Nester's Microbiology A Human Perspective, 10e by Anderson Test Bank by QuentinAxel

CHAPTER 1 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Spontaneous generation refers to the idea that organisms came from other organisms. ⊚ ⊚

true false

The human body only contains bacteria during illness. ⊚ ⊚

true false

Bacteria and eukarya both contain membrane-bound organelles. ⊚ true ⊚ false

The scientific name of an organism indicates its domain. ⊚ ⊚

true false

Viroids are naked (lacking a protein shell) pieces of RNA that infect plants. ⊚ ⊚

true false

Viruses simultaneously contain DNA, RNA, and protein. ⊚ true ⊚ false

Viruses, viroids, and prions are obligate intracellular agents. ⊚ ⊚

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true false

Viruses and bacteria are both unicellular. ⊚ ⊚

true false

An organism is categorized in a domain according to its cell size. ⊚ ⊚

true false

10)

Archaea are very similar to bacteria and have rigid cell walls made of peptidoglycan. ⊚ true ⊚ false

11)

Thiomargarita namibiensis cannot be a eukaryote because it is only 1 mm in width. ⊚ true ⊚ false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 12) The scientist usually credited with seeing the first microorganisms, which he called "animalcules", was ______. A) Redi B) van Leeuwenhoek C) Pasteur D) Tyndall E) Lister

13)

The word "animalcule" was first used by ______.

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A) Pasteur B) Redi C) van Leeuwenhoek D) Tyndall E) Hooke

14)

The idea of spontaneous generation postulated that A) organisms could evolve into the next generation of organisms. B) organisms could spontaneously turn into other types of organisms. C) living organisms could spontaneously arise from non-living material. D) living organisms could spontaneously arise from other living organisms. E) living organisms must contain at least ten cells.

15) Which of these scientists were involved in investigating the idea of spontaneous generation? A) Redi and van Leeuwenhoek B) Redi and Pasteur C) van Leeuwenhoek and Pasteur D) Pasteur and Escherich E) Escherich and Redi

16)

The work of Tyndall and Cohn

A) supported the idea of spontaneous generation rather than the idea of biogenesis. B) explained why some spontaneous generation investigators got different results from those of Pasteur. C) showed that all microbes caused spontaneous disease if they enter the human body. D) allowed scientists to see microorganisms (called "animalcules") using a simple microscope. E) showed that boiling fails to kill vegetative bacteria, leading to biogenesis.

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17) The structures present in the hay infusions used in experiments on spontaneous generation that made them difficult to sterilize are _____. A) chloroplasts B) endospores C) organelles D) toxins E) nuclei

18) The contradictory results obtained by different scientists apparently doing the same experiments in investigating spontaneous generation A) show that doing experiments once should be enough to prove something. B) show the importance of exactly duplicating experimental conditions. C) led to further experiments that ultimately proved spontaneous generation. D) could not be explained by anyone involved in the work. E) led to the development and production of swan-necked flasks.

19) If Pasteur had done his experiments investigating spontaneous generation in a horse stable, A) the results would probably have supported the idea of spontaneous generation. B) the results would probably not have supported the idea of spontaneous generation. C) the results would probably been the same as those obtained in a laboratory. D) the results would probablyhave supported the idea of spontaneous biogenesis. E) it would probably have taken several years to obtain any results.

20)

Cellulose is a major component of plants and is only directly digested by

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A) carnivores. B) termites. C) herbivores. D) microorganisms. E) birds.

21)

Plants are dependent on microorganisms for A) providing oxygen in a usable form. B) providing water and carbon dioxide. C) changing atmospheric nitrogen to a usable form. D) providing simplecarbohydrates in a usable form. E) providing simple and complex proteins.

22)

Microorganisms are useful for all of the following EXCEPT A) causing disease. B) curing/treating disease. C) preparing food. D) cleaning up pollutants. E) scientific research.

23) Bacteria have been used to help produce or modify all of the following food products EXCEPT A) cheeses. B) beer and wine. C) pickled products. D) bread. E) peanuts.

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24)

Microorganisms areinvolved in all of the following EXCEPT

A) production of medicinal products. B) food production. C) pollution cleanup. D) converting nitrogen to a form useful to plants. E) There are no exceptions here. There are microorganisms that participate in each of these activities.

25)

Bioremediation refers to A) rehabilitating wayward pathogenic bacteria. B) using bacteria to clean up environmental pollutants. C) development of new vaccines. D) monitoring newly discovered disease organisms. E) destroying organisms causing infectious diseases.

26)

Which of the following about the Golden Age of Medical Microbiology is FALSE? A) It started with the development of the first microscopes. B) It occurred during the late 1800s to the early 1900s. C) It is a time when the knowledge of bacteria and work with them expanded. D) It was the time when people realized that diseases could be caused by invisible

agents. E) It was a time when several major advances were made in microbiology.

27) Which of the following statements about newly emerging or reemerging diseases is FALSE? A) They may be caused by changing lifestyles. B) Examples include hepatitis C, Ebola disease and COVID-19. C) They may result from a breakdown in sanitation and social order. D) They are all caused by drug-resistant pathogens. E) They may result when microbes evolve and develop new characteristics.

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28)

Lyme disease is an example of a disease that is due to A) increased interaction between humans and tick-carrying animals. B) failure to effectively vaccinate children. C) a mutation in the human genome. D) climate change leading to a significantly greater mosquito population. E) an increase in the number of people travelling to Asia and Africa.

29)

The outbreak of measles within the last few years is due to A) mutation of the measles virus. B) change in the environment and climate. C) a decline in vaccination of children in the previous years. D) increase in sensitivity of detection techniques. E) emergence of novel measles viruses.

30)

Which of the statements regarding smallpox is TRUE?

A) Smallpox has been eliminated as a naturally occurring infection in human beings through vaccination. B) Smallpox still occasionally occurs in developing countries though failure to vaccinate everyone. C) Smallpox outbreaks sometimes occur in chimpanzee populations but seldom kills the animals. D) Smallpox outbreaks sometimes occur in chimpanzee populations and kills all the animals affected. E) Smallpox continues to be a common, naturally occurring infection in human beings.

31)

Smallpox

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A) has occurred in a few countries since 1977. B) has little potential as a weapon of bioterrorism. C) has not occurredanywhere in the word since 1977. D) very seldom kills people, but does scar them. E) is an emerging infectious disease.

32)

Ulcers, previously thought to be caused by stress, are in fact often caused by A) a bacterial infection. B) an insufficient diet. C) a genetic mutation. D) a fungal pathogen. E) a viral infection.

33)

Bacteria are useful to study because

A) they produce protein in a simpler manner than more complex organisms. B) they have the same fundamental metabolic and genetic properties as higher organisms. C) they produce energy in a simpler manner than more complex organisms. D) they both synthesize and are resistant to all known antibiotics. E) they produce peptidoglycan in a simpler manner than more complex organisms.

34)

Which of the following regarding normal microbiota is TRUE? A) Normal microbiota are only found in the lungs or digestive tract. B) Normal microbiota protect us from disease by competing with pathogenicbacteria. C) Normal microbiota are only found on small select parts of the human body. D) Normal microbiota typically cause disease when growing in or on our bodies. E) Normal microbiota play little or no role in the general health of humans.

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35)

Bacteria are present on the body A) only during disease-causing infections. B) at all times. C) only in certain areas. D) only after intense exercise. E) only after using public transport.

36)

Bacteria are good research models because they A) vary in size from microscopic to macroscopic. B) share manyproperties with more complex organisms. C) can be assembled into complex multicellular organisms. D) have similarly complicated growth requirements. E) develop the same diseases as humans and animals.

37)

Select the FALSE statement regarding bacteria. A) They are usually rod, sphere, or spiral in shape. B) They reproduce by binary fission. C) They contain a peptidoglycan cell wall. D) They are found as single cells. E) They are never photosynthetic.

38)

Which is usually NOT true of archaea? A) They move using flagella. B) They reproduce by mitosis. C) They contain rigid cell walls. D) They are found as single cells. E) They are prokaryotes.

39)

All of the statements regarding archaea are true EXCEPT

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A) they contain peptidoglycan in their cell walls. B) they reproduce by binary fission. C) they contain a rigid cell wall. D) they are found as single cells. E) they often grow in extreme environments.

40)

An extreme environment in which archaea have been found is A) lakes and oceans. B) boiling hot springs. C) marshes and swamps. D) refrigerators. E) animal digestive tracts.

41) The cell types that lack a membrane-bound nucleus and have rigid cell walls of peptidoglycan are A) eukaryotes. B) fungi. C) bacteria. D) archaea. E) protozoa.

42)

The prokaryotic domain includes A) bacteria AND fungi. B) archaea AND viruses. C) fungi AND bacteria. D) bacteria, archaea, AND fungi. E) bacteria AND archaea.

43)

Select the TRUE statement(s) regardingeukaryotes.

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A) Eukaryotes are all multicellular organisms AND have a membrane around the DNA. B) Eukaryotes have a more complex internal structure than archaea or bacteria. C) Eukaryotes have a simpler internal structure than archaea or bacteria AND have a membrane around the DNA. D) Eukaryotes have a membrane around the DNA. E) Eukaryotes have a more complex internal structure than archaea or bacteria AND have a membrane around the DNA.

44)

Which group(s) below contain single-celled and multicellular organisms? A) Algae AND bacteria B) Fungi AND archaea C) Protozoa AND bacteria D) Algae AND fungi E) Fungi AND protozoa

45)

All living organisms A) may be classified in four domains. B) may be classified in three domains. C) probably do not have a common ancestor. D) have never shared genes between domains. E) are capable of causing disease.

46)

The system by which organisms are named is referred to as A) systematics. B) naming. C) nomenclature. D) binomialism. E) bioinformatics.

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47)

The scientific name of an organism includes its A) family and genus. B) first name and last name. C) genus and species. D) domain and genus. E) domain and species.

48)

Which are the correctly written scientific name? A) Staphylococcus aureus B) Staphylococcus a. C) St. aureus D) Staph

49)

Which of these applies to the term strain? A) E. coli 0157:H7 B) E. coli C) Minor variation of a species D) Major variation of a species E) E. coli 0157:H7 AND minor variation of a species

50)

Select the statement that is TRUE regarding viroids. A) They are naked (lacking a protein shell) pieces of RNA. B) They are naked (lacking a protein shell) pieces of DNA. C) They are known to cause neurodegenerative diseases in animals. D) They are composed of protein encasing a DNA genome. E) They are composed of both RNA and DNA within a lipid coat.

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51)

Outside of a host cell, viruses are A) carrying out a few biochemical reactions. B) synthesizing proteins necessary for entry into the host. C) inert, and not capable of replication. D) constructing a membrane known as an envelope. E) capable of a few replication cycles.

52)

Viruses may only be grown A) in sterile growth media. B) in living cells. C) at body temperature. D) in darkness. E) in liquid broths.

53)

Viruses are in the domain(s) A) viridae. B) eukarya. C) archaeaAND bacteria. D) bacteria AND viridae. E) None of the answer choices is correct.

54)

Which if the following is TRUE regarding viruses? A) They are obligate intracellular parasites. B) They are single-celled organisms. C) They are composed of only proteins. D) They belong tothe domain Archaea. E) They containonly of DNA or RNA.

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55)

What do viruses, viroids, and prions all have in common? A) They contain only RNA and protein. B) They are acellular agents of disease. C) They contain only DNA or protein. D) They infect only animals. E) They cause neurodegenerative diseases.

56)

Viruses and viroids are A) capable of independent reproduction. B) obligate intracellular parasites. C) members of the domain Bacteria. D) larger than most bacteria in size. E) agents that cause disease in animals.

57)

Which is TRUE about prions? A) They are only composed of RNA. B) They are only composed of DNA. C) They are only composed of protein. D) They cause diseases in plants. E) They are only composed of RNA and DNA.

58) A new organism was found that was unicellular and 1 cm long. The "large" size of this organism alone would A) mean that it couldnot be a bacterium. B) mean that it must be a protozoan. C) not be useful for identifying it. D) mean that it belongs in the domain Eukarya. E) suggest that it is a virus.

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59) Although it is said that the twentieth century was the Age of Physics, it is predicted that the twenty-first century will be the age of A) chemistry. B) computers. C) microbial biodiversity. D) mathematics. E) psychology.

60) HIV/AIDS can be categorized as a new or emerging infectious disease. By putting it into this category, we areindicating that A) this infection hasn't been observed in the human population prior to recent (within the last 50 years) outbreaks. B) this disease hasbeen in susceptible populations for centuries, but has only recently achievedinfection levels that became detectable. C) the infectiousagent is still evolving and changing, unlike with older, moreestablisheddiseases such as plague or polio. D) the disease hasalways been in susceptible populations and causing disease, but we lacked thetechnology to detect it. E) this infection hasn't been observed in the human population prior to recent (within the last 5 years) outbreaks.

61) An illness outbreak occurs in New York City birds in the late 1990s. After an investigation, the Centers for Disease Control (CDC) determine that the agent causing theis the West Nile virus. Outbreaks of this illness have been observed in several other countries in Asia and the Middle East across the last 50 years, but not in the United States. With this information, what would be the best categorization of this infectious agent/disease?

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A) This isa reemerging infection. It is been around for a long time, and it is reappearing in a susceptible population again. B) This isa nosocomial (hospital-acquired)infection. It is transmitted from animals to human beings in urban environments. C) This is an emerging infection. It hasn't been around that long, and it has made a jump across continents into a new susceptible population. D) This is an unimportant infection thatnot a concern to human beings because it occurs in birds, so there is no need to classify it. E) This is a chronic infection. It has been around for many years, and it has made a jump across continents into a new susceptible population.

62)

Why are we concerned at all with monitoring emerging/reemerging diseases?

A) These representgrowing threats to human health that will require new scientific research andresources to effectively combat. B) Because globalization leads to more chances for spread of illnesses into new areas and populations. Monitoring these illnesses will help us to protect people. C) Because the speed of travel has increased, so it is far more likely that a serious pathogen can spread rapidly across the globe. Monitoring these illnesses will help us protect populations. D) All of the answer choices are correct. E) None of the answer choices is correct.

63) A microbiologist obtained two pure isolated biological samples: one is a virus, and one is a viroid. The labels came off the samples during a move from one lab to the next, however. The scientist felt she could distinguish between the two samples by analyzing for the presence of a single type of molecule. Whatwould she be looking for to differentiate between the two? A) DNA B) Protein C) Lipid D) RNA E) Carbohydrate

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64) A scientist has two samples—the first is a prion, while the second is a viroid. However, the samples are in unlabeled tubes.The scientistwants to run a simple analysis to determine which tube contains the prionand which one contains the viroid. What type of molecule would she look for to do this? A) Lipids B) DNA C) Protein D) Polysaccharides E) Peptidoglycan

65) A scientist discovers a new species near coral reefs in Australia. He finds that this singlecelled species is photosynthetic (using sunlight for energy), has a rigid cell wall structure with no peptidoglycan, uses a flagellum for motion, and contains a variety of internal structures that are membrane-bound. Given this information, this new species is most likely a(n) ______ cell in the ______ domain. A) bacterial; Eukarya B) fungal; Prokarya C) viral; Archaea D) algal; Eukarya E) protozoan; Bacteria

66) Scientists recently cloned Louis Pasteur and put him to work in a modern lab. He immediately developed a topical gel (used externally) that breaks down proteins. Since he hasn't been around for some time, he's unsure what the best application for his invention might be. Help him out. What pathogenic agent would this gel be most effective and safe at eliminating? A) Viroids on the surface of agricultural plant tissues. B) Prions inside the central nervous system of cows. C) Viruses on the surface of the skin. D) Bacteria in the intestines of human beings. E) The fungus that causes infections under people's toenails.

67)

Select the TRUE statement regarding viruses.

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A) Most viruses are smaller than bacteria but bigger than mitochondria. B) Viruses may be unicellular or multicellular. C) Viruses contain both DNA and RNA. D) Viruses always cause death of the host cells they infect. E) Virus are considered living because they contain nucleic acid.

68) You are examining a pea plant that is showing signs of disease—brown leaves and no pea pods. You isolate an agent from the plant that only contains RNA and protein. This is a(n) ______. A) viroid B) virus C) bacterium D) fungus E) protozoan

69)

Which terms refer to bacterial morphology? A) Bacillus AND polyhedral B) Coccus AND polyhedral C) Coccus AND Bacillus D) Polyhedral, coccus, AND Bacillus E) Coccus AND squarish

70) What was the significance of the shape of the flasks used by Pasteur in his experiments proving biogenesis?

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A) The flask shape allowed Pasteur to use less broth, so the experiments were cheaper and could be repeated more often. B) The swan neck of the flasks allowed “vital force” to enter them but prevented bacteria from falling into the broth. C) Swan-necked flasks have an opening too small for entry of microbes, while conical flasks have a wide neck that allows microbial entry. D) Pasteur could place gel in the bend of the swan-necked flask, trapping any entering microbes. E) There is no significance; Pasteur simply used any flasks available in his laboratory, in this case swan-necked.

71) A patient’s throat swab yields organisms that appear as long chains of round cells under light microscope. Given this information, it is possible that the organism is: A) Streptococcus pyogenes B) Staphylococcus aureus C) Bacillus species D) A virus E) Streptococcus pyogenes OR Staphylococcus aureus

72)

Which statement about normal microbiota is TRUE?

A) The body carries 10 times as many microbial cells as human cells. B) Normal microbiota is restricted to the gut and only plays a role in digestion and vitamin synthesis. C) The microbiome includes members of a microbial community and the genetic makeup of that community. D) The majority of microbes in a microbiome can be identified by culturing them in a laboratory. E) Bacterial species associated with gum disease also always cause Alzheimer’s disease.

73)

Which of the following bacterial pairs is LEAST related?

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A) Escherichia coli K AND Escherichia coli B12 B) Bacillus subtilis AND Bacillus cereus C) Vibrio cholerae O1 AND Vibrio cholerae O139 D) Escherichia coli O157:H7 AND E. coli O157:H4 E) Streptococcus pneumoniae AND Mycoplasma pneumoniae

74) Consider the Venn diagram pertaining to the three domains, and select the CORRECT characterization. Remember that characteristics shared by two or more items are found in the circle overlaps.

A) Prokaryote AND peptidoglycan - B B) Eukaryote AND multicellular - G C) Prokaryote AND multicellular - D D) Prokaryote AND nucleus - E E) Prokaryote - F

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75) Consider the Venn diagram pertaining to prokaryotes, eukaryotes and acellular agents, and select the INCORRECT classification. Remember that in a Venn diagram, common characterisitcs are found in the circle overlaps.

A) Peptidoglycan, 70S ribosomes and nucleoid - A B) Cytoplasm, ribosomes and DNA - B C) DNA or RNA, lipid and protein - G D) Ribosomes, cytoplasm and nucleic acid - E E) Mitochondria, Golgi and chloroplasts - C

SECTION BREAK. Answer all the part questions. 76) A scientist isolates a microbe from a contaminated water source. She thinks that the organism might be a new bacteria that is capable of surviving in the presence of lead, which is a heavy metal. She makes tubes of nutrient medium (supports microbial growth) containing either no lead, 0.1 mg lead, 0.25 mg lead, 0.5 mg of lead, or 1 mg of lead. She inoculates each tube with the 10 x 103 cells of the new organism and then incubates the tubes at 37oC. After 48 hours, she examines the tubes and finds that there is no growth in any of them. However, she finds that the organism grew well in medium that did not contain any lead. She decides to repeat the experiment using lower concentrations of lead than those she used initially.

76.1)

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Select which of the following is the hypothesisbeing tested by the scientist.

A) The newly isolated microbe can grow in the presence of lead. B) The newly isolated microbe is a bacteria. C) Lead can be placed into tubes of growth medium. D) Bacteria must be incubated for 72 hours before they grow. E) Lead is a good nutrient for all bacterial growth.

76.2)

Identify the control step in the scenario described.

A) Inoculating the test microbe into nutrient medium containing a different heavy metal. B) Isolating the microbe from a contaminated water source. C) Inoculating the test microbe into nutrient medium lacking lead. D) Inoculating the test microbe into medium containing lower levels of lead than used initally. E) Inoculating the test microbe into contaminated water containing high levels of lead.

76.3)

What conclusion can the scientist in this scenario make from her results?

A) The test bacteria take more than 48 hours to grow in the laboratory when incubated at 37 oC. B) All contaminated water contains high levels of lead and other heavy metals. C) The test organism was killed by the levels of lead tested. D) All experiments should be repeated three times or more. E) Lead-contaminated water never contains any living organisms.

77) Janus is a keen baseball player at the high school where you are employed as a nurse. He comes to your office and shows you an injury to his knee which he got by sliding into home base, scoring a game-winning run. His knee has araw patch where the skin has been scraped off, and the area around the wound is swollen.Janus tells you that he washed his knee with soap and water to remove any germs, and then put a bandage onit, but it is very painful and red.

77.1) You explain to Janus that he may have an infection in his wound, possibly caused by the organism Staphylococcus epidermidis. You tell him that the genus name of the organism indicates that Version 1

A) the cells are found in the digestive tract. B) the cells are round and grow in clusters. C) the organism is a pathogen. D) the organism is normal microbiota. E) the cells have a golden color.

77.2) Janus tells you he knows that yeast cells are also round. He asks how scientists can tell the difference between yeasts and bacteria. Select the choice that best answers his question. A) Bacteria are microscopic. B) Bacteria are photosynthetic. C) Bacteria are unicellular. D) Bacteria contain peptidoglycan. E) Bacteria can be pathogenic.

77.3) Janus asks you if there is something he can use to kill any bacteria in his wound without affecting any of his own body cells. You tell him that some antibiotics kill bacteria by targeting _____ , a compound unique to bacteria. A) protein B) nuclear membrane C) flagella D) peptidoglycan E) chitin

77.4) Janus' knee infection should be considered an emerging infectious disease, and you should report it to the Centers of disease Control (CDC). ⊚ ⊚

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true false

78) Sandy has been taking an antibiotic for a urinary tract infection (UTI). Although the signs and symptoms of Sandy's UTIresolved after a few days of taking the medication, she complains to you that she has been having watery diarrheafor the last two days, and she wonders whether the antibiotic is affecting her digestive tract. You take the opportunity to give her information about her normal microbiota.

78.1) You explain to Sandy that her body carries an enormous population of microorganisms, collectively called the normal microbiota. You tell her that this population has a vital role in maintaining her health. Select the FALSE statement regarding the role of the normal microbiota.  A) Normal microbiotaprevent disease by competing with pathogenic microbes. <!-Markup Copied from Habitat--> B) Normal microbiotahelp to degrade foods that the body otherwise could not digest.  C) Normal microbiotasynthesize vitamins that the body cannot produce.  D) Normal microbiotaproduce insulin for controlling blood sugar levels. E) Normal microbiotalikely affects the tendency to lose or gain weight.

78.2) You are concerned that Sandy may have a Clostridioides difficile infection (CDI). When normal microbiota is disturbed, organisms such as C. difficile may thrive. What caused the disturbance in Sandy's normal microbiota in this case? A) The bacteria causing Sandy's urinary tract infection. B) The antibiotics Sandy was taking to treat her UTI. C) Sandy's presence in the hospital. D) Sandy's watery diarrhea. E) Dehydration caused by Sandy's watery diarrhea.

78.3)

Digestive tract microbiome plays no role in maintaining a person's health.

⊚ ⊚

true false

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79) Five patients were admitted into the hospital, each one suffering of a different illness. Tests were carried out on each patient to identify the pathogens causing their illnesses. The chemical composition of the pathogens was established and is shown in Table 1: Table 1. Chemical composition of isolated pathogens. Protein

Lipid

DNA

RNA

Patient #1

Patient #2

Patient #3

Patient #4

Patient #5

Note: (+) indicates presence; (-) indicates absence

79.1)

What type of pathogen could be causing the disease in patient #1?

A) A virus B) A bacterium C) A fungus D) A prion E) A yeast

79.2)

Which patient(s) is/are being infected by an acellular infectious agent?

A) Patients 1, 3, and 4 B) Patients 1, 2, 3 and 4 C) Patients 2 and 3 D) Patients 1, 2, 3 and 5 E) Patients 2, 3, 4 and 5

79.3)

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What treatment(s) would likely be the most appropriate to treat patient #2?

A) Antiviral drug B) Antibiotic, antifungal or antiprotozoan drug C) Antifungal drug D) Antibiotic AND antiviral drug E) Antiprotozoan drug

79.4)

Which patient(s) is/are affected by a pathogen that specifically affects the brain?

A) Patient #1 ANDPatient #4 B) Patient #2 ANDPatient #3 C) Patient #3 D) Patient #1 AND Patient #3 E) Patient #4

79.5)

Which patient(s) is/are infected by a pathogen that divides by binary fission?

A) Patient #2 B) Patient #2 AND Patient #5 C) Patient #2 AND Patient #4 D) Patient #4 E) Patient #5

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Answer Key Test name: Chap 01_10e 1) FALSE 2) FALSE 3) FALSE 4) FALSE 5) TRUE 6) FALSE 7) TRUE 8) FALSE 9) FALSE 10) FALSE 11) FALSE 12) B 13) C 14) C 15) B 16) B 17) B 18) B 19) A 20) D 21) C 22) A 23) E 24) E 25) B 26) A Version 1

27) D 28) A 29) C 30) A 31) C 32) A 33) B 34) B 35) B 36) B 37) E 38) B 39) A 40) B 41) C 42) E 43) E 44) D 45) B 46) C 47) C 48) A 49) E 50) A 51) C 52) B 53) E 54) A 55) B 56) B Version 1

57) C 58) C 59) C 60) A 61) C 62) D 63) B 64) C 65) D 66) C 67) A 68) B 69) C 70) B 71) A 72) C 73) E 74) B 75) D 76) Section Break 76.1) A 76.2) C 76.3) C 77) Section Break 77.1) B 77.2) D 77.3) D 77.4) FALSE 78) Section Break 78.1) D Version 1

78.2) B 78.3) FALSE 79) Section Break 79.1) A 79.2) A 79.3) B 79.4) E 79.5) B

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CHAPTER 2 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) If you placed a DNA molecule in a vertical orientation, then from top to bottom, the two parallel strands are both orientedin the same, 5ʹ to 3ʹ, direction. ⊚ ⊚

RNA is a long double-stranded helix containing ribose and uracil. ⊚ ⊚

true false

Lipids, like nucleic acids and proteins, are made of chains of similar subunits. ⊚ ⊚

true false

Steroids are simple lipids. ⊚ ⊚

true false

5) Water-soluble substances easily pass through the phospholipid bilayer of a cell membrane. ⊚ true ⊚ false

DNA is always double-stranded, but RNA is always single-stranded. ⊚ ⊚

true false

Lipids are polar, hydrophilic molecules.

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⊚ ⊚

true false

Simple lipids contain carbon, hydrogen, and oxygen in a 1:2:1 ratio. ⊚ ⊚

true false

Phospholipids are polar molecules. ⊚ true ⊚ false

10)

Unsaturated fats have lower melting points than saturated fats. ⊚ ⊚

true false

CHECK ALL THE APPLY. Choose all options that best completes the statement or answers the question. 11) The atomic number for an atom of a specific element is equal to 2-12-2013 A) the number of protons plus electrons in a single atom of that element. B) the number of electrons plus neutrons in a single atom of that element. C) the number of protons plus neutrons in a single atom of that element. D) the position of an atom in the atomic table. E) the position of an ion on the periodic table.

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 12) In addition to investigations with bacteria that led to Pasteur being considered the Father of Microbiology, he also

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A) found that some molecules can exist as stereoisomersANDcreated aspartame. B) created aspartame ANDseparated organic acids using a microscope. C) found that some molecules can exist as stereoisomers AND separated organic acids using a microscope. D) separated organic acids using a microscope ANDdiscovered polarized light. E) discovered polarized light AND found that some molecules can exist as stereoisomers.

13)

The negatively charged component of the atom is the A) proton. B) electron. C) neutron. D) nucleus. E) valence.

14)

The part of the atom that is most involved in chemical reactivity is the A) proton. B) neutron. C) electron. D) nucleus. E) ion.

15)

Which of the following is TRUE regarding electrons? A) They are found in the area outside the nucleus known as the cloud. B) They may gain energy but do notlose energy. C) They cannot move from one shell to another within the cloud. D) They are located farthest from the nucleus and have the leastenergy. E) They are positively charged particles in an atom.

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16)

Sharing of electrons between two atoms forms a(n) A) hydrogen bond. B) ionic bond. C) covalence bond. D) atomic bond. E) covalent bond.

17)

If electrons are gained or lost when a bond is formed, that bond is a(n) ______ bond. A) ionic B) covalent C) hydrogen D) nonpolar E) intermediate

18)

Charged atoms are called A) ions. B) neutrons. C) molecules. D) polymers. E) atoms.

19)

Which statement regarding water is TRUE? A) Water is a polar molecule. B) Water is referred to as a universal solvent. C) Water makes up over 70% of an organism. D) Water is often a product or reactant in chemical reactions. E) All of the answer choices are correct.

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20)

Which statement regarding pH is CORRECT? A) pH is a measure of the hydrogen ion concentration in a solution. B) pH is measured using a scale from 5 to 8. C) pH is measured using a linear (not logarithmic)scale. D) pH is an abbreviation for "power of helium." E) pH reflects the tendency of a solution to donate or accept electrons.

21)

The subunits (building blocks) of proteins are A) nucleotides. B) phospholipids. C) amino acids. D) carbohydrates. E) monosaccharides.

22)

If the side chains of amino acids contain carboxyl (-COOH) groups, they

A) contribute a positive charge to the amino acid at pH 10 AND are considered acidic amino acids. B) contribute a negative charge to the amino acid at pH 10 AND are considered nucleic acids. C) contribute a positive charge tothe amino acid at pH 10 AND are considered nucleic acids. D) contribute a negative charge to the amino acid at pH 10 AND are considered acidic amino acids. E) contribute a negative charge to the amino acid at pH 10 AND are considered acidic monosaccharides.

23)

Amino acids that contain many methyl (-CH

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3) groups

A) are considered hydrophilic. B) are nonpolar. C) carry a positive charge. D) carry a negative charge. E) are considered hydrophilic AND carry a positive charge.

24)

D-amino acids are associated with A) radioactive isotopes. B) bacterial cell walls. C) plant proteins. D) human proteins. E) all proteins.

25)

The most important feature of a protein is its A) secondary structure. B) side group. C) shape. D) electric charge. E) size.

26)

Alpha helices and beta pleated sheets form a protein's A) primary structure. B) secondary structure. C) tertiary structure. D) quaternary structure. E) multi-structure.

27)

Select the CORRECT statement regarding acidic or basic amino acids.

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A) They are insoluble in water. B) They are readily soluble in water. C) They areunable to form ions. D) They are considered hydrophobic. E) They are unable to form peptide bonds.

28)

The N terminal in a protein is A) the end characterized by a free carboxyl group. B) the end characterized by a free amino group. C) typically found in the middle of a protein. D) the part of a protein that is bound to another protein. E) indicatedwith an "R".

29)

Select the FALSE statement regarding protein denaturation. A) Denaturation can occur due to certain chemicals. B) Denaturation can occur due to pH changes. C) Denaturation can occur due to high temperature. D) Denaturation may cause the protein to no longer function. E) Denaturationcannot be reversed.

30)

Select the FALSE statement regarding carbohydrates. A) They may be part of the structure of bacteria. B) They may serve as a source of food. C) They contain carbon, hydrogen, and oxygen in a 1:2:1 ratio. D) They may be bonded to proteins to form glycoproteins. E) Cholesterol and ergosterol are examples of carbohydrates.

31)

Select the CORRECT statement regarding carbohydrates.

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A) They form only ring structures. B) They form only linear structures. C) They may interconvert between ring and linear structures. D) They contain both ring and linear portions within the same molecule. E) They are all structural isomers of each other.

32)

Structural isomers

A) contain the same number of atoms/elements, butin different arrangements AND may be referred to as the -D and -P forms. B) are exemplified by glucose and galactose AND are formed by different arrangements of the -COOH groups C) contain the samenumber of atoms/elements, butin different arrangements AND areexemplified by glucose and galactose. D) are formed by different arrangements of the -COOH groups AND may be referred to as the -D and -L forms. E) may be referred to as the -D and -Pforms AND are exemplified by glucose and fructose.

33)

What type of bond holds one strand of DNA to the complementary strand of DNA? A) Covalent B) Hydrogen C) Disulfide D) Ionic E) Peptide

34)

How many carbon atoms do the sugars found in nucleic acids contain?

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A) 3 carbon atoms. B) 5 carbon atoms. C) 7 carbon atoms. D) 9 carbon atoms. E) either 5 or 7 carbon atoms.

35)

Which of the following are found in RNA but not in DNA? A) Adenine AND ribose B) Ribose AND thymine C) Ribose AND uracil D) Thymine AND uracil E) UracilAND deoxyribose

36)

Which base pairing example is INCORRECT? A) A:T B) G:C C) G:T D) A:U E) A:T, G:C, AND A:U

37)

The components of fats are fatty acids and A) amino acids. B) nucleotides. C) phosphate. D) glycerol. E) cholesterol.

38)

Select the CORRECT statement regardingsaturated fats and unsaturated fats.

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A) They have approximately the same melting temperature as each other. B) Saturated fats have a lower melting temperature than unsaturated fats. C) Unsaturated fats have a lower melting temperature than saturated fats. D) Unsaturated fats have a higher melting temperature than saturated fats. E) Saturated fats are more liquid at room temperature than unsaturated fats.

39)

Which is the positively charged component of the atom? A) Electron B) Neutron C) Proton D) Cation E) Anion

40)

Which is the uncharged component of the atom? A) Electron B) Proton C) Neutron D) Proline E) Neulon

41)

What determines the chemical and physical properties of an atom of an element? A) Atomic number B) Neutrons C) Atomic weight D) Electrons E) Atomic size

42)

Why does the atom have no charge overall?

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A) The number of protons in the atom equals the number of neutrons. B) The number of electrons in the atom equals the number of neutrons. C) Neutrons in the atom neutralize all the other charges. D) The number of protons in the atom equals the number of electrons. E) The number of protons in the atom exceeds the number of electrons.

43)

The mass number of an atom is equal to A) the number of electrons. B) the number of electrons and neutrons. C) the number of neutrons and protons. D) the number of protons. E) the number of electron shells.

44)

If electrons are shared unequally, a(n) ______ bond is formed. A) weak B) polar C) nonpolar D) ionic E) hydrogen

45)

Atoms that gain electrons become A) positively charged. B) negatively charged. C) neutral. D) lighter. E) elements.

46)

Which of these bonds are weak individually but are much stronger as a group?

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A) Covalent AND hydrogen B) Ionic AND covalent C) Neutron AND ionic D) Hydrogen AND neutron E) Ionic AND hydrogen

47)

The most important molecule(s) in the world is (are) _____. A) water B) proteins C) carbohydrates D) nucleic acids E) nitrogen

48)

The components of adenosine triphosphate are A) adenosine, deoxyribose, and three phosphates. B) adenosine, ribose, and three phosphates. C) a pyrimidine base, ribose, and three phosphates. D) a purine base, deoxyribose, and two phosphates. E) a pyrimidine base, deoxyribose, and three phosphates.

49)

How many different amino acids are there to choose from when assembling a protein? A) 5 B) 10 C) 20 D) 25 E) 64

50)

L-amino acids occur in proteins and are designated

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A) unnatural. B) left-handed. C) rare. D) right-handed. E) non-biological.

51)

Amino acids in proteins are linked to one another by peptide bonds between the A) methyl group of one amino acid and a side group of another amino acid. B) carbon atoms of two adjacent amino acids. C) carboxyl group of one amino acid and the amino group of another. D) nitrogen atom and carboxyl ion. E) phosphate group and nitrogenous base.

52)

The primary structure of a protein refers to A) the helical folding of a protein. B) the sequence of amino acids. C) two or more polypeptides linked to one another. D) the initial folding of a protein. E) the beta-pleated sheets in a protein.

53)

Side chains are important to proteins because they

A) help determine protein shape AND are a source of energy for hydration reactions in the cell. B) help determine the degree of solubility of the protein in water. C) are a source of energy for hydration reactions in the cell. D) form the peptide bonds that link amino acids to one another. E) help determine protein shape AND help determine the solubility of the protein in water.

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54)

Which statement(s) regarding a protein is/are CORRECT?

A) A protein can form any number of equally functional shapes. B) A protein may need help from chaperonesto assume the correct shape. C) A protein consists of a chain of hydroxyl acids AND is always polar. D) A protein is always polar AND may need help from chaperones to assume the correct shape. E) A protein assumes any number of equally functional shapes AND is always polar.

55)

Weak bonds are important for the ______ structure of proteins. A) primary AND secondary B) primary, secondary, AND tertiary C) secondary, tertiary, AND quaternary D) primary, tertiary, ANDquaternary E) quarternary

56)

Which statements about proteins are TRUE?

A) They are involved in almost every important function performed by a cell AND are characterized by a 1:3:1ratio of carbon to hydrogen to oxygen. B) They make upmore than 50% of the dry weight of a cell AND are composed of a chain of nucleotides. C) They are involved in almost every important function performed by a cell AND make up more than 50% of the dry weight of a cell. D) They are composed of a chain of amino acids AND are characterized by a 1:3:1 ratio of carbon to hydrogen and oxygen. E) They are characterized by a 1:2:1 ratio of carbon to hydrogen to oxygen AND are composed of a chain of nucleotides.

57)

The carbohydrate(s) found in nucleic acids is (are)

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A) ribose OR deoxyribose. B) ribose OR glucose. C) glucose OR galactose. D) galactose OR deoxyribose. E) deoxyriboseonly.

58)

The -OH group in a carbohydrate

A) may be found above or below the plane of the ring. B) is involved in the formation of stereoisomers. C) is involved when linking monosaccharides together. D) is involved in the formation of stereoisomers ANDmay be found above or below the plane of the ring. E) All of the answer choices are correct.

59)

Dehydration reactions are involved in A) the formation of polypeptides AND the formation of monosaccharides. B) the formation of polysaccharides AND the formation of nucleotides. C) the formation of polypeptides AND the formation of polysaccharides. D) the formation of monosaccharides AND the formation of amino acids. E) the formation of polypeptides AND the formation of nucleotides.

60)

Which statement is true of nucleotides? A) They are the basic subunits of DNA. B) There are 20 naturally occurring nucleotides. C) They are joined together by peptide bonds. D) They are double-stranded. E) All of the answer choices are correct.

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61)

The purines of DNA are A) adenine and guanine. B) thymine and adenine. C) serine and threonine. D) thymine and uracil. E) thymine, adenine AND uracil.

62) To which end of the nucleic acid chain are more nucleotides added during DNA synthesis? A) 5 prime (5') end. B) C terminal. C) 3 prime (3') end. D) N terminal. E) -COOHterminal.

63)

The characteristic common to all lipids is their A) solubility in organic solvents AND hydrophilic nature. B) solubility in organic solvents AND hydrophobic nature. C) hydrophilic nature AND large size. D) large size AND solubility in water. E) hydrophobic nature AND solubility in water.

64)

Which is NOT true of lipids? A) They are a major structural element of all cell membranes. B) They control the movement of molecules into and out of a cell. C) They separate a cell from its environment. D) Examples include steroids and phospholipids. E) They are a homogeneous group of molecules.

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65) Microorganisms use hydrogen bonds to attach themselves to the surfaces that they live on. Many of them lose hold of the surface because of the weak nature of these bonds and end up dying or being washed away. Why don't microbes just use covalent bonds instead? A) Covalent bonds depend on completely giving up or completely accepting an electron to form the bond. This isn't possible for many microbes without dramatically altering their basic molecular composition. B) Covalent bonds typically require enzymes to form/break, whereas hydrogen bonds don't. If covalent bonds were used, it would require much more energy and molecules to be contributed from the cell. Hydrogen bonds don't have these requirements. C) Bacteria grow in very moist environments, where water is freely available. Water is a supply of hydrogen atoms, so it makes sense for the bacteria to simply use hydrogen bonds for attachment. D) Hydrogen bonds typically require enzymes to form/break, whereas covalent bonds don't. Microorganisms have more enzymes than any other type of cell, so it makes sense that they use hydrogen bonds rather than covalent bonds. E) None of the answer choices is correct.

66) A biologist determined the amounts of several amino acids in two separate samples of pure protein. His data showed that Protein A contained 7% leucine, 12% alanine, 4% histidine, 2% cysteine, and 5% glycine. Interestingly, Protein B had the same percentagesof the same amino acids. He concluded from this datathat Proteins A and B are the same protein. Based on this information and his conclusion, determine which of the following is the correct statement regarding his findings: A) He is correct; the proteinshave the same percentages of each amino acid, so they are identical protein molecules. B) He is incorrect; there is no informationaboutthe amino acids sequence (which dictates the overall structure of a protein), so the two proteins could be very different in shape. C) He is correct; although there is no information on the amino acid sequence in each protein, the order of the amino acids is irrelevant. It's only the total number of each molecule that is important to structure. D) He is incorrect; he hasn't accounted at all for the effects of pH on the composition of the protein and its effects on the individual amino acids. E) He is partly correct; the percentage of the listed amino acids is the same in each protein, but Protein A is hydrophobic and Protein B is hydrophilic.

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67) You are a biochemist working on a molecule found in a recently discovered bacteria. You determine that the molecule is composed of a chain of similar subunits and can thus conclude that the molecule is unlikely to be a A) lipid. B) nucleic acid. C) protein. D) carbohydrate. E) lipid or protein.

68)

Which of the following pairs is mismatched? A) RNA - ribose sugar. B) Dehydration synthesis - water removal. C) Sharing electrons - covalent bond. D) Carboxyl - CH 3 E) Lipids - hydrophobic.

69)

Please identify the CORRECT definition.

A) Molecules that contain carbon and hydrogen are called inorganic compounds. <!-Markup Copied from Habitat--> B) Electrolytes are salts that conduct electricity when they are dissolved in water. C) A compound is a molecule composed of two or more identical elements. D) Electrons in a polar covalent bond are shared equally. E) The starting components of a chemical reaction are called products.

70)

Which of the following is the correct order from most acidic to least acidic?

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A) Stomach acid, vinegar, unpolluted rainwater, blood, drain cleaner B) Drain cleaner, blood, unpolluted rainwater, vinegar, stomach acid C) Unpolluted rainwater, blood, vinegar, drain cleaner, stomach acid D) Stomach acid, drain cleaner, unpolluted rainwater, blood, vinegar E) Vinegar, blood, unpolluted rainwater, drain cleaner, stomach acid

71) You are working in a laboratory, making media for growing bacteria. The recipe you are following calls for the addition of TRIS buffer. You can't find any TRISin the lab, so you decide to leave it out of the medium. Select the FALSE statement regarding your decision. A) The medium will likely not be useable, because bacteria live within a narrow pH range, near pH 14.  B) Maintaining the correct pH is essential for cells, because crucial molecules such as enzymes may lose function in the incorrect pH. C) Buffers are added to solutions to stabilize the hydrogen ion concentration of that solution. D) The acidity of the medium without buffer may change dramatically as the bacteria grow. E) The medium will likely not be useable, because bacteria live within a narrow pH range, near neutral.

72)

Which of the following statements about enzymes is FALSE? A) Enzymes are composed of amino acids. B) Enzymes help break covalent bonds. C) Enzymes position reactants so covalent bonds form more easily. D) Enzymes are essential for maintaining life. E) Enzymes increase the temperature of a reaction.

73)

Enzymes are required to break which of the following bonds?

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A) Covalent B) Ionic C) Peptide D) Hydrostatic E) Polar

74)

Which of the following statements about nucleic acids is FALSE? A) They are the subunits of nucleotides. B) They may be single stranded or double stranded. C) Eukaryotic cells have both DNA and RNA. D) All living cells have nucleic acids. E) They are composed of nucleotides.

75)

Please select the FALSE statement regarding butyrate. A) Butyrate is consumed in plant material. B) Butyrate is a short-chain fatty acid. C) Butyrate is produced by gut bacteria. D) Butyrate is a degradation product of plant material. E) Butyrate may protect against colon cancer.

76)

Please select the FALSE statement regarding lipids.

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A) Short-chain fatty acids contain five or fewer carbon atoms and may reduce the risk of colon cancer. B) Butyrate is a long-chain fatty acid that is produced by gut bacteria when they degrade undigested plant material. C) Phospholipids resemble triglycerides but one fatty acid is replaced with a phosphate group. D) A wax is a long-chain fatty acid covalently bonded to a long-chain alcohol and is insoluble in water. E) Steroids differ in structure from lipids but are classified as such because they are insoluble in water.

77)

Which of the following best describes the structure of DNA?

A) A double helix consisting of antiparallel two sugar-phosphate backbones with nucleobases oriented towards the interior. B) A double helix consisting of two chains of nucleobases held together by bonds between with sugar-phosphate groups. C) A triple helix consisting of three chains of nucleobases held together by bonds between with sugar-phosphate groups. D) A double helix consisting of two parallel sugar-phosphate backbones with nucleobases oriented towards the interior. E) A double helix consisting of two sugar-phosphate backbones with nucleobases oriented towards the exterior.

78) Which of the following correctly describes the pairing and hydrogen bonding of nucleobases in DNA?

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A) Adenine pairs with thymine via two hydrogen bonds; cytosine pairs with guanine via three hydrogen bonds. B) Adenine pairs with thymine via three hydrogen bonds; cytosine pairs with guanine via two hydrogen bonds. C) Adenine pairs with thymine via three hydrogen bonds; cytosine pairs with guanine via three hydrogen bonds. D) Adenine pairs with thymine via two hydrogen bonds; cytosine pairs with guanine via two hydrogen bonds. E) Cytosine pairs with thymine via two hydrogen bonds; adenine pairs with guanine via three hydrogen bonds.

79) What functional group is at the 5' end of a DNA strand, and which is at the 3' end of a DNA strand? A) Phosphate group at the 5' end; hydroxyl group at the 3' end B) Phosphate group at the 3' end; hydroxyl group at the 5' end C) Phosphate group at the 5' end and the 3' end on one strand; hydroxyl group at the 5' end and the 3' end on the other strand D) Phosphate group at the 5' end; deoxyribose at the 3' end E) Adenine or thymine at the 5' end; cytosine or guanine at the 3' end

80) Why are electrons not considered when determining the mass of an atom?  A) Electrons are too light too contribute to the mass of an atom. B) Every atom has random numbers of electrons, so they must be ignored. C) Electrons are too far away from the atom nucleus to contribute to its weight. D) Neutrons cancel out the mass of the electrons, so they are discounted. E) Protons cancel out the mass of electrons, so they are discounted.

81)

Which of the statements about ions is TRUE?

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A) Anions are negatively charged atoms while cations are positively charged atoms. B) Anions are positively charged atoms while cations are negatively charged atoms. C) An anion is an atom that has gained an electron and a proton. D) Cations and anions both have an overall positive charge. E) The ion Mg 2+ has gained two electrons while the ion Na + has gained one electron.

82)

In a redox reaction,

A) the reactant that loses an electron is oxidised and the reactant that gains an electron is reduced. B) the reactant that loses an electron is reduced and the reactant that gains an electron is oxidised. C) the reactant that loses an electron is a oxidising-oxidising agent. D) the reactant that gains an electron is reduced and is an oxidising reagent. E) both the reducing agent and the oxidising agent gain electrons.

83)

Which list goes from heaviest to lightest? A) Compound, atom, proton, electron B) Electron, proton, atom, compound C) Electron, proton, atom, molecule D) Proton, molecule, atom, electron E) Atom, molecule, proton, neutron

84)

Please select the CORRECT choice regarding pH and hydrogen ion concentration.

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A) A pH of 4 is more acidic than a pH of 5 AND the pH 4 solution has an H + concentration of 1 x 10 -4 B) A pH of 4 is less acidic than a pH of 5 AND the pH 4 solution has an H + concentration of 1 x 10 -4 C) A pH of 4 is more basic than a pH of 5 AND the pH 4 solution has an H + concentration of 1 x 10 -4 D) A pH of 4 is more acidic than a pH of 5 AND the pH 5 solution has an H + concentration of 1 x 10 5 E) A pH of 4 is more acidic than a pH of 5 AND the pH 4 solution has an OH concentration of 1 x 10 -4

85)

Dehydration synthesis is involved in the synthesis of all of the following EXCEPT A) glucose. B) DNA and RNA. C) peptidoglycan. D) enzymes. E) triglycerides.

86)

When the pH of a solution changes from 9 to 2, the H

concentration

A) increases as the solution becomes more acidic. B) decreases as the solution becomes more acidic. C) increases as the solution becomes more basic. D) decreases as the solution becomes more basic. E) remains unchanged as the solution becomes more basic.

SECTION BREAK. Answer all the part questions. 87) Dan is a body builder. He decides that he is going to change his diet in an effort to increase his muscle mass. Dan tells you that he plans to eat vegetables and proteins but nofats or carbohydrates, because cells do not naturally contain these molecules and do not need them. You advise Dan that his new diet is not a good choice, and that he would do better to follow a well balanced diet that incorporates healthy amounts of proteins, fats AND carbohydrates.

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87.1) You tell Dan that while many of his cell components do indeed contain amino acids, carbohydrates and lipids are also essential for cells. Which of the following components contain both amino acids AND lipids? A) Cytoplasmic membrane B) Nucleic acids C) Enzymes D) Peptidoglycan E) Ribosomes

87.2) Dan tells you that he knows proteins are needed to build muscle mass but that he doesn't quite understand the role of proteins in a cell. He tells you five things he believes proteins are needed for in cell function, but he is mistaken on one of these. Which of the following statements regardingthe role of proteins in cells is INCORRECT? A) Proteins are involved in transporting molecules into or out of cells. B) Proteins are involved in movement of certain cells. C) Proteins provide structural support in cells (cytoskeleton). D) Proteins are a major component of starch. E) Proteins catalyze chemical reactions within cells.

87.3) Dan tells you that he believes that proteins are the primary source of energy for his cells because proteins are easily digested. You tell him that this is. ⊚ ⊚

true false

87.4) Dan asks you how his cells are able to use complex molecules such as proteins. You explain to him that proteins are macromolecules composed of ______ and that proteins can be broken down by ______, a type of reaction in which the addition of ______ breaks covalent bonds between subunits.

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A) water; hydrolysis; amino acids B) amino acid; hydrolysis; water C) monosaccharides; hydrolysis; water D) amino acids; dehydration synthesis; water E) monosaccharides; dehydration synthesis; water

87.5) Dan is confused about the reason you advise him that in fact a healthy diet includes fats. He tells you that all fats are bad fats. You correct him, telling him that lipids are essential for cells. Which of the following is NOT true of lipids? A) Lipids are an essential component of the cytoplasmic membrane. B) Cholesterol provides rigidity to eukaryote cell membranes. C) Lipids are composed of identical subunits. D) The most common simple lipids in nature are the triglycerides. E) Oils contain unsaturated fatty acids.

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88) With so much research being carried out onthe gut microbiome, interesting discoveries are frequently made. Now scientists at MIT and Harvard University have investigateda novel bacterial enzyme that may have therapeutic potential for treating a disease called CDI, caused by the bacterium Clostridioides difficile. C. difficile is found at part of the gastrointestinal microbiotaof many healthy people. However, if the bacterial populations in those people are disturbed (a situation called dysbiota), for example by taking antibiotics, the organism can causeCDI. The research team discovered that C. difficile and a number of other gut bacteria produces an enzyme called hydroxyl-L-proline dehydratase (HypD). The scientists had previously shown that this enzyme carries out an unusual reaction, breaking down hydroxyl-L-proline into a precursor of proline, one of the 20 naturally occurring amino acids. In bacteria like C. difficile, proline can then be used to generate ATP through a process called amino acid fermentation. In other words, the microbes use HypD to help them grow. Now, using a method called X-ray crytallography, the team has been able to identify the active site on HypD where the chemical reaction takes place. Their aim is to now develop drugs that target and block that site, preventing the enzyme from functioning properly. In this way, they will potentially be able to slow the growth of C. difficile without necessarily killing it. The attempt to inhibit the growth of the bacteria rather than eliminating them entirely reflects the fact thatunder normal circumstances, the organism plays a rolein maintaining gastrointestinal health. Source: Massachusetts Institute of Technology. "Bacterial enzyme could become a new target for antibiotics." ScienceDaily. ScienceDaily, 17 March 2020. www.sciencedaily.com/releases/2020/03/200317130718.htm

88.1) The subunits of proteins are _____, joined together by _____ bonds called _____ bonds. A) amino acids; covalent; peptide B) nucleic acids; covalent; peptide C) amino acids; ionic; peptide D) monsaccharides; covalent; glycosidic E) amino acids; covalent; glycosidic

88.2)

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Which statement regarding HypD is FALSE?

A) It generates a precursor for the amino acid proline. B) It is uniquely synthesized by Clostridium difficile. C) It is involved in a dehydration chemical reaction. D) It may potentially be targeted for treating CDI. E) It is produced by a number of different gut bacteria.

88.3)

HypD is used by certain bacteria to generate ATP from amino acids.

⊚ ⊚

true false

88.4)

What is the significance of this research?

A) The researchers discovered a potential target for inhibiting growth of C. difficile. B) The authors discovered a new gut bacterium called Clostridium difficile. C) The research team discovered that Clostridium difficile can cause CDI. D) The researchers were able to reduce the growth of C. difficile in the gut. E) The teams proved that dysbiosis may lead to the development of CDI.

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Answer Key Test name: Chap 02_10e 1) FALSE 2) FALSE 3) FALSE 4) TRUE 5) FALSE 6) FALSE 7) FALSE 8) FALSE 9) TRUE 10) TRUE 11) [A] 12) C 13) B 14) C 15) A 16) E 17) A 18) A 19) E 20) A 21) C 22) D 23) B 24) B 25) C 26) B Version 1

27) B 28) B 29) E 30) E 31) C 32) C 33) B 34) B 35) C 36) C 37) D 38) C 39) C 40) C 41) A 42) D 43) C 44) B 45) B 46) E 47) A 48) B 49) C 50) B 51) C 52) B 53) E 54) B 55) C 56) C Version 1

57) A 58) E 59) C 60) A 61) A 62) C 63) B 64) E 65) B 66) B 67) A 68) D 69) B 70) A 71) A 72) E 73) A 74) A 75) A 76) B 77) A 78) A 79) A 80) A 81) A 82) A 83) A 84) A 85) A 86) A Version 1

87) Section Break 87.1) A 87.2) D 87.3) FALSE 87.4) B 87.5) C 88) Section Break 88.1) A 88.2) B 88.3) FALSE 88.4) A

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CHAPTER 3 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Bacillus and Clostridium are medically relevant groups of bacteria that characteristically stain acid-fast. ⊚ ⊚

true false

LPS is found in the outer membrane of Gram-negative bacteria. ⊚ ⊚

true false

3) Penicillin affects the synthesis of phospholipids, thereby producing weak membranes and lysis of the bacteria. ⊚ ⊚

Endospores are involved in bacterial reproduction. ⊚ ⊚

true false

Lysosomes are bags of digestive enzymes found in prokaryotic cells. ⊚ ⊚

true false

Smooth endoplasmic reticulum is involved in protein synthesis. ⊚ ⊚

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true false

7) Mitochondria and chloroplasts are thought to have once been free-living bacteria that invaded another cell. ⊚ true ⊚ false

Cilia and flagella project from the cell and are not covered by cytoplasmic membrane. ⊚ ⊚

true false

Prokaryotes may ingest particles via phagocytosis. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 10) Select the CORRECT statement regarding eukaryotic cells. A) Eukaryotic cell are less complex than prokaryotic cells. B) They are members of the domains Bacteria and Archaea. C) Eukaryote cell are defined by the presence of a membrane bound nucleus. D) They are able to divide more rapidly than prokaryotic cells. E) Eukaryoticcell are defined by the presence of a cell wall.

11)

The two magnifying lenses found in a light microscope are the A) basic and transverse. B) small and large. C) ocular and objective. D) simple and phase. E) ocular and phase.

12)

The resolving power of a microscope is described as the ability of the microscope to

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A) separate clearly two objects that are very close together. B) magnify an object and its surroundings. C) separate the colors of an organism's internal structure. D) magnify structures at various depths in a tissue. E) combine the images of two objects that are very close together.

13)

In viewing a microscopic specimen, oil is used to A) increase the refraction AND increase the reflection. B) decrease the refraction AND increase the reflection. C) decrease the refraction AND increase the resolution. D) increase the reflection AND increase the resolution. E) increase the resolution AND increase the refraction.

14)

The use of oil with certain high-power objective lenses increases A) magnification. B) reflection. C) resolution. D) contrast. E) color.

15) Under standard conditions, the best way to observe more details in a microscopic specimen is to A) increase resolution. B) increase magnification. C) decrease magnification. D) increase scatter. E) decrease resolution.

16)

The microscope that allows the specimen to appear three-dimensional is the

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A) phase contrast microscope. B) differential interference contrast microscope. C) fluorescence microscope. D) transmission electron microscope. E) compound microscope.

17) Which of the following microscope types would be LEAST useful in viewing unstained living cells? A) Phase contrast B) Differential interference contrast C) Bright-field D) Dark-field E) Fluorescence

18)

Electron microscopes differ from light microscopes in that A) light replaces electrons. B) glass lenses replace electromagnetic lenses. C) resolution is lower. D) magnification is lower. E) magnification is higher.

19)

Specimens can be observed at the atomic level using a(n) A) scanning electron microscope. B) transmission electron microscope. C) atomic force microscope. D) fluorescence microscope. E) light microscope.

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20)

Why must the lenses and specimenbe in a vacuum when usingan electron microscope?

A) Electrons are particles but there are other particles in air as well. Without a vacuum, the electrons would strike and be scattered by the particles within the air. B) Electrons are highly radioactive, and the chamber must be completely sealed and under vacuum to prevent them from escaping and contaminating the lab area. C) The vacuum fixing the specimen to the slide grid. Without fixing the specimen by vacuum, it would slide off and we wouldn't be able to visualize it. D) The vacuum bends rays of visible light through the lenses and specimen so that details of the specimen can be clearly vizualized from all angles. E) None of the answer choices is true.

21) Why are the lenses of anelectron microscopeshaped like donuts (with a hole in the middle) rather than solid, like the lenses in a light microscope? A) A magnetic field cannot be applied across a completely solid object—there must be an opening within the object for the field to be applied through. B) Electrons are particles, and particles cannot travel through a solid item. The hole in the middle allows them to travel from the source of the electrons to the specimen. C) The electronswould destroy the electromagnet material unless there was a physical hole forthem to travel through on their way to the specimen. D) The user has to be able to physically look through the magnets to focus the beam of electrons onto the specimen, since the metal of the magnets is opaque. Without a hole in the middle, the user wouldn't be able to see! E) All of the answer choices are correct.

22)

Which microscope would be the BEST selection for examination of a virus? A) Confocal scanninglaser microscope B) Scanning electron microscope C) Dark-field lightmicroscope D) Atomic force microscope E) Compound light microscope

23)

Individual atoms on the surface of prepared samples can be observed by using the

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A) scanning electron microscope. B) dark-field microscope. C) atomic force microscope. D) phase contrast microscope. E) light microscope.

24)

Select the CORRECT statement regarding basic dyes. A) They have a negative charge. B) They have a positive charge. C) They are electrically neutral. D) They contain both positively and negatively charged particles. E) They are always blue or purple.

25)

Which of the following stains are considered differential? A) Capsule stain AND Gram stain. B) Flagella stain AND acid-fast stain. C) Acid-fast stain AND Gram stain. D) Acid-fast stain AND capsule stain. E) Gram stain AND flagellastain.

26)

The Gram stain and the endospore stain both use A) crystal violet. B) iodine. C) safranin. D) malachite green. E) acidic dyes.

27)

The CORRECT order of reagent use in the Gram stain reaction is

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A) safranin, alcohol, methylene blue, iodine. B) crystal violet, iodine, alcohol, safranin. C) methylene blue, alcohol, safranin, iodine. D) crystal violet, alcohol, iodine, safranin. E) alcohol, safranin, iodine, crystal violet

28)

Which may result in Gram-positive bacteria appearing to be Gram-negative? A) Decolorizing for too long AND using young bacterial cultures. B) Not decolorizingfor long enough AND using young bacterial cultures. C) Decolorizing for too long AND using old bacterial cultures. D) Not decolorizing for long enough AND using old bacterial cultures. E) Forgetting to decolorize AND using old bacterial cultures.

29) in

The major criterion used in placing bacteria into different groups is based on differences

A) cell wall structure. B) cell membrane permeability. C) presence or absence of flagella. D) detergent susceptibility. E) presence or absence of cytoplasmic membrane.

30)

In a basic staining procedure, which is the correct order of steps? A) Fix, smear, stain B) Smear, fix, stain C) Fix, stain, decolorize D) Smear, decolorize, stain E) Smear, stain, fix

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31)

Which statements are TRUE for the acid-fast stain?

A) It is useful for distinguishing a small group of organisms, including MycobacteriumAND it reflects differences in cytoplasmic membrane structure. B) It is useful for distinguishing a small group of organisms, including Mycobacterium AND it uses carbolfuchsin and methylene blue. C) It is useful for distinguishing a small group of organisms, including Mycobacterium AND it uses carbolfuchsin and safranin. D) It is useful for distinguishing a small group of organisms, including MycoplasmaAND it uses carbolfuchsin and methylene blue. E) It is useful for distinguishing a small group of organisms, including BacillusAND it uses crystal violet and safranin.

32)

Select the FALSE statement regarding capsules. A) Capsules may increase an organism's ability to cause disease. B) Capsules are typically "negatively" stained. C) Capsules may be stained as a wet mount. D) Capsules are usually composed of polysaccharides. E) Capsules take up stains well.

33)

The endospore stain A) is applicable to many groups of bacteria. B) usually shows the spores as pink structures among a background of blue cells. C) uses crystal violet as the primary stain. D) is an example of a negative stain. E) is applicable to only a few groups of bacteria.

34)

Which of the statements about immunofluorescence is FALSE?

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A) It uses fluorescently tagged molecules. B) It makes use ofthe specificity in binding of antibodies. C) It uses the dyes methylene blue and safranin. D) It would require a special UV microscope. E) Stained cells often appear bright yellow-green against a black background.

35)

Which terms refer to bacterial morphology? A) Bacillus AND polyhedral B) Coccus AND polyhedral C) Coccus AND Bacillus D) Polyhedral, coccus, AND Bacillus E) Coccus AND squarish

36)

Which is NOT true of the cytoplasmic membrane? A) It defines the boundaries of the cell. B) It is a selectively permeable barrier. C) It consists mainly of a fixed, static, phospholipid bilayer. D) It contains proteins used as selective gates and sensors. E) All of the answer choices are true.

37)

Which is TRUE of simple diffusion of water? A) Water usually enters a cell and produces a high osmotic pressure. B) Water usually leaves the cell and produces negative osmotic pressure. C) Water tends to enter and leave the cell equally, resulting in no pressure in the cell. D) Waterdiffusion ultimately relies on the selectively permeable nature of the cell wall. E) Water usually enters a cell and produces a very low osmotic pressure.

38)

The cytoplasmic membrane of both eukaryotes and prokaryotes functions to

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A) form rough and smooth endoplasmic reticulum. B) produce energy in the form of ATP. C) regulate movement of molecules that enter and leave the cell. D) form lysosomes, peroxisomes, and Golgi apparatus. E) produce peptidoglycanor chitin cell walls.

39) The proteins of bacteria that are involved in the movement of small molecules into the cell are called A) transport proteins, carriers, AND peptidases. B) transport proteins, permeases, AND carriers. C) permeases, carriers, AND peptidases. D) carriers, peptidases, AND porases. E) peptidases, porases, AND permeases.

40)

Most solutes pass through the cytoplasmic membrane via A) osmosis. B) diffusion. C) transport proteins. D) secretion. E) aquaporins.

41)

Facilitated diffusion and active transport A) both transport molecules into or out of a cell. B) are both not very specific as to which molecules are transported. C) both require a concentration gradient to function. D) both require use of energy in order to transport the molecules. E) both only transport molecules into a cell.

42)

The macromolecule found in the cell walls of all bacteria is

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A) lipid A. B) teichoic acid. C) peptidoglycan. D) glycocalyx. E) chitin.

43)

Which is/are TRUE regarding the cell wall of bacteria? A) It determines the shape of the bacteria. B) It prevents the bacteria from bursting. C) It contains peptidoglycan. D) It may be targeted by antimicrobials. E) All of the answer choices are true.

44)

Which amino acid is found only in the cell walls of bacteria? A) Glycerol B) L-form of glycine C) Diaminopimelic acid D) L-form of methionine E) D-form of methionine

45)

The cell wall of Gram-positive bacteria A) contains a thin layer of peptidoglycan. B) contains a thick layer of peptidoglycan. C) is an excellent barrier to most molecules. D) contains an outer membrane containing LPS. E) contains a thick layer of peptidoglycose.

46)

Which molecule(s) is (are) NOT associated with the cell wall of Gram-positive bacteria?

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A) Peptidoglycan B) D-form amino acids C) Teichoic acids D) Peptidoglycan, D-form amino acids, AND teichoic acids E) Lipopolysaccharide

47)

The cell wall of Gram-negative organisms

A) has a thick peptidoglycan layer ANDis characterized by an outer membrane containing LPS. B) has a thick peptidoglycan layer. C) has a thin peptidoglycan layer AND is characterized by an outer membrane containing LPS. D) has a thin peptidoglycan layer. E) is more permeable to various molecules than the Gram-positive cell wall.

48)

Endotoxin A) consists of lipopolysaccharide. B) determines bacterial shape. C) may have different effects depending on thebacterial species. D) is toxic due to the effects of the peptide side chains. E) is found in Gram-positive cells.

49)

Penicillin would be most effective against A) actively non-growing bacteria AND Gram-positive bacteria. B) non-growing bacteria AND Gram-negative bacteria. C) actively growing bacteria AND Gram-positive bacteria. D) actively growing bacteria AND Gram-negative bacteria. E) any actively growing bacteria.

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50)

Which of the following statements regarding peptidoglycan is TRUE? A) It may be digested by penicillin. B) It consists of a long string of NAG coupled to a long string of NAM. C) It may be digested by lysozyme. D) It is found in bacteria, archaea, and plants. E) It is only found in Gram-positive cells.

51)

Which of the following bacteria lack(s) a peptidoglycan cell wall? A) Treponema pallidum B) Mycobacterium tuberculosis C) Mycoplasma pneumoniae D) Staphylococcus aureus E) These all contain a cell wall—they are bacteria.

52)

The capsule

A) may be used for protection AND may be involved in movement. B) may be used to help the bacteria adhere to surfaces AND may be involved in movement. C) may be used for protection AND may be used to help the bacteria adhere to surfaces. D) may be involved in movement AND may be involved in energy production. E) may be involved in energy production AND may be used for protection.

53)

The structures used for motility in both eukaryotes and prokaryotes are A) cilia. B) flagella. C) pili. D) fimbriae. E) microvilli.

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54)

Movement in bacteria A) is directly to or away from a stimulus. B) relies on the beating of cilia. C) is often referred to as run and tumble. D) may involve pili AND may be referred to as twist and turn. E) is by means of flagella AND may be referred to as run and tumble.

55)

Extrachromasomal DNA is found in ______. A) mitochondria AND plasmids B) mitochondria only C) plasmids only D) the nucleoid AND nucleolus E) mitochondria AND nucleus

56)

Endospores are A) a dormant cell type. B) involved in bacterial reproduction. C) obligate intracellular parasites. D) sensitive to heat and dessication. E) made by all bacterial genera.

57)

Which of the following is TRUE regarding eukaryotic cells? A) They are more obviously compartmentalized than prokaryotes. B) They usually have a single circular supercoiled piece of DNA. C) They contain peptidoglycan in the cell wall. D) They have the same size ribosomes as prokaryotes. E) They all produce endospores in adverse conditions.

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58)

The membranes of eukaryotes and Mycoplasma A) contain peptidoglycan. B) contain sterols for strength. C) contain ergosterol. D) are fixed static structures. E) are phospholipid unilayers.

59)

Which is the CORRECT definition of phagocytosis? A) It is the ingestion of particles and may be performed by animal cells. B) It is the ingestion of particles and may be performed by bacteria. C) It is the secretion of proteins from a bacterium into the environment. D) It is the formation of a lysosome filled with peroxidases. E) It is the uptake of particles across the animal cell wall.

60)

The eukaryotic cell cytoskeleton

A) is a dynamic structure composed of microtubules, microfilaments, and intermediate filaments. B) is a static structure that gives a rigid, defined shape to the cell. C) consists of flagella, filaments and cilia that have been internalized. D) has no known function in an animal cell. E) is a dynamic structure composed of nucleic acids, phospholipids, and proteins.

61)

The nucleus

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A) is a single phospholipid membrane sac containing prokaryotic DNA. B) is a smaller structure contained within the eukaryotic nucleolus. C) is a double membrane sac containing DNA and is found in eukaryotes. D) cannot transport molecules to the cytoplasm due to the double membrane barrier. E) is a triple phospholipid membrane sac containing prokaryotic RNA.

62)

Which is NOT true of mitochondria and chloroplasts? A) They contain DNA and 70S ribosomes. B) They are found in all organisms. C) They are capable of performing protein synthesis. D) They generate ATP. E) They are membrane-bound organelles.

63)

An advantage of the smaller size of prokaryotes, compared to eukaryotes, is

A) high surface area relative to low cell volume AND slower growth rates. B) high surface area relative to low cell volume AND more rapid growth rates. C) more rapid growth rates AND compartmentalization of cellular processes. D) compartmentalization of cellular processes AND low surface area relative to low cell volume. E) more rapid growth rates AND low surface area relative to high cell volume.

64) You want to examine the structure of the protein coat of a virus by microscopy. Which microscope is your best choice, and why?

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A) The scanning electron microscope—it has excellent resolution and magnification (much higher than a light microscope), and can clearly visualize viruses. B) An atomic force microscope—this has the highest resolution and magnification of the microscopes we discussed andwe want to visualize a subcomponent of the virus particles. C) A fluorescent microscope—this will let us tag the virus protein coat with colored dyes in order to visualize it using this light microscope at 1000x. D) A bright-field light microscope—of course, we'll need to stain the viruses before we can visualize them against the bright white background at 1000x total magnification. E) The phase-contrast microscope—it has excellent contrast and magnification, and can be used to visualize viruses very clearly.

65) Your instructor wants you to bring in an example of a biofilm to your lab. Which choice is the best selection for bringing in an INTACT biofilm for further study? A) Disconnecting and bringing in the old, mildewed showerhead from your bathroom. B) Scraping the mold offthe shower curtain in yourbathroom into a paper cup using a butter knife. C) Using a toothpick to scrape plaque off of your teeth and smearing it onto a slide to bring in to lab. D) Wiping a sponge across a slimy boulder in a stream in a nearby park and bringing it in to lab. E) Wiping a sponge across your dog's teeth, smearing it onto a glass slide and bringing it in to lab.

66) A newly developed antibiotic drug shows promise by inhibiting prokaryotic 70S ribosomes in initial studies. However, when animal studies are begun, it's noted that the drug also inhibits growth of animal cells. Select the statement that may be explain howthis can be happening.

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A) The function of ribosomes is identical, no matter their size, so a drug that can affect 70S ribosomes will also impair 80S ribosomes. B) Mitochondria and chloroplasts possess 70S ribosomes. This drug might be impairing the activity of chloroplasts in animal cells. C) Mitochondria and chloroplasts possess 70S ribosomes. This drug might be impairing the activity of mitochondria in animal cells. D) Prokaryote cells are identical to animal cells; a drug that impacts one will also always impact the other. E) There really is no reasonable explanation for this observation; the experiment should be repeated to get a different outcome.

67) A research laboratory is investigating environmental factors that would inhibit the growth of Archaea. One question they have is whetheradding the antibiotic penicillin would be effective in controlling their growth. What do you think the outcome would be if they tried this? A) The penicillin wouldn't affect the Archaea because it targets peptidoglycan, which is not foundin their cell walls. B) The penicillin will inhibit peptidoglycan synthesis and thus cell wall formation in the Archaea, killing them. C) The penicillin will slow down the growth of the Archaea by damaging the cell wall, but they will be able to grow slowly. D) The penicillin willenhance the growth of the Archaea by providing a rich nutrientsource. E) The penicillin will inhibit cell division in the Archaea, forcing them to form endospores for survival.

68) A research laboratory is trying to produce new antibiotics. They develop a medication that detaches the hydrophilic heads from the phospholipids in cytoplasmic membranes. This drug

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A) would be highly toxic and completely useless for human beings and could never be used—our cells also have cytoplasmic membranes with hydrophilic head groups! B) would be highly toxic for human beings if taken orally, but might be useful as a topical antibiotic skin cream. The top layer of skin cells is dead anyway, so it wouldn't matter if the drugdamaged those cells. C) would be highly toxic only to bacteria, making it an excellent drug to develop and test further. Humans have a different phospholipid structure in their cytoplasmic membranes from bacteria. D) would generally not be toxic enough to damage Gram-negative bacteria, as their cytoplasmic membranes lie under a thick layer of peptidoglycan. However, it would be effective against Gram-positive cells. E) would not work against any bacteria, because they do not have a cytoplasmic membrane; however, it might be effective against helminths and viruses.

69) A new medication is developed that targets and binds to the lipid A portion of LPS in Gram-negative bacterial cells. This drug shows a high degree of binding and activity against purified lipid A in an experiment carried out in test tubes. Based on this information, A) we should fast-track this drug and get it out to physicians immediately to help prevent Gram-negative toxic/septic shock in humans. B) we should do some animal testing with intact Gram-negative cells and the medication before we jump to any conclusions. C) we should next proceed by repeating the experiment in test tubes using intact Gramnegative cells to see if the drug binds with the same strength. D) we should abandon the drug entirely. Binding to lipid A won't kill the bacteria, so the drug is useless to develop further. E) we should assume that the medication will be effective against all bacteria, including Mycoplasmas, and that it is ready for use in humans.

70) A new drug is developed that inhibits formation of flagellafilament by impairing production of the protein flagellin. Is this going to be an effective medication?

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A) Potentially yes—it could be used against some bacteria, but wouldn't be effective for those that don't use a flagellum to move around. B) Potentially yes, but only if it could be shown that the drug also didn't impair the production of the eukaryotic flagellum. C) Not at all—our eukaryotic cells depend on flagella to move around in our body, and this drug would impair that function. D) Not at all—bacterial flagella are produced using microtubules, not the protein flagellin. This drug would be useless in eliminating bacteria. E) Not at all—this medication would affect cells like the ciliated respiratory epithelial cells, and would cause potentially fatal side-effects.

71)

Please select the MISMATCHED pair regarding prokaryotes, microscopes and staining. A) Light microscope - 1,000-fold magnification B) Acid fast stain - differential C) Mycoplasmapneumoniae- pleomorphic cells D) Capsules and slime layers - phospholipids E) Membrane-bound organelles - fungi

72)

Please select the CORRECT pair regarding prokaryote cell structure and microscopy. A) Transmission electron microscope - surface details B) 70S ribosomes - protozoa C) Bacillus and Clostridium - endospores D) Peptidoglycan - bacteria and archaea E) Gram-positive cells - O antigen

73)

Which of the following is most abundant in bacterial cells?

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A) Glucose B) Water C) Peptidoglycan D) Phospholipid E) Glycoprotein

74) You discover an encapsulatedGram-positive, peritrichous, spore-forming bacillus. Which of the following describes the organism? A) Sphericalbacterium with a thin cell wall, a slime layer, and flagella distributed over its surface, that can form endosporesfor survival of adverse conditions. B) Rod-shaped bacterium with a thick cell wall, a capsule, and flagella distributed over its surface, that can form endosporesfor survival of adverse conditions. C) Sphericalbacterium with a thick cell wall, a slime layer, and a single flagellum at one side of the cell. D) Rod-shaped bacterium with a thin cell wall, a capsule, and single flagellum at one end, that can form endosporesfor survival in adverse conditions. E) Rod-shaped bacterium with a thin cell wall, a slime layer, and single flagellum at one end, that can form endosporesfor survival in adverse conditions.

75)

Chemotaxis refers to A) movement toward light. B) movementtoward a chemical. C) movement away from a chemical. D) movement in response to a chemical. E) movement of a chemical.

76) You discover a new pathogen which you visualize using a light microscope. A negative stain reveals a clear halo around the cells. This suggests to you that the organism

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A) is motile. B) has a capsule. C) is spherical in shape. D) is Gram-positive. E) has an LPS layer.

77)

Select the FALSE statement regarding the proton motor force.

A) The proton motive force is set up when protons are moved out of the cell by the electron transport chain. B) The energy of the proton motive force is harvested by mechanisms that allow protons to move back into the cell.  C) The energy of the proton motive force is used to drive certain cellular processes, including ATP synthesis.  D) The energy of the proton motive force is used to power certain transport systems and some forms of motility.  E) The proton motive force involves moving electrons from one side of the nuclear membrane to the other.

78)

Select the TRUE statement(s) about the proton motive force.

A) The proton motive force always involves the inner mitochondrial membrane. B) The proton motive force involves a pH gradient component. C) The proton motive force can be used for active transport processes. D) The proton motive force involves movement of hydrogen ions across the nuclear membrane by the electron transport chain. E) The proton motive force involves a pH gradient component AND the proton motive force can be used for active transport processes.

79) When doing a Gram stain, leavingwhich of the following on for twice as long as directed would have the most significant consequence?

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A) Alcohol B) Crystal violet C) Iodine D) Safranin E) Carbol fuchsin

80) A modified Gram-stain procedure uses Bismark brown as a counterstain instead of safranin. In this case, Gram-negative cells would appear _____, while Gram-positive cells would appear _____. A) brown; purple B) purple; purple C) pink; purple D) colorless; brown E) brown; colorless

81) A student mistakenly swapped the two stains in the Gram stain, thereby using safranin as the primary stain and crystal violet as the counterstain. With this error, Gram-positive cells would appear _____, while Gram-negative cells would appear _____. A) purple; purple B) pink; pink C) purple; colorless D) pink; colorless E) colorless; colorless

82) You correctly Gram-stain an unknown bacterium in your microbiology laboratory and see chains of purple spherical cells. Based on this information you can conclude that this organism is a

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A) Gram-positive streptococcus. B) Gram-negative streptoccocus. C) Gram-positive sphere. D) Gram-negative streptobacillus. E) Gram-negative diplococcus.

83) Consider the figure. Select the CORRECT statement regarding penicillin and the bacterial cell wall.

A) Penicillin will likely have a greater effect on the wall shown in panel A, which shows a Gram-positive cell wall. B) Penicillin will likely have a greater effect on the wall shown in panel A, which shows a Gram-negative cell wall. C) Penicillin will likely have a greater effect on the wall shown in panel B, which shows a Gram-negative cell wall. D) Penicillin will likely have a greater effect on the wall shown in panel B, which shows a Gram-positive cell wall. E) Penicillin will always have an equal effect on the cell walls shown in panel A and panel B .

84)

Please select the TRUE statement regarding cell walls of Archaea. A) Some archeae have pseudopeptidogylcan in their cell walls. B) Some archeae have peptidoglycan in their cell walls but most do not. C) Archaea do not have cell walls; they have only cell membranes. D) The archaeal cell wall is highly sensitive to penicillin. E) The archaeal cell wall resembles a Gram-negative bacterial cell wall.

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85)

Which of the following statements about flagella, pili and archaella is CORRECT? A) Bacteria move by means of flagella, while archaea move by means of archaella. B) Archaella and flagella are identical in structure and are used for attachment. C) Flagella are unique to bacteria; no other cell type has them. D) Sex pili are used for slow, gliding motion in archaea. E) Pili and fimbriae are both types of flagella used for movement.

86)

Why is a bacterial smear heated before staining? A) To fix (attach) the bacteria to the microscope slide. B) To kill the bacteria to make them harmless. C) To remove any capsules that would affect the staining method. D) To make the cell wall porous so dye can enter the cell. E) To differentiate between Gram-positive and Gram-negative cells.

87)

How does the function of the cell membrane differ from that of the cell wall?

A) The membrane is the permeability barrier that defines the cell boundary, while the wall provides strength to the cell to prevent it from lysing. B) The cell wall is the permeability barrier that defines the cell boundary, while the cell membrane provides strength to the cell to prevent it from lysing. C) The cell membrane and the cell wall have the identical function: they confer specific shape to the organism and control substances entering and leaving it. D) The cell membrane defines the boundary of the cell, while the only function of the cell wall is to provide a means to identify different types of bacteria. E) The cell wall is the pemeable boundary of the cell while the cell membrane is the impermeable boundary of the cell.

88) Given what you know about the bacterial cell wall, infections caused by which of the following would theoretically respond best to treatment with penicillin?

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A) Streptococcus pyogenes, a Gram-positive bacterium that can cause strep throat. B) Escherichia coli, aGram-negative bacterium that can cause urinary tract infections. C) Vibrio cholerae, a Gram-negative organism that causes serious diarrhea. D) Mycoplasma pneumoniae,a pleomorphic bacterium that causes pneumonia. E) Candida albicans, a yeast that can cause diaper rash in infants.

89) In the name E. coli O157:H7, "O157" refers to O antigen. From this, you can conclude that E. coli A) is Gram-negative. B) is Gram-positive. C) is a pathogen. D) is a coccus. E) has a capsule.

