BECOM 2 Exam 5 – 2020

Session 154 – Principles of Microbiology and Infectious Disease I

1. Which of the following is the leading cause of death due to communicable diseases in the world?

  1. Heart Disease

  2. TB

  3. Cancer

  4. Lung Infections

  5. HIV/AIDS

 

2. Which of the following terms is best described as what takes place when an organism harmfully invades?

  1. Colonization

  2. Infection

  3. Toxin

  4. Pathogen

  5. Disease without colonization

 

3. Which of the following transmission styles would be classified as a form of contact?

  1. Transplacental

  2. Biting Insects

  3. Droplets

  4. Airborne

  5. Food/Water

 

4. Which of the following epidemiologic terms is best defined as an infectious disease that spreads rapidly to many people?

  1. Surveillance

  2. Endemic

  3. Outbreak

  4. Epidemic

  5. Pandemic

 

5. Coinfection with COVID-19 has caused the death rate of those with preexisting lung diseases to rise. How will this affect the incidence and prevalence?

  1. Neither incidence or prevalence change

  2. Incidence is unchanged, prevalence increase

  3. Incidence is unchanged, prevalence decreases

  4. Incidence increases, prevalence increases

  5. Incidence decreases, prevalence decreases

 

6. A wave of anti-vaxers has led to a decrease in vaccination usage for a particular disease. How will this affect incidence and prevalence for that disease?

  1. Neither incidence or prevalence change

  2. Incidence is unchanged, prevalence increase

  3. Incidence is unchanged, prevalence decreases

  4. Incidence increases, prevalence increases

  5. Incidence decreases, prevalence decreases

 

7. Garrett put on his yeehaw pants and went to the shooting range with his new quarantine pistol. After the first magazine, the target looks like the one pictured above. Which of the following could be said about it in relation to accuracy and precision?

  1. It had a low accuracy and low precision

  2. It had a low accuracy and high precision

  3. It had a high accuracy and low precision

  4. It had a high accuracy and high precision

  5. He’s definitely getting robbed if he shoots like that

Session 155 – Principles of Microbiology and Infectious Disease II

8. Which of the following diagnostic tests indicates the likelihood that a non-sick person tests negative?

  1. Sensitivity

  2. Specificity

  3. PPV

  4. NPV

  5. PPV:NPV ratio

 

9. Which of the following has the equation of TP/(TP+FN)?

  1. Sensitivity

  2. Specificity

  3. PPV

  4. NPV

  5. PPV:NPV ration

 

10. Which test do you utilize when ruling IN a disease?

  1. Sensitivity

  2. Specificity

  3. PPV

  4. NPV

  5. PPV:NPV ration

 

11. Within the threshold for disease application, what happens when you shift the happy medium to the left?

  1. Decrease Specificity, Increase PPV

  2. Increase Specificity, Increase PPV

  3. Increase Sensitivity, Decrease PPV

  4. Decrease Sensitivity, Decrease NPV

  5. Decrease Specificity, Decrease NPV

 

12. Prevalence has a HUGE impact, in Atchley’s words, on which of the following diagnostic values?

  1. Sensitivity

  2. Specificity

  3. PPV

  4. NPV

  5. Social Distancing

Session 156 – Microbiology Lab Diagnostics – Introduction

13. Viral hepatocyte damage would be most closely associated with which liver diagnostic test?

  1. ALT 

  2. AST 

  3. ALP 

  4. GGT 

  5. Bilirubin

 

14. Which of the following would be the best indicator of recent alcohol consumption?

  1. ALT 

  2. AST 

  3. ALP 

  4. GGT 

  5. Bilirubin

 

15. Which of the following would suggest an elevated white blood cell count in a CBC due to a bacterial source?

  1. Thrombocytopenia 

  2. Polycythemia 

  3. Neutrophilia 

  4. Lymphocytosis 

  5. Neutrophilia

 

16. Which of the following urine dipstick measurements would suggest an urinary tract infection?

  1. pH

  2. Nitrite 

  3. Ketone 

  4. Leukocyte esterase 

  5. Glucose

 

17. Which of the following would be positive in an individual with a Hepatitis B Immunization?

  1. HBsAg 

  2. Anti-HBsAg 

  3. HBeAg 

  4. anti-HBeAg 

  5. Anti-HBcAg

Session 157 – Microbiology Lab Diagnostics – Microscopy I

18. What is the correct step by step process of the gram stain?

  1. Crystal Violet → Safrinin → Alcohol → Iodine

  2. Iodine → Crystal Violet → Alcohol → Safrinin

  3. Crystal Violet → Iodine → Alcohol → Safrinin

  4. Crystal Violet → Alcohol → Iodine → Safrinin

  5. Crystal Violet → Alcohol → Safrinin → Iodine

 

19. What color do gram negative and gram positive bacteria stain in a gram stain respectively?

  1. Purple; Red

  2. Blue; Purple

  3. Red; Pink

  4. Red; Purple

  5. Blue; Green

 

20. Neisseria and Moraxella are two examples of ….?

  1. Gram Positive Cocci

  2. Gram Negative Cocci

  3. Gram Positive Bacillus

  4. Gram Negative Bacillus

  5. Gram Positive Streptococci

 

21. Rickettsia and Chlamydia are two microbes that gram stain poorly due to….

  1. Being obligate intracellular microbes

  2. Being too thin

  3. Having a high lipid content in their cell walls

  4. Having no cell wall

  5. Being too difficult to culture

 

22. A patient is suspected to have contracted the herpes virus, what process will be used to confirm your suspicions? 

  1. Acid Fast Stain

  2. Gram Stain

  3. Trichrome Stain

  4. Tzanck Stain

  5. India Ink Stain

Session 158 – Microbiology Lab Diagnostics – Microscopy II

23. What is the correct order for acid-fast staining?

  1. Carbolfuchsin → Heat Fix → Acid-Alcohol → Methylene Blue

  2. Methylene Blue → Heat Fix → Acid-Alcohol → Carbolfuchsin

  3. Heat Fix → Carbolfuchsin → Acid-Alcohol → Methylene Blue

  4. Heat Fix → Acid-Alcohol → Carbolfuchsin → Methylene Blue

  5. Acid-Alcohol → Heat Fix → Carbolfuchsin → Methylene Blue

 

24. A positive Auramine-Rhodamine acid-fast test will result in staining the acid-fast organism what color?

  1. Red

  2. Purple

  3. Blue

  4. Apple Green

  5. Silver

 

25. An acid-fast stain is used to stain what organism in particular?

  1. Mycoplasma

  2. Mycobacterium

  3. Nocardia

  4. Legionella

  5. Cryptococcus

 

26. What is the characteristic microscopic sign that you are looking at the US parasite that is often mistaken as malaria?

  1. Dark Halos

  2. Maltese Crosses

  3. Multinucleated “giant cells”

  4. Schizonts

  5. Trophozoites

 

27. It is important to ensure that a proper sputum sample is collected. What is a quick indicator that your patient did not collect sputum, but instead collected spit?

