Deck 16: Respiratory System Infections

Question 1

Although each of the following viral groups causes acute respiratory illnesses, can also be associated with conjunctivitis, gastroenteritis, or cystitis.

A) influenzas virus
B) human parainfluenza virus
C) respiratory syncytial virus
D) coronavirus
E) adenovirus

Answer 1

adenovirus

Question 2

Which component of the lower respiratory tract is incorrectly matched with a function or description?

A) lungs: contain the alveolar sacs
B) bronchi: direct air to the lungs
C) alveoli: site of gas exchange
D) larynx: contains the mucociliary escalator
E) bronchioles: have ciliated mucous membranes

Answer 2

larynx: contains the mucociliary escalator

Question 3

Influenza A strains are characterized by

A) whether or not humans are infected.
B) the type of HA and NA spikes found on the viral surface.
C) the type of animal in which the strain originated.
D) the country in which the strain originated.
E) whether the virus contains DNA or RNA.

Answer 3

the type of HA and NA spikes found on the viral surface.

Question 4

A child with no known congenital problems is diagnosed with inflammation of the heart valves. The medical history of the child is unremarkable except for a sore throat and fever six weeks prior, which the parents attributed to a common cold. The heart valve inflammation is most likely due to

A) autoimmune complications of Streptococcus pyogenes.
B) Corynebacterium diphtheriae.
C) Bordetella pertussis.
D) tuberculosis.
E) atypical pneumonia.

Question 5

A 21- year- old male is admitted to the hospital in severe respiratory distress. Despite care, he died of rapid pulmonary edema within 12 hours of admission. Family members report that he had recently started work at a nearby state park. He was on a detail to clean out and renovate a group of rodent- infested rental cabins. Based on the information, what is the likely diagnosis?

A) influenza H1N1
B) hanta pulmonary syndrome
C) respiratory syncytial virus
D) SARS
E) human parainfluenza virus infection

Question 6

Infection in the respiratory tract is limited by all except

A) coughing to bring microbes away from the lungs.
B) resident microbiota.
C) alveolar macrophage.
D) the epiglottis sealing the airway during swallowing.
E) ciliated mucous membranes.

Question 7

Which statement is not true about the resident microbiota of the respiratory tract?

A) Microbiota are only found in the upper respiratory tract.
B) The lungs have recently been found to contain a resident microbiome that resembles that found in the mouth.
C) Smoking affects the numbers and types of species in the microbiota.
D) Resident microbiota secrete antimicrobial peptides and compete with pathogens.
E) The resident microbiota of a healthy person is limited to just a few species of bacteria.

Question 8

A two- year- old child presents to a pediatric practice with a barking cough and loud wheezing. The parent is alarmed and insists on antibiotics. What is the likely diagnosis, and are antibiotics appropriate?

A) croup / no, most cases are viral
B) epiglottitis / yes, this is a life- threatening bacterial infection
C) allergies / no, allergies are caused by irritants and are not infections
D) sinusitis / no, most cases are due to viral infections or irritants
E) pneumonia / yes, this can be a life- threatening condition and is often bacterial

Question 9

A key factor in the high prevalence of otitis media in children is

A) the orientation of the eustachian tube in children prevents efficient fluid drainage.
B) the lack of a mature microbiome in the auditory canal.
C) children are more likely to suffer from colds and influenza than adults.
D) children do not complete their routine vaccine schedule until adolescence.
E) the maturing of the innate and adaptive immune responses in children.

Question 10

The upper respiratory tract is lined with mucous membranes which secrete mucous. What is the purpose of mucous?

A) traps microbes and debris from the air we breathe
B) warms and humidifies the air we breathe
C) warms and humidifies, and traps microbes and debris from the air we breathe
D) cools and dries the air we breathe
E) cools and dries, and traps microbes from the air we breathe

Question 11

Pneumonia is

A) shortness of breath.
B) inflammation of the alveoli which interferes with gas exchange.
C) rapid swelling of the airway that can block breathing.
D) inflammation of the entire lower respiratory tract except the lungs.
E) wheezing or loud breathing associated with airway obstruction.

