Chapter 22 - Respiratory System Infections

Chapter 22
Respiratory System Infections

Multiple Choice Questions

1. The process used for identifying the different carbohydrates of streptococci is called
A. Lancefield grouping.
B. CHO typing.
C. streptococci.
D. fermentation testing.

2. Rebecca Lancefield showed that almost all the strains of b-hemolytic streptococci from
human infections
A. could cause rheumatic fever.
B. had the same cell wall carbohydrate "A".
C. had variable cell wall carbohydrates.
D. responded to penicillin.

3. The scientist who developed a system of identifying the variety of strains of streptococci
was
A. Hans Zimmer.
B. Donald Sutherland.
C. O. T. Avery.
D. Rebecca Lancefield.

4. Enlargement of which of the following structures may contribute to ear infections by

interfering with normal drainage from eustachian tubes?
A. nasal chamber
B. nasal conchae
C. epiglottis
D. adenoids

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5. The conjuctivae
A. have no resident bacteria.
B. are often covered with bacteria.
C. are populated with S. aureus.
D. are populated with S. pyogenes.

6. The eyes are protected from infection by

A. the washing action of the tears and eyelids.
B. the chemical action of lysozyme.
C. the use of contact lenses.
D. the dryness of the eye surface.
E. the washing action of the tears and eyelids AND the chemical action of lysozyme.

7. The cause of strep throat is

A. Staphylococcus aureus
B. Streptococcus pyogenes- beta-hemolytic, group A
C. Staphylococcus pyogenes- alpha-hemolytic, group B
D. Streptococcus pneumoniae

8. Which of the following is associated with the upper respiratory system?

A. humidifying inhaled air
B. warming inhaled air
C. cooling inhaled air
D. drying inhaled air
E. humidifying inhaled air AND warming inhaled air

9. Rapid diagnostic tests for streptococcal infections may utilize

A. blood agar.
B. antibodies.
C. DNA probes.
D. the Kirby-Bauer test.
E. antibodies AND DNA probes.

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10. Virulence factors used by S. pyogenes may be

A. Protein F.
B. M Protein.
C. a capsule.
D. Protein G.
E. All of the choices are correct.

11. The disease characterized by the appearance of a toxin-mediated rash that spares the area
around the mouth and causes the tongue to look like the surface of a ripe strawberry is
A. measles.
B. chickenpox.
C. strep throat.
D. scarlet fever.

12. A bacteriophage is necessary for toxin production in

A. E. coli.
B. Staphylococcusaureus.
C. Streptococcus pyogenes.
D. C. diphtheriae.

13. Diphtheria toxin works on

A. lysosomes.
B. mitochondria.
C. chloroplasts.
D. elongation factor 2.

14. Which is used in the vaccination for C. diphtheriae?

A. protein A
B. M protein
C. toxoid
D. red blood cells

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15. The most common bacterial pathogen(s) involved with sinusitis, otitis media and
conjunctivitis is/are
A. S. aureus
B. H. influenzae
C. S. pneumoniae
D. S. epidermidis
E. H. influenzae AND S. pneumoniae

16. Otitis media and sinusitis are usually preceded by a(n)

A. middle ear infection.
B. pseudomonal infection.
C. oropharyngeal infection.
D. nasopharyngeal infection.

17. Otitis media probably develops from an infection that spread

A. from the outer ear to the middle ear.
B. from the sensory neurons of the middle ear.
C. through the tympanic membrane.
D. upward through the eustachian tube.

18. The eyes connect directly to the nasal passage through the
A. frontal sinuses.
B. nasolacrimal ducts.
C. middle ear.
D. tonsils.

