MiBi Ch. 22

The figure shows a frontal cross-section of a human head. The arrow points at the meatus, which goes from the middle ear deeper and down.

The structure indicated by the arrow connects the middle ear to what part of the respiratory system?

-trachea
-pharynx
-nasal cavity
-larynx
-sinuses

Which of the following is part of the upper respiratory system?

-alveoli
-bronchi
-pharynx
-trachea
-larynx

Which of the following is an opportunistic pathogen commonly present in the nasal cavity as a member of the microbiota?

-Staphylococcus aureus
-Pneumocystis jiroveci
-Veillonella species
-Legionella pneumophilia
-Bordetella pertussis

True or False?

Staphylococcus aureus is part of the upper respiratory microbiome.

The figure shows a side cross-section of a human head with internal cavities shown. The outgrowth of the cavity somewhere between the neck and head is signed A.

The structure indicated by the letter "A" is the (pharynx/larynx/epiglottis).

If an individual was diagnosed with inhalation anthrax, what would have been their early symptoms?

-sore throat, lower grade fever, muscle aches, cough
-sore throat, cough, and massive sputum production
-severe cough, nausea, vomiting, fainting, confusion, lethargy
-high fever, headache, delirium

Which of the following causes the characteristic palisade arrangement of Corynebacterium diphtheriae cells when viewed on a slide?

-lophotrichous flagella
-snapping division
-endospore formation
-the large glycocalyx

Which of the following traits will differentiate pathogenic streptococci found in a patient's pharynx from streptococci that are part of the normal microbiota?


-Pathogenic streptococci will be catalase positive, while others will not.
-Pathogenic streptococci will produce coagulase, while others will not.
-Pathogenic streptococci will be beta-hemolytic, while others will not.
-Pathogenic streptococci will produce beta-lactamases, while others will not

Inflammation of the pharynx with pus-filled abscesses and swollen tonsils is known as

-diphtheria.
-streptococcal pharyngitis ("strep throat").
-otitis media.
-croup.
-RSV.

The designation "group A," used to help classify Streptococcus pyogenes, refers to this bacterium's

-Lancefield antigen.
-type of streptokinase produced.
-disease associations.
-hemolysis pattern.
-M protein

Group A streptococci produce ________ which breaks down blood clots, allowing the bacteria to spread.

-M proteins
-a hyaluronic acid capsule
-streptokinase
-pyrogenic toxins
-C5a peptidase

Which of the following Streptococcus pyogenes virulence factors kills leukocytes and erythrocytes?

-the hyaluronic acid capsule
-C5a peptidase
-streptokinases
-pyrogenic toxins
-streptolysins

Pathogenic streptococci of the upper respiratory tract (such as Streptococcus pyogenes) are distinguished from non-pathogenic streptococci by

-the absence of a capsule.
-the presence of a lysogenic phage.
-no hemolytic activity.
-alpha hemolytic activity.
-beta hemolytic activity.

Diphtheria toxin kills cells by interfering with which of the following processes?

-protein synthesis
-adenylate cyclase activity
-cytoplasmic membrane function
-nucleic acid synthesis
-complement function

Which of the following statements is TRUE concerning diphtheria?

-A microscopic exam of bacterial samples is sufficient for conclusive diagnosis.
-A diffuse rash is the major sign of diphtheria.
-The signs and symptoms of the disease are directly caused by a bacterial toxin.
-The pseudomembrane is easily removed by surgery.
-No effective vaccine is available to prevent infection.

Which of the following is a common cause of otitis media?

-Pneumocystis jiroveci
-Mycobacterium tuberculosis
-Streptococcus pneumoniae
-Chlamydophila pneumoniae
-Blastomyces dermatitidis

True or False?

Haemophilus influenzae is a common cause of sinus infections.

True or False?

Otitis media is more common in adults than children because of differences in the anatomy of the head.

Otitis media is a bacterial infection of the (ear/pharynx/sinuses).

Some of the signs of scarlet fever (scarlatina) are due to the production of (pertussis/pneumolysin/pyrogenic) toxin.

Elongation factor, a protein required for eukaryotic (transcription/translation/expression), is the cellular target of the toxin produced by Corynebacterium diphtheriae.

Why is the production of a vaccine for the common cold so difficult?

-The common cold is caused by many different viruses from very different viral families.
-Cold viruses infect cells of the immune system.
-Our immune system does not respond to cold viruses.
-Cold viruses rapidly mutate

Which of the following statements is TRUE regarding the common cold?

-Cold viruses are frequently spread by contaminated fomites.
-Cold viruses reproduce most effectively at 37∘C.
-Only coronaviruses cause the common cold.
-The immune system cannot develop an effective response to cold viruses.
-The viruses can infect both the upper and lower respiratory tracts.

True or False?

The "common cold" is so common because there of the large number of viruses that cause it.

True or False?

Cold viruses are prevented from infecting most areas of the body because these areas are either too warm or too acidic.

The attachment protein for almost all rhinoviruses is (BCG/ICAM-1/IgA)

Which of the following diseases is NOT correctly matched with a diagnostic feature or test that distinguishes it?

