he didn't have them now and that he had been tested for AIDS and didn't have it. The doctor at the clinic noted that Jane's sores were somewhat like blisters, there were necrotic ulcers on her cervix, but there was no lymphadenopathy. Which of the following scenarios should the doctor warn Jane about?
She may have trouble getting pregnant because her Fallopian tubes might be occluded. If she becomes pregnant, she may pass her disease at any time during the pregnancy to her fetus, resulting in severe birth defects. She is at increased risk of cervical carcinoma. She may develop symptoms of meningitis (headache, photophobia, stiff neck) but will recover without neurological sequelae, although she may have recurrences of the blisters. She may develop encephalitis which can leave her unable to hear, in addition to having recurrences of the blisters.
Question 62 - Single Best Answer
The major symptom of Haemophilus ducreyi disease is most similar to disease caused by:
Neisseria gonorrhoea and Chlamydia trachomatis Treponema pallidum and Herpes simplex II Streptococcus pneumoniae and Neisseria meningitidis E. coli and Proteus mirabilus Haemohilus influenzae and Moraxella catarrhalis
Question 63 - Single Best Answer
What common mechanism do Neisseria gonorrhoea, Chlamydia trachomatis, and Herpes simplex have in common to make them highly successful pathogens?
obligate intracellular growth antigenic variation antigenic mimicry asymptomatic infections enzymes to cleave IgA
Question 64 - Single Best Answer
E. coli is the most common organism causing urinary tract infections. The immediate source of the organisms is:
intestinal flora bladder flora sexual partner(s) contaminated drinking water contaminated bath water
Question 65 - Single Best Answer
A young woman went to the infirmary because of pain on urination. She did not complain of an abnormal discharge or itching. A urine sample showed many white blood cells per high powered field, but a culture of her urine had only 3000 bacteria/ml. She likely has
viral cystitis Proteus cystitis E. coli pyelonephritis N. gonorrhoea urethritis C. albicans yeast infection
Question 66 - Single Best Answer
For most age ranges, women have a higher rate of urinary tract infections than men. In the higher age ranges, however, the rates converge. This is because:
women are more sexually active than men at most ages but this difference decreases with age. women have larger bladders, but bladders in older men expand due to weakening musculature. women have a shorter urethra so the bacteria have easier access to the bladder, but older men often have urinary blockage which increases their risk. women have a larger variety of intestinal flora, but men gain a more varied flora as they get older due to a decline in their cell mediated immunity. women urinate less frequently but as incontinence increases in women as they age (due to childbearing and other factors) their bladders drain more effectively.
Question 67 - Single Best Answer
After an abscess has been diagnosed the most important procedure is
determine the causative agent prior to further treatment administer an antibiotic into the abscess maintain normal blood pressure give tetanus prophylaxis drain surgically
Question 68 - Single Best Answer
Which of the following microorganisms is part of normal flora but causes problems by forming biofilm on catheters and prostheses?
Staphylococcus epidermidis Clostridium botulinum Streptococcus pneumoniae E. coli Bacteroides fragilis
Question 69 - Single Best Answer
Prevalence of gonorrhea disease in human is due to the following factors, EXCEPT
Infection with Neisseria gonorrhoeae is often asymptomatic Pili of the N. gonorrhoeae undergo antigenic variation Opa protein of the N. gonorrhoeae undergoes phase variation N. gonorrhoeae is ubiquitous in the environment Pili expression undergoes phase variation
Question 70 - Single Best Answer
Damage caused by Neisseria gonorrhoeae is caused by:
Pili Opa protein IgA protease Lipooligosaccharide (lipopolysaccharide) Polysaccharide capsules
Question 71 - Single Best Answer
What is the relationship between Systemic Inflammatory Response Syndrome (SIRS) and infection?
SIRS is always caused by bacteremia SIRS can be caused by other types of infection than bacteria, but is only caused by infection SIRS can be caused by infectious as well as non-infectious events Only gram-negative bacteria cause SIRS SIRS is synonymous with septicemia
Question 72 - Single Best Answer
The most common route of entry into the central nervous system by bacteria to cause meningitis is:
through the middle ear. through the cribiform plate. from the blood. through the optic nerve. through cranial wounds.
Question 73 - Single Best Answer
A 45 year old male contracts typhoid fever that was traced back to some chicken salad. The most likely scenario for this case is:
the chicken was not properly cooked. the food was prepared by an infected person. the patient is immunocompromised. the chicken was contaminated with soil. Any of the above could equally contribute to this case.
Question 74 - Single Best Answer
The unusual aspect of pathogenesis of Clostridium perfringens intestinal disease is:
The spores can invade to the mesenteric lymph nodes. Diarrhea is associated with inflammation mediated by endotoxin. The toxin is produced in the intestines during sporulation. Pathogenesis of diarrhea mimics that of gas gangrene in terms of tissue damage and outcome. The disease is spread from human to human via a fomite intermediate.
Question 75 - Single Best Answer
Dysentery is most likely to be caused by which type of pathogenesis?
Toxin acting in the stomach Toxin acting in the small intestine Invasion of the colon Invasion of the rectum None of the above.
Question 76 - Single Best Answer
What do cholera toxin and diphtheria toxin have in common?
They are both cytotoxic. They are both proteases. They are both encoded on plasmids. They are both encoded on bacteriophage. They are both increase cAMP levels of host cells.
Question 77 - Single Best Answer
A University student goes to the infirmary with a complaint of vaginal itching and abdominal discomfort. She also indicates that after intercourse she often smells a fishy odor. In a wet prep you see no large rod shaped bacteria, no pseudohyphae or budding yeast cells, and no protozoa. The epithelial cells look like bowling balls rolled in sand, grainy with rough edges. There are about 5 white blood cells for every epithelial cell. The most important other test that should be done is:
dark field microscopy for Treponema pallidum Gram-stain of vaginal exudate looking for gram-negative diplococci culture for Mobiluncus enumeration of bacteria in a urine sample culture for Chlamydia trachomatis on chocolate agar
Question 78 - Single Best Answer
A 50 year old male presents with a 30 day course of fever, chills, weakness, and weight loss. Auscultation reveals evidence of a heart murmur. Blood analysis shows normocytic, normochromic anemia, normal white blood cell counts, and elevated erythrocyte sedimentation rate. What type of organism is most likely to cultured from his blood?
Gram-positive cocci in chains Gram-negative rods Gram-negative diplococci Gram-positive diplococci None of the above - this is most likely a viral infection.