  1. High levels of neutrophils

  2. High levels of endothelial cells

  3. Low levels of amylase

  4. Frothy sample

  5. Not collected within the first hour of waking

Session 159 – Microbiology Lab Diagnostics – Culture and Sensitivity

28. Minimum Inhibitory Concentration (MIC) is best described by which of the following?

  1. A concentration greater than the Minimal Bactericidal Concentration (MBC)

  2. Its value is indicated by a test tube concentration that is the most turbid

  3. The greatest drug concentration that inhibits the bacterial replication

  4. The minimal drug concentration that kills the bacteria

  5. None of the above

 

29. Which of the following agar media is best for differentiating alpha, beta, and gamma hemolysis?

  1. Blood agar

  2. Chocolate agar

  3. Eosin Methylene Blue agar

  4. MacConkey agar

  5. Mannitol salt agar

 

30. Which of the following agar media is best for differentiating Staphylococcus aureus from other coagulase negative staphylococci?

  1. Blood agar

  2. Chocolate agar

  3. Eosin Methylene Blue agar

  4. MacConkey agar

  5. Mannitol salt agar

 

31. Which of the following agar media is best for differentiating lactose fermenters from non-lactose fermenters?

  1. Blood agar

  2. Chocolate agar

  3. Eosin Methylene Blue agar

  4. MacConkey agar

  5. Mannitol salt agar

 

32. Identify the most likely pathogen from the following lab results: 

Bacitracin: resistant

Blood agar: beta-hemolytic

Catalase: negative

Gram stain: purple cocci

Mannitol salt agar: no growth

  1. E. coli

  2. Sta. aureus

  3. Sta. epidermidis

  4. Str. agalactiae (GBS)

  5. Str. pyogenes (GAS)

 

33. Identify the most likely pathogen from the following lab results: 

Catalase: positive

Coagulase: negative

Gram stain: purple cocci

Mannitol salt agar: pink

  1. E. coli

  2. Sta. aureus

  3. Sta. epidermidis

  4. Str. agalactiae (GBS)

  5. Str. pyogenes (GAS)

 

34. Identify the most likely pathogen from the following lab results: 

Bacitracin: sensitive

Blood agar: beta-hemolytic

Catalase: negative

Gram stain: purple cocci

Mannitol salt agar: no growth

  1. E. coli

  2. Sta. aureus

  3. Sta. epidermidis

  4. Str. agalactiae (GBS)

  5. Str. pyogenes (GAS)

 

35. Identify the most likely pathogen from the following lab results: 

Catalase: positive

Coagulase: positive

Gram stain: purple cocci

Mannitol salt agar: yellow

  1. E. coli

  2. Sta. aureus

  3. Sta. epidermidis

  4. Str. agalactiae (GBS)

  5. Str. pyogenes (GAS)

Session 160 – Microbiology Lab Diagnostics – CBC and Body Fluids

36. A 56 year-old male presents to the E/R with fever, myalgia, and an indurated, purulent nodule on his left forearm. Blood and wound cultures are taken, and blood is drawn for hematologic lab analysis. CBC with differential indicates a left shift with an abnormal increase in the patient’s WBC. Which of the following cell types would you expect to see in a greater quantity compared to normal corresponding to the left shift?

  1. Reticulocyte

  2. Metamyelocyte

  3. Lymphocyte

  4. Basophil

  5. Megakaryocyte

37. A 26 year-old female presents to the E/R with hematuria, dysuria, pelvic inflammation, and increased urinary frequency. She claims that she just returned from a medical mission trip to Uganda where she took several “selfies” of herself wading in the Nile River. Microscopic urinalysis shows several spined-eggs in the patient’s urine belonging to the helminth, Schistosoma haematobium. Her CBC would show a spiked increase in which of the following cell types that also induces the release of histamine in such parasitic infections?

  1. A

  2. B

  3. C

  4. D

  5. E

38. A 19 year old male presents to the E/R with sore throat, fever, night sweats, and constant fatigue. He notes that he is sexually active with multiple partners at his university and that there has been a “strep”-bug going around in his dorm. PE reveals cervical lymphadenopathy. A CBC yielded the following results where a significant portion of lymphocytes were atypical in morphology. Additional labs were ordered with their results provided below. Which of the following preliminary interpretations is the most likely given the laboratory results and patient presentation?

Rapid Strep Test :: Negative

Heterophile Antibody Test :: Negative

CSF Gram Stain :: No organisms seen (NOS)

 

  1. Group A Streptococcus infection

  2. Mononucleosis infection

  3. Cytomegalovirus infection

  4. Group B Streptococcus infection

  5. Staphylococcus epidermidis infection

 

39. A 38 year old female presents to the E/R with mental confusion, sensitivity to light, fevers, chills, and an aching, stiff neck. Brudzinski’s neck sign is positive on physical examination. You proceed to perform a spinal tap and collect the CSF in in three tubes labeled: 

Tube 1 :: Tube 2 :: Tube 3

You tell the surgical assistant to deliver the tubes to the appropriate departments in the hospital laboratory, but they have no idea where they need to go. You correctly explain to them that:

  1. Tube 3 needs to go to Microbiology for the Cell Count and Differential. 

  2. Tube 1, the bloodiest sample, needs to go to Chemistry for Glucose and Protein analysis.

  3. Tube 2 needs to go to Hematology for the Cell Count and Differential.

  4. Tube 3, the least bloody sample, needs to go to Chemistry for Glucose and Protein analysis.

  5. Tube 1 needs to go to Microbiology for the Gram Stain and Culture.

 

40. The CSF Gram Stain for the previous case was reported to have “Gram Positive Cocci in Pairs and Clusters.” Which of the following CSF laboratory findings would you expect to see that coincide the Gram Stain report?

  1. Clear fluid: Normal PMNs: Marked lymph increase: Normal protein & glucose

  2. Viscous fluid: Slight PMN increase: Marked lymph increase: Normal protein: Decreased glucose.

  3. Cloudy fluid: Marked PMN increase: Normal lymphs: Marked protein increase: Decreased glucose.

  4. Viscous fluid: Normal PMN: Marked lymph increase: Normal protein: Decreased glucose.

  5. Clear fluid: Slight PMN increase: Normal lymphs, protein, & glucose.

41. What are the two most common tests for monitoring inflammation?

  1. C-reactive protein and PT/INR

  2. ESR and platelet count

  3. C-reactive protein and ESR

  4. WBC and PT/INR

  5. WBC and C-reactive protein

Session 161 – Microbiology Lab Diagnostics – Serology

42. A patient comes in with jaundice and elevated ALT levels. You want to see if they potentially have hepatitis so you go to get a blood draw and the titers show a 1:32 concentration of Anti-HepB IgG. You ask the patient to come back in two weeks for a redraw at which time the titers show a 1:256 concentration of Anti-HepB IgG. What conclusion can be drawn?

