Deck 22: Microbial Diseases of the Respiratory System

Question 1

Which of the following allows group A streptococci to spread through tissues by breaking down blood clots?

A) M proteins
B) a hyaluronic acid capsule
C) streptolysin
D) streptokinase
E) pyrogenic toxins

Answer 1

D

Question 2

The majority of cases of pneumonia are caused by

A) Mycoplasma pneumoniae.
B) Klebsiella pneumoniae.
C) Haemophilus influenzae.
D) Streptococcus pneumoniae.
E) Chlamydophila pneumoniae.

Answer 2

D

Question 3

What is the primary determinant of virulence in Streptococcus pneumoniae?

A) the presence of a particular Lancefield antigen
B) the production of pneumolysin
C) the presence of a polysaccharide capsule
D) the ability to lyse red blood cells
E) strain-specific teichoic acids in its cell wall

Answer 3

C

Question 4

Diphtheria toxin kills cells by interfering with which of the following processes?

A) complement function
B) nucleic acid synthesis
C) cytoplasmic membrane function
D) protein synthesis
E) adenylate cyclase activity

Question 5

Bordetella pertussis causes whooping cough by

A) interfering with the activity of ciliated epithelial cells in the trachea.
B) the development of pneumonia.
C) suppressing mucus production.
D) forming a pseudomembrane that obstructs the respiratory passages.
E) irritating the diaphragm, which leads to severe coughing attacks.

Question 6

Bordetella pertussis produces

A) dermonecrotic toxin.
B) adenylate cyclase toxin.
C) pyrogenic toxin.
D) dermonecrotic and adenylate cyclase toxins.
E) dermonecrotic, adenylate cyclase and pyrogenic toxins.

Question 7

Which of the following statements is TRUE concerning diphtheria?

A) No effective vaccine is available to prevent infection.
B) A diffuse rash is the major sign of diphtheria.
C) The signs and symptoms of the disease are directly caused by a bacterial toxin.
D) The pseudomembrane is easily removed by surgery.
E) A microscopic exam of bacterial samples is sufficient for conclusive diagnosis.

Question 8

The DTaP vaccine protects against which of the following respiratory diseases?

A) pneumonia
B) pertussis
C) anthrax
D) the common cold
E) tuberculosis

Question 9

Which of the following is part of the upper respiratory system?

A) larynx
B) trachea
C) bronchi
D) pharynx
E) alveoli

Question 10

Which of the following is associated with some cases of streptococcal pharyngitis?

A) acute glomerulonephritis
B) scarlet fever
C) rheumatic fever
D) both scarlet fever and rheumatic fever
E) acute glomerulonephritis, scarlet fever and rheumatic fever.

Question 11

Which of the following is extremely fastidious in its nutrient requirements, which include iron salts and cysteine?

A) Mycobacterium tuberculosis
B) Streptococcus pyogenes
C) Bordetella pertussis
D) Bacillus anthracis
E) Legionella pneumophila

Question 12

Which of the following is considered part of the microbiota of the lower respiratory system?

A) Staphylococcus aureus
B) Streptococcus pneumoniae
C) Streptococcus pyogenes
D) Pneumocystis jiroveci
E) Haemophilus influenzae

Question 13

Which of the following is an opportunistic infection?

A) inhalation anthrax
B) disseminated tuberculosis
C) whooping cough
D) legionellosis
E) SARS

Question 14

Inhalation anthrax is frequently fatal even with antibiotic therapy because

A) Bacillus anthracis is resistant to a wide range of antibiotics.
B) it is transmitted by endospores.
C) the anthrax toxin triggers severe edema of the lungs.
D) the bacteria are enclosed within a biofilm that antibiotics cannot penetrate.
E) the dying cells release lipid A, triggering a severe inflammatory response.

Question 15

Which of the following statements is TRUE regarding tuberculosis?

A) It occurs only in the lungs.
B) Several hundred cells are required for infection.
C) It remains viable in dried aerosol droplets for up to eight months.
D) Only virulent strains of Mycobacterium tuberculosis produce mycolic acid.
E) The immune system is not affected by the infection.

Question 16

The designation "group A," used to help classify Streptococcus pyogenes, refers to this bacterium's

A) Lancefield antigen.
B) hemolysis pattern.
C) M protein.
D) type of streptokinase produced.
E) disease associations.

Question 17

Which of the following Streptococcus pyogenes virulence factors decreases leukocyte movement into an infected area?

A) streptolysins
B) pyrogenic toxins
C) streptokinases
D) the hyaluronic acid capsule
E) C5a peptidase

Question 18

Which of the following statements is TRUE regarding the common cold?

A) Only coronaviruses cause the common cold.
B) The viruses can infect both the upper and lower respiratory tracts.
C) Cold viruses reproduce most effectively at 37°C.
D) Cold viruses are frequently spread by contaminated fomites.
E) The immune system cannot develop an effective response to cold viruses.

