Chapter 4 Bacterial Diseasess
- 1.A patient presents with a brain abscess. The dominant organism is an anaerobe normally found as part of the oral flora. Which of the following best fits that description?
- A.
Nocardia
- B.
Actinomyces
- C.
Mycobacterium
- D.
Pseudomonas aeruginosa
- 2.A 23-year-old male who has recently started working on a sheep farm in Nova Scotia develops pneumonia shortly after helping with lambing. His cough produces little sputum, and a saline-induced sputum sample shows no predominant organism either with Gram stain or with acid-fast stain. It is established that he acquired the pneumonia from parturition products from the sheep. Which agent is most likely to be the cause of his pneumonia?
- A.
Rickettsia akari
- B.
Rickettsia typhi
- C.
Rickettsia rickettsii
- D.
Coxiella burnetii
- E.
Anaplasma phagocytophila
- 3.A 3 year old presents with difficulty breathing and will not lie down to be examined. You suspect acute bacterial epiglottitis and examine the child’s epiglottis, which is highly inflamed. Which vaccine are you most likely to find that the child is missing?
- A.
Diphtheria
- B.
Neisseria meningitidis
- C.
Polio
- D.
Streptococcus pneumoniae (conjugate vaccine)
- E.
Haemophilus influenzae
- 4.A 22-year-old cystic fibrosis patient presents with fever and increasing dyspnea. A Gram-negative organism is found in unusually high numbers in the mucus. Which virulence factor is most important in colonization and maintenance of the organism in the lungs?
- A.
Exotoxin A
- B.
Pyocyanin (blue-green pigment)
- C.
Polysaccharide slime
- D.
Endotoxin
- 5.Exotoxin A most closely resembles the action of which other microbial toxin?
- A.
Heat-labile toxin (LT) of Escherichia coli
- B.
Shiga toxin
- C.
Diphtheria toxin
- D.
Vibrio cholerae toxin
- E.
Vero toxin
- 6.A 36-year-old immigrant who lived in a crowded resettlement camp before coming to the United States now has a cough that has been bothering him for several weeks. He has also lost 10 pounds. Which of the following factors is known to be most important in triggering the granulomatous reaction to wall off and contain the infection?
- A.
Cord factor
- B.
Mycolic acid
- C.
Purified protein derivative (PPD)
- D.
Sulfatides
- E.
Wax D
- 7.Patient develops diarrhea 5 days after starting antibiotic treatment for a serious staphylococcal infection. What is the most likely causative agent?
- A.
Clostridium perfringens
- B.
Clostridium difficile
- C.
Pseudomonas aeruginosa
- D.
Shigella sonnei
- 8.A patient develops mild gastroenteritis a few days after having a variety of sushi at a party. There is no blood or pus in the stool. Which causative agent is most likely to have caused this illness?
- A.
Vibrio cholerae
- B.
Vibrio parahaemolyticus
- C.
Salmonella typhi
- D.
Shigella sonnei
- 9.Yersinia pestis may be transferred by
- A.
Dermacentor tick bite
- B.
Human body louse bite
- C.
Ixodes tick bite
- D.
Respiratory droplets
- 10.A patient had surgery 2 months ago to put in a pace maker. He felt fine for 1 month, but over the past month, he has been feeling worse. He is running a low-grade fever, tires easily, and has worsening heart murmurs. Which of the following staphylococcal organisms causes sub-acute bacterial endocarditis that occurs 2 months or more after heart surgery?
- A.
Staphylococcus aureus
- B.
Staphylococcus epidermidis
- C.
Staphylococcus haemolyticus
- D.
Staphylococcus saprophyticus
- 11.A previously healthy 6 month old now looks limp. He cannot hold his eyes open, pupils do not react, and he cannot hold his head up. What is the proper treatment?
- A.
Send him home on amoxicillin and clindamycin (to stop the toxin production quickly)
- B.
Give him a dose of equine botulinum immunoglobulin
- C.
Monitored supportive care with antibiotics, and botulinum immunoglobulin
- D.
Monitored supportive care with human botulinum immunoglobulin
- E.
Monitored supportive care with no antibiotics and no antitoxin
- 12.A 78-year-old man develops a high fever, cough producing a blood-tinged sputum, and difficulty breathing. Sputum shows organism consistent with Streptococcus pneumoniae. What is the most important virulence factor?
- A.
Endotoxin
- B.
A phospholipase allowing Streptococcus pneumoniae To escape the phagosome quickly
- C.
Polypeptide capsule
- D.
Polysaccharide capsule
- 13.Which of the following organisms grows in 40% bile?
- A.
Enterococcus faecalis
- B.
Streptococcus pneumoniae
- C.
Group B streptococci
- D.
Viridans streptococci
- 14.A patient recently returned from Africa has been febrile for several days and now has abdominal pain. His blood cultures grow out Salmonella typhi. What was the most likely source of his infection?
- A.
Raw chicken
- B.
Undercooked hamburger
- C.
Contact with baby goats on a farm and then eating without washing hands
- D.
A food preparer with bad personal hygiene
- E.
Undercooked pork
- 15.A preterm (33-week) infant girl is born at home to a 16-year-old mom after 22 hours of labor after the rupture of the membranes. A friend helped the mother deliver the baby. The now 4 day old infant now shows signs of sepsis. What is the best description for the most likely causative agent? All organisms in the answer choices are Gram-positive, catalase-negative cocci found in pairs or short chains.
- A.
Non-hemolytic organisms found as part of the normal fecal flora; resistant to bile and optochin; carries a high level of drug resistance
- B.
Alpha-hemolytic diplococcic sensitive to both bile and optochin
- C.
Beta-hemolytic cocci in chains and carrying Lancefield’s Group B antigen
- D.
Alpha-hemolyticcocci in chains; resistant to bile and optochin
- 16.A patient has a gastric ulcer not induced by non-steroidal anti-inflammatory agents. Which characteristic appears to play a central role in the ability of the organism to survive transit of the lumen to colonize the stomach?
- A.
Phospholipase C production
- B.
Urease production
- C.
Micro aerophilic lifestyle
- D.
O antigens
- 17.A54-year-old man develops a pyogenic infection along the suture line after knee surgery. The laboratory gives a preliminary report of a beta-hemolytic, catalase-positive, coagulase-positive, Gram-positive coccus. The most likely causative agent is
- A.
Moraxella catarrhalis
- B.
Staphylococcus aureus
- C.
Staphylococcus epidermidis
- D.
Streptococcus agalactiae
- E.
Streptococcus pyogenes
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