-diphtheria: Elek test
-pertussis: pseudomembrane
-tuberculosis: presence of cords
-Streptococcus pneumoniae pneumonia: Quellung reaction

A nursing student has been given a tuberculin test prior to doing his clinical practicum at a nursing home. After about 36 hours, he notices a hard, red swelling at the test site. Which of the following is NOT a logical conclusion from this result?

-He should not be allowed to work at the nursing home, because he has an active case of tuberculosis.
-He has inactive (latent) tuberculosis.
-He was given the BCG vaccine as a child.
-One of his family members had tuberculosis

Which of the following organisms causes primary atypical pneumonia?

-Mycoplasma pneumoniae
-Klebsiella pneumoniae
-Haemophilus influenzae
-Streptococcus pneumonia

A doctor has diagnosed a patient with Legionnaires diseased based on a positive serological test for Legionella antibodies. What media should be used to grow the bacteria for further testing?

-Sabouraud agar
-blood agar
-standard nutrient agar
-buffered charcoal yeast extract agar

What is most likely to occur in a patient infected with a mutant strain of Bordetella pertussis that lacks functional adhesins?

-The bacterium would not be able to hide within blood clots.
-The bacterium would be highly pathogenic.
-The bacterium would more likely be phagocytized.
-The bacterium would be less likely to colonize the patient's lower respiratory system

Which of the following virulence factors is NOT correctly paired with its function?

-adenylate cyclase toxin: stimulates mucus production and inhibits leukocyte movement, phagocytosis, and killing
-diphtheria toxin: triggers endocytosis and blocks polypeptide synthesis in eukaryotic cells
-capsule: prevents phagocytosis
-pneumolysin: stimulates endocytosis of bacteria

Part complete
Which of the following diseases is NOT correctly matched with a pathogen that causes it?

-croup: respiratory syncytial virus
-viral pneumonia: parainfluenzaviruses 1, 2, and 3
-pertussis: Borrelia pertussis
-bronchitis: Chlamydophila pneumoniae

What is the primary determinant of virulence in Streptococcus pneumoniae?

-the presence of a polysaccharide capsule
-strain-specific teichoic acids in its cell wall
-the ability to lyse red blood cells
-the presence of a particular Lancefield antigen
-the production of pneumolysin

The majority of cases of pneumonia are caused by

-Chlamydophila pneumoniae.
-Haemophilus influenzae.
-Klebsiella pneumoniae.
-Mycoplasma pneumoniae.
-Streptococcus pneumoniae.

A pneumonia caused by Gram-positive diplococci is known as

-pleurisy.
-primary atypical pneumonia.
-pneumocystic pneumonia.
-pneumonic plague.
-pneumococcal pneumonia.

Ornithosis, a disease of birds that can be transmitted to humans, is caused by

-Yersinia pestis.
-Mycoplasma pneumoniae.
-Chlamydophila pneumoniae.
-Chlamydophila psittaci.
-Klebsiella pneumoniae

The microbe which causes primary atypical pneumonia is

-Chlamydophila pneumoniae.
-Bordetella pertussis.
-MERS.
-Mycoplasma pneumoniae.
-SARS

Neutrophils are inhibited from gathering at the site of infection by Mycobacterium tuberculosis by what virulence factor of the pathogen?

-hemolysin
-the capsule
-kinase
-mycolic acid
-cord factor

Which of the following statements is TRUE regarding tuberculosis?

- Several hundred cells are required for infection.
- It remains viable in dried aerosol droplets for up to eight months.
- The immune system is not affected by the infection.
- Only virulent strains of Mycobacterium tuberculosis produce mycolic acid.
- It occurs only in the lungs.

Strains of Mycobacterium tuberculosis called MDR are resistant to

- isoniazid.
- rifampin.
- levofloxacin.
- isoniazid and rifampin.
- levofloxacin, isoniazid and rifampin.

Bordetella pertussis produces

-dermonecrotic toxin.
-adenylate cyclase toxin.
-pyrogenic toxin.
-dermonecrotic and adenylate cyclase toxins.
-dermonecrotic, adenylate cyclase, and pyrogenic toxins.

The DTaP vaccine protects against which of the following respiratory diseases?

-pertussis
-pneumonia
-anthrax
-tuberculosis
-the common cold

Inhalation anthrax is frequently fatal even with antibiotic therapy because

-the bacteria are enclosed within a biofilm that antibiotics cannot penetrate.
-the dying cells release lipid A, triggering a severe inflammatory response.
-Bacillus anthracis is resistant to a wide range of antibiotics.the anthrax toxin triggers necrosis and severe edema of the lungs.
-it is transmitted as endospores.

Even though mycoplasmas pass through filters that normally trap bacteria, they are known to be bacteria, not viruses, because they

-synthesize peptidoglycan.
-contain both DNA and RNA.divide by binary fission.
-contain both DNA and RNA and divide by binary fission.
-synthesize peptidoglycan and divide by snapping division.

