Deck 21: Respiratory System Infections

Question 1

The conjuctivae

A) have few resident bacteria.
B) are often covered with bacteria.
C) are populated with S. aureus.
D) are populated with S. pyogenes.
E) are protected by IgE.

Answer 1

A

Question 2

Most colds are probably caused by

A) rhinovirus.
B) S. aureus.
C) Pseudomonas sp.
D) E. coli.
E) varicella.

Answer 2

A

Question 3

The most common bacterial pathogen(s) involved with sinusitis, otitis media, and conjunctivitis is/are

A) S. aureus AND H. influenzae.
B) H. influenzae AND S. pneumoniae.
C) H. influenzae AND S. epidermidis.
D) S. pneumoniae AND S. aureus.
E) S. epidermidis AND S. pneumoniae.

Answer 3

B

Question 4

Rapid diagnostic tests for streptococcal infections may use

A) blood agar AND the Kirby-Bauer test.
B) antibodies AND blood agar.
C) DNA probes.
D) the Kirby-Bauer test AND DNA probes.
E) antibodies AND DNA probes.

Question 5

The rhinovirus contains

A) single-stranded RNA and is an enveloped virus.
B) double-stranded RNA and is an enveloped virus.
C) single-stranded RNA and and is a non-enveloped virus.
D) double-stranded RNA and is a non-enveloped virus.
E) single-stranded RNA and and is a retrovirus.

Question 6

Otitis media probably develops from an infection that spread

A) from the outer ear to the middle ear.
B) from the sensory neurons of the middle ear.
C) upward through the Eustachian tube.
D) through the tympanic membrane.
E) via the meninges.

Question 7

Which is used in the vaccination for C. diphtheriae?

A) Protein A
B) M protein
C) Lipopolysaccharide
D) Intact bacteria
E) Exotoxin

Question 8

Virulence factors used by S. pyogenes include all of the following EXCEPT

A) protein F.
B) M protein.
C) a capsule.
D) lipopolysaccharide
E) protein G.

Question 9

The process used for identifying the different carbohydrates of streptococci is called

A) Lancefield grouping.
B) CHO typing.
C) peptidoglycan typing.
D) fermentation testing.
E) NAAT typing.

Question 10

The eyes are protected from infection by

A) the washing action of the tears and eyelids AND the use of contact lenses.
B) the washing action of the tears and eyelids AND the chemical action of lysozyme.
C) the chemical action of lysozyme AND the use of contact lenses.
D) the use of contact lenses AND the dryness of the eye surface.
E) the dryness of the eye surface AND the chemical action of lysozyme.

Question 11

Otitis media and sinusitis are usually preceded by a(n)

A) middle ear infection.
B) pseudomonal infection.
C) oropharyngeal infection.
D) nasopharyngeal infection.
E) gastrointestinal infection.

Question 12

The cause of strep throat is

A) Staphylococcus aureus.
B) Streptococcus pyogenes-beta-hemolytic, group A.
C) Staphylococcus pyogenes-alpha-hemolytic, group B.
D) Streptococcus pneumoniae.
E) Staphylococcus aureus-beta-hemolytic, group A.

Question 13

Enlargement of which of the following structures may contribute to ear infections by interfering with normal drainage from Eustachian tubes?

A) Nasal chamber
B) Nasal conchae
C) Adenoids
D) Epiglottis
E) Parotid glands

Question 14

Diphtheria toxin works on

A) lysosomes.
B) mitochondria.
C) chloroplasts.
D) elongation factor 2.
E) messenger RNA.

Question 15

Rhinoviruses need to be grown

A) in living cells AND at 39°C.
B) in synthetic media AND at 39°C.
C) on blood agar AND at 33°C.
D) in live animals or plants.
E) in living cells AND at 33°C.

Question 16

The scientist who developed a system of identifying the variety of strains of streptococci was

A) Hans Zimmer.
B) Donald Sutherland.
C) O. T. Avery.
D) Rebecca Lancefield.
E) Louis Pasteur.

Question 17

Which of the following is associated with the upper respiratory system?

A) Humidifying inhaled air.
B) Warming inhaled air AND drying inhaled air.
C) Cooling inhaled air AND drying inhaled air.
D) Cooling inhaled air AND humidifying inhaled air.
E) Humidifying inhaled air AND warming inhaled air

Question 18

A bacteriophage is necessary for toxin production in

A) E. coli.
B) Staphylococcus aureus.
C) Corynebacterium diphtheriae.
D) Streptococcus pyogenes.
E) All of the answer choices are correct.

