Deck 19: The Gram-Positive Bacilli of Medical Importance

Question 1

Production of a neurotoxin that binds to target sites on spinal cord neurons responsible for inhibiting skeletal muscle contraction is a characteristic of:

A)Clostridium botulinum.
B)Clostridium perfringens.
C)Clostridium difficile.
D)Clostridium tetani.
E)All of the choices are correct.

Answer 1

D

Question 2

All of the following pertain to Clostridium difficile infection, except:

A)it is due to ingestion of contaminated, improperly stored, cooked meats and gravies.
B)it is a colitis that is a superinfection.
C)it often has an endogenous source.
D)it may be on the rise due to increased use of gastric acid inhibitors.
E)it is major cause of diarrhea in hospitals.

Answer 2

A

Question 3

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 are correct.

Answer 3

C

Question 4

This organism can infect deeper wound sites and produce exotoxins, enzymes, and gas that cause tissue and muscle necrosis:

A)Clostridium botulinum
B)Clostridium perfringens
C)Clostridium difficile
D)Clostridium tetani
E)All of the choices are correct.

Question 5

Treatment and control of anthrax includes:

A)use of antimicrobics, such as ciprofloxacin for active cases.
B)vaccination of livestock.
C)toxoid for military and those with occupational exposure.
D)proper disposal of animals that have died from anthrax.
E)All of the choices are correct.

Question 6

Which of the following pertains to diphtheria?

A)it results in meningitis.
B)symptoms include vomiting and diarrhea.
C)it can be transmitted from mother's birth canal to neonate.
D)it is prevented by the DTaP immunization.
E)All of the choices are correct.

Question 7

All of the following pertain to infant botulism, except:

A)symptoms include "floppy baby" appearance.
B)neurotoxin is not involved in the disease process.
C)ingested spores can germinate in the immature intestines of the neonate.
D)symptoms include flaccid paralysis and respiratory complications.
E)it is the most common type of botulism in the United States.

Question 8

Characteristics of Bacillus anthracis include all the following, except:

A)capsule and exotoxins are virulence factors.
B)anaerobic.
C)reservoir includes infected grazing animals and contaminated soil.
D)gram positive bacillus.
E)sporeformer.

Question 9

The foodborne disease that involves neurotoxin is:

A)gastrointestinal anthrax.
B)Bacillus cereus intoxication.
C)botulism.
D)Clostridium perfringens gastroenteritis.
E)All of the choices are correct.

Question 10

Production of a neurotoxin that prevents acetylcholine release from motor neurons at neuromuscular junctions is a characteristic of:

A)Clostridium botulinum.
B)Clostridium perfringens.
C)Clostridium difficile.
D)Clostridium tetani.
E)All of the choices are correct.

Question 11

Botulin, the toxin of botulism is:

A)not as virulent as tetanospasmin.
B)detected and diagnosed by analyzing a patient's blood.
C)the cause of rigid paralysis.
D)only produced under anaerobic conditions.
E)produced when spores germinate in the intestines of adults after ingesting contaminated food.

Question 12

Formation of a pseudomembrane in the back of the throat is seen in:

A)diphtheria.
B)listeriosis.
C)tuberculosis.
D)erysipeloid.
E)botulism.

Question 13

All of the following pertain to listeriosis, except:

A)it causes symptoms of fever, diarrhea, and sore throat.
B)it causes a serious septicemia and meningitis in the elderly, immunocompromised, and infants.
C)intrauterine infection usually results in fetal death.
D)adequate pasteurization and thorough cooking of food can improve prevention.
E)enterotoxin of the organism causes symptoms.

Question 14

Anthrax is:

A)a zoonosis.
B)transmitted by contact, inhalation, and ingestion.
C)a disease that, in humans, can cause a rapidly fatal toxemia and septicemia.
D)only seen sporadically in the United States.
E)All of the choices are correct.

Question 15

All of the following pertain to Listeria monocytogenes, except:

A)gram positive
B)sporeformer
C)contaminant of dairy products, meats, poultry
D)causes foodborne listeriosis
E)bacterial cells multiply within the cytoplasm of a host cell

Question 16

This type of anthrax is called "wool-sorter's disease":

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

Question 17

Which of the following pertains to both tetanus and foodborne botulism?

A)it occurs when spore-contaminated soil enters deep wounds
B)it is caused by enterotoxins of the pathogen
C)exotoxin blocks acetylcholine release
D)nausea and diarrhea are symptoms
E)treatment involves antitoxin therapy

Question 18

Erysipeloid is transmitted by:

A)inhalation of spores from hides and wool of animals.
B)ingestion of improperly cooked hot dogs.
C)an abrasion on skin coming in contact with infected swine or other animals.
D)contaminated soil entering deep puncture wounds.
E)respiratory secretions.

