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chapter 23

front 1

1) Which of the following statements about sepsis is FALSE?
A) Symptoms include fever and decreased blood pressure.
B) Lymphangitis may occur.
C) It can be treated with antibiotics.
D) It usually is caused by gram-positive bacteria.
E) It may be aggravated by antibiotics.

back 1

D

front 2

2) Which of the following pairs is mismatched?
A) subacute bacterial endocarditis — alpha-hemolytic streptococci
B) acute bacterial endocarditis — Staphylococcus aureus
C) pericarditis — Streptococcus pyogenes
D) puerperal sepsis — Staphylococcus aureus
E) Burkitt's lymphoma — Epstein-Barr virus

back 2

D

front 3

3) Which of the following is NOT a recognized form of anthrax?
A) cutaneous
B) inhalationial
C) septic
D) gastrointestinal
E) None of the answers are correct; all of these are recognized forms of anthrax.

back 3

C

front 4

4) Which of the following is NOT typically treated with penicillin?
A) serious wounds at risk for gas gangrene
B) tularemia
C) patients at risk for rheumatic fever
D) puerperal sepsis
E) rat-bite fever

back 4

B

front 5

5) Which of the following statements about tularemia is FALSE?
A) It is caused by Francisella tularensis.
B) The most common reservoir is rabbits.
C) It may be transmitted by arthropods.
D) It may be transmitted by direct contact.
E) It occurs only in California.

back 5

E

front 6

6) Which of the following is a symptom of brucellosis?
A) gastroenteritis
B) relapsing fever
C) undulant fever
D) pneumonia
E) jaundice

back 6

C

front 7

7) Which of the following is NOT transmitted in raw milk?
A) toxoplasmosis
B) anthrax
C) brucellosis
D) listeriosis
E) All of these can be transmitted in raw milk

back 7

A

front 8

8) Which of the following is NOT a characteristic of Bacillus anthracis?
A) is aerobic
B) is gram-positive
C) forms endospores
D) found in soil
E) produces endotoxins

back 8

E

front 9

9) The symptoms of gas gangrene are due to all of the following EXCEPT
A) microbial fermentation.
B) necrotizing exotoxins.
C) proteolytic enzymes.
D) hyaluronidase.
E) endocarditis

back 9

E

front 10

10) Which of the following bacterial infections CANNOT be transmitted by dog or cat bites?
A) Pasteurella multocida
B) Streptobacillus
C) Bartonella henselae
D) Fusobacterium
E) None of the answers is correct; all of these bacterial infections can be transmitted by dog or cat bites.

back 10

B

front 11

11) Which of the following pairs is mismatched?
A) malaria — Anopheles (mosquito)
B) dengue — Aedes (mosquito)
C) epidemic typhus — Pediculus (louse)
D) Rocky Mountain spotted fever — Dermacentor (tick)
E) encephalitis — Ixodes (tick)

back 11

E

front 12

12) Unsanitary and crowded conditions increase the incidence of all of the following diseases EXCEPT
A) plague.
B) epidemic typhus.
C) endemic murine typhus.
D) Rocky Mountain spotted fever.
E) relapsing fever.

back 12

D

front 13

13) Which of the following statements about toxoplasmosis is FALSE?
A) It is caused by a protozoan.
B) The reservoir is cats.
C) It is transmitted by the gastrointestinal route.
D) It is a severe illness in adults.
E) It can be congenital.

back 13

D

front 14

14) Which of the following pairs does NOT apply to Chagas' disease?
A) causative agent — Trypanosoma cruzi
B) vector — kissing bug
C) reservoir — rodents
D) diagnosis of acute phase — serological tests for antibodies
E) treatment — nifurtimox

back 14

D

front 15

15) Which of the following is NOT caused by a bacterium?
A) epidemic typhus
B) tickborne typhus
C) malaria
D) plague
E) relapsing fever

back 15

C

front 16

16) A patient presents with inflammation of the heart valves, fever, malaise, and subcutaneous nodules at joints. The recommended treatment is
A) supportive care.
B) streptomycin.
C) chloroquine.
D) hyperbaric chamber.
E) praziquantel.

