Question 1 - Single Best Answer
The most common manifestation of disseminated gonococcal infection is:
A) urethritis
B) proctitis
C) pharyngitis
D) arthritis
E) meningitis
Question 2 - Single Best Answer
Enterotoxinogenic E. coli (ETEC) and Vibrio cholerae diseases are similar in the following ways EXCEPT:
A) both should be treated with antibiotics.
B) neither is endemic in the United States.
C) both can cause severe, watery diarrhea.
D) neither infection is invasive.
E) both involve toxins that are encoded on bacteriophage.
Question 3 - Single Best Answer
Surgical intervention (e.g., myringotomy with tubes or adenoidectomy) in otitis media with effusion should be performed:
A) if the effusion does not spontaneously clear within three months.
B) if the aspirated fluid is PCR-positive for bacteria.
C) only after aggressive medical intervention (steroids and antibiotics) have failed.
D) only after hearing loss has been documented above 30 decibels.
E) None of the above - surgical intervention is unnecessary, dangerous, and expensive and should not be used to treat otitis media with effusion.
Question 4 - Single Best Answer
Based on patient history and epidemiology, which of the following best describes the role of immunity in sexually transmitted bacterial infections (Gonorrhea, Chlamydia, Syphilis)?
A) Protective immunity is formed after initial infection.
B) The primary lesions are primarily caused by specific immune responses.
C) Immune responses from infection do not confer protection.
D) The nonspecific, constitutive defenses (PMNs and complement) are sufficient to stop the infections.
E) The vaccines for these diseases confer protective immunity.
Question 5 - Single Best Answer
Cystitis in women is sometimes called the "honeymoon infection" because:
A) it is a sexually transmitted infection of the urethra.
B) it is caused by yeast cells that infect the vagina when sexual intercourse is frequent.
C) it is caused by upsetting the normal flora of the vagina that happens when sexual intercourse is frequent.
D) it is caused by mechanical introduction of colon bacteria that have colonized the periurethral area into the distal urethra.
E) it is caused by forcing bacteria from the bladder up the ureter into the kidney.
Question 6 - Single Best Answer
Other than having an animal reservoir, all of the following zoonotic diseases (Rocky Mountain Spotted Fever, Lyme disease, Bubonic plague, Anthrax, Leptospirosis, Ehrlichiosis) have which of the following in common?
A) obligate intracellular pathogens
B) spread through tissues and/or the body
C) secreting potent exotoxins
D) entering the body through an arthropod bite
E) always causing a skin rash
Question 7 - Single Best Answer
A college student is scratched on his arm by his cat. His axillary lymph nodes become inflamed, tender, and swollen. After two weeks they rupture and begin to drain pus. The most likely causative agent:
A) is a gram-positive spore-former.
B) is a gram-positive coccus usually found in clumps.
C) is a spirochete.
D) is an obligate intracellular pathogen.
E) is a virus.
Question 8 - Single Best Answer
What do streptococcal pyogenic exotoxin and staphylococcal toxic shock toxin have in common?
A) They are both ADP-ribosylating toxins.
B) They both are superantigens.
C) They both contribute to necrotizing fasciitis.
D) They both are preformed in food and consumed in improperly prepared food.
E) All of the above.
Question 9 - Single Best Answer
Collectively, the major causes of greater than 90% of vaginitis consist of each of the following EXCEPT:
A) Lactobacillus.
B) Bacterial vaginosis.
C) Trichomoniasis.
D) Candidiasis.
E) All of the above ARE major causes of vaginitis.
Question 10 - Single Best Answer
In terms of its pathogenesis, syphilis is most like Lyme disease because:
A) the skin lesions can easily be confused between the diseases.
B) there are acute, latent, and tertiary manifestations.
C) both diseases are caused by toxins.
D) both diseases cannot be diagnosed by culture.
E) both diseases are transmitted by direct contact among people.