Question 19

Which is not correct about Bacillus cereus?

A)present in soil
B)produce enterotoxins
C)causes foodborne intoxication
D)causes a zoonosis
E)associated with cooked rice, potato, and meat dishes that are stored at room temperature

Question 20

Production of enterotoxin is a characteristic of:

A)Clostridium botulinum.
B)Clostridium perfringens.
C)Clostridium difficile.
D)Clostridium tetani.
E)All of the choices are correct.

Question 21

Botulism will always be a threat for people who:

A)are meat eaters.
B)are vegetarians.
C)have a weakened immune system.
D)consume home-preserved foods.
E)eat often in restaurants.

Question 22

Actinomyces israelii:

A)can be transmitted by respiratory droplets.
B)can cause pneumonia with symptoms similar to tuberculosis.
C)are filamentous rods that grow in clusters called sulfur granules in infected tissue.
D)lives in the soil.
E)causes most cases in the immunocompromised.

Question 23

Which is not a characteristic of Nocardia?

A)it can be transmitted by respiratory droplets.
B)it can cause pneumonia with symptoms similar to tuberculosis.
C)they are filamentous rods that grow in clusters called sulfur granules in infected tissue.
D)it lives in the soil.
E)it causes most cases in the immunocompromised.

Question 24

The major virulence factor of Corynebacterium diphtheriae that causes serious systemic effects is:

A)capsule.
B)metachromatic granules.
C)exotoxin.
D)endospores.
E)endotoxin.

Question 25

Which of the following is not true about leprosy?

A)it is caused by Hansen's bacillus in honor of its discoverer
B)the leprosy bacillus is highly virulent
C)armadillos harbor a genetically identical M.leprae
D)early signs appear as small, spotty lesions colored differently than the surrounding skin
E)the number of new cases in the U.S.each year is about 100 to 200

Question 26

A diagnosis of tuberculosis involves:

A)chest X-ray.
B)acid fast stain of sputum.
C)sputum culture.
D)tuberculin skin test.
E)All of the choices are correct.

Question 27

All of the following are true about diphtheria toxin, except:

A)it inhibits cellular protein synthesis.
B)it must be neutralized with antitoxin.
C)it primarily targets the heart and nerves.
D)it is an exotoxin.
E)antitoxin (DAT) comes from immunized human plasma donors.

Question 28

Which of the following is not true about diphtheria?

A)it is a zoonosis
B)humans can be healthy carriers
C)it is prevented with the DTaP vaccine
D)it is an upper respiratory infection
E)it can be transmitted via contaminated milk

Question 29

Lepromatous leprosy:

A)can cause lepromas.
B)is the most disfiguring.
C)pathogen grows extensively in cooler body areas, such as nose, ears, testes.
D)complications include secondary infections, kidney, or respiratory failure.
E)includes all of these choices.

Question 30

All of the following pertain to tuberculosis, except:

A)live bacilli can remain dormant in the lungs and reactivate later in life.
B)symptoms of active TB include low-grade fever, coughing, fatigue, weight loss, and night sweats.
C)lung infection can disseminate to many other organs in extrapulmonary TB.
D)the BCG vaccine is used in other countries.
E)antimicrobials cannot treat and cure tuberculosis.

Question 31

Swimming pool granuloma is caused by:

A)Mycobacterium avium complex (MAC).
B)Mycobacterium kansasii.
C)Mycobacterium scrofulaceum.
D)Mycobacterium fortuitum complex.
E)Mycobacterium marinum.

Question 32

Tuberculoid leprosy:

A)causes asymmetrical, shallow skin lesions with loss of pain sensation.
B)is the most disfiguring.
C)pathogen grows extensively in cooler body areas such as nose, ears, testes.
D)complications include secondary infections, kidney, or respiratory failure.
E)includes all of these choices.

Question 33

Causes a non-communicable pulmonary infection that resembles tuberculosis:

A)Mycobacterium avium complex (MAC)
B)Mycobacterium kansasii
C)Mycobacterium scrofulaceum
D)Mycobacterium fortuitum complex
E)Mycobacterium marinum

Question 34

Generally, what must healthy adults consume in order to contract botulism?

A)spores of C.botulinum
B)vegetative cells of C.botulinum
C)botulin toxin on contaminated food
D)botulin toxoid on contaminated food
E)botulin antitoxin on contaminated food

Question 35

For which of the following diseases does the "feather test" provide evidence of early infection?