  1. The patient has had a past Hepatitis B infection

  2. The patient has an acute Hepatitis B infection

  3. The patient has been vaccinated against Hepatitis B

  4. A mistake must have been made in the lab

  5. The patient does not have and has never had Hepatitis B

 

43. Which of the following correctly matches the type of ELISAs with its probes?

  1. Direct and indirect ELISA and antigen 

  2. Direct and indirect ELISA and antibody

  3. Direct ELISA and antigen. Indirect ELISA and antibody

  4. Direct ELISA and antibody. Indirect ELISA and antigen

  5. Direct ELISA and antigen or antibody

  6. Indirect ELISA and antigen or antibody

 

44. As a part of ongoing research into injecting healthy persons serum with COVID19 resistance, the above ELISA was performed to test patients for resistance to COVID-19. Wells 2-12 correspond to different participants (numbered 2-12). The A-G represents lessening concentrations of COVID19 which are halved with each dilution. If the ELISA is specific up to a concentration of 1:8, which of the following patients were most likely resistant to COVID?

  1. Patient 1

  2. Patient 2

  3. Patient 3

  4. Patient 7

  5. Patient 9

 

45. Your friend calls you crying because she has been trying to get pregnant and yet again the test came back negative, even after her period is five days late. She tells you this test didn’t even have one line come up like the last negative tests have. Which of the following advice should you give your friend?

  1. The test is positive, no lines means that the HCG in her urine went all the way to the absorbing pad

  2. The test is negative, no lines means that there is no HCG in her urine to make the line appear

  3. See if she accidently took a fertility test instead since those tests do not have a line that shows up unless you are ovulating

  4. The test is faulty and she should try another one

  5. Try again in a week when she has more HCG in her body

 

46. Which of the following ratios of antibody: antigen would result in the most agglutination?

  1. 1:4

  2. 1:2

  3. 1:1

  4. 2:1

  5. 4:1

Session 162 – Bacteria: Introduction

47. Which of the following is NOT a mechanism by which normal flora promote health in an individual?

  1. Occupy space

  2. Generate antimicrobial products

  3. Maintain vaginal acidic environment

  4. Increase water excretion 

  5. Produce Vitamin K

 

48. Which of the following is NOT found in or an accessory structure of  a typical bacterium?

  1. A single circular chromosome in a nucleoid 

  2. 80s Ribosomes

  3. A cell wall

  4. A flagella made of flagellin

  5. Conjugation pili

 

49. Which of the following are contained within the cell wall of a gram positive bacterium?

  1. O antigen

  2. Lipid A

  3. Mycolic Acid Lipids

  4. Teichoic Acids

  5. Porin channels

 

50. What is the mechanism of action of the antibiotic Penicillin?

  1. Bind and inactivates 70s ribosomes

  2. Creates pores in the cell wall causing lysis 

  3. Disrupts DNA replication leading to cell death

  4. Prevents the addition of teichoic acids

  5. Binds and inhibits transpeptidase

 

51. Why must a physician be careful when giving antibiotics to an individual with sepsis caused by a gram negative bacteria?

  1. Antibiotics don’t work well on gram negative bacteria due to their thin cell walls

  2. A physician should always be careful when administering antibiotics and assess for allergies

  3. The release of too much lipid A can cause a patient to go into shock

  4. Antibiotics can force bacteria to form spores which can later germinate and relapse the disease state

  5. Free floating bacterial DNA can be toxic in large amounts

 

52. Which of the following terms describe an organism that can live without oxygen but will preferentially utilize it if it is available?

  1. Obligate aerobe 

  2. Capnophiles

  3. Facultative anaerobe 

  4. Aerotolerant anaerobes

  5. Obligate anaerobe

 

53. Which of the following is NOT an obligate aerobe?

  1. Legionella

  2. Pseudomonas

  3. Bacteroides

  4. Nocardia

  5. Bacillus

 

54. Which of the following is NOT an obligate anaerobe?

  1. Mycobacterium

  2. Bacteroides

  3. Fusobacterium

  4. Clostridium 

  5. Actinomyces

 

55. During which phase of the bacterial growth curve are antibiotics the most effective/useful?

  1. Lag phase

  2. Log/exponential phase

  3. Stationary phase

  4. Death/decline phase

  5. None of the above, everyone knows antibiotics are for viral infections

 

56. Which type of toxin could lead to flaccid paralysis of muscle?

  1. Endotoxin

  2. Neurotoxin

  3. Enterotoxin

  4. Pyrogenic exotoxin

  5. Tissue invasive exotoxin

Session 163 – Bacteria: Microbial Genetics

57. This type of genetic transfer is the uptake of DNA from the environment?

  1. Conjugation

  2. Transformation

  3. Transduction

  4. HFR

  5. Phage genetic transfer

 

58. After phage injects its DNA, what is the next step in the LYSOGENIC phase?

  1. Transcription of phage genome

  2. Translation of phage genome

  3. Replication of phage genome

  4. Integration of phage genome

  5. Breakdown of host genome

 

59. What technique of genetic transfer was used to determine the time-of-entry mapping of genes?

  1. Conjugation

  2. Transformation

  3. Transduction

  4. HFR

  5. Phage genetic transfer

 

60. What is the correct order for the tryptophan operon?

  1. Cys; A; B; C; E

  2. Cys; B; A; C; E

  3. Cys; E; C; B; A 

  4. Cys; E; C; A; B

  5. B; A; C; E; Cys

 

61. Which of the following toxins are  genetic and are NOT bacterial toxins that are transferred to non-toxic strains via lysogenic phage?

  1. SpeC Exotoxin

  2. Botulinum Toxin

  3. Shiga toxin

  4. Verotoxin

  5. Diplopia toxin

Session 164 – Bacteria: Virulence Factors

62. Which of the following does NOT have a capsule?

  1. E. coli 

  2. H. influenzae

  3. S. pneumoniae 

  4. N. meningitidis 

  5. S. aureus

 

63. Protein A is a key virulence factor that is found on ___ that creates a Fab cloak by binding to ___?

  1. E. coli; IgM

  2. E. coli; IgG

  3. H. influenzae; IgM

  4. H. influenzae; IgG

  5. S. aureus; IgM

  6. S. aureus; IgG

 

64. Which of the following is NOT a key characteristic of endotoxins?

  1. Mostly produced by gram (-) bacteria 

  2. Highly toxic 

  3. Triggers IL-1/IL-6 release

  4. Released from the LPS via cell lysis 

  5. Does not promote enzymatic activity

 

65. Which of the following exotoxins damages the cell by binding to the 60S ribosome without invading the cell? 

  1. B. pertussis 

  2. C. diphtheria 

  3. P. aeruginosa 

  4. Shigella 

  5. EHEC

 

66. Which of the following exotoxins inhibits GABA and glycine release which leads to ‘rigid’ muscles?

  1. C. tetani 

  2. C. botulinum 

  3. B. pertussis 

  4. Shigella 

  5. EHEC

Session 165 – Bacteria: Gram Positive Cocci I

67. After isolating an unknown bacteria, you determine it to be a gram positive cocci due to its round and purple appearance. Based upon symptomatology you expect the bacteria to be Staph. Aureus. What test result will help you not only confirm it to be Staph. Aureus, but also differentiate it from other gram positive cocci?

