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Are You Suprised ? DAMB 721 Microbiology Exam 3A 100 points October 24, 2001 Your name (Print Clearly): _____________________________________________ I. Matching: The questions below consist of headings followed by a list of phrases. For each phrase select the ONE heading that best describes that phrase. Mark the answer in Part 2 of your answer sheet. 1. erythrogenic 7. acute glomerulonephritis 2. enterotoxin 8. streptokinases and staphylokinases 3. TSST-1 9. hyaluronidase 1 4. urinary tract infections 10. cellulitis and erysipelas 5. E. coli 11. rheumatic fever 6. exfoliative 12. Streptococcus pyogenes ____ 1. “spreading factor” produced by members of the staphylococci, streptococci and clostridia ____ 2. toxemia involving this staphylococcal toxin causes a fatal toxic shock that is characterized by multiple organ shut down ____ 3. streptococcal scarlet fever toxin ____ 4. staphylococcal and streptococcal enzymes that are fibrinolysins ____ 5. 4 to 6 hours after ingestion of food contaminated with this staphylococcal toxin symptoms of diarrhea and vomiting appear ____ 6. non-suppurative sequela of S. pyogenes infections, usually follows skin infectons ____ 7. toxin responsible for the symptoms of staphylococcal scalded skin syndrome ___ 8. non-suppurative sequela that follows repetitive cases of strep throat ____ 9. invasive skin diseases caused by Streptococcus pyogenes ____ 10. the most common cause of urinary tract infections ____ 11. the most common nosocomial infection ____ 12.β-hemolytic, bacitracin sensitive, cause of suppurative pharyngitis II. Multiple Choice: Choose the ONE BEST answer. Mark the correct answer in Part 1 of your answer sheet. Use a #2 pencil. 1. The disease caused by Shigella dysenteriae is more severe than the diseases caused by other Shigella species. What is the likely explanation for this? A. It produces a virulence factor, the shiga toxin, that other shigella do not produce. B. Its major virulence factor, a toxin, is similar in action and biochemistry to the major virulence factor of ETEC. In fact, it is possible that ETEC acquired the shiga toxin through horizontal gene transfer. C. It produces a neurotoxin. D. It is the only shigella that invades the small intestine. 2 2. The Clostridium botulinum , Clostridium perfringens and Corynebacterium diphtheria toxins have the following in common: A. They are comprised of two subunits; the B subunit binds the toxin receptor on the target cell while the A subunit is the toxic component. B. They are all neurotoxins. C. To be activated, they must be nicked by a protease and their disulfide bonds reduced. D. A and B. E. A and C. 3. The major virulence factor of Enterotoxigenic E. coli A. is the shiga-like toxin B. causes the major symptom of traveler’s diarrhea C. is the LT toxin D. A and B. E. B and C. 4. The major virulence factor found in strains of E. coli that cause acute pyelonephritis: A. The Tcp pilus B. n-methylphenylalanine pilus C. PAP pilus D. Bundle forming pilus 5. The strain of E. coli that attaches to the small intestine and causes effacement of the microvilli: A. EHEC B. EAEC C. ETEC D. EPEC 6. Gastroenteritis caused by this enteric bacterium is transmissible from animal to human but not from human to human: A. Salmonella typhimurium B. Clostridium botulinum C. Yersinia enterocolitica D. Shigella sonnei 7. A major cause of Gram-negative pneumonia in hospitals: A. Klebsiella pneumoniae B. Serratia marcescens 3 C. Proteus vulgaris D. Escherichia coli 8. 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 9. A bacterium that is a major cause of opportunistic infections in hospitalized patients suffering from severe burns: A. Klebsiella pneumoniae B. Serratia marcescens C. Proteus vulgaris D. Escherichia coli 10. Poultry is an important reservoir for the pathogenic species in this genus: A. Yersinia B. Escherichia C. Shigella D. Salmonella 11. Which of the following would be presumptive evidence of disease caused by Salmonella typhi? A. a bacterium isolated from a patient’s blood does not ferment lactose on MacConkey’s agar and is positive for H2S production B. a bacterium isolated from a stool sample does not ferment lactose on MacConkey’s agar and is positive for H2S production C. a bacterium isolated from a stool sample ferments lactose on MacConkey’s agar and is positive for H2S production D. Both A and B. E. Both B and C. 12. Asymptomatic carriers are important to the transmission of: A. Shigella B. Enteric (typhoid) fever C. Salmonella bacteremia D. Diphtheria E. B and D. 13. The bacterium that is the second most frequent cause of nosocomial infections is: 4 A. Escherichia coli B. Staphylococcus aureus C. Pseudomonas aeruginosa D. Klebsiella pneumoniae E. Enterococcus faecalis 14. A patient in the intensive care unit of a hospital is at high risk for a nosocomial infection; in part, this is because treatment of these patients often involves use of an invasive medical device such as a urinary catheter or respirator. A. The statement is true. B. The statement is false. 