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12 Dec 2019

1. Which of the following statements concerning Pneumocystis jirovecii is FALSE?

Which of the following statements concerning Pneumocystis jirovecii is FALSE?

Infection usually causes few or no symptoms if the individual is healthy.
P. jirovecii trophozoites produce sexually by fission.
P. jirovecii has characteristics of both fungi and protozoa but is now commonly classified as a fungus.

Cysts are found in the lining of the alveoli.

2. Which of the following is responsible for epidemics of respiratory disease in infants?

Which of the following is responsible for epidemics of respiratory disease in infants?

adenovirus
influenza
Mycoplasma
rhinovirus
respiratory syncytial virus

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Related questions

The epiglottis acts as a

voice box.

filter for microorganisms and debris.

cover over the larynx.

producer of mucus.

ANSWER:

(Level 1, Objective 1)

Collectively, the nose, oral cavity, pharynx, epiglottis, and larynx make up the

nasopharynx.

oropharynx.

laryngopharynx.

upper respiratory system.

ANSWER:

(Level 1, Objective 1)

The cilia present on cells of the lower respiratory system function by:

trapping microorganisms and foreign debris.

propelling microorganisms and particles out.

preventing colonization by potential pathogens.

all of the above.

ANSWER:

(Level 1, Objective 2)

The most common causative agent of a swollen and painful oropharynx is

Streptococcus pyogenes.

Arcanobacterium haemolyticum.

Corynebacterium diphtheriae.

Rhinovirus.

ANSWER:

(Level 1, Objective 3)

Infections associated with cystic fibrosis are due to inflammation of the:

bronchi.

bronchioles.

lungs.

alveoli.

ANSWER:

(Level 1, Objective 3)

A physician sends a nasal washing for viral culture. This specimen is

unacceptable because it is contaminated with upper respiratory flora.

acceptable as long as it contains epithelial cells.

unacceptable if it is for the detection of influenza or respiratory syncytial viruses.

acceptable if it has a thick consistency and is yellow or green in color.

ANSWER:

(Level 2, Objective 4)

A patient is unable to produce adequate sputum for routine, acid-fast, and fungal cultures. The physician may attempt to obtain a/an

induced sputum.

transtracheal aspirate.

bronchoalveolar lavage.

pleural fluid.

ANSWER:

(Level 1, Objective 4)

9. Two throat swabs are received from a 6-year-old female with orders for a rapid screen for group A Streptococcus. One swab is tested using the group A Streptococcus rapid screen, and it is negative. The second swab is used to inoculate

a. sheep blood agar.

b. chocolate agar.

c. no culture is necessary.

d. a and b.

ANSWER:

(Level 1, Objective 6)

Which of the following disease states requires the addition of selective and/or differential medium to ensure recovery of potential pathogens from the respiratory system?

Pertussis

Cystic fibrosis

Laryngitis

a and b

all of the above

ANSWER:

(Level 2, Objective 6)

11. A throat culture provides the following results:

Moderate growth of alpha-hemolytic, catalase-negative, optochin-susceptible, gram-positive diplococci

Heavy growth of alpha-hemolytic, catalase-negative, optochin-resistant, gram-positive cocci

Heavy growth of gamma-hemolytic, oxidase-positive, glucose- and maltose­-positive, gram­ diplococci

You would report

moderate growth of Streptococcus pneumoniae and heavy growth of normal upper respiratory flora.

heavy growth of Streptococcus pneumoniae and heavy growth of normal upper respiratory flora.

heavy growth of Neisseria meningitidis and heavy growth of normal upper respiratory flora.

heavy growth of normal upper respiratory flora.

ANSWER:

(Level 3, Objective 7)

Yeast colonies in a sputum culture are considered significant when they

are present.

comprise 25% of the organisms present.

comprise 50% of the organisms present.

comprise 75% of the organisms present.

ANSWER:

(Level 1, Objective 7)

13. An 8-year-old male presents with a red and sore throat. The rapid group A Streptococcus screen is negative, and a sheep blood agar is inoculated. At 24 hours, there are no beta-hemolytic colonies present and moderate growth of normal upper respiratory flora. At 48 hours, the same culture results are present. Which of the following statements does not explain these results?

a. His sore throat is due to Haemophilus influenzae, and it will not grow on blood agar.

b. The culture was taken very early in the infection.

c. The patient received treatment prior to specimen collection.

d. The causative agent is not bacterial.

ANSWER:

(Level 2, Objective 8)

17. A quantitative bronchial alveolar lavage culture requires:

1. sheep blood agar.

2. chocolate agar.

3. 0.01 mL pipette.