  1. Catalase (+)

  2. Catalase (-)

  3. Coagulase (+)

  4. Coagulase (-)

  5. Oxidase (+)

 

68. Which is an appropriate description of Staph aureus?

  1. Alpha Hemolytic

  2. Catalase Negative

  3. Coagulase Negative

  4. Mannitol Fermenter

  5. Lactose Fermenter

 

69. A 5 y/o patient presents to your clinic with blisters and a positive Nikolsky sign with gentle touch. You recognize the presentation as one consistent with a Staph aureus exotoxin that liquifies the stratum granulosum layer of the skin. What is that exotoxin?

  1. Panton-Valentine Leukocidin (PVL)

  2. Exfoliatin 

  3. TSST

  4. Enterotoxin

  5. Scalded Skin Syndrome Toxin A

 

70. Determine the diagnosis based upon the following clues:

  1. This infection is most commonly caused by Staph aureus

  2. In patients with sickle cell disease this infection is most commonly caused by Salmonella

  3. If there is direct penetrating trauma in a wet environment, Pseudomonas aeruginosa can cause this infection as well. 

 

  1. Toxic Shock Syndrome

  2. Scalded Skin Syndrome

  3. Osteomyelitis

  4. Pharyngitis 

  5. Food Poisoning

 

71. What important gene in MRSA codes for an altered penicillin binding protein that does not allow Penicillin to bind to the bacteria?

  1. Penicillinase

  2. aPBP

  3. Optochin

  4. mecA

  5. MRSA-1G

Session 166 – Bacteria: Gram Positive Cocci II

72. What test will help you differentiate Group A Strep from Group B Strep?

  1. Coagulase

  2. Catalase

  3. Oxidase

  4. Optochin

  5. Bacitracin

 

73. A patient visits your clinic complaining of a rash that covers the majority of their body aside from the palms and head and a sore throat. Upon inspection, you also notice what can only be described as a “strawberry tongue”. What is the most likely diagnosis of this patient? 

  1. Rheumatic Fever

  2. Scarlet Fever

  3. Post-Streptococcal Glomerulonephritis

  4. Rocky Mountain Spotted Fever

  5. Cellulitis

 

74. How would one differentiate Strep pneumo from Strep viridans? 

  1. Bacitracin resistance

  2. Optochin resistance

  3. Amoxicillin resistance

  4. Acid-fast stain

  5. Hemolysis typing on blood agar

 

75. When looking at a gram stain of Strep pneumo, what are you expecting to see?

  1. Red circles

  2. Purple circles

  3. Purple back to back lancets

  4. Purple rods

  5. Red rods

 

76. Strep pneumo is the most common cause of what infection in children?

  1. Pneumonia

  2. Otitis Externa

  3. Osteomyelitis

  4. Otitis Media

  5. Gingivitis

77. 4-month old Maggie is brought into the pediatrician’s office by her mother, who says that Maggie has been clutching at her left ear for the past 2 days. Upon otoscopic examination, Maggie is found to have acute otitis media, for which she is prescribed a 7-day course of amoxicillin. Which of the following is the most likely organism causing this?

  1. Staphylococcus aureus

  2. Streptococcus viridans

  3. Streptococcus pneumoniae

  4. Staphylococcus epidermidis

Answer Choice

78. Which of the following differentiates Streptococcus agalactiae from other Streptococcus species?

  1. Optochin sensitivity

  2. CAMP test

  3. Bacitracin sensitivity

  4. Coagulation testing

 

79. On your internal medicine rotation, you encounter a 55 year old male patient presenting with fever, new-onset murmur, and non-tender reddish spots on his palms and the soles of his feet. The patient’s history reveals past heroin usage. Given his history and presentation, you quickly suspect acute bacterial endocarditis and immediately order blood draw for surveillance cultures and a stat echocardiogram. Which organism is the most likely culprit?

  1. Staphylococcus saprophyticus

  2. Enterococcus faecium

  3. Streptococcus pneumoniae 

  4. Staphylococcus aureus

80. You encounter a 77 year old male patient on a cardiology rotation who recently received an aortic valve replacement for treatment of aortic stenosis. The patient reports feeling febrile and fatigued, and you notice characteristic non-tender red spots on his hands and feet. Suspecting endocarditis, what would be the most likely causative organism?

  1. Staphylococcus epidermidis 

  2. Staphylococcus aureus 

  3. Streptococcus pyogenes 

  4. Streptocuccus viridans

81. A patient at your family practice clinic presents with patchy white exudate in their throat as shown below

You suspect bacterial pharyngitis due to Strep. pyogenes, and quickly obtain a throat culture. Which of the following is NOT one of the serious sequelae that could potentially result from this infection?

  1. Scarlet fever

  2. Post-streptococcal glomerulonephritis

  3. Rheumatic fever

  4. Lobar pneumonia

Session 167 – Bacteria: Gram Negative Bacilli

82. Lactose fermenters typically present as which color growth on MacConkey agar?

  1. Blue 

  2. Clear

  3. Green

  4. Pink

  5. Yellow

 

83. Identify the most likely pathogen from the following lab results and physical exam: 

Gram stain: red bacilli

MacConkey agar: rapidly growing purple colonies, smelling of grapes, swarmer

Patient exam: currant jelly sputum, rose spots

  1. Aeromonas hydrophila

  2. E. coli

  3. Enterobacter

  4. Klebsiella pneumoniae

  5. Pseudomonas aeruginosa

 

84. How does the classical presentation of Salmonella typhi differ from non-typhoidal strains of Salmonella? 

  1. Rose spots

  2. Temperature dissociation

  3. Constipation preceding non-bloody diarrhea

  4. Rash

  5. All of the above

 

85. Which E. coli antigen increases the risk of meningitis in a newborn?

  1. H antigen

  2. K antigen

  3. O antigen

  4. All the above

  5. None of the above

 

86. Which of these is slowest in lactose fermentation?

  1. Klebsiella pneu

  2. moniae Enterobacter 

  3. Citrobacter 

  4. Escherichia coli

87. Which is NOT a component of the classical triad in hemolytic uremic syndrome?

  1. Thrombocytopenia

  2. Gastritis

  3. Acute renal failure

  4. Anemia

88. Which of the following species is associated with development of otitis externa (swimmer’s ear)?

  1. Serratia marcescens 

  2. Aeromonas hydrophila 

  3. Pseudomonas aeruginosa 

  4. Campylobacter jejuni

89. On a nephrology rotation, you encounter a patient experiencing intense flank pain radiating to their inner thigh and groin. Ultrasonography confirms the presence of a large staghorn kidney stone blocking the renal pelvis, and the patient is sent for percutaneous nephrolithotomy to remove the stone. Which of the following organisms is most likely responsible for producing the kidney stone?