back 16

A

front 17

17) Which of the following statements about puerperal sepsis is FALSE?
A) It is transmitted from mother to fetus.
B) It is caused by health care personnel.
C) It begins as a focal infection.
D) It is a complication of abortion or childbirth.
E) Its frequency of occurrence has decreased because of antibiotics and aseptic techniques.

back 17

A

front 18

18) Which of the following statements about schistosomiasis is FALSE?
A) The cercariae penetrate human skin.
B) They symptoms are caused by immune reactions to the eggs shed in the human host.
C) The intermediate host is an aquatic snail.
D) It is caused by a roundworm.
E) The female worm lives in a groove that runs down the body of the male.

back 18

D

front 19

19) Which of the following statements about rheumatic fever is FALSE?
A) It is a complication of a group A beta-hemolytic streptococcal infection.
B) It is an inflammation of the heart.
C) It is an inflammation of the joints.
D) It is rarely fatal, even when untreated.
E) The incidence has declined in the last ten years.

back 19

D

front 20

20) Which of the following pairs is mismatched?
A) Rickettsia — intracellular parasite
B) Brucella — gram-negative aerobic rods
C) Francisella — gram-positive facultatively anaerobic pleomorphic bacillus
D) Bacillus — gram-positive endospore-forming rods
E) None of the pairs is mismatched.

back 20

C

front 21

21) Which of the following can be transmitted from an infected mother to her fetus across the placenta?

  1. A) Borrelia
  2. B) cytomegalovirus
  3. C) Spirillum
  4. D) anthrax

E) Yersinia

back 21

B

front 22

22) Which of the following pairs is mismatched?
A) Borrelia — relapsing fever
B) Yersinia — plague
C) Streptobacillus — rat-bite fever
D) Pasteurella — cat-scratch disease
E) Spirillum — rat-bite fever

back 22

D

front 23

23) A patient returning from an extended trip into Mexico has the following symptoms: a papule at the site of a previous bug bite and enlarged lymph nodes. Microscopic examination of the papule reveals nucleated cells in white blood cells. The patient most likely has
A) anthrax.
B) brucellosis.
C) leishmaniasis.
D) malaria.
E) schistosomiasis.

back 23

C

front 24

24) Human-to-human transmission of plague is usually by
A) rat flea.
B) dog flea.
C) the respiratory route.
D) wounds.
E) unsanitary conditions.

back 24

C

front 25

25) A characteristic symptom of plague is
A) small red spots on the skin.
B) swollen lymph nodes.
C) rose-colored spots.
D) recurrent fever.
E) nausea and vomiting.

back 25

B

front 26

26) Which of the following pairs regarding the epidemiology of malaria is mismatched?
A) vector — Ixodes
B) etiology — Plasmodium
C) found in liver — sporozoites
D) diagnosis — presence of merozoites
E) treatment — chloroquine when possible

back 26

A

front 27

27) A predisposing factor for infection by Clostridium perfringens is
A) gangrene.
B) burns.
C) debridement.
D) hyperbaric treatment.
E) an infected finger.

back 27

A

front 28

28) Which of the following is NOT a zoonosis?
A) puerperal sepsis
B) Hantavirus infection
C) anthrax
D) brucellosis
E) tularemia

back 28

A

front 29

29) Arthropods can serve as a reservoir for all of the following diseases EXCEPT
A) plague.
B) brucellosis.
C) epidemic typhus.
D) yellow fever.
E) malaria.

back 29

B

front 30

30) Which of the following pairs is mismatched?
A) cat-scratch disease — malignant pustule developing into septicemia
B) brucellosis — a temperature of 40°C each evening
C) tularemia — a localized infection appearing as a small ulcer
D) Borrelia — rash and flulike
E) toxoplasmosis — congenital brain damage

back 30

A

front 31

31) Which of the following CANNOT be transmitted to humans from domestic cats?
A) toxoplasmosis
B) plague
C) Chagas' disease
D) Bartonella
E) None of the answers is correct; all of these diseases can be transmitted to humans from domestic cats.

