Exam

Name___________________________________

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

1) Which of the following statements about sepsis is FALSE? 1)

A) It usually is caused by gram-positive bacteria.
B) Lymphangitis may occur.
C) Symptoms include fever and decreased blood pressure.
D) It may be aggravated by antibiotics.
E) It can be treated with antibiotics.
Answer: A
Explanation: A)
B)
C)
D)
E)

2) Which of the following pairs does NOT apply to Chagas' disease? 2)

A) diagnosis of acute phase serological tests for antibodies
B) treatment nifurtimox
C) reservoir rodents
D) vector kissing bug
E) causative agent Trypanosoma cruzi
Answer: A
Explanation: A)
B)
C)
D)
E)

3) Which of the following pairs is mismatched? 3)

A) Streptobacillus rat-bite fever
B) Spirillum rat-bite fever
C) Pasteurella cat-scratch disease
D) Borrelia relapsing fever
E) Yersinia plague
Answer: C
Explanation: A)
B)
C)
D)
E)

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4) Which of the following statements about rheumatic fever is FALSE? 4)
A) The incidence has declined in the last ten years.
B) It is an inflammation of the heart.
C) It is rarely fatel, even when untreated.
D) It is an inflammation of the joints.
E) It is a complication of a group A beta-hemolytic streptococcal infection.
Answer: C
Explanation: A)
B)
C)
D)
E)

5) You advise your pregnant friend to give her cat away because she could contract 5)
A) Brukitt’s Lymphoma
B) listeriosis.
C) infectious mononucleosis.
D) plague.
E) toxoplasmosis.
Answer: E
Explanation: A)
B)
C)
D)
E)

6) Which of the following bacterial infections CANNOT be transmitted by dog or cat bites? 6)
A) Fusobacterium
B) Bartonella henselae
C) Streptobacillus
D) Pasteurella multocida
E) None of the answers is correct; all of these bacterial infections can be transmitted by dog or cat
bites.
Answer: C
Explanation: A)
B)
C)
D)
E)

7) A characteristic symptom of plague is 7)

A) small red spots on the skin.
B) recurrent fever.
C) rose-colored spots.
D) nausea and vomiting.
E) swollen lymph nodes.
Answer: E
Explanation: A)
B)
C)
D)
E)

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 8) Which of the following statements about puerperal sepsis is FALSE? 8)
A) Its frequency of occurrence has decreased because of antibiotics and aseptic techniques.
B) It is caused by health care personnel.
C) It is a complication of abortion or childbirth.
D) It begins as a focal infection.
E) It is transmitted from mother to fetus.
Answer: E
Explanation: A)
B)
C)
D)
E)

9) Which of the following is a symptom of brucellosis? 9)

A) jaundice
B) gastroenteritis
C) relapsing fever
D) pneumonia
E) undulant fever
Answer: E
Explanation: A)
B)
C)
D)
E)

10) Which of the following statements about toxoplasmosis is FALSE? 10)

A) It can be congenital.
B) It is caused by a protozoan.
C) It is a severe illness in adults.
D) The reservoir is cats.
E) It is transmitted by the gastrointestinal route.
Answer: C
Explanation: A)
B)
C)
D)
E)

11) Which of the following statements about group B streptococci is FALSE? 11)
A) They cause neonatal sepsis.
B) They cause gram-positive sepsis.
C) They are classified as Streptococcus agalactiae.
D) They cause strep throat.
E) They are present in healthy carriers.
Answer: D
Explanation: A)
B)
C)
D)
E)

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12) Which of the following is NOT a characteristic of Bacillus anthracis? 12)
A) produces endotoxins
B) found in soil
C) is aerobic
D) is gram-positive
E) forms endospores
Answer: A
Explanation: A)
B)
C)
D)
E)

13) A patient presents with inflammation of the heart valves, fever, malaise, and subcutaneous nodules 13)
at joints. The recommended treatment is
A) praziquantel.
B) chloroquine.
C) hyperbaric chamber.
D) anti-inflammatory drugs.
E) streptomycin.
Answer: D
Explanation: A)
B)
C)
D)
E)

