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(Micro) Chapter 20- Infectious Diseases Affecting the Gastrointestinal Tract

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The most common bacterial cause of diarrhea in the United States is A. E. coli. B. Salmonella. C. Shigella. D. Campylobacter. E. Yersinia.

D. Campylobacter.

Which of the following helminths is paired with a correct characteristic/s of its pathogenesis? A. Ascaris lumbricoides - life and transmission cycle B B. Necator americanus - life and transmission cycle A C. Trichuris trichuria - life and transmission cycle B D. Strongyloides stercoralis - life and transmission cycle B E. Taenia solium - life and transmission cycle A

D. Strongyloides stercoralis - life and transmission cycle B

(T/F) The only body fluid that can transmit hepatitis B virus is blood.

FALSE

Which toxin is specifically responsible for the systemic disease of HUS? A. IgA toxicity B. variable E. coli strains C. shiga toxin D. secondary C. difficile infection

C. shiga toxin

Which of the following is not a normal causative agent of acute diarrhea with vomiting (food poisoning)? A. Clostridium perfringes B. Staphylococcus aureus exotoxin C. Clostridium difficile D. Bacillus cereus E. All of the choices are correct.

C. Clostridium difficile

Production of enterotoxin is a characteristic of A. Clostridium botulinum. B. Clostridium perfringens. C. Clostridium difficile. D. Clostridium tetani. E. All of the choices are correct.

C. Clostridium difficile.

What are potential causes of Quinn's diarrhea? A. Shigella B. Clostridium difficile C. Giardia lamblia D. All of the choices are correct.

D. All of the choices are correct.

Which test is used to detect hepatitis B? A. radioimmunoassay B. ELISA C. antibody test D. All of the choices are correct.

D. All of the choices are correct.

(T/F) In the absence of dietary carbohydrates, bacteria do not cause tooth decay.

TRUE

(T/F) The best treatment for acute diarrhea is oral replacement of electrolytes and water.

TRUE

(T/F) There are vaccines for immunity to the hepatitis B virus.

TRUE

(T/F)Despite acidic conditions, some microorganisms have been found residing within the human stomach.

TRUE

(T/F) Boiling will not kill Giardia lamblia cysts in contaminated water.

FALSE

(T/F) Carriers of hepatitis B virus are not common

FALSE

(T/F) Most antihelminth medications act only against the worms, not the human host.

FALSE

(T/F) Mumps causes permanent sterility in young male adults.

FALSE

The causative organism for mumps is A. Paramyxovirus. B. Morbillivirus. C. Streptococcus pyogenes. D. Corynebacterium. E. Vibrio.

A. Paramyxovirus.

(T/F) E. coli O157:H7 secretes shiga exotoxin.

TRUE

The most immediate and important treatment needed to prevent death in cholera victims is A. water and electrolyte replacement. B. antimicrobials. C. antitoxin. D. surgery. E. None of the choices is correct.

A. water and electrolyte replacement.

Jennifer's parents are notably distressed. They are expressing extreme guilt over the entire incident, and feel it was there fault that Jennifer had contracted this illness. They start asking you what they could have done to prevent it. Which of the following responses is most appropriate in this situation? A. "There's no way you could have known that cookie dough was tainted with E. coli. However, the only way to prevent it is to never eat raw foods." B. "You should have had your daughter vaccinated with the E. coli vaccine." C. "If you would have brought her in to the emergency department sooner, you could have prevented this deeper illness." D. "Since nobody knows the true cause of HUS, there's nothing you could have done to prevent this from happening."

A. "There's no way you could have known that cookie dough was tainted with E. coli. However, the only way to prevent it is to never eat raw foods."

Jennifer's parents accuse your medical team of not doing everything possible to help cure Jennifer because she hasn't received any antibiotics. Why aren't antibiotics prescribed in HUS? A. Antibiotics are of no help and may increase the pathology. B. There are no antibiotics that can effectively treat E. coli. C. Antibiotic therapy may stunt immune system development. D. Antibiotics are reserved for the most virulent cases of HUS.

A. Antibiotics are of no help and may increase the pathology.

A common food intoxication is caused by enterotoxin-producing strains of A. Staphylococcus aureus. B. Staphylococcus epidermidis. C. Staphylococcus saprophyticus. D. Streptococcus pyogenes. E. Streptococcus agalactiae.

