1. The normal habitat of Clostridium tetani is
A. humans.
B. animals.
C. plants.
D. soil and dust.

D. soil and dust.

2. The researcher who did much of the early work on Clostridium tetani was
A. von Behring.
B. Koch.
C. Pasteur.
D. Kitasato.

D. Kitasato.

3. Wound healing can be slowed by the presence of
A. normal microbiota.

B. antiseptic ointments.
C. sweat.
D. foreign matter.

D. foreign matter.

4. Wound infections may result in
A. delayed healing.
B. abscess formation.
C. extension of bacteria or their products into surrounding tissues or bloodstream.
D. aerobic conditions.
E. delayed healing, abscess formation AND extension of bacteria or their products into surrounding tissues or bloodstream.

E. delayed healing, abscess formation AND extension of bacteria or their products into surrounding tissues or bloodstream.

5. A wound created by the drag of a knife across skin can be classified as
A. puncture.
B. incised.
C. lacerated.
D. contused.

B. incised.

6. The nodular, red, translucent surface material of a healing wound is called
A. soluble skin.
B. irritated scab.
C. granulation tissue.
D. abscess.

C. granulation tissue.

7. A localized collection of pus in a wound is termed a(n)
A. leukocyte.
B. dead tissue.
C. granulation mound.
D. abscess.

D. abscess.

8. Factor(s) not found in abscesses is/are
A. pus.
B. dead leukocytes.
C. tissue remnants.
D. blood vessels.

D. blood vessels.

9. Microorganisms in abscesses often are not killed by antimicrobial agents because
A. the microorganisms stop dividing.
B. of the chemical nature of the pus.
C. of the lack of blood vessels.
D. of the high level of oxygenation.
E. the microorganisms stop dividing, of the chemical nature of the pus AND of the lack of blood vessels.

E. the microorganisms stop dividing, of the chemical nature of the pus AND of the lack of blood vessels.

10. An important feature of many wounds that may lead to more serious problems is that they are
A. well aerated.
B. well fed.
C. sterile.
D. relatively anaerobic.

D. relatively anaerobic.

11. The most frequent genus causing wound infections in healthy people is
A. Pseudomonas.
B. Staphylococcus.
C. Pasteurella.
D. Rochalimea.

B. Staphylococcus.

12. Which of the following are involved in coating Staphylococcus with host proteins?
A. clumping factor
B. coagulase
C. protein A
D. leukocidin
E. clumping factor, coagulase AND protein A

E. clumping factor, coagulase AND protein A

13. Formation of biofilms attached to fibronectin and fibrinogen coating plastic devices like catheters and heart valves is a virulence mechanism of
A. Staphylococcus.

B. Streptococcus.

C. Clostridium.

D. Pseudomonas.

A. Staphylococcus.

14. Which of the following has been associated with the flesh-eating organism?
A. H. lechter
B. Pseudomonas aeruginosa
C. Staphylococcus aureus
D. Streptococcus pyogenes

D. Streptococcus pyogenes

15. S. pyogenes associated with invasive disease characteristically have
A. leukocidins.
B. coagulase.
C. streptococcal pyrogenic exotoxin A.

D. streptococcal pyrogenic exotoxin B.

E. streptococcal pyrogenic exotoxins A AND B.

E. streptococcal pyrogenic exotoxins A AND B.

16. Which of the following produces a greenish pigment that may appear in infected wounds?
A. E. coli
B. S. aureus
C. S. pyogenes
D. P. aeruginosa

D. P. aeruginosa

17. Which of the following virulence factors has been associated with Pseudomonas aeruginosa?
A. Endotoxin A

B. Exoenzyme S

C. Pyogenic exotoxin

D. Endoenzyme T

B. Exoenzyme S

18. The Gram-negative opportunistic rod that can grow in a wide variety of environments, including disinfectants and soaps, is
A. E. coli.
B. S. aureus.
C. S. pyogenes.
D. P. aeruginosa.

D. P. aeruginosa.

20. The popular name for tetanus is
A. hydrophobia.
B. lockjaw.
C. whooping cough.
D. consumption.

B. lockjaw.

21. The exotoxin produced by C. tetani is
A. tetanoxin.
B. exotetanus.
C. tetanospasmin.
D. endospasmin.

C. tetanospasmin.

22. The disease that involves the muscles and often manifests itself first with spasms of the jaw muscles is
A. polio.
B. rabies.
C. tetanus.
D. gastritis.

C. tetanus.

23. Tetanus prevents the release of neurotransmitters from
A. muscle cells.
B. excitatory neurons.
C. inhibitory neurons.
D. tetano cells.

C. inhibitory neurons.

24. Tetanus vaccine contains
A. inactivated bacteria.
B. inactivated spores.
C. live bacteria.
D. inactivated tetanospasmin.

