micro test 3

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Urease is produced by A. Enterococcus and group D Streptococcus. B. Klebsiella pneumoniae and Pseudomonas aeruginosa. C. Staphylococcus saprophyticus and Proteus mirabilis. D. Escherichia coli and Klebsiella pneumoniae.

C. Staphylococcus saprophyticus and Proteus mirabilis.

Which one of the following is considered a general characteristic of fungi that cause systemic mycoses? A. The primary site of the infection is the skin. B. They all grow as a mold in the human host. C. The infections can be asymptomatic and self-limited. D. Human to human transmission is very common. E. They are all very rapidly growing fungi.

C. The infections can be asymptomatic and self-limited.

Infections with Cryptosporidium parvum, Cyclospora cayetanensis, and Cystoisospora belli, which each cause an acute watery diarrhea, are diagnosed by A. sigmoidoscopy. B. serology for antibody. C. modified acid-fast stain of a stool specimen. D. Giemsa stain of a blood smear. E. dark field microscopy of a stool specimen.

C. modified acid-fast stain of a stool specimen.

The drug of choice for the treatment of syphilis (Treponema pallidum infection) is A. podofilox. B. ceftriaxone. C. penicillin. D. doxycycline. E. azithromycin.

C. penicillin.

Legionellosis outbreaks have been increasing in frequency. This is most likely due to A. an increase in human-to-human spread by contact with infected individuals. B. global spread of the bacterium by migratory birds. C. poor water quality. D. an insect vector.

C. poor water quality.

The best method to obtain a sample from a case of granuloma inguinale to confirm the causative agent as Klebsiella granulomatis is to A. collect the patient's urine. B. take blood from a vein near the infected area. C. collect sputum. D. perform a tissue scrape of the infected area.

D. perform a tissue scrape of the infected area.

One or more serologic antigens, such as polysaccharide capsule, of some Escherichia coli strains can be alternately expressed or not expressed. This type of genetic control of antigens is called A. virotype. B. invasion plasmid antigen (ipa) regulation. C. somatic mutation. D. phase variation.

D. phase variation.

Bacterial virulence factors that cause direct tissue damage to the host during periodontal disease include A. capsules. B. conjugative pili. C. bacteriocins. D. proteases.

D. proteases.

A 68-year-old male patient with a urinary catheter develops a urinary tract infection while in the hospital. His catheter is changed for a new one, and he is given sulfa-trimethoprim as therapy for the infection. Despite the catheter change and treatment, his infection persists and he develops renal stones. The bacterial virulence factor that caused his renal stones is A. polysaccharide capsule. B. lipopolysaccharide. C. heat-stable toxin. D. urease.

D. urease.

Fungi are described as having three life forms. These include A. yeast, molds, and sporangia. B. molds, saprobes, and yeast. C. mushrooms, conidiophores, and yeast. D. yeast, mushrooms, and molds E. mushrooms, pityriasis, and molds

D. yeast, mushrooms, and molds

Enterohemorrhagic Escherichia coli (EHEC) infections can lead to hemolytic-uremic syndrome (HUS) via A. vascular endothelial cell death by Shiga toxin. B. bacterial invasion of colonic epithelial cells. C. excessive chloride ion secretion from colonic epithelial cells. D. bacterial biofilm formation in the kidneys.

A. vascular endothelial cell death by Shiga toxin.

fasciola hepatica

sheep liver fluke RUQ pain, GI distress, eosinophilia, anemia, jaundice, cholecystitis, hypertrophic intrahepatic bile ducts eggs in stool or biliary drainage, serology ingestion of contaminated plants harboring infectious metacercarie?? (thats an answer somewhere) TREAT WITH: - triclabendazole - nitazoxanide okay I think thats all you got to know

Adult trematodes can be found in tissues throughout the body. Which of the following combinations correctly pairs an adult trematode and its body location? A. Schistosoma spp.: blood vessels B. Opisthorchis spp.: central nervous system C. Paragonimus spp.: skin D. Fasciola hepatica: vitreous humor of the eye E. Clonorchis spp.: myocardium

A. Schistosoma spp.: blood vessels portal blood flow and all that

Quorum sensing in Pseudomonas aeruginosa is a key mechanism involved in biofilm formation and toxin production, and is mediated by A. autoinducer molecules called homoserine lactones. B. Type VI secretion. C. extrinsic antibiotic resistance due to plasmid transfer. D. matrix metalloproteinases.

A. autoinducer molecules called homoserine lactones.

The two most frequently identified bacterial causes of gastroenteritis in the United States are A. Campylobacter and Salmonella. B. Campylobacter and Vibrio. C. Shigella and enteroinvasive Escherichia coli. D. Salmonella and Listeria.

A. Campylobacter and Salmonella. Camp (Uncle) Sam

Guillain-Barré syndrome, an autoimmune disorder of the peripheral nervous system, is linked to infection by A. Campylobacter jejuni. B. Escherichia coli. C. Klebsiella pneumoniae. D. Aeromonas hydrophila.

