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Pre-Test Microbiology - Bacteriology

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Bacteriology Pre-test Microbiology
Magen Ross
Quiz por Magen Ross, atualizado more than 1 year ago
Magen Ross
Criado por Magen Ross mais de 7 anos atrás
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Resumo de Recurso

Questão 1

Questão
A patient with a peptic ulcer was admitted to the hospital and a gastric biopsy was performed. The tissue was cultured on a chocolate agar, incubated in a micraerophilic environment at 37 F for 5 to 7 days. At 5 days of incubation, colonies appeared on the plate and were curved, Gram-negative rods, oxidase-positive. The most likely identity of this organism is
Responda
  • Campylobacter jejuni
  • Vibrio parahaemolyticus
  • Haemophilus influezae
  • Helicobacter pylori
  • Campylobacter fetus

Questão 2

Questão
An experimental compound is discovered that prevents the activation of adenyl cyclase and the resulting increase in cyclic AMP. The toxic effects of which of the following
Responda
  • Vibrio cholerae
  • Corynebacterium diphtheriae
  • Pseudomonas
  • Listeria monocytogenes
  • Brucella

Questão 3

Questão
An inhibitor was designed to block a biologic function in H. influenzae. If the goal of the experiment was to reduce the virulence of H. influenzae, the most likely target would be
Responda
  • Exotoxin liberator
  • Endotoxin assembly
  • Flagella synthesis
  • Capsule formation
  • IgA protease synthesis

Questão 4

Questão
A 21-year-old college student complained of malaise, low-grade fever, and a harsh cough, but not of muscle aches and pains. An x-ray revealed a diffuse interstitial pneumonia in the left lobes of the lung. The WBC count was normal. The student has been ill for a week. Based on the information given, the most likely diagnosis is
Responda
  • Mycoplasma pneumonia
  • Pneumococcal pneumonia
  • Staphylococcal pneumonia
  • Influenza
  • Legionellosis

Questão 5

Questão
There are millions of cases of leprosy (Hansen’s disease) worldwide, but predominately in Asia and Africa. The clinical spectrum of Hansen’s disease is best characterized by
Responda
  • Immunologic anergy
  • Chronic pneumonitis
  • Peripheral neuritis
  • Bacilli in lesions that digest tissues
  • Erythematous lesions resembling concentric circles

Questão 6

Questão
At a church supper in Nova Scotia, the following meal was served: baked beans, ham, coleslaw, eclairs, and coffee. Of the 30 people who attended, 4 senior citizens became ill in 3 days; 1 eventually died. Two weeks after attending the church supper, a 19-year-old girl gave birth to a baby who rapidly became ill with meningitis and died in 5 days. Epidemiologic investigation revealed the following percentages of people who consumed the various food items: baked beans, 30%; ham, 80%; coleslaw, 60%; eclairs, 100%; and coffee, 90%. Which of the following statements is true?
Responda
  • This is not a case of food poisoning because only 4 people became ill
  • A relationship between the death of the baby and the food consumed at the church supper can be ruled out
  • Based on the epidemiologic investigation, the eclairs can be isolated as the source of the disease
  • Based on the epidemiologic investigation, the baked beans can be ruled out as the source of the disease
  • Additional epidemiologic data should include the percentage of those who ate a particular food item who became ill

Questão 7

Questão
Microbiologic analysis revealed no growth in the baked beans, ham, or coffee; many Gram-positive beta-hemolytic, short, rod-shaped bacteria in the coleslaw; and rare Gram-positive cocci in the eclairs. The most likely cause of this outbreak is
Responda
  • Staphylococcus aureus
  • Listeria
  • Clostridium perfringens
  • Clostridium botulinum
  • Nonmicrobiologic

Questão 8

Questão
A 21-year-old college student complained of malaise, low-grade fever, and a harsh cough, but not of muscle aches and pains. An x-ray revealed a diffuse interstitial pneumonia in the left lobes of the lung. The WBC count was normal. The student has been ill for a week. Based on the information given, which of the following laboratory tests would most rapidly assist you in making the diagnosis?
Responda
  • Cold agglutinins
  • Viral culture
  • Complement fixation (CF) test
  • Gram stain of sputum
  • Culture of sputum