Which of the following statements is TRUE regarding infection with Mycoplasma pneumoniae?
-The causative agent attaches to ciliated cells in the respiratory tract.
-It is extremely difficult to treat.
-It is diagnosed by the appearance of typical "fried-egg" colonies on agar.
-It causes disease which is usually severe enough to require hospitalization.
-The causative agent is a fast-growing Gram-positive bacillus.

Which of the following factors is primarily responsible for the ability of Mycobacterium tuberculosis to survive long periods of time in dried droplets of respiratory aerosols?

-production of cord factor
-pyrogenic toxin
-the presence of mycolic acid in the cell wall
-the presence of LPS in the outer membrane
-formation of tubercles

A nursing student develops a positive reaction to the tuberculin skin test. A history reveals possible exposure to patients with tuberculosis. A sputum sample is acid-fast negative. When asked for vaccination records, the student reports that childhood vaccination records were lost when the family emigrated from a Southeast Asian country. What is the best explanation for the test results?

-The student has been infected with Mycobacterium tuberculosis.
-The student has been exposed to Mycobacterium tuberculosis or was vaccinated with BCG vaccine.
-The student has been exposed to Mycobacterium tuberculosis.
-The student is not infected.
-No conclusion is possible with the information provided.

Legionella pneumophila is an opportunistic pathogen that

-is capable of forming endospores.
-is part of the microbiome of the lower respiratory system.
-is a disease of birds transmissible to humans.
-survives in the environment as an intracellular parasite of a protozoan.
-is part of the microbiota of the nasal cavity which occasionally invades the lungs.

A woman who breeds parrots develops a fever and cough, and begins to have difficulty breathing. Small Gram-negative bacteria are detected inside cells of a sputum sample. Which of the following diseases is she likely to have contracted?

-influenza
-histoplasmosis
-ornithosis
-primary atypical pneumonia
-inhalation anthrax

True or False?

Pleurisy is the accumulation of pus in the lungs.

True or False?

Klebsiella pneumoniae is a leading cause of HAP infections.

True or False?

Macrophages effectively phagocytize and kill Mycobacterium tuberculosis.

A key diagnostic sign of diphtheria is the presence of the ______ (pseudomembrane/pharyngitis/rash/tubercle).

The smallest free-living microbes are _________ (mycobacteria/mycoplasmas/Chlamydophila).

Recent outbreaks of multidrug-resistant HAP are primarily caused by members of the genus_______ (Bordetella/ Klebsiella/Mycobacteria), Gram-negative opportunists.

A type of pneumonia in which the alveoli and bronchioles become filled with pus is _______ (emphysema/empyema/pleurisy).

The mycoplasmas have been successively classified as viruses, Gram-negative bacteria, and Gram-positive bacteria largely due to the lack of cell _______(membranes/walls/RNA) in their structure.

When Mycobacterium tuberculosis spreads to sites such as the bone marrow and spleen it results in ______ (disseminated/secondary/reactivated) tuberculosis.

Strains of Mycobacterium tuberculosis designated as ______ (BCG/MDR/XDR) strains are resistant in vitro to three or more antitubercular drugs in addition to isoniazid and rifampin.

Which of the following is NOT true of influenza?

-Antigenic drift is more likely to result in a major epidemic than is antigenic shift.
-Neuraminidase spikes on the influenzavirus hydrolyze mucus, allowing the virus to access the epithelial cells in the lung.
-The presence of fever distinguishes influenza from a cold.
-Influenzaviruses can remain infective for up to eight hours once they are outside the body.

Which of the following is the causative agent of SARS?

-coronavirus
-orthomyxovirus
-bunyavirus
-paramyxovirus

A farmer in Arizona has a sudden onset of fever and muscle aches in his legs and trunk, followed by nausea, vomiting, and diarrhea. His doctor discovers that his leukocyte count is high, platelet count is low, and his blood pressure is dropping. The doctor immediately orders hospitalization. What is the most likely diagnosis?

-histoplasmosis
-Pneumocystis pneumonia
-hantavirus pulmonary syndrome
-RSV infection

What distinguishes influenza from the common cold?
Nasal congestion

-Cough
-Fever
-Malaise
-Pharyngitis

A recently retired man appears at his doctor's office complaining of difficulty breathing, body aches and fatigue. He is also running a high fever and has a dry cough. He reports having just returned from a trip to the Middle East where he visited several historical sites. Test results are negative for a rapid test for influenza A. No bacteria are visible in a microscopic exam of his sputum. Which of the following is a likely explanation?

-coronavirus respiratory syndrome
-pertussis
-primary atypical pneumonia
-valley fever
-inhalation anthrax

The disease known as "Croup" is often a result of infection with which of the following?

-Mycoplasma pneumoniae
-influenzavirus
-Bordetella pertussis
-respiratory syncytial virus
-hantavirus

Limiting exposure to rodents and their waste is an important means of preventing

-Hantavirus pulmonary syndrome.
-histoplasmosis.
-inhalational anthrax.
-coccidioidomycosis.
-bronchiolitis.

