Exam 4 Questions

True or false: genital herpes may be cured with the use of acyclovir or famciclovir

false

The most important vector of Lyme disease in the eastern United States is A) Staphylococcus aureus. B) Dermacentor andersoni. C) Borrelia bergdorferi. D) Dermacentor virabilis. E) Ixodes scapularis.

E

The plague is typically transmitted via the bite of infected A) mosquitoes. B) lice. C) mites. D) ticks. E) fleas.

E

Which of the following groups contain diarrhea-causing E. coli? A) Enterotoxigenic B) Enteroinvasive C) Enteropathogenic D) Enterohemorrhagic E) All of the choices are correct

E

A common source of cholera infection is A) fecal contaminated water. B) unpasteurized milk. C) acid rain AND boiled water. D) acid rain. E) boiled water.

A

Felicia is recovering from a third degree burn on hand that she received after spilling hot grease on herself during a cooking incident. Felicia underwent several surgical procedures including skin grafts to repair the scarring on her hand. During her recovery, Felicia begins running a fever. Not able to reach her doctor over a weekend, Felicia quickly begins feeling worse and her fever quickly progresses to chills and shaking. Thinking on her feet she has her roommate to drive her to the ER where she is examined. Upon removing her burn dressing the surgical wound is clearly septic. While in the ER Felicia loses consciousness from a rapid drop in blood pressure. Despite all attempts to revive her, Felicia's blood pressure cannot be elevated, she slips into a coma and dies. Felicia most likely died from: A) Gram negative bacterial septic shock B) Gram positive bacterial severe sepsis C) Acute endocarditis D) Viral-induces sepsis E) Systemic Brucellosis (undulent fever).

A

Frank, a 20-year-old college student starts his part-time job at KFC as a High Temperature Fowl Flesh-Searing Technician (AKA: chicken frier). Frank begins employment on a weekend, and as such, he misses the mandatory safety training sessions emphasizing the importance of the safe and proper handling of raw chicken as well as decontamination procedures to be followed. Not realizing he should have been wearing disposable vinyl gloves when handling the chicken, Frank used his bare hands when handling the raw chicken during his Saturday and Sunday shifts. On Tuesday, Frank's expected next shift, he calls into work sick, complaining fever, vomiting, diarrhea and abdominal cramps. After 3-4 days, Frank is better and returns to work. Two weeks after the incident Frank begins feeling weak, dizzy and is experiencing what appears to be mild, yet progressive paralysis of his face. With these new symptoms, Frank contacts his physician. If you were Frank's physician, what would be your tentative diagnosis? A) Frank was suffering from Campylobacter gastroenteritis followed by Guillain-Barré syndrome. B) Frank was suffering from classic botulism C) Frank was suffering from mild Clostridium gastroenteritis followed by botulism poisoning D) Frank was suffering from Shigellosis followed by Guillain-Barré syndrome. E) Frank was suffering from Norovirus gastroenteritis.

A

Genital herpes, like other ulcerating genital diseases, A) promotes the spread of HIV. B) inhibits the spread of HIV. C) inhibits the growth of other viral disease. D) is easily cured with antibiotics. E) can be prevented by vaccination.

A

The food products most commonly contaminated with Salmonella strains are A) eggs and poultry. B) fruit and vegetables. C) milk and cheese. D) eggs and fruit. E) meat and seafood.

A

What is the difference between "bacteremia" and "sepsis"? A) Bacteremia is the presence of bacteria in the blood. Sepsis is caused by bacteria multiplying in the blood, and is the result of an inflammatory response to these organisms. B) There is no difference; both terms indicate the presence of living bacterial cells in the bloodstream. C) Sepsis is the presence of bacteria in the blood. Bacteremia is caused by bacteria multiplying in the blood, and is the result of an inflammatory response to these organisms. D) Bacteremia is an infection with bacteria. Sepsis is an infection with Septic protozoans. E) Bacteremia is a serious infection that is almost always fatal. Sepsis is less serious and can usually be treated with broad spectrum antibiotics.

A

What sign would differentiate meningococcal meningitis from pneumococcal meningitis A) Petechiae are seen in meningococcal meningitis but not in pneumococcal meningitis. B) Headache and neck stiffness are experienced with meningococcal meningitis but not with pneumococcal meningitis. C) It is impossible to differentiate between pneumococcal meningitis and meningococcal meningitis. D) Headache and neck stiffness are experienced with pneumococcal meningitis but not with meningococcal meningitis. E) Petechiae are seen in pneumococcal meningitis but not in meningococcal meningitis.