Questão 9

Questão
A 21-year-old college student complained of malaise, low-grade fever, and a harsh cough, but not of muscle aches and pains. An x-ray revealed a diffuse interstitial pneumonia in the left lobes of the lung. The WBC count was normal. The student has been ill for a week. The following laboratory data were available within 2 days: cold agglutinins—negative; complement fixation (M. pneumoniae)—1:64; viral culture—pending, but negative to date; bacterial culture of sputum on blood agar and MacConkey’s agar—normal oral flora. In order to confirm the diagnosis, which of the following procedures could be ordered to achieve a specific and sensitive diagnosis?
Responda
  • Culture of the sputum on charcoal yeast extract
  • A repeat cold agglutinin test
  • A DNA probe to the 16S ribosomal RNA of an organism lacking a cell wall
  • A repeat CF test in 5 days
  • Another viral culture in 1 week

Questão 10

Questão
Pathogenic mechanisms involved in tuberculosis can be primarily attributed to which of the following?
Responda
  • Toxin production by the mycobacteria
  • Specific cell adhesion sites
  • Cell-mediated hypersensitivity
  • Humoral immunity
  • Clogging of alveoli by large numbers of acid-fast mycobacteria

Questão 11

Questão
The class of antibiotics known as the quinolones are bactericidal. Their mode of action on growing bacteria is thought to be
Responda
  • Inhibition of DNA gyrase
  • Inactivation of penicillin-binding protein II
  • Inhibition of β-lactamase
  • Prevention of the cross-linking of glycine
  • Inhibition of reverse transcriptase

Questão 12

Questão
Vancomycin-indeterminate S. aureus (VISA) has recently been reported in the United States. Which one of the statements concerning VISA is the most correct?
Responda
  • Minimum inhibitory concentration (MIC) for vancomycin is at least 1.0 mcg/mL
  • VISA isolates are usually methicillin susceptible (methicillin-resistant S. aureus, MRSA)
  • VISAs have emerged because of the extended use of vancomycin for MRSAs
  • Patients with VISA isolates need not be isolated
  • VISA isolates are infrequent, so surveillance at the present time is not warranted

Questão 13

Questão
A sputum sample was brought to the laboratory for analysis. Gram stain revealed the following: rare epithelial cells, 8 to 10 polymorphonuclear leukocytes per high-power field, and pleomorphic Gram-negative rods. As the laboratory consultant, which of the following interpretations should you make?
Responda
  • The sputum specimen is too contaminated by saliva to be useful
  • There is no evidence of an inflammatory response
  • The patient has pneumococcal pneumonia
  • The patient has Vincent’s disease
  • The appearance of the sputum is suggestive of Haemophilus pneumonia

Questão 14

Questão
An isolate from a wound culture is a Gram-negative rod identified as Bacteroides fragilis. Anaerobic infection with B. fragilis is characterized by
Responda
  • A foul-smelling discharge
  • A black exudate in the wound
  • An exquisite susceptibility to penicillin
  • A heme-pigmented colony formation
  • Severe neurologic symptoms

Questão 15

Questão
Virtually all prokaryotic cells (bacteria, both Gram-positive and Gramnegative) contain peptidoglycan as well as specific enzymes for its synthesis. All of the following statements concerning Gram-positive and Gram-negative bacteria are true except
Responda
  • The extent of cross-linking of peptidoglycan is a function of different species of bacteria
  • The peptidoglycan-synthesizing enzymes can be antibiotic targets
  • Both Gram-positive and Gram-negative bacteria contain significant amounts of teichoic acid
  • With the exception of the structures that are cross-linked, peptidoglycan structure is common to most bacteria
  • The physical shape of bacteria is a function of peptidoglycan

Questão 16

Questão
L. monocytogenes causes a variety of diseases, including food poisoning. Listeria are small, Gram-positive, motile rod-shaped bacteria. Which of the following best describes these microorganisms?
Responda
  • Listeria are facultative intracellular pathogens
  • Once infected, the immune system cannot destroy Listeria
  • Listeria cannot be cultivated on artificial media
  • Flagella are produced both at room temperature and at 37°C
  • There is no relationship between Listeria serovars and human infection