A. Staphylococcus aureus.

Outbreaks of which disease have been associated with fecal-contaminated drinking water? A. cryptosporidiosis B. cyclosporiasis C. trichinosis D. toxoplasmosis E. None of the choices is correct.

A. cryptosporidiosis

Symptoms of cryptosporidiosis include A. headache, sweats, vomiting, severe abdominal cramps, and diarrhea. B. chills, fever, and sweats. C. bloody, mucus-filled stools and fever. D. a red-skin papule that spreads to a large ulcer. E. None of the choices is correct.

A. headache, sweats, vomiting, severe abdominal cramps, and diarrhea.

Inflammation of the liver with necrosis of the hepatocytes and swelling due to a mononuclear response is a disease called A. hepatitis. B. jaundice. C. liver cancer. D. mononucleosis. E. None of the choices are correct.

A. hepatitis.

All of the following pertain to Clostridium difficile infection except it A. is due to ingestion of contaminated, improperly stored, cooked meats and gravies. B. is a colitis that is a superinfection. C. often has an endogenous source. D. is associated with disruption of normal flora due to broad-spectrum antimicrobials. E. is the major cause of diarrhea in hospitals.

A. is due to ingestion of contaminated, improperly stored, cooked meats and gravies.

The doctor orders a 10-day course of antibiotics with amoxicillin. When you note the order, you call the doctor to clarify the order. What antibiotic do you advocate for in this specific infection? A. metronidazole B. erythromycin C. TMP-SMZ D. Antibiotics are not indicated.

A. metronidazole

E. coli O157:H7 characteristics include all the following except it A. only causes occupational illness in people who work with animals. B. is transmitted by ingestion of contaminated, undercooked food, especially hamburger. C. causes a bloody diarrhea. D. has a reservoir of cattle intestines. E. some cases go on to hemolytic uremic syndrome (HUS) with possible kidney failure.

A. only causes occupational illness in people who work with animals.

Liver flukes live in all of the following areas except the A. small intestine. B. liver. C. gallbladder. D. bile duct. E. All of the choices are correct.

A. small intestine.

DJ informs you he heard there is no treatment for hepatitis infections, and wants to know what the rest of his life is going to look like. What is the best response? A. "This is going to be a long and difficult road. What kind of support structure do you have in place to help you through this?" B. "There actually are many treatment modalities in place. You should talk to our doctors right away about starting a treatment." C. "Right now, the only treatable hepatitis is hepatitis C, but new modes of treatment are being developed and studied everyday." D. "Hepatitis can be well-controlled with lifestyle change. If we can figure out how you contracted the disease, we can figure out how to cure it."

B. "There actually are many treatment modalities in place. You should talk to our doctors right away about starting a treatment."

What is the best way to prevent infection with Giardia? A. Use proper filtration. B. Avoid drinking from freshwater sources. C. Set up your camp at least 250 feet from the nearest freshwater source. D. Giardia is an inherent risk of outdoor camping.

B. Avoid drinking from freshwater sources.

What organism is the leading cause of HUS in the United States? A. Shigella B. E. coli C. Salmonella D. Clostridium difficile

B. E. coli

The most common cause of liver cancer in the United States is A. HAV. B. HBV. C. HCV. D. HDV. E. HEV.

B. HBV.

The main causes of dental caries seem to be A. Streptococcus pyogens. B. Streptococcus mutans. C. Streptococcus pneumoniae. D. Both A and B are correct. E. Both B and C are correct.

B. Streptococcus mutans.

Which is true of Yersinia enterocolitica and Yersinia pseudotuberculosis? A. Y. pseudotuberculosis causes tuberculosis B. cause intense pain caused by inflammation of the ileum C. cause Guillain-Barre syndrome D. are gram-positive E. do not cause fever

B. cause intense pain caused by inflammation of the ileum

Outbreaks of which apicomplexan disease have been associated with fecal-contaminated imported raspberries and also fresh greens and drinking water? A. cryptosporidiosis B. cyclosporiasis C. trichinosis D. toxoplasmosis E. None of the choices is correct

B. cyclosporiasis

The most common infectious disease in humans is A. the common cold. B. dental caries. C. pharyngitis. D. diarrhea. E. gastritis.