A

Which of the following manifests itself in three clinical stages? A) Syphilis B) M. genitalium infection C) Trachoma D) Chancroid E) Gonorrhea

A

Which of the following statement regarding Acute Respiratory Syndrome (ARS) is incorrect: A) Though serious, ARS is rarely fatal B) ACE2 protects against Acute Respiratory Syndrome C) ARS is the most severe form of acute lung injury D) ARS can be triggered by sepsis E) ARS can be triggered by SARS-CoV2

A

Why is tertiary syphilis difficult to treat? A) The bacteria are no longer actively multiplying, and antibiotics work against dividing cells. B) The bacteria have migrated to the brain, which is protected by the blood-brain barrier. C) The bacteria have formed biofilms, which protect them from the effects of antibiotics. D) The bacteria have formed endospores, which are resistant to the effects of antibiotics. E) The bacteria have moved into deep tissues that are not accessible by medications.

A

Which of the following may lead to infertility A) Pyelonephritis B) All of these C) Cystitis D) Vaginosis E) Pelvic inflammatory disease

E

Among the most common of the sexually transmitted viral diseases agents is A) herpes simplex virus. B) human papillomavirus. C) leptospirosis virus. D) human immunodeficiency virus. E) varicella-zoster virus.

B

HIV typically attaches to A) complement component C3b AND a coreceptor. B) CD4 protein AND a coreceptor. C) protein A AND CD8 protein. D) complement component C5a AND CD4 protein. E) CD8 protein.

B

The leading cause of bacterial meningitis in adults is A) Haemophilus influenzae. B) Streptococcus pneumoniae. C) Escherichia coli. D) Mycoplasma pneumoniae. E) Neisseria meningitidis.

B

The single best (and most practical) way to prevent COVID19 infection is to: A) Avoid contacting sick people. B) Receive the COVID19 vaccination. C) Avoid large indoor gatherings. D) Wear a face covering. E) Avoid crowds.

B

Viral gastroenteritis in infants and children is most commonly caused by A) herpes. B) rotavirus. C) influenza virus. D) norovirus. E) hepatitis B.

B

Which is true of the Clostridium botulinum toxin? A) It is heat-resistant. B) It is a neurotoxin. C) It stimulates nerve to muscle signal transmission. D) It causes spastic paralysis. E) All the choices are correct.

B

Which of the following is associated with cervical cancer? A) Chancroid B) Genital warts C) Gonorrhea D) Genital herpes E) Syphilis

B

Which of the following is more likely to cause fatal septicemias? A) Negatively stained bacteria B) Gram-negative bacteria C) Acid-fast bacteria D) Mycoplasmas E) Gram-positive bacteria

B

Which of the following statements regarding SARS-CoV2 and COVID19 is incorrect? A) All of the above are correct B) The SARS-CoV2 virus genome exhibits high homology to a recent a bat Corona virus isolate C) The SARS-CoV2 Envelope protein attaches to the receptor on human lung epithelial cells. D) SARS-CoV2 is one of three deadly human Coronaviruses E) The receptor for SARS-CoV2 is the ACE2 protein.

C

During the COVID19 pandemic, the emphasis on virus testing has been a critically important feature of managing the pandemic. What is the rationale for the emphasis on testing with this particular illness? A) Widespread testing is always a good and necessary public health measure regardless of the illness. B) Testing provides public health officials with valuable data to retrospectively assess the trajectory of the pandemic so epidemiologist will have future data to study. C) Given the high percentage of asymptomatic, virus + individuals in the population, testing is imperative inform infected individuals of their need to quarantine to protects others around them. D) Testing assures people that they are safe, or not. E) All of the above are correct

C

Helicobacter pylori appears to have some connection with A) ulcers. B) dental caries. C) ulcers AND stomach cancer. D) stomach cancer. E) acid reflux disease.

C

Helicobacter pylori is able to survive in the stomach by its ability to produce A) fatty acids from sebum. B) neutralizing proteins from glucans. C) ammonia from urea. D) lactic acid from sugar. E) ammonia from urease.

