Question 1

Of infectious diseases, pneumonia is a major killer in the general population.

Accepted Answer

A) True 
 B)False  True

Question 2

Why is Legionella pneumophila detected using immunofluorescence?

Accepted Answer

A)  It is a virus. 
B)  It stains poorly with conventional dyes. 
C)  It is Gram-non-reactive. 
D)  It is an acid-fast bacterium. 
E)  It lacks a peptidoglycan cell wall. 
A)  It is a virus. 
B)  It stains poorly with conventional dyes. 
C)  It is Gram-non-reactive. 
D)  It is an acid-fast bacterium. 
E)  It lacks a peptidoglycan cell wall. B

Question 3

The spread of mycoplasma is through

Accepted Answer

A)  inhalation of infected droplets. 
B)  the fecal-oral route. 
C)  an insect vector. 
D)  a fomite such as a towel. 
E)  opportunistic normal microbiota. 
A)  inhalation of infected droplets. 
B)  the fecal-oral route. 
C)  an insect vector. 
D)  a fomite such as a towel. 
E)  opportunistic normal microbiota. A

Question 4

Why did it take so long to understand that L. pneumophila is the cause of a respiratory tract infection?

Accepted Answer

A)  It stains poorly and is difficult to detect. 
B)  It has fastidious growth requirements and is difficult to culture. 
C)  It is extremely rare in nature and is seldom present in a population. 
D)  It has fastidious growth requirements and is difficult to culture AND it stains poorly and is difficult to detect. 
E)  It is extremely small and can only be detected using electron microscopy AND it is extremely rare in nature and is seldom present in a population. 
A)  It stains poorly and is difficult to detect. 
B)  It has fastidious growth requirements and is difficult to culture. 
C)  It is extremely rare in nature and is seldom present in a population. 
D)  It has fastidious growth requirements and is difficult to culture AND it stains poorly and is difficult to detect. 
E)  It is extremely small and can only be detected using electron microscopy AND it is extremely rare in nature and is seldom present in a population.

Question 5

Which of the following does NOT explain why a patient with Klebsiella pneumonia is more likely to die than one with pneumococcal pneumonia?

Accepted Answer

A)  Treatment options for Klebsiella pneumonia are limited because the causative agent is resistant to many antibiotics. Pneumococcal pneumonia can be treated with antibiotics such as penicillin. 
B)  The causative agent of Klebsiella pneumonia is Gram-negative and may cause septic shock. Streptococcus pneumoniae is a Gram-positive bacterium so does not have endotoxin. 
C)  The most severe types of Pneumococcal pneumonia can be prevented with the PPSV23 vaccine. There is no vaccine that protects against Klebsiella pneumonia. 
D)  Klebsiella pneumoniae causes lung abscesses which may result in the death of the patient. Pneumococcal pneumonia does not result in permanent lung damage. 
E)  All of these statements explain why Klebsiella pneumonia is more frequently fatal than pneumococcal pneumonia. 
A)  Treatment options for Klebsiella pneumonia are limited because the causative agent is resistant to many antibiotics. Pneumococcal pneumonia can be treated with antibiotics such as penicillin. 
B)  The causative agent of Klebsiella pneumonia is Gram-negative and may cause septic shock. Streptococcus pneumoniae is a Gram-positive bacterium so does not have endotoxin. 
C)  The most severe types of Pneumococcal pneumonia can be prevented with the PPSV23 vaccine. There is no vaccine that protects against Klebsiella pneumonia. 
D)  Klebsiella pneumoniae causes lung abscesses which may result in the death of the patient. Pneumococcal pneumonia does not result in permanent lung damage. 
E)  All of these statements explain why Klebsiella pneumonia is more frequently fatal than pneumococcal pneumonia.

Question 6

Which is more likely to happen-antigenic DRIFT, or antigenic SHIFT-and why?

