Deck 18: The Gram-Positive and Gram-Negative Cocci of Medical Importance

Question 1

The enzyme that coagulates plasma is:

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

Answer 1

B

Question 2

Infections caused by Staphylococcus aureus include all of the following, except:

A)folliculitis.
B)furuncles and carbuncles.
C)sore throat.
D)osteomyelitis.
E)pneumonia.

Answer 2

C

Question 3

The bright red rash and fever of scarlet fever is due to:

A)enterotoxins.
B)hemolysins.
C)toxic shock syndrome toxin.
D)exfoliative toxin.
E)erythrogenic toxin.

Answer 3

E

Question 4

Streptococcal pharyngitis involves all the following, except:

A)a purulent exudate over the tonsils.
B)can lead to scarlet fever if it is an erythrogenic toxin-producing strain.
C)can lead to serious sequelae.
D)is usually caused by the viridans streptococci.
E)causes redness, difficulty in swallowing, and fever.

Question 5

Scarlet fever is caused by strains of:

A)Staphylococcus aureus.
B)Staphylococcus epidermidis.
C)Staphylococcus saprophyticus.
D)Streptococcus pyogenes.
E)Streptococcus agalactiae.

Question 6

Scarlet fever involves:

A)high fever.
B)bright red rash on face, trunk, inner arms and legs, and tongue.
C)eventual desquamation of epidermis.
D)septicemia as a complication.
E)All of the choices are correct.

Question 7

Symptoms of Toxic Shock Syndrome include all the following, except:

A)fever and muscle pain.
B)appearance of flesh being "eaten" down to the muscle.
C)nausea, vomiting, diarrhea.
D)sunburn-like rash.
E)kidney and liver failure.

Question 8

All the following pertain to Staphylococcus epidermidis infections, except:

A)they often from an endogenous source.
B)they typically occur after insertion of shunts and prosthetic devices.
C)catheterization can introduce the organism and lead to urinary tract infection.
D)the organism is coagulase negative.
E)the organism produces a large number of tissue damaging enzymes and toxins.

Question 9

Which organism is associated with commonly causing urinary tract infections in sexually active young adult and adolescent females?

A)Staphylococcus aureus
B)Staphylococcus epidermidis
C)Staphylococcus saprophyticus
D)Streptococcus pyogenes
E)Streptococcus agalactiae

Question 10

A common food intoxication is caused by enterotoxin-producing strains of:

A)Staphylococcus aureus.
B)Staphylococcus epidermidis.
C)Staphylococcus saprophyticus.
D)Streptococcus pyogenes.
E)Streptococcus agalactiae.

Question 11

All species of Staphylococcus:

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

Question 12

Which is incorrect about Staphylococcus aureus food intoxication?

A)Food becomes contaminated by a human carrier.
B)Common associated foods include custards, ham, cream pastries, processed meats.
C)After contamination, food must be left unrefrigerated for a few hours.
D)Ingestion of the pathogen allows it to multiply and damage the GI tract lining.
E)Symptoms come on quickly, and include nausea, vomiting, diarrhea.

Question 13

Rebecca Lancefield differentiated streptococci on the basis of differences in their:

A)cell wall carbohydrates in a serological test.
B)patterns of hemolysis on blood agar.
C)ability to produce catalase.
D)gram stain appearance.
E)All of the choices are correct.

Question 14

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 15

Staphylococci can be differentiated from streptococci by the:

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

Question 16

The most common site where carriers of Staphylococcus aureus carry this pathogen is:

A)all over the skin.
B)under the fingernails.
C)anterior nares (nostrils).
D)mouth.
E)intestines.

Question 17

Streptococcus pyogenes causes all the following, except:

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

Question 18

Which pathogen has drug resistant strains called MRSA?

A)Staphylococcus aureus
B)Staphylococcus epidermidis
C)Staphylococcus saprophyticus
D)Streptococcus pyogenes
E)Streptococcus agalactiae

Question 19

Which pathogen is the most common cause of neonatal pneumonia, sepsis, and meningitis in the United States?

A)Staphylococcus aureus
B)Staphylococcus epidermidis
C)Staphylococcus saprophyticus
D)Streptococcus pyogenes
E)Streptococcus agalactiae

Question 20

The M protein of Streptococcus pyogenes:

A)is the basis for the organism belonging to Lancefield group A.B.gives rise to a zone of b hemolysis on blood agar.C.protects against phagocytosis and enhances adherence.D.is also called streptokinase.E.protects against lysozyme damage.