Question 19

Rebecca Lancefield showed that almost all the strains of beta-hemolytic streptococci from human infections

A) could cause rheumatic fever.
B) had the same cell wall carbohydrate "A."
C) had variable cell wall carbohydrates.
D) responded to penicillin.
E) had the same cell wall carbohydrate "beta."

Question 20

The disease characterized by the appearance of a toxin-mediated rash that causes the tongue to look like the surface of a ripe strawberry is

A) scarlet fever.
B) measles.
C) chickenpox.
D) strep throat.
E) pharyngitis.

Question 21

The pneumococcal vaccine is directed against the

A) flagella.
B) pili.
C) cilia.
D) capsule.
E) A-B toxin.

Question 22

About 60% of the bacterial pneumonias that require hospitalization of adults are caused by

A) S. pyogenes.
B) S. pneumoniae.
C) S. aureus.
D) K. pneumoniae.
E) M. pneumoniae.

Question 23

The sudden, violent, uncontrollable cough of pertussis is described as

A) productive.
B) contagious.
C) infective.
D) paroxysmal.
E) catastrophic.

Question 24

The causative agent of the pneumonia that results in permanent lung damage, may be nosocomial, and has a high mortality if untreated is

A) S. pneumoniae.
B) K. pneumoniae.
C) S. pyogenes.
D) S. aureus.
E) M. pneumoniae.

Question 25

A vaccine for the common cold is not possible because

A) the surface antigens of rhinovirus mutate frequently.
B) there are more than 100 types of rhinovirus.
C) the causative agent of colds is unknown.
D) the rhinovirus cannot be grown in sufficient quantities.
E) rhinoviruses are resistant.

Question 26

The virulence of Klebsiella is due partly to the

A) motility of the organism AND exotoxin produced.
B) structure and organization of flagella.
C) structure of their pili AND exotoxin produced.
D) antiphagocytic properties of their capsules.
E) exotoxin produced AND antiphagocytic properties of their capsules.

Question 27

Adenoviral pharyngitis is effectively treated with

A) antibiotics.
B) lysozyme.
C) proteases.
D) nucleotide analogs.
E) None of the choices is correct.

Question 28

Both S. pneumoniae and K. pneumoniae use this as a virulence factor.

A) Pili
B) Flagella
C) Capsules
D) Cilia
E) Toxins

Question 29

The key virulence factor of S. pneumoniae interferes with

A) the action of C3.
B) the action of C3b.
C) the action of C5a.
D) interferon.
E) All of the answer choices are correct.

Question 30

The disease that closely resembles "strep throat" but is of viral origin is

A) adenoviral pharyngitis.
B) otitis media.
C) the common cold.
D) tonsilitis.
E) bronchitis.

Question 31

The characteristic virulence factor of S. pneumoniae is

A) a capsule.
B) flagella.
C) pili.
D) cilia.
E) A-B toxin.

Question 32

Which of the following are considered diseases of the lower respiratory tract?

A) Diphtheria and pneumonia
B) Influenza and diphtheria
C) Tuberculosis and pneumonia
D) Common cold and tuberculosis
E) Influenza and tuberculosis

Question 33

Effective preventive methods for avoiding the common cold include all of the following EXCEPT

A) hand washing.
B) avoiding crowds.
C) not touching one's face.
D) avoiding close contact with people with colds.
E) prophylactic antibiotics.

Question 34

Which is/are true of the causative agents of coccidioidomycosis and histoplasmosis?

A) They are both photosynthetic soil fungi.
B) They are both dimorphic parasitic fungi.
C) They both cause life-threatening illnesses.
D) They both cause diseases that may be treated with antibiotics.
E) They are both dimorphic soil fungi.

Question 35

The spread of mycoplasma is through

A) inhalation of infected droplets.
B) the fecal-oral route.
C) an insect vector.
D) a fomite such as a towel.
E) opportunistic normal microbiota.

Question 36

Mycoplasmal and Klebsiella pneumonias

A) have similar incubation periods.
B) have causative agents that lack cell walls.
C) are serious diseases often requiring hospitalization.
D) are both relatively mild diseases.
E) None of the choices is correct.

Question 37

Which antibiotics may be completely ineffective in treating a mycoplasmal infection?

A) Penicillin AND tetracycline
B) Penicillin AND cephalosporin
C) Tetracycline AND cephalosporin
D) Cephalosporin AND erythromycin
E) Erythromycin AND tetracycline

Question 38

The reservoir of the common cold is the

A) family pet.
B) human.
C) infected fomite.
D) fruit.
E) rhinovirus.

