Chapter 5 Requirements for Infection: Review questions

A. Multiple Choice

1. What is the general term for components of a pathogen that help it to be infectious?
A. Portals of entry
B. Parenteral characteristic
C. Transmissible factors
D. Virulence factors
E. Adhesion factors

2. Which is a portal of entry?

A. Mucous membrane
B. Skin surface
C. Gums
D. Skin cut
E. All of the choices

3. Which of the following diseases is not likely to have been acquired through a mucous
membrane-associated portal of entry?
A. Tuberculosis
B. Tetanus
C. Gonorrhea
D. Chickenpox
E. Cholera

4. Which of the following common pathogens is mismatched with the disease it causes?
A. Bordetella pertussis; whooping cough
B. Clostridium perfringens; tetanus
C. Vibrio cholera; cholera
D. Plasmodium falciparum; malaria
E. Treponema pallidum; syphilis

5. Which of the following is not a location where mucous membranes are found?
A. Lungs
B. Esophagus
C. Urinary bladder
D. Vagina
E. Pancreas

6. The respiratory tract is the main portal of entry for which of the following infectious
agents?
A. C. perfringens
B. HIV
C. Influenza virus
D. S. typhi
E. V. cholera

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7. Which of the following is not associated with the parenteral route?
A. Contaminated needles used by drug users
B. Transmission of malaria by mosquitoes
C. Contaminated food
D. Tick-derived Lyme disease
E. Blood products used by hemophiliacs

8. The fecaloral route of contamination refers to the situation where infectious pathogens
exit from the host through the _____ and enter another host through the _____.
A. anus; skin
B. Respiratory tract; gastrointestinal tract
C. Anus; mouth
D. Genitourinary tract; gastrointestinal tract
E. Gastrointestinal tract; genitourinary tract

9. Urinary tract infections are more prevalent in women than in men because
A. Women use tampons
B. Women prefer bathing to showering
C. Of the closer proximity of the anus to the urethra
D. The resident bacteria of women are different from those of men

10. An infection in an abrasion affecting only the epidermis of the skin is unlikely to spread
systemically to other sites because
A. The micro environment of the epidermis is unfavorable for microbial growth
B. The dermis beneath secretes antimicrobial substances that contain the infection
C. There is availability of blood in this layer of the skin
D. There is no availability of blood in this layer of the skin

11. What are produced by many pathogens to anchor them to host tissue?
A. Adhesions
B. Pellicles
C. Leucocidins
D. Hyaluronidase
E. Invasins

12. A(n) _____ is a thick film of protein secreted by mucous membranes in the mouth that
coats teeth and provides a substrate for Staphylococcus mutans to adhere and begin the
formation of a slime layer.
A. Biofilm
B. Pellicle
C. Extracellular matrix
D. Adhesion

13. Which of the following pathogens are virulent only if encapsulated?

A. Klebsiella pneumoniae
B. Bacillus anthracis

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C. Yersinia pestis
D. Streptococcus pneumoniae
E. All of the choices

14 To increase phagocytosis of encapsulated bacteria, the host produces

A. Antibiotics
B. Antibodies
C. Pseudopodia
D. Defensins
E. Adhesins

15. Both M protein and mycolic acid are

A. The same thing with different names
B. Made by Mycobacterium tuberculosis
C. Produced by the host as defensive molecules
D. Part of the cell wall
E. Inducers of phagocytosis

16. Which of the following made by bacteria destroys red blood cells in the host?
A. Coagulase
B. Hyaluronidase
C. Leukocidin
D. Collagenase
E. Hemolysin

17. Connective tissue in the host is compromised by the production of _____ by bacteria.
A. Hyaluronidase
B. Capsules
C. Streptokinase
D. M protein
E. Leukocidins

18. _____ enhances fibrin blood clots, whereas _____ breaks them down.
A. hemolysin; leukocidin
B. hyaluronidase; collagenase
C. coagulase; streptokinase
D. coagulase; collagenase
E. endotoxin; exotoxin

19. Which of the following is not a characteristic of exotoxins?

A. Highly antigenic
B. Cause disseminated intravascular clotting (DIC)
C. Converted to toxoids for vaccine use
D. Lethal in small quantities
E. Unstable at high temperatures

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20. The anthrax toxin is made up of
A. Cell binding protective antigen
B. Edema and lethal factors
C. Lethal factor
D. Hyaluronidase
E. Edema factor, lethal factor, and protective antigen

21. Which of the following toxins inhibits the release of acetylcholine from neuromuscular
junctions?
A. Botulinum toxin
B. Diphtheria toxin
C. Anthrax toxin
D. Tetanus toxin
E. Endotoxin

22. Lockjaw is a symptom of infection with

A. Clostridium perfringens
B. Clostridium botulinum
C. Bacillus anthracis
D. Clostridium tetani
E. Yersinia pestis

23. Which of the following exotoxins produces an effect that is the opposite of tetanus toxin?
A. Botulinum toxin
B. Diphtheria toxin
C. Anthrax toxin
D. Tetanus toxin
E. Endotoxin toxin