A)tuberculosis
B)botulism
C)tetanus
D)leprosy
E)anthrax

Question 36

Tuberculin skin testing:

A)injects PPD intradermally.
B)uses a purified protein filtrate of Mycobacterium tuberculosis.
C)will be positive if person has had previous exposure.
D)will be positive in active TB.
E)All of the choices are correct.

Question 37

Mycobacterium tuberculosis:

A)produces several virulence factor enzymes and an exotoxin.
B)has a cord factor that can prevent destruction by lysosomes and macrophages.
C)is a spore former.
D)has a capsule.
E)lives in the soil.

Question 38

Leprosy is a disease:

A)of lung tissue.
B)that has been eradicated around the world.
C)caused by a pathogen that cannot be cultured in the lab.
D)can be diagnosed by the Mantoux test.
E)caused by a sporeforming, gram-positive bacillus.

Question 39

The common soil mycobacteria that frequently cause systemic infection and death in AIDS patients is:

A)Mycobacterium avium complex (MAC).
B)Mycobacterium kansasii.
C)Mycobacterium scrofulaceum.
D)Mycobacterium fortuitum complex.
E)Mycobacterium marinum.

Question 40

Which is not correct about Mycobacterium species?

A)all species are human pathogens
B)cell walls have waxy lipids
C)acid fast
D)usually have a slow growth rate
E)long, slender rods

Question 41

Botulism is often referred to as lockjaw.

Question 42

The granulomas that develop in the lung tissue during tuberculosis are termed _____.

Question 43

Debridement of diseased tissue is important in the care of patients with gas gangrene.

Question 44

What is the usual cause of pseudomembranous colitis?

A)improperly home-preserved foods containing botulin toxin
B)eating unpasteurized dairy containing Listeria monocytogenes
C)handling infected animals contaminated with E.rhusiopathiae
D)therapy with broad-spectrum antibiotics leading to superinfection by C.difficile
E)living in close contact with someone infected with C.perfringens

Question 45

Botox injections contain botulin toxin.

Question 46

Hyperbaric treatment involves putting patients in a chamber that has a higher amount of _____.

Question 47

A black eschar develops on the hand or arm of a patient with erysipeloid.

Question 48

In both botulism and tetanus, respiratory muscles cannot facilitate breathing and, if untreated, respiratory collapse leads to death.

Question 49

The _____ test injects 0.1 ml of PPD intradermally into the forearm.

Question 50

Tetanus can be prevented with the DTaP childhood immunization and boosters of the tetanus toxoid.

Question 51

Which of the following is NOT characteristic of Actinomyces israelii?

A)Important for compost production
B)Found in soil
C)Rods with colonies displaying hyphael growth
D)Strict aerobe
E)Non-endospore former

Question 52

Listeria monocytogenes does not grow in refrigerated foods.

Question 53

Mild, uncomplicated cases of pseudomembranous colitis may be treated by:

A)debridement.
B)wound cleansing.
C)vancomycin for several weeks.
D)withdrawal of antibiotics and replacement of lost fluids and electrolytes.
E)All of the choices are correct.

Question 54

Which of the following may be recommended for treating gangrene?

A)debridement of the wound
B)hyperbaric chamber
C)amputation of affected limb
D)rigorous cleansing of deep wounds
E)All of the choices are correct

Question 55

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

Question 56

What is the causative agent of Farmer's Lung and Bagossis?

A)Actinomyces israelii
B)Nocardia
C)Mycobacterium tuberculosis
D)Bacillus anthracis
E)Clostridium perfringens

Question 57

Thoracic _____ is a complication of a burst appendix or gunshot wound.

Question 58

The fermentation by-products of Clostridium perfringens can destroy muscle structure in myonecrosis.

Question 59

Diphtherotoxin targets cells in the _____ and _____.

Question 60

People who have received the BCG immunization will generally have a negative tuberculin skin test.

Question 61

Using specific examples, discuss how gram positive bacilli are divided into major genera.At the very least include the oxygen requirements, sporulation characteristics, and acid-fast test results.

Question 62

_____ is a chronic progressive disease of the skin and nerves caused by Mycobacterium leprae.

Question 63

Mycobacterium bovis is attenuated and used in the _____ vaccine.

Question 64

Compare and contrast primary tuberculosis, secondary tuberculosis, and extrapulmonary tuberculosis.

Question 65

In addition to antimicrobics, patients with diphtheria are treated with _____.

Question 66

Discuss the types of foods and food preparation associated with foodborne botulism, and explain how neurotoxins gain entry to the foods.

Question 67

Compare and contrast botulism and tetanus with regard to: a) transmission, b) virulence factors, c) location of target tissue and effect on the tissue, d) symptoms, e) treatment, and f) prevention.

Question 68

When the centers of tubercles break down into _____ lesions, they gradually heal by calcification that replaces normal lung tissue.