Accepted Answer

A)  Antigenic DRIFT, since infection with only a single virus strain is required, and the random mutations happen as the virus replicates in the infected person's cells. 
B)  Antigenic SHIFT, since infection with only a single virus strain is required, and the random mutations happen as the virus replicates in the infected person's cells. 
C)  Antigenic DRIFT, since infection with only a single virus strain is required and random mutations occur more readily in this situation than if two virus strains are present. 
D)  Antigenic SHIFT, since multiple viruses in a cell at once means more RNA polymerase to copy the RNA, and therefore more possibilities for mistakes to be made (leading to mutations). 
E)  Antigenic drift and antigenic shift occur at the same frequency. Genetic change is just as likely to occur if one viral strain or more than one strain is/are present. 
A)  Antigenic DRIFT, since infection with only a single virus strain is required, and the random mutations happen as the virus replicates in the infected person's cells. 
B)  Antigenic SHIFT, since infection with only a single virus strain is required, and the random mutations happen as the virus replicates in the infected person's cells. 
C)  Antigenic DRIFT, since infection with only a single virus strain is required and random mutations occur more readily in this situation than if two virus strains are present. 
D)  Antigenic SHIFT, since multiple viruses in a cell at once means more RNA polymerase to copy the RNA, and therefore more possibilities for mistakes to be made (leading to mutations). 
E)  Antigenic drift and antigenic shift occur at the same frequency. Genetic change is just as likely to occur if one viral strain or more than one strain is/are present.

Question 7

Pneumonias are inflammatory diseases of the lung in which fluid fills the alveoli.

Accepted Answer

A) True 
 B)False

Question 8

How do adenoviruses avoid the adaptive immune system?

Accepted Answer

A)  They cloak themselves with a hyaluronic acid capsule. 
B)  They interfere with antigen presentation on MHC class I molecules. 
C)  They synthesize C5a peptidase. 
D)  They block interferon and antiviral protein production. 
E)  They interfere with antigen presentation on MHC class II molecules. 
A)  They cloak themselves with a hyaluronic acid capsule. 
B)  They interfere with antigen presentation on MHC class I molecules. 
C)  They synthesize C5a peptidase. 
D)  They block interferon and antiviral protein production. 
E)  They interfere with antigen presentation on MHC class II molecules.

Question 9

Which of the following are considered diseases of the lower respiratory tract?

Accepted Answer

A)  Diphtheria and pneumonia 
B)  Influenza and diphtheria 
C)  Tuberculosis and pneumonia 
D)  Common cold and tuberculosis 
E)  Influenza and tuberculosis 
A)  Diphtheria and pneumonia 
B)  Influenza and diphtheria 
C)  Tuberculosis and pneumonia 
D)  Common cold and tuberculosis 
E)  Influenza and tuberculosis

Question 10

Most colds are probably caused by

Accepted Answer

A)  rhinovirus. 
B)  S. aureus. 
C)  Pseudomonas sp. 
D)  E. coli. 
E)  varicella. 
A)  rhinovirus. 
B)  S. aureus. 
C)  Pseudomonas sp. 
D)  E. coli. 
E)  varicella.

Question 11

You are an RN working in the emergency department (ED) at a major hospital in New York City. During one shift, you see two patients who are exhibiting coughing with blood-containing sputum, and shortness of breath. Both patients report that they have experienced headaches, muscle aches, high fever, confusion, and shaking chills in the days preceding their ED visit. One of the patients also has some digestive tract symptoms including diarrhea, abdominal pain, and vomiting. You discover that the patients live in the same apartment building, although they do not know each other. You suspect that they have a type of pneumonia, and given the circumstances, think it may be legionellosis. You read up on this disease to refresh your memory about it.
-L. pneumophila was unrecognized as the causative agent of legionellosis for a long time. Why is this?

Accepted Answer

A)  L. pneumophila both stains poorly with common methods, and is difficult to culture in the laboratory. 
B)  The organism is fastidious and is difficult to culture in the laboratory. 
C)  L. pneumophila stains poorly with common methods, so is difficult to detect. 
D)  L. pneumophila has no surface antigens and thus cannot be stained with fluorescence. 
E)  There is no way to grow L. pneumophila in vitro; this organism can only be cultivated in cell cultures or viruses. 
A)  L. pneumophila both stains poorly with common methods, and is difficult to culture in the laboratory. 
B)  The organism is fastidious and is difficult to culture in the laboratory. 
C)  L. pneumophila stains poorly with common methods, so is difficult to detect. 
D)  L. pneumophila has no surface antigens and thus cannot be stained with fluorescence. 
E)  There is no way to grow L. pneumophila in vitro; this organism can only be cultivated in cell cultures or viruses.