Questão 17

Questão
A 30-year-old male patient was seen by the emergency service and reported a 2-week history of a penile ulcer. He noted that this ulcer did not hurt. Which one of the following conclusions/actions is most valid?
Responda
  • Draw blood for a herpes antibody test
  • Perform a dark-field examination of the lesion
  • Prescribe acyclovir for primary genital herpes
  • Even if treated, the lesion will remain for months
  • Failure to treat the patient will have no untoward effect, as this is a self-limiting infection

Questão 18

Questão
A 30-year-old male patient was seen by the emergency service and reported a 2-week history of a penile ulcer. He noted that this ulcer did not hurt. The laboratory reports that the Venereal Disease Research Laboratory (VDRL) test performed on the above patient is reactive at a dilution of 1:4 (4 dils). The patient also reports to you that he has recently been diagnosed with hepatitis A. Which one of the following actions would be most appropriate?
Responda
  • Report this patient to the health department, as he has syphilis
  • Order a confirmatory test such as the fluorescent treponemal antibody test (FTA)
  • Repeat the VDRL test
  • Order a rapid reagin test (RPR)
  • Perform a spinal tap to rule out central nervous system syphilis

Questão 19

Questão
A 30-year-old male patient was seen by the emergency service and reported a 2-week history of a penile ulcer. He noted that this ulcer did not hurt. The laboratory reports that the Venereal Disease Research Laboratory (VDRL) test performed on the above patient is reactive at a dilution of 1:4 (4 dils). The patient also reports to you that he has recently been diagnosed with hepatitis A. Which one of the following test combinations for syphilis is most appropriate?
Responda
  • FTA-Abs (IgG)/FTA-Abs (IgM)
  • RPR/FTA-Abs
  • RPR/culture of the lesion
  • VDRL/RPR
  • Treponema pallidum hemagglutination (TPHA)/microhemagglutination-Treponema pallidum (MHTP) tests

Questão 20

Questão
Assume that the patient absolutely denied any contact, sexual or otherwise, with a person who had syphilis. Assume also that both the RPR and the FTA Abs were positive on this patient. Which one of the following tests could be used to show that this patient probably does not have syphilis?
Responda
  • VDRL
  • Quantitative RPR
  • Treponema pallidum immobilization (TPI) test
  • Frei test
  • MHTP test

Questão 21

Questão
A 55-year-old man who is being treated for adenocarcinoma of the lung is admitted to a hospital because of a temperature of 38.9°C (102°F), chest pain, and a dry cough. Sputum is collected. Gram’s stain of the sputum is unremarkable and culture reveals many small Gram-negative rods able to grow only on a charcoal yeast extract agar. This organism most likely is
Responda
  • Klebsiella pneumoniae
  • Mycoplasma pneumoniae
  • Legionella pneumophila
  • Chlamydia trachomatis
  • S. aureus

Questão 22

Questão
A patient was hospitalized after an automobile accident. The wounds became infected and the patient was treated with tobramycin, carbenicillin, and clindamycin. Five days after antibiotic therapy was initiated, the patient developed severe diarrhea and pseudomembranous enterocolitis. Antibiotic-associated diarrhea and the more serious pseudomembranous enterocolitis can be caused by
Responda
  • Clostridium sordellii
  • Clostridium perfringens
  • Clostridium difficile
  • S. aureus
  • B. fragilis

Questão 23

Questão
Assuming that the average achievable serum level of gentamicin is 6 to 8 mcg/mL, which of the following bacteria is susceptible to gentamicin?
Responda
  • E. coli with a minimal inhibitory concentration (MIC) of 10 mcg/mL
  • E. coli with an MIC of 12 mcg/mL
  • Klebsiella with an MIC of 0.25 mcg/mL
  • Klebsiella with an MIC of 6.0 mcg/mL
  • Klebsiella with an MIC of 20 mcg/mL

Questão 24

Questão
A child comes to an emergency room because of an infected dog bite. The wound is found to contain small Gram-negative rods. The most likely cause of infection is
Responda
  • E. coli
  • H. influenzae
  • Pasteurella multocida
  • Brucella canis
  • Klebsiella rhinoscleromatis

