ch.21
The difference between CAP and HCAP is that
CAP may be caused by a variety of pathogens including Streptococcus pneumoniae, as well as viruses and mycoplasmas, whereas HCAP is predominantly caused by methicillin-resistant Staphylococcus aureus.
Organisms other than bacteria make up the microbiota; non-bacterial microbes that occupy the respiratory tract include ________.
Candida
Which of the following is not true of whooping cough?
Cold-like symptoms are common for the paroxysmal stage.
Antibiotic treatment immediately upon the diagnosis of otitis media is standard procedure today.
False
Legionellosis is a zoonosis.
False
People who have received the BCG immunization will generally have a negative tuberculin skin test.
False
Pneumonias have different signs and symptoms depending on whether they are classified as CAP or HCAP.
False
The causative organisms for CAP and HCAP differ, but the modes of transmission do not; that are all transmitted via aerosolized droplets which enter the lungs.
False
The trachea, due to its location in the body, is considered to be part of both the upper and lower respiratory tract.
False
Treatment for diphtheria requires only penicillin or erythromycin.
False
Which of the following does not describe S. pyogenes?
Forms endospores
Influenza viruses A and B contain eight RNA strands and influenza virus C has seven strands. During antigenic drift, genes coding for glycoproteins recognized by the host immune system are mutated, whereas during antigenic shift, whole RNA strands can be swapped with those of another influenza virus, greatly increasing the virulence and transmissibility of the virus and minimizing the ability of the host's defenses to recognize it. Which of the following statements is true?
Genetic drift creates a need for an annual flu vaccine to keep up with the seasonal genetic changes, and if genetic shift occurs, an additional vaccine will have to be administered since the shift creates a different strain of virus.
Which is incorrect about Mycoplasma pneumoniae?
Has birds as a reservoir
The vaccine for immunity to Haemophilus influenzae serotype b is ______.
Hib
Which antibody is concentrated in the respiratory tract?
IgA
Which of the following is not true of influenza?
Influenza B viruses undergo both antigenic drift and antigenic shift.
Which of the following is a characteristic of Histoplasma capsulatum?
It grows in moist soil, rich in nitrogen from bird and bat droppings.
Which of the following statements is not true regarding streptococcal pharyngitis?
It is usually caused by the viridans streptococci.
Diphtheria is considered to be an upper respiratory tract infection. However, it can have a very high mortality rate if not caught early and treated. Predict why this is so.
It makes a toxin that can be carried in blood and produce organ damage, particularly the heart.
Which is incorrect about histoplasmosis?
It never spreads to sites outside the respiratory tract.
Drug-resistant strains of Streptococcus pneumoniae are now treated with ______.
Ketek
Which disease involves transmission by aerosolized water from whirlpool spas, air conditioners, cooling towers, and supermarket vegetable misters?
Legionellosis
Which of the following is not a virulence factor of Bordetella pertussis?
M protein
The difference between MDR-TB and XDR-TB is that
MDR-TB strains are classified as having resistance to two antibiotics, whereas XDR-TB strains are classified when they are resistant to four antibiotics.
Which of the following respiratory tract defenses is mismatched?
Mucous membranes - third line of defense
Which of the following causes a noncommunicable pulmonary infection that resembles tuberculosis?
Mycobacterium avium complex (MAC)
Differentiate between disease caused by Haemophilus influenzaeand the disease caused by influenza virus.
One causes an upper respiratory disease, and the other causes a lower respiratory disease.
Which of the following is caused by Haemophilus influenzae in the respiratory tract?
Otitis media
Otitis media is commonly treated with broad spectrum antibiotics, although there is a lot of push-back or pressure against doing this. Why are these drugs given for this condition?
Otitis media is often caused by a variety of bacteria growing together in a biofilm, and the bacteria often exhibit different susceptibilities to drugs.
People at greatest risk for pneumococcal infections include all the following except
adolescents and young adults
All of the following pertain to tuberculosis except
antimicrobials cannot treat and cure tuberculosis.
Normal biota of the respiratory tract
can cause disease in immunocompromised patients
Mycobacterium tuberculosis
can survive for 8 months in fine aerosol particles.
Severe acute respiratory syndrome (SARS)
causes high fever, pneumonia, and respiratory distress.
Pneumocystis (carinii) jiroveci
causes serious infection in the elderly, premature infants, and AIDS patients.
Formation of a pseudomembrane in the back of the throat is seen in cases of _______.
diphtheria
Influenza virus can exhibit constant mutation of viral glycoproteins, called antigenic ________, or alternatively antigenic ________, which is a more serious phenomenon caused by the exchange of a viral gene with that of another influenza virus strain.
drift; shift
The highest incidence of histoplasmosis in the United States occurs in the ______.
east and Midwest
Rheumatic fever is caused by a(n) _____ infection.
endogenous
The most common mode of transmission for sinusitis is _______.
endogenous infection
The bright red rash and fever of scarlet fever is due to _______.
erythrogenic toxin
Infection travels to the middle ear by way of the ______.
eustachian (auditory) tubes
The major virulence factor of Corynebacterium diphtheriae that causes serious systemic effects is its ______.
exotoxin
Influenza is predominantly transmitted by the fecal-oral route.
false
Symptoms of influenza include
fever, myalgia, sore throat, cough, and nasal discharge.
