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Home , Borrelia recurrentis, Endospore, Ureaplasma urealyticum

DAMB 711 Final Exam B 100 points December 16, 2009

Your name (Print Clearly):

______

Exam # ______

Seat # ______

CPA # ______

I. Multiple Choice: Choose the ONE BEST answer. Mark the correct answer on Part 1 of the answer sheet. Use a #2 pencil.

1. Which of the following describes the infectious agent of a that causes atypical pneumoniae?

A. fecal material from a patient harboring typhi B. of botulinum C. pallidum in a chancre D. the reticulate body of trachomatis. E. the elementary body of

2. Many are intracellular parasites with specialized mechanisms for survival inside cells. One of the following is not a mechanism for survival in the cell. Which one?

A. ’s escape from the endosome. B. Mycobacterial prevention of phagosome and lysosome fusion. C. Salmonella’s transcription of an acid tolerance response gene. D. Aggregatibacter’s leukotoxin

3. Diabetic patients are predisposed to ______caused by______:

A. athlete’s foot: Candida albicans B. typhus: typhi C. rhino-cerebral zygomycosis: Mucor D. hypersensitivities: Aspergillus fumigatus E. lung : Coccidioides immitis

4. Chalmydia psittaci and Cryptococcus neoformans have the following in common:

A. They are both molds. B. They are both yeasts. C. Their infectious agents are transmitted in avian feces. D. A, B and C are true E. B and C are true.

5. Members of the are unique among bacteria because they:

A. have a rudimentary life cycle. B. have a primary arthropod host that is both a vector and a reservoir. C. have sterols stabilizing the . D. have human intermediate host.

6. that have a binding mechanism like the n-methylphenylalanine :

A. include Orthomyxoviruses. B. have neuraminidase activity. C. include naeslundii. D. A, B and C. E. All except C.

2 7. The Rickettsiales cause symptoms of intense headache, fever and rash; however ______does not cause a rash and can cause complications of myocarditis and pericarditis.

A. monocytogenes B. Rickettsia rickettsii C. Rickettsia typhi D. E. Erlichia chafeensis

8. The arthropod vector for, Rickettsia prowazekii, the cause of epidemic typhus, is:

A. a louse that is parasitic on a human B. a tick that is parasitic on a white tailed deer C. a flea that is parasitic on a mouse D. a tick that is parasitic on a sheep

9. Adult diseases caused by are spread through:

A. respiratory droplets. B. transplacental passage. C. consumption of contaminated meat and vegetables D. contact with family pets. E. B and C.

10. One of the following is a common cause of non-gonococcal , causes co-infections with Neisseria gonorrhoea, and some strains can cause a chronic conjunctivitis that leads to blindness. Which one?

A. B. C. Cryptococcus neoformans D. Listeria monocytogenes E.

11. This bacterium is never transmitted from human to human; instead it is transmitted from water sources where it may be parasitic on amoebae.

A. aeruginosa B. C. Legionella pneumophilia D. Rickettsia typhii

12. White patches that appear on the tongue and oral mucosa of AIDS patients:

A. may be a Candida albicans B. may be an infection caused by the Epstein-Barr virus C. A and B are true.

3 13. A Candida albicans infection that is caused by restricted contact between the maxillary mucosa and saliva:

A. denture induced stomatitis B. oral thrush C. angular chelitis D. midline glossitis

14. Untreated caries predisposes a patient to pulpitis. Usually this happens, because bacteria gain access to:

A. the apical foramina B. lateral canals C. periodontal ligament D. dentinal tubules E. periapical lesions

15. The infectious agent of a dimorphic fungus is a/an:

A. elementary body. B. . C. yeast cell. D. conidiospore. E. capsid

16. The bacterium that is the cause of 90% of aggressive periodontitis in adolescents is:

A. B. C. Aggregatibacter actinomycetemcomitans D. Campylobacter rectus

17. Statement A: LPS is elaborated by most of the periodontal and endodontic pathogens. Statement B: LPS induces tissue destruction by activating the host immune system. Statement C: LPS induces inflammation which leads to an excess of osteoclasts in the lesion and resulting bone resorption.