Question 39

The resistance of Klebsiella to antibiotics may be

A) chromosomal mediated AND lysosomal mediated.
B) plasmid mediated AND lysosomal mediated.
C) chromosomal mediated AND plasmid mediated.
D) lysosomal mediated AND capsule mediated.
E) capsule mediated AND plasmid mediated.

Question 40

Colds are effectively treated with

A) antibiotics.
B) aspirin and acetaminophen.
C) proteases.
D) nucleotide analogs.
E) None of the choices is correct.

Question 41

Klebsiella species easily acquire and are a source of R pneumococcal pneumonia.

Question 42

Otitis media is an infection of the middle ear that is rare in the first month of life.

Question 43

Streptococci are grouped by their cell wall carbohydrates.

Question 44

Which is FALSE about pertussis toxin?

A) It uses part B to attach to receptors on the host cell.
B) It uses part A to inactivate G protein.
C) It affects the level of cAMP in a cell.
D) It affects the level of mucus secretion.
E) It uses part A to attach to receptors on the host cell.

Question 45

Although unusually resistant to many control factors, the tubercle bacillus is easily killed by

A) strong acids.
B) disinfectants.
C) pasteurization.
D) strong alkalis.
E) All of the answer choices are correct.

Question 46

Mycoplasma is effectively treated with cell wall inhibiting antibiotics.

Question 47

Rhinoviruses are effectively treated with antibiotics.

Question 48

The virulence of the tubercle bacillus is due to its

A) toxin.
B) lysogenic conversion.
C) resistance to antibiotics.
D) survival within macrophages.
E) lysogenic conversion AND resistance to antibiotics.

Question 49

Humans are the only source of the cold virus.

Question 50

Projecting from the outer envelope of the influenza virus are two glycoproteins called

A) leukocidin and hemolysin.
B) hyaluronidase and coagulase.
C) hemagglutinin and neuraminidase.
D) lysozyme and coagulase.
E) coagulase and gp160.

Question 51

Influenza is caused by

A) orthomyxovirus.
B) H. influenzae.
C) cytomegalovirus.
D) adenovirus.
E) coronavirus.

Question 52

Pneumonias are inflammatory diseases of the lung in which fluid fills the alveoli.

Question 53

The destructive nature of tuberculosis can be characterized as a(n)

A) endotoxin pyrogenic response.
B) delayed-type cell-mediated hypersensitivity reaction.
C) immune complex reaction.
D) inflammatory response.
E) inflammatory pyogenic response.

Question 54

The resistance of the tubercle bacillus to various factors is probably due to its

A) cell wall.
B) capsule.
C) larger ribosomes.
D) ability to adhere tightly.

Question 55

Which is true of hantavirus?

A) It is a zoonosis involving mice.
B) It has three segments of single-stranded RNA.
C) The primary effect is to flood the lungs with fluid.
D) Shock and death occur in 30% of the cases.
E) All of the choices are correct.

Question 56

Two relatively widespread North American lung mycoses are

A) candidiasis and coccidioidomycosis.
B) candidiasis and aspergillosis.
C) aspergillosis and Reyes syndrome.
D) coccidioidomycosis and histoplasmosis.
E) None of the choices is correct.

Question 57

The causative agent of whooping cough is

A) parvovirus.
B) M. pneumoniae.
C) B. pertussis.
D) S. aureus.
E) W. pertussis.

Question 58

A vaccine is available for protection from pneumococcal pneumonia.

Question 59

Of infectious diseases, pneumonia is a major killer in the general population.

Question 60

Antigenic shifts may be the result of

A) two different viruses infecting a cell at the same time.
B) the lysogenic conversion of two viruses.
C) conjugation of two viruses.
D) blending of a bacterial and a viral genome.
E) the lysogenic conversion of two viruses AND blending of a bacterial and viral genome.

Question 61

Is antigenic shift alone likely to lead to influenza pandemics?

A) Yes. ONLY antigenic shift can lead to the large-scale mixing of gene elements required to produce a pandemic flu strain.
B) Perhaps, but it would most likely be a mixture of antigenic shift AND drift that would result in a pandemic strain.
C) No. ONLY antigenic DRIFT can lead to the large-scale mixing of gene elements required to produce a pandemic flu strain.
D) No. Antigenic SHIFT is responsible for changes in the hemagglutinin protein, while antigenic DRIFT is responsible for changes in the neuraminidase protein. You need both to lead to a pandemic strain.
E) No. Antigenic SHIFT is responsible for changes in the neuraminidase protein, while antigenic DRIFT is responsible for changes in the hemagglutinin protein. You need both to lead to a pandemic strain.

Question 62

Which of the following interferes with phagocytosis of S. pyogenes?

A) Hyaluronic acid capsule
B) M protein
C) C5a peptidase
D) Protein G
E) All of the answer choices are correct.