Questão 25

Questão
A patient complained to his dentist about a draining lesion in his mouth. A Gram’s stain of the pus showed a few Gram-positive cocci, leukocytes, and many branched Gram-positive rods. The most likely cause of the disease is
Responda
  • Actinomyces israelii
  • Actinomyces viscosus
  • C. diphtheriae
  • Propionibacterium acnes
  • S. aureus

Questão 26

Questão
A man who has a penile chancre appears in a hospital’s emergency service. The VDRL test is negative. The most appropriate course of action for the physician in charge would be to
Responda
  • Send the patient home untreated
  • Repeat the VDRL test in 10 days
  • Perform dark-field microscopy for treponemes
  • Swab the chancre and culture on Thayer-Martin agar
  • Perform a Gram stain on the chancre fluid

Questão 27

Questão
Fever of unknown origin in a farmer who raises goats would most likely be caused by which of the following organisms?
Responda
  • Brucella melitensis
  • Clostridium novyi
  • T. pallidum
  • Histoplasma capsulatum
  • Mycobacterium tuberculosis

Questão 28

Questão
Cholera is a toxicogenic dysenteric disease common in many parts of the world. In the treatment of patients who have cholera, the use of a drug that inhibits adenyl cyclase would be expected to
Responda
  • Kill the patient immediately
  • Eradicate the organism
  • Increase fluid secretion
  • Reduce intestinal motility
  • Block the action of cholera toxin

Questão 29

Questão
A box of ham sandwiches with mayonnaise prepared by a person with a boil on his neck was left out of the refrigerator for the on-call interns. Three doctors became violently ill approximately 2 h after eating the sandwiches. The most likely cause is
Responda
  • S. aureus enterotoxin
  • Coagulase from S. aureus in the ham
  • S. aureus leukocidin
  • C. perfringens toxin
  • Penicillinase given to inactivate penicillin in the pork

Questão 30

Questão
S. aureus causes a wide variety of infections, ranging from wound infection to pneumonia. Treatment of S. aureus infection with penicillin is often complicated by the
Responda
  • Inability of penicillin to penetrate the membrane of S. aureus
  • Production of penicillinase by S. aureus
  • Production of penicillin acetylase by S. aureus
  • Lack of penicillin binding sites on S. aureus
  • Allergic reaction caused by staphylococcal protein

Questão 31

Questão
Symptoms of C. botulinum food poisoning include double vision, inability to speak, and respiratory paralysis. These symptoms are consistent with
Responda
  • Invasion of the gut epithelium by C. botulinum
  • Secretion of an enterotoxin
  • Endotoxin shock
  • Ingestion of a neurotoxin
  • Activation of cyclic AMP

Questão 32

Questão
In people who have sickle cell anemia, osteomyelitis usually is associated with which of the following organisms?
Responda
  • Micrococcus
  • Escherichia
  • Pseudomonas
  • Salmonella
  • Streptococcus

Questão 33

Questão
The treatment of choice for a patient with C. jejuni enterocolitis is
Responda
  • Erythromycin
  • Ciprofloxacin
  • Ampicillin
  • Pepto-Bismol
  • Campylobacter antitoxin

Questão 34

Questão
A hyperemic edema of the larynx and epiglottis that rapidly leads to respiratory obstruction in young children is most likely to be caused by
Responda
  • K. pneumoniae
  • M. pneumoniae
  • Neisseria meningitidis
  • H. influenzae
  • H. hemolyticus

Questão 35

Questão
A 70-year-old female patient was readmitted to a local hospital with fever and chills following cardiac surgery at a major teaching institution. Blood cultures were taken and a Gram-positive coccus grew from the blood cultures within 24 hours. Initial tests indicated that this isolate was resistant to penicillin. The most likely identification is
Responda
  • Streptococcus pneumoniae
  • Neisseria
  • Group A streptococcus
  • Enterococcus
  • Group B streptococcus

Questão 36

Questão
Acute hematogenous osteomyelitis is often diagnosed by isolation of the organism from the blood and is caused most often by
Responda
  • Proteus mirabilis
  • Streptococcus faecalis
  • Staphylococcus epidermidis
  • S. aureus
  • E. coli

Questão 37

Questão
Diphtheria toxin is produced only by those strains of C. diphtheriae that are
Responda
  • Glucose fermenters
  • Sucrose fermenters
  • Lysogenic for β-prophage
  • Of the mitis strain
  • Encapsulated