Question 12

Which is used in the vaccination for C. diphtheriae?

Accepted Answer

A)  Protein A 
B)  M protein 
C)  Lipopolysaccharide 
D)  Intact bacteria 
E)  Exotoxin 
A)  Protein A 
B)  M protein 
C)  Lipopolysaccharide 
D)  Intact bacteria 
E)  Exotoxin

Question 13

Rebecca Lancefield showed that almost all the strains of beta-hemolytic streptococci from human infections

Accepted Answer

A)  could cause rheumatic fever. 
B)  had the same cell wall carbohydrate "A." 
C)  had variable cell wall carbohydrates. 
D)  responded to penicillin. 
E)  had the same cell wall carbohydrate "beta." 
A)  could cause rheumatic fever. 
B)  had the same cell wall carbohydrate "A." 
C)  had variable cell wall carbohydrates. 
D)  responded to penicillin. 
E)  had the same cell wall carbohydrate "beta."

Question 14

Which is more dangerous to human beings: antigenic DRIFT or antigenic SHIFT?

Accepted Answer

A)  Antigenic DRIFT, since this produces the quickest and largest degree of changes in the virus structure  and we may not have immunity against it. 
B)  Antigenic SHIFT, since this produces the quickest and largest degree of changes in the virus structure and we may not have immunity against it. 
C)  Antigenic DRIFT; the small changes make the virus look like something we already have an immune response in place for, but we actually don't, letting the virus hide from the immune responses for a longer period of time. 
D)  Antigenic SHIFT; the process completely changes the virus, allowing it to jump from one species to another (such as from birds into humans). As such, we have no responses in place for the new virus. 
E)  These are equally dangerous. In both cases, major genetic and phenotypic changes occur in the virus, which means that people have absolutely no immune responses in place for dealing with the infection. 
A)  Antigenic DRIFT, since this produces the quickest and largest degree of changes in the virus structure  and we may not have immunity against it. 
B)  Antigenic SHIFT, since this produces the quickest and largest degree of changes in the virus structure and we may not have immunity against it. 
C)  Antigenic DRIFT; the small changes make the virus look like something we already have an immune response in place for, but we actually don't, letting the virus hide from the immune responses for a longer period of time. 
D)  Antigenic SHIFT; the process completely changes the virus, allowing it to jump from one species to another (such as from birds into humans). As such, we have no responses in place for the new virus. 
E)  These are equally dangerous. In both cases, major genetic and phenotypic changes occur in the virus, which means that people have absolutely no immune responses in place for dealing with the infection.

Question 15

Which of the following statements regarding resistance in Klebsiella species is False?

Accepted Answer

A)  β-lactamase confers resistance to β-lactam antibiotics such as penicillin. 
B)  Extended-spectrum β-lactamase (ESBL) confers resistance to many of the cephalosporins. 
C)  Carbapenemase confers resistance to carbapenems as well as other β-lactam drugs. 
D)  There are few effective treatments available for carbapenem-resistant K. pneumoniae infections. 
E)  Strains of Klebsiella that produce β-lactamase are resistant to penicillin but will respond to all cephalosporins. 
A)  β-lactamase confers resistance to β-lactam antibiotics such as penicillin. 
B)  Extended-spectrum β-lactamase (ESBL) confers resistance to many of the cephalosporins. 
C)  Carbapenemase confers resistance to carbapenems as well as other β-lactam drugs. 
D)  There are few effective treatments available for carbapenem-resistant K. pneumoniae infections. 
E)  Strains of Klebsiella that produce β-lactamase are resistant to penicillin but will respond to all cephalosporins.

Question 16

Which of the following interferes with phagocytosis of S. pyogenes?

Accepted Answer

A)  Hyaluronic acid capsule 
B)  M protein 
C)  C5a peptidase 
D)  Protein G 
E)  All of the answer choices are correct. 
A)  Hyaluronic acid capsule 
B)  M protein 
C)  C5a peptidase 
D)  Protein G 
E)  All of the answer choices are correct.

Question 17

Otitis media probably develops from an infection that spread

Accepted Answer

A)  from the outer ear to the middle ear. 
B)  from the sensory neurons of the middle ear. 
C)  upward through the Eustachian tube. 
D)  through the tympanic membrane. 
E)  via the meninges. 
A)  from the outer ear to the middle ear. 
B)  from the sensory neurons of the middle ear. 
C)  upward through the Eustachian tube. 
D)  through the tympanic membrane. 
E)  via the meninges.