24. Rice-water stool is related to _____, which results in the release of large quantities of
_____.
A. Staphylococcal diarrhea; hemolysin
B. Bacillary dysentery; protein synthesis inhibitors
C. Cholera; electrolytes
D. Salmonella food poisoning; lipopolysaccharide
E. Tetanus; snare protein proteases

25. The reason for converting toxins to toxoids for vaccine use is
A. To reduce their antigenicity
B. To increase their toxicity
C. To stimulate better immune responses
D. To retain their antigenicity but destroy their toxicity

26. The portion of the lipopolysaccharide that is toxic to the host is the
A. subunit
B. The snare protein

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C. Lipid A
D. subunit

27. Disseminated intravascular clotting (DIC) is caused by

A. High levels of exotoxins
B. Low levels of exotoxins
C. High levels of endotoxins
D. Low levels of endotoxins
E. Gram-positive organisms

28. An autopsy report of a recently deceased person reveals Negri bodies in infected tissues.
The person was probably infected by
A. Respiratory syncytial virus
B. Mycobacterium tuberculosis
C. Bacillus anthracis
D. Rabies virus
E. Yersinia pestis

B. Essay

1. Explain how the bacterium Helicobacter pylori can survive the acidic environment of the
stomach. What is the consequence of a Helicobacter infection?

2. Identify three types of exotoxin and indicate their effect in the host. Provide two specific
examples of each type of exotoxin and the name of the organisms that produce it.

3. What is the test used to detect the presence of endotoxins on clinical instrumentation? Explain
how the test is performed.

Chapter 6 Transmission of Infection, the Compromised Host, Epidemiology, and

Diagnosing Infections: Review questions

A. Multiple Choice

1. Which of these describes vectors?

A. Vectors transmit organisms from one host to another
B. Vectors are always living organisms
C. Vectors must allow organisms to grow and increase in numbers
D. Mosquitos are not vectors
E. Fomites are not vectors

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2. An individual who seems healthy but infects others with disease-causing pathogens is
a(n)
A. Index case
B. Compromised patient
C. Immunodeficient patient
D. Public health hazard
E. Carrier

3. A disease that is transferred from animals to humans is called _____, with _____ serving
as an example.
A. Fomite-derived; malaria
B. Vector-derived; anthrax
C. Zoonotic; tuberculosis
D. Opportunistic; methicillin-resistant Staphylococcus aureus (MRSA)
E. Zoonotic; rabies

4. Which of the following zoonotic diseases is not transmitted by a tick bite?

A. Bubonic plague
B. Relapsing fever
C. Tularemia
D. Rocky Mountain spotted fever
E. Lyme disease

5. Tetanus, caused by Clostridium tetani, is often acquired by people walking barefooted

because its reservoir is
A. Food
B. Soil
C. Ticks
D. Water
E. Air

6. Contact transmission may occur indirectly when a nonliving intermediate, called a _____,
is involved.
A. Fomite
B. Vector
C. Droplet
E. Zoonotic agent

7. A factor that affects disease transmission is

A. Crowding
B. Travel
C. Potable water supply
D. War
E. All of the choices

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8. Chemicals with activities similar to antibiotics that are made by normal bacterial flora are
called
A. Bacteriocins
B. Opportunistic inhibitors
C. Super-antibiotics
D. Flora

9. Infections with _____ are particularly problematic in burn patients?

A. HIV
B. Escherichia coli
C. Pseudomonas aeruginosa
D. Borrelia burgdorferi
E. Clostridium tetani

10. The risk of a(n) _____ infection is increased in clinical settings.

A. Super-
B. Nosocomial
C. Opportunistic
D. Antibiotic susceptible
E. Ubiquitous

11. The most common anatomical site for a hospital-borne infection is

A. The urinary tract
B. The respiratory tract
C. Surgical wounds
D. The gastrointestinal tract
E. The skin

12. The statement Wash hands before and after patient contact and after removal of gloves.
comes from
A. Common sense
B. Biohazard control regulations
C. Surveillance measures
D. Center for Disease Control

13. Which term refers to diseases that persist in a population at low levels?
A. Endemic disease
B. Epidemic
C. Prevalent disease
D. Sporadic disease

14. In July 9, 2009 about 2% of patients visiting emergency rooms had influenza. This
number rose until in October of that year, when 10% had influenza. This was probably
a(n)
A. Superinfection
B. Sporadic outbreak

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C. Index case
D. Opportunistic outbreak
E. Epidemic

15. In 1832 Cholera was present in the Indian subcontinent, Russia, Hungary, Germany,
England, France, Canada and the USA. The technical term for this situation is a(n)
A. Pandemic
B. Epidemic
C. Global outbreak
D. Prospective disease
E. International emergency

16. Epidemiological studies that sometimes identify the index case are known as _____
studies.
A. Common-source
B. Retrospective
C. Prospective
D. Analytical
E. Descriptive

17. Control groups are required when performing _____ studies.

A. Descriptive epidemiological
B. Universal precaution
C. Superinfection
D. Nosocomial
E. Analytical epidemiological

18. Diseases that health care workers must report to the Centers for Disease Control are
known as _____ diseases.
A. Incidental
B. Nationally notifiable
C. Endemic
D. Propagated
E. Common-source

