Clinical Microbiology
Exam Answer Key
Course Introduction
Clinical Microbiology is the study of microorganisms such as bacteria, viruses, fungi, and parasites that cause infectious diseases in humans. This course explores the identification, characterization, and classification of pathogenic microorganisms, as well as the mechanisms by which they cause disease. Emphasis is placed on laboratory techniques used for microbial diagnosis, antimicrobial susceptibility testing, epidemiology of infectious diseases, and principles of infection control. Students will gain an understanding of host-pathogen interactions, emerging infectious threats, and the clinical relevance of microbiological findings in patient care.
Recommended Textbook
Microbiology A Clinical Approach 2nd Edition by Anthony Strelkauskas
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Chapter
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Sample Questions
Q1) The most common means by which multi-drug resistant tuberculosis is transmitted is
A)Through the use of contaminated needles or syringes
B)By dispersal of aerosols containing droplets carrying causative bacteria.
C)By inhaling spores of the causative agent
D)By ingesting undercooked ground beef
E)By individuals who fail to wash their hands after using the lavatory
Answer: B
Q2) A rapid rise has recently occurred in the number of tuberculosis patients and in the problems of treating this disease.What factors are contributing to this?
Answer: The main problems are the increased use of injected illegal drugs,which allows the disease to spread via needles,and the increased incidence of AIDS,which destroys the immune protection against tuberculosis.Poor socioeconomic conditions and migration also play a role.
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3
Chapter 2: Fundamental Chemistry for Microbiology
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Q1) _____ bonds form when electrons are transferred between atoms,whereas _____ bonds involve the sharing of electrons.
A)Covalent; hydrogen
B)Hydrogen; covalent
C)Ionic; hydrogen
D)Covalent; ionic
E)Ionic; covalent
Answer: E
Q2) Cations are different from anions because cations
A)Have a positive charge
B)Are formed by the loss of an electron
C)Are attracted to negatively charged ions
D)Include Na?, Li?, Mg²?, Al³?
E)All of the choices
Answer: E
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4
Chapter 3: Essentials of Metabolism
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Sample Questions
Q1) Which is an example of an oxidation reaction?
A)Amino acids to protein
B)DPN to DPNH
C)DPNH to DPN
D)Glycogen to glucose
E)Glucose to phosphoglucose
Answer: C
Q2) In feedback inhibition which reaction in the following pathway would the final product inhibit? W X Y Z
A)W X
B)X Y
C)Y Z
D)Y
E)Z
Answer: A
Q3) In the figure which step would produce a polysaccharide?
Answer: A
Q4) In the figure which step indicates the molecules produced by hydrolysis?
Answer: C
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Chapter 4: An Introduction to Cell Structure and Host-Pathogen Relationships
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Q1) The organelle where lysosome enzymes are packaged is
A)Plasma membrane
B)Endosome
C)Golgi apparatus
D)Smooth endoplasmic reticulum
E)Rough endoplasmic reticulum
Q2) All of the following are present in eukaryotic cells except
A)Lysosomes
B)Endosomes
C)Golgi apparatus
D)Cholesterol
E)Plasma membrane bound oxidative electron transport
Q3) Secretory vesicles fuse with the
A)Plasma membrane
B)Endosome
C)Golgi apparatus
D)Smooth endoplasmic reticulum
E)Rough endoplasmic reticulum
Q4) Describe three types of endocytosis in eukaryotic cells.
Q5) What is the endosymbiont theory? Provide an example of this process.
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Chapter 5: Requirements for Infection
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Q1) Which of the following is not a location where mucous membranes are found?
A)Lungs
B)Esophagus
C)Urinary bladder
D)Vagina
E)Pancreas
Q2) Which of the following is not associated with the parenteral route?
A)Contaminated needles used by drug users
B)Transmission of malaria by mosquitoes
C)Contaminated food
D)Tick-derived Lyme disease
E)Blood products used by hemophiliacs
Q3) How does tooth brushing protect teeth from cavity formation?
Q4) Which of the following made by bacteria destroys red blood cells in the host?
A)Coagulase
B)Hyaluronidase
C)Leukocidin
D)Collagenase
E)Hemolysin
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Chapter 6: Transmission of Infection, the Compromised
Host, Epidemiology, and Diagnosing Infections
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Q1) What is the mode of transmission for cholera?
