Deck 18: Diseases of the Respiratory System

Question 1

What is the one of the most common symptoms of a respiratory illness?

A) fever
B) sneezing
C) increased heart rate
D) high blood pressure

Answer 1

B

Question 2

Which of the following are characteristics of a sneeze?

A) produces about 40,000 droplets that are propelled out of the nose at 40 mph
B) produces large droplets easily that travel more than 5 meters and are inhaled by another person
C) produces small mucus drops that are not inhaled by others but may travel up to 7 meters
D) unlike coughs, sneezes are not implicated in respiratory disease transmission

Answer 2

A

Question 3

Progression of a simple upper respiratory infection may lead to:

A) bronchitis
B) pneumonia
C) resolution without serious disease if microbes attach to few tissue types
D) serious disease regardless of pathogen because all respiratory pathogens are capable of attachment to all tissues found in the respiratory tract

Answer 3

A,B,C

Question 4

Which characteristics make mucus such an effective defense?

A) mucus is hypertonic so it kills many pathogens via dehydration or plasmolysis
B) mucus is hypotonic so it kills many pathogens via dehydration or plasmolysis
C) mucus is sticky so it traps pathogens and is subsequently swept upward via the mucociliary escalator
D) mucus is thin and runny and flushes microbes away rapidly

Question 5

How do Staphylococcal spp. evade host respiratory defenses?

A) they produce toxins that damage tissue and inhibit mucociliary action
B) they produce capsules that are antiphagocytic
C) all Staphylococci are easily destroyed by the immune system
D) they grow in the mucus that coats the respiratory tract

Question 6

What largely determines the type of respiratory system disease that a pathogen may cause?

A) types of toxins a pathogen produces
B) types of physical structures a pathogen possesses
C) host location of pathogen attachment
D) number of pathogens required to produce an infection

Question 7

What phrase best characterizes microbiota of the respiratory tract?

A) respiratory microbiota are well adapted to their location and can resist removal or destruction.
B) less than 100 species of microorganisms reside in the respiratory tract.
C) skin microbiota are also residents of the lower respiratory tract
D) Streptococcus pneumoniae may be considered members of lower respiratory tract microbiota

Question 8

Is Corynebacterium diphtheriae normally toxigenic?

A) Yes, it always produces a cytotoxin that kills cells in the pharynx.
B) Yes, it always produces a cytotoxin that kills ciliated epithelial cells of the trachea.
C) No, it produces a cytotoxin only when it is infected by a lysogenic bacteriophage that expresses a toxin-producing gene.
D) No, it produces a cytotoxin only when a toxin-encoding plasmid is transmitted via conjugation from another bacterium.

Question 9

What does the diphtheria vaccine protect against?

A) infection with C. diphtheriae
B) replication of C. diphtheriae
C) attachment of C. diphtheriae to host cells
D) binding of C. diphtheriae cytotoxin to host cells

Question 10

Why is an antitoxin required to treat cases of diphtheria?

A) antitoxin specifically binds to and inactivates the cytotoxin
B) antitoxin specifically binds to and dissolves the pseudomembrane
C) antitoxin specifically binds to and kills the lysogenic bacteriophage
D) antitoxin specifically binds to and kills the infected tissue in the host

Question 11

A confirmed positive diagnosis of diphtheria includes growing an isolate on what special medium?

A) Eosin Methylene Blue Agar
B) Mannitol Salt Agar
C) Loeffler's Agar
D) MacConkey Agar

Question 12

To prevent an outbreak of diphtheria when one patient has been positively diagnosed, several steps must be taken to protect the very young and those who immunity has decreased over time. These steps include which of the following?

A) infected patient is vaccinated against C. diphtheriae toxin
B) infected patient is isolated from others
C) individuals in close contact with patient are given vaccine boosters and treated with antibiotics
D) throat swab of the patient is performed after 2 weeks to ensure patient is no longer contagious

Question 13

How long does it take to completely recover from pertussis/whooping cough?

A) 4-6 days
B) about 2 years
C) 1 week
D) between 4 weeks and several months

Question 14

What demographic group is most at risk for severe disease caused by Bordetella pertussis?

A) Children 6 to 18 months old
B) Children less than 6 months old
C) Children 2 to 5 years
D) Children 5 to 8 years

Question 15

B. pertussis has been called "one of the most contagious" respiratory pathogens because it can be spread in which of the following modes?

A) respiratory droplets
B) contaminated fomites
C) direct physical contact
D) airborne transmission

Question 16

Which description best characterizes Bordetella pertussis?