14) A predisposing factor for infection by Clostridium perfringens is 14)

A) an infected finger.
B) gangrene.
C) debridement.
D) hyperbaric treatment.
E) burns.
Answer: B
Explanation: A)
B)
C)
D)
E)

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15) Which of the following CANNOT be transmitted to humans from domestic cats? 15)
A) plague
B) Bartonella
C) Chagas' disease
D) toxoplasmosis
E) None of the answers is correct; all of these diseases can be transmitted to humans from
domestic cats.
Answer: C
Explanation: A)
B)
C)
D)
E)

16) Which of the following pairs is mismatched? 16)

A) cat-scratch disease malignant pustule developing into septicemia
B) tularemia a localized infection appearing as a small ulcer
C) brucellosis a temperature of 40°C each evening
D) toxoplasmosis congenital brain damage
E) Borrelia rash and flulike
Answer: A
Explanation: A)
B)
C)
D)
E)

17) A patient has the following symptoms: a papule, enlarged lymph nodes. Microscopic examination 17)
of the papule reveals nucleated cells in white blood cells. The patient most likely has
A) schistosomiasis.
B) anthrax.
C) brucellosis.
D) malaria.
E) leishmaniasis.
Answer: E
Explanation: A)
B)
C)
D)
E)

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18) Which of the following is the same for both relapsing fever and undulant fever? 18)
A) presence of rash
B) mode of transmission
C) reservoir
D) etiology
E) vector
Answer: E
Explanation: A)
B)
C)
D)
E)

19) Which of the following pairs regarding the epidemiology of malaria is mismatched? 19)
A) found in liver sporozoites
B) diagnosis presence of merozoites
C) etiology Plasmodium
D) treatment antibiotics
E) vector Anopheles
Answer: D
Explanation: A)
B)
C)
D)
E)

20) Scrapings from a patient's rash reveal cercariae. The disease is most likely 20)
A) Lyme disease.
B) Chagas' disease.
C) relapsing fever.
D) Rocky Mountain spotted fever.
E) swimmer's itch.
Answer: E
Explanation: A)
B)
C)
D)
E)

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21) A 62-year-old man was hospitalized with an eight-day history of fever, chills, sweats, and 21)
vomiting. His temperature on admission was 40°C. A routine peripheral blood smear revealed
ring-shaped bodies in the RBCs. What treatment would you prescribe?
A) streptomycin
B) hyperbaric oxygen
C) no treatment
D) penicillin
E) mefloquine
Answer: E
Explanation: A)
B)
C)
D)
E)

22) Which of the following pairs is mismatched? 22)

A) Rocky Mountain spotted fever Dermacentor (tick)
B) epidemic typhus Pediculus (louse)
C) dengue Aedes (mosquito)
D) encephalitis Ixodes (tick)
E) malaria Anopheles (mosquito)
Answer: D
Explanation: A)
B)
C)
D)
E)

23) Which of the following leads to all the others? 23)

A) bacterial growth in endothelial cells
B) breakage of capillaries
C) subcutaneous hemorrhaging
D) presence of antirickettsial antibodies
E) blockage of capillaries
Answer: A
Explanation: A)
B)
C)
D)
E)

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24) Bioweapons 24)
A) are all respiratory pathogens.
B) have been used for centuries.
C) are impossible to detect.
D) are all viruses.
E) are not susceptible to antibiotics.
Answer: B
Explanation: A)
B)
C)
D)
E)

25) Unsanitary and crowded conditions increase the incidence of all of the following diseases EXCEPT 25)
A) Rocky Mountain spotted fever.
B) epidemic typhus.
C) plague.
D) relapsing fever.
E) endemic murine typhus.
Answer: A
Explanation: A)
B)
C)
D)
E)

26) The symptoms of gas gangrene are due to all of the following EXCEPT 26)
A) endocarditis
B) microbial fermentation.
C) proteolytic enzymes.
D) necrotizing exotoxins.
E) hyaluronidase.
Answer: A
Explanation: A)
B)
C)
D)
E)