D. inactivated tetanospasmin.

25. Tetanus antitoxin is
A. antibody against the bacteria.
B. inactivated toxin.
C. inactivated bacteria.
D. antibody against the toxin.

D. antibody against the toxin.

26. The toxin implicated in C. perfringens toxicity is
A. tetanospasmin.
B. exoenzyme S.
C. alpha-toxin.
D. endoenzyme T.

C. alpha-toxin.

27. Gas gangrene is so named due to the formation of
A. carbon dioxide.
B. oxygen.
C. hydrogen.
D. carbon monoxide.
E. carbon dioxide AND hydrogen.

E. carbon dioxide AND hydrogen.

28. Effective treatment of gas gangrene primarily involves
A. use of an antitoxin.
B. use of immune globulins.
C. vaccination with inactivated toxin.
D. surgical removal of dead and infected tissues.

D. surgical removal of dead and infected tissues.

29. The organism that grows anaerobically in dead or damaged tissue and produces dense colonies that are the color and size of sulfur particles is
A. Escherichia coli.
B. Staphylococcus aureus.
C. Actinomyces israelii.
D. Pseudomonas aeruginosa.

C. Actinomyces israelii.

30. The disease most feared to develop after an animal bite is
A. tetanus.
B. rabies.
C. gas gangrene.
D. actinomycosis.

B. rabies.

31. The most common infectious agent acquired from the bite wounds of a number of kinds of animals is
A. Escherichia coli.
B. Pasteurella multocida.
C. Actinomyces israelii.
D. Pseudomonas aeruginosa.

B. Pasteurella multocida.

32. The infectious agent(s) that may arise in a wound from a human bite is/are
A. Escherichia coli.
B. Bacteroides.
C. Actinomyces israelii.
D. Staphylococcus aureus.
E. Bacteroides AND Staphylococcus aureus.

E. Bacteroides AND Staphylococcus aureus.

33. The most common cause of chronic lymph node enlargement at a localized body site in young children is
A. rat bite fever.
B. dead bat fever.
C. cat scratch fever.
D. mouse itch fever.

C. cat scratch fever.

34. Cat scratch fever is caused by
A. Bartonella (Rochalimaea) henselae.
B. Pasteurella multocida.
C. Teddis nugentaea.
D. Staphylococcus aureus.
E. Bartonella (Rochalimaea) henselae AND Staphylococcus aureus.

A. Bartonella (Rochalimaea) henselae.

35. Rat bite fever, characterized by fever, rash, and muscle aches, is caused by
A. Afipia felis.
B. Bartonella (Rochalimaea) henselae.
C. Pasteurella multocida.
D. Streptobacillus moniliformis.

D. Streptobacillus moniliformis.

36. Streptobacillus moniliformis is unusual in that it
A. forms spores.
B. spontaneously forms L-forms.
C. is anaerobic.
D. has a cell wall.

B. spontaneously forms L-forms.

37. Which of the following has not been associated with human bites?
A. Syphilis

B. Tuberculosis

C. Hepatitis B

D. Tetanus

D. Tetanus

Which of the following has been involved in causing small epidemics in the United States?

A. Tineasis

B. Candidiasis

C. Trichomoniasis

D. Sporotrichosis

D. Sporotrichosis

39. The fungal disease that may be associated with sphagnum moss is
A. candidiasis.
B. actinomycosis.
C. cat scratch fever.
D. sporotrichosis.

D. sporotrichosis.

40. Frequently sporotrichosis is caused when the infectious agent is introduced into the body by
A. lotions.
B. scissors.
C. thorns.
D. animal bites.

C. thorns.

41. Which is true about protein A?
A. It binds to the Fc region of antibody.
B. It hides bacteria from phagocytes.
C. It enhances binding of phagocytes.
D. It digests antibodies.
E. It binds to the Fc region of antibody AND it hides bacteria from phagocytes.

E. It binds to the Fc region of antibody AND it hides bacteria from phagocytes.

42. Which is true of leukocidins?
A. They are superantigens.
B. They kill neutrophils.
C. They make holes in host cell membranes.
D. They bind to Fc regions of antibodies.

B. They kill neutrophils.

43. Both Staphylococcus aureus and Streptococcus pyogenes
A. are rod-shaped.
B. have fibronectin binding proteins.
C. cause necrotizing fasciitis.
D. have exotoxin A.

B. have fibronectin binding proteins.

56. What is NOT a reason why an abscessed wound might not respond to antibiotic treatment?
A. The bacteria within the abscess have ceased replicating, and many antibiotics require actively replicating cells in order to be effective.
B. The blood vessels that would bring the drug to the area have been destroyed or clogged with clots, preventing the drug from getting to the microbes in the abscess.
C. The bacteria in an abscess have all acquired multi-drug antibiotic resistance, so any drugs that are used will have no effect.
D. The chemical composition of the pus in the abscess often inactivates antibiotic drugs, making them ineffective.

