Deck 16: Infectious Diseases Affecting the Skin and Eyes

Question 1

The integument includes all of the following except

A)skin.
B)hair.
C)nails.
D)sweat glands.
E)surface capillaries.

Answer 1

E

Question 2

All species of Staphylococcus

A)lack spores.
B)are motile.
C)have capsules.
D)produce coagulase.
E)All of the choices are correct.

Answer 2

A

Question 3

Protective features of the skin include all but

A)keratinized surface.
B)resident biota.
C)antimicrobial peptides.
D)high pH.
E)lysozyme.

Answer 3

D

Question 4

Which of the following is not true of cellulitis?

A)caused by Staphylococcus aureus or Streptococcus pyogenes
B)occurs in the epidermis
C)causes pain,tenderness,swelling,and warmth
D)lymphangitis may occur
E)treated with cephalexin

Question 5

Streptococcus pyogenes causes all of the following except

A)necrotizing fasciitis.
B)erysipelas.
C)impetigo.
D)scarlet fever.
E)scalded skin syndrome.

Question 6

What group of microorganisms do not usually call the skin "home"?

A)Streptococcus
B)Corynebacterium
C)Propionibacterium
D)yeasts
E)All of the choices are correct.

Question 7

Blisters

A)are confined to the epidermis.
B)originate in the dermis.
C)originate in the subcutaneous layer.
D)result from a separation of epidermis from dermis.
E)None of the choices is correct.

Question 8

The toxin of Staphylococcus aureus strains that causes blisters and desquamation of skin in scalded skin syndrome is

A)enterotoxin.
B)hemolysin.
C)toxic shock syndrome toxin.
D)exfoliative toxin.
E)erythrogenic toxin.

Question 9

Infections caused by Staphylococcus aureus include all of the following except

A)meningitis.
B)furuncles and carbuncles.
C)impetigo.
D)scalded skin syndrome.
E)acne.

Question 10

Impetigo is caused by

A)Propionibacterium acnes.
B)Corynebacterium diphtheriae.
C)Staphylococcus aureus.
D)Streptococcus pyogenes.
E)both Staphylococcus aureus and Streptococcus pyogenes.

Question 11

Which of the following is the most common form of microbe transmission in impetigo?

A)fomites
B)direct contact
C)mechanical vectors
D)blood
E)body fluids

Question 12

All Staphylococci can be differentiated from all Streptococci because only Staphylococci produce the enzyme _____ that is easily detected in the lab.

A)staphlokinase
B)exfoliative toxin A
C)exfoliative toxin B
D)catalase
E)lactase

Question 13

What material in skin cells provides protection from abrasions,water damage,and microorganism entry?

A)lysozyme
B)keratin
C)sweat
D)sebum
E)salt

Question 14

Which of the following is not true of Propionibacterium acnes?

A)anaerobic or aerotolerant
B)gram-negative rod
C)releases lipase
D)attracts white blood cells
E)present in hair follicles

Question 15

Staphylococcus can be differentiated from Streptococcus by the

A)Gram stain.
B)coagulase test.
C)catalase test.
D)fermentation of mannitol.
E)None of the choices is correct.

Question 16

Blood vessels are found in the

A)stratum corneum.
B)dermis.
C)stratum basale.
D)subcutaneous layer.
E)dermis and subcutaneous layer.

Question 17

MRSAs are Staphylococcus aureus strains that are

A)resistant to mupirocin.
B)responsive to mupirocin.
C)resistant to penicillin derivatives.
D)responsive to penicillin derivatives.
E)related to Streptococcus pyogenes.

Question 18

All of the following pertain to Streptococcus pyogenes except

A)is often from an endogenous source.
B)secretes streptokinase.
C)causes impetigo.
D)coats itself with host proteins.
E)causes gas gangrene.

Question 19

What enzyme is not found in Staphylococcus epidermidis but is found in Staphylococcus aureus?

A)peroxidase
B)catalase
C)lysozyme
D)coagulase
E)lipase

Question 20

The enzyme that coagulates plasma is

A)catalase.
B)coagulase.
C)hyaluronidase.
D)staphylokinase.
E)kinase.