90) You do a chemical analysis of three bacterial samples. In one (sample A), you find phospholipids, peptidoglycan, O antigen and lipid A. In the second(sample B) you find peptidoglycan, phospholipids and teichoic acids. In the third (sample C)you find phospholipids but no peptidoglycan. Select the TRUE statement. A) Sample A - Gram-negative cell; Sample B - Gram-positive cell; Sample C Mycoplasma B) Sample A - Gram-positive cell; Sample B - Gram-negative cell; Sample C Mycoplasma C) Sample A - Gram-negative cell; Sample B - Gram-positive cell; Sample C - prion D) Sample A - Gram-negative cell; Sample B - Gram-positive cell; Sample C Streptococcus E) Sample A - Gram-positive cell; Sample B - Gram-negative cell; Sample C Mycobacterium

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91) Consider the Venn diagram pertaining to the three domains and select the INCORRECT characterization.Remember that characteristics shared by two or more items are found in the circle overlaps.

A) Mitochondria, 80S ribosomes, cell wall - G B) Peptidoglycan, 70S ribosomes, diplococcus - A C) Mitochondria, nucleus, unicellular - F D) Unicellular, ribosomes, DNA - E E) Prokaryote, 70S ribosomes, DNA - B

92) Why is it possible to use an antibiotic to target prokaryote protein synthesis without affecting eukaryote protein synthesis? A) Eukaryotes do not carry out protein synthesis or cell wall synthesis. B) Eukaryotes do not contain cell walls of peptidoglycan. C) Prokaryote ribosomes and eukaryote ribosomes are different. D) Prokaryotes do not contain mitochondria or Golgi apparatus. E) All prokaryotes are unicellular while eukaryotes can be uni- or multicellular.

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93) Consider the Venn diagram pertaining to the bacterial cell wall and select the INCORRECT characterization.Remember that characteristics shared by two or more items are found in the circle overlaps.

A) Stains with simple stain - B B) Lipid A and O antigen - C C) Peptidoglycan and teichoic acids - A D) Protein and carbohydrate - B E) Peptidoglycan and outer membrane - B

94)

If a cell is placed into a solution and water leaves the cell, the cell is in A) a hypertonic environment. B) hypotonic environment. C) isotonic environment. D) anoxygenic environment. E) even environment.

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SECTION BREAK. Answer all the part questions. 95) A patient comes to see you, complaining of a very sore throat. When you examine her, you find that she has a fever of 39.9oC, and you observe that her throat is extremely red, with pus on her tonsils. You swab the pus and make a slide, which you then send to the clinical lab for Gram staining. The lab sends back a report in which it is noted that the slide has manylong chains of round cells that have stained purple in color.

95.1)

Based on the Gram staining, you suspect that the patient has a _____ infection.

A) fungal B) bacterial C) protozoan D) algal E) prion

95.2) You inform the patient that the results of the Gram stain indicate to you that the bacteria in her throat are ______ in shape, and have a ______ cell wall. A) round; thin B) cylindrical; thick C) round; thick D) spiral; thick E) cylindrical; thin

95.3)

Your patient asks you whether you also observed viruses on the slide. You tell her

A) yes, but they are of no concern because viruses are never pathogenic. B) maybe, but there were too few to observe among the bacteria. C) maybe, but viruses cannot be observed without an electron microscope. D) unlikely, because viruses seldom cause sore throats in people. E) no, because viruses are always Gram negative.

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95.4) You perform a rapid strep test on the patient, which comes up positive. You tell her that she most likely has strep throat, caused by Streptococcus pyogenes. You prescribe penicillin for her, and tell her that this antibiotic is effective because it interferes with the synthesis of ______ by the pathogen. A) peptidoglycan B) capsule material C) ribosomes D) proteins E) ATP

95.5) As she is preparing to leave your office, the patient mentions that her brother had pneumonia a couple of years ago and that penicillin had not helped him. You ask her if she remembers the name of the organism causing her brother's illness and she tells you it was Mycoplasmasomething or other, that she can't quite remember. You tell her that the reason penicillin did not help her brother is that A) you know her brother did not take the full course of antibiotics, so some of the Mycoplasma cells survived. B) Mycoplasma species are Gram-negative, and penicillin cannot penetrate the LPS layer of these cells, so the cells survive. C) Mycoplasma species are acid-fast bacteria, so they have mycolic acids in the cell wall that penicillin does not destroy. D) Mycoplasma species do not have a peptidoglycan cell wall and are thus not impacted by penicillin. E) Mycoplasmas are viruses and antibiotics do not work against viral infections.

96) Petrus brings his 87-year old grandmother to the emergency department where you work. His grandmother has a fever, is dehydrated and confused, and complains of pain when urinating. Petrus reports that she has not been eating or drinking, but she has no signs or symptoms of gastrointestinal distress. You request blood samples and also a urine sample. You decide to keep Petrus' grandmotherin the hospitalso that she can be given intravenous fluids. You also want to wait for the lab test results before you decide whether she required additional treatment or if she can return home.

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96.1) When Petrus' grandmother's test results are sent to you, you discover that while her blood work is normal, her urine has Gram-negative bacilli in it. Based on this, you know that the cells are A) stained blue and are cylindrical in shape. B) stained purple and are cylindrical in shape. C) stained pink and are spherical in shape. D) stained pink and are cylindrical in shape. E) stained green and are oval in shape.

96.2) You explain to Petrus and his grandmother that the cause of her infection is likely E. coli, and that the organism produces ______ that allow it to attach to the epithelial cells of the urinary tract. A) flagella B) a slime layer C) a glycocalyx D) pili E) cilia

96.3) Petrus asks you what the Gram-negative result means and you explain that the bacteria causing his grandmother's UTI A) have a thin cell wall and an outer membrane which makes the cells less sensitive to the antibiotic penicillin. B) have a thick cell wall and an outer membrane which makes the cells less sensitive to the antibiotic penicillin. C) have no cell wall but they have a thick outer membrane which makes the cells less sensitive to the antibiotic penicillin. D) have a thin cell wall and an inner cell membrane which makes the cells less sensitive to penicillin. E) have no cell wall which makes the cells more sensitive to the antibiotic penicillin.

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96.4) The lab report also details the results of a negative stain performed on the bacteria in the urine sample. In this method, the background of the sample is stained, rather than the cells themselves. The report indicates that the cells have a clear halo around them, indicating the presence of a(n) ______. You explain to Petrus that this structure helps bacteria avoid ______, part of the immune response. A) endospore; phagocytosis B) flagellum; antibodies C) LPS; antibodies D) capsule; pinocytosis E) capsule; phagocytosis

97) Your roommate at college complains of a sore throat, fatigue, fever, cough, and chest pain. She thinks shehas a cold, although she has not had a runny nose or any sneezing, and she has been feeling bad for more than a week. You persuade her to go to the urgent care, which she does. She comes home with a prescription for penicillin, telling you that she was told that she likely has pneumonia, caused by Streptococcus pneumoniae. She takes the penicillin according to instruction but doesn't feel any better, so she goes back to the urgent care facility. This time, the physician's assistanton shift takes a sputum sample and sends it for analysis. He also prescribes tetracycline for your friend. This antibiotic targets protein synthesis. Your friend takes the medication and recovers fully.

97.1) You are a microbiology student. You tell your roommate that Streptococcus pneumoniae A) is a bacterium that appears as chains of round cells when viewed with a microscope. B) is a virus that appears as chains of round cells when viewed with a microscope. C) is a bacterium that appears as pairs of rod-shaped cells when viewed with a microscope. D) is a protozoan that appears as clusters of round cells when viewed with a microscope. E) is a virus that cannot be viewed except with an electron microscope.

97.2) You explain to your roommate that penicillin is an antibiotic that interferes with the synthesis of peptidoglycan. Peptidoglycan

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A) is composed of glycan chains linked by tetrapeptidesAND is unique to pathogens. B) is composed of glycan chains linked by tetrapeptides AND is unique to bacteria and archaea. C) is composed of glycan chains linked by tetrapeptides AND is unique to bacteria. D) is composed of glycan chainsand phospholipids AND is unique to bacteria. E) contains phospholipids and carbohydrate chains AND is unique to prokaryotes.

97.3) You tell your friendyou think she may actually have pneumonia caused by Mycoplasmapneumoniae, a ______ organism that lacks a ______. A) spherical; peptidoglycan cell wall B) pleomorphic; phospholipid bilayer C) bacillus; capsule D) pleomorphic; peptidoglycan cell wall E) pleomorphic; nucleoid

97.4) How do you explain to your friend why tetracycline treated her infection but penicillin did not? A) Mycoplasma pneumoniaehas no lipopolysaccharide so is not impacted by penicillin, an inhibitor ofphospholipidsynthesis. However, the organism carries out protein synthesis, so is affected by tetracycline, which interferes with this process. B) Mycoplasma pneumoniaehas no proteins so is not impacted by penicillin, an inhibitor ofproteinsynthesis. However, the organism carries out peptidoglycan synthesis, so is affected by tetracycline, which interferes with this process. C) Mycoplasma pneumoniaehas no cell wall so is not impacted by penicillin, an inhibitor ofpeptidoglycansynthesis. However, the organism carries out protein synthesis, so is affected by tetracycline, which interferes with this process. D) Mycoplasma pneumoniaeis a Gram-positive cell, so has a peptidoglycan layer too thick to be impacted by penicillin. It can only be treated with tetracycline, which is a much stronger antibiotic. E) Mycoplasma pneumoniaeis an RNA virusso is not impacted by penicillin, an inhibitor of DNAsynthesis. However, tetracycline which interferes with DNA replication, so destroys this infectious agent.

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97.5) Mycoplasma pneumoniae is naturally resistant to penicillin because it lacks a peptidoglycan cell wall and penicillin interferes with peptidoglycan synthesis. ⊚ ⊚

true false

98) A bacterium commonly used for scientific studies is E. coli,a Gram-negative rod. As is typical with Gram-negative cells, E. coli has a thin wall composed of peptidoglycan, and an outer membrane composed of phospholipids on the inner surface and lipopolysaccharides (LPS) on the outer surface. For a long time now, scientists have known that the cell wall confers rigidity and shape to bacterial cells. However, the outer membrane of Gram-negative cells has been thought to simply be a lipid covering that isimportant from a medical standpoint: it forms a selective barrierthat can make it challenging for certain antibiotics to enter the cells and as a result, Gramnegative cells tend to be more resistant to antibiotics than Gram-positive cells, which lack the outer membrane. The outer membrane has not been thought to play a role in the morphology of the cells. Now however, collaborating scientists from several universities have shown that in fact, the outer membrane plays a significant role in physically protecting Gram-negative bacteria. The team, led by K.C. Huang at Stanford University, exposed E. coli cells to various stresses. In one experiment, they removed the bacterial cell wall, but left the outer membrane intact. Initially, all the cells lost their regular shape, and rounded up into what is known as L-forms. The team expected the cells to die (they take up water and burst) but many survived, and to the researchers’ surprise, those cells multiplied and eventually regained their original shape. In other experiments, the team left the cell wall intact but reduced the pressure inside the bacterial cells; they assumed that the walls would shrink and that the cells would lose their rod shape, but in fact they did not. It seemed that the outer membrane was able to maintain cell shape. In a different approach, the scientists exposed E. coli cells to alternating increases and decreases in pressure for two hours. Intact E. coli cells were completely unaffected by this treatment; however, if the team weakened the outer membrane of the cells and repeated the experiment, the cells soon died. It has come as a surprise to understand that the outer membrane of Gram-negative cells has such amazing strength. The significance of this research is that the outer membrane could provide a new target for antimicrobial medications; developing drugs that destroy the outer membrane of Gram-negative cells could provide a novel approach to treating infections caused by these organisms. Source:Stanford University. "Bacterial armor could be a new target for antibiotics." ScienceDaily. ScienceDaily, 18 July 2018. www.sciencedaily.com/releases/2018/07/180718131145.htm.

98.1) Version 1

Please select the TRUE statement regarding the bacterial cell wall. 34

A) The Gram-positive wall has a thick layer of peptidoglycan; the Gram-negative cell wall has a thin peptidoglycan layer and an outer lipid membrane. B) The Gram-positive wall has a thick layer of peptidoglycan; the Gram-negative cell wall has a thin peptidoglycan layer and an outer protein membrane. C) The Gram-negative wall has a thick layer of peptidoglycan; the Gram-positive cell wall has a thin peptidoglycan layer and an outer lipid membrane. D) The Gram-negative outer membrane has an inner lipopolysaccharide layer and an outer phospholipid layer. E) Cell shape is maintained by the peptidoglycan cell wall in Gram-positive cells but by the cell membrane in Gram-negative cells.

98.2)

Please select the FALSE statements regarding a Gram-negative cell wall.

A) It contains teichoic acids and lipoteichoic acids. B) The wall retains a pink color in the Gram-stain procedure. C) Outside the wall is a unique lipoloysaccharide layer. D) It confers shape to the bacterial cell. E) It is composed of a mesh-like material called peptidoglycan.

98.3)

What did the researchers demonstrate in this work?

A) The outer membrane of Gram-negative cells is very strong and helps maintain cell shape and integrity. B) E. coli is a Gram-negative bacterium that has an outer, impermeable LPS membrane. C) If the cell wall of E. coli is removed, the cells all take up water and burst; no cells survive. D) The cytoplasmic membrane of E. coli provides a novel target for antimicrobial drugs. E) The Gram-negative outer membrane has an inner lipopolysaccharide layer and an outer phospholipid layer.

98.4)

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What is the significance of this research?

A) The researchers suggest that drugs that destroy the outer membrane of Gramnegative cells could provide a novel therapy approach. B) The researchers suggest that drugs that destroy the cell wall of Gram-negative cells may provide a novel therapeutic approach. C) The researchers show that drugs that destroy the cytoplasmic membrane of Grampositive cells can be used as a novel way to kill those cells. D) The researchers prove that the outer membrane of Gram-negative cells is impermeable, making the cells impossible to destroy with any kind of medication. E) This research indicates that it is likely impossible to destroy many Gram-positive bacteria, because they do not have an outer membrane for targeting.

98.5)

Which of the following is demonstrated TRUE in this research?

A) E. coli that had the outer wall removed immediately underwent osmotic lysis. B) E. coli with a weakened outer membrane were unable to tolerate repeated stress events. C) E. coli with an intact outer membrane were unable to tolerate repeated stress events. D) Drugs targeting the outer membrane could be used against both Gram-positive and Gram-negative cells. E) L-forms are rod-shaped bacteria with their peptidoglycan layer removed.

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Answer Key Test name: Chap 03_10e 1) FALSE 2) TRUE 3) FALSE 4) FALSE 5) FALSE 6) FALSE 7) TRUE 8) FALSE 9) FALSE 10) C 11) C 12) A 13) C 14) C 15) A 16) B 17) C 18) E 19) C 20) A 21) B 22) B 23) C 24) B 25) C 26) C Version 1

27) B 28) C 29) A 30) B 31) B 32) E 33) E 34) C 35) C 36) C 37) A 38) C 39) B 40) C 41) A 42) C 43) E 44) C 45) B 46) E 47) C 48) A 49) C 50) C 51) C 52) C 53) B 54) E 55) A 56) A Version 1

57) A 58) B 59) A 60) A 61) C 62) B 63) B 64) B 65) A 66) C 67) A 68) B 69) C 70) A 71) D 72) C 73) B 74) B 75) D 76) B 77) E 78) E 79) A 80) A 81) A 82) A 83) A 84) A 85) A 86) A Version 1

87) A 88) A 89) A 90) A 91) C 92) C 93) E 94) A 95) Section Break 95.1) B 95.2) C 95.3) C 95.4) A 95.5) D 96) Section Break 96.1) D 96.2) D 96.3) A 96.4) E 97) Section Break 97.1) A 97.2) C 97.3) D 97.4) C 97.5) TRUE 98) Section Break 98.1) A 98.2) A 98.3) A 98.4) A Version 1

98.5) B

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CHAPTER 4 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) It is assumed that every colony observed on a streak plate arose from a single bacterium. ⊚ ⊚

true false

In microbiology, growth usually refers to an increase in size of the bacteria. ⊚ ⊚

true false

There are five stages of growth in an open system of culture. ⊚ true ⊚ false

Secondary metabolites produced during bacterial growth may be antibiotics. ⊚ ⊚

A single bacterial cell may multiply to form a visible colony on a culture medium. ⊚ ⊚

true false

Prokaryotes are the only organisms able to use atmospheric nitrogen as a nitrogen source. ⊚ ⊚

true false

Freezing is an effective means of destroying bacteria. ⊚ ⊚

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true false

One would expect most strict anaerobic organisms to have superoxide dismutase. ⊚ ⊚

true false

Differential media only allow certain bacteria to grow. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 10) All the bacterial cells that result from the replication of a single bacterial organism are referred to as a A) mixed population. B) pure culture. C) lag culture. D) mutant culture. E) single culture.

11)

The scientist that contributed most to the development of pure culture techniques was A) Alexander Fleming. B) Louis Pasteur. C) Edward Jenner. D) Robert Koch. E) Paul Ehrlich.

12)

The solidifying agent used most successfully in bacterial nutrient media is

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A) gelatin. B) peptone. C) agar. D) starch. E) agarose.

13)

Prokaryotic cells divide by a process known as A) conjugation. B) mitosis. C) binary fusion. D) binary fission. E) meiosis.

14)

In nature, bacteria A) rarely grow in close association with many other kinds of organisms. B) always go through a very short exponential phase. C) always synthesize structures such as slime layers. D) may adhere to surfaces by means of pili and slime layers. E) All of the answer choices are correct.

15)

Which of the statements about biofilmsis TRUE? A) Biofilms are very rarely involved in human bacterial infections. B) Biofilms may protect organisms against harmful chemicals. C) Biofilms are a peptidoglycan-encased community of microorganisms. D) Biofilms may significantly inhibitbioremediation efforts. E) Biofilms are very seldom found in a natural environment.

16)

The simplest technique for isolating bacteria is referred to as the

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A) streak-plate method. B) pour-plate method. C) serial dilution method. D) most probable number method. E) bacterial growth method.

17)

Bacteria may be stored for several months A) on a slant in the refrigerator, frozen in agar AND in broth at 37°C. B) in broth at 37°C, on a slant in the refrigerator ANDfrozen in glycerol solution. C) on a slant in the refrigerator, frozen in glycerol solution AND freeze-dried. D) freeze-dried, in broth at 37°C AND frozen in agar. E) freeze-dried, frozen in glycerol solutionAND in broth at 37°C.

18) In the growth curve of a bacteria population, the bacteria are rapidly increasing in number in the A) lag phase. B) exponential (log) phase. C) stationary phase. D) decline phase. E) death phase.

19)

During which phase of growth are bacteria most susceptible to antibiotics? A) Lag B) Stationary C) Exponential (log) D) Decline E) Infection

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20)

When doing experiments with bacteria, A) it is usually not necessary to standardize which stage of growth is used. B) it is best to use colonies, as all cells in a colony are at the same growth stage. C) it is best to use bacteria from the same stage of growth. D) the age of the bacteria is not important. E) it is best to use mixed populations and biofilms.

21) During which phase of the bacterial growth curve does the total number of viable (live) cells decline? A) Stationary B) Lag C) Exponential D) Death E) Infection

22)

The lag phase of the bacterial growth curve is characterized by A) a decrease in cell mass. B) dormant, metabolically inactive cells. C) metabolically active cells. D) vigorously dividing cells. E) spore-forming cells.

23)

Late log phase of the bacterial growth curve A) is characterized by the production of primary metabolites. B) is characterized by the production of secondary metabolites. C) is a transition into the death phase. D) shows a decline in cell numbers. E) is characterized by germination of endospores.

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24) During which phase of the bacterial growth curve does a bacterial population become much more resistant to harmful conditions? A) Lag phase B) Exponential phase C) Stationary phase D) Late log phase E) Decline phase

25) A urine sample with more than 100,000 organisms is considered indicative of infection. A urine sample containing 5,000 bacteria, with a generation time of 30 minutes, sits for 3 hours before finally being assayed. How many bacteria will then be present within the sample? A) 320,000 B) 100,000 C) 64,000 D) 15,000 E) 10,000

26) A pure culture in exponential growth phase has a bacterial concentration of 6.4 x 10 cells/ml. If the bacterium has a generation time of 1 hour, how long ago was the cell concentration 8.0 x 10 7 cells/ml? A) 1 hour B) 2 hours C) 3 hours D) 4 hours E) 24 hours

27)

In a rapidly multiplying bacterial population, cell numbers increase

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A) arithmetically. B) logarithmically. C) linearly. D) indirectly. E) additionally.

28)

Generally the proteins of thermophiles A) resist denaturation. B) react more efficiently with DNA. C) are easily denatured. D) have very few amino acids. E) are larger than those of mesophiles.

29)

A hot tub (with a water temperature of104°F or 40°C) would most likely contain A) psychrophiles. B) freezophiles. C) mesophiles. D) thermophiles. E) hyperthermophiles.

30)

The optimal temperature for most human pathogens might be expected to range from A) 20–45°C. B) 35–40°C. C) 15–25°C. D) 93–98.6°C. E) 35–40°F

31)

Bacteria on fish caught in the Arctic Ocean would

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A) be freezophiles ANDcontinue to grow while the fish is in the refrigerator. B) be mesophiles AND wouldcontinue to grow while the fish is in the refrigerator. C) be mesophiles AND wouldnot grow very well in the refrigerator. D) be psychrophiles AND wouldcontinue to grow while the fish is in the refrigerator. E) be thermophiles AND would not grow very well in the refrigerator.

32) Mycobacterium leprae is typically found infecting the ears, toes, and fingers of its host due to its A) requirement for well-oxygenated blood. B) easy access to those body parts. C) need for cooler temperatures. D) long incubation period. E) environmental distribution.

33)

Organisms that require gaseous oxygen for metabolism are referred to as A) facultative aerobes. B) obligate aerobes. C) facultative anaerobes. D) microaerobes. E) obligate anaerobes.

34)

Which of the following is (are) obligate aerobes? A) Clostridium botulinum B) Escherichia coli C) Micrococcus luteus D) Helicobacter pylori E) All of the answer choices are correct.

35)

Organisms that are indifferent to the presence of oxygen and do not use it are

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A) aerotolerant anaerobes. B) facultative anaerobes. C) obligate aerobes. D) microaerophiles. E) obligate anaerobes.

36)

The enzymes that deal with toxic oxygen-containing molecules are A) glycolase AND superoxide dismutase. B) superoxide dismutaseAND cytochrome oxidase. C) superoxide dismutase AND catalase. D) catalase AND cytochrome oxidase. E) cytochrome oxidase AND glycolase.

37)

Shake tubes are used to determine the A) pH requirements for bacterial growth. B) temperature requirements for bacterial growth. C) oxygen requirements for bacterial growth. D) salt requirements for bacterial growth. E) nutrient requirements for bacterial growth.

38)

The optimum pH for growth of most species of bacteria is ______. A) pH 5 B) pH 7 C) pH 9 D) pH 6 E) pH 1

39)

High concentrations of salt and sugar in foods

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A) are useful in preserving the food AND tend to force water into a cell, causing plasmolysis. B) have no effect on water availability AND are useful in preserving the food. C) are useful in preserving the food AND tend to draw water out of a cell. D) are useful in preserving the food AND forcebacteria to divide. E) tend to force water into a cell, causing plasmolysis AND forcebacteria to divide.

40)

Carbon, hydrogen, oxygen, nitrogen, phosphorus, and sulfur may be considered A) minor elements. B) major elements. C) neutral elements. D) acidic elements. E) trace elements.

41)

Which of the following are TRUE regarding trace elements?

A) They include zinc, copper, and manganese AND they may be needed for enzyme function. B) They include zinc, copper, and manganese AND they are required in large amounts. C) They may be needed for enzyme function AND they are involved in maintaining pH in the cell. D) They are required in large amounts AND they may be needed for enzyme function. E) They are involved in maintaining pH in the cell AND they include zinc, copper, and manganese.

42) Small organic molecules that must be provided to bacteria in order for them to grow are called

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A) minerals. B) growth factors. C) water. D) vitamins. E) ions.

43) The prefix photo- in the term photoautotroph indicates that an organism will make use of ______ for energy purposes. A) chemicals B) organics C) light D) inorganics E) water

44)

Organisms that use organic molecules as their source of carbon are called A) chemotrophs. B) heterotrophs. C) organoheterotrophs. D) autotrophs. E) organoautotrophs.

45)

Organisms may derive energy from A) sunlight AND temperature gradients. B) sunlight AND metabolizing chemical compounds. C) metabolizing chemical compounds AND temperature gradients. D) temperature gradients AND pH gradients. E) sunlight AND pH gradients.

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46)

Organisms that use CO

2 as their source of carbon are called

A) organotrophs. B) heterotrophs. C) autotrophs. D) chemotrophs. E) carbonotrophs.

47)

Which of the statements regarding chemoorganoheterotrophs is/are CORRECT? A) They use sunlight as an energy source. B) They use preformed organic molecules as a carbon source AND light as an energy

source. C) They use preformed organic molecules as an energy source. D) They use inorganic chemicals as an energy source. E) They use preformed organic molecules as a carbon source AND as an energy source.

48)

What would true about an organism called Bacillus fastidiosus? A) It might be expected to be very flexible in its growth requirements. B) It might be expected to be very strict in its growth requirements. C) It could probably be grown on a minimal medium. D) It might be expected to have a spherical shape. E) It might be expected to depend on sunlight for energy.

49)

Which is TRUE of peptone?

A) It is a hydrolysate of carbohydrates used in growth media. B) It is a hydrolysate of proteins used in growth media. C) It consists of a water extract of beef. D) It consists of a mix of monosaccharides and oligosaccharides. E) It is a hydrolysate of proteins used in growth media AND it consists of a water extract of beef.

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50)

Medically important bacteria are often A) grown on agar containing blood AND grown at 4°C. B) grown at 37°C AND grown at a pH of 5. C) grown on agar containing blood AND grown at 37°C. D) grown on agar containing chocolate AND grown at 4°C. E) grown at a pH of 5 AND grown at 4°C.

51)

Products that limit pH changes are often incorporated into media and are referred to as A) enzymes. B) buffers. C) bases. D) acids. E) neutrifiers.

52) a(n)

A medium that inhibits the growth of organisms other than the one being sought is called

A) synthetic medium. B) specific culture medium. C) selective medium. D) enrichment medium. E) differential medium.

53)

MacConkey agar is

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A) a selective medium. B) a selective and differential medium. C) a differential medium. D) an enrichment medium. E) an anaerobic medium.

54)

Candle jars are used to A) prevent candles from melting and going out. B) provide an atmosphere with increased CO 2 levels. C) stimulate the growth of obligate anaerobes. D) prevent the growth of obligate aerobes. E) enhance the growth of microaerophiles and aerobes.

55)

In the cultivation of microaerophilic and anaerobic bacteria,

A) a(n) candle/anaerobe jar is sufficient. B) atmospheric oxygen in a(n) candle/anaerobe jar is converted to water. C) a packet containing chemicals that generate CO2 and hydrogen is used in a(n) candle/anaerobic jar. D) oxidizing agents are incorporated into the media that react with oxygen. E) selective and differential media must always be used.

56)

Which of the folllowing is TRUE about agar? A) It has chemical and physical properties that make it almost ideal for solidifying

media. B) It is a useful nutrient source for most bacteria. C) It is a hydrolysate of carbohydrates and proteins. D) It stays liquid through the typical range of incubation temperatures. E) It only solidifies if it is cooled in a refrigerator for 48 hours.

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57)

Agar replaced gelatin as the solidifying agent for media because A) agar provides nutrientsfor rapidbacterial growth. B) fewer bacteria can break down agar compared with gelatin. C) agar is solid at temperatures as high as 90°C. D) agar provides a pH range from 4–11. E) agar is much easier to obtain than gelatin.

58) A microbe is discovered growing near a deep sea thermal vent. When researchers bring a sample up to the surface and try to grow it in a lab at room temperature in a regular incubator, they are unsuccessful. Why? A) The pressure isn't the same at sea level as it is on the ocean floor and the microbe may require a very specific pressure. B) Oxygen concentrations are very different between the two environments—it's possible the microbe is a strict anaerobe and cannot survive regular atmospheric oxygen levels. C) The salt concentration in the media the researchers are usingmay be different from that of sea water. This might be causing osmotic pressure differences that the microbe can't tolerate. D) The temperature is probably different—the thermal vent would be very hot, while these researchers are trying to grow this microbe at room temperature. E) All of the answer choices are correct.

59) You are a microbiologist working for a pharmaceutical company and discover a new secreted metabolite that can serve as a medication. Your company asks you to oversee the production of the metabolite. Which of the following does NOT need to be considered if you need to grow 5,000 liter cultures of bacteria for the purpose of harvesting the metabolite they secrete?

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A) The death rate ofthe bacteria after stationary phase is complete. B) The ideal rate ofinput of new nutrients into the culture to maintain the cells in log phase. C) The ideal rate ofpulling off some of the culture in order to maintain the cells in logphase. D) The best way to mix the large vat in order to keepnutrient levels, temperature, and oxygen levels constant. E) The best way to keep the pH of theentire mixture at the ideal level to promote log phase growth.

60) You are working in a clinical laboratory in a hospital setting. You're handed a throat swab from a patient. You are told specifically that the physician is only interested in the presence and type of Gram positive cells. Identification isn't the main goal here—just a first step to work towards determining what Gram positive cells might be there. What might you do first to go about working towards this goal? A) Perform a Gram stain on the patient's sample. B) Streak the samplefor isolation on a tryptic soy agar general purpose medium plate. C) Streak the sample for isolation on a medium that is selective for Gram positive cells. D) Grow the microbeson the swab by inoculating a tryptic soy broth liquid medium tube. E) Perform an acid-fast stain on the patient's sample.

61) A physician sends a fecal sample to your lab, and wants to know if there are lactose fermenting microbes in it. How might you determine if these microbes are present or not from this mixed-microbe specimen?

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A) Streak the samplefor isolation on Thayer-Martin agar (which contains lactose and particularantibiotics for selectivity). B) Streak the sample for isolation on a blood agar plate (which contains lactose and red blood cells that enrich the culture for iron). C) Streak the samplefor isolation on a MacConkey agar plate (which contains lactose and a pHindicator that turns pink when acid byproducts are present). D) Either Thayer-Martinagar or blood agar would work, as long as the plates are incubated in an anaerobic chamber. E) None of the answer choices are correct—there's no way to reliably determine this feature from the specimen given.

62) You are in charge of water quality for your city's water treatment plant. Which is the most efficient and cheapest method of determining the number of viable (living) bacteria in the water coming out of your plant? A) Direct countsusing a microscope and a counting chamber. B) Using a Coulter counter machine followed by placing the membrane in a growth medium for counting after incubation. C) Performing serial dilutionsand doing spread plate counts. D) Using membrane filtration followed by placing the membrane in a growth medium for colony counts after incubation. E) Biochemical analysis of secondary metabolites in the water that are given produced by the bacteria.

63) You take spectrophotometer absorbance readings of a culture of E. coli cells growing in tryptic soy broth (TSB) at 2, 4 and 6 hours. Your absorbance readings clearly indicate a lag phase, a log phase, and a stationary phase. You come back in and take additional readings at 8, 10, 12, 14, and 16 hours, but the absorbance number remains the same. Shouldn't it start coming down as the closed batch culture enters death phase? What's the most likely explanation for whatis happening?

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A) Something is likely wrong with the spectrophotometer and it isn't measuring the correct values. Perhaps something is on the detector, making it register falsely high absorbance numbers. B) Absorbance indicatescell number,but does not differentiate betweenlivedead cells. The presence of dead cellskeeps the absorbance high even into the death phase. C) E. coli just has a long generation time and grows extremely slowly. After 16 hours the cells are still in stationary phase, so the cell numbers remainconstant, as expected. D) Perhaps there's a big smudge of something on the culture tube that is blocking some of the light. This would cause a high value for every timepoint. E) There is no point in measuring the absorbance of the culture because the cells are bacterial. It would make more sense to measure the transmission value.

64) of O

Clostridium paradoxum grows optimally at 55°C, pH 9.3; it will not grow in the presence 2. Please select the TRUE statement about this organism. A) It is spherical in shape. B) It is a psychrophile. C) It is an obligate anaerobe. D) It is an acidophile. E) It is an aerotolerant anaerobe.

65) You are determining the number of colony forming units (CFUs) for Susan, who has a urinary tract infection (UTI). You added 1 mL of Susan's urine sample to 99 mL ofdiluent, and spread 0.1 mL of that dilution on a culture medium. After appropriate incubation, you count 143colonieson the plate. What was the concentration ofbacteriain the original urine sample? A) 1.43 cells/ mL B) 1.43 x 10 2 cells/ mL C) 1.43 x 10 3cells/ mL D) 1.43 x 10 5 cells/ mL E) Cannot be determined

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66) Eosin methylene blue agar (EMB) is a selective and differential medium. The dyes in the medium inhibit most Gram-positive organisms. Gram-negative organisms such as the coliformsgrow on this medium. Coliforms that are fecal in origin produce colonies with a metallic green color on EMB, while those that are non-fecal producecolorless colonies. You plate a urine sampleonto an EMB plate and incubate it. Metallic green colonies develop. From this, you can conclude that A) the sample contains bacteria thatare Gram-negative AND are non-fecal in origin. B) the sample contains bacteria thatare Gram-negative AND are fecal in origin. C) the sample contains bacteria thatare Gram-positive AND are fecal in origin. D) the bacteria in the colonies are Gram-positive AND are rod-shaped. E) normal microbiotain the bladder is fecal in origin AND is aerobic.

67) You are culturing a new bacterium in the laboratory. You cannot find any glucose it the lab when you are making growth medium, so you decide to use honey instead. You add twice as much honey than is called for in the medium recipe, because you want to give the organism the best opportunity or growth. To your surprise, the organism does not grow on your modified medium. Select the most likely explanation. A) The growth medium became hypotonic with the addition of so much honey; the bacteria underwent plasmolysis and died. B) The growth medium became hypertonic with the addition of so much honey; the bacteria underwent plasmolysis and died. C) The growth medium became halophilic with the addition of so much honey; the bacteria underwent plasmolysis and died. D) The growth medium became hypertonic with the addition of so much honey; the bacteria underwent osmotic lysis and died. E) The growth medium became hypotonic with the addition of so much honey; the bacteria underwent simple diffusionand burst.

68) A halophilic, aerobic mesophilehas a generation time of 20minutes. You place 1x10 4of these organismson an appropriate solid medium, and incubate the plate for 100 minutes. Select the FALSE statement.

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A) The growth medium contains NaCl. B) The organism will grow at 40 oC. C) After incubation, a colony on the plate contains 3.2 x 10 5 cells. D) After incubation, a colony on the plate contains 5 x 10 4 cells. E) The organism produces superoxide dismutase and catalase.

69)

Please select the INCORRECT pair regarding stages of bacterial growth.

A) Lag phase -stage characterized by extensive macromolecule and ATP synthesis but no increase in cell number. B) Log phase -stage during which bacterial cells divide at a rapidly increasing rate. C) Stationary phase -stage in which the number of viable cells remains constant. D) Death phase -stage in which the number of viable cells decreases at an exponential rate. E) Period of decline - stage during which most cells die, but a few are able to grow.

70)

Which of the following best defines the human intestinal tract? A) An open system containing a complex medium. B) An open system containing a selective medium. C) A closed system containing a complex medium. D) A closed system containing a chemically defined medium. E) An alternately open and closed system with a differential medium.

71) Clostridium tetani, an obligate anaerobe, is placed onto the same type of solid culture medium but incubated under two different conditions: aerobic and anaerobic. Which of the following best predicts what would be observed after 48 hours?

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A) Colony growth on the culture plate in aerobic conditions; no colony growth on culture plate in anaerobic conditions. B) Colony growth on the culture plate in anaerobic conditions; no colony growth on culture plate in aerobic conditions. C) Growth of large colonies on plate in aerobic conditions; growth of smaller colonies on plate in anaerobic conditions. D) Growth of large colonies on plate in anaerobic conditions; growth of smaller colonies on plate in aerobic conditions. E) No growth on either of the plates.

72) E. coli, a mesophile, is grown at two different temperatures. Which conditions would be appropriate for optimal growth of this organism? A) 220 minutes at 10°C; 20 minutes at 37°C B) 20 minutes at 10°C; 220 minutes at 37°C C) 20 minutes at 45°C; 220 minutes at 65°C D) 220 minutes at 37°C; 20 minutes at 95°C E) 220 minutes at 10°C; 1 minute at 65°C

73) Thioglycolate medium is used to determine the oxygen requirements of a microorganism. You inoculate a tube of this medium with a bacterium and observe dense growth at the surface of the tube, with turbidity throughout the rest of the tube. From this you can conclude that A) the organism is a facultative anaerobe. B) the organism is an obligate aerobe. C) the organism is an obligate anaerobe. D) the tubes should be incubated for more time. E) the organim is fastidious.

74) You leave several tomatoes in your refrigerator when you go on vacation. When you get home, the tomatoes are covered in microbial growth. Select the best description for these microbes.

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A) They are acidophilic, psyhrotrophic aerobes. B) They are acidophilic, psyhrophilic aerobes. C) They are acidophilic, psyhrophilic anaerobes. D) They are neutrophilic, thermophilic aerobes. E) They are acidophilic, psyhrotrophic Gram-positive aerobes.

75) Neisseria gonorrhoeae is routinely grown on Thayer-Martin agar. This medium contains red blood cells that are lysed by heat to release growth factors, as well as a variety of antibiotics, including vancomycin and polymyxin. What can you conclude about this medium? A) It is selective. B) It is differential. C) It is selective AND differential. D) It is thermophilic. E) It is fastidious.

76) Which of the following would absolutely NOT grow on a petri dish incubated on a bench top in the microbiology laboratory? A) Obligate anaerobe B) Obligate aerobe C) Facultative anaerobe D) Microaerophile E) Aerotolerant anaerobe

77) You go on a trip to the South Pole, Antarctica. Unfortunately, you catch a bacterial infection from a tea mate while you’re there, and you experience sore throat, fever, productive cough, and headache. The organism causing your illness is a

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A) psychrophile. B) mesophile. C) thermophile. D) psychrotroph. E) anaerobe.

SECTION BREAK. Answer all the part questions. 78) Mrs. Thomascomes to the emergency department where you work, complaining of nausea and vomiting, bloody diarrhea, abdominal discomfort and fever. She tells you that she went out to a picnic the previous day, where barbecued chicken was served. Mrs. Thomas is a vegan, so she ate only salad. You thinkthat she likely has salmonellosis, caused by the bacteriumSalmonella enterica. However, the presence of blood in her stool causes you concern, and you want to rule out the possibility that patient has shigellosis, caused byShigellabacterial species.

78.1) You take a fecal sample from Mrs. Thomas, and send it to the lab for analysis. You tell her that the technicians will do a variety of tests to confirm the identity of the organism causing her illness. The first thing that will be done is to inoculate some of her stool sample onto a medium called hektoenenteric (HE) agar. On this medium, Shigella species produce blue-green colonies, while Salmonella produces blue-green colonies with a black center, and most Gram-positive bacteria do not grow at all. You explain to Mrs. Thomas that this type of medium is called a(n) ______ medium. A) selective B) differential C) enrichment D) selective and differential E) differential and enrichment

78.2) On HE medium, Shigellaspecies produce blue-green colonies, while Salmonellaproduces blue-green colonies with a black center. There are two noticeable types of colonies growing on the hektoen enteric (HE) medium in Mrs. Thomas' test. One type of colonyis greenish in color. This leads you to conclude that the bacteria in these colonies

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A) is Gram-negative and is likely Shigella. B) is Gram-negative and is likely Salmonella. C) is Gram-positive and is likely Shigella. D) is Gram-positiveand is likely Salmonella. E) is Gram-neutral and is likely Salmonella.

78.3) In addition to the few Shigellacolonies that are noted, there are also abundant salmon pink colonies, around which the medium has turned yellow, losing its original bluecolor. You know that hektoen enteric agar must contain ______. A) lactose B) a pH indicator C) a weak acid D) malachite green E) penicillin

78.4) The colonies of interest in this case are the blue-green presumptive Shigella colonies. However, growth on hektoen enteric agar is not sufficient for definitive identification. Further tests are needed. First, the lab technicians need to prepare larger numbers of Shigella from your patient's stool sample, and thenthey need to ensure that they are culturing a single species. The methods used to do this are ______, followed by ______. A) streak plating; pour plates B) enrichment culture; Gram staining C) Gram staining; enrichment culture D) Gram staining; capsule staining E) enrichment culture; streak plating

78.5) Shigellaspecies and Salmonella species are classified as facultative anaerobes. You know that given this information, the bacteria in your patient's fecal culture will grow best

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A) in the absence of oxygen. B) in the presence of oxygen. C) at low levels of oxygen. D) in high levels of carbon dioxide. E) if catalase is added to the medium.

79) Mr. Jones comes to your clinic complaining of genital discharge. He admits that he recently had unprotected sex with an old friend with whom he reconnected after a school reunion. You suspect that he may have gonorrhea. You take a sample of the discharge and send it to the hospital lab for analysis.

79.1) The causative organism of gonorrhea is Neisseria gonorrhoeae, a fastidious, Gram-negative diplococcus. What does fastidious mean in this context? A) An organism with complex nutritional requirements. B) An organism that requires oxygen for growth. C) An organism that survives in the presence of specific antibiotics. D) An organism that only grows in pure culture. E) An organism that requires a living host.

79.2) The lab technicians culture the sample on Thayer-Martin agar. This complex medium contains 5% sheep blood and a combination of antibiotics. This medium is A) differential. B) selective AND differential. C) selective. D) aerobic. E) chemically defined.

79.3) Thayer-Martin agar typically contains a combination of antibiotics: vancomycin, colistin, nystatin, and trimethoprim. Please select the TRUE statement.

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A) The antibiotics in Thayer-Martin agar do not kill bacteria. B) The antibiotics in the Thayer-Martin medium lysethe sheep RBCs. C) Neisseria gonorrhoeae is not sensitive to the included antibiotics. D) Fastidious bacteria are never impacted by common antibiotics. E) Sheep blood cells in a growth medium protects bacteria from the impact of antibiotics.

79.4) If you are asked to make 200 mL of Thayer-Martin agar, who much sheep's blood would you add to the medium? Recall that thiscomplex medium contains 5% sheep blood. A) 10% B) 5 mL C) 10 mL D) Random quantities E) 10,000 RBCs

80) A cluster of cases of legionellosishave occurred in your neighborhood. People with the illness have cough, fever, shortness of breath, chest pain and sometimes diarrhea. The illness is caused by the bacterium Legionella pneumophila, a facultative intracellular parasite that survives in certain ameba. The organism has an absolute requirement for L-cysteine.

80.1) Diagnosis of legionellosis depends partly on culture of the causative agent from medical samples. Typically, the organism is grown on buffered charcoal yeast extract (BCYE) agar. What essential component must this medium have to ensure growth of L. pneumophila? A) red blood cells B) chlorine C) NaCl D) cysteine E) All of the answer choices are correct.

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80.2) L. pneumophila is widespread and is foundin various water sources, including hot tubs, water cooling towers, swimming pools, grocery store misters, and shower water. Select the FALSEstatement regarding the organism, given this information. A) It survives in the presence of chlorine. B) It is a mesophile. C) It is an obligate anaerobe. D) It can survive in water pipes. E) It is a mesophile AND it can survive the presence of chlorine.

80.3) In some labs, samples containing suspected L. pneumophila are cultured on traditional BCYE medium containing L-cysteine, as well as BCYE medium lacking Lcysteine. How would L. pneumohila be identified in this situation? A) Compare the two plates. Colonies that grow on traditional BYCE medium but not on BYCE medium lacking cysteinearelikely L. pneumophila. B) Compare the two plates. Colonies that grow on BYCE medium lacking cysteinebut not on traditional BYCE medium arelikely L. pneumophila. C) Compare the two plates. Colonies that grow on both traditional BYCE medium and on BYCE medium lacking cysteinearelikely L. pneumophila. D) Compare the two plates. Colonies that do not grow on traditional BYCE medium or on BYCE medium lacking cysteine, but do grow on nutrient agararelikely L. pneumophila. E) Compare the two plates. Colonies that grow on traditional BYCE medium and are blue, yellow or cyan in colorarelikely L. pneumophila.

80.4) A modification of the BCYE medium used to culture L. pneumophila is BCYE with DGVP. Thismedium contains glycine, polymixinB (an antifungal agent), and and vancomycin (antibiotic), as well as two dyes (bromocreson purple and bromthymol blue) that facilitate identification of the organism based on colony color. What type of medium is BCYEwith DGVP?

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A) Selective B) Differential C) Selective AND differential D) Anaerobic AND selective E) Anaerobic

81) You work as an RN in the emerency department(ED) at a large regional hospital. A 37year-old man is admittedexhibitingdizziness, dry mouth, blurred vision, and slurred speech. He also reportsabdominal symptoms, including pain, nausea, vomiting, and diarrhea.The patient'sfamily tells you that he was recently at a church potluck, where heate bread, homemade tomato-beefstew and home-canned green beans.Based on the patient's signs and symptoms, the physician with whom you are workingsuspects botulism, a neurological disease that is caused by consumption of a toxin produced bythe Gram-positive, spore-forming, obligate anaerobic bacterium Clostridium boltulinum. The patient develops breathing difficulty and is placed on a mechanical ventilator. A stool sample from the patient is cultured on amedium called CBI. Thismedium contains theantibiotics cycloserine, sulfamethoxazoleand trimethoprim asinhibitory agents—C. botulinumhas a high level ofresistanceto these drugs. Some normal fecal bacteria can grow on CBI medium but they producecolonies that are easy to idenitify because they are pinpoint (tiny). The stool sample shows colonygrowth on the CBI agar,confirmingthe presence of C. botulinum. The stool sample,leftover stew and green beans are also tested for botulinum toxin; the stool sample and the green beans test positive for the toxin, butthe stew is negative for the toxin. The testresults confirmthe diagnosis of foodborne botulism and the patient is treated appropriately. He remains in the hospital for several weeks, before being discharged.

81.1) Clostridium botulinum grows optimally at 26-30oC, pH higher than 4.6 and 1% oxygen. How should it be classified? A) Obligate anaerobe, neutrophile, mesophile B) Obligate anaerobe, neutrophile, psychrophile C) Obligate aerobe, neutrophile, mesophile D) Microaerophile, alkaliphile, mesophile E) Microaerophile, alkaliphile, thermophile

81.2)

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Select the CORRECT statement regarding CBI medium.

A) It is both selective AND differential. The antibiotics make it a selective medium, and the colony characteristics on it make it differential. B) It is selective only. The antibiotics make it a selective medium, preventing the growth of any other microbes. C) It is differential. Non- Clostridial organisms produce pinpoint colonies, while Clostridial colonies are larger. D) It is neither selective NOR differential. Any types of bacteria can grow on this medium. E) It is selective. CBI is an anaerobic medium specifically used for isolating Clostridium.

81.3) What is the likely reason that Clostridium botulinum was found in the homecanned green beans but not the tomato-beef stew? A) Green beans have a neutral pH but the tomatoes in the beef stew made it acidic and unfavorable for bacterial growth. B) Green beans have an acidic pH but the tomatoes in the beef stew made it basic and unfavorable for bacterial growth. C) There are no nutrients in beef. C. botulinum growth is supported by the abundance of nutrients in green beans. D) Green beans, being plants, are antibiotic free. All beef has high levels of penicillin in it that suppresses bacterial growth. E) Bacteria cannot digest meat proteins but they can use plants proteins under aerobic conditions.

81.4)

Why is botulism primarily a problem in canned foods rather than fresh ones?

A) Canned food is never sterilized, so bacteria such as C. botulinum thrive in cans. B) Fresh food contains normal microbiota that prevents the growth of pathogens such as C. botulinum. C) The canning process dramatically reduces the pH of food, and C. botulinum is an acidophile. D) The causative agent is an obligate anaerobe—there is no O 2 in a full can. E) All of the answer choices are correct.

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81.5)

Select the CORRECT statement that explains the results of this case study.

A) The green beans were home-canned. The person making them likely did not use a high enough temperature for the canning process. B) The green beans were home-canned. The person making them likely did not add enough antibiotics for the canning process. C) The green beans were home-canned. The person making them likely did not use a low enough temperature for the canning process. D) The tomato-beef stew was store bought. All commercial food suppliers are required to autoclave their produce, so the beef was safe. E) The tomato-beef stew was store bought. All commercial food suppliers are required to add antibiotics their produce, so the beef was safe.

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Answer Key Test name: Chap 04_10e 1) TRUE 2) FALSE 3) FALSE 4) TRUE 5) TRUE 6) TRUE 7) FALSE 8) FALSE 9) FALSE 10) B 11) D 12) C 13) D 14) D 15) B 16) A 17) C 18) B 19) C 20) C 21) D 22) C 23) B 24) D 25) A

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Recall that the number of cells at any given time Nt is equal to the initial number of cells N0 times 2n where n is the number of generations. The final equation is Nt = N0x 2n. Calculate the number of generations by multiplying the time interval elapsed by the generation time. 26) C Recall that the number of cells at any given time Nt is equal to the initial number of cells N0 times 2n where n is the number of generations. The final equation is Nt = N0 x 2n. Calculate the number of generations by multiplying the time interval elapsed by the generation time. 27) B 28) A 29) C 30) B 31) D 32) C 33) B 34) C 35) A 36) C 37) C 38) B 39) C 40) B 41) A 42) B 43) C 44) B 45) B 46) C 47) E Version 1

48) B 49) B 50) C 51) B 52) C 53) B 54) B 55) B 56) A 57) B 58) E 59) A 60) A 61) C 62) D 63) B 64) C 65) D 66) B 67) B 68) D 69) B 70) A 71) B 72) A 73) A 74) A 75) A 76) A 77) B Version 1

78) Section Break 78.1) D 78.2) A 78.3) B 78.4) E 78.5) B 79) Section Break 79.1) A 79.2) C 79.3) C 79.4) C 80) Section Break 80.1) D 80.2) C 80.3) A 80.4) C 81) Section Break 81.1) A 81.2) A 81.3) A 81.4) D 81.5) A

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CHAPTER 5 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Prions are easily destroyed by common sterilization procedures. ⊚ true ⊚ false

The endospores of Pseudomonas make that organism very difficult to kill. ⊚ ⊚

Upon heat treatment, bacteria die at a constant proportion. ⊚ ⊚

true false

Boiling is very effective at removing most common waterborne pathogens. ⊚ ⊚

true false

Heat treatment is an effective method for sterilization or disinfection of all materials. ⊚ ⊚

true false

The more bacteria one starts with, the longer it will take to kill them all. ⊚ ⊚

true false

Pasteurization results in the sterilization of food products. ⊚ ⊚

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true false

Dry heat takes a much shorter time to sterilize material than wet heat. ⊚ ⊚

true false

100% ethanol is twice as effective as 60% ethanol at controlling bacteria. ⊚ ⊚

true false

10) Generally, heavy metals, except silver, have been proven to be too toxic for use on human tissue and are no longer used medically. ⊚ ⊚

11)

Hydrogen peroxide may be used as a sterilant on living tissue. ⊚ ⊚

12)

true false

Cold temperatures and freezing are very effective in killing bacteria. ⊚ ⊚

true false

13) Organic acids, such as benzoic acid, are often added to foods to prevent microbial growth. ⊚ ⊚

14)

true false

The only protective gear required for working in a BSL-4 laboratory is a lab coat.

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⊚ ⊚

15)

true false

When you eat food that has been irradiated, you are exposed to radiation. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 16) Lister developed his ideas on prevention of infection during medical proceduresafter studying the work of A) Koch. B) Pasteur. C) Jenner. D) Fleming. E) Ehrlich.

17)

One of the first chemicals used by Lister to prevent surgical infections was A) alcohol. B) iodine. C) carbolic acid. D) mercury. E) soap.

18)

The process of killing or removing all of the microorganisms in or on a material is called

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A) sterilization. B) disinfection. C) sanitation. D) antisepsis. E) degerming.

19)

A sterile item is free of A) microbes, viruses, AND prions. B) all viable microbes, endospores, AND viruses. C) endospores, viruses, AND prions. D) microbes, endospores, AND prions. E) prions only.

20)

A suffix used to describe a killing action would be A) -static. B) -cidal. C) -cillin. D) -tion. E) -side.

21)

Pasteurization

A) is the use of high moist heat to remove all bacteria and viruses from fresh food products for safety. B) is a process that uses intense cold to kill only pathogenic microorganisms on packaged foods. C) is the use of heatto reduce numbers of pathogenic/spoilage bacteria in a food item to a safelevel. D) is a process that uses short bursts of radiation to kill microorganisms on foods. E) is a mild heating process used to preserve only milk and milk products.

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22) Hand washing with plain soap is very useful in controlling spread of microorganisms because A) plain soap is bacteriostaticand inhibits bacterial growth. B) it is very effective at the mechanical removal of microorganisms. C) all soaps are virucidal and killall viruses. D) plain soap is bactericidal and kills all bacteria. E) all soaps are bacteriostatic and kill endospores.

23)

Which is TRUE of HAIs? A) They are acquired by susceptible peopleat various social events. B) They are acquired by susceptible peoplein the hospital. C) They are acquired by susceptible peopleat sporting events. D) They occur in communities butvery seldom occur in hospitals. E) They occur most frequently in isolated communities.

24)

To reduce or eliminate disease-/spoilage-causing organisms, food is often treated with A) heat. B) chemical additives. C) radiation. D) cold. E) All of the answer choices are correct.

25)

Which of the followingare resistant to destruction by typical disinfection methods? A) Clostridium endospores B) Escherichia coli C) Enveloped viruses D) Mycoplasmaspecies E) Vegetative bacteria

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26) is

A common environmental organism that may even grow in certain chemical disinfectants

A) Escherichia coli. B) Streptococcus pneumoniae. C) Pseudomonas aeruginosa. D) Influenza virus (enveloped). E) Adenoviruses (non-enveloped).

27)

When treated with heat or chemicals, bacteria will A) all die immediately. B) die at a constant rate. C) form endospores and survive. D) die at a geometric rate. E) develop resistance.

28) In a one D process, how many D values would it take to reduce a population of 10 cells to one survivor? A) 2 B) 4 C) 5 D) 10 E) 100

29) If a process kills 90% of the organisms per minute, how many minutes would it take to kill all organisms when starting with 100,000 organisms?

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A) 6 minutes B) 3 minutes C) 2 minutes D) 1 minute E) 60 minutes

30)

Microbial death rates may be affected by A) pH. B) temperature. C) the presence of organics. D) growth ina biofilm. E) All of the answer choices are correct.

31)

Moist heat kills microorganisms by A) irreversible denaturation of proteins. B) destruction of carbohydrates in the cell wall. C) denaturation of nucleic acids. D) dissolving the capsule. E) destruction of the nuclear membrane.

32)

Boiling is not reliable for sterilization because A) heat-sensitive instruments may be destroyed. B) water boils at a higher temperature at lower altitudes. C) heat-resistant endospores are unaffected. D) viruses are more sensitive to heat than bacteria. E) most pathogens are heat stable.

33)

Typical conditions used for sterilization are

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A) 100°C at 15 psi for 10 minutes. B) 121°C at 15 psi for 15 minutes. C) 80°C at 15 psi for 15 minutes. D) 72°C at 5 psi for 15 seconds. E) 100°C at 1.5 psi for 10 seconds.

34)

Which are essentially equivalent treatments? A) Dry 200°C heat for 1.5 hours; wet 121°C heat for 15 minutes B) Dry 160°C heat for 1.0 hour; wet 200°C heat for 30 minutes C) Dry 121°C heat for 1.5 hours; wet 200°C heat for 15 minutes D) Dry 100°C heat for 2.0 hours; wet 100°C heat for 30 minutes E) Dry 100°C heat for 30 minutes; wet 100°C heat for 30 minutes

35)

Which of the following is/are not (a) sterilization method(s)? A) Hot air oven B) Autoclave C) Pasteurization D) Filtration E) Vaping

36)

Which of the following methods sterilizes the materials? A) Pasteurization B) High-temperature-short-time pasteurization (HTST) C) Ultrahigh-temperature (UHT) method D) Medium-temperature-intermediate-time pasteurization (MTIT) E) Low-temperature-short-time pasteurization (LTST)

37)

The autoclave treatment may be monitored by

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A) heat-sensitive tape AND pressure indicators. B) heat-resistant endospores of Bacillus subtilis. C) pressure indicators AND waiting for contaminants to appear on freshly poured media. D) waiting for contaminants to appear on freshly poured media. E) heat-sensitive tape AND heat-resistant endospores ofGeobacillus stearothermophilus.

38)

Commercial canning processes

A) destroy Clostridium botulinum spores,are especially needed on low acid foods, ANDare 12D processes (designed to kill 1012 endospores). B) kill all endospores,are especially needed on moderately acidic foods, ANDare 12D processes (designed to killendospores in 12 days). C) are especially needed on low acid foods, are 12D processes (designed to kill 1012 endospores), AND destroy E. coli endospores. D) destroy E. coli endospores, are especially needed on acidic foods, AND are 12D (designed to kill 1012 endospores)processes. E) destroy Clostridium botulinum spores,are especially needed on very acidic foods, ANDare 12D processes (designed to kill endospores in 12 days).

39)

Oxidation of proteins is achieved most readily A) by moist heat. B) by moist heat under pressure. C) in a hot air oven. D) in the presence of organics. E) in a refrigerator.

40)

A common application of dry heat in the microbiology laboratory is to

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A) prepare specimens for study. B) sterilize media. C) sterilize plastics. D) sterilize the inoculating loop. E) sterilizePetri dishes.

41)

Liquid media containing heat-sensitive components would best be sterilized by A) ultraviolet light at 500 nm. B) membrane filtration. C) freezing. D) lyophilization. E) refrigeration.

42)

Generally, membrane filters are used for all of the following EXCEPT A) removing bacteria from liquids. B) removing enzymes from liquids. C) removing microorganisms from gases. D) removing spoilage agents from alcoholic beverages. E) removing bacteria from nutrient broths.

43)

Gamma rays cause biological damage in living systems by A) producing reactive molecules such as superoxide. B) causing breakdown ribosomes and peptidoglycan. C) introducing life-threatening toxins. D) making the substance radioactive. E) causing a cell to multiply too fast for its environment.

44)

Gamma irradiation

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A) has not been approved for use on any types of food. B) can be used to either sterilize or pasteurize, depending on the dose of radiation. C) leaves some dangerous radioactive particles in the treated substance. D) usually kills by generating heat and denaturing proteins and ribosomes. E) frequently causes a product to become carcinogenic (cancer-causing).

45)

Which would be most effective against Pseudomonas? A) Alcohol B) Radiation C) Quaternary ammonium compounds D) Iodophors E) Hand soap

46)

Ultraviolet radiation at the bactericidal wavelength destroys bacteria by A) destroying endospores. B) damaging nucleic acid. C) preventing spore formation. D) denaturing proteins. E) disrupting ribosomes.

47)

Microwaves do not kill organisms directly but kill by A) the heat they generate in a product. B) generating free radicals. C) generating toxins. D) creating thymine dimers. E) decreasing the pressure in the cells.

48)

Chemical germicides

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A) may react irreversibly with proteins/enzymes. B) may react with cytoplasmic membranes or viral envelopes. C) may be disinfecting or even sterilizing. D) are sensitive to dilution factor, time of contact, and temperature of use. E) All of the answer choices are true.

49)

Alcohols are not reliably effective at destroying A) vegetative bacteria AND endospores. B) enveloped viruses AND endospores. C) non-enveloped viruses AND enveloped viruses. D) non-enveloped viruses AND endospores. E) non-enveloped viruses AND vegetative cells

50)

Chlorhexidine A) is an aldehyde. B) is extensively used in antiseptics. C) is ineffective against vegetative bacteria. D) is limited in use due to its high toxicity. E) commonly causes adverse side effects.

51)

Glutaraldehyde A) is very good for use on heat-sensitive medical items. B) inactivates lipids. C) does not affect non-enveloped viruses. D) is used in gaseous form. E) kills bacteria but does not affect endospores.

52)

Ethylene oxide is a gas that

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A) is very useful for sterilizing heat- or moisture-sensitive items. B) is harmless to people and issafe to use. C) is used as a 37% aqueous solution. D) destroys microbes excludingendospores and viruses. E) reacts with nucleic acids in a cell.

53)

Which of the statements regarding chlorine is CORRECT? A) It readily reacts with organics to produce potentially carcinogenic trihalomethanes. B) It is very expensive but is able to destroy all types of microorganisms. C) It is unaffected by the presence of organic material. D) It is ineffective when diluted. E) It can be used very effectively as an antiseptic.

54)

Which is TRUE of iodine? A) It readily kills endospores. B) It may be used as an antiseptic but not as a disinfectant. C) It can be used at any dilution. D) It is usually found as tinctures or iodophors. E) It may be used as a disinfectant but not as an antiseptic.

55)

Select the FALSE statement regarding hydrogen peroxide. A) It is a sterilant for inanimate objects and is quickly inactivated on living tissue. B) It leaves no toxic residue and is safe on materials such as glass and plastic. C) It is broken down by catalase into water and oxygen. D) It is even more effective when used in combination with peracetic acid. E) It immediately kills all bacteria when applied to a wound.

56)

Which statement regarding phenolics is TRUE?

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A) They denature proteins and destroy cytoplasmic membranes. B) They become ineffective in the presence of detergents or organic material. C) Phenolics such as triclosan have very limited commercial use. D) They reliably inactivate all groups of viruses. E) They are ineffective against Mycobacterium species.

57)

Hexachlorophene has been particularly effective against A) Staphylococcus aureus. B) Micrococcus aureus. C) Escherichia coli. D) Enterobacter aerogenes. E) Streptococcus pneumoniae.

58)

Quaternary ammonium compounds are A) cationic detergents that help wash surfaces. B) attracted to the positive charge on the microbial cell surface. C) toxic and cannot be used on food preparation surfaces. D) very effective against endospores and non-enveloped viruses. E) anionic detergents that help wash surfaces.

59)

Which of the following is (are) considered when selecting a germicidal chemical?

A) Toxicity AND cost, BUT not environmental impact or compatability with the material being treated. B) Cost, toxicity AND compatibilitywith the material being treated. C) Compatibility with the material being treated, cost AND environmental impact. D) Environmental impact, toxicity AND cost BUT not environmental impact. E) Environmental impact, toxicity, cost AND compatibility with the material being treated.

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60)

Silver sulfadiazine, which is a combination of silver and a sulfa drug, is used to A) disinfect water for drinking. B) prevent infection of surgical wounds. C) prevent infection of second- and third-degree burns. D) counteract lead poisoning. E) prevent ophthalmia neonatorum in babies.

61) Compounds of tin, mercury, arsenic, and copper are no longer used to prevent microbial growth in cooling water primarily because A) antibiotics are cheaper. B) other chemicals were shown to be much more effective. C) microbes developed resistance to these metals. D) their use contributes to serious pollution of natural waters. E) All of the answer choices are correct.

62)

The most important function of nitrites in processed foods is to A) prevent browning of the product. B) inhibit the germination of Clostridium botulinum endospores. C) prevent carcinogen formation. D) make the food more acidic. E) destroy cell membranes of potential pathogens.

63)

Please select the INCORRECTLY matched pair.

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A) Bacterial endospores - highly resistant. B) D-value - time to destroy 10% of microbes present. C) Critical instrument - scalpels and needles. D) Incineration - burns cells to ashes. E) Sterilants -destroy all microbes including endospores and viruses.

64)

Please select the TRUE statement regarding preservation of perishable products.

A) Nitrites and nitrates are always converted into carcinogens by intestinal bacteria. B) Refrigeration destroys most pathogens and all spoilage microorganisms. C) Salting and drying increase the availability of water in food above the limits required for growth of most microbes.  D) Drying stops microbial growth, and reliably kills all bacteria and fungi in or on foods.  E) Bacterial resistance to some of the chemicals included to perishable products has been reported.

65) Which of the following lists the organisms/structures from MOST resistant to killing to LEAST resistant to killing? A) Prions, endospores, Mycobacterium species, Pseudomonas species, enveloped viruses B) Endospores, Mycobacterium species, Pseudomonas species, enveloped viruses, prions C) Endospores, Pseudomonas species, enveloped viruses, Mycobacterium species, prions D) Enveloped viruses, endospores, Pseudomonas species, Mycobacterium species, prions E) Prions, enveloped viruses, endospores, Pseudomonas species, Mycobacterium species

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66) Which of the following is listed in correct order for LEAST resistant to killing to MOST resistant to killing? A) COVID-19 coronavirus, poliovirus, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Giardia lamblia cysts, Clostridium botulinum spores B) Clostridium botulinum spores, COVID-19 coronavirus, poliovirus, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Giardia lamblia cysts C) COVID-19 coronavirus, poliovirus, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Giardia lamblia cysts, Clostridium botulinum spores D) Poliovirus, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Giardia lamblia cysts, Clostridium botulinum spores,COVID-19 coronavirus E) Poliovirus, COVID-19 coronavirus, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Giardia lamblia cysts, Clostridium botulinum spores

67) Why are low-acid foods processed at a higher temperature than high-acid foods in canning? A) Higher temperature ensures destruction of endospores in low-acid food; if spores are not destroyed, they could germinate and give rise to Clostrium botulinum cells that would produce disease-causing toxin. B) Lower temperature ensures destruction of endospores in low-acid food; if spores are not destroyed, they could germinate and Clostrium botulinum cells would grow and produce disease-causing toxin. C) Clostridium botulinum endospores are extremely sensitive to acid and are quickly destroyed in high-acid foods; any remaining vegetative bacterial cells are easily killed by low heat. D) Although Clostridium botulinum endospores are extremely sensitive to acid and are quickly destroyed in high-acid foods, vegetative cells are acid-resistant and must be killed by high heat. E) Low-acid foods have to be processed at a high temperature to ensure that all pathogens that occur naturally in canned foods are completely eliminated, without changing the taste of the food.

68)

The D value is defined as

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A) the time it takes to kill 90% of bacteria in a population. B) the time it takes for 90% of bacteria in a population to divide. C) the time it takes to kill 10% of bacteria in a population of 90. D) the time it takes to kill 99.9% of bacteria in a population. E) the time is takes to reduce a population of dividing bacteria by 9%.

69) You are making a hand sanitizer using aloe gel and alcohol. Which is the most appropriate concentration of alcohol in your final product? A) 70% B) 10% C) 100% D) 50% E) 25%

70)

Please select the FALSE statement regarding sterilization.

A) A high-level disinfectant cannot be used as a sterilant. B) Critical items must be sterilized before use. C) Low numbers of endospores may remain on semi-critical items. D) Standard sterilization procedures do not destroy prions. E) Quaternary ammonium compounds can be used to disinfect food preparation surfaces.

71)

Which of the following pieces of medical equipment requires sterilization? A) Scalpel B) Blood pressure cuff C) Stethoscope D) Thermometer E) All of the choices are correct.

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72) Which of the following is the term used to describe the time needed to kill all the bacteria in a population at a particular temperature? A) D value B) Death reduction time C) T value D) Thermal death time E) Thermal reduction time

73) You work in a BSL-4 laboratory. What type of organism do you work with in this setting? A) Easily transmitted pathogen likely to cause fatal disease. B) Pathogen spread by respiratory droplets, likely to cause serious disease. C) Pathogenic microbe not known to cause disease in humans. D) Moderate-risk pathogen that may cause disease but doesn't spread easily. E) Any type of human pathogen that may cause any type of disease.

74)

Which of the following does not kill microbes but physically removes them? A) Filtration B) Pasteurization C) Microwaving D) Irradiation E) Autoclaving

75)

Please select the CORRECT statement regarding autoclaving and freezing.

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A) Autoclaving kills any microbes in a sample, sterilizing it; freezing inhibits the growth of microbes in a sample but may not kill all of them. B) Autoclavinginhibits the growth of microbes in a sample but some may survive; freezing kills any microbes in a sample, sterilizing it. C) Autoclaving involves the use of heat at greater than 100 oC while freezing involves the use of temperatures between 4 oC and 7 oC. D) Autoclaving kills most microbes but endospores can withstand the treatment; freezing kills all microbes, and also destroys endospores. E) Autoclaving causes plasmolysis in bacterial cells, inhibiting their growth; freezing causes ice crystal formation in cells, killing them.

76) From a microbiology and health standpoint, what is the role of nitrates and nitrites in preserving meat? A) They inhibit the gemination of Clostridium botulinum endospores. B) They react with the protein myoglobin in the meat, giving it a red color. C) They create a hypertonic environment, preventing the growth of pathogens on the meat. D) They are converted to nitrosamines, which are effective at eliminating all pathogens, including prions. E) They create ice crystals in the cytoplasm of Clostrium botulinum cells, killing them.

SECTION BREAK. Answer all the part questions. 77) Jasmine's boyfriend Paul has a large boil on his back. The boil is very painful to touch, and is surrounded by an area of redness that is warm to the touch. Jasmine tells you that she and Paul have decided that Jasmine will "pop" the boil later that evening when they are both home from school. You ask Jasmine what she plans to use to open the boil and she tells you she has a knife with a sharp point that she will use, and that she will wash it well with dishwashing liquid before she uses it.

77.1) You tell Jasmine that it is important that she use a sterile instrument to pierce Paul's boil. Jasmine does not know what "sterile" means or why she needs to use something sterile for her "boil surgery", so you explain. Select the best answer.

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A) A sterile instrument is free of all most pathogens but not environmental organisms. Jasmine needs to use a sterile blade because it will come into contact with Paul's tissues, and is thus a semi-critical instrument. B) A sterile instrument is free of most microbes. Jasmine needs to use a sterile blade because it will come into contact with Paul's tissues, and is a critical instrument, although the risk for infection is low. C) A sterile instrument comes in a sealed pack and is returned to that before its next use. Jasmine needs to use a sterile blade because it will come into contact with Paul's tissues, and is thus a critical instrument. D) A sterile instrument is free of all microbes,endospores, and viruses. Jasmine needs to use a sterile blade because it will come into contact with Paul's tissues, and is thus a critical instrument. E) The only known sterile instruments are hypodermic syringes, so Jasmine should use that to pop Paul's boil. Syringes are non-critical instruments because they make small wounds.

77.2) Jasmine tells you she plans to wash her hands with soap and water before working on Paul's boil, to get rid of all the bacteria on her skin and prevent the possibility of Paul getting an infection. You tell her A) that washing and scrubbing with soap will be fine because the soap will destroy absolutely all of the bacteria on Jasmine's hands, whether pathogenic or normal microbiota. B) that washing and scrubbing with soap is generally sufficient to control microbes in routine situations but that soap itself does not destroy many organisms. Jasmine should try to get some sterile gloves.  C) the likely problem is not going to be the bacteria on Jasmine's hands but those on Paul's back. She doesn't need to wash her hands but she should wash Paul's back before she works on his boil. D) that people who are shower regularly are clean and don't have any bacteria on them. Jasmine doesn't need to bother with trying to wash any bacteria off her hands because there won't be any if she showered that day. E) that people have so many bacteria on their skin, it is impossible to remove them. Even washing with soap won't remove any bacteria because they exist in biofilmson the skin. You tell Jasmine that the bacteria are normal microbiota and are harmless.

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77.3) You tell Jasmine that there are various ways that she can in fact sterilize the knife she plans to use. Which of the following is unlikely to be available to Jasmine for sterilizing her knife in her home? A) Household bleach, used at a 1:100 dilution. B) Heating the knife in a flame, such as that on a gas stove. C) Irradiating the knife with gamma rays. D) Cleaning the knife with rubbing alcohol from the pharmacy. E) Heating the knife to a high temperature in the oven.

77.4) At the end of your conversation with Jasmine, you tell her that the best course of action for her and Paul is to go to the clinic and have the boil treated there. A boil is a serious infection and the risks of trying to treat it at home are just too great. ⊚ ⊚

true false

78) You go hiking with some friends in a nearby national park. The weather is cool when you set out but it quickly becomes very warm. Neither you nor your friends are carrying enough water. Eventually you find a stream and because you are so thirsty, you drink from it. About a week later you start to feel unwell. You have vomiting, abdominal cramps, and explosive diarrhea (loud, severe diarrhea). Your stool seems kind of oily and is difficult to flush away. You tell your RN brother about your signs and symptoms, and he tells you he thinks you may have giardiasis, a gastrointestinal infection caused by the protozoan Giardia lamblia.

78.1) Your brother tells you that most likely you ingested Giardiacysts that were in the stream water. He says you should have treated the water before you drank it. Which of the following would NOT have been a possible way for you to do this, as a hiker? A) Boiling the water. B) Using a portable hiker's filter. C) Using commercial water-purifying tablets (iodine). D) Using pasteurization. E) None of the choices would be possible for a hiker.

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78.2)

Which of the following statements is FALSE regarding Giardia?

A) It contains 80S ribosomes. B) It is found in fresh water. C) It has a phospholipidcytoplasmic membrane. D) It has a peptidoglycan cell wall. E) It's DNA is contained within a membrane.

78.3) You ask your brother which method of eliminating microbes is the best in general. He tells you that there is no one perfect method and that various factors must be taken into account when considering any antimicrobial approach. These include all of the following EXCEPT A) the type of microbes to be controlled.  B) environmental conditions such as temperature. C) whether a potential infection can be easily treated. D) situational considerations (is a method practical for the situation?).  E) the number of microbes to be controlled.

78.4) Your brother goes on to explain the concept of decimal reduction (D-value) time to you. To illustrate his point, he tells you that if the D-value for Giardiawas 3 minutes and the starting number of cells was 10 4, the time it would take to eliminate allof the Giardia cells would be A) 15 minutes. B) 3 minutes. C) 10 minutes. D) 9 minutes. E) 12 minutes.

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79) A patient who had recently undergone abdominal liposuction developed a bacterial infection in the wound. A sample was takenand was cultured on Lowenstein-Jensen (LJ) medium. This medium contains penicillin and nalidixic acid to inhibit the growth of Grampositive and Gram-negative bacteria, as well as malachite green, which inhibits most other types of bacteria. After four weeks of incubation, colonies grew and were identified as Mycobacterium chelonae. An investigation was carried out at the facility where the liposuction was carried out to identify the source of the infection. It was found that other than the physician, none of the workers in the facility waslicensed medical personnel. The staff weretrained to clean the equipment used, but there were no written protocols for reusable equipment, or logs of sterilization procedures such as autoclaving. When autoclaving was performed, no biological indicators were used. There were no written infection control policies. Staff mixed leftover solutions of povidone iodine and placed the mixtures in larger containers. Alcohol-soaked cotton balls used for wiping multiuse vials were kept in large, multiuse containers. Single-use 70% alcohol prep pads were not used to clean the tops of the vials. The liposuction equipment was flushed with 70% isopropyl alcohol solution from an open, non-sterile bottle. Laboratory testing of surfaces, equipment, solutions and materials did not yield M. chelonae and it was concluded that the patient’s case was an isolated one. However, this organism can take up to five months to culture because it is acid-fast and has a generation time of 15-20 hours. The physician was advised to put controlto put cleaning, disinfection and sterilization policies and procedures in place and to educate the staff in basic infection control methods. Source and adapted from: Kim, M.J. and Mascola, L. 2010. Mycobacterium chelonae Wound Infection after Liposuction. Emerging Infectious Diseases 16 (7): 1173-1174. DOI: 10.3201/eid1607.090156

79.1)

How would you classify LJ medium, given the information in this article?

A) Selective B) Differential C) Aerobic D) Acidic E) Selective AND differential

79.2)

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Mycobacterium chelonae has a generation time of 15 - 20 hours. This means that

A) it takes 15 - 20 hours for a population of this organism to double. B) it takes 15 - 20 hours to eliminate this organism from a surface. C) it takes 15 - 20 hours for a single cell to become a large population. D) 90% of a population of these cells can be killed in 15 - 20 hours. E) this organism will be killed by 15 - 20 hours in an autoclave.

79.3) Which of the following best describes the use and purpose of Geobacillus strearothermophilus a biological indicator? A) Endospores of Geobacillus stearothermophilus are included with an item in the autoclave. After autoclaving, the endospores are added to a growth medium. If the medium changes color during incubation, microbial growth has occurred, indicating an unsuccessful process. B) Geobacillus stearothermophiluscells are included with an item in the autoclave. After autoclaving, the cells are added to a growth medium. If the medium changes color during incubation, microbial growth has occurred, indicating an unsuccessful process. C) Endospores of Geobacillus stearothermophilus are included with an item in the autoclave. After autoclaving, the endospores are added to a growth medium. If the medium changes color during incubation, microbial growth has not occurred, indicating a successful process. D) Geobacillus stearothermophiluscells are included with an item in the autoclave. After autoclaving, the cells are added to a growth medium. If the medium changes color during incubation, microbial growth has not occurred, indicating a successful process. E) Endospores of Bacillus subtilis are included with an item in the autoclave. After autoclaving, the endospores are added to a growth medium. If the medium changes color during incubation, microbial growth has occurred, indicating an unsuccessful process.

79.4)

Select the INCORRECT statement regarding alcohol and iodine.

A) Alcohols denature proteins such as enzymes and damage lipid membranes. B) 99% alcohol is a more effective disinfectant than 70% alcohol. C) Iodine tincture is an effective alcohol-based disinfectant. D) Alcohol can be used on both skin and medical instruments. E) Iodine is a highly reactive oxidizing agent.

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79.5) Which of the following statements regarding the procedures used by the staff of the facility in this case is TRUE? A) They used 70% alcohol to flush the liposuction equipment. B) They included a biological indicator when autoclaving equipment. C) They used alocohol pads to wipe the lids of multiuse vials. D) They used single-dose povidine iodine prep pads to wipe vials. E) They used gloves, gowns and masks when working with clients.

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Answer Key Test name: Chap 05_10e 1) FALSE 2) FALSE 3) TRUE 4) TRUE 5) FALSE 6) TRUE 7) FALSE 8) FALSE 9) FALSE 10) TRUE 11) FALSE 12) FALSE 13) TRUE 14) FALSE 15) FALSE 16) B 17) C 18) A 19) B 20) B 21) C 22) B 23) B 24) E 25) A 26) C Version 1

27) B 28) D D is defined as the time required to kill 90% of the total population. After the first D, 10% or 109 cells would be left. After the second D 108 cells would be left. Each D reduces the cell number by one order of magnitude. To reduce by 10 orders of magnitude to 100 = 1, it would take 10 D. 29) A 30) E 31) A 32) C 33) B 34) A 35) C 36) C 37) E 38) A 39) C 40) D 41) B 42) B 43) A 44) B 45) B 46) B 47) A 48) E 49) D 50) B 51) A Version 1

52) A 53) A 54) D 55) E 56) A 57) A 58) A 59) E 60) C 61) D 62) B 63) B 64) E 65) A 66) A 67) A 68) A 69) A 70) A 71) A 72) A 73) A 74) A 75) A 76) A 77) Section Break 77.1) D 77.2) B 77.3) C 77.4) TRUE Version 1

78) Section Break 78.1) D 78.2) D 78.3) C 78.4) A 79) Section Break 79.1) A 79.2) A 79.3) A 79.4) B 79.5) A

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CHAPTER 6 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The change in free energy of a reaction varies. ⊚ ⊚

Both glycolysis and the pentose phosphate pathway oxidize glucose to pyruvate. ⊚ ⊚

true false

Enzymes are changed by the reaction as they raise the activation energy. ⊚ ⊚

true false

4) Competitive inhibition usually involves both substrate and inhibitor competing for binding at the allosteric site. ⊚ ⊚

true false

5) The production of ATP via the electron transport system, in either eukaryotes or prokaryotes, requires the use of a membrane. ⊚ ⊚

true false

6) The TCA cycle must "turn twice" in order to complete the oxidation of one glucose molecule. ⊚ ⊚

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true false

7) The terminal electron acceptor in aerobic respiration is water, which is broken down to hydrogen and oxygen. ⊚ ⊚

true false

8) In fermentation, the only ATP produced was during glycolysis and the fermentation reactions usually result in converting NADH to NAD. ⊚ true ⊚ false

10)

2S and NH

⊚ ⊚

true false

3 may be used by some prokaryotes as energy sources.

The Calvin cycle produces six ATP for every six turns of the cycle. ⊚ true ⊚ false

11) In Gram-negative bacteria, the electron transport chain involved in respiration is located in the lipopolysaccharide layer. ⊚ ⊚

true false

12) Cells must secrete enzymes that degrade macromolecules into their subunits before they can use these compounds. ⊚ ⊚

13)

true false

Purines and pyrimidines are produced by the same process.

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⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 14) Experiments designed by ______ suggested that living cells caused the fermentation of sugar to produce alcohol. A) Pasteur B) Koch C) Wohler D) Fleming E) Jenner

15) Studies done by Buchner showed that ground-up yeast cells were able to convert sugar to alcohol. The components of the mixture that were responsible for this transformation were A) DNA molecules. B) enzymes. C) lipids. D) carbohydrates. E) phospholipids.

16)

Which of the statements aboutcatabolism and anabolism isTRUE? A) They refer only to the reactions dealing involved in the metabolism of lipids. B) The intermediates of catabolism serve as products inanabolism. C) The energy gathered during catabolismis used during anabolism. D) They refer only to the reactions involvedin carbohydrate synthesis. E) The energy gathered during anabolismis used during catabolism.