A new vaccine for the upcoming flu season is developed from an influenza isolate designated A/Shanghai/2/2013(H7N9). This nomenclature means the isolate is

-a type A with antigens HA 7 and NA 9 isolated in Shanghai in February 2013.
-the second type A strain with HA 7 and NA 9 antigens isolated in Shanghai in 2013.
-a type B strain with antigens HA 7 and NA 9, first isolated in February 2013.
-a type A with 7 HA antigens and 9 NA antigens isolated in Shanghai in February 2013.
-a hybrid of 2 type As combining 7 HA and 9 NA antigens, created in February 2013.

A young man who works on a ranch and lives in the log bunkhouse experiences sudden fever with muscle aches. A few days later he begins to cough and have difficulty breathing, and goes to an urgent care clinic. His blood pressure is low. A blood sample reveals a low platelet count. A Gram stain of a sputum sample shows only a few small bacteria present. Which of the following is the most likely infecting agent?

-Mycoplasma pneumonia
-Bacillus anthracis
-Histoplasma capsulatum
-Hantavirus
-influenza

True or False?

Hantavirus pulmonary syndrome can be transmitted from person-to-person and from rodents to humans.

A major change in the surface glycoproteins of influenza A, which occurs every 10 years on average, is called _______ (antigenic/genetic/protein) shift.

Inflammation of the trachea and bronchi, commonly called _______ (croup/pertussis/pneumonia), is frequently caused by paramyxoviruses.

What is the geographic distribution of coccidioidomycosis?

-no particular geographic region, as it is a normal member of the respiratory microbiota
-the southeastern United States north to Canada
-the Ohio River Valley
-the southwestern United States

Which of the following would be the best preventive measure against histoplasmosis?

-scrubbing the skin with antimicrobial soap after exposure to soil
-prophylactic antimicrobial therapy
-wearing goggles when working around pigeons
-wearing a mask when working around bat or bird droppings

Why is it so difficult to prevent Pneumocystis pneumonia infections from occurring in AIDS patients?

-The disease is caused by a protozoan with resistant cysts that spread through the dust in the air.
-The disease is caused by a fungus, and it is difficult to control the spread of spores.
-It is asymptomatic, so it is difficult to detect.
-Pneumocystis jirovecii is a member of the normal microbiota for most people, and it is difficult to prevent contact with it.

A pathologist has narrowed her diagnosis of a respiratory infection to a fungal pathogen. What feature would be most likely to lead her to a diagnosis of coccidioidomycosis?

-dimorphism
-spherules
-cysts
-spiny spores

Blastomycosis results from

-inhalation of spherules.
-inhalation of fungal spores.
-contact with infected sputum.
-inhalation of respiratory droplets.
-contact with fomites.

Dust storms in arid regions of the Southwestern U.S. may lead to outbreaks of

-coccidioidomycosis.
-histoplasmosis.
-Hantavirus pulmonary syndrome.
-blastomycosis.
-Pneumocystis pneumonia.

Exposure to large accumulations of bird dropping may result in which of the following mycoses?

-histoplasmosis
-Pneumocystis pneumonia
-blastomycosis
-valley fever
-coccidioidomycosis

W
Which of the following diseases is almost diagnostic for AIDS?

-histoplasmosis
-coccidioidomycosis
-blastomycosis
-Pneumocystis pneumonia
-Hantavirus pulmonary syndrome

Why are nearly all AIDS patients at risk of developing Pneumocystis pneumonia?

-The pathogen is easily transmitted from infected persons to others.
-Pneumocystis jiroveci is commonly found in a wide variety of soils.
-Pneumocystis jiroveci is becoming a wide-spread contaminant in health care environments.
-Pneumocystis jiroveci is zoonotic in a wide range of vertebrates and exposure is unavoidable.
-Pneumocystis jiroveci is a common member of the respiratory microbiome in humans and opportunistic pathogen.

True or False?

Pneumocystis jiroveci infects only immunocompromised patients.

Exposure to soil with decaying plant material may result in pus-filled lesions characteristic of ____ (coccidioidomycosis/blastomycosis/histoplasmosis).

Which of the following is an opportunistic pathogen commonly present in the nasal cavity as a member of the microbiota?

-Pneumocystis jiroveci
-Veillonella species
-Staphylococcus aureus
-Bordetella pertussis
-Legionella pneumophilia

True or False?

All bacteria that belong to the genus Streptococcus are responsible for causing pharyngitis.

True or False?

Staphylococcus aureus is part of the upper respiratory microbiome.

True or False?

Haemophilus influenzae is a common cause of sinus infections.

Which of the following is a common cause of otitis media?

-Streptococcus pneumoniae
-Chlamydophila pneumoniae
-Blastomyces dermatitidis
-Pneumocystis jiroveci
-Mycobacterium tuberculosis

Which of the following Streptococcus pyogenes virulence factors kills leukocytes and erythrocytes?

-streptokinases
-C5a peptidase
-streptolysins
-the hyaluronic acid capsule
-pyrogenic toxins

Which of the following statements is TRUE concerning diphtheria?