A. Campylobacter jejuni.

Different serovars of this organism can cause adult and neonatal conjunctivitis, blinding trachoma, trichiasis, and sexually transmitted disease. A. Chlamydia trachomatis B. Leptospira interrogans C. Calymmatobacterium granulomatis D. Chlamydophila pneumoniae E. Treponema pallidum

A. Chlamydia trachomatis

Different serovars of this organism can cause adult and neonatal conjunctivitis, blinding trachoma, trichiasis, and sexually transmitted disease. A. Chlamydia trachomatis B. Leptospira interrogans C. Calymmatobacterium granulomatis D. Chlamydophila pneumoniae E. Treponema pallidum

A. Chlamydia trachomatis neonatal conjunc.

A 9-year-old boy was brought to the Emergency Department by his mother. The boy was lethargic and unable to respond to commands. He was febrile to 102.5 ˚F. Suspecting meningitis, a lumbar puncture was performed, which showed trophozoites on the Giemsa stain of the CSF. Last week the boy swam in a lake near his house in Vicksburg, MS. Which of the following statements below is TRUE? A. Despite treatments such as miltefosine and hypothermic therapy, there is high mortality with this infection. B. The findings are consistent with Granulomatous Amebic Encephalitis, caused by Acanthamoeba spp. C. The causative agent requires an intermediate host such as a snail. D. The infective form is the unsporulated oocyst.

A. Despite treatments such as miltefosine and hypothermic therapy, there is high mortality with this infection.

A 5-year-old boy is brought to the pediatrician's office by his father. The child has been vigorously scratching at his anus in the morning, much to the embarrassment of the father. The pediatrician gives instructions to the father, and the father returns the next day with diagnostic material. Eggs were visualized under the microscope in the image below. Which of the following nematodes is affecting the boy? A. Enterobius vermicularis B. Ascaris lumbricoides C. Ancylostoma duodenale D. Trichuris trichiura E. Strongyloides stercoralis

A. Enterobius vermicularis "pinworm" scotch tape test

This Pseudomonas aeruginosa protein binds to mucin-1 (MUC1) ectodomains on airway epithelial cells, and is important for bacterial invasion of the airway epithelium. A. Flagellin B. Exotoxin A C. Protease IV D. Exoenzyme S

A. Flagellin

Using Items I-VI below, which of the following considerations are important in choosing whether antibiotic therapy is appropriate? I. Making the correct diagnosis II. Prescribing the newest drug on the market III. Always choosing the generic when available IV. Treating for the appropriate duration V. Choosing the right drug for the suspected infection VI. Prescribing the appropriate dose A. I, IV, V, VI B. II, III, IV, V C. III, IV, V, VI D. I, II, IV, V E. I, III, IV, VI

A. I, IV, V, VI NOT II and III

This organism, which lacks a cell wall, binds to respiratory ciliated epithelial cells to cause an atypical "walking" pneumonia characterized by a persistent, dry cough and a patchy, diffuse, non-lobular pattern on X-ray. A. Mycoplasma pneumoniae B. Klebsiella pneumoniae C. Rickettsia rickettsii D. Borrelia recurrentis E. Streptococcus pneumoniae

A. Mycoplasma pneumoniae

This organism, which lacks a cell wall, binds to respiratory ciliated epithelial cells to cause an atypical "walking" pneumonia characterized by a persistent, dry cough and a patchy, diffuse, non-lobular pattern on X-ray. A. Mycoplasma pneumoniae B. Klebsiella pneumoniae C. Rickettsia rickettsii D. Borrelia recurrentis E. Streptococcus pneumoniae

A. Mycoplasma pneumoniae

A 20 cm worm was passed in the stool of a 7 year-old child, who is a resident of Jackson, MS. The mother brought in the worm and the anterior end was visualized by the pathologist as seen in the image below. Which of the following statements below is TRUE of Ascaris lumbricoides? A. Some patients can manifest Loeffler's syndrome, characterized by an eosinophilic pneumonitis associated with larval migration. B. Transmission is limited to the American south and parts of the Caribbean. C. The treatment of choice is metronidazole. D. The organism has an incomplete gastrointestinal tract.

A. Some patients can manifest Loeffler's syndrome, characterized by an eosinophilic pneumonitis associated with larval migration. ascaris = loefflers

A 62-year-old male complains that his teeth wiggle and gums are constantly bleeding. He admits to neglecting dental visits for 20 years and not flossing regularly. He currently exhibits severe calculus, receded and swollen gingivae, and alarmingly periodontal pockets. X-rays show bone loss. The bacteria that are most likely involved in the pathogenesis of this patient's symptoms include A. Tannerella forsythia, Treponema denticola, Porphyromonas gingivalis, and Fusobacterium nucleatum. B. Actinomyces israelii, Streptococcus mutans, Lactobacillus acidophilus, and Veillonella spp. C. Streptococcus pneumoniae, Neisseria gonorrhoeae, Streptococcus pyogenes, and Corynebacterium diphtheriae. D. Propionibacterium acnes, Nocardia asteroides, Mycobacterium tuberculosis, and Clostridium difficile

A. Tannerella forsythia, Treponema denticola, Porphyromonas gingivalis, and Fusobacterium nucleatum.

A 45-year-old woman comes to the emergency room with seizures. She reports having months of worsening headaches. A brain MRI showed three cystic lesions. Since two cysts were interfering with ventricular outflow, the patient underwent neurosurgery to remove the offending cysts, seen grossly in the image below. Histopathologic examination of the cysts revealed a scolex with hooks, confirming the diagnosis of neurocysticercosis. Which of the following descriptions below is TRUE? A. The causative agent is Taenia solium, and it is transmitted by eating embryonated eggs. B. The causative agent is Taenia solium, and it is transmitted by eating undercooked pork. C. The causative agent is Taenia saginata, and it is transmitted by eating embryonated eggs. D. The causative agent is Taenia saginata, and it is transmitted by eating undercooked beef. E. The causative agent is Taenia neurocysticus, and it is transmitted by eating undercooked fish.