A)Droplets
B)Mosquito
C)Flea
D)Drinking water
E)Direct contact
Q2) What is the mode of transmission for plague?
A)Droplets
B)Mosquito
C)Flea
D)Drinking water
E)Direct contact
Q3) A factor that affects disease transmission is
A)Crowding
B)Travel
C)Potable water supply
D)War
E)All of the choices
Q4) Explain how global warming could affect the spread of infectious diseases.
Q5) What are potential sources of nosocomial infections? List at least six.
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Chapter 7: Principles of Disease
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Q1) Name and describe the three strategies used by health professionals to control communicable diseases.Characterize each of them.
Q2) Which of the following is a mismatched pair?
A)Secondary infection: symptoms arise years after an initial infection
B)Septicemia: multiplication of organisms in the blood
C)Acute infection: rapid onset of symptoms
D)Local infection: restricted to small area
E)Focal infection: original location of spreading infection
Q3) The eyelash mite (Demodex folliculorum),is a harmless parasite which lives inside human hair follicles.Its relationship to humans is
A)Parasitism
B)Mutualism
C)Microbial antagonism
D)Commensalism
E)Opportunism
Q4) List and describe the five specific periods of infection.
Q5) Explain why Koch's postulates cannot be applied to all pathogens.
Q6) Explain the process by which Streptococcus pyogenes causes streptococcal toxic shock syndrome (STSS).
Page 9
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Chapter 8: Emerging and Re-Emerging Infectious Disease
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Q1) Which of the following groups is susceptible to tuberculosis (TB)?
A)Malnourished individuals
B)AIDS patients
C)Immunocompromised individuals living in long-term care facilities
D)Alcoholics
E)All of the choices
Q2) The _____ of the SARS coronavirus is used to bind to receptors on the host cell membrane.
A) Small membrane protein (M protein)
B)Nucleocapsids protein
C)RNA
D)Spike protein (S protein)
Q3) Explain which measures led to the development of resistance to amantadine and rimantadine in the H5N1 influenza virus and why this resistance is a problem.Are there any alternative drugs to combat H5N1 and,if so,could sufficient protection be provided if there was an influenza pandemic?
Q4) Bovine spongiform encephalitis seems to be related to scrapie,a disease in sheep,and to Creutzfeldt-Jacob disease in humans.Compare and contrast BSE and CJD.
Q5) In the figure which letter (A to E)indicates recruitment by chemokines?
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Chapter 9: The Clinical Significance of Bacterial Anatomy
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Q1) Describe the strategy used by Neisseria species for immune escape involving pili.
Q2) Which of the following is not an example of active transport?
A)Group translocation
B)Efflux pumping
C)Simple diffusion
D)ABC transport systems
E)ATP dependent diffusion
Q3) You are examining a blood agar plate that contains colonies exhibiting a wet,sticky appearance.Explain what characteristic of bacteria gives rise to this feature and why it can be problematic in the host during an infection.
Q4) Describe two types of passive transport.Explain how they are similar and different from each other.
Q5) A feature that distinguishes slime layers from capsules is that
A)Only capsules are secreted exterior to the cell wall
B)Only slime layers are composed of polysaccharides
C)Slime layers adhere loosely to the cell wall
D)Only slime layers inhibit phagocytosis
E)Only capsules are used for cellular motility
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Chapter 10: Bacterial Growth
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Q1) Which growth characteristic best matches Helicobacter pylori?
A)Extreme thermophile
B)Spirochete
C)Obligate anaerobe
D)Short doubling time
E)Grows inside mucous layer
Q2) The enzyme catalase catalyzes conversion of _____ to water and oxygen.
A)Free-radical oxygen
B)Hydrogen ion
C)Hydroxyl ion
D)Hydrogen peroxide
Q3) You have cultured a bacterial specimen obtained from an abscess on mannitol salt agar.On the following day you note growth and a yellow zone around the colonies.Your specimen is most likely to be
A)Gram-negative
B)Gram-positive
C)Salt-sensitive
D)Unable to ferment mannitol
Q4) Explain why growth rate is an important consideration in the context of the disease process and diagnosis.
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Chapter 11: Microbial Genetics and Infectious Disease
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Q1) Discuss five ways in which transcription differs from DNA replication.
