Exam

Name___________________________________

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

1) All of the following pertain to pinworm infections EXCEPT 1)

A) it is a helminth disease.
B) all family members living with the patient must also be treated.
C) diagnosis is by detecting eggs on transparent tape pressed to the perianal area.
D) transmission is typically by contact with fomites or inhalation of eggs.
E) it is most commonly transmitted by cysts in water.
Answer: E
Explanation: A)
B)
C)
D)
E)

2) Poultry products are a likely source of infection by 2)

A) Helicobacter pylori.
B) Salmonella enterica.
C) Vibrio cholerae.
D) Clostridium perfringens.
E) Shigella spp.
Answer: B
Explanation: A)
B)
C)
D)
E)

3) Which of the following is mismatched? 3)

A) beef - E. coli O157:H7
B) chicken - Campylobacter jejuni
C) eggs - Trichinella spirlais
D) oysters -Vibrio parahaemolyticus
E) custard and cream pies - Staphylococcus aureus
Answer: C
Explanation: A)
B)
C)
D)
E)

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4) In humans, beef tapeworm infestations are acquired by ingesting 4)
A) water contaminated with Diphyllobothrium latum eggs.
B) cystycerci of Taenia saginata in undercooked meat.
C) cystycerci of Taenia solium in undercooked meat.
D) the eggs of Taenia saginata.
E) segments of Taenia solium tapeworms.
Answer: B
Explanation: A)
B)
C)
D)
E)

5) Which of the following is directly involved in the initiation of dental caries? 5)

A) lactic acid
B) lysozyme
C) dentin
D) sucrose
E) crevicular fluid
Answer: A
Explanation: A)
B)
C)
D)
E)

6) Which of the following pertains to typhoid fever? 6)

A) Causative microorganism multiplies in patient phagocytes.
B) It is also call bacillary dysentery.
C) Enterotoxin spreads via the blood.
D) It is acquired via ingestion of contaminated meat.
E) It is caused by several different species of Salmonella.
Answer: A
Explanation: A)
B)
C)
D)
E)

7) Which of the following is mismatched? 7)

A) pinworm infestation humans ingest parasite's eggs
B) hydatid disease humans are the definitive host
C) trichinellosis humans eat larva of parasite
D) Taenia infestation humans are the definitive host
E) hookworm infestation parasite bores through skin
Answer: B
Explanation: A)
B)
C)
D)
E)

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 8) Helicobacter pylori can grow in the stomach because it 8)
A) hides in macrophages.
B) possesses an enzyme that neutralizes HCl.
C) invades epithelial cells.
D) makes HCl.
E) makes a capsule.
Answer: B
Explanation: A)
B)
C)
D)
E)

9) Epidemics related to bacterial infection of the digestive system are typically caused by 9)
A) biological vectors.
B) exposure to contaminated soil.
C) contaminated food and water.
D) unpasteurized milk.
E) the respiratory route.
Answer: C
Explanation: A)
B)
C)
D)
E)

10) Dental plaque is an example of 10)

A) a biofilm.
B) gingivitis.
C) tooth enamel.
D) dentin.
E) a pellicle.
Answer: A
Explanation: A)
B)
C)
D)
E)

11) Which of the following statements about salmonellosis is FALSE? 11)

A) Severity of disease depends on number of organisms ingested.
B) It is a bacterial infection.
C) The mortality rate is high.
D) It is often associated with poultry products.
E) A healthy carrier state exists.
Answer: C
Explanation: A)
B)
C)
D)
E)

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12) The most common cause of traveler's diarrhea is 12)
A) Salmonella enterica.
B) Giardia lamblia.
C) Escherichia coli.
D) Campylobacter jejuni.
E) Shigella spp.
Answer: C
Explanation: A)
B)
C)
D)
E)

13) Which of the following diseases of the gastrointestinal system is transmitted by the respiratory 13)
route?
A) staphylococcal enterotoxicosis
B) traveler's diarrhea
C) Vibrio gastroenteritis
D) bacillary dysentery
E) mumps
Answer: E
Explanation: A)
B)
C)
D)
E)

14) Which of the following organisms is likely to be transmitted via undercooked pork and horse? 14)
A) Staphylococcus aureus
B) Trichinella spiralis
C) Shigella spp.
D) Entamoeba histolytica
E) Salmonella enterica
Answer: B
Explanation: A)
B)
C)
D)
E)

15) Typhoid fever differs from salmonellosis in that in typhoid fever 15)
A) the microorganisms multiply within macrophages.
B) infection occurs due to ingestion of endospores.
C) the symptoms are due to infection of the gallbladder.
D) the incubation period is much longer.
E) infection is spread only in the feces of domesticated animals.
Answer: D
Explanation: A)
B)
C)
D)
E)