15. The bacterium that is the most frequent cause of human actinomycosis is: A. Norcardia asteroides B. Actinomyces naeslundii C. Actinomyces israelii D. Actinomyces viscosus 16. A bacterium that causes root caries is: A. Actinomyces naeslundii B. Actinomyces viscosus C. Actinomyces israelii D. Both A and B. E. Both A and C. 17. An example of an endogenous infection is: A. tuberculosis B. actinomycosis C. diphtheria D. tetanus 18. This bacterium gives a weak positive on an acid fast stain and causes a pyogenic, chronic lobar pneumoniae: A. Norcardia asteroides B. Mycobacterium tuberculosis C. Actinomyces israelii D. Actinobacillus actinomycetemcomitans 19. A bacterium that has no known virulence determinants, such as endotoxins or exotoxins is: A. Shigella dysenteriae B. Mycobacterium tuberculosis 5 C. Actinomyces viscosus D. Clostridium perfringens 20. A bacterium that gives a strong acid fast reaction and that is likely to be isolated from a granulomatous lung lesion is: A. Norcardia asteroides B. Mycobacterium tuberculosis C. Actinomyces israelii D. Actinobacillus actinomycetemcomitans 21. The mycobacteria as a group are resistant to drying, dyes and alkali. They do not Gram stain, and they have an extremely slow growth rate. These characteristics are all due to: A. Cord factor B. Wax D C. Sulfolipids D. the high proportion (60%) of lipid that makes up the mycobacterial cell wall 22. Mycobacteria are intracellular parasites that survive and live in the: A. neutrophil B. macrophage C. fibroblast D. endothelial cell 23. A zoonotic mycobacterium that causes disease in birds and humans and that frequently causes tuberculosis in AIDS patients: A. Mycobacteruim kansasii B. Mycobacterium tuberculosis C. Mycobacterium bovis D. Mycobacterium avium (avium-intracellulaire) 24. The infectious form of tuberculosis is: A. Disseminated (miliary) tuberculosis B. Secondary (active) tuberculosis C. The tubercle D. Latent tuberculosis 6 25. A patient is admitted to a hospital with violent coughing episodes that produce a caseous sputum. Which of the following tests would confirm a positive diagnosis of active tuberculosis? A. a positive tuberculin test B. a chest X-ray that reveals tubercules in the lungs C. In laboratory analyses, acid fast rods are seen in the sputum, and when Lowenstein-Jensen medium is inoculated with the sputum, Mycobacterium tuberculosis grows after 3 weeks. D. A, B and C. E. A and B only. 26. The most important factor in the transmission of diseases caused by the Bacillus and Clostridium species is: A. Both produce bacterial endospores that may remain dormant in soil for decades. B. Clostridia are anaerobes and bacilli are not. C. Both genera produce intoxications rather than infections. D. Both are the cause of zoonoses. 27. A rigid paralysis that occurs after a penetrating wound is caused by: A. Clostridium tetani B. Clostridium perfringens C. Clostridium botulinum D. Bacillus anthrasis 28. The most important toxin that causes the tissue destruction that is characteristic of clostridial myonecrosis is : A. a hyaluronidase B. edema factor with lethal factor C. botulinum toxin D. phospholipase C 29. The toxoids in the DPT vaccine are inactivated, antigenic forms of these toxins: A. diphtheria and tetanus toxins B. lethal factor and tetanus toxins C. botulinum and tetanus toxins D. lecithinase and tetanus toxins 30. If a person inhaled endospores from a Bacillus anthrasis that could produce the protective antigen (PA) and lethal factor (LF), but not edema factor (EF) the prognosis for this individual would be: A. Poor, without early treatment the person would likely die from “Woolsorter’s” disease. 7 B. Good, the individual would not develop any disease or symptoms. C. They would have some discomfort from localized swelling, otherwise the prognosis would be good. D. They would develop localized skin lesions, but the prognosis is still good especially with treatment. 31. The gene for the diphtheria toxin, A. is encoded by a bacteriophage B. is regulated by a repressor protein encoded on the host chromosome C. is expressed in environments with a low iron concentration D. iron is a corepressor that regulates expression of the diphtheria toxin E. All of the above are true. 32. The etiology of subacute bacterial endocarditis is as follows: A. 80 to 90% of cases are caused by viridans streptococci B. 5 to 10% of cases are caused by Enterococcus faecalis C. 80 to 90% of cases are caused byStreptococcus pyogenes or Staphylococcus aureus D. A and B. E. B and C. 33. Epidemiologic investigations of nosocomial infections caused by Staphylococcus aureus depend on identification of the offending strains through: A. serotyping B. Lancefield typing C. analysis of the M protein D. plasmid analysis E. bacteriophage typing 34. Which streptococci are the early colonizers of dental plaque? A.
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