Question 1

Enlargement of which of the following structures may contribute to ear infections by interfering with normal drainage from Eustachian tubes?

Accepted Answer

A)  Nasal chamber 
B)  Nasal conchae 
C)  Adenoids 
D)  Epiglottis 
E)  Parotid glands 
A)  Nasal chamber 
B)  Nasal conchae 
C)  Adenoids 
D)  Epiglottis 
E)  Parotid glands

Question 2

Which of the following is a virulence factor of Streptococcus pyogenes?

Accepted Answer

A)  M protein 
B)  Capsule 
C)  Endotoxin AND pili 
D)  M protein AND pili 
E)  M protein AND capsule 
A)  M protein 
B)  Capsule 
C)  Endotoxin AND pili 
D)  M protein AND pili 
E)  M protein AND capsule

Question 3

Which of the following about Bacillus anthracis is True?

Accepted Answer

A)  It contains lipopolysaccharide. 
B)  It is flagellated. 
C)  It is rod-shaped. 
D)  It stains pink in the Gram stain. 
E)  It causes hemolysis on blood agar. 
A)  It contains lipopolysaccharide. 
B)  It is flagellated. 
C)  It is rod-shaped. 
D)  It stains pink in the Gram stain. 
E)  It causes hemolysis on blood agar.

Question 4

Which is True of hantavirus?

Accepted Answer

A)  It is a zoonosis involving mice. 
B)  It has three segments of single-stranded RNA. 
C)  The primary effect is to flood the lungs with fluid. 
D)  Shock and death occur in 30% of the cases. 
E)  All of the choices are correct. 
A)  It is a zoonosis involving mice. 
B)  It has three segments of single-stranded RNA. 
C)  The primary effect is to flood the lungs with fluid. 
D)  Shock and death occur in 30% of the cases. 
E)  All of the choices are correct.

Question 5

Why do some otitis media cases not respond to antibiotic treatment?

Accepted Answer

A)  About 30% of cases are caused by respiratory viruses-antibiotics do not help these cases. 
B)  Most cases are caused by bacteria that are resistant to commonly prescribed antibiotics. 
C)  Otitis media is caused by viruses that constantly undergo antigenic shift and/or antigenic drift. 
D)  The bacterial causative organisms mutate frequently, changing their antibiotic target sites. 
E)  Unless the exact causative organism is identified, it is impossible to prescribe the correct antibiotic. 
A)  About 30% of cases are caused by respiratory viruses-antibiotics do not help these cases. 
B)  Most cases are caused by bacteria that are resistant to commonly prescribed antibiotics. 
C)  Otitis media is caused by viruses that constantly undergo antigenic shift and/or antigenic drift. 
D)  The bacterial causative organisms mutate frequently, changing their antibiotic target sites. 
E)  Unless the exact causative organism is identified, it is impossible to prescribe the correct antibiotic.

Question 6

Both S. pneumoniae and K. pneumoniae use this as a virulence factor.

Accepted Answer

A)  Pili 
B)  Flagella 
C)  Capsules 
D)  Cilia 
E)  Toxins 
A)  Pili 
B)  Flagella 
C)  Capsules 
D)  Cilia 
E)  Toxins

Question 7

The pneumococcal vaccine is directed against the

Accepted Answer

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

Question 8

Your son comes home from school complaining that he is ill. He tells you he thinks he has the flu—he has a sore throat, runny nose, and a cough, and his eyes are very red. Everyone in your family received a influenza vaccine about a month ago, and as the CDC reports that this year's vaccine is approximately 70% effective, you think it is unlikely that your son does in fact have this disease. In addition, your son does not seem to have muscle aches or a headache, which generally occur with flu. Nonetheless, he does look ill and when you take his temperature, you find that he has a fever of 38.9S1U1P1oS1S1P0C. You take him to see his doctor, because you suspect that while your son likely does not have influenza, he also does not have a common cold.
-The doctor knows that your son is unlikely to have a common cold, based on which sign/symptom?

Accepted Answer

A)  Sore throat 
B)  Fever 
C)  Cough 
D)  Runny nose 
E)  Fatigue 
A)  Sore throat 
B)  Fever 
C)  Cough 
D)  Runny nose 
E)  Fatigue

Question 9

Which statement about S. pyogenes and strep throat pathogenesis is False?

Accepted Answer

A)  S. pyogenes strains that produce streptococcal pyrogenic exotoxins are lysogens. 
B)  Streptococcal pyrogenic exotoxins are A-B toxins that bind to host cells using the B portion. 
C)  Streptolysins O and S produced by S. pyogenes destroy blood cells by making holes in their cell membranes. 
D)  Spread of S. pyogenes is aided by streptokinase, an enzyme that breaks down blot clots. 
E)  The hyaluronic acid capsule of S. pyogenes helps it avoid the innate immune defenses. 
A)  S. pyogenes strains that produce streptococcal pyrogenic exotoxins are lysogens. 
B)  Streptococcal pyrogenic exotoxins are A-B toxins that bind to host cells using the B portion. 
C)  Streptolysins O and S produced by S. pyogenes destroy blood cells by making holes in their cell membranes. 
D)  Spread of S. pyogenes is aided by streptokinase, an enzyme that breaks down blot clots. 
E)  The hyaluronic acid capsule of S. pyogenes helps it avoid the innate immune defenses.