17)

The general term used to describe the anabolic and catabolic reactions in a cell is

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A) enzymatic. B) thematic. C) aerobic respiration. D) metabolism. E) canabolism.

18)

Energy is defined as A) water flowing up a dam. B) the capacity to do work. C) the use of high-level phosphate bonds. D) the potential to fall. E) the result of work.

19) Biosynthetic reactions that require energy for the conversion of molecular subunits into larger molecules are called A) kinetic energy. B) anabolic reactions. C) catabolic reactions. D) precursor molecules. E) canabolic reactions.

20)

Exergonic reactions A) occur when there is more free energy in the products than the reactants. B) occur when there is more free energy in the reactants than the products. C) are defined as a decrease in entropy. D) are chemoorganotrophic. E) are definedas a decrease in energy AND are chemoorganotrophic.

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21)

Free energy A) is the amount of energy gained by breaking bonds of a chemical. B) includes the energy lost as heat. C) differs for a given reaction depending on the number of steps involved. D) always results in a decrease in total energy. E) is the amount of energy lost by breaking bonds of a chemical.

22)

Bacteria that can absorb light energy and convert it into ATP are commonly called A) cytotrophs. B) metatrophs. C) chemotrophs. D) phototrophs. E) photochromes.

23)

The readily usable energy currency of cells is _____. A) electricity B) the electron transport system C) ATP D) CTP E) CTP AND the electron transport system

24)

Each of the following statements about chemoorganotrophs is true EXCEPT

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A) they may use substrate-level phosphorylation to produce ATP. B) they may use oxidative phosphorylation to produce ATP. C) they may use photophosphorylation to produce ATP. D) they obtain energy by degrading organic compounds.  E) they generally rely on the metabolic activities of photosynthetic organisms. <!-Markup Copied from Habitat-->

25) The name given to the reaction involving removal of electrons or hydrogen atoms from a compound is A) glycolysis. B) oxidation. C) reduction. D) metabolism. E) respiration.

26) The name given to the reaction involving addition of electrons or hydrogen atoms to a compound is A) reduction. B) glycolysis. C) oxidation. D) metabolism. E) respiration.

27)

NAD in its reduced form is symbolized as

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A) NADH. B) NAD. C) NAD −. D) NADP. E) NADP +.

28)

The most common starting pathway for the breakdown of sugars is A) respiration. B) fermentation. C) oxidation. D) glycolysis. E) anabolism.

29) Glycolysis, the Entner-Duodoroff pathway, and the pentose phosphate pathway all produce A) pyruvate. B) NAD. C) NADP. D) acetyl-CoA. E) pyrite.

30)

Why do cells degrade sugar? A) To gain energy. B) To use energy. C) To convert fat to energy. D) To usecoenzymes. E) To generate pyruvate.

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31)

Oxygen serves as the terminal electron acceptor in A) fermentation. B) aerobic respiration. C) anaerobic respiration. D) reduction. E) oxidation.

32)

The terminal electron acceptor in respiration may be A) NAD, oxygen, OR nitrate. B) oxygen, nitrate, OR an inorganic molecule. C) NAD, nitrate,OR an inorganic molecule. D) NAD, water, OR an inorganic molecule. E) an inorganic molecule, water, OR oxygen.

33)

Which of the following processes generates the greatest amount of energy? A) Fermentation B) Aerobic respiration C) Krebs cycle D) Glycolysis E) Phosphorylation

34)

Select the TRUE statement regarding fermentation. A) It uses an inorganic molecule as the final electron acceptor. B) It uses an organic molecule as the final electron acceptor. C) It results in the production of a large amount of ATP. D) It is necessary in some organisms to produce reduced electron carriers. E) It uses an organic molecule as the final electron donor.

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35)

Which is (are) true regarding organic acids? A) They are weak acids. B) They are often involved in metabolic reactions. C) They often exist in the ionized form at the near-neutral pH found in a cell. D) Pyruvate and pyruvic acid refer to different forms of the same substance. E) All of the answer choices are true.

36)

Pyruvate can be metabolized along two major routes. They are A) oxidation and reduction. B) fermentation and respiration. C) metabolism and anabolism. D) anabolism and catabolism. E) fermentation and oxidation.

37)

The use of the suffix "ase" on a word denotes a(n) A) substrate. B) product. C) enzyme. D) electron acceptor. E) electron donator.

38)

Enzymes act as A) substrates. B) catalysts. C) products. D) catabolites. E) reducters.

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39)

Enzymes act on ______ to generate ______. A) products, catabolites B) substrates, products C) products, substrates D) glucose, anabolites E) ATP, glucose

40)

Enzymes speed up reactions by A) raising activation energy. B) producing heat. C) reducing entropy. D) lowering activation energy. E) electron carriers.

41)

The mutual interaction of substrate and enzyme is described as a(n) A) lock and key arrangement. B) induced fit. C) active site. D) allosteric site. E) active site AND allosteric site.

42)

Most enzymes A) are generic, typically recognizing a number of different substrates. B) are specific, typically recognizing a single or a few substrates. C) are active over a wide pH range. D) are active over a wide temperature range. E) are unaffected by heat or acidity.

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43)

Allosteric enzymes A) may bind two substrates at the same time. B) are used to bind to other enzymes. C) have an additional binding site that is involved in regulating enzyme activity. D) are twice as fast as single-site enzymes. E) have an additional binding site that is never involved in regulating enzyme activity.

44)

Feedback inhibition A) is a way of regulating the amount of product produced. B) rarely involves the use of allosteric enzymes. C) involves inhibiting the last of a series of reactions. D) results in raising the activation energy for the reaction. E) is only observed in bacteria.

45)

Coenzymes are derivatives of A) minerals. B) proteins. C) lipids. D) vitamins. E) enzymes.

46) The small, non-protein molecules that can be readily separated from an enzyme and are responsible for transfer of atoms from one molecule to another are referred to as

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A) vitamins. B) coenzymes. C) enzymes. D) hormones. E) active sites.

47)

Which is (are) true of coenzymes? A) They are organic molecules. B) They transfer atoms from one molecule to another. C) They may bind to a number of different enzymes. D) They are synthesized from vitamins. E) All of the answer choices are correct.

48)

Environmental factors that may affect enzyme activity include A) temperature. B) pH. C) salt. D) temperature, pH, AND salt. E) temperature AND salt only.

49)

Most enzymes function best at A) acidic pH and high salt concentrations. B) basic pH and low salt concentrations. C) slightly above pH 7 and low salt concentrations. D) neutral pH and high salt concentrations. E) slightly above pH 7 and high salt concentrations.

50)

Which is true of competitive inhibition?

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A) It involves an allosteric enzyme. B) Substrate and inhibitorbind to different active sites. C) A sulfa antibiotic is a competitive inhibitor. D) Mercury is a competitive inhibitor. E) Inhibitor permanently changes active site shape.

51)

Mercury in mercurochrome inhibits growth

A) through competitive inhibition. B) through a reversible action. C) by oxidizing the sulfhydryl groups in cysteine. D) by changing the shape of proteins. E) by oxidizing the sulfhydryl groups in cysteine AND by changing the shape of proteins.

52)

The term "precursor metabolite" refers to molecules that

A) activate cell components. B) are used in biosynthesis. C) are the starting materials for catabolic processes. D) are present but inactive. E) denature enzymes.

53)

Which is true regarding the three central metabolic pathways? A) They form high-energy bonds that can be used to synthesize ATP. B) They form intermediates that can be oxidized to generate reducing power. C) They form precursor metabolites. D) All of the answer choices are correct. E) None of the answer choices is correct.

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54)

Glycolysis A) requires oxygen. B) may occur under aerobic or anaerobic conditions. C) produces 3 ATP molecules per molecule glucose. D) produces 4 molecules of NAD per molecule glucose. E) always occurs under aerobic conditions.

55)

The energy yield of any energy-transforming pathway

A) is alwaysfixed, despite the removal of precursor metabolites for biosynthesis. B) is variable depending on the type of enzymes used. C) is variable depending on the amount of precursor metabolites removed for biosynthesis. D) is fixed by the amount of oxygen available. E) is fixed by the amount of carbon dioxide available.

56)

The transition step A) links glycolysis to the pentose phosphate pathway. B) links the pentose phosphate pathway to the electron transport chain. C) links glycolysis to the TCA cycle. D) takes place in the matrix of the nucleus. E) links the TCA cycle to fermentation.

57)

The TCA cycle produces A) ATP, FAD, and precursor metabolites B) NADH, ATP, andFAD. C) FADH2, NADH, and precursor metabolites. D) FADH2, ADP, and NADH. E) precursor metabolites, NAD, andFADH2.

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58) What happens to the carbon molecules in the pyruvic acid that goes through the TCA cycle? A) They get incorporated into cell material. B) They are excreted as waste organic acids. C) They become carbon dioxide . D) They form "energy storage molecules" for the cell. E) They become phosphorylated.

59)

The electron transport system

A) requires a membrane AND requires mitochondria and ribosomes. B) uses the nuclear membrane of eukaryotes ANDgenerates a concentration gradient of protons. C) requires a membrane AND generates a concentration gradient of protons. D) uses the mitochondrial membrane of prokaryotes AND generates a concentration gradient of protons. E) requires mitochondria and ribosomes ANDgenerates a concentration gradient of protons.

60)

Which type of phosphorylation does not require a membrane? A) Substrate-level phosphorylation B) Oxidative phosphorylation C) Photophosphorylation D) All types of phosphorylation require a membrane. E) Phosphorylation never requires a membrane.

61)

In the electron transport system

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A) NADH and FADH 2 both donate electrons at the same location. B) NADH donates electrons "upstream" of where FADH 2 donates electrons. C) NAD donates electrons at the head of the chain. D) NADP donates electrons in the middle of the chain. E) NADP removeselectrons in the middle of the chain.

62)

Proton motive force A) is used to synthesize ATP. B) is used to synthesize ADP. C) is used to produce NADH. D) is used to produce FADH 2. E) uses ADP and ATP.

63)

In the phototrophic production of energy, the oxygen originates from A) carbon dioxide. B) water. C) glucose. D) hydrogen peroxide. E) sulfates.

64)

Anoxygenic photosynthetic bacteria A) obtain electrons from water. B) produce oxygen as a by-product. C) may obtain electrons from H 2S. D) are obligate aerobes. E) produce oxygen as a by-product AND may obtain electrons from H2S.

65)

The sugar component of RNA and DNA nucleotides is synthesized

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A) as deoxyribose and then changed to ribose. B) as ribose and then changed to deoxyribose. C) as ribose and then changed to riboxy. D) using the Calvin cycle. E) as deoxyribose and then changed to deboxy.

66) Fermentation is sometimes used as a means of slowing food spoilage. Why would fermentation lead to this outcome? A) Fermentation is THEprocess that directly reduces sugars in food. Without sugars, bacteriacannot grow and spoil the food. B) Fermentation will lead to production of high levels of ethanol (95% or higher)— ethanol will kill bacteria. C) Fermentation will lead to production of acidic by-products, dropping the pH of the food below a level that bacteria can tolerate. D) This is a trick question—fermentation actually IS food spoilage and cannot be used to prevent it under any circumstances. E) Fermentation will lead to production of acidic by-products, raising the pH of the food above a level that bacteria can tolerate.

67)

Why would a cell ferment rather than respire?

A) There's no oxygenpresent, and it cannot respire anaerobically. B) It lacks theability to respire (i.e. no electron transport chain). C) There is no oxygen present and it cannot use anaerobic respiration OR it lacks the ability to respire (i.e., no electron transport chain). D) More ATP is produced forthe cell by fermentationthan by aerobic respiration. E) There is too much oxygen available and fermentation is a safer alternative.

68) How would cellulose-degrading bacteria in the rumen (stomachs) of a cow benefit the animal?

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A) The bacteria would produce, secrete, and incorporate organic molecules as they obtain energy from the cellulose in grass and replicate. The cow could then digest both the secreted organic molecules AND the bacteria that synthesized them. B) The bacteria wouldproduce sugars as they digested the cellulose. These sugars would begiven off to the cow as a symbiotic relationship in exchange for the protectedlocation of the stomachs of the cow for the bacteria to grow and replicatein. C) They wouldn't benefit the animal - they would replicate and cause disease in the animal, leading to its death. D) They wouldn't benefit the animal but they would benefit the other bacteria within the animal. This is why cows must have food sources other than grass in order to survive. E) They are needed to break down endospores of potential pathogens that are certain to cause illness or even death in the cow if it consumes them when it eats grass.

69) A worker in a cheese-making facility argued that whey, a nutrient-rich by-product of the process, should be dumped into a nearby pond to serve as fish food. Is this a good idea or a bad one, and why? A) It's a great idea! Let's feed the fish and help them multiply! In fact, other organisms could also benefit from this approach. B) Bad idea—the fish won't be able to eat the whey, so it will sit there rotting and pollute the waters, making them uninhabitable for the fish. C) Bad idea—bacteria would thrive on this rich nutrient source and multiply, usingthe oxygen in the water to harvest the energy from the whey. Without the oxygen, the fish will die. D) Great idea! This will not only feed the fish, but also microbes and other small organisms. It'll enhance the entire food chain and help all of them! E) Bad idea—whey stimulates the growth of any pathogenic bacteria in water; these pathogens will then infect and kill all the fish in the pond.

70) A student argued that aerobic and anaerobic respiration should produce the same amount of energy. He argued that both processes are essentially the same—only the terminal electron acceptor is different. What's wrong with his argument?

Version 1

A) Nothing—they SHOULD both produce the same amount of energy. Clearly he knows more than his professors or the writers of his textbook. B) Not all electrons are brought into the electron transport chain with the same amounts of potential energy. NADH, for example, enters the electron transport chain "further up" than FADH2—so it will lead to less proton motive force being generated, and thus less eventual ATP. C) Not all electron acceptors are the same—some are closer in terms of electronegativity to their high-energy electron carrier molecules (e.g., NADH) than others, and this impacts the amount of produced energy. Oxygenhas the highest electron affinity of the terminal electron acceptors used. D) He should believe what his instructors tell him, without question—and they say aerobic respiration is better, so it MUST be so.

71) Chemolithotrophs near hydrothermal vents support a variety of life forms. Why is this analogous to photosynthetic microbes supporting life forms closer to the surface of the planet? A) Because all life forms need some energy source, electron source, and carbon source. Chemolithotrophs fix inorganic carbon and, if consumed by other microbes, could serve as sources for all three requirements for life. This is very similar to the role that photosynthetic microbes play in the top levels of the oceans/lakes. B) Because chemolithotrophs will also use energy from sunlight to form their sugars/get their chemical energy...much like photosynthetic microbes. C) Becausechemolithotrophs also pull in carbon dioxide as their carbon source, just likephotosynthetic microbes. D) Because photosynthetic microbes use heat energy from the sun as an energy source. Chemolithotrophs use heat energy from hydrothermal vents, but it's still heat energy. This makes both microbes similar. E) Because chemolithotrophs are also photosynthetic. They use the thermal energy from the vent to generate glucose from the ocean water around them. This glucose is then used by all the other organisms in the environment to support their growth.

72) The linking of N-acetyleglucosamine, N-acetylemuramic acid, and tetrapeptides is a(n) ______ reaction that ______ ATP.

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A) catabolic; releases B) anabolic; requires C) fermentation; releases D) catabolic; requires E) degradation; releases

73)

Please select the TRUE statement regarding metabolic processes.

A) Anabolic processes degrade subunits of macromolecules, using ATP and precursor metabolites. B) Catabolic processes harvest the energy released during breakdown of compounds to synthesize ATP. C) Anabolic processes assemble subunits of macromolecules, releasing ATP and precursor metabolites. D) Catabolic processes harvest the energy released during synthesis of compounds to break down ATP. E) Anabolic and catabolic processes have no relation to each other; they function completely independently.

74)

Please identify the TRUE statement.

A) Exergonic reactions consume energy because the starting compounds have less free energy than the products. B) "Substrate" refers to a substance on which an enzyme acts to form products OR a surface on which an organism can grow. C) A terminal electron acceptor is a chemical that is ultimately oxidizedas a consequence of fermentation or respiration. D) Aerobic respiration is a metabolic process in which electronsare transferred from the electron transport chain to an organic intermediate. E) Activation energy is the energy required to create a bond in a chemical reaction.

75) What is the effect of poisons such as mercury in antimicrobial products? Recall that mercuryoxidizes the S–H groups of the amino acid cysteine in proteins,converting it to cystine.

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A) Competitive inhibition—the mercury binds to the active site of a bacterial enzyme, inhibiting the function of the enzyme. B) Reversible non-competitive inhibition—the mercury binds to an allosteric site on a bacterial enzyme, changing the active site shape temporarily and inhibiting enzyme function. C) Irreversible non-competitive inhibition—the mercury binds to an allosteric site on the enzyme and permanently changes the shape of the active site, so that the enzyme becomes nonfunctional. D) Reversible non-competitive inhibition—the mercury binds tothe active site of an enzyme temporarily, inhibiting its function. E) Competitive inhibition—the mercury binds to an allosteric site on a bacterial enzyme, blocking attachment of the appropriate substrateand inhibiting the function of the enzyme.

76) Your brother has a bacterial infection. He tells you he going to the gym where he plans to sit in the sauna for an hour. He thinks that this will cure his infection, because the heat in the sauna will denature the enzymes of the bacteria making him ill. You are a nursing student who is currently studying microbiology. You tell him that A) his plan is sure to work because pathogens are mesophiles, so their enzymes will definitely become denatured and stop working. B) his plan won't work; homeostasis will keep his body temperature constant even in the sauna, so the bacteria (and his normal microbiota and body cells)will not be impacted. C) his plan will work because his body temperature will likely rise to about 60 oC in the sauna, which is enough to denature the pathogen's enzymes. D) his plan will work; the organism causing his illness will likely dehydrate and be killed in the sauna but he is probably going to contract a different pathogen in that environment. E) his plan won't work; most pathogens are thermophiles so the temperature of the sauna will not affect the enzymes of the organism causing his illness.

77)

Which of the following produces the most precursor metabolites?

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A) Fermentation B) TCA cycle C) Pentose phosphate pathway D) Glycolysis E) Transition step

78)

Please select the FALSE statement regarding the central metabolic pathways.

A) Glycolysis oxidizes glucose to pyruvate, yielding some ATP and NADH, and six different precursor metabolites.  B) The pentose phosphate pathway oxidizes glucose, producing two different precursor metabolites and NADPH for biosynthesis.  C) The transition step and TCA cycle complete the oxidation of glucose, yielding ATP, reducing power, and three different precursor metabolites.  D) The transition step and TCA cycle are repeated four times to yieldATP, reducing power, and three different precursor metabolites. E) Two molecules of acetyl-CoA are generated for each glucose molecule that enters glycolysis, so the breakdown of one molecule of glucose causes the TCA cycle to turn twice. <!-Markup Copied from Habitat-->

79)

Which is FALSE regarding glycolysis? A) It yields ATP. B) It is an anaerobic process. C) The end product is acetyl-CoA. D) It occurs during fermentation. E) ATP is used.

80) The electron transport chain is a group of membrane-embedded carriers that pass electrons from one to the next, while simultaneously pumping ______ across the membrane, generating a(n) ______.

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A) glucose; proton motive force B) hydrogen ions; electron gradient C) electrons; ATP gradient D) hydrogen ions; proton motive force E) protons; electron motive force

81)

Which pair is correctly matched, regarding electron transport carriers in eukaryotes? A) Complex I -succinate dehydrogenase complex  B) Complex II -cytochrome c oxidase complex  C) Complex III -cytochrome bc 1 complex D) Complex IV -NADH dehydrogenase complex  E) None of the answer choices is correct.

82)

Which enzyme drives ATP synthesis in respiration? A) ATP synthase B) ADP phosphorylase C) Proton movase D) Oxidoreductase E) ATP dehydrogenase

83) Which of the following is NOT common to aerobic respiration, anaerobic respiration, AND fermentation? A) Breakdown of glucose B) Generation of ATP C) Electron transport chain D) Reduction of NAD E) Production of pyruvate

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84) Heart muscle is damaged after a heart attack (MI) because blood flow to the heart is stopped.A researcher injected cyanobacteria into the damaged hearts of test animals that has been given MIs. The animals' conditions improved after the procedure, but not significantly. The researcher repeated the experiment, this time illuminating the cyanobacteria with high intensity light after injecting the cells into the damaged hearts. Now the animals did much better, recovering well from their heart attacks. Which of the following explains this outcome? A) Cyanobacteria have the capacity to carry blood. Illuminating the cells increases their ability to transport blood into the damage heart muscle. B) Cyanobacteria produce alcohol through photosynthesis, and this stimulates the heart cells. Illuminating the bacteria increases this reaction. C) Illuminated cyanobacteria multiply rapidly; the expanding mass of cells dilates blood vessels to the heart, bringing more nutrients and oxygen to the heart cells. D) Illuminated cyanobacteria produce carbon dioxide by photosynthesis. Illumination increases the amount of released CO 2 that the heart cells then use for anaerobic respiration. E) Cyanobacteria produce oxygen by photosynthesis. Illuminating the cells increases amount of O 2 released that is then used by heart cells for aerobic respiration.

85)

An atom that has a lower affinity for electrons than another is ______ than the other. A) more electronegative B) less electronegative C) equallyelectronegative D) more electropositive E) less electropositive

86) Degradation of fats as an energy source involves all of the following except  A) β-oxidation. B) acetyl-CoA.  C) glycerol.  D) lipase.  E) transamination.

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87)

Please select the CORRECT statement regarding catabolism and anabolism.

A) Catabolism breaks down compounds to release their energy; anabolism uses energy to make compounds. B) Anabolism breaks down compounds to release their energy; catabolism uses energy to make compounds. C) Catabolic processes use the ATP and precursor molecules produced by anabolic processes. D) Catabolic processes involve linear metabolic pathways while anabolic processes involve cyclical metabolic processes. E) Anabolic pathways involve catalytic enzyme activity while catabolic processes take place without the help of enzymes.

88)

How do enzymes catalyze chemical reactions?

A) They hold substrates in a way that lowers the activation energy of a specific reaction. B) They hold substrates in a way that increases the activation energy of a specific reaction. C) They hold products in a way that lowers the activation energy of a specific reaction. D) They hold products in a way that increases the activation energy of a specific reaction. E) They add ATP to the reaction, speeding it up enormously.

89) Howare precursor molecules are involved in cata-bolic pathways as well as anabolic pathways?

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A) Anabolic processes produce precursor metabolites and release ATP; catabolic processes use precursor metabolites in biosythetic pathways. B) Catabolic processes produce precursor metabolites and release ATP; anabolic processes use precursor metabolites in biosythetic pathways. C) Catabolic processes produce precursor metabolites; anabolic processes produce ATP. D) Catabolic processes use precursor metabolites to synthesize the enzymes needed for anabolic processes. E) Precursor metabolites are actually only involved in catabolic processes, which use them in biosynthetic pathways.

90)

Select the CORRECT statement regarding allosteric regulation of enzymes.

A) Only enzymes involved in anabolism are under allosteric regulation. B) Only enzymes involved in catabolism are under allosteric regulation. C) In allosteric regulation, a molecule binds to an allosteric site of an enzyme, changing the shape of its active site. D) In allosteric regulation, a molecule binds to the active site of an enzyme, changing the overall shape of that enzyme. E) The end product of a given biosynthetic pathway always acts as an allosteric inhibitor of the preceding enzyme in the reaction.

91)

Which of the following does/ do NOT affect enzyme activity? A) Temperature AND humidity B) Temperature AND pH C) pH AND salt concentration D) Temperature AND salt concentration E) Temperature, pH AND salt concentration

92)

Which of the following does/ do NOT affect enzyme activity?

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A) Temperature AND humidity B) Temperature, coenzymes AND pH C) pH AND salt concentration D) Salt concentration AND allosteric compounds E) pH AND coenzymes

93) Stopping which of the following would cause a bacterium to lose the ability to produce FADH 2? A) TCA cycle B) Glycolysis C) Biosynthesis D) Fermentation E) The pentose-phosphate pathway

94)

Degradation of fats as an energy source involves all of the following EXCEPT A) transamination. B) acetyl-CoA. C) lipases. D) β-oxidation. E) dihydroxyacetone phosphate.

95)

Why do cells secrete hydrolytic enzymes that degrade macromolecules?

Version 1

A) They cannot bring macromolecules into the cell; hydrolytic enzymes break the molecules into their subunits that can then be transported into the cell. B) Not all components of a macromolecule are always needed by a cell; hydrolytic enzmyes allow a cell to bring in only essential components. C) Cells do not contain water and are thus unable to break down macromolecules in their cytoplasm; hydrolytic enzymes in the environment help them do that. D) Macromolecules are usually toxic to a cell; hydrolytic enzyme strip the toxic components from macromolecules, makng them safe for the cell to use. E) These are all valid reasons for a cell to secrete hydrolytic enzymes into the environment.

96)

What three components are needed for photosynthesis? A) Sunlight, water and carbon dioxide B) Light, water and soil C) Water, soil and bacteria D) Sunlight, carbon monoxide and water E) Carbon dioxide, water and bacteria

97)

Which of the following does a competitive inhibitor resemble most in structure? A) Active site B) Allosteric site C) Substrate D) Product E) Coenzyme

98)

Where is the electron transport chain located in prokaryotes?

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A) Cytoplasmic membrane B) Inner mitochondrial membrane C) Outer mitochondrial membrane D) Outer membrane E) The cytoplasm

99)

Which of the following products does not involve fermentation? A) Penicillin B) Ethanol C) Butanol D) Acetic acid E) Acetone

100)

Which of the following is NOT a group of chemolithotrophs? A) Hydrogen bacteria B) Sulfur bacteria C) Iron bacteria D) Nitrifying bacteria E) Copper bacteria

101)

Select the FALSE statement regarding glutamate. A) It is synthesized in a single step reaction. B) It involves addingammonia to α-ketoglutarate. C) It uses a precursor metabolite from the TCA cycle. D) It uses a precursor metabolite from glycolysis. E) It is used to produce other amino acids.

102)

Which of the following is NOT true of aromatic amino acids and their synthesis?

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A) Tyrosine, phenylalanine and tryptophan are aromatic amino acids. B) Synthesis involves precursor metabolites phosphoenolpyruvate and erythrose-4phosphate.  C) Synthesis involves a cyclical metabolic pathway. D) The percursors orginate from glycolysis and the pentose phosphate pathway. E) Synthesis of aromatic amino acids is a multistep process.

103)

In which of the following processes is H

2S an electron source?

A) Anoxygenic photosynthesis B) Oxygenic photosynthesis C) Anaerobic respiration D) Aerobic respiration E) Lipid biosynthesis

104)

What is the Calvin cycle?

A) The most common pathway by whichcarbon dioxide is incorporated into organic compounds.  B) A step in aerobic respiration, during which NADH and FADH 2 are produced. C) A step in fermentation, the products of which include alcohols and organic acids. D) Processes used by phototrophs to harvest energy from sunlight, genrating ATP. E) Reactions used to harvest the energy of light to synthesize ATP, which is then used to power carbon fixation.

SECTION BREAK. Answer all the part questions. 105) Your patient has a mitochondrial disease. The child suffers from muscle weakness, problems with coordination, and fatigue, as well as a number of other symptoms. You are asked by the child's parents to help them understand their child's condition.

105.1)

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You explain to the child's parents that the role of the mitochondria is

A) to transport proteins to the cytoplasmic membrane. B) to produce the energy currency, ATP, for a cell. C) to break down toxins in the body. D) to initiate DNA replication during cell division. E) to protect the body from bacterial invaders.

105.2) You tell your patient's parents that muscle weakness is frequently a sign of mitochondrial disease because A) muscle cells require a lot of energy, which is provided by the many mitochondria within these cells. B) muscles require a lot of energy which is provided by the mitochondrial DNA of the red blood cells. C) people with mitochondrial disease seldom eat sufficient protein to fuel the mitochondria. D) the diseased mitochondria release toxins into the muscles of the affected people, weakening them. E) the diseased mitochondria consume all the energy that is supposed to be directed to the muscle cells.

105.3) The cellular process directly impacted in muscle cells of people with mitochondrial disease is A) protein synthesis. B) DNA replication. C) transcription. D) aerobic respiration. E) fermentation.

105.4) Your patient's parents ask you why their child's mitochondria do not function properly. You explain that one explanation is that mitochondria contain their own ______, which may contain mistakes called ______, resulting in insufficient mitochondrial activity.

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A) DNA; missense B) plasmids; mutations C) normal microbiota; mutations D) DNA; mutations E) proteins; mismatches

106) Your patient has just returned from vacation in Asia. She has come to the clinic where you work, complaining of abdominal pain, fever, diarrhea, and nausea. She reports that the last day of her trip included a visit to a turtle sanctuary, where tourists have an opportunity to handle rescued turtles. You suspect that your patient has salmonellosis, caused the the bacterium Salmonella enterica. You get a stool sample from the patient and send it to the lab for analysis. There,the sample isinoculated into tetrathionate broth and incubated overnight. The lab reports that the broth is turbid (cloudy) after incubation, indicating bacterial growth. A sample is then inoculated onto an agar plate designed to isolate S. enterica and after 24 hours of aerobic incubation, colonies of suspected S. entericaare seen. Further tests confirmS. enterica, supporting your presumptive diagnosis.

106.1) Tetrathionate broth is a selective, enrichment medium for S. enterica. What does this mean? A) This is a medium that encourages the growth of normal microbiota and reduces the growth of S. enterica. B) This is a medium that inhibits the growth of some bacteria and enhances the growth of S. enterica. C) This is a medium that inhibits the growth of some bacteria and in which S. enterica colonies exhibit an identifiable color. D) This is a medium that facilitates the growth of all bacteria but enhances the growth of S. enterica. E) This is a medium that facilitates the growth of all bacteria but in which S. enterica exhibits a noticeable color.

106.2) Tetrathionate is an oxidized form of sulfur that can act as a terminal electron acceptor. What does the fact that S. enterica can grow in this mediumthis tell you about this organism?

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A) It is an obligate aerobe. B) It is an obligate anaerobe. C) It is a facultative anaerobe. D) It is Gram negative. E) It has a capsule.

106.3) Tetrathionate broth is an enrichment medium. Initially, when a mixed bacterial stool sample is inoculated into this medium, the bacteria respire aerobically. Once O 2 is depleted, most bacteria switch to fermentation in order to continue growth. However, Salmonella can use the tetrathionatein this medium as a terminal electron acceptor, so can grow anaerobically. Why does this give the bacteria a competitive advantage over other bacteria in the sample? A) Tetrathionateinhibits the growth of fermenters. B) Fermentation yields more ATP than aerobic respiration. C) Anaerobic respiration yields more ATP than aerobic respiration. D) Anaerobic respiration yields more ATP than fermentation. E) Tetrathionateyields more ATP than glucose.

106.4) Why was it necessary for the lab to inoculate a sample of the incubated tetrathionate broth onto a medium selective for Salmonella? A) To confirm that the bacteria in the broth is Salmonella and not another bacterial species. B) To confirm that the bacteria in the broth is E. coli and not another bacterial species. C) To check whether the Salmonella has the ability to form endospores. D) To confirm that Salmonella is a bacterium and not a virus or protozoan. E) To confirm that Salmonella is a facultativeanaerobe and not an obligate acidophile.

106.5) Because S. enterica is a facultative anaerobe, it would not grow well in an aerobic environment. ⊚ ⊚ Version 1

true false 33

107) Samuel and Caitlin are thrilled when their baby boy Jimmy is born apparently healthy, although with a somewhat low birth weight. However, they soon notice that Jimmy has developed a number of disturbing symptoms: he has poor muscle tone (hypotonia), seems very tired (lethargy), breaths rapidly (tachypnea), has abnormal eye movements and has suffered a number of seizures. Jimmy has attended day care since he was three months old, and his parents are concerned that he has contracted a microbial disease. They take him to the pediatrician, who does a series of tests on him. Jimmy shows no signs of an infectious disease; however, one blood test indicates that he has high levels of lactic acid in his blood, a condition called lactic acidosis. He also has elevated levels of the amino acid alanine. Further tests finally reveal that he is suffering from a genetic condition called pyruvate dehydrogenase complex (PDC) deficiency.Jimmy’s PDA deficiency is caused by a mutation in a gene called PDHA1; the mutation causes the PDC complex to malfunction and as a result, pyruvate is not converted to acetyl-CoA.The doctor tells Jimmy’s parents that his condition cannot be cured but can be treated. He will be given cofactors including carnitine, thiamine and lipoic acid in an effort to stimulate his PDC to function as best as possible. He will also be kept on a high fat/ low carbohydrate (ketogenic) diet and will be given medications to prevent the seizures. Unfortunately, Jimmy’s long-term prognosis is not very good: people with PDC deficiency sometimes pass away early in life. Those that survive may experience additional problems such as intellectual disability.

107.1)

Which of the following symptoms does Jimmy NOT have?

A) Fever B) Hypotonia C) Lethargy D) Lactic acidosis E) Tachypnea

107.2) The pyruvate dehydration complex catalyzes formation of acetyl-CoA. If there is a mutation in one of the genes coding for this enzyme complex, which of the following statements would be CORRECT?

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A) There is no entry of carbon atoms from glycolysis into the TCA cycle. B) Pyruvate is converted directly back into glucose rather than acetyl-CoA. C) Pyruvate enters the electron transport chain directly from glycolysis. D) The TCA cycle "turns" only once, rather than twice. E) The TCA cycle makes reducing power but no ATP.

107.3) Jimmy has increased levels of lactic acid and the amino acid alanine. What can you conclude from this? A) Pyruvate is being converted to lactic acid and alanine, rather than acetyl-CoA. B) Acetyl-CoA is being converted to lactic acid and alanine, rather than pyruvate. C) Products of the TCA cycle in people with PDCD are lactic acid and alanine. D) The TCA cycle in people with PDCD yields large amounts of lactic acid and ATP. E) The TCA cycle in people with PDCD yields large amounts of alanine and ATP.

107.4)

Why does PDCD cause lethargy and hypotonia?

A) The TCA cycle malfunctions in the cells of people with PDCD, resulting in low ATP yields. B) The TCA cycle malfunctions in the cells of people with PDCD, using up all available ATP. C) Disfunctional pyruvate dehydrogenase causes malfuntion of ribosomes, the site of ATP synthesis in cells. D) The TCA cycle malfunctions in the cells of people with PDCD, resulting in high ATP yields. E) The excess ATP production in people with PDCD leads to fatigue.

107.5)

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Select the TRUE statement regarding Jimmy's treatment for PDCD.

A) The cofactors will boost the function of his PDC enzymes; the low carbohydrate diet will reduce production of lactic acid and alanine. B) The cofactors will reduce the function of his PDC enzymes; the high carbohydrate diet will reduce production of lactic acid and alanine. C) The cofactors will completely inhibit the function of his PDC enzymes; the low protein diet will reduce production of lactic acid and alanine. D) The cofactors will correct the mistake in the PDC genes; the low carbohydrate diet will reduce production of lactic acid and alanine. E) The high protein diet will increase lactic acid and alanine production; the low carbohydrate diet will stimulate the TCA cycle.

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Answer Key Test name: Chap 06_10e 1) FALSE 2) TRUE 3) FALSE 4) FALSE 5) TRUE 6) TRUE 7) FALSE 8) TRUE 9) TRUE 10) FALSE 11) FALSE 12) TRUE 13) FALSE 14) A 15) B 16) C 17) D 18) B 19) B 20) B 21) A 22) D 23) C 24) C 25) B 26) A Version 1

27) A 28) D 29) A 30) A 31) B 32) B 33) B 34) B 35) E 36) B 37) C 38) B 39) B 40) D 41) B 42) B 43) C 44) A 45) D 46) B 47) E 48) D 49) C 50) C 51) E 52) B 53) D 54) B 55) C 56) C Version 1

57) C 58) C 59) C 60) A 61) B 62) A 63) B 64) C 65) B 66) C 67) C 68) A 69) C 70) C 71) A 72) B 73) B 74) B 75) C 76) B 77) D 78) D 79) C 80) D 81) C 82) A 83) C 84) E 85) B 86) E Version 1

87) A 88) A 89) B 90) C 91) A 92) A 93) A 94) A 95) A 96) A 97) C 98) A 99) A 100) E 101) D 102) C 103) A 104) A 105) Section Break 105.1) B 105.2) A 105.3) D 105.4) D 106) Section Break 106.1) B 106.2) C 106.3) D 106.4) A 106.5) FALSE 107) Section Break Version 1

107.1) A 107.2) A 107.3) A 107.4) A 107.5) A

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CHAPTER 7 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Adenine binds to thymine via three hydrogen bonds. ⊚ true ⊚ false

One end of a strand of DNA is different from the other end. ⊚ ⊚

DNA replication is usually unidirectional. ⊚ ⊚

true false

The minus strand of DNA serves as the template for RNA production. ⊚ ⊚

true false

5) Antisense RNA is the complement of the plus strand and may be useful in inhibiting translation. ⊚ ⊚

true false

The genetic code is nearly universal. ⊚ true ⊚ false

A codon consists of two nucleotides. ⊚ true ⊚ false

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The anticodon determines which amino acid is linked to its tRNA. ⊚ ⊚

Ribozymes are non-protein molecules with catalytic activity. ⊚ ⊚

10)

true false

Two mRNAs can have different nucleotide sequences and yet code for the same protein. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 11) The report that genes direct the synthesis of proteins was first made by A) Lederberg. B) Watson and Crick. C) Beadle and Tatum. D) Mendel. E) Curie.

12)

The two strands of DNA are bonded to one another by A) covalent bonds. B) oxygen bonds. C) hydrogen bonds. D) carbon bonds. E) disulfide bridges.

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13)

Which pairing is incorrect? A) A:T B) G:C C) A:U D) A:G E) C:G

14)

What structure is indicated by: 10A, 15T, 3G, 7C? A) Double-stranded DNA B) Double-stranded RNA C) Single-stranded DNA D) Single-stranded RNA E) A DNA virus

15) Without changing the sequence or the orientation of the sequence(s), which is/are complementary to the sequence 5' AGGCUAAC 3'? A) 5' TCCGATTG 3' B) 3' TCCGATTG 5' C) 5' CTTAGCCT 3' D) 3' TAAGCTTA 5' E) 3' TCCGATTC 5' AND 5' CTTAGCCT 3'

16)

GCCCAAAG is a molecule of A) RNA. B) DNA. C) protein. D) DNA OR lipid E) Cannot tell as written.

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17)

Which may be or is an RNA molecule? A) AGCCTAC andGGGCCCA B) GGGCCCA andAAATTTA C) GGGCCCA and GCCCUUA D) GCCCUUA and AAATTTA E) AGCCTAC and GGUCCCU

18)

RNA is characterized by which one of the following features? A) Deoxyribose B) Thymine C) Ribose D) Double-stranded E) All of the answer choices are correct.

19)

DNA is characterized by which of the following feature(s)? A) Ribose AND single-stranded B) Single-stranded AND uracil C) Deoxyribose AND single-stranded D) Deoxyribose AND thymine E) Thymine AND uracil

20)

Which is not true of RNA? A) It is usually single-stranded. B) It contains both uracil and thymine. C) It functions in the cytoplasm. D) It contains ribose. E) It is a component of ribosomes.

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21)

The 3' end of DNA A) has a hydroxyl group attached to the number 3 carbon of deoxyribose. B) attaches to the 3' phosphate group of the incoming nucleotide. C) always has thymine and uracil attached to it. D) usually has guanine and guanine attached to it. E) has a hydroxyl group attached to the number 3 carbon of ribose.

22)

Which of the following is/are true of DNA replication? A) It starts at the origin of duplication. B) Nucleotides are added to the 3' end. C) It requires a DNA primer to get started. D) It is carried out by transcriptases. E) All of the choices are true.

23)

DNA replication is A) conservative. B) interspersive. C) semiconservative. D) redundant. E) configurative.

24)

Which is true about DNA replication? A) It is semiconservative. B) It starts at an origin of replication. C) It is bidirectional. D) It requires RNA primers. E) All of the choices are correct.

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25)

The term antiparallel A) refers to thestructure of single-stranded RNA. B) is synonymous with semiconservative. C) refers to the opposite orientation of the two strands in DNA. D) refers to a type of prokaryotic replication. E) refers to the sequence of nucleotides in DNA.

26)

The lagging strand A) is another name for any single-stranded DNA foundin slowly dividing cells. B) is formed duringRNA replication because of the nature ofthe enzymes involved in it. C) is formed during DNAreplicationbecause oftheantiparallel nature of DNA. D) is always the bottom strand of DNA or RNA during the replication process. E) is always the upper strand of DNA or RNA during the replication process.

27)

Which is FALSE about the RNA transcript? A) It is formed using the DNA minus strand as a template. B) It has the same 5'–3' orientation as the DNA positive strand. C) It is made in short fragments that are then stitched together. D) The template starts at the promoter region. E) All the answers are false.

28)

Which is true about prokaryotic (bacterial) RNA polymerase? A) It is used during transcription. B) It requires a primer. C) It has a detachable subunit, alpha factor, which recognizes the promoter. D) It reads the template in the 5'-3' direction. E) All of the choices are true.

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29) the

The specific sequence of nucleotides in the DNA to which the RNA polymerase binds is

A) regulatory region. B) promoter region. C) sigma region. D) core region. E) starter region.

30)

The transcription terminator

A) results in a hairpin loop structure in RNA, AND stops DNA polymerase. B) results in a hairpin loop structure in RNA, AND results in the polymerase falling off the DNA template. C) stops DNApolymerase, ANDresults in the polymerase falling off the DNA template. D) stops DNA polymerase, AND adds a terminator nucleotide to the RNA. E) adds a terminator nucleotide to the RNA, AND results in a hairpin loop structure in RNA.

31)

How many nucleotides are in a codon? A) 1 B) 2 C) 3 D) 4 E) 5

32)

There are ______ codons to code for the 20 possible amino acids.

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A) 20 B) 30 C) 61 D) 64 E) 3

33)

The genetic code has more than one codon for some amino acids. This is an example of A) evolution. B) stringency. C) redundancy. D) translation. E) replication.

34)

Which molecule carries an anticodon? A) DNA B) mRNA C) rRNA D) tRNA E) ribosome

35)

AUG A) is only used as the start codon. B) codes for methionine. C) determines the reading frame. D) is one of the stop codons. E) codes for methionine AND determines the reading frame.

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36) The amino acid that is placed first during translation in bacteria, mitochondria, and chloroplasts is A) methionine. B) N-formyl-methionine. C) glycine. D) N-formyl-glycine. E) the promoter.

37)

The placement of the amino acid during translation is determined by the A) DNase, which transcribes both molecules. B) complementarity of the codon-anticodon. C) sequence of nucleotides at the 5' end of the tRNA. D) secondary structure of the newly forming protein. E) antiparallelnature of mRNA.

38)

What is the number of tRNA molecules that may be associated with translation? A) 20 B) Fewer than 20 C) 64 D) Fewer than 64 E) 2

39)

The P-site A) is found on the polymerase enzyme. B) is an allosteric site on an enzyme. C) is a promoter site on the ribosome. D) is the peptidyl site on the ribosome. E) is an allosteric site AND is a promoter site.

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40)

The E-site A) is found on the RNA polymerase enzyme. B) is responsible for the release of the tRNA. C) is found on the 35S polysome. D) is the aminoacyl site on the ribosome. E) is another name for anticodon.

41)

A stop codon A) codes for the stop amino acid s-methyl-methionine. B) forms a hairpin loop forcing the ribosome to fall off. C) codes for no amino acid. D) enhances the binding of the e-polymerase. E) codes for the stop amino acidAUG.

42)

Post-translational modification may include

A) formation of exons and introns. B) folding of the protein, often with the aid of chaperones. C) removal of the signal sequence. D) addition of glycine tags. E) folding of the protein, often with the aid of chaperones, AND removal of the signal sequence.

43)

The ribosomes

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A) move along the tRNA in a 3'–5' direction AND provide a platform that brings the amino acids into a favorable position for joining. B) move along the mRNA in a 3'–5' direction AND provide a platform that brings the amino acids into a favorable position for joining. C) move along the mRNA in a 5'–3' direction AND provide a platform that brings the amino acids into a favorable position for joining. D) move along the DNA in a 5'–3' directionANDprovide a platform that brings the amino acids into a favorable position for joining. E) move along the DNA in a 3'–5' directionANDprovide a platform that brings the amino acids into a favorable position for joining.

44)

All of the following are true about DNA sequence analysis EXCEPT A) the (−) strand of DNA is used. B) the start codon is ATG. C) ORFs are searched for. D) codon usage is a helpful indicator for protein coding areas. E) All of the answer choices are correct.

45)

Some segments of the precursor mRNA in eukaryotes are non-coding and are called A) exons. B) introns. C) integrans. D) uselessans. E) genes.

46) Bacteria use ______ attached to the polymerase to direct RNA polymerase to promoters; eukaryotic cells use ______ that attach directly to the DNA first instead.

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A) sigma factors;transcription factors B) transcriptionfactors; sigma factors C) ribosomes; sigmafactors D) tRNA; rRNA E) sigma factors; tRNA

47)

Ribozymes A) are complexes of ribosomes and RNA. B) are self-catalytic RNA. C) suggest that nucleic acids evolved before proteins. D) are enzymes that degrade RNA and therefore have potential for clinical applications. E) are self-catalytic RNA AND suggest that nucleic acids evolved before proteins.

48)

The scientists responsible for the idea that RNA can act as a catalyst were A) Watson and Crick. B) Beadle and Tatum. C) Altman and Cech. D) Lederberg and Stanley. E) Curie and Curie.

49)

Signal transduction A) is the relay of information about conditions outside a cell to inside the cell. B) often relies on a four component system. C) never involves phosphorylation of various molecules. D) is used by certain pathogens to sense high magnesium conditions. E) All of the answer choices are correct.

50)

Quorum sensing

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A) is used by bacteria to sense the density of cellswithin their population AND is used by eukaryotes to sense the presence of bacteria in their environment. B) involves the production and monitoring of signaling moleculesAND is used by eukaryotes to sense the presence of bacteriawithin their population. C) is used by bacteria to limit the density of cells in a populationANDis used by eukaryotes to sense the presence of bacteriawithin their environment. D) involves the production and monitoring of signaling moleculesANDis used by bacteria to sense the density of cells within their population. E) is used by bacteria to limit the density of cells in a populationANDis used by eukaryotes to sense the presence of pathogens within their cells.

51)

Gene regulation may entail A) turning on genes only when needed. B) turning off genes when not needed. C) turning on or off entire groups of genes. D) All of the answer choices are correct. E) None of the answer choices is correct.

52)

The regulatory protein A) binds to the promoter region of DNA. B) may inhibit or enhance transcription. C) may control translation of the operon. D) affects the activity of the DNA polymerase. E) binds to the operator region of RNA.

53)

Operon(s) in bacteria

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A) refers to a group of genes that are controlled in a coordinated manner AND involve monocistronic mRNA. B) refers to a group of genes that are controlled in a coordinated manner AND involve both monocistronic and polycistronic DNA. C) refers to a group of genes that are controlled in a coordinated manner AND involve monocistronic DNA. D) refers to a group of genes that are controlled in a coordinated manner AND involve polycistronic DNA. E) refers to a group of genes that are controlled in a coordinated manner AND involve polycistronic mRNA.

54) The set of genes in bacteria that are linked together and transcribed as a single unit is referred to as a(n) A) operon. B) regulon. C) operator. D) repressor. E) promoter.

55)

The DNA site to which the repressor protein binds is the A) operon. B) regulon. C) operator. D) repressor. E) starter.

56) The molecules that bind to a repressor and cause it to no longer bind to the operator are called

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A) activators. B) repressors. C) introns. D) inducers. E) stimulons.

57)

Repressors

A) bind or do not bind to the operator depending on their shape (conformation) AND are involved in positive control. B) bind or do not bind to the operator depending on their shape (conformation) AND are involved in negative control. C) always bind to the promoter ANDare involved in positive control. D) always bind to the promoter AND are involved in negative control. E) always bind to the ribosome AND are involved in negative control.

58)

Activators A) are involved in negative control AND bind to the terminator. B) are involved in positive control AND bind to the terminator. C) are allosteric proteins ANDare involved in positive control. D) are allosteric proteins AND are involved in negative control. E) are involved in negative control AND bind to the start codon.

59)

Negative control means a regulator molecule is A) bound, and transcription starts. B) removed, and transcription is inhibited. C) bound, and transcription is inhibited. D) removed, and transcription starts. E) bound, and transcription is inhibited OR removed, and transcription starts.

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60)

In the lac operon, glucose

A) is preferentially used over lactose in E. coli as a result of catabolite repression AND levels are correlated with cAMP levels. B) is preferentially used over sucrose in E. coli as a result of catabolite repression AND levels are directly sensed via catabolite repression. C) is preferentially used over lactose in E. coli as a result of catabolite repression AND glucose levels are the inverse of cAMP levels. D) is preferentially used over lactose in E. coli as a result of catabolite repression ANDlevels directly affect the production of lactose dehydrogenase. E) is preferentially used over sucrose in E. coli as a result of catabolite repression ANDlevels are correlated with cAMP levels.

61)

The lac operon A) positively regulated by the presence of lactose B) positively regulated by the presence of glucose C) negatively regulated by the presence of lactose D) negatively regulated by the absence of glucose

62)

CAP A) is involved in positive control AND stands for cyclic amp protein. B) is involved in positive control AND works in conjunction with cAMP. C) stands for cyclic amp protein AND is a regulon. D) stands for cyclic amp proteinANDworks in conjunction with cAMP. E) is involved in negative control AND works in conjunction with cAMP.

63)

RNAi

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A) is the form of mRNA that initiates translation in most pathogenic bacteria. B) uses short pieces of double-stranded RNA to direct the degradation of specific RNA transcripts. C) is a mechanism of genetic regulation found in all prokaryotes. D) is any chemical that inhibits transcription. E) uses short pieces of single-stranded RNA to direct the degradation of specific RNA transcripts

64) A drug that inhibits the activity of bacterial DNA gyrase ______ be a good antibiotic because ______. A) would; it wouldinhibit all DNA synthesis B) would NOT; it would inhibit all DNA synthesis, even our own cell's DNA synthesis C) would; it would selectively inhibit bacterial DNA synthesis due to differences between bacterial/human gyrase D) would NOT; the DNAreplication machinery could still function, even with impaired DNA gyraseenzyme E) would; it would selectively impair bacterial DNA structure thus killing the cells

65) Why is it beneficial for a bacterial cell to be able to use glucose FIRST as an energy source (until it is depleted), THEN switch to lactose?

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A) Lactose can onlybe used by a small number of bacteriaas an energy source AND for conservation of energy:why use the energy to make the enzymes for breaking down lactose when glucose doesn't need any extra enzymes for breakdown? B) For conservation of energy:why use the energy to make the enzymes for breaking down lactose when glucose doesn't need any extra enzymes for breakdown AND because breakdown of lactose produces inhibitory compounds. C) Glucose is aneasier compound to break down and obtain energy from than lactose AND for conservation of energy:why use the energy to make the enzymes for breaking down lactose when glucose doesn't need any extra enzymes for breakdown? D) Glucose provides 10x as much energy when broken down as lactose AND for conservation of energy:why use the energy to make the enzymes for breaking down lactose when glucose doesn't need any extra enzymes for breakdown? E) For conservation of energy:why use the energy to make the enzymes for breaking down lactose when glucose doesn't need any extra enzymes for breakdown AND because lactose always triggers endospore formation, which may be unnecessary.

66) Does the presence of introns/exons in eukaryotic cells provide more potential diversity in gene products (proteins) than is possible in prokaryotic cells? A) It doesn't. There is the same potential for gene products (proteins) in a bacterium with 1,000 genes as there is in a eukaryotic cell with 1,000 genes. B) It does. Each exon and each intron could be used individually and discretely to make a gene product (protein). Since bacteria lack these, they will have less ability to create different proteins. C) It does. Exons/introns can be spliced together in different ways post-transcription to yield different mRNAs (and therefore, different proteins). Bacteria lack this system. D) It does. Exons/introns can be spliced together in different ways at the DNA level to eventually yield different mRNAs (and therefore, different proteins). Bacteria lack this system. E) It doesn't. Bacteria and eukaryotes have the same number of introns and exons, and can thus synthesize the same types and numbers of proteins.

67) A graduate student is trying to isolate bacterial mRNA for an enzyme that will degrade trinitrotoluene (TNT). She's frustrated to find that the enzyme isn't produced when the bacterium in question is grown on nutrient agar. What might she do to solve the problem and obtain the mRNA?

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A) Add nitrogen and toluene to the agar which willdrive up synthesis of TNT, leading to production of the mRNA the student is looking for. B) Add TNT to the agar—this will drive synthesis of the enzyme to degrade it, leading to production of the mRNA the student is looking for. C) Remove glucose from the agar—this will cause the bacteria to shift to other compounds for their energy purposes. D) Remove nitrogen and toluene fromthe agar whichwill lead todrivingup synthesis of TNT,leading to production of the mRNA the student is looking for. E) Remove TNT from the nutrient agar; it acts as an inhibitor of all microbial growth, and prevents the bacteria from synthesizing any enzymes at all.

68) Cells are often ground up with abrasive to get to their internal enzymes/molecules, followed by removal of the abrasives. Here are two situations and two outcomes. What is the correct interpretation of the results? In situation #1, radioactive amino acids are mixed with ground-up cell material. Radioactive proteins are produced. In situation #2, radioactive amino acids AND the enzyme RNAse (an enzyme that degrades RNA) are mixed with ground-up cell material. No radioactive proteins are produced. A) The mRNA from thecell can be used to make proteins with the radioactive amino acids in the firstsituation. In the second situation, the mRNA is destroyed by the RNAsebefore it can be translated into protein containing the radioactive aminoacids. B) The DNA from thecell can be translated into protein using the radioactive amino acids in thefirst situation. The RNAse in the second situation degrades the ribosomalRNA (rRNA), preventing ribosomes from forming and making proteins with theradioactive amino acids. C) The radioactivityin the amino acids corrupts the tRNA molecules, leading to no proteinproduction in the second scenario. D) The radioactivity in the medium causes the DNA of the bacteria to mutate. This causes a malfunction of all the enzymes of that cell. E) The results cannot be interpreted—there isn't enough information given in the question.

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69) Cells are often ground up with abrasive to get to their internal enzymes/molecules, followed by removal of the abrasives. Here are three situations and three outcomes. What is the correct interpretation of the results? In situation #1, radioactive amino acids are added to cell material, and radioactive proteins are produced. In situation #2, radioactive amino acids, cell material, and the enzyme DNAse (degrades DNA) are added together. Radioactive proteins are still produced. In situation #3, the ground-up cell material is allowed to sit for 24 hours before radioactive amino acids and DNAse are added to it. No radioactive protein is produced. What is the most likely interpretation? A) RNA polymerase has no activity after 24 hours, so no mRNA is transcribed and translated into radioactive proteins in the last scenario. B) The radioactivityin the amino acids is altering/degrading the tRNA molecules, leading to noprotein production in the last scenario. C) Natural RNAses present in the ground-up material will degrade any existing mRNAs in that 24-hour interval. Added DNAses break down DNA so that new RNAs are not synthesized. This will lead to a loss of capability to translate protein in the last scenario. D) The radioactivity in the amino acids completely disappears within 24 hours. Transcription and translation occur as usual, but there is no radioactivity left in the system, so proteins are untagged. E) No conclusions can be made from the information given. More results are needed to interpret these experiments.

70) Transcription begins at the ______ and ends at the ______, while translation begins at the ______ and ends at the ______. A) start codon; stop codon; promoter; terminator B) promoter; stop codon; terminator; stop codon C) promoter; start codon; terminator; stop codon D) promoter; terminator; start codon; stop codon E) initiator; ender; starter; stopper

71)

Which tasks must a bacterial cell accomplish in order to multiply?

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A) Replication, translation, protein synthesis B) DNA duplication, RNA synthesis, protein synthesis C) Protein synthesis, mitosis, capsule formation D) Mitosis, gene expression, apoptosis E) DNA replication, mitosis, cytokinesis

72)

Which of the following is INCORRECT? A) Transcription is the conversion of DNA into RNA. B) Replication is the process of duplicating a DNA molecule. C) Binary fission is the process of bacterial cell division. D) Transcription is the process of copying mRNA from DNA. E) Translation is the process of synthesizing protein using information in mRNA.

73)

DNA polymerases A) add nucleotides to the 3' end of RNA during transcription. B) generate short stretches of RNA called primers to initiate replication. C) unwind the DNA template at the replication fork. D) move in a 3' to 5' direction on the template DNA. E) only add nucleotides to the leading strand during replication.

74)

Which pair is INCORRECT? A) Okazaki fragments—generated on the lagging strand during DNA replication. B) Splicing—removal of introns from prokaryote mRNA following transcription. C) Signal transduction—transmission of information from outside a cell to inside the

cell. D) Constitutive enzymes—enzymes that are constantly produced by a cell. E) Promoter—nucleotide sequence to which RNA polymerase binds to start transcription.

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75)

Which of the following is an example of phase variation? A) N. gonorrhoeaeexpressing different types of pilinprotein. B) Influenza virus expressing variations of glycoprotein HA and NA spikes. C) S. pyogenes producing a capsule of hyaluronic acid, which is also ahost component. D) E. coli producing pilifor attachment to epithelial cells. E) These are all examples of phase variation.

76)

How can some bacteria sense the density of cells in an environment? A) Detecting the concentration of a signaling molecule. B) Quantifying the accumulation of waste products. C) Measuring the depletion of oxygen in the environment. D) Sensing the depletion of water in the environment. E) Detecting the accumulation of endospores.

77)

The simultaneous regulation of many bacterial genes is A) quorum sensing. B) a regulon. C) local control. D) induction. E) global control.

78) A regulatory protein binds to the operator in a strand of DNA, blocking transcription. The protein is

Version 1

A) a repressor. B) an inducer. C) an operon. D) a terminator. E) an activator.

79) If a DNA triplet is AGT, the mRNAcodonwould be ______ and the tRNA anticodon would be ______. A) TCA; AGU B) UCA; AGU C) TGA; serine D) UCA; stop E) AGU; UGA

80)

For synthesis of an inducible enzyme to occur, A) a compound must bind to the repressor. B) a compound must bind to the operator. C) a product must bind to the terminator. D) a corepressor must bind to the start codon. E) lactose must be present without fructose.

81)

When E. coli is grown in medium containing both glucose and lactose, A) the cells growth fastest after lactose is used up. B) the cells use lactose first, then glucose. C) the cells grow fastest initially when glucose is available. D) the cells use the glucose and then stop growing. E) the cells grow at the same rate until all sugars are depleted.

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82) When E. coli is placed in a medium containing both glucose and lactose, why does cell growth stop temporarily when the glucose is used up? A) Once glucose is depleted, the cell must use the lactose; before it can do this, it must express the lac operon and synthesize the enzymes needed to use lactose, which takes time. B) Once lactose is depleted, the cell must use the glucose; before it can do this, it must express the lac operon and synthesize the enzymes needed to use lactose, which takes time. C) Once glucose is depleted, the cell must use the lactose; before it can do this, it must express the lac operon—it can only do this if the culture medium is placed in the dark at 22 oC. D) Glucose is the preferred medium of the cells—when it is available, they grow extremely fast, and this depletes all the energy in the cell which must be replaced before it can use lactose. E) The presence of glucose denatures the lactose in the medium; once the glucose is depleted, the lactose has to regain its original shape before the cells can use it.

83)

Why is the position of the first AUG after the ribosome binding site critical? A) Every polypeptide must start with methionine. B) It initiates transcription. C) Every polypeptide must start with arginine. D) It establishes the reading frame. E) Every polypeptide must end with methionine.

84)

What does semiconservative mean with respect to DNA replication?

A) In the two new DNA molecules generated, one has two new strands and one has two original strands. B) In the two new molecules generated, each has one new DNA strand and one original RNA strand. C) In the two new DNA molecules generated, each has one new strand and one original strand. D) In the two new DNA molecules generated, one has a single strand and the other has a double strand. E) None of the choices are correct.

Version 1

85) Select the CORRECT statement regarding regulation by a repressor and regulation by an activator. A) Repressors bind to the operator, blocking the progress of RNA polymerase. Activators bind to the activator-binding site, facilitating the progress of RNA polymerase. B) Repressors bind to the activator-binding site, blocking the progress of RNA polymerase. Activators bind to the operator, facilitating the progress of RNA polymerase. C) Repressors bind to the activator-binding site, blocking the progress of DNA polymerase. Activators bind to the operator, facilitating the progress of DNA polymerase. D) Repressors bind to the operator, blocking the progress of DNA polymerase. Activators bind to the activator-binding site, facilitating the progress of DNA polymerase. E) Repressors bind to the stop codon, blocking the progress of RNA polymerase. Activators bind to the start codon, facilitating the progress of RNA polymerase.

86)

Which of the following is NOT involved in transcription? A) Ribosome B) Uracil C) Promotor D) Polymerase E) Sigma factor

87)

Which of the following statements about gene expression in prokaryotes is FALSE? A) More than one RNA polymerase can be transcribing a specific gene at a given time. B) More than one ribosome can be translating a specific transcript at a given time. C) Translation begins at a site called a promoter. D) Transcription stops at a site called a terminator. E) Some amino acids are coded for by more than one codon.

88) If a 100 base-pair double-stranded DNA fragment has 40 cytosines, how many adenines does it contain?

Version 1

A) 60 B) 40 C) 30 D) 20 E) 100

89)

In replication, synthesis of which strand requires the repeated action of DNA ligase? A) The lagging strand B) The leading strand C) Both the leading AND the lagging strand D) The top strand E) The bottom strand

90)

How do activators facilitate transcription?

A) They bind to DNA, thereby making it easier for RNA polymerase to initiate transcription. B) They bind to RNA, thereby making it easier for DNA polymerase to initiate transcription. C) They bind to DNA, thereby making it easier for DNA polymerase to initiate transcription. D) They bind to DNA, thereby making it easier for RNA polymerase to initiate translation. E) They bind to RNA, thereby making it easier for RNA polymerase to initiate translation.

91)

Which of the following is NOT found in DNA?

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A) Peptide bond B) Thymine C) Hydrogen bond D) Complementary base pairing E) Hydroxyl group

92)

Select the INCORRECT statement regarding DNA structure. A) Thymine base pairs with cytosine. B) Purines base pair with pyrimidines. C) The two strands are held together by hydrogen bonds. D) The two strands are antiparallel. E) Base pairing ocurs at the interior of the double helix.

93)

Which of the following may use RNA as its genome? A) Virus B) Bacterium C) Protozoan D) Prion E) Yeast

94)

Under which of the following conditions will transcription of the lac operon occur? A) Lactose present/glucose present B) Lactose present/glucose absent C) Lactose absent/glucose present D) Lactose absent/glucose absent E) Lactose present/glucose present/xylose present

95)

Which of the following statements about repressors is TRUE?

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A) A repressor is a protein that binds to an operator site on DNA and prevents transcription. B) A repressor is a protein that binds to an operator site on RNA and prevents transcription. C) A repressor is a carbohydrate that binds to an operator site on DNA and prevents transcription. D) A repressor is a protein that binds to an activator-binding site and prevents transcription. E) Repressors attach to corepressor, changing their shape to they longer attach to the operator.

SECTION BREAK. Answer all the part questions. 96) Your patient has a fever of 39oC, sore throat, cough, and chest pain. You ask her whether she has had pneumococcalvaccine this year, which protects against the the 23 most common strains of the causative bacterium Streptococcus pneumoniae. She says she has not. Your patient has a number of questions that you answer to help her understand the genetics of the organism causing her illness.

96.1) Your patient took biology many years ago. You remind her of the structure of DNA and RNA. Which statement is NOT correct? A) DNA is usually a double-stranded, helical structure composed of nucleotides, each of which contains a sugar, a phosphate group, and a nucleobase (A, T, C or G). B) The two strands of DNA are complementary and are held together by hydrogen bonds between the nucleobases.  C) RNA is a single-stranded molecule composed of nucleotides that contain the nucleobases adenine, thymine, uracil, or cytosine. D) RNA nucleotides contain the 5-C sugar ribose while DNA nucleotides contain the 5C sugar deoxyribose. E) A single linear strand of DNA will always have a 5ʹPO 4 at one end and a 3ʹOH at the other, referred to as the 5ʹ end (5 prime end) and the 3ʹ end (3 prime end) respectively.

Version 1

96.2) You give your patient some general information on gene expression in cells. You explain that when cells divide, two processes are involved: replication and gene expression. Gene expression includes two related events: (i) copying the information encoded in DNA into RNA, a process called ______, followed by (ii) the interpretation of the information carried by the RNA to synthesize the encoded protein in a process called ______.  A) transcription; translation B) translation; transcription C) replication; transcription D) replication; translation E) binary fission; transcription

96.3) You explain that transcription starts at a particular region on the DNA template called the ______, and ends at a sequence called the ______. A) promoter; stop codon B) promoter; terminator C) start codon; terminator D) start codon; stop codon E) initiator; terminator

96.4) Your patient somewhat remembers the details of replication but can't really recall what role various enzymes play in the process. You give her the information. Which of the following would you NOT tell her?

Version 1

A) DNA gyrasetemporarily breaks the strands of DNA, relieving the tension caused by unwinding the two strands of the DNA helix.  B) DNA polymerases synthesize the new stand of DNA using the parent strand as a template. C) The antiparallel strands of DNA are joined together by DNA ligase. D) Helicaseunwind the DNA helix at the replication fork.  E) Primasesynthesizes small fragments of RNA to serve as primers for DNA synthesis.

96.5) You remind your patient that information for proteins is encoded in DNA ______. These are copied into ______ in the mRNA. A) triplets; codons B) codons; triplets C) nucleotides; codons D) codons; anticodons E) anticodons; triplets

96.6) You tell your patient that the genetic code is used when translating mRNAto synthesize protein. You explain that the code is degenerate and that this is important because A) one codon codes for more than one amino acid. B) one amino acid codes for more than one codon. C) base-pairing errors made during transcription may not result in a change in the encoded protein. D) one amino acidcodes for more than one codon AND base-pairing errors made during transcription will result in a change in the encoded protein. E) one codoncodes for more than one amino acid AND base-pairing errors made during transcription may not result in a change in the encoded protein.

Version 1

96.7) Your patient tells you she didn't get theflu vaccine either because she heard that she would have to get it every year. She doesn't understand why this is that case. You explain that flu viruses have two types of glycoproteinspikes that have a role in flu virus pathogenesis. Every year, minor changes occur in the genes that code for these spikes, resulting in slight changes in their amino acid sequence. These changes to the spikes on the surface of the virus is an example of ______. A) antigenic variation B) phase variation C) quorum sensing D) two-component regulation E) gene splicing

97) Your niece has been diagnosed with Diamond-Blackfananemia, an extremely rare disorder of the bone marrow that causes people have a low red blood cell (RBC) count. The disease is classified as a ribosomal protein disease, meaning that one or more of the genesinvolved in ribosome production is/are mutated, and the ribosomes are not synthesized properly. Although it is not currently understood why mutations in ribosome biosynthesis affectblood cell formation particularly, you are able to help your sister understand the role of ribosomes in the cell and the consequence of ribosome failure, so that she has a better grasp of her child's condition.

97.1)

You explain to your sister that ribosomes are the site of ______ in cells.

A) protein synthesis B) lipid synthesis C) peptidoglycan synthesis D) DNA replication E) the nucleolus

97.2) Ribosomes are involved in generating proteins in a cell. The other components directly needed for this process to occur are

Version 1

A) mRNA, tRNA, and amino acids B) mRNA, tRNA, and nucleic acids C) DNA, DNA polymerase, and amino acids D) a nucleus,tRNA, and amino acids E) a nucleolus,tRNA, and nucleic acids

97.3) Your sister asks you what the difference is between protein synthesis and translation. You explain to your sister that the process of generating proteins in a cell is called translation because the information for the protein is in the form of ______ but proteins are composed of _____. A) codons; anticodons B) anticodons; codons C) amino acids; nucleic acids D) nucleic acids; amino acids E) 70S; 80S

97.4) One of the genes affected inDiamond-Blackfan Anemia is called RPS19. This gene plays a role in maturation of the 40S subunit. Your sister tells you she heard that protein synthesis can occur normally if the large ribosomal subunit is present, even if the small subunit is not because the large subunit is the part that decodes the information. You tell her that this is ⊚ ⊚

true false

97.5) sister?

Which of the following statements would NOT be good information for your

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A) Ribosomes have two subunits—a large subunit and a small subunit. B) Ribosomes catalyze peptide bond formation between amino acids. C) Mitochondria have ribosomes and also synthesize proteins. D) Protein synthesis is an anabolic reaction and requires ATP. E) Protein synthesis takes place in the cytoplasm of a cell.

98) You are a genetic counselor working with the parents of a child with Lesch-Nyhan Syndrome (LNS). LNS is a rare, inherited genetic disease that is almost always found in males. It is characterized by neurological and behavioral problems, including tense muscles (dystonia), jerky movements (chorea), involuntary flailing limbs (ballismus), head banging and self-biting. LNSresults from a mutation (change)in a gene called HPRT1, that leads to a deficiency in an enzyme called hypoxanthine-guanine phosphoribosyltransferase 1 (HGPRT). HGPRT is involved in the break down and recycling of purines back into nucleic acid synthesis through a series of reactions called the purine salvage pathway. In one part of this pathway, HGPRT catalyzes the conversion of the purine guanineinto gaunosine monophosphate; this isthenconverted into guanosineand then finally back into guanine which isrecycled intonucleic acid synthesis. In the absense of HGPRT, theguanine is is not salvaged and recycled. Instead, it is degraded and forms uric acid. This accumulates in the blood, a condition called hyperuricemia, that results in themanifestations associated with LNS. Although uric acid accumulation can be modulated with medications, LNS cannot be cured.

98.1)

Which of the following are nucleic acid purines?

A) Guanine AND adenine B) Guanine AND thymine C) Thymine AND adenine D) Cytosine AND guanine E) Thymine AND cytosine

98.2)

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Which of the following is mismatched?

A) Flailing - uncontrolled waving or swinging B) Hyperurecemia - low uric acid blood levels C) Dystonia - tense muscles D) Chorea - jerky body movements E) Ballismus - involuntary body movements

98.3)

Which of the following statements regarding LNS is CORRECT?

A) People with LNS can only make DNA, not RNA. B) People with LNS can only make RNA, not DNA. C) People with LNS do not recycle guanine correctly. D) People with LNS have a mutation in their proteins. E) LNS would be easily cured with antiviral medication.

98.4)

What is the function ofhypoxanthine-guanine phosphoribosyltransferase 1?

A) It is involved in recycling certain nucleotides. B) It catabolizes pyrimidines into uric acid. C) It anabolizes adenine and thymine into uric acid. D) It transfers ribosomes to guanine. E) It catalyzes transfer of RNA out of the nucleus.

98.5) HGPRT is involved in recycling of guanine. It thus has an impact on DNA synthesis but not RNA synthesis. ⊚ ⊚

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true false

Answer Key Test name: Chap 07_10e 1) FALSE 2) TRUE 3) FALSE 4) TRUE 5) TRUE 6) TRUE 7) FALSE 8) TRUE 9) TRUE 10) TRUE 11) C 12) C 13) D 14) C 15) B 16) E 17) C 18) C 19) D 20) B 21) A 22) B 23) C 24) E 25) C 26) C Version 1

27) C 28) A 29) B 30) B 31) C 32) C 33) C 34) D 35) E 36) B 37) B 38) D 39) D 40) B 41) C 42) E 43) C 44) A 45) B 46) A 47) E 48) C 49) A 50) D 51) D 52) B 53) E 54) A 55) C 56) D Version 1

57) B 58) C 59) E 60) C 61) A 62) B 63) E 64) C 65) C 66) C 67) B 68) A 69) C 70) D 71) B 72) A 73) D 74) B 75) D 76) A 77) E 78) A 79) B 80) A 81) C 82) A 83) D 84) C 85) A 86) A Version 1

87) C 88) A 89) A 90) A 91) A 92) A 93) A 94) B 95) A 96) Section Break 96.1) C 96.2) A 96.3) B 96.4) C 96.5) A 96.6) C 96.7) A 97) Section Break 97.1) A 97.2) A 97.3) D 97.4) FALSE 97.5) C 98) Section Break 98.1) A 98.2) B 98.3) C 98.4) A 98.5) FALSE

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CHAPTER 8 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Organisms termed his - are considered prototrophic for histidine. ⊚ ⊚

Each gene mutates at a characteristic frequency. ⊚ ⊚

true false

DNA polymerase is able to proofread the DNA sequence. ⊚ ⊚

true false

4) Mutations are likely to persist after SOS repair, but not after light-induced or excision repair. ⊚ ⊚

The Ames test determines antibiotic sensitivity of a bacterium. ⊚ ⊚

true false

Double-stranded DNA enters the recipient cell during transformation. ⊚ ⊚

true false

Plasmids often carry the information for antibiotic resistance.

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⊚ ⊚

F plasmids and oftentimes R plasmids are both able to code for production of a pilus. ⊚ ⊚

true false

Transposons may leave a cell by incorporating themselves into a plasmid. ⊚ ⊚

10)

true false

Crown gall is caused by a prokaryote plasmid that can be expressed in plant cells. ⊚ ⊚

true false

11) The restriction-modification system always has two genes involved, the cutting enzyme and the methylating enzyme. ⊚ ⊚

true false

12) Genomic islands can be identified by the fact that they have a different C-G content from the rest of the cell's genome. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 13) The properties of a cell that are determined by its DNA composition are its

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A) phenotype. B) genotype. C) metabolism. D) nucleoid. E) plasmids.

14)

The source of variation among microorganisms that were once identical is A) antibiotic resistance. B) virulence factors. C) mutation. D) sigma factors. E) mutant.

15)

The characteristics displayed by an organism in any given environment is its A) archaetype. B) phenotype. C) genotype. D) mutatotype. E) phenogene.

16) Which change in a gene's DNA sequence would have the least effect on the eventual amino acid sequence produced from it? A) Deletion of two consecutive nucleotides B) Addition of one nucleotide C) Addition ordeletion of three consecutive nucleotides D) Substitution of one nucleotide AND addition of onenucleotide E) Addition of two consecutive nucleotides

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17)

The designation his

refers to

A) the genotype of bacteriathat lacka functional gene for histidine synthesis AND bacteria that are auxotrophic for histidine. B) the genotype of bacteriathat havea functional gene for histidine synthesis AND bacteria that requireaddition of histidine to the growth medium. C) the genotype of bacteriathat havea functional gene for histidine synthesis ANDbacteria that are auxotrophic for histidine. D) the genotype of bacteriathat lacka functional gene for histidine synthesis AND bacteria that have a hers gene. E) the genotype of bacteriathat lacka functional gene for histidine synthesis AND bacteria that do not requireaddition of histidine to the growth medium.

18)

Segments of DNA capable of moving from one area in the DNA to another are called A) base analogs. B) intercalating agents. C) transposons. D) inverted repeats. E) mutagens.

19)

Which of the following about transposons is not true? A) They are informally known as jumping genes. B) They may cause insertion mutations. C) They may cause knockout mutations. D) They were first recognized in fungi. E) All of the statements are true.

20)

Chemical mutagens often act by altering the

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A) alkyl groups of thenucleobase. B) nucleobasesequence. C) number of bindingsites on the nucleobase. D) hydrogen bondingproperties of the nucleobase. E) nucleobases.

21)

The largest group of chemical mutagens consists of A) radiation. B) alkylating agents. C) nitrous acid. D) base analogs. E) intercalating agents.

22)

Chemical mutagens that mimic the naturally occurring bases are called A) nitrogen mustards. B) alkylating agents. C) base analogs. D) nitrous oxide. E) nucleobase copiers.

23)

Planar molecules used as chemical mutagens are called A) intercalating agents. B) nitrous oxide. C) base analogs. D) alkylating agents. E) acids.

24)

Intercalating agents

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A) act during RNA synthesis AND often result in frameshift mutations. B) act during RNA synthesis AND change the hydrogen bonding properties of nucleotides. C) act during DNA synthesis AND often result in frameshift mutations. D) change the hydrogen bonding properties of nucleotides AND always result in nonsense mutations. E) act during DNA synthesis AND always result in nonsense mutations.

25)

Irradiation of cells with ultraviolet light may cause A) four nucleotides to covalently bind together. B) thymine dimers. C) adenine complementary base pairing with cytosine. D) the addition of uracil. E) cytosine trimers.

26)

On which of the following DNA strands would UV radiation have the most effect? A) AATTAGTTC B) AACCGGG C) TATATACG D) AUAUCGAU E) TATATACG AND AATTAGTTC

27)

Thymine dimers are removed by

A) cold-activated repair mechanisms. B) SOS repair ANDphotoreactivation repair. C) SOS repair AND excision repair. D) SOS repair, photoreactivation repair, AND excision repair. E) photoreactivation repair AND excision repair.

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28)

The formation of a covalent bond between two adjacent thymines is caused by A) X-rays. B) alkylating agents. C) UV radiation. D) microwave radiation. E) heat.

29)

X-rays A) have no effect on DNA. B) cause thymine trimers. C) cause breaks in DNA molecules. D) make the DNA radioactive. E) destroy lipopolysaccharide.

30)

DNA repair mechanisms occur A) only in prokaryotes. B) only in eukaryotes. C) in both eukaryotes and prokaryotes. D) in neither eukaryotes nor prokaryotes. E) None of the answer choices is correct.

31)

Which is not true about mismatch repair?

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A) It uses an endonuclease. B) It requires DNA polymerase and DNA ligase. C) It uses methylation of the DNA to differentiate between strands. D) It removes both strands in the mismatch area. E) It fixes errors missed by the proofreading of DNA polymerase.

32)

Antibiotics A) cause mutations to occur. B) may act as alkylating mutagens. C) provide an environment in which preexisting mutants survive. D) increase the rate of spontaneous mutation. E) destroy all mutant bacteria.

33)

The diploid character of eukaryotic cells may mask the appearance of a mutation since A) the matching chromosome may carry the correct version of the gene. B) the matching chromosome may repairthe mutated gene. C) the mutation is usually reversible. D) the mutation may create inverted repeats. E) All answer choices are correct.

34)

Direct selection involves inoculating cells onto growth media on/in which A) the mutant but notthe parental cell type will grow. B) the mutation will be reversed. C) the nutrients necessary for mutation to occur are present. D) the mutagen is present. E) histidine has been added.

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35)

Among the easiest of the mutations to isolate are those which A) involve polyploid chromosomes ANDallow populations to be measured. B) involve antibiotic resistance AND allow populations to be measured. C) allow populations to be measured AND use an indirect method for measurement. D) involve haploid chromosomes AND involve antibiotic resistance. E) use an indirect method for measurement AND involve antibiotic resistance.

36)

Indirect selection A) is necessary to isolate auxotrophic mutants. B) uses media on whichthe mutant but not the parental cell type will grow. C) uses media that reverses the mutation. D) uses media upon which neither the parental cell type nor mutant grows. E) is necessary to isolate his + prototrophs.

37)

Replica plating

A) is useful for direct selection of antibiotic resistance ANDis useful for identifying auxotrophs. B) uses media on which the mutant willgrow but the parental cell typewill notANDis useful for identifying prototrophs. C) is useful for identifying auxotrophs AND uses media on which the mutant will not grow but the parental cell typewill. D) is useful for identifying auxotrophs ANDuses media on which the mutant willgrow but the parental cell typewill not. E) is useful for direct selection of antibiotic resistance ANDis useful for identifying prototrophs.

38)

A clever technique that streamlines the identification of auxotrophic mutants is

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A) gas chromatography. B) replica plating. C) direct selection. D) reversion. E) intercalation.

39) use

To increase the proportion of auxotrophic mutants in a population of bacteria, one may

A) direct selection. B) replica plating. C) penicillin enrichment. D) individual transfer. E) mutant reversion.

40)

A quick microbiological test for potential carcinogens was developed by A) Fleming. B) Lederberg. C) Ames. D) Crick. E) McClintock.

41)

The Ames test is useful as a rapid screening test to identify those compounds that A) will respond to chemical agents. B) are mutagens. C) respond to the deletion of DNAses. D) will protect an organism from cancer. E) will respond to chemical agents AND will protect an organism from cancer.

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42) To increase the chance of detecting carcinogens in the Ames test, the test substance is treated with A) penicillin. B) heat. C) ground-up rat liver. D) reverse transcriptase. E) penicillin AND heat.

43)

Bacteria that have properties of both the donor and recipient cells are the result of A) UV light. B) SOS repair. C) frame shift mutations. D) genetic recombination. E) antibiotic resistance.

44)

The mechanism by which genes are transferred into bacteria via viruses is called A) ellipsis. B) transduction. C) replica plating. D) transformation. E) conjugation.

45)

In conjugation the donor cell is recognized by the presence of A) an F plasmid. B) a Y chromosome. C) diploid chromosomes. D) an SOS response. E) an F plasmid AND diploid chromosomes.

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46)

The F plasmid carries the information for A) the sex pilus. B) recipient cell DNA replication. C) antibiotic resistance. D) the Y chromosome. E) bacterial flagella.

47)

Competent cells

A) are able to take up naked DNA, can be created in the laboratory,AND are alwaysantibiotic resistant. B) are able to take up naked DNA, occur naturally, AND can be created in the laboratory. C) are always antibiotic resistant, are always auxotrophs,AND occur naturally. D) can be made in the laboratory, are alwaysantibiotic resistant, AND are always auxotrophs. E) are able to take up naked DNA,occur naturally, AND are always antibiotic resistant.