  1. Proteus mirabilis 

  2. Escherichia coli 

  3. Shigella 

  4. Salmonella enteritidis

90. Which of the following pathogens is found in unpasteurized milk and can cause inflammation of the appendix similar to appendicitis?

  1. Salmonella enteritidis 

  2. Shigella dysenteriae

  3. Yersinia enterocolitica 

  4. Campylobacter jejuni

91. What is the major neurological consequence of Campylobacter infection?

  1. Tabes dorsalis 

  2. Multiple sclerosis 

  3. Guillain-Barre syndrome 

  4. Brown-Sequard syndrome

92. Which of the following pathogens is associated with internal jugular vein thrombophlebitis secondary to peritonsillar abscess formation?

  1. Bacteroides fragilis 

  2. Fusobacterium necrophorum

  3. Neisseria gonorrhoeae 

  4. Moraxella catarrhalis

  5. Shigella dysenteriae

Session 168 – Bacteria: Other Gram Negative Bacteria

93. What is a potential sequelae of Chlamydia trachomatis infection in women?

  1. Urethritis 

  2. Pelvic Inflammatory Disease 

  3. Cystitis

  4. Cervicitis

 

94. Which of the following is not part of the classic triad of reactive autoimmune arthritis (Reiter’s syndrome) secondary to C. trachomatis infection?

  1. Urethritis 

  2. Cystitis

  3. Conjunctivitis 

  4. Arthritis

95. Which of the following serotypes of C. trachomatis can lead to lymphogranuloma venereum upon infection?

  1. L2 

  2. B 

  3. F 

  4. K

96. Epiglottitis is a dangerous condition that can develop in unvaccinated children whereby the epiglottis can become inflamed and cause airway obstruction, as well as dysphagia. Infection by which pathogen is usually responsible for this?

  1. Acinetobacter baumannii 

  2. Legionella pneumophila 

  3. Haemophilus influenzae 

  4. Moraxella catarrhalis

97. Which is the main site of colonization for Haemophilus influenzae?

  1. Oropharynx 

  2. Lungs 

  3. Nasopharynx

  4. Tonsils

98. Which of the following organisms causes development of painful chancroid genital ulcers following sexual intercourse?

  1. Neisseria gonorrhoeae 

  2. Chlamydia trachomatis 

  3. Treponema pallidum 

  4. Haemophilus ducreyi

99. What is the required agar for growth of Legionella cultures?

  1. MacConkey’s agar 

  2. Hektoen Enteric 

  3. BCYE 

  4. Chocolate

     

100. What electrolyte imbalance is often observed in elderly patients with Legionella infection (Legionnaires disease)?

  1. Hypomagnesemia 

  2. Hyperkalemia 

  3. Hyponatremia 

  4. Hypocalcemia 

  5. Hypokalemia

     

101. What condition is Neisseria gonorrhoeae infection a primary cause of in sexually active adults?

  1. Septic arthritis 

  2. Chancre 

  3. Conjunctivitis 

  4. Meningitis

102. What is an endocrine consequence of meningococcemia due to Neisseria meningitidis infection?

  1. Decreased testosterone production

  2. Decreased cortisol production

  3. Decreased ACTH release

  4. Increased GH release

Session 169 – Bacteria: Gram Positive Bacilli I

103. Which of the following is the only bacterium to possess a capsule made from D-glutamate polypeptide rather than polysaccharides?

  1. Bacillus cereus 

  2. Bacillus anthracis 

  3. Listeria monocytogenes 

  4. Corynebacterium diphtheriae

104. Which is the most lethal form of anthrax infection?

  1. Injected 

  2. Intestinal 

  3. Inhaled 

  4. Cutaneous

     

105. What is the main function of the cell-binding component (PA) of the tripartite anthrax toxin?

  1. Prevention of phagocytosis 

  2. Cause edema 

  3. Endocytosis of EF and LF 

  4. None of the above

106. For lunch, a 24 year old broke-ass medical student is eating leftover brisket with reheated rice from a potluck 2 days ago. Later on at night, he experiences a rumbling in his gut and he is soon firmly planted on the john with diarrhea. Which of the following pathogens might be responsible for his current predicament?

  1. Bacillus cereus 

  2. Clostridium difficile 

  3. Clostridium perfringens 

  4. A & C

     

107. Botox is a cosmetic treatment using isolated neurotoxin from Clostridium botulinum to paralyze muscles of the face, such as the frontalis muscle, to decrease wrinkling. What is the mechanism by which this occurs?

  1. Increase GABA release 

  2. Decrease acetylcholine release 

  3. Decrease norepinephrine release 

  4. Increase glycine release

108. A 46-year old female patient with a history of IV drug use is admitted to the hospital and found to have been infected with community acquired MRSA. She is prescribed a course of clindamycin which resolves the infection. However, within 24 hours, she becomes febrile with abdominal pain and massive watery diarrhea. Stool sample examination shows presence of fecal leukocytes and she is diagnosed with pseudomembranous colitis. This would be caused by which of the following organisms?

  1. Clostridium perfringens 

  2. Bacillus cereus 

  3. Clostridium botulinum 

  4. Clostridium difficile

 

Session 170 – Bacteria: Gram Positive Bacilli II

109. Which of the following enzymes from the alpha toxin of Clostridium perfringens is responsible for the destruction of the cell membranes in gas gangrene?

  1. Lecithinase 

  2. Transpeptidase 

  3. Hyaluronidase

  4. Elongase 

  5. Hemolysin

 

110. In which of the following ways is food poisoning from Clostridium perfringens different from the food poisoning caused by Staphylococcus aureus?

  1. It is caused by an enterotoxin

  2. It causes a bloody diarrhea

  3. It is gram negative 

  4. It has a later onset

  5. It disrupts blood supply

 

111. Clostridium tetani toxin interferes with which of the following neurotransmitters?

  1. Acetylcholine

  2. Norepinephrine

  3. GABA/glycine

  4. Serotonin

  5. Dopamine

 

112. What is the mechanism of action for Corynebacterium diphtheriae?

  1. Activates adenylate cyclase and increases cAMP

  2. Inhibits cell signalling and causes release of TNF-a and IL-1B

  3. Inhibits the release of neurotransmitters

  4. Causes the increase in efflux of chloride and water follows

  5. Inactivation of elongation factor (EF-2)

 

113. What is one of the major reasons Listeria is so good at avoiding the immune system?

  1. It binds the Fc region of IgG to hide 

  2. It is an intracellular organism that moves cell to cell

  3. It has an IgA protease to digest IgA

  4. It has a polysaccharide capsule which resist phagocytosis

  5. It enters as a spore which are difficult for the immune system to recognize before germination

 

114. Which of the following foods could be contaminated with Listeria and should be avoided during pregnancy?

  1. Reheated rice

  2. Raw poultry

  3. Raw/unpasteurized milk or cheese

  4. Raw beef

  5. Reheated sauces

 