A) gram negative streptococcus
B) gram positive coccobacillus
C) gram negative streptobacillus
D) gram negative coccobacillus

Question 17

What signs and symptoms characterize the paroxysmal phase of pertussis?

A) fever, malaise, runny nose
B) a slow decrease in symptoms, especially cough
C) cyanosis, post-tussive vomiting
D) dry cough, congestion

Question 18

In recent years, more cases of pertussis or whooping cough have occurred because of waning immunity in vaccinated individuals. Increased susceptibility to disease can begin at what point in time?

A) 7 years after the last vaccination
B) 5 years after the last vaccination
C) 12 years after the last vaccination
D) 20 years after the last vaccination

Question 19

Which description best characterizes the microscopic appearance of Mycobacterium tuberculosis?

A) gram positive coccobacillus
B) gram negative cocci
C) acid fast streptobacillus
D) acid-fast staphylococci

Question 20

Which of the following accurately describes Mycobacterium tuberculosis?

A) its cell membrane contains mycolic acid, a waxy substance that makes the bacterium difficult to gram stain.
B) it has a cell membrane that contains ergosterol
C) it has a thick endospore coat containing mycolic acids.
D) its cell wall mycolic acids block antibiotic entry into the cell, making this bacterium difficult to destroy.

Question 21

M. tuberculosis exposure may result in which of the following?

A) latent tuberculosis in which the patient is infected but shows no signs or symptoms of disease
B) granuloma formation in the lungs
C) active tuberculosis in individuals that are HIV⁺
D) active tuberculosis manifesting in the CNS, skeletal, and lymphatic systems.

Question 22

Signs and symptoms of an active case of tuberculosis (TB) include

A) dry cough
B) presence of fever and night sweats
C) high blood pressure
D) erupting skin rash

Question 23

Why does treatment for active tuberculosis (TB) include using multiple drugs?

A) to prevent antibiotic side effects in patients
B) to provide aggressive therapy to kill the quickly-replicating bacterium
C) to prevent development of drug-resistance
D) to promote patient compliance with drug treatment

Question 24

What does a positive Mantoux test indicate?

A) previous exposure to the TB protein
B) an active case of TB
C) a positive test for Corynebacterium diphtheriae
D) diagnosis of latent TB

Question 25

Diagnosis of active TB requires which of the following criteria?

A) PCR positive sputum sample for M. tuberculosis
B) history of BCG vaccination
C) isolation of acid fast bacteria from sputum
D) fever, cough, night sweats, weight loss

Question 26

What is a basic difference between common cold viruses and influenza viruses?

A) cold viruses only attach to epithelial tissues in the nasal cavity
B) cold viruses may attach to tissues throughout the respiratory tract
C) cold viruses may cause serious diseases of the lower respiratory tract
D) influenza viruses cause a localized infection in the upper respiratory tract

Question 27

Which age groups are most likely to be infected by cold-causing viruses?

A) >65 yo
B) 10-18 yo
C) 20-50 yo
D) infants and very young children

Question 28

Rhinoviruses are most often transmitted by:

A) vectors
B) companion animals
C) the parenteral route
D) respiratory droplets from coughing and sneezing

Question 29

Why do fomites pose a particular risk for spreading cold viruses?

A) cold viruses are resistant to disinfectants
B) cold viruses survive low humidity and temperature fluctuations
C) cold viruses form cysts which allows them to remain on objects indefinitely
D) cold viruses can only be destroyed by autoclaving

Question 30

Why are cold viruses more easily spread in the winter months?

A) The cold air in the winter makes it easier for the cold viruses to survive
B) The lower humidity of the air dries the mucus membranes of the upper respiratory tract allowing cold viruses to attach to host cells
C) The higher humidity of the air in the winter makes it easier for the cold viruses to survive
D) Poorly dressed individuals go outside and get chilled which makes them more susceptible to viruses

Question 31

Which demographic group(s) is(are) typically at greatest risk for Influenza complications?
For each molecule of glucose that enters glycolysis, the Citric Acid Cycle must make _______turns producing __________ molecules of ATP.

A) infants
B) infants and young children
C) individuals over the age of 65
D) young and mature adults

Question 32

What is typically the source of pandemic Influenza A virus strains? (Select all that apply)

A) antigenic shift in the H and N genes
B) antigenic drift in the H and N genes
C) recombination of viral segments between birds and swine
D) point mutations in pre-existing influenza virus strain genomes

Question 33

Which descriptions are true for influenza viruses?