A. Only Statement A is true. B. Only Statement B is true. C. Only Statement C is true. D. All of the statements are true. E. None of the statements are true.

18. Collagenase is a virulence factor and serves as a means of obtaining a carbon source for:

A. Porphyromonas gingivalis B. Campylobacter rectus C. D. E. Aggregatibacter actinomycetemcomitans

4 19. The BPB that is/are most often isolated from infected pulp with acute apical abscess.

A. Porphyromonas endodontalis B. Porphyromonas gingivalis C. Prevotella intermedia D. A and B

20. Which of the following microorganisms causes an esophagitis that is seen in AIDS patients?

A. Cryptococcus neoformans B. Aspergillus fumigatis C. Histoplasma capsulatum D. Coccidioides immitis E. Candida albicans

21. The BPB that is/are most often associated with pregnancy gingivitis:

A. Porphyromonas endodontalis B. Porphyromonas gingivalis C. Prevotella intermedia D. A and B

22. Which of the following microorganisms is a common cause of periodontitis in insulin dependent diabetic patients and requires formate and fumarate to grow in vitro?

A. Candida albicans B. Treponema denticola C. Campylobacter rectus D. E. Prevotella intermedia

23. Which of the following microorganisms is the cause of interstitial plasma cell pneumonia?

A. Chlamydia pneumoniae B. Aspergillus fumigatis C. Histoplasma capsulatum D. Cryptococcus neoformans E. Pneumocystis carinii

24. ______, ______, and ______are in the “Red Complex” and are associated with the symptoms of ______.

A. Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Treponema denticola: necrotizing ulcerative gingivitis B. Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola: aggressive periodontitis C. Prevotella intermedia, Tannerella forsythia and Treponema denticola: chronic periodontitis D. Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola: chronic periodontitis

5 Use the choices below to answer. Questions 25 through 28 refer to the sequence of plaque formation.

A. If it describes secondary plaque buildup and maturation. B. If it describes the initial bacterial colonization of the dental pellicle. C. If it describes formation of the dental pellicle on the tooth surface. D. If it does not describe plaque formation.

B25. Actinomyces viscosus attaches to the tooth surface via type 1 fimbriae and to sanguis via type 2 fimbriae

D26. Crevicular fluid components such as albumin and inorganic phosphates adhere to the cemental surface of the tooth.

C27. Calcium and phosphate ions attach salivary mucins to the enamel surface of the tooth.

A28. Co-aggregating pairs of anaerobic Gram-negative rods form a on the tooth surface.

29. To be considered etiologic in periodontal disease a bacterium must satisfy Socransky's Postulates. Which situation below, would not satisfy Socransky’s postulates?

A. A specific bacterial species is eliminated from a periodontal lesion and the lesion begins to heal.

B. A patient’s serum has high antibody titers to a specific bacterium that is isolated from a disease site.

C. The patient in A has 2 teeth that show deep pockets with bleeding on probing. The bacterial species described in A is present in large numbers in these pockets and is not found in subgingival sites anywhere else in the mouth. .

D. The bacterial species in A is tested in vitro and does not possess virulence factors that would cause tissue destruction, and it is Gram positive.

30. Which of the following microflora would most likely be found in a periodontal lesion?

A. Gram negative, facultatively anaerobic, nonmotile rods B. Gram positive, facultatively anaerobic, cocci C Gram negative and gram positive facultative rods D. Gram negative, anaerobic, motile rods and spirochetes

31. The DaPT is not:

A. a vaccine B. partially comprised of Fha, pertussis toxin and pertactin C. partially comprised of two toxoids. D. partially comprised of inactivated Bordetella pertussis E. C and D

6 32. Dental plaque is a microbiological biofilm. The statements, below, describe some characteristics of the biofilm; however, one is not characteristic. Which one?

A. The bacteria in the biofilm establish a food chain in which the metabolic by products of one species furnish nutrients for another species.

B. The biofilm is encased in a polysaccharide matrix that is absorbed from saliva in the oral cavity.

C. The water channels in the biofilm are the only conduits for materials to enter or leave the biofilm.

D. Bacteria can survive within the biofilm without dividing.

E. Bacteria living in a biofilm are up to 1000X more resistant to antimicrobials than bacteria growing planktonic conditions.

