Question 1

A characteristic of IL-1 is

Accepted Answer

A)  It inhibits T cells 
B) It initiates the acute phase reactant response 
C) Its synthesis is restricted to phagocytic cells 
D) It suppresses tumor necrosis factor

Question 2

An elderly woman presents with chronic fatigue, difficulty sleeping, a rapid heartbeat, and bulging eyes. Lab tests revealed autoantibodies to thyroid-stimulating hormone. The most likely diagnosis is

Accepted Answer

A)  Hashimoto's disease 
B)  Cancer of the thyroid 
C)  Graves' disease 
D)  Pernicious anemia

Question 3

An asymptomatic 35-year-old male Catholic missionary has returned to the United States following 12 years in rural Mexico. His routine physical examination shows elevated transaminases. His medical history in Mexico was unremarkable except for an auto accident requiring a blood transfusion of 3 pints of blood. What definitive lab test should be performed to determine what effective treatment should be prescribed?

Accepted Answer

A)  Blood culture on MacConkey media 
B)  Differential cytology of the blood 
C)  Electron microscopy for Dane particles 
D)  Molecular genotyping of circulating virus 
E)  Serology for levels of IgG HEV

Question 4

The mother of a 9-year-old who is in the same school as another child just diagnosed with meningitis (even though the child did not know nor had any direct contact with the infected child) called the pediatrician, demanding her son be prophylactically treated. The physician suggests vaccinating the boy, doing surveillance cultures, and watching the child for symptoms. The medium that the lab will use has antibiotics in it and therefore is called a(n)

Accepted Answer

A)  Minimal medium 
B) Differential medium 
C) Selective medium 
D) Inhibitory medium

Question 5

A 5-year-old girl is brought to your office by her mother who reports the child had a flu-like disease for the past week and now has developed a rash. Examination of the rash on the face and trunk shows general redness consistent with a slapped cheek. A singlestranded DNA virus that could be responsible is

Accepted Answer

A) Coxsackie A virus 
B) Echovirus 
C) JC virus 
D) Parvovirus

Question 6

A 57-year-old man presents with paranasal swelling, hemorrhagic exudates in the eyes and nares, and mental lethargy. Nonseptate hyphae are found invading the tissues. Rhinocerebral Mucor infection (zygomycosis) is diagnosed. What is the most likely underlying condition?

Accepted Answer

A) C5 to C8 deficiencies 
B) Epstein-Barr virus infection 
C) Hepatitis A infection 
D) Hepatitis B infection 
E) Ketoacidotic diabetes
F)Severe neutropenia

Question 7

Which of the following cells is capable of attacking a certain tumor cell spontaneously (i.e., without prior sensitization)?

Accepted Answer

A) Monocyte-macrophage 
B) $CD8^+$ cell 
C) Mature B cell 
D) Natural killer (NK) cell 
E) Null (K) cell

Question 8

A pale 6-year-old girl from a poor rural area of Appalachia presents with chronic complaints of "tiredness, upset tummy and the runs." She is found to have microcytic hypochromic anemia. Bile-stained eggs with polar plugs are found in her feces. This infection can be prevented by

Accepted Answer

A) Not swimming in contaminated water 
B) Not using human excrement as vegetable fertilizer 
C) Heating all canned foods to 60°C for 10 minutes 
D) Avoiding cat litter or taking proper care when changing litter 
E) Wearing shoes outside in endemic regions

Question 9

The T-cell antigen receptor is associated with which of the following characteristics?

Accepted Answer

A) It is a monomeric immunoglobulin M 
B) It requires free antigen for triggering 
C) It is associated with CD4 or CD8 
D) It is nonspecific

Question 10

Demyelinating lesions, increased IgG in spinal fluid, and chronic relapsing occurrences are characteristic of which autoimmune disease?

Accepted Answer

A) Ulcerative colitis 
B) Multiple sclerosis 
C) Systemic lupus erythematosus (SL
E)  
D) Congenital thymic aplasia 
E) Myasthenia gravis

Question 11

A 4-year-old boy has a yearlong history of repeated staphylococcal and streptococcal infections. He was referred to the genetic counseling unit where he was found to have depressed superoxide dismutase activity. Treatment with which of the following is most likely to be successful?

Accepted Answer

A) Interferon gamma 
B) $CD4^+$ T helper cells 
C) Insertion of the gene for adenosine deaminase 
D) Transforming growth factor $\beta$

Question 12

A 34-year-old woman presents with abdominal pain made better by ingestion of bland food. A diagnosis of Helicobacter pylori is made. If the DNA had been analyzed, a region of unique DNA coding for the Cag A protein and its type VI injection-like secretion system would be found. What is this segment of DNA called?

