Deck 19: The Gram-Positive Bacilli of Medical Importance

Question 1

Production of enterotoxin is a characteristic of

A)Clostridium botulinum.
B)Clostridium perfringens.
C)Clostridium difficile.
D)Clostridium tetani.
E)All of these choices are correct.

Answer 1

B

Question 2

Which of the following pertains to both tetanus and food-borne botulism?

A)It can be treated with antibiotics.
B)It is caused by enterotoxins of the pathogen.
C)Exotoxin blocks acetylcholine release.
D)Nausea and diarrhea are symptoms.
E)Treatment involves antitoxin therapy.

Answer 2

E

Question 3

Which is not correct about Bacillus cereus?

A)present in soil
B)produce enterotoxins
C)causes food-borne intoxication
D)causes a zoonosis
E)associated with cooked rice, potato, and meat dishes that are stored at room temperature

Answer 3

D

Question 4

All of the following pertain to infant botulism, except

A)symptoms include "floppy baby" appearance.
B)neurotoxin is not involved in the disease process.
C)ingested spores can germinate in the immature intestines of the neonate.
D)symptoms include flaccid paralysis and respiratory complications.
E)it is the most common type of botulism in the United States.

Question 5

Formation of a pseudomembrane in the back of the throat is seen in

A)diphtheria.
B)listeriosis.
C)tuberculosis.
D)erysipeloid.
E)botulism.

Question 6

Which organism can infect deeper wound sites and produce exotoxins, enzymes, and gas that cause tissue and muscle necrosis?

A)Clostridium botulinum
B)Clostridium perfringens
C)Clostridium difficile
D)Clostridium tetani
E)All of these choices are correct.

Question 7

Which of the following pertains to diphtheria?

A)It results in meningitis.
B)Symptoms include vomiting and diarrhea.
C)It can be transmitted from mother's birth canal to neonate.
D)It is prevented by the DTaP immunization.
E)All of these choices are correct.

Question 8

Production of a neurotoxin that binds to target sites on spinal cord neurons responsible for inhibiting skeletal muscle contraction is a characteristic of

A)Clostridium botulinum.
B)Clostridium perfringens.
C)Clostridium difficile.
D)Clostridium tetani.
E)All of these choices are correct.

Question 9

The food-borne disease that involves neurotoxin is

A)gastrointestinal anthrax.
B)Bacillus cereus intoxication.
C)botulism.
D)Clostridium perfringens gastroenteritis.
E)All of these choices are correct.

Question 10

All of the following pertain to Clostridium difficile infection, except

A)it is due to ingestion of contaminated, improperly stored, cooked meats and gravies.
B)it is a colitis that is a superinfection.
C)it often has an endogenous source.
D)it may be on the rise due to increased use of gastric acid inhibitors.
E)it is major cause of diarrhea in hospitals.

Question 11

Which type of anthrax is called "woolsorter's disease?"

A)pulmonary
B)gastrointestinal
C)cutaneous
D)All of these choices are correct.

Question 12

Which form of anthrax involves a black eschar on the skin?

A)pulmonary
B)gastrointestinal
C)cutaneous
D)All of these choices are correct.

Question 13

All of the following pertain to listeriosis, except

A)it causes symptoms of fever, diarrhea, and sore throat.
B)it causes a serious septicemia and meningitis in the elderly, immunocompromised, and infants.
C)intrauterine infection usually results in fetal death.
D)adequate pasteurization and thorough cooking of food can improve prevention.
E)enterotoxin of the organism causes symptoms.

Question 14

Erysipeloid is transmitted by

A)inhalation of spores from hides and wool of animals.
B)ingestion of improperly cooked hot dogs.
C)an abrasion on skin coming in contact with infected swine or other animals.
D)contaminated soil entering deep puncture wounds.
E)respiratory secretions.

Question 15

Production of a neurotoxin that prevents acetylcholine release from motor neurons at neuromuscular junctions is a characteristic of

A)Clostridium botulinum.
B)Clostridium perfringens.
C)Clostridium difficile.
D)Clostridium tetani.
E)All of these choices are correct.

