final

Which type of anthrax is called "woolsorter's disease"? A) PulmonaryB) GastrointestinalC) CutaneousD) All of the choices are correct.

A

An 85-year-old man has been experiencing weight loss, night sweats, and a dry cough for several months and just recently he has begun coughing up sputum with tinges of blood in it. Following a chest X-ray showing some white spots on his lungs, an AFB (Mycobacterial) stain and culture were ordered and both were positive for the presence of mycobacteria. He has been PPD positive since his 20s. Which of the following most accurately describes his current situation? A) Latent tubercular infectionB) Primary tubercular infectionC) Systemic tuberculosisD) Primary tubercular diseaseE) Reactivation tuberculosis

E

Which of the following characteristics can be used to differentiate between the genera Bacillus and Clostridium? a. oxygen preference b. gram stain reaction c. endospore formation d. cell morphology

a

Which poses the highest risk for botulism? a. home-processed foods b. acidified foods c. commercially canned foods d. frozen foods

a

A_______________is a serum globulin that neutralizes a specific toxin.

antitoxin

Which of the following is NOT a species of Clostridium responsible for human disease? a. difficile b. anthracis c. botulinum d. perfringens e. tetani

b

The major source for infection with L. monocytogenes is ______. a. infected humans b. infected animals c. contaminated foods d. contaminated soils

c

How are clostridial infections acquired? a. They are spread via an aerosol route from animals b. They are spread via an aerosol route from humans c. They are communicable between humans d. They are acquired through contamination of injured skin

d

M. tuberculosis is a long, thin, rod that grows in strands called ______ which appear red with ______ stain. a. hyphae, gram b. filaments, acid-fast c. cords, gram d. cords, acid-fast

d

Which of the following is not used to subdivide gram-positive bacilli into three general groups? a. Acid-fast reaction b. Presence of endospores c. Absence of endospores d. Cell morphology

d

Members of the genus Clostridium are gram-______________ _________________

positive, rods

Which of the following is not a similarity between Bacillus cereus and Clostridium perfringens? A) They are both Gram-positive, endospore-forming bacteria.B) They cause disease through contaminated foods.C) They are both obligate anaerobes.D) Symptoms of infection with either bacteria include nausea, vomiting, and diarrhea.

C

Which of the following is the most likely method if transmission of nocardiosis? A) Consuming contaminated home-preserved foodsB) Consuming unpasteurized milkC) Inhaling dust containing cells of NocardiaD) Touching an individual who has nocardiosis with an ungloved hand

C

The three genera in the irregular non-spore-forming bacilli group with the greatest clinical significance include ____________, ___________________, and ____________________.

Corynebacterium, Nocardia, Mycobacterium

Tuberculin skin testing A) injects PPD intradermally.B) uses a purified protein filtrate of Mycobacterium tuberculosis.C) will be positive if person has had previous exposure.D) will be positive in active TB.E) All of the choices are correct.

E

36) Formation of a pseudomembrane in the back of the throat is seen in A) diphtheria.B) listeriosis.C) tuberculosis.D) erysipeloid.E) botulism.

A

Mycobacterium tuberculosis A) produces several virulence factor enzymes and an exotoxin.B) has a cord factor that can prevent destruction by lysosomes and macrophages.C) is a spore-former.D) has a capsule.E) lives in the soil.

B

The nurse is reviewing instructions with a pregnant client. Which statement by the client indicates a need for further teaching? A) "I will limit my caffeine intake."B) "I can eat soft cheeses to ensure I get enough protein and calcium."C) "I will take a prenatal vitamin with iron and folic acid every day."D) "I will avoid alcohol."

B

What is used to subdivide the gram-positive bacilli into three general groups? cata a. presence of endospores b. acid-fast staining properties c. shape of the cells d. layers in the cell wall e. cardinal temperatures

a, b

Which occupations have the greatest risk for Erysipelothrix infections? cata a. slaughterhouse workers b. butchers c. veterinarians d. health care workers

a, b, c

Which of the following describe the characteristics of Clostridium? cata a. catalase-negative b. catalase-positive c. gram-negative d. cocci e. gram-positive f. rods

a, e, f

Which term refers to a group of nonmotile, filamentous rods that may be acid-fast and are closely related to Mycobacterium? a. Propionibacterium b. Actinomycetes c. Nontuberculosis Mycobacteria d. Corynebacterium

b

Which of the following characteristics can differentiate between the genera Bacillus and Clostridium? cata a. gram stain reaction b. oxygen requirements c. cell morphology d. presence of catalase

b, d

Which of the following causes a non-communicable pulmonary infection that resembles tuberculosis? A) Mycobacterium avium complex (MAC)B) Mycobacterium kansasiiC) Mycobacterium scrofulaceumD) Mycobacterium fortuitum complexE) Mycobacterium marinum

