Question 1

When does an untreated patient develop tertiary syphilis?

Accepted Answer

A)  Decades after the initial infection 
B)  2 to 3 years after the initial infection 
C)  1 year after the initial infection 
D)  5 years after the initial infection 
A)  Decades after the initial infection 
B)  2 to 3 years after the initial infection 
C)  1 year after the initial infection 
D)  5 years after the initial infection A

Question 2

Spirochetes are made up of all the following, except

Accepted Answer

A)  Helicobacter. 
B)  Leptospira. 
C)  Borrelia. 
D)  Treponema. 
A)  Helicobacter. 
B)  Leptospira. 
C)  Borrelia. 
D)  Treponema. A

Question 3

How are Borrelia organisms transmitted to the host?

Accepted Answer

A)  Respiratory droplets 
B)  Arthropods 
C)  Birds 
D)  Blood or body fluids 
A)  Respiratory droplets 
B)  Arthropods 
C)  Birds 
D)  Blood or body fluids B

Question 4

Leptospiral organisms are susceptible to all the following antimicrobial agents, except

Accepted Answer

A)  streptomycin. 
B)  tetracycline. 
C)  penicillin. 
D)  macrolides. 
A)  streptomycin. 
B)  tetracycline. 
C)  penicillin. 
D)  macrolides.

Question 5

What medium is used in the laboratory to grow leptospiral organisms?

Accepted Answer

A)  MacConkey 
B)  Fletcher's 
C)  Sheep blood agar 
D)  None of the above 
A)  MacConkey 
B)  Fletcher's 
C)  Sheep blood agar 
D)  None of the above

Question 6

What organism causes relapsing fever?

Accepted Answer

A)  Borrelia recurrentis 
B)  B. burgdorferi 
C)  Leptospira interrogans 
D)  C. psittaci 
A)  Borrelia recurrentis 
B)  B. burgdorferi 
C)  Leptospira interrogans 
D)  C. psittaci

Question 7

Once infected with Borrelia recurrentis, a 2- to 15-day incubation period follows where high numbers of organisms are found in the blood. The infected individual experiences high fever, rigors, severe headache, muscle pains, and weakness. This febrile period lasts for about 3 to 7 days, but ends quickly with the induction of an immune response. However, a similar but less severe course of symptoms recurs several days to weeks later. What causes this relapse?

Accepted Answer

A)  The organism systematically changes its surface antigens during the course of a single infection. 
B)  The organism produces extracellular toxins that cause the symptoms. 
C)  This organism survives inside infected cells and once the cell dies, the organism is released into the blood, causing this relapse. 
D)  This relapse occurs as the host is trying to mount the secondary antibody response. 
A)  The organism systematically changes its surface antigens during the course of a single infection. 
B)  The organism produces extracellular toxins that cause the symptoms. 
C)  This organism survives inside infected cells and once the cell dies, the organism is released into the blood, causing this relapse. 
D)  This relapse occurs as the host is trying to mount the secondary antibody response.

Question 8

What is the drug of choice for treating Borrelia infections?

Accepted Answer

A)  Aminoglycosides 
B)  Macrolides 
C)  Tetracyclines 
D)  Penicillins 
A)  Aminoglycosides 
B)  Macrolides 
C)  Tetracyclines 
D)  Penicillins

Question 9

How is congenital syphilis transmitted from the mother to her unborn child?

Accepted Answer

A)  During birth from the birth canal 
B)  During the microhemorrhages that occur as the placenta breaks away from the uterus 
C)  Crossing the placenta 
D)  None of the above 
A)  During birth from the birth canal 
B)  During the microhemorrhages that occur as the placenta breaks away from the uterus 
C)  Crossing the placenta 
D)  None of the above

Question 10

A man is taking a shower and notices a lesion on his penis that is not tender but is firm with a clean surface and raised edges. He goes to his physician. The physician orders a rapid plasmin reagin (RPR) and a dark-field microscopy. Both tests are positive. What is the probable diagnosis?

Accepted Answer

A)  Gonorrhea 
B)  Nongonococcal urethritis 
C)  Syphilis 
D)  Human papillomavirus 
A)  Gonorrhea 
B)  Nongonococcal urethritis 
C)  Syphilis 
D)  Human papillomavirus

Question 11

Where on the body is the secondary syphilis rash typically seen?

Accepted Answer

A)  Chest and back 
B)  Back and soles 
C)  Buttocks and palms 
D)  Palms and soles 
A)  Chest and back 
B)  Back and soles 
C)  Buttocks and palms 
D)  Palms and soles

Question 12

A young woman notices a red bruiselike lesion that looks like a target on her lower leg. She cannot remember getting bruised, even though she went hiking through the woods last weekend. The bruise goes away in about a week and she thinks nothing more about it. About 2 weeks later, she develops joint and bone pain, extreme fatigue, and her heart just "doesn't feel right." What disease does she have, and what antimicrobial agent is used to treat it?

Accepted Answer

A)  Lyme disease and doxycycline 
B)  Relapsing fever and macrolides 
C)  Parrot fever and penicillin 
D)  Hemorrhagic fever and gentamicin 
A)  Lyme disease and doxycycline 
B)  Relapsing fever and macrolides 
C)  Parrot fever and penicillin 
D)  Hemorrhagic fever and gentamicin

Question 13

What is a Leptospira infection called when it becomes a severe systemic disease?

Accepted Answer

A)  Niemann-Pick 
B)  Bordet-Gengou 
C)  Gaucher disease 
D)  Weil disease 
A)  Niemann-Pick 
B)  Bordet-Gengou 
C)  Gaucher disease 
D)  Weil disease

Question 14

The microscopic method of choice in detecting treponemes in clinical specimens

Accepted Answer

A)  Gram stain. 
B)  Giemsa stain. 
C)  unstained wet mounts. 
D)  dark-field microscopy. 
A)  Gram stain. 
B)  Giemsa stain. 
C)  unstained wet mounts. 
D)  dark-field microscopy.