Question 16

Treatment and control of anthrax includes

A)use of antimicrobics, such as ciprofloxacin for active cases.
B)vaccination of livestock.
C)toxoid for military and those with occupational exposure.
D)proper disposal of animals that have died from anthrax.
E)All of these choices are correct.

Question 17

All of the following pertain to Listeria monocytogenes, except

A)it is gram-positive.
B)it produces endospores.
C)it frequently contaminates dairy products, meats, poultry.
D)it causes food-borne listeriosis.
E)bacterial cells multiply within the cytoplasm of a host cell.

Question 18

Anthrax is

A)a zoonosis.
B)transmitted by contact, inhalation, and ingestion.
C)a disease that, in humans, can cause a rapidly fatal toxemia and septicemia.
D)only seen sporadically in the United States.
E)All of these choices are correct.

Question 19

Botulin, the toxin of botulism is

A)not as virulent as tetanospasmin.
B)detected and diagnosed by analyzing a patient's blood.
C)the cause of rigid paralysis.
D)only produced under anaerobic conditions.
E)produced when spores germinate in the intestines of adults after ingesting contaminated food.

Question 20

Characteristics of Bacillus anthracis include all the following, except

A)capsule and exotoxins are virulence factors.
B)anaerobic.
C)reservoir includes infected grazing animals and contaminated soil.
D)gram-positive bacillus.
E)spore-former.

Question 21

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

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

Question 22

The common soil mycobacteria that frequently cause systemic infection and death in AIDS patients is

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

Question 23

Leprosy is a disease

A)of lung tissue.
B)that has been eradicated around the world.
C)caused by a pathogen that cannot be cultured in the lab.
D)can be diagnosed by the Mantoux test.
E)caused by a spore-forming, gram-positive bacillus.

Question 24

Which of the following is/are characteristic of lepromatous leprosy?

A)Granulomatous thickenings and folds of the skin may develop.
B)Lepromatous leprosy is the most disfiguring form of the disease.
C)The pathogen grows extensively in cooler body areas, such as nose, ears, testes.
D)Complications include secondary infections, kidney, or respiratory failure.
E)All of these choices are correct.

Question 25

Fish tank granuloma is caused by

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

Question 26

All of the following are true about diphtheria toxin, except

A)it inhibits cellular protein synthesis.
B)it must be neutralized with antitoxin.
C)it primarily targets the heart and nerves.
D)it is an exotoxin.
E)antitoxin (DAT) comes from immunized human plasma donors.

Question 27

Actinomyces israelii

A)can be transmitted by respiratory droplets.
B)can cause pneumonia with symptoms similar to tuberculosis.
C)are filamentous rods that grow in clusters called sulfur granules in infected tissue.
D)lives in the soil.
E)causes most cases in the immunocompromised.

Question 28

Which of the following causes a non-communicable pulmonary infection that resembles tuberculosis?

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

Question 29

Which is not correct about Mycobacterium species?

A)All species are human pathogens.
B)Mycobacterial cell walls have waxy lipids.
C)Mycobateria are acid-fast.
D)Many mycobacterial species have a slow growth rate.
E)Mycobacterial cells are long, slender rods.

Question 30

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 31

Mycobacterium tuberculosis

A)produces several virulence factor enzymes and an exotoxin.
B)has a cord factor that can prevent destruction by lysosomes and macrophages.
C)is a spore-former.
D)has a capsule.
E)lives in the soil.

Question 32

Tuberculin skin testing

A)injects 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 these choices are correct.

Question 33

Which is not a characteristic of Nocardia?

A)It can be transmitted by respiratory droplets.
B)It can cause pneumonia with symptoms similar to tuberculosis.
C)They are filamentous rods that grow in clusters called sulfur granules in infected tissue.
D)It lives in the soil.
E)It causes most cases in the immunocompromised.

Question 34

For which of the following diseases does the "feather test" provide evidence of early infection?

A)tuberculosis
B)botulism
C)tetanus
D)leprosy
E)anthrax

Question 35

Which of the following is not true about diphtheria?

A)It is a zoonosis.
B)Humans can be healthy carriers.
C)It is prevented with the DTaP vaccine.
D)It is an upper respiratory infection.
E)A pseudomembrane may form in the back of the throat.