-A diffuse rash is the major sign of diphtheria.
-The signs and symptoms of the disease are directly caused by a bacterial toxin.
-A microscopic exam of bacterial samples is sufficient for conclusive diagnosis.
-No effective vaccine is available to prevent infection.
-The pseudomembrane is easily removed by surgery

Which of the following virulence factors of Streptococcus pyogenes helps it prevent leukocyte migration in the host?

-Streptokinase
-Streptolysin O
-hyaluronic acid capsule
-M protein
-C5a peptidase

Group A streptococci produce ________ which breaks down blood clots, allowing the bacteria to spread.

-M proteins
-C5a peptidase
-a hyaluronic acid capsule
-streptokinase
-pyrogenic toxins

The designation "group A," used to help classify Streptococcus pyogenes, refers to this bacterium's

-M protein.
-Lancefield antigen.
-disease associations.
-type of streptokinase produced.
-hemolysis pattern

Inflammation of the pharynx with pus-filled abscesses and swollen tonsils is known as

-diphtheria.
-RSV.
-streptococcal pharyngitis ("strep throat").
-croup.
-otitis media.

Diphtheria toxin kills cells by interfering with which of the following processes?

-adenylate cyclase activity
-cytoplasmic membrane function
-protein synthesis
-complement function
-nucleic acid synthesis

True or False?

Otitis media is more common in adults than children because of differences in the anatomy of the head.

True or False?

The "common cold" is so common because of the large number of viruses that cause it.

True or False?

All viruses that cause the common cold bind to the ICAM-1 receptors found in the cells of the respiratory tract.

True or False?

Cold viruses are prevented from infecting most areas of the body because these areas are either too warm or too acidic.

Viruses that cause the common cold most effectively reproduce at

-10°C
-37°C
-0°C
-25°C
-33°C

Which of the virulence factors of Bordetella pertussis interferes with the movement of cilia in the respiratory tract cells?

-dermonecrotic toxin.
-hemagglutinin.
-pyrogenic toxin.
-adenylate cyclase toxin.
-tracheal toxin

Which of the following statements is TRUE regarding infection with Mycoplasma pneumoniae?

-The causative agent is a fast-growing Gram-positive bacillus.
-It is diagnosed by the appearance of typical "fried-egg" colonies on agar.
-It is extremely difficult to treat.
-It causes disease that is usually severe enough to require hospitalization.
-The causative agent attaches to ciliated cells in the respiratory tract.

Which of the following factors is primarily responsible for the ability of Mycobacterium tuberculosis to survive long periods of time in dried droplets of respiratory aerosols?

-pyrogenic toxin
-production of cord factor
-the presence of LPS in the outer membrane
-formation of tubercles
-the presence of mycolic acid in the cell wall

The DTaP vaccine protects against which of the following respiratory diseases?

-anthrax
-pertussis
-pneumonia
-tuberculosis
-the common cold

Pertussis is characterized by a "whoop" sound during coughing. This takes place during the ________ stage of the disease.

-paroxysmal
-catarrhal
-incubation
-convalescence
-paroxysmal and catarrhal

A nursing student develops a positive reaction to the tuberculin skin test. A history reveals possible exposure to patients with tuberculosis. A sputum sample is acid-fast negative. When asked for vaccination records, the student reports that childhood vaccination records were lost when the family emigrated from a Southeast Asian country. What is the best explanation for the test results?

-The student has been exposed to Mycobacterium tuberculosis or was vaccinated with BCG vaccine.
-The student has been infected with Mycobacterium tuberculosis.
-The student is not infected.
-The student has been exposed to Mycobacterium tuberculosis.
-No conclusion is possible with the information provided.

Inhalation anthrax is frequently fatal even with antibiotic therapy because

-the dying cells release lipid A, triggering a severe inflammatory response.
-it is transmitted as endospores.
-the bacteria are enclosed within a biofilm that antibiotics cannot penetrate.
-the anthrax toxin triggers necrosis and severe edema of the lungs.
-Bacillus anthracis is resistant to a wide range of antibiotics

Legionella pneumophila is a fastidious bacterium, which

-is part of the microbiome of the lower respiratory system.
-survives in the environment as an intracellular parasite of a protozoan.
-can be easily cultured in nutrient agar plates.
-is part of the microbiota of the nasal cavity which occasionally invades the lungs.
-is capable of forming endospores

A woman who breeds parrots develops a fever and cough, and begins to have difficulty breathing. Small Gram-negative bacteria are detected inside cells of a sputum sample. Which of the following diseases is she likely to have contracted?

-primary atypical pneumonia
-influenza
-inhalation anthrax
-histoplasmosis
-ornithosis

Even though mycoplasmas pass through filters that normally trap bacteria, they are known to be bacteria, not viruses, because they

-contain both DNA and RNA and divide by binary fission.
-synthesize peptidoglycan and divide by snapping division.
-divide by binary fission.
-contain both DNA and RNA.
-synthesize peptidoglycan

Neutrophils are inhibited from gathering at the site of infection by Mycobacterium tuberculosis by what virulence factor of the pathogen?