48)

The material responsible for transformation was shown to be DNA by A) Watson and Crick. B) Avery, MacLeod, and McCarty. C) Lederberg. D) Stanley. E) Beadle and Tatum.

49) In conjugation, transformation, or transduction, the recipient bacteria is most likely to accept donor DNA

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A) from any source. B) from any species of bacteria. C) from the same species of bacteria. D) only through plasmids. E) from any source AND only through plasmids.

50)

Gene transfer that requires cell-to-cell contact is A) transformation. B) competency. C) conjugation. D) functional genomics. E) transduction.

51)

Insertion sequences A) are the simplest type of transposon, code for a transposase enzyme AND can produce

pili. B) code for a transposase enzyme AND are characterized by an inverted repeat. C) are characterized by an inverted repeat AND can produce pili. D) can produce pili AND are the simplest type of transposon. E) are the simplest type of transposon, code for a transposase enzyme, AND are characterized by an inverted repeat.

52) The transfer of vancomycin resistance from Enterococcus faecalis to Staphylococcus aureus is thought to have involved A) conjugation AND transformation. B) conjugation AND transposons. C) transformation AND transduction. D) transduction AND transposons. E) transformation AND transposons.

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53)

Which is TRUE about a crown gall tumor?

A) It is a unique viral infection of plants. B) It results from the transfer ofa transposonto the plant. C) It results from an Agrogallerium infection of the plant. D) It results from the incorporation of bacterial plasmid DNA into the plant chromosome. E) It results from the incorporation of plant plasmid DNA into the bacterial chromosome.

54)

The study of the crown gall tumor found A) a bacterial plasmid promoter that was similar to plant promoters. B) an R plasmid in plant cells. C) incorporation of the bacterial chromosome into the plant. D) incorporation of the plant chromosome into the bacteria. E) a bacterial plasmid promoter that was similar to plant terminators.

55) Is it as effective to take two antibiotics sequentially for an infection as it is to take them simultaneously, as long as the total length of time of the treatment is the same? A) No. There'salways one specific antibiotic that will be the most effective, and that is theonly antibiotic that should be used to treat a particular infection. B) Yes. Aslong as the length of time is the same, the two treatments should be essentially the same in terms of effectively eliminating the infection. C) No. Taken sequentially, the first antibiotic will select for the small portion of the population that will spontaneously mutate toward resistance. Then, the second antibiotic will do the exact same thing—selecting for resistance to the second drug from the few bacterial cells that remained from the first drug treatment. D) No. If the antibiotics are given sequentially, there is a chance that resistance to either one may arise through mutation. When antibiotics are given simultaneously, thechance of resistance to two different antibiotics occurring is extremely low. E) Yes. Each antibiotic will kill all the cells that are sensitive to it, no matter if the drugs are taken simultaneously or sequentially. The important thing is to take the medication for as few days as possible.

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56)

Strong chemical mutagens may be used to treat cancer cells. Is this a good or bad idea?

A) Good—kill those cancer cells as quickly as possible to cure the patient! B) Bad—these mutagens will also affect the non-cancerous cells, possibly leading to new cancerous states! C) Good and bad—they're very good at killing cancer cells, but they could also be dangerous to non-cancerous cells. D) Bad—the cancer cells are already mutated. We don't want to mutate them more and make them more cancerous! E) Bad—the medications are toxic and will cause healthy normal microbiotsto become cancerous.

57) Every 24 hours, every genome in every cell of the human body is damaged 10,000 times or more. Given the possible DNA repair mechanisms, which order listed below would be most effective at repairing these as quickly as possible in order to prevent mutations from being carried forward in DNA replication? A) Proofreading by DNA polymerase, glycosylase enzyme activities, excision repair, SOS repair B) SOS repair, excision repair, glycosylase enzyme activities, proofreading by DNA polymerase C) SOS repair, proofreading by DNA polymerase, glycosylase enzyme activities, excision repair D) Glycosylase enzyme activities, SOS repair, proofreading by DNA polymerase, excision repair E) Proofreading by DNA polymerase, SOS repair,glycosylase enzyme activities, excision repair

58) To maximize the number of thymine dimer mutations following UV exposure, should you keep human cells in tissue culture in the dark, in the light, or does it matter at all?

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A) The dark—light will activate the photorepair systems that can break thymine dimers induced by UV light. B) The light—it's important to keep on producing the thymine dimers by keeping the plate exposed to light as much as possible. C) Alternatinglight and dark every hour to increase the chances that thymine dimers will form, but prevent photorepair systems from correcting them as they are formed. D) It doesn't matter—human cells don't have the enzymes needed for photorepair of thymine dimers. E) Alternatinglight and dark every 24 hours to increase the chances that thymine dimers will form.

59) Two bacterial genes are transduced simultaneously. What does this suggest about their proximity to each other within the original host genome? A) Nothing. It's highly likely that two separate virus particles were carrying each gene, and that they coinfected the new target cell at the same time.This could mean the two original genes might not even be from the same original host cell! B) It's highly likely that the two genes are located next to each other in thehost cell chromosome. Since transduction results from a packaging error or an excision error that occurs during the infection cycle of the bacteriophage , the genes must lie close to each other to be transduced into a new cell simultaneously. C) They must be within five gene lengths of each other, but not necessarily immediately adjacent. If they were immediately adjacent, the transposons that facilitate the transfer of genetic information between the two cells wouldn't be able to "jump" into them. D) It doesn't mean anything. Transduction relies on the ability of a cell to take up foreign DNA. It's possible here that the cell has simply taken up two separate bits of DNA at the same time from the surrounding environment. E) It's highly likely that one gene was on the chromosome but the other was actually on a plasmid; if those two elements are in one cell, genes can be transferred simultaneously.

60) DNA transfer by conjugation is more efficient in a liquid medium setting, subjected to very mild agitation (stirring), rather than on an agar plate format. Why?

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A) Directcell-to-cell contact is required for this process, and this is more likely tobe achieved in the plate format than in the fluid format (especially forrelatively non-motile types of bacteria). B) Directcell-to-cell contact isn't required for this process, so the ability to secretethe DNA into the surrounding fluid medium makes the process more efficient thanthe dry surface of an agar plate. C) Directcell-to-cell contact is required for this process, and this is more likely tobe achieved in the fluid liquid format than on an agar plate (especially forrelatively non-motile types of bacteria). D) Trick question—it can take place with the same degree of efficiency on either format. It doesn't matter! E) Agitation is only needed if the bacteria are known to be non-motile and can't move around on a solid medium. Otherwise, it doesn't really matter what type of medium is used as long as it contains chemicals to make cells competent.

61) Some bacteria have a higher incidence rate of thymine dimer mutations following exposure to UV light than others. What might be going on here to lead to this outcome? A) They may simplyhave a higher proportion of T nucleotides next to each other in their DNAsequences than other bacteria, leading to more possible dimers beingformed. B) They may simply have a higher proportion of T nucleotides next to each other in their DNA sequences than other bacteria, leading to more possible dimers being formed AND they may have a strongerexpression of photoreactivation enzymes, leading to formation of more thymine dimers. C) They may simply have a higher proportion of T nucleotides next to each other in their DNAthan other bacteria, leading to more possible dimers being formed AND they may have a weaker expression of photoreactivation enzymes, leading to formation of more thymine dimers. D) They may have astronger expression of photoreactivation enzymes, leading to more thyminedimers being formed and retained. E) They may have aweaker expression of photoreactivation enzymes, leading to more thymine dimersbeing formed and retained.

62)

DNA is protected from restriction enzymes by being

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A) sequestered in a lysosome. B) turned into RNA. C) methylated. D) made into double-stranded RNA. E) phosphorylated.

63) The clustered, regularly interspaced short palindromic repeats (CRISPR) system in bacterial cells has been called the “immune” system of bacteria. CRISPR protect bacteria from a repeat infection from the same phage because bacterial cells A) recognize proteins on the surface of the phage and secrete enzymes that digest the phage. B) recognize proteins on the surface of the phage and secrete proteins that block the binding of the phage. C) integrate fragments from the phage DNA in their own chromosomes and target for destruction any DNA that contains the same fragments in the future. D) modify the attachment sites for the phages so that new infections cannot take place. E) integrate fragments from the phage RNA in their own chromosomes and target for destruction any RNA that contains the same fragments in the future.

64) A mutation in E. coli results in the loss of both restriction endonucleases and modification enzymes. Would you expect any difference in the frequency of gene transfer via transduction FROM Salmonella INTO this E. coli strain?

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A) No—since the Salmonella strain is normal, the rate of production of transducing virus particles would still be the same, resulting in the same frequency of gene transfer. B) Yes—the loss of the restriction endonucleases would leave the recipient E. coli unable to break down "invading"' viral DNA from the transducing phage. This would lead to higher rates of successful transduction. C) Yes—the loss of the modification enzymes would leave the recipient E. coli unable to tag its own DNA as "self," leaving the viral DNA untagged and recognizable as "foreign," and targeted for destruction. This would lead to higher rates of successful transduction. D) No—transduction efficiency isn't affected by either restriction endonucleases or modification enzymes, so there'd be no effect on the overall rate. E) Yes—the loss of the restriction endonucleases would leave the recipient E. coli unable to break down "invading" viral DNA from the transducing phage, AND the loss of the modification enzymes would leave the recipient E. coli unable to tag its own DNA as "self," leaving the viral DNA untagged and recognizable as "foreign," and targeted for destruction. Together, these would lead to higher rates of successful transduction.

65) Cells that are His -, Str containing

could be isolated from a mixed sample by using a medium

A) streptomycin B) histidine AND glucose C) penicillin AND streptomycin D) glucose AND streptomycin E) histidineAND streptomycin

66) Colonies of the bacterium Serratia marcescens are red when incubated at 22°C but white when incubated at 37°C. This is an example of A) antigenic variation. B) genotypic change. C) phenotypic change. D) mutation. E) selective media.

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67)

Please select the INCORRECT statement regarding mutation.

A) A reversion is a mutation that correctsa defect caused by an earlier mutation. B) A base substitution is a mutation in which the wrong nucleotide has been incorporated. C) A missense mutation is also called a synonymous mutation, meaning no change in the amino acid encoded. D) Insertionalinactivation is the disruption of a gene's function due to a DNA segment inserted into the gene. E) Spontaneous mutations are those that occur during the normal processes of a cell.

68)

Which of the following statements about spontaneous mutation is TRUE?

A) A single mutation is common but a double mutation is very rare. B) If the mutation ratetoantibiotic A is 10 -9per cell division, and to antibiotic B is 10 6 per cell division, the probability of the cell being resistant to both medications is 10 -15. C) If the mutation ratetoantibiotic A is 10 -9per cell division, and to antibiotic B is 10 6 per cell division, the probability of the cell being resistant to both medications is 10 -54. D) A frameshift mutation in which three nucleotides are added is less likely to impact a cell that a frameshift mutation in which two nucleotides are deleted. E) A transposon may insertionally inactivate a gene when it jumps from one place in a genome to another.

69) You make two agar plates: one is a nutrient agar plate (plate A) that contains histidine andpenicillin. The other is a glucose salts agar (plate B) that also contains penicillin. You inoculate a sample onto both plates using replica plating technique, incubate the plates, and compare the growth after 48 hours. There are 12 colonies on the nutrient agar plate and 11 colonies on the glucose salts medium. Which of the following statements is INCORRECT?

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A) The colony that is missing from plate B is an auxotroph that cannot synthesize histidine. B) The prototrophs are resistant to penicillin but the auxotrophs are sensitive to this antibiotic. C) Prototrophs and auxotrophs in this experiment are resistant to penicillin. D) Approximately 92% of the bacteria in the original sample are prototrophs. E) This experiment describes indirect selection of a mutant.

70) If you were carrying out a penicillin enrichment culture andyou forgot to addpenicillinasebefore plating the sample onto nutrient agar, what would happen? A) You would get the same results whether you add this enzyme of not because penicillin naturally rapidly degrades in agar. B) The prototrophs would be able to grow on the agar plates but the auxotrophs would not. C) The auxotrophs would be able to grow on the agar plates but the prototrophs would not. D) Prototrophs and auxotrophs would both be killed by the penicillin; only Pen R mutants would grow and you would not enrich for auxotrophs. E) Prototroph and auxotroph colonies would change color from cream to red in the presence of the penicillin.

71) You mix two bacterial stains in a tube of glucose-salts agar. One strain is His −, Val −, while the other strain is Trp −, Leu −. You previously showed that neither strain grows on glucose-salts agar. After incubating the tube, you plate a sample onto a new glucose-salts agar plate. Several colonies grow. What do you know is TRUE about these colonies? A) The bacteria in the colonies are His −, Val −, Trp +, Leu +. B) The bacteria in the colonies are His −, Val +, Trp +, Leu +. C) The bacteria in the colonies are His −, Val −, Trp −, Leu −. D) The bacteria in the colonies are His +, Val +, Trp +, Leu +. E) The bacteria in the colonies are His +, Val +, Trp +, Leu +, Pen R.

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72)

A bacterial strain is resistant to infection by abacteriophage. Which statement is FALSE?

A) The bacteria make restriction enzymes that degrade the virus genome. B) The bacterial host DNA is protected from restriction enzymedegradationby phosphorylation. C) The bacterial host DNA is protected from restriction enzyme degradationby methylation. D) If the phage DNA was methylated, it would be protected from restriction enzyme degradation. E) The statements are ALL false.

73)

In order for insertional inactivation to occur, the transposon must be placed A) upstream from the gene in question. B) downstream from the gene in question. C) within the gene in question. D) randomly in the genome. E) in an intron.

74)

Not all bacteria can take up DNA from the environment. Those that can are referred to as A) mutants. B) F −. C) F +. D) competent. E) transducers.

75)

Which of the following genera has proved useful for manipulating plant cells?

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A) Escherichia B) Bacillus C) Agrobacterium D) Pseudomonas E) Rhizobium

76)

The Ti plasmid is naturally found in A) Escherichia. B) Agrobacterium. C) Pseudomonas. D) Staphylococcus. E) E. coli AND Staphylococcus.

77)

The Ti plasmid is used as a vector to transfer DNA into A) viruses. B) bacteria. C) plant cells. D) animal cells. E) protozoa.

78)

Which of the following does not introduce DNA into a bacterial cell? A) Transcription B) Conjugation C) Transduction D) Transformation E) All of these introduce DNA into a cell.

79)

What do you know about a bacterium that is His -/Trp

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/Str

/Pen

A) It can be cultured on a selective medium containing histidine and penicillin. B) It can be cultured on a selective medium containing tryptophan and streptomycin. C) It can be cultured on a selective medium containing streptomycin and penicillin. D) It cannot be cultured on a selective medium containing histidine and tryptophan. E) It can be cultured anaerobically on a selective medium containing histidine and penicillin.

80)

Please select the INCORRECT statement regarding restriction-modification systems.

A) The restriction enzyme identifies and cuts a short nucleotide sequence in the virus genome. B) The restriction enzyme identifies and cuts a short nucleotide sequence in the bacterial genome. C) The modification enzyme adds methyl groups to bacterial nucleobases recognized by the restriction enzyme.  D) A restriction enzyme will not degrade DNA that has been methylated. E) The modification enzyme may add methyl groups to viral DNA.

81)

What is the pan-genome? A) The sum total of genes encoded by the various strains of a given species. B) The sum total of genes encoded by the various strains of Escherichia coli. C) DNA sequences found in all strains of a particular species. D) DNA sequences found in all strains of Escherichia coli. E) Segments of DNA that can move from one DNA molecule to another.

82)

Select the CORRECT statement regarding genomic islands.

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A) Genomic islandsare large DNA segments in a cell’s genome that originated in other species; pathogenicity islands are genomic islands that code for factors that allow an organism to cause disease. B) Genomic islandscode for factors that allow an organism to cause disease; pathogenicity islands are large DNA segments in a cell’s genome that originated in other species. C) Genomic islandsare large DNA segments in a cell’s genome that originated in other species; pathogenicity islands are genomic islands that code for factors that protect an organism from disease. D) Genomic islandsare large DNA segments in a cell’s genome that move from one place to another; pathogenicity islands are genomic islands that code for factors that allow an organism to cause disease. E) Genomic islandsare large DNA segments in a cell’s genome that originated in other species; pathogenicity islands are genomic islands that confer antibiotic resistance on an organism.

83)

What comprises the pan-genome of a given species? A) Core genome; accessory genome; unique genes B) Core genome; accessory genome C) Core genome; unique genes D) Core genome; accessory genome; unique genes; genomic islands E) Core genome; accessory genome; unique genes; pathogenicity islands

84) What would be the outcome if a bacterial cell failed to make a Cas nuclease-crRNA complex?  A) The cell would not recognize and destroy invading viral DNA. B) The cell would be unable to transcribe the CRISPR array. C) The cell would be unable to generate a CRISPR array. D) The bacterial cell would die. E) The cell would not be able to make a Cas nuclease.

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SECTION BREAK. Answer all the part questions. 85) A patient comes to see you complaining of a spider bite. He shows you a sore on his wrist—the area around it is red and swollen, and the lesion is leaking pus. The patient tells you he found a spider in his car, which is why he thinks this is a bite. He also tells you that he has been taking penicillin tablets that his wife had left over after being prescribed the drug a few months previously for pneumonia. Even though he has taken the tablets for four days,the lesion is not healing and that he is really feeling terrible, with pain, fever, and chills. You suspect that your patient has a wound infection, so you sample the pus and send it to the lab for analysis.

85.1) Your patient asks why the penicillin he has been taking hasn't helped his infection. Which of the following is a possible explanation for your patient? A) The patient has become resistant to penicillin and he needs to take a different medication. B) The bacteria causing the infection are resistant to penicillin; a different antibiotic is needed. C) Bacteria are never killed by a single type of antibiotic; combinations of drugs are needed. D) Penicillin has been overused by people and it no longer works against any bacteria; it can be used against viruses. E) The patient's body is neutralizing the antibiotic; he needs to take a probiotic to help the penicillin work.

85.2) The lab results indicate that the pus from your patient's "bite" contains clusters of spherical cells that stained purple in the Gram stain. You tell your patient that his wound contains bacteria from the genus______ and is classified as a ______ organism. A) Escherichia; Gram-negative B) Streptococcus; Gram-positive C) Staphylococcus; Gram-positive D) Streptobacillus; Gram-positive E) Vibrio; Gram-negative

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85.3) Further tests indicate that your patient has a methicillin-resistant Staphylococcus aureus (MRSA) infection. You explain to the patient that these bacteria are not impacted by penicillin or the related drug methicillin. This resistance is thought to have arisen originally by a random change in the cell's chromosome through a process called A) spontaneous mutation. B) antigenic variation. C) quorum sensing. D) vertical gene transfer. E) indirect selection.

85.4) Your patient asks whether there is any way for him to get rid of this infection. You tell him that he will be given a different antibiotic such as doxycycline. This antibiotic works by binding to a cell structure called the 30S ribosomal subunit, which stops the bacterial cells from growing by A) preventing DNA replication. B) inhibiting transcription. C) stopping capsule formation. D) inhibiting protein synthesis. E) preventing protein packaging.

85.5) You explain to your patient that there has been an increase in the number of strains of S. aureusthat are now resistant to methicillin. The gene conferring resistance has moved from one strain to another via mobile gene elements, an example of which is a(n) ______. A) bacteriovirus B) insertional divider C) histone D) transposon E) chromosome

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86) You are a volunteer for Nurses Without Borders and are being sent on a humanitarian mission. Youaresomewhat concerned because you have learned from the CDC website that antibiotic-resistant Haemophilus influenzaeis common in thecountry to which you are being sent. This encapsulated, Gram-negative bacterium can cause a variety of illnesses, including community-acquired pneumonia.You do some research on the geneticsofthis pathogen.

86.1) H. influenzaehas genes that it needs to make pili for attachment to host cells. These pili genes are not always expressed; sometimes the bacterium turns them off and does not produce pili. This is an example of A) phase variation. B) antigenic sensing. C) two-component control. D) transduction. E) gene splicing.

86.2) What concerns you most about the strain of H. influenzaethat you may be exposed to while you are away is antibiotic resistance. The genes for resistance can be acquired by this organism as naked DNA from the environment, an example of A) conjugation. B) transformation. C) induced mutation. D) vertical gene transfer. E) transduction.

86.3)

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Which of the following statements is CORRECT regarding transformation?

A) DNA is transferred from one bacterial cell to another by means of a bacteriophage. B) Transformation is the uptake of "naked" DNA from the environment. C) Transformation involves the formation of a sex pilus through which plasmid DNA is shared between bacteria. D) Transformation depends on a donor cell containing an F plasmid and a recipient cell that does not. E) Transformation is a process that depends on physical contact between two bacterial cells.

86.4) On further reading, you learn that strains of H. influenzaevary genotypically. Many of them have synonymous mutations. Select the TRUE statement regarding this type of mutation. A) It is a point mutation—a single base pair is altered, causing the change of one amino acid in the protein that changes the function of that protein. B) It is a point mutation—a single base pair is altered, causing the change of one amino acid in the protein that stops the correct formation of a protein. C) It is a point mutation—a single base pair is altered, causing the change of one amino acid in the protein that does not affect the function of that protein. D) It is a frameshift mutation—base pairs are added or deleted, causing the change of one or more amino acids in the protein but does not affect the function of that protein. E) It is a point mutation—several base pairs are altered, causing the change of many amino acids in the protein that completely changes the function of that protein.

86.5) Penicillin affects peptidoglycan synthesis. Pneumonia caused by penicillinresistant H. influenzae could likely be treated with an antibiotic that targets protein synthesis. ⊚ ⊚

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true false

87) You are completing a research project for a Microbiology honors class. You are working with two bacteria: E. coli and Deinococcus radiodurans. You inoculate each organism onto TSA plates, and you then expose the plates to ultraviolet (UV) radiation for a specified time. You then incubate the plates overnight at 37oC for 24 hours, after which you count the number of colonies on each plate. Your results are shown in the table. Colony number Exposure Time (seconds)

E. coli

D. radiodurans

150

153

137

153

152

151

Your mentor tests your knowledge about your project.

87.1)

UV light exposure forms

A) covalent bonds between the two strands of DNA. B) hydrogen bonds between the two strands of DNA. C) covalent bonds between adjacent thymine nucleobases on the same strand of DNA. D) covalent bonds between adjacent guanine and cytosine nucleobases on the same strand of DNA. E) hydrogen bonds between adjacent guanine and cytosine nucleobases on the same strand of DNA.

87.2) When bacteria are exposed to UV light, what type of mutation occurs and is it spontaneous or induced? A) Thymine dimer; induced B) Guanine trimer; induced C) Nucleotide substitution; spontaneous D) Insertional inactivation; induced E) Thymine trimer; spontaneous

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87.3)

How do thymine dimers cause the death of bacteria?

A) They distort the DNA molecule, and stop replication and transcription. Without repair, the cell dies. B) They distort RNA molecules, and stop transcription and translation. Without repair, the cell dies. C) They causes single- and double-stranded breaks in DNA, preventing replication. Without repair, the cell dies. D) They insert between adjacent pairs of nucleotides, leading to frameshift mutations that always kill a cell. E) They alter the base-pairing properties of all the nucleotides, so that the pairing becomes A-C and G-T; this always kills a cell.

87.4)

In your experiment, what is the control?

A) E. coli and D. radiodurans not exposed to UV at all (0 s). B) Exposing E. coli to UV while not exposing D. radiodurans to UV. C) Exposing D. radiodurans to UV while not exposing E. coli to UV. D) Exposing E. coli and D. radiodurans to UV for at least 80 s. E) Comparing growth of E. coli and D. radiodurans exposed to UV with growth of a different, unexposed organism.

87.5)

Consider your results and select the CORRECT statement.

A) UV radiation does not appear to cause mutation in D. radiodurans. B) E. coli and D. radiodurans are equally sensitive to UV radiation. C) UV radiation effectively eliminated 90% of the D. radiodurans cells. D) E. coli is able to repair any mutations caused by UV exposure. E) UV radiation effectively eliminated 80% of the E. coli cells.

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Answer Key Test name: Chap 08_10e 1) FALSE 2) TRUE 3) TRUE 4) TRUE 5) FALSE 6) FALSE 7) TRUE 8) TRUE 9) TRUE 10) TRUE 11) TRUE 12) TRUE 13) A 14) C 15) B 16) C 17) A 18) C 19) D 20) D 21) B 22) C 23) A 24) C 25) B 26) A Version 1

27) D 28) C 29) C 30) C 31) D 32) C 33) A 34) A 35) D 36) A 37) C 38) B 39) C 40) C 41) B 42) C 43) D 44) B 45) A 46) A 47) B 48) B 49) C 50) C 51) E 52) B 53) D 54) A 55) D 56) C Version 1

57) A 58) D 59) B 60) C 61) C 62) C 63) C 64) E 65) E 66) C 67) C 68) B 69) B 70) D 71) D 72) B 73) C 74) D 75) C 76) B 77) C 78) A 79) A 80) B 81) A 82) A 83) A 84) A 85) Section Break 85.1) B Version 1

85.2) C 85.3) A 85.4) D 85.5) D 86) Section Break 86.1) A 86.2) B 86.3) B 86.4) C 86.5) TRUE 87) Section Break 87.1) C 87.2) A 87.3) A 87.4) A 87.5) A

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CHAPTER 9 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Agarose gel electrophoresis may be considered as a partial purification technique. ⊚ ⊚

Most eukaryotic genes are cloned directly into the vector for expression in prokaryotes. ⊚ ⊚

true false

A very common vector is a plasmid. ⊚ ⊚

true false

Vectors must have at least one restriction enzyme recognition site. ⊚ ⊚

true false

PCR typically results in the generation of fragments of all sizes. ⊚ ⊚

true false

PCR is useful for amplifying a particular section of DNA. ⊚ ⊚

true false

When using lacZ containing vectors, colonies containing intact vector turn white. ⊚ true ⊚ false

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DNA probes are used to find regions of complementary DNA. ⊚ ⊚

FISH uses labeled probes to detect specific whole cells. ⊚ ⊚

10)

true false

A DNA microarray contains oligonucleotides that contain a label. ⊚ ⊚

11)

true false

Bacteria use CRISPR for gene editing. ⊚ ⊚

true false

12) It is useful to have a reference sequence when assembling DNA sequence data in high through-put methods because assembly will be quicker if two sequences can be compared. ⊚ ⊚

13)

true false

Cas9 nuclease cut both strands of target DNA while dCas9 cuts only one strand. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 14) Short tandem repeats (STRs)

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A) are useful in identifying specific individuals. B) are important sites in vectors where foreign DNA can be integrated. C) are errors that can arise during DNA sequencing. D) are DNA fragments generated during PCR. E) are generally found in exons.

15)

Mitochondrial DNA (mtDNA) in humans A) is always donated to the offspring from both parents. B) can be used to identify related people. C) can be isolated only from intact embryos. D) can be used to establish paternity. E) is linear, single-stranded DNA.

16)

DNA molecules that contain pieces of DNA from two different sources are defined as A) biotechnology. B) gene cloning. C) recombinant DNA. D) genetic engineering. E) mutation.

17)

Common vectors used for cloning genes are A) bacteria. B) viruses. C) nucleotides. D) plasmids. E) viruses AND plasmids.

18)

The molecules used to cut target DNA in genetic engineering are

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A) exonucleases. B) restriction enzymes. C) proteases. D) RNA polymerases. E) DNA ligases.

19)

Identify thestatementabout digestion of DNA by restriction enzymes that is NOT true. A) It produces sticky ends. B) It produces blunt ends. C) One strand of the DNA molecule is cut. D) It generates restriction fragments. E) Both strands of the DNA molecule are cut.

20)

Restriction enzymes have proved so useful in manipulating DNA because

A) they cut at defined sites AND the sticky ends make it very easy to allow recombination of DNA with RNA. B) they cut at random sites ANDthe sticky ends make it very easy to allow recombination of any type of DNA. C) they cut at defined sites AND the sticky ends make it very easy to allow recombination of any type of DNA. D) they protect eukaryotes against virus attack AND they cut both RNA and DNA. E) they protect eukaryotes against virus attack ANDthe sticky ends make it very easy to allow recombination of DNA with RNA.

21)

The molecule(s) that act as molecular glue to bind DNA fragments together is/are

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A) DNAse. B) DNA ligase. C) ligandase. D) polymerase. E) DNAse AND ligandase.

22)

Agarose gel electrophoresis separates nucleic acid fragments according to A) density. B) shape. C) size. D) nucleobase sequence. E) type of 5C sugar.

23)

The energy to separate fragments during agarose gel electrophoresis is supplied by A) gravity. B) electricity. C) active transport. D) agarosis. E) buffers.

24)

The agarose used in electrophoresis A) interacts electrically with the DNA. B) chemically binds to the DNA. C) separates DNA fragments by size. D) selectively sorts recombinant DNA from host DNA. E) denatures DNA/RNA.

25)

The gene for human insulin has been successfully cloned in

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A) S. aureus. B) E. coli. C) rhinovirus. D) human cells. E) pig cells.

26)

Genetic engineering

A) allows the use of bacteria as production factories for a number of molecules AND is dependent on RNA enzymes. B) relies on recombinant DNA technology AND relies completely on conjugation. C) allows the use of bacteria as production factories for a number of molecules ANDrelies completely on conjugation. D) allows the use of bacteria as production factories for a number of molecules AND relies on recombinant DNA technology. E) is dependent on RNA enzymes ANDrelies on recombinant DNA technology.

27)

Genetic engineering of plants has so far produced A) pest-resistant plants. B) plants that are herbicide resistant. C) plants with increased nutritional value. D) All of the answer choices are correct. E) None of the answer choices is correct.

28)

The entire set of cloned fragments of the complete human genome is termed a A) DNA library. B) book of genes. C) recombinant gene. D) restructured genome. E) genetic set.

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29)

Which of the following is NOT true about an ideal vector? A) A vector may be a plasmid or bacteriophage. B) A vector has a restriction enzyme recognition site. C) A vector contains an RNA primer. D) A vector contains an origin of replication. E) A vector contains a selectable marker.

30) the

Host cells containing recombinant DNA can be selected on the basis of the properties of

A) vector. B) ribosomes. C) enzymes. D) virus. E) introns.

31)

Selecting for transformants involves A) identifying organisms that have taken up recombinant DNA. B) identifying organisms that have taken up recombinant RNA. C) identifying organisms that are producingproteins. D) identifying organisms that are producingDNA. E) identifying organisms that are producing antibiotics.

32) Whichof the following is NOT true about laboratory strains of E. coli being desirable hosts for genetic engineering?

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A) E. coli is fastidious but can usuallybe grown in the lab. B) The genetics of E. coli is very well known. C) E. coli is especially able to express foreign genes. D) E. coli has known phenotypic characteristics. E) All of the answer choices are correct.

33)

A danger in using E. coli in cloning is that A) E. coli could cause disease. B) the outer membrane is toxic to humans. C) the human cells may reject the insertion. D) the exons may invert the introns. E) working with E. coli requires a BSL3laboratory.

34) When a vector that uses the lacZ gene as a second marker is used in a cloning experiment, bacteria that contain the recombinant DNA will give rise to A) red colonies. B) white colonies. C) blue colonies. D) cream colonies. E) All of the answer choices are correct.

35)

Goal(s) of gene cloning may be to produce

A) a protein. B) many copies of the gene to be used as a probe. C) many copies of the gene for sequencing. D) more copies of the host cell. E) a protein, many copies of the gene to be used as a probe, AND many copies of the gene for sequencing.

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36) In order to get around the lack of ability of prokaryotes to remove introns from precursor RNA, it may be necessary to A) use the DNA directly. B) use the DNA after it has been processed. C) use different promoters. D) generate cDNA from mRNA. E) turn cDNA into mRNA.

37)

Genetically modified food has raised some concerns because A) it contains radioactive nucleic acids. B) it contains very dangerous allergens. C) it releases radioactivity into the environment. D) the modified DNA may transfer to other organisms. E) All of the choicesare valid concerns.

38)

Knowing the sequence of a genome is useful in

A) identifying genetic alterations associated with disease AND studying evolutionary relationships. B) studying evolutionary relationships AND determining protein sequences. C) determining protein sequences AND identifying genetic alterations associated with disease. D) determining protein sequences BUT not identifying genetic changes. E) identifying genetic alterations associated with disease, studying evolutionary relationships, AND determining protein sequences.

39)

The polymerase chain reaction is used to duplicate small sections of

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A) DNA. B) RNA. C) proteins. D) lipids. E) lipopolysaccharides.

40)

The polymerase chain reaction is used to A) amplify mRNA. B) amplify certain sections of DNA. C) produce proteins. D) produce long polymers of carbohydrates to be used in electrophoresis. E) produce long polymers of amino acids to be used in electrophoresis.

41)

PCR is particularly useful in A) detecting viable yet non-culturable organisms. B) assessing impure (multiple types of bacteria present) samples. C) dealing with very small numbers of bacteria. D) relatively quickly producing results. E) All of the answer choices are correct.

42)

Double-stranded DNA will separate into two strands when exposed to A) high temperature AND low pH B) high pH AND low salt C) low temperature AND high salt D) low salt AND low pH E) high temperature AND high pH.

43)

Starting with a single piece of dsDNA, after 3 PCR cycles there are

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A) 2 additional pieces of dsDNA. B) 4 additional pieces of dsDNA. C) 8 additional pieces of dsDNA. D) 16 additional pieces of dsDNA. E) 1 additional piece of dsDNA.

44)

Taq polymerase is A) a reverse transcriptase. B) an RNA polymerase. C) an enzyme fromEscherichiacoli. D) a heat-stable DNA polymerase from Thermus aquaticus. E) an RNA polymerase AND an enzyme fromEscherichiacoli.

45)

PCR produces A) DNA fragments of all possible sizes. B) DNA fragments that are one nucleotide larger than the next fragment. C) DNA fragments of a particular size. D) protein fragments of all possible sizes. E) DNA fragments that are three nucleotides smaller than the previous fragment.

46)

The size of the amplified DNA fragment generated during PCR is determined by A) how many cycles are performed. B) the size of the template DNA. C) the location to which the primers anneal. D) how much Taqpolymeraseis used. E) the time for each cycle.

47)

All of the following are trueaboutDNA probes EXCEPT they

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A) may be obtained from denatured tagged dsDNA. B) are usually tagged dsRNA. C) may be obtained from similar genes from another organism. D) may be synthesized usually using information based on the protein sequence. E) may be tagged with a fluorescent dye.

48) A common way to identify the E. coli that carries the desired recombinant DNA is by using a(n) A) vector. B) probe. C) host. D) plasmid. E) antibiotic.

49)

Which of the following aboutDNA microarray technology is NOT true?

A) It may use many DNA fragments that function like probes. B) It involves attachingnucleotides to a solid support such as a glass slide. C) It relies on visual detection of the labeled probes after hybridization. D) It uses nucleic acid hybridization. E) It involves the use of fluorescently labeled singe-stranded cDNA.

50)

Fluorescence in situ hybridization (FISH)

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A) uses virus hosts, uses a labeled probe, AND is useful in microbial ecology. B) uses a labeled probe, allows identification of particular bacterial groups in mixed samples, AND uses virus hosts. C) is useful in microbial ecology, allows identification of particular bacterial groups in mixed samples AND depends on electron microscopy. D) uses a labeled probe, is useful in microbial ecology, AND allows identification of particular bacterial groups in mixed samples. E) is useful in microbial ecology, allows identification of particular bacterial groups in mixed samples AND uses virus hosts.

51) Possessing the entire sequence of a particular human genome may not be as useful as we think. Why not? A) Every human genomeis different enough that knowing ONE human's DNA sequence can't tell us almostanything about ALL humans. B) It's not the DNA sequence that matters—we need to know the mRNA sequence of the human genome. C) Due to the presence of introns/exons, and splicing of RNA after transcription, the DNA sequence doesn't necessarily tell us the exact number/type of proteins that will eventually be made from it. D) The amount of "junk DNA" present in the human genome masks any useful genetic information that we'd like to obtain. E) Due to the presence of introns/exons, and pre-transcriptional modification, the protein profile varies considerably among people, so it would be better to determine that.

52) Polymerase chain reaction (PCR) can be used to perform DNA sequencing reactions. In this case, are two primers (a forward and a reverse) necessary?

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A) Yes—you can't perform PCR without two specific primers to amplify the region in question in the DNA. B) No—dideoxynucleotide sequencing depends on different length fragments being formed and then separated based on size. This can take place with only a specific forward OR a specific reverse primer. C) No—you actually need a primer pair for each round of DNA amplification ... so you'll need many, many primer pairs, depending how many rounds you plan to do. D) Yes—and it will be important to make sure that the primer pairs are made with dideoxynucleotides that are labeled with fluorescent dyes. Otherwise, you won't be able to detect the fragments that are made in the PCR process. E) Yes—if you only have one primer, you will only be able to determine the dideoxynucleotidesequence of RNA, which is a single-stranded molecule.

53)

In a FISH experiment, what would happen if unbound probe was not washed off?

A) Nothing—it's not necessary to wash off the unbound probe and doing so just adds an extra step to the procedure. B) You would get false-positive results in different areas where the probe hadn't actually bound, but it was still sitting there and lighting up. C) Your FISH would befloating at the top of the tank due to the toxicity of the probe building upwithin them. D) Nothing—the target nucleotide sequences are labeled, not the probe. Therefore, excess unbound probe wouldn't matter for the experiment. E) You would get an intermediate color on the array because of the presence of both bound and unbound probes that fluoresceat different temperatures.

54) A graduate student wants to clone a particular gene into a plasmid. The sequence includes AluI and BamHI sites on both sides of the desired fragment. AluI cuts symmetrically directly between the G and C nucleotides in a palindromic 5' AGCT 3' sequence. BamHI cuts asymmetrically directly between the G and G nucleotides in a palindromic 5' GGATCC 3' sequence. Which of the two restriction endonucleases should the graduate student choose, and why?

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A) BamHI to cut both sides—since this enzyme cuts asymmetrically, it'll leave the sticky, cohesive single-strand DNA ends that will make it easier to ligate into a BamHI-cut plasmid DNA sequence. B) AluI to cut both sides—it's always easier to ligate together blunt ends of DNA. She should also use AluI on the plasmid she wants to put the fragment into. C) BamHI on the fragment, and AluI on the plasmid—this will give her the matching sequences to anneal/ligate together on the fragment/plasmid combination. D) BamHI on one side of the fragment, and AluI on the other side—this would keep the fragment from sticking right back to where it was cut out from in the original DNA. E) Neither of these endonucleases will really be useful; she should look for a single enzyme that creates either blunt ends or sticky ends, depending on the plasmid that she is using as a vector.

55)

Why must an agarose gel be placed in a buffer solution for DNA gel electrophoresis?

A) Ions in the buffer conduct the electric current needed to move the DNA fragments in the gel matrix. B) The DNA fragments will disintegrate unless there is a buffer present to prevent this from happening. C) Even distilled, autoclaved water has a high number of DNases in it that would destroy the DNA. D) The buffer contains phosphates, and the DNA fragments must be phosphorylatedbefore they move in agarose. E) DNA cannot be detected unless buffer is added to the system; the buffer colors the DNA fragments for visualization.

56) You are examining the DNA profile of an unknown pathogen. The pathogen's DNA has been digested with EcoRI restriction enzyme. There are 7 bands on DNA on the gel. Which of the following is NOT true?

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A) The original piece of DNA has seven EcoRI restriction sites. B) The original piece of DNA has six EcoRI restriction sites. C) The DNA has not been completely restricted. D) The restriction enzyme has been denatured. E) The restriction enzyme EcoRIwas isolated from E. coli.

57) Scientists have cloned the human insulin gene into E. coli. Which of the following would NOT have been used in the procedure? A) A plasmid B) Competent bacteria C) A restriction enzyme D) DNA ligase E) A bacteriophage

58)

Plasmids work well for insertion of foreign DNA into a cell. Which statement is FALSE? A) Plasmids have an origin of replication. B) Plasmids are relatively small compared with a chromosome. C) Plasmids can replicate independent of the chromosome. D) Plasmids usually contain a selectable marker such as antibiotic resistance. E) All known bacteria contain plasmids of some kind.

59)

Human DNA cut with restriction enzyme A can be joined to A) uncut human DNA. B) uncut bacterial DNA. C) bacterial DNA cut with restriction enzyme H. D) bacterial DNA cut with restriction enzyme A. E) bacterial DNA cut with a human restriction enzyme.

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60)

During PCR, which primer anneals to template DNA at its 3' end? A) The forward primer only. B) The reverse primer only. C) Either the forward primer or the reverse primer. D) Both the forward primer and the reverse primer. E) Primers don't bind to template DNA.

61) Identify the correct sequence in which the steps below occur during a single PCR cycle. 1. Complementary base pairing between primers and target DNA. 2. Addition of DNA nucleotides byTaqDNA polymerase. 3. Heat separation of strands of target DNA. A) 3; 1; 2 B) 1; 2; 3 C) 1; 3; 2 D) 2; 3; 1 E) 2; 1; 3

62) The sequence of cDNA synthesized from an mRNA template with the sequence AUGGUA would be ______. This cDNA probe would hybridize to gene chip DNA with the sequence ______. A) UACCAU; ATGGTA B) TACCAT; AUGGUA C) AUGGUA;AUGGUA D) TACCAT; ATGGTA E) AUGGUA; TACCAT

63)

Which of the following is a reason that restriction enzymes are useful in biotechnology?

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A) Some of them generate "sticky ends" when they cut, making it easy to join DNA fragments. B) They are bacterial enzymes, so they are useful for bacterial engineering. C) They produce fragments of regular size, essential for genetic engineering. D) They can generate a DNA copy of an RNA fragment for cloning. E) Bacteria can use them for genome replication in cells lacking polymerase.

64)

Which of the following recombinant proteins may be used to treat a microbial infection? A) Interferon alpha B) Platelet derived growth factor C) Factor VIII D) Tissue plasminogen activator E) Insulin

65)

Which of the following is NOT an application molecular cloning? A) Determining the nucleotide sequence of a bacterial genome. B) Determining the function of a particular gene by silencing it. C) Production of a vaccine such as the hepatitis B vaccine. D) Production of human insulin by bacterial cells. E) Development of antibiotic resistance in bacteria.

66)

These are all steps in creating a DNA library EXCEPT A) Total cellular DNA is extracted and cut into fragments using restrition enzymes. B) DNA fragments are cloned into the plasmid using DNA polymerase. C) A plasmid with selectable markers is cut using the same restriction enzyme. D) Recombinant plasmids are introduced into competent bacteria. E) Transformed bacteria are grown on differential/ selective medium.

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67) During generation of a DNA library, once a DNA fragment has been successfully joined with a vector A) the selectable marker is still functional but the second genetic marker is not functional. B) the selectable marker is no longer functional but the second genetic marker is functional. C) neither the selectable marker nor the second genetic marker is still functional. D) both the selectable marker and the second genetic marker arestill functional. E) the multiple cloning site is substituted with a selectable marker gene.

68)

What enzyme is used to generate cDNA from pre-mRNA? A) Reverse transcriptase B) DNA polymerase C) RNA polymerase D) ATP synthase E) DNA ligase

69)

Select the INCORRECT statement regarding CRISPR-Cas technology. A) Cas9 nucleases cut DNA at a target site. B) dCas9 binds to but does not cut target DNA. C) gRNA contains guanisine in place of uracil. D) gRNA directs Cas9 nucleases to target sites. E) dCas9 is used for studying gene function.

70)

All of the following are examples of gene function studies using dCas9 EXCEPT

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A) delivery of an activator that turns on gene expression. B) methylation of DNA to study effects of DNA modification. C) tagging DNA with a detectable marker. D) blocking transctiption of a particular gene. E) creating a recombinant DNA molecule.

71)

Which of the following is not a reasonable concern regarding biotechnology? A) Risk that genetically modified foods contain DNA. B) Risk that GMOs may impact the environment. C) Risk that CRISPR-Cas technology may be used unethically. D) Risk that GM food may contain unexpected allergens. E) Risk that genes from a GMO may get into a different species.

72)

Why is the concern that genetically modified foods contain DNA an unfounded one? A) All food contains DNA; every cell has DNA in it. B) Genetically modified food doesn't have any DNA in it; it's food. C) Even if the food has DNA in it, cooking removes the DNA. D) Genetic modification techniques involve RNA, not DNA. E) Genetically modified foods are not real, so there's no problem.

73)

All of the following are concerns about biotechnology EXCEPT A) the use of biotechnology in cancer and disease diagnostics. B) the risk of GMOs having an unintended negative environmental impact. C) the possibility that microbes are modified for use in bioterrorism. D) the possibility of using it for treating a genetic disease. E) using biotechnology to generate products such as insulin.

74)

Which of the following is not a direct application of sequencing?

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A) Editing a mutated gene in an organism. B) Determining evolutionary relatedness of microbes. C) Tracking pathogens in an outbreak. D) Gaining insights into protein function. E) Studying gene expression in an organism.

75)

Whole genome sequencing has been used for all of the following EXCEPT: A) identifying cancer genes. B) determining evolutionary relatedness among organisms. C) tracking pathogens around the globe. D) initiating pathogenic outbreaks. E) understanding the role of certain proteins.

76) In late 2019, a novel coronavirus, SARS-CoV-2 was reported in China. The virus, which has an RNA genome, spread rapidly around the globe, starting a pandemic that is still ongoing. Within weeks of identifying the virus, scientists published its complete genome sequence, using A) RNA-seq. B) DNA cloning. C) gel electrophoresis. D) pan genomics. E) proteomics.

77)

What is cDNA?

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A) DNA synthesized from an mRNA template (copy DNA). It does not contain introns. B) DNA synthesized from an mRNA template (copy DNA). It does not contain exons. C) DNA synthesized from a chloroplast mRNA template (copy DNA). It does not contain introns. D) DNA synthesized from a chloroplast mRNA template (copy DNA). It does not contain exons. E) Clonal DNA obtained from a selection of highly related microorganisms.

78)

What is a DNA library?

A) A collection of clones that together contain the entire genome of an organism. B) A collection of clones that together contain all of the introns of an organism. C) A collection of clones that together contain all of the exons and proteins of an organism. D) A repository in which samples of DNA from all organisms can be found. E) A place where DNA can be studied in depth.

SECTION BREAK. Answer all the part questions. 79) Sexually transmitted human papillomavirus (HPV) strains are among the most common of the sexually transmitted infection (STI) agents.Some HPV strains(low risk) cause papillomas—warty growths of the external and internal genitalia. Other strains (high risk) cause lesions of mucosal surfaces and are more problematic—approximately 15 of these strains are strongly associated with cancer of the cervix, penis, rectum, vagina, orthroat. These high-risk strains include HPVs 16, 18, 31, and 45. You have been asked to give a short presentation on HPV and its detection by PCR (the HPV test). Following your presentation, you answer questions from your audience.

79.1) HPV is a non-enveloped, double stranded DNA virus. What are the components of this virus?

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A) DNA and protein B) RNA and protein C) DNA, RNA, and protein D) DNA, protein, and phospholipids E) RNA, protein, and phospholipids

79.2)

Which is the CORRECT definition of PCR?

A) Use of the enzyme reverse transcriptase to generate cDNA frommRNA, and then amplifying the cDNAexponentially using RNA polymerase. B) In vitro process of determining the nucleotide sequence of a DNA molecule using a variety of enzymes. C) In vitro technique used to repeatedly duplicate (amplify) a specific region of a DNA molecule, increasing the number of copies exponentially. D) Procedure in which a fragment of DNA is inserted into a vector and then transferred into another cell, where it then replicates. E) The process in which two complementary strands of DNA from different sources are annealed to create a hybrid double-stranded molecule.

79.3) The DNA polymerase used in PCR comes from the bacterium thermophile Thermus aquaticus, and is called Taq polymerase. Why is this enzyme used, and not a DNA polymerase from an organism such as E. coli?

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A) The DNA synthesis step of the PCR cycle occurs at 95 oC; Taq polymerase is from a bacterium that grows in high temperatures andcan function at this temperature, while DNA polymerase from a mesophile such as E. coli would be denatured at this temperature. B) The DNA synthesis step of the PCR cycle occurs at72 oC; Taq polymerase can function at this temperature, while DNA polymerase from a mesophile such as E. coli requires significantly higher temperatures in order to function correctly. C) E. coli is an RNA organismand therefore depends on RNA polymerase for its replication cycle; it is not possible to obtain DNA polymerase from this bacterium. D) The DNA synthesis step of the PCR cycle occurs at72 oC; Taq polymerase is from a bacterium that grows in high temperatures andcan function at this temperature, while DNA polymerase from a mesophile such as E. coli would be denatured at this temperature. E) DNA polymerase from Thermus aquaticusis a very active enzyme. It is able to synthesize DNA at a faster rate than any other known DNA polymerase which is important because the key to successful PCR is a speedy reaction.

79.4) HPV is a DNA virus and can be detected in a sample using PCR. Is it possible to detect an RNA virus using this technique or something similar? A) No; there is no known process by which RNA can be copied because the subunits of RNA are amino acids and these cannot be amplified without the use of ribosomes. B) Yes; a variation of PCR is RT-PCR in which an enzyme called reverse transcriptasegenerates cDNA frommRNA in a sample, and that cDNA is then amplified exponentially. C) Yes; Taq polymerase is a unique DNA polymerase that can copy either RNA or DNA, so it doesn't matter what type of virus is present—the enzyme will still detect it in a PCR reaction. D) No; PCR can only be carried out on a double-stranded molecule such as DNA, and RNA is a single-stranded molecule. E) There is no answer to this question because nobody has ever tried to amplify RNA; viruses contain both DNA and RNA so it is always possible to detect the DNA component.

79.5) PCR generates a DNA fragment of a distinct size even when the whole viral chromosome is used as a template. What determines the boundaries of the amplified fragment?

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A) The concentration of one particular deoxynucleotide in the reaction.  B) The length of time of the elongation step in each cycle.  C) The position of a termination sequence, which causes the Taq polymerase to fall off the template. D) The sites on the template DNA to which the specific primers used in the reaction anneal.  E) The temperature at which the elongation step in each cycle is carried out. <!-Markup Copied from Habitat-->

79.6) If PCR is carried out on a sample using primers specific for HPV 16 and no DNA is amplified, can a person assume that they are HPV-free? A) No. The person likely does not have HPV16but they may have another HPV strain. B) Yes. If there is no HPV16 present, there definitely won't be any other strain of HPV present either. C) Yes. Primers specific for HPV 16 would also detect all other strains of HPV, so a negative test indicates the person is free of any HPV. D) No. The negative result simply indicates that HPV is not a DNA virus but is in fact an RNA virus. E) No. The negative result simply indicates that HPV is not a DNA virus but is in fact a bacterium which has a different type of DNA.

80) Tuberculosis (TB) is caused by the acid-fast bacterium Mycobacterium tuberculosis. Although most TB cases affect the lungs (pulmonary TB), some infections occur in other body sites (extrapulmonary TB). Amongthese cases, lymph node tuberculosis (LNTB) is the most common. Diagnosis of LNTB by conventional methods (staining, biochemical tests) has limitations—for example, formaldehyde preservation of tissue biopsies interferes with the acidfast stain, leading to underdiagnosisor misdiagnosis. Now fluorescencein situ hybridization (FISH) is being used to diagnose extrapulmonaryTB.

80.1) When a tissue sample such as lymph node tissue is to be analyzed by FISH, it must first be treated with chemicals. Which of the following is NOT a reason that this step is needed? Version 1

A) To maintain cell shape. B) Toinactivate enzymes that might otherwise degrade the nucleic acid of the cells. <!-Markup Copied from Habitat--> C) Tomake the cells more permeable so that the labeled probe can easily enter. <!-Markup Copied from Habitat--> D) Toinactivate enzymes that might otherwise degrade the nucleic acid of the cells AND to maintain cell shape. E) To break down the cellulose walls of the tissue so that the probes can enter those cells.

80.2) When detecting microorganisms, a probe that hybridizes to sequences on ribosomal RNA (rRNA) is generally used. This is because  A) not all bacteria have DNA but they all have large quantities of ribosomal RNA. B) rRNA is in the cytoplasm so is easy to detect but DNA is in the nucleus so is harder to detect. C) cells that are dividing can have thousands of copies of rRNA, increasing the technique’s sensitivity. D) RNA is a single-stranded molecule but DNA is a triple helix and must be denatured. E) These are all reasons that rRNA is targeted.

80.3) In a recent research article describing the use of FISH to detect LNTB, the authors noted that they used probes that were only 20 base pairs (bp) in length rather than the conventional 100 bp—500 bp. Given what you know about acid-fast bacteria, why do you think they took this approach?

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A) The nature of the Mycobacterial cytoplasmic membrane likely makes is difficult for larger probes to enter the cell. B) The nature of the Mycobacterial capsule likely makes is difficult for larger probes to enter the cell. C) The nature of the Mycobacterial cell wall likely makes is difficult for larger probes to enter the cell. D) Mycobacteriahave alipopolysaccharide outer membrane through which larger probes cannot enter. E) Mycobacteria have smaller ribosomes than any other bacteria and the probes are targeted at rRNA.

80.4)

How are target cells identified using the FISH technique?

A) Using an electron microscope. B) Using DNA microarrays. C) UsingDNA sequencing. D) Using a fluorescence microscope. E) By detecting UV levels.

80.5) What would the outcome be if you forgot to do the washing step when carrying out FISH on a sample containing bacteria? A) Nothing. The washing step is recommended but is not necessary and can be omitted. B) Unbound probe would remain on the slide and would fluoresce, making it impossible to see individual cells. C) The unbound probe would anneal strongly to the glass slide in random patterns that would look like bacteria. D) The unbound probe would cause lysis ofthe target bacterial cells, destroying their nuclei and mitochondria. E) Nothing. Unbound probe will not fluoresce, so even if it is present, it will not affect the results.

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81) You are an RN who works with kidney transplant patients. Your patients take immune suppression medications to reduce the chance that they will reject their new organs. However, you know that these drugs also put your patients at risk of getting sick from infections. They have to be closely monitored for signs of both tissue rejection and infection. Usually this is done by blood tests and tissue biopsies, but these methods are invasive, time-consuming and expensive. A novel urine-based diagnostic approach using a bacterial system called CRISPR-Cas has now beendeveloped. CRISPR-Cas systems were first discovered in bacteria when scientists found very small pieces of phage (virus) DNA in these cells. They understood that bacteria use CRISPR-Cas to protect themselves against foreign DNA: they use CRISPR and Cas, a nucleaseenzyme, to recognizeand destroyinvading DNA.Modifications of the CRISPR-Cas systemhave now been developed for diagnostics. In these, Cas is directed to a target sequence ofDNA with the help of a small piece of RNA called guide RNA (gRNA). When Caslocates andbinds to the target DNA sequence, it cleaves it and at the same time, a reporter molecule attached to Cas is activated. When this happens,a color or a flourescent signal is emited that can then be detected.The system promises to be highly accurate and sensitive, and has the advantage that the test can be performed on urine samples. Ultimately, they may be done at home, like a pregnancy test. You are educating your patients in the potential use of CRISPR-Cas in diagnostics.

81.1) CRISPR systemswere discovered when scientists recognized that certain bacterial genomes include very small pieces of phage DNA.  ⊚ ⊚

true false

81.2)

What is the function of gRNA in CRISPR-Cas technologies?

A) It cuts DNA at a targeted sequence and inserts a new sequence. B) It cuts protein at a targeted sequence and inserts a new sequence. C) It ensures the Cas enzyme cuts at the correct place in the target DNA. D) It ensures the Cas enzyme cuts at the correct place in the RNA. E) It replaces uracil nucleotides with thymine nucleotides.

81.3)

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When CRISPR is used in diagnostics, a positive result would be indicated by

A) detection of color or a flourescent signal. B) detection of virus DNA in the sample. C) the presence of CRISPR in your patient's samples. D) the presence of novel gRNA in your patient's samples. E) the identification of Cas by color coding.

81.4) If you were to use CRISPR diagnostics to check for infection in your kidney transplant patient, what critical information woud you need? A) Which pathogen(s) you suspect has/have infected your patient. B) The genome sequence of your patient's microbiome. C) Whether your patient faints at the sight of blood. D) Whether your patient has an allergy to CRISPR-Cas. E) Whether your patient can make gRNA in his/her microbiome.

81.5)

What is the function of the reporter molecule in CRISPR diagnostics?

A) When Cas binds to and cleaves target DNA, the reporter molecule on the enzyme is activated and emits a detectable signal. B) The reporter molecule contains a fluorescent dye that allows the technician to determine whether the patient's sample has any DNA in it. C) The reporter molecule is a protein that directs the Cas nuclease to the correct site on the target DNA. D) The reporter molecule is a single-stranded RNA that directs the Cas nuclease to the correct site on the target DNA. E) The reporter molecule connects CRISPR and Cas via peptide bonds, so that they can be used as a unit in diagnosing tissue rejection.

81.6) Which of the following is NOT given as an advantage of using CRISPR-Cas in diagnosing infections in kidney transplant patients?

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A) It is based on urine samples, so is not invasive. B) It is a very sensitive approach. C) It may eventually be available as a home test kit. D) It will protect the patient's kidney from invading DNA. E) It is a very accurate approach.

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Answer Key Test name: Chap 09_10e 1) TRUE 2) FALSE 3) TRUE 4) FALSE 5) TRUE 6) TRUE 7) FALSE 8) TRUE 9) TRUE 10) TRUE 11) FALSE 12) TRUE 13) FALSE 14) A 15) B 16) C 17) E 18) B 19) C 20) C 21) B 22) C 23) B 24) C 25) B 26) D Version 1

27) D 28) A 29) C 30) A 31) A 32) A 33) B 34) B 35) E 36) D 37) D 38) E 39) A 40) B 41) E 42) E 43) C 44) D 45) C 46) C 47) B 48) B 49) C 50) D 51) C 52) B 53) B 54) A 55) A 56) A Version 1

57) E 58) E 59) D 60) D 61) A 62) D 63) A 64) A 65) E 66) B 67) A 68) A 69) C 70) E 71) A 72) A 73) A 74) A 75) D 76) A 77) A 78) A 79) Section Break 79.1) A 79.2) C 79.3) D 79.4) B 79.5) D 79.6) A 80) Section Break Version 1

80.1) E 80.2) C 80.3) C 80.4) D 80.5) B 81) Section Break 81.1) TRUE 81.2) C 81.3) A 81.4) A 81.5) A 81.6) D

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CHAPTER 10 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The three domain systems consist of Archaea, Bacteria, and Eukarya. ⊚ true ⊚ false

2) All known species of bacteria are described in Bergey's Manual of Systematic Bacteriology. ⊚ ⊚

true false

3) Size and shape may allow one to differentiate between a bacterium, fungus, and protozoan. ⊚ ⊚

true false

Serratia marcescenscolonies are red when incubated at 37°C. ⊚ ⊚

true false

5) Streptococcus pyogenes can be easily distinguished microscopically from other Streptococcus species. ⊚ ⊚

Based on DNA hybridization, humans and chimpanzees are the same species. ⊚ ⊚

true false

rRNA sequence comparisons are useful for determining evolutionary relationships.

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⊚ ⊚

If each of two bacteria have a GC content of 50%, they are both definitely closely related. ⊚ ⊚

true false

Horizontal DNA transfer may make it more difficult to construct phylogenetic trees. ⊚ ⊚

true false

10) A probe is a single-stranded piece of nucleic acid labeled with a detectable marker, used to locate a unique nucleotide sequence that identifies a particular microbial species.  ⊚ ⊚

true false

11) Strains of an organism can always reliably be identifiedusing RFLPs(restriction fragment length polymorphisms). ⊚ ⊚

true false

12) You isolate a prokaryote. After performing analysis on the organism, youcannot find a description matching that of your organism in the reference text Bergey’s Manual of Systematic Bacteriology. This suggests that you have likely isolated a new organism. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 13) An early attempt by Cohn at bacterial classification grouped bacteria according to their Version 1

A) biochemistry. B) Gram stain. C) shape. D) arrangement. E) size.

14)

In 1908 Orla-Jensen suggested that bacteria be grouped according to their A) arrangement. B) morphology. C) physiology. D) Gram stain. E) flagella.

15)

In the 1930s Kluyver and van Niel proposed a classification scheme based on A) Gram reactions. B) biochemical relationships. C) DNA sequences. D) presumed evolutionary relationships. E) cell wall.

16)

In 1970 Stanier proposed that classification be based on A) evolution. B) Gram stain. C) physiology. D) DNA sequence. E) flagella.

17)

Woese

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A) was involved in determining rRNA sequences AND proposed breaking prokaryotes into two groups. B) was involved in determining rRNA sequences AND proposed breaking eukaryotes into domains Archaea and Bacteria. C) proposed breaking prokaryotes into two groups AND was involved in refining the Gram stain for classification purposes. D) proposed breaking eukaryotes into domains Archaea and Bacteria ANDwas involved in refining the Gram stain for classification purposes. E) was involved in determining DNA sequences AND proposed breaking eukaryotes into domains Archaea and Bacteria.

18)

Which technique(s) is/are used to help identify and classify bacteria? A) Microscopic examination B) Culture characteristics C) Biochemical tests D) Nucleic acid analysis E) All of the choices are correct.

19)

In higher organisms, successful mating can occur between members of the same A) genus. B) species. C) class. D) order. E) family.

20)

From most general to most specific, which is the correct order?

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A) Phylum, class, kingdom, order, family, genus, species B) Kingdom, phylum, class, order, family, genus, species C) Kingdom, phylum, family, class, order, genus, species D) Kingdom, order, family, genus, phylum, class, species E) Genus, species, class, order, phylum, kingdom, family

21)

The basic taxonomic unit in the classification scheme of plants and animals is A) kingdom. B) class. C) order. D) genus. E) species.

22)

The three domain classification scheme uses A) order, phylum, class. B) Archaea, Bacteria, Eukarya. C) Plants, Animals, Bacteria. D) Protista, Prokaryotae, Fungi. E) Bacteria, Archaea, Animalia

23)

The reference for taxonomic descriptions of bacteria is A) Gray's Anatomy. B) Websters Manual of Taxonomic Bacteriology. C) Bergey's Manual of Systematic Bacteriology. D) Big Book of Bacteriology. E) Oxford Book of Bacterial Classification.

24)

The name Lactococcus (Streptococcus) lactis

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A) indicates that Streptococcus is the old genus name. B) indicates that the subgenus is Streptococcus. C) indicates that the family is Lactococcus. D) indicates that Lactococcus is the old class name. E) indicates that Lactis is the strain.

25)

Very often clinically relevant information may be obtained by examining A) a wet mount. B) the size and shape of the organism. C) the sequence of the organism's proteins. D) the transformation ability of the organism. E) a wet mount AND the size and shape of the organism.

26)

Gram-positive encapsulated diplococci found in sputum are likely A) Escherichiacoli. B) Pseudomonas aeruginosa. C) Streptococcus pneumoniae. D) Neisseria gonorrhea. E) Bacillus cereus.

27) Intracellular Gram-negative diplococci found in a urethral sample from a male is indicative of A) Escherichiacoli. B) Pseudomonas aeruginosa. C) Streptococcus pneumoniae. D) Neisseria gonorrhoeae. E) Staphylococcus epidermidis.

28)

Mycobacterium tuberculosis is one of the few species of bacteria that

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A) is encapsulated. B) is acid-fast. C) stains Gram-negative. D) stains Gram-positive. E) lacks a peptidoglycan cell wall.

29)

A soluble greenish pigment is produced by A) Serratia marcescens. B) Pseudomonas aeruginosa. C) Escherichiacoli. D) all streptococci. E) Streptococcus pneumoniae.

30)

A selective growth medium A) allows only certain bacteria to grow. B) allows all bacteria to grow. C) allows no bacteria to grow. D) accentuates differences between the growing bacteria. E) is cultured anaerobically.

31)

Streptococcus pyogenes would be A) beta hemolytic ANDcatalase negative. B) beta hemolytic AND catalase positive. C) alpha hemolytic AND catalase negative. D) alpha hemolytic AND catalase positive. E) gamma hemolytic AND catalase neutral.

32)

Media that change color as a result of the biochemical activity of growing bacteria

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A) usually contain a pH indicator. B) usually contain blood. C) usually require the addition of various reagents before the color is evident. D) contain a colorless reagent that breaks down. E) are always selective media.

33) A breath test assaying for radioactive carbon dioxide may be used to indicate the presence of A) E. coli. B) Pseudomonasspecies. C) Streptococcus pyogenes. D) Helicobacter pylori. E) Bacillus cereus.

34)

APITM, EnterotubeTM, and VitekTM are all A) methods for extracting DNA from bacteria. B) used to measure gas production. C) commercially available methods used to identify bacteria. D) used to show the presence of bacteria in a sample. E) methods for extracting protein from bacteria.

35)

Serological methods A) are useful in identifying bacteria. B) always rely on microscopy to view antigen-antibody reactions. C) may be simple but are always time consuming. D) can rarely be used to identify bacteria. E) All of the answer choices are correct.

36)

Nucleic acid techniques have great power as diagnostic tools because they may be

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A) used to differentiate species. B) quick and easy to perform. C) used to enhance the growth of bacteria. D) used toinhibit the growth of certain bacteria. E) All of the answer choices are correct.

37)

DNA probes have been very useful in A) coding the DNA of organisms grown in vivo. B) identifying organisms in pure culture. C) detecting toxins. D) diagnosing diseases of protozoa. E) sequencing rRNAgenes.

38) Organisms that grow very slowly, cannot be cultured, are present in very small numbers, or are mixed with a number of other bacteria may still be identified using A) Southern blotting. B) replica plating. C) PCR. D) the Ames test. E) positive selection.

39)

Which of the rRNA molecules has proven the most useful in taxonomy/identification? A) 5S B) 16S C) 23S D) 80S E) 70S

40)

Two isolates with identical RFLPs are considered

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A) definitely the same strain. B) different strains. C) possibly the same strain. D) different genera. E) identical.

41)

Strain differences are helpful in A) understanding replica plating. B) carrying out electrophoresis. C) performing transformation in the laboratory. D) initiating transduction in E. coli. E) tracing the source of outbreaks of disease.

42)

Various strains of E. coli A) may cause disease. B) may be harmless. C) are all exactly the same. D) are all very different from one another. E) may cause disease AND may be harmless.

43) E. coli 0157:H7 produces clear colonies on MacConkey agar, while common strains of the organism produce pink colonies on this medium. The organism stains pink in the Gram stain. Select the TRUE statement, given this information. A) E.coli0157:H7 is Gram-positive ANDis a normal constituent of the intestinal tract. B) E.coli0157:H7is a normal constituent of the intestinal tract AND does not ferment sorbitol. C) E.coli0157:H7 does not ferment sorbitol AND is Gram negative. D) E.coli0157:H7does not ferment sorbitol AND is Gram-positive. E) E.coli0157:H7produces a toxin AND is a normal constituent of the intestinal tract.

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44)

In E. coli O157:H7, the O157:H7 refers to the A) specific type of DNA present. B) specific genus. C) general family. D) the specific LPS and flagella type present. E) pathogenic ability.

45)

Phenotypically identical bacteria A) are genetically exactly the same. B) may be told apart by DNA sequence analysis. C) have similar protein profiles. D) cannot be told apart by any means. E) are referred to by the strain O157:H7.

46)

Phage typing A) is useful for determining eukaryotic cell types. B) is used to extract DNA from cells. C) is used to distinguish bacterial strains. D) is dependent on the type of eukaryotic cell. E) is used to distinguish bacterial strains AND is dependent on the type of eukaryotic

cell.

47)

The more closely related two organisms are,

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A) the less likely they belong to one genus. B) the more similar their nucleic acid sequence. C) the less similar their nucleic acid sequence. D) the more they are phenotypically similar. E) the less they are phenotypically similar.

48)

The point at which two organisms diverged from a common ancestor A) can be determined by comparing the nucleic acid sequences. B) depends on transcriptional and translational control. C) depends on metabolic activity and antibiotic resistance. D) is determined on MacConkey's media. E) is impossible to determine.

49)

Modern approaches to evolutionary taxonomy often involve A) biochemical differences. B) comparison of DNA or RNA. C) protein similarities. D) lactose fermentation abilities. E) staining techniques.

50)

To study the phylogeny of eukaryotes, A) 16S rRNA is used. B) 18S rRNA is used. C) 40S rRNA is used. D) 80S rRNA is used. E) 70S rRNA is used.

51)

Sequencing of rRNA is useful for

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A) determining evolutionary relationships ANDdetermining protein sequences. B) determining protein sequences AND identification of unknown bacteria. C) determining evolutionary relationships ANDdetermining serological relationships. D) determining serological relationships AND determining protein sequences. E) determining evolutionary relationships AND identification of unknown bacteria.

52) Disagreements between conclusions obtained from rRNA data and other techniques may be explained by A) horizontal DNA transfer. B) vertical DNA transfer. C) the difference in translation machinery. D) vertical RNA transfer. E) differences in post-replication modification.

53)

If the GC content of two organisms is 45% in both, A) they are definitely related. B) they are definitely not related. C) they may or may not be related. D) the AT content is 65%. E) they are definitely related AND the AT content is 65%.

54)

A DNA similarity of 75% between two organisms A) suggests the organisms are closely related at the species level. B) suggests the organisms are not closely related at all. C) suggests the organisms may or may not be related. D) means the GC content in both organisms is 45%. E) means the GC content in one organism is 75% and 25% in the other.

55)

Phylogenetic relationships between prokaryotes are most accurately determined using

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A) phenotypic characterizations. B) genotypic information. C) the fossil record. D) carbon dating. E) phenotypic characterizations AND genotypic information.

56) Why might it be easier to identify the bacterium that caused pneumonia than one that caused a wound infection? A) There are very few microorganisms that can cause pneumonia, while there are many that can cause wound infections, including normal microbiota and a variety of environmental organisms. B) Bacteria that cause pneumonia can be identified with few tests because the lungs have no normal microbiota. Many bacteria are normally found on the skin however;these may be in the wound, complicating identification. C) We have much better tests for bacteria in the lungs than we do for bacteria on the skin which may be the causative agents of wounds infection. D) The techniques of 16S rRNA sequencing are easier to perform on a sample taken from the lungs than a sample taken from a wound, because it is easier to get a sputum sample than it is a wound sample. E) Very few people actually get pneumonia, so tests are quick and easy to carry out; on the other hand, many people get very serious wound infections, so the tests are more complicated.

57) A sample must contain many microorganisms in order for them to be seen any using microscopy techniques. Why is this so?

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A) The area on a microscope slide is very large compared to the relative size of microbes, and you take a very small amount of your sample to place on the slide surface. Therefore, you must have a large number of microbes initially in the culture to increase the chances that you'll be able to see bacteria on the slide. B) Bacteria are very small. It is only possible to see them if there is a large biofilm of them on the slide. If you don't have a LOT of them, how are you going to see them? C) This statement is misleading. Microscopy allows us to magnify a specimen to the point where we would be able to visualize even just a few microbes on the surface of the slide. Even if there are only a few microbes in a sample, we could easily visualize them with a microscope. D) Microscopes only magnify objects on the slide. If you don't have a lot of microbes on the slide surface, you can't magnify the specimen enough to see them as individual cells. E) When bacteria are placed on a slide, they automatically swarm together into one area of the slide, allowing them to be seen. If there are too few bacteria in the sample, they are unable to swarm effectively and thus cannot be seen, even with staining.

58) Why are molecular methods particularly useful for identification of microbes that are difficult to grow? A) While all microbescan (and should) be grown for identification purposes, sometimes it's simplyfaster to use a molecular technique. B) They AREN'T useful—growing a microbe is clearly the only way to properly identify it. C) Since all microbes have DNA, and we can often detect and identify them through even very small amounts of their DNA, molecular methods allow us to identify microbes even when they can't be grown at all. D) Molecular methodsare far cheaper methods than growing microbes for identification.

59)

Explain the difference between a biotype and a serotype.

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A) A biotype is theliving type of microorganism identified, while the serotype is an individual'stype of blood serum. B) A biotype is thetype of biological environment a microbe will grow in, while the serotype isthe type of blood serum that the microbe can grow in. C) A biotype is theparticular phenotypic traits and characteristic structures of a biologicalmicroorganism, while the serotype is the list of molecules the microbe is ableto make and secrete into the serum of an infected individual. D) A biotype is thebiochemical profile of a particular microorganism, while the serotype is thedifference in its surface structures/antigens that will lead to separate immuneresponses from an organism (characterized by presence of different antibodiesin the individual's serum). E) There is no real difference between a biotype and a serotype. These two words mean essentially the same thing and can be used interchangeably.

60) When DNA probes are used to identify bacterial DNA similarities by hybridization, the probe DNA is heated and the template DNA is treated to separate the two strands. Why would the probe DNA be heated? A) This is the onlyway to properly label the probe DNA. B) The probe may contain parts that are double-stranded. Heating it up breaks thehydrogen bonds holding the strands together, creating single-stranded sequences that hybridize with their complementary targets. C) Heating it upactivates the tag on the probe DNA before it hybridizes to the bacterialtemplate DNA. D) DNA hybridizationcan only take place at high temperatures, so all the DNA must be heated upprior to hybridization. E) The probe may contain many parts that are single-stranded. Heating it up creates hydrogen bonds that hold the probe tightly to its complementary target sequences.

61)

Which statement regarding the Gram stain is FALSE?

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A) A Gram stain may give sufficient information to start appropriate antibiotic treatment—for example a Gram-positive diplococcus in sputum is likely to be Streptococcus pneumoniae. B) A Gram stain can sometimes be used to make a diagnosis—for example a Gramnegative diplococcusin WBC from urethral discharge is Neisseriagonorrhoeae. C) Gram staining can be used to differentiate intestinal normal microbiotafrom pathogens—for example differentiating E. coli from Salmonella enterica. D) In most cases, Gram staining is not sufficient to identify an organism—for example, Gram-positive staphylococci on skin may be either S. aureusor S. epidermidis. E) Medically important bacteria can seldom be identified by Gram staining alone—for example the throat may harbor Streptococcuspyogenes (pathogen) as well as Streptococcus species that are normal microbiota.

62)

Please select the FALSE statement regarding taxonomic hierarchy.

A) A species is a group of closely related strains or an organism; it is the basic unit of taxonomy. B) A genus is a collection of related species. C) A phylum is a collection of similar classes; it may also be called a division. D) A domain is a collection of similar kingdoms; there are three domains: Bacteria, Archaea,and Animalia. E) A kingdom is a group of several phyla or divisions; a collection of similar kingdoms makes up a domain.

63)

In a MALDI-TOF assay,

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A) antibodies are used to detect specific proteins and polysaccharides, particularly those that make up surface structures.  B) a microorganism’s proteins are separated and sorted by mass to generate a profile that provides a fast way to identify a colony. C) part of a colony is transferred to a microscope slide, and a drop of hydrogen peroxide (H 2O 2) is added to it to test for catalase. D) specimens are inoculated onto differential media and aset of biochemical tests are used to identify a microorganism.   E) the nucleotide sequence of ribosomal RNA molecules (rRNAs), or the DNA that encodes them (rDNAs), is used to identify microbes.

64)

Which type of ribosomal RNA is most often used in taxonomy? A) 5S B) 23S C) 70S D) 80S E) 16S

65) You have isolateda bacterium from a contaminated river but you are unable to culture it in the laboratory. Which method could you use to identify the organism?  A) Gram staining B) Biochemical testing C) MALDI-TOF mass spectrometry D) Nucleic acid amplification tests E) Antibiograms

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66) You are working in a clinical lab. Two E. coli samples are sent to you for analysis and you are asked to determined whether they are the same strain. You perform an antibiogram andfind that the two samples exhibit the same sensitivity to the antibiotics you use in the procedure. This indicates A) the organisms are likely the same strain but you need to confirm this with other methods. B) the organisms are likely different strains but you need to confirm this with other methods. C) the two organisms are not likely to be susceptible to the same bacteriophages. D) the two organisms will show different results if they are Gram stained. E) the organisms are the same strains but they will react differently in serology tests.

67) You are sent three clinical samples and are asked to determine whether they are the same strain. You perform standard identification techniques but cannot come to a conclusion. You decide to do an RFLP test. You digest the genomes of the organisms with the same restriction enzyme and run a gel. Each organism yields 5 bands on the gel, of the following sizes: Organism A: 3 kb, 7 kb, 11 kb; 14 kb, 21 kb; Organism B: 3 kb, 7 kb, 2 kb, 8 kb, 11 kb; Organism C: 11 kb, 3 kb, 14 kb,7 kb; 21 kb What conclusion(s) can you make from this result? A) Organisms A and B are likely the same strainbut are different from organism C. B) Organisms B and C are likelythe same strainbut are different from organism A. C) Organisms A and C are likelythe same strainbut are different from organism B. D) The organisms are all likely the same strain. E) The organisms are all likely different strains.

68)

If the GC content of two organisms is 60%, the  A) organisms are most likely related.  B) organisms are definitely not related.  C) organisms will have identical RFLP profiles. D) organisms are probably both pathogens. E) AT content is 60%.

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69) Please select the FALSE statement regarding phenotypic approaches to identifyingmicroorganisms. A) Most of these methods do not require sophisticated equipment and can easily be done anywhere in the world.  B) Size, shape, and staining characteristics can give suggestive information about the identity of an organism but additional testing is usually required. C) MALDI-TOF MS separates and sorts an organism’s carbohydrates by mass, generating a profile that provides a fast way to identify an organism grown in culture. D) A set of biochemical tests that examine the metabolic capabilities of a microorganism can be used to identify it.   E) Colony morphology can give initial clues to the identity of an organism but additional testing is required for absolute identification.

70)

Which of the following regarding taxonomy is INCORRECTLY matched? A) Identification — the process of characterizing organisms. B) Classification — the process of arranging organisms into similar or related groups. C) Nomenclature — the assignment of names to organisms. D) Phylogeny— the evolutionary relatedness of organisms. E) Domain —a collection of similar species.

71)

If an acid-fast bacterium is detected in a clinical sample, then the organism could be

A) Mycobacterium leprae B) Streptococcus pyogenes C) Geobacillus stearothermophilus D) Escherichia coli E) Mycoplasma pneumoniae

72)

Which of the following explains the difference between a biotype and a serotype?

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A) A biotype is a group of strains that has a characteristic biochemical pattern, whereas a serotype is a group of strains that has a particular cell surface antigen. B) A serotype is a group of strains that has a characteristic biochemical pattern, whereas a biotype is a group of strains that has a particular cell surface antigen. C) A biotype is a group of strains that has a characteristic GC content, whereas a serotype is a group of strains that has a particular cell wall type. D) A biotype is a group of strains that has a characteristic RFLP pattern, whereas a serotype is a group of strains that have complementary CG contents. E) A biotype is a group of strains that has identical 16S rRNA sequences, whereas a serotype is a group of strains that has identical 16S rDNA sequences.

73)

What specifically causes the color to change in the sugar fermentation and urease tests? A) Change in pH plus a pH indicator. B) Change in temperature plus a pH indicator. C) Change in disease state plus a pH indicator. D) Addition of protein plus a pH indicator. E) Reaction between protein and hydrogen peroxide.

74)

Which of the following describes a method used to test for the enzyme urease?

A) A biochemical test conducted in the laboratory using a medium that contains urea and a pH indicator. B) A biochemical test conducted in the laboratory using a medium that contains urea and hydrogen peroxide. C) A 16S rRNA analysis test conducted in the laboratory on cells obtained from a patient with high CO 2 levels. D) A staining method in which enymes with an active site for urea are identified with a fluorescent marker. E) A biochemical test conducted in the laboratory using a medium that contains hydrogen peroxide and a pH indicator.

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75) You are a lab technician processing patient samples. You perform a Gram stain on the sample and observe chains of spherical purple cells. From this you can conclude that A) the patient has strep throat, caused by Streptococcus pyogenes. B) the patient has a gastrointestinal infection, caused by Salmonella species. C) the sample contains a streptococcus and additional identification is needed. D) the patient has pneumonia, caused by Streptococcus pneumoniae. E) the sample contains a Mycobacterium, and additional testing is needed.

76) You are a lab technician processing a patient sample taken from a throat swab. You have performed a Gram stain and observed chains of purple spherical cells. A catalase test is positive. Colonies on blood agar areβ-hemolytic. From these results you can conclude that A) the sample does NOT contain Streptococcus pyogenes. B) the sample contains Streptococcus pyogenes. C) the isolated bacteria are normal throat microbiota. D) the sample likely contains Escherichia coli. E) the sample contains Mycobacterium tuberculosis.

77) You are a microbiology student working on your final project. You place a sample of bacteria on a slide and add hydrogen peroxide to it. You observe vigorous bubbling. What test have you performed and what can you conclude? A) Catalase test; the bacteria are catalase positive. B) Citrate test; the bacteria are citrate positive. C) Catalase test; the bacteria are catalase negative. D) Gelatinase test; the bacteria are gelatinase negative. E) Indole test; the bacteria are indole positive.

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78) You perform a series of tests on an unknown bacterium in an effort to identify it. The organism is a Gram-negative, catalase positive and coagulase positive coccus. Consider the dichotomous key and select the CORRECT statement.

A) The organism cannot be identified with this key. B) The organism is Staphylococcus aureus. C) The organism is Staphylococcus saprophyticus. D) The organism is Pseudomonas aeruginosa. E) The organism does not exist.