C

How would crowded conditions in cities favor spread of bubonic plague? A) Plague is transmitted by direct contact (e.g. skin to skin). More people in an area provides more chances for infected individuals to directly contact and infect other individuals, spreading plague. B) Plague is transmitted by rats; more people means more waste, and more waste means more rats. This would favor the spread of plague. C) Plague is transmitted by infected fleas; these fleas may be found on rodents (such as rats). More people in an area means a greater chance of interactions with animals carrying infected fleas, increasing the spread of plague. D) Plague is transmitted by mosquitoes; more people close together gives an infected mosquito more chances to bite humans and transmit the causative agent, spreading plague. E) Bubonic plague is transmitted by aerosol droplets. People in cities are always dependent on public transport, which is typically overcrowded, so are at risk of acquiring plague bacteria.

C

In which disease is a gumma formed? A) Cutaneous diphtheria B) Primary syphilis C) Tertiary syphilis D) Secondary gonorrhea E) M. genitalium infection

C

Lorenzo, a high school biology teacher undergoes hip surgery to repair a fracture from a cycling accident. While hospitalized, Lorenzo develops a nosocomial urinary tract infection. After two rounds of Augmentin (penicillin plus a beta lactamase inhibitor), Lorenzo is given a third-generation cephalosporin in combination with ciprofloxacin (Cipro). After a week, the UTI is gone, however, Lorenzo is experiencing diarrhea, fever, and abdominal pain. The pain is so severe, Lorenzo's physician decides to do rectal endoscopy to look for a potential obstruction of the bowl or some other lesion. The endoscopy reveals intense colorectal inflammation with elevated yellow-white plaques that coalesce to form a thick yellowish mucous membrane-like substance on the intestinal mucosa. Lorenzo is suffering from: A) Intense gastritis due to Helicobacter pylori B) Shigellosis and acute colitis C) Clostridium difficile infection caused by antibiotic-induced dysbiosis and the resulting pseudomembranous colitis. D) Colorectal cancer from persistent Helicobacter pylori infection E) Campylobacteriosis

C

Otis, a high school senior visited his local free health clinic complaining that he was having pain during urination and that there was a thick pus-containing discharge from his penile urethra. During his examination, the clinician took a sample of the urethral exudate and prepared it for Gram staining. What did the clinician observe and what was the diagnosis? A) Large protozoa with a ruffled membrane; trichomoniasis B) Multiple spherical gram-negative bacteria inside of urethral epithelial cells; Chlamydia C) Gram-negative diplococci inside of neutrophils; gonorrhea D) Slender gram-negative spirochetes; syphilis

C

The disease responsible for the death of approximately 25% the population of Europe from 1346 to 1350 was A) endocarditis. B) pneumonia. C) plague. D) influenza. E) typhus.

C

Viral gastroenteritis that affects people of all ages and usually lasts less than 3 days is caused by A) rotavirus. B) influenza virus. C) norovirus. D) herpes. E) hepatitis B.

C

The unique characteristic of Lyme disease is A) rash on palms. B) fever. C) carbuncle. D) furuncle. E) erythema migrans.

E

Typically, pathogenic Neisseria gonorrhoeae A) secretes transferrin. B) destroys IgM. C) secretes exotoxin A. D) is very immunogenic. E) destroys IgA.

E

Alice, a daycare worked wakes up one morning not feeling well at all with symptoms that included, fever, diarrhea containing blood and mucous, vomiting, headache, stiff neck, and joint pain. Though she experienced several episodes of diarrhea throughout the day, the volumes of stool were relatively small. Alice calls her primary care provider and after an extensive interview and some history of her occupation and contacts, her physician tells her that she believes Alice is suffering from: A) Norovirus B) Cholera C) Salmonellosis D) Shigellosis E) Campylobacteriosis

D

The genome of the SARS-CoV2 virus is: A) A 30 kb (-) sense, single-stranded RNA molecule B) 30 kb double-stranded DNA molecule C) A 30 kb (+) sense, single-stranded DNA molecule D) A 30 kb (+) sense, single-stranded RNA molecule E) A 30 kb double-stranded RNA molecule

D

When Lyme disease was first being investigated, the observation that frequently only one person in a household was infected was a clue leading to the discovery that the disease was transmitted by arthropod bites. Why was this so? A) Mosquitoes (an example of arthropods) are never inside a house. They are strictly outdoor insects, so they couldn't spread the infection inside the household. B) Arthropods lose their mechanical ability to bite a human after a single bite, much like certain bees lose their stinger after a single sting. This prevents them from transmitting the infection to more than one individual in a household. C) These are all valid reasons that support the theory that Lyme disease must be transmitted by arthropod bites. D) If the infection is spread by the bite of an arthropod, it wouldn't spread easily by respiratory secretions, direct contact, or sexual contact between individuals within the family. E) Mosquitoes (an example of arthropods) only bite once in their lifetime. As such, they can only transmit the illness once before they die. Even if an infected mosquito was inside a house, it could only infect one human.

