MMID Exam 3 - November 20 2004

Question 1 - Single Best Answer

Gonorrhea can be contracted multiple times. The major reason for this is that:

it is often asymptomatic.
the capsule is not immunogenic.
the pili can undergo antigenic variation.
it can grow intracellularly.
there is no toxoid vaccine that can prevent the disease.

Question 2 - Single Best Answer

A patient with lower urinary tract infection symptoms completes the standard antibiotic regimen, but symptoms persist. A urine culture is performed and is negative. The most appropriate course of action is:

nothing - the patient does not have a urinary tract infection.
anti-inflammatory agents - the patient has a self-limiting viral infection
increase antibiotic treatment for two weeks
treat for Chlamydia
treat for Syphilis

Question 3 - Single Best Answer

What is the relationship between the genetics of virulence of Enterohemorrhagic E. coli (EHEC) and antibiotic treatment?

antibiotics that result in DNA damage also induce Shiga-like toxin production from a lysogenic phage
protein synthesis inhibitors increase copy number of a plasmid encoding the cellular invasion system
beta-lactam antibiotics release chromosomally encoded beta-galactosidase that helps the bacteria grow in the intestines
folic acid inhibitors cause the bacteria to stop replicating, hence transposon-encoded antibiotic resistances are not passed among bacteria
None of the above

Question 4 - Single Best Answer

Both Chlamydia trachomatis and Neisseria gonorrhoeae cause each of the following EXCEPT:

proctitis
urethritis
endocervicitis
pharyngitis
Pelvic Inflammatory Disease

Question 5 - Single Best Answer

Which of the following is NOT in the etiology of the top 90% of vaginitis?

Treponema pallidum.
Candida albicans.
Mobiluncus.
Gardnerella vaginalis.
Trichomonas vaginalis.

Question 6 - Single Best Answer

A 10 year old girl camps in the mountains of Virginia with the Girl Scouts. Five days after she returns home she experiences fever, headache, myalgia, and a petechial rash that spreads from her hands and feet to her trunk. Each of the following are part of the pathogenesis of this disease EXCEPT:

The organism uses actin to move within and between host cells.
The organism is infecting the vascular endothelium.
The organism was transmitted by a tick.
The disease is contagious to household contacts.
If untreated, this disease could be fatal.

Question 7 - Single Best Answer

Each of the following is a meningeal symptom EXCEPT:

headache
stiff neck
lethargy
fever
vomiting

Question 8 - Single Best Answer

Which of the following scenarios and organism pairs for skin/wound infection is NOT CORRECT?

burns - Pseudomonas
bed sores - Gram-negative bacteria
catheters - Staphylococcus epidermidis
shellfish - Vibrio vulnificus
surgical wounds - Clostridium perfringens

Question 9 - Single Best Answer

A woman is hospitalized due to car accident. Five days after she is placed on antibiotics she experiences watery diarrhea. The most likely cause is:

Clostridium difficile
Enterotoxinogenic E. coli (ETEC)
Staphylococcus aureus
Clostridium perfringens
Salmonella enterica serovar Typhimurium

Question 10 - Single Best Answer

The most frequent cause of simple watery diarrhea in the U.S. is:

Salmonella enterica serovar Typhimurium
Viruses
Campylobacter jejuni
Vibrio cholerae
Shigella flexneri

Question 11 - Single Best Answer

Acute otitis media and acute sinusitis are similar in each of the following ways EXCEPT:

spectrum of causative agents
initiation by blockage of a draining system
the endogenous nature of the infection/disease
damage is primarily inflammation-mediated
use of radiography in diagnosis

Question 12 - Single Best Answer

How does the Haemophilus influenzae type b vaccine work?

sIgA is produced that inhibits attachment via pili
Cell-mediated immunity enables macrophages to kill intracellular bacteria
Anti-LPS antibodies opsonize the bacteria in the blood
Anti-capsular antibodies opsonize the bacteria in the blood
Cytotoxic T cells kill bacterially infected host cells

Question 13 - Single Best Answer

In August a high school student experiences photophobia, fever, headache, but no confusion. Her CSF contains lymphocytes, normal glucose, and elevated protein of 130 mg%. Her disease should be treated with:

third generation cephalosporins.
first generation cephalosporins.
meningeal doses of a cidal antibiotic.
at least three antibiotics to prevent selection of resistant organisms.
analgesics and anti-inflammatory agents.

