Deck 20: The Gram-Negative Bacilli of Medical Importance

Question 1

All of the following are coliforms that cause opportunistic and nosocomial infections, except

A) Enterobacter.
B) Citrobacter.
C) Shigella.
D) Klebsiella.
E) Serratia.

Answer 1

C

Question 2

Salmonella are

A) coliforms.
B) motile.
C) gram-positive rods.
D) lactose fermenters.
E) All of these choices are correct.

Answer 2

B

Question 3

Pertussis has the following characteristics, except

A) the pathogen has virulence factors to destroy the action of respiratory cilia.
B) the catarrhal stage has persistent, hacking coughs with "whoops".
C) an early stage resembles a cold with nasal discharge and sneezing.
D) DTaP immunization will prevent it.
E) transmission is by respiratory droplets.

Answer 3

B

Question 4

Rabbits and rodents are the reservoirs of the causative agent of

A) tularemia.
B) pertussis.
C) legionellosis.
D) brucellosis.
E) shigellosis.

Question 5

Shigella species have the following characteristics, except

A) they are non-motile.
B) they release endotoxin.
C) they belong to Enterobacteriaceae.
D) they infect the small intestine.
E) they produce enterotoxin.

Question 6

Which color pigment is produced by Pseudomonas aeruginosa?

A) lemon yellow
B) red-orange
C) golden
D) blue-green
E) pale orange

Question 7

Genes for which of the following may be transferred between fecal bacteria?

A) toxin production
B) capsules
C) fimbriae
D) hemolysins
E) All of these choices are correct.

Question 8

Pseudomonas aeruginosa is

A) found in soil and water.
B) an opportunist that produces many diverse enzymes.
C) highly chemical resistant.
D) motile.
E) All of these choices are correct.

Question 9

Brucellosis is

A) a zoonosis.
B) seen in the patient as a fluctuating fever, with headache, muscle pain, and weakness.
C) associated with pathogen in the blood.
D) an occupational illness of people that work with animals.
E) All of these choices are correct.

Question 10

Salmonelloses are

A) not caused by Salmonella typhi.
B) associated with undercooked poultry and eggs, and reptile and rodent feces.
C) gastroenteritis with vomiting and diarrhea.
D) enteric fevers that often include septicemia.
E) All of these choices are correct.

Question 11

Which is not associated with tularemia?

A) The causative agent is a pathogen of concern on the lists of bioterrorism agents.
B) Tularemia is transmitted by arthropod vectors.
C) The reservoir can be rabbits and squirrels.
D) Symptoms include fever, swollen lymph nodes, ulcerative lesions, conjunctivitis, and pneumonia.
E) In animals, tularemia infects the placenta and fetus.

Question 12

Which is mismatched?

A) H antigen - fimbriae
B) K antigen - capsule
C) O antigen - cell wall, somatic
D) All of these choices are correct.

Question 13

Legionella pneumophila

A) requires special lab growth media.
B) often lives in close associations with amoebas.
C) causes fever, cough, and diarrhea.
D) causes a severe pneumonia.
E) All of these choices are correct.

Question 14

Pseudomonas aeruginosa causes all the following, except

A) severe nosocomial infection in burn patients.
B) skin rashes from contaminated hot tubs and bath sponges.
C) diarrheal illness.
D) external ear infection.
E) serious infection in lung tissue of cystic fibrosis patients.

Question 15

Which disease involves transmission by aerosolized water from whirlpool spas, air conditioners, cooling towers, and supermarket vegetable misters?

A) legionellosis
B) pertussis
C) brucellosis
D) plague
E) traveler's diarrhea

Question 16

Pasteurization of milk helps to prevent

A) tularemia.
B) pertussis.
C) legionellosis.
D) brucellosis.
E) shigellosis.

Question 17

Typhoid fever has the following characteristics, except

A) it is spread by handling reptiles.
B) it is transmitted by ingesting fecally contaminated food and water.
C) chronic carriers harbor the pathogens in their gallbladder.
D) it can infect the small intestine with fever, diarrhea, and abdominal pain.
E) it can become a septicemia, spread to lymph nodes and spleen, and cause liver abscesses.

Question 18

Characteristics of all the members of the family Enterobacteriaceae include

A) lactose fermentation.
B) their role as normal flora of human intestines.
C) production of enterotoxins.
D) glucose fermentation.
E) All of these choices are correct.

Question 19

Escherichia coli infections

A) are often transmitted by fecal contaminated water and food.
B) include urinary tract infections from normal flora strains.
C) involve enterotoxin in traveler's diarrhea.
D) can cause an inflammatory disease similar to Shigella dysentery.
E) All of these choices are correct.

Question 20

Which is incorrect about shigellosis?

A) Outbreaks have occurred in day-care centers.
B) It is characterized by watery diarrhea with bloody, mucoid stools, and abdominal cramps.
C) It frequently involves septicemia.
D) Human carriers cause fecal transmission.
E) It is also called bacillary dysentery.

Question 21

Although Burkholderia cepacia could be very useful in bioremediation programs, it is not feasible to use it. Why?

