Question 1 - Single Best Answer
In the United States, persistent, watery diarrhea in an AIDS patient is most likely caused by:
a curved gram-negative rod that secretes a toxin a worm that invaded the patient through the feet a sporozoan parasite with no effective treatment a protozoan that infects red blood cells a fungus that forms pseudohyphae
Question 2 - Single Best Answer
All of the following contribute to Falciparum malaria being more severe than other forms EXCEPT:
There can be multiple infection of single red blood cells The percentage of infected red blood cells is higher The infected red blood cells adhere to the vascular endothelium A pigment produced by the organisms causes kidney and nervous system damage The infection recurs after treatment at a very high rate.
Question 3 - Single Best Answer
It is important to differentiate liver abscess caused by bacteria versus Entamoeba histolytica because:
bacterial abscesses usually require surgical drainage while amoebic abscesses usually respond to drugs bacterial abscesses can be treated with antibiotics but there is no cure for amoebic abscess amoebic abscesses have a high association with liver cancer, hence surgery is indicated amoebic abscess only occurs in immunocompromised patients, hence can serve as a sentinel disease for AIDS None of the above - both diseases respond to metronidazole, hence can be treated without knowing the causative agent.
Question 4 - Single Best Answer
Useful antifungal agents target each of the following except:
chloroplasts ergosterol RNA/DNA membrane sterols microtubules
Question 5 - Single Best Answer
A transplant patient on corticosteroids presents with fever, stiff neck, and confusion. A CSF culture fails to grow any bacteria, but an India ink test shows encapsulated organisms. The most likely cause for this disease is:
Streptococcus pneumoniae that has become antibiotic resistant. Cryptococcus neoformans Entamoeba histolytica Yersinia pestis Candida albicans
Question 6 - Single Best Answer
The most common portal of entry for systemic mycoses is the:
skin hair intestinal tract lungs wounds
Question 7 - Single Best Answer
Which of the following do inhalation anthrax and pneumonic plague have in common?
They both are highly contagious. They both are acquired from spores. They both are endemic to the United States. They both are highly fatal if untreated. All of the above.
Question 8 - Single Best Answer
A 20 year old male was camping in New England during the summer. Three weeks after returning to Florida he presents with flu-like symptoms and an erythematous lesion on his leg consisting of concentric circles. If this disease is not treated, which of the following is a likely future event?
The patient could suffer from arthritic disease because of immune responses to the pathogen. The patient will transmit the disease to his close friends. The patient's pet dogs and cats will be at risk for acquiring the disease. The patient could suffer from respiratory distress followed by hepatosplenomegaly and recurring fevers. None of the above - this is a self-limiting disease.
Question 9 - Single Best Answer
A skin test for reactivity to the hyphal antigen histoplasmin is not a useful diagnostic technique for histoplasmosis in Louisville, KY because:
Delayed hypersensitivity takes at least 2 weeks to develop and, therefore, takes too long to be of use. The Ohio River Valley is outside the endemic area for histoplasmosis. Most people in this region have been exposed to Histoplasma capsulatum and have an immune response to histoplasmin. This particular assay has too many false negative results in this part of the country. Histoplasma capsulatum grows as a yeast form in patients.
Question 10 - Single Best Answer
Amphotericin B is the mainstay of therapy for many disseminated mycoses. However, it presents difficulties for treatment for all of the following reasons EXCEPT:
Amphotericin must be delivered intravenously. Amphotericin has nephrotoxic side effects. Amphotericin binds cholesterol in addition to binding ergosterol. Amphotericin doses needed to destroy disseminated fungi are often toxic to the patient. Amphotericin cannot be used in immunocompromised patients.
Question 11 - Single Best Answer
A African-American male that works in a slaughter house in Apex, North Carolina has complained of recurring fevers for several weeks. Today he presents at the E.R. with a fever of 104F and very painful and swollen testicles. His liver and spleen are also enlarged. Blood cultures are negative. A test most likely to reveal the organism causing all of his symptoms would be:
VDRL Gram stain of urethral swab bacterial culture of the bone marrow bacterial culture of the CSF viral antibody test
Question 12 - Single Best Answer
A child is brought to your office in rural Georgia suffering from a severe headache, fever, and swollen lymph nodes. She also has a rash on her trunk, extremities, palms and soles. She was bitten by a tick last week. Blood cultures and a VDRL are negative. The organism causing her problems is most likely
growing in the vascular endothelium growing in the spinal fluid growing in the macrophages a virus a spirochete
Question 13 - Single Best Answer
A person diagnosed with plague in this country would most likely
be from the southwest be from the northeast have handled wild rabbits have been bitten by a tick have been on a camping trip and bathed in a pond
Question 14 - Single Best Answer
What zoonotic disease is most likely to cause a false positive VDRL?