A. The causative agent is Taenia solium, and it is transmitted by eating embryonated eggs. solium= hooks, pig, eggs

A 49-year-old woman presents to her primary care physician with a 2-week history of abdominal pain and bloody diarrhea. She had returned from a 4 month world tour, including trips to Bali, Vietnam, Laos, the Gambia, Senegal, Cape Verde, and Las Vegas. She denies taking any prophylactic medications. The trichrome stain of the stool exam for ova, cysts, and parasites revealed structures such as the one seen in the image below. Which of the following statements is TRUE about this disease? A. The organism has the potential to disseminate to extraintestinal sites, especially the liver B. The organism is Entamoeba dispar and the infective form is the trophozoite. C. Treatment of the diarrheal disease includes oral vancomycin. D. The diarrheal/dysentery disease never involves the appendix, cecum, and colon.

A. The organism has the potential to disseminate to extraintestinal sites, especially the liver

Bacteria present in mature subgingival plaque are predominantly A. anaerobic rods and spirochetes. B. anaerobic streptococci. C. facultative gram-positive cocci. D. facultative Veillonella species.

A. anaerobic rods and spirochetes.

A 19-year-old female college freshman who reports recently becoming sexually active develops fever and pain on urination. A quantitative streak of a fresh, clean catch urine sample from this patient detects 6 x 106 colony-forming units of a bacterium that most likely A. forms brick-red colonies when cultured on MacConkey agar plates. B. has a fruity odor and a shiny, metallic color when cultured on blood agar plates. C. does not produce bubbles when tested with hydrogen peroxide (H2O2). D. produces a greenish color around colonies on blood agar plates.

A. forms brick-red colonies when cultured on MacConkey agar plates.

Plasmodium falciparum malaria is the most dangerous type of malaria and is responsible for most malaria deaths because A. infected red blood cells become cytoadherent and clog capillary beds. B. the parasite can infect cells in the bone marrow and cause pancytopenia. C. it is the predominant species of malarial parasite in the world. D. it can remain dormant in the liver and cause relapse of the disease years after the initial infection. E. there are no effective drugs for treatment or prophylaxis.

A. infected red blood cells become cytoadherent and clog capillary beds. occlude capillaries

Saliva is comprised of A. inorganic ions, proteins, glycoproteins, urea, and vitamins. B. serum, cementum, and calculus. C. intracellular food storage granules, pulp, and enamel. D. bacteriocins and sorbitol.

A. inorganic ions, proteins, glycoproteins, urea, and vitamins.

Streptococcus mutans can cause demineralization of tooth structure, and thus contribute to dental caries, by fermenting sugar to produce A. organic acids. B. alcohol. C. glucose. D. proteins

A. organic acids.

Uropathogenic Escherichia coli adhesins necessary for attachment to cells lining the bladder and urinary tract are A. pili/fimbriae. B. capsules. C. translocated intimin receptors. D. colonization factor antigens.

A. pili/fimbriae. ribbon

A major concern regarding Acinetobacter baumannii infections is A. the organism is multiply drug resistant. B. that only immune competent individuals are infected. C. a lack of concern about this bacterium from the Centers for Disease Control. D. the organism is rapidly killed by complement

A. the organism is multiply drug resistant.

An organism that produces an acid-over-acid (A/A) reaction on Triple Sugar Iron Agar (TSI) A. uses glucose in the but(t) portion of the media. B. uses lactose and amino acids in the but portion of the media. C. lacks beta-galactosidase. D. lacks genes that code for the catabolism of amino acids.

A. uses glucose in the but portion of the media. I know thats not how you spell it (BUT T) lol but quizlet thinks im using "profanity"

A three-year-old is noted to have poor eating habits. She is slightly malnourished and has developed a white powdery growth on her tongue. Which one of the following is the likely cause of this overgrowth? A. Histoplasma capsulatum B. Candida albicans C. Blastomyces dermatitidis D. Aspergillus fumigatus E. Candida auris

B. Candida albicans

Which of the following organisms is second only to malaria as a protozoan cause of mortality, is a cause of dysentery and colitis as well as extra-intestinal infections of the liver and other organs, may cause colonic perforations with resulting peritonitis, and responds to treatment with metronidazole and paramomycin? A. Giardia lamblia B. Entamoeba histolytica C. Balantidium coli D. Cyclospora cayetanensis E. Endolimax nana

B. Entamoeba histolytica

A 75-year-old man presented to the emergency room with profound right-upper quadrant pain. The patient had recently immigrated from Greece for retirement, where he worked his whole life raising sheep. Imaging showed cystic lesions of the liver and the patient was sent to the operating room for a partial hepatectomy. While in the OR, gray, grainy fluid was extracted from the lesions. Wet mount and Giemsa staining of the material demonstrated protoscolices and hooklets. Which of the following statements is TRUE? A. The causative agent is Echinococcus bilious; the sheep is the definitive host. B. Hydatid cysts can be found in various organs, however, the liver is most common. C. Infection is diagnosed based on the presence of ova and parasites in stool. D. Transmission is by ingestion of trophozoites.