Question 14 - Single Best Answer

TSST-1 (toxic shock syndrome toxin) produces effects on the host that are most similar to:

endotoxin
enterotoxin
diphtheria toxin It does not kill cells or affect protein synthesis
cholera toxin
pertussis toxin

Question 15 - Single Best Answer

Which of the following represents the most likely target for a new vaccine to prevent sexually transmitted diseases?

Pili of Neisseria gonorrhoeae
Opacity proteins of Neisseria gonorrhoeae
Flagella of Treponema pallidum
Elementary bodies of Chlamydia trachomatis
Reticulate bodies of Chlamydia trachomatis

Question 16 - Single Best Answer

Borrelia burgdorferi and Treponema pallidum have each of the following in common EXCEPT:

They are spirochetes.
They can cause latent infections.
Damage can be caused by specific immune responses of the host.
They can cause neurological symptoms.
None of the above - B. burgdorferi and T. pallidum do share all of the characteristics.

Question 17 - Single Best Answer

Pathogenesis of gas gangrene includes each of the following EXCEPT:

introduction of spores into a wound
endotoxic shock
production of phospholipase C
necrosis of tissue
production of gas in tissues

Question 18 - Single Best Answer

Which of the following best describes the pathogenesis of Streptococcal Toxic Shock-Like syndrome?

host immune response following scarlet fever
superantigen produced during necrotizing fasciitis
endotoxin produced during cellulites
streptokinase produced during pharyngitis
secondary infection with Staphylococcus following erysipelas

Question 19 - Single Best Answer

Which of the following is most likely to be associated with chronic/persistent diarrhea?

Enterotoxinogenic E. coli (ETEC)
Enteropathogenic E. coli (EPEC)
Viruses
Parasites
Shigella dysenteriae

Question 20 - Single Best Answer

Which of the following best describes the genetic relationship between Yersinia pestis and Yersinia pseudotuberculosis?

Like E. coli and Shigella, these are essentially the same organisms and should be placed in the same species.
Y. pestis and Y. pseudotuberculosis are very different and should not be placed even in the same genus.
The similar diseases caused by these organisms are based on the fact that they share the same virulence genes.
Y. pestis evolved from Y. pseudotuberculosis by gaining some genetic elements and losing some functional genes.
Y. pseudotuberculosis evolved from Y. pestis as a result of a combination of selective pressures of antibiotic treatment and vaccination.

Question 21 - Single Best Answer

What do painless chancre and erythema chronicum migrans have in common?

They are both symptoms of primary infection by spirochetes.
They are the primary and secondary symptoms, respectively, of syphilis.
They are mediated by an exotoxin.
They are caused by autoimmune reactions.
None of the above.

Question 22 - Single Best Answer

Which of the following do Bacillus anthracis and Yersinia pestis have in common?

They both are spore-forming rods.
Their cutaneous forms are usually self-limiting.
Their respiratory forms are highly contagious.
They are transmitted by the bite of an arthropod.
None of the above.

Question 23 - Single Best Answer

A 24 year old medical student is mowing his grass, which has been neglected for weeks because he has been intently attending and studying MMID. Suddenly, fur shoots out of the lawn mower, and the student realizes that he has run over a dead rabbit! Four days later he experiences high fever, malaise, and severe respiratory distress. Being an astute student he tells the ER physician to instruct the lab not to culture for the causative agent because:

Chlamydia pneumoniae cannot be cultured except in tissue culture.
Mycobacterium leprae cannot be cultured at all, not even in tissue culture.
culturing the causative agent would pose a hazard to the microbiology lab workers.
this is most likely a viral infection.
this is most likely an allergic reaction.

Question 24 - Single Best Answer

Which of the following best describes the standard of care for management of acute otitis media in the United States?

Antibiotic treatment is only to relieve concerns and inconvenience of parents.
Topical antibiotics and steroids are adequate.
Systemic antibiotics because this self-limiting disease can have lethal complications.
Obtain exudate by tympanostomy, followed by culture. Treat only Streptococcus pneumonia with antibiotics.
Antibiotics must be initiated within one hour of presentation to prevent pneumonia.

Question 25 - Single Best Answer

A diabetic 30 year old woman experiences hoarseness, ear pain, drainage from her ear, granulation tissue in her ear canal, and lack of motor function in her face and neck. The diagnosis is confirmed by a gallium scan of her head. Which of the following best describes the pathogenesis of her disease?