27) Which of the following is NOT controlled by a mosquito eradication program? 27)
A) yellow fever
B) dengue fever
C) malaria
D) schistosomiasis
E) chikungunya fever
Answer: D
Explanation: A)
B)
C)
D)
E)

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28) Which of the following is NOT caused by a bacterium? 28)
A) plague
B) epidemic typhus
C) tickborne typhus
D) malaria
E) relapsing fever
Answer: D
Explanation: A)
B)
C)
D)
E)

29) Which of the following is NOT a zoonosis? 29)

A) Hantavirus infection
B) puerperal sepsis
C) tularemia
D) brucellosis
E) anthrax
Answer: B
Explanation: A)
B)
C)
D)
E)

30) Which of the following is NOT typically treated with penicillin? 30)
A) puerperal sepsis
B) pericarditis
C) rat-bite fever
D) anthrax
E) animal bites
Answer: A
Explanation: A)
B)
C)
D)
E)

31) Arthropods can serve as a reservoir for all of the following diseases EXCEPT 31)
A) brucellosis.
B) plague.
C) epidemic typhus.
D) malaria.
E) yellow fever.
Answer: A
Explanation: A)
B)
C)
D)
E)

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32) Which of the following is NOT treated with antibiotics? 32)
A) Lyme disease
B) plague
C) ebola
D) anthrax
E) tularemia
Answer: C
Explanation: A)
B)
C)
D)
E)

33) Which of the following statements about tularemia is FALSE? 33)

A) It is caused by Francisella tularensis.
B) It may be transmitted by direct contact.
C) It may be transmitted by arthropods.
D) The most common reservoir is rabbits.
E) It occurs only in California.
Answer: E
Explanation: A)
B)
C)
D)
E)

34) Which of the following pairs is NOT correctly matched for Gram reaction? 34)
A) anthrax gram-positive
B) Rocky Mountain spotted fever gram-negative
C) Ehrlichia gram-positive
D) tularemia gram-negative
E) Lyme disease gram-negative
Answer: C
Explanation: A)
B)
C)
D)
E)

35) Which of the following is NOT transmitted in raw milk? 35)

A) brucellosis
B) toxoplasmosis
C) anthrax
D) listeriosis
E) All of these can be transmitted in raw milk.
Answer: B
Explanation: A)
B)
C)
D)
E)

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36) Which of the following pairs is mismatched? 36)
A) Francisella — gram-positive facultatively anaerobic pleomorphic coccirods
B) Bacillus — gram-positive endospore-forming rods
C) Brucella — gram-negative aerobic rods
D) Rickettsia — intracellular parasite
E) None of the pairs is mismatched.
Answer: A
Explanation: A)
B)
C)
D)
E)

37) Epstein-Barr virus has been implicated in all of the following EXCEPT 37)
A) endocarditis.
B) infectious mononucleosis.
C) Hodgkin's disease.
D) nasopharyngeal carcinoma.
E) Burkitt's lymphoma.
Answer: A
Explanation: A)
B)
C)
D)
E)

38) Which of the following produces a permanent carrier state following infection? 38)
A) Borrelia
B) Yersinia
C) cytomegalovirus
D) Toxoplasma
E) Spirillum
Answer: C
Explanation: A)
B)
C)
D)
E)

39) Human-to-human transmission of plague is usually by 39)

A) dog flea.
B) the respiratory route.
C) unsanitary conditions.
D) wounds.
E) rat flea.
Answer: B
Explanation: A)
B)
C)
D)
E)

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40) Which of the following pairs is mismatched? 40)
A) acute bacterial endocarditis Staphylococcus aureus
B) puerperal sepsis Staphylococcus aureus
C) pericarditis Streptococcus pyogenes
D) Burkitt's lymphoma Epstein-Barr virus
E) subacute bacterial endocarditis alpha-hemolytic streptococci
Answer: B
Explanation: A)
B)
C)
D)
E)