C. The bacteria in an abscess have all acquired multi-drug antibiotic resistance, so any drugs that are used will have no effect.

57. Why is it not surprising that Staphylococci are the leading cause of wound infections?
A. This genus is readily present as a part of the normal microbiota on most people's skin, so it could easily enter wounds.

B. Members of this genus are all particularly virulent and highly capable of causing numerous infections.
C. Staphylococci cannot be eradicated from the skin due to multidrug resistance in most members of the genus. Drugs simply don't kill them.
D. Staphylococci are capable of a higher degree of spontaneous mutation than most microbes. This makes them able to acquire antibiotic resistance very readily, making them hard to eliminate by pre-surgical antibacterial scrubs. As such, they commonly infect surgical wound sites.

A. This genus is readily present as a part of the normal microbiota on most people's skin, so it could easily enter wounds.

58. Would babies need to be immunized against lockjaw (tetanus) if their mother had been immunized against the disease? Why or why not?
A. No-because the mother's IgG antibodies would be passed along through the placenta before birth, protecting the baby from the infection.
B. Yes-because even though maternal IgG antibodies might be passed along through the placenta, they will not last forever. The baby will need to create its own antibody response to be protected against future tetanus.
C. No-because maternal IgG antibodies would be passed along in the breast milk, protecting the baby from infection.

B. Yes-because even though maternal IgG antibodies might be passed along through the placenta, they will not last forever. The baby will need to create its own antibody response to be protected against future tetanus.

59. Why might Candida albicans become pathogenic in an individual receiving antibacterial medications?
A. This fungal organism can actually utilize the destroyed bacterial cells as a nutrient source and begin to multiply out of control. This can cause a pathogenic state.
B. This is an opportunistic pathogen not normally found in normal microbiota. As such, when the bacterial normal microbiota is wiped out by broad-spectrum antibacterial drugs, this opportunist can adhere to and colonize the area left behind.

C. This is a usual member of the normal microbiota. However, when the bacterial members of the normal microbiota are wiped out by a broad-spectrum antibacterial drug, this fungal cell type has little to no competition for resources in the affected area. As such, it quickly overgrows and can cause a pathogenic state.

C. This is a usual member of the normal microbiota. However, when the bacterial members of the normal microbiota are wiped out by a broad-spectrum antibacterial drug, this fungal cell type has little to no competition for resources in the affected area. As such, it quickly overgrows and can cause a pathogenic state.

60. Rowley Pharmaceutical company produces a drug that promotes new blood vessel growth. Is there any application for this drug in wound treatment?
A. It could be very beneficial-one of the biggest problems with wound infections is their largely anaerobic nature. The blood supply to the area is usually compromised, helping to create the anaerobic environment. Certain pathogenic microbes then thrive in this environment, creating very serious wound infections.
B. It could be disastrous! Part of the reason abscesses lack blood flow is to keep toxins and bacteria from spreading to other areas of the body. Increasing blood flow to the area will provide a highway for these bacteria to seed other organ systems!
C. It could be dangerous-wounds need to cut off blood supply to prevent the patient from bleeding to death. Increasing blood vessel development in the wound site might cause the patient to bleed out.
D. There would be no beneficial effect-the immune response is already in place in the wound site, so increasing blood cell delivery to the area wouldn't increase or decrease the rate of wound healing.

A. It could be very beneficial-one of the biggest problems with wound infections is their largely anaerobic nature. The blood supply to the area is usually compromised, helping to create the anaerobic environment. Certain pathogenic microbes then thrive in this environment, creating very serious wound infections.

1. Who determined that the cholera outbreak in 1850s London was due to contaminated water and approached the problem by removing the pump handle at the contaminated site?
A. Pasteur
B. Snow
C. Koch
D. Smith

B. Snow

2. The passage from the mouth to the anus is termed the
A. gut canal.
B. oral cavity.
C. grand canal.
D. gastrointestinal tract.

D. gastrointestinal tract.

3. Collections of bacteria that adhere to the surfaces of the teeth are called
A. dental caries.
B. dental plaque.
C. halitosis.
D. periodontal disease.

B. dental plaque.

4. The most common infectious disease of humans is
A. the common cold.
B. dental caries.
C. hepatitis A.
D. halitosis

B. dental caries.

5. The principal cause of dental caries is
A. S. mutans.
B. S. salivarius.
C. S. mitis.
D. S. sanguis.

A. S. mutans.

6. Part of the ability of S. mutans to produce dental caries depends on its ability to
A. invade plaque and dissolve the gums.
B. convert sucrose to lactic acid.
C. convert proteins to sugars.
D. attach to the gums.

B. convert sucrose to lactic acid.

7. This chemical compound, typically added to drinking water, makes enamel more resistant to dissolving in acid.

A. Calcium

B. Chlorine

C. Chloramine

D. Fluoride

D. Fluoride

8. The chronic inflammatory process involving the gums and tissues around the teeth is called
A. dental caries.
B. periodontal disease.
C. dental plaque.
D. root caries.