Question 36

Which of the following is not true about leprosy?

A)It is caused by Hansen's bacillus in honor of its discoverer.
B)Mycobacterium leprae is highly virulent, causing disease in most individuals that are exposed.
C)Armadillos harbor a genetically identical M.leprae.
D)Early signs appear as small, spotty lesions colored differently than the surrounding skin.
E)The number of new cases in the U.S.each year is about 50 to 100, mostly associated with recent immigrants.

Question 37

Generally, what must healthy adults consume in order to contract botulism?

A)endospores of C.botulinum
B)vegetative cells of C.botulinum
C)botulism toxin in contaminated food
D)botulism toxoid in contaminated food
E)botulism antitoxin in contaminated food

Question 38

The individuals most at risk for botulism are those that

A)eat meat.
B)are vegetarians.
C)have a weakened immune system.
D)consume home-preserved foods.
E)eat often in restaurants.

Question 39

Tuberculoid leprosy

A)causes asymmetrical, shallow skin lesions with loss of pain sensation.
B)is the most disfiguring.
C)is characterized by a large number of acid fast bacilli in the infected tissues (multibacillary).
D)may have complications including secondary infections, kidney, or respiratory failure.
E)All of these choices are correct.

Question 40

A diagnosis of tuberculosis involves

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

Question 41

The _____ test injects 0.1 mL of Purified Protein Derviative intradermally into the forearm.

Question 42

Botox injections contain botulinum toxin.

Question 43

Listeria monocytogenes does not grow in refrigerated foods.

Question 44

A black eschar develops on the hand or arm of a patient with erysipeloid.

Question 45

_____ is a chronic progressive disease of the skin and nerves caused by Mycobacterium leprae.

Question 46

All of the following body sites may be affected by diptheria, except

A)the pharynx.
B)the heart.
C)the peripheral and cranial nerves.
D)the skin.
E)All of these choices are correct.

Question 47

Hyperbaric chamber treatment involves putting patients with myonecrosis in a chamber that has a higher amount of _____.

Question 48

Propionibacterium acnes is normal flora of sebaceous glands of the skin.

Question 49

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

Question 50

Botulism is often referred to as lockjaw.

Question 51

Debridement of diseased tissue is important in the care of patients with gas gangrene.

Question 52

In both botulism and tetanus, respiratory muscles cannot facilitate breathing and, if untreated, respiratory collapse leads to death.

Question 53

What is the usual cause of pseudomembranous colitis?

A)improperly home-preserved foods containing botulin toxin
B)consuming unpasteurized dairy products containing Listeria monocytogenes
C)handling infected animals contaminated with E.rhusiopathiae
D)therapy with broad-spectrum antibiotics leading to superinfection by C.difficile
E)living in close contact with someone infected with C.perfringens

Question 54

In addition to antimicrobics, patients with diphtheria are treated with _____.

Question 55

The fermentation by-products of Clostridium perfringens can destroy muscle structure in myonecrosis.

Question 56

Mild, uncomplicated cases of pseudomembranous colitis may be treated by

A)debridement.
B)wound cleansing.
C)vancomycin for several weeks.
D)withdrawal of antibiotics and replacement of lost fluids and electrolytes.
E)All of these choices are correct.

Question 57

Which of the following is NOT characteristic of Actinomyces israelii?

A)non-motile
B)may live in human oral cavity or intestine
C)Colonies may display mycelium-like growth.
D)endospore former
E)Discharge from infections may contain sulfur granules.

Question 58

Tetanus can be prevented with the DTaP childhood immunization and boosters of the tetanus toxoid.

Question 59

The granulomas that develop in the lung tissue during tuberculosis are termed _____.

Question 60

Which of the following may be recommended for treating gangrene?

A)debridement of the wound
B)hyperbaric chamber
C)amputation of affected limb
D)rigorous cleansing of deep wounds
E)All of these choices are correct.

Question 61

Mycobacterium bovis is attenuated and used in the _____ vaccine.

Question 62

Discuss the types of foods and food preparation associated with food-borne botulism, and explain how neurotoxins gain entry to the foods.