19. What is the mode of transmission for mononucleosis?

A. Droplets
B. Mosquito
C. Flea
D. Drinking water
E. Direct contact

20. The mode of transmission for the common cold is

A. Droplets
B. Mosquito
C. Flea

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D. Drinking water
E. Direct contact

21. What is the mode of transmission for plague?

A. Droplets
B. Mosquito
C. Flea
D. Drinking water
E. Direct contact

22. The mode of transmission for malaria is

A. Droplets
B. Mosquito
C. Flea
D. Drinking water
E. Direct contact

23. What is the mode of transmission for cholera?

A. Droplets
B. Mosquito
C. Flea
D. Drinking water
E. Direct contact

24. What is achieved when widespread vaccination is administered to a population as a

means of protecting unvaccinated potential hosts?
A. Immunosuppression
B. Super-vaccination
C. Multi-drug resistance
D. Quarantine
E. Herd immunity

B. Essay

1. It is sometimes difficult to identify human reservoirs of infectious disease. Discuss three

reasons and provide an example.

2. Identify and describe three types of reservoir with a role in the transmission of infectious
diseases to humans and provide an example of a disease for each type of reservoir.

3. The likelihood that a particular host will succumb to an infectious microorganism depends on
many factors. Identify and describe at least five different circumstances that contribute to disease
susceptibility in a host.

4. Explain why patients with malignant tumors who are receiving cytotoxic chemotherapy are
more susceptible to infections.

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Chapter 7 Principles of Disease: Review questions

A. Multiple Choice

1. What is the study of the underlying cause of a disease?

A. Toxemia
B. Etiology
C. Focal infection
D. Primary infection
E. Parasitism

2. The presence of bacteria in the blood is referred to as

A. Toxemia
B. Septicemia
C. Primary infection
D. Focal infection
E. Bacteremia

3. Which of the following defines an acute disease?

A. Pathogens use blood or lymph to access all organs
B. Symptoms reappear long after initial infection
C. Symptoms immediately follow a primary infection
D. Rapid symptom development and rapid subsequent improvement
E. Symptoms are between those of acute and chronic disease

4. Which of the following describes a secondary infection?

A. Pathogens use blood or lymph to access all organs
B. Symptoms reappear long after initial infection
C. Symptoms immediately follow a primary infection
D. Rapid symptom development and rapid subsequent improvement
E. Symptoms are between those of acute and chronic disease

5. Which of the following is the definition for systemic disease?

A. Pathogens use blood or lymph to access all organs
B. Symptoms reappear long after initial infection
C. Symptoms immediately follow a primary infection
D. Rapid symptom development and rapid subsequent improvement
E. Symptoms are between those of acute and chronic disease

6. Which of the following is the definition for latent disease?

A. Pathogens use blood or lymph to access all organs
B. Symptoms reappear long after initial infection
C. Symptoms immediately follow a primary infection
D. Rapid symptom development and rapid subsequent improvement
E. Symptoms are between those of acute and chronic disease

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7. If pathogens spread to the bloodstream or lymphatics and disseminate to other parts of the
body, a(n) _____ occurs.
A. Acute disease
B. Latent disease
C. Secondary infection
D. Systemic infection

8. The eyelash mite (Demodex folliculorum), is a harmless parasite which lives inside
human hair follicles. Its relationship to humans is
A. Parasitism
B. Mutualism
C. Microbial antagonism
D. Commensalism
E. Opportunism

9. Which of the following is an example of mutualism?

A. M. tuberculosis in the lungs
B. S. enterica serovar Typhi surviving in the gallbladder
C. Bacteria in the colon providing vitamins K and B
D. Chlamydia species surviving in epithelial cells of the genital tract
E. Saprophytic bacteria surviving on sloughed cells of the ear

10. Escherichia coli cells producing bacteriocins are participating in

A. Opportunism
B. Antibiotic resistance
C. Commensalism
D. Parasitism
E. Microbial antagonism

11. Diseases that take a long period to develop and also remain for long periods are referred
to as
A. Sub-acute
B. Acute
C. Chronic
D. Subclinical
E. Nosocomial

12. Chickenpox can cause a rash known as shingles. This is an example of

A. Sub-acute development
B. Granuloma formation
C. Reactivation
D. Megasome activation
E. Systemic spread

13. Carriers of Salmonella enterica serovar Typhi, the agents of typhoid fever, can have
persistent infections in the

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A. Gall bladder
B. Respiratory tract
C. Nasopharynx
D. Digestive tract

14. Which of the following is characteristic of toxic shock?

A. Granulomas form in the lungs
B. Neutrophils are inhibited
C. Phagolysosomes cannot form properly
D. The blood pressure decreases

B. Essay

1. Explain why normally harmless bacteria that comprise our microbial flora have the potential
to be pathogenic. Provide examples.

2. Explain why Kochs postulates cannot be applied to all pathogens.

3. List and describe the five specific periods of infection.

4. Name and describe the three strategies used by health professionals to control communicable
diseases. Characterize each of them.

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