33. Hutchinson’s teeth are the result of a congenital infection with:

A. B. HIV C. D. Neisseria gonorrhoea E. burghdorferi

34. One of the following is transmitted almost exclusively through human contact. Which one?

A. Campylobacter jejuni B. Salmonella typhimurium C. Shigella sonnei D. Yersinia enterocolitica E. Listeria monocytogenes

35. Carriers are very important to the spread of a disease caused by one of the following bacteria. Which one?

A. Helicobacter pylori B. Salmonella typhi C. cholera D. Campylobacter jejuni E. Yersinia enterocolitica

36. The antigen used to subdivide S. pyogenes into serotypes, the M protein, is also an important virulence factor that:

A. forms a fibrin clot around the cell to protect it from phagocytosis B. is an adhesin that binds keratinocytes C. is a toxin D. A, B and C. E. A and B.

7 37. Pseudomonas aeruginosa causes diseases that are characterized by necrotizing lesions. A virulence factor that invades and kills cells is primarily responsible for this. Which one?

A. A B. Uronic acid capsule C. elastase D. the N-methylphenylalanine pilus E.

38. The window of opportunity for laboratory diagnosis of whooping cough is during the:

A. Paroxysmal stage B. Convalescent stage C. Latent stage D. Incubation stage E. Prodromal stage

39. A patient presents with a high fever and rose spots on his chest and abdomen. Laboratory diagnosis of this condition will require:

A. sputum B. blood C. stool D. A, B and C. E. B and C.

40. Media containing tellurite is:

A. selective for faecalis B. differential for C. differential for Corynebacterium diphtheria D. selective and differential for Staphylococcus aureus E. selective and differential for Corynebacterium diphtheria

41. Staphylococcus aureus is potentially etiologic in all except the following:

A. B. food poisoning C. scalded skin syndrome D. E. pyoarthrosis

42. Gangrene (necrotizing fasciitis) caused by is primarily due to the action of this .

A. lecithinase (phospholipase C) B. hyaluronidase C. collagenase D. lipase E. streptokinase

8 43. This bacterium is an intracellular parasite whose virulence depends on actin-dependent intracellular motility and intercellular spread:

A. Clostridium difficile. B. Shigella flexneri. C. Listeria monocytogenes. D. A and B. E. B and C.

44. All of the following are resistant to stomach acid except:

A. botulinum toxin B. Shigella sonei C. staphylococcal enterotoxin D. Helicobacter pylori E. toxin

45. A child suffers from a pharyngitis with symptoms of redness, edema and a suppurative exudate in the oropharynx. The child is also running a fever in excess of 99o F. The child is predisposed to this sequelae.

A. toxic shock syndrome B. C. acute glomerulonephritis D. rheumatoid arthritis

46. Gangrene caused by is primarily due to the action of this enzyme.

A. lecithinase (phospholipase C) B. hyaluronidase C. collagenase D. lipase E. streptokinase

47. Which structural component of bacteria is unique to bacterial endospores?

A. B. nucleic acid C. lipid A D. O antigen E.

48. Otitis media is a childhood disease that is caused by:

A. Pseudomonas aeruginosa and B. non-typeable Haemophilus influenzae and Listeria monocytogenes C. non-typeable Haemophilus influenzae and Bordetella pertussis D. non-typeable Haemophilus influenzae and Streptococcus pneumoniae E. Pseudomonas aeruginosa and

9 49. All except the following, would be a positive laboratory test for Neisseria meningitidis.