back 31

C

front 32

32) Which of the following is the same for both relapsing fever and undulant fever?
A) rising and falling body temperature
B) mode of transmission
C) presence of rash
D) reservoir
E) etiology

back 32

A

front 33

33) Which of the following is NOT treated with antibiotics?
A) plague
B) tularemia
C) Lyme disease
D) Ebola
E) anthrax

back 33

D

front 34

34) Which of the following produces a permanent carrier state following infection?
A) Borrelia
B) cytomegalovirus
C) Spirillum
D) Toxoplasma
E) Yersinia

back 34

B

front 35

35) Epstein-Barr virus has been implicated in all of the following EXCEPT
A) endocarditis.
B) infectious mononucleosis.
C) Burkitt's lymphoma.
D) nasopharyngeal carcinoma.
E) Hodgkin's disease.

back 35

A

front 36

36) Which of the following leads to all the others?
A) subcutaneous hemorrhaging
B) presence of antirickettsial antibodies
C) blockage of capillaries
D) bacterial growth in endothelial cells
E) breakage of capillaries

back 36

D

front 37

37) A patient complains of fever, severe muscle and joint pain, and a rash. The patient reports returning from a Caribbean vacation one week ago. Which of the following do you suspect?
A) Lassa fever
B) dengue
C) Hantavirus hemorrhagic fever
D) typhus
E) yellow fever

back 37

B

front 38

38) Which of the following pairs is NOT correctly matched for Gram reaction?
A) Lyme disease — gram-negative
B) tularemia — gram-negative
C) anthrax — gram-positive
D) Rocky Mountain spotted fever — gram-negative
E) Ehrlichia — gram-positive

back 38

E

front 39

39) Scrapings from a patient's rash reveal cercariae. The disease is most likely
A) Lyme disease.
B) Rocky Mountain spotted fever.
C) relapsing fever.
D) swimmer's itch.
E) Chagas' disease.

back 39

D

front 40

40) You advise your pregnant friend to not adopt a new kitten from her neighbor because she could contract
A) plague.
B) Brukitt's Lymphoma.
C) toxoplasmosis.
D) listeriosis.
E) infectious mononucleosis.

back 40

C

front 41

41) Which of the following is evidence that the arthritis afflicting children in Lyme, Connecticut, was due to bacterial infection?
A) treatable with penicillin
B) not contagious
C) accompanied by a rash
D) affected mostly children
E) transmitted by ticks

back 41

A

front 42

42) Which of the following is NOT controlled by a mosquito eradication program?
A) chikungunya fever
B) yellow fever
C) dengue fever
D) schistosomiasis
E) malaria

back 42

D

front 43

43) A 62-year-old man was hospitalized with an eight-day history of fever, chills, sweats, and vomiting. His temperature on admission was 40°C (104°F). A routine peripheral blood smear revealed ring-shaped bodies in the RBCs. What treatment would you prescribe?
A) hyperbaric oxygen
B) mefloquine
C) no treatment
D) penicillin
E) streptomycin

back 43

B

front 44

44) Which of the following statements about group B streptococci is FALSE?
A) They are present in healthy carriers.
B) They cause gram-positive sepsis.
C) They cause strep throat.
D) They cause neonatal sepsis.
E) They are classified as Streptococcus agalactiae.

back 44

C

front 45

45) Brucella bacteria are considered a potential agent of bioterrorism because
A) they are not susceptible to antibiotics.
B) they easily become airborne.
C) infection causes a fever.
D) it is a endospore-forming organism.
E) it causes ulcerating lesions of the skin

back 45

B

front 46

1) All lymph that returns to the heart must pass through at least one lymph node.

back 46

TRUE

front 47

2) Lymph contains red blood cells.

back 47

FALSE

front 48

3) Pathogens must be blood-borne in order to initiate sepsis.

back 48

FALSE

front 49

4) Neonatal sepsis is most commonly caused by group A streptococci.

back 49

FALSE

front 50

5) Subacute bacterial endocarditis is commonly the result of infections initially focused on the oral cavity.

back 50

TRUE

front 51

6) All viral hemorrhagic fever outbreaks have been confined to the Eastern Hemisphere.

back 51

FALSE

front 52

7) Netting modified for sandflies should also be useful in preventing malaria.

back 52

TRUE

front 53

8) Tularemia is considered to be a potential bioterrorism agent due its high infective dose.

back 53

FALSE

front 54

9) All forms of typhus are associated with arthropod vectors.

back 54

TRUE

front 55

10) The most likely primary site of replication during mononucleosis is the B lymphocyte.

back 55

TRUE