Questão 38

Questão
A 28-year-old menstruating woman appeared in the emergency room with the following signs and symptoms: fever, 104°F (40°C); WBC, 16,000/ μL; blood pressure, 90/65 mmHg; a scarlatiniform rash on her trunk, palms, and soles; extreme fatigue; vomiting; and diarrhea. The patient described in the case above most likely has
Responda
  • Scalded skin syndrome
  • Toxic shock syndrome
  • Guillain-Barré syndrome
  • Chickenpox
  • Staphylococcal food poisoning

Questão 39

Questão
Culture of the menstrual fluid in the case of a woman with Toxic Shock Syndrome (TSS) would most likely reveal a predominance of
Responda
  • S. aureus
  • S. epidermidis
  • C. perfringens
  • C. difficile
  • Gardnerella vaginalis

Questão 40

Questão
A new latex agglutination (LA) reagent for H. influenzae polysaccharide antigen in cerebrospinal fluid was evaluated. Results were compared with the isolation of H. influenzae from the CSF. Results were as follows: LA POS, CULT POS: 25 LA POS, CULT NEG: 5 LA NEG, CULT POS: 5 LA NEG, CULT NEG: 95 The sensitivity of LA is
Responda
  • 0%
  • 30%
  • 85%
  • 95%
  • 100%

Questão 41

Questão
A new latex agglutination (LA) reagent for H. influenzae polysaccharide antigen in cerebrospinal fluid was evaluated. Results were compared with the isolation of H. influenzae from the CSF. Results were as follows: LA POS, CULT POS: 25 LA POS, CULT NEG: 5 LA NEG, CULT POS: 5 LA NEG, CULT NEG: 95 The specificity of LA is
Responda
  • 0%
  • 30%
  • 80%
  • 95%
  • 100%

Questão 42

Questão
A new latex agglutination (LA) reagent for H. influenzae polysaccharide antigen in cerebrospinal fluid was evaluated. Results were compared with the isolation of H. influenzae from the CSF. Results were as follows: LA POS, CULT POS: 25 LA POS, CULT NEG: 5 LA NEG, CULT POS: 5 LA NEG, CULT NEG: 95 The negative predictive value of LA is
Responda
  • 10%
  • 80%
  • 95%
  • 110%
  • Not calculable

Questão 43

Questão
The incidence of H. influenzae meningitis in the general population is less than 1%. If during an epidemic the incidence rose to 3%, the negative predictive value of the LA test would
Responda
  • Increase
  • Decrease
  • Remain the same
  • Be impossible to calculate
  • Vary as a function of the specificity of the LA test

Questão 44

Questão
Methicillin-resistant S. aureus (MRSA) was isolated from 7 patients in a 14-bed intensive care unit. All patients were isolated and the unit closed to any more admissions. Which one of the following reasons best explains these rigorous methods to control MRSA?
Responda
  • MRSA is inherently more virulent than other staphylococci
  • The alternative for treatment of MRSA is vancomycin, an expensive and potentially toxic antibiotic
  • MRSA causes toxic shock syndrome
  • MRSA spreads more rapidly from patient to patient than antibiotic-susceptible staphylococci do
  • MRSA is resistant to penicillin

Questão 45

Questão
A patient with AIDS returned from Haiti with acute diarrhea. The stool revealed an oval organism (8 to 9 μm in diameter) that was acid-fast and fluoresced blue under ultraviolet light. The most likely identification of this organism is
Responda
  • Cyclospora
  • Giardia
  • Enterocytozoon
  • Cryptosporidium
  • Prototheca

Questão 46

Questão
A 2-year-old infant is brought to the emergency room with hemolytic uremic syndrome and thrombocytopenia. Which one of the following bacteria would most likely be isolated from a stool specimen?
Responda
  • Shigella
  • Salmonella
  • Aeromonas
  • E. coli 0157/H7
  • Enterobacter

Questão 47

Questão
E. coli causes disease by a variety of different methods. Which one of the following E. coli types is characterized by the presence of LT (heat-labile) and ST (heat-stable) proteins?
Responda
  • Enteroinvasive (EIEC)
  • Enterotoxigenic (ETEC)
  • Enterohemorrhagic (EHEC)
  • Enteropathogenic (EPEC)
  • Enterohemolytic (EHEEC)