Fungi have eroded from the nasal sinuses into the middle ear space.
Pseudomonas aeruginosa invaded from the external ear canal into the base of the skull.
Streptococcus pneumoniae meningitis infection has extended outward from the meninges into the ear canal.
Moraxella catarrhalis otitis media has eroded from the middle ear into the mastoid air cells.
Emboli from vegetations of endocarditis have lodged in the capillaries of the external ear canal resulting in ischemic necrosis.

Question 26 - Single Best Answer

The single most important diagnostic sign for acute otitis media is:

fever
ear pain
purulent middle ear effusion
myringitis
hearing loss

Question 27 - Single Best Answer

Differences in the etiologies of outpatient versus inpatient urinary tract infections include:

E. coli is more prevalent in outpatient than inpatient.
There is a broader range of bacteria causing inpatient
Yeast are more frequently involved with inpatient
All of the above.
None of the above.

Question 28 - Single Best Answer

A 40 year old sexually active woman presents with painful urination, increased frequency of urination, suprapubic pain, fever and chills. The most appropriate management of this patient is:

urine culture and two weeks of oral antibiotics.
urinalysis and three day course of antibiotics
urine culture, urinalysis, and ultrasonography, then intravenous antibiotics if indicated
one day of antibiotics followed by urine culture to confirm success
microscopic examination of urine sediment, unspun urine Gram stain, two weeks of intravenous antibiotics only if bacteria are observed

Question 29 - Single Best Answer

A sexually active 21 year old male college student presents with purulent penile discharge. A Gram stain of the discharge reveals numerous neutrophils, but no visible bacteria. What is the current method for definitively diagnosing this case?

tissue culture for Chlamydia, culture on Thayer-Martin plate for gonorrhea
culture on blood agar plate for Chlamydia, culture on Thayer-Martin plate for gonorrhea
serology for Chlamydia, nucleic acid probe for gonorrhea
nucleic acid probes for Chlamydia, culture on Thayer-Martin plate for gonorrhea
nucleic acid probes for both Chlamydia and gonorrhea

Question 30 - Single Best Answer

Of the following skin manifestations of disease, which is NOT contagious?

dermatitis of disseminated gonorrhea
secondary syphilis
erythema chronicum migrans
streptococcal impetigo
All of the above are contagious between humans

Question 31 - Single Best Answer

Which of the following presents the greatest risk for a fetus in utero if the mother is infected with the microorganism?

Treponema pallidum
Neisseria gonorrhoeae
Chlamydia trachomatis
All of the above are equally devastating to the fetus in utero.
None of the above - these agents only are risk factors during and after birth.

Question 32 - Single Best Answer

Which of the following describes the appropriate search for anatomic defects associated with urinary tract infection?

MRI for all UTIs in all males
CT scan for all UTIs in young girls
Ultrasonography for all upper tract disease
Ultrasonography for all upper and lower tract disease
Intravenous pyelogram for all upper tract disease

Question 33 - Single Best Answer

Which of the following agents of otitis media and sinusitis could be inhibited by currently available vaccines?

nontypeable Haemophilus influenzae
Moraxella catarrhalis
Streptococcus pyogenes
Streptococcus pneumoniae
Neisseria meningitidis

Question 34 - Single Best Answer

Type III secreted proteins of gram-negative bacterial pathogens are known perform each of the following functions EXCEPT:

induce endocytosis and facilitate bacterial invasion of host cells by Salmonella
prevent phagosome-lysosome fusion by Salmonella
stimulate attaching-effacing lesions by EPEC and EHEC
induce endocytosis and facilitate bacterial invasion of host cells by Shigella
lyse red blood cells by E. coli

Question 35 - Single Best Answer

Which of the following has the LEAST similar reservoirs?

Salmonella enterica serovar Typhimurium and Campylobacter jejuni
Salmonella enterica serovar Typhi and Shigella flexneri
Enterohemorrhagic E. coli and Staphylococcus aureus
Bacillus cereus and Clostridium botulinum
Enterotoxinogenic E. coli and Enteraggregative E. coli

Question 36 - Single Best Answer

Two men in Florida died over the past week after eating raw oysters. They experienced fever, shock, and bullous skin lesions on their legs. Despite antibiotic treatment and amputation of the affected limbs, they succumbed to the disease. Which of the following statements most accurately describes a critical component of this disease process?

One of the men likely gave the infection to the other.
These men likely had liver damage or iron imbalance.
The oysters were contaminated with human sewage.
Since this was a heat stable preformed toxin, even cooking the oysters would have been useless.
A toxin was produced locally in the gut, was spread systemically, and destroyed the vascular endothelium leading to tissue damage and shock.

