Exam #5 Microbiology

Alan D. Wilson, MD

Read each question carefully, then either choose the best answer or use the
word bank to fill in each blank or answer “True or False” (*). Use each word
bank answer only once.

For the following questions refer to Figure #22.1 in the text book

1 ___C_ The following structures are found in the dermal layer except:
a. nerve ending.
b. lymphatic vessel.
c. fat tissue.
d. arteriole.
e. sebaceous gland.

2 *__true___ Sweat glands and hair follicles traverse the dermis and epidermis
acting as potential portals of entry for normal and pathologic micro-organisms.

3 Propionibacterium acnes (normal skin microbiota) resides in sebaceous

glands and produces ______lipase___________ which degrades the sebum.

4 Staphylococcus epidermidis (normal skin microbiota) competes for nutrients

with other potential skin inhabitants and appears as ________gram
positive______________________ on a Gram stain.

5 ____B__ Staphylococcus aureus can cause (choose the incorrect answer):

a. furuncles.
b. carbuncles.
c. folliculitis.
d. keratin.
e. abscesses.

For the following questions refer to Figure #22.25 in the text book
6 Malassezia furfur can cause this superficial skin condition called ____tinea
versicolor_________________________________.

7 The staining of a skin scraping shows the individual yeast and __stubby hyphal
in the shape of spaghetti & meatballs_____________________________.

For the following questions refer to Figure #22.4 in the text book

8 The causative agent of this condition: B

a. is carried by the bloodstream to diffuse areas of the skin.
b. is produced by all of Staphylococcus aureus strains.
c. does not cause a life-threatening situation.
d. requires a co-infection with HIV.
e. causes disease only in newborns.

9 The toxin (called ______exfolitation_________________) destroys the

material that binds together the layers of the skin.

10 The toxin producing bacteria (Staphylococcus aureus) appears as a ____gram

positive grape like clusters_______________________ on a Gram stain.

11 *_False_____ Staphylococcus aureus produces this toxin as its only virulence

factor.

For the following questions refer to Figure #22.5 in the text book

12 Impetigo: B
a. involves only the dermis.
b. can be caused by Staphylococcus aureus and Streptococcus
pyogenes.
c. is not associated with any serious systemic complications.
d. suggests that significant trauma occurred to the skin before infection
began.
e. is never spread by fomites.
13 Skin infection characterized by purulence is called a
____pyoderma______________.

For the following questions refer to Figure #22.6 in the text book

14 ___E___ The disease which causes this rash

a. is an example of a zoonosis.
b. also can cause hemorrhagic disease in the heart and kidney.
c. has it highest incidence in the south east and south central USA.
d. is caused by the bacteria Rickettsia rickettsii.
e. all of the above are correct.

15 *____False__ Both the wood tick and the dog tick act as main vectors of this
disease; therefore, the disease is most prevalent in warm months of the year.

16 The organism which causes this disease is seen as ___gram negative non-
mobile obligate intracellular
bacteria_____________________________________ on a Gram stain.

For the following questions refer to Figure #22.10 in the text book

17 *__False____ This rash is the hallmark of the second stage of Lyme disease.

18 ___C___ In Lyme disease,

a. 100% of those infected complain of / or notice the rash of erythema
migrans.
b. few of those infected ever progress past the first stage of the illness
(despite receiving no antibacterial medication).
c. passage of the infectious agent requires that the adult tick lay its
eggs into the host animal.
d. the human population is the only reservoir of this infectious agent.
e. the heart, the nervous system, the skeletal system, and the
psychological system can all be affected.

For the following questions refer to Figure #22.15 in the text book
19 *___true___ The child with chicken pox can have macules, papules, and
vesicles all at the same point in time.

20 *_false____ Approximately 95% of adults with acute varicella infection will

develop viral pneumonia.

For the following question refer to Figure #22.16 in the text book

21 __A____ Herpes Zoster (choose the incorrect answer)

a. is considered a reactivation of the chickenpox virus.
b. usually occurs a few months after the acute case of chickenpox.
c. starts with pain in the distribution of one sensory nerve..
d. Increases in incidence as one’s age increases.
e. , after resolution of the rash, can leave the patient with chronic pain
which is termed “post herpetic neuralgia”.