B. Hydatid cysts can be found in various organs, however, the liver is most common. ecchinoccus grnulosus sheep and dogs

Trichinella spiralis is the causative agent of trichinosis. What is the usual route of infection? A. Infective L3 larvae penetrate the skin B. Ingestion of undercooked meat, particularly pork, containing encysted larvae C. Fecal-oral transmission of infective oocysts D. Accidental ingestion of racoon feces E. Inhalation of infectious respiratory droplets

B. Ingestion of undercooked meat, particularly pork, containing encysted larvae represented by pig in pic

A blood culture of an organism isolated from a newborn who died of septicemia and meningitis yielded a gram-negative rod-shaped organism that was positive for lactose fermentation, indole negative, and generated colonies which were described as "very goopy" when grown on blood agar. The organism was most likely to be A. Escherichia coli. B. Klebsiella pneumoniae. C. Proteus mirabilis. D. Pseudomonas aeruginosa.

B. Klebsiella pneumoniae. goopy= currant jelly sputum

The presence of unsheathed microfilaria in skin snip samples from a patient with corneal opacities, peripheral eosinophilia, dermatitis, and fibrous subcutaneous nodules on the head is diagnostic of infection with the following parasite. A. Ascaris lumbricoides B. Onchocerca volvulus C. Diphyllobothrium latum D. Fasciola hepatica E. Wuchereria bancrofti

B. Onchocerca volvulus blindness, eosinophilia

A 19-year-old woman presents to the campus health clinic at her local college. She is complaining of pelvic cramps and a frothy, fishy-smelling discharge. She is sexually active with her male partner, who is present with her at the clinic; he has no symptoms. A vaginal swab is obtained and the contents are placed on a glass slide for wet mount microscopy. Motile trichomonads are visualized, confirming the diagnosis of trichomoniasis. What is the next appropriate step? A. Prescribe metronidazole for the patient only, as this is the treatment of choice. B. Prescribe metronidazole for the patient and her partner, as this is the treatment of choice. C. Prescribe albendazole for the patient only, as this is the treatment of choice. D. Prescribe albendazole for the patient and her partner, as this is the treatment of choice. E. Counsel the patient and her partner about avoiding sexual activity prior to marriage.

B. Prescribe metronidazole for the patient and her partner, as this is the treatment of choice.

A 25-year-old female complains that her teeth are too close together to floss properly. She is worried about tartar buildup. She reports brushing 3 times per day, and gargles with an antiseptic mouth rinse once per day, and has tooth cleanings and dental examinations at 6 month intervals. Her teeth and gums are healthy and X-rays are normal. The predominant bacterial genus isolated from the supragingival plaque of this patient would most likely be A. Porphyromonas. B. Streptococcus. C. Fusobacterium. D. Treponema.

B. Streptococcus.

A 29-year-old male, who has recently returned from an extended stay with family in rural Mexico, is brought to the UMMC emergency room after suffering a seizure while working in the hot sun with a highway construction crew. On examination he appeared to be healthy and his physical findings were all normal. Tests for infectious agents including stool ova and parasites were negative. The seizure responded to anti-convulsive therapy and he was released. Two weeks later he returned to the hospital after suffering another seizure. A CT scan showed two intraparenchymal ring-enhanced lesions measuring 8 mm by 15 mm, and scattered punctuate calcifications. The results of serologic tests showed a strongly positive titer to antigens from which organism? A. Echinococcus multilocularis B. Taenia solium C. Acanthamoeba spp. D. Strongyloides stercoralis E. Trypanosoma cruzi

B. Taenia solium seizure

A 45-year-old civil engineer presents to the Emergency Department with profound fatigue and altered mental status. He returned from a trip to Ghana where he was surveying waterways throughout various parts of the country. He has experienced shaking chills and fevers for the past several days. He has lived in the United States his whole life, and took no chemoprophylaxis during his trip. A peripheral blood smear revealed 5% of his erythrocytes contained structures as shown in the image below. Which of the following statements is true? A. The patient is likely suffering from an infection with Babesia microti, which means he was likely bitten by ticks while on his trip. B. The patient is likely suffering from an infection with Plasmodium falciparum, and he is at risk of cerebral sequelae of the disease. C. The infective form of this parasitic infection is the ookinete. D. The treatment of choice is trimethoprim-sulfamethoxazole. E. The treatment of choice is clindamycin.

B. The patient is likely suffering from an infection with Plasmodium falciparum, and he is at risk of cerebral sequelae of the disease.

Congenital infection with this organism during the first or second trimester of pregnancy can cause macrocephalus, jaundice, hepatosplenomegaly, and bilateral retinochoroiditis. A. Plasmodium vivax B. Toxoplasma gondii C. Ascaris lumbricoides D. Heterophyes heterophyes E. Echinococcus multilocularis

B. Toxoplasma gondii pregnant woman

Several people fell ill with diarrhea following a wedding. Subsequent investigation found that all of those who fell ill ate cake, which contained contaminated fresh raspberries. Examination of stool from those affected revealed unsporulated oocysts that were 8-10 µm as demonstrated in the wet mount below. Which of the following statements below is true about this organism? A. The organism only undergoes asexual reproduction in the intestinal mucosa; sexual reproduction takes place in the environment. B. Trimethoprim-sulfamethoxazole is the treatment of choice. C. The oocysts fail to demonstrate autofluorescence under UV light. D. It is unusual to observe infection in community outbreaks. E. The organism is transmitted by ingesting an infected flea.

B. Trimethoprim-sulfamethoxazole is the treatment of choice. ?? idk

Yersinia pestis is transmitted to a new mammalian host by A. ingestion or skin contact with undercooked shellfish. B. bite of an infected flea or aerosol droplets. C. claw wounds or contact with feces from a rabid bat. D. contact with the skin of an armadillo. E. drinking of contaminated well water or unpasteurized juice.