Q2) A five carbon sugar is a component of A)RNA
B)DNA
C)Both DNA and RNA
D)Neither DNA or RNA
Q3) Topoisomerase is required for replication because
A)It links DNA to the primer
B)It prevents unnecessary replication forks from forming
C)It is a DNA polymerase
D)It relaxes the supercoiling of DNA to allow replication
E)It is a DNA ligase
Q4) Answer true or false to the following statement: Elongation of DNA from the 5' end is required because of the stereochemistry of the bases.
A)True
B)False
Q5) Identify the three types of RNA that are made in bacterial cells.How are they similar and what is the specific function of each?
Q6) In the figure which letter (A-C)refers to the codon,UAA?
Page 13
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Chapter 12: The Structure and Infection Cycle of Viruses
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Q1) In the figure which letter (A-D)indicates the matrix protein?
Q2) Regions on the host cell's plasma membrane rich in cholesterol and particular types of fatty acids to which some viruses attach are called
A)Syncytia
B)Protein coats
C)Capsomeres
D)Lipid rafts
Q3) A nucleocapsid
A)A protective protein shell surrounding nucleic acid
B)The complete viral particle
C)A phospholipid bilayer that contains glycoproteins
D)A protein molecule that forms the capsid
E)The sum of the nucleic acid and the capsid
Q4) A capsomere is
A)A protective protein shell surrounding nucleic acid
B)The complete viral particle
C)A phospholipid bilayer that contains glycoproteins
D)A protein molecule that forms the capsid
E)The sum of the nucleic acid and the capsid
Q5) How does a simple icosahedral virus differ from a complex icosahedral virus?
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Chapter 13: Viral Infection
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Q1) An example of a virus that does not use host neurons for the establishment of latency is
A)Herpes simplex virus type 2
B)Varicella-zoster virus
C)Hepatitis C virus
D) Herpes simplex virus type 1
Q2) Which of the following uses host intestinal proteases to be converted into infectious viral particles?
A)Rhinovirus
B)Norwalk virus
C)Poliovirus
D)Reovirus
E)Adenovirus
Q3) The varicella-zoster virus establishes latency in the _____,and if reactivated causes the development of _____.
A)Conjunctiva; seed warts
B)Respiratory tract; pneumonia
C)Central nervous system; Negri bodies
D)Sensory ganglia; shingles
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Chapter 14: Parasitic and Fungal Infections
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Q1) Explain how genetic recombination occurs in fungi.
Q2) Which of the following parasites does not use more than one host to complete its life cycle?
A)Plasmodium falciparum
B)Trichomonas vaginalis
C)Taenia saginata
D)Trypanosoma cruzii
Q3) The American form of trypanosomiasis is called
A)Chagas' disease
B)Amebiasis
C)Sleeping sickness
D)Enterobiasis
E)Ascariasis
Q4) Which of the following is a correctly matched pair?
A)Superficial mycoses: tissue response
B)Tinea capitis: between toes
C)Onychomycosis: mucous membranes
D)Keratitis: colonization of corneal epithelium
E)Systemic mycoses: folliculitis
Q5) Identify and describe three categories of pathogenic fungal infection.
Page 16
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Chapter 15: The Innate Immune Response
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Q1) Answer true or false to the following statement: The adaptive immune response is nonspecific and lacks memory.
A)True
B)False
Q2) All of the following describe the activity of mast cells except
A)Increase effector cell recruitment to sites of infection
B)Proliferate in tissues as part of a replacement process
C)Rapidly release inflammatory mediators including histamine and chemokines
D)Release perforin and granzyme to kill target cells
E)Influence adaptive immune responses
Q3) Answer true or false to the following statement: Yersinia pestis resists digestion in the phagolysosome.
A)True
B)False
Q4) Which of the following is incorrect regarding natural killer (NK)cells?
A)Induce apoptosis in target cells
B)Recognize target cells using Toll-like receptors
C)Kill tumor cells
D)Produce gamma interferon
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Chapter 16: The Adaptive Immune Response
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Q1) Compare and contrast the heavy and light chains of a soluble antibody.Which part contains sulfide?
A)Heavy chain
B)Light chain
C)Both heavy and light chains
D)Neither of the heavy or light chains
Q2) T lymphocytes mature in the
A)Thyroid
B)Bone marrow
C)Spleen
D)Lymph nodes
E)Thymus
Q3) Specialized antigen-collecting cells of the gastrointestinal tract are called
A)NK cells
B)Macrophages
C)Dendritic cells
D)M cells
E)Goblet cells
Q4) Describe the process of transcytosis of dimeric IgA.Why is this process especially important in relation to newborns and passive immunity?