Question 11 - Single Best Answer
What separates endocarditis caused by Staphylococcus aureus from that caused by the viridans streptococci?
A) Staphylococcus aureus can infect otherwise undamaged heart valves.
B) Staphylococcus aureus endocarditis can be treated with a short course of bacteriostatic antibiotics, while the streptococci require a long course of bactericidal antibiotics.
C) There is a vaccine for Staphylococcus aureus, but there is not a vaccine for the viridans streptococci.
D) Blood cultures are usually negative for Staphylococcus aureus, but are positive for viridans streptococci.
E) None of the above - there are no differences in pathogenesis of endocarditis caused by Staphylococcus aureus and the viridans streptococci.
Question 12 - Single Best Answer
Young sexually active women have more UTIs than young sexually active men, but old men have more UTIs than young men. The reasons for these two facts are:
A) women have shorter urethras than men, but old men are more sexually active than young men.
B) women have shorter urethras than men, but old men are more likely to develop urine blockages than young men.
C) women have more glucose in their urine than men but the amount of glucose that old men excrete is greater than the amount that young men secrete.
D) young women's urethras are more easily blocked by inflammation than young mens, but this changes as men age.
E) women have shorter urethras than men but this changes as men age.
Question 13 - Single Best Answer
Many of the systemic symptoms of endocarditis are caused by:
A) toxins released by the bacteria.
B) autoimmunity.
C) release of septic emboli.
D) shock.
E) secondary viral infection.
Question 14 - Single Best Answer
Pathogenesis of acute sinusitis and acute otitis media have all of the following in common EXCEPT:
A) They both involve blockage of drainage of closed spaces.
B) They both involve normal bacterial flora.
C) The organisms are primarily extracellular pathogens.
D) Most of the damage of the diseases can be explained by inflammation.
E) All of the above ARE common to acute sinusitis and otitis media.
Question 15 - Single Best Answer
The three most common forms of bacterial meningitis in newborns:
A) are all intracellular pathogens.
B) consist of a gram-negative rod, a gram-positive coccus, and a gram-positive rod.
C) all secrete potent exotoxins.
D) can be prevented with vaccines that can be administered to pregnant women.
E) are the same agents as for young children and adults.
Question 16 - Single Best Answer
Major differences in etiologies of urinary tract infection between outpatients and inpatients can be explained by the fact that:
A) outpatient UTIs are mainly caused by agents of sexually transmitted disease.
B) inpatient UTIs are caused by blood borne pathogens.
C) outpatient UTIs are caused by viruses.
D) inpatient UTIs are caused by diverse flora because of catheterization.
E) None of the above - the etiologies of inpatient and outpatient UTIs are essentially the same.
Question 17 - Single Best Answer
In which part of latent syphilis is the risk for perinatal transmission of syphilis the greatest?
A) early latent
B) late latent
C) tertiary latent
D) quaternary latent
E) None of the above - by definition, syphilis cannot be perinatally transmitted during the latent phase.
Question 18 - Single Best Answer
The most common cause of nosocomial bacterial meningitis is:
A) Streptococcus pneumoniae.
B) Neisseria meningitidis.
C) an acid fast bacterium.
D) viridans streptococci.
E) gram-negative bacilli.
Question 19 - Single Best Answer
Untreated bacterial meningitis is characterized by which of the following CSF profiles?
A) lymphocytes, low glucose, elevated protein
B) PMNs, low glucose, elevated protein
C) lymphocytes, normal glucose, elevated protein
D) PMNs, elevated glucose, elevated protein
E) One cannot characterize the causative agent by the CSF profile. One must wait for culture results and Gram stain.
Question 20 - Single Best Answer
The standard of care for initiating antibiotics in treating suspected bacterial meningitis is:
A) 5 minutes.
B) 30 minutes.
C) 2 hours.
D) 5 hours.
E) as long as it takes to get the CT scan and CSF Gram stain.