B. bite of an infected flea or aerosol droplets.

A 28-year-old male comes to the health department and requests evaluation for penile discharge of three days duration. Physical exam reveals a yellow urethral discharge but no other abnormalities. The gram stain of the discharge reveals gram-negative intracellular diplococci. The most likely diagnosis is A. nongonococcal urethritis (NGU). B. gonococcal urethritis. C. bacterial cystitis. D. pelvic inflammatory disease. E. inguinal adenopathy

B. gonococcal urethritis. male, yellow discharge

Enterobacter, Citrobacter, Morganella, and Serratia species are common causes of A. hospital-acquired infections in immunocompetent adults. B. hospital-acquired infections in neonates and immunocompromised patients. C. community-acquired infections in immunocompetent adults. D. community-acquired infections in neonates and immunocompromised individuals.

B. hospital-acquired infections in neonates and immunocompromised patients.

The PRP-conjugate vaccine that protects against Haemophilus influenzae type B (Hib) is more effective than purified capsular antigen because the conjugate vaccine A. consists of heat-killed whole cells of H. influenzae. B. recruits T cell help for H. influenzae reactive B cells. C. prevents both Hib and nontypeable H. influenzae infections. D. contains lipooligosaccharide which triggers inflammatory responses. E. eliminates the requirement for booster vaccinations.

B. recruits T cell help for H. influenzae reactive B cells.

The drug of choice for both treatment and prophylaxis of PCP, a pneumonia caused by Pneumocystis jirovecii (formerly P. carinii) is A. ivermectin. B. sulfa-trimethoprim. C. clindamycin. D. tetracycline. E. metronidazole.

B. sulfa-trimethoprim. eggs in jar ping pong

Acinetobacter baumannii has become an infectious agent of importance to hospitals worldwide. This is due in part to A. the organism's ability to infect healthy individuals. B. the ability of A. baumannii to survive for a long time on surfaces. C. A. baumannii infections in animals that transmit the organism to humans. D. the development of antibiotic stewardship programs.

B. the ability of A. baumannii to survive for a long time on surfaces.

When Legionella pneumophila infects a macrophage, it is not killed because A. macrophages only kill gram-positive bacteria. B. the bacterium avoids the lysosomal network. C. this bacterium replicates outside of a macrophage vacuole. D. it is able to migrate from one macrophage to another without lysing the macrophage.

B. the bacterium avoids the lysosomal network.

A veterinarian responsible for vaccinating cattle develops recurring episodes of fever, chills, malaise, and copious sweating during a four-week period. Which ONE of following tests would best be used to investigate the cause? A. Physical exam for the presence of inguinal buboes B. Fecal cultures for cholera toxin-producing bacteria C. Blood cultures for slow growing gram-negative bacteria D. Breath test for urease E. Skin biopsy and dark-field microscopy for spirochaetes

C. Blood cultures for slow growing gram-negative bacteria

A 38-year- old man with a past history of syphilis develops a cluster of painful genital lesions that suppurate, and has swollen inguinal lymph nodes. Culture of the lesion yields gram-negative bacteria requiring hemin (X factor) for growth. This illness is most likely to be which of the following? A. Syphilis caused by Treponema pallidium B. Brazilian Purpura caused by Haemophilus aegyptius C. Chancroid caused by Haemophilus ducreyi D. Anthrax caused by Bacillus anthracis E. Hypersensitivity caused by a latex allergy

C. Chancroid caused by Haemophilus ducreyi

Which one of the following organisms has recently been implicated in hospital outbreaks in patients >65 years of age? A. Streptococcus pyogenes B. Porphyromonas gingivalis C. Elizabethikingia anopheles D. Corynebacterium diphtheria

C. Elizabethikingia anopheles queen elizabeth was older than 65

A 39-year-old female with dyspepsia, heartburn, nausea, and abdominal pain, is referred to a gastrointestinal specialist to diagnose her condition. Her blood work is negative for genetic markers of Crohn's disease. A gastric tissue biopsy is performed during esophageal endoscopy, and histology of the tissue shows the presence of numerous gram-negative bacilli. The tissue also is positive for urease. The most likely cause of this patient's symptoms is A. Proteus vulgaris. B. Campylobacter jejuni. C. Helicobacter pylori. D. Salmonella enterica.

C. Helicobacter pylori. presents like GERD

Which one of the following would be considered a risk factor for infection by Legionella pneumophila? A. Unprotected sex B. Strenuous exercise C. Immunosuppression D. Playing contact sports

C. Immunosuppression

Fasciola hepatica adult trematodes are large, often in excess of 3 cm in length. Which of the following describes the natural route of F. hepatica transmission to humans? A. Ingestion of encysted adults in undercooked pork B. Ingestion of gravid proglottids from undercooked sheep C. Ingestion of contaminated plants harboring infectious metacercariae D. Transdermal migration of larvae picked up from contaminated soil E. Transplacental infection of tachyzoites

C. Ingestion of contaminated plants harboring infectious metacercariae

Which of the following is a gram-negative pathogen causing pneumonia that is difficult to treat due to extensive drug resistance mediated by carbapenemase and metallo-beta-lactamase production? A. Burkholderia cepacia complex (BCC) B. Staphylococcus aureus C. Klebsiella pneumoniae D. Streptococcus pneumoniae

C. Klebsiella pneumoniae

Which of the following is a TRUE statement about infections by Bordetella pertussis? A. Greater than 90% of colonized adults develop severe cases of Whooping Cough. B. The primary source of infection is transmission from domestic animals. C. Pathogenesis initiates after bacterial attachment to ciliated respiratory epithelial cells. D. Antibiotic treatment is most effective if it is initiated during the paroxysmal stage of disease. E. Bacterial invasion of the bloodstream is essential for production of disease.