Questão 48

Questão
Yersinia pestis, the causative agent of plague, is enzootic in the United States west of the one-hundredth meridian. Human plague can be bubonic or pneumonic. The primary epidemiologic difference between the two clinical forms of plague is
Responda
  • Season of the year
  • Route of infection
  • Age of the patient
  • Health of the animal vector
  • Geographic location of the animal vector

Questão 49

Questão
A 9-year-old child is brought to the emergency room with the chief complaint of enlarged, painful axillary lymph nodes. The resident physician also notes a small, inflamed, dime-sized lesion surrounding what appears to be a small scratch on the forearm. The lymph node is aspirated and some pus is sent to the laboratory for examination. A Warthin-Starry silver impregnation stain reveals many highly pleomorphic, rod-shaped bacteria. The most likely cause of this infection is
Responda
  • Y. pestis
  • Yersinia enterocolitica
  • Mycobacterium scrofulaceum
  • B. canis
  • Bartonella henselae

Questão 50

Questão
Recently, there have been sensational media reports of patients infected with invasive, “flesh-eating” bacteria that spread rapidly through the tissues. This necrotizing fasciitis is usually caused by
Responda
  • S. aureus
  • Group A streptococci
  • Micrococcus
  • Bacillus cereus
  • Clostridium tetani

Questão 51

Questão
The most effective noninvasive test for the diagnosis of Helicobacter-associated gastric ulcers is
Responda
  • Detection of H. pylori antigen in stool
  • Growth of H. pylori from a stomach biopsy
  • Growth of H. pylori in the stool
  • IgM antibodies to H. pylori
  • Culture of stomach contents for H. pylori

Questão 52

Questão
The following test results were observed in a woman tested in November who reported being in the woods in Pennsylvania during the past summer, was bitten by a tick, and now has Bell’s palsy: Lyme IgG antibody 1:1280; Lyme IgM antibody negative. Which one of the following courses of action is most appropriate?
Responda
  • Order tests for syphilis (VDRL, FTA-ABS) because there are cross-reactions reported with Borrelia burgdorferi
  • Ask the patient if she has a severe headache
  • Consider treatment of the patient with an appropriate antibiotic such as tetracycline
  • Ask the patient if she has had a urinary tract infection with E. coli
  • Ignore the results because there is no Lyme disease in Pennsylvania

Questão 53

Questão
Mycobacterium avium is a major opportunistic pathogen in AIDS patients. M. avium from AIDS patients can be best characterized by which one of the following statements?
Responda
  • The majority of M. avium isolates from AIDS patients are nonpigmented
  • M. avium isolates from AIDS patients are of multiple serovars
  • Few isolates from AIDS patients are acid-fast
  • Most isolates from AIDS patients are sensitive to isoniazid and streptomycin
  • M. avium can be isolated from the blood of AIDS patients

Questão 54

Questão
Rheumatic fever (RF) is a disease seen in children and young adults. Which one of the following statements best typifies the disease?
Responda
  • It is characterized by inflammatory lesions that may involve the heart, joints, subcutaneous tissues, and the central nervous system
  • The pathogenesis is related to the similarity between a staphylococcal antigen and a human cardiac antigen
  • Prophylaxis with benzathine penicillin is of little value
  • It is a complication of group A streptococcal skin disease but usually not of pharyngitis
  • It is very common in developing countries but extremely rare and decreasing in incidence in the United States

Questão 55

Questão
Bacteria cause disease in a number of ways. One mechanism of pathogenesis is the secretion of potent protein toxins. All the following diseases are caused by microbial protein toxins, but one toxin has been used for a variety of maladies. It is
Responda
  • Tetanus
  • Botulism
  • Bacillary (Shigella) dysentery
  • Diphtheria
  • Disseminated intravascular coagulation

Questão 56

Questão
A 2-year-old child was admitted to the hospital with acute meningitis. The Gram stain revealed Gram-positive short rods, and the mother indicated that the child had received “all” of the meningitis vaccinations. What is the most likely cause of the disease?
Responda
  • N. meningitidis, group A
  • N. meningitidis, group C
  • Listeria
  • S. pneumoniae
  • H. influenzae

