Deck 37: Integumentary System

Question 1

If you have an infection of the eponychium, you have an infected

A) hangnail.
B) hair follicle.
C) toenail bed.
D) sudoriferous gland.

Answer 1

hangnail.

Question 2

Which of the following is responsible for the waterproof skin barrier that is also effective against microorganisms?

A) Melanin
B) Keratin
C) Horny solehorn
D) Merkel discs

Answer 2

Keratin

Question 3

If you were a microorganism living as normal flora between your toes, you could be:

A) Enterobacteriaceae.
B) yeast.
C) diphtheroids.
D) all of the above.
E) b and c.

Answer 3

all of the above.

Question 4

The presence of normal skin flora provides all of the following functions except

A) prevents colonization by potential pathogens.
B) produces vitamins B and D.
C) offers some protection against ultraviolet rays.
D) metabolizes sweat and fatty acids produced.

Question 5

An acute red and warm skin infection presenting with pain, swelling, and tenderness but lacking the presence of visible pus is known as

A) carbuncle.
B) erythrasma.
C) impetigo.
D) cellulitis.

Question 6

A patient presents to her physician with what looks like an infected spider bite on her arm. The physician submits a swab of the drainage from the bite. The culture results demonstrate a catalase positive, coagulase positive gram positive cocci that also has the mecA gene present. Rather than an infected spider bite, the patient probably had

A) erysipelas.
B) impetigo.
C) erysipeloid.
D) a furuncle.

Question 7

A farmer presents with a skin infection that his physician determines to be possible erysipeloid. The physician calls the laboratory for information on what type of specimen to collect. You advise

A) blood cultures.
B) a swab of the skin infection.
C) both a and b.
D) biopsy of the skin infection.
E) both a and d.

Question 8

To monitor the presence of bacteria in burn wounds, most facilities now routinely use ____________________cultures.

A) biopsy
B) quantitative
C) qualitative
D) cultures are no longer routinely performed

Question 9

Which of the following specimen types/diagnoses requires the addition of a chocolate agar to the other routine media used for plating?

A) Animal bite
B) Burn wound
C) Necrotizing fasciitis
D) Dermatophytosis

Question 10

Which of the following specimen types/diagnoses should be processed for the recovery of anaerobes?

A) Carbuncle
B) Erysipelas
C) Necrotizing fasciitis
D) Cellulitis

Question 11

Which of the following suggests improper anaerobic specimen collection when observed on a direct specimen Gram stain?

A) white blood cells.
B) squamous epithelial cells.
C) cilitated epithelial cells.
D) red blood cells.

Question 12

Review the image provided. The presence of this organism in a tissue sample suggests
Source: CDC and Don Stalons

A) Corynebacterium spp.
B) yeast.
C) Clostridium spp.
D) Erysipelothrix rhusiopathiae.

Question 13

A 37-year-old female diabetic presented as seen in the image provided. The physician described the affected facial area as shiny, raised, hardened, and tender with a distinct margin. Which of the following organisms is most likely the causative agent?
Source: CDC/Dr. Thomas F. Sellers/Emory University

A) Catalase-negative, bacitracin-susceptible, gram-positive coccus
B) Catalase-positive, coagulase-positive, gram-positive coccus
C) Oxidase-positive, gram-negative rod that produces a blue-green pigment and a grape-like odor
D) Fungus

Question 14

Smooth gray colonies were isolated from an infected cat scratch on BAP and CHOC. The organism showed no growth on MAC. Gram stain revealed small gram-negative coccobacilli. You would expect this organism to be

A) oxidase positive and catalase negative.
B) oxidase negative and catalase positive.
C) oxidase and catalase positive.
D) oxidase and catalase negative.

Question 15

A 29-year-old male was seen by his primary care physician for a large boil located on his neck. The physician lanced the boil and expressed a large amount of pus. A sample was sent to the laboratory for culture. The culture yielded heavy growth of a yellow pigmented, beta-hemolytic colony. The Gram stain revealed gram-positive cocci in clusters. The organism was catalase positive and Staphylococcus latex agglutination negative. You would:

A) report the organism as Staphylococcus aureus.
B) report the organism as normal skin flora.
C) perform a thermonuclease test.
D) boil a suspension of the organism and repeat the latex agglutination test.

Question 16

Large, rectangular, anaerobic gram-positive rods have been isolated from the anaerobic culture of a wound due to the puncture of the patient's foot by a rusty nail. No spores were observed on Gram stain of the specimen or culture isolate. The organism produced a double zone of beta hemolysis around its colonies on reducible blood agar. This organism will also be

A) catalase negative.
B) lecithinase negative.
C) lipase positive.
D) a swarming colony.

Question 17

A 48-hour culture of a finger lesion biopsy from a veterinarian produced small, slightly alpha-hemolytic colonies on BAP. The Gram stain revealed short grampositive rods.
Biochemical reactions included:
$\begin{array}{lrr} \text {Catalase: no bubbles }& \text {Nonmotile}& \text { Vancomycin: resistant}\end{array}$
TSI: no change except for blackening along the line of inoculation
What is the most likely identification of this organism?

A) Pasteurella multocida
B) Eikenella corrodens
C) Erysipelothrix rhusiopathiae
D) Capnocytophaga spp.

Question 18

A 48-year-old liver transplant recipient celebrates his newfound health by spending a week on the beach in Florida. He swims, suns, and indulges in his favorite seafood, oysters. About four days into his vacation, he develops a rapidly spreading cellulitis and fluid-filled blisters on his right leg. Culture of the lesions reveals an oxidase-positive, gram-negative rod that is halophilic. You suspect the organism to be

A) Pseudomonas aeruginosa.
B) Vibrio vulnificus.
C) Vibrio cholerae.
D) Aeromonas hydrophila.

Question 19

In many medical facilities, the most common cause of nosocomial burn wound infections is a/an

A) catalase-positive, coagulase-negative, gram-positive cocci.
B) oxidase-negative, indole-positive, lactose fermenter.
C) oxidase-positive, pyocyanin-positive, non-lactose fermenter.
D) chlamydoconidia-positive yeast.

Question 20

A swab of the serous fluid of skin blisters was obtained from lesions around the mouth and nose of 4-year-old female. The image provided demonstrates the direct Gram stain of the serous fluid.
Source: CDC
You would expect this organism to be

A) nonhemolytic.
B) catalase negative.
C) coagulase positive.
D) sodium hippurate positive.