Deck 21: Infectious Diseases Affecting the Respiratory System

Question 1

What features of the respiratory system protect it from infection?

A) Nasal hairs
B) Cilia
C) Mucus
D) Macrophages
E) All of the choices are correct.

Answer 1

All of the choices are correct.

Question 2

Which of the following is/are the main causative agent/s of pharyngitis?

A) Streptococcus pyogenes
B) Aspergillus fumigatus
C) Viruses
D) Both Aspergillus fumigatus and viruses are correct.
E) Both Streptococcus pyogenes and viruses are correct.

Answer 2

Both Streptococcus pyogenes and viruses are correct.

Question 3

The most common causative agent of otitis media is ______.

A) Aspergillus fumigatus
B) Haemophilus in?uenzae
C) Candida albicans
D) Corynebacterium diphtheriae
E) Streptococcus pneumoniae

Answer 3

Streptococcus pneumoniae

Question 4

Which of the following is true about sinusitis caused by allergy?

A) Produces a greenish or yellowish mucous discharge
B) Caused by Streptococcus pneumoniae
C) Usually introduced by trauma
D) Produces a clear, watery discharge
E) Preceded by viral rhinitis

Question 5

The most common type of virus leading to rhinitis is _______.

A) coronavirus
B) adenovirus
C) rhinovirus
D) herpes simplex virus
E) retrovirus

Question 6

Which antibody is concentrated in the respiratory tract?

A) IgA
B) IgE
C) IgG
D) IgM
E) IgD

Question 7

Which of the following statements is not true regarding streptococcal pharyngitis?

A) It presents with a purulent exudate over the tonsils.
B) It can lead to scarlet fever if it is an erythrogenic toxin-producing strain.
C) It can lead to serious sequelae.
D) It is usually caused by the viridans streptococci.
E) It causes redness, di?culty in swallowing, and fever.

Question 8

Infection travels to the middle ear by way of the ______.

A) auditory canal
B) sinuses
C) nasal cavity
D) eustachian (auditory) tubes
E) subarachnoid space

Question 9

Rheumatic fever is caused by a/an ______ infection.

A) primary streptococcal
B) primary viral
C) opportunistic streptococcal
D) endogenous

Question 10

The bright red rash and fever of scarlet fever is due to _______.

A) enterotoxins
B) hemolysins
C) toxic shock syndrome toxin
D) exfoliative toxin
E) erythrogenic toxin

Question 11

Which of the following is not part of the lower respiratory system?

A) Alveoli
B) Bronchi
C) Bronchioles
D) Trachea
E) Sinuses

Question 12

What is the function of normal biota of the respiratory tract?

A) Competes with pathogens for resources and space
B) Microbial antagonism
C) Provides antibodies
D) Both competes with pathogens for resources and space / microbial antagonism are correct.

Question 13

Untreated streptococcal pharyngitis can lead to all of the following except _______.

A) scarlet fever
B) otitis media
C) rheumatic fever
D) glomerulonephritis

Question 14

The most common causative agent in fungal sinusitis is _______.

A) Aspergillus fumigatus
B) Haemophilus in?uenzae
C) Candida albicans
D) Corynebacterium diphtheriae
E) Streptococcus pneumoniae

Question 15

Normal biota of the respiratory tract _______.

A) are localized to the nasopharynx only
B) can cause disease in immunocompromised patients
C) do not include yeasts or viruses
D) only include Staphylococcus aureus
E) are only comprised of staphylococcal species

Question 16

Virulence factors of S. pyogenes include _______.

A) polysaccharides on the cell wall
B) lipoteichoic acid
C) spiky M proteins
D) hyaluronic acid capsule
E) All of the choices are correct.

Question 17

Which of the following is not part of the upper respiratory tract?

A) Mouth
B) Nasal cavity
C) Trachea
D) Pharynx
E) Larynx

Question 18

Cold viruses are transmitted by _______.

A) droplet contact
B) indirect contact
C) direct contact
D) All of the choices are correct.

Question 19

The most common mode of transmission for sinusitis is _______.

A) exotoxin
B) direct contact
C) indirect contact
D) endogenous infection
E) droplet contact

Question 20

Superantigens _______.

A) include streptolysin O
B) include erythrogenic toxin
C) induce production of tumor necrosis factor
D) are potent stimulators of T cells
E) All of the choices are correct.

Question 21

Which of the following is not a virulence factor of Bordetella pertussis?