Accepted Answer

A) A replicon 
B) An integron 
C) A pathogenicity island 
D) A transposon

Question 13

Parents bring in a 5-month-old who suddenly has lost developmental ground and is no longer able to hold his head up or sit up. In taking the health history, they did note constipation a couple of days before. The EEG confirms a pattern consistent with botulism. After assuring them that with monitoring and support the child will survive, the parents become terribly concerned that the loss of development might be permanent. What can you tell them about their child's prognosis?

Accepted Answer

A) Elevated cerebrospinal fluid pressure occurs in over half of the children, resulting in some permanent neurologic defects 
B) Almost all of the children have some permanent neurologic defects 
C) There is some permanent muscle weakness following recovery that, like polio, may worsen late in life 
D) Neurological recovery, although slow, is expected to be complete in all children

Question 14

Which of the following statements characterizes idiotypic determinants?

Accepted Answer

A) They are found in the crystallizable fragment of immunoglobulins 
B) They are found on protein antigens 
C) They can be antigenic 
D) They are responsible for rejection of transplants

Question 15

Which bacterial gene transfer process would be inhibited by free extracellular exonucleases?

Accepted Answer

A)  Conjugation 
B)  Generalized transduction 
C)  Specialized transduction 
D)  Transformation 
E)  Transposition

Question 16

There is an outbreak of watery diarrhea in six members of a party of 20 who ate at a Chinese restaurant the day before. Fried rice is implicated. What is the most likely causative agent?

Accepted Answer

A) Bacillus cereus 
B) Giardia lamblia 
C) Norwalk agent 
D) Rotavirus 
E) Salmonella enteritidis
F)Staphylococcus aureus

Question 17

A 10-year-old boy presents with an itchy scalp with the underlying hair becoming lighter. The patch has expanded to 2 inches. What should you expect to see in a KOHdigested mount of skin scrapings taken at the infected margin of a lesion from this patient with tinea capitis?

Accepted Answer

A)  Yeast cells, pseudohyphae, and true hyphae 
B) Regular septate hyphae with little branching 
C) Irregular but broad, aseptate hyphae 
D) Septate hyphae regularly branching dichotomously at an acute angle 
E) Yeasts only

Question 18

A 28-year-old neutropenic woman with Pseudomonas aeruginosa septicemia develops shock. What triggers the shock?

Accepted Answer

A) Catalase 
B) Lipid A 
C) Flagella from Gram-negative bacteria 
D) O-specific polysaccharide side chain of endotoxin 
E) Teichoic acid-peptidoglycan fragments

Question 19

A noncompliant 70-year-old HIV-positive man with a $CD4^+$ cell count of $40/mm^3$ presents with a pulmonary infection caused by an organism that requires 4 weeks to grow on Lowenstein-Jensen medium. What is the best descriptor of the most likely causative agent?

Accepted Answer

A)  Acid-fast organism 
B)  Dimorphic fungus 
C)  Filamentous fungus 
D)  Gram-positive coccus 
E)  Gram-negative coccus
F) Gram-negative rod

Question 20

A 25-year-old man who has recently started doing intravenous drugs presents to the emergency department with fever and evidence of mild tricuspid valve insufficiency. As far as he knows, he had no previous damage to his heart. What is the most likely causative agent?

Accepted Answer

A) Candida albicans 
B) Coxsackie virus 
C) Enterococcus faecalis 
D) Pseudomonas aeruginosa 
E) Staphylococcus aureus

Exam 11: Travelers Diarrhea: Identifying the Causative Agent

A characteristic of IL-1 is

An elderly woman presents with chronic fatigue, difficulty sleeping, a rapid heartbeat, and bulging eyes. Lab tests revealed autoantibodies to thyroid-stimulating hormone. The most likely diagnosis is

A 57-year-old man presents with paranasal swelling, hemorrhagic exudates in the eyes and nares, and mental lethargy. Nonseptate hyphae are found invading the tissues. Rhinocerebral Mucor infection (zygomycosis) is diagnosed. What is the most likely underlying condition?

Which of the following cells is capable of attacking a certain tumor cell spontaneously (i.e., without prior sensitization) ?

