Medical Microbiology
Exam Answer Key
Course Introduction
Medical Microbiology is the study of microorganisms, including bacteria, viruses, fungi, and parasites, that cause diseases in humans. This course explores the fundamental concepts of microbial structure, physiology, genetics, and pathology, with an emphasis on the mechanisms by which these organisms invade, evade immune responses, and inflict damage on the host. Students will gain insight into methods of microbial identification, diagnosis of infections, antimicrobial treatments, and principles of infection control and prevention. Case studies and laboratory practices are integrated to reinforce the application of theoretical knowledge in clinical and laboratory settings.
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) Carbon atoms can form how many bonds with other atoms?
A)6
B)12
C)4
D)2
E)8
Answer: C
Q2) Which of the following statements is correct?
A)A base is a H? ion donor
B)Pure water is completely neutral and has a pH of 0
C)On a pH scale, gastric fluids are classified as alkaline
D)H? ion concentration is inversely related to pH
E)If the hydroxyl ions outnumber the H? ions, the pH will be less than 7.0
Answer: D
Q3) The components of ATP include
A)Adenine, ribose sugar, and three phosphates
B)Amino acid and three phosphates
C)Adenine, triglycerols, and one phosphate
D)Adenine, deoxyribose sugar, and three phosphates
Answer: A
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Chapter 3: Essentials of Metabolism
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Sample Questions
Q1) In the figure which step indicates the molecules produced by dehydration?
Answer: D
Q2) What has occurred when a large molecule is broken down into small molecules?
A)Anabolism
B)Anaerobic respiration
C)Catabolism
D)Feedback inhibition
Answer: C
Q3) What is the result if an enzyme is subjected to extremely high temperatures?
A)The enzyme's rate of reaction will increase
B)There will be an alteration in electrical charges, which will interfere with substrate interaction
C)The substrate concentration will be too low for enzyme activity
D)The hydrogen bonds stabilizing the three-dimensional structure will break and the enzyme will become denatured
E)The enzyme's activity will cease as a result of feedback inhibition
Answer: D
Q4) In the figure which step would produce carbon dioxide?
Answer: B
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Chapter 4: An Introduction to Cell Structure and Host-Pathogen Relationships
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Sample Questions
Q1) In the Gram stain,_____ is used as a mordant to stabilize crystal violet in _____ cells.
A)Alcohol; Gram-positive
B)Alcohol; Gram-negative
C)Iodine; Gram-positive
D)Iodine; Gram-negative
E)Safranin; Gram-nonreactive
Q2) An outbreak of food poisoning occurs at a family picnic after the growth of Staphylococcus aureus in unrefrigerated potato salad left sitting in the hot sun for several hours.What would microscopic examination of the potato salad reveal?
A)Long chains of cocci
B)Diplococcic
C)Tetrads
D)Clusters of cocci
E)Spirillum
Q3) Explain why ribosomes are suitable therapeutic targets for some,but not all,infections.
Q4) Describe quorum sensing.Why is it advantageous for a pathogen to use quorum sensing during an infection?
Page 6
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Chapter 5: Requirements for Infection
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Q1) What is the general term for components of a pathogen that help it to be infectious?
A)Portals of entry
B)Parenteral characteristic
C)Transmissible factors
D)Virulence factors
E)Adhesion factors
Q2) Explain how the bacterium Helicobacter pylori can survive the acidic environment of the stomach.What is the consequence of a Helicobacter infection?
Q3) A dose of 1000 bacteria can kill 50% of the animals and a dose of 2400 can kill 70% of the animals.What is the approximate LD<sub>50</sub>?
A)1000
B)2400
C)150
D)1700
Q4) How does Bacillus anthracis ensure that the activity of the anthrax toxin is exerted only inside the host cell?
Q5) How does tooth brushing protect teeth from cavity formation?
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Chapter 6: Transmission of Infection, the Compromised
Host, Epidemiology, and Diagnosing Infections
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Q1) Identify and describe three types of reservoir with a role in the transmission of infectious diseases to humans and provide an example of a disease for each type of reservoir.
Q2) What is the mode of transmission for plague?
A)Droplets
B)Mosquito
C)Flea
D)Drinking water
E)Direct contact
Q3) Control groups are required when performing _____ studies.
A)Descriptive epidemiological
B)Universal precaution
C)Superinfection
D)Nosocomial
E)Analytical epidemiological
Q4) It is sometimes difficult to identify human reservoirs of infectious disease.Discuss three reasons and provide an example.
Q5) How does morbidity rate differ from incidence rate?