B. periodontal disease.

9. Helicobacter pylori is, in part, able to survive in the stomach by its ability to produce

A. lactic acid from sugar.
B. fatty acids from sebum.
C. neutralizing proteins from glucans.
D. ammonia from urea.

D. ammonia from urea.

10. Helicobacter pylori appears to have some connection with

A. acid reflux disease.
B. ulcers.
C. dental caries.
D. stomach cancer.
E. ulcers AND stomach cancer.

E. ulcers AND stomach cancer.

11. Where in the body does the latent, non infectious, non replicating form of the herpes simplex virus persist?

A. Motor neurons

B. Red blood cells

C. Cranial nerves

D. Sensory nerves

D. Sensory nerves

21. The symptoms of cholera are due to the action of
A. an endotoxin.
B. modified mucus.
C. flagella.
D. an exotoxin.

D. an exotoxin

12. A painful finger infection attributable to herpes virus is known as a(n)
A. finger sore.
B. abrasion lesion.
C. furuncle.
D. herpetic whitlow.

D. herpetic whitlow.

13. Which of the following has shown some effectiveness in treating a herpes infection?
A. AZT
B. Protease inhibitors

C. Acyclovir

D. Cephalosporin

C. Acyclovir

14. The viral disease that characteristically infects the parotid glands is
A. measles.
B. herpes.
C. chickenpox.
D. mumps.

D. mumps.

15. Mumps is a good candidate for elimination from the population due to
A. the existence of an effective vaccine.
B. a human-only reservoir.

C. the absence of a latent state.
D. a single serotype.
E. All of the choices are correct.

E. All of the choices are correct.

16. Most bacterial intestinal infections may be traced to

A. Vibrio spp.
B. C. jejuni.
C. Salmonella spp.
D. Enterobacteriaceae.

E. All of the choices are correct.

E. All of the choices are correct.

17. The initial attachment required for establishment of an intestinal infection is by
A. flagella.
B. cilia.
C. pseudopodia.
D. pili.

D. pili.

18. The toxins involved in intestinal infections typically
A. kill cells by inhibiting protein synthesis.
B. modify cell physiology resulting in increased secretion of water and electrolytes.
C. modify cell physiology resulting in decreased secretion of water and electrolytes.
D. kill cells by inhibiting DNA synthesis.
E. kill cells by inhibiting protein synthesis AND modify cell physiology resulting in increased secretion of water and electrolytes.

E. kill cells by inhibiting protein synthesis AND modify cell physiology resulting in increased secretion of water and electrolytes.

19. Cholera is the classic example of a(n)
A. food borne illness.

B. zoonosis.
C. opportunist.
D. very severe form of diarrhea.

D. very severe form of diarrhea.

20. The diarrhea of cholera has been described as
A. a viscous fluid.
B. small in volume.
C. somewhat watery.
D. a rice water stool.

D. a rice water stool.

22. A common source of cholera infection is
A. acid rain.
B. unpasteurized milk.
C. fecal contaminated material, especially water.
D. boiled water.
E. acid rain AND boiled water.

C. fecal contaminated material, especially water.

23. The primary treatment for cholera is
A. the administration of antibiotics.
B. vaccination.
C. by blood transfusion.
D. simply rehydration.
E. vaccination AND by blood transfusion.

D. simply rehydration.

24. Shigella and cholera toxin both
A. have an A-B arrangement.
B. work through ADP ribosylation.
C. increase cAMP levels.
D. prevent protein synthesis

A. have an A-B arrangement.

25. Shigella
A. are themselves nonmotile.
B. may be pushed from cell to cell by actin tails.
C. utilize pili to move.
D. utilize flagella to move.
E. are themselves nonmotile AND may be pushed from cell to cell by actin tails.

E. are themselves nonmotile AND may be pushed from cell to cell by actin tails.

26. Which of the following groups contain diarrhea-causing E. coli?
A. enterotoxigenic
B. enteroinvasive
C. enteropathogenic
D. enterohemorrhagic
E. All of the choices are correct.

E. All of the choices are correct.

27. Which of the following groups give rise to a disease similar to that caused by Shigella sp.?
A. enterotoxigenic
B. enteroinvasive
C. enteropathogenic
D. enterohemorrhagic
E. All of the choices are correct.

B. enteroinvasive

28. Which group produces a toxin somewhat similar to that produced by Shigella dysenteriae?
A. enterotoxigenic
B. enteroinvasive
C. enteropathogenic
D. enterohemorrhagic
E. All of the choices are correct.

D. enterohemorrhagic

29. Vibrio cholerae and most salmonellae are

A. killed by acid conditions.
B. stimulated by acid conditions.
C. killed by low concentrations of salt.
D. killed by neutral conditions.