SECTION BREAK. Answer all the part questions. 79) Wisconsin state health authorities alerted the CDC about an E. coli O157:H7 outbreak. Soon thereafter, officials from two other states reported that they also had cases of illness associated with this pathogen. Within days, the CDC determined that the E. coli strains from all three states were the same, and the likely source of the outbreak was a particular brand of prepackaged fresh spinach. The CDC then issued a press release advising people not to eat bagged fresh spinach.

79.1) E. coli is a Gram-negative bacillus that is found as intestinal normal microbiota. Which of the following wouldnot be useful for an initial step in identifying E. coli O157:H7 strains in a stool sample?

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A) Gram staining, because E. coli strains will appear identical using this approach. B) Serology, because E. coli strains all express the same antigens. C) Growth on selective media, because all strains of E. coli will have the same metabolic capabilities. D) RFLPs, because E. coli strains will be identical at the genome level. E) These methods can all be used to differentiate between E. coli strains.

79.2) If you were the lab technician trying to identify the causative organism of this foodborne outbreak, would you inoculate several biochemical tests at the same time, or would you inoculate each test after getting the results from the previous test? A) I would inoculate each test after obtaining results from the last one becausethe tests are very quick and give instant results, and doing one test at a time will avoid confusion in the results. B) I would inoculate several tests simultaneously, because most biochemical tests require at least 18 hours of incubation, so inoculating several tests simultaneouslysaves time and also aids in conclusive identification. C) I would inoculate each test after obtaining results from the last one because the tests are extremely expensive so the fewer tests I can do, the less money I have to invest in the identification process. D) I would inoculate several tests simultaneously, because these tests can only be analyzed using specialized equipment, so I need to have the tests ready at the same time. E) I would inoculate each test after obtaining results from the last one because these tests are very time consuming and difficult to set up, so it would be more practical to take this approach.

79.3) You have identified the causative organism of the outbreak as E. coli. In an effort to characterize the strain of the organism involved, you do different tests. The results are as follows: Gram stain—Gram-negative rods; Oxidase test—negative; Lactose fermentation— positive; Serological testing—O157:H7; Colony morphology—smooth, creamy colonies;RFLPs—E. coli O157:H7; Antibiogram—resistant to ampicillin. Which test(s) confirm the identity of the organism at the strain level?

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A) Gram stain AND antibiogram B) Serological testing AND colony morphology C) RFLPs AND serological testing D) Oxidase test AND RFLPs E) Lactose fermentation AND oxidase test

79.4)

Please select the FALSE definition regarding microbial identification.

A) A biotype is agroup of strains that have a characteristic biochemical pattern different from other strains. B) A serovar is agroup of strains that have a characteristic antigenic structure that differs from other strains. C) A species is agroup of closely related strains; it is the basic unit of taxonomy. <!-Markup Copied from Habitat--> D) RFLPs are patterns of fragment sizes obtained by digesting polypeptides with one or more proteases. E) A signature sequence isa nucleotide sequence in rRNA that characterizes a certain species or a group of related organisms.

79.5) Which of the following is NOT a method used to differentiate E. coli O157:H7 from other strainsbased directly on genotype? A) Fluorescence in situ hybridization (FISH) B) Nucleic acid amplification tests (NAATs) C) Matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOFMS) D) 16S rRNAgene sequencing E) Radioisotope-labeled probes or fluorescent dye-labeled probes

80) A male patient comes to the clinic where you work complaining ofurethral discharge andpain on urination. He has recently had unprotected sex with someone he met at a party. You take a sample of the urethral discharge for analysis.

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80.1) You tell the patient that his sample contains white blood cells in which Gramnegative diplococci can be detected. Your patient asks how you obtained this result and you tell him you A) performed a Gram stain. B) performed an acid-fast stain. C) cultured his discharge on Gram-positive medium. D) cultured his discharge on Gram-negative medium. E) performed an antibiogram.

80.2) Based on the Gram stain results, you tell your patient that you think he has gonorrhea, a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. You are able to make this diagnosis based on A) the fact that N. gonorrhoeae is the only Gram-negative diplococcus found within white blood cells in the male urethra. B) signs and symptoms AND the fact that there are bacteria in the urethral discharge. C) signs and symptoms AND because N. gonorrhoeae is the only Gram-negative diplococcus found within white blood cells in the male urethra. D) signs and symptoms AND the fact that bacteria in the discharge are Gram-positive. E) the fact that bacteria are present in red blood cells ANDbecause N. gonorrhoeae is the only Gram-negative diplococcus found within the male urethra.

80.3) You patient tells you he has heard that N. gonorrhoeae is increasingly difficult to treat because of resistance to antibiotics. He asks whether it is possible to determine which antibiotics will be affective in treating his infection. You tell him that ______ indicate antibiotic susceptibility.

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A) colony morphology B) antibiograms C) metabolic assays D) 16S rRNA sequencing E) MALDI-TOF MS assays

80.4) Despite the fact that you are certain that your patient has gonorrhea based on the Gram stain results, it is essential to confirm your diagnosis by 16S rRNAsequencing. ⊚ ⊚

true false

80.5) Your patient asks what other types of tests are available for identifying N. gonorrhoeae. You tell him that the organism is fastidious, oxidizes only glucose as a carbohydrate source, breaks down H 2O 2, exhibits cytochrome c oxidase activity, is resistant to the antibiotic colistin, and produces at least four different colony types. Based on this, which of the following would you NOT use for characterization of this pathogen? A) Colony morphology B) Oxidase test C) Ability to utilize different carbohydrates D) Catalasetest E) Growth on selective medium

81) Your patient is a 54-year old man, who has experienced four months of unexplained fever, shortness of breath, fatigue and chest pain while breathing. He has also developed a heart murmur, which you can detect by stethoscope. You suspect he may have infective endocarditis (IE). The leading cause of IE is Staphylococcus aureus. However, cultures of the patient's blood have not yielded any colonies on any of the different types of media commonly used to cultivate this organism. The patient's heart murmur becomes more severe, and he requires an aortic valve replacement. You try to culture organisms from the removed valve tissue, but as in the case of the blood culture, you are unsuccessful.You send a biopsy of the diseased valve to a lab for analysis.

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81.1)

Which part of the body is affected with endocarditis?

A) Heart B) Skin C) Digestive tract D) Urogenital tract E) Nervous system

81.2) A labeled probe called EUB338 was used on a section of the aorta biopsy. The probe is specific for a 16S rRNA sequence in a bacterium called Coxiella burnetii. The probe binds to the patient's tissue sample, observed using a fluorescence microscope. What technique was used in this analysis? A) Fluorescence in situ hybridization B) Whole genome sequencing C) DNA-DNA hybridization D) Polymerase chain reaction E) Ribosomal RNA sequencing

81.3) In some cases, autofluorescence is observed in tissue that has calcifications. What does this mean? A) The probe binds non-specifically to calcifications, giving a false positive result. B) A positive result actually alway indicates calcifications, not infectious disease. C) The technician used the wrong type of probe, which binds to any tissue. D) The probe binds non-specifically to calcifications, giving a false negative result. E) Tissue calcifications can exhibit fluorescence even without the use of a probe.

81.4) You failed to culture microorganisms from your patient's blood or tissue sample. What is a possible explanation for this result?

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A) The organism is a fungus and thus needed to be cultured in live heart cells. B) The organism is fastidious and has highly specific requirements for culture. C) The probe used for analysis killed all the bacteria with 16S rRNA in the patient's blood. D) The bacterium in the patient's blood is resistant to commonly used antibiotics. E) These are all possible explanations for failing the culture the organism

81.5) Which of the following would be used to confirm the identity of the pathogen in this case? A) PCR with C. burnetii-specific primers , or MALDI-TOF MS. B) MALDI-TOF MS, or sequencing 80S rRNA genes. C) Gram stain, or injecting a volunteer with the same organism. D) Performing a Gram stain, or sequencing 80S rRNA genes. E) Anaerobic culture, or PCR with C. burnetii-specific primers.

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Answer Key Test name: Chap 10_10e 1) TRUE 2) TRUE 3) TRUE 4) FALSE 5) FALSE 6) TRUE 7) TRUE 8) FALSE 9) TRUE 10) TRUE 11) FALSE 12) TRUE 13) C 14) C 15) D 16) D 17) A 18) E 19) B 20) B 21) E 22) B 23) C 24) A 25) E 26) C Version 1

27) D 28) B 29) B 30) A 31) A 32) A 33) D 34) C 35) A 36) A 37) B 38) C 39) B 40) C 41) E 42) E 43) C 44) D 45) B 46) C 47) B 48) A 49) B 50) B 51) E 52) A 53) C 54) A 55) B 56) B Version 1

57) A 58) C 59) D 60) B 61) C 62) D 63) B 64) E 65) D 66) A 67) C 68) A 69) C 70) E 71) A 72) A 73) A 74) A 75) C 76) A 77) A 78) A 79) Section Break 79.1) A 79.2) B 79.3) C 79.4) D 79.5) C 80) Section Break 80.1) A Version 1

80.2) C 80.3) B 80.4) FALSE 80.5) A 81) Section Break 81.1) A 81.2) A 81.3) E 81.4) B 81.5) A

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CHAPTER 11 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The skin and oral cavity may have anaerobic microenvironments. ⊚ ⊚

true false

2) Lactic acid bacteria such as Streptococcus are obligate fermenters that can exist in an aerobic environment due to their use of catalase to mitigate the presence of oxygen. ⊚ ⊚

true false

3) Bacteria and Archaea both have members that use sulfur compounds as a terminal electron acceptor. ⊚ ⊚

Anoxygenic phototrophs grow photosynthetically only under aerobic conditions. ⊚ ⊚

true false

The most medically relevant species of Pseudomonas is P. aeruginosa. ⊚ ⊚

true false

Obligate aerobes may transform energy via fermentation. ⊚ ⊚

true false

Streptomyces produce a number of antibiotics.

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⊚ ⊚

Rhizobium is considered an endosymbiont with plants. ⊚ ⊚

true false

Chlamydia occurs in two forms, a reticulate body and an elementary body. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 10) It has been estimated that 99% of intestinal bacteria are A) obligate aerobes. B) facultative anaerobes. C) obligate anaerobes. D) facultative aerobes. E) thermophiles.

11)

The methanogens

A) are part of the domain ArchaeaANDappear only in aerobic environments. B) oxidize hydrogen gas to produce methane AND appear only in aerobic environments. C) use oxygen as a terminal electron acceptor AND appear only in aerobic environments. D) use oxygen as a terminal electron acceptor AND oxidize hydrogen gas to produce methane. E) are part of the domain Archaea AND oxidize hydrogen gas to produce methane.

12)

Methanogens often grow in association with

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A) nitrifying bacteria. B) fermentative bacteria. C) lithotrophic bacteria. D) photosynthetic bacteria. E) pathogenic bacteria.

13)

Comparatively greater energy is released when A) carbon dioxide is the final electron acceptor. B) hydrogen is the final electron acceptor. C) oxygen is the final electron acceptor. D) nitrate is the final electron acceptor. E) fermentation occurs.

14)

Hydrogen sulfide A) is produced when nitrateis used as terminal electron acceptor. B) is produced by Desulfovibrio. C) may react with iron to produce a deep red precipitate. D) has a strong citrus smell. E) All of the answer choices are correct.

15)

Endospores

A) are a dormant form of a bacterium AND are formed by members of medically relevant groups of bacteria. B) are a form of reproduction ANDare formed by members of medically relevant groups of bacteria. C) are a dormant form of a bacterium AND are involved in anaerobic respiration. D) are formed by members of medically relevant groups of bacteria AND are involved in anaerobic respiration. E) are a dormant form of a bacterium AND are found in any environmental bacteria.

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16)

Lactic acid bacteria such as Lactococcus A) produce catalase. B) are obligate fermenters. C) require anaerobic environments. D) use oxygen as a final electron acceptor. E) are always pathogenic.

17)

Streptococcus pyogenes A) is alpha-hemolytic. B) isgamma-hemolytic. C) isbeta-hemolytic. D) may form endospores. E) is alpha-hemolytic AND may form endospores.

18) The lactobacilli, in their role as normal microbiota of the vagina, help the vagina resist infection by contributing to A) the neutrality of the vaginal mucus. B) food for the resident vaginal microbiota. C) acidity of the vagina. D) fertility of the host. E) a high vaginal pH.

19)

Which of the following colonize the vagina during childbearing years?

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A) Clostridium B) Streptococci C) Enterobacter D) Lactobacilli E) Clostridium AND lactobacilli

20)

A particular characteristic of disease-causing Streptococcus is A) catalase production. B) beta-hemolysis. C) lactic acid production. D) growth at refrigerator temperatures. E) endospore formation.

21)

Propionibacterium A) produces propionic acid AND is responsible for the holes in Swiss cheese. B) produces propionic acid AND requires aerobic environments. C) produces lactic acid AND is responsible for the holes in Swiss cheese. D) is responsible for the holes in Swiss cheese AND requires aerobic environments. E) produces lactic acid AND is a Gram-negative organism.

22)

Which of the following microbes is(are) important to cheese-making? A) lactic acid bacteria B) Clostridium acetylbutylicum C) Desulfovibrio D) Propionibacterium E) Lactic acid bacteria AND Propionibacterium

23)

Clostridium, Lactobacillus, and Propionibacterium all

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A) oxidize inorganic compounds ANDuse sulfur compounds as terminal electron acceptors. B) oxidize organic compounds AND use sulfur compounds as terminal electron acceptors. C) oxidize inorganic compounds ANDuse organic compounds as terminal electron acceptors. D) oxidize organic compounds AND use organic compounds as terminal electron acceptors. E) neutralize organic compounds AND use organic compounds as terminal electron acceptors.

24)

Which of the following contains bacteriochlorophyll? A) Bacillus ,Chromatium, Thiospirillum B) Staphylococcus, Thiospirillum, Thidictyon C) Streptococcus, Chromatium,Thidictyon D) Escherichia,Chromatium, Thiospirillum E) Chromatium, Thiospirillum, Thidictyon

25)

Anoxygenic phototrophs A) produce oxygen. B) use water as a source of electrons. C) use hydrogen sulfide or organic compounds as a source of electrons. D) use the same form of chlorophyll found in terrestrial plants. E) produce oxygen AND use the same form of chlorophyll found in terrestrial plants.

26)

The purple sulfur and green sulfur bacteria

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A) both use hydrogen sulfide as a source of electrons. B) generate oxygen. C) preferentially use organic molecules as an electron source. D) both lack gas vesicles. E) generate oxygen and lack gas vesicles.

27)

The earliest oxygenic phototrophs are thought to be A) purple sulfur bacteria. B) green non-sulfur bacteria. C) purple non-sulfur bacteria. D) cyanobacteria. E) cyanoarchaea.

28)

Cyanobacteria A) are a form of algae. B) are prokaryotes. C) use hydrogen sulfide as an electron source. D) are eukaryotes. E) contribute to global CO 2 buildup.

29)

Phycobiliproteins are

A) found in purple sulfur bacteria AND are used to gather wavelengths of light that are not well absorbed by chlorophyll. B) found in cyanobacteria ANDare used to reduce hydrogen sulfide. C) used to gather wavelengths of light that are not well absorbed by chlorophyll AND are used to reduce hydrogen sulfide. D) are used to reduce hydrogen sulfide AND are found in purple sulfur bacteria. E) found in cyanobacteria AND used to gather wavelengths of light that are not well absorbed by chlorophyll.

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30)

The genus of bacteria that is able to fix nitrogen and form heterocysts is A) pseudomonas. B) anabaena. C) escherichia. D) vibrio. E) streptococcus.

31)

Heterocysts A) are found in nitrogen-fixing cyanobacteria AND produce catalase. B) are found in nitrogen-fixing cyanobacteria AND are used to protect nitrogenase. C) are used to protect nitrogenaseAND generate oxygen. D) produce catalase AND are found in nitrogen-fixing cyanobacteria. E) are found in nitrogen-fixing cyanobacteriaANDgenerate oxygen.

32)

Purple sulfur bacteria and filamentous sulfur-oxidizers both A) accumulate sulfur as intracellular granules. B) fix nitrogen. C) produce oxygen from carbon dioxide. D) use gliding motility. E) have gas vesicles.

33)

Sulfuric acid is

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A) involved in bioleachingAND produced by Lactobacillus. B) produced by unicellular sulfur-oxidizers AND is a result of reduction of metal sulfides. C) involved in bioleaching AND produced by unicellular sulfur-oxidizers. D) a result of reduction of metal sulfides AND involved in bioleaching. E) is a result of reduction of metal sulfides AND is produced by Lactobacillus.

34)

The conversion of ammonium to nitrate could be accomplished by the presence of A) Nitrosomonas alone. B) Nitrobacter alone. C) Anabaena alone. D) Nitrosomonas and Nitrobacter. E) Nitrosomonas, Nitrobacter, and Anabaena.

35)

The Gram-positive rod that is also acid-fast and is a human pathogen is A) Corynebacterium diphtheria. B) Mycobacterium tuberculosis. C) Streptococcus pyogenes. D) Listeria monocytogenes. E) Mycoplasma pneumoniae.

36)

Which organism(s) is/are acid-fast? A) Nocardia AND Mycobacterium B) Pseudomonas AND Escherichia C) EscherichiaAND Mycobacterium D) Mycobacterium ANDPseudomonas E) NocardiaANDPseudomonas

37)

Which of the following organisms is the causative agent of Hansen's disease (leprosy)?

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A) Pseudomonas aeruginosa B) Mycobacterium avium C) Mycobacterium leprae D) Mycobacterium smegmatis E) Mycoplasma leprae

38)

Pseudomonasspecies

A) are resistant to many disinfectants and antimicrobialsAND do not contain plasmids. B) are mostly harmless except for the opportunistic P. aeruginosaAND do not contain plasmids. C) require nutrient-rich environments AND are mostly harmless except for the opportunistic P. aeruginosa.. D) require nutrient-rich environments AND do not contain plasmids. E) are resistant to many disinfectants and antimicrobials AND are mostly harmless except for the opportunistic P. aeruginosa.

39)

Thermus and Deinococcus A) are both thermophilic. B) are both radiation resistant. C) both serve as the source of Taq polymerase. D) are both Gram-positive. E) survive in extreme environments.

40) Which of the following statements about members of the family Enterobacteriaceae is NOT true? A) It includesE. coli, Enterobacter, Salmonella, and Shigella. B) It includes many medically relevant bacteria. C) Members only reside in the intestinal tract of humans. D) Members are facultative anaerobes. E) All of the choices are correct.

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41)

Coliforms A) are an informal grouping of enterics. B) ferment lactose. C) include E. coli. D) are used as indicators of fecal contamination. E) All of the choices are correct.

42)

Bacteria that may form endospores include A) E. coli AND Bacillus. B) Pseudomonas AND Micrococcus. C) Clostridium ANDBacillus. D) Enterococcus AND Deinococcus. E) Clostridium AND Deinococcus.

43) Which of the following structures would be the best choice as a biological indicator to test autoclave operations? A) Cysts formed by Azotobacter species. B) Microcysts withinthe fruiting bodies of myxobacteria. C) Dormant spores in the conidia of Streptomyces species. D) Endospores formed by Geobacillusstearothermophilus. E) Sulfur granules produced by Thiothrix species.

44)

Azotobacter A) forms endospores. B) fixes nitrogen. C) fixes carbon dioxide. D) is used as an indicator of fecal pollution. E) is a hyperthermophile.

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45)

Streptomyces

A) resemble fungi in their pattern of growth AND produce a number of antibiotics. B) resemble fungi in their pattern of growth AND produce a characteristic blue-green pigment. C) produce a number of antibiotics AND form endospores. D) produce a characteristic blue-green pigment AND form endospores. E) form endospores AND resemble fungi in their pattern of growth.

46)

Complex structures called fruiting bodies are a characteristic of A) Clostridia. B) Streptomyces. C) lactic acid bacteria. D) myxobacteria. E) bacilli.

47)

Agrobacterium species

A) contain the Ti plasmid that modifies the growth of plant tissue. B) produce antibiotics. C) infect animal cells. D) resemble fungus. E) are a group of Gram-negative rod-shaped bacteria that often fix nitrogen. <!-Markup Copied from Habitat-->

48)

Rhizobium species

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A) resemble fungi. B) fix nitrogen inside nodules on the roots of legumes. C) produce antibioticsinside nodules on the roots of legumes. D) produce a gall in plants. E) contain the Ti plasmid that modifies the growth of plant tissue.

49)

Which causes uncontrolled growth of plant tissue, resulting in a tumor? A) Bacillus anthracis B) Rhizobium C) Yersinia pestis D) Agrobacterium E) Cyanobacteria

50)

Sphaerotilus and Leptothrix are examples of A) purple sulfur bacteria. B) Enterobacteriaceae. C) sheathed bacteria. D) green non-sulfur bacteria. E) prosthecate bacteria.

51)

Swarmer cells are A) formed by Myxobacteria. B) formed by sheathed bacteria. C) also known as coliforms. D) part of the green non-sulfur bacteria. E) used in sewage treatment.

52)

Bdellovibrio species

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A) prey on other bacteria. B) are parasites of plants. C) may fix nitrogen. D) are photosynthetic. E) are filamentous.

53)

Luminescence A) is catalyzed by luciferase. B) may be controlled by quorum sensing. C) may be produced by bacteria. D) All of the choices are correct. E) None of the choices is correct.

54)

Movement of spirochetes occurs by means of structures called A) cilia. B) flagella. C) endoflagella. D) pili. E) microvilli.

55)

Many spirochetes are difficult to cultivate, so their classification is based on their A) morphology AND ability to cause disease. B) number of flagella AND morphology. C) pattern of piliAND flexible cell wall. D) number of chromosomes AND pattern of flagella. E) ability to cause diseaseAND pattern of flagella.

56)

Helicobacter pylori

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A) inhabits squid ink sacs. B) causes crown gall in plants. C) inhabits the stomach. D) has axonemes. E) produces luminescence.

57)

Organisms that typically produce colonies with a fried egg appearance are the A) Mycobacteria. B) Mycoplasmas. C) Actinomyces. D) Chlamydia. E) Escherichia.

58)

Which of the following aboutMycoplasma is FALSE? A) Theylack peptidoglycan. B) They are the smallest free-living organisms. C) They have sterols in their membranes. D) They are killed by penicillin. E) They are pleomorphic.

59)

Treponema and Borrelia A) are luminescent. B) are endosymbionts. C) are both easily grown on artificial media. D) are spirochetes. E) are never motile.

60)

Which of the following is/are obligate intracellular parasites?

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A) Chlamydia and Rickettsia B) E. coli and Pseudomonas C) Mycoplasma and E. coli D) Treponema and Chlamydia E) Rickettsia, Chlamydia and Pseudomonas

61)

Reticulate and elementary bodies are two forms in the life cycle of A) Mycoplasma. B) Caulobacter. C) Chlamydia. D) Myxobacteria. E) Treponema.

62)

Wolbachiais found only in A) hot springs. B) plants. C) mammals. D) arthropods . E) marine water.

63)

The Euryarchaeota includes all A) known extreme acidophiles. B) the bacteria. C) known methanogens. D) green sulfur bacteria. E) intracellular parasites.

64)

Members of the Archaea typically thrive in conditions of excessive

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A) heat. B) acidity. C) alkalinity. D) salinity. E) All of the choices are correct.

65)

Archaea are typically found living in extreme environments. An exception to this are the A) sulfur-oxidizing archaea. B) sulfur-reducing archaea. C) methanogens. D) sulfur-oxidizing archaea AND sulfur-reducing archaea. E) methanogens AND sulfur-reducing archaea.

66) Approximately 99% of the microbes in the intestines are obligate anaerobes. We have plenty of blood vessels that can bring oxygen to the tissues of the intestines. Why would there be obligate anaerobes within these areas? A) The bacteria in theintestines are protected from exposure to the oxygen in the tissues by thelining of the intestines. B) The bacteriaconsume all the oxygen in the tissue areas brought by the blood vessels,creating an anaerobic environment. C) The inside space of the intestines is highly anaerobic. It is deep inside the body where oxygen cannot reach andit is not supplied with blood. D) The aerobicmicrobes are outcompeted for nutrients in these areas by the anaerobicmicrobes. E) The inside space of the intestines is highly anaerobic. It is deep inside the body where carbon dioxide accumulates.

67)

Relatively little is known about many obligate anaerobes. Why might this be so?

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A) There are far more obligate aerobes in any environment, so it is much easier to study them. B) It is difficult to provide the right atmospheric environment to cultivate obligate anaerobes, so it's been harder to study them. C) Only obligate aerobes cause disease, so we have had little reason to study obligate anaerobes. D) The majority of obligate anaerobes are very nutritionally fastidious, which makes it difficult to study them. E) It is difficult to provide the right temperature to cultivate obligate anaerobes, so it's been harder to study them.

68) How do anoxygenic phototrophs benefit from having accessory pigments that allow light to be harvested at deeper areas of a moist or aquatic environment? A) Accessory pigments allows even anaerobic microbes to carry out photosynthesis, as they can harvest light energy in the deeper areas where oxygen won't be present. B) The cells can use wavelengths of light that have not been absorbed by the photosynthetic organisms closer to the surface of the water. C) These organisms don't have to compete with other cells that use oxygen in the upper levels for the scarce nutrients in the aquatic environment. D) This allows even anaerobic microbes to conduct photosynthesis, as they can harvest light energy in the deeper areas where oxygen won't be present AND can use wavelengths of light not absorbedby the photosynthetic organisms closer to the surface of the fluid. E) This allows even anaerobic microbes to conduct photosynthesis, as they can harvest light energy in the deeper areas where oxygen won't be present, use wavelengths of light not absorbed by the photosynthetic organisms closer to the surface of the water; AND don't have to compete with other cells that use oxygen in the upper levels for the scarce nutrients in the fluid environment.

69) How could heavily fertilized lawns contribute to cyanobacterial blooms in lakes and oceans?

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A) Run-off from the lawns will get into the water system, leading to large amounts of nitrogen that can be used by cyanobacteria in water systems. B) Nutrient-rich grass will be mowed down, with grass clipping bits eventually washing into sewer systems and into larger bodies of water. These grass clippings will serve as a nutrient source for cyanobacteria, leading to blooms. C) Large amounts of fertilizer will lead to excessive production of greenhouse gases (like CO2) from grass in lawns. Excessive CO2 production will lead to large blooms of cyanobacteria in water systems. D) Fertilizers contains compounds that encourage the production ofbacteriochlorophylls; after rain, fertilizersget into water and are used by cyanobacteria. <!-Markup Copied from Habitat--> E) They won't—the two systems are completely unrelated. How could grass in lawns contribute to effects in lakes and oceans?

70) The genomes of free-living spirochetes are larger than those living in animal hosts. Why might this be so? A) Free-living spirochetes will need genesfor additional proteins to synthesize or obtain their own food from the environment. Parasitic spirochetes obtain nutrients from the animal host. B) The spirochetes inanimal hosts are different species entirely. As different species, theywould naturally have smaller genomes. C) A smaller genome implies simplicity—the spirochetes living in animal hosts have fewer needs, so they need fewer genes. D) It isn't so—all spirochetes would have the same size genomes, since they're all the same species of microbe. E) Parasitic spirochetes are smaller than free-living spirochetes. Because of this, their genomes are also smaller; they need less genes.

71) A student complains that it makes no sense to worry about coliform bacteria in water, since we naturally have harmless coliforms in our intestines anyway. Is the student correct?

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A) No. The coliforms in our intestines are usuallyharmful, causing intestinal infections.Coliforms in water might add to this potential problem. B) No. Not all coliforms are harmless to humans. In addition,the presence of coliforms in waterindicates fecal pollution in that water. C) No. Multiple types of coliforms in water might lead to greater antibiotic resistance in other aquatic bacteria, creating an environmental problem. D) Yes. Regulatory agencies that monitor coliform levels in water are over cautious. There is no real danger from coliforms in water supplies. E) No. Clean water should not have any bacteria in it at all, so if any are present, they always pose a health risk to anyone drinking that water.

72)

Please select the definition that is INCORRECT.

A) Chemotrophs—organisms that obtain energy by oxidizing chemical compounds. B) Chemolithotrophs—organisms that harvest energy by oxidizing inorganic chemicals. C) Anoxygenic phototrophs—photosynthetic organisms that do not produce O 2. D) Nitrifiers—Gram-negative bacteria that obtain energy by oxidizing inorganic nitrogen compounds. E) Mycobacteria—Gram-negative bacteria that group together to form complex fruiting bodies.

73) What roles do hydrogen gas and carbon dioxide play in the metabolism of methanogens?  A) Hydrogen gas is their energy source, and carbon dioxide is their terminal electron acceptor. B) Hydrogen gas is their terminal electron acceptor, and carbon dioxide is their energy source. C) Hydrogen gas is their energy source, and carbon dioxide is their carbohydrate source. D) Hydrogen gas is their initial electron acceptor, and carbon dioxide is their energy source. E) They use hydrogen gas in respiration, and they use carbon dioxide in photosynthesis.

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74)

Which of the following is NOT associated with a Clostridium species? A) Tetanus B) Botulism C) Strep throat D) Gas gangrene E) Antibiotic-associated diarrheal disease

75)

Which of the following are spirochetes? A) Borrelia AND Treponema B) Clostridium AND Borrelia C) Leptospira AND Escherichia D) Treponema AND Bacillus E) Escherichia AND Neisseria

76) Which of the following genera have dormant forms that areresistant to extreme environmental conditions? i. Bacillus ii. Clostridium iii. Neisseria iv. Micrococcus v. Leptospira A) i, ii, AND v B) i, iii, AND v C) iii AND iv D) i AND ii E) ii ONLY

77) Which of the following genera are obligate intracellular parasites?

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A) Chlamydia AND Mycoplasma B) Chlamydia, Mycoplasma, AND Micrococcus C) EscherichiaAND Erlichia D) Chlamydia, Coxiella, AND Rickettsia E) Mycoplasma, Chlamydia, Coxiella, AND Rickettsia

78) Sulfolobus species are found at the surface of acidic sulfur-containing hot springs such as many of those found in Yellowstone National Park. They only grow at temperatures above 50°C and at a pH between 1 and 6. How would you classify these organisms? A) Anaerobic, acidophilicmesophiles B) Aerobic, acidophilicthermophiles C) Microaerophilic, halotolerantbasophiles D) Aerobic, psychrophilic acidophiles E) Psychrotrophic neutrophiles

79)

Please select the FALSE statement regarding sheathed bacteria.

A) The sheath protects the bacteria from predators. B) The sheath allows these bacteria to perform photosynthesis. C) Sheathed bacteria frequently block industrial pipes. D) Sheathed bacteria spread by means of swarmer cells. E) The sheath allows these bacteria to attach to surfaces.

80) What distinguishes Staphylococcus, species from Streptococcus, Enterococcus and Lactococcus species?

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A) Their morphology. B) The nature of their cell walls. C) The production of catalase. D) Their ability to cause disease. E) All of the choices are correct.

81)

Anaerobic chemolithotrophs A) obtain energy by reducing inorganic chemicals. B) may be found in the gastrointestinal tract of humans. C) are abundant and occur mostly in aquatic environments. D) may generate ATP by oxidizing CO 2, using H 2 as a terminal electron acceptor. E) produce ATP by substrate-level phosphorylation.

82)

Compare anaerobic chemolithotrophs with anaerobic chemoorganotrophs.

A) Chemolithotrophsobtain energy by oxidizing inorganic chemicals such as hydrogen gas, while chemoorganotrophsoxidize organic compounds such as glucose to obtain energy. B) Chemolithotrophsobtain energy by oxidizing organic compounds such as glucose, while chemoorganotrophs obtain energy by reducing those same organic compounds. C) Chemolithotrophsinclude organisms such as the methanogens, which use methane as an energy source; chemoorganotrophs include organisms such as sulfate-reducing bacteria which produce H 2S. D) Chemolithotrophs that reduce sulfur are essential in the sulfur cycle; chemoorganotrophs play an important role in fementation processes. E) Chemolithotrophs are extremely abundant in nature, and are found almost everywhere; chemoorganotrophs are limited to only hot and dry environments.

83)

Which is NOT true of anoxygenic phototrophs? They

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A) require oxygen for survival. B) contain a pigment calledbacteriochlorophyll. C) are found in habitats such as lakes and bogs. D) may appear red, orange or purple in color. E) use hydrogen sulfide or organic compounds as an energy source.

84)

Anaerobic phototrophs A) always use inorganic compounds as an energy source. B) are always found in terrestrial habitats. C) contain bacteriochlorophyll and other pigments. D) never grow aerobically. E) harvest energy from sunlight and produce O 2.

85)

Oxygenic prototrophs are primary producers. What does this mean? A) They convert CO 2into organic compounds, sustaining other forms of life. B) They convert organic compounds intoCO 2, sustaining other forms of life. C) They are the first organisms to colonize a habitat. D) They make organic compounds first, then secondary metabolites. E) They are the most important members of intestinal normal microbiota.

86)

Which of the following is a characteristic of the cyanobacteria? A) They play a role in making N 2 available to other organisms. B) They are frequently parasitic in marine mammals. C) They are either anaerobic or microaerophiles. D) They are either Gram-positive or Gram-negative. E) They are only found in marine and other aquatic environments.

87)

Select the TRUE statement regarding aerobic chemoorganotrophs.

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A) Mycobacteria are the only acid-fast members of this group. B) They use inorganic compounds as a terminal electron acceptor. C) Members of the genus Micrococcus are often airborne. D) Aerobic chemoorganotrophs are never pathogenic. E) Members of the group all require low levels of Na + for growth.

88) What unique characteristic of the genus Deinococcus in the aerobic chemoorganotrophs makes them inportant? A) They are pathogenic and cause potentially fatal disease. B) They are resistant to the damaging effects of radiation. C) They can withstand high temperatures. D) They can degrade synthetic compounds. E) They are resistant to disinfectants and medications.

89)

Which statement about Rhizobia is INCORRECT? A) The are Gram-positive rods. B) They can convert N 2 into ammonia. C) They are endosymbionts with plants. D) They help plants absorb water. E) They live in plant root nodules.

90)

Which statement comparing Rhizobia

and Agrobacterium is TRUE?

A) Rhizobia carry a plasmid called Ti; Agrobacterium is a plant endosymbiont. B) Rhizobia are plant endosymbionts; Agrobacterium is a plant pathogen. C) Agrobacterium enters plants via root nodules; Rhizobia enter plants through conjugation. D) Agrobacterium is a Gram-positive rod; Rhizobia are Gram-negative rods. E) Agrobacterium gives nutrients to a plant; Rhizobia take nutrients from plants.

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91) What is considered a potential use for genetically engineered members of the genus Deinococcus? A) They may be used to clean up environments contaminated with radioactive waste. B) Their enzymes may be used in detergents used in high temperature cleaning. C) They may be used to degrade synthetic environmental contaminants like plastic. D) They may be used to generate antibiotics effective against resistant pathogens. E) They may be used to reduce the damaging effects of ultra violet radiation on skin.

SECTION BREAK. Answer all the part questions. 92) You examine a patient who is complaining of belching (burping), bloating, and some vomiting. She also has some abdominal discomfort which she describes as a dull, burning pain that is worse when she is hungry and is often relieved when she takes antacids. You suspect that she may have Helicobacter pylori gastritis, and send herfor a urea breath test. The breath test is positive; based on this, you get the patient's stooltested for blood, and you send herfor an endoscopy, during which a biopsy is taken. Your diagnosis is confirmed by the results of these tests—she does indeed have H. pylori infection.

92.1) Helicobacter pylori,a curved, Gram-negative microaerophilic motile bacterium. Based on this, how do you describe the organism to your patient?

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A) The organism causing your signs and symptoms is a virus that requires oxygen for survival, has a thin cell wall composed of a compound called peptin, and can move by means of tail-like structures called flagella. B) The organism causing your signs and symptoms is a bacterium that requires atmospheric levels of oxygen for survival, has a thick cell wall composed of a compound called peptidoglycan, and can move by means of appendages called cilia. C) The organism causing your signs and symptoms is a protozoan that requires low levels of oxygen for survival, has a thin cell wall composed of a compound called chitin, and moves around your stomach by means of structures called flagella. D) The organism causing your signs and symptoms is a bacterium that requires low levels of oxygen for survival, has a thin cell wall composed of a compound called peptidoglycan, and can move by means of tail-like structures called flagella. E) The organism causing your signs and symptoms is a bacterium that cannot grow in the presence of oxygen, has a thick cell wall composed of a compound called peptidoglycan, and can move by means of tail-like structures called flagella.

92.2) Your patient asks you how a bacterium can survive in her stomach, which she knows is very acidic. You explain that A) H. pylori produces ureasethat converts urea into carbon dioxide and ammonia; the ammonia neutralizes the pH of the stomach, allowing the bacteria to survive. B) H. pylori has the ability to form endospores in hostile environmental conditions. It does this in the acidic stomach, only germinating once they reach the small intestine. C) H. pylori is an acidophile, and as such prefers acidic pH levels of 1–3; gastric juices contain hydrochloric acid which has a very low pH. D) H. pylori is encased in the very thick polysaccharide capsule that protects it from the degradative effects of the HCl found in the stomach. E) H. pylori forms a biofilmwith the other normal microbiota of the stomach. The structure of the biofilmcovers and protects the bacteria within it.

92.3) Your patient asks you to explain how the urea breath test works. You tell her that in the test, she had been asked to swallowurea containing an unusual form of carbon—nonradioactive 13C (an isotope). After 10–30 minutes, she was asked to breathe into a receptacle, and her breath had been analyzed for the presence of this form of carbon in the carbon dioxide that she exhaled. You explain that the CO 2 she exhaled contained 13C, so

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A) her test indicates the presence of H. pylori—the organism produces ammoniase that breaks down the 13C-containingurea that the patient swallowedinto urea andCO 2 containing 13C which could be measured. B) her test indicates the presence of H. pylori—the organism contains 13C in its cell wall, and in the presence of stomach acid, the cell wall is broken down to release CO 2 containing 13C which could be measured. C) her test indicates the presence of H. pylori—the organism produces urease that breaks down the 13C-containingurea that the patient swallowedinto ammonia andCO 2 containing 13C which could be measured. D) her test indicates that her stomach cells used the 13C-containing urea in cellular respiration, producing glucose and releasing CO 2 containing 13C as a byproduct. E) nobody really understands how the ureabreath test works, but that it is well known that anybody who drinks urea containing 13C and exhales CO 2 containing this element afterwards needs treatment for an ulcer.

92.4) You prescribe two antibiotics for your patient, to be taken at the same time. You explain that two medications are used A) to prevent your patient from developing antibiotic resistance. B) because H. pylori makes endosporesand is very resistant. C) because viruses are always treated with two different antibiotics. D) because H. pylori forms cysts that are difficult to destroy. E) to prevent the H. pylori from developing antibiotic resistance.

92.5) The blood in your patient's stool suggests an ulcer. The endoscopy confirms this. You discuss with the patient how H. pylori can cause ulcers. After H. pylorienters your body, it can cause damage to cells in the lining of the stomach, some of which usually produce a protective mucus layer. Once the bacteria have done enough damage, the mucus layer thins and stomach acid can get through the lining, leading to ulcers.You prescribe an antacid medication

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A) to kill the H. pylori which can only live in acidic conditions. B) to reduce the acidity of the stomach, thereby allowing the lining to heal. C) to prevent the H. pylori from making CO 2 which is causing the patient's burping. D) to stimulate the patient's stomach E. coli populationso it out-competes the pathogen. E) All of the answer choices are correct.

93) Recently, a region of Lake Erie was covered with thick green scum during the summer months, and fish and other aquatic animals in the area were dying. Microscopic analysis revealed that the green scum was a bloom of cyanobacteria, a group of photosynthetic bacteria. The aquatic animals were dying because the waters had insufficient dissolved O2, causing the animals to suffocate. The source of the problem was high levels of phosphorus in the lake. When excess phosphorus is available, cyanobacteria may grow to high numbers, causing a bloom. There are many potential sources of this type of pollution, ranging from industries to individuals. For example, manure and chemical fertilizers used by farms and homeowners to promote plant growth often contain phosphate, a source of phosphorus for both plants and other organisms, including cyanobacteria. Fertilizers applied to soils can be washed into the lake by rain. Another source of phosphate is wastewater treatment plants; detergents as well as biological materials can contain phosphate, and most wastewater treatment processes do not remove this substance. Liquid from septic systems also contains phosphate. Once the source of the phosphorous was idenitified (in this case a farm), steps were taken to prevent it entering the lake, and the problem resolved.

93.1)

Which of the following is NOT a characteristic of the cyanobacteria?

A) They are Gram-negative. B) They are anoxygenic protorophs. C) They may form multicellular associations. D) Some of them fix nitrogen. E) They are primary producers.

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93.2) Lake Erie gets a lot of sun. Why would sunlight in combination with phosphoruscontaining pollution promote the growth of cyanobacteria?  A) Cyanobacteria are photosynthetic, using sunlight energy and CO 2 to synthesize glucose. Phosphorous is a limiting nutrient, so when it is available, the bacteria can grow excessively. B) Cyanobacteria are photosynthetic, and warm temperatures are needed for this process. Phosphorous is a limiting nutrient, so when it is available, the bacteria can grow excessively. C) Cyanobacteria are photosynthetic; the enzymes invovled in this process are UVdependent. Phosphorous is a limiting nutrient, so when it is available, the bacteria can grow excessively. D) Cyanobacteria are fermenters, using sunlight energy and CO 2 to synthesize glucose. Phosphorous is a limiting nutrient, so when it is available, the bacteria can grow excessively. E) Cyanobacteria are photosynthetic, using sunlight energy and CO 2 to synthesize glucose. High levels of phosphorous stimulate release of CO 2 from the water, for use by the cyanobacteria.

93.3)

Why would cyanobacterial growth lead to decreased levels of O

2 in the water?

A) Some of the cyanobacteria die. When they do, they provide nutrients for other organisms such as chemoheterotrophs that use O 2 during aerobic respiration. B) The process of photosynthesis involves harvesting energy from sunlight and using it to generate glucose from water and oxygen. C) The process of photosynthesis involves harvesting energy from sunlight and using it to generate glucose from carbon dioxide and oxygen. D) The cyanobacteria use up all the available oxygen in the water because like all photosynthetic organisms, they carry out fermentation over night when they cannot perform photosynthesis. E) Cyanobacteria always attract large numbers of ducks and geese to water bodies. These birds consume the cyanobacteria and thus every source of oxygen in that water.

93.4) Although cyanobacteria may cause fish and other aquatic animals to die, they are harmless to humans. Version 1

⊚ ⊚

true false

93.5) Bacteria such as Spirillum volutans make volutin granules, which are storage forms of phosphate. How might these bacteria be useful in this situation? A) They could be added to the lake, where they would take up and accumulate phosphorous; after sufficient time, theycould then be removed. B) They could be added to the lake, where they would provide an alternative source of food for the fish and other aquatic animals adversely affected by the bloom. C) They could be genetically engineered so that they produce toxins that kill cyanobacteria; they could then be added to the lake, where they would get rid of the bloom. D) They could be genetically engineered to produce antibiotics so that any person drinking from the contaminated lake would not be affected by any cyanbacteria toxins. E) They would not actually be useful. Adding another microorganism to the lake would definitely worsen the oxygen deficit, leading to more fish and animal death.

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Answer Key Test name: Chap 11_10e 1) TRUE 2) FALSE 3) TRUE 4) FALSE 5) FALSE 6) TRUE 7) TRUE 8) TRUE 9) TRUE 10) C 11) E 12) B 13) C 14) B 15) A 16) B 17) C 18) C 19) D 20) B 21) A 22) E 23) D 24) E 25) C 26) A Version 1

27) D 28) B 29) E 30) B 31) B 32) A 33) C 34) D 35) B 36) A 37) C 38) E 39) E 40) C 41) E 42) C 43) D 44) B 45) A 46) D 47) A 48) B 49) D 50) C 51) B 52) A 53) D 54) C 55) A 56) C Version 1

57) B 58) D 59) D 60) A 61) C 62) D 63) C 64) E 65) C 66) C 67) B 68) E 69) A 70) A 71) B 72) E 73) A 74) C 75) A 76) D 77) D 78) B 79) B 80) C 81) B 82) A 83) A 84) C 85) A 86) A Version 1

87) C 88) B 89) D 90) B 91) A 92) Section Break 92.1) D 92.2) A 92.3) C 92.4) E 92.5) B 93) Section Break 93.1) B 93.2) A 93.3) A 93.4) FALSE 93.5) A

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CHAPTER 12 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Fungi are often capable of locomotion through the use of flagella. ⊚ ⊚

Algae may directly infect humans and cause disease. ⊚ ⊚

true false

Algae have a vascular system very similar to that found in plants. ⊚ ⊚

true false

4) Protozoans are eukaryotes and as such will always possess a nucleus, mitochondria, and chloroplasts. ⊚ ⊚

Protozoa are usually multicellular and found in arid environments. ⊚ ⊚

true false

Fungus grows well on fruits and many vegetables due to their alkaline pH. ⊚ ⊚

true false

Slime molds and water molds are types of fungi.

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⊚ ⊚

Most of the medically important multicellular parasites are helminths. ⊚ ⊚

true false

Typically, arthropods serve as vectors of disease, while helminths directly cause disease. ⊚ true ⊚ false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 10) In the late nineteenth century, immigration from Ireland to the United States occurred in high numbers due to an infection of potatoes by A) bacteria. B) viruses. C) fungi. D) protozoa. E) water molds.

11) Plant pathology grew in importance as a field of study after it was shown that the Irish potato blight was caused by A) bacteria. B) viruses. C) fungi. D) protozoa. E) water molds.

12)

Fungi are

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A) aerobesor facultativeanaerobes. B) obligate anaerobes. C) obligate aerobes. D) microaerophiles. E) photosynthetic.

13)

Fungi are particularly good at infecting A) protozoans. B) plants. C) algae. D) animals. E) fish.

14) The return of carbon dioxide to the atmosphere and nitrogen to the soil is due to the action of A) viruses and plants. B) bacteria and viruses. C) fungi and bacteria. D) fungi and viruses. E) plants and bacteria.

15)

All fungi have ______ in their cell walls. A) chitin B) cellulose C) pectin D) peptidoglycan E) ergesterol

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16)

Fungi are classified according to their A) mode of locomotion. B) morphology. C) mode of nutrition. D) method of sexual reproduction. E) cap color.

17)

The terms yeast, mold, and mushrooms refers to fungal A) reproduction. B) nutrition. C) morphology. D) parasites. E) staining.

18)

A tangle of fungal hyphae is generally known as a A) mycelium. B) bud. C) germ tube. D) spore. E) biofilm.

19)

Dimorphic fungi A) may grow as mycelia or yeast AND are mushrooms. B) may grow as mycelia or yeast AND are often associated with disease in humans. C) are often associated with disease in humans AND are mushrooms. D) are strictly hyphaeANDare often associated with disease in humans. E) are strictly yeastsANDare often associated with disease in humans.

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20)

Fungal spores are a major cause of A) anaerobic disease. B) fermentation. C) asthma. D) sepsis. E) hallucinations.

21)

The pH at which most fungi thrive is ______. A) 3 B) 5 C) 7 D) 8 E) 14

22)

Lichens may be an association of A) several different fungi. B) protozoa and bacteria. C) algae and fungi. D) virus and algae. E) fungus and ants.

23)

Mycorrhizae

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A) are vital for the survival of lichens AND are vital for the survival of many plants. B) are vital for the survival of many plants AND increase the absorptive ability of roots. C) are vital for the survival of many plants AND are used in the production of wine, beer, and bread. D) increase the absorptive ability of roots AND are used in the production of wine, beer, and bread. E) are used in the production of wine, beer, and bread AND are vital for the survival of lichens.

24)

Fungi capable of dimorphism grow either as A) rhizoids or hyphae. B) yeast-like or mycelium. C) germ tubes or buds. D) spores or mushrooms. E) yeast-like or mushrooms.

25)

Fungal diseases are generally referred to as A) mycoses. B) infections. C) systemics. D) infestations. E) funguses.

26)

Which statement about aflatoxins is NOT true? A) They are produced by Aspergillus. B) They are possible carcinogens. C) They may be found in peanuts. D) They are toxins. E) They are produced by Candida.

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27)

Fungi that are important for fermentation of fruits A) are mushrooms. B) are obligate aerobes. C) grow well at neutral pH. D) secrete degradative enzymes. E) All of the choices are correct.

28)

Coccidioidomycosis is A) a fungal diseasecaused by Coccidioides sp. B) a protozoandiseasecaused by Coccidioides sp. C) a fungal diseasecaused by Candida sp. D) a protozoandisease caused by Candida sp. E) a viral diseasecaused by Coccidioides sp.

29)

Fungi are important in A) foodproduction. B) food spoilage. C) production of antibiotics. D) disease of plants. E) All of the choices are correct.

30)

Fungi are important for all of the reasons EXCEPT A) helping many plants grow. B) cause disease in plants. C) making certain foods and beverages. D) spoiling fruits and vegetables. E) producing oxygen through photosynthesis.

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31)

Algae are important environmentally as A) major producers of carbon dioxide. B) major producers of oxygen. C) local flora. D) local contaminants. E) supporting fungal growth.

32)

Free-floating, photosynthetic organisms found in marine environments are A) saprotrophs. B) phytoplankton. C) blue-green algae. D) krill. E) mycelia.

33)

Algae A) often grow in areas where other forms of life may have difficulty. B) are strictly macroscopic organisms. C) have a vascular system similar to that of plants. D) are only found in the soil. E) are always saprophytic or parasitic.

34) Macroscopic algae possess a special structure that acts as an anchor and is commonly called

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A) a thallus. B) a holdfast. C) roots. D) the stipe. E) the bladder.

35)

Agar is obtained from A) bacteria. B) algae. C) protozoans. D) plants. E) yeasts.

36)

Diatoms are algae whose silicon dioxide-containing shells are useful economically as A) filters. B) fertilizers. C) stabilizers. D) thickeners. E) agar.

37)

The site in a photosynthetic eukaryotic cell where photosynthesis occurs is the A) nucleus. B) carotenoid. C) mitochondria. D) chloroplast. E) Golgi.

38)

Sexual reproduction in algae involves meiosis that results in the production of

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A) spores with twice as much DNA as the parental cells. B) gametes with half the amount of DNA as in the parental cells. C) spores with the same amount of DNA as the parental cells. D) swarming cells with the same amount of DNA as the parental cells. E) gametes with the same amount of DNA as in the parental cells.

39)

One of the organisms that may cause red tide is A) green algae. B) dinoflagellates. C) brown algae. D) euglenids. E) diatoms.

40)

Single-celled eukaryotic organisms that lack chlorophyll include A) protozoa AND yeasts. B) algae AND yeasts. C) protozoa AND cyanobacteria. D) yeasts AND cyanobacteria. E) algae AND archaea.

41)

Protozoan classification used to be based on their means of A) locomotion. B) growth. C) reproduction. D) obtaining nutrients. E) causing disease.

42)

Many protozoa (for example Sarcodina) move by means of

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A) flagella. B) apicomplexans. C) cilia. D) pseudopodia. E) microvilli.

43)

Protozoans are an important part of the food chain, ingesting large numbers of A) fish and crabs. B) bacteria and algae. C) shellfish and algae. D) other protozoans. E) bacteria and fungi.

44)

The most necessary habitat requirement of protozoa is A) moisture. B) light. C) heat. D) UV light. E) basic pH.

45)

The ability to exist as either a trophozoite or a cyst is characteristic of many A) fungi. B) viruses. C) protozoa. D) bacteria. E) archaea.

46)

One of the greatest causes of human deaths through time has been due to

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A) Giardia species. B) Histoplasma species. C) Plasmodium species. D) Trypanosoma species. E) Escherichia species.

47)

When cellular slime molds run out of food, they form a A) plasmodium. B) slug. C) myxamoeba. D) rhizoid. E) bladder.

48)

Lyme disease is transmitted by A) ticks. B) lice. C) mosquitoes. D) fleas. E) bacteria.

49)

Pediculus humanus A) only uses humans as a host ANDis carried by mosquitoes. B) only uses humans as a host AND can transmit a bacterial disease. C) only infects feet ANDcan transmit a bacterial disease. D) can transmit a bacterial disease AND only infects feet. E) is an obligate intracellular parasite AND only uses humans as a host.

50)

Lice and mites

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A) are both arachnids. B) may both be spread by personal contact. C) are intestinal parasites. D) cause Lyme disease. E) both cause respiratory illness.

51)

Which are not arthropods? A) Mosquitoes B) Fleas C) Lice D) Ticks E) Flukes

52)

Phthirus pubis A) transmit bacterial disease. B) cause "crabs". C) infect the blood. D) are transmitted by mosquitoes. E) are biological vectors.

53)

Fleas A) may transmit Yersinia pestis. B) may transmit Lyme disease. C) may transmit a toxin. D) have only one host—humans. E) have only two hosts—cats and dogs.

54)

Nematodes

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A) only infect aquatic plants. B) may enter the gastrointestinal tract or the blood. C) are carried by bacteria and fungi. D) have flat, segmented bodies. E) includes the trematodes.

55)

Which of the statements BEST describes tapeworms?

A) Theyhave a complicated digestive system. B) Theydo not have a digestive system. C) They may be transmitted by eating undercooked meat. D) They do not have a digestive system AND they may be transmitted by eating undercooked meat. E) Theyhave a complicated digestive system AND they may be transmitted by eating undercooked meat.

56)

Why would all protozoa be expected to require large amounts of water in their habitats? A) Without being in water, they would quickly dehydrate (due to their small size) and

die. B) They require waterto help them during photosynthesis by providing an electronsource. C) They require water to move around in to seek food particles and would be unable to move without water. D) Without being in water, they would quickly undergo plasmolysis (due to their small size) and die. E) None of the statements is correct.

57)

Are all fungi detrimental (bad) for other organisms?

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A) Yes—think of molds that destroy plant crops, or fungal infections that cause athlete's foot. All fungi are bad for organisms they colonize. B) Yes—fungi feed directly on organic material. Theyusually killthe otherorganism andfeedon it after it has died. As such, they are always bad for other organisms. C) No—it depends on thefungus and the relationship it has with the other organism. Some fungican form a symbiotic relationship with plant roots that increases their nutrient and water absorption. This is good. D) No—fungi are ALWAYS good when they interact with other organisms. There is never a negative aspect to such interactions. Both sides always benefit from the relationship. E) Yes—fungi are generally parasitic. Parasitic relationships always result in damage to the host organism while the parasite benefits from the association. As such, fungi are always bad for other organisms.

58)

Why were the slime molds and water molds once considered to be fungi?

A) Earlyidentification methods focused on appearances rather than biochemicalcharacteristics. B) Earlyidentification methods focused on appearances rather than geneticsimilarities/differences. C) Water molds and slime molds are STILL considered to befungi. D) They have the same material in their cell walls (chitin) that fungi possess. E) Water molds and slime molds always occur in the same habitats as fungi.

59) How would increased travel lead to increased spread of multicellular eukaryotic parasites?

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A) Many eukaryotic parasites are transmitted directly from person to person via airborne transmission, so getting an infected individual onto a plane of susceptible individuals would increase spread. B) Many eukaryotic parasites depend on vectors (often small blood-sucking insects) for transmission, so moving an infected individual into an area with newvectors and new susceptible humans would increase spread. C) It really would NOT; most individuals are screened for parasitic infections prior to traveling out of highly infected areas. We also have quarantine abilities at customs stations for individuals entering the United States. D) Eukaryotic parasites are too small to travel great distances effectively; by hitching a ride on luggage, clothing, fruit/vegetables, and other food products, they can enter new geographic areas. E) Traveling generally weakens a person's immune system, making them vulnerable to parasitic eukaryotes in any new place that they visit.

60) Why would it be more difficult to treat diseases in humans caused by members of the Eukarya than diseases caused by the Bacteria? A) Multicellular organisms always have their own immune systems for protection, so any treatment we develop needs to overcome this built-in protection mechanism. B) Since bacteria are so much simpler (being single-celled) than multi-cellular eukaryotic microbes, they are naturally easier to kill off. C) Eukaryotic microbes use many of the same enzymes and systems as humans, so we lose the ability to target certain molecules that might be present ONLY in the cell type we want to eliminate. D) Eukaryoticmicrobes (unlike prokaryotes) often secrete compounds that breakdown andeliminate drugs used against them. This makes them much harder toeffectively eliminate than bacteria. E) Eukaryotic pathogens multiply much more effectively in a human host than bacterial pathogens do; they attain extremely high numbers in the host, making it very difficult to get rid of them.

61)

Which of the following definitions is CORRECT?

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A) Saprophytes—organisms that take in nutrients from dead and decaying matter. B) Mycelium—thread-like structure that characterizes the growth of most fungi and some bacterial species. C) Zooplankton—microscopic free-floating photosynthetic organisms. D) Kinetoplastids—agroup of protozoa that penetrate host cells by means of a structure called an apical complex. E) Proglottids—short, non-segmented, bilaterally symmetrical flatworms.

62)

What is a definitive host in the life cycle of a parasite? A) An organism in which asexual reproduction or an immature form of a parasite

occurs. B) An organism in which either sexual reproduction or asexual reproduction of the parasite occurs. C) An organism in which sexual reproduction or the adult form of a parasite occurs. D) An organism in which the parasite multiplies asexually, without causing any damage to the host. E) An organism from which a parasite typically is not passed to another host, so that the parasite cannot complete its life cycle.

63)

Which disease is INCORRECTLY matched with its arthropod vector? A) Malaria— Anopheles mosquito B) Plague—fleas C) African sleeping sickness—sand fly D) Lyme disease—ticks E) Dengue fever—mosquitoes

64) Please select the INCORRECT statement regarding helminths and the diseases they cause.

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A) Some helminths are inadvertently eaten with food. For example, eating undercooked pork containing Trichinella spiralis larvae is the most common cause of trichinellosis. B) Some helminths are transmitted through insect bites. For example, Wuchereria bancrofti, the cause of elephantiasis, is transmitted bymosquitoes. C) Some helminths are inadvertently ingested. For example , Onchocerca volvulus, the cause of River blindness, is transmitted by drinking contaminated water or eating fish carrying this parasite. D) Some helminths burrow into people. For example, immature forms of hookworm larvae live in the soil and can burrow through human skin.  E) Sometime helminth eggs are ingested on the surface of contaminated foods. For example, pinworm eggs ( Enterobius vermicularis) may be transmitted a food surface.

65) How does Ascaris lumbricoides, an intestinal parasite, cause choking and pulmonary symptoms in some people? A) People inadvertentlyinhale Ascaris worms when they bring contaminated food close to their mouths; these cause pulmonary blockages. B) Ingested Ascarislarvae penetrate intestinal capillaries, from where they are carried to the lungs, causing coughing and shortness of breath. C) Ascaris larvae are highly allergenic; when they are ingested, they cause an allergic reaction which includes coughing. D) Ascaris is a pulmonary parasite; it only enters the intestineof people with other lung conditions, including asthma. E) Ascaris, being anaerobic,form large cysts in pulmonary tissue; these accumulate in the lungs, causing coughing.

66)

Which of the following are diseases caused by protozoa? A) Giardiasis, malaria, AND trichinellosis. B) Giardiasis, malaria, ANDtoxoplasmosis. C) Amebiasis, malaria,AND plague. D) Schistosomiasis, amebiasis, AND primary amebic meningoencephalitis. E) Dengue fever, malaria, AND plague.

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67) Which are the three ways in which fungi cause illness in humans? 1. Hypersensitivity - person has allergic reaction to fungal components. 2. Intoxication - fungus produces a toxin that is ingested. 3. Immune suppression - fungus destroys all red blood cells. 4.Infection - fungus grows on body as a mycosis. A) 1, 2, and 3 B) 2, 3, and 4 C) 1, 3, and 4 D) 4 only E) 1, 2, and 4

68) Which of the following statements regarding protozoa is FALSE?  A) All protozoa lack mitochondria. B) Some protozoa are photosynthetic. C) Some protozoa are parasitic. D) Trichomoniasisis caused by a protozoan. E) Protozoa are unicellular organisms.

69)

Which of the following statements regarding tapeworms is FALSE?

A) They absorb nutrients from the host's gut through their skin. B) A single worm contains broth male and female reproductive organs. C) They complete their life cycle in a single host. D) They can sometimes cause neurological signs and symptoms in the host. E) They do not have a digestive system.

70)

Which of the statements regarding Naegleria fowleriis FALSE?

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A) It is a small, Gram-negative, flagellated diplococcus. B) It is swims though water as a flagellated form. C) Once in a human host, it assumes an amoeboid form. D) It causes primary amebic meningoencephalitis (brain eating disease). E) It forms a cyst under adverse environmental conditions.

71)

Which of the following are characteristics of fungi?

A) They have a peptidoglycan cell wall AND they may be photosynthetic. B) Their cell wall contains chitin AND theyuse nutrients from dead or decaying organic matter.  C) Their cell wall contains cellulose ANDthey use nutrients from dead or decaying organic matter.  D) Their cytoplasmic membrane contains ergesterol AND they are always multicellular. E) They have a nuclear membrane AND their cell wall contains cellulose.

72)

Select the TRUE statement regarding algae. A) Although most algae have a cellulose/pectin cell wall, some algae lack a cell wall. B) Some algae can directly cause infectious diseases in humans and other animals. C) Algae are plants and therefore possess a highly organized vascular system. D) Algae are generally saprophytic, living off dead and decaying matter. E) Algae always reproduce sexually, producing both haploid and diploid generations.

73)

Which of the following is NOT an economic importance of fungi? A) Fungi may be a food source, for example mushrooms. B) Fungi are used in food production, for example bread. C) Some common antibiotics are produced by fungi. D) Genetically engineered fungi can be used to produce hormones. E) Fungi may form symbiotic relationships with algae.

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74)

Which of the following is FALSE about mycoses? A) They are diseases caused by fungi. B) An example is athlete's foot. C) They are diseases caused by protozoa. D) An example is histoplasmosis. E) They may be systemic infections.

75)

Which group has chitin in the cell walls? A) Fungi B) Algae C) Bacteria D) Helminths E) Protozoa

76)

Select the FALSE statement regarding protozoa. A) All protozoa contain mitochondria. B) Some protozoa cause disease. C) Protozoa may be motile. D) Zooplankton contains protozoa. E) Not all protozoa contain mitochondria.

77)

Which of the following fungi is mismatched with the type of infection it causes? A) Pneumocystis jirovecii - systemic B) Candida albicans - opportunistic C) Sporothrix schenkii - subcutaneous D) Cryptococcus neoformans - opportunistic E) Histoplasma capsulatum - systemic

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78)

Why does conidia formation increase when food supplies of a fungus are diminishing?

A) Spores help the fungus survive under poor conditions such as a low food supply until conditions improve. B) Spores can serve as a food source for the fungus under poor conditions until conditions improve. C) Spores allow the fungus to move away from areas where poor conditions exist. D) Spores are photosynthetic so allow the fungus to generate its own food when other food is scarce. E) Spores are parasitic, so allow the fungus to enter a host when environmental conditions are poor.

79)

Which of the following is NOT an algal pigment? A) Bilirubin B) Chlorophyll a C) Chlorophyll b D) Phycoerythrin E) Phycocyanin

80)

Which statement regarding protozoa is INCORRECT? A) Many protozoa are motile. B) Some protozoa lack mitochondria. C) Protozoa are important in the food chain. D) The infectious form of some protozoa is the trophozoite. E) Cats are the definitive host for Toxoplasma gondii.

81)

What do hemoflagellates have in common with bacteria?

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A) They divide by binary fission. B) They have a peptidoglycan cell wall. C) They have many large mitochnodria. D) They complete part of their life cycle in the bloodstream. E) Their DNA is found in a structure called a kinteoplast.

82)

Please select the CORRECT definition for primary endosymbiosis.

A) A non-photosynthetic eukaryotic cell engulfs a cyanobacterium, which becomes a chloroplast. B) A non-photosynthetic prokaryotic cell engulfs a cyanobacterium, which becomes a chloroplast. C) A photosynthetic eukaryotic cell engulfs a cyanobacterium, which becomes a nucleus. D) A non-photosynthetic eukaryotic cell engulfs a cyanobacterium, which becomes a nucleus. E) A non-photosynthetic eukaryotic cell engulfs a photosynthetic eukaryotic cell, which becomes a chloroplast.

83)

Convergent evolution

A) explains the morphological similarity yet major genetic differences found between slime molds and fungi. B) refers to two different organisms that develop similar characteristics in adaptation to similar environments. C) refers to the one organism dividing into two ANDrefers to two different organisms that develop similar characteristics in adaptation to similar environments. D) explains the morphological similarity yet major genetic differences found between slime molds and fungi AND refers to two different organisms that develop similar characteristics in adaptation to similar environments. E) refers to one organism dividing into two AND explains the morphological similarity yet major genetic differences found between slime molds and fungi.

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84)

Please select the INCORRECT statement regarding eukaryotic toxins. A) Aflatoxin is produced by some Aspergillus species. B) Rye mold (ergot) produces an hallucigenic toxin. C) Brevetoxin is associated with red tides. D) Saxitoxin is produced by some photosynthetic dinoflagellates. E) Red algae produce the toxin corraline.

85)

Tapeworms

A) lack a digestive system and absorb nutrients from the host. B) contain segments called proglottids that contain either male or female reproductive structures. C) commonly usecattle, fish or pigsas definitive hosts. D) sometimes reach lengths of 1.5 cm over as much as 10 years. E) are tremotodes and have flat, leaf-shaped bodies.

86)

Which of the following about helminths is TRUE?

A) Cestodes do not have a digestive system; they absorb predigested nutrients from the host through their skin. B) Trematodes have a regular digestive system with a mouth that takes in food and an anus through waste is eliminated. C) Nematodes have a mouth but no anus; food and wastes enter and exit the same opening on the head of the worm. D) Trematodes attach to the intestinal wall of the host by means of the scolex, which has hooks and suckers. E) Blood flukes are hermaphroditic, having male and female sex organs in the same worm.

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SECTION BREAK. Answer all the part questions. 87) You and your exercisepartnerdecide to go to Yosemite National Park to hike the famous El Capitan trail. You book your trip through a well known agency but before you leave for your vacation, you learn thatthere have been two cases of plague reported in people who recently visited a different area of the park. Your friend is anxious and tells you he thinks that plague is really dangerous and kills people everyone who gets it. He points out that this disease killed a lot of people during the Middle Ages, and says he doesn't want to do the trip after all. You decide to do some research on the plague and its causative agent before making a decision about your trip.

87.1) Plague is caused by Yersinia pestis, a Gram-negative facultatively anaerobic rod. Itis non-motile and grows best at 28°C. Because you are a microbiology student, you know that the organism is A) a mesophilethat grows best in the presence of oxygen but can also grow without it. B) a psychrophilethat grows best in the presence of oxygen but can also grow without it. C) a psychrophilethat grows best without oxygen but can also grow when oxygen is present. D) a mesophilethat grows best without oxygen but can also grow when oxygen is present. E) a mesophilethat cannot grow when oxygen is present.

87.2) Yersinia pestisis transmitted by fleas. The organism forms biofilms in the digestive tract of infected fleas, often blocking the tract. This prevents the flea from feeding properly,causing bacteria to be regurgitated into the bite wound that the flea has made. In this situation, the flea isa A) mechanical vector. B) biological vector. C) mechanical host. D) biological host. E) dead-end host.

87.3)

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Which of the following is NOT a vector?

A) Flea B) Mosquito C) Tick D) Fly E) Water

87.4)

Please select the FALSE statement regarding arthropod vectors.

A) Mechanical vectors simply transfer a pathogen from one surface to another. <!-Markup Copied from Habitat--> B) Biological vectors play an essential role in the life cycle of the pathogen. C) Arthropods are very specific and always bite only one type of host. D) The incidence of vector-borne diseases can be decreased by controlling the vector or the infected hosts.  E) Some arthropods cause disease even when they do not act as a vector.

87.5) Some arthropods cause disease even when they do not act as a vector. Which of the following is an example of this?

A) Scabies is characterized by an itchy rash caused by allergic reactions to female mites that have burrowed into the outer layers of skin.  B) The pubic louse is commonly transmitted during sexual intercourse and can cause an unpleasant itch associated with “crabs.” C) Dust mites do not transmit infectious disease, but inhalation of the mites and their waste products can sometimes trigger asthma.  D) The larvae of some mites are called “chiggers” and may cause intense itching where they attach and feed on fluids within skin cells. E) These are all examples of the situation described.

87.6) Once Y. pestis is in the human host, it is ingested by macrophages. Conditions within the macrophage activate certain genes in the bacterium, one of which is a gene for a capsule production. The capsule

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A) allows the bacteria to float in water. B) allows the bacteria to exchange DNA with other bacteria. C) allows the bacteria to avoidphagocytosis. D) provides a source of nutrients for the bacteria. E) allows the bacteria to survive excess heat.

87.7)

Please select the FALSE statement regarding plague and its transmission.

A) Plague is caused by a Gram-negative organism and is thus completely untreatable with antibiotics. B) Yersinia pestisis a Gram-negative organism and thus possess an outer lipopolysaccharidelayer. C) People can contract plague when they are bitten by fleas from rodents infected with the causative organism. D) Y. pestis is typically transmitted by the bites of infected fleas, an example of biological transmission. E) The incidence of vector-borne diseases such as plague can be decreased by controlling the vector or the infected hosts.

87.8) Yersinia pestis can be transmitted in more than one way. Most commonly, a person is bitten by an infected flea from which he or she may contract bubonic plague, characterized by large and tender lymph nodes (called buboes). If a person inhales respiratory droplets from an infected patient or animal, he or she may develop pneumonic plague with signs and symptoms of pneumonia (rare).When the causative organism spreads via the bloodstream, the person may develop septicemic plague in which there is bleeding in the skin and organs (rare). Which of the following would you tell your friend to put his mind at ease about going to Yosemite?

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A) Most people who get plague actually get the pneumonic form of the disease, transmitted through inhaled droplets. If you wear a face mask while you hike, you will be perfectlysafe and will not contract the disease. B) The people who contracted plague while in Yosemite were camping and were likely exposed to fleas from groundsquirrels in the camp grounds. As you will be staying in a hotel, your risk of getting bitten by squirrel fleas is very low. C) Plague is really not a very serious disease. People in the Middle Ages died from it because their immune systems were very weak in those days because of bad air pollution. D) Plague is a serious disease but your immune systemcan easily get rid of it because the causative agent has no way to avoid your immune defenses. As such, it doesn't matter if you contract plague because you will easily recover. E) Plague is a seasonal disease because the causative organism only grows at 28 oC. It has only been reported to occur during May or October, so if you hike in July, there will be no risk.

88) Your sister Sally loves seafood and often goes to her local bay, where she digs up fresh clams. She calls you to tell you that she has had a great time that day and that she found and ate nine fresh little neck clams. Several hours later, Sally calls you back, complaining that she is feeling unwell. She reports that she is experiencing dizziness, ataxia (lack of coordination), lip parathesia (tingling sensation), nausea, vomiting and shortness of breath. You immediately suspect that Sally has paralytic shellfish poisoning (PSP) and tell her to get to the hopsital as soon as possible. She is admitted to the ICU, where she is placed on mechanical ventilation to help her breathe and given other supportive care. She makes a full recovery.

88.1)

PSP is caused by a toxin produced by a dinoflagellate. Dinoflagellates are

A) protozoa. B) fungi. C) photosynthetic algae. D) non-photsynthetic algae. E) helminths.

88.2) The toxin that Sally ate in the clams was saxitoxin. This toxin is a neurotoxin, which means that it

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A) affects the nervous system. B) kills seafood containing it. C) is always fatal. D) only affects humans. E) is a novel type of toxin.

88.3)

Which of the following about Sally's symptoms is INCORRECT?

A) She has parathesia, which means she is weak. B) She has ataxia, exhibiting coordination problems. C) She is dizzy, indicating nervous system involvement. D) She has nausea and vomiting, indicating gastrointestinal involvement. E) She has shortness of breath, indicating muscle system involvement.

88.4) The source of the toxin causing Sally's illness is a dinoflagellate. Which statement about dinoflagellates is CORRECT? A) All dinoflagellates are photosynthetic. B) Several specis of dinoflagellates produce neurotoxins. C) Dinoflagellates are red algae and cause red tides. D) Dinoflagellates have a cell wall composed of peptidoglycan. E) Dinoflagllates move by means of fimbriae and pili.

88.5) Sally is admitted to the intensive care unit (ICU), where she is placed on a ventilator and given other supportive treatment. What can you infer about saxitoxin and PSP, given this information? A) There are no medications available to treat PSP. B) It always stops a person from breathing. C) Neurotoxin poisoning always requires ICU admission. D) Saxitoxin causes permanent nerve damage. E) Paralytic shellfish poisoning is always fatal.

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Answer Key Test name: Chap 12_10e 1) FALSE 2) FALSE 3) FALSE 4) FALSE 5) FALSE 6) FALSE 7) FALSE 8) TRUE 9) TRUE 10) E 11) E 12) A 13) B 14) C 15) A 16) D 17) C 18) A 19) B 20) C 21) B 22) C 23) B 24) B 25) A 26) E Version 1

27) D 28) A 29) E 30) E 31) B 32) B 33) A 34) B 35) B 36) A 37) D 38) B 39) B 40) A 41) A 42) D 43) B 44) A 45) C 46) C 47) B 48) A 49) B 50) B 51) E 52) B 53) A 54) B 55) D 56) A Version 1

57) C 58) B 59) B 60) C 61) A 62) C 63) C 64) C 65) B 66) B 67) E 68) A 69) C 70) A 71) B 72) A 73) E 74) C 75) A 76) A 77) A 78) A 79) A 80) D 81) A 82) A 83) D 84) E 85) A 86) A Version 1

87) Section Break 87.1) A 87.2) B 87.3) E 87.4) C 87.5) E 87.6) C 87.7) A 87.8) B 88) Section Break 88.1) A 88.2) A 88.3) A 88.4) B 88.5) A

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CHAPTER 13 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) A lysogenic cell contains viral DNA (a prophage)integrated into the host chromosome. ⊚ ⊚

true false

2) The integration of phage DNA into host DNA occurs in much the same fashion as seen in transformation, transduction, or conjugation. ⊚ true ⊚ false

A filamentous phage is incapable of causing a lytic infection. ⊚ ⊚

Completed filamentous phages are often found in the cytoplasm of infected bacteria. ⊚ ⊚

true false

Transduction often involves defective virus. ⊚ ⊚

true false

Virulent as well as temperate phages can serve as generalized transducing phages. ⊚ ⊚

true false

The host range of a virus depends on the presence of host receptor molecules.

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⊚ ⊚

true false

8) Bacteriophages, unlike animal viruses, often have special viral-specific enzymes carried in the capsid, which enter the host cell at the same time as the nucleic acid. ⊚ true ⊚ false

9) The structure of plant, animal, and bacterial viruses are each, fundamentally, very different from one another. ⊚ true ⊚ false

10)

Capsids are made of a number of capsomeres that are covalently bonded to one another. ⊚ true ⊚ false

11)

Non-enveloped and enveloped viruses both may enter the host via endocytosis. ⊚ true ⊚ false

12)

All viruses must separate the nucleic acid from the capsid before replication. ⊚ ⊚

13)

If a virus utilizes a lytic life cycle of reproduction, it will not induce tumors. ⊚ ⊚

14)

true false

Viruses that cause acute infection result in productive infections.

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⊚ ⊚

true false

15) Electron microscopy is useful for counting viruses and distinguishing between infective and non-infective virions. ⊚ ⊚

16) agar.

true false

Infective and non-infective viruses may be distinguished by growth on MacConkey's ⊚ ⊚

true false

17) It is necessary to have more bacteria than phages in the plaque assay to ensure that each bacterial cell is only infected with a single virion, leading to a single plaque. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 18) Viruses that infect bacteria are referred to as A) viralcidens. B) bacteriocidins. C) bacterialogens. D) bacteriophages. E) virophages.

19)

A virion is a(n)

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A) pathogenic virus. B) subviral particle. C) complete, extracellular virus particle. D) enveloped virus particle. E) non-enveloped virus particle.

20)

A virion is composed of A) lipid, protein, and either RNA or DNA. B) protein, either RNA or DNA, and possibly lipid. C) protein and either RNA or DNA, but no lipid. D) protein and both RNA and DNA, but no lipid. E) protein, and possibly lipid.

21)

Which of the following BEST describes theprotein coat of a virus? It

A) is called a capsomere,AND is involved in the recognition of host cell receptors by non-enveloped viruses. B) is called a capsid,AND is involved in the recognition of host cell receptors by nonenveloped viruses. C) protects the nucleic acid,AND is involved in the recognition of host cell receptors by non-enveloped viruses. D) is called a capsomere, protects the nucleic acid, AND is involved in the recognition of host cell receptors by non-enveloped viruses. E) is called a capsid, protects the nucleic acid, AND is involved in the recognition of host cell receptors by non-enveloped viruses.

22)

Which does not refer to the shape of a virus?

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A) Bacillus B) Icosahedral C) Helical D) Complex E) These are all virus shapes.

23)

The shape of the virus is determined by its A) nucleic acid. B) capsid. C) envelope. D) tail. E) spikes.

24)

The viral envelope closely resembles the A) prokaryotic cell wall. B) capsomere. C) eukaryotic cytoplasmicmembrane. D) cytoplasm. E) eukaryotic cell wall.

25) The protein projections on the surface of a virus that are involved in attachment to the host cell are called A) suckers. B) pili. C) cilia. D) spikes. E) hooks.

26)

Outside of living cells, viruses are

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A) scavenging glucose. B) gaining ATP from the mitochondria. C) metabolically inert. D) using cilia to move to the next host. E) replicating by binary fission.

27)

What part of the attached bacteriophage enters through the host cell wall? A) The entire virus. B) Only the enzymes necessary for replication. C) The nucleic acid. D) The nucleic acid and capsid. E) The capsid only.

28)

A phage that replicates inside the host cell and then lysis its host during its release is a A) virulent or lytic phage. B) latent phage. C) lysogenic phage. D) dormant phage. E) temperate phage.

29)

The correct order for the stages of a phage infection is

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A) penetration, transcription, attachment, replication of nucleic acid and protein, assembly, release. B) attachment, penetration, transcription, replication of nucleic acid and protein, assembly, release. C) attachment, replication of nucleic acid and protein, penetration, transcription, assembly, release. D) transcription, attachment, replication of nucleic acid and protein, assembly, penetration, release. E) attachment, replication of nucleic acid and protein, assembly, penetration, transcription, release.

30) Phages that can either replicate and cause cell lysis or can integrate their DNA into the host DNA are called A) temperate phages. B) lytic phages. C) virulent phages. D) segmented phages. E) bacteriophages.

31)

One of the most intensively studied virulent phages which infects E. coli is ______. A) T9 B) T4 C) beta D) gamma E) lambda

32)

During attachment of phage to E. coli, the phage

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A) actively seeks out the bacteriaAND attaches to proteins or carbohydrates on the bacterial surface. B) randomly bumps into the bacteria AND attaches to proteins or carbohydrates on the bacterial surface. C) randomly bumps into the bacteria ANDattaches to the bacterial RNA. D) randomly bumps into the bacteria AND attaches to the bacterial DNA. E) actively seeks out the bacteriaAND attaches to the bacterial DNA.

33)

What part of the E. coli T4 phage attaches to the host cell receptors? A) Capsid fragments around the nucleic acid. B) Protein fibers at the end of the phage tail. C) Pili of the envelope. D) Spikes of the envelope. E) Spikes of the cell wall.

34)

During penetration of E. coli by the T4 phage, A) lysozyme is used to allow entry of the phage capsid. B) the tail acts as a "hypodermic needle," injecting the phage DNA into the cell. C) the protein fibers digest a hole in the cell wall. D) the bacterial receptor molecules open a hole through the cell wall. E) the intactphage enters the hostby endocytosis.

35)

Phage-encoded proteins are A) coded for by host DNA. B) coded for by phage DNA. C) proteins normally present in the uninfected cell. D) early proteins. E) coded for by phage DNA AND early proteins.

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36)

Phage-encoded enzymes are

A) all produced simultaneously AND are used to customize the cell for viral production. B) produced in a sequential manner AND maintain the integrity of the host cell membrane. C) are strictly host enzymes AND areused to customize the cell for viral production. D) produced in a sequential manner AND are used to customize the cell for viral production. E) all produced simultaneously AND are used to destroy the host cell.

37)

Assembly of the T4 phage A) is completely self-assembly B) is completely dependent on scaffolds. C) may involve some self-assembly AND may involve the use of scaffolds. D) may involve some self-assembly ANDis completely dependent on scaffolds. E) is completely self-assembly ANDis never dependent on scaffolds.

38)

In the case of T-even phages, the burst size is about A) 1 per host cell. B) 5 per host cell. C) 20 per host cell. D) 200 per host cell. E) 1,000 per host cell.

39)

The time from absorption to release for T-even phage is about

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A) 1 day. B) 30 minutes. C) 10 minutes. D) 1 minute. E) 45 seconds.

40)

The replicative form of nucleic acid in filamentous phages is A) dsDNA. B) dsRNA. C) positive ssRNA. D) negative ssDNA. E) positive ssDNA.

41)

Filamentous phages A) only infect E. coli that have pili. B) only infect E. coli lacking pili. C) infect E. coli regardless of the presence of pili. D) do not infect E. coli. E) only infect Gram-negative E. coli.