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Chapter 17: Failures of the Immune Response
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Q1) Rheumatic fever is an autoimmune disease commonly caused by what bacterial species?
A)Staphylococcal species
B)Streptococcal species
C)Listeria species
D)Mycobacterium species
Q2) Type IV hypersensitivity reactions are caused by
A)Immune complexes of soluble antigens and IgG
B)Antigen-specific T cells
C)Eosinophil activation
D)Anti-drug IgG antibodies
E)IgE cross-linking on mast cell surfaces
Q3) Which of the following is a mismatched pair?
A)Reverse transcriptase: cDNA
B)Co-receptor: CD4
C)Sub-acute encephalitis: AIDS dementia
D)Opportunistic pathogen: Pneumocystis (carinii) jiroveci
E)Integrase: long terminal repeats
Q4) Explain what accounts for the high level of mutation associated with HIV. Why does this pose a problem for the host?
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Chapter 18: Control of Microbial Growth with Disinfectants and Antiseptics
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Q1) Answer true or false to the reason given in the following statement: Oxidative reagents are very effective against infections of deep tissues,because they release hydroxyl radicals which kill anaerobic organisms.
A)True
B)False
Q2) Degerming is best described as
A)A mechanical process for removing microbes
B)The disinfection of public places
C)The use of heat to kill microbes in food items
D)The use of chemical agents to kill microbes
E)A practice used to maintain a germ-free environment
Q3) Which of the following is not used as an antiseptic for skin?
A)Ethanol
B)Iodophor
C)Formaldehyde
D)phenol-containing compounds
E)Hydrogen peroxide
Q4) Identify and describe five factors that affect the death of microbes by antimicrobial agents.
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Chapter 19: Antibiotics and Antimicrobial Drugs
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Q1) Which of the following is not a drug used for protozoan and helminth infections?
A)Metronidazole
B)Flucytosine
C)Chloroquine
D)Piperazine
E)Melarsoprol
Q2) Which of the following antibiotics prevents ?-lactamase cleavage by binding to it?
A)Cephalosporins
B)Carbapenems
C)Monobactams
D)Glycopeptide antibiotics
E)Penicillins
Q3) Which of the following is the drug combination of choice when treating tuberculosis?
A)Vancomycin, imipenem, aztreonam
B)Methicillin, teicoplanin, isoniazid
C)Polymyxin B, ethambutol, erythromycin
D)Isoniazid, ethambutol, rifampin
E)Tetracycline, rifamycin, ciprofloxacin
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Chapter 20: Antibiotic Resistance
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Q1) Answer true or false to the reason given in the following statement: Because antibiotics are not effective against viruses,taking the antibiotic a doctor prescribes for a viral infection does nothing to relieve symptoms.
A)True
B)False
Q2) Which of the following statements is false?
A)Escherichia coli O157:H7 decreases the production of porin to decrease membrane permeability and thus block antibiotic uptake
B)The expression of the Tet A gene is regulated
C)Pseudomonas increases the production of porin to facilitate the exportation of antibiotics
D)Antibiotic target modification to escape antibiotic activity is successful only if the target retains its ability to function
E)Methicillin-resistant Staphylococcus aureus (MRSA) organisms have imported the mecA gene, which encodes a modified penicillin-binding protein (PBP) that is insensitive to penicillin antibiotics
Q3) Why is selective toxicity particularly problematic when developing antimicrobials to treat viral infections?
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Chapter 21: Infections of the Respiratory System
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Q1) Compare the parainfluenza and influenza viruses.Which is a single-stranded RNA virus?
A)Parainfluenza virus
B)Influenza virus
C)Both parainfluenza and influenza viruses
D)Neither parainfluenza and influenza
Q2) Answer true or false to the reason given in the following statement: Colonies of Corynebacterium diphtheriae resemble Chinese letters because of a unique interaction between the cells and the agar.
A)True
B)False
Q3) Answer true or false to the reason given in the following statement: Because of the large number of serotypes of Rhinovirus,it is unlikely that an effective vaccine will ever be developed.