A) Endotoxin
B) Tracheal cytotoxin
C) M protein
D) Pertussis toxin
E) Filamentous hemagglutinin

Question 22

Which is not correct about Mycobacterium species?

A) All species are human pathogens.
B) Cell walls have waxy lipids.
C) It is an acid-fast bacterium.
D) It exhibits a very slow growth rate.
E) Cells appear as long, slender rods via microscopy.

Question 23

The major virulence factor of Corynebacterium diphtheriae that causes serious systemic effects is its ______.

A) capsule
B) metachromatic granules
C) exotoxin
D) endospores
E) endotoxin

Question 24

The causative organism of whooping cough is ______.

A) Bordetella pertussis
B) Streptococcus pneumoniae
C) Haemophilus in?uenzae
D) Streptococcus pyogenes
E) Cornyebacterium diphtheriae

Question 25

Which of the following is not true of in?uenza?

A) In?uenza has glycoprotein spikes of hemagglutinin (H) and neuraminidase (N).
B) Antigenic drift changes the antigens to reduce immune recognition.
C) Antigenic shift causes changes in the RNA strands.
D) In?uenza B viruses undergo both antigenic drift and antigenic shift.
E) H5N1 is the bird ?u strain that may cause a pandemic.

Question 26

Which of the following causes a noncommunicable pulmonary infection that resembles tuberculosis?

A) Mycobacterium avium complex (MAC)
B) Mycobacterium kansasii
C) Mycobacterium scrofulaceum
D) Mycobacterium fortuitum complex
E) Mycobacterium marinum

Question 27

Which of the following pertains to diphtheria?

A) Results in meningitis
B) Symptoms include vomiting and diarrhea
C) Can be transmitted from mother's birth canal to neonate
D) Prevented by the DTaP immunization

Question 28

Symptoms of in?uenza include _______.

A) nasal discharge, mild fever, and absence of cough
B) fever, diarrhea, and vomiting
C) fever, myalgia, sore throat, cough, and nasal discharge
D) fever, sore throat, rash, and cough
E) fever and pneumonia

Question 29

A diagnosis of tuberculosis involves a/an ______.

A) chest X ray
B) acid-fast stain of sputum
C) sputum culture
D) tuberculin skin test
E) All of the choices are correct.

Question 30

Mycobacterium tuberculosis _______.

A) produces several virulence factor enzymes and an exotoxin
B) integrates its genome into host cell DNA
C) can survive for 8 months in ?ne aerosol particles
D) has a capsule
E) lives in the soil

Question 31

The enzyme associated with the in?uenza virus that hydrolyzes the protective mucous coating of the respiratory tract is ______.

A) catalase
B) reverse transcriptase
C) hyaluronidase
D) neuraminidase
E) kinase

Question 32

In addition to antimicrobials, patients with diphtheria are treated with ______.

A) antitoxin
B) tracheostomy
C) heart medication
D) bronchoscopy
E) All of the choices are correct.

Question 33

Tuberculin skin testing _______.

A) involves the injection of PPD intradermally
B) uses a puri?ed protein ?ltrate of Mycobacterium tuberculosis
C) will be positive if person has had previous exposure
D) will be positive in active TB
E) All of the choices are correct.

Question 34

Pertussis has all of 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) the early stage resembles a cold with nasal discharge and sneezing
D) DTaP immunization will prevent it
E) transmission is by respiratory droplets

Question 35

Which of the following does not describe S. pyogenes?

A) Group A streptococcus
B) Gram-positive
C) Forms endospores
D) Sensitive to bacitracin
E) Beta-hemolytic

Question 36

Formation of a pseudomembrane in the back of the throat is seen in cases of _______.

A) diphtheria
B) pharyngitis
C) tuberculosis
D) pertussis
E) SARS

Question 37

Which of the following is not true of whooping cough?

A) Secondary infections can occur during the convalescent phase.
B) It is caused by a small, aerobic, gram-negative rod.
C) Incubation period is 3-21 days.
D) Cold-like symptoms are common for the paroxysmal stage.
E) An uncontrollable cough occurs during the paroxysmal stage.

Question 38

All of the following pertain to tuberculosis except _______.

A) live bacilli can remain dormant in the lungs and reactivate later in life
B) symptoms of active TB include low-grade fever, coughing, fatigue, weight loss, and night sweats
C) lung infection can disseminate to many other organs in extrapulmonary TB
D) the BCG vaccine is used in other countries
E) antimicrobials cannot treat and cure tuberculosis

Question 39

In?uenza vaccines include all of the following except _______.