42)

Which is a filamentous phage? A) M13 B) T4 C) Lambda D) TMV E) T2

43)

The bacterial viruses that are released by a process termed extrusion are called

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A) lysogenic viruses. B) temperate phages. C) filamentous phages. D) lambdaviruses. E) helical phages.

44)

The filamentous phages all contain A) single-stranded DNA. B) double-stranded DNA. C) single-stranded RNA. D) double-stranded RNA. E) single-stranded RNA, OR single-stranded DNA.

45)

An exit method used by viruses that does not immediately destroy the host bacterium is A) lysis. B) inversion. C) extrusion. D) excising. E) endocytosis.

46)

In the replication of phage containing positive-sense DNA,

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A) the host's enzymes are used to make dsDNA. B) the host's DNA polymerase uses the phage RNA as a template to make negativesense DNA. C) a phage-encodedDNA polymerase is used to make negative-sense RNA using the phagepositive-sense RNA as a template. D) a phage-encoded DNA polymerase is used to make DNA using the phage positivesense RNA as a template. E) a phage-encoded RNA polymerase is used to make DNA using the phage positivesense RNA as a template.

47)

Which statement about mostphages that contain single-stranded DNA is NOT true? A) They are extruded from the host cell. B) They contain a negative-sense DNA strand. C) Their DNA is transformed to dsDNA before replication and transcription occur. D) All of the choices are correct. E) None of the choices is correct.

48)

Which statement regardingphage replication is TRUE? A) A lysogen is a bacterial cell with an integratedprophage. B) When integrated into host DNA, phage DNA is called a virophage. C) Lambda is a good example of a lytic phage. D) Lambda can be alytic or a temperate phage. E) A lysogen is a virus that has bacterial DNA in it.

49)

A temperate phage

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A) may be lysogenic. B) may be lytic. C) enters a lysogenic or lytic life cycle shortly after entering the host cell. D) may be lytic ANDenters a lysogenic or lytic life cycle shortly after entering the host cell. E) may be lysogenic AND enters a lysogenic or lytic life cycle shortly after entering the host cell.

50)

The integration of phage DNA into the bacterial chromosome occurs because of

A) the phage's ability to synthesize an enzyme that integrates its DNA into the host's chromosome. B) the phage's ability to synthesize enzymes that allow itto enter the bacterium. C) similarity in RNA nucleotides in both the phage and the bacterial host. D) the similarity in enzyme metabolism in the phage and the bacterial cell. E) the phage's ability to synthesize enzymes to enter the bacterium AND similar RNA nucleotides in both.

51)

Once integrated, phage DNA can remain in the prophage state as long as A) the bacteria is frequently plated on new media. B) certain phage genes are excised. C) certain phage genes are repressed. D) bacterial repressor genes are activated. E) bacterial repressor genes are deactivated.

52)

The activation of the SOS system in a bacterium infected with a prophage results in

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A) destruction of certain bacterial genes ANDdestruction of the viral repressor through host protease activity. B) destruction of the viral repressor through host protease activity AND lysis of the bacterial cell. C) destruction of the viral repressor through host protease activity ANDmutation of the DNA D) lysis of the bacterial cell, destruction of the viral genes, AND mutation of the DNA. E) destruction of certain bacterial genes AND lysis of the bacterial cell.

53)

Whichistrue of lysogenized cells?

A) They are immune to any further infection by any virus. B) They are immune to infection by the same virus. C) They may have new properties AND they respond to infection with the SOS response. D) They respond to infection with the SOS response. E) They are immune to infection by the same virus AND may have new properties.

54) The phenomenon responsible for the ability of Corynebacterium diphtherium to produce the virulent toxin responsible for the devastating effects of diphtheria is called A) self-assembly. B) matrix conversion. C) lysogenic conversion. D) prion protein. E) phase variation.

55)

Transducing virulent phages do not lyse the cells they invade because

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A) transformation is taking place in the phage and this is transferred to the bacterium. B) bacterial DNA has replaced critical viral DNA in the phage. C) their virulence is dependent on the bacteria and virus replicating together. D) the lytic genes are unable to enter during penetration and are shed outside the host. E) viral DNA has replaced critical bacterial DNA in the phage.

56)

A limiting factor for viral infection of animals cells is A) presence of specific receptor molecules on the host cell. B) internal metabolic temperature of the host cell. C) nutrition of the host cell. D) stage of cell cycle of the host cell. E) culture conditions of the host cell.

57) If the infecting phage lacks some critical pieces of DNA necessary for replication, it is called A) incomplete. B) mutated. C) defective. D) vegetative. E) carcinogenic.

58)

All of the statements about specialized transduction are correct EXCEPT A) it involves the random transmission of any gene. B) it involves the transfer of a few specific genes. C) it involves a defective virus. D) it only involves genes near the viral DNA integration site. E) it involvestemperate phages.

59)

Once inside the host cell, phage DNA

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A) is replicated. B) is transcribed. C) may get degraded by bacterial nucleases. D) may integrate into the host chromosome. E) All of the choices are correct.

60)

Using phages to treat a bacterial infection is an interesting idea because

A) a single type of phage can destroy a wide range of strains of the same pathogen. B) of the increasing problem of antibiotic resistance in pathogens. C) lysed bacteria pose no threat to a person's health. D) a single phage canbe genetically engineered to infect many different species of bacteria. E) of the increasing problem of antibiotic resistance in people.

61)

What are two ways that phage can replicate without directly lysing their host cell? A) Conjugation and lysogeny B) Lysogeny and transduction C) Extrusion and transformation D) Extrusion and lysogeny E) Extrusion and lysis

62)

What is a defective phage?

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A) A virus that has lost some of its genetic material, and therefore cannot infect a new target cell. B) A virus that has lost some of its genetic material, and therefore cannot replicate within a new target cell. C) A virus that lacks the ability to replicate independently of its host cell and cannot survive. D) A virus that cannot attach to its host cell and therefore cannot enter the target cell. E) A virus that lacks a prophage, cannot enter a host cell, and cannot survive.

63)

The nucleocapsid is composed of A) DNA and RNA and protein. B) DNA or RNA, and protein. C) protein located in the nucleus. D) nucleic acid in the ribosome. E) DNA or RNA, lipid, and protein.

64)

Enveloped viruses A) never use spikes for attachment to host cells. B) have a lipid bilayer membrane containing various proteins. C) are surrounded by an additional layer of carbohydrate. D) surround the boundary of a host cell. E) are difficult to destroy using detergents.

65)

The term "segmented" refers to viruses that A) may contain several pieces of RNA. B) have an icosahedral-shaped capsid. C) are linked together before budding out. D) have an envelope that has several components. E) may contain RNA with undefined regions in it.

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66)

The terms helical, icosahedral, and complex refer to A) viral life cycles. B) forms of nucleic acid. C) types of viral envelopes. D) shapes of viruses. E) types of bacteriophages.

67)

Animal viruses are divided into a number of families whose names end in A) -virus. B) -viridae. C) -viscous. D) -eieio. E) -virum.

68)

There are ______ major families of DNA-containing viruses that infect vertebrates. A) 7 B) 5 C) 4 D) 2 E) 6

69)

There are ______ major families of RNA containing viruses that infect vertebrates. A) 2 B) 5 C) 7 D) 13 E) 6

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70)

Viruses are commonly referred to by their ______ name. A) locale AND genus B) genus AND species C) disease AND species D) disease AND locale E) disease AND genus

71)

The common species name of the virus is frequently based on the A) presence or absence of a nuclear membrane. B) type of nucleic acid it contains. C) disease the virus causes. D) geographic area it is found. E) shape of the viral nucleocapsid.

72)

The family to which the Rhinovirus belongs is the A) Picornaviridae. B) Enterovirus. C) Enteroviridae. D) Picornavirus. E) Rhinoviridae.

73)

A key feature of all viral infections is the A) integration of viral DNA into host DNA. B) separation of viral nucleic acid from the capsid. C) disintegration of host DNA. D) addition of a lipid membrane to the virus. E) lysis of the host cell.

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74)

An infection in which the virus is continually present in the body is referred to as A) acute. B) balanced. C) determinant. D) persistent. E) fatal.

75)

Attachment of animal viruses to the host cell may be by means of A) a tail. B) the envelope. C) spikes. D) a capsid. E) a membrane.

76)

The receptors to which animal virus attachment proteins usually bind are A) glycoproteins. B) proteins. C) carbohydrates. D) nucleic acid. E) lipids.

77)

Resistance of some animals to certain viral diseases is based on A) lack of spikes for attachment. B) lack of specific receptors on the host cell. C) phagocytosis of the virus by the host cell. D) the presence of the viral envelope. E) immunity in the host cell.

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78) When a non-enveloped animal virus adsorbs to the host cell with its protein spikes, the virions are taken into the cell by the process of A) penetration. B) production. C) endocytosis. D) fusion. E) budding.

79)

Entry of bacteriophages and animal viruses into host cells

A) is by endocytosis. B) is by fusion. C) involve entry of the entire nucleocapsid. D) differs because bacteriophages leave the capsid outside the cell, while animal virus entry involves the entry of the whole nucleocapsid. E) differs because animal viruses leave the capsid outside the cell, while bacteriophage entry involves the entry of the whole nucleocapsid.

80)

For which of the following processes are enzymes not required? A) Replication B) Self-assembly C) Translation D) Maturation E) All of the answer choices are correct.

81)

Cells infected with animal viruses lyse because

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A) the release of the virions depletes the cell of energy. B) the virus releases enzymes that lyse the cell. C) functions necessary for cell survival are not carried out and the cell dies. D) the virus RNA and cellular protein interact to kill the cell. E) the viruses release lysozyme which destroys the host cell wall.

82)

In addition to lysis, animal viruses may exit the host cell by A) extrusion. B) budding. C) fission. D) fusion. E) endocytosis.

83)

In the region of budding, the inside of the cytoplasmic membrane becomes coated with A) enzymes. B) carbohydrates. C) steroids. D) matrix proteins. E) phospholipids.

84)

In the region of budding, the cytoplasmicmembrane acquires A) carbohydrates AND spike proteins. B) spike proteins AND enzymes. C) spike proteins AND matrix proteins. D) matrix proteins AND carbohydrates. E) enzymes AND matrix proteins.

85)

The enveloped viruses typically obtain their envelope

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A) from the host cytoplasmicmembrane as they exit the host. B) from a newly constructed viral-derived membrane. C) from the nuclear membrane as they exit the host. D) from endoplasmic reticulum in the host. E) from the host peptidoglycan as they exit.

86)

Carriers A) may have a persistent infection. B) may be a source of infection. C) usually show symptoms of the disease AND may be a source of infection. D) have been cured of the infection. E) may have a persistent infection AND may be a source of infection.

87)

In latent infections, the virions are A) constantly produced. B) primarily produced during reactivation. C) produced very slowly. D) continually being slowly budded out. E) always detectable in the infected person.

88)

The best known chronic infection involves A) hepatitis B. B) hepatitis A. C) chickenpox. D) herpes. E) influenza.

89)

The genome of retroviruses is made of

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A) ssDNA. B) dsDNA. C) ssRNA. D) dsRNA. E) protein and RNA.

90)

The best-known examples of viruses that cause latent infections are A) polio AND herpes. B) herpes AND measles. C) measles AND chickenpox. D) chickenpox AND polio. E) herpes AND chickenpox.

91)

Diseases of short duration frequently followed by long-term immunity are referred to as A) intermittent infections. B) chronic infections. C) acute infections. D) persistent infections. E) nonacute infections.

92)

Retroviruses are unique in that they A) replicate in nervous system cells. B) use RNA as a template to make DNA. C) do not have a capsid. D) use DNA as a template to make RNA. E) use RNA as a template to make more RNA.

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93) Genetic exchange in segmented viruses that allows a zoonotic virus to infect humans is an example A) antigenic shift. B) hemagglutination. C) genetic reassortment. D) antigenic drift. E) mutagenesis.

94)

Which statement(s) about cells taken from a tumor is/are true? A) They may be used to grow viruses. B) Theymay be used to grow bacteriophages. C) They divide 50 times and then die. D) They may be used to grow viruses AND they may be used to grow bacteriophages. E) They divide 50 times and then die AND they may be used to grow bacteriophages.

95)

Viruses are not cultivated in A) live organisms. B) embryonated chicken eggs. C) tissue culture. D) blood agar. E) plants.

96) The changes that occur in virally infected cells are characteristic for a particular virus and are referred to as the A) cytopathic effect. B) phenotypic effect. C) genotypic expression. D) cytology. E) symptomatic effect.

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97) Normal tissue taken from animals and prepared immediately as a medium for viral growth is termed a(n) A) advantageous group. B) monolayer culture. C) primary culture. D) plaque. E) virus culture.

98) If reasonably pure preparations of virus are available, the number of virus present may be determined by A) photocolorimetry. B) electron microscopy. C) gas chromatography. D) light microscopy. E) spectrophotometry.

99)

The approximate viral concentration of a sample may be determined by A) quantal assay. B) endpoint assay. C) the titer. D) the lysate assay. E) cytopathic assay.

100)

The concentration of virus that infects or kills 50% of the host cells is referred to as the

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A) LD50 B) ID50 C) ID100 D) LD100 AND ID100 E) LD50 AND ID50

101)

One group of animal viruses that are able to agglutinate red blood cells are the A) coronaviruses. B) orthomyxoviruses. C) retroviruses. D) reoviruses. E) rhinoviruses.

102) The site at which a virus has infected and subsequently lysed the infected cell, releasing its progeny to infect and lyse surrounding cells, thereby forming a "clear zone," is A) a burst area. B) a lyse area. C) a plaque. D) a dead zone. E) a zone of inhibition.

103) Which of the following is not a characteristic of normal cells grown in vitro in a cell culture? A) They grow as a monolayer. B) They grow as multiple layers. C) They undergo a limited number of divisions and then die. D) They stick tightly to the surface of glass culture dishes. E) These are all characteristics of normal cells grown in vitro in cell cultures.

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104)

Plant viruses enter the host plant via A) wound sites. B) specific receptors. C) nonspecific receptors. D) seeds. E) endocytosis.

105)

Plant viruses may be transmitted by A) worms. B) contaminated seeds. C) humans. D) insects. E) All of the choices are correct.

106)

Which of the following is NOT true of prions?

A) Prions replicate by converting normal host prion proteins into abnormal prion proteins. B) Prions responsible for "mad cow disease" can cause a similar disease in humans. C) Prions can be transmitted by consumption of dried food or cooked food. D) Prions that cause spongiformencephalopathies have a different amino acid sequencefrom PrP c. E) All of the answer choices are correct.

107)

Prions

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A) consist of a special nucleocapsid. B) are made of protein only. C) are made of RNA only. D) are made of dsRNA and protein. E) consist of proteinsand phospholipids.

108)

Prions affect the A) respiratory system. B) gastrointestinal tract. C) nervous system. D) lymphatic system. E) urogenital system.

109)

Viroids characteristically are composed of A) ssRNA. B) dsRNA. C) ssDNA. D) dsDNA. E) protein only.

110)

Viroids cause disease in A) animals. B) plants. C) bacteria. D) fungi. E) plants and fungi.

111)

Prions are

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A) a form of RNA virus. B) a form of DNA virus. C) a viroid. D) an infectious protein. E) an infected protein.

112)

Spongiform encephalopathy occurs in all of the following EXCEPT A) plants. B) humans. C) cattle. D) sheep. E) cattle AND sheep.

113) An antibiotic is added to a culture of E. coli, resulting in death of the cells. Bacteriophages are then added. Would the phages replicate in the E. coli cells? Why or why not? A) Yes, because the cellular machinery of the bacteria is most likely still active. The bacteriophages could use that machinery to replicate new virus particles. B) No, because the bacteriophages would depend too much on having the active machinery of a living host cell for replication. C) Yes, because bacteriophages are capable of reanimating dead cells to force them to produce more virus particles. D) No, because entry of the bacteriophages into the target cell is dependent on the cell being alive to conduct endocytosis of the virus. E) No, because dead E. coli cells do not have any receptors on their cell walls to which the bacteriophages can attach for entry into the host cell by fusion.

114) Most temperate phages integrate into the host chromosome, whereas some replicate as plasmids. Which kind of relationship do you think would be more likely to maintain the phage in the host cell, and why?

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A) Plasmids; they're smaller, so they would be easier to replicate by the host cell. B) Integrated; the host cell would be less likely to view this DNA as "foreign" on subsequent rounds of replication, and would retain it more easily. C) Plasmids; these structures often carry other genes that may give the host cell a selective advantage over cells that don't have them. D) Integration, because plasmids are frequently lost during cell division, which could leave a daughter cell without the virus genome. E) Either plasmids or integration because once a virus genome is in a host cell, there is not way for that genome to be removed from the infected cell.

115) You add an unknown phage to a mixture of F + and F − cells of E. coli and plate out the bacteria. The bacterial colonies that grow are all F −. How can you explain this phenomenon? A) The phage bound to a receptor on the sex pilus, and therefore only infected the F + cells (leaving the F − cells alone). B) The phage bound to a receptor on the F − cells, leaving only them alive and allowing the F + cells to die off. C) The phage integrated (lysogenized) the F − cells, giving them a selective advantage over the F + cells. D) F + cells are uniquely susceptible to phage attack for unknown reasons. E) F + are well known to die in the presence of any type of bacteriophage.

116)

Why do animal viruses have envelopes and phages rarely do?

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A) Since bacteriadon't have cell membranes, the bacterial viruses (phages) don't pick them upwhen they leave the target cells. B) Phages acquire anouter surrounding that is a part of the cell wall of the bacterium they werecreated in, rather than an outer surrounding of plasma membrane. C) Animal viruses will often use the envelope in order to fuse with the plasma membrane of a new target cell, gaining entry into the cytoplasm. D) Animal viruses build the envelope inside of the target cell as they are being replicated, but before the cell breaks open and releases them into the extracellular environment. The envelope is a remnant of this building process. E) This is a trick question. Plenty of bacteriophages have envelopes that they acquire when they bud through the lipopolysaccharide layerof the bacterial host.

117) Explain why HIV becomes resistant so quickly when a single drug is used therapeutically. A) The virus is an RNA genome virus. By using host RNA polymerase to directly copy the genome to make more virus particles, there's no proofreading capability. This leads to a high rate of mutation of the viral genome and increased chance for drug resistance. B) HIV uses reverse transcriptase to make a cDNA version of its RNA genome. This polymerase is "'sloppy," with a high rate of error and lack of a proofreading capability. This leads to a high rate of mutation of the viral genome and increased chance for drug resistance. C) HIV synthesizes aprotein enzyme that directly cleaves anti-HIV drugs, giving it acharacteristically high rate of resistance to a single drug type. D) HIV is constantlychanging its genetic structure by swapping genetic elements with other virusstrains. This leads to a high rate of mutation of the viral genome andincreased chance for drug resistance. E) Like bacteria, HIV undergoes spontaneous mutation in the presence of antibiotics, so multiple medications are used simultaneously to reduce the chance of this happening.

118)

Why is it not surprising that AIDS patients frequently suffer a viral-induced tumor?

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A) HIV genomesintegrate into the host cell chromosome. This integration might result inloss of control of the cell cycle (also known as cancer). B) The immune system'sCD4 + T cells are directly responsible for elimination of tumorcells. HIV attacks them and eliminates them, making a person moresusceptible to cancer. C) The therapies forHIV are highly mutagenic, which may lead to cancerous states in people takingthe drug regimen. D) Products of an active HIV infection are highly mutagenic; as a person's illness progresses, these compounds build up and induce a cancerous state. E) The DNA polymerases of people with AIDS lose any proofreading ability, so any mistakes that happen during DNA replication automatically lead to development of cancer.

119) Would you expect the number of virions to be the same if you measured them by the plaque assay or by counting using the electron microscope? Why? A) Yes—both methods measure the total number of virus particles in a solution. B) No—the plaque assay only measures viable virus particles, while the electron microscope cannot distinguish between defective and viable virus. C) No—you cannot count virus particles by using a plaque assay. You can only get a relative difference in quantity from one preparation of virus particles to another with this method. D) Yes—only fully functioning viruses will be released from a host cell, so the quantified number of virus particles in a plaque assay should be identical to the number of free virus particles counted by electron microscopy.

120)

Why are viroids resistant to nucleases?

A) Having a circular RNA "genome," they are resistant tomost exonucleases (that digest the free ends of RNA or DNA). B) Having a circular RNA "genome," with no protein shell, they are resistant to the protein-degrading activities of nucleases. C) Nucleases will only digest DNA, not RNA, so viroids are protected. D) Viroids have onlybeen identified in plants. Plant nucleases cannot digest RNA. E) Viroids are composed of single stranded RNA; nucleases only act on double-stranded molecules.

Version 1

121)

Would ID

50 and LD

50 necessarily be the same for a given virus? Why or why not?

A) Yes, because thenumber of viruses that infect 50% of a test population should also kill 50% ofthat test population. B) No, because a virus may be highly infectious (very low ID50value) but only marginally lethal (very high LD50value), for example the rhinovirus (common cold virus). C) No, because very few viruses are lethal, yet many are highly infectious. The two values should ALWAYS be different. D) Yes, because what we're actually describing here is the infection/ killing of individual cells, not of entire organisms. If a cell is infected, it will always be killed. E) Yes, because ID 50 and LD 50 are actually measurements of the same thing: effectiveness of a virus in entering and damaging a host cell.

122)

Why is it virtually impossible to eradicatea disease caused by a zoonotic virus?

A) You would have to drive the vector organism extinct to do so. B) Many vector organisms have multiple stages of their life cycle that can carry a zoonotic virus, which complicates controlling the vector-borne transmission. C) Many virusestransmitted in this manner may utilize more than one vector organism. D) Many zoonotic viruses may be able to reside in more than one host organism, complicating control measures. E) All of the answer choices are correct.

123) If you had three tubes of flu viruses and you exposed tube 1 to protease, tube 2 to proteaseand RNase,and tube 3 to protease and DNase, and the contents of tube 2 were be degraded, you would be able to conclude that A) an RNA virus. B) a DNA virus. C) a protein virus. D) resistant to proteases. E) an opportunist.

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124) You are setting up a plaque assay to estimate the number of viruses in a sample of seawater. You take the agar from the autoclave, add the bacteria and the water sample, and prepare the assay. After incubation, the plate is completely clear. What is the MOST likely reason for this result? A) The agar was too hot and killed the host bacteria. B) It is well known that there are no phages in sea water. C) Bacteria are not the correct host for the phages in the sample. D) The sample was not diluted enough and all the bacteria were killed. E) The sample was not diluted enough and all the phages were killed.

125)

What are the plaques in the plaque assay? A) Areas where all of the host bacteria have died. B) Areas where there are no viruses. C) Areas where the host bacteria are resistant. D) Areas where bacteria divide more than normal. E) Areas where someone forgot to add bacteria.

126)

Select the INCORRECT statement about prions. A) Normal and abnormal prion proteins have identical amino acids. B) Normal and abnormal prion proteins fold differently. C) Normal and abnormal prion proteins are found in different types of cells. D) Misfolded prion proteins accumulate in neurons. E) Abnormal prions resist degredation.

127)

How do prions accumulate in brain tissue?

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A) Prions have DNA and can replicate in neuronal cells. B) Prions have RNA and can replicate in neuronal cells. C) Abnormal prion proteins change normal prion proteins into the abnormal form. D) Normal prion proteins change abnormal prion proteins into the normal form. E) Prions have DNA and RNA and can divide by binary fission.

128) not?

Why does abnormal prion protein accumulate in cells while normal prion protein does

A) Normal prion proteins are susceptible to protease digestion, while abnormal prion proteins are not. B) Abnormal prion proteins are found in every type of cell, while normal prion proteins are only in brain cells. C) Abnormal prion proteins are found in every part of a cell, while normal prion proteins are only in the membrane. D) Abnormal prion proteins are only found in the cell membrane, while normal prion proteins are found in every part of the cell. E) Abnormal prion proteins are significantly larger than normal prion proteins.

SECTION BREAK. Answer all the part questions. 129) You are a volunteer for Nursing Beyond Borders and are being sent to a countryin Africa. You are excited, because you will have opportunities to go on safari, but you are also somewhat concerned because you have learned from the CDC website that there is currently cholera in thecountry to which you are going. Patients with cholera experiencevomiting and severe diarrhea, producing several liters of liquid stool in a day. This results in signs of dehydration, including sunken eyes, muscle cramps, and in a few cases, convulsions and death. Cholera is caused by the bacterium Vibrio cholerae. You make a list of questions about V.cholerae that you answer with the help of your nursing school study group.

129.1) The signs and symptoms of cholera are caused by cholera toxin that is synthesized and secreted by the bacteria.The toxin causes chloride and other electrolytes to leave the intestinal cells. Water follows the electrolytes, resulting in an outpouring of water into the intestinal lumen. The gene for cholera toxin is a bacteriophagegene. This situation is an example of ______.

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A) lysogenic conversion B) DNA-mediated transformation C) mutation D) vertical gene transfer E) indirect selection

129.2)

The phage from which the cholera toxin gene originates is a ______ phage.

A) filamentous B) lytic C) temperate D) Gram-positive E) double-stranded RNA

129.3)

A lysogen is

A) abacteriophage that carries bacterialDNAintegrated into its genome. B) an insect that carries virus DNA in its genome. C) a temperate phage that can insert its DNA into the host’s DNA. D) abacterium that carries phage DNA (a prophage) integrated into its genome. E) a bacteriophagethat lyses its host as a result of its replication cycle.

129.4)

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Please select the TRUE statement regarding bacteriophage life cycles.

A) Temperate phages lyse their host cells, whereas lytic phages either lyse their host or integrate their DNA into the host cell’s genome. B) Lytic phages lyse their host cells, whereas temperate phages either lyse their host or integrate their DNA into the host cell’s genome. C) In the bacteriophage life cycle, the entire virus enters the host bacterial cell through a hole in the cell wall. D) Phage particles seek out their bacterial hosts by means of chemotaxis and then attach to random receptors on the host's cell wall. E) The burst size is the number of bacterial cells that are lysed as a result of being infected by a bacteriophage such as T4.

129.5) All bacteriophages must be able to: 1. inject their DNA into the host cell 2. cause a genetic change in the host cell 3. kill the host cell 4. replicate in the absence of a host 5. exit a host cell by extrusion A) 1, 2, and 4 B) 2 and 3 C) 1, 4, and 5 D) 2 only E) 1 only

129.6) In order to treat cholera, antiviral medication must be given to get rid of the bacteriophagethat carries the cholera toxin gene. ⊚ ⊚

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true false

130) You are graduatingfrom nursing school in three months and have already lined up anew job. However, your employer informs you that before you start your job,it is mandatory for you to be vaccinated against hepatitis B, a double-stranded DNA virus that can cause the disease hepatitis. Your boyfriend, a biology major,wonders why you need to get the vaccine. You aced your microbiology class and you know a lot about both viruses and vaccines, so you understand why getting this vaccination is essential. You give your boyfriend a mini lesson on this by answering a few of his questions.

130.1) Your boyfriend asks how animal viruses enter a host cell. You tell him that they can use one of two mechanisms: A) exocytosis OR fusion B) endocytosis OR fusion C) fusion OR phagocytosis D) endocytosis OR budding E) budding OR fusion

130.2) To give more information on virus replication strategies, you explain to your friend the difference between a DNA virus and a RNA virus in terms of replication. You tell him that

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A) RNA virus replication always requires a virally encoded RNA polymerase thatis an RNA-dependent RNA polymerase; this enzyme uses an RNA template to synthesize a new strand of RNA. DNA viruses use DNA-dependent DNA polymerase in replication. <!-Markup Copied from Habitat--> B) RNA virus replication always requires a virally encoded DNA polymerase, thatis an RNA-dependent DNA polymerase; this enzyme uses a DNA template to synthesize a new strand of RNA.DNA viruses use DNA-dependent DNA polymerase in replication. C) RNA viruses always encode an enzyme called reverse transcriptase, which is an RNA-dependent DNA polymerase thatsynthesizes DNA from an RNA template.DNA viruses use DNA-dependent RNA polymerase in replication.  D) DNA viruses replicate their genome by means of an RNA-dependent DNA polymerase thatsynthesizes DNA from an RNA template. RNA viruses replicate their genome by means of a virally encoded replisome. E) DNA viruses must always first enzymatically degrade one DNA strand before they are able to replicate the remaining strand using the enzyme DNA-dependent RNA polymerase. RNA viruses are single-stranded, so can replicate their genome directly.

130.3) Your boyfriend wonders whether hepatitis B is really a problematic disease. He says that the job of your immune system is to get rid of viruses and virus-infected cells. You tell him that hepatitis B causes an infection in which the causative agent remains in the body for years or even a lifetime, often without causing symptoms of disease. This type of infection ischaracterized by the continuous low-levelproduction ofviral particles and is called a(n) ______ infection. A) persistent only B) persistent AND latent C) chronic only D) latent only E) persistent AND chronic

130.4) You friend wonders whether the same type of virus can cause both an acute and a persistent infection? You answer

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A) Yes—the initial infection might be acute but the virus can later become latent by becoming integrated into the host cell genome. B) No—a virus causes either an acute infection or a persistent infection, but never both. C) No—if the initial infection is acute, the virus would have to mutate in the host before being able to cause a persistent infection. D) Yes—acute and persistent infections are really the same thing except that people with persistent infections recover more quickly than those with acute infections. E) Yes—acute and persistent infections are really the same thing except that people with acute infections recover more quickly than those with persistent infections.

130.5) You tell your friend that you are happy to be receiving your vaccination because hepatitis B is associated with hepatocellular carcinoma (liver cancer). Select the FALSE statement regarding viruses and cancer. A) Viruses that lead to cancer formation are called oncogenic viruses.  B) The most common viral causes of tumors arecertain DNA viruses such as hepatitis B virus.  C) Some viruses carry an oncogene—infection with these virusesinterferes with the host cell’s own growth-control mechanisms. D) The majority of tumors arecaused by oncogenic viruses but some may be caused by mutations in host genes that regulate cell growth.  E) Viruses that insert their genome into the host cell’s chromosome may cause changes at the insertionsite, converting a proto-oncogene into an oncogene.

130.6) Most enveloped viruses, like hepatitis B, are released by budding, a process whereby the virus acquires its envelope. Before budding occurs, virally encoded protein spikes insert into specific regions of the host cell’s membrane. Given this information, which of the following would you tell your friend best describes the structure of the viral envelope?

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A) Phospholipidbilayer B) Phospholipid bilayer with host-derived proteins. C) Phospholipid bilayer studded with both virus- and host-derived proteins. D) Protein layer with host-derived spikes. E) Phospholipid monolayerstudded with virus- and host-derived proteins.

131) In August 2007, a foot-and-mouth disease (FMD) outbreak was confirmed in cattle on a farm in Surrey, in the United Kingdom. Although the number of infected animals was small, the news was significant, particularly to livestock farmers, because the disease spreads easily and affects cattle, goats, sheep, and pigs. Infected animals develop a high fever, followed by blisters in the mouth and on the feet. The animals sometimes die. Control measures are aimed at preventing the spread of the disease and include destroying at-risk animals and restricting trade— actions that obviously create a hardship for the affected farms. In a previous outbreak in 2001, the tourist industry was also devastated because travel in the British countryside, where many small farms are found, was restricted. The virus that causes the disease is called FMDV (foot-and-mouth disease virus), and the strain implicated in this outbreak was identified as O1 BFS67-like, a strain that had not circulated in animals in the United Kingdom since 1967. Of particular note was the fact that the same strain was being used for research and vaccine development by laboratories located at a site very near the Surrey farm where the FMD outbreak was identified. A later investigation concluded that wastewater from the laboratories was probably the source of the virus; a drainage pipe had leaked and contaminated the surrounding soil. From there, vehicles, workers, or wild animals likely carried the virus to nearby farms. In the end, all susceptible livestock from the affected farms were destroyed, which successfully stopped the outbreak.

131.1) What does the proposed mechanism of virus spread from the laboratory to the farm animals suggest about the structure of FMDV?

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A) It is a non-enveloped virus. Non-enveloped viruses are not easily destroyed and persist in the environment. B) It is an enveloped virus. Enveloped viruses are easily destroyed because of the outer membrane. C) It is a retrovirus. Retroviruses cannot be destroyed in any environment. D) It is a DNA virus. DNA viruses are easily destroyed because DNA is unstable. E) It is an RNA virus. RNA viruses are easily destroyed because RNA is inherently unstable.

131.2) Developing a long-lasting vaccine against FMDV is difficult because the virus has a relatively high mutation rate; a vaccine against one strain might not protect against another one that develops later. What does the high mutation rate suggest about the viral genome structure?  A) It is an RNA virus. RNA viruses depend on replicases, which do not have proofreading ability. B) It is a DNA virus. DNA viruses depend on replicases, which do not have proofreading ability. C) It is a retrovirus virus. Retroviruses depend on replicases, which do not have proofreading ability. D) It is an acute virus. Accute viruses are removed by the immune system too quicky for a vaccine to work. E) It is a bacteriophage. Bacteriophages depend on error-prone reverse transcriptase for replication.

131.3)

Select the FALSE statement regarding this report.

A) FMDV affects livestock such as cattle. B) The source of the FMDV was a research laboratory. C) Animals with FMD always recover without problem. D) The outbreak of FMD was stopped by killing susceptible animals. E) Animals commonly affected by FMDV are cattle, goats, sheep and pigs.

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131.4) How did the investigators in this case realize that the FMDV likely came from a nearby research facility? A) The strain had not been found in the UK for more than 50 years. B) The strain wasO1 BFS67, which is a man-made virus. C) The strain did not affect any vaccinated animals on the farms. D) The strain affected humans and animals alike, not normal for FMDV. E) The researchers at the facility told the investigators that they made the strain.

131.5) Enveloped viruses are more easily destroyed by detergents than non-enveloped viruses. Why is this so? A) The lipid outer membrane of enveloped viruses is easily destroyed by detergents. B) The outer protein coat of enveloped viruses is easily destroyed by detergents. C) The spikes of enveloped viruses are lipids and are easily destroyed by detergents. D) Enveloped viruses are RNA viruses and RNA is easily destroyed by detergents. E) Enveloped viruses are DNA viruses and DNA is easily destroyed by detergents.

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Answer Key Test name: Chap 13_10e 1) TRUE 2) TRUE 3) TRUE 4) FALSE 5) TRUE 6) TRUE 7) TRUE 8) FALSE 9) FALSE 10) FALSE 11) TRUE 12) TRUE 13) TRUE 14) TRUE 15) FALSE 16) FALSE 17) TRUE 18) D 19) C 20) B 21) E 22) A 23) B 24) C 25) D 26) C Version 1

27) C 28) A 29) B 30) A 31) B 32) B 33) B 34) B 35) E 36) D 37) C 38) D 39) B 40) E 41) A 42) A 43) C 44) A 45) C 46) A 47) B 48) A 49) E 50) A 51) C 52) B 53) E 54) C 55) B 56) A Version 1

57) C 58) A 59) E 60) B 61) D 62) B 63) B 64) B 65) A 66) D 67) B 68) A 69) D 70) C 71) C 72) A 73) B 74) D 75) C 76) A 77) B 78) C 79) D 80) B 81) C 82) B 83) D 84) C 85) A 86) E Version 1

87) B 88) A 89) C 90) E 91) C 92) B 93) A 94) A 95) D 96) A 97) C 98) B 99) A 100) E 101) B 102) C 103) B 104) A 105) E 106) D 107) B 108) C 109) A 110) B 111) D 112) A 113) B 114) D 115) A 116) C Version 1

117) B 118) A 119) B 120) A 121) B 122) E 123) A 124) A 125) A 126) C 127) C 128) A 129) Section Break 129.1) A 129.2) C 129.3) D 129.4) B 129.5) E 129.6) FALSE 130) Section Break 130.1) B 130.2) A 130.3) E 130.4) A 130.5) D 130.6) C 131) Section Break 131.1) A 131.2) A 131.3) C Version 1

131.4) A 131.5) A

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CHAPTER 14 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Pattern recognition is involved in innate immunity. ⊚ ⊚

true false

2) Defensins are short antimicrobial peptides found within mucous membranes and phagocytes. ⊚ true ⊚ false

White blood cells also called leukocytes are important in immunity. ⊚ true ⊚ false

Mast cells are only found in the blood. ⊚ ⊚

Lymphocytes are the cells primarily responsible for the adaptive immune responses. ⊚ ⊚

true false

All pathways of complement activation follow the same sequence after C3. ⊚ ⊚

true false

7) Gram-negative bacteria are less susceptible to complement lysis than Gram-positive bacteria.

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⊚ ⊚

Interferon directly interacts with and destroys viruses. ⊚ ⊚

true false

Neutrophils are the second phagocytic cell to respond to an infection. ⊚ ⊚

10)

true false

Fever often enhances bacterial survival during an infection. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 11) Phagocytes were first discovered and named by A) Pasteur. B) Koch. C) Metchnikoff. D) Lister. E) Hooke.

12)

In which organism were phagocytes first reported?

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A) Bacteria B) Amoeba C) Red blood cells D) Starfish larvae E) Humans

13)

Which is not a component of innate immunity? A) Skin B) Antibody C) Inflammation D) Fever E) Mucus membranes

14)

Which is not involved in adaptive immunity? A) Tear flow B) Antibody production C) T cells D) B cells E) Tear flow AND B cells

15)

Skin and mucous membranes are mostly involved in A) adaptiveimmunity. B) innateimmunity. C) autoimmunity. D) irregularimmunity. E) secondaryimmunity.

16)

Which statement about skin and mucous membranes is NOT correct?

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A) They are the first line of innate immunity. B) They are the first line of adaptive immunity. C) They act as physical barriers to infection. D) They contain antimicrobial secretions. E) They separate us from our environment.

17)

Interferons, complement, lysozyme, and lactoferrin are all examples of A) specific antimicrobial factors. B) immune enzymes. C) nonspecific antimicrobial factors. D) cytokines. E) antipeptides.

18)

Normal microbiota

A) are the organisms that typically reside on and in your body. B) protect againstinfection by pathogens. C) enhance infection by pathogens. D) play no role in affecting pathogen growth. E) are the organisms that typically reside on and in your body AND protect against infection by pathogens.

19)

Iron A) is required bymicroorganisms. B) binds to lactoferrin. C) is necessary for the functioning of some enzymes. D) binds to transferrin. E) All of the answer choices are correct.

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20) Factors that work generically against any foreign substance entering the host are described as A) innate immunity. B) specific immunity. C) irregular immunity. D) immune metabolism. E) adaption.

21)

The cells primarily involved in all immune responses are the A) erythrocytes. B) platelets. C) leukocytes. D) lymphocytes. E) chondrocytes.

22)

In humans, the stem cells from which all blood cells arise are found in the A) peripheral circulation. B) bone marrow. C) lymphatic vessels. D) lymph nodes. E) spleen.

23)

All blood cells originate from the A) erythrocyte stem cell. B) leukocytic stem cell. C) eosinophilic stem cell. D) hematopoietic stem cell. E) osteocytes (bone cells).

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24)

Which of the following are phagocytic cells found in the human body? A) Erythrocytes AND neutrophils B) Neutrophils AND megakaryocytes C) Neutrophils AND macrophages D) Megakaryocytes AND leukocytes E) Macrophages AND erythrocytes

25)

The leukocyte that contains histamine is the A) lymphocyte. B) basophil. C) monocyte. D) macrophage. E) eosinophil.

26)

Allergic reactions mainly involve A) macrophages. B) monocytes. C) mast cells. D) neutrophils. E) eosinophils.

27)

Which of the following are referred to as mononuclear phagocytes? A) Monocytes and macrophages B) Lymphocytes and basophils C) Mast cells and eosinophils D) Basophils and eosinophils E) Neutrophils and macrophages

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28)

The cells responsible for adaptive immunity are the A) lymphocytes. B) monocytes. C) eosinophils. D) neutrophils. E) leukocytes.

29)

The "voices" of a cell, which carry messages, are A) surface receptors. B) cytokines. C) platelets. D) antigens. E) adhesion molecules.

30)

Toll-like receptors

A) are cytokines, are embedded in cellular membranes, AND are part of adaptive immunity. B) each recognize a specific "danger" molecule AND are cytokines. C) are embedded in cellular membranes ANDare part of adaptive immunity. D) each recognize a specific "danger" molecule AND are embedded in cellular membranes. E) each recognize a specific "danger" molecule AND are part of adaptive immunity.

31)

Which statement about complement proteins is FALSE?

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A) They may be activated through three differentpathways. B) They disruptthe cytoplasmic membrane of invading bacteria and foreign cells. C) They arepart of the specific immune defense system. D) They area group of blood proteins produced by the liver. E) They are part of the innate immune response.

32)

The complement pathway that requires antibodies to be activated is the A) alternate pathway. B) classical pathway. C) properdin pathway. D) inflammatory pathway. E) lectin pathway.

33)

A group of interacting serum proteins that provide a nonspecific defense mechanism is A) complement. B) interferon. C) glycoprotein. D) lysozyme. E) antibody.

34)

The complement pathway that is activated by mannan-binding protein is the A) classical pathway. B) alternativepathway. C) C3 pathway. D) lectin pathway. E) properdin pathway.

35)

The complement pathway that is activated by binding of C3b to cell surfaces is the

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A) classical pathway. B) alternate pathway. C) C3 pathway. D) mucociliary pathway. E) All of the answer choices are correct.

36)

The key molecule upon which all complement pathways converge is ______. A) C1 B) C2 C) C3 D) C6 E) C9

37)

C3a and C5a are involved in A) inflammation AND fever. B) interferon production AND attraction of phagocytes. C) properdin activation AND inflammation. D) attraction of phagocytes AND properdin activation. E) inflammation AND attraction of phagocytes.

38)

C3b is involved in A) opsonization. B) interferon production. C) properdinactivation. D) endotoxin production. E) inflammation.

39)

The complex resulting from complement activity that leads to cell lysis is the

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A) prostaglandin complex. B) leukotriene activating complex. C) membrane attack complex. D) histamine complex. E) macrophage antibody complex.

40)

Which of the following are most susceptible to complement lysis? A) Gram-positive bacteria B) Gram-negative bacteria C) Bacteriophages D) Prions E) Acid-fast bacteria

41) is

The low molecular weight protein produced by animal cells in response to viral infections

A) complement. B) lysozyme. C) histamine. D) interferon. E) transferrin.

42)

Interleukins are A) produced by leukocytes. B) important in both innate and adaptive immunity. C) involved in directly killing tumor cells. D) protein molecules. E) produced by leukocytes AND protein molecules.

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43)

The presence of long double-stranded RNA (> 30 bp) A) indicates infection by any virus. B) indicates exposure to mutagens. C) induces synthesis of interferon. D) indicates infection by a retrovirus. E) indicates complement activity.

44)

Interferons secreted by a viral-infected cell A) prevent viral replication in nearby cells. B) impair motility in viral-infected cells. C) make cells resistant to phagocytosis. D) cause cells to form endospores. E) directly destroy viruses.

45)

Which of the following cytokines is most antiviral in its action? A) Interleukin-1 B) Interleukin-2 C) Interferon D) Tumor necrosis factor E) Colony-stimulating factor

46)

Which of the following statements about interferon is incorrect? A) It is produced by host cells in response to viral RNA. B) It causes nearby cells to produce antiviral proteins. C) It indirectly causes virally-infected cells to undergo apoptosis. D) It prevents the entry of viruses into nearby cells. E) It does not directly inactivate viruses.

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47)

Which activity of the virally invaded cell triggers production of interferon? A) Activation of rRNA B) Movement of nuclear proteins to the cytoplasm C) Production of glycolipids D) Production of dsRNA E) Production of dsDNA

48)

The cellular organelle responsible for the digestion of ingested infectious agents is the A) endoplasmic reticulum. B) phagolysosome. C) Golgi apparatus. D) lysosome. E) peroxisome.

49)

Following digestion of a microorganism by phagocytes, the debris is excreted by A) ingestion. B) exocytosis. C) extrusion. D) budding. E) lysis.

50)

The four cardinal signs of inflammation are A) Flare, wheals, fever, cough B) Redness, heat, swelling, pain C) Rash, pus, heat, rubor D) Heat, pain, vesicles, fever E) Heat, pain, redness, fainting

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51)

The first host response to a nonspecific tissue injury is described as A) inflammation. B) reaction. C) antibodies. D) trauma. E) fever.

52)

The first kind of leukocyte lured to the site of inflammation is the A) neutrophil. B) monocyte. C) macrophage. D) basophil. E) B cell.

53)

The attraction of leukocytes to the area of inflammation is referred to as A) parasitism. B) infection. C) phototaxis. D) chemotaxis. E) exotaxis.

54)

One of the strongest indications of infectious disease is A) a rash. B) fever. C) pustules. D) vesicles. E) vomiting.

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55)

Pyrogens are A) fever-inducing substances. B) fever-inhibiting substances. C) phagocytosis-enhancing substances. D) complement activators. E) pus-producing substances.

56)

During apoptosis, a cell will A) die because it is damaged and, as a result, cause an inflammatory response. B) self-destruct and, as a result, cause an inflammatory response. C) die because it is accidentally damaged, and, as a result, cause fever. D) self-destruct without causing an inflammatory response. E) divide to repair damaged tissue, leading to an inflammatory response.

57)

Fever A) inhibits bacterial growth AND speeds up the body's reactions. B) enhances bacterial growth AND speeds up the body's reactions. C) inhibits bacterial growth AND triggers complement activation. D) speeds up the body's reactions AND triggers complement activation. E) enhances bacterial growth AND triggers complement activation.

58)

What two functions do phagocytes serve in immune responses?

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A) Production of antibodies AND engulfment/destruction of foreign cells. B) Engulfment/destruction of foreign cells AND alerting the other cells of the immune system to an invader. C) Alerting the other cells of the immune system to an invader AND serving as a physical barrier against microbial invasion. D) Production ofantibodies AND serving as a physical barrier against microbial invasion. E) Alerting the other cells of the immune system to an invader AND production of antibodies.

59)

How do cytokines function?

A) They are produced by several cell types and bind directly to microbes to enhance their chance of being ingested, in a process called opsonization. B) They are secreted by lysozomes into the phagosomes of neutrophils to enhance the killing of ingested microbes within those organelles. C) They are secreted by one cell type, then work as a series of serum proteins to produce holes in the cytoplasmic membranes of microbes to directly lyse them. D) They are secreted by microbes that have been engulfed by phagocytes, causing those cells to produce destructive enzymes and undergo apoptosis. E) They are secreted by one cell type,then bind to a receptor on target cell causing a signal within that cell that turns on (or off) certain genes to achieve a response.

60) Toll-like receptors (TLRs) bind molecules on pathogens. Why is this helpful to the immune response?

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A) It provides ahighly specific response to very small and highly unique areas on an individualpathogenic microbe, providing the most specific and selective responsepossible. B) It provides ageneral response to broad categories of molecules/cells that should NOT be inour system, as we don't have these molecules on our own cells. C) These secreted molecules help bind pathogens and then direct them to receptors on the immune system cells that can eliminatethem from our systems. D) TLRs are capableof directly lysing (destroying) the microbes, helping our immune responses byeliminating pathogens. E) All of the statements are correct.

61) Smoking impairs the ciliated cells of the middle portion of the respiratory tract. Many analgesic drugs (painkillers) impair peristalsis (the churning motion of the digestive tract). The result of either of these activities leads to an increased risk of infection in their respective areas. Why? A) The actions of the cells in these areas help to propel pathogens out of the area, serving as a part of the physical barrier system. When they are impaired/slowed, bacteria and other pathogens have an easier time adhering to the tissues in the area and causing an infection. B) Ciliated cellsalso line the digestive tract, and these cells secrete strong naturalantibacterial compounds. When they are impaired, bacteria can more easilyinfect these areas. C) Chemicals incigarette smoke and the chemicals in painkillers impair our immune systems,making us generally more predisposed to infections (regardless of the tissuearea). D) Chemicals incigarette smoke and the chemicals in painkillers impair the ability of ourimmune system cells to move into areas that are infected. As such, theycan't perform their job of eliminating microbes as well as they should andinfections result more easily. E) The actions of the cells in these areas help to propel pathogens into the stomach, where they are destroyed by acid. When they are impaired/slowed, bacteria and other pathogens do not get destroyed by and can cause an infection.

62) A physician is attempting new therapies for HIV patients who are suffering from an impaired immune response. He decides to try using a recombinant form of colony-stimulating factor cytokine (CSF). Why?

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A) CSF is a strong inducer of antiviral activities in our cells, and may help our immune system fight off the effects of an HIV infection for a longer period of time. B) CSF will help to stimulate the production of new lymphocytes, the very cells that are affected by HIV. This may help to keep the patients' immune responses "normal" for aperiod of time. C) CSF will hyperstimulate the activities of the macrophages, leading to aggressive ingestion and successful destruction of HIV-infected cells. D) CSF will drive up the production of lactoferrin and transferrin, strong antiviral compounds produced in our mucus membrane secretions that trap and destroy viruses. E) CSF is a cytokine that allows cells to communicate. If levels of CSF are elevated, HIV-infected cells can alert other healthy cells so that they produce protectiveIFNs.

63) Syphilis, an STI, was once treated by intentionally infecting the patient with the parasite that causes malaria, a disease characterized by repeated bouts of fever, shaking, and chills. Why might this treatment cure syphilis? A) Malaria parasites produce strong antibacterial compounds (since they're eukaryotic in nature–they are trying to eliminate their competition for resources). This helps to eliminate ALL bacteria in and on the human body for a short period of time. B) Malaria parasites track down and feed upon ALL bacterial cells in the human body as a part of their life cycle. This makes them a "natural antibiotic" of sorts, and highly effective at clearing the bacterial infection of syphilis. C) One of the side effects of malarial infection is a massive overproduction of macrophages. This drives up the ability to ingest and destroy any microbe, including the bacterium that causes syphilis. D) The effect ofdriving up the body temperature for periods of time can shut down thetemperature-sensitive replication of the bacterium that causes syphilis.This gives the immune system time to eliminate it properly. E) The bacteria that cause syphilis track down and destroy the protozoan that causes malaria. By doing this, the bacteria are "occupied" and do not cause damage to the human host.

64) A cell infected by viruses may die due to the actions of interferons. The same result would occur WITHOUT interferon—any cell infected by a virus would die directly from the virus. Is there any apparent benefit to the host organism from the interferon action?

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A) No; interferon is just an evolutionary leftover from a much earlier form of antiviral activity. It has no function now. Virus infections are always treated with medications. B) Yes; when the interferon acts on a virally infected cell, it shuts downvirus replication. Without interferon, the virus will eventually kill the cell, but only after it has replicated many times. IFNs may kill the host cell, but they will also prevent it from being used to replicate virus. C) Yes; by killing host cells, the number of cells that are available targets for viral infection is limited. This is a good way of preventing viral infection. D) No; viruses will replicate in cells regardless of the effects of interferons, so their action of killing the cell has no benefit to the host organism during the infection process. E) Yes; IFNis needed to activate complement which stimulates otherwise phagocytes in the host so that they recognize and destroy not only the virus but also any infected cells. Without complement, all phagocytes are inert.

65)

Please identify the INCORRECT definition regarding innate immunity.

A) First line defenses—the barriers that separate and shield the interior of the body from the surrounding environment (skin and mucous membranes). B) Sentinel cells—host cells that help the immune system detect signs of invasion by producing cytokines when their PRRs recognize an invading microbe. C) Inflammatory response—coordinated innate response involved in containinga site of damage, localizing the response, eliminating the invader, and restoring tissue function. D) Innate lymphoid cells—a group of lymphocytes that have increased specificity in their mechanism of antigen recognition (example: natural killer (NK) cells). E) RIG-like receptors—a group of pattern recognition receptors within cells that recognize molecules associated with infecting viruses.

66)

Which of the following is a bacterial product? A) Lactoferrin B) Transferrin C) Colicin D) Defensin E) Mucus

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67) Which of the following are enzymes found in neutrophil granules, saliva, and milk that react with hydrogen peroxide to form antimicrobial compounds? A) Peroxidases B) Lactoferrins C) Transferrins D) Peroxidases AND lactoferrins E) Lactoferrins AND transferrins

68)

Please identify the mismatched pair regarding mononuclear phagocytes. A) Kupffer cells—liver B) Microglial cells—brain C) Alveolar macrophages—lungs D) Mesangialmacrophages—kidneys E) Peritoneal macrophages—meninges

69)

How are macrophages and neutrophils similar, and how are they different?

A) Macrophages and neutrophils both circulate in the blood. Macrophages are phagocytic cells while neutrophils are granulocytes but not phagocytes. B) Macrophages and neutrophils are both phagocytic cells. Macrophages reside in the tissues while neutrophils typically circulate in the blood. C) Macrophages and neutrophils are both abundant cell types in tissues. Macrophages are phagocytic cells while neutrophils are not. D) Macrophages and neutrophils are both phagocytic cells. Macrophages are granulocytes while neutrophils are effector cells. E) Macrophages and neutrophils are both leukocytes. Macrophages are granulocytes and neutrophils are lymphocytes.

70)

Which of the following are lymphocytes?

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A) B cells B) T cells C) NK cells D) B cells AND T cells E) B cells, T cells, AND NK cells

71)

Please select the TRUE statement regarding Toll-like receptors (TLRs).

A) A number of different TLRs have been described, all of which are found in the phospholipid membranes ofendosomes and phagosomes.  B) TLRs anchored in the membrane of endosomes generally detect components of the outermost layers of microbial cells, including lipopolysaccharide (LPS), lipoproteins, and flagellin.  C) TLRsallow cells to detect patterns associated with microbes, indicating that the innate immune responses involve some specificity (although not the specificity of adaptive immunity). D) TLRsrepresent a very important early-warning system for viral infections. They allow any virally infected cell to alert neighboring cells that a virus is present.  E) All of the statements are true of TLRs.

72)

Which of the following would NOT trigger an inflammatory response? A) Activation of complement proteins. B) Binding of microbial products to PPRs. C) Tissue damage caused by microbial invasion. D) Induction of antiviral protein synthesis by IFNs. <!--Markup Copied from Habitat--

> E) Release of TNF by macrophages.

73)

Which of the following is least likely to be detected by pattern recognition receptors?

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A) O antigen on Gram-negative bacteria B) Peptidoglycan in Gram-positive cells C) Flagellin and pilin D) Double-stranded viral RNA E) Enzymes involved in glycolysis

74) Which of the following is the correct sequence of events in the interferon response? 1. IFN induces synthesis of inactive antiviral proteins (iAVPs). 2. Virus enters host cell (cell 1) and replicates, producing long dsRNA. 3.Activated AVPsinduce apoptosis of infected cell. 4. dsRNAinduces synthesis and secretion of IFN to neighboring cells. 5. Entry of virus into cell armed with iAVPs (cell 2) activates these proteins. A) 2, 4, 1, 5, 3 B) 1, 2, 3, 4, 5 C) 3, 1, 2, 5, 4 D) 5, 4, 1, 2, 3 E) 2, 1, 4, 3, 5

75)

Which of the following is mismatched regarding protection of the body from pathogens? A) Stomach—acid conditions and normal microbiota B) Skin—salt, fatty acids, and normal microbiota C) Respiratory tract—mucociliary escalator D) Peroxidases—milk, saliva, mucus, and some phagocytes E) Saliva—lysozyme, peroxidase, and lactoferrin

76)

Which of the following is not true of phagocytosis?

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A) Phagocytic cells are recruited to the site of an injury by chemoattractantssuch as complement C3b. B) The phagocytic cell binds microbial invaders and engulfs them by means of pseudopodia, internalizing them in a phagosome. C) If a phagocyte encounters something too large to engulf, it releases its toxic contents as a means of destroying that invader.  D) Within a phagolysosome, O 2 consumption decreases dramatically, allowing an enzyme to produce reactive oxygen species (ROS), which are toxic. E) The phagolysosome releases undigested debris to the outside of the cell by fusing with the phagocyte’s cytoplasmic membrane.

77) Please select the correct sequence for the steps of phagocytosis: 1. Conditions in the phagosomechange, increasing its antimicrobial activities. 2. The phagocytic cell binds microbial invaders and engulfs them, internalizing them in a phagosome. 3. Phagocytic cells are recruited to the site of an injury by chemoattractants. 4. Withinthe phagolysosome, various factors work together to destroy an engulfed invader. 5. The phagosome fuses with enzyme-filled lysosomes, forming a phagolysosome.

A) 1, 2, 3, 4, 5 B) 2, 4, 3, 5, 1 C) 3, 2, 1, 5, 4 D) 1, 3, 5, 2, 4 E) 1, 5, 2, 4, 3

78) Fever allows the body to fight microbial invaders by which of the following mechanisms?

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A) Fever prevents microbes with lower optimum temperatures from growing, giving the immune system time to eliminate those cells.  B) A moderate fever reduces the inflammatory response but stimulates phagocytic activity in neutrophils and eosinophils. C) Fever increasesthe inflammatory response, but reduces the production of interferonsunless the invader is a dsRNA virus.  <!-Markup Copied from Habitat--> D) Fever increases the multiplication of lymphocytes and enhances the release of substances that attract basophils that then engulf the microbial invader.  E) All of the choices are ways fever allows the body to fight microbial invaders.

79) The body’s own cells do not trigger the alternative pathway of complement system activation. Why is this? A) Host cells produce convertase3b which changes C3b into C3a that does not activate the complement pathway. B) Molecules in host cell membranes bind regulatory proteins that will inactivate any C3b molecules that attach to the membrane.  C) C3b triggers the alternative pathway in prokaryotes but not in eukaryotes. D) Molecules in host cell membranes bind regulatory proteins that will stimulate the bindingof C3b molecules to bacterial cells. E) Molecules in host cell membranes bind any MACs, deactivating them and preventing the activation of the alternative pathway.

80) How do some pathogens prevent complement activation or avoid the effects of activated complement?

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A) Some pathogens produce C5a peptidase that destroys complement C5a, a chemoattractantthat recruits phagocytes to the area of infection. B) Some pathogens hijack the host’s regulatory membrane proteinsthat inactivate C3b, preventing the triggering of the alternative activation pathway. C) Some pathogens produce C5a peptidase that causes destruction of phagoctyes recruited to the area of infection. D) Some pathogens hijack the host’s regulatory membrane proteinsthat inactivate C3b, preventing the triggering of the alternative activation pathway AND some pathogens produce C5a peptidase that destroys complement C5a, a chemoattractantthat recruits phagocytes to the area of infection. E) Some pathogens hijack the host’s regulatory membrane proteinsthat inactivate C3b, preventing the triggering of the alternative activation pathway AND some pathogens produce C5a peptidase that causes destruction of phagoctyes recruited to the area of infection.

81) Please select the INCORRECT statement about the components of the innate immune system. A) First-line defenses include the skin and mucous membranes, antimicrobial substances that bathe them, and the normal microbiota. B) Sentinel cells possess pattern recognition receptors that allow them to detect components such as peptidoglycan on invading microbial cells. C) Pattern recognition receptors of sentinel cells are located only on the surface of those cells, allowing those cells to detect invasion of the host. D) Complement proteins circulate in the blood; they sense the presence of invaders, become activated and lead to the elimination of the invader. E) An effector action in response to invasion by a viral pathogen is the synthesis of interferon that warns neighboring cells about that invader.

82) Which is the CORRECT sequence of immune events when a pathogen enters a host? i. Activation of immune components such as phagocytes and interferon. ii.Breaching of first line defenses. iii.Elimination of invader. iv. Invader detection by PPRs on sentinel cells

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A) ii, i, iii, iv B) ii, iv, i, iii C) i, ii, iii, iv D) iv, iii, ii, i E) i, iv, iii, ii

83)

Which statement regarding innate immunity is NOT correct?

A) The skin and mucous membranes, and the antimicrobial substances that bathe them, form the first line of defense. B) Skin and mucous membranes are a physical barrier to invaders. C) Innate effector actions occur in a specific sequence: interferon, phagocytosis, cytokine activation, inflammation, fever. D) Phagocytosis is the process by which certain cells engulf microbial invaders and cellular debris for elimination from the body. E) Pattern recognition receptors are found both at the surface of and within sentinel cells, where they detect microbial invaders.

84)

Which is NOT a protective mechanism of normal microbiota? A) Preventing attachment of pathogen to binding site. B) Inhibiting pathogen growth by consuming available nutrients. C) Producing fatty acids or lactic acids that lower the pH of the environment. D) Producing toxic compounds that kill potential pathogens. E) Recruiting neutrophils to areas of intense microbial activity.

85) Which of the following sheds cells to which microbes may be attached, thereby removing those microbes?

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A) Epidermis B) Dermis C) Hypodermis D) Musous membranes E) All of the choices are correct.

86)

Bacteriocins and defensins are examples of A) cytokines. B) antimicrobial peptides. C) complement proteins. D) phagocytes. E) first line cells.

87)

Which statement about neutrophils is CORRECT? A) They are the most abundant lymphocyte. B) They have a single-lobed nucleus. C) They can release DNA when degranulating. D) They contain darkly-staining granules. E) They arise from monocytes.

88) Hematopoietic stem cells can develop into which of the following? i. Red blood cells ii. Lymphocytes iii. Monocytes iv. Platelets v. Macrophages

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A) i, ii, iii, iv, v B) i, ii, iv, v C) i, ii, iii, v D) i, ii, v

89) Please select the statement regarding pattern recognition receptors (PPRs) that is INCORRECT. A) When a PPR detects a microbial compound, it releases chemicals to destroy that microbe. B) Surface nod-like receptors are found in the cytoplasmic membrane of cells. C) Rig-like receptors can detect double-stranded RNA molecules. D) Detection of MAMPs by macrophage PPRs leads to initiation of an inflammatory response. E) If a virally-infected cell's PPRs detect viral nucleic acid, that cell produces interferon.

90) Please select the incorrectly matched pair regarding pattern recognition receptorsv (PPRs). A) RLRs - detect single-stranded RNA. B) PPRs - detect MAMPs and DAMPs. C) TLRs - anchored in the cytoplasmic membrane. D) NLRs - component of inflammasomes. E) TLRs - can detect microbial nucleic acid.

91)

Select the INCORRECT statement regarding PRRs on phagocytes.

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A) Phagocytes have specific TLRs anchored in phagosome and endosome membranes. B) Phagocytic TLRs use methylation to differentiate between microbe and host DNA. C) TLRs in phagosome membranes are oriented toward the inside of the organelle. D) Some phagocyte TLRs are only functional after the phagosome fuses with a lysosome. E) Phagocytic TLRs can detect MAMPs and PAMPs.

92)

Inflammasomes A) are generated by neutrophils and monocytes. B) are NLRs combined with certain proteins. C) are a type of cell surface receptor. D) are RLRs combined with certain carbohydrates. E) detect inflammation in a host cell.

93) Select the INCORRECT statement regarding pattern recognition receptors (PPRs) in macrophages and dendritic cells. A) When a dendritic cell's PPRs detect MAMPs, the cell sends cytokines to lymphocytes, allowing then to initiate a response. B) If a macrophage's PPRs detect MAMPS, that cell releases pro-inflammatory cytokines, leading to an inflammatory response. C) When certain NLRs in macrophages detect invasion, they combine with other proteins in the cytoplasm to form a structure called an inflammasome.  D) When certain NLRs in dendritic cells detect invasion, they combine with other proteins in the cytoplasm to form a structure called an inflammasome.  E) When RLRs in macrophages detect viral PAMPs, they combine with other proteins in the cytoplasm to form a structure called a virosome.

94)

Please select the TRUE statement regarding apoptosis, pyroptosis and necroptosis.

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A) Apoptosis initiates an inflammatory response while pyroptosis and necroptosis do not. B) Apoptosis does not trigger an inflammatory response while pyroptosis and necroptosis do. C) Apoptosis is a type of programmed cell death while pyroptosis and necroptosis are uncontrolled events. D) Pyroptosis leads to the development of fever, while apoptosis and necroptosis do not cause fever. E) Necroptosis involves the initiation of the complement cascade while apoptosis and pyroptosis do not.

95) Chronic granulocytic leukemia is a disease in which too many white blood cells are produced. In which tissue/organ is this likely to occur? A) Bone marrow B) Spleen C) Thymus D) Blood E) Lymph nodes

96)

Neutrophils A) can destroy microbial invaders through a variety of mechanisms. B) contain darkly-staining granules. C) act as sentinel cells. D) can fuse to form giant, multinuclear phagocytes. E) contain granules composed of inflammatory mediators.

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SECTION BREAK. Answer all the part questions. 97) Your sister recently had her first child, aboy who she names Owen. Unfortunately, Owen seems to get sick really often, and after some investigation, he is diagnosed withan extremely rare genetic disorder calledleukocyte adhesion deficiency(LAD). People with LAD suffer from repeated bacterial infections because their leukocytes have adhesion defects—they cannot adhere to the endothelium and as a result areunable to leave the blood vessels to move into tissues containing microbial invaders. Without this inflammatory response, the person experiences severe tissue infections and frequently hasneutrophilia (high levels of neutrophils in the blood). You help your sister understand this disease, using your knowledge of the immune system.

97.1)

Which of the following is NOT a leukocyte?

A) B cell B) Basophil C) Macrophage D) Neutrophil E) These are all leukocytes

97.2)

Which of the following is NOT true of neutrophils?

A) They are phagocytic and efficiently engulf and destroy bacteria and other material.  B) They are the most numerous and important granulocytes of the innate responses. <!-Markup Copied from Habitat--> C) Their their numbers significantly decrease during most bacterial infections. <!-Markup Copied from Habitat--> D) They are the first leukocytes recruited to the site of an infection. E) Their granulescontain many enzymes and antimicrobial substances that help destroy engulfed materials.

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97.3) When microbes are introduced into normally sterile body sites, or when tissues are damaged, inflammation occurs. The purpose of this is to contain a site of damage, localize the response, eliminate the invader, and restore tissue function. Select the correct sequence of events for an inflammation response. 1. The phagocytesthen produceotheradhesion molecules that strengthentheir attachment to the endothelial cells. 2. Tight junctions between endothelial cells are disrupted, allowingleakage from the vessels into the tissue. 3. Endothelial cells of the blood vessels produce adhesion molecules that loosely “grab” phagocytic cells. 4. In response to various chemoattractants, the phagocytes leave the blood vessels and move into the surrounding tissues. 5. The diameter of local blood vessels increases due to the action of inflammatory mediators, slowingblood flow in the area. A) 1, 2, 3, 4, 5 B) 5, 2, 3, 1, 4 C) 3, 2, 4, 1, 5 D) 1, 3, 5, 2, 4 E) 4, 5, 1, 2, 3

97.4) Given what you understand about inflammation, why do you think a person with LAD experiences neutrophilia (high numbers of neutrophils in the blood)?

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A) When a person has an infection, their number of neutrophils increases. In a person with LAD, the neutrophils do not attach to endothelial cells, and thus cannot not leave the blood vessel to enter infected tissue. As a result, they accumulate in the blood. B) The inflammation response in a person with LAD is overactive. They produce an excess of phagocytic cells such as neutrophils and although some of these cells migrate into infected tissue, there are so many of these cells that the rest accumulate in the blood. C) In a person with LAD, the neutrophils become "sticky" and adhere strongly to blood vessel walls. At the same time, endothelial cell junctions always tighten during inflammation, so the neutrophils cannot not leave the blood vessel and they accumulate in the blood. D) When a person has an infection, their number of neutrophils always decreases significantly. In a person with LAD, there are so few neutrophils that these cells do not leave the blood vessel to enter infected tissue. As a result, they accumulate in the blood. E) None of the choices explain why a person with LAD suffers from neutrophilia.

97.5) Given the name "leukocyte adhesion deficiency", which of the following steps in the inflammation process given below do you think is/are not carried out in a person with this condition? 1.Tight junctions between endothelial cells are disrupted, allowing fluid to leak from the vessels into the tissue. 2. The phagocytesbind to the endothelial cellsand exit the blood vessel by a process called diapedesis. 3. Once in the tissues, phagocyticcells engulf and destroy any microbial invaders. 4.The increase of fluids in the tissues causes the swelling and pain associated with inflammation. 5. The diameter of local blood vessels increases due to the action of inflammatory mediators. A) 1 B) 2 C) 3 D) 1 and 2 E) 2, 3, and 5

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97.6) Which of the following do you think would be a possible way to cure a person with LAD? A) Giving the person inflammatory mediators daily to enhance the vasodilation process during inflammation. B) Giving the person a single blood transfusion with blood containing healthy leukocytes. C) Keeping the person on multiple antimicrobial medications for their whole life to fight any potential infections. D) Giving the person a hematopoietic stem cell transplant—this would replace the person's defective leukocytes with healthy leukocytes. E) Keeping the person in a completely microbe-free environment so that they are never at risk of contracting a microbial infection.

98) Yourfirst patient of the day is complaining of pain in the area of his new tattoo. When you examine the tattoo, you note that the area around it is firm, red, and swollen. There is no evidence of pus,and your patient has a normal pulse, and nofever. You tell your patient that you have seen this type of response to a tattoo before, and that it is called a granulomatous reaction. You give him more information on the condition.

98.1) You tell your patient that when he got his tattoo, his first line of defense of his innate immunity was breached because his skin was damaged by the process. He asks you to explain what is included in the first line of defense and you tell him A) skin B) mucous membranes. C) skin and mucous membranes. D) white blood cells. E) skin, mucous membranes, and lymphocytes.

98.2) You go on to explain to your patient that his skin and mucous membranes are protected from microbes by a number of antimicrobial substances. You inadvertentlymake a mistake during this explanation. Which of the following definitions is INCORRECT?

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A) Lysozyme—enzyme that degrades the peptidoglycan layer of the bacterial cell wall. B) Defensins—short chains of carbohydratesthat have strong antimicrobial properties. C) Peroxidases—enzymes found in neutrophils, saliva, and milk that react with H 2O 2 to form antimicrobial compounds. D) Transferrin—an iron-binding protein found in blood and tissue fluids that deprives microbes of Fe, inhibiting their growth. E) Perspiration—source of salty residue on the skin thatinhibitsall microbes except those that aresalt-tolerant.

98.3) You tell your patient that tattoo ink can sometimes cause the skin reaction he is experiencing; red ink in particular can cause this because it commonly contains mercury and/or other heavy metals. Your patient has developed a granuloma at the site of his tattoo. When he asks you what a granuloma is, you tell him A) a collection of macrophages, giant cells, and T cells.  B) a collection of neutrophils, giant cells, eosinophils and red blood cells. C) a mass of macrophages, activated complement proteins, and keratin. D) an acute inflammation response involving mast cells and dendritic cells. E) a collection of microbes, keratin, and white blood cells.

98.4) Your patient doesn't understand all of the cell names that you have used. You educate him on the role of each cell type. One cell type that plays a role in adaptive immunity rather than innate immunity. Which cell is this?

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A) Neutrophils—type of phagocytic cell in the blood that quickly move to infected tissues, where they engulf and destroy invading microbes. B) Macrophages—type of phagocytic cell that resides in tissues, engulfing invaders and debris, and producing pro-inflammatory cytokines. C) Dendritic cells—antigen-presenting cells that "show" antigens to T cells, playing an essential role in their activation. D) Eosinophils—primary role is to rid the body of parasitic worms; also involved in allergy. E) Mast cells—tissue cells that areimportant in the inflammatory response and immediate allergic reactions.

98.5) Your patient wonders what giant cells are and how they form. You explain that giant cells A) are very large cells with a single nucleus; they are formed by the fusion of many neutrophils during a chronic inflammatory response. B) are macrophages that have large extensions in their cytoplasmic membranes which both increases their size and enhances their phagocytic ability. C) are any cells in body that have a diameter of greater than 10 -3m. D) are very large cells with multiple nuclei; they are formed by the fusion of many macrophages during a chronic inflammatory response. E) cells that have engulfed a large number of particles that get stored inside the cell, causing it to absorb water and swell.

98.6) Your patient questions why he has developed a granuloma. You explain to him that granulomas

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A) are formed to recruit macrophages and neutrophils to an area of persistent inflammation such as that observed with a tattoo. B) result from activation of complement proteins; once complement C3 is activated, it causes a cascade of activation of C4 - C25. These activated proteins concentrate to form the granuloma. C) are immune cells that are normally synthesized to fight virus infections. In your patient's case, these cells were formed in response to ink particles. D) are proteins that recognize compounds unique to microbes or tissue damage; in your patient's case, these are made as a result to the tissue damage caused by the tattoo. E) are formed asan attempt by the body to wall off and contain persistent antigens - in his case, the red tattoo ink (red ink contains mercury compounds).

99) In April 2020, physicians in the United Kingdom and United States reported increased numbers of children presenting with a severe inflammatory syndrome. The symptoms exhibited by the children were similar to those of Kawasaki disease, an illness that causes inflammation of blood vessels throughout the body, and that typically affects children under the age of 5. The cases were found in children with that tested positive for current or repeated infections with SARS-CoV-2, the novel coronavirus that causes COVID-19. Patients had several symptoms, including fever, hypotension (low blood pressure), multiorgan involvement and elevated inflammatory markers. These included, but were not limited to, increased C-reactive protein (CRP), high interleukin 6 (IL-6), elevated neutrophils and low blood albumin levels. The patients did not all present with respiratory symptoms. The cases were identified as Multisystem Inflammatory Syndrome in Children (MIS-C). By definition, children are diagnosed with MIS-C if they are 21 years or younger in age, have fever and laboratory indicators of inflammation, are critically ill (requiring hospitalization and intensive care) with multiorgan involvement, and test positive for SARS-CoV-2 by RT-PCR, serology or antigen testing, or are confirmed to have been exposed to others with COVID-19 within four weeks of symptom development. In the U.S., clinicians treating children meeting the criteria of MIS-C are required to report it to the CDC. Source:https://emergency.cdc.gov/han/2020/han00432.asp

99.1)

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Select the CORRECT statement about Kawasaki disease.

A) It is characterized by inflamed blood vessels thoughout the body. B) It is only found in children who are five years of age or younger. C) It is caused by SARS-CoV-2, a newly emerged novel coronavirus. D) It causes multiorgan failure in any individuals who have the disease. E) It is fatal in all children under the age of five years old.

99.2)

Which of the following is NOT an indication of inflammation?

A) Raised levels of C-reactive protein. B) High interleukin-6 levels. C) Increased numbers of neutrophils. D) Low blood albumin levels. E) Low blood pressure (hypotension).

99.3)

What is interleukin-6?

A) A pro-inflammatory cytokine. B) A defensin. C) A dermal antimicrobial factor. D) An antibody. E) An antibiotic.

99.4)

All of the following are criteria for diagnosis of MIS-C except

A) Fever. B) Indicators of inflammation. C) Positive for SARS-CoV-2 by RT-PCR. D) Positive for SARS-CoV-2 by antibody testing. E) Positive for Kawasaki disease by serology.

99.5) Version 1

Which of the following is NOT a step in inflammation?

A) The diameter of local blood vessels increases due to the action of histamine and other inflammatory mediators.  B) Neutrophils are "grabbed" by adhesion molecules produced by the endothelial cells of blood vessels. C) Blood vessels releaseexudate that contains transferrin, complement system proteins, antibodies, and other antimicrobial substances.  D) Macrophages may initiate pyroptosis, recruiting various components of the immune system to the region.  E) Positively charged AMPs called defensinsinsert into cell membranes, forming pores that damage them.

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Answer Key Test name: Chap 14_10e 1) TRUE 2) TRUE 3) TRUE 4) FALSE 5) TRUE 6) TRUE 7) FALSE 8) FALSE 9) FALSE 10) FALSE 11) C 12) D 13) B 14) A 15) B 16) B 17) C 18) E 19) E 20) A 21) C 22) B 23) D 24) C 25) B 26) C Version 1

27) A 28) A 29) B 30) D 31) C 32) B 33) A 34) D 35) B 36) C 37) E 38) A 39) C 40) B 41) D 42) E 43) C 44) A 45) C 46) D 47) D 48) B 49) B 50) B 51) A 52) A 53) D 54) B 55) A 56) D Version 1

57) A 58) B 59) E 60) B 61) A 62) B 63) D 64) B 65) D 66) C 67) A 68) E 69) B 70) E 71) C 72) D 73) E 74) A 75) A 76) D 77) C 78) A 79) B 80) D 81) C 82) B 83) C 84) E 85) A 86) B Version 1

87) C 88) C 89) A 90) A 91) B 92) B 93) E 94) B 95) A 96) A 97) Section Break 97.1) E 97.2) C 97.3) B 97.4) A 97.5) B 97.6) D 98) Section Break 98.1) C 98.2) B 98.3) A 98.4) C 98.5) D 98.6) E 99) Section Break 99.1) A 99.2) E 99.3) A 99.4) E 99.5) E Version 1

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CHAPTER 15 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The immune response is directed against an entire molecule. ⊚ ⊚

All antigens are immunogens. ⊚ ⊚

true false

Gene rearrangement is responsible for the generation of the various antibody molecules. ⊚ ⊚

true false

IgA is the most abundant immunoglobulin made by the body. ⊚ ⊚

true false

Antibody and antigen are held to one another by covalent bonds. ⊚ ⊚

true false

Antibody molecules are very rigid in structure. ⊚ ⊚

true false

T cells are responsible for directly manufacturing antibodies. ⊚ ⊚

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true false 1

T cell receptors are identical to antibodies. ⊚ ⊚

true false

T-independent antigens can activate B cells directly. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 10) The scientist who received the first Nobel Prize in Medicine for his work on antibody therapy was A) Koch. B) von Behring. C) Jenner. D) Roux. E) Pasteur.

11) Proteins that react specifically with the chemical structures in the antigen that induced them are called A) determinants. B) antibodies. C) proteases. D) macroproteins. E) epitopes.

12)

Antibodies are made by

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A) red blood cells. B) macrophages. C) B cells/plasma cells. D) T cells. E) all leukocytes.

13)

Cytotoxic T cells primarily are responsible for A) humoral immunity. B) cell-mediated immunity. C) anamnestic immunity. D) producing haptens. E) producing antibodies.

14)

Secondary lymphoid organs A) facilitate interactions between cells. B) are hematopoietic. C) are the site of T cell maturation. D) include the bone marrow and thymus. E) are the site of B cell maturation.

15)

Epitopes or antigenic determinants A) are parts of the antibody molecule. B) are T cell receptors. C) are parts of an antigen recognized by an antibody. D) are B cell receptors. E) are parts of an antibody recognized by an antigen.

16)

The humoral immune response is delivered by

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A) antibodies. B) T cells. C) lymphokines. D) antigens. E) antibodies AND lymphokines.

17)

Which of the following is not typical of an antigen? A) Protein B) Foreign C) Low molecular weight D) Polysaccharide E) Low molecular weight AND protein

18)

Specific regions on an antigen molecule to which the immune response is directed are A) antigenic determinants. B) an autoimmune response. C) monomers. D) allergens. E) antibody determinants.

19)

Which of the following molecules would be expected to be immunogenic? A) Progesterone, a lipid hormone. B) Serum albumin, a large protein. C) Glucose, a simple sugar. D) Linoleic acid, a fatty acid. E) These are all equally immunogenic.

20)

Which of the following is/are secondary lymphoid organ(s)?

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A) Thymus AND spleen B) Spleen AND lymph nodes C) Lymph nodes AND bone marrow D) Spleen AND bone marrow E) Thymus AND bone marrow

21)

A term synonymous with antibody is A) antigen. B) immunoglobulin. C) epitope. D) determinant. E) immunotope.

22)

Which of the following do not induce a strong immune response? A) Lipids B) Proteins C) Polysaccharides D) Simple sugars E) Lipids AND simple sugars.

23)

There are ______ class(es) of antibody. A) one B) three C) five D) seven E) twelve

24)

Which of the following antibodies is a pentamer?

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A) IgA B) IgD C) IgM D) IgE E) IgG

25)

The chains of an antibody molecule are bonded to one another by A) disulfide bonds. B) hydrogen bonds. C) ionic bonds. D) oxygen bonds. E) ligases.

26)

Which of the following antibodies is a dimer? A) IgD B) IgA C) IgM D) IgE E) IgG

27)

The immunoglobulin monomer consists of A) four large chains. B) two heavy and two light chains. C) five light chains. D) three heavy and three light chains. E) one heavy and two light chains.

28)

Which class of antibody accounts for most of the circulating antibodies?

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A) IgA B) IgD C) IgG D) IgE E) IgM

29)

The characteristic function and properties of each class of antibody is determined by the A) variable region on the light chains. B) hinge region of all chains. C) constant region on the light chains. D) constant region on the heavy chains. E) variable region on the heavy chains.

30)

An IgG molecule has two A) heavy chains,light chains, AND antibody binding sites. B) heavy chains, light chains, AND antigen binding sites. C) light chains,antigen binding sites, AND antibody binding sites. D) antibody binding sites AND antigen binding sites. E) Fc regions AND one Fab region.

31)

The variable region of an antibody occurs A) only on the heavy chains. B) only on the light chains. C) on one of the light chains. D) on all four chains. E) at the hinge region only.

32)

Each class of antibody is specifically defined by its

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A) amino acid sequence of the constant region of the heavy chain. B) amino acid sequence of the variable region of the light chain. C) ability to cross the placenta. D) presence of disulfide bonds. E) ability to bind a range of antigens.

33)

Antigens interact with antibodies at A) the outer end of each arm of the Y. B) the junction of heavy and light chains. C) different regions depending on the class of antibody. D) the bottom stem of the heavy chain of the Y. E) the disulfide bridges of the antibody molecule.