Q6) Explain the difference between morbidity rate and mortality rate.
Q7) What are potential sources of nosocomial infections? List at least six. Page 8
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Chapter 7: Principles of Disease
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Sample Questions
Q1) 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
Q2) Escherichia coli cells producing bacteriocins are participating in A)Opportunism
B)Antibiotic resistance
C)Commensalism
D)Parasitism
E)Microbial antagonism
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.
10
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Chapter 8: Emerging and Re-Emerging Infectious Disease
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Sample Questions
Q1) In the figure which letter (A to E)indicates a macrophage?
Q2) 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
Q3) All of the following are characteristics of Ebola hemorrhagic fever except
A)Circulatory shock
B)Possibility of transmission from human to human
C)Effective vaccine if received in advance of exposure
D)Disseminated intravascular coagulation (DIC)
E)Petechial hemorrhaging
Q4) Which is not a characteristic of prions?
A)Resistant to degradation by proteinases
B)Found mainly on outer membranes of nerve cells.
C)Resistant to autoclave treatment.
D)Unable to pass through the intestinal wall
E) Resistant to autoclave treatment and unable to pass through the intestinal wall
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Chapter 9: The Clinical Significance of Bacterial Anatomy
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Q1) 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
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) A bacterium with a tuft of flagella at one end of the cell has _____ flagella.
A)Peritrichous
B)Amphitrichous
C)Lophotrichous
D)Monotrichous
Q4) In the figure which letter (A to E)indicates a Gram-negative cell portion?
Q5) In the figure which letter (A to E)indicates the structure that permanently stains with crystal violet?
Page 12
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Chapter 10: Bacterial Growth
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Q1) Answer true or false to the following statement: Pathogens of humans are chemoautotrophs.
A)True
B)False
Q2) The _____ growth temperature is the temperature at which the fastest growth rate occurs.
A)Minimum
B)Suboptimal
C)Maximum
D)Optimal
Q3) Which of the following is not a method used to count viable bacteria?
A)Flow cytometry
B)Spectrophotometry
C)Measurement of biomass
D)Plate count
Q4) Answer true or false to the following statement: Differential medium contains ingredients that that allow only a few species of bacteria to grow.
A)True
B)False
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Chapter 11: Microbial Genetics and Infectious Disease
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Sample Questions
Q1) Which enzyme facilitates the attachment of amino acids to tRNA molecules?
A)Peptidyl transferase
B)RNA polymerase
C)Helicase
D)Aminoacyl-tRNA synthetase
E)Topoisomerase
Q2) During DNA replication,the lagging strand moves _____ the replication fork and requires the synthesis of _____ primer(s).
A)Away from; one
B)Toward; one
C)Away from; many
D)Toward; many
Q3) Answer true or false to the following statement: No errors are made during DNA replication
A)True
B)False
Q4) In the figure which letter (A-C)refers to the codon,UAA?
Q5) Explain how RNA differs from DNA in structure and function.
Q6) In the figure which letter (A-C)refers to the codon at the 3' end of the messenger RNA?
Page 14
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Chapter 12: The Structure and Infection Cycle of Viruses
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Q1) A capsid 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
Q2) A viral envelope 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
Q3) 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
Q4) Explain the difference between helical and icosahedral symmetry.Provide an example of each.
15
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Chapter 13: Viral Infection
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Sample Questions
Q1) All of the following cause skin rashes in humans except
A)Rubella virus
B)Measles virus
C)Parvovirus
D)Hepatitis C virus
E)Varicella-zoster virus
Q2) Which of the following is not a requirement of an effective vaccine?
A)The components of the vaccine should induce protective immune responses
B)The host should mount a memory response that has the capacity to respond if the pathogen is encountered at a later time
C)The vaccine should induce only mild disease
D)The vaccine should be biologically stable
E)The cost to produce and administer the vaccine should be minimized to promote effective use in target populations
Q3) Why is vaccination the most promising approach to the control of viral epidemics?
Describe the three classes of viral vaccine administered to humans and provide examples of each.
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Chapter 14: Parasitic and Fungal Infections
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Q1) Rearrange the following into the order of events following ingestion of Ascaris eggs.Which is the fourth event?
A)Invasion of intestinal epithelium
B)Pumped into the lung
C)Conversion to larval stage
D)Coughed into mouth
E)Liver invasion
Q2) Answer true or false to the following statement: The study of fungi is called parasitology.
A)True
B)False
Q3) Explain how genetic recombination occurs in fungi.
