Chapter 13: Microbe-Human Interactions: Infection, Disease, and

Epidemiology

Multiple Choice Questions

1. Infection occurs when

A. contaminants are present on the skin.
B. a person swallows microbes in/on food.
C. a person inhales microbes in the air.
D. pathogens enter and multiply in body tissues.
E. All of the choices are correct.

2. All infectious diseases

A. are contagious.
B. only occur in humans.
C. are caused by microorganisms or their products.
D. are caused by vectors.
E. involve viruses as the pathogen.

3. Which is not the terminology used for resident flora?

A. Pathogenic flora
B. Normal flora
C. Indigenous flora
D. Normal microflora
E. All of the choices are correct

4. Endogenous infectious agents arise from microbes that are

A. in food.
B. the patient's own normal flora.
C. on fomites.
D. in the air.
E. transmitted from one person to another.

5. The human body typically begins to be colonized by its normal flora

A. before birth, in utero.
B. during, and immediately after birth.
C. when a child first goes to school.
D. when an infant gets its first infectious disease.
E. during puberty.

6. Resident flora are found in/on the

A. skin.
B. mouth.
C. nasal passages.
D. large intestine.
E. All of the choices are correct.

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7. All of the following genera are considered resident flora of skin sites, except
A. Escherichia.
B. Staphylococcus.
C. Corynebacterium.
D. Micrococcus.
E. Mycobacterium.

8. Resident flora of the intestines include

A. Streptococcus.
B. Bacteroides.
C. Staphylococcus.
D. Haemophilus.
E. All of the choices are correct.

9. Which genus is resident flora of the mouth, large intestine, and, from puberty to
menopause, the vagina?
A. Lactobacillus
B. Streptococcus
C. Haemophilus
D. Escherichia
E. Mycobacterium

10. Which genus is the most common resident flora of mouth surfaces?
A. Lactobacillus
B. Streptococcus
C. Haemophilus
D. Escherichia
E. Mycobacterium

11. The body site with resident flora that produces beneficial body products, including
vitamin K and several other vitamins is the
A. skin.
B. mouth.
C. large intestine.
D. vagina.
E. nasal passages.

12. Virulence factors include all the following, except

A. capsules.
B. ribosomes.
C. exoenzymes.
D. endotoxin.
E. exotoxin.

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13. STORCH is an acronym that represents the most common
A. genera of resident flora.
B. sexually transmitted diseases.
C. portals of entry.
D. vectors.
E. infections of the fetus and neonate.

14. Microbial hyaluronidase, coagulase, and streptokinase are examples of

A. adhesive factors.
B. exotoxins.
C. hemolysins.
D. antiphagocytic factors.
E. exoenzymes.

15. Exotoxins are

A. proteins.
B. only released after a cell is damaged or lysed.
C. antiphagocytic factors.
D. secretions that always target nervous tissue.
E. lipopolysaccharides.

16. Enterotoxins are

A. virulence factors.
B. toxins that target the intestines.
C. proteins.
D. exotoxins.
E. All of the choices are correct.

17. Which is mismatched?

A. Fimbriae - adherence to substrate
B. Capsules - antiphagocytic factor
C. Coagulase - dissolve fibrin clots
D. Leukocidins - damage white blood cells
E. Hemolysins - damage red blood cells

18. The stage of an infectious disease when specific signs and symptoms are seen and the
pathogen is at peak activity is
A. prodromal stage.
B. convalescent stage.
C. incubation period.
D. period of invasion.
E. All of the choices are correct.

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19. The time from when pathogen first enters the body and begins to multiply, until
symptoms first appear is the
A. prodromal stage.
B. convalescent stage.
C. incubation period.
D. period of invasion.
E. All of the choices are correct.

20. The initial, brief period of early, general symptoms such as fatigue and muscle aches, is
the
A. prodromal stage.
B. convalescent stage.
C. incubation period.
D. period of invasion.
E. All of the choices are correct.

21. Which is mismatched?

A. Secondary infection - infection spreads to several tissue sites
B. Mixed infection - several agents established at infection site
C. Acute infection - rapid onset of severe, short-lived symptoms
D. Local infection - pathogen remains at or near entry site
E. Toxemia - pathogen's toxins carried by the blood to target tissues

22. The subjective evidence of disease sensed by the patient is termed

A. syndrome.
B. symptom.
C. sign.
D. pathology.
E. inflammation.

23. The objective, measurable evidence of disease evaluated by an observer is termed

A. syndrome.
B. symptom.
C. sign.
D. pathology.
E. inflammation.

24. Local edema, swollen lymph nodes, fever, soreness, and abscesses are indications of
A. toxemia.
B. inflammation.
C. sequelae.
D. a syndrome.
E. latency.