Question 21 - Single Best Answer
The usefulness of potassium hydroxide (KOH) in diagnosing vaginitis is:
A) treating the endocervix to eliminate normal flora that interferes with culture.
B) making yeast and hyphae more visible on a wet prep.
C) lysing epithelial cells to expose Clue cells.
D) stimulating motility of Trichomonas.
E) None of the above - KOH is used to TREAT vaginitis.
Question 22 - Single Best Answer
Symptoms and signs that suggest viral versus bacterial meningitis are:
A) higher fever and more severe headache.
B) no stiff neck or headache.
C) photophobia but no loss of consciousness.
D) red blood cells in CSF.
E) Kernig and Brudzinski's signs are only found with viral meningitis.
Question 23 - Single Best Answer
The most important symptom in diagnosing chronic otitis externa is:
A) granuloma tissue adjacent to the tympanic membrane.
B) itching and inflammation that do not go away.
C) long-term (several weeks) fever.
D) perforation of the tympanic membrane.
E) long-term (several weeks) exudation of pus, as opposed to serous fluid.
Question 24 - Single Best Answer
The most FREQUENT outcome of untreated acute otitis media is:
A) mastoiditis.
B) chronic otitis media.
C) otitis media with effusion (OME).
D) meningitis.
E) None of the above - acute otitis media is most often self-limiting.
Question 25 - Single Best Answer
The standard of care for acute otitis media in the United States is:
A) parenteral antibiotics and analgesics.
B) topical antibiotics only.
C) topical anesthetics only.
D) analgesics (acetaminophen) only.
E) None of the above - "watchful waiting" to observe spontaneous cure is the norm.
Question 26 - Single Best Answer
An infant experiences an infection that results in large patches of epidermis falling off, as if burned. The strain of the organism causing this particular form of the disease is unique from related strains that do not cause this disease in that it:
A) is producing a novel toxin.
B) is invading inside host cells and causing cytotoxicity.
C) is stimulating an aggressive specific immune response in the skin tissues.
D) was acquired from an animal.
E) produces very large quantities of gas in the skin tissues.
Question 27 - Single Best Answer
A man is shucking raw oysters and cuts his finger with a shell. Some juice from the oyster contaminates the wound. The next day the wound is erythematous, swollen, and painful. Within another day the lesion has extended to the hand and up the wrist becoming necrotic. All of the following describe the most likely causative agent EXCEPT:
A) It is encapsulated.
B) It is a gram-negative curved rod.
C) It contaminated the oyster from human sewage.
D) It can give predisposed people who eat the raw oysters septicemia.
E) Although incidence is low, the mortality rate is high, even with antibiotic treatment.
Question 28 - Single Best Answer
If a patient acquires diarrhea during hospitalization, the stool is generally not cultured for diagnosis because:
A) It is likely viral.
B) It is likely a protozoan.
C) It is likely an obligate anaerobe whose toxin is assayed.
D) It is likely a non-culturable intracellular pathogen.
E) It is likely a fungal infection.
Question 29 - Single Best Answer
Why are antibiotics not indicated for Enterohemorrhagic E. coli disease?
A) They can stimulate production of toxin and cause hemolytic uremic syndrome.
B) Lysing the bacteria in the vasculature can precipitate endotoxic shock.
C) The bacteria are resistant to most antibiotics, so they would be useless.
D) Clearing the normal flora of the gut leads to hemorrhagic colitis and hemolytic uremic syndrome.
E) None of the above - antibiotics should always be used to treat EHEC.
Question 30 - Single Best Answer
The major causes of blood in stool are:
A) ischemia and tissue invasion by pathogens.
B) production of enterotoxins and viruses.
C) dehydration and oxidative stress.
D) ingestion of preformed toxins and constipation.
E) electrolyte imbalance and defensins.
Question 31 - Single Best Answer
A 24 year old woman presented to the emergency room with a two-hour history of recurrent vomiting and one bout of watery diarrhea. The vomiting started about 3 hours after she ate at a deli restaurant. Which of the following is the most likely causative organism of her gastrointestinal complaint?