A) H and N proteins are on the surface of the viral envelope
B) the virus contains 6 segments of single-stranded RNA
C) the virus contains 8 segments of double-stranded DNA
D) there are three groups of influenza viruses: A, B, and C

Question 34

What is the role of N (neuraminidase) proteins of influenza viruses?

A) a protein that is needed for viral attachment
B) a protein that is needed for release of virions from cell
C) a protein that functions as the replication enzyme
D) a capsid protein that aids in host cell entry

Question 35

How are Influenza viruses transmitted?
In eukaryotes the electron transport system is located in the ______________ while in prokaryotes it occurs in __________________.

A) mucus droplets
B) small aerosolized particles transmitted via coughing and sneezing
C) indirect contact via fomites
D) vectors

Question 36

Which group(s) of antiviral medications is (are) currently used to treat influenza in the U.S.?

A) amantadanes
B) neuraminidase inhibitors
C) replication inhibitors such as baloxavir marboxil
D) proteases

Question 37

Which influenza vaccine is only recommended for individuals ages 2-49 yo?

A) TIIV
B) QIIV
C) LAIV
D) DaPT

Question 38

Why are influenza vaccines administered on an annual schedule?

A) Capsid polymorphisms
B) vaccines are easily produced and are affordable
C) short-lived immune responses
D) antigenic drift

Question 39

What physical characteristic of children makes them more likely to develop otitis media?

A) small ears
B) small nasal cavity
C) short Eustachian tubes
D) more common colds

Question 40

What demographics do children with otitis media share?

A) are bottle fed and use a pacifier
B) have a smoker in the household
C) are small for their age
D) have a history of diarrheal disease

Question 41

Which of the following is often indicated as the etiological agent of otitis media?

A) rhinoviruses
B) respiratory syncytial virus (RSV)
C) Streptococcus pneumoniae
D) Mycoplasma pneumoniae

Question 42

Which demographic cohort is more likely to develop Streptococcal sore throat?

A) infants
B) young children
C) teens
D) mature adults

Question 43

Which feature of S. pyogenes acts as a superantigen to give rise to high fever and rash as a complication of streptococcal sore throat?

A) teichoic acids in the cell wall
B) M protein on fimbriae
C) exotoxin
D) neuraminidase

Question 44

Identify the correct associations between diseases of the respiratory tract with their correct description. (Select all correct associations)

A) Laryngitis: most commonly caused by parainfluenza virus
B) Croup: inflammation causes obstruction of airway resulting in hypoxia
C) Tracheitis: serious but rare pediatric bacterial infection resulting in formation of a membrane of pus and mucus
D) Epiglottitis: common pediatric illness with vially-induced damage to larynx and trachea

Question 45

What is the most common feature of bronchitis?

A) a purulent cough that persists for about 10 days
B) a fever accompanied by sore throat
C) it is caused by both bacteria and viruses
D) inflammation of the bronchioles

Question 46

Which phrase most accurately describes pneumonia?

A) an acute inflammation of the bronchioles and bronchi
B) an acute inflammation of the lower respiratory tract
C) an inflammation of the mucociliary escalator of the respiratory system
D) an alveolar inflammation that results in fluid accumulation in the lungs

Question 47

Identify the INCORRECT associations between pneumonias and their epidemiological characteristics. (Select all incorrect associations)

A) Community-acquired pneumonia (CAP): develops at least 48 hr after hospital admission
B) Health-care associated pneumonia (HCAP): develops in the outpatient setting
C) Hospital-acquired pneumonia (HAP): often caused by a drug-resistant pathogen
D) Ventilator-associated pneumonia (VAP): develops within 48 hr of inserting or removing ventilator tubes

Question 48

Identify the correct associations between pneumonia causes and their descriptions. (Select all correct associations)

A) Bacterial: caused by different types of internal helminths migrating through the lungs
B) Viral: cause most pneumonias in children and those over 60 years of age
C) Fungal: patients are usually immunosuppressed/major cause of mortality for AIDS patients
D) Parasitic: rapid onset of symptoms

Question 49

Identify the correct associations between emerging microbial pneumonia pathogens and their descriptions. (Select all correct associations)

A) Covid-19: highly transmissible virus causing an acute respiratory syndrome
B) Hantavirus: caused by a 2003 coronavirus isolate
C) SARS: caused by Sin Nombre virus
D) MERS: first found in Saudi Arabia with 30% fatality rate

Question 50

What is the host cell receptor for the newest (2019) emerging corona virus; SARS-CoV-2?

A) ICAM
B) ACE-1
C) ACE-2
D) sialic acid residues