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25. The study of the frequency and distribution of a disease in a defined population is
A. pathology.
B. clinical microbiology.
C. medicine.
D. immunology.
E. epidemiology.

26. The principal government agency responsible for tracking infectious diseases in the
United States is the
A. Centers for Disease Control and Prevention.
B. World Health Organization.
C. National Institutes of Health.
D. United States Department of Agriculture.
E. Infection Control Committee.

27. The number of new cases of a disease in a population over a specific period of time
compared with the healthy population is the
A. mortality rate.
B. morbidity rate.
C. incidence rate.
D. prevalence rate.
E. epidemic rate.

28. A disease that has a steady frequency over time in a population is

A. epidemic.
B. endemic.
C. pandemic.
D. sporadic.
E. chronic.

29. The primary, natural habitat of a pathogen where it continues to exist is called the
A. fomite.
B. carrier.
C. vector.
D. reservoir.
E. source.

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30. Someone who inconspicuously harbors a pathogen and spreads it to others is a
A. fomite.
B. carrier.
C. vector.
D. reservoir.
E. source.

31. An animal, such as an arthropod, that transmits a pathogen from one host to another is a
A. fomite.
B. carrier.
C. vector.
D. reservoir.
E. source.

32. An inanimate object that harbors and transmits a pathogen is a

A. fomite.
B. carrier.
C. vector.
D. reservoir.
E. source.

33. Which of the following is an example of vertical transmission?

A. Drinking contaminated water.
B. A sneeze transmitting a cold.
C. Oral-fecal transmission involving a diaper.
D. A mosquito bite.
E. A mother transmitting syphilis to her fetus.

34. Reservoirs include

A. humans
B. animals
C. soil
D. water
E. All of the choices are correct

35. A laboratory technologist splashed a blood specimen onto his face, eyes, nose, and mouth.
This specimen was from an HIV positive patient. If this blood exposure leads to HIV infection
in the technologist, the transmission route is
A. direct.
B. fomite.
C. vehicle.
D. droplet nuclei.
E. aerosols.

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36. The dried residues of fine droplets from mucus or saliva that harbor and transmit
pathogen are
A. fomites.
B. aerosols.
C. mechanical vectors.
D. droplet nuclei.
E. biological vectors.

37. Animals that participate in the life cycles of pathogens and transmit pathogens from host
to host are
A. fomites.
B. aerosols.
C. mechanical vectors.
D. droplet nuclei.
E. biological vectors.

38. Nosocomial infections involve all the following, except

A. they are only transmitted by medical personnel.
B. they often involve the patient's urinary tract and surgical incisions.
C. the patient's resident flora can be the infectious agent.
D. Escherichia coli and staphylococci are common infectious agents.
E. medical and surgical asepsis help lower their occurrence.

39. When would Koch's Postulates be utilized?

A. To determine the cause of a patient's illness in a hospital microbiology lab.
B. To develop a new antibiotic in a pharmaceutical lab.
C. To determine the cause of a new disease in a microbiology research lab.
D. To formulate a vaccine against a new pathogen in a genetic engineering lab.
E. Whenever the scientific method is used to investigate a microbiological problem.

40. All of the following are correct about mechanical vectors, except
A. cockroaches are an example.
B. the vector can carry the pathogen on its feet and mouthparts.
C. the vector is important to the life cycle of the infectious agent.
D. they can spread viral, bacterial, protozoan, and worm infections.
E. some, like flies feed on garbage and feces.

41. Which of the following is correct about skatole?

A. It is the general term for the flora of the gastrointestinal tract.
B. It is a mixture of amines and gases that gives feces its characteristic stench.
C. It is another term for the sexually transmitted disease, syphilis.
D. It is a general term for the endogenous flora in humans.
E. It is a chemical released by gram positive bacilli during inflammation.

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42. Which portal of entry is the most commonly used by pathogens?
A. urogenital
B. gastrointestinal
C. respiratory
D. skin
E. They are all equally used as portals.