C. Pathogenesis initiates after bacterial attachment to ciliated respiratory epithelial cells. `

Which of the following situations represents the most appropriate use of antibiotics? A. Prescribing azithromycin for your child who has a head cold B. Prescribing a month-long course of clindamycin for an otherwise healthy patient who has a dental abscess, but no fever or evidence of disseminated infection C. Prescribing amoxicillin for a patient with a prosthetic heart valve and prior history of prosthesis-related complications before that patient undergoes a tooth extraction D. Prescribing ciprofloxacin for a patient who telephoned complaining of bronchitis

C. Prescribing amoxicillin for a patient with a prosthetic heart valve and prior history of prosthesis-related complications before that patient undergoes a tooth extraction

An 85-year-old male, who resides in an assisted living facility, is transported to the emergency department with symptoms of intense gastrointestinal cramps, a fever of 103 °F, bloody stools, and dehydration. He is administered IV fluids and ampicillin as empiric therapy, and a sample of his stool is sent to the clinical microbiology laboratory for analysis. He is admitted to the hospital, and his condition improves the following day. The microbiology laboratory reports that culture of his stool on triple sugar iron (TSI) agar after 16 hours of growth produced a red slant and a yellow butt with no gas or hydrogen sulfide production. The likely etiologic agent of this patient's illness is A. Salmonella enterica. B. Yersinia pestis. C. Shigella sonnei. D. Escherichia coli.

C. Shigella sonnei. shigella is red and yellow

A 37-year-old pregnant woman presented to the emergency room with seizures. She is at 15 weeks gestation based on her last menstrual period. Her social history is significant for intravenous drug use. Diagnostic workup revealed multiple ring-enhancing lesions on an MRI of her brain, as seen below. Further evaluation revealed blood CD4-positive T-cell count of <10 cells/microliter, and a serum HIV viral load of >10 million copies/mL. Serologic tests demonstrated antibodies against Toxoplasma gondii. Which of the following statements is TRUE? A. The mouse, Mus musculus, is the definitive host of Toxoplasma gondii, harboring infectious oocysts in its feces. B. There is little risk of trans-placental transmission of Toxoplasma gondii to the patient's fetus. C. The patient should be evaluated for chorioretinitis, inflammation of the choroid of the eye. D. The patient should be placed on droplet precautions while in the hospital, as she is considered infectious. E. The pig, Sus scrofa, is the definitive host of Toxoplasma gondii, harboring infectious oocysts in its feces.

C. The patient should be evaluated for chorioretinitis, inflammation of the choroid of the eye.

A 39-year-old man presented to his primary care physician with weakness, fatigue, diarrhea, and tingling sensations in his hands and feet. Upon questions about his diet, the man discloses he routinely consumes raw wild-caught Atlantic salmon. CBC demonstrated a megaloblastic anemia. Serum studies showed normal glucose and low vitamin B12. His diarrheal stool was examined for ova, cysts, and parasites and the structures below were observed. Which of the following statements is TRUE? A. The parasite's eggs do not have an operculum. B. The tapeworm is less than 10 cm meters in length. C. The treatment of choice is praziquantel. D. The causative agent is Dipylidium caninum.

C. The treatment of choice is praziquantel. Diphyllobothrium latum, longest tapeworm (longer than 10 cm)

The chronic phase of the disease caused by this organism is characterized by the presence of intracellular amastigote stages in cardiac muscle cells. A. Coxiella burnetii B. Leishmania mexicana C. Trypanosoma cruzi D. Clonorchis sinensis E. Trichinella spiralis

C. Trypanosoma cruzi

Tularemia most often results in which one of the following clinical forms of disease? A. Oropharyngeal B. Gastrointestinal C. Ulceroglandular D. Genitourinary E. Oculoglandular

C. Ulceroglandular

Candida auris has been identified in hospital outbreaks. A concern about this fungal pathogen is A. that it is spread by pigeons. B. it is heavily encapsulated. C. it can be multidrug resistant. D. it infects a wide range of animals.

C. it can be multidrug resistant.

The Pseudomonas aeruginosa Tse toxin delivered by the Type VI secretion system A. is a phospholipase that targets human cell membranes. B. inactivates host Rho GTPases directly by Rho GAP (GTPase-activating protein) activity. C. targets bacterial peptidoglycan and can kill neighboring bacterial competitors. D. ADP-ribosylates elongation factor 2 (EF-2), halting host protein synthesis.

C. targets bacterial peptidoglycan and can kill neighboring bacterial competitors

An acellular material consisting mostly of mucins, proteins, minerals, immunoglobulins, and compounds from saliva and some bacterial molecules best describes A. gingival crevicular fluid. B. calculus. C. the salivary pellicle. D. a biofilm.

C. the salivary pellicle.

The drug of choice for treatment of infection with Fasciola hepatica is A. choramphenicol. B. pyrantel pamoate. C. triclabendazole. D. primaquine phosphate. E. praziquantel.