19. Most colds are probably caused by

A. rhinovirus.
B. S. aureus.
C. Pseudomonas sp.
D. E. coli.

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20. Rhinoviruses need to be grown

A. in living cells.
B. in synthetic media.
C. on blood agar.
D. at 33C.
E. in living cells AND at 33C.

21. The rhinovirus contains

A. single-stranded RNA.
B. double-stranded RNA.
C. double-stranded DNA.
D. multiple pieces of single-stranded DNA.

22. The reservoir of the common cold is the

A. family pet.
B. human.
C. infected fomite.
D. fruit.

23. A vaccine for the common cold is not feasible because

A. the surface antigens of rhinovirus mutate frequently.
B. the cause is unknown.
C. the rhinovirus cannot be grown in sufficient quantities.
D. there are more than 100 types of rhinovirus.

24. Colds are effectively treated with

A. antibiotics.
B. aspirin and acetaminophen.
C. proteases.
D. nucleotide analogs.
E. None of the choices is correct.

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25. Effective preventive methods for avoiding the common cold is/are
A. hand washing.
B. avoiding crowds.
C. not touching one's face.
D. avoiding close contact with people with colds.
E. All of the choices are correct.

26. The disease that closely resembles "strep throat" but is of viral origin is
A. the common cold.
B. otitis media.
C. tonsilitis.
D. adenoviral pharyngitis.

27. Adenoviral pharyngitis is effectively treated with

A. antibiotics.
B. lysozyme.
C. proteases.
D. nucleotide analogs.
E. None of the choices is correct.

28. Which of the following are considered diseases of the lower respiratory tract?
A. diphtheria and pneumonia
B. influenza and diphtheria
C. tuberculosis and pneumonia
D. common cold and tuberculosis

29. About 60% of the bacterial pneumonias that require hospitalization of adults are caused
by
A. S. pyogenes.
B. S. pneumoniae.
C. S. aureus.
D. K. pneumonia.

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30. The characteristic virulence factor of S. pneumoniae is

A. a capsule.
B. flagella.
C. pili.
D. cilia.

31. The key virulence factor of S. pneumoniae interferes with

A. the action of C3.
B. the action of C3b.
C. the action of C5a.
D. interferon.

32. The pneumococcal vaccine is directed against the

A. flagella.
B. pili.
C. cilia.
D. capsule.

33. Both S. pneumoniae and K. pneumoniae use this as a virulence factor.

A. pili
B. flagella
C. capsules
D. cilia

34. The causative agent of the pneumonia that causes permanent lung damage, may be
nosocomial and has a high mortality if untreated is
A. S. pneumoniae.
B. K. pneumoniae.
C. S. pyogenes.
D. S. aureus.

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35. The virulence of Klebsiella is due partly to the

A. motility of the organism.
B. exotoxin produced.
C. engorgement of blood vessels.
D. antiphagocytic properties of their capsules.
E. exotoxin produced AND antiphagocytic properties of their capsules.

36. The resistance of Klebsiella to antibiotics may be

A. chromosomal mediated.
B. plasmid mediated.
C. lysosomal mediated.
D. capsule mediated.
E. chromosomal mediated AND plasmid mediated.

37. Mycoplasmal and klebsiellal pneumonias

A. have similar incubation periods.
B. have causative agents that lack cell walls.
C. are serious diseases often requiring hospitalization.
D. are both relatively mild diseases.
E. None of the choices is correct.

38. The spread of mycoplasma is through

A. inhalation of infected droplets.
B. the fecal-oral route.
C. an insect vector.
D. a fomite.

39. Which is/are true of coccidioidomycosis and histoplasmosis?

A. They are both soil fungi.
B. They are both dimorphic fungi.
C. They are both life-threatening.
D. They may be treated with antibiotics.
E. They are both soil fungi AND they are both dimorphic fungi.

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40. Which antibiotics may be completely ineffective in treating a mycoplasmal infection?

A. penicillin
B. cephalosporin
C. tetracycline
D. erythromycin
E. penicillin AND cephalosporin

41. The sudden, violent, uncontrollable cough of pertussis is described as

A. productive.
B. contagious.
C. infective.
D. paroxysmal.

42. The causative agent of whooping cough is

A. parvovirus.
B. M. pneumoniae.
C. B. pertussis.
D. S. aureus.

43. Pertussis toxin

A. uses part B to attach to receptors on the host cell.
B. uses part A to inactivate G protein.
C. affects the level of cAMP in a cell.
D. affects the level of mucus secretion.
E. All of the choices are correct.

