Deck 30: Agents of Bioterror

Question 1

What document prohibits the use of biological agents during war?

A) Geneva Protocol
B) Treaty of Versailles
C) Antiproliferation Pact
D) Law of Armed Conflict

Answer 1

A
Despite a Geneva Protocol prohibiting the use of biological agents during war signed by many nations,a number of countries began biological warfare research programs in the 1920s.

Question 2

What type of anthrax is most deadly and most likely to be seen in a bioterrorism attack?

A) Gastrointestinal
B) Inhalation
C) Cutaneous
D) Spinal

Answer 2

B
Inhalation anthrax occurs when a patient inhales Bacillus anthracis; it usually takes at least 8000 spores to initiate this form of the disease.Inhalation anthrax is the form of anthrax most likely to be seen in a bioterrorism event.Data from the accidental spore release in Sverdlosk,Russia,in 1976 suggested a mortality rate of almost 100%.However,the mortality rate of patients with inhalation anthrax in the United States in 2001 was only 45% (5 out of 11).

Question 3

All the following organizations established the Laboratory Response Network EXCEPT:

A) United States Army Medical Research Institute for Infectious Diseases (USAMRIID)
B) Centers for Disease Control and Prevention (CDC)
C) Central Intelligence Agency (CIA)
D) Federal Bureau of Investigation (FBI)

Answer 3

C
In an effort to increase responsiveness and to create a nationwide ability to rapidly detect the covert or overt deployment of biological weapons in the United States and its territories,the CDC,the Association of Public Health Laboratories (APHL),the FBI,and USAMRIID established the Laboratory Response Network (LRN)in 1999; later that year,most states and territories were implementing training for the detection of biological attacks using standardized LRN protocols.

Question 4

How can biological weapons enter the host?

A) Through the respiratory tract
B) Through the gastrointestinal (GI) tract
C) Through the mucous membranes
D) All of the above

Question 5

A microbiologist is looking at a sheep blood agar (SBA)plate from a patient who might have been exposed to a biological agent.The colonies that are growing on the plate are nonhemolytic,large,have a ground-glass appearance,and look like a Medusa's head.On Gram stain,the colonies are large gram-positive rods that seem to have central spores.What is the most probable organism?

A) Bacillus anthracis
B) Brucella mallei
C) Burkholderia cepacia
D) Yersinia pestis

Question 6

What federal regulation establishes the rules of possession,use,and transfer of select agents and toxins?

A) Public Health Security and Bioterrorism Preparedness and Response Act of 2002
B) 42 CFR 73
C) Animal Health and Inspection Act
D) Infectious Agent Act

Question 7

What category of bioterrorism agents would have the greatest impact?

A) Category A
B) Category B
C) Category C
D) Category D

Question 8

Which of these are designated as sentinel hospitals in the Laboratory Response Network (LRN)?

A) Centers for Disease Control and Prevention (CDC)
B) Reference laboratories
C) State public health laboratories
D) Community hospitals with microbiology laboratories

Question 9

What type of plague is the most common and results from the bite of a flea?

A) Bubonic plague
B) Septicemic plague
C) Pneumonic plague
D) Osmotic plague

Question 10

What classification system was developed in 1999 by academic infectious disease experts,government officials,military intelligence experts,and law enforcement officials?

A) Biosafety levels
B) High, moderate, and low categories
C) A, B, C categories
D) Normal, increased, and high categories

Question 11

A microbiology technician is looking at a set of plates from a seriously ill patient.The sheep blood agar (SBA)plate shows small,nonhemolytic colonies that have a fried egg appearance.On MacConkey,these organisms grow as a small,nonlactose fermenter.On Gram stain,this organism is a bipolar staining,plump gram-negative rod.What is the most probable organism?

A) Brucella mallei
B) Brucella anthracis
C) Yersinia pestis
D) Burkholderia cepacia

Question 12

What is the specimen of choice for gastrointestinal and inhalation anthrax?

A) Sputum
B) Vesicular fluid from lesions
C) Spinal fluid
D) Blood

Question 13

What is the specimen of choice for cutaneous anthrax?

A) Blood
B) Spinal fluid
C) Vesicular fluid from lesions
D) Sputum

Question 14

Who will be most likely to suspect a covert bioterrorism attack?

A) Firefighters and the police
B) Microbiologists and physicians
C) The public health department
D) Centers for Disease Control and Prevention (CDC) and Homeland Security

Question 15

Yersinia pestis causes all the following EXCEPT:

A) Bubonic plague
B) Septicemic plague
C) Pneumonic plague
D) Meningococcal plague

Question 16

What is bioterrorism?