C. triclabendazole. fasciola burski would be praziquantel

A high school student living in a town near the Mississippi River presents with headache, night sweats, cough, fatigue, and weight loss. He has spent several weekends exploring caves. Biopsy of a skin lesion reveals small intracellular yeast. Which one of the following is the most likely cause of his infection? A. Aspergillus fumigatus B. Coccidioides immitis C. Paracoccidioides brasiliensis D. Histoplasma capsulatum E. Cryptococcus neoformans

D. Histoplasma capsulatum CAVE :-)

A 22-year-old UMMC medical student visits the student health complaining of an intensely itching lesion on her foot. She had recently spent a week of sun and fun on the beach in Miami, Florida during spring break. On examination, she had a red excoriated track approximately 6 cm in length on her right foot. The remainder of the physical exam was normal. Which parasite is the most likely to account for these symptoms? A. Echinococcus multilocularis B. Clonorchis sinensis C. Taenia solium D. Ancylostoma braziliense E. Trichinella spiralis

D. Ancylostoma braziliense

A localized red-brown papule and swollen lymph node near the site of a cat-scratch would most likely be caused by which of the following bacteria? A. Brucella abortus B. Yersinia pestis C. Bordetella pertussis D. Bartonella henselae E. Salmonella typhimurium

D. Bartonella henselae

Which one of the following is the most likely cause of side-effects from anti-mycotic drug therapy? A. All fungi are extremely slow growing and only produce chronic infections. B. Because some fungi are dimorphic. C. All fungal infections are acquired from the environment. D. Because fungi are eukaryotic organisms. E. Because fungi have so many possible drug targets

D. Because fungi are eukaryotic organisms.

A 25-year-old male cystic fibrosis patient, who recently developed pneumonia, was given a poor prognosis for survival after microbiological identification tests of his sputum were completed. Which of the following organisms was likely identified that prompted the poor prognosis? A. Pseudomonas aeruginosa B. Staphylococcus aureus C. Haemophilus influenzae D. Burkholderia cepacia complex (BCC)

D. Burkholderia cepacia complex (BCC) CF

Two days after a hysterectomy, a 43-year-old woman complained of fever and chills, and experience a drop in blood pressure. Blood cultures were positive for an organism that was lactose fermentation negative, and yielded a TSI result of K/A with a black color developing in the booty of the tube. Which of the following is most likely to be observed? A. Bacterial growth with a fruity odor and a green color on TSA plates B. No growth on TSA plates except around an XV strip C. A greenish color forming around colonies on blood agar plates D. Foul odor and swarming growth on blood agar plates

D. Foul odor and swarming growth on blood agar plates

Which of the following organisms is the most common intestinal protozoan parasite in the USA, may cause diarrhea with flatulence, anorexia, cramps, epigastric pain, and fatty, yellow stool containing food chunks, and is associated with daycare transmission and drinking fecally contaminated water? A. Entamoeba histolytica B. Balantidium coli C. Cryptosporidium parvum D. Giardia lamblia E. Blastocystis hominis

D. Giardia lamblia yellow stool

A patient with acute myeloid leukemia was admitted to the medical intensive care unit in acute hypoxic respiratory failure. After being administered stress corticosteroids, the patient worsened. Aspirates from the patient's tracheostomy were submitted to the laboratory and motile larvae were observed under light microscopy, confirming an infection with Strongyloides stercoralis. Which of the following is TRUE of strongyloidiasis? A. There is only a single infectious lifecycle: indirect infection. B. Eggs, which are identical to hookworm eggs, are usually visualized in stool specimens of infected patients. C. Ivermectin treatment is contraindicated. D. Hyperinfection is characterized by accelerated cycling between the gastrointestinal tract and the respiratory tract. E. Larvae are found only in the skin in disseminated disease.

D. Hyperinfection is characterized by accelerated cycling between the gastrointestinal tract and the respiratory tract.

Your patient is a 70-year-old male with a history of hypertension and diabetes. He smokes two packs of cigarettes per day. It is September, and he has been on a two-week fishing trip. He has a cough and complains of a shortness of breath. Which one of the following would be a likely cause of infection in this case? A. Acinetobacter baumannii B. Vibrio vulnificus C. Escherichia coli D. Legionella pneumophila

D. Legionella pneumophila smoker

A 14-year-old boy presented to the ED in the middle of summer with a recent onset of sore throat, runny nose, headache, vomiting, stiff neck, mental confusion and lethargy that rapidly proceeded to coma. His health had previously been excellent, and the only significant history that could be elicited from the family was that he had been swimming in a shallow, stagnant lake near his home with friends a few days earlier. During the diagnostic evaluation, the cerebrospinal fluid was found to be turbid with decreased glucose, elevated protein, and leukocytosis, but Gram stain and culture for bacteria were negative. Despite aggressive clinical management, the patient died. Which of the following organisms is the most likely cause of this illness? A. Blastocystis spp. B. Ehrlichia chaffeensis C. Toxoplasma gondii D. Naegleria fowleri E. Entamoeba coli

D. Naegleria fowleri trophozoites from water

Nontypeable Haemophilus influenzae is a frequent cause of which of the following illnesses? A. Meningitis B. Wound infection C. Dental caries D. Otitis media E. Bacillary angiomatosis

D. Otitis media

Which of the following is a property of nontypeable Haemophilus influenzae strains that renders antibodies to the Hib PRP-conjugate vaccine ineffective against them? A. They evade antibodies by growing inside cells. B. They produce IgA protease. C. They do not disseminate into the bloodstream. D. They do not produce capsular antigen. E. They produce a potent exotoxin.