plague Lyme disease tularemia listeria brucellosis
Question 15 - Single Best Answer
The organism causing Giardiasis is structurally most similar to:
Campylobacter jejuni Entamoeba histolytica Borrelia burgdorferi Trichomonas vaginalis Coccidioides immitis
Question 16 - Single Best Answer
The symptomology of amoebiasis is most similar to:
Shigellosis Giardiasis Malaria Brucellosis Cholera
Question 17 - Single Best Answer
Malaria acquired in this country is most likely to be in communities in the proximity of
slaughter houses sewage treatment plants zoos airports deserts
Question 18 - Single Best Answer
A child who is normally happy and easy-going becomes irritable and inattentive in school. This is the only significant symptom. Which of the following parasites most likely causes this situation?
plasmodium whipworm pinworm ascaris hookworm
Question 19 - Single Best Answer
The mechanism by which whipworms can cause rectal prolapse is
antibodies, autoimmunity inflammation, tenesmus a toxin, apoptosis intracellular growth, cell death exoenzymes, digestion of the bowel wall with flask-shaped lesions
Question 20 - Single Best Answer
The association of histoplasmosis with bats is due to:
contamination of the bat fur mosquito transmission from the bat growth of the organism in the bats growth of the organism in the bat excrement None of the above - histoplasmosis is associated with pigeons, not bats.
Question 21 - Single Best Answer
Coccidioides is most likely found in:
the desert Southwest the Mississippi River valley Africa South America world-wide (no specific areas)
Question 22 - Single Best Answer
Dr. Joe Spacey suggested that a safer anthrax vaccine could be made from just the capsule, rather than whole cells. This probably would not work because
all antibacterial vaccines must have as at least one component of a toxoid the capsule is made of a substance not recognized by the immune system Bacillus anthracis does not have a capsule polysaccharide vaccines are not effective unless conjugated to a protein polysaccharide vaccines have the most serious side effects
Question 23 - Single Best Answer
Which of the following pairs of disease/diagnostic procedures is NOT correct?
Giardiasis - string test Pinworm - "Scotch tape test" Strongyloides - string test Amoebiasis - Wright stain of stool (ingested RBCs) Whipworm - eosinophilia
Question 24 - Single Best Answer
A reason for the geographical limitation of schistosomiasis is the range of the:
mosquito vector. tick vector. snail host. rodent host. None of the above - there is no geographical limit to schistosomiasis
Question 25 - Single Best Answer
A routine chest X-ray shows a floating fungal ball in a cavitary lesion in an otherwise healthy patient's lung. There is no bleeding. This case requires which of the following actions?
Surgical removal. Administer antineoplastic drugs. Administer isoniazid. Administer high dose Amphotericin B and ketoconazole. Observation only.
Question 26 - Single Best Answer
Which of the following causes mycotic infections that are best described as endogenous disease processes?
Aspergillus Candida Histoplasma Cryptococcus Coccidiomycosis
Question 27 - Single Best Answer
When worms that normally infect other animals find themselves in humans (an inappropriate host), which of the following is/are a possible outcome:
Migrating skin lesions from the nematodes. Large cysts containing numerous immature tapeworms. Migration of nematodes through deep tissues. All of the above. None of the above. In inappropriate hosts, the worms always die without causing any apparent pathology.
Question 28 - Single Best Answer
Which of the following is NOT a typical part of microbial populations associated with pelvic inflammatory disease?
Neisseria gonorrhoeae Chlamydia trachomatis mixed normal flora Candida albicans All of the above are typically associated with PID
Question 29 - Single Best Answer
The potentially serious complications of Pelvic Inflammatory Disease include each of the following EXCEPT:
chronic pain infertility ectopic pregnancy recurring infection All of the above ARE complications of PID
Question 30 - Single Best Answer
A diabetic patient in ketoacidosis presents with invasive sinusitis. The most likely causative agent has which morphology?
Right angled branching hyphae Acute angled branching hyphae Encapsulated yeast Encapsulated, gram-negative bacterium Gram-positive spore forming bacterium