Question 21

Which form of anthrax involves a black eschar on the skin?

A)pulmonary
B)gastrointestinal
C)cutaneous
D)All of the choices are correct.
E)None of the choices is correct.

Question 22

Which of the following is not true of staphylococcal scalded skin syndrome (SSSS)?

A)affects mostly newborns and babies
B)an exotoxin-mediated disease
C)toxin causes bullous lesions
D)split in skin occurs between the dermis and epidermis
E)split in skin occurs within the epidermis

Question 23

Transmission of the pathogen of Leishmaniasis is by the

A)reduviid "kissing" bug.
B)tsetse fly.
C)anopheles mosquito.
D)sand fly.
E)hard-bodied tick.

Question 24

Oral lesions called Koplik's spots are seen in patients with

A)croup.
B)mumps.
C)influenza.
D)measles (rubeola).
E)rubella.

Question 25

Varicella zoster virus (human herpesvirus-3)

A)uses the respiratory epithelium as its portal of entry.
B)becomes latent in dorsal root ganglia that serve specific dermatomes.
C)has humans as its reservoir.
D)causes chickenpox and shingles.
E)All of the choices are correct.

Question 26

Transmission of tineas includes

A)human to human.
B)animal to human.
C)soil to human.
D)fomites to human.
E)All of the choices are correct.

Question 27

The smallpox vaccine uses the _____ virus.

A)smallpox
B)herpes simplex
C)vaccinia
D)herpes virus 6
E)None of the choices is correct.

Question 28

Smallpox is a disease

A)in which fever,prostration,rash,and possible toxemia and shock occur.
B)in which the virus becomes latent in ganglia of sensory neurons.
C)in which recurrent episodes are called shingles.
D)that can only be transmitted by direct skin contact with skin crusts.
E)All of the choices are correct.

Question 29

Fifth disease

A)is caused by Parvovirus B19.
B)is a childhood febrile disease with a bright red rash on the cheeks.
C)cannot be prevented at this time with vaccination.
D)has a maculopapular rash that lasts for days to weeks.
E)All of the choices are correct.

Question 30

Rubella is

A)caused by the measles virus (Morbillivirus).
B)a very contagious disease.
C)associated with congenital transmission causing miscarriage,deafness,and cardiac and mental defects.
D)seen as high fever,severe sore throat,severe cough,and myalgia.
E)All of the choices are correct.

Question 31

All of the following pertain to measles (rubeola)except

A)it is transmitted by direct contact with the rash.
B)humans are the only reservoir for the pathogen.
C)secondary bacterial otitis media and sinusitis can occur.
D)it involves a fatal complication called subacute sclerosing panencephalitis (SSPE).
E)dry cough,sore throat,fever,and conjunctivitis are symptoms.

Question 32

Which of the following is mismatched?

A)tinea capitis - ringworm of the beard
B)tinea pedis - ringworm of the foot
C)tinea cruis - ringworm of the groin
D)tinea corporis - ringworm of the body
E)tinea unguium - ringworm of the nails

Question 33

Human herpesvirus 6 (HHV-6)has the following characteristics except

A)starts with a high fever.
B)causes roseola in infants and young children.
C)appears as a mononucleosis-like illness in adults.
D)a rash appears on the fourth day.
E)it is a very rare form of herpesvirus.

Question 34

If a person who has never been infected with the varicella zoster virus comes in contact with a person who has shingles,the first person will come down with

A)herpes labialis.
B)shingles.
C)chickenpox.
D)infectious mononucleosis.
E)herpes keratitis.

Question 35

Chickenpox

A)is transmitted by droplet contact.
B)lesion distribution is centripetal.
C)has an incubation of 10 to 20 days.
D)has fever and vesicular rash that occurs in successive crops.
E)All of the choices are correct.

Question 36

Which of the following is not true of rubeola?

A)causative agent is a member of the Morbillivirus genus
B)it is a single-stranded,nonenveloped RNA virus
C)it is in the Paramyxovirus family
D)causes cell membranes to fuse to form syncytia
E)transmitted by respiratory droplets

Question 37

This febrile disease with a rash has a pathogen that can cross the placenta and cause serious fetal damage.