D. They do not produce capsular antigen.

A 51-year-old man is referred to the urologist for one month of intermittent, mildly painful bloody urine. The man had immigrated from Egypt within the last year. A microscopic analysis of the man's urine revealed numerous red blood cells as well as the structures in the image below, which were 120 µm in length. Which of the following statements is true regarding the man's diagnosis? A. This is an infection with Taenia solium, and head imaging should be performed to look for neurocysticercosis. B. The man must have been bitten by the tsetse fly in order to acquire this infection. C. Treatment with trimethoprim-sulfamethoxazole is associated with complete cure in 75% of cases. D. This infection is associated with bladder cancers. E. The sheep is the definitive host that harbors mating adults.

D. This infection is associated with bladder cancers. schistosoma haematobium

A patient sample cultured on Sabouraud's agar yielded a thick-walled, broad-based budding yeast in liquid culture at 37 °C (see below). This organism is most likely to be associated with A. a white overgrowth in the mouth of a neonate recently diagnosed with SCID. B. an unsightly skin lesion in the groin area of a teenage male on the High School wrestling team. C. a fungus ball in the sinus of an HIV patient. D. a respiratory infection acquired by inhaling spores in a dusty rural environment in the Great Lakes region.

D. a respiratory infection acquired by inhaling spores in a dusty rural environment in the Great Lakes region. BROAD BASED BUDDING, blasto!

Cholera toxin is A. a small monomeric toxin that binds to and activates host guanylyl cyclase, increasing intracellular cGMP. B. a Type 3-secreted toxin that is injected into host cells, causing host actin rearrangements leading to engulfment of the bacteria. C. an A-B type toxin that cleaves the 28S rRNA of the 60S subunit of the host ribosome, disrupting host protein synthesis. D. an A-B type toxin that binds to host ganglioside GM1, internalizes into host cells and activates adenylyl cyclase.

D. an A-B type toxin that binds to host ganglioside GM1, internalizes into host cells and activates adenylyl cyclase.

Superficial mycoses A. rapidly disseminate from the outer layers of the body to the liver. B. elicit intense cellular responses from the host. C. cause extreme physical discomfort to the patient. D. are generally considered cosmetic problems.

D. are generally considered cosmetic problems.

A 35-year-old male, who is HIV-positive, complains that there is something wrong with his gums. Oral examination reveals the presence of gray membrane on the gingivae which partially sloughed off during examination, revealing bleeding beneath. The pathogenesis of this patient's oral disease is primarily due to A. bacteriocin production by Streptococcus spp. B. the high caries conduciveness of sorbitol. C. secondary effects from cervicofacial actinomycosis. D. invasion of underlying connective tissue by spirochetes.

D. invasion of underlying connective tissue by spirochetes.

Enterobius vermicularis infection A. is least severe in children. B. causes a pneumonitis in the lungs. C. is acquired by ingesting infective larval forms in meat. D. is characterized by perianal pruritis. E. is diagnosed by finding unembryonated eggs with a mammilated coat in feces.

D. is characterized by perianal pruritis.

The biochemical test included in MacConkey agar tests for A. indole production. B. urease activity. C. lactose synthesis. D. lactose catabolism.

D. lactose catabolism.

The drug treatment of choice for infection with Trichomonas vaginalis (trichomoniasis) and for treatment of bacterial vaginosis, an alteration of normal vaginal flora, is A. penicillin. B. doxycycline. C. podofilox. D. metronidazole. E. ceftriaxone.

D. metronidazole.

Infection with which one of these organisms is associated with hematuria, the presence of blood in the urine? A. Schistosoma mansoni B. Ehrlichia chafeensis C. Leishmania tropica D. Trichomonas vaginalis E. Schistosoma hematobium

E. Schistosoma hematobium bleeding jellyfish

A 35-year-old florist presented with a series of seven nodules ascending from his left hand to his elbow. They were regularly space red nodules that were not painful to touch. He reported that four weeks prior, he had prepared a large floral display from fresh cut local roses that were dressed with sphagnum moss. He noted that the first nodule appeared on his left hand. Within two weeks, the additional nodules had appeared. The most likely diagnosis is A. Diphtheria B. Anthrax C. Dermatophytosis D. Blastomycosis E. Sporotrichosis

E. Sporotrichosis

The presence of live larvae with a short buccal chamber in the stool of a patient suffering from epigastric pain, diarrhea, vomiting and urticarial skin eruptions is diagnostic for infection with A. Ancylostoma caninum. B. Cystoisospora belli. C. Schistosoma japonicum. D. Enterobius vermicularis. E. Strongyloides stercoralis.

E. Strongyloides stercoralis.

Which of the following insect vectors transmits babesiosis, Rocky Mountain spotted fever, and Lyme disease? A. Fleas B. Mosquitoes C. Reduviid bugs D. Lice E. Ticks

E. Ticks

Which one of the following would be a dermatophytosis of the hands? A. Tinea barbae B. Tinea corporis C. Tinea unguium D. Tinea cruris E. Tinea manuum

E. Tinea manuum barbae beard corporis body unguium nails cruris inguinal area

Soil-transmitted helminths (Ascaris, Trichuris, and hookworms) which cause gastrointestinal worm infections are treated with A. acyclovir. B. ceftriaxone. C. tetracycline. D. penicillin. E. albendazole.

E. albendazole.

Infection with Paragonimus westermani, the lung fluke, is acquired by A. being penetrated by cercariae in water that can enter through unbroken skin. B. ingesting encysted metacercariae on raw water plants. C. inhalation of infective spore-like forms. D. the bite of an infected mosquito. E. ingesting encysted metacercariae in crabs or crayfish.

E. ingesting encysted metacercariae in crabs or crayfish. penguins


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