115. What is a major difference between Nocardia and Actinomyces?

  1. Nocardia has branching filaments while Actinomyces does not

  2. Nocardia undergoes spore formation while actinomyces does not

  3. Nocardia is found in normal oral flora while Actinomyces is not 

  4. Nocardia is aerobic while Actinomyces is anaerobic 

  5. Nocardia produces yellow sulfur granules while Actinomyces does not

Session 171 – Bacteria: Spirochetes

116. Which of the following spirochetes causes Lyme disease?

  1. Borrelia burgdorferi

  2. Borrelia recurrentis 

  3. Borrelia hermsii

  4. Treponema pallidum 

  5. Leptospira interrogans

 

117. Which spirochete is shown in the image above?

  1. Borrelia burgdorferi

  2. Borrelia recurrentis 

  3. Borrelia garinii

  4. Treponema pallidum 

  5. Leptospira interrogans

 

118. Myocarditis is symptomatic in which stage of Lyme disease?

  1. Stage 1

  2. Stage 2

  3. Stage 3

  4. Stage 4

  5. Not answer E

 

119. A patient presents to the clinic with flu-like illness (fever, headache, rigors, myalgias) and conjunctival hemorrhage. You notice spirochetes in his blood sample. What infectious agent is present in your patient?

  1. Borrelia burgdorferi

  2. Borrelia recurrentis 

  3. Borrelia garinii

  4. Treponema pallidum 

  5. Leptospira interrogans

 

120. Weil’s disease (icteric type) has 2 phases, which of the following is characteristic of the leptospirotic phase?

  1. Headache

  2. Conjunctival injection

  3. bradycardia

  4. Encephalopathy 

  5. Polymorphic rashes

 

121. Utilizing a chancre fluid dark field microscopy you can identify which of the following diseases?

  1. Lyme Disease

  2. Syphilis

  3. Leptospirosis

  4. Relapsing Fever

  5. Corona Virus

 

122. Which of the following is NOT a false positive to a syphilis diagnosis?

  1. Leprosy

  2. Mononucleosis

  3. Gonorrhea 

  4. Pregnancy

  5. Lupus

 

123. What cardiac conduction abnormality is observed in patients within the early disseminated stage (Stage 2) of Lyme disease?

  1. Atrial flutter 

  2. 3rd degree AV block 

  3. Bradycardia 

  4. Tachycardia 

  5. Atrial fibrillation

124. A 20 year old man presents to the family practice clinic with pronounced flu-like symptoms, jaundice, and reddened conjunctiva. In the course of taking the patient’s history, you learn that the symptoms began approximately 2 days ago after swimming in a local pond near the patient’s neighborhood. You draw up blood for serological testing, and within 24 hours confirm the diagnosis of leptospirosis. What is an appropriate antibiotic to prescribe for treatment?

  1. Doxycycline 

  2. Amoxicillin 

  3. Penicillin G 

  4. None of the above

125. What is a neurological manifestation of tertiary syphilis which presents with loss of proprioception, decreased DTRs, ataxia and a wide-based gait?

  1. Multiple sclerosis 

  2. Friedrich’s ataxia 

  3. Tabes Dorsalis 

  4. Subacute combined degeneration

     

126. What ophthalmologic abnormality involving decreased reactivity to light with normal accommodation occurs as a manifestation of tertiary syphilis?

  1. Marcus-Gunn pupil 

  2. Argyll-Robertson pupil 

  3. Anisocoria 

  4. Nystagmus

 

Session 172 – Bacteria: Zoonotic I

127. The presence of a classic ‘maltese-cross’ in a blood smear would be evident in ___ transmitted by ____?

  1. Malaria; ticks

  2. Malaria; mosquitos

  3. Babesia; ticks

  4. Babesia; mosquitos 

  5. Babesia; birds

 

128. Administration of which medication is used for most animal borne-illnesses?

  1. Penicillin 

  2. Doxycycline 

  3. Azithromycin 

  4. Streptomycin 

  5. Rifampin

 

129. Which disease is commonly caused my cat scratches and presents as red ‘stretch marks

 7-10 days later?

  1. Brucellosis 

  2. Psittacosis 

  3. Q-Fever 

  4. Bartonellosis 

  5. Tularemia

 

130. Which of the following is found in Bacillary Angiomatosis but NOT Kaposi Sarcoma?

  1. Common in HIV/AIDS 

  2. Etiological agent is HHV-8 

  3. Lymphocyte infiltration 

  4. Raised red/purple lesions 

  5. PMN infiltration

 

131. A pet store owner who has spent hours cleaning bird cages finds themselves with a fever and headache due to which most likely illness?

  1. Brucellosis 

  2. Psittacosis 

  3. Q-Fever 

  4. Bartonellosis 

  5. Tularemia

 

132. Which characteristic is key in distinguishing the difference between asymptomatic vs severe leptospirosis?

  1. Conjunctival suffusion 

  2. Fever 

  3. Myalgias 

  4. Jaundice 

  5. Headache

Session 173 – Bacteria: Zoonotic II

133. What pertinent information from a history may clue you into the cause of your patient’s cellulitis being caused from Pasteurella Multocida?

  1. Exposure to an armadillo

  2. Exposure to contaminated water

  3. Recent tick bite

  4. Recent pet bite

  5. Promiscuity

 

134. A patient presents with flu-like symptoms to your clinic. A blood test reveals leukopenia and elevated liver enzymes. The patient states that he had to cut his hunting trip for white-tailed deer short because of his illness. What is the patient’s diagnosis as revealed by the Giemsa stain below?:

  1. Babesia

  2. Monocytic Ehrlichiosis

  3. Malaria

  4. Granulocytic Anaplasmosis

  5. Borrelia Burgdorferi

 

135. What species of tick transmits an infection that is identified by its maculopapular rash starting on the wrist and ankles and has a classic triad of headache/fever/rash?

  1. Rhipicephalus

  2. Dermacentor

  3. Amblyomma

  4. Ixodes

  5. Sanguinis

 

136. Following a flea bite, your patient presents with a bubo on their neck. What would you expect to see on a Giemsa stain?

  1. Red Coccobacilli 

  2. Morulae inside granulocytes

  3. Morulae inside monocytes

  4. Pushpin dense coccobacilli

  5. Bipolar Safety Pin

 

137. What is the method of transmission for Rickettsia prowazekii?

  1. Lice feces

  2. Flea Bites

  3. Tick Bites

  4. Pet Bites

  5. Human to Human

Session 174 – Introduction to Fungi and Viruses

138. As opposed to bacteria, which component of the cell membrane is unique to fungi?

  1. Proteins

  2. Cholesterol

  3. Cell Wall

  4. Chitin

  5. Lipid Bilayer

 

139. A patient comes to the clinic with what appears to be a fungal infection of his toenails. You diagnose him with tinea unguium. You want to prescribe one of the following and make sure that the drug has the lowest possibility to cross react with cholesterol. Which of the following meets the criteria?

  1. Azoles

  2. Polyene

  3. Allylamines

  4. Terbinafine

  5. Doxycycline

 

140. A wrestler comes to the clinic with a raised lesion on his arm. It appears to be fungal. What is the most likely type of mycoses?