Question 63

Which statement about S. pyogenes and strep throat pathogenesis is FALSE?

A) S. pyogenes strains that produce streptococcal pyrogenic exotoxins are lysogens.
B) Streptococcal pyrogenic exotoxins are A-B toxins that bind to host cells using the B portion.
C) Streptolysins O and S produced by S. pyogenes destroy blood cells by making holes in their cell membranes.
D) Spread of S. pyogenes is aided by streptokinase, an enzyme that breaks down blot clots.
E) The hyaluronic acid capsule of S. pyogenes helps it avoid the innate immune defenses.

Question 64

The best way to speed up recovery from a common cold is

A) to dose the patient with ibuprofen to keep the fever down. Reducing fever speeds up recovery.
B) to take decongestants as a means of alleviating the symptoms of the cold.
C) to take 1,000 mg of vitamin C every day during the illness. Vitamin C destroys cold viruses.
D) let the immune system do its job. Several of the treatments listed may actually increase the recovery time.
E) take an antibiotic such as penicillin that will rid the body of the cold virus.

Question 65

Which of the following is/are not associated with strep throat?

A) Sore throat and fever.
B) Patches of pus in the throat.
C) Enlarged lymph nodes in the neck.
D) Abdominal pain and headache.
E) Cough and nasal discharge.

Question 66

Why do some otitis media cases not respond to antibiotic treatment?

A) About 30% of cases are caused by respiratory viruses-antibiotics do not help these cases.
B) Most cases are caused by bacteria that are resistant to commonly prescribed antibiotics.
C) Otitis media is caused by viruses that constantly undergo antigenic shift and/or antigenic drift.
D) The bacterial causative organisms mutate frequently, changing their antibiotic target sites.
E) Unless the exact causative organism is identified, it is impossible to prescribe the correct antibiotic.

Question 67

Histoplasmosis may mimic tuberculosis.

Question 68

What is the most likely reason why smokers are more at risk for respiratory system infections?

A) Cigarette smoke is carcinogenic (cancer-causing), leading to a much higher incidence of lung cancer.
B) They aren't; this is just a rumor used to get people to stop smoking.
C) Smokers take in microbes from their hands into their lungs as they handle cigarettes and inhale the smoke.
D) Tobacco contains viruses that are inhaled when a person smokes; these cause respiratory infections.
E) Chemicals in cigarette smoke can impair the mucociliary escalator, preventing natural cleansing of the respiratory tract.

Question 69

Why would it be reasonable to treat strep throat but not diphtheria with antibacterial antibiotics?

A) The signs and symptoms of diphtheria are mostly caused by the exotoxin produced by the causative agent. An antibiotic won't affect the exotoxin.
B) The signs and symptoms of strep throat are mostly from the exotoxin produced by the causative agent. An antibiotic effectively eliminates these exotoxins.
C) The causative agent of diphtheria is a virus, not a bacterium. The drug would have no effect against this infectious agent.
D) There are no antibiotics that have proven effective against the bacterium that causes diphtheria.
E) The causative agent of diphtheria is pleomorphic and does not have a cell wall. There are thus no antibiotics that would be effective against this organism.

Question 70

Which is more dangerous to human beings: antigenic DRIFT or antigenic SHIFT?

A) Antigenic DRIFT, since this produces the quickest and largest degree of changes in the virus structure and we may not have immunity against it.
B) Antigenic SHIFT, since this produces the quickest and largest degree of changes in the virus structure and we may not have immunity against it.
C) Antigenic DRIFT; the small changes make the virus look like something we already have an immune response in place for, but we actually don't, letting the virus hide from the immune responses for a longer period of time.
D) Antigenic SHIFT; the process completely changes the virus, allowing it to jump from one species to another (such as from birds into humans). As such, we have no responses in place for the new virus.
E) These are equally dangerous. In both cases, major genetic and phenotypic changes occur in the virus, which means that people have absolutely no immune responses in place for dealing with the infection.

Question 71

Which is more likely to happen-antigenic DRIFT, or antigenic SHIFT-and why?

A) Antigenic DRIFT, since infection with only a single virus strain is required, and the random mutations happen as the virus replicates in the infected person's cells.
B) Antigenic SHIFT, since infection with only a single virus strain is required, and the random mutations happen as the virus replicates in the infected person's cells.
C) Antigenic DRIFT, since infection with only a single virus strain is required and random mutations occur more readily in this situation than if two virus strains are present.
D) Antigenic SHIFT, since multiple viruses in a cell at once means more RNA polymerase to copy the RNA, and therefore more possibilities for mistakes to be made (leading to mutations).
E) Antigenic drift and antigenic shift occur at the same frequency. Genetic change is just as likely to occur if one viral strain or more than one strain is/are present.