Question 19

V shapes and palisade arrangements are characteristic of which of the following?

A) Streptococcus pyogenes
B) Streptococcus pneumoniae
C) Chlamydophila psittaci
D) Legionella pneumophila
E) Corynebacterium diphtheriae

Question 20

Pathogenic streptococci of the upper respiratory tract (such as Streptococcus pyogenes) are distinguished from non-pathogenic streptococci by

A) alpha hemolytic activity.
B) beta hemolytic activity.
C) no hemolytic activity.
D) the absence of a capsule.
E) the presence of a lysogenic phage.

Question 21

Even though mycoplasmas pass through filters that normally trap bacteria, they are known to be bacteria, not viruses, because they

A) contain both DNA and RNA.
B) synthesize peptidoglycan.
C) divide by binary fission.
D) contain both DNA and RNA and divide by binary fission.
E) synthesize peptidoglycan and divide by snapping division.

Question 22

A young man who works on a ranch and lives in the log bunkhouse experiences sudden fever with muscle aches. A few days later he begins to cough and have difficulty breathing, and goes to an urgent care clinic. A blood sample reveals a high leukocyte count and low platelets. A Gram-stain of a sputum sample shows only a few small bacteria present. Which of the following is the most likely infecting agent?

A) Bacillus anthracis
B) Hantavirus
C) Histoplasma capsulatum
D) influenza
E) Mycoplasma pneumonia

Question 23

Which of the following is the most common fungal systemic disease in humans?

A) Pneumocystis pneumonia
B) blastomycosis
C) coccidioidomycosis
D) histoplasmosis
E) valley fever

Question 24

A woman who breeds parrots develops a fever and cough, and begins to have difficulty breathing. Small Gram-negative bacteria are detected inside cells of a sputum sample. Which of the following diseases is she likely to have contracted?

A) histoplasmosis
B) influenza
C) primary atypical pneumonia
D) ornithosis
E) inhalation anthrax

Question 25

Limiting exposure to rodents and their waste materials is an important means of controlling

A) coccidioidomycosis.
B) Hantavirus pulmonary syndrome.
C) histoplasmosis.
D) bronchiolitis.
E) inhalational anthrax.

Question 26

Blastomycosis results from

A) inhalation of spherules.
B) inhalation of respiratory droplets.
C) inhalation of fungal spores.
D) contact with fomites.
E) contact with infected sputum.

Question 27

Pneumocystis jiroveci is

A) difficult to treat with antimicrobial drugs.
B) an opportunistic pathogen encountered in a desert environment.
C) actually a protozoan, not a fungus.
D) a common member of the respiratory microbiota in humans.
E) not a danger to immunodeficient patients.

Question 28

Legionella pneumophila is an opportunistic pathogen that

A) is part of the microbiota of the lower respiratory system.
B) is part of the microbiota of the nasal cavity which occasionally invades the lungs.
C) survives in the environment as an intracellular parasite of a protozoan.
D) is capable of forming endospores.
E) is a disease of birds transmissible to humans.

Question 29

Which of the following diseases is almost diagnostic for AIDS?

A) blastomycosis
B) coccidioidomycosis
C) Pneumocystis pneumonia
D) histoplasmosis
E) Hantavirus pulmonary syndrome

Question 30

Which of the following factors is primarily responsible for the ability of Mycobacterium tuberculosis to survive long periods of time in dried droplets of respiratory aerosols?

A) production of cord factor
B) pyrogenic toxin
C) formation of Ghon complexes
D) the presence of LPS in the outer membrane
E) the presence of mycolic acid in the cell wall

Question 31

Coccidioides germinates in the alveoli into a form called a(n)

A) yeast.
B) spore.
C) arthroconidium.
D) syncytium.
E) spherule.

Question 32

Coronaviruses cause

A) the common cold.
B) SARS.
C) valley fever.
D) both the common cold and SARS.
E) the common cold, SARS, and valley fever.

Question 33

The typical signs and symptoms of flu are a result of

A) cytokines released as part of the immune response.
B) the release of viral toxins.
C) syncytium formation.
D) secondary bacterial infections.
E) the death of cells outside the lungs.

Question 34

The CDC reports concern about a new influenza strain designated A/Bali/2/2010 (H5N2). This nomenclature means

A) the virus is a type A with antigens HA 5 and NA 2 isolated in Bali in February 2010.
B) the strain is a type A with 5 HA antigen and 2 NA antigens isolated in Bali in February 2010.
C) the virus is the second type A strain with HA 5 and NA 2 antigens isolated in Bali in 2010.
D) the virus is a type B strain with antigens HA 5 and NA 2, first isolated in February 2010.
E) the virus is a hybrid of type A and B with 5 HA and 2 NA antigen, discovered in February 2010.

Question 35

Which of the following statements is TRUE regarding infection with Mycoplasma pneumoniae?