A. Gram negative diplococci in cerebral spinal fluid B. microscopic observation of a large polysaccharide capsule C. positive D. oxidase positive E. growth in the presence of colistin, vancomycin and amphoteracin B

50. ______meningitis is most often caused by Neisseria meningitidis:

A. new borne B. epidemic C. childhood (5 months to 5 years) D. nosocomial E. transplacental

51. The virulence factor for Neisseria meningitidis that is expressed by all bacteria that cause meningitis and pneumoniae is:

A. the N-methyl phenylalanine pilus B. the polysaccharide capsule C. antigenic variation D. LPS E. an IgA1 protease

52. Only a competent bacterium can be a recipient cell in this form of bacterial gene transfer:

A. conjugation B. transduction C. transformation D. locomotion

53. The infectious form of is:

A. Disseminated (miliary) tuberculosis. B. Secondary (active) tuberculosis. C. The tubercle. D. Latent tuberculosis.

54. A new strain of influenzae virus may emerge as a result of:

A. antigenic drift.

B. a mixed infection with two or more strains of influenzae virus one of which is an avian strain.

C. antigenic variation

D. reassortment of the genes which encode the reverse transcriptase.

E. All except A.

10 55. A middle-aged patient presents with wasting and paralysis of the thigh and calf muscles. The patient’s medical history indicates a childhood disease characterized by a flaccid paralysis. The etiology of the disease is likely:

A. a congenital HSV2. B. . C. the polio virus. D. . E. the Coxsackie virus.

56. The virus and zoster virus are latent in ______.

A. neurons. B. leukocytes. C. lymph nodes. D. liver.

57. This\these HBV marker(s) indicate(s) an early acute infection.

A. HBsAg + HBeAg + Anti-HBc IgM B. HBsAg + Anti-HBs IgG + Anti-HBc IgG C. HBsAg + anti-HBc IgG D. HBsAg

58. A patient with shingles is most likely to have had a previous infection with:

A. Vaccinia. B. Zoster. C. Varicella. D. 1. E. herpes simplex virus 2.

59. A species of bacteria that does not induce its own phagocytosis.

A. Salmonella typhi B. Rickettsia rickettsii C. Porphyromonas gingivalis D. Listeria monocytogenes E. Legionella pneumophilia

60. Saliva has some of the same antimicrobial agents found in the phagolysosome:

A. The statement is true. B. The statement is false.

61. A patient suffers intermittent episodes of arthritis; these persist for several months. The first symptoms of arthritis appear 1 year after a disease with symptoms of panophthalmitis and musculoskeletal pain. Six months prior to the panophthalmitis she had a strange skin lesion that resembled a bull’s-eye. This patient has been infected with:

A. Treponema pallidum. B. Borrelia recurrentis. C. Borrelia burghdorferi. D. Vibrio vulnificus. E. Helicobacter pylori.

11 62. Detection of this marker in serum in the absence of other HBV markers indicates vaccination against hepatitis B.

A. anti-HBcAg IgG B. HBeAg C. anti-HBsAg IgG D. HBsAg

63. Infectious hepatitis:

A. is blood borne. B. is HAV. C. is spread through fecal/oral contamination. D. has a short incubation time. E. All except A are true.

64. The bacterium that is etiologic in actinomycosis is:

A. Actinomyces viscosus. B. Actinomyces bovis. C. Actinomyces israelii. D. Nocardia asteroides.

65. Characteristics of the Staphylococcus aureus enterotoxin that make it a dangerous cause of food poisoning:

A. It resists heat. B. Staphylococcus aureus grows in high salt environments. C. It resists proteases such as trypsin. D. A and C. E. A, B and C.

66. Bacteria that grow in low oxygen levels of 5 to 10% are:

A. facultative anaerobes B. microaerophilic C. aerobes D. facultative aerobes E. capneic

67. The streptococci that cause human caries are:

A. Streptococcus cricetus and S. ferus B. S. gordonii and S. mutans C. S. mutans and S. sobrinus D. S. salivarius and S. sobrinus

68. The most important polymer that comprises the extracellular matrix of a persistent cariogenic biofilm will be the:

A. alpha-1,3-branched levan B. alpha-1,3-branched mutan C. alpha-1,6-banched glucan D. alpha-1,6-branched mutan

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69. Hepatitis D cannot cause disease except in a coinfection with:

A. HAV B. HBV C. HCV D. HSV1 E. HHV7

70. A Staphylococcus aureus that cannot produce this enzyme is avirulent.

A. B. lipase C. D. hyaluronidase E. staphylokinase

71. One of the following viruses is not oncogenic, which one?

A. HAV B. HCV C. HBV D. Papilloma virus E. Epstein Barr virus

72. If the portal of exit and portal of entry of a disease is on the same person:

A. this is an endogenous infection. B. this is evidence that the disease is spread by a fomite. C. this is evidence of spread by a biological vector. D. the individual must be immunocompromised.