Question 72

How are pleurisy and pneumonia are different?

A) Pleurisy is inflammation of the lungs (not necessarily due to a microbe), while pneumonia is microbial infection of the linings that surround the lungs.
B) Pneumonia is active microbial infection of the lungs, while pleurisy is inflammation of the linings that surround the lungs (not necessarily due to a microbe).
C) Pleurisy is caused by viruses (single-stranded or double-stranded RNA), while pneumonia is caused by bacteria (Gram-positive only).
D) Pneumonia is caused by viruses (single-stranded or double-stranded DNA), while pleurisy is caused by bacteria (Gram-negative or Gram-positive).
E) Pneumonia is always a fatal infection and cannot be easily treated while pleurisy is not-treatment of this condition is by antiviral medications.

Question 73

Which of the following statements about otitis media is FALSE?

A) The causative organisms may form a biofilm, leading to chronic infections.
B) It is usually preceded by infections of the nasal cavity and upper pharynx.
C) It may sometimes spread to the membranes covering the brain, causing meningitis.
D) Using decongestants and antihistamines to treat otitis media is generally very effective.
E) Otitis media during the "flu" season can be decreased by giving the flu vaccine to infants in day-care facilities.

Question 74

Why are pneumococcal pneumonia infections so dangerous in nursing homes?

A) There is a vaccine for protecting children against pneumococcal pneumonia but no vaccine available for protection of older adults.
B) There is no longer an antibiotic effective against the infection, and older adults are unable to fight the infection without medication.
C) This type of pneumonia causes permanent lung damage, and old people often have impaired lung function in the first place.
D) The immune system of older people is usually impaired, leaving them predisposed to more serious and potentially life-threatening pneumonia.
E) This question is misleading. Pneumococcal infections are not dangerous.

Question 75

Are people infected with M. tuberculosis always highly infectious to everyone around them?

A) Yes. The infected person is constantly shedding bacteria to the environment around them in high numbers, facilitating transmission.
B) No. While in the early stages of the illness, the infected person does not have the cough required to spread the organism in respiratory droplets very easily.
C) Yes. As the mode of transmission of M. tuberculosis is direct contact, anyone or anything the infected person touches can be infected.
D) No. TB has a very high infectious dose. In the early stages of the disease, the patients aren't producing enough bacteria in their respiratory secretions to be infectious.
E) Yes. Mycobacterium tuberculosis is shed in all body secretions as well as in respiratory droplets, so is very easily spread.

Question 76

Which of the following is a virulence factor of Streptococcus pyogenes?

A) M protein
B) Capsule
C) Endotoxin AND pili
D) M protein AND pili
E) M protein AND capsule

Question 77

If you are a 20-year-old healthy young adult and you have to CHOOSE a type of pneumonia to become infected with (and you will NOT get treatment for it), which would be the "best," and why?

A) Pneumococcal pneumonia; the causative agent doesn't destroy lung tissue and it is possible to recover completely from this disease.
B) Mycoplasmal pneumonia; this type of pneumonia causes the the mildest signs and symptoms and can be effectively treated when treated early.
C) Viral pneumonia; there are many antiviral medications that can be given for this type of pneumonia and are effective, with very few side effects.
D) Klebsiella pneumonia; this is the mildest form of pneumonia, can easily be treated with antibiotics, and has the shortest recovery time.
E) Fungal pneumonia; these types of pneumonia are very mild, remain latent, and are easily treated with antifungal medications in the majority of patients.

Question 78

How can Streptococcus pyogenes initially be differentiated from other Streptococcus species that form part of the throat normal microbiotia?

A) By Gram staining-it is a Gram-positive organism.
B) By culturing the bacteria on nutrient agar and checking for hemolysis.
C) By morphology-the bacteria are spherical and grow in long chains.
D) By detection of the "A" carbohydrate in its cell wall using antibodies.
E) By specific disease signs and symptoms, including sore throat and fever.

Question 79

Which step(s) of phagocytosis are avoided by Streptococcus pyogenes?

A) Recruitment of phagocytes AND phagolysosome formation
B) Phototaxis AND recognition and attachment
C) Recruitment of phagocytes AND recognition and attachment
D) Phagolysosome formation
E) Phagolysosome formation AND lysis

Question 80

Which of the following indicates bacterial conjunctivitis rather than viral conjunctivitis?

A) Increased tear production
B) Redness of conjunctiva
C) Swelling and pus
D) Sensitivity to light
E) All of the answer choices are correct.