A) Because it can cause opportunistic infections in the respiratory tract.
B) Because it cannot be cultured in the lab to necessary numbers.
C) Because it is too expensive at this time to grow it.
D) It encourages the overgrowth of fungus in the environment, which is not desirable.
E) It produces a foul odor making it a poor choice for most situations.

Question 22

Which of the following is not correct concerning the plague?

A) Mice, voles, and other rodents are primary long-term reservoirs.
B) It is transmitted by flea vectors.
C) Less than 10 cases per year occur in the U.S.
D) The etiological agent is Yersinia pestis.
E) Strains of the plague bacillus are less virulent today compared to strains prevalent in the Middle Ages.

Question 23

The vaccine for immunity to Haemophilus influenzae serotype b is

A) DtaP.
B) Pneumovax.
C) MMR.
D) Hib.

Question 24

Which of the following are symptoms of septic shock?

A) tachycardia
B) reduced blood flow to vital organs
C) respiratory failure
D) weak pulse
E) All of these choices are correct.

Question 25

Chancroid is characterized by

A) sexually transmission.
B) geographical distribution in the tropics and subtropics.
C) lesions which develop at the portal of entry.
D) bubo-like swelling of the lymph nodes.
E) All of these choices are correct.

Question 26

All of the following are associated with bubonic plague, except

A) it is transmitted by human feces.
B) it is caused by Yersinia pestis.
C) the patient often has enlarged inguinal lymph nodes.
D) the patient has fever, headache, nausea, weakness.
E) it can progress to a septicemia.

Question 27

Which of the following are true about plague?

A) There is a septicemic form called the Black Death.
B) There is a bubonic form, during which buboes develop.
C) There is a pneumonic form, in which the sputum is highly contagious.
D) The disease can be controlled by controlling the rodent population.
E) All of these choices are correct.

Question 28

Nationwide, over 100,000 patients a year die from septic shock. This is due to

A) the presence of lipopolysaccharide in the outer membrane of bacteria.
B) lipoteichoic acid in the cell wall of bacteria.
C) a cytotoxin similar to the diphtheria toxin.
D) coagulase.
E) a neurotoxin similar to botulin.

Question 29

All of the following are correct about salmonelloses except

A) non-typhoidal strains of salmonella are zoonotic in origin.
B) foods contaminated by rodent feces may cause outbreaks.
C) outbreaks have been caused by eggs.
D) drug resistance of salmonella is on the rise.
E) strains are normal flora in dogs and cats.

Question 30

Which of the following is normal oral and nasopharyngeal flora but is involved in infective endocarditis in adults who have underlying congenital or rheumatic heart disease?

A) Haemophilus influenzae
B) Haemophilus aphrophilus
C) Haemophilus aegyptius
D) Haemophilus ducreyi
E) All of these choices are correct.

Question 31

Which of the following is not caused by Haemophilus influenzae?

A) bacterial meningitis
B) influenza flu)
C) otitis media
D) bronchitis
E) epiglottitis

Question 32

Which of the following is an agent of the sexually-transmitted disease chancroid?

A) Haemophilus aegyptius
B) Haemophilus influenzae
C) Haemophilus parainfluenzae
D) Haemophilus ducreyi
E) Haemophilus aphrophilus

Question 33

Which of the following is not correct concerning Legionnaires'disease?

A) L. pneumophila lives in close associations with free-living amoebas.
B) The disease is communicable from person to person.
C) Symptoms include cough, diarrhea, and abdominal pain.
D) It is more common in males over 50 years of age.
E) Cases have been traced to the fallout from the Mount Saint Helen's volcano.

Question 34

Which of the following species was once considered so benign that microbiologists used it to trace movements of air currents in hospitals and over cities?

A) Morganella
B) Providencia
C) Citrobacter
D) Serratia
E) Legionella

Question 35

The gram-negative bacillus associated with abscesses from dog and cat bites or scratches is

A) Salmonella typhimurium.
B) Yersinia enterocolitica.
C) Pasteurella multocida.
D) Brucella suis.
E) Francisella tularensis.

Question 36

A cause of epiglottitis in children and young adults is

A) Haemophilus influenzae.
B) Haemophilus ducreyi.
C) Haemophilus aegyptius.
D) Haemophilus parainfluenzae.
E) Haemophilus aphrophilus.

Question 37

Yersinia pestis

A) was virulent in the Middle Ages but is no longer virulent.
B) has humans as an endemic reservoir.
C) does not respond to antimicrobic drugs.
D) is usually transmitted by a flea vector.
E) All of these choices are correct.

Question 38

Salmonella typhi

A) multiplies within phagocytes.
B) is not a coliform.
C) can be treated with antimicrobics.
D) causes invasive infection of the small intestine.
E) All of these choices are correct.

Question 39

The buildup of mucus and blockage of airways in pertussis is due to

A) endotoxin.
B) lipopolysaccharide.
C) toxins that destroy the ciliated cells of the respiratory tract.
D) Pseudomonas aeruginosa.
E) the presence of a capsule.