Question 63

A specimen was collected from a deep wound.A smear was prepared and Gram stained and samples were inoculated onto two blood agar plates.Both blood agar plates were incubated for 48 hours at 35°C, but one blood agar plate was incubated aerobically and the other was incubated in an anaerobe jar.The Gram stain of the original specimen showed large gram-positive bacilli.After incubation, there was no growth on the blood agar plate that was incubated aerobically, but the plate incubated in the anaerobe jar grew beta hemolytic colonies.A Gram stain of these colonies showed large gram positive bacilli, some with unstained inclusions, suggestive of endospores.What is the most likely genus of bacteria observed?

A)Bacillus
B)Mycobacterium
C)Listeria
D)Clostridium
E)Corynebacterium

Question 64

Which of the following is the most likely method if transmission of nocardiosis?

A)consuming contaminated home-preserved foods
B)consuming unpasteurized milk
C)inhaling dust containing cells of Nocardia
D)touching an individual who has nocardiosis with an ungloved hand

Question 65

A seasonal farmworker has been brought into the emergency room showing early symptoms of tetanus, including spastic contractions of face and neck muscles.His coworkers indicated that he had received a puncture wound in his hand a week prior to the onset of symptoms.His tetanus vaccination status is uncertain.Which of the following should be administered to the patient first, as soon as possible?

A)tetanus toxoid
B)tetanus immune globulin
C)antibiotics
D)hyperbaric oxygen chamber therapy
E)a tetanus titer

Question 66

Janice had been experiencing mild flu-like symptoms before going into premature labor at seven months.The premature baby boy developed complications immediately after birth, running a fever and demonstrating neurologic abnormalities.A cerebrospinal fluid specimen was collected and a gram stain of the specimen showed short Gram-positive bacilli.The CSF culture grew small beta hemolytic colonies that were catalase positive.A CAMP test was positive on this isolate.The same organism grew from blood cultures done on the baby.What is the most likely identification?

A)Bacillus anthracis
B)Listeria monocytogenes
C)Streptococcus agalactiae
D)Corynebacterium diphtheriae

Question 67

Compare and contrast primary tuberculosis, secondary tuberculosis, and extrapulmonary tuberculosis.

Question 68

All of the following are typical of nocardiosis, except

A)it may be caused by Nocardia brasiliensis, Nocardia asteroides, or Nocardia caviae.
B)infections may involve the lungs, the skin, or subcutaneous sites.
C)nocardiosis usually develops in individuals with a healthy immune response.
D)symptoms of pulmonary nocardiosis may resemble the symptoms of tuberculosis.

Question 69

Which of the following would be a significant risk factor for the development of listeriosis?

A)consumption of meat, poultry, eggs, and dairy products.
B)being a vegan.
C)receiving immunosuppressive drugs for treatment of an autoimmne disease
D)consuming home-canned foods.

Question 70

Using specific examples, discuss how gram-positive bacilli are divided into major genera.At the very least include the oxygen requirements, sporulation characteristics, and acid-fast test results.

Question 71

Vegans are not at risk for infection caused by Listeria monocytogenes because they don't consume animal products.

Question 72

An 85-year-old man has been experiencing weight loss, night sweats, and a dry cough for several months and just recently he has begun coughing up sputum with tinges of blood in it.Following a chest X-ray showing some white spots on his lungs, an AFB (Mycobacterial) stain and culture were ordered and both were positive for the presence of mycobacteria.He has been PPD positive since his 20's.Which of the following most accurately describes his current situation?

A)latent tubercular infection
B)primary tubercular infection
C)systemic tuberculosis
D)primary tubercular disease
E)reactivation tuberculosis

Question 73

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

Question 74

Compare and contrast botulism and tetanus with regard to: a) transmission, b) virulence factors, c) location of target tissue and effect on the tissue, d) symptoms, e) treatment, and f) prevention.

Question 75

What do the bacteria that cause botulism, tetanus, and diphtheria have in common?

A)Each of these diseases is caused by an endospore-forming bacterial species.
B)Each of these diseases is caused by obligately anaerobic bacteria.
C)Vaccines are widely used to prevent each of these diseases.
D)Each of these bacteria make an exotoxin that is responsible for the disease.