B

Which of the following is a significant risk factor for the development of listeriosis? A) Consumption of meat, poultry, eggs, and dairy productsB) Being a veganC) Receiving immunosuppressive drugs for treatment of an autoimmne diseaseD) Consuming home-canned foods

C

the genus___________includes mostly saprobic, aerobic, gram-positive, spore-forming rods.

bacillus

A butcher enters the hospital with an inflamed, itchy forearm with dark red lesions surrounding a three-inch scratch. He ensures that he wears gloves and an apron while working with animal carcasses, but not long-sleeved shirts. Bacteria are isolated from the wound and are confirmed to be Gram-positive rods that do not form spores. What is the most likely pathogen causing his discomfort? A) Erysipelothrix rhusiopathiaeB) Listeria monocytogenesC) Mycobacterium lepraeD) Clostridium perfringensE) Bacillus anthracis

A

All of the following pertain to Clostridium difficile infection, except A) it is due to ingestion of contaminated, improperly stored, cooked meats and gravies.B) it is a colitis that is a superinfection.C) it often has an endogenous source.D) it may be on the rise due to increased use of gastric acid inhibitors.E) it is a major cause of diarrhea in hospitals.

A

Paucibacillary Hansen's disease A) causes asymmetrical, shallow skin lesions with loss of pain sensation.B) is the most disfiguring.C) is characterized by a large number of acid fast bacilli in the infected tissues (multibacillary).D) may have complications including secondary infections, kidney, or respiratory failure.E) All of the choices are correct.

A

Production of a neurotoxin that prevents acetylcholine release from motor neurons at neuromuscular junctions is a characteristic of A) Clostridium botulinum.B) Clostridium perfringens.C) Clostridium difficile.D) Clostridium tetani.E) All of the choices are correct.

A

The common soil mycobacteria that frequently cause systemic infection and death in AIDS patients is A) Mycobacterium avium complex (MAC).B) Mycobacterium kansasii.C) Mycobacterium scrofulaceum.D) Mycobacterium fortuitum complex.E) Mycobacterium marinum.

A

Which is not correct about Mycobacterium species? A) All species are human pathogens.B) Mycobacterial cell walls have waxy lipids.C) Mycobateria are acid-fast.D) Many mycobacterial species have a slow growth rate.E) Mycobacterial cells are long, slender rods.

A

Which of the following is not true about diphtheria? A) It is a zoonosis.B) Humans can be healthy carriers.C) It is prevented with the DTaP vaccine.D) It is an upper respiratory infection.E) A pseudomembranemay form in the back of the throat.

A

A seasonal farmworker has been brought into the emergency room showing early symptoms of tetanus, including spastic contractions of face and neck muscles. His coworkers indicated that he had received a puncture wound in his hand a week prior to the onset of symptoms. His tetanus vaccination status is uncertain. Which of the following should be administered to the patient first, as soon as possible? A) Tetanus toxoidB) Tetanus immune globulinC) AntibioticsD) Hyperbaric oxygen chamber therapyE) Tetanus titer

B

Actinomycosis is an infection by various species of Actinomyces derived from A) contaminated foods.B) normal microbiota.C) droplets aerosolized by sneezing or coughing.D) soil-dwelling microbes.

B

All of the following pertain to Listeria monocytogenes, except A) it is gram-positive.B) it produces endospores.C) it frequently contaminatesdairy products, meats, poultry.D) it causes food-borne listeriosis.E) bacterial cells multiply within the cytoplasm of a host cell.

B

All of the following pertain to infant botulism, except A) symptoms include "floppy baby" appearance.B) neurotoxin is not involved in the disease process.C) ingested spores can germinate in the immature intestines of the neonate.D) symptoms include flaccid paralysis and respiratory complications.E) it is the most common type of botulism in the United States.

B

Characteristics of Bacillus anthracis include all the following, except A) capsule and exotoxins are virulence factors.B) anaerobic.C) reservoir includes infected grazing animals and contaminated soil.D) gram-positive bacillus.E) spore-former.

B

Janice had been experiencing mild flu-like symptoms before going into premature labor at seven months. The premature baby boy developed complications immediately after birth, running a fever and demonstrating neurologic abnormalities. A cerebrospinal fluid specimen was collected and a gram stain of the specimen showed short Gram-positive bacilli. The CSF culture grew small beta hemolytic colonies that were catalase positive. A CAMP test was positive on this isolate. The same organism grew from blood cultures done on the baby. What is the most likely identification? A) Bacillus anthracisB) Listeria monocytogenesC) Streptococcus agalactiaeD) Corynebacterium diphtheriae

B

Which of the following is not true about leprosy? A) It is caused by Hansen's bacillus in honor of its discoverer.B) Mycobacterium lepraeis highly virulent, causing disease in most individuals that are exposed.C) Armadillos harbor a genetically identical M. leprae.D) Early signs appear as small, spotty lesions colored differently than the surrounding skin.E) The number of new cases in the U.S. each year is about 50 to 100, mostly associated with recent immigrants.