Question 12

SARS is caused by a(n)

A) coronavirus.
B) influenza virus.
C) paramyxovirus.
D) rhinovirus.
E) adenovirus.

Question 13

Influenza differs from the common cold in that

A) it has a greater fatality rate.
B) the virus is not subject to mutation.
C) it can cause seasonal outbreaks.
D) you can get only get influenza once.
E) it is not treatable with antivirals.

Question 14

Vaccine prevention of acute respiratory infections (the common cold) is unlikely because

A) colds are easily misdiagnosed as something else.
B) humans do not generate a strong immune response to common cold viruses.
C) there is a relatively low social and economic cost associated with the common cold.
D) there are many distinct virus strains and serovars that cause the common cold.
E) antibiotics easily cure the common cold.

Question 15

A contributing factor to the spread of the SARS virus during the initial 2003 outbreak was

A) global air travel.
B) transmission of the virus in healthcare settings.
C) high smoking rates in Asia.
D) air pollution in crowded urban environments.
E) similarity to 1918 influenza outbreak.

Question 16

The development of a pseudomembrane on the tonsils and throat is characteristic of

A) diphtheria.
B) pertussis.
C) pneumococcal pneumonia.
D) tuberculosis.
E) streptococcal pharyngitis.

Question 17

An unusual feature of the 1918 Spanish influenza pandemic is that

A) victims had unusually poor immune responses to the virus.
B) most fatalities were among young adults, and victims had unusually poor immune responses to the virus.
C) most fatalities were among young adults, rather than infants or the elderly.
D) it originated in Europe, most fatalities were among young adults, and victims had unusually poor immune responses.
E) it originated in Europe, rather than Asia as most influenza strains do.

Question 18

The demographic most at risk from respiratory syncytial virus are

A) the elderly.
B) pet owners.
C) immunocompromised individuals.
D) young children.
E) smokers.

Question 19

This disease is caused by strains of Streptococcus pyogenes which produce an erythrogenic toxin due to the presence of a lysogenized bacteriophage.

A) scarlet fever
B) rheumatic fever
C) streptococcal pharyngitis
D) bacterial pneumonia
E) necrotizing fasciitis

Question 20

A life- threatening bacterial infection that results in complete blockage of the airway due to swelling of a flap of tissue that normally protects the lungs during swallowing is

A) hay fever.
B) stridor.
C) dyspnea.
D) croup.
E) epiglottitis.

Question 21

Which of the following is not a factor in increased incidence of fungal infections?

A) increasing number of people living with immunosuppression
B) increasing antibiotic resistance
C) urban development
D) climate change
E) deforestation

Question 22

Sinusitis is routinely treated with antibiotics, which is appropriate because most cases are due to bacterial infections.

Question 23

Pertussis is characterized by

A) severe coughing attacks where the patient struggles to catch their breath.
B) a high fever with a bright red rash across the body.
C) a positive tuberculin skin test.
D) high prevalence among those who handle birds.
E) a pneumonia- like infection acquired from air conditioning or water systems.

Question 24

An endemic fungal infection that is found in the semi- arid to dry soils in the southwestern United States and Mexico is

A) coccidioidomycosis.
B) murcomycosis.
C) aspergillosis.
D) blastomycosis.
E) histoplasmosis.

Question 25

Vaccination against diphtheria is a toxoid vaccine against inactivated toxin, therefore, the prevalence of asymptomatic carriers of Corynebacterium diphtheriae may be high even as prevalence of the disease itself is low.

Question 26

The infectious agent that causes tuberculosis is

A) an acid- fast bacterium of the genus Mycobacterium.
B) one of several Gram- negative bacterial species.
C) HIV.
D) avian influenza virus.
E) unpasteurized milk.

Question 27

A wildlife biologist might be more likely than the average person to contract which types of atypical pneumonia?

A) walking pneumonia, chlamydophila pneumonia, and Legionnaire's disease
B) Legionnaire's disease and Q fever
C) tularemia, chlamydophila pneumonia, and psittacosis
D) Legionnaire's disease and psittacosis
E) Q fever, psittacosis, and tularemia

Question 28

Recent reemergence of pertussis is due in part to

A) waning immunity in adolescents and adults from the short- lived DTaP vaccine.
B) ease of global travel.
C) increased human contact with animal reservoirs.
D) increased antibiotic resistance.
E) reactivation of latent infections in older individuals.

