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DAMB 711 Final Exam B 100 points December 15, 2010

Your name (Print Clearly):

______

I. Matching: The questions below consist of headings followed by a list of phrases. For each phrase select the heading that best describes that phrase. The headings may be used once, more than once or not at all. Mark the answer in Part 2 of your answer sheet.

1. capsid 7. CD4 2. pneumoniae 8. faecalis 3. oncogenic 9. hyaluronidase 4. pyruvate 10. interferon 5. Koplik’s spot 11. hydrophilic viruses 6. congenital pallidum 12. pyogenes

91. “spreading factor” produced by members of the staphylococci, streptococci and

12. viral protein coat

43. central intermediate in bacterial fermentation

84. causes persistant endodontic

25. a cause of atypical pneumonia

106. non-specific defense against viral

27. has a rudimentary life cycle

78. HIV receptor

69. Hutchinson’s Triad

510. measles

1111. resistant to disinfection

1212. -hemolytic, sensitive, cause of suppurative pharyngitis

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Matching (Continued): The questions below consist of diseases followed by a list of etiologic agents. Match each disease with the etiologic agent. Continue using Part 2 of your answer sheet.

1. dysentery 6. Legionnaire’s 2. 7. 3. cholera 8. tuberculosis 4. diphtheria 9. summer outbreaks of meningitis 5. enteric fever 10. pneumoniae/meningitis

213. botulinum

314. Vibrio cholera

815. bovis

116. Shigella

1017.

718.

519. Salmonella typhi

920. Echo virus

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

1. A toxin derived from the of Gram-negative is:

A. B. leukotoxin C. aflatoxin D. ergosterol E. TSST

2. The toxin that is heat resistant and survives high osmotic pressure:

A. TSST1 B. enterotoxin C. exfoliative toxin D. alpha toxin E. lipopolysaccharide

3. Which of the following is an untrue statement about ornithosis?

A. close association with parrots can be a risk factor B. it is also called C. it is transmitted to humans via inhalation of D. it is transmitted to humans via inhalation of Coxiella burnettii E. B and C are untrue statements.

4. Which of the following induces a granulomatous lesion in the lung and is diagnosed with a skin test that is like tuberculosis?

A. Pneumocystis carinii B. Candida albicans C. Blastomyces dermatiditis D. Coccidiodies immitis E. Histoplasma capsulatum

5. Complication of influenzae that occurs in children in conjunction with aspirin therapy:

A. viral pneumonia B. bacterial pneumonia C. Reye’s syndrome D. croup

6. Dental equipment that penetrates intact skin:

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

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7. One of the bacteria listed below is a common cause of nongonococcal and eye diseases. In addition, it often causes coinfections with Neisseria gonorrhoea. Which one?

A. pneumoniae B. Coxiella burnetii C. D.

Use the following choices to answer questions 8 and 9

A. B. Dialister invisus C. Pseudoramibacter alactolyticus D. Bacteriodetes clone X083 E. Porphyromonas endodontalis

E8. Is not among the top four species of bacteria that cause acute apical periodontitis.

A9. Is not among the top four species of bacteria that cause chronic apical periodontitis

10. The streptococci that cause human caries are:

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

11. The most important polymer that comprises the extracellular matrix of a persistent cariogenic 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

12. A child that suffers from a pyogenic cellulitis is predisposed to this sequelae of S. pyogenes infections.

A. B. acute glomerulonephritis C. D. rheumatoid arthritis

13. The antigen used to subdivide S. pyogenes into serotypes is:

A. the Lancefield carbohydrate B. the  hemolysin C. the M protein D. the E. A, C, and D.

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14. A negative species of staphylococcus that cannot produce coagulase but is a cause of urinary tract infections, mostly in hospitalized patients.

A. Staphylococcus aureus B. Staphylococcus saprophyticus C. Staphylococcus epidermidis D. A and B E. B and C

15. Members of the Mycoplasma 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. lack a cell wall and instead have a trilaminar membrane D. have a human intermediate host

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

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

17. A shift in the environment of subgingival plaque that would favor the development of a periodontal pocket would be to ______conditions.

A. aerobic B. acidic C. microaerophilic D. anaerobic E. hypertonic

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

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

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

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

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20. This rickettsial pathogen is transmitted in aerosols of dried animal waste.

A. Campylobacter fetus B. Rickettsia typhi C. Coxiella burnettii D. Rickettsia rickettsii E. Ehrlichia chaffeensis

21. A shift in the environment of supra-gingival plaque that would favor the development of caries would be to ______conditions.

A. aerobic B. acidic C. microaerophilic D. anaerobic E. hypertonic

22. The following is a virulence factor for Vibrio cholera, Pseudomonas aeruginosa and Neisseria gonorrhoea:

A. n-methylphenylalanine B. a polysaccharide capsule C. an alginate capsule D. filamentous hemagglutinin E. AB toxin

23. One of the following is not a common cause of meningitis in newborns. Which one?

A. Streptococcus pneumoniae B. Escherichia coli C. monocytogenes D.

24. Two of these bacteria cause significant percentages of both and with acute apical abscess:

A. Treponema denticola and B. Porphyromonas endodontalis and Treponema denticola C. Dialister pneumosintes and D. Treponema denticola and Porphyromonas gingivalis E. A and D are true

25. Neonatal diseases caused by are spread through:

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

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26. Which of the following is the best description of the symptoms of diseases caused by the Rickettsiales?