A) inactivated, intramuscular vaccine
B) usually incorporates three or four different strains
C) attenuated, nasal drops vaccine
D) provides lifelong immunity
E) has an overall effectiveness of 70% - 90%

Question 40

Respiratory syncytial virus _______.

A) causes serious disease in infants 6 months old or younger
B) uses the nasopharynx as its main replication site
C) can be treated with the antiviral aerosol ribavirin
D) has symptoms of dyspnea and rales
E) All of the choices are correct.

Question 41

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 42

Which of the following is caused by Haemophilus in?uenzae in the respiratory tract?

A) Bacterial meningitis
B) In?uenza (?u)
C) Otitis media
D) Bronchitis
E) Epiglottitis

Question 43

Hantavirus has all of the following characteristics except _______.

A) the reservoir is human carriers
B) it is a zoonosis
C) symptoms are abrupt fever, lung edema, respiratory distress, and hypotension
D) it is transmitted by aerosol transmission from rodent excreta
E) the ?rst U.S. outbreak occurred in 1993 in the southwest

Question 44

The tubercles formed in primary tuberculosis are caused by an in?ux of ______.

A) neutrophils
B) basophils
C) mononuclear cells
D) polymorphonuclear leukocytes
E) antibodies

Question 45

Legionella pneumophila _______.

A) requires special lab growth media
B) often lives intracellularly in amoebas
C) causes fever, cough, and diarrhea
D) always causes a severe pneumonia

Question 46

When the centers of tubercles break down into _____ lesions, they gradually heal by calci?cation that replaces normal lung tissue.

A) primary
B) secondary
C) necrotic caseous
D) granuloma
E) tertiary

Question 47

The vaccine for immunity to Haemophilus in?uenzae serotype b is ______.

A) DTaP
B) Pneumovax
C) MMR
D) Hib

Question 48

Which is incorrect about Mycoplasma pneumoniae?

A) Has birds as a reservoir
B) Common cause of primary atypical pneumonia
C) Initially causes fever, malaise, sore throat, and headache
D) After 2 to 3 weeks, develops into an unproductive cough and earache
E) Is a bacterial cell without a cell wall

Question 49

Drug-resistant strains of Streptococcus pneumoniae are now treated with ______.

A) penicillin V
B) eryrthromycin
C) tetracyline
D) vancomycin
E) Ketek

Question 50

Streptococcus pneumoniae is _______.

A) alpha-hemolytic on blood agar
B) found in up to 50% of people as normal biota
C) a gram-positive diplococcus with a capsule
D) a pathogen with endotoxin
E) All of the choices are correct.

Question 51

Severe acute respiratory syndrome (SARS) _______.

A) causes high fever, pneumonia, and respiratory distress
B) began with an initial outbreak in the United States and then spread to Canada and China
C) is caused by the respiratory syncytial virus
D) is classi?ed as an opportunistic infection

Question 52

The highest incidence of histoplasmosis in the United States occurs in the ______.

A) southeast
B) southwest
C) east and Midwest
D) northeast
E) Rocky Mountains

Question 53

Disease/s caused by Streptococcus pneumoniae include _______.

A) otitis media
B) meningitis
C) lobar pneumonia
D) bronchial pneumonia
E) All of the choices are correct.

Question 54

Which is incorrect about histoplasmosis?

A) The pathogen grows inside macrophages.
B) It is transmitted by inhalation of spores.
C) It causes respiratory infections that range from mild to severe.
D) Chronic cases have symptoms similar to tuberculosis.
E) It never spreads to sites outside the respiratory tract.

Question 55

Which of the following is a characteristic of Histoplasma capsulatum?

A) It grows in moist soil, rich in nitrogen from bird and bat droppings.
B) It is a protozoan.
C) It is a dermatophyte.
D) It grows in dry, arid soil.

Question 56

Inhalation of respiratory secretions is involved in the transmission of all of the following except ______.

A) in?uenza
B) rhinitis
C) legionella
D) diphtheria
E) SARS

Question 57

Pneumocystis (carinii) jiroveci _______.

A) is a bacterium
B) lacks ergosterol in its plasma membrane
C) is an obligate parasite
D) causes serious infection in the elderly, premature infants, and AIDS patients

Question 58

Which opportunist is the most frequent cause of life-threatening pneumonia in AIDS patients?

A) Cryptococcus neoformans
B) Candida albicans
C) Malassezia furfur
D) Pneumocystis (carinii) jiroveci

Question 59

People at greatest risk for pneumococcal infections include all the following except _______.