Question 21

Long-term sequelae of Group A streptococcal infections include all the following, except:

A)risk decreased with prompt treatment of skin infections and pharyngitis.
B)development of rheumatic fever.
C)appearance of sequelae within a few weeks after an initial infection.
D)transmission of sequelae via respiratory secretions from a patient with streptococcal sore throat.
E)development of acute glomerulonephritis.

Question 22

Which chemical produced by S.aureus is also known as "spreading factor"?

A)Coagulase
B)Penicillinase
C)Hemolysin
D)Hyaluronidase
E)Toxic shock syndrome toxin

Question 23

Necrotizing fasciitis is:

A)also called impetigo.
B)possibly caused by antibodies to Group A streptococci that cross-react with body tissues.
C)associated with strains of Streptococcus pyogenes producing destructive enzymes and toxins.
D)typically a sequelae of streptococcal pharyngitis.
E)not treatable with antimicrobic drugs.

Question 24

The instillation of antibiotics in newborn's eyes will prevent ophthalmia neonatorum in newborns.This disease is caused by:

A)Neisseria meningitidis.
B)Staphylococcus aureus.
C)Streptococcus pyogenes.
D)Neisseria gonorrhoeae.
E)Branhamella (Moraxella) catarrhalis.

Question 25

All of the following pertain to Neisseria meningitidis, except:

A)virulent factors include a capsule, pili, endotoxin, and IgA protease.
B)it causes serious meningitis.
C)the reservoir is the nasopharynx of human carriers.
D)it is more easily transmitted in day care facilities, dorms, and military barracks.
E)it is a common cause of bacterial pneumonia.

Question 26

The Group A streptococcal infection that has symptoms of fever, edema of skin near portal of entry, and an elevated red, hot vesicular lesion is:

A)erysipelas.
B)impetigo.
C)necrotizing fasciitis.
D)scarlet fever.
E)None of the choices are correct.

Question 27

A positive Quellung reaction, or capsular swelling, is confirmatory for:

A)Neisseria meningitidis.
B)Staphylococcus aureus.
C)Streptococcus pyogenes.
D)Branhamella (Moraxella) catarrhalis.
E)Streptococcus pneumoniae.

Question 28

The viridans streptococci are:

A)not entirely groupable by Lancefield serology.
B)the most numerous residents of the oral cavity.
C)opportunists that can cause subacute endocarditis.
D)introduced to deeper body tissues by dental or surgical procedures.
E)All of the choices are correct.

Question 29

Streptococcus pneumoniae is:

A)called the meningococcus.
B)in the viridans group.
C)a gram positive diplococcus with a capsule.
D)a pathogen with endotoxin.
E)All of the choices are correct.

Question 30

All of the following pertain to Enterococcus faecalis, except:

A)normal flora of the human large intestine.
B)increasingly resistant to many antimicrobics.
C)cause nosocomial wound infections, urinary tract infections, and septicemias.
D)can cause endocarditis.
E)belong to Lancefield Group B streptococci.

Question 31

Neisseria gonorrhoeae is:

A)the cause of ophthalmia neonatorum.
B)the cause of gonorrhea.
C)called the gonococcus.
D)virulent due to fimbriae and a protease that inactivates IgA.
E)All of the choices are correct.

Question 32

All of the following pertain to gonorrhea, except:

A)a chancre-type lesion develops at the portal of entry.
B)it is a reportable infectious disease.
C)pelvic inflammatory disease (PID) and infertility are complications.
D)females can have asymptomatic infection.
E)symptoms include painful urination and discharge.

Question 33

The majority of otitis media in children is mainly due to infection with:

A)Streptococcus pneumoniae.
B)Streptococcus pyogenes.
C)Branhamella (Moraxella) catarrhalis.
D)Streptococcus agalactiae.
E)Staphylococcus saprophyticus.

Question 34

People at greatest risk for pneumococcal infections include all the following, except:

A)elderly.
B)those with underlying lung disease and viral infections.
C)patients without a spleen.
D)adolescents and young adults.
E)young infants.

Question 35

A patient has a suspicious skin infection and a culture is taken.Which media would be appropriate to select for staphylococci?

A)Nutrient agar
B)Blood agar
C)Chocolate agar
D)MacConkey agar
E)Mannitol salt agar

Question 36

Which chemical, produced by S.aureus, digests blood clots?