A)True
B)False
Q4) Describe three ways in which host defenses can be breached,leading to predisposition to respiratory tract infections.
Q5) Identify and describe the three stages of a pertussis infection.
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Chapter 22: Infections of the Digestive System
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Q1) Which family of viruses does Hepatitis C belong to?
A)Hepadnaviridae
B)Flaviviridae
C)Reoviridae
D)Picornaviridae
E)Caliciviridae
Q2) Explain how hepatitis B produces a partly double-stranded DNA genome.
Q3) Which of the following is not a characteristic of typhoid fever?
A)Humans are the only reservoir of the etiological agent
B)Infections are treated with tetracycline to control diarrhea
C)A persistent fever is induced by endotoxin
D)Chronic carriage in the gall bladder may occur
E)It is caused by Salmonella enterica serotype Typhi
Q4) Which of the following organisms is the most appropriate match for traveler's diarrhea?
A)Staphylococcus aureus
B)Enterotoxigenic Escherichia coli (ETEC)
C)Clostridium difficile
D)Campylobacter jejuni
E)Salmonella enterica
Page 24
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Chapter 23: Infections of the Genitourinary System
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Q1) Infants delivered vaginally by a woman with an active Chlamydia trachomatis infection usually develop
A)Oral thrush
B)Skin rashes
C)Pneumonia
D)Urethritis
E)Conjunctivitis
Q2) Which of the following is usually linked to an increased incidence of bacteriuria in the elderly?
A)Prostate enlargement
B)Gynecological surgery
C)Prostatic surgery
D)Incontinence
E)All of the above
Q3) What is congenital syphilis and what are the physiological consequences? Can this condition be avoided?
Q4) Identify and differentiate between the four types of urinary tract infection (UTI)affecting men.How are UTIs treated?
Q5) Explain why antiviral drugs are ineffective for the eradication of HSV-2.
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Chapter 24: Infections of the Central Nervous System
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Q1) Which of the following is a mismatched pair?
A)Haemophilus influenzae type b: acute purulent meningitis
B)Clostridium tetani: neurogenic toxin
C)Botulinum toxin: increased synthesis and release of acetylcholine
D)Measles: Subacute sclerosing panencephalitis
E)Rabies virus: Negri bodies
Q2) The _____ restricts the translocation of material between the blood and the central nervous system.
A)Cerebrospinal fluid
B)Skull bone
C)Arachnoid mater
D)Blood-brain barrier
E)Cerebrum
Q3) Which of the following does not cause chronic meningitis?
A)Rabies virus
B)Toxoplasma gondii
C)Cryptococcus neoformans
D)Mycobacterium tuberculosis
E)Treponema pallidum
Q4) Describe the three forms of botulism.
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Chapter 25: Infections of the Blood and Lymph
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Q1) Compare the Ebola and Marburg infections.Effective treatment is available for which disease?
A)Ebola
B)Marburg
C)Both Ebola and Marburg
D)Neither Ebola or Marburg
Q2) Which of the following is not a characteristic of pneumonic plague?
A)Localization of Yersinia pestis in the lungs
B)Usually fatal if not treated
C)Treated with streptomycin
D)Not usually contagious
E)Development of necrotizing hemorrhagic pneumonia
Q3) Compare the Ebola and Marburg infections.A vaccine is available for A)Ebola
B)Marburg
C)Both Ebola and Marburg
D)Neither Ebola or Marburg
Q4) Discuss three conditions that facilitate the accumulation of pathogens on heart valves during infectious endocarditis.
Q5) Explain the difference between bubonic plague and pneumonic plague.
Page 27
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Chapter 26: Infections of the Skin and Eyes
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Q1) Which of the following is the best match for smallpox?
A)Variola major
B)Dermal warts
C)Scarring of conjunctiva
D)MMR vaccine
E)Latency in nerve ganglia
Q2) Which of the following is characteristic of scaled skin syndrome?
A)Skin lesions common in adolescents
B)Congenital infection can be dangerous
C)Exotoxins termed exfoliatins
D)Inflammation of mucous membranes of vagina or oral cavity
E)Staphylococcal or streptococcal skin lesions
Q3) Which of the following identifies skin lesions that are not palpable?
A)Erythema
B)Pustules
C)Macules
D)Vesicles
E)Papules
Q4) Explain the similarities and differences between cold sores and warts.
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