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16) Disease-causing exotoxins are produced by all of the following organisms EXCEPT 16)
A) Clostridium botulinum
B) Staphylococcus aureus
C) Shigella dysenteriae
D) Vibrio cholerae
E) Clostridium perfringens
Answer: C
Explanation: A)
B)
C)
D)
E)

17) What is a Dane particle? 17)

A) the chlorine-resistant virus that causes HAV
B) the infectious virion that causes HBV
C) another name for an HBV surface antigen
D) the filamentous particles that cause HAV
E) the spherical particles found in serum of patients with HBV
Answer: A
Explanation: A)
B)
C)
D)
E)

Table 25.1

Food Relative Risk

Black beans 0.58
Corn soup 0.75
Jalapeño peppers 34.13
Roma tomatoes 5.40

18) The relative risks shown in Table 25.1 were calculated for foods suspected of transmitting 18)
Salmonella. Which food is the most likely source of infection?
A) black beans
B) corn soup
C) jalapeño peppers
D) roma tomatoes
E) The answer cannot be determined based on the information provided.
Answer: C
Explanation: A)
B)
C)
D)
E)

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 Situation 25.1
Following a county fair, 160 persons complained of gastrointestinal symptoms. Symptoms included diarrhea (84 percent),
abdominal cramps (96 percent), nausea (84 percent), vomiting (82 percent), body aches (50 percent), fever (60 percent;
median body temperature = 38.3°C); median duration of illness 6 days (range 10 hr to 13 days).

19) In Situation 25.1, fecal samples were found to be negative when cultured. The next step in 19)
diagnosing the cause of illness would be
A) to begin antibiotic therapy.
B) muscle biopsy.
C) blood cultures.
D) microscopic examination of fecess for oocysts.
E) microscopic examination of feces for viruses.
Answer: D
Explanation: A)
B)
C)
D)
E)

20) All of the following are eukaryotic organisms that cause diarrheal disease EXCEPT 20)
A) Entamoeba.
B) Cryptosporidium.
C) Campylobacter.
D) Giardia.
E) Cyclospora.
Answer: C
Explanation: A)
B)
C)
D)
E)

21) Microscopic examination of a patient's fecal culture shows spiral bacteria. The bacteria probably 21)
belong to the genus
A) Shigella spp.
B) Campylobacter jejuni.
C) Salmonella typhi.
D) Vibrio cholerae.
E) Escherichia coli.
Answer: B
Explanation: A)
B)
C)
D)
E)

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22) A 38-year-old man had onset of fever, chills, nausea, and myalgia while vacationing on the Gulf of 22)
Mexico. On April 29, he had eaten raw oysters and gone wading in the warm coastal waters. On
May 2, he was admitted to a hospital because of a fever of 39°C and two circular necrotic lesions on
the left leg. He had a history of alcoholic liver disease. He was transferred to the ICU; therapy with
antibiotics was initiated. On May 4, he died. Which of the following is the most likely cause?
A) Salmonella typhi
B) Cyclospora cayetanensis
C) Vibrio vulnificus
D) Bacillus cereus
E) hepatitis C virus
Answer: C
Explanation: A)
B)
C)
D)
E)

23) Many bacterial infections of the lower digestive tract are treated with 23)
A) water and electrolytes.
B) antitoxin.
C) penicillin.
D) thorough cooking.
E) quinacrine.
Answer: A
Explanation: A)
B)
C)
D)
E)

24) Which of the following helminthic diseases is a common infestation found in the southeastern 24)
United States?
A) Taenia saginata
B) Enterobius vermicularis
C) Echinococcus granulosus
D) Trichuris trichiura
E) Ascaris lumbricoides
Answer: E
Explanation: A)
B)
C)
D)
E)

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25) Which of the following is included in GALT? 25)
A) salivary glands
B) liver
C) thymus
D) Peyer’s patches
E) tonsils
Answer: D
Explanation: A)
B)
C)
D)
E)

26) Which of the following correctly lists the stages of tooth decay? 26)
A) plaque accumulation, destruction of enamel, decay in tooth pulp, advancement of decay
through enamel, decay in dentin
B) destruction of enamel, advancement of decay through enamel, plaque accumulation, decay in
dentin, decay in tooth pulp
C) destruction of enamel, plaque accumulation, advancement of decay through enamel, decay in
dentin, decay in tooth pulp
D) decay in dentin, plaque accumulation, destruction of enamel, advancement of decay through
enamel, decay in tooth pulp
E) plaque accumulation, destruction of enamel, advancement of decay through enamel, decay in
dentin, decay in tooth pulp
Answer: E
Explanation: A)
B)
C)
D)
E)

