Microbiology – Chapter 13

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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

D) pathogens enter and multiply in body tissues (p.387)

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

C) are caused by microorganisms or their products (p.387)

Which is not terminology used for resident flora

A) pathogenic flora
B) normal flora
C) indigenous flora
D) normal microflora
E) all of the choices are correct

A) pathogenic flora (p.387)

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 form one person to another

B) the patient’s own normal flora (p. 397)

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

B) during, and immediately after birth (p.389)

Resident flora are found in/on the

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

E) all of the choices are correct (p.390-392)

All of the following genera are considered resident flora of skin sites except

A) Escherichia
B) Staphylococcus
C) Corynebacterium
D) Micrococcus
E) Mycobacterium

A) Escherichia (p.390-391)

Resident flora of the intestines include:

A) Streptococcus
B) Bacteroides
C) Staphylococcus
D) Haemophilus
E) all of the choices are correct

B) Bacteroides (p.392)

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

A) Lactobacillus (p.391-393)

Which genus is the most common resident flora of mouth surfaces?

A) Lactobacillus
B) Streptococcus
C) Haemophilus
D) Escherichia
E) Mycobacterium

B) Streptococcus (p.391)

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

C) large intestine (p.392)

Virulence factors include all the following except

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

B) ribosomes (p.400-402)

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

E) infections of the fetus and neonate (p.399)

Microbial hyaluronidase, coagulase, and streptokinase are examples of

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

E) exoenzymes (p.402)

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

A) proteins (p.402)

Enterotoxins are

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

E) all of the choices are correct (p.399-402)

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

C) coagulase – dissolve fibrin clots (p.402)

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

D) period of invasion (p.405)

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

C) incubation period (p. 404)

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

A) prodromal stage (p.405)

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

A) secondary infection – infection spreads to several tissue sites (p. 406)

The subjective evidence of disease sensed by the patient is termed

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

B) symptom (p.406)

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

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

C) sign (p.406)

Local edema, swollen lymph nodes, fever, soreness, and abscesses are indications of

A) toxemia
B) inflammation
C) sequelae
D) a syndrome
E) latency

B) inflammation (p.406)

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

E) epidemiology (p. 415)

The principal government agency responsible for tracking infectious diseases in the United States is

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

A) Centers for Disease Control and Prevention (p.416)

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

C) incidence rate (p. 416)

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

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

B) endemic (p.416)

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

D) reservoir (p.409)

Someone who inconspicuously harbors a pathogen and spreads it to others is a

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

B) carrier (p. 409)

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

C) vector (p. 409)

An inanimate object that harbors and transmits a pathogen is a

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

A) fomite (p. 412)

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

E) a mother transmitting syphilis to her fetus (p. 411)

Reservoirs include

A) humans
B) animals
C) soil
D) water
E) all of the choices are correct

E) all of the choices are correct (p.409)

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

A) direct (p.412)

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

D) droplet nuclei (p. 413)

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

E) biological vectors (p.409)

Nosocomial infections involve all the following except

A) are only transmitted by medical personnel
B) 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

A) are only transmitted by medical personnel (p. 413)

When would Koch’s Postulates be utilized

A) determination of the cause of a patient’s illness in a hospital microbiology lab
B) development of a new antibiotic in a pharmaceutical lab
C) determination of the cause of a new disease in a microbiology research lab
D) formulation of a vaccine against a new pathogen in a genetic engineering lab
E) whenever the scientific method is used to investigate a microbiological problem

C) determination of the cause of a new disease in a microbiology research lab (p. 419)

All of the following sites in the gastrointestinal tract harbor appreciable permanent flora except

A) small intestine.
B) large intestine.
C) oral cavity.
D) rectum.
E) None of the choices; they all have flora.

A) small intestine. (p.391)

Which of the following is correct about skatole?

A) It is the general term for the flora of the gastrointestinal tract.
B) It is s 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 rods during inflammation.

B) It is s mixture of amines and gases that gives feces its characteristic stench. (p. 392)

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.

