Deck 32: Upper and Lower Respiratory Tract Infections

Question 1

If a patient has a throat culture done and the culture reveals the presence of a-hemolytic colonies,what does this indicate?

A) These organisms are pathogenic and must be treated.
B) These organisms are normally found in the pharynx and are normal.
C) The patient is suffering from a viral pharyngitis.
D) The patient has mouth ulcers that require antiviral treatment.

Answer 1

B
Isolation of a-hemolytic colonies from a pharyngeal culture from a patient with pharyngitis arouses little clinical interest,because a-hemolytic streptococci are normal florae in the oropharynx.

Question 2

A patient's normal florae can be altered by all of the following EXCEPT:

A) Broad-spectrum antibiotics
B) Recent hospitalization
C) Chronic illness
D) Visited a nursing home

Answer 2

D
Normal upper respiratory tract florae in an asymptomatic patient may change depending on the clinical setting.Patients who have previously received broad-spectrum antibiotics,have been hospitalized recently,or have chronic illnesses may have different pharyngeal florae.

Question 3

What bacteria may cause up to 50% of all cases of pneumonia in the summer months?

A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Klebsiella pneumoniae
D) Haemophilus influenzae

Answer 3

A
Diseases associated with M.pneumoniae typically occur throughout the year,without marked seasonal variability.The incidence of viral infections and secondary bacterial pneumonias is reduced during the summer months; therefore M.pneumoniae may cause up to 50% of all pneumonias in the summer months.

Question 4

Elements of the respiratory tract that can help prevent infection include all the following EXCEPT:

A) Nasal hair
B) Normal florae
C) Coughing
D) Epiglottis

Question 5

All of the following are complications of acute sinusitis EXCEPT:

A) Acute pharyngitis
B) Meningitis
C) Osteomyelitis
D) Orbital cellulitis

Question 6

What are the two most frequently identified bacterial causes of community-acquired sinusitis?

A) Staphylococcus aureus and Escherichia coli
B) Streptococcus pneumoniae and Haemophilus influenzae
C) S. pneumoniae and Mycoplasma pneumoniae
D) H. influenzae and Neisseria meningitidis

Question 7

Which of the immunocompromised circumstances listed here is a form of functional immunodeficiency?

A) Sex
B) Age
C) Chronic illness
D) Pregnancy

Question 8

What organisms are most frequently isolated from cultures of individuals with otitis media?

A) Staphylococcus aureus and Escherichia coli
B) Streptococcus pneumoniae and Haemophilus influenzae
C) S. pneumoniae and Mycoplasma pneumoniae
D) H. influenzae and Neisseria meningitidis

Question 9

What is the cause of reduced clearance of respiratory secretions that predisposes people to respiratory infections?

A) Obstruction of a foreign body
B) Alterations in the viscosity of the mucus
C) Immature anatomic development
D) All of the above

Question 10

What organism causes epiglottis?

A) Haemophilus influenzae
B) Streptococcus pneumoniae
C) Moraxella catarrhalis
D) Bordetella pertussis

Question 11

All the following are virulence factors that allow microorganisms to produce disease,EXCEPT:

A) Adherence
B) Toxin elaboration
C) Mucus production
D) Host evasion

Question 12

What common condition will predispose individuals to acute sinusitis?

A) Cold sores
B) Ear infections
C) Nosebleeds
D) Allergies

Question 13

Why is pharyngitis produced by group A streptococcus treated with antibiotics?

A) To prevent rheumatic fever and acute glomerulonephritis
B) To prevent epiglottis
C) To prevent swelling of tonsils
D) To prevent swelling of soft tissues in the pharynx

Question 14

When reading culture plates from respiratory specimens,what must the microbiologist take into consideration?

A) The types of organisms normally found at the culture site
B) The amount of media inoculated
C) The quality control performed on the media
D) The patient's physician

Question 15

What is helpful when initiating empiric antimicrobial therapy?

A) Knowing the patient's age
B) Knowing the pathogens most likely to cause a particular type of infection
C) Knowing a patient's medical history
D) Knowing the anatomy of the respiratory tract

Question 16

All of the following factors can help the microbiologist differentiate between colonization and infection,EXCEPT:

A) Presence of a pure culture or mixed florae on the culture plates
B) Method and site of collection of the specimen
C) Presence of white blood cells (WBCs) and the number of organisms seen on Gram stain
D) A compatible clinical syndrome

Question 17

Why do most physicians treat otitis media empirically instead of obtaining cultures before prescribing antibiotics?

