Deck 33: Respiratory System

Question 1

The epiglottis acts as a

A) voice box.
B) filter for microorganisms and debris.
C) cover over the larynx.
D) producer of mucus.

Answer 1

cover over the larynx.

Question 2

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

A) nasopharynx.
B) oropharynx.
C) laryngopharynx.
D) upper respiratory system.

Answer 2

upper respiratory system.

Question 3

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

A) trapping microorganisms and foreign debris.
B) propelling microorganisms and particles out.
C) preventing colonization by potential pathogens.
D) all of the above.

Answer 3

propelling microorganisms and particles out.

Question 4

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

A) Streptococcus pyogenes.
B) Arcanobacterium haemolyticum.
C) Corynebacterium diphtheriae.
D) Rhinovirus.

Question 5

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

A) bronchi.
B) bronchioles.
C) lungs.
D) alveoli.

Question 6

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

A) unacceptable because it is contaminated with upper respiratory flora.
B) acceptable as long as it contains epithelial cells.
C) unacceptable if it is for the detection of influenza or respiratory syncytial viruses.
D) acceptable if it has a thick consistency and is yellow or green in color.

Question 7

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

A) induced sputum.
B) transtracheal aspirate.
C) bronchoalveolar lavage.
D) pleural fluid.

Question 8

Review the image provided. The presence of this cell in an expectorated sputum indicates
Source: CDC and James Volk

A) an unacceptable specimen unless accompanied by the presence of white blood cells.
B) an acceptable specimen if <10 per low power field are present.
C) an acceptable specimen if <25 per high power field are present.
D) an unacceptable specimen for Legionella spp. culture.

Question 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.

Question 10

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?

A) Pertussis
B) Cystic fibrosis
C) Laryngitis
D) a and b
E) all of the above

Question 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

A) moderate growth of Streptococcus pneumoniae and heavy growth of normal upper respiratory flora.
B) heavy growth of Streptococcus pneumoniae and heavy growth of normal upper respiratory flora.
C) heavy growth of Neisseria meningitidis and heavy growth of normal upper respiratory flora.
D) heavy growth of normal upper respiratory flora.

Question 12

Yeast colonies in a sputum culture are considered significant when they

A) are present.
B) comprise 25% of the organisms present.
C) comprise 50% of the organisms present.
D) comprise 75% of the organisms present.

Question 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.

Question 14

A 82-year-old female is hospitalized with pneumonia. The image provided is the direct Gram stain of her sputum.
The sputum culture, after 48 hours incubation, reveals:
Moderate growth of Enterobacter aerogenes
Light growth of normal upper respiratory flora
Based on all information obtained, you determine

A) the results are accurate.
B) the direct Gram stain slide was under-decolorized.
C) there are discrepant results.
D) this is a case of hospital-acquired pneumonia.

Question 15

A comatose 28-year-old male was hospitalized three days ago due to head trauma after a motorcycle accident. He has been on a ventilator since admission. He has developed a fever. The physician orders blood, urine, and sputum cultures. The direct sputum Gram stain reveals the results noted in the image provided.
The blood and urine cultures are negative at 48 hours. The sputum culture grows a predominance of Klebsiella pneumoniae with no normal upper respiratory flora present. This patient's infection
Is probably due to

A) aspiration pneumonia.
B) ventilator-associated pneumonia.
C) hospital-acquired pneumonia.
D) all of the above.

Question 16

A pleural fluid is received in a capped syringe. A portion is centrifuged and the sediment is used to plate to sheep blood, chocolate, and MacConkey agars as well as a thioglycolate broth. The direct Gram stain results are demonstrated in the image
provided
Source: CDC and Dr. Norman Jacobs
At 24 hours, 2 colonies of a white, gamma-hemolytic colony were present on the sheep
Blood agar. The organism is a catalase-positive, Staphylococcus latex
Agglutination- negative, gram-positive coccus. The organism proved to be oxacillin
Resistant on susceptibility testing. Based on these results, you

A) report very light growth Staphylococcus aureus.
B) report very light growth Staphylococcus not S. aureus.
C) complete a variance report because a reducible blood agar should have been added initially.
D) a and c.
E) b and c.

Question 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

Question 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.
B) Francisella tularensis.
C) mould.
D) Pneumocystis jiroveci.

Question 19

A 92-year-old male is hospitalized with community-acquired pneumonia. The image provided is the direct Gram stain of his sputum.
The sputum culture, after 48 hours incubation, reveals:
Moderate growth of small "hockey puck" colonies that produce a blue-green
Butyrate esterase result
Light growth of normal upper respiratory flora
Based on all information obtained, you report moderate growth of

A) normal upper respiratory flora.
B) Moraxella catarrhalis.
C) Neisseria meningitidis.
D) Neisseria gonorrhoeae.

Question 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