44. Although unusually resistant to many control factors, the tubercle bacillus is easily killed
by
A. strong acids.
B. disinfectants.
C. pasteurization.
D. strong alkalis.

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45. The resistance of the tubercle bacillus to various factors is probably due to its
A. capsule.
B. larger ribosomes.
C. ability to adhere tightly.
D. cell wall.

46. The virulence of the tubercle bacillus is due to its

A. toxin.
B. lyosgenic conversion.
C. resistance to antibiotics.
D. survival within macrophages.
E. lyosgenic conversion AND resistance to antibiotics.

47. The destructive nature of tuberculosis can be characterized as a(n)

A. endotoxin pyrogenic response.
B. immune complex reaction.
C. inflammatory response.
D. delayed hypersensitivity reaction.

48. The bacterial lung infection acquired by inhalation of aerosols of contaminated water is
known as
A. whooping cough.
B. walking pneumonia.
C. influenza.
D. Legionnaires' disease.

49. Influenza is caused by

A. orthomyxovirus.
B. H. influenza.
C. cytomegalovirus.
D. adenovirus.

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50. Projecting from the outer envelope of the influenza virus are two glycoproteins called
A. leukocidin and hemolysin.
B. hyaluronidase and coagulase.
C. hemagglutinin and neuraminidase.
D. lysozyme and coagulase.

51. Antigenic shifts may be the result of

A. two different viruses infecting a cell at the same time.
B. the lysogenic conversion of two viruses.
C. conjugation of two viruses.
D. blending of a bacterial and a viral genome.
E. the lysogenic conversion of two viruses AND blending of a bacterial and viral genome.

52. Which is true of hantavirus?

A. It is a zoonosis involving mice.
B. It has three segments of single stranded RNA.
C. The primary effect is to flood the lungs with fluid.
D. Shock and death occurs in 40% of the cases.
E. All of the choices are correct.

53. Two relatively widespread North American lung mycoses are

A. candidiasis and coccidioidomycosis.
B. candidiasis and aspergillosis.
C. apergillosis and Reyes syndrome.
D. coccidioidomycosis and histoplasmosis.

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Matching Questions

54. Which of the following best matches the description:

1. H. influenzae fungus 3
2. Tuberculosis bacteria 1
3. Coccidioidomycosis virus 4
4. Influenza bacteria 2
5. Reye's syndrome virus 5

True / False Questions

55. Streptococci are grouped by their cell wall carbohydrates.

TRUE

56. Otitis media is an infection of the middle ear that is rare in the first month of life.
TRUE

57. Humans are the only source of the cold virus.

TRUE

58. Rhinoviruses are effectively treated with antibiotics.

FALSE

59. Of infectious diseases, pneumonia is a major killer in the general population.

TRUE

60. A vaccine is available for protection from pneumococcal pneumonia.

TRUE

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61. Klebsiella easily acquire and are a source of R factors.

TRUE

62. Pneumonias are inflammatory diseases of the lung in which fluid fills the alveoli.
TRUE

63. Mycoplasma is effectively treated with cell wall inhibiting antibiotics.

FALSE

64. Histoplasmosis may mimic tuberculosis.

TRUE

Essay Questions

65. Why is it so difficult to protect against influenza?

The vaccine is fairly effective in protecting against the flu. However, a problem comes from
the changing nature of the flu virus. The antibody generated from the last exposure may be
useless against the next iteration of the virus. The virus has several segments of RNA and is
also found in animals. Both of these characteristics allow for changing and mixing of the
nucleic acid, which may be reflected in changes in the antigenic nature of the virus. Therefore,
every year there is a possibility that the antigens have changed enough from the last infection
to be unrecognizable. In particular, the changes appear in the neuraminidase and
hemagglutinin molecules coating the virus.

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