43. If the ID for gonorrhea is 1,000 cells and the ID for tuberculosis is 10 cells, which
organism is more virulent?
A. Neisseria gonorrhoeae
B. Mycobacterium tuberculosis
C. They are equally virulent
D. It is impossible to determine

44. All of the following are signs of infectious diseases, except

A. fever.
B. leucopenia.
C. swollen lymph nodes.
D. antibodies in serum.
E. nausea.

45. When a disease occurs occasionally at irregular intervals and random locales, it is
referred to as
A. sporadic.
B. pandemic.
C. endemic.
D. epidemic.
E. chronic.

46. Joe contracted Hepatitis A by eating contaminated doughnuts from a local bakery. The
source of the disease is ___________ and the reservoir is ______________.
A. Joe, the doughnut
B. the doughnut, humans
C. humans, flour
D. flour, Joe
E. humans, Joe

47. A person with which occupation is most at risk for a zoonotic disease?
A. accountant
B. teacher
C. nurse
D. dental hygienist
E. forest ranger

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48. Marion is going to the hospital for a triple bypass operation. She will have general
anesthesia, intravenous catheter, surgical wounds, and a urinary catheter. Which nosocomial
infection is she at greatest risk for contracting?
A. respiratory
B. septicemia
C. urinary tract
D. surgical site
E. meningitis

49. Some diseases can be vertically transmitted. This is understood to mean the disease is
transmitted
A. from parent to offspring via milk, ovum, sperm, or placenta.
B. from parent to offspring via respiratory route.
C. by contact between siblings.
D. between people living or working in the same building.
E. between higher and lower animals.

50. A veterinary hospital had an outbreak of Salmonella infantis. Within the facility, how can
Salmonella can be spread?
A. Unwashed hands
B. Feces
C. Contaminated objects
D. Multiple animals using the same stalls without proper cleaning
E. All of the choices are correct

51. A student has their teeth cleaned. The hygienist nicks their gum tissue. The student
develops endocarditis due to Streptococcus. What kind of pattern of infection is this?
A. Localized
B. Mixed Infection
C. Focal
D. Systemic
E. All of the choices are correct

True / False Questions

52. Most of the skin's resident flora is found in the uppermost, superficial layers of the
epidermis. FALSE

53. Under certain circumstances, a person's resident flora can be opportunistic pathogens.
TRUE

54. The virulence factors of a pathogen are established by how strong or weak a patient's
body defenses are at the time of infection. FALSE

55. The Centers for Disease Control and Prevention assigns the most virulent microbes
known to cause human disease to biosafety level 4. TRUE

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56. A fetus can get an infection when a pathogen in the mother's blood is capable of crossing
the placenta to the fetal circulation and tissues. TRUE

57. When an infected person is in the incubation period, that person cannot transmit the
pathogen to others. FALSE

58. Septicemia means that a pathogen is present and multiplying in the blood. TRUE

59. Sentinel animals are monitored for specific diseases in order to determine the potential
for human exposure to a disease. TRUE

60. Fomites, food, and air serve as indirect transmission routes of pathogens. TRUE

Fill in the Blank Questions

61. Leukopenia is the _____ in the level of white blood cells in a patient. decrease

62. A _____ is an infection indigenous to animals that can, on occasion, be transmitted to

humans. zoonosis

63. _____ carriers are shedding and transmitting pathogen while they are recovering from an
infectious disease. Convalescent

64. _____ is the presence of small numbers of bacteria in the blood. Bacteremia

65. _____ are toxins that are the lipopolysaccharide of the outer membrane of gram negative
cell walls. Endotoxins

66. _____ are various bacterial enzymes that dissolve fibrin clots. Kinases

67. The total number of deaths in a population due to a disease is the _____ rate.
mortality

68. _____ are a set of criteria used to identify and link a specific microorganism as the
etiologic agent of a new infectious disease. Koch's Postulates

Short Answer Questions

69. Discuss 5 specific contributing factors in the occurrence of nosocomial infections, and
then discuss 3 actions that can help decrease their rate at health-care facilities.

70. Compare and contrast exotoxins and endotoxins with regard to their: a) chemical nature,
b) source, c) effects on human body cells and resulting symptoms, and d) examples.

71. Select 5 specific virulence factors and explain how each factor increases a pathogen's
virulence.

72. Describe the criteria that make up Koch's Postulates and discuss their importance in
modern epidemiology.

73. Write about some ways to prevent any contamination in lab while making sub-cultures.

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