B. dental caries.

Salmonella are A. methane producers. B. motile. C. gram-positive rods. D. lactose fermenters. E. All of the choices are correct.

B. motile.

Orchitis and epididymitis are seen in young adult males as a complication of A. croup. B. mumps. C. influenza. D. measles (rubeola). E. rubella.

B. mumps.

The mucinous glycoprotein covering teeth that streptococci attach to is called the A. enamel. B. pellicle. C. gingiva. D. lactoferrin. E. oral membrane.

B. pellicle.

Which is not a characteristic of Helicobacter pylori? A. gram-negative B. produces enteroxin that causes diarrhea C. curved rods D. lives in the stomach E. produces urease that buffers stomach acidity

B. produces enteroxin that causes diarrhea

The primary viral cause of chronic diarrhea, globally is A. cryptosporidium. B. rotavirus. C. adenovirus. D. norovirus. E. astrovirus.

B. rotavirus.

Which of the following is not a virulence factor of E. coli O157:H7? A. secretes shiga exotoxin from a bacteriophage B. secretes shiga exotoxin from the E. coli chromosome C. has a protein called intimin for host attachment D. has a type III secretion system E. provides the receptor for intimin to attach to the host

B. secretes shiga exotoxin from the E. coli chromosome

Oral flora bacteria on the tooth surface A. develop a biofilm. B. use fimbriae and slime layers to adhere. C. include Streptococci that metabolize sucrose, produce sticky glucans, and form plaque. D. include Lactobacilli and Streptococci, which ferment carbohydrates and produce acids that cause caries. E. All of the choices are correct.

B. use fimbriae and slime layers to adhere.

Why does a patient with HUS present with bloody diarrhea? A. The blood is actually from the kidneys, which are in failure. B. The diarrhea is red in color because that is the color of shiga toxin. C. E. coli exotoxins damage the gut lining which produces bleeding. D. E. coli camps out in small bowel outpouchings and leaches blood from the venous system.

C. E. coli exotoxins damage the gut lining which produces bleeding.

Quinn tells you that he should have known better than to drink untreated lake water. He had always heard that mountain streams were fresh. He then asks you to tell him why the lake water caused his diarrhea. What is the most likely source of Giardia in lake water? A. Since the human GI tract is used to chlorinated water, it does not have the capacity to deal with foreign organisms. B. Stagnant water sources are literal cest-pools for microorganisms, and any outdoor water source should be suspected. C. Giardia is found in the GI tracts of many animals, and their stool often ends up in lakes and streams. D. Giardia, as an organism, has the beneficial effect of being excellent feed for fresh water fish. However, it is toxic to humans.

C. Giardia is found in the GI tracts of many animals, and their stool often ends up in lakes and streams.

A stool culture is taken, and protozoa are noted upon microscopic examination. Which of the following microbes is the probable cause of Quinn's diarrhea? A. Shigella B. Clostridium difficile C. Giardia lamblia D. Yersinia

C. Giardia lamblia

After DJ was tested for hepatitis B, the healthcare worker that drew DJ's blood set the needle down on the counter instead of in the sharps container. Several hours later, another healthcare worker stuck herself with the needle. How concerned should she be that she could contract hepatitis B? A. She should not be concerned at all. The virus dies once the blood dries. B. She should not be concerned at all. The virus is not transmitted blood-to-blood. C. She should be very concerned. The virus can survive several hours in dried blood. D. She should be very concerned. The virus multiplies indefinitely on hard surfaces.

C. She should be very concerned. The virus can survive several hours in dried blood.

"Rice-water stools" are associated with disease caused by which organism? A. Vibrio vulnificus B. Vibrio parahaemolyticus C. Vibrio cholerae D. Campylobacter jejuni E. Helicobacter pylori

C. Vibrio cholerae

Enterobius vermicularis is A. a whipworm. B. common only to the tropics and subtropics. C. an intestinal worm that easily contaminates fingers and fomites. D. often fatal in heavy infestations. E. All of the choices are correct.

C. an intestinal worm that easily contaminates fingers and fomites.

Which is incorrect about shigellosis? A. outbreaks have occurred in day care centers B. watery diarrhea with bloody, mucoid stools and abdominal cramps C. frequently involve septicemia D. human carriers cause fecal transmission E. also called dysentery

C. frequently involve septicemia

Parasitic helminthes have the following characteristics except A. are multicellular animals. B. have a definitive host where the adult form lives. C. have larval forms that do not affect humans. D. include roundworms. E. include tapeworms.