34)

Ag-Ab binding may result in all of the following EXCEPT A) neutralization. B) immobilization. C) agglutination. D) opsonization. E) fever.

35)

The Fc region on IgG A) interacts with complement AND contains a variable region. B) attaches to receptors on macrophages AND contains a variable region. C) interacts with complement AND attaches to receptors on macrophages. D) reacts with and coats the antigen AND interacts with complement. E) reacts with and coats the antigenAND attaches to receptors on macrophages.

36) How long after initiation of a primary response do significant amounts of antibody appear in the blood? Version 1

A) One day B) 10–14 days C) 4 weeks D) 6 months E) 48 hours

37)

The only class of antibody that can cross the placenta is ______. A) IgA B) IgD C) IgG D) IgE E) IgM

38)

Which is the first antibody class made during the primary response to an antigen? A) IgA B) IgM C) IgG D) IgE E) IgD

39)

Which of the following is the most abundant immunological class produced? A) IgA B) IgD C) IgG D) IgE E) IgM

40)

Which is the most efficient at initiating the classical pathway of the complement cascade?

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A) IgA B) IgD C) IgM D) IgE E) IgG

41)

Which of the following class of antibody is primarily found in external secretions? A) IgA B) IgD C) IgG D) IgE E) IgM

42)

The function of the secretory component of the IgA molecule is

A) to protect IgA from being destroyed by proteolytic enzymes. B) to coat the antigen. C) to facilitateopsonization. D) to protect breast-fed infants against intestinal pathogens.  E) to protect IgA from being destroyed by lipases.

43)

The immunoglobulin that is important in hypersensitivity reactions is ______. A) IgA B) IgD C) IgG D) IgE E) IgM

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44)

According to the clonal selection theory

A) antibodies are modified, at the time of antigen exposure, to specifically react with the antigen. B) self-reactive T cells are killed in the thymus. C) B cells producing autoantibodies are eliminated in the thymus. D) each B cell is already programmed to produce a specific antibody. E) self-reactive Tcells are killed in the thymus AND B cells producing autoantibodies areeliminated in the thymus.

45)

"Clonal selection" and "clonal expansion" A) imply that each individual lymphocyte produces a single antibody. B) describehow a single lymphocyte proliferates in a population of effector cells. C) depend on an antibody recognizing a specific epitope. D) explain how an antigen stimulates the production of matching antibodies. E) All of the answer choices are correct.

46)

T cells and B cells are produced in the A) bone marrow. B) thymus. C) Peyer'spatches. D) nervous tissue. E) appendix.

47)

T cells mature in the A) bone marrow. B) thymus. C) Peyer'spatches. D) nervous tissue. E) tonsils.

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48)

The cells that actually secrete antibodies are A) natural killer cells. B) phagocytes. C) plasma cells. D) T cells. E) naive B cells.

49)

CD4 cells are also known as A) T helper cells. B) natural killer cells. C) T cytotoxic cells. D) macrophages. E) neutrophils.

50)

CD8 cells are A) T helper cells. B) natural killer cells. C) T cytotoxic cells. D) macrophages. E) plasma cells.

51)

Antigens may be processed for presentation by A) macrophages AND erythrocytes. B) dendritic cells AND erythrocytes. C) erythrocytes, macrophages, AND dendritic cells. D) T cytotoxic cells, B cells, AND dendritic cells. E) macrophages, B cells, AND dendritic cells.

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52)

Macrophages and dendritic cells are A) T cells. B) B cells. C) antigen-presenting cells. D) antibody-producing cells. E) lymphocytes.

53)

Only antigen-presenting cells A) produce MHC class I molecules. B) produce MHC class II molecules. C) produce antibodies. D) activate cytotoxic T cells. E) activate regulatory T cells.

54)

It would be useful if antigens were delivered directly to A) Peyer's patches. B) W Cells. C) M cells. D) red blood cells. E) Peyer's patches AND M cells.

55)

Class II MHC molecules are found primarily on A) macrophages AND erythrocytes. B) dendritic cells AND erythrocytes. C) T cytotoxic cells AND dendritic cells. D) macrophages AND dendritic cells. E) T cytotoxic cells AND macrophages

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56)

The stimulation of B cells to divide and mature is provided by A) T helper cells. B) macrophages. C) T cytotoxic cells. D) plasma cells. E) erythrocytes.

57)

The peptides presented by MHC class II peptide molecules are A) from plasma cells. B) exogenous antigens. C) endogenous antigens. D) from T helper cells. E) antibodies.

58)

T-independent antigens A) include polysaccharides. B) require the involvement of T cells. C) interact with MHCI molecules. D) are usually proteins. E) include polysaccharides AND require the involvement of T cells.

59) Which of the following does NOT form a memory population after activation and differentiation? A) B cells. B) T cytotoxic cells. C) T helper cells. D) Macrophages. E) These all form memory cells.

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60)

The surface receptors on B and T cells both A) play the same role in each type of cell. B) bind to free antigen. C) have two binding sites for antigen. D) have variable and constant regions. E) play the same role in each type of cell AND bind to free antigen.

61)

Which is involved in reacting to virus-infected cells? A) B cells AND cell-mediated immunity B) MHC class II molecules, B cells AND cytotoxic T cells C) B cells, leukocytes AND MHC class II molecules D) MHC class I molecules, helper T cells AND humoralimmunity E) MHC class I molecules, cell-mediated immunity ANDcytotoxicT cells

62)

Perforin is produced by A) B cells. B) macrophages. C) NK cells. D) T helper cells. E) B cells AND NK cells.

63)

Giant cells are A) a fusion of B cells. B) a fusion of T cells. C) used to contain bacterial infections. D) activated T helper cells. E) used to engulf very large pathogens.

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64)

Apoptosis

A) is a form of programmed cell death ANDresults specificallyin T cell death. B) is induced in target cells by effector T cytotoxic cells ANDresultsspecifically in T cell death. C) results specificallyin T cell death ANDrefers to the transformation of B cells into plasma cells. D) is a form of programmed cell death AND is induced in target cells by effector T cytotoxic cells. E) refers to the transformation of B cells into plasma cells.

65) How is the central portion of a T cell receptor complex functionally analogous to the center of the B cell receptor complex? A) It has two protein chains, just like a B-cell receptor. B) Both receptors bindepitopes (small amino acid sections of antigen molecules). C) Both bindstructures directly on the surface of microbes. D) Both can besecreted from lymphocytes to bind to pathogens under certain situations. E) Both have two heavy chains and two light chains.

66)

How is a T-cell receptor different from a B-cell receptor?

A) T-cell receptors must have antigen broken down inside a cell and presented to them by a major histocompatibilitycomplex (MHC) molecule. B) B-cell receptors must have antigen broken down inside a cell and presented to them by a major histocompatibilitycomplex (MHC) molecule. C) T-cell receptors are composed of fourprotein chains (pieces), while B-cell receptors are composed of only twochains. D) T-cell receptorsare eventually secreted into the bloodstream by activated T-cells, whereasB-cell receptors are not; they always stay with the B-cell. E) B-cell receptors are composed of chains of amino acids, while T-cell receptors are composed of chainsof carbohydrates.

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67) Why would a person who has their tonsils removed be more susceptible to certain types of infections of the throat and respiratory tract? A) Tonsils are primary lymphoid organs found in the oral cavity that produce high levels of lactoferrin and transferrin; these are strong natural antibacterial compounds that protect the lungs. B) Tonsils are secondary lymphoid organs found in the oral cavity that produce large amounts of interferons; theseare natural antiviral compounds that protect the respiratory tract. C) Tonsils are secondary lymphoid organs; they help to provide a constant response to the microbes in the oral cavity, helping to keep them in check and preventing them from spreading to other areas. D) Tonsils are thelocation where T cells develop and mature. Without them, a person won'thave T cells, and will be more likely to suffer from infections that wouldnormally be eliminated by such cells. E) Tonsils are primary lymphoid organs; they help to provide a constant response to the microbes in the gut, helping to keep them in check and preventing them from spreading to other areas.

68) Would a denatured antigen be expected to have the same epitopes as its native (nondenatured) counterpart? Why? A) Yes; epitopes are just a sequence of amino acids in a row, so they do not change regardless of 3D shape of the protein molecule they lie within. B) Yes; all proteins must be broken down into individual epitopes for presentation to B and T cells on MHC molecules, so each antigen protein MUST be denatured to yield ANY epitopes. C) No; ALL epitopes are dependent on being in the proper original 3D conformation of the protein. Denaturing them would destroy them by destroying that conformation. D) No; denaturing an antigen results in epitopeswith a different amino acid sequence from those on an intact antigen, so they are not the same at all. E) Yes AND No; SOME epitopes are dependent on 3D conformation (conformational epitopes), while some simply depend on the sequence of amino acids (linear epitopes). So, really, it depends on the particular epitope.

69) In opsonization with IgG, why would it be important that IgG react with the antigen BEFORE a phagocytic cell recognizes the antibody molecule? Version 1

A) If the IgG is bound to the phagocyte BEFORE opsonization, it would most likely be ingested by the phagocyte before it could bind to a pathogen (it would be "naked," so to speak). B) Binding of IgG byphagocytes would block the antigen binding sites on the IgG molecules,preventing them from binding to the microbes. C) Binding of IgG by phagocytes changes their conformation—and by changing their protein conformation, their antigen binding sites are changed and they can no longer recognize their specific antigenic epitopes. D) Binding ofantibody by phagocytes results in immediate release of proteindestroyingenzymes to the outside of the cell. Since antibodies are proteins, theywould be destroyed by these enzymes (and would then be unable to bind to theirspecific antigenic epitopes).

70) A scientist reports the isolation of a new blood-borne virus that completely shuts down presentation of viral epitopes on MHC molecules in the cells it infects. He produces an internet video describing the virus, claiming it will be indestructible by CD8+ cytotoxic T cells and will kill millions of people. The medical community quickly denounces thewarning as irrelevant, and the whole thing is quickly forgotten. Why? A) CD8+ T cells are not the cells that are responsible for killing virally infected cells. Thescientist has confused the information. The medical community denounces the information so that people are not unnecessarily alarmed by the video. B) While CD8+ T cells ARE important for eliminating a viral infection, they are not the ONLY things that can doso. Natural killer cells can kill virally infected cells that have shut down MHC antigen presentation, and interferons can assist in cleaning virally infected cells. C) A blood-borne virus would not be capable of rapidly infecting millions of people, due to its difficult mode of transmission ANDCD8+ T cells are not the cells that are responsible for killing virally infected cells. Thescientist has confused the information. The medical community denounces the information so that people are not unnecessarily alarmed. D) B cells would be primed right away to produce complement proteins to destroy the virus. This would prevent cells from being infected with it in the first place. The medical community denounces the scientist's video to prevent people from becoming alarmed. E) While CD8+ T cells ARE important for eliminating a viral infection, they are not the ONLY things that are capable of doing so. Natural killer cells can kill virally infected cells that have shut down MHC antigen presentation, and interferons can assist in cleaning virally infected cells AND a blood-borne virus would not be capable of rapidly infecting millions of people, due to its difficult mode of transmission.

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71) The best possible analogy available for the way in which variable (V), diversity (D), and joining (J) antibody gene segments get put together to create the diversity possible in hypervariable regions is A) to think of the various segments as a deck of cards—when you get dealt a hand of five cards, you have a very high likelihood of getting a different hand every time. The quality of the hand you have dealt will dictate whether you have a "winning" hand (capable of binding to antigenic epitopes). B) to think of the various segments as the pieces of a house—you need a strong foundation first (the joining segments), followed by a frame (the diversity segments), then the interior walls (the variable segments) before the structure is complete. C) to think of the various segments as building a highway—you need to prepare the area first by clearing a path (the joining segments do this), then grade/slope the area (the diversity segments) before you can finally lay down the asphalt (the variable segments). D) to think of the various segments as a bingo game—each segment is randomly selected, but you're going to need one of each (V, D, and J)to form a functional molecule. The "right" combination varies depending on which antigen is eventually going to be binding to the molecule (i.e., your bingo card would be the eventual antigen, and the random calling out of the number/letter combinations would be the forming of the VDJ hypervariable region). E) to think of the various segments as the characters in a game of Clue. Each character is assigned a specific weapon with which to commit a murder (the joining segments), but once that is assigned, the room in which the murder occurs is random (the diversity segments); to get a complete picture, you need to know the name of the victim (variable segments).

72)

Which of the following is/are a(n) antigen-presenting cell(s)? A) Macrophages B) Dendriticcells C) B cells D) Macrophages, dendritic cells, AND B cells E) Macrophages AND dendritic cells

73)

What is a naive lymphocyte?

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A) A lymphocyte that has an antigen receptor but has not yet encountered the antigen recognized by the receptor. B) A lymphocyte that has encountered the antigen recognized by its receptor but has not yet made antibodies. C) A lymphocyte that has encountered the antigen recognized by its receptor but has not yet made antibodies and cytokines. D) A lymphocyte that has encountered the antigen recognized by its receptor but has not yet undergone apoptosis. E) A lymphocyte that has not yet encountered the antigen recognized by its receptor but is making antibodies.

74)

What happens when a helper Tcell is activated?

A) Two populations of cells are formed: helper Tcells and cytotoxic Tcells; the T H cells activate B cells and the T C cells target virus-infected cells. B) Two populations of cells are formed: memory T H cells and effector T H cells; the effector T H cells produce a variety of antibodies. C) Two populations of cells are formed: memory T H cells and effector T H cells; the effector T H cells play a role in activating B cells. D) Two populations of cells are formed: effector T H cells and effector T Ccells; these work together to activate B cells and macrophages. E) Activated T H cells produce cytokines that stimulate dendritic cells, converting them into antigen-presenting cells.

75)

Please identify the incorrect definition.

A) Cytotoxic T cell—type of lymphocyte programmed to destroy infected or cancerous “self” cells. B) Plasma cell—effector form of a B cell; it functions as an antibody-secreting factory. C) T cell receptor—molecule on a T cell that enables the T cell to recognize a specific antigen. D) MHC class II—molecules that cells use to present antigen to cytotoxic T cells. E) Fab region—portion of an antibody molecule that binds to the antigen.

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76)

Please select the CORRECT statement regarding MHC molecules. A) Cytotoxic T cells recognizeantigens presented on MHC class II molecules. B) Dendritic cells are the only cells that make MHC class II molecules. C) All nucleated cells express MHC class II molecules. D) Helper T cells recognize antigens presented on MHC class II molecules. E) Endogenous antigens are presented on MHC class II molecules.

77)

Which of the following contribute to antibody diversity? A) Gene rearrangement AND imprecise joining B) Imprecise joining AND combinatorial associations C) Imprecise joining AND negative selection D) Gene rearrangement, imprecise joining AND combinatorial associations E) Positive selection, negative selection AND gene rearrangement

78)

Identify the role(s) of natural killer cells.

A) Phagocytosis of virus infected cells ANDproduction of cytokines that help regulate and direct certain immune responses.  B) Antibody-dependent cellular cytotoxicity AND negative selection of lymphocytes that recognize normal "self" molecules ANDregulationand direction of certain immune responses.  C) Destruction of stressed host cells such as those infected with viruses ANDnegative selection of lymphocytes that fail to recognize normal "self" molecules.  D) Antibody-dependent cellular cytotoxicity ORdestruction of stressed host cells such as those infected with viruses. E) Regulationand direction of certain immune responses AND phagocytosis of virus infected cells AND stimulation of MHC class I molecules.

79) What would be an appropriate response if an antigen is presented on MHC class II molecules?   Version 1

A) An effector CD4 cell activates the presenting cell.  B) An effector CD8 cell activates the presenting cell.  C) An effector CD4 cell kills the presenting cell.   D) An effector CD8 cell kills the presenting cell.   E) An effector CD8 cell activates a naive CD4 cell.

80)

Which of the following is the definition of clonal selection?

A) The killing of antibody-coated target cells by natural killer cells, granulocytes, or macrophages. B) The process in which a lymphocyte’s antigen receptor binds to an antigen, allowing the lymphocyte to multiply. C) The process that allows a B cell to change the antibody class it is programmed to make. D) The immune response that protects the mucous membranes, which involves secretory IgA. E) The generation of diversity in antigen specificity through rearrangement of gene segments.

81)

Select the CORRECT statement regarding central tolerance/ peripheral tolerance.

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A) Central tolerance takes place as lymphocytes mature; it eliminates immature T and B cells found to recognize certain “self” molecules. B) Central tolerance takes place after lymphocytes mature; it eliminates immature B cells found to recognize certain “self” molecules. C) Peripheral tolerance occurs after the lymphocytes mature; it stimulates T and B cells that were not eliminated during central tolerance to react against self molecules.  D) Peripheral tolerance occurs before the lymphocytes mature; it activates T and B cells that were not eliminated during central tolerance react against harmless molecules.  E) Central and peripheral tolerance occur simultaneously as lymphocytes mature; they eliminate any activated B cells and T cells that are not reacting to "self" molecules.

82)

Peripheral tolerance

A) eliminates B cells and T cells that are self-reactive but were not eliminated by central tolerance. B) prevents B cells and T cells that escaped central tolerance from reacting to self molecules. C) occurs before central tolerance and eliminates self reactive B cells and T cells. D) eliminates inappropriately actived naive B cells and T cells from peripheral blood. E) directs appropriately activated naive lymphoctyes to tolerate common pathogens.

83) A patient contracts chickenpox, a skin disease characterized by fluid-filled blisters. The disease is caused by a double-stranded DNA virus that can go latent in nerve cells. The patient's immune response clears the symptoms of the disease and he recovers fully. Two years later, he develops shingles, a more painful skin disease caused by reactivation of the same virus that caused the chickenpox. Again, his immune system clears the symptoms and he recovers fully. In this situation, the immune response that cleared the chickenpoxwas a(n) _______ response, while that which cleared the shingles was a _______ response that involved _______.

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A) primary; secondary; memory cells B) IgM; IgE; B cells C) memory; secondary; naive lymphocytes D) initial; final; memory cells E) latent; curative; natural killer cells

84)

What is the role of MHC molecules? A) Presenting antigens to B lymphocytes. B) Stimulating phagocytosis by neutrophils. C) Inhibiting phagocytosis by macrophages. D) Presenting antigens to T lymphocytes. E) Hiding antigens from lymphocytes.

85)

Central tolerance is the A) production of lymphocytes specific for self antigens. B) destruction of lymphocytes that are specific for self antigens. C) production of antigens that are specific for self lymphocytes. D) destruction of self antigens that are specific for lymphocytes. E) production of self antigens that are specific for B cells.

86)

What is clonal selection?

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A) An antigen, by binding to a lymphocyte receptor, "selects" that lymphocyte to begin multiplying. B) An antigen, by binding to a lymphocyte receptor, "selects" that lymphocyte for apoptosis. C) An antibody, by binding to a lymphocyte receptor, "selects" that lymphocyte to begin multiplying. D) An antigen, by binding to a lymphocyte receptor, "selects" that lymphocyte for recognizing self cells. E) An antigen, by binding to an MHC protein on a B cell, "selects" that lymphocyte to begin multiplying.

87)

The primary lymphoid organs A) include the lymph nodes, tonsils and spleen. B) give rise to lymph fluid. C) are the bone marrow and the thymus. D) descend from hematopoietic stem cells. E) recognize only a single epitope.

88)

Peyer's patches A) are primary lymphoid organs. B) are secondary lymphoid organs. C) are found in the spleen. D) are skin-associated lymphoid tissue. E) play no role in mucosal immunity.

89)

Please select the CORRECT statement regarding the lymphatic system.

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A) Secondary lymphoid organs such as the spleen are where T and B cells develop. <!-Markup Copied from Habitat--> B) Primary lymphoid organs are where antigens are brought into contact with dense collections of lymphocytes. C) Peyer's patches are important part of skin-associated lymphoid tissue and mucosalassociated lymphoid tissue. D) Peyer’s patch dendritic cells reach through the intestinal epithelial layer, "grabbing" material to present to naive T cells. E) B cells mature in the bone marrow while T cells mature in the thyroid.

90)

Dendritic cells A) activate memory and effector B cells. B) sample antigens using exocytosis. C) activate helper T cells and cytotoxic T cells. D) present antigen fragments on MHC class I molecules only. E) present antigen fragments on MHC class II molecules only.

91)

Activation of naive T cells is best achieved by which antigen presenting cell? A) Macrophage B) Neutrophil C) Dendritic cell D) B cell E) All of the choices are correct.

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SECTION BREAK. Answer all the part questions. 92) Your friendEllieis pregnant. She tells you that her mother, a microbiologist,has warned her not to clean out the cat's litter box while she is pregnant in case she contracts a disease called toxoplasmosis, which can affect her fetus. She says her mom told her toxoplasmosisis causedby a parasite called Toxoplasma gondii, that may befound in the feces of infected cats and also in raw meat. Your friend's mom explained to her that if a personhas not had a particular disease, they are notimmune to the pathogen that causes the disease, and lack antibodiesagainst that microbe. Your friend has never had toxoplasmosis but she doesn't quite understand why this, and the fact that she doesn't have antibodies to T. gondii,is important. You help her understand some facts about her adaptive immune system.

92.1) You explain to Ellie that when a person is exposed to an antigen, they generateantibodies against the antigen. Antibodies are ______ generated by______. A) carbohydrates; plasma cells B) epitopes; plasma cells C) proteins; effector B cells D) carbohydrates; effectorB cells E) proteins; effectorT cells

92.2)

You tell your friend that antibodies

A) bind to and destroy an antigen such as the toxoplasmosis parasite. B) bind to and tag an antigen for eliminationby white blood cells such as macrophages. C) bind to and destroy any self cells in which a pathogen may reside and multiply. D) coat the cytoplasmic membrane of a self cell so a pathogen cannot enter it. E) All of the choices are correct.

92.3) Ellie doesn't understand why it is important as to whether a woman has a first or subsequent exposure to a pathogen such as T. gondii when she is pregnant. Youexplain to her the difference between a primary and a secondary immune response. Which of the following would you NOT say to her?

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A) When memory B cells become activated, some quickly differentiate to form plasma cells, resulting in the rapid production of antibodies. IgG crosses the placenta and protects the fetus.   B) In the first (primary) exposure to an antigen, it takes about 10 to 14 days for a significant concentration of antibodies to accumulate. IgM is made, followed by IgG. <!-Markup Copied from Habitat--> C) The second exposure to an antigen, which characterizes the memory of adaptive immunity, causes rapid production of relatively large quantities of IgM but no IgG. <!-Markup Copied from Habitat-->   D) If the same antigen is encountered later in life, a stronger antigen-specific adaptive immune response occurs, called the secondary response. Large amounts of IgG are made.   E) The first adaptive immune response to an antigen is the primary response; effector cells and memory cells are formed as a result of this initial encounter.

92.4) A fetus is protected by maternal antibodies that cross the placenta. You explain to Ellie that the fetus A) is protected by both maternal IgG and maternal IgM, because these can easily cross the placenta. B) is protected by maternal IgM but not by maternal IgG, because IgM can cross the placenta but IgG cannot because it is a pentamer. C) will make large amounts of its own IgG and IgM immediately if the mother contracts some type of pathogen. D) is protected by maternal IgG but not by maternal IgM—IgG can cross the placenta but IgM cannot because it is a pentamer. E) will make its own IgG if the mother contracts any type of pathogen; it cannot make IgM because this is a pentamer.

92.5) Your friend asks you how her B cells "know" when to make antibodies. You tell her that B cells must become activated, and that she has another type of cell that assists in this. These are the

Version 1

A) T H cells that bind to the B cell and release cytokines that activate that B cell. B) T C cells that bind to the B cell and release cytokines that activate that B cell. C) T H cells that bind to the B cell and release cytokines that activate that T cell. D) T C cells that bind to the B cell and release cytokines that activate that T cell. E) T H cells that present the antigen to the B cell, leading to activation of that B cell.

92.6) Ellie wonders whether she has fully understood what you have told her, so she tells you what she knows but she makes one mistake. Which statementmade by your friend is INCORRECT? A) When a person is exposed to an antigen, B cells get activated by T H cells, proliferating and differentiating to form populations of plasma cells and memory cells. B) Plasma cells produce antibodies which are specific proteins that bind to the antigens, tagging them for elimination by other immune cells such as macrophages and neutrophils. C) On first exposure to an antigen, a person makes IgM followed by IgG. On second exposure to that same antigen, memory cells produce large amounts of IgG. D) If a woman experiences a primary exposure to a particular while pregnant, she makes IgM in response. This antibody crosses the placenta and protects her fetus from that pathogen. E) If a woman experiences a secondary exposure to a particularpathogen while pregnant, she makes IgG that crosses the placenta and protects the fetus from that antigen.

93) Your patient has recently been diagnosed with an immunodeficiency disorder. Your supervisor asks you to help the patient understand what this means and the impact it will have on her.

93.1) You inform your patient that the human body has several mechanisms of defense: innate immunity, whichis routine protection present at birth, and adaptive immunity, which is a more specific response that develops after birth. You tell your patient that her adaptive immune response uses two basic strategies for eliminating foreign material: humoral immunity, which involves ______ and cell-mediated immunity, which involves ______.

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A) T lymphocytes; B lymphocytes B) B lymphocytes; T lymphocytes C) T lymphocytes; NK cells D) B cells; neutrophils E) neutrophils; macrophages

93.2) You explain to your patient the role of the lymphocytes in her adaptive immune response. In the middle of your explanation, you are distracted and you tell her something that is NOT correct. Identify that statement. A) After activation, T lymphocytes divide and proliferate to form a population of helper T cells and a population of cytotoxic T cells; activated T cells secrete cytokines that exert an effect on other cells. B) After activation, B lymphocytes divide and proliferate to form a population of plasma cells and a population of memory cells; plasma cells produce antibodies that tag microbial invaders for elimination by phagocytes. C) Once activated, helper T cells form a population of T H effector cells and a population of T H memory cells; T H effector cells produce cytokines that activate B cells and macrophages. D) Once activated, cytotoxic T cells form a population of T C effector cells and a population of T C memory cells; T C effector cells produce cytokines that induce apoptosis in virally infected self cells. E) EffectorB cells and T cells express traits thathelp eliminate invaders in a primary response.Memory B cells and T cells are responsible for the effectiveness of the secondary response.

93.3) You describe for your patient the sequence of events that occurs when a B cell is activated. Please select the correct order of statements. 1. TH cells recognize the presented antigen-MHC complex on the B cell and bind to it. 2. B cell receptorbinds to an antigen and the antigen is internalized by endocytosis. 3. The bound THdelivers cytokines to the B cell thatinitiatethe process of clonal expansion of that particular B cell. 4. The antigen is degraded and peptide fragments are expressed at the B cell membrane with MHC class II molecules.

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A) 1, 2, 3, 4 B) 4, 3, 1, 2 C) 1, 3, 2, 4 D) 2, 3, 1, 4 E) 2, 4, 1, 3

93.4) that

You explain to your patient the role of cytotoxic T cells in immunity, telling her

A) T C cells induce apoptosis in infected “self” cells. B) T Cproduce antibodies AND T C destroy cancerous “self” cells. C) T C destroy cancerous “self” cells ANDT C cells induce apoptosis in infected “self” cells. D) T C cells activate B cells ANDT C cells induce apoptosis in infected “self” cells. E) T C cells activate B cells and macrophages AND T C cells produce antibodies AND T C destroy cancerous “self” cells

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94) A 13-year old female came to the hospital with a life-threateningvaricella zoster virus infection. This virus (which is a herpesvirus) causes chickenpox, and indeed, the patient was covered with chickenpox lesions. She also had varicella pneumonia. She was treated with intravenous doses of the antiviral medication acyclovir. The patient’s medical history indicated repeated otitis media (middle ear) infections since infancy, and recurrent leukopenia (low white blood cell counts). While in the hospital, the patient went on to develop hepatitis (liver inflammation) and polymicrobial bacterial sepsis (blood infection), that was treated with antibiotics. The patient responded to antiviral treatment, but her leukocyte and lymphocyte levels were very low. After 10 days she recovered and was discharged. Over the next three years the patient was hospitalized twice with fever and rashes; these resolved, and no microbial cause could be determined. At the age of 17, the patient returned with fever, chills and malaise (general feeling of illness). She exhibited both leukopenia and thrombocytopenia. She was HIV-negative. She was diagnosed with bacterial sepsis, which was treated. She wasalso diagnosedwith viralpneumonia caused by cytomegalovirus.She was again treated with antiviral medication, recovered, and was subsequently maintained on a regimen of intravenous gamma globulin. This patient had remarkable sensitivity to herpesviruses, but blood tests revealed that her innate immune responses, B- and T-cell levels and responses, and antibody production, were essentially normal. The patient, however, was completely deficient in natural killer cells. Source: Biron, C.A. 1984. Severe herpes infections in an adolescent without natural killer cells. NEJM 320:1731-1734.

94.1) In this case, the patient reported to the hospital with a skin infection caused by the varicella zoster virus. Which other infection did she have at the time she entered the hospital? A) Viral pneumonia B) Polymicrobial sepsis C) Hepatitis D) Otitis media E) Leukopenia

94.2)

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What were the causes of the patient's pneumonia at 13 and 17 years of age?

A) Varicella zoster virus; cytomegalovirus B) Cytomegalovirus; bacteria C) Bacteria in both cases D) Varicella zoster virus in both cases E) We are not give this information

94.3)

Select the INCORRECT statement regarding NK cells.

A) They play no role in destroying virus-infecting cells. B) They recognise cells that do not express MCH class I molecules. C) They destroy cells that do not express MHC class I molecules. D) They identify and destroy virus-infected cells that Tc cells do not destroy. E) They are involved in antibody-dependent cellular cytotoxicity.

94.4) The patient in this case had normal innate immunity responses and also produced functional B cells and T cells. ⊚ ⊚

true false

94.5)

What was the significance of the fact that this patient lacked NK cells?

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A) NK cells play a key role in identifying and destroying virus-infected cells; the patient had repeated serious viral diseases because her immune system was ill-equipped to deal with viral infections. B) NK cells play a key role in destroying bacterially-infected cells; the patient had repeated serious viral diseases because her immune system was focused on eliminating the bacterial pathogens. C) There is no real significance; the paper states that the patient had functional innate immune responses as well as B-cells and T-cells, so her immunity was basically intact. D) The patient was a child. There is no way to evaluate the significance of her lack of NK cells until much later in life, when she has been exposed to more serious pathogens. E) Without NK cells, this patient would be unable to survive any viral or bacterial infections without medication; the NK cells are the most important immune cells in the body.

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Answer Key Test name: Chap 15_10e 1) FALSE 2) FALSE 3) FALSE 4) FALSE 5) TRUE 6) TRUE 7) FALSE 8) FALSE 9) TRUE 10) B 11) B 12) C 13) B 14) A 15) C 16) A 17) C 18) A 19) B 20) B 21) B 22) E 23) C 24) C 25) A 26) B Version 1

27) B 28) C 29) D 30) B 31) D 32) A 33) A 34) E 35) C 36) B 37) C 38) B 39) A 40) C 41) A 42) A 43) D 44) D 45) E 46) A 47) B 48) C 49) A 50) C 51) E 52) C 53) B 54) E 55) D 56) A Version 1

57) B 58) A 59) D 60) D 61) E 62) C 63) C 64) D 65) B 66) A 67) C 68) E 69) A 70) E 71) D 72) D 73) A 74) C 75) D 76) D 77) D 78) B 79) A 80) B 81) A 82) B 83) A The first response is the primary response; the second response is the secondary response and is carried out by long-lived memory cells. 84) D Version 1

85) B 86) A 87) C 88) B 89) D 90) C 91) C 92) Section Break 92.1) C 92.2) B 92.3) C 92.4) D 92.5) A 92.6) D 93) Section Break 93.1) B 93.2) A 93.3) E 93.4) C 94) Section Break 94.1) A 94.2) A 94.3) A 94.4) TRUE 94.5) A

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CHAPTER 16 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The most successful parasites are the ones that live in harmony with their hosts. ⊚ ⊚

A human fetus has no resident microbial population. ⊚ ⊚

true false

Infection always leads to disease. ⊚ ⊚

true false

An infectious disease is an infection that impairs the normal state of health. ⊚ true ⊚ false

Obligate intracellular parasites may be grown in special synthetic media. ⊚ ⊚

During incubation and convalescence a person may still spread infectious organisms. ⊚ ⊚

true false

The infectious dose of most pathogens is about equal. ⊚ ⊚

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true false

A strong attachment of a microorganism to a host cell automatically leads to disease. ⊚ ⊚

true false

9) High concentrations of some bacteria are necessary for successful invasion because their virulence genes are only expressed at high population densities. ⊚ ⊚

10)

true false

Only Gram-positive bacteria produce exotoxins. ⊚ ⊚

true false

11) Although the microbiome composition varies throughout a persn's lifetime, there are some genera that are constantly present in the microbiome. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 12) The connection between a particular organism and a specific disease was first made by A) Jenner. B) Pasteur. C) Koch. D) van Leeuwenhoek. E) Hooke.

13)

The series of steps used to connect an organism to a disease are known as

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A) Pasteur's postulates. B) Lister's aseptics. C) Linnaeus' taxonomics. D) Koch's postulates. E) Bergey's manual

14) The interaction of all organisms within a biological community with their environment is called a(n) A) group. B) cluster. C) ecosystem. D) network. E) family.

15) The microorganisms that are regularly found in or on the body, yet do no apparent harm are called A) abnormal microbiota. B) normal microbiota. C) transient microbiota. D) variant microbiota. E) random biota.

16)

The microorganisms that are occasionally found in or on the body are called A) abnormal microbiota. B) transient microbiota. C) variant microbiota. D) normal microbiota. E) random biota.

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17) Organisms that are found together and interact on a more or less permanent basis are in a relationship termed A) mutualism. B) parasitism. C) symbiosis. D) transient microbiota. E) variance.

18)

The symbiotic relationship wherein both partners benefit is termed A) commensalism. B) parasitism. C) independence. D) mutualism. E) dysbiosis.

19)

A relationship in which one partner benefits and the other is unaffected is termed A) commensalism. B) parasitism. C) independence. D) mutualism. E) dysbiosis.

20)

A relationship in which one partner benefits and the other is harmed is termed A) commensalism. B) parasitism. C) independence. D) mutualism. E) normal microbiota.

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21)

Newborn babies acquire microbiota A) when passing through the birth canal. B) through breastfeeding. C) by contact with the mother's skin. D) from the environment. E) All of the above are a source of microbiota.

22) Which of the following is NOT true about the role normal microbiota plays in maintaining host health? A) They provide a surface that is incompatible for attachment of an invader. B) They establish competition for nutrients and vitamins. C) They produce antimicrobial substances. D) They inhibit the innate immune system. E) All of the answer choices are correct.

23) Which of the following members of the normal microbiota inhibit the growth of Candida albicans? A) E. coli B) Lactobacillus species C) Staphylococci species D) Propionibacterium species E) All of the answer choices are correct.

24)

The composition of the normal microbiota may be affected by A) hormonal changes. B) use of antibiotics. C) obesity level. D) diet. E) All of the answer choices are correct.

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25)

The "hygiene hypothesis" proposes that A) lack of exposure to microbes can lead to development of allergies. B) good hygiene always prevents development of disease. C) hand washing is the best preventative measure against infection. D) the immune system develops best in a clean environment. E) adaptive immunity only develops in a sterile environment.

26)

The infectious dose A) is the same for all microorganisms. B) may be 10–100 cells for Salmonella. C) is defined as the number of microbes needed to causeinfection. D) is defined as the number of microbes needed to kill the host. E) is the same for all bacteria but varies for viruses.

27)

The number of organisms necessary to cause infection is termed the A) infectious dose. B) fatal number. C) minimum lethal dose. D) pathogenic number. E) incidence number.

28)

Growth of a parasitic organism in or on the host is referred to as A) colonization. B) infection. C) pathogenism. D) mutualism. E) commensalism.

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29)

A disease-causing microorganism or virus is referred to as a(n) A) avirulent infection. B) colony. C) commensal. D) pathogen. E) virulent.

30)

Opportunists or opportunistic pathogens A) are usually saprophyte, like fungi. B) take advantage of special circumstances. C) are usually mutualistic. D) always cause disease. E) are never normal microbiota.

31)

The suffix -emia means in the A) body. B) lymph. C) interstitial fluid. D) blood. E) cerebrospinal fluid.

32)

Attributes of an organism that promote pathogenicity are called A) disease factors. B) colonization factors. C) virulence factors. D) mutualistic factors. E) pathogenic factors.

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33)

Virulent pathogens are A) more likely to cause disease. B) more likely to cause severe disease. C) unable to cause disease. D) more likely to be opportunists. E) most likely normal microbiota.

34)

Which of the following would NOT be considered virulence factor(s)? A) Adhesins B) Capsules C) Endotoxins D) Proteases E) Ribosomes

35)

Which of the following does S. pneumoniae use to survive in the host? A) Plasmids B) Capsule C) Pili D) Flagella E) Spikes

36)

Which of the following would be considered a sign of a disease? A) Severe headache B) Throbbing pain C) Intense nausea D) A rash E) All of the choices are signs of a disease.

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37) People who carry and may spread pathogenic organisms without any apparent signs or symptoms of illness are called A) carriers. B) primary infectors. C) secondary infectors. D) mutualists. E) opportunists.

38)

The spread of toxin via circulation is called ______. A) septicemia B) bacteremia C) toxemia D) sepsis E) viremia

39) If a disease affects only a human and not an animal, then it would be difficult to fulfill Koch's postulate number ______. A) 4 B) 3 C) 2 D) 1 E) 8

40)

A more modern equivalent to Koch's postulates is termed

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A) Pasteur's systematics. B) Hoch'spostulates. C) atomic theory. D) molecular postulates. E) protein theory.

41)

Species of both Shigella and Streptococcus A) invade host cells AND cause a rash. B) produce a toxin AND cause a rash. C) cause diarrhea AND are delivered by flea bites. D) are delivered via flea bites AND produce a toxin. E) invade host cells AND produce a toxin.

42)

Which of the following cause a foodborne intoxication? A) Staphylococcus aureus AND E. coli O157:H7 B) E. coli O157:H7 AND Clostridium botulinum C) Clostridium botulinum AND Mycobacterium tuberculosis D) Mycobacterium tuberculosis AND Staphylococcus aureus E) Staphylococcus aureus, E. coli O157:H7, AND Clostridium botulinum

43)

Adhesins are A) involved in the first step of the infectious process AND are endotoxins. B) involved in the first step of the infectious process AND are often found at the tip of

pili. C) often found at the tip of pili AND are endotoxins. D) exotoxinsAND are involved in the first step of the infectious process. E) are exotoxins OR are endotoxins.

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44)

The first step in the establishment of infection is that the organism must A) invade host tissues. B) attach to host cells. C) evade phagocytes. D) produce toxins. E) cause apoptosis.

45) Which of the following factors is not considered important for the establishment of an infection? A) Adherence B) Dose C) Toxicity D) Virulence factors E) None of the choices are important.

46) Which of the following members of the normal microbiota inhibit the growth of Candida albicans? A) E. coli B) Lactobacillus species C) Staphylococci species D) Propionibacterium species E) Neisseriaspecies

47)

The lack of susceptibility to diseases of other species in humans may be due to the A) lack of any cytokine production. B) presence of endotoxins. C) lack of any cytokineproduction ANDsecretion of exotoxins. D) presence of endotoxins AND secretion of exotoxins. E) lack of receptors that are recognized by adherence factors.

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48)

An example of genetic variation used in pathogen survival may be

A) preventing encounters with phagocytes.  B) avoid the killing effects of complement system proteins.  C) changing the pilus type. D) surviving within a phagocyte.  E) protease production.

49)

Colonization of the body is inhibited by A) the shedding of skin cells. B) the movement of mucus by cilia. C) peristalsis in the digestive tract. D) the flushing action of the urinary tract. E) All of the answer choices are correct.

50)

The process by which infectious agents are ingested by host cells is A) exocytosis. B) pinocytosis. C) endocytosis. D) phagosome fusion. E) endofusion.

51)

Bacteria that resist killing by complement proteins are termed

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A) serum strong. B) serum resistant. C) balanced pathogens. D) mutualistic. E) mutualistic AND serum resistant.

52)

C5a peptidase A) is a virulence factor. B) synthesizes C5a. C) is produced by the host cell in response to infection. D) is a molecule promoting chemotaxis. E) is a virulence factor AND is a molecule promoting chemotaxis.

53)

Bacteria may survive phagocytosis by

A) preventing fusion of the lysosome with the phagosome AND mimicking host molecules. B) avoiding recognition and attachment of lymphocytes AND lysing the phagosome. C) lysing the phagosome AND mimicking host molecules.  D) preventing encounters with phagocytes AND <!--Markup Copied from Habitat->preventing fusion of two phagosomes. E) preventing fusion of the lysosome with the phagosome AND lysing the phagosome.

54)

The chemical nature of endotoxins is that of a/an

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A) protein. B) lipopolysaccharide. C) nucleic acid. D) amino acid. E) carbohydrate.

55)

The chemical nature of exotoxins is that of a A) protein. B) carbohydrate. C) lipid. D) lipopolysaccharide. E) carbohydrate.

56)

Which is true about superantigens? A) They are a type of exotoxin AND they stimulate an abnormally high number of T C

cells . B) They bind to MHC class II molecules on T cells AND they are a type of endotoxin. C) They bind to MHC class II molecules on T cells AND they enhance specific antibody production. D) They are processed intracellularlyAND they are a type of endotoxin. E) They are a type of exotoxin AND they stimulate an abnormally high number of T H cells.

57)

Which of the following is/are true about endotoxins? A) Lipid A is the toxic portion of the molecule. B) The toxic effects depend on the bacteria from which it came. C) The lipid A portion is heat sensitive. D) They are proteins. E) The toxic effects depend on the bacteria from which it came AND they are proteins.

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58)

Which is/are TRUE of viruses? A) They may suppress the production of MHC class II molecules. B) They may prevent induction of host cell apoptosis. C) They may bind to MHC class II antigens. D) They may produce an MHC class III mimic molecules. E) They are facultative intracellular parasites.

59)

Disease(s) in which the causative agent becomes latent is/are A) cold sores AND influenza. B) genital herpes AND pneumonia. C) chickenpox AND influenza. D) shingles, genital herpes, AND cold sores. E) shingles, genital herpes, AND common colds.

60)

The damage caused by parasites may be due to all of the following EXCEPT A) competition for nutrients. B) the parasite's immune response. C) the physical blocking of organs. D) the direct digestion of host tissue. E) the host's immune response.

61) The normal microbiota provides protection against potentially harmful organisms and stimulates the immune system. Why would the immune responses to members of the normal microbiota cross-react with pathogens?

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A) Because one person's normal microbiota is another person's pathogen—when we pick up "normal" microbes from a different person, they will always cause infection within us. B) Because pathogens are often more virulent strains of our own normal microbiota, so they will appear similar to those cellsto our immune system, and may be acted upon by our immune responses. C) Because the normal microbiota keeps the adaptive immune responses tuned up, active, and ready to respond to broad, general categories of microbes such as Gram-positive and Gram-negative bacteria andviruses. D) Because if the immune systemisn't used on a regular basis, itloses the ability to respond to pathogens. The normal microbiota keeps the system going so that it can be ready to respond to pathogens when we're exposed to them. E) Because normal microbiotaare often more virulent strains of our pathogens, so they will appear similar to those cellsto our immune system, and may be acted upon by our immune responses.

62) Which of the following is NOT a likely reason why diseases caused by opportunists are becoming more frequent in the U.S. population? A) People with impaired immune systems such as those with HIV disease survive longer due to more effective therapies, but this gives them a longer period of time to be infected by opportunists. B) People in the U.S. are living longer than ever before, but they're living with a number of chronic health issues that can impair the immune system. This leads to a greater likelihood of opportunistic infections. C) Cancer treatments have improved significantly in the last 30 years, but they often suppress the immune system. This leads to a greater likelihood of opportunistic infections in people receiving these treatments. D) Travel into and out of the U.S. has increased significantly. This has the potential to bring in many new pathogens that can causeinfections, even in otherwise healthy and immunocompetent individuals. E) People in the U.S. are living longer than ever before, but their immune systems decline with age. This leads to a greater likelihood of opportunistic infections, especially if they receive any kind of invasive procedure.

63) In two of Koch's postulates (#2 and #3), a pure culture of the organism is required. Which of the following would NOT be a possible consequence of using a contaminated culture?

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A) You can't necessarily attribute the illness directly to the microbe in question; it may in fact be caused by the contaminating microbe. B) There's the possibility that the test animal might be acutely susceptible to the contaminating microbe, but completely resistant to the microbe you suspect causes the illness of interest. As such, when you introduce it into the test animal, it could confuse your final results. C) Even though there's a contaminating microbe present, as long as the original suspect microbe is also present, the disease should still manifest in test animals and the organism should still be recoverable from test animals. As such, there's really no consequence to using a contaminated culture. D) The problem is that one microbe may be toxic to the other. It may have killed all of your suspect microbe in the culture. Therefore, you can't be sure that you're infecting your test animals with the microbe you suspect is causing the illness, or if it's only thesecond (contaminating) microbe. E) These would all be consequences of using contaminated cultures.

64) Is it a good strategy for a microbe to adhere to a receptor that plays a critical function for a host cell? A) No, it ISN'T a good strategy. Host cells could use an alternative receptor and shut down production of the main receptor. The microbe would not have anything to attach to and the cell would thus prevent infection. B) Yes, it IS a good strategy. If it's a receptor the cell MUST use, it doesn't have an alternative receptor to switch to, soeven though that receptormakes the cell susceptible to infection, it HAS to put that target out there.This benefits the microbe. C) No,it ISN'T a good strategy.Microbes need to evade detection and elimination by the immune system. If they adhere to a receptor that plays a critical function, they are less likely to trigger destructive immune responses. This would be similar to using a hostage as a shield in a police-standoff situation. D) No, it ISN'T a good strategy. By binding to receptors, the microbes will be phagocytosed by cells and destroyed within them, thus failing to infect the host cell. E) Yes,it IS a good strategy.If the microbe attaches to a critical receptor, the host cell will be forced to try to rid itself of the pathogen. One way it can do this is to phagocytosethe pathogen, thereby taking it into its own nucleus, which benefits the pathogen.

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65) Home-canned foods should be boiled before consumption to prevent botulism. Considering that this treatment does NOT destroy endospores, why would it be helpful in preventing the disease? A) Because it woulddestroy the vegetative cells, and only the vegetative cells cause thedisease. B) Because it would atleast weaken the endospores, making them more susceptible to elimination by ourimmune system. C) Because the heat would denature the botulism endotoxin and inactivate it. The endotoxin is what leads to the disease symptoms, so this would make the food safer. D) Because although botulism exotoxinis harmless, it has a bad odor and boiling removes this, making the food more appealing to eat. E) Because the heat would denature the botulism exotoxin and inactivate it. The exotoxin is what leads to the disease symptoms, so this would make the food safer.

66) A number of viruses often include a similar set of symptoms when they cause an infectious disease state (fever, headache, fatigue, runny nose). Why would they all cause the same symptoms if they're different viruses? A) They all possessthe same basic virulence genes and molecules, so they all trigger the sameresponses. B) The symptoms are associated with the immune system's response, NOT the molecules from the pathogens themselves. Our responses against viruses are fairly similar, regardless of virus type, so the symptoms are similar. C) Most viruses infect the upper respiratory tract. This leads to the common set of symptoms listed above. Only a few viruses infect areas away from this region. D) Viruses specifically infect mainly epithelial membranes. As such, the virally induced reaction is similar in different areas of the body due to the same basic cell types (epithelial cells) being infected in each area. E) All animal viruses must attach to and enter host cells. Since this step in the life cycle is identical in all viruses, the signs and symptoms that follow will also be identical.

67) The period of time between exposure to an agent and the onset of disease signs and symptoms is called the

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A) prodromal phase. B) decline phase. C) incubation period. D) lag phase. E) carrier phase.

68) Please select the CORRECT definition regarding interactions between hosts and microbes. A) Immunocompetent—having a weakness or defect in the innate or adaptive defenses. B) Parasitism—relationship between two organisms in which one partner benefits and the other is unaffected. C) Dysbiosis—an imbalance in the microbiome thatmay be caused by taking antimicrobial medications. D) Secondary infection—infection in a previously healthy person, such as measles in a child who has not had measles before. E) Fc receptors—molecule that binds the antigen-bindingregion of an antibody.

69)

What is the difference between a primary pathogen and an opportunistic pathogen?

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A) A primary pathogen is amicrobe that is able to cause disease in an otherwise healthy individual, while an opportunistic pathogen is amicrobe that causes disease only when introduced into an unusual location or into an immunocompromised host. B) An opportunistic pathogen is amicrobe that is able to cause disease in an otherwise healthy individual, while a primary pathogen is amicrobe that causes disease only when introduced into an unusual location or into an immunocompromised host. C) A primary pathogen is an environmental microbe that is able to cause disease in an otherwise healthy individual, while an opportunistic pathogen is always a member of the normal microbiotaand causes disease only when introduced into an unusual location. D) A primary pathogen is an environmental microbe that is able to cause disease in an otherwise healthy individual, while an opportunistic pathogen is always a member of the normal microbiotaandonlycauses disease in an immunocompromised host. E) A primary pathogen is amicrobe that is able to cause disease in an otherwise healthy individual, while opportunistic pathogens are the microorganisms routinely found growing in and on the body of a healthy individual.

70)

Select the INCORRECT definition regarding the progression of an infectious disease.

A) Illness phase—period of time during which symptoms and signs of disease occur. B) Incubation period—interval between the entrance of a pathogen into a susceptible host and the onset of illness caused by that pathogen. C) Prodromal period—aperiod of early, vague symptoms indicating the onset of a disease. D) Period of convalescence—period of recuperation and recovery from an illness. E) Carrier phase—period in which a pathogen is harbored without noticeable ill effects, but may be transmitted to other hosts.

71) The length of the incubation period depends on a variety of factors, including <!-Markup Copied from Habitat-->

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A) the growth rate of the pathogen AND environmental conditions. B) the host’s condition AND the carrier's vaccination status. C) number of infectious cells or virions encountered AND the host's condition. D) number of infectious cells or virions encountered,the host’s condition, ANDthe growth rate of the pathogen. E) the growth rate of the pathogen only.

72) Select the correct sequence for proving Koch's postulates. 1.The microorganism must be recovered from the experimentally infected hosts. 2.The microorganism must be present in every case of the disease. 3.The same disease must be produced when a pure culture of the microorganism is introduced into susceptible hosts. 4.The microorganism must be grown in pure culture from diseased hosts. A) 2, 4, 3, 1 B) 1, 2, 3, 4 C) 1, 3, 2, 4 D) 4, 3, 1, 2 E) 4, 1, 2, 3

73) Why was it not possible until recently to use Koch’s postulates to show that Treponema pallidum causes syphilis? A) T. pallidum is a Gram-negative organism. B) T. pallidum could not be grown in pure culture. C) T. pallidum causes different diseases in different hosts. D) Syphilis is a polymicrobial disease; T. pallidum is only one of the causative agents involved in the disease. E) T. pallidum does not contain a genome.

74)

Please select the correct definition of balanced pathogenicity.

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A) A host-parasite relationship in which the parasite persists in the host, causing maximal harm.The pathogen becomes more virulent while the host becomes increasingly susceptible. B) A generated balance in the microbiome that may be caused by taking antimicrobial medications. It generally helps the host maintain optimal health. C) A mechanism that allows bacteria to transfer gene products directly into host cells,inducingchanges such as altering the cell’s cytoskeleton structure. D) A situation in whichan abnormally high number of T H cells (effector helper T cells) are stimulated, causing a massive release of cytokines (a “cytokine storm”). E) A host-parasite relationship in which the parasite persists in the host while causing minimal harm.The pathogen becomes less virulent while the host becomes less susceptible. <!-Markup Copied from Habitat-->

75)

Which of the following is NOT a mechanism for avoiding destruction by a phagocyte?

A) Some pathogens escape from the phagosome before it fuses with lysosomes. <!-Markup Copied from Habitat--> B) Some pathogensprevent phagosome-lysosome fusion.  C) Somemicrobes can survive the destructive environment within the phagolysosome.  D) Some microbes produce IgA protease that cleaves IgA, the class of antibody found in mucus and other secretions.  E) These are all mechanisms for avoiding phagocytic destruction.

76) Would an antibody response against the B subunit of an A-B toxin protect against the effects of the toxin?

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A) Yes.If antibodies bind to the B portion, the toxin can no longer bind to target cells and will thus not affect thosecells. B) No. Even if antibodies bind to the B portion of the toxin, it is the A portion that actually causes damage to the cell. C) Yes.If antibodies bind to the B portion, that portion of the toxin does not become activated, and thus does not damage the host cell. D) No. Even if antibodies bind to the B portion of the toxin, the toxin is still taken into the host cell by phagocytosis, damaging that cell. E) This question cannot be answered. The immune system does not mount a strong response against proteins, so this situation is unlikely to occur.

77) Please select the FALSE statement regarding viral avoidance of the immune response.  A) Some viruses interfere with antigen presentation by MHC class I molecules. <!-Markup Copied from Habitat--> B) Some viruses produce enzymes that, when activated, make holes in the phagocyte membrane, killing the cell.  C) Someviruses move directly from one cell to its immediate neighbors, thus avoiding antibodies.  D) Some viruses encode proteins that shut down expression of host genes such as those encoding IFNs and AVPs.  E) Some viruses display “fake” MHC class I molecules, tricking the immune system into believing that the cell is uninfected.

78) A person's microbiome changes over time. Which of the following does not indicate such change? A) Babies that breastfeed have a different microbiome from those that do not. B) Babies born by cesarean section have a different microbiome from those born vaginally. C) A baby's microbiome changes when they begin to eat solid foods. D) Hormonal changes can alter the composition of a person's microbiome. E) Genera such as Firmicutes in the gut are only sometimes present.

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79) In order to colonize a host, a pathogen has to deal with the host's defenses. Which of the following is NOT a mechanism for doing this? A) Production of siderophores for binding iron. B) Rapid turnover of pili to shed bound antibodies. C) Production of IgA proteases for cleaving IgA. D) Antigenic variation by changing surface molecules. E) Producing lactoferrins for binding iron.

80) You have three patients: patient A has a deep cut on his arm, while patient B is complaining of diarrhea. Patient B is a smoker. Patient C has a respiratory viral infection. Pick the CORRECT statement regarding the risk of patients A and B to acquiring the respiratory virus from patient C. A) Patient B is more at risk - being a smoker compromises the mucociliary escalator which protects the respiratory system. B) Patient B is less at risk - being a smoker toughens up the mucociliary escalator, protecting the respiratory system. C) Patient A is at most risk - the person's first line of defense (skin) has been compromised by the injury. D) Patients A and B are at equal risk - they both have other health issues which increase their susceptibility to respiratory viruses. E) Neither patient A nor patient B is at risk; we all have a mucociliary escalator that completely protects the respiratory tract.

81)

Which person is LEAST at risk of acquiring a pathogen via the skin? A) Person getting a tattoo. B) Person taking a recreational run. C) Person getting a body piercing. D) Person bitten by a mosquito. E) Veterinarian handling a feral cat.

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82) Which of the following is NOT a method by which pathogens penetrate a mucous membrane? A) Through a bite wound or knife cut. B) Via M cells in the antigen-sampling process. C) By directing/ enhancing uptake by macrophages. D) By directing uptake by non-phagocytic cells. E) These are all methods used by pathogens to penetrate mucous membranes.

83)

Membrane ruffling

A) is induced by some bacteria that trigger rearrangements of a cell’s actin, leading toengulfment of those bacteria. B) is induced by some bacteria that trigger breakdown of a cell’s actin, leading toexocytosis of those bacteria. C) is induced by some bacteria that trigger rearrangements of a cell’s myosin, leading topinocytosis of those bacteria. D) is induced by some bacteria that trigger increased synthesis of a cell’s actin, leading toexpulsion of those bacteria. E) is induced by some host cells that trigger rearrangements of their actin, leading toengulfment of some bacteria.

84)

Which statement applies to endotoxins?

A) A-B toxins arecomposed of an active subunit (A subunit) and a binding subunit (B subunit). B) Membrane-damaging toxins include pore-forming toxins and phopholipases. C) Superantigens stimulate T H cells, resulting in a cytokine storm. D) The immune system produces neutralizing antibodies against them. E) Toxin is part of the outer cell membrane and has no effect unless released.

85)

Which of the following could be the result of an enterotoxin?

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A) Vomiting and diarrhea B) Inability to contract muscles C) Inability to relax muscles D) Accumulation of respiratory secretions E) Separation of dermis and epidermis

86)

Which is NOT a mechanism by which viruses avoid the immune system? A) Interfering with antigen presentation on MHC class I molecules. B) Encoding the production of "fake" MHC class I molecules. C) Remaining intracellular and inducing syncytium formation. D) Inducing an overproduction of cytokines, causing a cytokine storm. E) Shutting down genes involved in a host cell's interferon response.

87)

Which of the following is an example of damage caused by inflammation?

A) Glomerulonephritis - resulting from activation of complement system proteins. B) Ectopic pregnancy - resulting from fallopian tube scarring caused by cross-reactive antibodies. C) Meningitis - caused by presence of immune complexes in the membranes surrounding the brain. D) Acute rheumatic fever - resulting from damaging enzymes and toxic products released by phagocytes. E) Acute rheumatic fever - caused by scarring of the heart tissue following complement activation.

88)

Which step is not directly involved in virus pathogenesis?

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A) Attachment to host receptors via protein spikes. B) Entry into host cell by receptor-mediated endocytosis or fusion. C) Avoiding host immune defenses by mechanisms such as antigenic variation. D) Initiating flu-like symptoms, including malaise, fever and body aches. E) Replication and release from host cells, sometimes damaging those cells.

SECTION BREAK. Answer all the part questions. 89) As a school RN, you sometimes see students who came to school feeling well but start to feel ill during the course of the school day. Jay comes to you complaining of abdominal pain and chills. You take his temperature and find that it is 38.2oC. While you are examining him, he confides that directly before he came to see you, he went to the bathroom and haddiarrhea. He tells you that he and his family went out for dinner the night before and that he had been feeling completely fine until a couple of hours ago.

89.1) You think that Jay may have a Salmonella infection. Although a person's normal gastrointestinal microbiotaprotects them from pathogenic infections, in this case, Jay has contracted the disease. You explain to Jay the role his normal microbiota plays in excluding pathogens, including A) covering binding sites that might otherwise be used for attachment by a pathogen B) consuming available nutrients (thus "starving") the pathogen AND reducing water and oxygen availability in their immediate environment <!--Markup Copied from Habitat-> C) producing compounds toxic to other bacteria AND phagocytizingany incoming pathogenic cells D) producing compounds toxic to other bacteria,consuming available nutrients (thus "starving" the pathogen) ANDcovering binding sites that might otherwise be used for attachment by a pathogen. E) producing compounds toxic to other bacteria, secreting carbohydrate "traps" that catch foreign bacteria AND phagocytizingany incoming pathogenic cells

89.2) Jay tells you that he ate chicken for dinner, which you suspect is the source of his infection. You tell Jay that infectious disease progresses through several stages, and that he is in the

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A) incubation period. B) prodromal period. C) illness phase. D) recovery phase. E) convalescence stage.

89.3) You explain to Jay that infections and the associated diseases are often described according to the timing and duration of the symptoms. You define the different categories to him, telling him that he has  A) a chronic infection, which is an infection that develops slowly and may last for months or years.  B) a latent infection—the microbe causing Jay's illness will continue to exist in him, although likely without causing any symptoms. C) a localized infection, in which the microbe is limited to a small area—in Jay's case the gastrointestinal tract. D) an inopportunistic infection, because Salmonella species are part of a person's gastrointestinal normal microbiota. E) an acute infection,characterized by symptoms that develop quickly but last only a short time.

89.4) You describe to Jay the initial events that must have occurred in order for him to become ill. Which of the following statements is FALSE? A) All pathogens must inject molecules into the host cell thatinduce a specific change in those cells; this is performed via structures called injectisomes.  B) Following adhesion, the pathogen must colonize the host, growing on the host cell surface.  C) Pathogens must adhere to host cells to initiate infection; bacteriause adhesins to attach to receptors on host cells. D) In order to colonize, a pathogen mustoften compete with the normal microbiota, prevent binding of secretory IgA, and obtain iron. E) All of the statements are correct.

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89.5) You explain to Jay that some pathogensinduce non-phagocytic cells to engulf them.Gram-negative bacteria such as Salmonella often inject effector proteins that induce engulfment by host cells. In the case of Salmonella,specific proteins are delivered to intestinal epithelial cells via A) a type I secretion system. B) a type II secretion system. C) a type III secretion system. D) a type IV secretion system. E) atype I OR a type III secretion system.

89.6) Finally, you use a diagram to illustrate to Jay how some pathogens avoid phagocytosis, which is part of the innate immune defense. You tell him that Salmonella is able to avoid phagocytosis by preventing formation of the phagolyososome. Which of the following is NOT a way for a pathogen to avoid phagocytosis? A) Some pathogens escape from the phagosomebefore it fuses with lysosomes. <!-Markup Copied from Habitat--> B) Some pathogens survive the destructive environment within the phagolysosome. <!-Markup Copied from Habitat--> C) Some pathogens avoid being recognized by phagocytes and thus avoid being engulfed by the cell. D) Some pathogens kill phagocytes, often by using toxins to form pores in their membranes.  E) Some pathogens are serum-resistant, avoiding the killing effects of phagocyte complement proteins.

90) A young couple brings their 3-month old baby to the emergency department where you work as a triage nurse. The parents tell you that the babyhad a runny nose, low grade fever, and mild cough two days earlier, which they assumed was a cold. However, the cough has become significantly worse and they are really worried about the gasping sound the child makes when breathing in after a coughing spell. The baby's cough is so bad that she has been vomiting and is refusing to feed. You are concerned that the baby has pertussis, commonly known as whooping cough. You give the parents some information while they are waiting for a physician to examine their child.

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90.1) Pertussis is caused by Bordetella pertussis, an encapsulated, aerobic Gramnegative bacterium. You tell Baby A's parents that when Bordetella is inhaled, it attaches specifically to ciliated respiratory epithelial cells. Attachment is facilitated by ______ on the bacteriumthat attach to specific ______ on the host cells. A) receptors; adesins B) adhesins; receptors C) adhesions; proteins D) adhesins; flagella E) adhesions; capsule

90.2) You examine the baby thoroughly, telling the parents that you need to record all signs and symptoms for your report to the clinician who will also assess the baby. The parents tell you they know what symptoms are but they don't know what you mean by signs. You tell them that A) symptoms areobjective and can be measured (such as fever) while signs are subjective and cannot be measured (such as pain). B) signs areobjective and can be measured (such as pain) while symptoms are subjective and cannot be measured (such as a rash). C) symptoms areobjective and can be measured (such as pain) while signs are subjective and cannot be measured (such as a rash). D) signs areobjective and can be measured (such as fever) while symptoms are subjective and cannot be measured (such as nausea).  E) signs and symptoms mean the same thing, and can be used interchangeably.

90.3) that

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You explain to the parents that pertussis is a highly contagious disease, meaning

A) it is a disease thatcan be easily transmitted from one host to another. B) it is a disease thatis not easily transmitted from one host to another. C) it is a disease that is acquired by inhaling the pathogen. D) it is a disease that is acquired via the placenta. E) it is a disease caused by an opportunistic pathogen.

90.4) You are very concerned about your patient because you know that B. pertussisreleases three toxins that play a role in disease progression. One of these, pertussis toxin (PT) is an A-B toxin that causes an increase in mucus production by cells in the respiratorytract. The parents ask you to explain what you mean by an A-B toxin. Which of the following would you NOT tell them? A) Exotoxins are proteins, so the immune system can generally produce neutralizing antibodies against them.  B) A-B toxinsconsist of two parts: the A subunit is the toxic (active) portion and the B subunit binds to a specific surface molecule on cells.  C) A-B toxins are exotoxins that are produced by Gram-positive cells but not by Gramnegative cells. D) Epithelial cells of the respiratory system possess receptors to which the B portion of PT can bind. E) A vaccine that protects againsttoxin-mediated disease are call toxoids; these vaccines contain inactivated toxins.

90.5) The parents tell you that their baby has already had a DTaPvaccine and that they thought this would protect the child from pertussis. You explain that this vaccine is given in a series and that with each shot in the series, the child's immunity will increase. You explain that while their baby was born with ______ immunity, she only started to develop ______ immunity after birth, so is still vulnerable to certain infections such as pertussis. A) adaptive; innate B) innate; adaptive C) cell-mediated; humoral D) humoral; cell-mediated E) cell-mediated; B-cell

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91) In 1980, an illness now called staphylococcal toxic shock syndrome became epidemic in young, healthy, menstruating women who were using a brand of high-absorbency tampon that has since been removed from the market. People with the syndromesudden development of high temperature, headache, muscle aches, bloodshot eyes, vomiting, diarrhea, a sunburn-like rash, and confusion. Typically, the skin peels about a week after symptoms begin. Without treatment, the blood pressure can drop, leading to multi-organ failure, coma, and sometimes death. Staphylococcal toxic shock syndrome is caused by strains of Staphylococcus aureus that producea superantigen called toxic shock syndrome toxin-1 (TSST-1), or other related exotoxins.Tampon-associated toxic shock syndrome usually begins 2 to 3 days after the start of menstruation when tampons are used. The staphylococci grow in the blood-soaked tampon. Asthe bacteriamultiply, they produce exotoxin, which is then absorbed into the bloodstream. From there, it spreads around the body, exerting its effect on T cells. Staphylococcal toxic shock syndrome can be effectively treated with antibacterial medication active against the infecting S. aureus strain, intravenous fluid, and other measures to prevent shock and organ failure. The source of the infection should be eliminated if possible. Although most people recover fully in 2 to 3 weeks, the disease can be fatal within a few hours. The graph below summarizes the events that occurred when the toxic shock syndrome epidemic started.

91.1)

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Which statement about TSST-1 is INCORRECT?

A) It is not very potent and only exerts its effect when present in high amounts. B) It is made in the cytoplasm of some bacteria and is secreted from those cells. C) It is a protein and would be denatured by high heat. D) It is only produced by certain strains of Staphylococcus aureus. E) It has a distinct mechanism of action.

91.2)

TSST-1 is a superantigen. Which statement does NOT apply to this type of toxin?

A) It is an exotoxin and is composed of amino acids. B) It is made by Gram-positive bacterial cells. C) It causes stimulation of an abnormally high number of T H cells. D) It causes massive release of cytokines (cytokine storm). E) It has two portions: one for attachment to a receptor and one that acts as a toxin.

91.3)

Consider the graph. The maximum number of cases not related to tampon use was

A) approximately 175. B) approximately 1050. C) approximately 1200. D) approximately 1980. E) approximately 200,000.

91.4) ⊚ ⊚

Consider the graph: All cases of toxic shock syndrome occur in women. true false

91.5) Consider the graph. The year in which essentially no cases of toxic shock syndrome were recorded was

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A) 1980. B) 1998. C) 2018. D) 1990. E) 1982.

91.6)

Which statement about the action of superantigens is not correct?

A) The superantigen binds to the outer part a MHC class II molecule and a T-cell receptor. B) Binding of the toxin to the T-cell receptor and MHC class II activates the T cell. C) Binding of the toxin "fools" the T-cell into inappropriately recognizing an antigen presented on the T-cell receptor. D) Binding of the toxin to the T-cell receptor "fools" the T cell into expressing MHC class I molecules. E) The superantigen causes activation of a huge number of T H cells, which then release cytokines.

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Answer Key Test name: Chap 16_10e 1) TRUE 2) TRUE 3) FALSE 4) TRUE 5) FALSE 6) TRUE 7) FALSE 8) FALSE 9) TRUE 10) FALSE 11) TRUE 12) C 13) D 14) C 15) B 16) B 17) C 18) D 19) A 20) B 21) E 22) D 23) B 24) E 25) A 26) C Version 1

27) A 28) B 29) D 30) B 31) D 32) C 33) B 34) E 35) B 36) D 37) A 38) C 39) B 40) D 41) E 42) E 43) B 44) B 45) C 46) B 47) E 48) C 49) E 50) C 51) B 52) A 53) E 54) B 55) A 56) E Version 1

57) A 58) B 59) D 60) B 61) B 62) D 63) C 64) B 65) E 66) B 67) C 68) C 69) A 70) E 71) D 72) A 73) B 74) E 75) D 76) A 77) B 78) E 79) E 80) A 81) B 82) A 83) A 84) E 85) A 86) D Version 1

87) A 88) D 89) Section Break 89.1) D 89.2) C 89.3) E 89.4) A 89.5) C 89.6) E 90) Section Break 90.1) B 90.2) D 90.3) A 90.4) C 90.5) B 91) Section Break 91.1) A 91.2) E 91.3) A 91.4) FALSE 91.5) B 91.6) D

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CHAPTER 17 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Active immunity develops only after a natural infection and not after vaccination. ⊚ ⊚

Attenuated agents often give rise to a long-lasting immunity. ⊚ ⊚

true false

Inactivated vaccines typically require booster shots. ⊚ ⊚

true false

4) Recombinant vaccines and inactivated vaccines typically require several shots to be effective. ⊚ ⊚

Alum is an adjuvant. ⊚ ⊚

true false

An adjuvant has been developed from lipid A. ⊚ true ⊚ false

7) The effectiveness of DNA vaccines stems from the effective production of antibodies against the naked DNA molecule.

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⊚ ⊚

true false

8) DNA vaccines are dangerous due to the possibility of the DNA causing reversion in the inactivated pathogen. ⊚ ⊚

true false

9) The risk of serious illness from measles is 500 times greater than from vaccination against the disease. ⊚ ⊚

10)

Agglutination reactions utilize particles rather than molecules. ⊚ ⊚

11)

true false

A monoclonal antibody is typically IgE and recognizes several epitopes. ⊚ ⊚

12)

true false

Immune checkpoints prevent cytotoxic T cells from killing "self" cells. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 13) The practice of deliberately stimulating the immune system is called

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A) acquired immunity. B) vaccination. C) hypersensitivity. D) memory immunity. E) autoimmunity.

14)

The procedure developed by the Chinese to protect against smallpox was called A) Oriental poxination. B) humoral immunity. C) variolation. D) naturally acquired immunity. E) vacciolation.

15)

Variolation is a procedure once used to protect against A) measles. B) bubonic plague. C) rabies. D) smallpox. E) cowpox.

16)

The scientist who made variolation safer and more effective was A) Pasteur. B) Jenner. C) Metchnikoff. D) Fleming. E) Ehrlich.

17)

All of the following are true about theterm vaccination EXCEPT it

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A) is a general term that would include the process of variolation. B) was coined by Pasteur and comes from the Latin term for cow, vacca. C) comes from the Latin for cow, vacca. D) was coined by Jenner andcomes from the Latin term for cow, variola. E) is also referred to as inoculation.

18)

The virus originally used for vaccination against smallpox is named A) vaccinia. B) cowpox. C) rubella. D) herpes. E) polio.

19)

Almost all of the antibodies found in a newborn are A) the result of infection. B) the result of passive immunity. C) self-made. D) IgM. E) the result of active immunity.

20)

Which antibodies cross the placenta and protect the fetus? A) IgA B) IgG C) IgM D) IgD E) IgM and IgG

21)

Herd immunity

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A) only occurs in a population in which all individuals are immune. B) occurs in a population in which a large percentage of the population is immune. C) only provides protection to those that are already immune. D) is responsible for dramatic increases in childhood diseases. E) occurs in a population in which a large percentage of the population is immune AND is responsible for dramatic increases in childhood diseases.

22)

Attenuated agents are A) dead viruses. B) toxins. C) weakened butreplicating microbes. D) parts of an organism. E) weakened, nonreplicatingmicrobes.

23)

All of the following are trueabout attenuated agents EXCEPT A) they only induce immunity after several doses. B) they may cause disease in immunocompromised individuals. C) they multiply in the body. D) they may revert or mutate to disease-causing strains. E) they cause a strong cell-mediated immune response.

24)

Inactivated immunizing agents are prepared by treatment with A) alcohol. B) phenol. C) formalin. D) histamine. E) mercury.

25)

The Salk vaccine

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A) contains live attenuated virus. B) contains inactivated virus. C) contains a portion of the polio virus. D) occasionally causes disease. E) is a DNA-based vaccine.

26)

The Salk polio vaccine

A) protects against nervous system and gastrointestinal infection. B) protects only against gastrointestinal infection. C) is a subunit vaccine. D) protects only against nervous system infection. E) protects against nervous system and gastrointestinal infection AND is a subunit vaccine.

27)

Whole agent vaccines may contain A) viruses. B) bacteria. C) toxins. D) polysaccharides. E) viruses OR bacteria.

28)

Toxoids are used in vaccines against A) Haemophilus influenza type b. B) diphtheria. C) herpes simplex type I. D) polio. E) diphtheria AND herpes simplex type I.

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29) Substances that are contained in vaccines to help induce a better immune response are called A) primary substances. B) secondary substances. C) adjuncts. D) secondary adjuncts. E) adjuvants.

30)

A recombinant vaccine is used to protect against A) hepatitis B. B) polio. C) diphtheria. D) pertussis. E) influenza.

31)

The most common adjuvant is A) ethanol. B) formalin. C) aluminum. D) hydroxide. E) alum.

32)

For which of the following childhood diseases is a subunit vaccine recommended? A) Polio B) Measles C) Hepatitis B D) Pertussis E) Chickenpox

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33)

Which type of vaccine has been used in place of inactivated whole cell vaccine? A) Acellular subunit B) Whole cell attenuated C) Adjuvant D) Toxin E) Partial cell attenuated

34) The vaccine that is stable to heat, has little unwanted material and causes minimal side effects is called a(n) A) inactive vaccine. B) peptide vaccine. C) active vaccine. D) toxoid. E) lipid vaccine.

35) A poorly understood, yet promising type of vaccine that causes the host to produce microbial antigens for a short time involves the use of A) subunits. B) DNA. C) alum. D) toxoids. E) glycoproteins.

36)

DNA vaccines work by

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A) stimulating production of antibodies against DNA. B) stimulating interferon production. C) inactivating the host DNA. D) having the cell use the introduced DNA to make the microbial protein antigen. E) having the cell use the introduced DNA to make inactivatingmicrobial mRNA.

37)

Monoclonal antibodies obtained from a hybridoma provide A) a large amount of an antibody that is specific for a particular epitope. B) a single antibody that recognizes many epitopes. C) many epitopes that recognize a specific antibody. D) a large number of B cells. E) a large amount of an antibody that reacts with a wide range of epitopes.

38)

Injection of a single antigen usually results in production of A) antibody to a single epitope. B) an antibody that recognizes several epitopes. C) additional antigen. D) epitopes against that particular antigen. E) a number of antibodies each recognizing a different epitope.

39)

Monoclonal antibodies A) are usually of different classes. B) usually recognize several epitopes. C) have the same variable regions. D) are always IgE. E) All of the answer choices are correct.

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40) The change from negative serum, without antibodies specific to an infecting agent, to positive serum, containing antibodies against that infecting agent, is called A) seroconversion. B) complement fixation. C) ELISA. D) serum reversion. E) serology.

41)

Immunological tests may determine the presence of A) only antibody. B) only antigen. C) antigen or antibody. D) neither antibodynor antigen. E) only IgG.

42)

If a positive reaction is last observed at a dilution of 1:256, the titer is ______. A) 128 B) 1/512 C) 1/256 D) 256 E) 512

43)

Serological tests are most often conducted in A) test tubes. B) flasks. C) graduated cylinders. D) Petri dishes. E) microtiter plates.

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44)

An immune complex is defined as A) antigen combined with antigen. B) antigen combined with antibody. C) antibody combined with antibody. D) complement combined with LPS. E) complement bound to neutrophils.

45)

Precipitation reactions depend on A) the antigen having one epitope. B) the antibody having one epitope. C) the antigen having two or more epitopes. D) the antigen having no epitopes. E) the epitope have one or more antigens.

46)

Precipitation reactions carried out in agarose are called A) hemagglutination tests. B) immunodiffusion tests. C) complement fixation tests. D) ELISA tests. E) disc diffusion assays.

47)

Precipitation occurs when A) antigen combines with antigen at optimal proportions.. B) antibody combines with antibody at optimal proportions.. C) antibody combines with complement at optimal proportions. D) antibody combines with antigen at optimal proportions. E) antigen combines with complementat optimal proportions.

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48)

Immunodiffusion tests A) allow detection of specific antigens. B) are a simple method that produces visible results in the zone of optimal proportion. C) allow quantitation of antigen concentrations. D) None of the answer choices are correct. E) All of the answer choices are correct.

49)

Agglutination tests can be used to detect A) bacteria AND viruses. B) hormones AND drugs. C) fungi, bacteria, AND viruses. D) viruses, bacteria, AND hormones. E) viruses, bacteria, fungi, hormones AND drugs.

50) The serology test that may show the antigen-antibody complex as yellow-green under the microscope while using an ultraviolet light is known as the A) Western blot. B) fluorescent antibody test. C) ELISA test. D) agglutination test. E) the Ouchterlony test.

51)

Anti-human IgG antibodies are often used in

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A) direct fluorescent antibody tests, radioimmunoassay, AND direct ELISA. B) complement fixation test, radioimmunoassay, AND Western blotting. C) radioimmunoassay, indirect ELISA, AND indirect fluorescent antibody tests. D) indirect fluorescent antibody tests, complement fixation tests, AND Western blotting. E) indirect ELISA, Western blotting, AND indirect fluorescent antibody tests.

52)

Blood for transfusion is frequently tested for HIV by using the A) complement fixation test. B) agglutination test. C) ELISA method. D) Ouchterlony test. E) light microscope.

53)

Anti-human-gamma-globulin antiserum is often used in A) direct fluorescent antibody tests AND indirect ELISA. B) indirect ELISA AND Western blot. C) Western blot AND indirect fluorescent antibody tests. D) indirect fluorescent antibody tests. E) indirect ELISA, Western blot, AND indirect fluorescent antibody tests.

54) Which of the following methods allows monitoring of the progressive destruction of CD4 T cells during an HIV infection by tagging the cells with specific antibodies to CD4 surface proteins and measuring their concentrations in serum? A) Western blot B) ELISA C) Latex beads agglutination D) Fluorescence-activated cell sorter E) FA test on a microscope slide

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55) Which of the following tests allows the separation of cells according to their sizes, densities, and surface markers tagged by specific fluorescent antibodies? A) Western blotting B) ELISA C) Fluorescence-activated cell sorter D) FA test on a microscope slide E) DNA gel electrophoresis

56) What would be a primary advantage of passive immunity with diseases such as tetanus or botulism? A) Time. You can quickly neutralize the toxin with a passive administration of antibodies to save the patient's life during the period it takes fortheir own active immune response to occur. B) Cost. It's much cheaper to administer a dose of antibodies harvested from the serum of an actively immunized animal or human than it is to administer a vaccine. C) Safety of delivery. It's far safer to administer a dose of antibodies harvested from the serum of an actively immunized animal or human than it is to administer a vaccine. D) Handling of treatment. It's difficult to keep vaccines stored properly to keep their potency, especially in countries without adequate refrigeration facilities. It's much easier to keepantibodies stable, even in extremes of heat and humidity. E) Recovery time. Even if the person actually develops the disease, the antibodies that are delivered in passive immunity will actively seek out and destroy the pathogen, facilitating a quicker recovery.

57) What would be a primary advantage of using an attenuated agent rather than just a subunit of that agent for a vaccine?

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A) An attenuated agent strongly stimulates both the humoral AND cellmediatedadaptive immune response, giving the best comprehensive long-term protection available. B) There is no advantage. It's much more dangerous to use an attenuated agent over a subunit vaccine due to the possibility of reversion of the microbe to a pathogenic state. C) An attenuated agent strongly stimulates ONLY the antibody production (humoral response) of the adaptive immune system. This provides the best and strongest long-term protection. D) An attenuated agent strongly stimulates ONLY the cytotoxic T cell (CTL, cellmediated) sideof the adaptive immune system. This provides the best and strongest long-term protection. E) There is no advantage. If a subunit is used from that agent, all the T cells that are activated will make antibodies against that single antigen, causing a very strong response.

58) Since many childhood diseases such as mumps and measles are rare now within the United States, why is it still important for children to be immunized against them? A) If we lose herdimmunity by removing mandatory vaccination, our population will becomesusceptible to these illnesses again in a short period of time. B) There is always the likelihood that an individual from another country could import one of these illnesses into the United States, sparking an outbreak of new infections, if we aren't all properly vaccinated. C) By keeping the population vaccinated, we keep incidence rates of these illnesses very low.This helps to protect people that cannot be vaccinated (very young children, pregnant women, immunocompromised individuals, the elderly). D) Many of these diseases are HIGHLY contagious, and commonly through respiratory droplet (airborne) transmission. This makes an outbreak within a susceptible population very possible.Keeping the population resistant through mandatory vaccination prevents this possibility. E) All of the answer choices are correct.

59) Would antibodies produced by a patient in response to infection be monoclonal, or polyclonal?

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A) Since theinfection is from only a single agent/microbe, the antibodies would bemonoclonal. B) Since a single pathogen has multiple epitopes, the responding antibodiesto a whole pathogen would be polyclonal. C) Since the pathogenwould most likely mutate slightly during the infection (producing differentepitopes), the responding antibodieswould be polyclonal. D) Since the pathogenwould acquire and modify self-antigens during the infectious process, theantibodies produced during the response would be polyclonal. E) Since only one B cell is ever activated in response to a pathogen, the antibodies that are produced would be monoclonal.