A. intense headache, fever and rash B. a soft gummy tumor that may form in any organ in the body C. patchy infiltrates in the lungs D. consolidation of the lungs

27. 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.

28. Form of bacterial gene transfer in which either a fragment of DNA or a plasmid from the donor bacterium is transferred across the of the recipient bacterium This nuclear material is not contained in a viral coat, and it is not passed through a pilus.

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

29. Synergistic action of these toxins will cause death of the affected cell:

A. EF and LF. B. PA and EF. C. LF and PA. D. PA.

30. HAART is used to treat ______it consists of ______:

A. HIV: two reverse transcriptase inhibitors and one protease inhibitor B. HIV: one reverse transcriptase inhibitor and two protease inhibitors C. HBV: two reverse transcriptase inhibitors and one protease inhibitor D. HIV: indinavir, zidovudine and didanosine E. A and D

31. The infectious form of tuberculosis is:

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

32. Mutations in the influenzae virus that result in a new strain of virus are:

A. antigenic drift B. the result of mixed infection with two or more strains of influenzae virus one of which is an avian strain C. antigenic shift D. possible because the segmented ssRNA genome allows reassortment of the genes that encode the hemagglutinin and neuraminidase E. All except A

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

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

34. Meningitis may occur following a respiratory infection with this microorganism. Transmission of this organism is through inhalation of dried avian (pigeon) feces. What is the pathogen?

A. Chalmydia psittaci B. Echovirus C. Cryptococcus neoformans D. Listeria monocytogenes E. Streptococcus pneumoniae

35. A non-infectious lesion is:

A. gumma B. chancre C. maculopapule D. furuncle

36. Latency is an outcome particularly characteristic of which one of the following virus groups?

A. Polioviruses B. Herpesviruses C. Rhinoviruses D. Influenza viruses

37. An opportunistic cancer that is associated with human herpes virus 8:

A. Kaposi’s sarcoma B. Nasopharyngeal carcinoma C. B cell lymphoma D. Burkitt’s lymphoma

38. A viral disease has symptoms of water filled vesicles that disappear without crusting when the disease has resolved. This disease is ______caused by ______.

A. : II (HSV II)

B. shingles: zoster

C. hand, foot and mouth disease: Coxsacchie virus

D. herpangina: Coxsacchie virus

E. either C or D.

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39. A 50 year old patient with shingles is most likely to have had a childhood infection with:

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

40. A common opportunistic pathogen that causes infection of the nasal cavity, paranasal sinuses, orbit and CNS in diabetic patients is:

A. Candida albicans B. Coccidioides immitis C. Cryptococcus neoformans D. Blastomyces dermatiditis E. Zygomycete (Mucor species)

41. Hemolytic uremic syndrome and thrombocytopenia are severe symptoms caused by:

A. EHEC. B. ETEC. C. EPEC. D. Salmonella typhi. E. Vibrio cholera.

42. The most common cause of infant diarrhea is the ______while a related virus, the ______, causes adult gastroenteritis.

A. polio virus: Norwalk virus B. RSV: Norwalk virus C. rotavirus: adenovirus D. rotavirus: Norwalk virus E. adenovirus: rotavirus

43. The Epstein-Barr virus is implicated in all of the following diseases EXCEPT:

A. Burkitt’s lymphoma B. mononucleosis C. nasopharyngeal carcinoma D. cervical cancer E. oral hairy leukoplakia

44. Detection of this marker in serum in the absence of other HBV markers indicates vaccination against .

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

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45. One of the following is an etiologic agent of non-gonococcal urethritis. Which one?

A. Mycoplasma pneumoniae B. Legionella pneumophilia C. Chlamydia pneumoniae D. E. Pneumocystis carinii

46. A 56-year-old male presented with a large lesion on his right chest wall. The patient was an alcoholic with a history of severe . He was taken to surgery for drainage of his chest lesion. At surgery, 1 L of pus was drained from the chest lesion and the lung. Examination of the pus revealed yellow granules. The granules were crushed, Gram stained, and examined under a microscope. What would be the most likely observation?

A. Gram negative rods. B. Gram positive, spore forming rods. C. Gram positive, pleomorphic rods. D. Gram negative, curved rods.

47. 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.

48. The bacterium that is etiologic in actinomycosis is:

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

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

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

50. A Candida albicans infection that is common in HIV infected patients whose serum concentration of T lymphocytes is less than 200 per microliter.