Question 10

The key virulence factor of S. pneumoniae interferes with

Accepted Answer

A)  the action of C3. 
B)  the action of C3b. 
C)  the action of C5a. 
D)  interferon. 
E)  All of the answer choices are correct. 
A)  the action of C3. 
B)  the action of C3b. 
C)  the action of C5a. 
D)  interferon. 
E)  All of the answer choices are correct.

Question 11

If you are a 20-year-old healthy young adult and you have to CHOOSE a type of pneumonia to become infected with (and you will NOT get treatment for it), which would be the "best," and why?

Accepted Answer

A)  Pneumococcal pneumonia; the causative agent doesn't destroy lung tissue and it is possible to recover completely from this disease. 
B)  Mycoplasmal pneumonia; this type of pneumonia causes the the mildest signs and symptoms and can be effectively treated when treated early. 
C)  Viral pneumonia; there are many antiviral medications that can be given for this type of pneumonia and are effective, with very few side effects. 
D)  Klebsiella pneumonia; this is the mildest form of pneumonia, can easily be treated with antibiotics, and has the shortest recovery time. 
E)  Fungal pneumonia; these types of pneumonia are very mild, remain latent, and are easily treated with antifungal medications in the majority of patients. 
A)  Pneumococcal pneumonia; the causative agent doesn't destroy lung tissue and it is possible to recover completely from this disease. 
B)  Mycoplasmal pneumonia; this type of pneumonia causes the the mildest signs and symptoms and can be effectively treated when treated early. 
C)  Viral pneumonia; there are many antiviral medications that can be given for this type of pneumonia and are effective, with very few side effects. 
D)  Klebsiella pneumonia; this is the mildest form of pneumonia, can easily be treated with antibiotics, and has the shortest recovery time. 
E)  Fungal pneumonia; these types of pneumonia are very mild, remain latent, and are easily treated with antifungal medications in the majority of patients.

Question 12

The conjuctivae

Accepted Answer

A)  have few resident bacteria. 
B)  are often covered with bacteria. 
C)  are populated with S. aureus. 
D)  are populated with S. pyogenes. 
E)  are protected by IgE. 
A)  have few resident bacteria. 
B)  are often covered with bacteria. 
C)  are populated with S. aureus. 
D)  are populated with S. pyogenes. 
E)  are protected by IgE.

Question 13

The disease characterized by the appearance of a toxin-mediated rash that causes the tongue to look like the surface of a ripe strawberry is

Accepted Answer

A)  scarlet fever. 
B)  measles. 
C)  chickenpox. 
D)  strep throat. 
E)  pharyngitis. 
A)  scarlet fever. 
B)  measles. 
C)  chickenpox. 
D)  strep throat. 
E)  pharyngitis.

Question 14

The eyes are protected from infection by

Accepted Answer

A)  the washing action of the tears and eyelids AND the use of contact lenses. 
B)  the washing action of the tears and eyelids AND the chemical action of lysozyme. 
C)  the chemical action of lysozyme AND the use of contact lenses. 
D)  the use of contact lenses AND the dryness of the eye surface. 
E)  the dryness of the eye surface AND the chemical action of lysozyme. 
A)  the washing action of the tears and eyelids AND the use of contact lenses. 
B)  the washing action of the tears and eyelids AND the chemical action of lysozyme. 
C)  the chemical action of lysozyme AND the use of contact lenses. 
D)  the use of contact lenses AND the dryness of the eye surface. 
E)  the dryness of the eye surface AND the chemical action of lysozyme.

Question 15

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.
-Which of the following is the causative agent of legionellosis?

Accepted Answer

A)  Legionella pneumophila, a fastidious Gram-negative rod. 
B)  Legionella pneumophila, an aerobic, Gram-positive rod. 
C)  Mycoplasma legionella, a pleomorphic, poorly staining coccus. 
D)  Acanthamoeba legionella, an acid-fast, anaerobic spirillum. 
E)  Acanthamoeba species, a freshwater protozoan. 
A)  Legionella pneumophila, a fastidious Gram-negative rod. 
B)  Legionella pneumophila, an aerobic, Gram-positive rod. 
C)  Mycoplasma legionella, a pleomorphic, poorly staining coccus. 
D)  Acanthamoeba legionella, an acid-fast, anaerobic spirillum. 
E)  Acanthamoeba species, a freshwater protozoan.

Question 16

Which of the following most accurately describes the pathogenesis of inhalation anthrax?