Question 29

In an immunocompromised patient with pulmonary or rhinocerebral invasive fungal disease, suspect

A) murcomycosis.
B) aspergillosis.
C) either aspergillosis, murcomycosis, or pneumocystis pneumonia.
D) pneumocystis pneumonia.
E) either aspergillosis or murcomycosis.

Question 30

A diagnostic sign of typical pneumonia is consolidation which

A) is fluid rather than air in the alveoli.
B) is a granuloma walling off infected phagocytes in the lungs and appears as a clear region on a chest X- ray.
C) appears as a clear region on a chest X- ray.
D) is fluid rather than air in the alveoli and appears as a clear region on a chest X- ray.
E) is a granuloma walling off infected phagocytes in the lungs.

Question 31

A healthy respiratory microbiome is dominated by species from the phyla Bacteroides, Firmicutes, and Proteobacteria.

Question 32

Endemic mycoses are

A) caused by species who inhabit multiple ecological niches.
B) restricted to a specific geographic location.
C) due to changes in the patient's normal microbiota.
D) unable to establish infections in healthy people.
E) easily transmitted person- to- person.

Question 33

Histoplasmosis should be suspected in cases of fungal respiratory infections found in

A) construction workers.
B) dog owners.
C) the Mississippi and Ohio River valley regions.
D) cattle or dairy farm workers.
E) HIV- AIDS patients.

Question 34

A fungal species which can grow in varied climates and under diverse conditions is termed

A) normal.
B) mycosis.
C) endemic.
D) ubiquitous.
E) microbiotic.

Question 35

Latent tuberculosis

A) will eventually progress to active TB in most individuals.
B) will result in a negative tuberculin skin test.
C) results when M. tuberculosis bacteria are phagocytized and effectively walled off within granulomas in the lungs.
D) accounts for only a small minority of cases.
E) is easily spread through respiratory droplets.

Question 36

The most common cause of atypical pneumonia, Mycoplasma pneumoniae, has all the following characteristics except

A) no cell wall.
B) a parasitic lifestyle inside host cells.
C) one of the smallest self- replicating organisms known.
D) contains more genes than most other bacteria.
E) difficult to see with a standard light microscope.

Question 37

In most individuals, symptoms of the common cold and of influenza are virtually impossible to tell apart in severity.

Question 38

An elderly patient with no recent hospitalizations presents with shortness of breath, chest pain, a deep productive cough, and evidence of consolidation. Acid- fast and Gram stains are performed on a sputum sample. No acid- fast bacteria are detected but Gram- negative, non- encapsulated bacteria are observed. A likely diagnosis is

A) Streptococcus pneumoniae.
B) influenza.
C) Mycobacterium avium.
D) nontypable Hemophilus influenzae B.
E) Legionnaire's disease.

Question 39

To date, only zoonotic strains of hantavirus have been detected.

Question 40

Which statement does not apply to pneumocystis pneumonia and its causative organism, Pneumocystis jirovecii?

A) HIV- AIDS patient are high- risk for this infection.
B) The organism has some characteristics found in protozoans rather than fungi.
C) Serological evidence suggests that most people are exposed to the organism in early childhood.
D) Like all other pathogenic fungi, the reservoir is soil.
E) The fungus does not make spores.

Question 41

A positive tuberculin skin test definitively indicates the presence of an active tuberculosis infection.

Question 42

Endemic fungal infections are most likely to occur in immunocompromised patients while ubiquitous fungal infections are routinely found in otherwise healthy individuals.

Question 43

Describe the progression of infection in latent vs. active tuberculosis along with diagnostic criteria and treatment options.

Question 44

Contrast endemic and ubiquitous fungal infection, and describe two examples of each type.

Question 45

Describe the anatomical and physiological features of the respiratory system that limit the establishment of pathogenic organisms.

Question 46

Mycoses are becoming more common due to changes in the patient population, such as immunosuppression, as well as environmental and ecological changes.