Q4) All of the following are matched correctly except
A)Malaria: mosquito transmission
B)Amebiasis: fecal-oral transmission
C)Trichomoniasis: sexual transmission
D)Toxoplasmosis: feline transmission
E)Trypanosomiasis: fecal-oral transmission
Q5) Identify and describe three categories of pathogenic fungal infection.
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Chapter 15: The Innate Immune Response
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Sample Questions
Q1) Low pH is associated with all of the following except A)Stomach acid
B)Tears
C)Sebum
D)Urine
Q2) Why is it problematic for the host if a pathogen is able to resist phagocytosis?
Provide an example of a pathogen that can resist phagocytosis and explain how this is achieved.
Q3) Which of the following is a mismatched pair?
A)Microglial cells: spleen
B)Liver: Kupffer cells
C)Epidermis: dendritic cells
D)Blood: monocytes
E)Lung: alveolar macrophages
Q4) Answer true or false to the following statement: Interleukin-6 is a cytokine that induces acute-phase protein production in the liver.
A)True
B)False
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Chapter 16: The Adaptive Immune Response
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Q1) How many antigen-binding sites do T cell receptors have in comparison with B cell receptors?
A)Half the number
B)Twice the number
C)The same number
D)Three times as many
Q2) 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
Q3) Describe the process of transcytosis of dimeric IgA.Why is this process especially important in relation to newborns and passive immunity?
Q4) Explain what is meant by the phrase "T and B cell cooperation" in the context of adaptive immune responses.Why is it important that the B cell functions as an antigen-presenting cell for this cooperation to occur and how is this accomplished?
Q5) Explain why dendritic cells are considered "watch dogs" for pathogens.
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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) Which of the following is false?
A)Myasthenia gravis results from the formation of autoantibodies specific for neurotransmitter receptors
B)Systemic lupus erythematosus is characterized by the formation of anti-DNA antibodies
C)Rheumatic fever follows influenza infections when antibodies against the virus cross-react with host components
D)Tolerance is the process whereby self-reactive T and B cells are inactivated or eliminated
E)Autoimmune responses are controlled by specialized CD25-positive T cells called regulatory T cells
Q3) 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) Which of the following is a target for disinfectants and antiseptics?
A)Nucleic acid synthesis
B)Cell wall synthesis
C)Plasma membrane
D)Protein structure
E)All of the above
Q2) Answer true or false to the reason given in the following statement: The death of a microbe such as a bacterium can be hard to identify,because it is difficult to detect DNA synthesis.
A)True
B)False
Q3) Answer true or false to the reason given in the following statement: The sizes of the zones of inhibition seen with different chemicals are not comparable because bacteria move at different rates.
A)True
B)False
Q4) Explain what happens when a protein becomes denatured and why this process is likely to be detrimental to microbes.Provide three examples of how proteins can be denatured.
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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) The most appealing target for antibiotics is the bacterial cell wall,because it is on the outside of the cell.
A)True
B)False
Q3) Discuss selective toxicity as it relates to antimicrobials.
Q4) Which of the following is a mismatched pair?
A)Acyclovir (nucleoside analog): herpes simplex virus
B)Zanamivir (neuraminidase inhibitor): cytomegalovirus
C)Azidothymidine (AZT; nucleoside analog): HIV
D)Ribavirin (nucleoside analog): respiratory syncytial virus
E)Amantadine (viral un-coating inhibitor): influenza A
Q5) Explain how sulfa drugs exert their antimicrobial effects.Why is this lethal to the bacterium and how are these drugs selectively toxic?
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Chapter 20: Antibiotic Resistance
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Q1) By incorporating antibiotics into animal feed,farmers
A)Increase the weight gains of their livestock and can create antibiotic resistant microbes
B)Extend the period cattle spend in feedlots
C)Prevent viral diseases in their herds
D)Reduce the incidence of foot-and-mouth disease in their livestock
Q2) Answer true or false to the reason given in the following statement: The hospital is a place where resistance can develop rapidly because there is a high concentration of bacteria and small amounts of antibiotics are constantly used.
A)True
B)False
Q3) Identify and describe five factors that contribute to the growing problem of antibiotic resistance in today's world.
Q4) Which of the following antibiotics is MRSA not resistant to?
A)Aminoglucosides
B)Methicillin
C)Tetracyclines
D)Vancomycin
E)Erythromycin
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Chapter 21: Infections of the Respiratory System
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Q1) Which of the following best describes aspergillosis?
A)Not associated with AIDS
B)Spores are encased in spherules
C)Associated with bird and bat droppings
D)Contains cholesterol in plasma membrane
E)100% mortality when invasion of lung tissue occurs
Q2) Explain how Ghon complexes are formed.How are they diagnosed and why are they problematic?