Inhalation of respiratory secretions is involved in the transmission of all of the following except ______.
legionella
The tubercles formed in primary tuberculosis are caused by an influx of ______.
mononuclear cells
Pertussis has all of the following characteristics except
the catarrhal stage has persistent, hacking coughs with "whoops."
A paroxysmal cough is associated with Legionnaires' disease.
False
The most common type of virus leading to rhinitis is _______.
rhinovirus
Your patient has pneumonia. Since there are so many microorganisms causing pneumonia, what might be the best test to do first for identification of the agent?
A culture from a lung aspirate
Hantavirus is transmitted by which of the following ways?
Aerosolized particles of deer mouse feces, urine, or saliva
A factor in the development of multidrug-resistant strains of Mycobacterium tuberculosis is that
All of the above contribute to the development of resistant strains of Mycobacterium tuberculosis.
A diagnosis of tuberculosis involves a/an ______.
All of the choices are correct.
Cold viruses are transmitted by _______.
All of the choices are correct.
Disease/s caused by Streptococcus pneumoniae include _______.
All of the choices are correct.
In addition to antimicrobials, patients with diphtheria are treated with ______.
All of the choices are correct.
Respiratory syncytial virus
All of the choices are correct.
Streptococcus pneumoniae is
All of the choices are correct.
Superantigens
All of the choices are correct.
Tuberculin skin testing
All of the choices are correct.
Virulence factors of S. pyogenes include
All of the choices are correct.
What features of the respiratory system protect it from infection?
All of the choices are correct.
Which is not correct about Mycobacterium species?
All species are human pathogens.
The most common causative agent in fungal sinusitis is _______.
Aspergillus fumigatus
The causative organism of whooping cough is ______.
Bordetella pertussis
Which of the following is/are the main causative agent/s of pharyngitis?
Both Streptococcus pyogenes and viruses are correct.
What is the function of normal biota of the respiratory tract?
Both [competes with pathogens for resources and space] and [microbial antagonism] are correct.
Which opportunist is the most frequent cause of life-threatening pneumonia in AIDS patients?
Pneumocystis (carinii) jiroveci
Which of the following pertains to diphtheria?
Prevented by the DTaP immunization
Which of the following statements is false regarding RSV?
RSV infects infants aged 6 months and younger; it is unlikely that a 4-year-old would develop a respiratory disease as a result of this virus.
Which of the following is not part of the lower respiratory system?
Sinuses
The most common causative agent of otitis media is ______
Streptococcus pneumoniae
Pertussis has been making a big comeback in the last few years, after being on the decline for quite a long time. Why is this?
The pertussis vaccine does not seem to protect for a lifetime, so those who received the vaccine as kids may become susceptible in adulthood.
Your dog has flu caused by an H3N8 strain. Assume that you breathe in this strain, after you have already come in contact with an H1N1 strain. Both viruses go into the cells of your upper respiratory tract. During the viral replication cycle inside of your epithelial cells, genetic information for hemagglutinin antigen and for neuraminidase antigen are recombined. Your cells end up producing a new variant---H3N1. Predict what might happen as a result of this set of events.
This novel virus will spread through the human population without much resistance.
Which of the following is not part of the upper respiratory tract?
Trachea
An induration of less than 5mm in the Mantoux test is negative for TB.
True
Pertussis outbreaks still occur in the United States.
True
Respiratory syncytial virus is a major cause of global respiratory infection outbreaks in infants 6 months of age or younger.
True
Secondary bacterial infections may occur with the common cold.
True
The high mortality rate for patients with MDR-TB and XDR-TB is due in part because of the severe side effects from the daily multidrug regimen and the stimulation of a strong cell-mediated immune response.
True
The major reservoir for the hantavirus is the deer mouse.
True
The pathogen that causes Legionnaires' pneumonia also causes a milder infection called Pontiac fever.
True
The primary transmission route for acquiring agents of the common cold is by contact with hands and fomites contaminated with the nasal discharges of an infected person.
True
When the centers of tubercles break down into _____ lesions, they gradually heal by calcification that replaces normal lung tissue.
necrotic caseous
The enzyme associated with the influenza virus that hydrolyzes the protective mucous coating of the respiratory tract is ______.
neuraminidase
Legionella pneumophila
often lives intracellularly in amoebas.
Untreated streptococcal pharyngitis can lead to all of the following except _______.
otitis media
Influenza vaccines include all of the following except
provides lifelong immunity
Annual influenza vaccinations are important for all individuals because
the highly contagious nature of the virus means that transmission from a robust individual to those with a weaker immune system, such as the young or the elderly, is facilitated in crowded winter conditions.
Hantavirus has all of the following characteristics except
the reservoir is human carriers.
Extrapulmonary TB is more common in
young children and immunosuppressed patients.