  1. Superficial

  2. Cutaneous

  3. Subcutaneous

  4. Systemic

  5. Opportunistic

 

141. Viruses can be grouped together based on which tissues they infect. Which of the following groups does SARS-CoV-2 fit in?

  1. Pneumotropic

  2. Dermotropic

  3. Viscerotropic

  4. Neurotropic

 

142. Which is the correct order for the replication of viruses?

  1. Attachment → Biosynthesis → Penetration → Maturation → Release

  2. Biosynthesis → Maturation → Attachment → Penetration → Release

  3. Attachment → Penetration → Biosynthesis → Release → Maturation

  4. Release → Maturation → Attachment → Penetration → Biosynthesis

  5. Attachment → Penetration → Biosynthesis → Maturation → Release

Session 175 – Bacteria: Mycobacteria

143. Due to the lipid rich mycolic acid component of the mycobacteria cell wall, which is the preferred staining method for visualizing this class of bacteria?

  1. Acid-fast

  2. Gram

  3. India ink

  4. Potassium Hydroxide

  5. Silver

 

144. Presence of a Ghon complex is indicative of which form of tuberculosis?

  1. Bone and joint tuberculosis

  2. Primary respiratory tuberculosis

  3. Secondary respiratory tuberculosis

  4. Tuberculosis enteritis

  5. Tuberculosis meningitis

 

145. Tuberculosis infections typically result in dense granulomas consisting of an aggregation of which cell type?

  1. Cytotoxic T-cells

  2. Helper T-cells

  3. Macrophages

  4. Neutrophils

  5. A and C

  1. A and D

  2. B and C

  3. B and C

 

146. Which of the following is the animal reservoir for Tuberculosis leprae?

  1. Aardvark

  2. Anteater

  3. Armadillo

  4. Groundhog

  5. Opossum

 

147. In a patient of suspected leprosy, which of the following traits leads to a differential diagnosis of tuberculoid leprosy over lepromatous leprosy?

  1. Absence of granulomas

  2. Hypopigmentation and loss of hair

  3. Patches of hypopigmented skin

  4. Severe neuropathy

  5. Th2 response

Session 176 – DNA Viruses I

148. An infection with Parvo B-19 would be most devastating in what kind of patient?

  1. Someone previously infected with another strain of Parvo B-19

  2. Someone with Cystic Fibrosis

  3. Someone with an allergy to Penicillin

  4. Someone with Sickle Cell Anemia

  5. Someone with Onychomycosis

149. The classic “Slapped Cheek” appearance in a child infected with Parvo B-19 is due to which of the following?

  1. Pathogen colonization in the maxillary sinuses

  2. Type 2 Hypersensitivity reaction

  3. Type 3 Hypersensitivity reaction

  4. Type 4 Hypersensitivity reaction

  5. Type 1 Hypersensitivity reaction

150. A PAP smear is taken from a 38 year old woman who complains of vaginal skin changes. The collected sample is stained and Koilocytes are confirmed via microscopy. Which of the following would NOT lead to these atypical Koilocytes that lead to cervical cancer?

 

  1. HPV Serotypes 6 and 11

  2. HPV strain expressing EP6 gene

  3. HPV Serotype 16

  4. HPV strain expressing EP7 gene

  5. HPV Serotype 18

151. A 33 year old female presents to her family physician complaining of rectal pain “unlike anything she has ever had before”. She is currently sexually active 3 men and takes the progesterone pill as daily as her birth control. Urine hCG is negative and temperature is 102oF. Physical exam shows tender, erythematous vesicles with crust on the perianal skin along with bilateral inguinal lymphadenopathy. Which of the following is true regarding the viral pathogen responsible for this infection and symptomatology?

  1. It is a naked, ds-DNA virus that replicates in the nucleus.

  2. It is responsible for oral herpetic cold sores in 20% of the cases.

  3. Its site of latency is in Lymphocytes in the inguinal lymph nodes.

  4. Tzanck smear displays Giant Cells with Basophilic Intranuclear Inclusions.

  5. Recurrent flares routinely accompanied by fever and lymphadenopathy. 

152. A 4 year old boy and his mother present to the E/R. The boy’s mother states that her son has experienced pain when peeing and that his pee is dark and “bloody” colored. A urine sample is collected to which the child shows symptoms of dysuria and the urinalysis confirms 2+ rbcs under microscopy. The patient is non-febrile. The symptomatology and laboratory findings most closely indicate which kind of infection?

  1. An enveloped dsDNA virus, subgroup B, serotype 21

  2. A naked ssDNA virus, subgroup A, serotype 11

  3. Acute Hemorrhagic Cystitis

  4. An enveloped dsDNA virus, subgroup A. serotype 11

  5. A naked ssDNA virus, subgroup B, serotype 21

153. A 27 year old female presents to the E/R with flu-like symptoms. She states that she is 26 weeks pregnant and urinary hCG confirms pregnancy. She additionally complains of bilateral joint pain in her wrists and there is a diffuse, erythematous rash on her chest and abdomen. Serology testing for throat and sputum specimens are negative for pneumococcal pathogens. She is sent home with supportive care. 2 weeks later she experiences a spontaneous abortion. This symptomatology is most closely associated with which of the following:

  1. HPV

  2. Parvo B-19

  3. Adenovirus

  4. EBV

  5. HHV-8

154. A 16 year old female presents to her family physician with complaining of pink eye. She just returned from a surfing competition in Honolulu and is currently doing competitive swimming at her high school pool where she has been swimming two-a-days for the past 10 days. Physical exam shows bilateral erythematous conjunctiva with a non-purulent, watery and clear discharge. PCR confirms a ds-DNA virus. Which of the following viral pathogens is best associated with the clinical symptoms and patient history?

  1. HSV-1

  2. Epstein-Barr Virus

  3. Leptospirosis

  4. Chlamydia

  5. Adenovirus

155. A 26 year old, sexually active male presents to the E/R complaining of vision changes in their left eye. You note a crusted, healing lesion on their right vermillion border. Fluorescein application to their left eye reveals a “tree-like” ulcer with “lightning bolt-like branches.” This finding is most indicative of which of the following pathogens: 

  1. CMV

  2. HSV-1

  3. HHV-8

  4. EBV

  5. HHV-6

Session 177 – DNA Viruses II

156. Who of the following is at the most risk for shingles?

  1. Tommy, a 25 year old child of anti-vaxxers whose parents took him to a chicken pox party as a kid where he contracted chicken pox

  2. Angel, a 15 year old who was vaccinated as a child and never got chicken pox.

  3. Irene, a 68 year old who never had chicken pox and also never was vaccinated, but who grew up on a chicken farm

  4. Marvin, a 62 year old who had chickenpox as a kid, but is not old enough for his insurance to cover a zostavax vaccine.  

  5. Mary, a 76 year old grandma who had chickenpox as a child, has not had her zostavax shot, but watched her 5 grandkids when they got the chickenpox 5 years ago.