D

After seemingly recovered from a serious case of bacterial pneumonia, a 55-year old man was rushed to the ER having symptoms that included: throbbing headache; fever; pain and stiffness of neck and back; nausea and vomiting. Suspecting meningitis, the attending physician orders a lumbar puncture for cerebral spinal fluid (CSF) analysis. What came back from the spinal tap analysis? A) The CSF was cloudy and a gram stain revealed gram-negative diplococci. B) The CSF was cloudy and a gram stain revealed what appeared to be fungi. C) The CSF was cloudy and a gram stain revealed short gram-negative rods. D) The CSF was clear and the diagnosis is aseptic (viral) meningitis. E) The CSF was cloudy and a gram stain revealed gram-positive diplococci.

E

Following biding and cellular entry, down-regulation of angiotensin converting enzyme-2 by SARS-CoV2 predisposes the individual to: A) Developing full immunity against the virus B) COVID19 infection C) Protection against COVID19 D) All of the above E) Acute respiratory syndrome

E

HIV may be present in A) tears, sweat, AND colostrum. B) vaginal secretions, colostrum, AND sweat. C) blood, semen, AND tears. D) semen, vaginal secretions, AND tears. E) blood, semen, AND vaginal secretions.

E

Please select the TRUE statement regarding Haemophilus influenzae. A) It is a highly motile spirochete. B) It is a virus. C) It frequently causes meningitis in adults. D) All strains are encapsulated. E) Polysaccharide antigen from type b is used in vaccination.

E

Why are infants at risk of developing botulism after they ingest honey, but adults are not? A) The spores of C. botulinum produce a strong endotoxin. This endotoxin has little effect on adults because their immune system is fully developed. Infants, however, do not have a fully developed immune system and therefore far more susceptible to the toxin than adults. B) Honey can contain C. botulinum endospores. These may germinate in the intestines of adults that have eaten it. The bacteria are then sampled by M cells within the adult intestinal tract, leading to resistance to botulism. Infants do not have any M cells in their tract. C) Bees cultivate C. botulinum bacteria within their hives as a food source. This gets mixed in with the honey they make, and is ingested by infants they are given food containing honey. Adults seldom eat honey, so are not exposed to this organism. D) The infant digestive tract is immature and is extremely susceptible to the effects of botulism toxin which found in the honey in relatively high levels. The adult digestive tract is immune to the effects of botulinum toxin because of M cells and Peyer's patches. E) Honey can contain C. botulinum endospores. These may germinate in the intestines of infants that have eaten it, leading to colonization and pathogenesis as the bacteria begin forming botulism toxin. Adults' normal intestinal microbiota will out-compete the new microbes.

E

Why do Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae seldom cause meningitis in newborns? A) Infants are vaccinated against these pathogens. B) Infants are protected by maternal IgM against these pathogens. C) Infants seldom come into contact with these pathogens. D) These pathogens are unable to colonize infants. E) Infants are protected by maternal IgG against these pathogens.

E

Why might a person with an STI need to be checked for other STIs, even though he/she has no symptoms of any others? A) It's a public health issue. It's best to know who is positive for what in the population of sexually-active individuals. This lets healthcare professionals act to best safeguard the population as a whole from the range of STIs. B) They don't need to be tested. When a person becomes infected with one STI, they automatically become immune to any others, so will not acquire any further infections. C) They don't need to be tested. All STIs are highly obviously symptomatic, so there is no need to test for other diseases than the one currently manifesting itself in the patient. D) Several STI-causing pathogens are known to coexist with each other, being carried into the genital tract together. E) A diagnosis of an STI implies that the person had unprotected sex. Several STIs are largely asymptomatic, so it is wise to test for a variety of typical STIs when the patient admits to or shows signs of engaging in such risky behavior.

E

True or False: one way to protect yourself from an STI is to engage in sexual practices that avoid vaginal intercourse; other methods are safer.

False

True or false: Regarding testing for SARS-CoV2, the antigen testing methods out-perform nucleic acid amplification methods because of their greater sensitivity

False

True or false: gram-positive organisms are more likely than other infectious agents to cause fatal sepsis

False

True or False: there is no long-lasting immunity to gonorrhea and a person may contract gonorrhea repeatedly

True

True or False: the initial symptoms of bacterial meningitis are the same regardless of the causative agent

true