4. 0.001 mL pipette.

a. 1 and 3

b. 1, 3, and 4

c. 2, 3, and 4

d. 2 and 4

ANSWER:

(Level 1, Objective 9)

18. A bronchial washing is plated to a BCYE. This agar should be examined under a laminar flow hood due to the potential for recovery of Legionella pneumophila and

a. Bordetella pertussis.

Francisella tularensis.

mould.

Pneumocystis jiroveci.

ANSWER:

(Level 2, Objective 9)

20. A physician submits a sputum with a culture request for Legionella. Select the growth medium that should be used to cultivate this organism.

a. 7H10

b. TCBS

c. BCSA

d. BCYE

ANSWER:

(Level 1, Objective 6)

16. All of the following are true about ear infections EXCEPT:

Middle ear infections (otitis media) often produce a puslike exudate (referred to as otitis media with effusion) due to infection by genera of Streptococcus, Haemophilus, or various species of anaerobes.

External auditory canal (otitis externa) infections are typically caused by Staphylococcus aureus or Pseudomonas aeruginosa.

After successful treatment of middle ear infections with antibiotics, sometimes tubes are inserted to prevent fluid accumulation, repeated infections, and hearing loss.

Pseudomonad infections are common in swimmers because these organisms are able to produce a soluble greenish-blue pigment.

Repeated ear infections in children often decrease markedly because as the child ages and the Eustachian tube changes shape and develops an angle that prevents most organisms from reaching the middle ear.

17. Why are colds difficult to treat and prevent?

Different cold viruses predominate during different seasons.

Because there are so many different types of rhino- and coronaviruses, each with different antigens, development and administration of vaccines are currently prohibitive.

Although some human interferons have been shown to block or limit rhinovirus infections, delivery to infection sites is difficult, and unwanted side effects can occur.

All of the above.

Both a and c.

18. Which of the following is NOT true about parainfluenza viruses?

Most infants by the age of 6 months have been exposed to and develop antibodies against all 4 parainfluenza viruses.

They cause rhinitis characterized by nasal, pharyngeal, and bronchial inflammation, primarily in children.

Parainfluenza virus infection can be prevented by vaccination.

They can cause noisy respiration (stridor) and acute obstruction of the larynx called croup.

The viruses are spread by direct contact or by large droplets.

19. In whooping cough, patients experience violent coughing episodes during the _________ stage and can have bluing of the skin or _________ due to lack of oxygen from massive mucus and bacterial airway blockage.

Paroxysmal; cyanosis

Catarrhal; pigmentation

Convalescent; osmosis

Pneumotic; hydrolysis

Primary; emesis

20. Penicillins have no effect on Mycoplasma pneumoniae because:

Mycoplasmas are viruses

Mycoplasmas possess beta lactamases

Mycoplasmas are too small

Mycoplasmas are eukaryotes

Mycoplasmas lack cell walls

21. How many cases of tuberculosis are reported globally each year?

10

10,000

100,000

3 million

10 million

22. Mycobacteria are difficult to Gram stain, and are termed “acid-fast” due to their:

Ability to survive in acidic conditions

Resistance to drying

Thick, waxy cell walls

Resistance to sunlight

Lack of a peptidoglycan layer

23. Which of the following is true about pathogenic mycobacteria?

They have a long generation time of 12 to 18 hours.

They are obligate anaerobes sensitive to small amounts of oxygen.

They are highly resistant to drying and can remain viable in dried sputum 6 to 8 months later.

Both a and b.

Both a and c.

24. Clinical symptoms of tuberculosis are primarily due to:

Host inflammatory response

Mycotoxins

Endotoxin

Mucus production

Exotoxin

25. What characteristic of Coxiella burnetii, the causative agent of Q fever, allows it to survive for up to 2 years?

Metachromatic granule

Exotoxin

Endospore

Hemagglutinin

Cilia

26. The normal microflora of the heart includes species of:

Gram-positive bacteria

Gram-negative bacteria

Fungi

Viruses

None of these

27. Which of the following is commonly directly responsible for causing septic shock today?

Bacterial hemagglutinins

Bacterial endotoxins

Bacterial exotoxins

Fungal aflatoxins

Bacterial neurotoxins

28. All of the following are symptoms of septic shock EXCEPT

Shock

Lymphangitis

Chills

Fever

Collapsed blood vessels

29. What is the most likely explanation of how Streptococcus pyogenes causes rheumatic fever?

Strep throat infections migrate down to the heart.

Endotoxin production causes septicemia.

Vegetation followed by fibrin deposition.

Cross-reactivity of an antibody for a Streptococcus pyogenes antigen to a heart cell antigen.

It is an opportunistic infection triggered by coronary artery disease and atherosclerosis.

30. Bacterial endocarditis is an infection and inflammation of the lining and valves of the heart and occurs as a result of transient bacteria attaching to fibrin from exposed collagen fibers of damaged valvular surfaces. True or false?

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