A)croup
B)mumps
C)influenza
D)measles (rubeola)
E)rubella

Question 38

Measles is described as a ______ skin lesion.

A)purpura
B)bulla
C)papule
D)macule
E)maculopapular

Question 39

Which is incorrect about the MMR immunization?

A)contains attenuated virus
B)contains toxoids
C)is given in early childhood
D)protects against three different viral diseases
E)None of the choices is correct.

Question 40

Measles is also known as

A)rubella.
B)shingles.
C)rubeola.
D)fifth disease.
E)varicella.

Question 41

Herpes keratitis is an infection of the eye.

Question 42

Varicella and herpes zoster are caused by the same virus.

Question 43

The most serious teratogenic effects of intrauterine rubella infection occur if it is acquired during the third trimester.

Question 44

Based on the patient's symptoms,you suspect that she will be diagnosed with

A)smallpox.
B)chickenpox.
C)shingles.
D)systemic wart syndrome.

Question 45

Mottled,discolored pigmentation is seen in patients with tinea versicolor.

Question 46

What is the only way to prevent conjunctivitis?

A)wear insect repellent
B)good hygiene
C)trifluridine or acyclovir treatment
D)ivermectin treatment
E)prophylactic antibiotics

Question 47

Which of the following is not true of bacterial conjunctivitis?

A)transmitted through both direct and indirect contact
B)can be caused by Streptococcus pyogenes or Streptococcus pneumoniae
C)treatment is with a broad-spectrum topical antibiotic
D)has a clear discharge
E)can be caused by Staphylococcus aureus,Haemophilus influenzae,or Neisseria gonorrhoeae

Question 48

One of your nurses begins calling the state health department to report a suspected case of smallpox infection.You stop her,citing the distinct differences between the symptoms of chickenpox and smallpox.Which of the following answers is not true concerning the two diseases?

A)Smallpox features deep lesions mainly on the extremities,whereas chickenpox features superficial lesions mainly on the trunk.
B)Smallpox patients exhibit a prodromal fever,whereas chickenpox patients do not.
C)Smallpox lesions are filled with clear fluid,whereas chickenpox lesions are filled with a thick,opaque liquid and are distinctly indented in the center.
D)Smallpox is caused by the variola virus,whereas chickenpox is caused by human herpesvirus 3.

Question 49

Propionibacterium acnes is normal flora of sebaceous glands of the skin.

Question 50

Smallpox is caused by an orthopoxvirus.

Question 51

Herpesviruses are double-stranded,nonenveloped DNA viruses.

Question 52

Keratitis is usually caused by

A)Streptococcus pyogenes.
B)Staphylococcus aureus.
C)herpes simplex.
D)Neisseria gonorrhoeae.
E)All of the choices are correct.

Question 53

The eye generally has a large percentage of normal biota present.

Question 54

Which of the following is not a causative agent of cutaneous mycoses?

A)Malassezia
B)Trichophyton
C)Microsporum
D)Epidermophyton
E)All of the choices are correct.

Question 55

Which of the following is the causative agent of tinea versicolor?

A)Malassezia
B)Trichophyton
C)Microsporum
D)Epidermophyton
E)None of the choices is correct.

Question 56

Which is true of viral conjunctivitis?

A)caused by Chlamydia trachomatis or Neisseria gonorrhoeae
B)has a mucopurulent discharge
C)caused by adenoviruses
D)must be treated with topical and oral antibiotics
E)caused by Moraxella

Question 57

Which of the following provides the eye with its best defense against microorganisms?

A)conjunctiva
B)eyelids
C)lymphocytes
D)tears
E)eyelashes

Question 58

Occassionally Staphylococcus epidermidis may be isolated from the eye.

Question 59

The eye's best defense is/are the

A)optic nerve.
B)eyelid.
C)eyelashes.
D)tear film.
E)cornea.

Question 60

Impetigo involves itching papules that break and form a very contagious yellow crust.