Question 37 - Single Best Answer

A 60 year old patient has fever, shortness of breath, heart murmur, and petechia of the conjunctiva and palate. He has an elevated erythrocyte sedimentation rate and normocytic normochromic anema. The diagnosis is confirmed by transesophogeal echocardiogram. He would most likely have bacteremia of which type?

polymicrobic (numerous species)
low grade but constant
intermittent with high peaks and low troughs
gram-negative rods
acid-fast bacteria

Question 38 - Single Best Answer

Hemolytic uremic syndrome (HUS) is uncommon in shigellosis patients the United States because:

there is an effective vaccine
of prompt antibiotic treatment with fluoroquinolones
there are low numbers of Shigella dysenteriae infections
our society does not consume raw chicken
None of the above are true.

Question 39 - Single Best Answer

Which of the following is NOT a typical event preceding bacterial endocarditis?

Non Bacterial Thrombotic Endocarditis (NBTE)
myocardial infarction
turbulence across abnormal valves
damage of cardiac endothelium by the venturi effect
All of the above ARE typical events involved in the pathogenesis of bacterial endocarditis

Question 40 - Single Best Answer

Which of the following does NOT accurately reflect the most likely causative agent of meningitis originating from each anatomical sight?

sinus infection - Streptococcus pneumoniae
endocarditis - Staphylococcus aureus
gastrointestinal tract - Listeria monocytogenes
pulmonary infection - Streptococcus pneumoniae
All of the above ARE correct

Question 41 - Single Best Answer

Potassium hydroxide (KOH) is used in a wet prep of a vaginal sample to:

hydrolyze cotton fibers from the swab
sterilize the slide
make the <i>Candida</i> structure more obvious
make Clue cells easier to identify
stimulate <i>Trichomonas</i> to move and be seen more easily

Question 42 - Single Best Answer

The appropriate initial management of suspected bacterial meningitis is:

lumbar puncture whenever one is being considered, but only after empiric antibiotics have been started
lumbar puncture whenever one is being considered, administration of antibiotics within 30 minutes of presentation
lumbar puncture, if necessary, only after CT scan, administration of antibiotics after the CSF smear has been examined to aid in appropriate choice of antibiotics
lumbar puncture if at least three meningeal signs are present AND there is a positive Brudzinski's or Kernig's sign, followed by empiric antibiotics
All of the above are appropriate initial management strategies.

Question 43 - 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:

Candidiasis
Non-gonococcal urethritis.
Trichomoniasis
Bacterial vaginosis
Allergic vaginitis

Question 44 - Single Best Answer

Bacteria could be isolated from a red and painful joint to diagnose an infection if the arthritis was caused by:

Borrelia burgdorferi.
Chlamydia trachomatis.
Treponema pallidum.
Clostridium tetani.
Neisseria gonorrhoea.

Question 45 - Single Best Answer

In terms of evading the host defenses, which of the following pairs of organisms is LEAST similar?

Neisseria meningitidis and Streptococcus pneumoniae
Streptococcus pneumoniae and Haemophilus influenzae type b
Haemophilus influenzae type b and Escherichia coli K1
Escherichia coli K1 and Group B streptococci
Group B streptococci and Listeria monocytogenes

Question 46 - Single Best Answer

Each of the following is an important question to ask of patients with diarrhea to aid in focusing the diagnosis EXCEPT:

how long the symptoms have occurred
the patient's travel history
smell of the stool
the volume and texture of the stool
associated symptoms such as pain, vomiting, fever

Question 47 - Single Best Answer

An 8 year old child who lived with his parents on their hog farm in North Carolina was hospitalized with bloody diarrhea. He was diagnosed with Campylobacter, treated with fluids and antibiotics and sent home after 2 days. A week later he began to experience muscle weakness and trouble breathing. He was eventually returned to the hospital for respiratory support. He recovered from this, however, with no sequelae. The damage that caused his muscle weakness is most like the damage of which of the following?

infant botulism
gonococcal arthritis
endocarditis
rheumatic fever
meningitis

Question 48 - Single Best Answer

A patient presents with flu-like symptoms. A chest X-ray reveals widening of the mediastinum. The most likely disease is:

mycoplasma pneumonia.
tuberculosis.
inhalation anthrax.
influenza.
bubonic plague.