For the following questions refer to Figure #22.18 in the text book

22 *_false_____ Rubeola has a 50% chance of the complication of viral

encephalitis, which would result in mental retardation, deafness, and epilepsy.

23 Another rare complication of rubeola is a degenerative condition of the brain

termed ____subacute sclerosing
panecephalitis_________________________________________ which may
occur months or years after the initial viremia.

For the following question refer to Figure #22.19 in the text book

24 Mucous membrane involvement in rubeola produces _koplik

spots____________________________________, erythematous lesions on
the buccal mucosa near the molar region. No other disease will present with
this finding.

For the following questions refer to Figure #22.20 in the text book

25 *__False___ Rubella is generally a mild viral illness with over 40% of those
infected remaining asymptomatic.
26 __c____ Congenital rubella syndrome
a. is a transient condition that causes no significant sequelae.
b. can occur even if the mother has no exposure to rubella during
pregnancy.
c. results in surviving infants shedding the virus in throat secretions and
urine for many months after birth.
d. typically does not effect the infant.
e. is classified as a zoonotic disease.

For the following question refer to Figure #22.26 in the text book

27 Candida albicans can

a. cause a blood born condition termed fungemia.
b. live harmlessly on the skin as normal microbiota.
c. thrive in moist skin folds.
d. invade into deep layers of the skin and subcutaneous tissue.
e. All of the above are correct.

For the following questions refer to Figure #21.2 in the text book

28 If this fluorescent microscope field were a Gram stain, Streptococcus

pyogenes would appear as strept gram positive in
chains____________________________________.

29 ___E___ Late complications of Streptococcal pharyngitis include all of the

following except:
a. glomerulonephritis.
b. Rheumatic fever.
c. neurologic complications.
d. bowel dysfunction.
e. heart valve dysfunction.

For the following question refer to Figure #22.5 in the text book
30 This beta-hemolytic culture of Streptococcus pyogenes proves that this
organism produces hemolysins, strept( O &S)___streptokinase, DNASE &
others____________________________________.

For the following questions, there is no figure

31*____False_ Respiratory syncytial virus (RSV) infects adults and children

with the same degree of morbidity and mortality.

32*_true____ RSV can produce only weak and short-lived immunity, regardless
of the clinical severity. Therefore, a patient can have the infection again.

For the following questions refer to Figure #21.18 in the text book

33 ___A__ The acid fast organism in this patient’s sputum

a. is associated with cavitary pulmonary disease.
b. would be dead if this person did not have AIDS.
c. is readily seen on a Gram stain.
d. will cause pneumonia in every person who is exposed to these
respiratory secretions.
e. should be treated immediately with a single, high-dose antifungal
agent.

34 *__false___ This micro-organism is associated with a reaction called a

granuloma, and predisposes the patient to lung cancer.

For the following questions refer to Figure #21.21 in the text book

35 The purified protein derivative test (PPD) is also known as the _Mantoux TB
skin__________________ test.

36 The PPD is read at 48 to 72 hours after delivery due to the body’s

____reaction__________________________ to the tubercle bacillus.

For the following questions refer to Figure #27.4 in the text book
37 This wet prep slide of vaginal epithelial cells shows a “Clue cell” which is
indicative of __vaginitis__________________________________.

38 *__false___ Lowering the vaginal pH to 4.5 (or lower) promotes a decrease

in lactobacilli (normal microbiota) and, therefore, an increase in other
undesirable organisms.

For the following question refer to Figure #27.5 in the text book

39 _____ Vulvovaginal candidiasis is associated with

a. diabetes mellitus.
b. oral contraceptive pills.
c. antibacterial therapy.
d. pregnancy.
e. All of the above are correct.

40 This slide shows yeast cells with budding and _psuedohyphae(chain of

cells)_______________________ which is classically seen in the discharge
of women with vulvovaginal candidiasis.

For the following question refer to Figure #27.9 in the text book

41 This gram stain of Neisseria gonorrhoeae shows organisms described as

__gram negative
diplococcus______________________________________.

42 *__True___ Disseminated gonococcal infection is characterized by fever,

pustular rash, and infective arthritis.