Question 61

You discover the child shares a bedroom with her 12-year-old sister,who has not had chickenpox and has not been vaccinated against it either.She is supposed to go to summer camp in 1 week.The mother wants to know if it is safe to let her go to camp.How will you best respond to her question?

A)"Yes,it is safe for her to go.Since chickenpox has an incubation period of 3-5 days,she would have exhibited symptoms of the disease already if she had contracted it."
B)"Yes,it is safe for her to go.Chickenpox is rarely contracted by children older than 10 years of age."
C)"No,it is not safe for her to go.Since chickenpox has an incubation period of 10-20 days,she could begin exhibiting symptoms at camp."
D)"No,it is not safe for her to go.Since she was exposed to her sister,she will be contagious to other kids at camp but will probably not exhibit symptoms."

Question 62

You need to obtain a specimen for microbial analysis.What is the best location to culture from in this case?

A)The lesion itself,since there seems to be a superficial infection.
B)The mouth for sputum,since it is most likely the culprit.
C)The blood,since the infection was probably carried systemically.
D)The urine,since the kidneys are probably flushing the infection from the body.

Question 63

The mother demands antibiotics to treat her daughter's infection.How will you best respond to her request?

A)Advocate that the physician should write a prescription for oral amoxicillin,because the mother always knows best.
B)Inform the mother that she is not a trained professional and should not be advising medical staff on proper treatments.
C)Tell the mother she can purchase a triple-antibiotic ointment over the counter to apply to all lesions three times daily.
D)Inform the mother that chickenpox is caused by a virus and does not respond to antibiotics,but is self-limiting and will heal on its own.

Question 64

What is the most likely diagnosis based on your clinical findings?

A)keratitis
B)neonatal conjunctivitis
C)bacterial conjunctivitis
D)viral conjunctivitis
E)The discharge must be cultured to make a diagnosis.

Question 65

As you suspect,the doctor diagnoses the lesions as S.aureus impetigo.The mother then asks you why her daughter's affected skin seems so fragile and blisters so easily.What will be your response to her question?

A)"The constant exposure to moisture makes your daughter's skin very fragile,and blistering is the natural response."
B)"Your daughter's constant itching irritates the skin,making it very fragile and irritable."
C)"The blood beneath the surface of the skin is broken down by waste products from S.aureus,and superficial blisters are the clinical sign."
D)"An exotoxin produced by S.aureus targets a protein responsible for cell-to-cell binding,and blisters are the result."

Question 66

What infectious control procedures,if any,should be carried out?

A)Send the kids home,but they can come back to school in the morning as long as hand washing is encouraged.
B)Send the kids home until symptoms have cleared,recommend good hand washing and hygiene to the rest of the school.
C)Obtain prescriptions of ciprofloxacin drops for those affected students.
D)Recommend total school shutdown until further notice to the superintendent.

Question 67

One student came back to school the next day with a note from her mother stating her child's doctor had prescribed oral ceftriaxone.She is really not comfortable with the use of antibiotics.What is the best response to the mother's question?

A)"Antibiotics are effective at clearing viral infections."
B)"Antibiotics are often given prophylactically,even if viral conjunctivitis is suspected."
C)"Antibiotics are needed to reduce her daughter's chances of contracting MRSA."
D)"Antibiotics were not indicated in her daughter's case;she actually needed an antiprotozoal drug for treatment."

Question 68

In the lab,the specimen is Gram-stained and inoculated onto blood agar.Microscopic analysis of the slide revealed gram-positive cocci arranged in grapelike clusters,while the blood agar produced large,round,creamy colonies with clear areas of hemolysis.After reading this information,you believe the causative agent to be

A)Streptococcus pyogenes.
B)Staphylococcus aureus.
C)Corynebacterium diphtheriae.
D)Pseudomonas aeruginosa.

Question 69

The lab results also indicate that the specimen was inoculated into a test tube of plasma.Remembering the coagulase test from microbiology class,which result would be consistent with a diagnosis of S.aureus infection?

A)The sample remains liquid.
B)The sample completely coagulates.
C)The sample develops a flocculent precipitate.
D)The sample turns yellow and remains liquid.