Question 40

Which is incorrect about Yersinia pestis?

A) It exhibits bipolar staining.
B) It is a gram-negative rod.
C) It produces coagulase enzyme.
D) It has a capsule.
E) It produces enterotoxin.

Question 41

Shigellosis is typically acquired via the respiratory route.

Question 42

Fever, vomiting, stiff neck, and neurological impairment are symptoms associated with _____.

Question 43

Whooping cough is transmitted via respiratory droplets. The___stage lasts 1-2 weeks, while the _________stage is characterized by severe coughing.

A) primary; secondary
B) catarrhal; paroxysmal
C) incubation; convalescent
D) low T-cell; high macrophage
E) incubation; invasion

Question 44

The pathogen that causes Legionnaires'pneumonia also causes a milder infection called Pontiac fever.

Question 45

The virulence factor associated with the events of gram-negative sepsis and septic shock is _____.

Question 46

The Enterobacteriaceae do not produce oxidase compared to the pseudomonads that do produce oxidase.

Question 47

The IMViC series of biochemical tests are used to identify the Enterobacteriaceae.

Question 48

Exotoxins that target and bind to surface receptors of the intestinal lining are specifically termed _____.

Question 49

The member of the Enterobacteriaceae that has enteroinvasive, enterotoxigenic, enteropathogenic, and enterohemorrhagic strains is _____.
E) coli

Question 50

Proteus species often cause urinary tract infections.

Question 51

Inflammation of the lining of the stomach and intestines is called _____.

Question 52

The two true pathogenic enteric genera of the Enterobacteriaceae are _____ and _____.

Question 53

Klebsiella has a large _____ that contributes to its ability to cause chronic lung infections.

Question 54

Whooping cough is transmitted via respiratory droplets. The___stage lasts 1-2 weeks, while the _________stage is characterized by severe coughing.

A) primary; secondary
B) catarrhal; paroxysmal
C) incubation; convalescent
D) low T-cell; high macrophage
E) incubation; invasion

Question 55

Pseudomonas is an enteric gram-negative rod.

Question 56

Legionellosis is a zoonosis.

Question 57

Plague is a quarantinable disease.

Question 58

Pseudomonas aeruginosa is resistant to many antimicrobics.

Question 59

Whooping cough is transmitted via respiratory droplets. The___stage lasts 1-2 weeks, while the _________stage is characterized by severe coughing.

A) primary; secondary
B) catarrhal; paroxysmal
C) incubation; convalescent
D) low T-cell; high macrophage
E) incubation; invasion

Question 60

A paroxysmal cough is associated with Legionnaires'disease.

Question 61

The designation CRE refers to

A) a group of bacteria that are resistant to many classes of antibiotics.
B) an antibiotic that is effective against most gram-negative organisms.
C) a number of gram-negative bacteria which frequently cause infections in childhood.
D) a common methodology used in hospital inspections to enumerate and destroy bacteria on surfaces- count, record, eliminate.

Question 62

Antibiotics generally reduce the severity of septic shock by lysing the target bacteria.

Question 63

The bacteria classified as carbepenem-resistant Enterobacteriaceae CRE) primarily are species within the genera

A) Salmonella.
B) Escherichia.
C) Enterobacter.
D) Proteus.
E) Klebsiella.

Question 64

Occasionally when doing serologic testing to identify strains of Salmonella isolates, the test for different O antigens is negative. What is the most likely explanation?

A) The H antigens are masking the O antigens.
B) The K antigens are masking the O antigens.
C) The K antigens are maskng the H antigens.
D) There is no O antigen present.

Question 65

Carbapenem-resistant Enterobacteriaceae CRE) are typically resistant to carbapenem but sensitive to most other antibiotics.

Question 66

Discuss Legionella pneumophila with regard to: a) reservoir, b) virulence, c) transmission, d) types of diseases, and e) prevention.

Question 67

Which are considered true enteric pathogens?

A) Salmonella
B) Klebsiella
C) Proteus
D) Enterobacter
E) Shigella

Question 68

Species of Shigella are characteristically non-motile. Based on this information you ca predict that members of the Shigella genus

A) have K antigens.
B) do not have H antigens.
C) will not grow on MacConkey agar.
D) will not have O antigens.

Question 69

Discuss the patients at greatest risk for Pseudomonas aeruginosa infections and describe the type of infections that they acquire.

Question 70

Compare and contrast typhoid fever and salmonellosis.

Question 71

Compare and contrast the three forms of plague with regard to: a) pathogenesis, b) transmission, c) symptoms, and d) prevention.

Question 72

Describe the characteristics of the Enterobacteriaceae and discuss the difference between the coliforms and noncoliforms in the family.

Question 73

Distinguish the four different pathogenic strains of
E. coli with regard to: a) names of the strains, b) virulence factors, and c) symptoms.

Question 74

Patients with legionellosis should be placed in isolation when hospitalized due to the contagious nature of the pathogen.

Question 75

Compare and contrast shigellosis and salmonellosis.