27) Which of the following causes inflammation of the liver? 27)

A) hepatitis A virus
B) Escherichia coli
C) Vibrio cholerae
D) Shigella spp.
E) Salmonella enterica
Answer: A
Explanation: A)
B)
C)
D)
E)

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28) Bacterial intoxications differ from bacterial infections of the digestive system in that intoxications 28)
A) are transmitted via contaminated water.
B) have shorter incubation times.
C) are more severe.
D) are treated with antibiotics.
E) are accompanied by high fever.
Answer: B
Explanation: A)
B)
C)
D)
E)

29) Which of the following statements about staphylococcal food poisoning is FALSE? 29)
A) It can be prevented by heating foods to 50°C for 15 minutes.
B) It can be prevented by adequate refrigeration of food.
C) It is treated by replacing water and electrolytes.
D) It is caused by ingesting an enterotoxin.
E) It is characterized by rapid onset and short duration of symptoms.
Answer: A
Explanation: A)
B)
C)
D)
E)

30) The most common mode of HAV transmission is 30)

A) contamination of food before it reaches a food service establishment.
B) airborne.
C) contamination of food during preparation.
D) contaminated hypodermic needles.
E) blood transfusion.
Answer: C
Explanation: A)
B)
C)
D)
E)

31) Clostridium difficile-associated diarrhea is usually preceded by 31)

A) a blood transfusion.
B) extended use of antibiotics.
C) travel to an underdeveloped country.
D) eating contaminated food.
E) improper food storage.
Answer: B
Explanation: A)
B)
C)
D)
E)

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32) Thorough cooking of food will prevent all of the following EXCEPT 32)
A) staphylococcal food poisoning.
B) beef tapeworm.
C) trichinellosis.
D) shigellosis.
E) salmonellosis.
Answer: A
Explanation: A)
B)
C)
D)
E)

33) Which of the following organisms feeds on red blood cells? 33)
A) Taenia spp.
B) Escherichia coli
C) Entamoeba histolytica
D) Giardia lamblia
E) Vibrio parahaemolyticus
Answer: C
Explanation: A)
B)
C)
D)
E)

34) A vaccine to provide active immunity to HBV is prepared from 34)

A) viruses grown in embryonated eggs.
B) genetically modified yeast.
C) viruses grown in tissue culture.
D) pooled gamma globulin.
E) viral particles in patients.
Answer: B
Explanation: A)
B)
C)
D)
E)

35) Gums bleeding while brushing one’s teeth is most commonly associated with 35)
A) gingivitis.
B) cavities.
C) trench mouth.
D) periodontitis.
E) halitosis.
Answer: A
Explanation: A)
B)
C)
D)
E)

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36) Which of the following is mismatched? 36)
A) aflatoxin liver cancer
B) ergot gangrene
C) Vibrio enterotoxin secretion of Cl-, K+ , and H2 O
D) Salmonella endotoxin coagulates blood
E) shiga toxin tissue destruction
Answer: D
Explanation: A)
B)
C)
D)
E)

37) Most of the normal microbiota of the digestive system are found in the 37)
A) mouth.
B) stomach.
C) stomach and small intestine.
D) small intestine and large intestine.
E) accessory structures.
Answer: D
Explanation: A)
B)
C)
D)
E)

38) The digestive tract is essentially one long tube. The order of the structures, beginning with the 38)
mouth, is
A) pharynx, esophagus, stomach, small intestine, large intestine.
B) esophagus, stomach, pharynx, small intestine, large intestine.
C) esophagus, pharynx, stomach, small intestine, large intestine.
D) pharynx, stomach, esophagus, small intestine, large intestine.
E) pharynx, esophagus, stomach, large intestine, small intestine.
Answer: A
Explanation: A)
B)
C)
D)
E)

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39) Acute gastroenteritis that occurs after an incubation period of two to three days and commonly 39)
affects children is probably caused by
A) Giardia.
B) rotavirus.
C) Trichinella.
D) Staphylococcus aureus.
E) Salmonella.
Answer: B
Explanation: A)
B)
C)
D)
E)

40) "Rice water stools" are characteristic of 40)

A) cholera.
B) salmonellosis.
C) bacillary dysentery.
D) tapeworm infestation.
E) amebic dysentery.
Answer: A
Explanation: A)
B)
C)
D)
E)

41) All of the following infections can result from drinking contaminated water EXCEPT 41)
A) trichinellosis.
B) Cyclospora infection.
C) cholera.
D) giardiasis.
E) cryptosporidiosis.
Answer: A
Explanation: A)
B)
C)
D)
E)

