Deck 32: Upper and Lower Respiratory Tract Infections

Question 1

If a patient has a throat culture done and the culture reveals the presence of a-hemolytic colonies, what does this indicate?

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

Answer 1

B
Isolation of a-hemolytic colonies from a pharyngeal culture from a patient with pharyngitis arouses little clinical interest, because a-hemolytic streptococci are normal flora in the oropharynx.

Question 2

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

Answer 2

B
Considering the similarities in their pathogenesis, it is not surprising that the same group of pathogens is involved in both acute otitis media and acute sinusitis.S.pneumoniae and H.influenzae account for more than 50% of the isolates from cases of acute otitis media.

Question 3

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

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

Answer 3

A
The isolation of certain organisms from respiratory specimens may represent either colonization or disease, depending on the circumstances.An interpretation must be based on several factors.The method and site of collection of the specimen can influence the risk of contamination with organisms that are part of the normal flora.Characteristics of the specimen such as the presence of white blood cells and the number of organisms in the specimen can help distinguish between colonization and infection.Most important, a compatible clinical syndrome should be present to determine whether the presence of a potential pathogen is clinically relevant.

Question 4

Why do most physicians treat otitis media empirically instead of obtaining cultures before prescribing antibiotics?

A)It is hard to hard to obtain cultures from children.
B)Cultures do not always correlate with the true pathogen.
C)Pathogens causing otitis media never become resistant to antibiotics.
D)The predominant infection causing organisms are known.

Question 5

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 6

Acute sinusitis usually occurs as a complication of:

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

Question 7

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

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

Question 8

A patient's normal pharyngeal flora can be altered by all of the following except:

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

Question 9

What bacteria 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 10

Which of the immunocompromised circumstances listed here is a form of functional immunodeficiency?

A)Sex
B)Age
C)Chronic illness
D)Pregnancy

Question 11

What common condition will predispose individuals to acute sinusitis?

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

Question 12

Elements of the respiratory tract that can help prevent infection include which of the following?

A)Nasal hair
B)Normal flora
C)Coughing
D)All of the above

Question 13

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

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

Question 14

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 15

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 16

What organism causes epiglottis?

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

Question 17

All of the following are complications of acute sinusitis except:

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

Question 18

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

Question 19

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

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

Question 20

Why is pharyngitis produced by group A Streptococcus treated with antibiotics?

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

Question 21

Chronic pneumonia is a:

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

Question 22

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

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

Question 23

What type of pneumonia has been associated with Staphylococcus aureus that produces Panton-Valentine leukocidin?

A)Methicillin-resistant pneumonia
B)Necrotizing pneumonia
C)Bacterial
D)Viral

Question 24

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

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

Question 25

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

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

Question 26

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 27

Nosocomial pneumonia are commonly caused by all of the following except:

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

Question 28

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

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

Question 29

To what does infection with influenza predispose patients?

A)Secondary otitis media
B)Secondary sinusitis
C)Secondary pharyngitis
D)Secondary bacterial pneumonia

Question 30

The clinical picture of this condition includes an incubation period of 2 to 10 days, fever, with or without cough, and dyspnea.The condition may resolve or progress to a more severe form.What is this condition?

A)Severe acute respiratory syndrome (SARS)
B)Streptococcal pneumonia
C)Viral pneumonia
D)Viral bronchitis

Question 31

What is the major cause for chronic bronchitis?

A)Acute bronchitis
B)Respiratory allergies
C)Pneumonia
D)Smoking

Question 32

Empyema is a collection of:

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

Question 33

What is the most common complication of pertussis?

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