41) A patient complains of fever, severe muscle and joint pain, and a rash. The patient reports 41)
returning from a Caribbean vacation one week ago. Which of the following do you suspect?
A) typhus
B) Bolivian hemorrhagic fever
C) yellow fever
D) dengue
E) Hantavirus hemorrhagic fever
Answer: D
Explanation: A)
B)
C)
D)
E)

42) Which of the following can be transmitted from an infected mother to her fetus across the placenta? 42)
A) Spirillum
B) Yersinia
C) anthrax
D) Borrelia
E) cytomegalovirus
Answer: E
Explanation: A)
B)
C)
D)
E)

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 43) Which of the following is evidence that the arthritis afflicting children in Lyme, Connecticut, was 43)
due to bacterial infection?
A) treatable with penicillin
B) transmitted by ticks
C) accompanied by a rash
D) not contagious
E) affected mostly children
Answer: A
Explanation: A)
B)
C)
D)
E)

44) Which of the following statements about schistosomiasis is FALSE? 44)

A) The female worm lives in a groove that runs down the body of the male.
B) The cercariae penetrate human skin.
C) It is caused by a roundworm.
D) A parasite of birds causes swimmer's itch in humans.
E) The intermediate host is an aquatic snail.
Answer: C
Explanation: A)
B)
C)
D)
E)

45) Which of the following is NOT a recognized form of anthrax? 45)

A) septic
B) cutaneous
C) gastrointestinal
D) inhalationial
E) None of the answers are correct; all of these are recognized forms of anthrax.
Answer: A
Explanation: A)
B)
C)
D)
E)

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

46) All forms of typhus are associated with arthropod vectors. 46)
Answer: True False
Explanation:

47) Netting modified for sandflies should also be useful in preventing malaria. 47)
Answer: True False
Explanation:

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 48) Neonatal sepsis is most commonly caused by group A streptococci. 48)
Answer: True False
Explanation:

49) Lymph contains red blood cells. 49)

Answer: True False
Explanation:

50) The most likely primary site of replication during mononucleosis is the B lymphocyte. 50)
Answer: True False
Explanation:

51) Pathogens must be blood-borne in order to initiate sepsis. 51)

Answer: True False
Explanation:

52) All viral hemorrhagic fever outbreaks have been confined to the Eastern Hemisphere. 52)
Answer: True False
Explanation:

53) All lymph that returns to the heart must pass through at least one lymph node. 53)
Answer: True False
Explanation:

54) Tularemia is considered to be a potential bioterrorism agent due its high infective dose. 54)
Answer: True False
Explanation:

55) Subacute bacterial endocarditis is commonly the result of infections initially focused on the oral 55)
cavity.
Answer: True False
Explanation:

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

56) Humans are not the normal hosts for Ixodes and Xenopsylla. How, then, do humans contract Lyme disease and
plague?
Answer:

57) Worldwide, which disease is the most serious public health threat: malaria, Chagas’ disease, or brucellosis?
Explain why, and provide a plan to reduce the incidence of the disease.
Answer:

58) On June 1, a 32-year-old hiker was bitten by a tick. After one week, he noticed an erythrematous ring at the
location of the bite. Four weeks later, a physician found a large, macular, centrifugally spreading ring. During
the next month, it expanded to 35 cm and faded. Over the next 2.5 years, the man experienced recurrent
inflammation of a knee. Identify the periods of incubation, prodromal, illness, and decline. What is the etiology?
What caused the symptoms? What treatment should have been administered in July? What treatment should be
administered two years later?
Answer:

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Answer Key
Testname: C23

1) A
2) A
3) C
4) C
5) E
6) C
7) E
8) E
9) E
10) C
11) D
12) A
13) D
14) B
15) C
16) A
17) E
18) E
19) D
20) E
21) E
22) D
23) A
24) B
25) A
26) A
27) D
28) D
29) B
30) A
31) A
32) C
33) E
34) C
35) B
36) A
37) A
38) C
39) B
40) B
41) D
42) E
43) A
44) C
45) A
46) FALSE
47) TRUE
48) FALSE
49) FALSE
50) TRUE
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Answer Key
Testname: C23

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

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