42) Aflatoxin is a(n) ________ associated with ingestion of contaminated ________. 42)
A) mycotoxin; peanuts
B) endotoxin; peanuts
C) enterotoxin; rye or other cereal grains
D) mycotoxin; rye or other cereal grains
E) enterotoxin; peanuts
Answer: A
Explanation: A)
B)
C)
D)
E)

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 Situation 25.1
Following a county fair, 160 persons complained of gastrointestinal symptoms. Symptoms included diarrhea (84 percent),
abdominal cramps (96 percent), nausea (84 percent), vomiting (82 percent), body aches (50 percent), fever (60 percent;
median body temperature = 38.3°C); median duration of illness 6 days (range 10 hr to 13 days).

43) In Situation 25.1, fecal samples should be cultured for all of the following EXCEPT 43)
A) Giardia lamblia.
B) enteropathogenic Escherichia coli.
C) Campylobacter jejuni.
D) Shigella spp.
E) Salmonella enterica.
Answer: A
Explanation: A)
B)
C)
D)
E)

44) All of the following are gram-negative rods that cause gastroenteritis EXCEPT 44)
A) Salmonella typhi.
B) Yersinia enterocolitica.
C) Clostridium perfringens.
D) Escherichia coli.
E) Shigella spp.
Answer: C
Explanation: A)
B)
C)
D)
E)

45) Which of the following organisms is likely to be transmitted via contaminated shrimp? 45)
A) Giardia lamblia
B) Trichinella spiralis
C) Staphylococcus aureus
D) Clostridium perfringens
E) Vibrio parahaemolyticus
Answer: E
Explanation: A)
B)
C)
D)
E)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.

46) Bacterial infections, but not intoxications, can cause diarrhea. 46)
Answer: True False
Explanation:

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 47) Lactic acid, an end product of fructose fermentation, causes breakdown of tooth enamel and, 47)
eventually, cavities.
Answer: True False
Explanation:

48) Aflatoxin poisoning is associated with liver cancer. 48)

Answer: True False
Explanation:

49) An outbreak of viral gastroenteritis occurs in a pediatrics ward. Rotavirus is the most likely 49)
causative agent.
Answer: True False
Explanation:

50) Approximately 30 percent of the body’s immune system is located in the intestinal tract. 50)
Answer: True False
Explanation:

51) Dental caries is also known as periodontal disease. 51)

Answer: True False
Explanation:

52) EHEC is a major cause of diarrhea in developing countries and may result in the death of small 52)
children.
Answer: True False
Explanation:

53) Campylobacter gastroenteritis is the leading cause of foodborne illness in the United States. 53)
Answer: True False
Explanation:

54) H. pylori is able to survive the acidic environment of the stomach as a result of adaptations 54)
that allow it to increase the pH of the immediate environment.
Answer: True False
Explanation:

55) Gastroenteritis due to ingestion of food contaminated with Staphylococcus aureus is due to 55)
intoxication by enterotoxins.
Answer: True False
Explanation:

ESSAY. Write your answer in the space provided or on a separate sheet of paper.

56) Multiple pathovars of E. coli are well characterized. Identify four different pathogenic strains and discuss the
mechanism of disease for each.
Answer:

57) Describe the process of periodontal disease.

Answer:

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58) Mary made her family’s favorite cream of broccoli soup for lunch. Lunch was forgotten when her son suddenly
remembered he had a soccer game at noon. The family finally returned several hours later and sat down to eat.
Although Mary reheated the soup (which had been left out at room temperature while they were gone), why is
this no guarantee that Mary and her family will not become sick due to food poisoning?
Answer:

59) Discuss why cholera epidemics are often associated with floods.
Answer:

60) Compare the modes of transmission for hepatitis A, B, and C.

Answer:

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Answer Key
Testname: C25

1) E
2) B
3) C
4) B
5) A
6) A
7) B
8) B
9) C
10) A
11) C
12) C
13) E
14) B
15) D
16) C
17) A
18) C
19) D
20) C
21) B
22) C
23) A
24) E
25) D
26) E
27) A
28) B
29) A
30) C
31) B
32) A
33) C
34) B
35) A
36) D
37) D
38) A
39) B
40) A
41) A
42) A
43) A
44) C
45) E
46) FALSE
47) TRUE
48) TRUE
49) TRUE
50) FALSE
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Answer Key
Testname: C25

51) FALSE
52) FALSE
53) TRUE
54) TRUE
55) TRUE
56)
57)
58)
59)
60)

17