A) Salmonella
B) Campylobacter
C) Staphylococcus aureus
D) Giardia
E) Entamoeba
Question 32 - Single Best Answer
An 18 year old college student is hospitalized with lethargy, fatigue, nausea and vomiting. Ten days ago she had a 4-day history of diarrhea characterized by 4 to 5 watery bowel movements per day. No blood or mucus was noted in the stool. Several other students had a similar illness, and a few reportedly had bloody stools. Patient's laboratory was remarkable for anemia, and elevated blood urea nitrogen and creatinine (both are signs of renal failure). Stool study revealed 2+ blood but no WBC. Which of the following is the most likely causative organism?
A) Campylobacter
B) Shigella
C) Enteropathogenic E. coli
D) Enterotoxinogenic E. coli
E) Enterohemorrhagic E. coli 0157:H7
Question 33 - Single Best Answer
In the United States, the two most common causes of bacterial diarrhea are:
A) Vibrio cholerae and Enterotoxinogenic E. coli.
B) Non-typhoid Salmonella and Campylobacter.
C) Shigella and Vibrio vulnificus.
D) Enteropathogenic E. coli and Enteroinvasive E. coli.
E) Clostridium dificile and Staphylococcus aureus.
Question 34 - Single Best Answer
Helicobacter pylori is associated with:
A) hemolytic uremic syndrome (HUS).
B) severe vomiting disease.
C) dysentery.
D) peptic ulcers.
E) colon cancer.
Question 35 - Single Best Answer
The functions of pili and Opa proteins for Neisseria gonorrhoeae are:
A) invasion of host cells and toxicity, respectively.
B) adherence to host cells and antibiotic resistance, respectively.
C) adherence to host cells and invasion of host cells, respectively.
D) evasion of PMNs and iron acquisition, respectively.
E) invasion of host cells and resistance to dessication, respectively.
Question 36 - Single Best Answer
The life cycle of Chlamydia trachomatis is best described as:
A) a vegetative cell and a spore.
B) a form that is culturable on lab media and one that is not.
C) an infectious elementary body and a replicating reticular body.
D) an animal reservoir and a human reservoir.
E) an environmental reservoir and a human reservoir.
Question 37 - Single Best Answer
Which of the following is NOT a disease manifestation caused by Staphylococcus aureus?
A) sepsis
B) impetigo
C) food intoxication (food poisoning)
D) endocarditis
E) None of the above - all ARE caused by Staphylococcus aureus
Question 38 - Single Best Answer
Why does Clostridium dificile cause diarrhea after antimicrobial therapy?
A) The antibiotics stimulate toxin production by the phage-encoded genes.
B) C. dificile growth in suppressed by the normal flora.
C) The antibiotics disrupt the intestinal mucosa sensitizing the epithelium to the toxins.
D) Antibiotics are often contaminated with the spores of C. dificile.
E) None of the above - C. dificile does NOT cause antibiotic-associated diarrhea.
Question 39 - Single Best Answer
Neonates born to women infected with Chlamydia trachomatis are uniquely at risk for which disease compared with those born to women infected with Neisseria gonorrhoeae?
A) pneumonia
B) eye infection
C) meningitis
D) arthritis
E) None of the above - neonates have the same risks when born to mothers infected with N. gonorrhoeae and C. trachomatis.
Question 40 - Single Best Answer
A farmer cleans out his rat-infested barn. A week later he experiences headache and fever, followed by jaundice and a rash. A spirochete is identified in his blood by dark-field microscopy. These symptoms resolve but are followed by two weeks of diffuse lymphadenopathy and hepatosplenomegaly. He most likely acquired this illness by:
A) encounter with rat urine.
B) being bitten by ticks infected with the causative agent.
C) sexual encounter with a prostitute.
D) bite of a rat.
E) inhaling spores of the causative agent.