Question 49 - Single Best Answer

PilC phase variation in Neisseria gonorrhea is caused by:

a stop codon interrupting an open reading frame.
addition of guanine residues in the DNA.
a frame shift mutation.
all of the above
none of the above

Question 50 - Single Best Answer

Which of the following best describes the relation between rheumatic fever and bacterial endocarditis?

These are two different names for the same disease.
Rheumatic fever is a non-suppurative sequela of endocarditis.
Rheumatic fever and endocarditis are both due to an immunological reaction.
Rheumatic fever predisposes to endocarditis.
Both diseases involve hematogenous spread of the bacteria.

Question 51 - Single Best Answer

Mrs. Ima Goodperson made some potato salad which she took to church and then to the annual church picnic in the afternoon. Several hours after the picnic 25 people who had eaten the potato salad experienced severe vomiting. Which of the following is most likely true?

The sick individuals will experience flaccid paralysis in about 10 days.
The sick individuals should be treated with an antibiotic so the disease will not progress to bloody diarrhea.
Mrs. Goodperson carries a catalase-positive, coagulase-positive bacterium in her anterior nares.
Mrs. Goodperson is colonized with a spore-forming, aerobic organism.
Mrs. Goodperson will later experience toxic shock syndrome.

Question 52 - Single Best Answer

On May 6, l975, a midwife delivered a male infant at home in a town across the Mexican border from Laredo, Texas. The umbilical cord was cut with the fathers pocket knife and olive oil was applied to the stump. Two weeks later the child contracted a paralytic disease that caused rigid spasms. The role the olive oil may have played in the child's disease was:

it contained Campylobacter jejeuni which can precede Guillain-Barre syndrome.
it created an anaerobic environment at the wound in which spores from the knife could germinate.
it stimulated the growth of the EHEC from the manure on the knife.
it contained botulism spores and caused infant botulism.
None of the above, olive oil is a good antibacterial agent.

Question 53 - Single Best Answer

The disease whose symptoms are most like those caused by Haemophilus ducreyi is:

otitis externa.
sinusitis.
meningococcal meningitis.
gonorrhea.
syphillis.

Question 54 - Single Best Answer

Which of the following is a virulence mechanism of virtually all organisms that cause sexually transmitted disease?

the ability to increase sexual activity
obligate intracellular growth
inapparent infection
antigenic variation of surface components
IgAse enzymes

Question 55 - Single Best Answer

Why are women more susceptible to bladder infections than men?

women can't get benign prostatic hypertrophy, which protects men from bladder infections
women are more susceptible to sexually transmitted diseases in general
men have longer urethras
women have smaller bladders
women get more kidney infections than men and the bacteria can get into the bladder by traveling down the ureter

Question 56 - Single Best Answer

A one day old infant experiences high fever and a bulging fontanelle. A lumbar puncture reveals PMNs, low glucose and elevated protein. Which of the following is LEAST LIKELY to be observed in a Gram stain of the CSF?

encapsulated gram-negative rods
gram positive rods
gram-positive cocci
gram-negative diplococci

Question 57 - Single Best Answer

The rash of secondary syphilis, because it is found on the palms and soles, could potentially be confused with the rash of:

Lyme disease
Rocky Mountain spotted fever
Cat scratch fever
lymphogranuloma venereum
chancroid

Question 58 - Single Best Answer

In terms of diagnosing syphilis, the VDRL test:

is highly sensitive.
produces few false positives.
is very expensive.
is highly specific.
is definitive in identifying syphilis.

Question 59 - Single Best Answer

In an otherwise healthy patient with watery diarrhea, no PMNs, blood, or mucus in the stool, the standard of care is:

empiric antibiotics and antiperistaltic drugs
empiric antibiotics alone
rehydration and antiperistaltic drugs
culture followed by antibiotics
antibiotics followed by culture

Question 60 - Single Best Answer

The damage in a Chlamydia infection of the Fallopian tubes is caused by

spores
endoflagella
exotoxin
inflammation
the elementary bodies

Question 61 - Single Best Answer

What organism causes the most cases of community acquired bladder, kidney, and prostate infections?