 

157. Paul, a 18 year old college student, comes into your clinic complaining of being tired all the time and says his throat has been sore but he doesn’t have a cough. He is unsure if he has had a fever. You order a Heterophile antibody test that comes back positive. Which of the following is the most likely diagnosis?

  1. Cytomegalovirus

  2. Syphilis

  3. Epstein-Barr Virus infection

  4. Oral hairy leukoplakia

  5. Streptococcus pyogenes infection

 

158. Which of the following is false regarding CMV or EBV mononucleosis?

  1. CMV negative transplant patients are at an increased risk of rejecting their organs if they do not receive CMV negative blood transfusions

  2. EBV causes false positives on syphilis screenings

  3. CMV has a negative heterophile antibody test

  4. EBV is associated with an increased risk of nasopharyngeal carcinoma

  5. CMV can cause deaf, blueberry muffin babies, with cataracts

 

159. Johnny is a 17 month old infant presenting to your clinic with a high fever, swollen lymph nodes and a rash on his neck, body and face. His parents said he has had the fever for about 3 days and they can’t break it, they also tell you that the rash just spread to his face this morning which is why they took him in. Which of the following is the most likely causative agent for his condition?

  1. Herpes simplex Virus 1

  2. Herpes simplex Virus 2

  3. Human Herpes Virus 6

  4. Human Herpes Virus 8

  5. Varicella Zoster Virus

 

160. While doing an infectious disease rotation, your preceptor asks: which of the following is the most likely poxvirus seen in the US today? You respond:

  1. Variola

  2. Smallpox

  3. Molluscum contagiosum

  4. Cowpox

  5. Chickenpox

Session 178 – RNA Negative Sense Viruses

161. Which of the following RNA viruses is NOT segmented?

  1. Reo

  2. Arena

  3. Orthomyxo

  4. Paramyxo

  5. Bunya

 

162. All negative sense RNA viruses are which of the following?

  1. Double stranded

  2. Enveloped 

  3. Segmented 

  4. Icosahedral

  5. Naked

 

163. Which negative sense RNA virus replicates in the nucleus?

  1. Retro

  2. Pox

  3. Orthomyxo

  4. Paramyxo

  5. Rhabdo

 

164. Which of the following types of viruses is it necessary to be kept in BSL-4 isolation due to its human-human transmission, high mortality rate, and lack of vaccine?

  1. Arenaviridae

  2. Bunyaviridae

  3. Paramyxoviruses

  4. Orthomyxoviruses 

  5. Filoviridae

 

165. Which of the following types of viruses causes Ebola (a thrombocytopenic hemorrhagic disease with a near 100% mortality rate)?

  1. Arenaviridae

  2. Bunyaviridae

  3. Paramyxoviruses

  4. Orthomyxoviruses 

  5. Filoviridae

 

166. Which of the following types of viruses causes the rodent-borne Hanta virus that is typically found in the four corners region (New Mexico, Arizona, Colorado, and Utah)?

  1. Arenaviridae

  2. Bunyaviridae

  3. Paramyxoviruses

  4. Orthomyxoviruses 

  5. Filoviridae

 

167. A young “chipmunk appearing” boy presents to the ED screaming, “my balls are on fire!” You condescendingly look at the mother knowing she probably didn’t get her child vaccinated against which disease?

  1. Influenza

  2. Rubella

  3. Rubeola

  4. Diphtheria

  5. Mumps

 

168. A patient presents with a red maculopapular rash that appears to only be on their body from the trunk down. They tell you it started on their head/face and progressed downward and has now resolved from their neck up. Which of the following diseases does this individual most likely have?

  1. Influenza

  2. Rubella

  3. Rubeola

  4. Diphtheria

  5. Mumps

 

169. Which type of influenza can infect birds, pigs, and humans but birds are the natural hosts?

  1. A

  2. B

  3. C

  4. D

  5. E

 

170. Which type of avian influenza could potentially cause the next pandemic to effect millennials when God has decided we haven’t had enough yet?

  1. H1N1

  2. H3N2

  3. H5N1

  4. H7N3

  5. H9N7

 

171. Which type of change occurs frequently in Influenza that requires the development of a new vaccine?

  1. Shifts

  2. Conjugations

  3. Transductions

  4. Drifts

  5. Reassortments

 

172. Which type of virus travels in the nerves and is 100% fatal after it incubates?

  1. Ebola

  2. Rhabdovirus

  3. H5N1 avian flu

  4. Lassa fever

  5. Hanta Virus

 

173. Lets face it. You’re a special type of weird person who thinks skunks are “cool”. So what happens? You get bit by one trying to get a selfie for instagram. After going to the ED, animal control finds the skunk that bit you and kills it to check for rabies. What are they looking for in its brain to confirm/deny that it had rabies?

  1. Lewy bodies

  2. Neurofibrillary tangles 

  3. Tau plaques 

  4. IgM antibodies

  5. Negri bodies

Session 179 – RNA Positive Sense Viruses

174. Which of the following RNA viruses are Helical and positive sense ?

  1. Reovirus

  2. Dengue

  3. Covid-19

  4. HIV

  5. Rubella

 

175. A patient presents with a high fever, severe muscle and bone pain after being bit by an Aedes mosquito in South America. You aren’t terribly worried and tell them it is because only second infections are fatal. What do you think your patient is infected with?

  1. West Nile Virus

  2. Dengue

  3. Rubella

  4. HTLV-1

  5. SARS

 

176. Our current COVID-19 virus is most comparable to which of the following RNA positive sense viruses?

  1. West Nile Virus

  2. Dengue

  3. Rubella

  4. HTLV-1

  5. SARS

 

177. Poliovirus is categorized into which of the following ?

  1. Coronaviridae 

  2. Retroviridae

  3. Togaviridae

  4. Picornaviridae

  5. Flaviviridae

 

178. This naked, positive sense ssRNA virus is the #1 cause of gastroenteritis in adults and absolutely has a field day on cruise ships?

  1. Norovirus

  2. Coltivirus

  3. Rotavirus

  4. Coxsackievirus

  5. Echovirus

Session 180 – Fungi I

179. Which of the following is found in yeasts but NOT molds?

  1. Reproduction by forming spores 

  2. ‘Bacteria-like’ appearance 

  3. Formation of hyphae 

  4. ‘Cotton-like’ appearance 

  5. Formation of mycelium

 

180. Which pulmonary fungal infection is NOT found in the United States?

  1. Histoplasmosis 

  2. Blastomycosis 

  3. Coccidioidomycosis 

  4. Paracoccidioidomycocis  

  5. Sporothrix

 

181. Which fungal infection acts as a mold in cooler temperatures but a yeast at warmer temperatures?

  1. Histoplasmosis 

  2. Blastomycosis 

  3. Coccidioidomycosis 

  4. Paracoccidioidomycocis 

  5. Sporothrix

 

182. Onychomycosis would refer to a fungal infection of which area?

  1. Feet  

  2. Head  

  3. Groin  

  4. Nails 

  5. Back