Question 41 - Single Best Answer
Which of the following is/are sequellae of BOTH Chlamydia trachomatis and Neisseria gonorrhoeae in women?
A) infertility
B) ectopic pregnancy
C) chronic pelvic pain
D) all of the above
E) None of the above are common between the two organisms
Question 42 - Single Best Answer
The major manifestations of tertiary syphilis are in the:
A) heart and nervous system
B) skin
C) respiratory tract
D) muscular system
E) None of the above - by definition tertiary syphilis has no symptoms.
Question 43 - Single Best Answer
A patient undergoes a procedure that could cause transient bacteremia. The most effective time to administer prophylactic antibiotics to prevent endocarditis is:
A) 1 day before the procedure.
B) 1 hour before the procedure.
C) 1 day after the procedure.
D) 1 week after the procedure.
E) 3 weeks after the procedure when symptoms usually first appear.
Question 44 - Single Best Answer
The most common route of infection of the meninges during community acquired bacterial meningitis is:
A) direct infection from the middle ear.
B) direct infection through a defective cribiform plate.
C) infection via the blood.
D) infected macrophages crossing the blood-brain barrier.
E) trauma.
Question 45 - Single Best Answer
Antibiotic treatment for uncomplicated primary syphilis, gonococcal urethritis, and chlamydial endocervicitis consists of:
A) a single administration of a systemic antibiotic.
B) a week-long course of a systemic antibiotic.
C) a month-long course of topical antibiotics.
D) multiple antibiotics for two weeks.
E) None of the above - treatment consists of immune globulins for these diseases.
Question 46 - Single Best Answer
Antibiotic treatment of initial lower tract urinary tract disease should:
A) only be initiated after urine cultures have been read.
B) only be initiated if symptoms do not resolve in three days.
C) be high dose for a short course (three days).
D) be low dose for an extended course (two weeks).
E) consist of multiple antibiotics.
Question 47 - Single Best Answer
The most typical serious outcome of untreated Lyme disease is:
A) severe sepsis and death.
B) meningitis.
C) death.
D) arthritis and neurological damage.
E) None of the above - the disease is self-limiting.
Question 48 - Single Best Answer
The most sensitive and practical way to visualize the vegetations associated with endocarditis is:
A) CT scan.
B) MRI.
C) transthoracic echocardiogram.
D) transesophogeal echocardiogram.
E) dye contrast radiography.
Question 49 - Single Best Answer
The currently licensed vaccine for Haemophilus influenzae type b works by:
A) stimulating sIgA to the filamentous hemagglutinin.
B) stimulating cell-mediated immunity to this intracellular pathogen.
C) stimulating IgG to the capsule to opsonize bacteria and prevent bacteremia.
D) stimulating IgG to the locally produced, yet systemically active exotoxin.
E) None of the above - there is no vaccine since the capsule is poly-sialic acid, and this is antigenic mimicry.
Question 50 - Single Best Answer
The VDRL and RPR tests for syphilis are:
A) sensitive but nonspecific tests for antibodies.
B) insensitive by highly specific test for antibodies.
C) sensitive and specific PCR tests.
D) insensitive but specific tests for treponemes using a dark-field microscope.
E) insensitive but specific tests for treponemes using fluorescence microscopy.
Question 51 - Single Best Answer
Observing a wet prep from a case of bacterial vaginosis, one should see:
A) intracellular diplococci in PMNs.
B) highly motile trichomonads.
C) inclusion bodies.
D) Clue cells and few PMNs .
E) All of the above.
Question 52 - Single Best Answer
The physical state of the bacterial infection of the heart valves in endocarditis can be best described as:
A) intracellular proliferation of bacteria.
B) vegetative cells sporulating to produce spores.
C) asymptomatic colonization.
D) a biofilm.
E) None of the above - endocarditis is cause by Nonbacterial Thrombotic Endocarditis (NBTE), hence the valves are sterile.