A. killed by acid conditions.

30. Most cases of Salmonella gastroenteritis have a(n)
A. water source.
B. human source.
C. plant source.
D. animal source.

D. animal source.

31. The food products most commonly contaminated with Salmonella strains are
A. meat and seafood.
B. milk and cheese.
C. fruit and vegetables.
D. eggs and poultry.

D. eggs and poultry.

32. The animal(s) often associated with Salmonella strains is/are
A. turtles.
B. iguanas.
C. baby chickens.
D. ducks.
E. All of the choices are correct.

E. All of the choices are correct.

33. In which of these organs does a carrier of typhoid bacilli maintain the bacteria?
A. liver
B. gallbladder
C. Peyer's patches
D. colon
E. liver AND Peyer's patches

B. gallbladder

34. The most notorious typhoid carrier was
A. Typhoid Tilly.
B. Typhoid Tom.
C. Typhoid Mary.
D. Typhoid Mark.

C. Typhoid Mary.

35. Which of these bacteria require a special medium and microaerophilic conditions?
A. Escherichia coli

B. Pseudomonas aeruginosa

C. Staphylococcus aureus

D. Campylobacter jejuni

D. Campylobacter jejuni

36. A mysterious sequel to Campylobacter jejuni infections is

A. Reye's syndrome.
B. Tourette's syndrome.
C. Pasteur's syndrome.
D. Guillain-Barré syndrome.

D. Guillain-Barré syndrome.

37. The animal(s) most often associated with Campylobacter jejuni is/are

A. turtles.
B. iguanas.
C. chickens.
D. ducks.
E. All of the choices are correct.

C. chickens.

38. Viral gastroenteritis in infants and children is most commonly caused by
A. herpes.
B. hepatitis B.
C. Norovirus.

D. rotavirus.

D. rotavirus.

39. Viral gastroenteritis that affects people of all ages and usually lasts less than 3 days is caused by
A. herpes.
B. hepatitis B.
C. norovirus.
D. rotavirus.

C. norovirus.

40. The most common chronic blood-borne infection in the U.S. is

A. hepatitis A
B. hepatitis B
C. hepatitis C
D. hepatitis D

C. hepatitis C

41. Hepatitis A spreads via
A. the respiratory route.
B. blood transfusion.
C. body fluids.
D. the fecal-oral route.

D. the fecal-oral route.

42. HBV is mainly spread by
A. blood.
B. blood products.
C. semen.
D. saliva.
E. blood, blood products AND semen.

E. blood, blood products AND semen.

43. Intestinal protozoan infections are typically spread by
A. the respiratory route.
B. blood transfusion.
C. body fluids.
D. the fecal-oral route.

D. the fecal-oral route.

44. The most commonly identified waterborne illness in the United States is
A. amoebiasis.
B. cryptosporidiosis.
C. balantidiasis.
D. giardiasis.

D. giardiasis.

45. Giardiasis may be contracted from
A. another person.
B. clear mountain streams.
C. chlorinated city water.
D. cold filtered beer.
E. another person, clear mountain streams AND chlorinated city water.

E. another person, clear mountain streams AND chlorinated city water.

46. may infect

A. dogs.
B. pigs.
C. cattle.
D. humans.
E. All of the choices are correct.

E. All of the choices are correct.

47. Most North American outbreaks of Cyclospora cayetanensis have been associated with
A. cattle.
B. iguanas.
C. imported leafy vegetables and berries.

D. chickens.

C. imported leafy vegetables and berries.

48. The oocytes of Cyclospora cayetanensis
A. are mature when eliminated in the stool.
B. do not contain sporozoites when passed in the feces.
C. are smaller than the oocytes of Cryptosporidium parvum.
D. give rise to three sporozoites.
E. All of the choices are correct.

B. do not contain sporozoites when passed in the feces.

49. Entamoeba histolytica
A. causes amebiasis.
B. may form cysts.
C. cysts survive passage through the stomach.
D. may produce a cytotoxic enzyme.
E. All of the choices are correct.

E. All of the choices are correct.

50. Amebiasis
A. is caused by .

B. often causes a bloody diarrhea.
C. is an infection of the stomach.
D. is restricted to temperate climates.
E. is caused by AND often causes a bloody diarrhea.

B. often causes a bloody diarrhea.

61. Why is it that the tongue and cheek epithelium doesn't provide a sufficient anaerobic environment for plaque anaerobes to grow, but the surface of teeth might?
A. The epithelium is supplied with oxygen by capillary beds. This makes it a relatively aerobic environment and hostile to anaerobes.
B. The tooth enamel is supplied with oxygen by capillary beds. This makes it a relatively anaerobic environment and hostile to aerobes.
C. The surface of the tongue and cheek are constantly scraped by the action of consuming food. Layers of bacterial growth that might help to supply an anaerobic environment are scraped away, exposing lower levels to oxygen-rich air.
D. The surface of teeth (especially the molars) have many pits and crevices that can serve as 'pockets' for layers of bacteria to grow in. Once the layers get deep enough, the bottom portions are anaerobic. This isn't possible on the very smooth surface of the tongue and cheek epithelium.