-the capsule
-cord factor
-kinase
-hemolysin
-mycolic acid

Strains of Mycobacterium tuberculosis called MDR are resistant to

-levofloxacin.
-isoniazid.
-rifampin.
-isoniazid and rifampin.
-levofloxacin, isoniazid and rifampin

Which of the following statements is TRUE regarding tuberculosis?

-Several hundred cells are required for infection.
-The immune system is not affected by the infection.
-It remains viable in dried aerosol droplets for up to eight months.
-Only virulent strains of Mycobacterium tuberculosis produce mycolic acid.
-It occurs only in the lungs.

Ornithosis, a disease of birds that can be transmitted to humans, is caused by

-Mycoplasma pneumoniae.
-Yersinia pestis.
-Klebsiella pneumoniae.
-Chlamydophila pneumoniae.
-Chlamydophila psittaci

Which of the following is FALSE for Mycoplasma pneumoniae?

-It has sterols in its cell membrane.
-It is the causative agent of walking pneumonia.
-It is a pleomorphic bacterium.
-It causes seasonal pneumonia.
-Infections are treated using erythromycin.

The majority of cases of pneumonia are caused by

-Streptococcus pneumoniae.
-Klebsiella pneumoniae.
-Mycoplasma pneumoniae.
-Chlamydophila pneumoniae.
-Haemophilus influenzae

What is the primary determinant of virulence in Streptococcus pneumoniae

-the ability to lyse red blood cells
-the presence of a polysaccharide capsule
-the production of pneumolysin
-strain-specific teichoic acids in its cell wall
-the presence of a particular Lancefield antigen

Which of the following classes of antibodies is found in the mucosal secretions that help remove Streptococcus pneumoniae and other mucosal pathogens?

-IgG
-IgD
-IgA
-IgE
-IgM

True or False?

Klebsiella pneumoniae is a leading cause of HAP infections.

True or False?

Pleurisy is the accumulation of pus in the lungs.

True or False?

Macrophages effectively phagocytize and kill Mycobacterium tuberculosis.

Limiting exposure to rodents and their waste is an important means of preventing

-Hantavirus pulmonary syndrome.
-bronchiolitis.
-histoplasmosis.
-inhalational anthrax.
-coccidioidomycosis.

The disease known as "Croup" is often a result of infection with which of the following?

-Mycoplasma pneumoniae
-respiratory syncytial virus
-Bordetella pertussis
-influenza virus
-hantavirus

What distinguishes influenza from the common cold?

-Cough
-Pharyngitis
-Malaise
-Nasal congestion
-Fever

A new vaccine for the upcoming flu season is developed from an influenza isolate designated A/Shanghai/2/2013(H7N9). This nomenclature means the isolate is

-the second type A strain with HA 7 and NA 9 antigens isolated in Shanghai in 2013.
-a type B strain with antigens HA 7 and NA 9, first isolated in February 2013.
-a type A with 7 HA antigens and 9 NA antigens isolated in Shanghai in February 2013.
-a hybrid of 2 type A combining 7 HA and 9 NA antigens, created in February 2013.
-a type A with antigens HA 7 and NA 9 isolated in Shanghai in February 2013.

A recently retired man appears at his doctor's office complaining of difficulty breathing, body aches and fatigue. He is also running a high fever and has a dry cough. He reports having just returned from a trip to the Middle East where he visited several historical sites. Test results are negative for a rapid test for influenza A. No bacteria are visible in a microscopic exam of his sputum. Which of the following is a likely explanation?

-valley fever
-inhalation anthrax
-pertussis
-coronavirus respiratory syndrome
-primary atypical pneumonia

True or False?

Hantavirus inhibits interferon response using a viral protein, allowing the virus to keep infecting host cells.

Exposure to large accumulations of bird dropping may result in which of the following mycoses?

-valley fever
-blastomycosis
-histoplasmosis
-Pneumocystis pneumonia
-coccidioidomycosis

Blastomycosis results from

-inhalation of respiratory droplets.
-inhalation of fungal spores.
-contact with fomites.
-contact with infected sputum.
-inhalation of spherules.

Dust storms in arid regions of the Southwestern U.S. may lead to outbreaks of

-Hantavirus pulmonary syndrome.
-Pneumocystis pneumonia.
-histoplasmosis.
-blastomycosis.
-coccidioidomycosis

Why are nearly all AIDS patients at risk of developing Pneumocystis pneumonia?

-The pathogen is easily transmitted from infected persons to others.
-Pneumocystis jiroveci is commonly found in a wide variety of soils.
-Pneumocystis jiroveci is becoming a widespread contaminant in health care environments.
-Pneumocystis jiroveci is a common member of the respiratory microbiome in humans and opportunistic pathogen.
-Pneumocystis jiroveci is zoonotic in a wide range of vertebrates and exposure is unavoidable.

Which of the following diseases is almost diagnostic for AIDS?