C) respiratory (p.397)

If the ID for gonorrhea is 1,000 cells and the ID for tuberculosis is 10 cells, which organism is more virulent?

A) Neisseria gonorrhea
B) Mycobacterium tuberculosis
C) They are equally virulent
D) It is impossible to determine.

B) Mycobacterium tuberculosis (p. 399) – smaller infectious doses have greater virulence

All of the following are signs of infectious diseases except

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

E) nausea. (p. 406-407)

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.

A) sporadic. (p.416)

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

B) the doughnut, humans (p.409)

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

E) forest ranger (p. 410)

Marion is going to the hospital for a triple bypass operation. She will have general anesthesia, intravenous catheter. Which nosocomial infection is she at greatest risk for contracting?

A) respiratory
B) septicemia
C) urinary tract
D) surgical site
E) meningitis

C) urinary tract (p. 413-414)

Some disease 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.

A) from parent to offspring via milk, ovum, sperm, or placenta. (p. 411)

Most of the skin’s resident flora are found in the uppermost, superficial layers of the epidermis

A) True
B) False

B) False (p.397)

Under certain circumstances, a person’s resident flora can be opportunistic pathogens.

A) True
B) False

A) True (p. 389)

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

A) True
B) False

B) False (p.399) ??

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

A) True
B) False

A) True (p. 416)

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.

A) True
B) False

A) True (p.398)

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

A) True
B) False

B) False (p. 409)

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

A) True
B) False

B) False (p. 407)

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

A) True
B) False

A) True (p. 410-411)

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

A) True
B) False

A) True (p.412)

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

decrease (p. 407)

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

zoonosis (p.409)

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

Convalescent (p. 409)

A _____ is the presence of small numbers of bacteria in the blood.

bacteremia (p. 407)

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

Endotoxin (p.403)

_____ are various bacterial enzymes that dissolve fibrin clots.

Bacterial kinases (Streptokinase, Staphylokinase) (p. 402)

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

mortality (p. 416)

_____ 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 (p.419)

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.

Nosocomial infections are acquired in a hospital directly or indirectly from fomites, surgical procedures, medical equipment, other patients, medical personnel, visitors, exposure to drug-resistant microorganisms, air and water. Medical asepsis includes practices that lower the microbial load in patients, caregivers, and hospital environment which include proper hand washing, disinfection, sanitization, and patient isolation. Surgical asepsis ensures that all surgical procedures are conducted under sterile condition. Using universal precaution (UPs) and body substance isolation (BSI) techniques. (p. 413-414)

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.

A) Exotoxins have small protein & endotoxins have lipopolysaccharide of cell wall B) Exotoxins have a few gram-positive and gram-negative & endotoxins have all gram-negative bacteria C) Exotoxins are specific to a cell type (blood, liver, nerve) – does not usually stimulate fever & endotoxins are systemic: fever, inflammation, weakness, shock – fever stimulation D) Exotoxins examples are tetanus, diphtheria, cholera, anthrax & endotoxins are meningitis, endotoxic shock, salmonellosis. * see Table 13.9 (p. 403)

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

1) Mucinase digests the protective coating on mucous membranes and is a factor in amoebic dysentery. 2) Keratinase digests the principal component of skin and hair, and is secreted by fungi that cause ringworm. 3) Collagenase digests the principal fiber of connective tissue and is an invasive factor of Clostridium species and certain worms. 4) Hyaluonidase digests hyaluronic acid, the ground substance that cements animal cells together. 5) Hemotoxins lyse red blood cells (p. 402)

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

Criteria that makes up Koch’s Postulates are: 1. find evidence of a particular microbe in every case of a disease 2. isolate that microbe from an infected subject and cultivate it artificially in the laboratory 3. inoculate a susceptible healthy subject with the laboratory isolate and observe the same resultant disease 4. re-isolate the agent from this subject. Their importance in modern epidemiology is to develop a standard for determining the precise etiologic, or causative, agent. (p. 419)

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