A) It is extremely difficult to treat.
B) The causative agent attaches to ciliated cells in the respiratory tract.
C) The causative agent is a fast-growing Gram-positive bacillus.
D) It causes disease which is usually severe enough to require hospitalization.
E) It is diagnosed by the appearance of typical "fried-egg" colonies on agar.

Question 36

Croup is often a result of infection with which of the following?

A) hantavirus
B) influenzavirus
C) Bordetella pertussis
D) Mycoplasma pneumoniae
E) respiratory syncytial virus

Question 37

Influenzaviruses are exhibiting increased resistance to which of the following drugs?

A) amantadine
B) oseltamivir
C) zanamivir
D) acyclovir
E) ribavirin

Question 38

The majority of cases of otitis media are caused by

A) Haemophilus influenzae.
B) Mycoplasma pneumonia.
C) Staphylococcus aureus.
D) Streptococcus pneumoniae.
E) Streptococcus pyogenes.

Question 39

Ornithosis, a disease of birds that can be transmitted to humans, is caused by

A) Yersinia pestis.
B) Klebsiella pneumoniae.
C) Chlamydophila psittaci.
D) Mycoplasma pneumoniae.
E) Chlamydophila pneumoniae.

Question 40

A nursing student develops a positive reaction to the tuberculin skin test. A history reveals possible exposure to patients with tuberculosis. A sputum sample is acid-fast negative. When asked for vaccination records, the student reports that childhood vaccination records were lost when the family emigrated from a southeast Asian country. What is the best explanation for the test results?

A) The student has been infected with Mycobacterium tuberculosis.
B) The student has been exposed to Mycobacterium tuberculosis.
C) The student is not infected.
D) The student has been exposed to Mycobacterium tuberculosis or was vaccinated with BCG vaccine.
E) No conclusion is possible with the information provided.

Question 41

Cell death and tissue destruction result from the action of __________ toxin produced by Bordetella pertussis.

Question 42

ICAM-1 serves as an attachment protein for almost all __________.

Question 43

Mycoplasmas are unique among prokaryotes because of the presence of __________ in their cytoplasmic membranes. (This answer should be plural.)

Question 44

BCG vaccine is composed of attenuated Mycobacterium tuberculosis.

Question 45

Cold viruses are prevented from infecting most areas of the body because these areas are either too warm or too acidic.

Question 46

Pneumocystis jiroveci infects only immunocompromised patients.

Question 47

Haemophilus influenzae is a common cause of sinus infections.

Question 48

The presence of distinctive spiny spores is diagnostic for the causative agent of __________.

Question 49

Hantavirus pulmonary syndrome can be transmitted from person-to-person and from rodents to humans.

Question 50

Microscopic evaluation of suitable specimens is a useful way of diagnosing histoplasmosis.

Question 51

Protective membranes called __________ surround the lungs.

Question 52

Elongation factor, a protein required for eukaryotic __________, is the cellular target of the toxin produced by Corynebacterium diphtheriae.

Question 53

Anti-influenza drugs are effective at any stage of the disease.

Question 54

Specimens suspected to contain Bordetella pertussis must be inoculated onto appropriate media at the patient's bedside.

Question 55

Otitis media is more common in adults than children because of differences in the anatomy of the head.

Question 56

The smallest free-living microbes are __________

Question 57

Loeffler's medium was developed especially to culture the bacterium that causes __________.

Question 58

The seriousness of Coccidioides infections can be attributed to the cycle of formation and rupture of spherules.

Question 59

A type of pneumonia in which the alveoli and bronchioles become filled with pus is __________.

Question 60

Group A Streptococcus produces a class of molecules called __________ toxins that stimulate leukocytes to release fever-inducing cytokines.

Question 61

Why is immunity to the common cold so hard to develop, either naturally or through vaccines?

Question 62

Pneumonia caused by the bacterium Klebsiella pneumoniae has a higher __________ rate than pneumococcal or mycoplasmal pneumonias.

Question 63

Describe the various ways in which the respiratory system is protected from invasion by pathogens.

Question 64

A major change in the antigens of influenza A, which occurs every 10 years on average, is called __________ shift.

Question 65

Disseminated __________ results when macrophages carry Mycobacterium tuberculosis to a variety of extrapulmonary sites such as the bone marrow and spleen.

Question 66

Compare and contrast pneumococcal and mycoplasmal pneumonia.

Question 67

Strains of Mycobacterium tuberculosis designated as __________ strains are resistant in vitro to three or more antitubercular drugs in addition to isoniazid and rifampin. (Be sure to use capital letters.)

Question 68

Explain the necessity of producing a new vaccine for each year's flu season.

Question 69

Inflammation of the trachea and bronchi, commonly called __________, is frequently caused by paramyxoviruses.

Question 70

Describe the pathogenesis of tuberculosis, paying special attention to the characteristics of Mycobacterium tuberculosis that make it so pathogenic.