B

Which organism can infect deeper wound sites and produce exotoxins, enzymes, and gas that cause tissue and muscle necrosis? A) Clostridium botulinumB) Clostridium perfringensC) Clostridium difficileD) Clostridium tetaniE) All of the choices are correct.

B

A 26-year-old woman enters the hospital with an itchy, pustule-like infection in her new tattoo. The clinical laboratory confirms that this is an infection with an NTM which contaminated the tattoo ink. What is the best recommendation for treatment? A) Standard course of anti-TB chemotherapeutics including isoniazid, rifampin, ethambutol, and pyrazinamideB) Amputation of the infected limbC) Debridement of the infected tissueD) Treatment is not required. NTMs typically resolve on their own.

C

A 3-year-old child returns to the clinic after two days to have a Mantoux tuberculin skin test evaluated. The nurse measures an induration of 10 mm. This is considered A) a positive test.B) a negative test.C) an inconclusive test.D) too early to determine the results.

C

Actinomyces israelii A) can be transmitted by respiratory droplets.B) can cause pneumonia with symptoms similar to tuberculosis.C) are filamentous rods that grow in clusters called sulfur granules in infected tissue.D) lives in the soil.E) most often causes cases in the immunocompromised.

C

All of the following are typical of nocardiosis, except A) it may be caused by Nocardia brasiliensis, Nocardiaasteroides, or Nocardia caviae.B) infections may involve the lungs, the skin, or subcutaneous sites.C) nocardiosisusuallydevelops in individuals with a healthy immune response.D) symptoms of pulmonary nocardiosismay resemble the symptoms of tuberculosis.

C

Erysipeloid is transmitted by A) inhalation of spores from hides and wool of animals.B) ingestion of improperly cooked hot dogs.C) an abrasion on skin coming in contact with infected swine or other animals.D) contaminated soil entering deep puncture wounds.E) respiratory secretions.

C

Generally, what must healthy adults consume in order to contract botulism? A) Endospores of C. botulinumB) Vegetative cells of C. botulinumC) Botulism toxin in contaminated foodD) Botulism toxoid in contaminated foodE) Botulism antitoxin in contaminated food

C

Leprosy is a disease A) of lung tissue.B) that has been eradicated around the world.C) caused by a pathogen that cannot be cultured in the lab.D) that can be diagnosed by the Mantoux test.E) caused by a spore-forming, gram-positive bacillus.

C

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

The food-borne disease that involves neurotoxin is A) gastrointestinal anthrax.B) Bacillus cereus intoxication.C) botulism.D) Clostridium perfringens gastroenteritis.E) All of the choices are correct.

C

The major virulence factor of Corynebacterium diphtheriae that causes serious systemic effects is A) the capsule.B) themetachromatic granules.C) itsexotoxin.D) the endospore.E) itsendotoxin.

C

Which form of anthrax involves a black eschar on the skin? A) PulmonaryB) GastrointestinalC) CutaneousD) All of the choices are correct

C

Which is not a characteristic of Nocardia? A) It can be transmitted by respiratory droplets.B) It can cause pneumonia with symptoms similar to tuberculosis.C) They are filamentous rods that grow in clusters called sulfur granules in infected tissue.D) It lives in the soil.E) It causes most cases in the immunocompromised.

C

A specimen was collected from a deep wound. A smear was prepared and Gram stained and samples were inoculated onto two blood agar plates. Both blood agar plates were incubated for 48 hours at 35°C, but one blood agar plate was incubated aerobically and the other was incubated in an anaerobe jar. The Gram stain of the original specimen showed large gram-positive bacilli. After incubation, there was no growth on the blood agar plate that was incubated aerobically, but the plate incubated in the anaerobe jar grew beta hemolytic colonies. A Gram stain of these colonies showed large gram positive bacilli, some with unstained inclusions,suggestive of endospores. What is the most likely genus of bacteria observed? A) BacillusB) MycobacteriumC) ListeriaD) ClostridiumE) Corynebacterium

D

Botulin, the toxin of botulism is A) not as virulent as tetanospasmin.B) detected and diagnosed by analyzing a patient's blood.C) the cause of rigid paralysis.D) only produced under anaerobic conditions.E) produced when spores germinate in the intestines of adults after ingesting contaminated food.

D

For which of the following diseases does the "feather test" provide evidence of early infection? A) TuberculosisB) BotulismC) TetanusD) Hansen's diseaseE) Anthrax

D

Mild, uncomplicated cases of pseudomembranous colitis may be treated by A) debridement.B) wound cleansing.C) vancomycin for several weeks.D) withdrawal of antibiotics and replacement of lost fluids and electrolytes.E) All of the choices are correct.