A) It is hard to hard to obtain cultures from children.
B) Cultures do not always correlate with the true pathogen.
C) Pathogens causing otitis media never become resistant to antibiotics.
D) The predominant infection causing organisms are known.

Question 18

What is the most common localized infection of the upper respiratory tract in preschool-age patients?

A) Orbital cellulitis
B) Acute sinusitis
C) Otitis media
D) Mastoiditis

Question 19

Acute sinusitis usually occurs as a complication of:

A) Bacterial pneumonia
B) Viral pneumonia
C) Common cold
D) Streptococcal pharyngitis

Question 20

What should a microbiologist do if he or she finds a-hemolytic colonies on a properly collected sputum specimen on a patient suspected of having lobar pneumonia?

A) Ignore the colonies because they are normal florae.
B) Ignore the colonies because no known pathogens for pneumonia are a-hemolytic.
C) Do a full workup to identify the organism.
D) Suspect a bioterror agent, and send the isolate to a laboratory response network (LRN) reference laboratory.

Question 21

How is acute bronchitis differentiated from acute pneumonia?

A) The degree and extent of involvement of the lower respiratory tract with the infectious process
B) The involvement of the bronchial tree with the infectious process
C) The degree of obstruction of the alveoli with the purulent secretions
D) The amount of mucus secretion produced by the lower respiratory tract

Question 22

What is the specimen of choice for recovery of Bordetella pertussis?

A) Dacron nasopharyngeal swabs
B) Rayon nasopharyngeal swabs
C) Calcium alginate nasopharyngeal swabs
D) Cotton nasopharyngeal swabs

Question 23

Nosocomial pneumonia can be caused by all of the following EXCEPT:

A) Pseudomonas aeruginosa
B) Streptococcus pneumoniae
C) Acinetobacter baumannii
D) Methicillin-resistant Staphylococcus aureus (MRSA)

Question 24

What virus causes community-wide seasonal outbreaks of bronchiolitis in infants?

A) Rhinovirus
B) Parainfluenza virus
C) Respiratory syncytial virus (RSV)
D) Influenzae virus

Question 25

What does infection with influenza predispose patients to?

A) Secondary otitis media
B) Secondary sinusitis
C) Secondary pharyngitis
D) Secondary bacterial pneumonia

Question 26

What is the major cause for chronic bronchitis?

A) Acute bronchitis
B) Respiratory allergies
C) Pneumonia
D) Smoking

Question 27

What organism is the most common opportunistic pathogen that routinely infects patients with HIV/AIDS?

A) Pneumocystis carinii
B) Mycoplasma pneumoniae
C) Serratia marcescens
D) Respiratory syncytial virus (RSV)

Question 28

What is the most common complication of pertussis?

A) Otitis media
B) Pneumonia
C) Acute sinusitis
D) Streptococcal pharyngitis

Question 29

The clinical picture of this condition includes an incubation period of 2 to 10 days,fever,with or without cough,and dyspnea.The condition may resolve or progress to a more severe form.What is this condition?

A) Severe acute respiratory syndrome (SARS)
B) Streptococcal pneumonia
C) Viral pneumonia
D) Viral bronchitis

Question 30

What is empyema?

A) A collection of fluid in the lung resulting from the pathogenesis of bacterial pathogens
B) A collection of fluid in the lung resulting from the pathogenesis of viral pathogens
C) A collection of purulent fluid in the pleural space between the lung and the chest wall
D) A collection of purulent fluid in the bronchii and alveoli

Question 31

What is a chronic pneumonia?

A) A viral pneumonia that lasts for months
B) A pneumonia that is caused by a slow-growing bacteria such as Bacillus anthracis and takes months to resolve
C) A bacterial pneumonia that become resistant to antibiotic therapy
D) A pneumonia that appears to resolve clinically, but where radiographic lung abnormalities persist for a long period

Question 32

What type of pneumonia has been associated with Staphylococcus aureus that produces Panton-Valentine leukocidin?

A) Methicillin-resistant pneumonia
B) Necrotizing pneumonia
C) Bacterial
D) Viral

Question 33

What usually causes community-acquired pneumonias in children during the winter months?

A) Haemophilus influenzae
B) Streptococcus pneumoniae
C) Viral pathogens
D) Legionella spp.