Questão 57

Questão
The most common portal of entry for C. tetani, the cause of tetanus, is the
Responda
  • Skin
  • Gastrointestinal tract
  • Respiratory tract
  • Genital tract
  • Nasal tract

Questão 58

Questão
The most common way in which tuberculosis is acquired is via the
Responda
  • Skin
  • Gastrointestinal tract
  • Respiratory tract
  • Genital tract
  • Nasal tract

Questão 59

Questão
Shigellosis is common in travelers to developing countries. Infection is commonly acquired through the
Responda
  • Skin
  • Gastrointestinal tract
  • Respiratory tract
  • Genital tract
  • Nasal tract

Questão 60

Questão
A person who contracts gonorrhea is most likely to have acquired it via the
Responda
  • Skin
  • Gastrointestinal tract
  • Respiratory tract
  • Genital tract
  • Nasal tract

Questão 61

Questão
There are a variety of “unusual” bacteria that infect humans. While rare, disease caused by these microorganisms is serious and occasionally difficult to identify. Branhamella is best characterized as
Responda
  • A Gram-negative pleomorphic rod that can cause endocarditis
  • The causative agent of trench fever
  • A Gram-negative rod, fusiforme-shaped, that is associated with periodontal disease but may cause sepsis
  • The causative agent of rat-bite fever
  • The causative agent of sinusitis, bronchitis, and pneumonia

Questão 62

Questão
Cardiobacterium is best characterized as
Responda
  • A Gram-negative pleomorphic rod that can cause endocarditis
  • The causative agent of trench fever
  • A Gram-negative rod, fusiforme-shaped, that is associated with periodontal disease but may cause sepsis
  • The causative agent of rat-bite fever
  • The causative agent of sinusitis, bronchitis, and pneumonia

Questão 63

Questão
Capnocytophyga is best characterized as
Responda
  • A Gram-negative pleomorphic rod that can cause endocarditis
  • The causative agent of trench fever
  • A Gram-negative rod, fusiforme-shaped, that is associated with periodontal disease but may cause sepsis
  • The causative agent of rat-bite fever
  • The causative agent of sinusitis, bronchitis, and pneumonia

Questão 64

Questão
An enterococcus (E. faecium) was isolated from a urine specimen (100,000 cfu/mL). Treatment of the patient with ampicillin and gentamicin failed. The most clinically appropriate action is
Responda
  • Do no further clinical workup
  • Suggest to the laboratory that low colony counts may reflect infection
  • Determine if fluorescent microscopy is available for the diagnosis of actinomycosis
  • Consider vancomycin as an alternative drug
  • Suggest a repeat antibiotic susceptibility test

Questão 65

Questão
A patient with symptoms of urinary tract infection had a culture taken, which grew 5 × 103 E. coli. The laboratory reported it as “insignificant.” The most clinically appropriate action is
Responda
  • Do no further clinical workup
  • Suggest to the laboratory that low colony counts may reflect infection
  • Determine if fluorescent microscopy is available for the diagnosis of actinomycosis
  • Consider vancomycin as an alternative drug
  • Suggest a repeat antibiotic susceptibility test

Questão 66

Questão
A patient appeared in the emergency room with a submandibular mass. A smear was made of the drainage and a bewildering variety of bacteria were seen, including branched, Gram-positive rods. The most clinically appropriate action is
Responda
  • Do no further clinical workup
  • Suggest to the laboratory that low colony counts may reflect infection
  • Determine if fluorescent microscopy is available for the diagnosis of actinomycosis
  • Consider vancomycin as an alternative drug
  • Suggest a repeat antibiotic susceptibility test

Questão 67

Questão
The antibiotic therapy of choice for legionellosis is
Responda
  • Penicillin
  • Ampicillin
  • Erythromycin
  • Vancomycin
  • Ceftriaxone

Questão 68

Questão
The antibiotic of choice for pneumococcal pneumonia is
Responda
  • Penicillin
  • Ampicillin
  • Erythromycin
  • Vancomycin
  • Ceftriaxone

Questão 69

Questão
The antibiotic of choice for Lyme disease is
Responda
  • Penicillin
  • Ampicillin
  • Erythromycin
  • Vancomycin
  • Ceftriaxone