Question 53 - Single Best Answer
Which of the followings is NOT associated with the virulence of Neisseria gonorrhoeae
A) lipooligosaccharide (LOS)
B) Pili
C) O-antigen
D) Opacity protein
E) Antigenic variation
Question 54 - Single Best Answer
Which of the following is NOT a characteristic of secondary syphilis?
A) The appearance of a generalized skin rash
B) Lymphadenopathy
C) Fever
D) Negative RPR or VDRL
E) Lesions that are highly infectious
Question 55 - Single Best Answer
For which of the following toxin mediated illnesses would antibiotic therapy not be indicated?
A) Group A streptococcal toxic shock-like syndrome
B) Staphylococcus aureus food poisoning
C) Scalded skin syndrome
D) Staphylococcus aureus toxic shock syndrome
E) Scarlet fever
Question 56 - Single Best Answer
A soft, painful genital ulcer is most likely associated with:
A) a gram-negative coccobacillus
B) a spirochete.
C) a virus.
D) a gram-negative diplococcus.
E) an obligate intracellular bacterium lacking peptidoglycan.
Question 57 - Single Best Answer
A 65-year-old man underwent bowel surgery for colon cancer 3 days ago. He now has a fever and abdominal pain. You are concerned that he may have peritonitis. Which of the following organism is MOST likely to be the primary causative agent?
A) Bacteroides fragilis
B) Salmonella enterica serovar Typhimurium
C) Campylobacter jejuni
D) Shigella dysentariae
E) Klebsiella pneumoniae
Question 58 - Single Best Answer
Symptoms which specifically direct attention to the meninges ("meningeal symptoms") include each of the following EXCEPT:
A) fever.
B) headache.
C) stiff neck.
D) lethargy.
E) vomiting.
Question 59 - Single Best Answer
Which of the following best describes the relationship between rheumatic fever and bacterial endocarditis?
A) These are two different names for the same disease.
B) Rheumatic fever is a non suppurative sequellae of endocarditis.
C) Rheumatic fever and endocarditis are both active infections of the heart.
D) Rheumatic fever predisposes to endocarditis.
E) Both can be acquired from a cat bite.
Question 60 - Single Best Answer
Which of the following is most like the disease caused by Vibrio cholerae in terms of its pathogenesis?
A) Campylobacter diarrhea
B) Salmonella enteritis
C) Vibrio vulnificus septicemia
D) Traveler's diarrhea caused by ETEC
E) Typhoid fever
Question 61 - Single Best Answer
Differences between wound botulism and tetanus include:
A) Wound botulism causes flaccid paralysis and tetanus causes spastic paralysis.
B) Botulism is treated with anti-toxin antibodies but tetanus is treated with penicillin.
C) There is a vaccine to prevent wound botulism but none to prevent tetanus.
D) Tetanus is caused by a spore-forming organism and the organism causing wound botulism cannot make spores.
E) Wound botulism is caused by an aerobic organism while tetanus is caused by an anaerobic organism.
Question 62 - Single Best Answer
Inflammation of the mediastinal lymph nodes observed in a chest X-ray is a characteristic of pulmonary infection by:
A) Chlamydia.
B) Rickettsia.
C) Francisella tularensis.
D) Bacillus anthracis.
E) Brucella abortus.
Question 63 - Single Best Answer
One of the University of Florida football players practices tackling by catching wild hogs at his Newberry farm with his bare arms. Sometimes the hogs are butchered and barbecued. This activity puts him at risk for:
A) Lyme disease.
B) plague.
C) brucellosis
D) shigellosis.
E) Rocky Mountain spotted fever.
Question 64 - Single Best Answer
Rocky Mountain spotted fever is most similar to which of the following in its mode of transmission?
A) Leptospirosis
B) plague
C) Lyme disease
D) brucellosis
E) cat scratch fever
Question 65 - Single Best Answer
Septic arthritis is commonly caused by:
A) Borrelia burgdorferi.