Staphylococcus saprophiticus
Pseudomonas aeurinosa
Escherichia coli
Staphylococcus aureus
Chlamydia trachomatis

Question 62 - Single Best Answer

A woman in her sixth month of pregnancy experienced an episode of a mild flu-like illness that progressed to severe headache with nausea, vomiting, and fever. A week later she delivered a stillborn infant. The cause of her illness was likely:

Staphylococcus aureus
Chlamydia trachomatis
Neisseria gonorrhoea
Listeria monocytogenes
Brucella abortus

Question 63 - Single Best Answer

The elevated protein and decreased glucose levels in CSF fluid in bacterial meningitis are best explained by:

proteins present in the bacterial cells and bacteria consuming the glucose
proteins present in the PMNs and their consumption of glucose
disruption of the barrier and transport functions of the blood-brain barrier endothelium
CNS anoxia and ischemia
None of the above

Question 64 - Single Best Answer

A worker at a slaughterhouse in North Carolina has been suffering from recurrent fevers and now has orchitis (inflammation of the testicles). He was in the war in Iran for 6 months prior to his episodes of fever where he did not practice either abstinence or monogamy. His recurrent fevers and orchitis are most likely due to

chancroid
lymphogranuloma venereum
AIDS
brucellosis
leptospirosis

Question 65 - Single Best Answer

Organisms most likely to infect a burn are

E. coli and Klebsiella
Clostridum tetani and Clostridium perfringins
Pseudomonas aeruginosa and Staphylococcus aureus
Streptococcus pyogenes and Proteus mirabilus
Aeromonas hydrophila and Pasteurella multocida

Question 66 - Single Best Answer

Risk factors for urinary tract infections include

diabetes
spinal chord injury
pregnancy
all of the above
none of the above

Question 67 - Single Best Answer

Condyloma latta and gummas are symptoms of the late stages of

plague
pelvic inflammatory disease
dysentary
syphilis
Lyme disease

Question 68 - Single Best Answer

Which of the following best describes the epidemiology of community acquired bacterial meningitis?

Streptococcus pneumoniae is most prevalent, Neisseria meningitidis is most responsible for outbreaks.
Neisseria meningitidis is most prevalent, Streptococcus pneumoniae is most responsible for outbreaks.
Gram-negative rods are most prevalent, Streptococcus pneumoniae is most responsible for outbreaks.
Streptococcus pneumoniae is most prevalent, Gram-negative rods are most responsible for outbreaks.
Streptococcus pneumoniae is most prevalent and is most responsible for outbreaks.

Question 69 - Single Best Answer

How does tetanus cause paralysis?

Once a muscle fiber contracts, its relaxation is directly inhibited.
Anoxia results in lactic acid buildup and a cramp-like spasm.
Inhibition of opposing muscle contraction is inhibited.
Nerve cells are stimulated to produce acetylcholine.
Inhibition of the release of acetylcholine.

Question 70 - Single Best Answer

Observing a wet prep from a case of bacterial vaginosis, one would most likely see:

intracellular diplococci in PMNs.
highly motile trichomonads.
inclusion bodies.
Clue cells and few PMNs
All of the above.

Question 71 - Single Best Answer

Which of the following is a unique characteristic of Rickettsia prowazekii?

Its only mammalian host is humans.
It has dual intracellular cellular forms - elementary body and reticulate body.
The respiratory form of the disease is less contagious than the skin form.
It can be cultured on blood agar plates.
It causes typhoid fever not acquired by the oral route.

Question 72 - Single Best Answer

Which of the following pairs have the most similar mechanism of damage?

Enterotoxinogenic E. coli and Vibrio cholera
Enterohemorrhagic E. coli and Enteroinvasive E. coli
Campylobacter jejeuni and Enteropathogenic E. coli
Shigella dysenteriae and Enteroaggregative E. coli
Giardia lamblia and Salmonella enterica serovar Typhi

Question 73 - Single Best Answer

The first recorded cases of syphilis in Europe were: NOTE - THIS IS IMPORTANT BECAUSE DISEASES COME AND GO, THEY DO NOT JUST EXIST, AND YOU SHOULD UNDERSTAND SOME OF THE FACTORS INVOLVED IN THIS. IN 1500, SYPHILIS WAS AN EMERGING DISEASE!

before the time of Christ
after Columbus came to America
quickly cured with penicillin
congenital syphilis
at the same time that AIDS came to Europe

Question 74 - Single Best Answer

Fever with no obvious other cause in a spinal chord injury patient is most often due to

meningitis
encephalitis
urinary tract infection
decubitus ulcers (bed sores)
pseudomembranous colitis

Question 75 - Single Best Answer

.jpgThis photomicrograph is most consistent with:

fluid removed from behind the eardrum of a child.
a painless ulcer on the vagina.
a purulent urethral discharge.
urine sediment from a woman with a fever and costal vertebral angle pain
a skin lesion at the site of a tick bite.

   

  Updated: November 24, 2004