Accepted Answer

A)  EF binds to host cell membranes, forming a pore that allows PA or LF to enter the cells, where they disrupt critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema. 
B)  PA binds to host cell membranes, forming a pore that allows EF or LF to enter the cells, where they disrupt critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema. 
C)  LF binds to host cell membranes, forming a pore that allows EF or PA to enter the cells, where they disrupt critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema. 
D)  PA and EF bind to host cell membranes, forming a pore that allows LF to enter the cells, where they disrupt critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema. 
E)  EF and LF bind to host cell membranes, forming a pore that allows PA to enter the cells, where it disrupts critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema. 
A)  EF binds to host cell membranes, forming a pore that allows PA or LF to enter the cells, where they disrupt critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema. 
B)  PA binds to host cell membranes, forming a pore that allows EF or LF to enter the cells, where they disrupt critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema. 
C)  LF binds to host cell membranes, forming a pore that allows EF or PA to enter the cells, where they disrupt critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema. 
D)  PA and EF bind to host cell membranes, forming a pore that allows LF to enter the cells, where they disrupt critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema. 
E)  EF and LF bind to host cell membranes, forming a pore that allows PA to enter the cells, where it disrupts critical cell functions. This triggers a series of events that cause death of the cell resulting in pulmonary edema.

Question 17

Which step(s) of phagocytosis are avoided by Streptococcus pyogenes?

Accepted Answer

A)  Recruitment of phagocytes AND phagolysosome formation 
B)  Phototaxis AND recognition and attachment 
C)  Recruitment of phagocytes AND recognition and attachment 
D)  Phagolysosome formation 
E)  Phagolysosome formation AND lysis 
A)  Recruitment of phagocytes AND phagolysosome formation 
B)  Phototaxis AND recognition and attachment 
C)  Recruitment of phagocytes AND recognition and attachment 
D)  Phagolysosome formation 
E)  Phagolysosome formation AND lysis

Question 18

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 is a facultative intracellular parasite. How does it manipulate the immune system so as to enter host cells?

Accepted Answer

A)  The bacterial cells bind complement component C3b (an opsonin), enhancing phagocytosis. 
B)  The bacteria have macrophage invasion potentiator (Mip) that promotes their uptake by alveolar macrophages. 
C)  The bacteria cause necrosis of alveolar cells, leading to an inflammatory response. 
D)  The bacteria survive in alveolar macrophages by preventing phagosome-lysosome fusion AND the bacteria cause necrosis of alveolar cells, leading to an inflammatory response. 
E)  The bacterial cells bind complement component C3b (an opsonin), enhancing phagocytosis AND the bacteria have a surface protein (Mip) that promotes their uptake by alveolar macrophages. 
A)  The bacterial cells bind complement component C3b (an opsonin), enhancing phagocytosis. 
B)  The bacteria have macrophage invasion potentiator (Mip) that promotes their uptake by alveolar macrophages. 
C)  The bacteria cause necrosis of alveolar cells, leading to an inflammatory response. 
D)  The bacteria survive in alveolar macrophages by preventing phagosome-lysosome fusion AND the bacteria cause necrosis of alveolar cells, leading to an inflammatory response. 
E)  The bacterial cells bind complement component C3b (an opsonin), enhancing phagocytosis AND the bacteria have a surface protein (Mip) that promotes their uptake by alveolar macrophages.

Question 19

Which of the following is specifically associated with diphtheria?

Accepted Answer

A)  Pseudomembrane in throat 
B)  General malaise 
C)  Fever and sore throat 
D)  Microhemorrhages 
E)  Widespread rash 
A)  Pseudomembrane in throat 
B)  General malaise 
C)  Fever and sore throat 
D)  Microhemorrhages 
E)  Widespread rash

Question 20

Although unusually resistant to many control factors, the tubercle bacillus is easily killed by

Accepted Answer

A)  strong acids. 
B)  disinfectants. 
C)  pasteurization. 
D)  strong alkalis. 
E)  All of the answer choices are correct. 
A)  strong acids. 
B)  disinfectants. 
C)  pasteurization. 
D)  strong alkalis. 
E)  All of the answer choices are correct.

Exam 21: Respiratory System Infections

Enlargement of which of the following structures may contribute to ear infections by interfering with normal drainage from Eustachian tubes?

Which of the following is a virulence factor of Streptococcus pyogenes?

Which of the following about Bacillus anthracis is True?

Which is True of hantavirus?

Why do some otitis media cases not respond to antibiotic treatment?

Both S. pneumoniae and K. pneumoniae use this as a virulence factor.

The pneumococcal vaccine is directed against the

Which statement about S. pyogenes and strep throat pathogenesis is False?

The key virulence factor of S. pneumoniae interferes with

If you are a 20-year-old healthy young adult and you have to CHOOSE a type of pneumonia to become infected with (and you will NOT get treatment for it), which would be the "best," and why?

The conjuctivae

The disease characterized by the appearance of a toxin-mediated rash that causes the tongue to look like the surface of a ripe strawberry is

The eyes are protected from infection by

Which of the following most accurately describes the pathogenesis of inhalation anthrax?

Which step(s) of phagocytosis are avoided by Streptococcus pyogenes?

Which of the following is specifically associated with diphtheria?

Although unusually resistant to many control factors, the tubercle bacillus is easily killed by

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