B) Chlamydia trachomatis.
C) Staphylococcus aureus.
D) Pseudomonas aeruginosa.
E) Clostridium tetani.
Question 66 - Single Best Answer
Which of the following best describes the transmission of brucellosis?
A) It can be acquired by inhalation.
B) It can be acquired by ingestion.
C) It can be acquired by wound infection.
D) It does not involve an arthropod vector.
E) All of the above are true.
Question 67 - Single Best Answer
Differences between cystitis and pyelonephritis include:
A) There are bacteria in the urine in cystitis but not pyelonephritis.
B) There is pain on urination with pyelonephritis but not cystitis.
C) There is fever with pyelonephritis but not cystitis.
D) There are casts in the urine with cystitis but not pyelonephritis.
E) E. coli causes most cases of cystitis but Staphylococcus aureus causes most cases of pyelonephritis.
Question 68 - Single Best Answer
The role of urease in Helicobacter pylori infections is to:
A) breakdown the urea in the bladder and use the CO2 as a carbon source.
B) breakdown the urea in the bladder to reduce the viscosity.
C) produce ammonia to neutralize the acid in the stomach.
D) produce ammonia to use as a nitrogen source.
E) produce ammonia which is cytotoxic and causes an ulcer.
Question 69 - Single Best Answer
Bacillus anthracis has a dual phase life cycle in humans that can best be described as:
A) changing from gram-positive to gram-negative within host cells.
B) changing from obligate aerobe to obligate anaerobe in host tissues.
C) germinating within macrophages then being extracellular as vegetative cells.
D) producing a polyglutamate capsule then producing a polysaccharide capsule.
E) producing exotoxins then changing to produce endotoxins.
Question 70 - Single Best Answer
Chronic sinusitis and chronic otitis media differ from the acute forms of the diseases in that:
A) anaerobic bacteria and mixed infections become more frequent with the chronic diseases.
B) the chronic forms of the diseases cannot be treated with antibiotics.
C) the chronic forms of the diseases are uniformly life-threatening unless treated promptly.
D) the chronic forms of the diseases are always invasive of tissues, spreading deeper.
E) None of the above - the only difference between the chronic and acute forms of these diseases is the length of time of infection.
Question 71 - Single Best Answer
When should a lumbar puncture be done in diagnosing bacterial meningitis?
A) Whenever one is being considered.
B) When there are focal neurological deficits.
C) When the CBC shows increased PMNs and decreased glucose.
D) After a CT scan.
E) When the patient is unconscious.
Question 72 - Single Best Answer
Neisseria gonorrhoeae and Chlamydia trachomatis infections share many clinical manifestations. Which of the following is NOT common between the two?
A) septic arthritis
B) urethritis
C) proctitis
D) pelvic inflammatory disease
E) endocervicitis
Question 73 - Single Best Answer
Which of the following most accurately describes the severity of symptoms and risk for complications among the pathogens causing acute otitis media - from most severe to least severe?
A) Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis
B) Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae
C) Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
D) Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis
E) None of the above are correct.
Question 74 - Single Best Answer
A major difference in the pathogenesis and disease caused by Salmonella enterica serovar Typhi and serovar Typhimurium is:
A) Typhi is human-specific, while Typhimurium has an animal reservoir.
B) In immunocompetent people, Typhi usually causes systemic disease, while Typhimurium usually is limited to the intestinal tract.
C) Typhi has a vaccine, while Typhimurium does not.
D) Typhi has a capsule, while Typhimurium does not.
E) All of the above are differences.
Question 75 - Single Best Answer
A sexually active 21 year old female student presents at the health clinic with yellow-green, frothy vaginal discharge and extremely bright red cervix. A wet prep reveals highly motile cells about the same size as PMNs and numerous PMNs as well. The most likely diagnosis is:
A) Candidiasis
B) Non-gonococcal urethritis.
C) Trichomoniasis
D) Bacterial vaginosis
E) Allergic vaginitis