A. The epithelium is supplied with oxygen by capillary beds. This makes it a relatively aerobic environment and hostile to anaerobes.

62. Explain how Vibrio cholerae causes cholera without apparent damage to the intestinal epithelium.
A. This microbe causes destruction of the cellular structures underneath the intestinal epithelium-this is what induces the watery rice-stool characteristic of the illness. This leaves the overlying intestinal epithelium intact.
B. This microbe directly invades the intestinal epithelial cells, but does not kill them. Instead, while multiplying inside them, it causes them to secrete large amounts of chloride ions. This induces water to follow by osmosis, resulting in the watery rice-stool characteristic of the illness.
C. This microbe attaches to the surface of intestinal epithelial cells, secreting an exotoxin that causes the epithelium to secrete large amounts of chloride ions. This induces large amounts of water to follow by osmosis, resulting in the watery rice-stool characteristic of the illness.
D. The inflammatory reaction to the presence of this microbe causes the watery rice-stool characteristic of the illness. Therefore, it's technically the immune response that initiates the disease, although this response is induced by the presence of the microbe on the intestinal epithelium.

C. This microbe attaches to the surface of intestinal epithelial cells, secreting an exotoxin that causes the epithelium to secrete large amounts of chloride ions. This induces large amounts of water to follow by osmosis, resulting in the watery rice-stool characteristic of the illness.

63. Why might it be more difficult to prepare a vaccine against noroviruses than against rotaviruses?
A. We haven't been able to culture noroviruses in a lab setting yet. Without a starting culture, we can't create a vaccine.
B. Noroviruses are RNA viruses, where rotaviruses are DNA viruses. RNA viruses mutate far more easily than DNA viruses, so we COULD make a vaccine, but it would be rendered useless fairly quickly as the virus mutates.
C. We lack a proper culturing method for large-scale production of target cells for norovirus, whereas we have such a system for the target cells of rotaviruses. Without a system to get large numbers of target cells, we can't produce a vaccine.
D. Norovirus is much more infectious than rotavirus. As such, it's much harder to work with safety. This makes production of a vaccine too dangerous and unpredictable.

A. We haven't been able to culture noroviruses in a lab setting yet. Without a starting culture, we can't create a vaccine.

64. Would you expect an individual with giardiasis who has diarrhea to be more likely to transmit the disease than an individual with giardiasis who does NOT have diarrhea? Why or why not?
A. No. This illness is spread by respiratory droplets, so diarrhea as a symptom shouldn't matter for transmission of the disease.
B. No. This illness is spread by sexual contact, so diarrhea as a symptom shouldn't matter for transmission of the disease.
C. Yes. This illness is spread by the fecal-oral route, so presence of diarrhea as a symptom should dramatically increase the possibility of transmission of infection.
D. Yes. This illness is spread by insects that feed on contaminated fecal matter, becoming infected themselves. The disease is spread to new individuals when these infected insects bite a susceptible person, transmitting the cysts of the protozoan. As such, diarrhea as a symptom would increase the risk of transmission through biting insects to new individuals.
E. No. This illness is spread when people ingest cysts, and a person with severe diarrhea excretes primarily trophozoites; an asymptomatic person is more likely to excrete cysts and is therefore more infectious.

E. No. This illness is spread when people ingest cysts, and a person with severe diarrhea excretes primarily trophozoites; an asymptomatic person is more likely to excrete cysts and is therefore more infectious.

1. The scientist responsible for the development of the first anti-plague vaccine in 1866 was
A. Alexandre Yersin.
B. Robert Koch.
C. Louis Pasteur.
D. Josef Marburg.

A. Alexandre Yersin.

2. The plague bacillus is known as
A. Plasmodium vivax.
B. Pneumocystis carinii.
C. Streptococcus pyogenes.
D. Yersinia pestis.

D. Yersinia pestis.

3. The circulation of an agent in the bloodstream is given a name ending in
A. -ase.
B. -ing.
C. -emia.
D. -ation.

C. -emia.

4. The sac which surrounds the heart is called the
A. endocardium.
B. pericardium.
C. atrium.
D. myocardium.

B. pericardium.

5. The heart chamber that passes blood to the lungs is the
A. left ventricle.
B. right ventricle.
C. right atrium.
D. left atrium.

B. right ventricle.

6. Which organism may be implicated in arteriosclerosis?
A. Escherichia coli
B. Pseudomonas aeruginosa
C. Staphylococcus aureus
D. Chlamydia pneumoniae

D. Chlamydia pneumoniae

7. The fluid which bathes and nourishes the tissue cells is the
A. cytoplasm.
B. lymph.
C. blood.
D. interstitial fluid.

D. interstitial fluid.

8. The small bean-shaped bodies into which the lymphatic vessels drain are the
A. lymph nodes.
B. adrenals.
C. subclavian veins.
D. valves.