A pale 6-year-old girl from a poor rural area of Appalachia presents with chronic complaints of "tiredness, upset tummy and the runs." She is found to have microcytic hypochromic anemia. Bile-stained eggs with polar plugs are found in her feces. This infection can be prevented by

The T-cell antigen receptor is associated with which of the following characteristics?

Demyelinating lesions, increased IgG in spinal fluid, and chronic relapsing occurrences are characteristic of which autoimmune disease?

A 4-year-old boy has a yearlong history of repeated staphylococcal and streptococcal infections. He was referred to the genetic counseling unit where he was found to have depressed superoxide dismutase activity. Treatment with which of the following is most likely to be successful?

Which of the following statements characterizes idiotypic determinants?

Which bacterial gene transfer process would be inhibited by free extracellular exonucleases?

There is an outbreak of watery diarrhea in six members of a party of 20 who ate at a Chinese restaurant the day before. Fried rice is implicated. What is the most likely causative agent?

A 10-year-old boy presents with an itchy scalp with the underlying hair becoming lighter. The patch has expanded to 2 inches. What should you expect to see in a KOHdigested mount of skin scrapings taken at the infected margin of a lesion from this patient with tinea capitis?

A 28-year-old neutropenic woman with Pseudomonas aeruginosa septicemia develops shock. What triggers the shock?

A noncompliant 70-year-old HIV-positive man with a $CD4^+$ cell count of $40/mm^3$ presents with a pulmonary infection caused by an organism that requires 4 weeks to grow on Lowenstein-Jensen medium. What is the best descriptor of the most likely causative agent?

A 25-year-old man who has recently started doing intravenous drugs presents to the emergency department with fever and evidence of mild tricuspid valve insufficiency. As far as he knows, he had no previous damage to his heart. What is the most likely causative agent?

Exam 11: Travelers Diarrhea: Identifying the Causative Agent

A characteristic of IL-1 is

An elderly woman presents with chronic fatigue, difficulty sleeping, a rapid heartbeat, and bulging eyes. Lab tests revealed autoantibodies to thyroid-stimulating hormone. The most likely diagnosis is

A 57-year-old man presents with paranasal swelling, hemorrhagic exudates in the eyes and nares, and mental lethargy. Nonseptate hyphae are found invading the tissues. Rhinocerebral Mucor infection (zygomycosis) is diagnosed. What is the most likely underlying condition?

Which of the following cells is capable of attacking a certain tumor cell spontaneously (i.e., without prior sensitization) ?

A pale 6-year-old girl from a poor rural area of Appalachia presents with chronic complaints of "tiredness, upset tummy and the runs." She is found to have microcytic hypochromic anemia. Bile-stained eggs with polar plugs are found in her feces. This infection can be prevented by

The T-cell antigen receptor is associated with which of the following characteristics?

Demyelinating lesions, increased IgG in spinal fluid, and chronic relapsing occurrences are characteristic of which autoimmune disease?

A 4-year-old boy has a yearlong history of repeated staphylococcal and streptococcal infections. He was referred to the genetic counseling unit where he was found to have depressed superoxide dismutase activity. Treatment with which of the following is most likely to be successful?

Which of the following statements characterizes idiotypic determinants?

Which bacterial gene transfer process would be inhibited by free extracellular exonucleases?

There is an outbreak of watery diarrhea in six members of a party of 20 who ate at a Chinese restaurant the day before. Fried rice is implicated. What is the most likely causative agent?

A 10-year-old boy presents with an itchy scalp with the underlying hair becoming lighter. The patch has expanded to 2 inches. What should you expect to see in a KOHdigested mount of skin scrapings taken at the infected margin of a lesion from this patient with tinea capitis?

A 28-year-old neutropenic woman with Pseudomonas aeruginosa septicemia develops shock. What triggers the shock?

A noncompliant 70-year-old HIV-positive man with a CD4+CD4^+CD4+ cell count of 40/mm340/mm^340/mm3 presents with a pulmonary infection caused by an organism that requires 4 weeks to grow on Lowenstein-Jensen medium. What is the best descriptor of the most likely causative agent?

A 25-year-old man who has recently started doing intravenous drugs presents to the emergency department with fever and evidence of mild tricuspid valve insufficiency. As far as he knows, he had no previous damage to his heart. What is the most likely causative agent?

A noncompliant 70-year-old HIV-positive man with a $CD4^+$ cell count of $40/mm^3$ presents with a pulmonary infection caused by an organism that requires 4 weeks to grow on Lowenstein-Jensen medium. What is the best descriptor of the most likely causative agent?