Questão 70

Questão
The antibiotic of choice for streptococcal pharyngitis is
Responda
  • Penicillin
  • Ampicillin
  • Erythromycin
  • Vancomycin
  • Ceftriaxone

Questão 71

Questão
The therapy of choice for pseudomembranous enterocolitis is
Responda
  • Penicillin
  • Ampicillin
  • Erythromycin
  • Vancomycin
  • Ceftriaxone

Questão 72

Questão
C. jejuni is best described as
Responda
  • “String-test”-positive isolate; three serotypes—Ogawa (AB), Inaba (AC), Hikojima (ABC)
  • Human pathogen, halophilic, lactose-positive; produces heat-labile, extracellular toxin
  • Human pathogen, halophilic, lactose-negative, sucrose-negative; causes gastrointestinal diseases primarily from ingestion of cooked seafood
  • Cause of gastroenteritis; reservoir in birds and mammals, optimal growth at 42°C
  • Urease-positive; cause of fetal distress in cattle

Questão 73

Questão
V. cholerae, the causative agent of cholera, is best described as
Responda
  • “String-test”-positive isolate; three serotypes—Ogawa (AB), Inaba (AC), Hikojima (ABC)
  • Human pathogen, halophilic, lactose-positive; produces heat-labile, extracellular toxin
  • Human pathogen, halophilic, lactose-negative, sucrose-negative; causes gastrointestinal diseases primarily from ingestion of cooked seafood
  • Cause of gastroenteritis; reservoir in birds and mammals, optimal growth at 42°C
  • Urease-positive; cause of fetal distress in cattle

Questão 74

Questão
V. parahaemolyticus, first described in Japan, is best characterized as
Responda
  • “String-test”-positive isolate; three serotypes—Ogawa (AB), Inaba (AC), Hikojima (ABC)
  • Human pathogen, halophilic, lactose-positive; produces heat-labile, extracellular toxin
  • Human pathogen, halophilic, lactose-negative, sucrose-negative; causes gastrointestinal diseases primarily from ingestion of cooked seafood
  • Cause of gastroenteritis; reservoir in birds and mammals, optimal growth at 42°C
  • Urease-positive; cause of fetal distress in cattle

Questão 75

Questão
Vibrio vulnificus, which can be found in the oceans and bays in temperate and tropical climates, is best characterized as
Responda
  • “String-test”-positive isolate; three serotypes—Ogawa (AB), Inaba (AC), Hikojima (ABC)
  • Human pathogen, halophilic, lactose-positive; produces heat-labile, extracellular toxin
  • Human pathogen, halophilic, lactose-negative, sucrose-negative; causes gastrointestinal diseases primarily from ingestion of cooked seafood
  • Cause of gastroenteritis; reservoir in birds and mammals, optimal growth at 42°C
  • Urease-positive; cause of fetal distress in cattle

Questão 76

Questão
Y. enterocolitica, formerly a Pasteurella, is best described by which of the following statements?
Responda
  • Commonly inhabits the canine respiratory tract and is an occasional pathogen for humans; strongly urease-positive
  • Pits agar, grows both in carbon dioxide and under anaerobic conditions, and is part of the normal oral cavity flora
  • Typically infects cattle, requires 5 to 10% carbon dioxide for growth, and is inhibited by the dye thionine
  • Typically is found in infected animal bites in humans and can cause hemorrhagic septicemia in animals
  • Manifests different biochemical and physiologic characteristics, depending on growth temperature, and causes a spectrum of human disease, most commonly mesenteric lymphadenitis

Questão 77

Questão
Brucella abortus, one of the three species causing brucellosis, a possible bioterrorism agent, is best described by which of the following statements?
Responda
  • Commonly inhabits the canine respiratory tract and is an occasional pathogen for humans; strongly urease-positive
  • Pits agar, grows both in carbon dioxide and under anaerobic conditions, and is part of the normal oral cavity flora
  • Typically infects cattle, requires 5 to 10% carbon dioxide for growth, and is inhibited by the dye thionine
  • Typically is found in infected animal bites in humans and can cause hemorrhagic septicemia in animals
  • Manifests different biochemical and physiologic characteristics, depending on growth temperature, and causes a spectrum of human disease, most commonly mesenteric lymphadenitis

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