A)Coagulase
B)Penicillinase
C)Staphylokinase
D)Hyaluronidase
E)Toxic shock syndrome toxin

Question 37

All of the following are associated with subacute endocarditis, except:

A)it occurs in patients that have prior heart damage.
B)it is caused by immune system autoantibodies that attack heart and valve tissue.
C)oral bacteria get introduced by dental procedures to the blood.
D)bacteria colonize previously damaged heart tissue resulting in vegetation.
E)signs and symptoms include fever, heart murmur, and possible emboli.

Question 38

Meningococcemia is:

A)common during gonorrhea.
B)associated with vascular hemorrhage and petechiae.
C)frequently seen in elderly.
D)caused by a gram positive diplococcus.
E)All of the choices are correct.

Question 39

A pregnant woman is told she has a positive CAMP test and should be treated with a course of antibiotics and globulin.This test is indicative of

A)Group A streptococci.
B)Group B streptococci.
C)S.saprophyticus.
D)S.epidermidis.
E)S.aureus.

Question 40

Disease/s caused by Streptococcus pneumoniae include:

A)otitis media.
B)meningitis.
C)lobar pneumonia.
D)bronchial pneumonia.
E)All of the choices are correct.

Question 41

It is theorized that rheumatic fever and acute glomerulonephritis could be the result of antibodies to Group A streptococci that cross-react with patient tissues.

Question 42

All of the following are correct about Streptococcus pyogenes, except:

A)humans are the only significant reservoir.
B)some of the streptococcal toxins act as superantigens.
C)most strains do not have a capsule.
D)it can cause impetigo and erysipelas.
E)infection is generally through direct contact.

Question 43

Streptococcus agalactiae is known as Group _____ streptococci.B

Question 44

Pneumovax is a vaccine for prevention of disease caused by strains of Neisseria meningitidis.

Question 45

Local Staphylococcus aureus infections often involve formation of an abscess.

Question 46

The two important hemolysins of Group A streptococci are _____ and _____.

Question 47

If left untreated, an infection with ___ can lead to pelvic inflammatory disease and infertility.

A)Streptococcus pneumoniae
B)N.meningitidis
C)N.gonorrhoeae
D)Streptotoccus pyogenes
E)Staphylococcus aureus

Question 48

Most strains of Streptococcus pyogenes produce penicillinase.

Question 49

Neisseria meningitidis and Neisseria gonorrhoeae are fastidious, gram-negative cocci that produce oxidase.

Question 50

Streptokinase causes the symptoms of scarlet fever.

Question 51

Sue brought her daughter Amy to the pediatrician complaining of a sore throat.The physician examines Amy and observes that her throat is bright red and there are white pus-filled nodules on her tonsils.Which of the following conclusions should be made?

A)She has a strep throat and should begin antibiotics.
B)She should have a rapid strep test performed before a diagnosis is made.
C)She should go home and rest because most sore throats are viral in origin.
D)She should go home and come back in two days for a strep test since it may take that long to show up.
E)She has a staphylococcal sore throat and should begin antibiotics immediately.

Question 52

Which of the following antibiotics specifically disrupt protein synthesis of streptococci?

A)Beta-lactams
B)Macrolides
C)Cephalosporins
D)Ansamycin
E)Aminoglycosides

Question 53

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

Question 54

List three enzymes and four toxins produced by Staphylococcus aureus.For each enzyme and toxin, discuss its effect on patient tissues and how it contributes to virulence of this pathogen.

Question 55

All of the following are correct about Staphylococcus aureus, except:

A)it is the coagulase-positive species.
B)the body's most powerful defense against it lies in the T-cell response.
C)carriers may be treated with antibiotics to clear them of the bacteria.
D)most strains are resistant to penicillin and ampicillin.
E)it causes furuncles, carbuncles, and abscesses.

Question 56

The viridans group of streptococci and the pneumococcus produce _____ hemolysis on blood agar.

Question 57

Staphylococcus, Streptococcus, and Neisseria tend to stimulate pus production and are collectively referred to as _____ cocci.

Question 58

The production of the enzyme _____ by Staphylococcus aureus is a key characteristic used to identify it from other species of Staphylococcus.

Question 59

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

Question 60

An individual with asymptomatic N.gonorrhoeae may not spread the disease.

Question 61

Explain what is meant by MRSA, why it is a particular concern to hospitals, and what action hospitals are taking to prevent MRSA spread.

Question 62

Describe the transmission of the meningococcus, and discuss the pathogenesis of meningococcal disease in the body including associated signs and symptoms.

Question 63

Discuss in detail why strep sore throat must be diagnosed and treated rapidly.

Question 64

Discuss how normal flora Staphylococcus epidermidis can cause disease in the body, and describe the diseases that it causes.