A. lymph nodes.

9. A visible red streak in an infected hand or foot is referred to as
A. septicemia.
B. bacteremia.
C. lymphangitis.
D. edema.

C. lymphangitis.

10. Blood and lymph may carry
A. antibodies.
B. complement.
C. lysozyme.
D. interferon.
E. All of the choices are correct.

E. All of the choices are correct.

11. The spleen, in part, functions to cleanse the
A. lymph.
B. interstitial fluid.
C. cytoplasm.
D. blood.

D. blood.

12. The condition that develops on a previously damaged heart valve is called
A. an aneurysm.
B. acute bacterial endocarditis.
C. myocarditis.
D. subacute bacterial endocarditis.

D. subacute bacterial endocarditis.

13. The most common agent(s) causing subacute bacterial endocarditis is/are
A. Streptococcus pyogenes.
B. Pseudomonas aeruginosa.
C. normal skin or mouth microbiota.

D. Escherichia coli.

C. normal skin or mouth microbiota.

14. High levels of antibodies in patients with SBE cause inflammation because

A. they make the bacteria clump together and get trapped in skin and eyes.

B. the surface antigens change rapidly and become unrecognizable.
C. the antibodies are defective.
D. the antibodies degrade quickly.

A. they make the bacteria clump together and get trapped in skin and eyes.

15. The inflammatory effects of immune complexes lodged in the kidney is called
A. renal phritis.
B. rendema.
C. glomerulonephritis.
D. urethritis.

C. glomerulonephritis.

16. Bacteria which cause subacute bacterial endocarditis may gain access to the bloodstream by
A. trauma.
B. dental procedures.
C. brushing teeth.
D. ingestion.
E. trauma, dental procedures AND brushing teeth.

E. trauma, dental procedures AND brushing teeth.

17. Acute bacterial endocarditis differs from subacute bacterial endocarditis in the
A. suddenness and severity of onset.
B. population affected.
C. resultant damage.
D. development of exotoxin shock.

A. suddenness and severity of onset.

18. Which of the following is more likely to cause fatal septicemias?
A. Gram-positive bacteria
B. Gram-negative bacteria
C. negative stained bacteria
D. acid-fast stained bacteria

B. Gram-negative bacteria

19. The material released from bacteria that may lead to shock and death in septicemia is
A. exotoxin.
B. protein A.
C. endotoxin.
D. interferon.

C. endotoxin.

20. The cytokine released from macrophages that seems to play a major role in endotoxic shock is
A. macrophage factor.
B. tumor necrosis factor.
C. protein A.
D. interferon.

B. tumor necrosis factor.

21. Although endotoxemia affects many organs, the organ most seriously and irreversibly affected is the
A. heart.
B. lung.
C. kidney.
D. spleen.

B. lung.

22. Enlargement of lymph nodes or spleen is often associated with
A. tularemia.
B. brucellosis.
C. plague.
D. gastritis.
E. tularemia, brucellosis AND plague.

E. tularemia, brucellosis AND plague.

23. In order to culture the organism responsible for tularemia, the growth media must contain
A. charcoal.
B. glucose.
C. cysteine.
D. NAD.

C. cysteine.

24. The common name for tularemia is
A. Bang's disease.
B. rabbit fever.
C. Hansen's disease.
D. Chagas' disease.

B. rabbit fever.

25. The development of lymph node enlargement in the region of a skin ulcer after a tick or insect bite or handling of a wild animal suggests
A. brucellosis.
B. endocarditis.
C. septicemia.
D. tularemia.

D. tularemia.

26. Which of the following is/are able to survive phagocytosis?
A. Brucella sp.
B. Staphylococcus aureus
C. Francisella tularensis
D. Brucella sp AND Francisella tularensis

D. Brucella sp AND Francisella tularensis

27. Brucellosis may also be known as
A. Bang's disease.
B. undulant fever.

C. Hansen's disease.
D. rabbit fever.
E. Bang's disease AND undulant fever.

E. Bang's disease AND undulant fever.

28. Traditionally the animal(s) associated with hosting Brucella is/are
A. cattle.
B. dogs.
C. goats.
D. pigs.
E. All of the choices are correct.

E. All of the choices are correct.

29. The "Black Death" may also be known as
A. tularemia.
B. brucellosis.
C. endocarditis.
D. plague.

D. plague.

30. The disease responsible for the death of approximately ¼ the population of Europe from 1346 to 1350 was
A. typhus.
B. pneumonia.
C. influenza.
D. plague.

D. plague.

31. Symptoms of plague appear in
A. two to three months.
B. one to two years.
C. three to six hours.
D. one to six days.

D. one to six days.

32. The causative agent of plague is
A. Vibrio cholerae.
B. Staphylococcus aureus.
C. Brucella abortus.
D. Yersinia pestis.