D

Production of a neurotoxin that binds to target sites on spinal cord neurons responsible for inhibiting skeletal muscle contraction is a characteristic of A) Clostridium botulinum.B) Clostridium perfringens.C) Clostridium difficile.D) Clostridium tetani.E) All of the choices are correct.

D

The individuals most at risk for botulism are those that A) eat meat.B) are vegetarians.C) have a weakened immune system.D) consume home-preserved foods.E) eat often in restaurants.

D

What do the bacteria that cause botulism, tetanus, and diphtheria have in common? A) Each of these diseases is caused by an endospore-forming bacterial species.B) Each of these diseases is caused by obligately anaerobic bacteria.C) Vaccines are widely used to prevent each of these diseases.D) Each of these bacteria make an exotoxin that is responsible for the disease.

D

What is the usual cause of pseudomembranous colitis? A) Improperly home-preserved foods containing botulin toxinB) Consumingunpasteurized dairy products containing Listeria monocytogenesC) Handling infected animals contaminated with E. rhusiopathiaeD) Therapy with broad-spectrum antibiotics leading to superinfection by C. difficileE) Living in close contact with someone infected with C. perfringens

D

Which is not correct about Bacillus cereus? A) Present in soilB) Produces enterotoxinsC) Causes food-borne intoxicationD) Causes a zoonosisE) Associated with cooked rice, potato, and meat dishes that are stored at room temperature

D

Which of the following is not acharacteristic of Actinomyces israelii? A) Non-motileB) May live in human oral cavity or intestineC) May display mycelium-like growthD) Endospore formerE) Discharge from infections may contain sulfur granules

D

Which of the following pertains to diphtheria? A) It results in meningitis.B) Symptoms include vomiting and diarrhea.C) It can be transmitted from mother's birth canal to neonate.D) It is prevented by the DTaP immunization.E) All of the choices are correct.

D

A diagnosis of tuberculosis involves A) chest X-ray.B) acid-fast stain of sputum.C) sputum culture.D) tuberculin skin test.E) All of the choices are correct.

E

All of the following are true about diphtheria toxin, except A) it inhibits cellular protein synthesis.B) it must be neutralized with antitoxin.C) it primarily targets the heart and nerves.D) it is an exotoxin.E) antitoxin (DAT) comes from immunized human plasma donors.

E

All of the following body sites may beaffected by diphtheria, except A) the pharynx.B) the heart.C) the peripheral and cranial nerves.D) the skin.E) All of the choices are correct.

E

All of the following pertain to listeriosis, except A) it causes symptoms of fever, diarrhea, and sore throat.B) it causes a serious septicemia and meningitis in the elderly, immunocompromised, and infants.C) intrauterine infection usually results in fetal death.D) adequate pasteurization and thorough cooking of food can improve prevention.E) enterotoxin of the organism causes symptoms.

E

All of the following pertain to tuberculosis, except A) live bacilli can remain dormant in the lungs and reactivate later in life.B) symptoms of active TB include low-grade fever, coughing, fatigue, weight loss, and night sweats.C) lung infection can disseminate to many other organs in extrapulmonary TB.D) the BCG vaccine is used in other countries.E) antimicrobials cannot treat and cure tuberculosis.

E

Anthrax is A) a zoonosis.B) transmitted by contact, inhalation, and ingestion.C) a disease that, in humans, can cause a rapidly fatal toxemia and septicemia.D) only seen sporadically in the United States.E) All of the choices are correct.

E

Fish tankgranuloma is caused by A) Mycobacterium avium complex (MAC).B) Mycobacterium kansasii.C) Mycobacterium scrofulaceum.D) Mycobacterium fortuitum complex.E) Mycobacterium marinum.

E

Treatment and control of anthrax include A) use of antimicrobics, such as ciprofloxacin for active cases.B) vaccination of livestock.C) toxoid for military and those with occupational exposure.D) proper disposal of animals that have died from anthrax.E) All of the choices are correct.

E

Which of the following is/are characteristic of Multibacillary Hansen's disease? A) Granulomatous thickenings and folds of the skin may develop.B) Lepromatous leprosy is the most disfiguring form of the disease.C) The pathogen grows extensively in cooler body areas, such as nose, ears, testes.D) Complications include secondary infections, kidney, or respiratory failure.E) All of the choices are correct.

E

Which of the following may be recommended for treating gangrene? A) Debridement of the woundB) Hyperbaric chamberC) Amputation of affected limbD) Rigorous cleansing of deep woundsE) All of the choices are correct.

E

Which of the following pertains to both tetanus and food-borne botulism? A) It can be treated with antibiotics.B) It is caused by enterotoxins of the pathogen.C) Exotoxin blocks acetylcholine release.D) Nausea and diarrhea are symptoms.E) Treatment involves antitoxin therapy.

E