Question 15

What is an example of a nontreponemal test?

Accepted Answer

A)  RPR 
B)  Fluorescent treponemal antibody, absorbed (FTA-ABS) 
C)  Treponema pallidum particle agglutination (TPP
A)  
D)  Microhemagglutination-Treponema pallidum (MHA-TP) 
A)  RPR 
B)  Fluorescent treponemal antibody, absorbed (FTA-ABS) 
C)  Treponema pallidum particle agglutination (TPP
A)  
D)  Microhemagglutination-Treponema pallidum (MHA-TP)

Question 16

Early-onset congenital syphilis is characterized by all the following symptoms, except

Accepted Answer

A)  osteochondritis. 
B)  anemia. 
C)  hepatosplenomegaly. 
D)  encephalitis. 
A)  osteochondritis. 
B)  anemia. 
C)  hepatosplenomegaly. 
D)  encephalitis.

Question 17

What structure is responsible for motility in spirochetes?

Accepted Answer

A)  Axiles 
B)  Periplasmic flagella 
C)  Flexible cell wall 
D)  Compressed nucleus 
A)  Axiles 
B)  Periplasmic flagella 
C)  Flexible cell wall 
D)  Compressed nucleus

Question 18

What diseases do Borrelia spp. cause?

Accepted Answer

A)  Undulant and hemorrhagic fevers 
B)  Lyme disease and parrot fever 
C)  Rocky Mountain spotted fever and relapsing fever 
D)  Lyme disease and relapsing fever 
A)  Undulant and hemorrhagic fevers 
B)  Lyme disease and parrot fever 
C)  Rocky Mountain spotted fever and relapsing fever 
D)  Lyme disease and relapsing fever

Question 19

All of the following are symptoms of tertiary syphilis, except

Accepted Answer

A)  gummas in the skin, bones, and liver. 
B)  encephalitis. 
C)  aortitis. 
D)  aortic valve insufficiency. 
A)  gummas in the skin, bones, and liver. 
B)  encephalitis. 
C)  aortitis. 
D)  aortic valve insufficiency.

Question 20

Acceptable specimens during the first week of leptospirosis include which of the following:

Accepted Answer

A)  Cerebrospinal fluid (CSF) 
B)  Blood 
C)  Urine 
D)  A and B 
A)  Cerebrospinal fluid (CSF) 
B)  Blood 
C)  Urine 
D)  A and B

Exam 23: The Spirochetes

When does an untreated patient develop tertiary syphilis?

Spirochetes are made up of all the following, except

How are Borrelia organisms transmitted to the host?

Leptospiral organisms are susceptible to all the following antimicrobial agents, except

What medium is used in the laboratory to grow leptospiral organisms?

What organism causes relapsing fever?

What is the drug of choice for treating Borrelia infections?

How is congenital syphilis transmitted from the mother to her unborn child?

A man is taking a shower and notices a lesion on his penis that is not tender but is firm with a clean surface and raised edges. He goes to his physician. The physician orders a rapid plasmin reagin (RPR) and a dark-field microscopy. Both tests are positive. What is the probable diagnosis?

Where on the body is the secondary syphilis rash typically seen?

What is a Leptospira infection called when it becomes a severe systemic disease?

The microscopic method of choice in detecting treponemes in clinical specimens

What is an example of a nontreponemal test?

Early-onset congenital syphilis is characterized by all the following symptoms, except

What structure is responsible for motility in spirochetes?

What diseases do Borrelia spp. cause?

All of the following are symptoms of tertiary syphilis, except

Acceptable specimens during the first week of leptospirosis include which of the following:

Bacterial Cell Structure, Physiology, Metabolism, and Genetics

Hostparasite Interaction

The Laboratory Role in Infection Control

Control of Microorganisms

Performance Improvement in the Microbiology Laboratory

Specimen Collection and Processing

Microscopic Examination of Materials From Infected Sites

Use of Colony Morphology for the Presumptive Identification of Microorganisms

Biochemical Identification of Gram-Negative Bacteria

Immunodiagnosis of Infectious Diseases

Applications of Molecular Diagnostics

Antimicrobial Agent Mechanisms of Action and Resistance Mechanisms

Antimicrobial Susceptibility Testing

Staphylococci

Streptococcus, Enterococcus, and Other Catalase-Negative, Gram-Positive Cocci

Aerobic Gram-Positive Bacilli

Neisseria Species and Moraxella Catarrhalis

Haemophilus, Hacek, Legionella, and Other Fastidious Gram-Negative Bacilli

Enterobacteriaceae

Vibrio, Aeromonas, and Campylobacter Species

Nonfermenting and Miscellaneous Gram-Negative Bacilli

Anaerobes of Clinical Importance

Chlamydia, Rickettsia, and Similar Organisms

Mycoplasma and Ureaplasma

Mycobacterium Tuberculosis and Nontuberculous Mycobacteria

Medically Significant Fungi

Diagnostic Parasitology

Clinical Virology

Agents of Bioterror and Forensic Microbiology

Biofilms: Architects of Disease

Upper and Lower Respiratory Tract Infections

Skin and Soft Tissue Infections

Gastrointestinal Infections and Food Poisoning

Infections of the Central Nervous System

Bacteremia and Sepsis

Urinary Tract Infections

Genital Infections and Sexually Transmitted Infections

Infections in Special Populations

Zoonotic Diseases

Ocular Infections

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