For the following questions refer to Figure #27.11 in the text book

43 _____ Chlamydia trachomatis in the Fallopian tube may result in

a. ectopic pregnancy.
b. urethritis.
c. vaginal irritation.
d. appendicitis.
e. None of the above are true.
44 *__false___ Non-sexual transmission of Chlamydia trachomatis can occur in
poorly-chlorinated swimming pools.

For the following questions refer to Figure #27.12 in the text book

45 The etiologic agent of this painless ulcer is seen on Dark Field microscopy as
a __spirochete bacteria(treponema
pallidum)____________________________________.

46 *__true___ Tertiary syphilis is characterized by diffuse, granulomatous,

necrotizing masses and is not easily transmitted to other people.

For the following question refer to Figure #27.13 in the text book

47 __B___ Lesions of secondary syphilis

a. Are only in the oral cavity.
b. Are oral and cutaneous.
c. Are not infectious.
d. Are present for 6 to 10 weeks duration.
e. Imply that the patient is self-cured without
antimicrobial therapy.

For the following question refer to Figure #27.17 in the text book

48 The causative agent of chancroid, Haemophilus ducreyi, is seen as a gram

positive coccobacillus__________________________________ on a Gram
stain.

For the following questions refer to Figure #27.18 in the text book

49 _false_____ Herpes simplex virus II is never infectious when all ulcerous

lesions are healed.

50 __true____ All gential ulcerous lesions increase the risk of co-infection with
HIV.
 For the following question refer to Figure #27.19 in the text book

51 *___true___ Human papillomavirus (HPV) is the causative agent for

external and internal genital warts and can be a major factor in the
development of cervical cancer.

For the following questions refer to Figure #21.11 in the text book

52 Sputum from a patient with Streptococcal pneumoniae will show white

blood cells and _gram positive diplococcus AKA
pneumoccus_________________________________________ on a Gram
stain.

53 _E____ Factors that increase the risk of pneumococcal pneumonia include

a. alcohol abuse.
b. age over 50.
c. influenza.
d. heart disease.
e. All of the above are correct.

For the following question, there is no figure in the text book

54 *_true____ Mycoplasma pneumonia is the leading cause of pneumonia in

college students and military recruits.

For the following question refer to Figure #27.22 in the text book

55 __C___ Once the initial viremia of HIV occurs,

a. HIV totally disappears from the human body.
b. those infected immediately begin to have immunocompromised.
c. the number of HIV viral particles in the bloodstream decrease as
HIV continues to multiply and damage CD4 lymphocytes.
d. HIV is 100% undetectable within the body cell tissue.
e. patients exhibit signs that can easily be diagnosed as AIDS.

For the following question, there is no figure in the text book

56 *__true___ A dual or co-infection with HIV and Epstein-Barr virus (EBV) can
result in the condition called Oral Hairy Leukoplakia, thickened tongue
epithelium which inhibits dietary intake.

For the following questions refer to Figure #27.25 in the text book

57 *____true__ HIV is a single stranded RNA virus and, therefore, is

reproduced in the cytoplasm of the CD4 lymphocyte, as it is unable to be
incorporated into the cell’s genome which resides in the nucleus of the cell.

58. Remember all those steps of viral replication (attachment, entry, enzyme
activation, genome/protein reproduction, assembly, release)?
*___true antiretrovirals__ Drugs designed to interrupt (stop) any of the steps
would be able to stop HIV replication and, therefore, stop immune damage
and disease progression.

The answers for the following questions are not included in the word bank

59 ______epidemic___________________ implies that there are an unusually

large number of infections in a given population at a given time.

60 _____prevelance____________________ is a term used to describe the

number of existing cases of a specific disease at a point in time.

61 The __mortality________________________ rate reflects the percentage

of a population that dies from a specific disease.

62 An epidemic that spreads world wide is called a/an

_______pandemic________________________.

63 ________incidence_________________________, an epidemiologic term,

describes the number of new cases of a specific illness during a given time
period.

64 Diseases that are constantly present in a given population are said to be

____endemic______________________.
65 __________incidence_______________________ rate is calculated as the
number of symptomatic illnesses in a given time period divided by the total
population at risk.s