-blastomycosis
-Pneumocystis pneumonia
-Hantavirus pulmonary syndrome
-coccidioidomycosis
-histoplasmosis

True or False?

Pneumocystis jiroveci infects only immunocompromised patients.

What is unique about Streptococcus pyogenes strains that cause scarlet fever?

-They have flagella.
-They have M protein, which inhibits complement proteins.
-They carry a lysogenic bacteriophage.
-They have Lancefield antigens

What effect do pyrogenic toxins have?

-They lyse red and white blood cells.
-They camouflage bacteria to protect them from phagocytosis.
-They kill cells in the throat.
-They cause fever.

A pseudomembrane in the back of the throat is a sign of which disease?

-Strep throat
-Rhinosinusitis
-Diphtheria
-Common cold

Why is it necessary to test for beta-hemolytic streptococcal strains to diagnose strep throat?

-To determine the best antibiotics to use against the infection
-Streptococcal bacteria are abundant normal microbiota in respiratory samples.
-Gram stains aren't accurate enough to identify the causal agent of strep throat.
-To determine whether the strain has the pyrogenic toxin that can lead to scarlet fever

Why do rhinoviruses typically cause only mild upper respiratory disease and do not affect the lungs?

-The cells of the lower respiratory tract do not have the correct receptors.
-The ciliary escalator prevents the virus from entering the lower respiratory tract.
-Alveolar macrophages in the lungs prevent rhinovirus from affecting the lower respiratory tract.
-The temperature in the lungs is too high.

Which is the most common type of pneumonia?

-Mycoplasmal pneumonia
-Ventilator-associated pneumonia
-Staphylococcal pneumonia
-Pneumococcal pneumonia

What is the best way to prevent pneumococcal pneumonia?

-Protection against exposure to respiratory droplets
-Immunization
-Giving prophylactic penicillin to high-risk patients
-Good hand hygiene

Why is mycoplasmal pneumonia also referred to as "walking pneumonia"?

-Patients contract this disease from walking around contagious people.
-It is named after Dr. Walking, who discovered the cause of this disease.
-The pathogen travels so quickly from the upper to the lower respiratory tract that it is said to be "walking" into the lungs.
-The symptoms are mild.

What is the natural reservoir of Legionella pneumophila?

-Air conditioning ducts
-Aquatic bacteria
-Freshwater amoebas
-Humans

How is legionellosis different from most other forms of pneumonia?

-It infects only healthy people rather than those who have a compromised immune system.
-It is not communicable.
-It is rarely fatal, compared to other forms of pneumonia.
-It is preventable by immunization

What role does cord factor play in the virulence of Mycobacterium tuberculosis?

-It increases resistance to antibiotics.
-It inhibits migration of neutrophils.
-It makes mycobacteria divide faster, decreasing the generation time.
-It enables intracellular bacterial growth

What is a tubercle?

-A group of T lymphocytes surrounding Mycobacterium tuberculosis cells
-A group of bacteria, of which the outer layer dies, providing protection to bacteria deeper inside the group
-A cluster of tightly packed macrophages surrounding Mycobacterium tuberculosis bacteria
-A leftover alveolus after death due to Mycobacterium tuberculosis infection

How does pertussis toxin result in an increase of infected cells?

-It causes the characteristic whooping cough that takes the bacteria from the upper respiratory tract to the lower respiratory tract.
-It increases the ability of the Bordetella pertussis bacteria to divide.
-It causes cells to synthesize more receptors to which the Bordetella pertussis bacteria can attach.
-It attracts additional Bordetella pertussis bacteria through chemotaxis

How are the manifestations of inhalational anthrax different from those of influenza?

-Inhalational anthrax causes coughing, whereas influenza does not.
-Chest discomfort is a symptom of anthrax, but not influenza.
-Rhinorrhea is a sign of inhalational anthrax, but not influenza.
-Inhalational anthrax does not cause a fever, whereas influenza does.

What is the role of hemagglutinin in influenza infections?

-It is an RNA polymerase that replicates the influenzavirus genome once a cell is invaded.
-Hemagglutinin binds to epithelial cells, triggering endocytosis of the virus.
-It forms the envelope of influenzavirus during viral release.
-Hemagglutinin hydrolyzes mucus in the lungs, allowing influenzavirus access to epithelial cells.

Consider antigenic drift and antigenic shift. Which is the reason that a new influenza vaccine is necessary every year?

-Antigenic drift only
-Antigenic shift only
-Both antigenic drift and antigenic shift
-Neither antigenic drift nor antigenic shift

Which fungal disease is found almost exclusively in the southwestern United States?

-Histoplasmosis
-Pneumocystis pneumonia
-Coccidioidomycosis
-Blastomycosis

How is histoplasmosis transmitted?

-By inhalation of spores from bird or bat droppings
-By spores that directly contact the skin
-By inhalation of spores from desert soil
-By spores entering wounds from contaminated soil

What is a physiological difference between truly pathogenic fungi and opportunistic fungal pathogens?