Question 18

The most common bacterial pathogen(s) involved with sinusitis, otitis media, and conjunctivitis is/are

Accepted Answer

A)  S. aureus AND H. influenzae. 
B)  H. influenzae AND S. pneumoniae. 
C)  H. influenzae AND S. epidermidis. 
D)  S. pneumoniae AND S. aureus. 
E)  S. epidermidis AND S. pneumoniae. 
A)  S. aureus AND H. influenzae. 
B)  H. influenzae AND S. pneumoniae. 
C)  H. influenzae AND S. epidermidis. 
D)  S. pneumoniae AND S. aureus. 
E)  S. epidermidis AND S. pneumoniae.

Question 19

Which of the following statements about otitis media is False?

Accepted Answer

A)  The causative organisms may form a biofilm, leading to chronic infections. 
B)  It is usually preceded by infections of the nasal cavity and upper pharynx. 
C)  It may sometimes spread to the membranes covering the brain, causing meningitis. 
D)  Using decongestants and antihistamines to treat otitis media is generally very effective. 
E)  Otitis media during the "flu" season can be decreased by giving the flu vaccine to infants in day-care facilities. 
A)  The causative organisms may form a biofilm, leading to chronic infections. 
B)  It is usually preceded by infections of the nasal cavity and upper pharynx. 
C)  It may sometimes spread to the membranes covering the brain, causing meningitis. 
D)  Using decongestants and antihistamines to treat otitis media is generally very effective. 
E)  Otitis media during the "flu" season can be decreased by giving the flu vaccine to infants in day-care facilities.

Question 20

The characteristic virulence factor of S. pneumoniae is

Accepted Answer

A)  a capsule. 
B)  flagella. 
C)  pili. 
D)  cilia. 
E)  A-B toxin. 
A)  a capsule. 
B)  flagella. 
C)  pili. 
D)  cilia. 
E)  A-B toxin.

Exam 21: Respiratory System Infections

Of infectious diseases, pneumonia is a major killer in the general population.

Why is Legionella pneumophila detected using immunofluorescence?

The spread of mycoplasma is through

Why did it take so long to understand that L. pneumophila is the cause of a respiratory tract infection?

Which of the following does NOT explain why a patient with Klebsiella pneumonia is more likely to die than one with pneumococcal pneumonia?

Which is more likely to happen-antigenic DRIFT, or antigenic SHIFT-and why?

Pneumonias are inflammatory diseases of the lung in which fluid fills the alveoli.

How do adenoviruses avoid the adaptive immune system?

Which of the following are considered diseases of the lower respiratory tract?

Most colds are probably caused by

Which is used in the vaccination for C. diphtheriae?

Rebecca Lancefield showed that almost all the strains of beta-hemolytic streptococci from human infections

Which is more dangerous to human beings: antigenic DRIFT or antigenic SHIFT?

Which of the following statements regarding resistance in Klebsiella species is False?

Which of the following interferes with phagocytosis of S. pyogenes?

Otitis media probably develops from an infection that spread

The most common bacterial pathogen(s) involved with sinusitis, otitis media, and conjunctivitis is/are

Which of the following statements about otitis media is False?

The characteristic virulence factor of S. pneumoniae is

Humans and the Microbial World

The Molecules of Life

Microscopy and Cell Structure

Dynamics of Microbial Growth

Control of Microbial Growth

Microbial Metabolism: Fueling Cell Growth

The Blueprint of Life, from DNA to Protein

Bacterial Genetics

Biotechnology

Identifying and Classifying Microorganisms

The Diversity of Bacteria and Archaea

The Eukaryotic Members of the Microbial World

Viruses, Viroids, and Prions

The Innate Immune Response

The Adaptive Immune Response

Host-Microbe Interactions

Immunological Disorders

Applications of Immune Responses

Epidemiology

Antimicrobial Medications

Skin Infections

Wound Infections

Digestive System Infections

Blood and Lymphatic Infections

Nervous System Infections

Genitourinary Tract Infections

Microbial Ecology

Environmental Microbiology: Treatment of Water, Wastes, and Polluted Habitats

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