C. have larval forms that do not affect humans.

Hepatitis B infection A. has an incubation of 2 to 7 weeks. B. can be transmitted by the fecal-oral route. C. increases risk for hepatocellular cancer. D. is responsible for most cases of posttransfusion hepatitis. E. All of the choices are correct.

C. increases risk for hepatocellular cancer.

All of the following are characteristics of Campylobacter jejuni except A. transmitted through ingestion of contaminated chicken, meat, milk, and water. B. causes fever and a watery stool. C. infects the stomach. D. produces an enterotoxin that stimulates diarrhea. E. gram-negative curved rods with darting motility.

C. infects the stomach.

General symptoms of helminth infection includes all of the following except A. eggs, larvae, or adult worms found in feces. B. increased sensitivity to helminth antigens. C. intense abdominal pain. D. increased eosinophil count. E. vague nausea.

C. intense abdominal pain.

All of the following can be transmitted by drinking contaminated water except A. cryptosporidiosis. B. cyclosporiasis. C. malaria. D. campylobacter. E. giardiasis.

C. malaria.

Which is incorrect about hepatitis A infection? A. transmitted by the oral-fecal route B. has flu-like symptoms with discomfort near the liver and darkened urine C. predisposes a person for liver cancer D. immunoglobulin therapy helps decrease the severity E. HAVRAX is an inactivated vaccine for prevention

C. predisposes a person for liver cancer

Giardiasis involves A. a protozoan that does not form cysts. B. infection by a bacteria. C. symptoms of abdominal pain, flatulence, and diarrhea. D. fimbriae for adherence. E. All of the choices are correct.

C. symptoms of abdominal pain, flatulence, and diarrhea.

Shigella species have the following characteristics except A. not motile, gram-negative rods. B. reservoir is human carriers. C. they produce urease and hydrogen sulfide. D. infect the large intestine. E. produce enterotoxin called shiga toxin.

C. they produce urease and hydrogen sulfide.

DJ is very upset about his diagnosis. He wants to know "how on earth" he could have contracted this disease. In what way is the hepatitis B infection transmitted? A. needle sticks B. sexual contact C. sharing a toothbrush D. All of the choices are correct.

D. All of the choices are correct.

Which of the following is mismatched? A. H antigen - flagellar B. K antigen - capsule C. O antigen - cell wall D. All of the choices are correct. E. None of the choices is correct.

D. All of the choices are correct.

The virulence of Vibrio cholerae is due to its A. capsule. B. neurotoxin. C. invasive enzymes. D. enterotoxin. E. All of the choices are correct.

D. enterotoxin.

Which is mismatched? A. hepatitis A virus - nonenveloped, single-stranded RNA enterovirus B. hepatitis B virus - enveloped DNA virus C. hepatitis C virus - RNA virus D. hepatitis D virus - defective RNA virus that coinfects with HAV E. hepatitis E virus - self-limiting RNA virus

D. hepatitis D virus - defective RNA virus that coinfects with HAV

Which is incorrect about Staphylococcus aureus food intoxication? A. food gets contaminated by a human carrier B. common associated foods include custards, ham, cream pastries, and processed meats C. after contamination, food must be left unrefrigerated for a few hours D. ingestion of the pathogen allows it to multiply and damage the GI tract lining E. symptoms come on quickly and include nausea, vomiting, and diarrhea

D. ingestion of the pathogen allows it to multiply and damage the GI tract lining

Which organ of the GI tract has a large commensal population of microorganisms? A. liver B. salivary glands C. pancreas D. large intestine E. small intestine

D. large intestine

Which of the following is not true of schistosomiasis? A. caused by blood flukes B. larvae called cercariae can invade intact skin C. may cause liver swelling or malfunction D. worms can invade the brain E. can "cloak" itself with proteins in the blood

D. worms can invade the brain

Ascaris lumbricoides A. is an intestinal roundworm. B. spreads to humans by ingestion of Ascaris eggs in food. C. larvae penetrate into lymphatics and capillaries around intestines. D. larvae migrate to the pharynx, get swallowed, and return to intestines to mature. E. All of the choices are correct.