Deck 32: Upper and Lower Respiratory Tract Infections

Question 1

Acute sinusitis usually occurs as a complication of

A) bacterial pneumonia.
B) viral pneumonia.
C) the common cold.
D) streptococcal pharyngitis.

Answer 1

C

Question 2

What is the cause of reduced clearance of respiratory secretions that predisposes people to respiratory infections?

A) Obstruction by a foreign body
B) Alterations in the viscosity of the mucus
C) Immature anatomic development
D) All of the above

Answer 2

D

Question 3

When reading culture plates from respiratory specimens, what must the microbiologist take into consideration?

A) The types of organisms normally found at the culture site
B) The amount of media inoculated
C) The quality control performed on the media
D) The patient's physician

Answer 3

A

Question 4

What does the presence of $\alpha$ -hemolytic colonies on a throat culture indicate?

A) These organisms are pathogenic and must be treated.
B) These organisms are normal microbiota found in the pharynx.
C) The patient is suffering from a viral pharyngitis.
D) The patient has mouth ulcers that require antiviral treatment.

Question 5

What common condition will predispose individuals to acute sinusitis?

A) Cold sores
B) Ear infections
C) Nosebleeds
D) Allergies

Question 6

All the following are virulence factors that allow microorganisms to produce disease, except

A) adherence.
B) toxin production.
C) mucus production.
D) host evasion.

Question 7

Why do most physicians treat otitis media empirically?

A) Many agents of these infections are noncultivable.
B) Cultures do not always correlate with the true pathogen.
C) Pathogens causing otitis media never become resistant to antimicrobial agents.
D) The predominant infection causing organisms are known.

Question 8

What is helpful when initiating empiric antimicrobial therapy?

A) Knowing the patient's age
B) Knowing the pathogens most likely to cause a particular type of infection
C) Knowing a patient's medical history
D) Knowing the anatomy of the respiratory tract

Question 9

What is the most common cause of community-acquired pneumonia in adults?

A) Influenza virus
B) Streptococcus pneumoniae
C) Staphylococcus aureus
D) Legionella pneumophila

Question 10

Why is pharyngitis produced by group A Streptococcus treated with antimicrobial agents?

A) To prevent rheumatic fever and acute glomerulonephritis
B) To prevent epiglottis
C) To prevent swelling of the tonsils
D) To prevent swelling of soft tissues in the pharynx

Question 11

What bacterium may cause up to 50% of all cases of pneumonia in the summer months?

A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Klebsiella pneumoniae
D) Haemophilus influenzae

Question 12

A patient's normal pharyngeal biota can be altered by all of the following, except

A) broad-spectrum antimicrobials.
B) recent hospitalization.
C) chronic illness.
D) visiting a nursing home.

Question 13

What are the two most frequently identified bacterial causes of community-acquired sinusitis?

A) Staphylococcus aureus and Escherichia coli
B) Streptococcus pneumoniae and Haemophilus influenzae
C) S. pneumoniae and Mycoplasma pneumoniae
D) H. influenzae and Neisseria meningitidis

Question 14

What is the most common localized infection of the upper respiratory tract in preschool-age patients?

A) Orbital cellulitis
B) Acute sinusitis
C) Otitis media
D) Mastoiditis

Question 15

What should a microbiologist do if he or she finds $\alpha$ -hemolytic colonies on a properly collected sputum specimen on a patient suspected of having lobar pneumonia?

A) Ignore the colonies because they are normal microbiota.
B) Ignore the colonies because no known pathogens for pneumonia are $\alpha$ -hemolytic.
C) Do a full workup to identify the organism.
D) Suspect a bioterror agent and send the isolate to a laboratory response network reference laboratory.

Question 16

Elements of the respiratory tract that can help prevent infection include

A) nasal hair.
B) normal microbiota.
C) coughing.
D) All of the above

Question 17

All of the following are complications of acute sinusitis, except

A) acute pharyngitis.
B) meningitis.
C) osteomyelitis.
D) orbital cellulitis.

Question 18

What organisms are most frequently isolated from cultures of individuals with otitis media?

A) Staphylococcus aureus and Escherichia coli
B) Streptococcus pneumoniae and Haemophilus influenzae
C) S. pneumoniae and Mycoplasma pneumoniae
D) H. influenzae and Neisseria meningitidis

Question 19

All of the following factors can help the microbiologist differentiate between colonization and infection, except

A) presence of a pure culture or mixed biota on the culture plates.
B) method and site of collection of the specimen.
C) presence of white blood cells and the number of organisms seen on Gram stain.
D) a compatible clinical syndrome.

Question 20

What organism is the predominate cause of epiglottis?

A) Haemophilus influenzae
B) Streptococcus pneumoniae
C) Moraxella catarrhalis
D) Bordetella pertussis

Question 21

All the following are potentially pathogenic organisms found in the nasopharynx of healthy individuals, except

A) Haemophilus influenzae.
B) Streptococcus pneumoniae.
C) Streptococcus mutans.
D) Neisseria meningitidis.

Question 22

Nosocomial pneumonia is commonly caused by all of the following, except

A) Pseudomonas aeruginosa.
B) Streptococcus pneumoniae.
C) Acinetobacter baumannii.
D) Methicillin-resistant Staphylococcus aureus.

Question 23

What is the specimen of choice for recovery of Bordetella pertussis?

A) Sputum specimens
B) Throat swabs
C) Nasopharyngeal swabs
D) Bronchial aspirate

Question 24

What virus causes community-wide seasonal outbreaks of bronchiolitis in infants?

A) Rhinovirus
B) Parainfluenza virus
C) Respiratory syncytial virus
D) Influenzae virus

Question 25

How is acute bronchitis differentiated from acute pneumonia?

A) The degree and extent of involvement of the lower respiratory tract with the infectious process
B) The involvement of the bronchial tree with the infectious process
C) The degree of obstruction of the alveoli with the purulent secretions
D) The amount of mucus secretion produced by the lower respiratory tract

Question 26

Most influenza epidemics and pandemics

A) are due to influenza B virus.
B) are due to influenza C virus.
C) are due to parainfluenza viruses.
D) follow a recombination event in causative agent's genome.

Question 27

What is the most common complication of pertussis?

A) Otitis media
B) Pneumonia
C) Acute sinusitis
D) Streptococcal pharyngitis

Question 28

Patients with influenza virus infection are predisposed to

A) secondary otitis media.
B) secondary sinusitis.
C) secondary pharyngitis.
D) secondary bacterial pneumonia.

Question 29

What is empyema?

A) A collection of fluid in the lung resulting from the pathogenesis of bacterial pathogens
B) A collection of fluid in the lung resulting from the pathogenesis of viral pathogens
C) A collection of purulent fluid in the pleural space between the lung and the chest wall
D) A collection of purulent fluid in the bronchi and alveoli

Question 30

What is a chronic pneumonia?

A) A viral pneumonia that lasts for months
B) A pneumonia that is caused by a slow-growing bacteria such as Bacillus anthracis and takes months to resolve
C) A bacterial pneumonia that becomes resistant to antibiotic therapy
D) A pneumonia that appears to resolve clinically, but where radiographic lung abnormalities persist for a long period

Question 31

What organism is the most common opportunistic pathogen that routinely infects patients with HIV/AIDS?

A) Pneumocystis jirovecii
B) Mycoplasma pneumoniae
C) Serratia marcescens
D) Respiratory syncytial virus

Question 32

What usually causes community-acquired pneumonias in children during the winter months?

A) Haemophilus influenzae
B) Streptococcus pneumoniae
C) Viral pathogens
D) Legionella spp.