D. Yersinia pestis.

33. Yersinia pestis typically contains
A. one plasmid.
B. two plasmids.
C. three plasmids.
D. four plasmids.

C. three plasmids.

34. The major virulence factors of Yersinia pestis are carried on
A. the chromosome.
B. a plasmid.
C. three separate plasmids.
D. nuclear membrane.

C. three separate plasmids.

35. The virulence factor of Yersinia pestis that is a protease that destroys C3b and C5a is
A. Yops.
B. pla.

C. F1.
D. protein A.

B. pla.

37. The plague is typically transmitted via the bite of
A. ticks.
B. fleas.
C. lice.
D. mites.

B. fleas.

38. Enlargement of lymph nodes or spleen is often associated with
A. tularemia.
B. brucellosis.
C. plague.
D. infectious mononucleosis.
E. All of the choices are correct.

E. All of the choices are correct.

39. The cause of infectious mononucleosis is
A. varicella virus.
B. Staphylococcus aureus.
C. Epstein-Barr virus.
D. Francisella tularensis.

C. Epstein-Barr virus.

40. Epstein-Barr virus may become latent in
A. red blood cells.
B. T cells.
C. nerve cells.
D. B cells.

D. B cells.

41. The production of heterophile antibody is associated with
A. tularemia.
B. brucellosis.
C. plague.
D. infectious mononucleosis.

D. infectious mononucleosis.

42. Which of the following may be transmitted by saliva?
A. infectious mononucleosis
B. Dengue fever

C. plague
D. yellow fever

A. infectious mononucleosis

43. Yellow fever is transmitted by
A. ticks.
B. fleas.
C. Anopheles mosquitoes.
D. Aedes mosquitoes.

D. Aedes mosquitoes.

44. The disease caused by an enveloped single-stranded RNA arbovirus of the flavivirus family is
A. AIDS.
B. malaria.
C. yellow fever.
D. herpes.

C. yellow fever.

45. Which of the following is caused by a protozoan infection?
A. malaria
B. yellow fever
C. tularemia
D. infectious mononucleosis

A. malaria

46. Which of the following is transmitted by mosquitoes?
A. plague
B. yellow fever
C. malaria
D. tularemia
E. yellow fever AND malaria

E. yellow fever AND malaria

47. Which species of Plasmodium causes the most serious form of malaria?
A. ovale
B. malariae
C. vivax
D. falciparum

D. falciparum

48. In which of the following diseases does the spleen enlarge?
A. infectious mononucleosis
B. malaria
C. leishmaniasis
D. brucellosis
E. All of the choices are correct.

E. All of the choices are correct.

59. What is the difference between 'bacteremia' and 'septicemia?'
A. Bacteremia is an infection with bacteria. Septicemia is an infection with Septic protozoans.
B. Bacteremia is the presence of living, multiplying bacteria in the bloodstream. Septicemia is the presence of endotoxins, but not necessarily of living microbial agents.
C. Septicemia is the presence of living, multiplying bacteria in the bloodstream. Bacteremia is the presence of endotoxins, but not necessarily of living microbial agents.
D. There is no difference-both terms denote the presence of living bacterial cells in the bloodstream.

B. Bacteremia is the presence of living, multiplying bacteria in the bloodstream. Septicemia is the presence of endotoxins, but not necessarily of living microbial agents.

60. How would crowded conditions in cities favor spread of plague?
A. Plague is transmitted by rats-more people means more waste, and more waste means more rats. This would favor the spread of plague.
B. Plague is transmitted by mosquitoes-more people close together gives an infected mosquito more chances to bite humans and transmit the causative agent, spreading plague.
C. Plague is transmitted by infected fleas-these fleas may be found on rodents (such as rats). More people in an area means a greater chance of interactions with animals carrying infected fleas, increasing the spread of plague.
D. Plague is transmitted by direct contact (e.g. skin to skin). More people in an area provides more chances for infected individuals to directly contact and infect other individuals, spreading plague.

C. Plague is transmitted by infected fleas-these fleas may be found on rodents (such as rats). More people in an area means a greater chance of interactions with animals carrying infected fleas, increasing the spread of plague.

61. Why does it take more than a week before a mosquito just infected with yellow fever virus can transmit the disease?
A. The virus must replicate in the gut of the mosquito before it can reach high enough numbers for transmission to a new human.
B. Mosquitoes only feed once a week, which limits their ability to transmit the disease rapidly.
C. Yellow fever is caused by a protozoan. It must develop from the sporozoite form into the mature form to become infectious, and this takes time.
D. The virus multiplies in the gut of the mosquito, but then needs to migrate to the proboscis (biting nose) of the animal in order to infect a new human being after a new bite. This migration takes time.

A. The virus must replicate in the gut of the mosquito before it can reach high enough numbers for transmission to a new human.