-At room temperature, true fungal pathogens grow as yeasts.
-They spread from skin lesions to the lungs.
-At body temperature, the true fungal pathogens grow as yeasts.
-There is wide selection of effective antifungal drugs available to treat truly pathogenic infections; whereas, there is only a single drug effective against opportunistic fungi.

What is the function of the hairs that line the nasal cavity?

A. to protect the nasal passages from excess moisture
B. to filter out large particles and microbes
C. to keep nasal passages warm
D. to propel mucus to the digestive system

What is the function of the tonsils?

A. They have no function; that is why some people have them removed.
B. to combat microbes using immune cells and
various chemicals
C. to filter out large particles and dust
D. to secrete mucus

Which genus of bacteria is NOT considered normal microbiota of the upper respiratory system?

A. Haemophilus
B. Staphylococcus
C. Neisseria
D. Veillonella

Which of the following is NOT used by group A Streptococci to survive in the body?

A. M protein
B. C5a peptidase
C. mycolic acids
D. streptokinases

How can physicians distinguish bacterial pharyngitis from viral pharyngitis?

A. Bacterial pharyngitis results in swollen lymph nodes; viral does not.
B. swabbing the throat and culturing in the lab
C. There is no way to tell.
D. serological testing

Which of the following is TRUE regarding diphtheria?

A. Rabbits are the only known source.
B. Initial diagnosis of diphtheria is based upon the presence of bacterial cells.
C. There is no known vaccine.
D. Treatment involves administration of
antitoxin before the toxin binds to cells.

What is the basis for the Elek test for a confirmatory diagnosis of diphtheria?

A. Antibodies react with diphtheria toxin present in the patient sample.
B. C. diphtheriae glows under UV light.
C. A sample of the patient's blood will not coagulate.
D. Hemolysis is seen when bacteria in a patient sample are cultured on Loeffler's medium.

Why is otitis media more common in children than in adults?

A. frequency of swimming and immersion under water
B. size and position of auditory tubes
C. failure of children to properly clean their ears
D. frequency of exposure to contaminated soil

________ describes inflammation of the lungs where alveoli and bronchioles become filled with fluid.

A. Pneumonia
B. Sinusitis
C. Pharyngitis
D. Alveolitis

Streptococcus pneumoniae has a capsule to protect it from killing by alveolar macrophages, which kill bacteria by

A. cytokines.
B. antibodies.
C. complement.
D. phagocytosis.

What class of antibody aids in clearing pneumonia-causing bacteria from the airways?

A. IgM
B. IgE
C. IgA
D. IgD

How do people acquire Legionnaires' disease?

A. person-to-person contact
B. inhaling bacteria-filled vesicles released by protozoa
C. puncture wounds
D. fecal-oral route

All of the following are true for Mycobacterium tuberculosis and tuberculosis EXCEPT

A. extensively drug-resistant strains have emerged.
B. tuberculosis is the leading disease killer in the world.
C. the bacteria are often lysed upon phagocytosis.
D. virulent strains produce cord factor.

Which of the following is TRUE for the common cold?

A. A live, attenuated vaccine is available against all cold viruses.
B. A live, attenuated vaccine is
available against adenoviruses.
C. Multi-drug antibiotic therapy is the most effective treatment.
D. A live, attenuated vaccine is currently available against rhinovirus

What is the function of the hemagglutinin spikes of the flu virus?

A. to cause blood to clot
B. to bind to epithelial cells in lungs
C. to hydrolyze mucus in the lungs
D. to bind complement proteins

What fact about the influenza virus allows the dramatic antigenic shift that generates novel strains?

A. very large size
B. enveloped
C. segmented genome
D. over 100 genes

Which statement regarding the pathogenesis of RSV infection is accurate?

A. RSV is the most common respiratory disease in healthy adults.
B. RSV is the leading cause of bronchiolitis.
C. RSV is a +ssDNA virus.
D. RSV can remain stable outside the body
for weeks.

All of the following are true of Hantavirus pulmonary syndrome (HPS) EXCEPT

A. no pharmacological treatment exists.
B. Hantavirus is a -ssRNA virus of the family Bunyaviridae.
C. transmission is through a mosquito vector.
D. there is a 50% mortality rate among diagnosed patients.

What type of mycosis is found almost exclusively in the southwestern United States and northern Mexico?

A. histoplasmosis
B. coccidioidomycosis
C. blastomycosis
D. pneumocystis

Which mycosis is basically diagnostic for AIDS?

A. histoplasmosis
B. coccidioidomycosis
C. blastomycosis
D. pneumocystis

What fungus is associated with the droppings of bats and birds?

A. Candida albicans
B. Blastomyces dermatitidis
C. Histoplasma capsulatum
D. Coccidioides immitis

Which of the following is TRUE about H. capsulatum?

A. It becomes a pathogenic yeast at 15°C.
B. It produces proteins that inhibit macrophage activation.
C. In the mold form, it produces an exotoxin.
D. It is one of the most virulent viruses ever discovered.

SARS and MERS are both caused by

A. a coronavirus.
B. type B influenza viruses.
C. a Staphylococcus bacteria.
D. pneumoviruses.