73. A unit of measurement used to describe the size of bacteria:

A. a foot B. a micrometer (10-6 meters) C. a millimeter (10-3 meters) D. a meter

74. The antibacterial substances and penicillin attack:

A. the lipopolysaccharide B. C. teichoic acids D. the

13 75. The highest level of infection control in a hospital includes HEPA (high efficiency particulate air) filtration of rooms housing patients that are infected with:

A. tuberculosis, varicella and influenzae because these organisms can become airborne

B. coli, Staphylococcus aureus and Klebsiella pneumoniae because these organisms can become airborne

C. Mycobacterium tuberculosis, varicella and influenzae because these organisms are spread through droplet inhalation

D. , Staphylococcus aureus and Klebsiella pneumoniae because these organisms tend to develop resistance

76. Bacteria are only susceptible to penicillin during the log (exponential) phase of because:

A. the bacterial cells are producing new B. the bacterial cells are actively dividing and producing new peptidoglycan C. the cell population has exhausted all nutrients and cell division is slowing down D. more cells are dying than are dividing

77. Dental equipment that is reusable and that is used in surgical procedures:

A. Is critical and should be disinfected with a high level . B. Is semi-critical and should be disinfected with a low level disinfectant. C. Is critical and should be sterilized. D. Is semi-critical and should be disinfected with a high level disinfectant or sterilized. E. Is non-critical and should be sterilized.

78. OSHA regulates the following:

A. Hazardous waste disposal. B. Employee Exposure to blood borne pathogens. C. Employee Exposure to hazardous chemicals. D. Both A and B. E. Both B and C.

79. Bacteria as a group produce a variety of acids, gasses, aldehydes and alcohols through fermentation reactions. The most common intermediate in these bacterial fermentation reactions is:

A. pyruvate B. lactate C. D. citrate E. formate

14 80. A form of gene transfer that requires a bacteriophage is:

A. conjugation B. transduction C. transformation D. locomotion

81. A bacterium that undergoes a chromosomal mutation that results in a change in the major surface antigen has undergone:

A. a phage conversion B. an antigenic variation C. a phase variation D. generalized transduction

82. One of the following is not true of C reactive protein. Which one?

A. it is an acute phase protein B. it is chemotactic to macrophages C. it is released by the liver D. it is an indication of inflammation caused by periodontal disease E. it is an opsonin

83. A dental clinic treats fewer than six patients with active tuberculosis in a period of one year, but there is evidence of TB transmission in the facility. The risk category for this facility is:

A. High B. Intermediate C. Low D. Very Low E. Minimal

84. Viruses that may resist killing by an intermediate level disinfectant are:

A. hydrophobic viruses B. hydrophilic viruses C. all viruses D. blood borne viruses

15 Part II. Matching: The questions below consist of headings followed by a list of phrases. For each phrase select the ONE heading that best matches that phrase. Each phrase may be used more than once. Mark the answer in Part 2 of your answer sheet.

1. tetanus toxin 7. Shiga toxin 2. botulinum toxin 8. Koplik’s spots 3. cholera toxin 9. CD4 4. pertussis toxin 10. capsid

5. diphtheria toxin 11. H2S 6. superantigen 12. sorbitol

21. resists proteases in the upper g.i. tract 52. inhibits EF-2 33. ADP ribosylates Gs to cause overproduction of cAMP 34. activity identical to the LT toxin 55. in low iron environments 46. ADP ribosylates Gi to cause overproduction of cAMP 67. TSST – 1 78. inhibits EF-1 119. Salmonella species produce on Triple Sugar Iron agar. 1210. EHEC do not ferment 311. virulence factor for salt water bacterium 412. cause of hyper-production of mucus secretions 113. capable of retrograde axonal transport 1014. viral protein coat

815. measles

916. cell receptor for HIV

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