Deck 21: Infectious Diseases Affecting the Respiratory System

Question 1

Which antibody is concentrated in the respiratory tract?

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

Answer 1

A

Question 2

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.

Answer 2

B

Question 3

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.

Answer 3

E

Question 4

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 5

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

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

Question 6

Rheumatic fever is caused by a(n)_____ infection.

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

Question 7

Cold viruses are transmitted by _______.

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

Question 8

The most common mode of transmission for sinusitis is _______.

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

Question 9

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.

Question 10

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] and [microbial antagonism] are correct.
E) All of these three functions are correct.

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

The most common causative agent in fungal sinusitis is _______.

A) Aspergillus fumigatus
B) Haemophilus influenzae
C) Candida albicans
D) Corynebacterium diphtheriae
E) Streptococcus pneumoniae

Question 13

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 14

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.

Question 15

The most common causative agent of otitis media is ______.

A) Aspergillus fumigatus
B) Haemophilus influenzae
C) Candida albicans
D) Corynebacterium diphtheriae
E) Streptococcus pneumoniae

Question 16

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

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

Question 17

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 18

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 19

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

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

Question 20

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, difficulty in swallowing, and fever.

Question 21

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 fine aerosol particles.
D) has a capsule.
E) lives in the soil.

Question 22

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 23

Influenza 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 24

Which of the following is not true of influenza?

A) Influenza 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) Influenza B viruses undergo both antigenic drift and antigenic shift.
E) H5N1 is the bird flu strain that may cause a pandemic.

Question 25

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 26

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 27

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 28

Symptoms of influenza 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

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 30

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 31

Tuberculin skin testing

A) involves the injection of PPD intradermally.
B) uses a purified protein filtrate 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 32

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 33

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 34

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 35

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 36

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 37

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 38

The causative organism of whooping cough is ______.

A) Bordetella pertussis
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Streptococcus pyogenes
E) Cornyebacterium diphtheriae

Question 39

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 40

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

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

Question 41

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

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

Question 42

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 43

Pneumocystis (carinii)jiroveci

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

Question 44

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 45

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 46

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 classified as an opportunistic infection.

Question 47

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 48

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 first U.S. outbreak occurred in 1993 in the southwest.

Question 49

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

A) Bacterial meningitis
B) Influenza (flu)
C) Otitis media
D) Bronchitis
E) Epiglottitis

Question 50

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 51

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 52

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 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

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

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

Question 55

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

A) influenza
B) rhinitis
C) legionella
D) diphtheria
E) SARS

Question 56

The vaccine for immunity to Haemophilus influenzae serotype b is ______.

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

Question 57

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

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

Question 58

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 59

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 60

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 61

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

Question 62

A paroxysmal cough is associated with Legionnaires'disease.

Question 63

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 64

Your dog has flu caused by an H3N8 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---H3N1.Predict what might happen as a result of this set of events.

A) Only people who have never had flu before will get sick from the new H3N1 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 65

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

Question 66

The major reservoir for the hantavirus is the deer mouse.

Question 67

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 biofilm, 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 68

Your patient has pneumonia.Since there are so many microorganisms causing pneumonia,what might be the best test to do first for identification 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 69

Influenza is predominantly transmitted by the fecal-oral route.

Question 70

Legionellosis is a zoonosis.

Question 71

Of the six Category A diseases listed by the U.S.Public Health Service,which affect/s the respiratory tract?

A) Botulism
B) Pneumonic plague
C) Tularemia
D) Smallpox
E) Both pneumonic plague and tularemia are correct.

Question 72

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

Question 73

Pertussis outbreaks still occur in the United States.

Question 74

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

Question 75

Influenza 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 influenza virus strain.

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

Question 76

Treatment for diphtheria requires only penicillin or erythromycin.

Question 77

Differentiate between disease caused by Haemophilus influenzae and the disease caused by influenza virus.

A) One causes an upper respiratory disease, and the other causes a lower respiratory disease.
B) One causes a mild flu, and the other causes a severe flu.
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

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

Question 79

Secondary bacterial infections may occur with the common cold.

Question 80

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.