A) the elderly
B) those with underlying lung disease and viral infections
C) patients without a spleen
D) adolescents and young adults
E) young infants

Question 60

Extrapulmonary TB is more common in _______.

A) young children and immunosuppressed patients
B) the elderly
C) organ transplant patients
D) AIDS patients
E) All of the choices are correct.

Question 61

Influenza is predominantly transmitted by the fecal-oral route.

Question 62

Secondary bacterial infections may occur with the common cold.

Question 63

Legionellosis is a zoonosis.

Question 64

Pertussis outbreaks still occur in the United States.

Question 65

Your dog has ?u caused by an H?N8 strain. Assume that you breathe in this strain, after you have already come in contact with an H1N1 strain. Both viruses go into the cells of your upper respiratory tract. During the viral replication cycle inside of your epithelial cells, genetic information for hemagglutinin antigen and for neuraminidase antigen are recombined. Your cells end up producing a new variant---H?N1. Predict what might happen as a result of this set of events.

A) Only people who have never had ?u before will get sick from the new H?N1 variant.
B) This is not a problem because the human immune system can respond quickly to any new antigens never seen before.
C) This novel virus will spread through the human population without much resistance.
D) Since this new virus has antigens from a dog strain, the new strain will not be able to infect human cells.

Question 66

Your patient has pneumonia. Since there are so many microorganisms causing pneumonia, what might be the best test to do ?rst for identi?cation of the agent?

A) An antibody test
B) A culture from a lung aspirate
C) A skin test
D) A Gram stain of a saliva specimen

Question 67

The primary transmission route for acquiring agents of the common cold is by contact with hands and fomites contaminated with the nasal discharges of an infected person.

Question 68

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

Question 69

The major reservoir for the hantavirus is the deer mouse.

Question 70

Both Streptococcus pyogenes and Corynebacterium diphtheriae are highly pathogenic, and the disease symptomology can be very severe. Why is this?

A) Infants and children are the high-risk groups, and their mortality rate is higher than for other ages.
B) Both bacteria produce potent exotoxins.
C) They induce autoimmune states in the patients.
D) There are no antibiotics useful for diseases caused by these bacteria.

Question 71

An induration of less than 5mm in the Mantoux test is negative for TB.

Question 72

Respiratory syncytial virus is a major cause of global respiratory infection outbreaks in infants 6 months of age or younger.

Question 73

People who have received the BCG immunization will generally have a negative tuberculin skin test.

Question 74

A paroxysmal cough is associated with Legionnaires' disease.

Question 75

Otitis media is commonly treated with broad spectrum antibiotics, although there is a lot of push- back or pressure against doing this. Why are these drugs given for this condition?

A) No other kinds of drugs and antibiotics can kill the bacteria causing otitis media other than the broad-spectrum class of drugs.
B) The narrow-spectrum drugs are very toxic as opposed to the rather benign broad- spectrum ones.
C) Otitis media is often caused by a variety of bacteria growing together in a bio?lm, and the bacteria often exhibit different susceptibilities to drugs.
D) Fungi are the most common cause of otitis media, and the fungi do not respond well to the narrow-spectrum drugs.

Question 76

In?uenza virus can exhibit constant mutation of viral glycoproteins, called antigenic ________, or alternatively antigenic ________, which is a more serious phenomenon caused by the exchange of a viral gene with that of another in?uenza virus strain.

A) drift; exchange
B) exchange; drift
C) drift; shift
D) shift; drift

Question 77

Differentiate between disease caused by Haemophilus in?uenzae and the disease caused by in?uenza virus.

A) One causes an upper respiratory disease, and the other causes a lower respiratory disease.
B) One causes a mild ?u, and the other causes a severe ?u.
C) One organism is a virus while the other is a fungus.
D) One organism causes symptomatic disease, while the other organism always causes asymptomatic disease.

Question 78

Diphtheria is considered to be an upper respiratory tract infection. However, it can have a very high mortality rate if not caught early and treated. Predict why this is so.

A) It makes a toxin that can be carried in blood and produce organ damage, particularly the heart.
B) It successfully hides from the immune system of the patient.
C) The patient cannot eat or drink and so basically starves to death.
D) The bacterium moves from the throat to the brain, causing strokes to occur.

Question 79

Treatment for diphtheria requires only penicillin or erythromycin.

Question 80

Antibiotic treatment immediately upon the diagnosis of otitis media is standard procedure today.