A) The use of bacteria, viruses, fungi, or toxins to injure people, animals, or crops to cause civil unrest
B) The use of synthetic biological substances to kill innocent people
C) The use of biological substances to kill, maim, or injure as many people as possible
D) The use of biohazardous substances to cause chaos

Question 17

Organisms that have the following characteristics-aerobic growth,nonhemolytic colonies 2 to 5 mm in diameter,catalase positive,nonmotile,large gram-positive bacilli recovered from lesions,blood,cerebrospinal fluid (CSF)or lymph nodes-can be presumptively identified as:

A) Brucella mallei
B) Brucella anthracis
C) Yersinia pestis
D) Burkholderia cepacia

Question 18

One of the first recorded terror attacks occurred in 1984 in a restaurant in The Dalles,Oregon.What organism was used in this attack?

A) Salmonella
B) Escherichia coli
C) Clostridium
D) Staphylococcus

Question 19

What organism caused the disease known as the Black Death?

A) Brucella mallei
B) Brucella anthracis
C) Yersinia pestis
D) Burkholderia cepacia

Question 20

What is the role of the sentinel laboratory?

A) To rule out or refer suspicious isolates
B) To identify suspicious isolates
C) To act as a reference laboratory for physician office laboratories
D) None of the above

Question 21

A microbiologist is looking at the blood culture plates taken from a woman who had ingested fresh,unpasteurized milk.The growth on the blood agar and chocolate agar showed small,circular,smooth,convex,nonpigmented,and nonhemolytic colonies.Gram stain revealed tiny gram-negative rods.The organism was catalase,oxidase,nitrate reduction,and urease positive,but showed a lack of motility.What is the most probable organism?

A) Francisella tularensis
B) Brucella abortus
C) Yersinia pestis
D) Burkholderia cepacia

Question 22

What organism causes glanders?

A) Francisella tularensis
B) Brucella abortus
C) Yersinia pestis
D) Burkholderia mallei

Question 23

What disease is associated with rabbits?

A) Francisella tularensis
B) Brucella anthracis
C) Yersinia pestis
D) Burkholderia cepacia

Question 24

What is ricin?

A) A potent biological toxin that disrupts native DNA strands
B) A potent biological toxin that stops cell wall synthesis
C) A potential biological toxin that inhibits protein synthesis
D) All of the above

Question 25

Viral hemorrhagic fevers include all the following EXCEPT:

A) Ebola
B) Crimean-Congo
C) Lassa fever
D) Black fever

Question 26

How is smallpox diagnosed?

A) Through a Centers for Disease Control and Prevention (CDC) algorithm
B) By clinical signs
C) Through cell culture
D) All of the above

Question 27

All of the following are synonyms for brucellosis EXCEPT:

A) Malta fever
B) Undulant fever
C) Gibraltar fever
D) Relapsing fever

Question 28

What is the most common presentation for tularemia?

A) Pneumonic tularemia
B) Ulceroglandular tularemia
C) Bubonic tularemia
D) Septicemic tularemia

Question 29

When should a microbiology technician consider Francisella tularensis?

A) Tiny, gram-negative coccobacilli that do not grow well on chocolate or MacConkey's and are biochemically inert
B) Tiny, gram-negative coccus that grows well on blood agar
C) Tiny, pleomorphic, poor-staining, gram-negative coccobacilli that do not grow well, if at all on blood agar
D) None of the above

Question 30

A microbiologist observes culture plates that have larger nonpigmented gray colonies at 24 hours that are indole negative,nonmotile,catalase positive,and resistant to polymyxin B discs.The Gram stain shows this is a gram-negative coccobacilli.What is the most probable organism?

A) Francisella tularensis
B) Brucella mallei
C) Yersinia pestis
D) Burkholderia cepacia

Question 31

What is characteristic of smallpox?

A) The pustules penetrate deeply into the tissue.
B) Infections also occur on the palms and the soles of the feet.
C) The synchronous progression of the lesions.
D) All of the above.

Question 32

Botulism toxin is:

A) A neurotoxin primarily produced by Clostridium botulinum
B) A mucosal toxin primarily produced by C. botulinum
C) An enterotoxin primarily produced by C. botulinum
D) An endotoxin primarily produced by C. botulinum

Question 33

What organism causes Q fever?

A) Coxiella burnetii
B) Brucella abortus
C) Yersinia pestis
D) Burkholderia cepacia