Q3) Which of the following is most appropriate for histoplasmosis?
A)Not associated with AIDS
B)Spores are encased in spherules
C)Associated with bird and bat droppings
D)Contains cholesterol in plasma membrane
E)100% mortality when invasion of lung tissue occurs
Q4) A child diagnosed with "croup" most probably has a(n)_____ infection.
A)Diphtheria
B)Parainfluenza
C)Mycoplasma
D)Pertussis
E)Influenza
Page 24
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Chapter 22: Infections of the Digestive System
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Q1) Which family of viruses does Hepatitis B belong to?
A)Hepadnaviridae
B)Flaviviridae
C)Reoviridae
D)Picornaviridae
E)Caliciviridae
Q2) What is the most likely mode of transmission for Vibrio cholera?
A)Shellfish
B)Contaminated water
C)Chronic human carriers
D)Ground meat
E)Undercooked poultry
Q3) Compare the pathogenesis of enterotoxigenic Escherichia coli (ETEC),enteropathogenic
E. coli (EHEC).
E. coli (EPEC), and enterohemorrhagic
Q4) Describe the life cycle of a hookworm.
Q5) Identify and describe the three categories used to classify gastrointestinal infections,and provide several examples of microbes responsible for each category.
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Chapter 23: Infections of the Genitourinary System
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Q1) Which of the following is not a characteristic of pelvic inflammatory disease?
A)Caused by human papillomavirus
B)May cause infertility
C)Can lead to ectopic pregnancy
D)Sometimes causes infection of fetus or newborn
Q2) Which of the following is not a means by which Neisseria gonorrhoeae escapes host defenses?
A)Induction of apoptosis by neutrophils
B)Production of large quantities of catalase
C)Interference with bacteriocidal activity of antibodies
D)Blocking C3 deposition on bacterial surface
E)Inhibition of phagocyte attachment
Q3) Answer true or false to the following statement: An individual's predisposition to sexually transmitted diseases increases with sexual promiscuity.
A)True
B)False
Q4) Explain why antiviral drugs are ineffective for the eradication of HSV-2.
Q5) Identify four ways in which candidiasis arises.Discuss the morphological and enzymatic changes that are associated with the pathogenesis of Candida albicans.
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Chapter 24: Infections of the Central Nervous System
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Q1) Answer true or false to the reason given in the following statement: Poliomyelitis is essentially nonexistent in developed countries because of intensive supportive care.
A)True
B)False
Q2) All of the following are characteristic of most cases of aseptic meningitis except
A)More than 90% of cases are caused by enterovirus
B)Self-limiting with symptoms lasting 7-10 days
C)High fever, stiff neck, and headache
D)Diagnosis requires cerebrospinal fluid sample
E)Treated with antibiotics
Q3) Compare abortive to paralytic polio in relation to the following statement: It can be prevented by vaccination.
A)Abortive
B)Paralytic
C)Both abortive and paralytic
D)Neither abortive or paralytic
Q4) How do the effects on the nervous system differ between botulism and tetanus?
Q5) Describe the three forms of botulism.
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Chapter 25: Infections of the Blood and Lymph
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Q1) All of the following are examples of how tularemia is transmitted to humans except A)Inhalation
B)Ingesting tainted meat
C)Flea bite
D)Direct contact with wound
E)Contaminated water
Q2) A bacterial infection affecting heart valves or septa is referred to as
A)Disseminated intravascular coagulation
B)Septic shock
C)Thrombophlebitis
D)Infectious endocarditis
Q3) 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
Q4) What are the most common complications of infectious endocarditis? Identify the four most common bacterial sources of infectious endocarditis.
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Chapter 26: Infections of the Skin and Eyes
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Q1) Answer true or false to the reason given in the following statement: Because of the close proximity to the respiratory tract,eye infections can become life threatening.
A)True
B)False
Q2) Compare cutaneous to inhalation anthrax.Which is transmitted as spores?
A)Cutaneous anthrax
B)Inhalation anthrax
C)Both cutaneous and inhalation anthrax
D)Neither cutaneous or inhalation anthrax
Q3) All of the following are transmitted or caused by arthropods except A)Loaiasis
B)Pediculosis
C)Neonatal gonorrheal ophthalmia
D)Trachoma
E)Cutaneous leishmaniasis
Q4) Explain the similarities and differences between cold sores and warts.
Q5) What is the etiological agent of gas gangrene? Explain the sequence of events leading to the development of this condition and the associated pathology.How is gas gangrene treated?
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