A. esophagitis B. chronic mucocutaneous candidiasis C. denture induced stomatitis D. angular chelitis E. candidemia

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51. There is no vaccine for:

A. HCV B. Papilloma virus C. Morbillivirus D. Streptococcus pneumoniae E. Varicella \ Shingles virus

52. This viral chemotherapeutic agent is an ion channel blocker that inhibits replication of the influenzae virus.

A. acyclovir B. zidovudine (AZT) C. amantadine D. ritonavir

53. Aggregatibacter actinomycetemcomitans produces a virulence factor that kills PMNs. What is it?

A. neutrotoxin B. vacuolating cytotoxin C. neurotoxin D. leukotoxin E. fibrinolysin

54. The bacterium that is the cause of 90% of in adolescents:

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

55. This virulence factor, which is elaborated by most of the periodontal and endodontic pathogens, can induce tissue destruction and bone resorption by activating the host’s macrophages to release cytokines and other toxic products.

A. leukotoxin B. hemagglutinin C. endotoxin D. capsule E. sideraphore

56. The most common means through which bacteria gain access to the dentinal tubules and subsequently produce inflammation and infection in the dental pulp is:

A. treatment for periodontal disease B. mechanical exposure due to operative procedures C. trauma D. caries

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57. Under what conditions might a periradicular infection be a direct source of inflammation or infection in the pulp?

A. Operative procedures may denude dentin to expose dentinal tubules.

B. Plaque bacteria involved in periodontal disease may cover the entire length of the root and invade the apical foramina.

C. Bacteria and bacterial toxins in the infected pulp may move out through the lateral canals, dentinal tubules or the apical foramina.

D. Anaerobic bacteria at the base of carious lesions may invade the dentinal tubules.

58. Which Porphyromonas gingivalis virulence factor enzymatically digests connective tissue in the and pulp?

A. hemagglutinin B. fimbriae C. collagenase D. IgA protease

59. One of the following would not be a strategy used to develop an anti-microbic effective against viruses:

A. targeting reverse transcriptase B. targeting the of actively growing viruses C. targeting proteases D. targeting ion channels in the viral capsid E. targeting DNA polymerases

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

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

61. The adhesin that allows the bacterium to bind both galactose in the dental pellicle and collagen in the dentin is:

A. Spa A B. Ag I/II C. Fim A D. Glucan binding protein E. Hemagglutinin

62. Statement one: In a cariogenic biofilm, the only acid that lowers the pH to critical values is lactic acid. Statement two: In a cariogenic biofilm, only the mutans streptococci produce acid.

A. Statement one is true. B. Statement two is true C. Both statements are true. D. Neither statement is true.

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63. A patient is asked to rinse with a 10% glucose solution and the resting pH of his plaque is 6.8. His plaque pH is measured at 5 minute intervals for an hour following the rinse. Right after the rinse, the pH falls rapidly to 4.8, stays there for 5 minutes and, then, over the next 25 to 30 minutes returns to resting pH. What is the probable caries status of this individual?

A. rampant caries B. caries free C. medium caries D. The data is insufficient to judge the caries status of this individual.

64. Which of the following microorganisms causes severe congenital birth defects?

A. Pneumocystis carinii B. Rubella virus C. Histoplasma capsulatum D. Morbillivirus

65. One of the following is least likely to be contaminating raw chicken. Which one?

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

66. The infectious agent of a dimorphic fungus is:

A. a hyphae B. a yeast C. a conidiospore D. a mycelium

67. In modern times, Koch’s postulates cannot be applied to periodontal and endodontic infections because:

A. the lesions tend to be anaerobic B. there is not a single etiologic agent C. the bacteria retrieved from a periodontal pocket can differ depending on the part of the pocket sampled D. numerous species are found and many are uncultivable E. all except A

68. What is the main pathogenic mechanism of Ehrlichia chaffeensis?

A. They disrupt endothelium. B. They produce hyaluronidase. C. They release of cytokines with an adjuvant effect. D. They grow in white blood cells. E. Damage to respiratory epithelium.

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69. During early formation Streptococcus mutans competes with Actinomyces viscosus for galactose binding sites. The A. viscosus adhesin that is involved in this activity is the:

A. Type I fimbriae B. Type II fimbriae C. Ag I/II D. Fim A E. Cnm

70. Koch’s postulates are not useful for periodontal disease, so ______are applied instead.

A. Siquiera’s B. River’s C. Tannerella’s D. Socransky’s E. Forsynthensi’s

71. 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

72. Pelvic inflammatory disease could be caused by all of the following except:

A. Neisseria gonorrhoeae B. Mycoplasma hominus C. Ureaplasma urealyticum D. Chlamydia trachomatus E.

73. A 50 year old man suffers from a flaccid paralysis that is a sequelae of a childhood disease. As a child he had a serious disease caused by the:

A. Poliovirus B. Rubella virus C. Morbillivirus D. Mumps E. Coxsacchie

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Your name: ______

III. Short answer: Write your answer on this page.

1. (4 points) For each stain listed below, list one genus of bacteria that the stain could be used to identify.

A. Methylene Blue for metachromatic granules______.

B. Spore stain ______

C. Acid fast stain ______

D. Gram stain ______

2. (3 points) Name three antimicrobial factors in saliva.

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