60) Why is a false positive more significant in HIV testing of patients than in screening donated blood for transfusions? A) It isn't—both are equally dangerous/significant. False positives in people can lead to psychological trauma, but false positives in blood could lead to the useful blood being discarded. B) A false positive in a person is easily re-testable. This makes it more significant, because we would simply quickly retest the person to verify their actual HIV status. C) A false positive in bloodis easily re-testable. This makes it less significant, because we would simply quickly retest the blood to verify its actual HIV status. D) This statement is backwards. False positives in blood testing are more significant. If the false positive rate is high, we're more likely to discard useful blood that may lead to acute blood shortages for patients needing transfusions. E) This question is misleading because like all immunological testing, the HIV test is infallible and there is absolutely no possibility of false positive results.

61)

Which of the following is NOT true of naturally acquired immunity?

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A) It is the gain of adaptive immunity through normal events, such as exposure to an infectious agent.  B) It involves injecting a person with antibodies produced by other people or animals.  C) It occurs as a result of breast feeding; the secretory IgA in breast milk protects the digestive tract of the child.  D) It occurs during pregnancy when the mother’s IgG antibodies cross the placenta and protect the fetus. E) These all characterizenaturally acquired immunity.

62)

Why does passive immunity not give lifetime protection, while active immunity may?

A) In active immunity, the body's own lymphocytes respond, producing a memory cell population that can respond to a subsequent exposure to the same antigen. Passive immunity only lasts as long as the injected antibodies remain in the body. B) In passive immunity, the body's own lymphocytes respond, producing a memory cell population that can respond to a subsequent exposure to the same antigen. Active immunity only lasts as long as the injected antibodies remain in the body. C) In active immunity, the body's own lymphocytes respond, producing an effector cell population that continually produces antibodies for the duration of the person's lifetime. Passive immunity only lasts as long as the injected antibodies remain in the body. D) In active immunity, the body's own lymphocytes respond, producing an effector cell population that continually produces antibodies for the duration of the person's lifetime. Passive immunity results in the production of antibodies only when an antigen is present. E) This question is misleading. Both passive immunity and active immunity provide lifetime protection.

63) Which of the following is NOT true of artificially acquired passive immunity? <!-Markup Copied from Habitat-->

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A) Itinvolves injecting a person with antibodies produced by other people or animals.  B) It can be used toprevent disease immediately before or after likely exposure to a pathogen.  C) It can be used to cure certain diseases. D) It can be used to limit the duration of certain diseases.  E) It can be used toblock the action of microbial toxins.

64)

Select the FALSE statement regarding artificially acquired passive immunity.

A) Immuneglobulinis used to prevent or treat specific diseases, for example using rabies immune globulin (RIG) to protect against rabies . <!-Markup Copied from Habitat--> B) It involves the use ofantiserum(a preparation of serum that contains protective antibodies) or antitoxin (antibody preparation that protects against a given toxin).  C) Hyperimmune globulinis used to protect unvaccinated people who have been recently exposed to certain diseases, including measles and hepatitis A.  D) Itoccurs naturally in response to infections, and artificially in response to vaccination, when antigens are deliberately introducedinto the body.  E) These statements are all false.

65)

Which of the following is NOT an example of an inactivated vaccine? A) Toxoid vaccines B) Subunit vaccines C) Conjugate vaccines D) Virus-like particles E) Adjuvants

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66) Many inactivated vaccines contain an adjuvant, a substance that enhances the immune response to antigens. An adjuvant thatuses a derivative of lipid A hasrecently been developed. Would lipid Awork well as an adjuvant?

A) Yes. Lipid A alerts the immune system to the presence of Gram-negative bacteria. It would similarly alert the immune system to the components of a vaccine if used as an adjuvant in the vaccine. B) Yes. Lipid A alerts the immune system to the presence of Gram-positive bacteria. It would likely also alert the immune system to the components of a vaccine if used as an adjuvant in the vaccine. C) Yes. Lipid A alerts the immune system to the presence of Gram-negative AND Gram-positive bacteria. It would similarly alert the immune system to the components of a vaccine if used as an adjuvant in the vaccine. D) No. Lipid A is actually unlikely to be successful as an adjuvant because it always causes an intense inflammatory reaction in a host, resulting in extensive tissue damage. E) No. Lipid A is actually unlikely to be successful as an adjuvant because even minimal amounts of this moleculecauses endotoxic shock in a person, usually resulting in death.

67) A patient is tested for antibodies to a particular infectious agent and is found to be positive. What would account for the positive result in this person? A) The person is currently infected with the agent AND the person was previously vaccinated against the agent. B) The person was previously vaccinated against the agent. C) The person was infected with the agent sometime in the past AND the person is currently infected with the agent. D) The person is currently infected with the agent, the person was infected with the agent sometime in the past, OR the person was previously vaccinated against the agent. E) The person was previously exposed to the infectious agent OR the person was previously vaccinated against the agent.

68)

How can a monoclonal antibody be used to reduce inflammation?

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A) The mAb can bind to and block the action of pro-inflammatory cytokines such as IL6. B) Some mAbs interfere with growth factors involved in cancer cell proliferation. C) Conjugated mAbs bound to toxins attach to pro-inflammatory cytokines, destroying them. D) Some mAbs destroy all the leukocytes involved in releasing pro-inflammatory cytokines. E) Some mAbs can destroy neutrophils that would normally cause inflammation by degranulation.

69) In cancer therapy, what is the advantage of a CAR T cell over a conventional T cell? <!-Markup Copied from Habitat--> A) A CAR T cell recognizes and responds to a specific epitope, without interaction with a dendritic cell. B) A CAR T cell is bigger and more powerful than a Tc cell. C) A CAR T cell has antibodies on its surface in place of regular T cell receptors. D) A CAR T cell responds more vigorously to a dendritic cell that is presenting a specific epitope. E) A CAR T cell is programmed to recognize and react to several different tumor antigens simultaneously.

70)

Which statement regarding checkpoints and checkpoint inhibitors is INCORRECT?

A) Checkpoints are proteins on the cytoplasmic membrane of cytotoxic T cells that prevent those cells from destroying "self" cells. B) When a checkpoint (such as PD-1) and its partner (such as PD-L1) bind, the immune cell receives an "on" signal and is activated. C) When a checkpoint (such as PD-1) and its partner (such as PD-L1) bind, the immune cell receives an "off" signal and is not activated. D) CTLA-4 inhibitors bind to a receptor that normally competes with another receptor in binding co-stimulatory molecules on dendritic cells. E) Monoclonal antibodies that bind to checkpoints allow the immune system to recognize and destroy cancer cells.

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71)

What is a bi-specific antibody? A) An antibody with two different antigen-binding sites. B) An antibody with two copies of the same antigen-binding site. C) An antibody that has two different Fc regions. D) An antibody that is either IgG or IgM. E) An antibody with two different conformations.

72) Your patient has an acute lymphocytic leukemia and is receiving the medicationblinatumomab, a bi-specific antibody. This antibody A) has two antigen-binding sites: one binds a protein on T cells and the other binds to a protein on cancerous B cells, connecting the two cells and increasing the chances that the T cell kills the B cell. B) has two antigen-binding sites: these bind a protein on the membrane of cancerous B cells, marking them for destruction by neutrophils, macrophages, or cytotoxic T cells. C) has two antigen-binding sites: these bind a protein on the membrane of cytotoxic T cells, marking them for destruction by neutrophils, macrophages, or dendritic cells. D) has two antigen-binding sites: one binds a protein on T cells and the other binds to a protein on cancerous B cells, connecting the two cells and preventing cytotoxic T cells from destroying the B cell. E) has two antigen-binding sites: these bind a protein on the membrane of the cancerous B cells, marking them for destruction by neutrophils, macrophages, or Tc cells.

73) Antibody titer (concentration) is expressed as the reciprocal of the last dilution that gives a detectable antigen-antibody reaction. Thus, if a positive reaction is observed in the dilution1:512 butbut not in 1:1024. Given this information, the titer of the antibody is <!-Markup Copied from Habitat-->

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A) 1:512 B) 512 C) 0.512 D) 1024 E) About 750

74) In the figure showing the principle of immunoassays, A is the _______, B is the _______ and C indicates a _______ result. {MISSING IMAGE} A) antigen; antibody; positive B) antibody; antigen; positive C) virus; antigen; positive D) bacteria; antigen; negative E) antigen; antibody; antigen:antibody

SECTION BREAK. Answer all the part questions. 75) Your patient has brought her 2-year old in to see you because he has a bad cold. The child has leukemia and is receiving chemotherapy, and until relatively recentlyhas been immunocompromised, although he is currently stable. You give the mother advice on what to do for her child's illness, and they leave your office. The next child you see also has the signs and symptoms of what appears to be a cold, but on further examination you discover that she has a fever of 39.8oC. She also has a rash and when you look at her throat, you notice small white spots called Koplik's spot. These are diagnostic for measles, caused by measles virus. You question the child's parentand discover that the child has not received her MMRVvaccine.

75.1)

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The MMRV vaccine is an attenuated vaccine, which means that the vaccine

A) contains empty virus capsids produced bygenetically engineered microorganisms such as yeasts.  B) containsviruses inactivated with formalin or another chemical that does not significantly change the surface epitopes.  C) is composed of a weakened form of the pathogen that is generally unable to cause disease. D) containstoxins that are treated to destroy the toxic part of the molecules while retaining the antigenic epitopes.  E) is composed only ofkey protein antigens or antigenic fragments from the pathogen.

75.2) Attenuated vaccines have several advantages. Which of the following is NOT an advantage of these vaccines? A) One or two doses of an attenuated agent are often enough to induce relatively longlasting immunity.  B) Attenuated vaccines are very stable in all temperatures, so are easily transported to remote areas and do not require special storage. C) The vaccine strain may be spread from the person being immunized to other nonimmune people, thereby immunizing the contacts of the vaccine recipient.  D) Attenuated vaccines can sometimes be delivered orally or nasally, preventing the need for using syringes. E) Attenuated vaccines cause a very strong cell-mediated immune response.

75.3)

The type of immunity conferred by giving a person a vaccine is

A) natural passive immunity. B) artificial passive immunity. C) natural active immunity. D) artificial active immunity. E) artificial active AND passive immunity.

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75.4) You are very concerned about the child with leukemia who was in your office before you saw the measles patient. You know that the two children had been in the same waiting room for at least 20 minutes and that measles is a highly contagious disease. You also know that the patient with cancer has not received his MMRV vaccine because A) attenuated vaccines that contain fully virulent pathogens, and thus poses a significant risk to immunocompromised people who cannot fight off any microbial infection. B) attenuated vaccines contain live but weakened disease agents; these may occasionallymutate to become pathogenic again , so there is some risk in giving these vaccines to immunocompromised people. C) all vaccines are dangerous because of the adjuvants and additives in them, and should only be given to people who are at significant risk of life-threatening diseases such as rabies. D) measles, mumps, rubella, and varicella are very mild childhood diseases that pose no risk; the leukemia child's immune system is already overwhelmed by fighting that cancer. E) the child with leukemia is only two, which is way too young to receive too many vaccines; he should probably only get the MMRvaccine before he goes away to college.

75.5) You explain to the parent of the child with measles the importance of vaccinations. She responds by saying that measles, mumps, rubella, and varicella are very rare diseases in developed countries and she doesn't want her child to go through getting her shots. She worries about the safety of the MMRV vaccine. Which is the best response regarding this concern?

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A) These diseases are rare BECAUSE of successful vaccination BUT the pathogens still exist and with enough susceptible hosts, they can spread in a population. B) These diseases are rare BECAUSE of successful vaccination AND the MMRV vaccine is safe and does NOT cause autism. C) An immunocompromised person such as your patient with leukemia depends on others being vaccinated to remain healthy (herd immunity) AND the MMRV vaccine is safe and is NOT associated with autism. D) These diseases are rare BECAUSE of successful vaccinationBUTthe pathogens still exist, and with enough susceptible hosts they can spread in a population AND the MMRV vaccine is safe and does NOT cause autism. E) These diseases are rare BECAUSE of successful vaccination, butthe pathogens still exist, and with enough susceptible hosts they can spread in a population. The MMRV vaccine is safe and is NOT associated with autism, and immunocompromised people who cannot receive an attenuated vaccine depend on herd immunity to remain healthy.

76) You are about to graduate as a RN. Your final term project is to prepare a presentation onHIV/AIDS. HIV (human immunodeficiency virus) is a retrovirus—itis an enveloped singlestranded virus that has duplicate copies of a single-stranded RNA genome. All retroviruses encode reverse transcriptase, an enzyme that uses an RNA genome as a template to make a complementary DNA strand. HIV can infect a variety of human cell types, but the most importantare the helper T cells (also called CD4 cells)—the virus infects these cells and causes their death;their numbers slowly decline until the immune system can no longer resist infections ortumordevelopment. You give your presentation to the class and are asked by your professor at the end of the sessionto answer some questions that your peers have on diagnosing HIV.

76.1)

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One of your peers asks you to explain the term immunoassay. You tell him that it

A) is an in vivo test in which known antibodies or antigens are used to detect or quantify given antibodies or antigens. B) is an in vitro test in which known antibodies or antigens are used to detect or quantify given antibodies or antigens. C) is the study of in vitro antibody-antigen reactions, particularly those that detect antibodies in serum. D) is an in vitro test that uses unlabeled antibodies to detect a very common antigen in a sample. E) is an in vitro test in which unknown antigens are used to detect unknown antibodies.

76.2)

The initial test used to diagnose HIV is the ELISA test. This test is

A) acolorimetric assay that is used to locate enzyme-labeled antibodies bound to antigens, often in a microtiterplate.  B) a piece of equipment that separates and determines the relative concentrations and certain characteristics of fluorescent-antibody-labeled cells.  C) the use of fluorescence microscopy to locate fluorescently labeled antibodies bound to antigens fixed to a microscope slide.  D) a “sandwich method” in which a known antigen is trapped between two radioactively labeled microscope slides for viewing. E) None of the answer choices is correct.

76.3) You explain to the class that ELISA tests may be direct or indirect. Please select the FALSE statement regarding these tests.

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A) In direct ELISAs,specific antigens in the sample are “captured” by antibodies that have been attached to the inside surface of the well B) ELISAshave advantages over other common immunoassays in that they are easy to do and often require minimal technical skills.  C) ELISA tests are 100% accurate; unlike other immunoassays, ELISAs never yield false positive results, so additional testing is not required. D) ELISA testsare often done in microtiter plates, allowing multiple samples to be tested all at once.  E) Indirect ELISAsrequire a labeled secondary antibody to detect the unlabeled first (primary) antibody.

76.4) The Western blot is used to confirm the results of an ELISA test. Which of the following is the correct sequence of steps involved in this procedure? 1.To determine if a patient’s serum has antibodies specific for any of the proteins in the sample (in this case HIV proteins), some of that serum is added to the blot, after which unbound antibodies are washed off. 2.The antigen proteins separate according to size. The separated proteins in the gel are then transferred (“blotted”) to a nylon membrane to immobilize them in the same positions they were in the gel. 3.A type of gel electrophoresis (SDS-PAGE)is used to separate the proteins of an antigen, which involvesloading the sample onto a polyacrylamide gel matrix, and running an electrical current through it. 4.Labeled anti-human IgG antibodies are added, which bind to any serum antibodies that have attached to the proteins. Unbound labeled antibodies are then washed off and attached label is detected. A) 1, 2, 3, 4  B) 3, 2, 4, 1   C) 3, 4, 2, 1  D) 3, 2, 1, 4 E) 2, 4, 3, 1

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76.5) You tell the class that ELISAs and Western blots are performed in a clinic or laboratory. However, there are a variety of tests that can be performed at home.With the oral fluid antibody self-test, a person swabs their own mouth and uses a kit to test the sample. The kit looks similar to a pregnancy test. Saliva is collected on a swab which is then inserted into the "tube" containing a test strip on which certain HIV proteins are bound. The salivamoves up the test strip until it reachestwo windows on the tube - one is labeled C and the other is labeled T.When the saliva reacts with the bound virus proteins, a color change is seen.Results are interpreted as follows: No color in the C window—test is not working. Color in the C window but none in theT window—negative result. Color in the C window and color in the T window—positive result. Given this information, select the FALSE statement. A) The C window is a positive control—if color appears there, it confirms that the test is working properly. B) The T window is the test window. If color appears both there and in the C window, it indicates that anti-HIV antibodies are present in the person's saliva. C) This test is an ELISA test that is used to detect antibodies in a person's saliva. D) If color appears in the T window but not in the C window, the kit is not working properly. E) This test is an ELISA test that is used to detect the presence of viral capsid proteins in a person's saliva.

77) Your patient is complaining of a abdominal pain and vaginal discharge. She also has flulike symptoms, including fever, headache, chills and fatigue. She has recently engaged in unprotected sex. You examine her and observe that she has a painless genital ulcer, which she has not noticed. You suspect that she has syphilis, caused by the spirochete Treponema pallidum. You take a swab of the discharge and send it for immunoanalysis. You explain to your patient what the analysis is and what information it will give you.

77.1) Examine the figure showing the principle of the immunoassay. In the figure, A is _______, B is _______ and C shows a _______ result; the patient _______ have syphilis. %media:1ag-abdiagnostics_png.ext%

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A) Treponema pallidum; antibodies to Treponema pallidum; positive; does B) an unknown organism; antibodies to Treponema pallidum; positive; does C) Treponema pallidum; antibodies to unknown organism; positive; does not D) an unknown organism; antibodies to unknown organism; negative; does not E) Treponema pallidum; antibodies to Treponema pallidum; negative; does

77.2)

What do the green circles attached to the antibodies represent?

A) Green circles B) Detectable marker C) Fc receptors D) Adhesins E) Immunoglobulin

77.3)

In this type of assay, how would the results be obtained?

A) Fluorescence microscope B) Light microscope C) Electron microscope D) Polymerase chain reaction E) Fluorescent microscope

77.4) If the patient does NOT have syphilis, what would you expect to see when you view her test? A) Fluorescent antibodies but no bacteria B) Bacteria but no antibodies C) No bacteria would be visible D) Fluorescent bacteria E) Bacteria that appear red

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77.5)

What can you conclude from the immunofluorescence assay figure below?

©Evans Roberts A) The organism shown is a streptococcus. B) The patient has syphilis. C) The organism is Treponema pallidum. D) The patient does not have syphilis. E) This is an indirect test.

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Answer Key Test name: Chap 17_10e 1) FALSE 2) TRUE 3) TRUE 4) TRUE 5) TRUE 6) TRUE 7) FALSE 8) FALSE 9) TRUE 10) TRUE 11) FALSE 12) TRUE 13) B 14) C 15) D 16) B 17) D 18) B 19) B 20) B 21) B 22) C 23) A 24) C 25) B 26) D Version 1

27) E 28) B 29) E 30) A 31) E 32) D 33) A 34) B 35) B 36) D 37) A 38) E 39) C 40) A 41) C 42) D 43) E 44) B 45) C 46) B 47) D 48) E 49) E 50) B 51) E 52) C 53) E 54) D 55) C 56) A Version 1

57) A 58) E 59) B 60) C 61) B 62) A 63) C 64) D 65) E 66) A 67) D 68) A 69) A 70) B 71) A 72) A 73) B 74) A 75) Section Break 75.1) C 75.2) B 75.3) D 75.4) B 75.5) E 76) Section Break 76.1) B 76.2) A 76.3) C 76.4) D 76.5) E Version 1

77) Section Break 77.1) B 77.2) B The circles represent a detetable marker such as a fluorecent dye. 77.3) A 77.4) C 77.5) A All you can conclude here is that organism shown is a streptococcus. It is not Treponema, which is a spirochete.

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CHAPTER 18 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) First exposure to an allergen results in a violent hypersensitivity reaction. ⊚ ⊚

true false

2) Anaphylaxis is the name given to allergic reactions caused by IgE-mediated release of mast cell granules. ⊚ ⊚

Generalized anaphylaxis may be quickly controlled with the use of antihistamines. ⊚ ⊚

true false

Type O blood is missing both anti-A and anti-B antibodies. ⊚ ⊚

true false

Allergic rhinitis and hives may both respond to antihistamines. ⊚ ⊚

true false

Anti-A and anti-B antibodies are natural antibodies and are present at birth. ⊚ ⊚

true false

7) Mismatch of either the Rh antigen or the AB antigen results in lysis of red blood cells by complement.

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⊚ ⊚

Anti-Rh antibodies may not cross the placenta. ⊚ ⊚

true false

MHC plays a pivotal role in transplant rejection. ⊚ ⊚

10)

true false

A lack of T cells makes one more vulnerable to intracellular parasites. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 11) The initial work on anaphylaxis was done by A) Watson and Crick. B) Pasteur. C) Richet and Portier. D) Fleming. E) van Leeuwenhoek.

12)

If the immune system responds inadequately to antigenic stimulation, this is termed

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A) hypersensitivity. B) immunodeficiency. C) autoimmunity. D) cell-mediated immunity. E) allergy.

13)

The immunoglobulin associated with Type I hypersensitivity is A) IgG. B) IgE. C) IgA. D) IgM. E) IgD.

14)

IgE molecules involved in hypersensitivity reactions have become attached to A) neutrophils. B) mast cells. C) B cells. D) macrophages. E) mast cells AND B cells.

15)

To produce an allergic reaction in Type I hypersensitivity, the antigen A) must bind to mast cells. B) must bind to free IgE molecules. C) must just bind to IgE on mast cells. D) must bind to two neighboring IgE molecules on mast cells, crosslinking them. E) must bind to two neighboring IgM molecules on mast cells, crosslinking them.

16)

During a Type I hypersensitivity reaction, the mast cells

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A) become phagocytic AND release IgG. B) degranulate AND release IgE antibodies. C) take up histamine AND immediately degranulate. D) become phagocytic AND immediately release histamine. E) degranulate AND immediately release histamine.

17)

Urticaria is characterized by A) diarrhea. B) wheal and flare. C) asthma. D) inflammation. E) weeping edema.

18)

Generalized anaphylaxis is generally characterized by A) wheal and flare. B) inflammation. C) shock. D) rash. E) sepsis.

19)

Most cases of generalized anaphylaxis are a result of A) fire ant stings and bites. B) aspirin and heparin. C) bananas and strawberries. D) peanuts, bee stings, or penicillin injections. E) All of the answer choices are correct.

20)

Desensitization

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A) stimulates an increase in IgG AND reduces the number of mast cells. B) reduces the number of mast cells AND increases the number of basophil cells. C) stimulates an increase in IgG AND is a treatment for hypersensitivity reactions. D) increases the number of basophil cells ANDis a treatment for hypersensitivity reactions. E) increases the number of mast cells AND decreases the number of basophil cells.

21) The hypersensitivity treatment that stimulates an increase of IgG and regulatory T cells, as well as causes a decrease in IgE, is known as A) desensitization. B) immunity. C) sensitization. D) exposure. E) anaphylaxis.

22)

Recombinant human monoclonal antibody (rhuMAb)

A) appears promising as a treatment for asthma AND uses an engineered form of an IgG molecule. B) promotes cross-linking between IgE molecules on the mast cells AND appears promising as a treatment for asthma. C) appears promising as a treatment for asthma AND decreases the levels of IgG. D) uses an engineered form of an IgG molecule AND promotes crosslinking between IgE molecules on the mast cells. E) appears promising as a treatment for asthma AND uses an engineered form of an IgM molecule.

23)

The type of hypersensitivity expressed with the lysing of red blood cells is

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A) type I. B) type II. C) type III. D) type IV. E) type V.

24)

A hemolytic transfusion reaction primarily involves A) leukocytes. B) erythrocytes. C) phagocytes. D) platelets. E) IgE.

25) The natural antibodies in serum that react with A or B polysaccharide antigens are mostly of the class A) IgG. B) IgE. C) IgM. D) IgD. E) IgA.

26)

Anti-A and anti-B antibodies A) are considered natural antibodies. B) are present at birth. C) are typically IgM. D) easily cross the placenta. E) are considered natural antibodies AND are typically IgM.

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27)

Regarding a mismatch of either the Rh antigen or the AB antigen, both A) result in destruction of red blood cells by the foreign antigen. B) use complement to destroy red blood cells. C) use antibody-dependent cellular cytotoxicity to destroy the red blood cells. D) result in destruction of only leukocytes. E) use either complement or ADCCto destroy red blood cells.

28) Antibodies that have arisen in the blood plasma without any obvious or deliberate stimulus are called A) natural. B) acquired. C) injurious. D) active. E) inactive.

29)

Hemolytic disease of the newborn A) may not manifest itself fully until after birth. B) is due to the action of IgM. C) is due to the action of IgE. D) is a type I hypersensitivity reaction. E) may not manifest itself fully until after birth AND is due to the action of IgE.

30)

The cell type responsible for type II hypersensitivity is the A) mast cell. B) B cell. C) macrophage. D) platelet. E) neutrophil.

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31)

Which of the following about immune complexes is FALSE? A) They consist of antigen-antibody bound together. B) They are usually cleared rapidly from the body. C) They bind to Fc receptors on cells. D) They are involved in type IIhypersensitivity reactions. E) They are involved in type IIIhypersensitivity reactions

32) Localized injury or death of tissue resulting from repeated injections of an antigen into a person with high levels of circulating specific antibody is known as A) farmer's lung. B) German measles. C) serum sickness. D) an Arthus reaction. E) disseminated intravascular coagulation.

33)

Arthus reactions and serum sickness are examples of ______ hypersensitivity. A) type I B) type II C) type III D) type IV E) type V

34)

Which of the following disease states is not among those caused by immune complexes? A) Systemic lupus erythematosus B) Serum sickness C) Hay fever D) Glomerulonephritis E) Disseminated intravascular coagulation

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35)

Delayed-type cell-mediated hypersensitivity is also known as ______ hypersensitivity. A) type I B) type II C) type III D) type IV E) type V

36)

Delayed-type cell-mediated hypersensitivity primarily involves A) erythrocytes. B) B cells. C) T cells. D) mast cells. E) T cells and platelets.

37)

Type IV hypersensitivity reactions typically peak within A) 2–3 days. B) 12 hours. C) weeks. D) minutes. E) seconds.

38)

Which of the following is associated with contact dermatitis? A) poison ivy. B) latex. C) tuberculin skin test. D) hay fever. E) poison ivy, latex, AND tuberculin skin test.

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39)

The redness and induration found after a tuberculin skin test involve the action of A) sensitized T cells. B) IgE. C) complement proteins. D) basophil cells. E) activated dendritic cells.

40)

Patch tests are used to detect A) hives. B) serum sickness. C) immune complexes. D) contact hypersensitivity. E) Arthus reaction.

41) Which of the following have been an effective immunosuppressant for use in transplantation? A) Amphotericin B and cephalosporin B) Amphotericin B and cyclosporin A C) Amphotericin B and tacrolimus D) Cephalosporinand tacrolimus E) Cyclosporin A and tacrolimus

42)

Graft-versus-host disease is primarily a

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A) type I reaction. B) type II reaction. C) type III reaction. D) type IV reaction. E) type V reaction.

43)

The tissue antigens most involved in graft rejection involve A) Rhesus antigen. B) ABO antigens. C) MHC molecules. D) MLB proteins. E) immune complexes.

44)

Killing of graft cells occurs through a complex series of mechanisms including A) sensitized T cytotoxic cells AND NK cells. B) sensitized T cytotoxic cells AND erythrocytes. C) NK cells AND erythrocytes. D) erythrocytes ANDbasophils. E) sensitizedT cytotoxic cells ANDbasophilic cells.

45)

Cyclosporin A A) is a relatively general immunosuppressive agent AND activates macrophages. B) suppresses T-cell proliferation AND activates macrophages. C) activates macrophages AND stimulates antibody production. D) stimulates antibody production AND stimulates T-cell proliferation. E) is a relatively general immunosuppressantAND suppresses T-cell proliferation.

46)

Immunosuppressive drugs

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A) are only needed during the first week after transplantation. B) are only needed for the first year after transplantation. C) are needed indefinitely after transplantation. D) are needed for transplants between identical twins. E) are needed indefinitely after transplantation AND are needed for transplants between identical twins.

47)

Allografts A) are normally rejected within hours. B) are grafts between non-identical members of the same species. C) involve tissues from non-human animals.  D) are grafts between identical members of the same species. E) are grafts between identical twins.

48)

The fetus is not rejected because A) it is too small. B) it is in an immunologically privileged site. C) the father is immunosuppressed. D) it has no antigens. E) it has no normal microbiota.

49)

Which of the following primary immunodeficiencies is/are the most common? A) Severe combined immunodeficiency B) Selective IgA deficiency C) Agammaglobulinemia D) Di George's syndrome E) Agammaglobulinemia AND Di George's syndrome

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50)

If the thymus fails to develop, A) functional T cells are absent. B) functional B cells are absent. C) Di George's syndrome exists. D) complement deficiencies exist. E) functional T cells are absent AND Di George's syndrome exists.

51)

If a patient lacks B cells, the resulting disease is A) SCID. B) AIDS. C) agammaglobulinemia. D) Di George's syndrome. E) chronic granulomatous disease.

52)

Defects in bone marrow stem cells result in a condition known as A) SCID. B) AIDS. C) Di George's syndrome. D) Chediak-Higashi disease. E) Chronic granulomatous disease.

53)

A secondary immunodeficiency disease is not the result of A) genetic defects. B) malignancies. C) advanced age. D) malnutrition. E) certain virus infections.

54)

Which of the following is NOT true aboutHIV?

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A) It leads to development ofAIDS. B) It is a retrovirus virus. C) It destroys T helper cells. D) It makes the patient vulnerable to infections. E) It is a dsDNA virus.

55)

If the body recognizes parts of itself as being foreign, this is termed A) immunodeficiency disease. B) agammaglobulinemia. C) autoimmune disease. D) AIDS. E) hypersensitivity.

56)

Myasthenia gravis is an example of an autoimmune disease that involves A) sensitized T cells. B) cytotoxic T cells. C) antibodies. D) IgD. E) muscle genes.

57) Insulin-dependent diabetes mellitus is an example of an autoimmune disease that involves A) sensitized T cells. B) cytotoxic T cells. C) antibodies. D) IgD. E) phagocytosis.

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58)

Gene therapy technology A) may be used to generate cells for transplantation. B) may overcome graft rejection. C) may treat cancer. D) may down-regulate the immune response. E) may overcome graft rejections AND may treat cancer.

59)

Stem cells A) have an almost unlimited capacity to divide. B) can differentiate into different tissues. C) may be used to test the effects of drugs on human cells. D) come from fetal material. E) All of the answer choices are correct.

60) Why do Rh-negative but not Rh-positive mothers sometimes have babies with hemolytic disease of the newborn? A) This disease results when an Rh-negative mother's immune system is primedto produce anti-Rh IgG antibodies that can cross the placenta. If the mother is Rh-positive, she won't produce any anti-Rh antibodies at all. B) Rh-positive mothers produce IgM antibody, not IgG. Even although they make antiRh antibody, IgM antibody can't cross the placenta, so it can't cause hemolytic disease of the newborn. C) Rh-positive mothers will receive a preventative shot from their physician prior to conception. This will provide the protection the fetus needs AFTER conception to avoid the disease. D) Rh-negativity is also associated with hyperproduction of antibodies. As such, Rhnegative mothers are more likely than Rh-positive mothers to produce the antibodies needed to produce this disease. E) This disease results when an Rh-positive mother's immune system is primedto produce anti-Rh IgG antibodies that can cross the placenta. If the mother is Rh-negative, she won't produce any anti-Rh antibodies at all.

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61) What is NOT a reason that the kidneys are particularly prone to damage caused by immune complexes? A) Kidney blood vessel wall cells have receptors for antibodies on them, which makes them take up antibodies or immune complexesfrom the bloodstream. This blocks the kidneys up and causes them to malfunction and become damaged. B) Blood is pushed through the kidneys at a very high pressure. Any blockage of the vessels, such as what might be caused by immune complex deposits, can lead to ruptures/inflammation and damage of these organs. C) While blood vessel walls do NOT have receptors for antibodies, large immune complexes forced through small diameter vessels can become embedded within them. This can trigger complement system inflammation and cell destruction. D) Trapped immune complexes that initiate inflammation can attract neutrophils. The neutrophils degranulate in the area of the immune complexes, leading to cell/tissue destruction. E) These are all reasons that the kidneys are very susceptible to damage caused by immune complexes.

62) In the tuberculin skin test, what would be the most likely reason why a positive test would NOT necessarily indicate an infection in progress in a patient who was born and grew up in the United States? A) False-positives occur all the time. This might simply be an example of that. B) The TB skin test is a measure of reactivation of memory T cells. The memory T cells would be formedduring an active infection and would remain after the infectioncleared. This would result inthe test still showingpositive, even though the patient is cleared of actual infection. C) Each person in the United States receives the BCG tuberculosis vaccine. This is an attenuated mycobacterium vaccine. The response to this vaccine makes us positive for the TB skin test, even though we may not have actually had a TB infection at any point in our lives. D) A positive TB skin test ALWAYS indicates a current, active infection.

63) If a patient received a kidney transplant that was matched well across each of the major histocompatibility complex (MHC) molecules, but they stopped taking their anti-rejection drugs, what would happen and why?

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A) Nothing; the transplant is matched, so the patient doesn't need the drugs to prevent rejection. The new organ should be seen by the recipient's immune system as "self." B) The organ will be rejected very quickly, as allografts (tissue from the same species, but a different individual) are seen by the recipient's immune system as "foreign," and are quickly attacked. C) The organ will be rejected, but it will be a gradual process since it was matched well. There are a number of other proteins that cannot be matched between donors, so the graft will still be viewed as "foreign" by the recipient's immune system, and will still be attacked and rejected. D) Nothing; since the transplant was accepted for so long with the anti-rejection drugs, the person's immune system has had the time to become accustomed to it and now views the graft as "self." It will not be attacked. E) Nothing. The anti-rejection drugs are not really necessary once the patient's surgery wounds have healed. At the time their immune system returns to normal, so the new organ will not be rejected.

64) What might be an advantage to using an individual's own stem cells instead of pancreatic cell allografts to treat type I diabetes? A) Stem cells can disable the immune responses that led to the diabetes state in the first place. B) This process should be far cheaper than the surgical intervention needed for the allograft. C) You can't do this—stem cell research it is still theoretical, not approved by the FDA, and is currently illegal in the United States. As such, there is no advantage. D) If you were able to use a person's own cells, it would be considered an autograft rather than an allograft. As such, there should be no HLA/MHC matching required, and no longterm anti-rejection drugs would be needed. E) This process should be far cheaper than the surgical intervention needed for the allograft AND stem cells can disable the immune responses that led to the diabetes state in the first place.

65) Multiple myeloma is a plasma cell tumor in which a clone of malignant plasma cells produces large amounts of immunoglobulin. With all this excess immunoglobulin, how can a person with multiple myeloma be immunodeficient?

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A) All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter. B) The multiplicationof the malignant plasma cells may crowd out normal production of other immunecells required for protective responses. C) The massiveoverproduction of immunoglobulin impairs the kidneys, preventing production ofthe correct hormones from the kidneys to balance immune system cell productionfrom the bone marrow. D) Through a negative feedback loop, the large amount of immunoglobulin tricks the immune system into thinking it's making a strong response that is needed. As such, it shuts down production of other responses that might truly BE needed to fight off a pathogen. E) All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter AND the multiplication of the malignant plasma cells may crowd out normal production of other immune cells required for protective responses.

66)

Please select the INCORRECT definition regarding hypersensitivity.

A) Hypersensitivity—an exaggerated immune response that damages tissues. B) Degranulation—release of mediators from a cell’s granules, such as histamine released from mast cells. C) Systemic anaphylaxis—an immediate hypersensitivity reaction caused by IgE attached to circulating basophils. D) Anaphylactic shock—raisedblood pressure and increased circulation caused by a severe allergic reaction. E) Delayed-type cell-mediated hypersensitivity—an exaggerated immune response of antigen-specific T cells.

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67) Allergic reactions occur only in people who are sensitized by prior exposure to a specific allergen. Please identify the correct sequence of events that occur in a type I response. 1. The activated B cells proliferate into IgE-producingplasma cells and memorycells. 2.The Fc portion of the IgEbinds to Fc receptors on either mast cells or basophils,so that theFab sites of the antibodiescan interact with a specific allergen. 3.Sensitization begins when the first contact with the allergen induces an antibody response— helper T cells activate naive B cells. 4. Cross-linkingtriggers the mast cell or basophil to undergo degranulation, a process that releases its inflammatory mediators. 5. On second exposure to the antigen, when adjacentIgE molecules on a mast cell or basophil bind to that antigen, the IgE molecules are cross-linked. 6.These inflammatory mediators can have a variety of effects associated with a type I allergy response. A) 3, 4, 1, 2, 5, 6 B) 2, 3, 1, 4, 6, 5 C) 6, 4, 3, 2, 5, 1 D) 3, 1, 2, 5, 4, 6 E) 3, 1, 6, 5, 2, 4

68)

Which allergic condition is characterized by the formation of a wheal and flare? A) Hives B) Transfusion reaction C) Arthus reaction D) Serum sickness E) All of the choices are correct.

69) Why does a sensitized person not experience a skin reaction immediately after exposure to poison oak?

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A) The reaction is caused by activation of memory B cells formed as a result of the first exposure. Active B cells are not formed immediately. B) The reaction is caused by activation of plasma cells formed as a result of the first exposure. Active B cells are not formed immediately. C) The reaction is caused by activation of memory T cells formed as a result of the first exposure. Active T cells are not formed immediately. D) The reaction is caused by activation of macrophages formed as a result of the first exposure. Activated macrophages are not formed immediately. E) The reaction is caused by activation of dendritic cells formed as a result of the first exposure. Activated dendritic cells are not formed immediately.

70)

What type of hypersensitivity reaction causes rejection of transplanted organs? A) ImmediateIgE-mediated B) Cytotoxic C) Immune-complex mediated D) Delayed-type cell-mediated E) Cytotoxic OR delayed-type cell-mediated

71)

Select the statement that best explains how RhoGAMworks.

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A) RhoGAM contains anti-Rh antibodies; these bind to any Rh + erythrocytes that may have entered the mother’s circulation from an Rh +baby, preventingthese RBCs from stimulating a primary immune response in the mother . B) RhoGAM contains anti-Rh antibodies; these bind to any Rh -erythrocytes that may have entered the mother’s circulation from an Rh -baby, preventingthese RBCs from stimulating a primary immune response in the mother . C) RhoGAM contains anti-Rh antibodies; these bind to any Rh + leukocytes that may have entered the mother’s circulation from an Rh +baby, preventingthese WBCs from stimulating a primary immune response in the mother . D) RhoGAM contains anti-Rh antibodies; these bind to any Rh + erythrocytes that may have entered the mother’s circulation from an Rh +baby, preventingthese RBCs from stimulating a secondary immune response in the mother . E) RhoGAM contains anti-ABO antibodies; these bind to any ABO + erythrocytes that may have entered the mother’s circulation from a ABO +baby, preventingthese RBCs from stimulating a primary immune response in the mother .

72) Please select the correct sequence of events that occur during an immune-complex hypersensitivity reaction. 1.When antigen is in slight excess , immune complexes form. 2. Immune-complexes activate complement, resulting in increased vascular permeability. 3. Neutrophils are attracted, andrelease enzymes that cause tissue damage. 4. Circulating immune complexes are trapped in the blood vessels, initiating inflammation. A) 1, 2, 3, 4 B) 1, 2, 4, 3 C) 4, 3, 1, 2 D) 1, 3, 2, 4 E) 4, 3, 2, 1

73)

Which of the following is/are caused by immune-complex mediated hypersensitivities?

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A) Arthus reaction AND hemolytic disease of the newborn B) Arthus reaction, glomerulonephritis, ANDdisseminated intravascular coagulation <!-Markup Copied from Habitat--> C) Hemolytic disease of the newborn AND transplanted organ rejection D) Serum sickness, glomerulonephritis, AND allergic contact dermatitis E) Only disseminated intravascular coagulation

74)

Which of the following is the correct explanation of desensitization?

A) In desensitization, a person is injected with dilute preparations of an allergen, causing their immune system to produce IgE against that allergen. The IgE antibodies protect the patient by binding to the antigen, coating it and facilitating its removal before it can attach to bound IgG on mast cells or basophils. B) In desensitization, a person is injected with dilute preparations of an allergen, causing their immune system to produce multiple varied antibodies against that allergen. These antibodies protect the patient by binding to the antigen, coating it and destroying it before it can attach to bound IgE on mast cells or basophils. C) In desensitization, a newborn baby is exposed to multiple common allergens, stimulating the infant's immune system to produce antibodies against those allergens. The antibodies protect the child later in life by binding to any antigens they come into contact with, tagging them for destruction before they cause an allergic response. D) In desensitization, a pregnant woman is injected with dilute preparations of an allergen, causing their immune system to produce IgG against that allergen. The IgG antibodies cross the placenta, protecting the fetus by preventing it from being exposed to those allergens after birth. E) In desensitization, a person is injected with dilute preparations of an allergen, causing their immune system to produce IgG against that allergen. The IgG antibodies protect the patient by binding to the antigen, coating it and facilitating its removal before it can attach to bound IgE on mast cells or basophils.

75)

Which autoimmune disease is CORRECTLY described?

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A) Systemic lupus erythematosus— antibodies bind to acetylcholine receptors at the neuromuscular junction, thereby blocking nerve impulses that normally cause muscle contraction. B) Type I diabetes mellitus— characterized by a variety of autoantibodies and immune complexes that lodge in tissues around the body, causing damage. C) Graves' disease— antibodies bind to the TSH receptor of the thyroid and activate it inappropriately, leading to increased thyroid hormone production and enlargement of the gland. D) Myasthenia gravis— infiltration ofconnective tissues, most often within joints, by T cells that release cytokines and cause inflammation. E) Rheumatoid arthritis— formation of immune complexes in small blood vessels caused by autoantibodies to DNA and other nuclear components.

76) If the thymus is removed from a 2-year-old child, which of the following is likely to occur?   A) Decreased success of an organ transplant and increased incidence of cancer. <!-Markup Copied from Habitat--> B) Decreased incidence of cancer and decreased incidence of viral infections. <!-Markup Copied from Habitat-->  C) Decreased success of an organ transplant and increased incidence of viral infections.  D) Increased success of an organ transplant and increased incidence of bacterial infections.  E) Increased success of an organ transplant and decreased incidence of bacterial infections.

77)

In which of the following is/are B cells involved?

A) Asthma, hemolytic disease of the newborn, AND allergic contact dermatitis B) Hives, transplanted organ rejection, AND transfusion reactions C) Systemic anaphylaxis, hives, AND graft-versus-host reactions D) Anaphylacticshock, hemolytic disease of the newborn, AND glomerulonephritis E) Hives, transfusion reactions, disseminated intravascular coagulation, AND allergic contact dermatitis

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78)

Select the incorrect pair regarding autoimmune diseases.

A) Systemic lupus erythematosus (SLE) -characterized by destructive autoantibodies that target DNA and other nucleus molecules.   B) Graves’ disease - characterized byweight loss, fatigue, irritability, heat intolerance, and rapid heartbeat. C) Rheumatoid arthritis (RA) -mechanisms of damage include inflammatory cytokines released by T cells and immune complex formation. D) Multiple sclerosis (MS) - binding of autoantibodies to acetylcholine receptors at the neuromuscular junction and activation of the complement system.   E) Type 1 diabetes mellitus -caused by the destruction of pancreatic β cells by cytotoxic T cells causing insulin deficiency.

79) You are working with the parents of a baby recently diagnosed with severe combined immunodeficiency (SCID). Which of the following would you not say to the parents? A) Your baby has a primary immunodeficiency, which is genetic. B) The baby has very few cells called lymphocytes which are important in immunity. C) We can cure your baby with a combination of antibiotics and chemotherapy drugs. D) Infants with this condition have been cured with a stem cell transplant. E) Immunodeficiencies develop when the body cannot initiate or sustain an immune response.

80)

Compare primary and secondary immunodeficiencies.

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A) Primary immunoficienciesare the result of genetic mutations; secondary immunodeficiencies may be caused by viruses and malignancies. B) Primary immunoficiencies may be caused by viruses and malignancies; secondary immunodeficiencies are the result of genetic mutations. C) HIV/AIDS is an example of a primary deficiency; DiGeorge syndrome and selective IgA deficieny are example of secondary immunodeficiencies. D) Primary deficiencies can be treated and/or cured with antibiotics; secondary immunodeficiencies are always treated with stem cell transplants. E) Primary deficiencies are the result of degranulating mast cells; secondary immundeficiencies are the result of immune complex formation.

81)

Select the incorrect pair regarding immunodeficiencies.

A) DiGeorge syndrome - inherited secondary immunodeficiency B) SCID - lack of B cells, T cells and NK cells C) Selective IgA deficiency - prone to gastrointestinal infections D) Chronic granulomatous disease -production of many non-functional phagocytes <!-Markup Copied from Habitat-->  E) Acquired immunodeficiency syndrome -highly susceptible to opportunistic infections

82) Your sister frequently get gastrointestinal infections, which manifest with diarrhea. You suspect she may have selective IgA deficiency. Why does this immunodeficiency make her prone to this type of infection?

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A) People with selective IgA deficiency only make certain types of IgA and so are protected against only some microbes, but not those that cause diarrhea. B) People with IgA deficiency do not make any B cells; as a result, their humoral immune response is lacking and they get frequent infections. C) IgA is present in mucus and protects against invasion by microorganisms; without it, people are more vulnerable to microbes that cause diarrheal disease. D) IgA is present in stomach acid and protects against invasion by bacteria; without it, people are more vulnerable to microbes that cause diarrhea. E) People with this condition make very few antibodies of any kind; as a result, they have little protection against any kind of gastrointestinal microbial invader.

83) Which statement about primary immunodeficiencies that affect the complement system is INCORRECT? A) Deficiencies in complement proteins C1 and C2 may lead to developement of immune complex diseases. B) Deficiencies in complement proteins C5, C6, C7 and C8 predisposes people to Neisseria infections. C) Deficiency in complement system regulatory proteins may developfluid accumulation and potentially fatal tissue swelling.  D) People with defects in the complement system components acquire the condition from certain environmental influnces. E) People who lack late complement components (C5, C6, C7, C8) cannot make membrane attack complexes.

84)

Which is not a treatment for autoimmune disease?

A) Prolonged course of multiple antibiotics. B) Medications targeting pro-inflammtory cytokines. C) Medications that block certain hormone synthesis and release.  D) Medications that inhibit the activity of certain enzymes. E) Injections of certain hormones.

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85) People with which of the following can generally mount an immune response to most pathogens except a few common microbes, including Staphylococcus aureus? A) Primary immunodeficiency - antibody deficiency B) Primary immunodeficiency -lymphocyte deficiencies  C) Primary immunodeficiency - defects in phagocytic cells D) Secondary immunodeficiency - defects in complement system components <!-Markup Copied from Habitat--> E) Secondary immunodeficiency - infections or malignancies

86) Which of the following is a genetic disease that results in almost complete lack of B cells and T cells, and no adaptive immunity? A) HIV/ AIDS B) Severe combined immunodeficiency C) Chronic granulomatous disease D) Agammaglobulinemia  E) DiGeorge syndrome

87)

Which of the following can be successfully treated with hormone injections? A) Type I diabetes mellitus B) Systemic lupus erythematosus  C) Myasthenia gravis D) Rheumatoid arthritis E) Multiple sclerosis

88) Which of the following autoimmune diseases involve inappropriate binding of autoantibodies to receptors?

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A) Graves' disease and rheumatoid arthritis B) Myasthenia gravis and type I diabetes mellitus C) Graves' disease and myasthenia gravis D) Multiple sclerosis and myasthenia gravis E) Systemic lupus erythematosus and Graves' disease

89)

Which of the following affect nervous system components and/or function? A) Myasthenia gravis and multiple sclerosis B) Type I diabetes mellitus and Graves' disease C) Rheumatoid arthritis and multiple sclerosis D) Multiple sclerosis and type 1 diabetes mellitus  E) Systemic lupus erythematosus and agammaglobulinemia

90)

Which of the following genetic immunodeficiencies involve B cells?

A) Selective immunoglobulin A deficiency, severe combined immunodeficiency and HIV/AIDS B) Selective immunoglobulin A deficiency, agammaglobulinima and severe combined immunodeficiency C) DiGeorge syndrome, selective immunoglobulin A deficiency and HIV/AIDS D) DiGeorge syndrome, severe combined immunodeficiency and chronic granulomatous disease E) DiGeorge syndrome, selective immunoglobulin A deficiency and agammaglobulinemia

SECTION BREAK. Answer all the part questions. 91) After a long cold winter, you are looking forward to spring semester, when you will complete your nursing degree. The only thing that concerns you is the allergies that hit you in April/May every year, exactly when you will be taking your final exams. Your roommate is currently taking microbiology, so you decide to review what you know about hypersensitivity with him.

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91.1) Your friend reminds you thathypersensitivity is an exaggerated immune response that injures tissue and can be categorized into one of four groups according to the mechanisms and timing of the response. He tells you that seasonal allergies are an example of type I hypersensitivity and describes the characteristics of this response. What statement made by your friend is INCORRECT?  A) The effector cells involved in a type I response are B cells. B) A very commonform of IgE-mediated allergy is systemic anaphylaxis.  C) The mediators involved in the response includehistidines, leukotrienes and prostaglandins. D) Examples of type I hypersensitivities include hives, asthma, and anaphylactic shock. E) Other cells involved in the response are basophils and mast cells.

91.2) You are very allergic to ragweed pollen, which gives you terrible hay fever. You remember from your own microbiology class that for you to have a reaction to this allergen every year, you must have become sensitized to it. Which step is not involved in or does not lead to sensitization? A) On first contact with the allergen, an antibody response is induced in the person. <!-Markup Copied from Habitat--> B) Helper T cells activate naive B cells, which proliferate and differentiate. C) Plasma cells produce IgE specific for the antigen that initiated the response. D) The Fc portion of the IgE binds to receptors on mast cells or basophils, positioned so that their Fab sites are free.  E) These are all steps involved in sensitization.

91.3) You've forgotten what happens after sensitization, so your friend gives you a summary. Which is the CORRECT statement?

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A) Complement protein C3a binds to two IgE molecules bound to the surface of the basophil, causing it to degranulate and release histamine and other mediators. B) On second exposure, complement protein C3a binds to two IgG molecules attached to the surface of the mast cell, causing it to degranulate and release interleukins. C) On second exposure, complement protein C5bcross-links two allergen molecules bound to the surface of the basophil, causing it to degranulate and release histamine and other mediators. D) On second exposure,the allergencross-links two IgE antibodies bound to the surface of the basophil, causing it to degranulate and release histamine and other mediators. E) Second exposure to the allergen causes activation of B cells thatare initially programmed to produce IgM molecules, but then undergo class switching to produce IgE.

91.4) You tell your friend that ragweed pollen gives you hay fever, but now he needs some revision—he can't remember the signs and symptoms of this allergy. You remind him that they include A) spasms of smooth muscle tissue lining the bronchial tubes and increased mucus production, causedbyinflammatory mediators.  <!-Markup Copied from Habitat--> B) extensive blood vessel dilation and fluid loss from the blood, causing a severe drop in blood pressure that may lead to failure of vital organs.  C) teary eyes, a runny nose, and sneezing, caused by fluid leakage from dilated capillaries in the mucous membranes. D) anitchy swelling generally resembling a mosquito bite, surrounded by redness called a flare.  E) contraction of smooth muscles, itching and pain due to effects on nerve endings, and increased mucus production.

91.5) Your allergies are so bad every year that you finally decide that you are going to go for desensitization treatments. These treatments

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A) involve getting concentrated shots of allergen that causes the immune system to produce IgM against it. When exposed to the allergen again, the IgM antibodies bind to it, coating it and preventing it from cross-linking bound IgE on T cells. B) involve you sitting in a room into which ragweed pollen will be introduced via the air system. This will force your immune system to recognize the allergen as "friendly" and stop reacting to it by causing basophils to degranulate. C) include receiving increasingly high doses of antihistamine so that a maximum level is reached on your blood stream. The antihistamines will neutralizethe allergen by binding to it before it has the opportunity to bind to basophil-bound IgE. D) involve getting shots of very dilute allergen that causes the immune system to produce IgG against it. When exposed to the allergen again, the IgG antibodies bind to it, coating it and preventing it from cross-linking bound IgE on mast cells or basophils. <!-Markup Copied from Habitat--> E) involves recombinant humanized monoclonal antibodies (rhuMabs).These will bind to and neutralize the IgA made on on first exposure to ragweed pollen, and prevent your B cells from undergoing class switching.

92) Your father has just been diagnosed with rheumatoid arthritis. He has pain and the sensation of "pins and needles" in some if his finger joints and also in his wrists. He knows you covered autoimmune diseases in your microbiology class, so asks you to help him understand his condition.

92.1) You explain to your Dad that the causes of RA are not clear, but may involve all of the following EXCEPT A) insufficient production of B cells, helper T cells, and cytotoxic T cells, so that the adaptive immune response is unable to differentiate "self" from "foreign". B) infections—an immune response against a pathogen engaged in molecular mimicry may inappropriately attack healthy tissues as well. C) regulatory T cell problems—sometimes these cells are deficient or do not function properly; these cells play a role in regulating inappropriately activated lymphocytes. D) genetics—RA is often seen in related people who share genes for major histocompatibility molecules. E) These are all factors involved in developing RA.

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92.2) Your father wonders howviruses or bacteria can potentially initiate an autoimmune disease. You tell him that  A) viruses or bacteria could contain antigens that are similar to host tissue. Antibodies made in response to these agents may cross react with autoantigens. B) viruses and bacteria frequently over-stimulate cytotoxic T cellsso that inappropriate antibodies are made against self antigens. C) autoimmunity usuallydevelops when hematopoietic stem cells in the bone marrow fail to produce functional lymphocytes, as frequently happens during an infection. <!-Markup Copied from Habitat--> D) viruses or bacteria could contain antibodies that are similar to those of host tissue. Antigens made in response to these agents may cross react with self antibodies. E) autoimmunityoften occurs when T cells do not differentiate and are absent in circulation; many pathogens suppress T cell maturation.

92.3) You explain to your father that usually, the immune system routinely eliminates or silences any lymphocytes that recognize autoantigens, which are the “self” antigens found in cells and on body tissues. This process is called self-tolerance. In autoimmune disease, self-tolerance is faulty. There are at least two mechanisms that lead to selftolerance. Which are they? 1. Negative selectionof developing lymphocytes that recognize autoantigens, resultingin apoptosis of those cells . 2. Introductionofantigenby the oral route, so that the immune system “learns” to tolerate it, just as it does the many antigens ingested in food. 3. Eliminationoflymphocytes that recognize antigen but do not recognise the MHC molecule presenting it. A) 1 and 2 B) 1 and 3 C) 2 and 3 D) 1, 2, and 3 E) 1 only

92.4)

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In an effort to help your father understand his symptoms, you tell him that RA

A) is a localized disease, affecting only a single joint, usually the left knee. B) occurs when B cells infiltrate the joints and, when stimulated by specific antigens, release cytokines that cause inflammation.  C) is one of the most rarest autoimmune diseases, and unlike arthritis that arises from wear and tear of joints, only occurs later in life.  D) is characterized by joint damage that results when antibodies in the joints form immune complexes characteristic of type III hypersensitivity.  E) is a condition in which cells called cytotoxic T cells release antibodies that target connective tissues, most often within joints.

92.5) You discuss treatment approaches for various autoimmune diseases. Which of the following is NOT a reasonable option for treating autoimmunity? A) Limiting the immune response with anti-inflammatory or immunosuppressant medications.  B) Replacement therapy to restore damaged tissues or tissue products, for example giving insulin to diabetics.  C) Gene therapy, to replace defective genes coding for enzymes involved in recognizing "self" antigens. D) Inducing tolerance byintroducing the antigen by the oral route, so that the immune system “learns” to tolerate it. E) These are all reasonable approaches to treating autoimmunity.

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93) Doctors working with a 2-year old child experiencing a variety of immunological disorders and a persistent viral infection have discovered a new immunodeficiency disease. The boy failed to thrive from infancy and was found to be suffering from inflammatory bowel disease (IBD), eczema, food allergies, lung disease and a cytomegalovirus (CMV) infection that did not resolve, despite antiviral treatment. Examination of his younger sister revealed that she had similar problems, which suggested that they both had an immune dysregulation. Genetic investigation showed that the children had a single mutation in a gene called IL2Rβ, which codes for the beta subunit of theinterleukin-2 (IL-2)receptor. As a result of the mutation, the children had a deficit in regulatory T (Treg) cells. In addition, although they had high numbers of natural killer cells, the majority of these had failed to mature and were non-functional. Both children received a hematopoietic stem cell transplant; the boy recovered fully but the transplant was unsuccessful in the girl and she died of complications and multiorgan failure. Source: Fernandez, I.Z. et. al. 2019. A novel human IL2RB mutation results in T and NK cell– driven immune dysregulation. J. Exp. Med. 216:1255-1267. https://doi.org/10.1084/jem.20182015

93.1)

Select the INCORRECT pair regarding immunity.

A) T H cells - release cytokines that activate B cells and macrophages. B) Denidritic cells - play a role in activation of naive T cells. C) T C cells - eliminate virus-infected self cells and cancer cells. D) T reg cells - prevent the development of autoimmune disease. E) NK cells - produce immunoglobulins in response to viruses.

93.2) What suggested to the investigators in this case that the children had a genetic mutation? A) Both children had uncontrolled virus infections. B) The children suffered the same varied immune-related illnesses. C) The children had the same problems despite being different genders. D) A stem cell transplant completely cured both children. E) Neither child had any IL-2 in their blood.

93.3)

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The immune system problem described in this case is a

A) primary immunodeficiency. B) secondary deficiency. C) primary autoimmunity. D) secondary autoimmunity. E) type IV hypersensitivity.

93.4) The children in this case had persistent viral infections. Which of the following explains this? A) The NK cells play a role in preventing the development of autoimmunity. B) The children's NK cells failed to mature and so were non-functional. C) They lacked T reg cells; these cells play a role in virus elimination. D) They lacked activated cytotoxic T cells; these cells play a role in virus elimination. E) The NK cells lacked IL-2 receptors so could not proliferate.

93.5)

What is the significance of the deficiency in T

reg cells in this case?

A) T reg cells normally prevent the development of autoimmunity; the children had several autoimmune diseases. B) T reg cells normally prevent the development of hypersensitivity; the children had types II and III hypersensitivities. C) T reg cells play a role in activating cytotoxic T cells; the children had persistent cytomegalovirus infections. D) T reg cells play a role in activating NK cells; the children both had persistent cytomegalovirus infections. E) It is insignificant; the children's problems were related solely to their lack of mature NK cells.

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Answer Key Test name: Chap 18_10e 1) FALSE 2) TRUE 3) FALSE 4) TRUE 5) TRUE 6) FALSE 7) TRUE 8) FALSE 9) TRUE 10) TRUE 11) C 12) B 13) B 14) B 15) D 16) E 17) B 18) C 19) D 20) C 21) A 22) A 23) B 24) B 25) C 26) E Version 1

27) E 28) A 29) A 30) B 31) D 32) D 33) C 34) C 35) D 36) C 37) A 38) E 39) A 40) D 41) E 42) D 43) C 44) A 45) E 46) C 47) B 48) B 49) B 50) E 51) C 52) A 53) A 54) E 55) C 56) C Version 1

57) B 58) E 59) E 60) A 61) A 62) B 63) C 64) D 65) E 66) D 67) D 68) A 69) C 70) D 71) A 72) B 73) B 74) E 75) C 76) D 77) D 78) D 79) C 80) A 81) A 82) C 83) D 84) A 85) C 86) B Version 1

87) A 88) C 89) A 90) B 91) Section Break 91.1) B 91.2) E 91.3) D 91.4) C 91.5) D 92) Section Break 92.1) A 92.2) A 92.3) B 92.4) D 92.5) C 93) Section Break 93.1) E 93.2) B 93.3) A 93.4) B 93.5) A

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CHAPTER 19 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Generally, the smaller the infective dose, the lower the chance of disease. ⊚ ⊚

A fly may serve as a mechanical vector. ⊚ ⊚

true false

A gradual rise in numbers during an epidemic indicates a common source epidemic. ⊚ ⊚

true false

Diseases with long incubation periods are more likely to spread extensively. ⊚ ⊚

true false

The very young and the elderly are more susceptible to infectious disease. ⊚ ⊚

true false

The portal of entry typically has little effect on the course of a disease. ⊚ ⊚

true false

Cross-sectional surveys are very useful in establishing cause of a disease. ⊚ ⊚

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true false 1

A placebo is a mock drug. ⊚ ⊚

In a double-blind test the treating physician knows who is getting the actual treatment. ⊚ ⊚

10)

true false

Nosocomial infections are those acquired at a hospital. ⊚ ⊚

11)

true false

Human population growth and expansion contribute to emergence of diseases. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 12) Women died after childbirth of A) S. aureus intoxication. B) toxic shock syndrome. C) Klein's disease. D) puerperal fever. E) shock.

13) was

The doctor responsible for introducing the idea of hand washing before attending patients

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A) Klein. B) Semmelweis. C) Koch. D) Pasteur. E) Galen.

14)

Diseases that can be transmitted from one person to another are termed A) symptomatic. B) clinical. C) acute. D) latent. E) communicable.

15)

The natural habitat of a pathogen is referred to as its A) home. B) reservoir. C) primary inhabitance. D) infectious site. E) place.

16)

The number of cases of a specific disease per one hundred people exposed is called the A) attack rate. B) index rate. C) mortality rate. D) obesity rate. E) attack index.

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17) Thenumber of people in a defined population who die during a given period is called the  A) mortality rate. B) morbidity rate. C) attack rate. D) incidence rate. E) case rate.

18)

Diseases constantly present in a population are called A) epidemic. B) chronic. C) latent. D) endemic. E) prodromic.

19)

An epidemic that spreads worldwide is called a(n) A) epidemical. B) endemic. C) pandemic. D) syndemic. E) plague.

20)

A cluster of cases in a specific population occurring in a brief period of time is called a(n) A) outbreak. B) endemic. C) pandemic. D) attack break. E) mortality.

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21)

Apparently healthy people who may transmit a pathogen they harbor are called A) vectors. B) carriers. C) fomites. D) vehicles. E) arthropods.

22)

Gonorrhea is a disease that may be A) zoonotic. B) pandemic. C) syndemic. D) asymptomatic. E) All of the answer choices are correct.

23) A dramatic increase in the incidence of a specific disease in a given population is referred to as a(n) A) pandemic. B) endemic. C) epidemic. D) mortality. E) outburst.

24)

Diseases that primarily exist in animals, but may be transmitted to humans are called

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A) parasitic. B) zoonotic. C) symbiotic. D) epidemic. E) commensal.

25)

The reservoir of infection for botulism and tetanus is A) humans. B) soil. C) water. D) animals. E) soil AND water.

26)

Which of the following is considered a zoonotic disease? A) Measles B) Typhoid C) Common cold D) Influenza E) Plague

27)

Vertical transmission involves A) droplet transmission. B) fomites. C) pregnant woman to fetus. D) pasteurization. E) insect to human.

28)

The single most important measure to prevent the spread of disease is

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A) hand washing. B) canning. C) pasteurization. D) home cooking. E) antibiotics.

29)

Inanimate objects capable of transferring infectious disease agents are A) vectors. B) fomites. C) vehicles. D) reservoirs. E) arthropods.

30)

Large respiratory droplets typically travel no farther from point of release than A) 3 meters. B) 5 meters. C) 1 meter. D) 20 meters. E) 12 inches.

31)

Important sources of contamination in crowded locations are A) droplets of blood. B) droplets of saliva or mucus. C) restrooms. D) kitchen surfaces. E) All of the answer choices are correct.

32)

Droplet nuclei typically travel no farther from point of release than

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A) 3 meters. B) 5 meters. C) 1 meter. D) 12 inches. E) They are suspended indefinitely.

33) In order to prevent spread of microorganisms from the microbiology laboratory, the room air should be A) under positive pressure AND filtered. B) under negative pressure AND filtered. C) under negative pressure, chilled, AND filtered. D) under positive pressure, chilled, AND filtered. E) under neutral pressure, chilled, AND filtered.

34)

Which of the following is not a vector? A) Fomite B) Human C) Fly D) Flea E) Fomite AND human

35)

Which of the following is not a mechanical vector? A) Fomite B) Human C) Fly D) Flea E) Fomite AND human

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36)

The amount of infecting agent received by susceptible individuals is called the A) exposure. B) infectious number. C) infectious dose. D) infecting level. E) infective exposure.

37) The period of time between exposure to an agent and the onset of disease signs and symptoms is called the A) prodromal phase. B) decline phase. C) incubation period. D) lag phase. E) carrier phase.

38) When an infectious disease cannot spread in a population because it lacks a significant number of susceptible hosts, the phenomenon is referred to as A) protected population. B) active immunity. C) passive immunity. D) herd immunity. E) protective immunity.

39)

The immunity of some black Africans to malaria is probably due to their A) general health. B) genetic background. C) cultural practices. D) age. E) All of the answer choices are correct.

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40) The type of epidemiological study that determines the characteristics of the persons involved and the time and place of the outbreak is called a(n) A) descriptive study. B) inspection study. C) cohort study. D) retrospective study. E) cohesive study.

41)

The first identified case in an outbreak is called the A) starter case. B) traceable case. C) primary case. D) index case. E) initiator case.

42) If the number of people who become ill during an epidemic rises and falls rapidly, this is called a(n) A) propagated epidemic. B) promulgated epidemic. C) common source epidemic. D) index epidemic. E) contagious epidemic.

43) a(n)

If the number of people who become ill during an epidemic rises gradually, this is called

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A) propagated epidemic. B) promulgated epidemic. C) common source epidemic. D) index epidemic. E) confluent epidemic.

44) An experimental study in which neither the doctor nor the patient knows who is getting the actual treatment is called a ______ study. A) single-sided B) double-sided C) double-blind D) double-barrier E) test-sided

45) Because of the natural evolution of microorganisms, it is necessary to use techniques that allow distinguishing them at the level of A) species. B) genus. C) family. D) strain. E) domain.

46) The publication of the CDC that reports new cases of reportable infectious diseases is titled A) Morbidity and Mortality Weekly Report ( MMWR). B) State Health News Letter ( SHNL). C) Federal Report of Infectious Disease ( FRID). D) National Morbidity Weekly (NMW). E) Monthly Death and Disease Report (MDDR).

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47)

The World Health Organization (WHO) is part of the A) Food and Drug Administration. B) Department of Health and Human Services. C) Department of Human Resources. D) United Nations. E) North Atlantic Treaty Organization.

48)

WHO has targeted for elimination of A) polio. B) dracunculiasis. C) measles. D) plague. E) polio, dracunculiasis, AND measles.

49)

So far, the only disease that has been globally eradicated is A) polio. B) smallpox. C) measles. D) diphtheria.

50) A new serotype of Vibrio cholerae, V. cholerae 0139, has picked up the ability to produce A) pili. B) flagella. C) a capsule. D) a toxin. E) endotoxin.

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51)

Schistosomiasis has increased in areas where A) snails have become a delicacy. B) crayfish are eaten. C) dams have been built. D) swamps have been drained. E) people fish for sport.

52) Approximately what percentage of hospitalized patients may develop a nosocomial infection? A) 0% B) 5% C) 15% D) 20% E) 70%

53)

An infection acquired during hospitalization is referred to as a(n) ______ infection. A) antibiotic-induced B) therapeutic C) medication-stimulated D) nosocomial E) herd initiated

54)

All of the following are commonly associated with nosocomial disease EXCEPT

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A) Enterococcus species. B) Clostridium difficile. C) Pseudomonas species. D) Staphylococcus aureus. E) Clostridium botulinum.

55)

Which of the following contributes to nosocomial disease? A) Susceptible population B) Hospital environment C) Other patients D) Patient's own normal microbiota E) All of the choices are correct.

56) The member of the hospital staff who surveys the types and numbers of nosocomial infections is called the A) head nurse. B) infection control practitioner. C) staff control. D) attending physician. E) external epidemiologist.

57) The guidelines designed for prevention of nosocomial disease during care of all patients is called A) Standard Precautions. B) Universal Disposables. C) Disinfection Manifesto. D) Asepsis Preference. E) Hand Hygiene Precautions.

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58)

Transmission-Based Precautions

A) is an online informative course all health workers must take on an annual basis. B) are guidelines from WHO for dealing with emerging infectious diseases. C) are instructions on the care of all patients given to nurses at their place of employment. D) are guidelines touse with patients infected with a highly transmissible or epidemiologicallyimportant pathogen. E) are guidelines given to patients before they enter the hospital to educate them on HAIs.

59) with

Prevention of patient-to-personnel transmission of disease depends on limiting contact

A) patients. B) personnel. C) administrators. D) physicians. E) body fluids.

60)

Which of the following is recommended by the Standard Precautions guidelines? A) Glove use AND hand washing B) Hand washing AND a face shield C) A face shield AND antibiotics D) Antibiotic use AND glove use E) Glove use, hand washing, AND a face shield

61)

The threat of bioterrorism

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A) is due largely to the ease of spread and severity of diseases AND has prompted WHO to prepare a readiness plan. B) is due largely to the ease of spread and severity of diseases AND may include rarely seen infectious agents. C) is exaggerated in light of the efficiency of our healthcare system AND has prompted WHO to prepare a readiness plan. D) has prompted the CDC to prepare a readiness plan AND is due largely to the ease of spread and severity of diseases. E) has prompted the WHO to prepare a readiness plan, may include rarely seen infectious agents, AND is due largely to the ease of spread and severity of diseases.

62) Explain the most likely reason why smallpox was successfully eradicated but rabies probably never will be. A) Smallpox was only found in humans; rabies is found in numerous animal reservoirs. We cannot reasonably eliminate rabies in all of the animal reservoirs that exist. B) It was far easier to vaccinate the world population against smallpox than against rabies, due to the lower number of injections required for the smallpox vaccine. It becomes a compliance issue. C) Since there arevery few cases of rabies each year, there is little financial incentive to pushhealth organizations to eradicate the illness through worldwidevaccination. D) The symptoms of smallpox are easier to identify than the symptoms of rabies, so some carriers of rabies are not accurately diagnosed. This can lead to asymptomatic carriers present within the population of susceptible individuals, spreading the virus. E) Smallpox was eradicated because anyone who got the disease died from it, so at some point there was no reservoir for the virus.

63)

Explain how the incubation period can influence the spread of an infectious agent.

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A) Incubation period does not affect the spread of an infectious agent. An infectious carrier will only spread the illness when they are showing acute symptoms. As such, the length of incubation period is not important for spreading the illness. B) Depending on the microbe and the illness, an asymptomatic carrier in the incubation period might be shedding infectious microbes to his/her surroundings.In such a case, a longer incubation period would lead to a greater spread of the disease as the carrier comes into contact with more individuals while he/she is generally appearing to be healthy. C) A very short incubation period will place a patient into the highly infectious active disease state sooner. Since people avoid contact with actively ill individuals, a very short incubation period will always lead to a decrease in the spread of an infectious disease. D) A very long incubation period will place a patient into the highly infectious active disease state later. Since people generally avoid contact with actively ill individuals, a very long incubation period will always lead to a decreasein the spread of an infectious disease. E) A short incubation period leads to an increase in the spread of an infectious agent. This is because diseases with a short incubation period are always far more severe than those with a long incubation period, so the infectious agent is spread more vigorously.

64) Why is it important to include a placebo in a scientific study to assess the effectiveness of a drug? A) It's actually unethical to include a placebo and it is usually not done. If you have a drug that you know to be effective, it's unethical to withhold that treatment from an ill patient. B) A placebo-treatedgroupwill determine if the changes observed in the drug-treated illnessgroup are due to a psychological effect rather than a physiologic/pharmacologicone. C) It isn't scientifically important to include a placebo. A placebo simply helps investigators satisfy the legal requirements of the Food and Drug Administration in their testing process. D) A placebo-treatedgroupwill determine if the changes observed in the illness in thisnon-treated group are due to a physiologic/pharmacologic effect rather than apsychological one. E) Both groups of people are actually given the drug and a placebo. This is a way to ensure patient compliance, without which the study would not yield any useableinformation.

65) Which of the following is NOT a political/societal reason for a decrease in rates of childhood immunizations?

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A) Distrust of the healthcare body administering the vaccinations. B) Distrust of the government funding the vaccination process. C) A lack of a proper "cold chain" for stable transport of vaccines into tropical areas. D) Distrust of the scientific community advocating for administration of vaccines. E) Lack of awareness of the seriousness of diseases such as pertussis.

66)

Please identify the CORRECT statement regarding basic epidemiology concepts.

A) Contagious disease—an infectious disease that can not be transmitted from one host to another. B) Attack rate—the number of susceptible people developing illness in a population exposed to an infectious agent. C) Incidence—the total number of cases of a disease in a given population at any time or for a specific period. D) Prevalence—the number of new cases of a disease in a population at risk during a specified time period. E) Morbidity rate—the proportion of people diagnosed with a specific disease who die from that disease.

67) In 1918-1919, an influenza virus infected about 500 million people worldwide, killing at least 50 million of them. This disease is best described as a(n) ______. A) epidemic B) pandemic C) outbreak D) sporadic outbreak E) endemic disease.

68) A picnic was attended by 1,000 people. Potato saladwas served at the event. The next day, 140 people reported vomiting and diarrhea. What was the attack rate of this food-borne illness?

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A) 1.4% B) 14% C) 140% D) 10% E) More information is needed.

69) A fly that walks on feces and picks up E. coli O157:H7thenlands on food and transfers the microorganisms, is considered a A) mechanical vector. B) biological vector. C) mechanical OR biological vector. D) fomite. E) cross-contaminator.

70) Select the sequence that indicates the steps that occur in the chain of infection. 1. Transmission. 2. Susceptible host. 3. Reservoir ofinfectious agent. 4. Portal of exit. 5. Portal of entry. A) 3, 4, 1, 5, 2 B) 2, 3, 5, 4, 1 C) 1, 2, 3, 4, 5 D) 5, 3, 1, 2, 4 E) 3, 2, 1, 5, 4

71)

Which pathogen is INCORRECTLY matched with a portal of exit?

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A) Influenza virus—respiratory droplets. B) Vibrio cholerae—feces. C) Mycobacterium tuberculosis—droplets of saliva and mucus. D) Neisseriagonorrhoeae—urethral and vaginal secretions. E) E. coli—urine.

72)

Which of the statements about transmission of pathogens is TRUE?

A) Vertical transmission of a pathogen is from the environment to a person. B) Horizontal transmission refers to spread of a pathogenfrom mother to fetus. C) Sexual intercourse is an example of indirect contact. D) Droplet transmissionis a particularly important source of contamination in densely populated buildings such as schools.  E) Droplet nuclei are large drops of pathogen-containing fluid discharged by talking; they fall to the ground within a meter of the person.

73)

All of the following is/are reservoirsof infection in a hospital setting EXCEPT A) patient's normal microbiota. B) other patients. C) medical personnel. D) visitors. E) sterile surgical equipment.

74) Which of the following pathogens/diseases would be the easiest to eradicate? <!-Markup Copied from Habitat-->

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A) A pathogen that only infects humans and rarely causes signs and symptoms. B) A pathogen that only infects humans and causes obvious signs and symptoms. C) A pathogen that causes disease in both animals and humans. D) A pathogen that mostly infects animals but also sometimes causes disease in humans. E) A disease that is asymptomatic and is carried by a large number of people in a population.

75)

Please select the FALSE statement.

A) A common source epidemicoccurs when all of the cases result from exposure to a single source of the infectious agent.  B) A case-control studyoccurs when all of the cases result from exposure to a single source of the infectious agent.  C) The natural habitat of a pathogen is called the reservoir of infection. D) Herd immunity can never be overcome by a pathogen. E) Emerging infectious diseases arethose that are novel or have recently increased in incidence.

76) Which of the following best defines an endemic disease?  A) It is a disease that has a much higher incidence than usual.  B) It is a disease that used to be common but is eradicated through vaccination programs.   C) It is a disease that is transmitted by an arthropod vector.  D) It is a disease that occurs naturally in animals but may spread to people. E) It is a disease that is always present at some level in a population.

77)

Which factors made it possible to eradicate smallpox?

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A) Succesful vaccine and found only in humans. B) Succesful vaccine and found only in animals. C) Found only in animals and not highly contagious. D) Asymptomatic and long incubation period. E) Found only in animals and short incubation period.

78)

Which of the following can lead to the reemergence of a disease? A) Decline in vaccination rates for that disease. B) Mutation in a pathogen that allows it to infect humans. C) A change in the reporting procedures for an infectious disease. D) Increased education on transmission of a particular disease. E) Discovery of a new antibiotic for treating a disease.

79) SARS-CoV-2, the virus that causes COVID-19, appears to have originated as a virus that infects bats. Thefactor that contributed to the emergence of this diseases is A) microbial evolution. B) failure in vaccination programs. C) population expansion.  D) climate changes. E) overuse of antibiotics.

80) Why might a person immunized against cholera contract the disease anyway? <!-Markup Copied from Habitat-->

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A) A new serotype of Vibrio cholerae has emerged; previous immunity does not ensure immunity against this new encapsulated strain. B) Overuse of the antibiotic penicillin has led to the emergence of resistant strains of Vibrio cholerae that cause repeated infections. C) Vibrio cholerae is a virus that mutates frequently, giving rise to antigenic variation. D) Vibrio cholerae is an encapsulated organism; B cells cannot make antibodies to capsule material. E) These are all valid reasons that a person may not be immune to a serotype of Vibrio cholerae.

81) Which of the following is NOT a political or societal factor that might lead to emerging disease? A) Fear or complacency B) Microbial evolution C) War D) Civil unrest E) Population expansion

82) Why are there relatively accurate data on the number of cases of measles that occur in the United States but not on the number of cases of the common cold? A) People are sicker with measles, so are more likely to go to a doctor or hospital but the common cold is a notifiable disease. B) There is a successful vaccine protecting against measles, so the number of cases is very low; colds are so common it is impossible to keep track. C) People are sicker with measles, so are more likely to go to a doctor or hospital; measles is also a notifiable disease. D) Measles is a notifiable disease; the common cold is also a notifiable disease but so many people get colds that they cannot be tracked. E) Measles can be tracked because it only infects children under the age of five; colds affect people of all ages so are untrackable.

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83)

Which is not a common cause of healthcare-associated infections? A) Yeasts such as Candida albicans. B) Bacteria such as Staphylococcus aureus. C) Bacteria such as Escherichia coli. D) Bacteria such as Clostridioides difficile. E) Yeasts such as Saccharomyces cerevisiae.

84) Please select the INCORRECT match between a hospital-acquired infection and its cause. A) Diarrhea and colitis - Clostridioides difficile B) Burn wound infections - Pseudomonas species C) Yeast infections - Candida albicans D) Burn wound infections - Candida species E) Gastrointestinal infection - Clostridioides difficile

85) Please select the INCORRECT match between a hospital-acquired infection and the source of the causative agent. A) Bloodstream infections - central lines B) Pneumonia - mechanical ventilator use C) Clostridioides gastrointestinal infections - antibiotic use D) Urinary tract infections - intravenous catheters E) Surgical site infections - gastrointestinal microbiota

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SECTION BREAK. Answer all the part questions. 86) Your class decides to celebrate the last day of spring break by having a picnic. You arrange to meet at your local park and everyone agrees to bring a dish of food to the event. On the day, there is a wide variety of things to eat, but the snackthat everyone agreed was the best was the hot chicken wings made by Paul. Almost everyone ate at least two to three wings. The picnic was a huge success. The next morning you wake up feeling awful. You have a low grade fever and you have both vomiting and diarrhea. You call your friend Susan to tell her you won't make it to class that day and to please take good notes, which she promises to do. About 20 minutes later, Susan calls you back and tells you that three other people have also called her and are experiencing the same symptoms as you. You realize that you must have all eaten something at the picnic that is causing your illness. After finding out that none of the vegetarians or vegans in the class are ill, you figure out that it was likelya meat product.

86.1)

In this case, the reservoir of infectionwas likely the

A) chicken wings. B) Susan. C) flatware used at the picnic. D) river in the park. E) mosquitoes.

86.2)

The portal of entry of the pathogen causing illness in this case is the

A) skin. B) large intestine. C) nose. D) mouth. E) mucociliary escalator.

86.3) Some populations more than others are likely to be affected by a given pathogen. Many population characteristics influence the occurrence of disease. Which of the following MOST likely explains why some students at the picnic did not get ill?

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A) Herd immunity, thatprotects non-immune people from an infectious agent—the agentcannot spread in a population because most potential hosts are immune. Most students were probably immune to the foodborne pathogen. B) Age, becausethe immune system starts to weaken after childhood, and consequently people are vulnerable to certain diseases when they reach adulthood. The younger students in the group remained healthy.  C) Behavioral practices, that significantly influence the rate and type of disease transmission; in this case the vegetarians and vegans remained healthy, suggesting that not eating meat protected them from the pathogen. D) Gender, because females are always more likely than malesto acquire gastrointestinal diseases due to differences in their gut normal microbiota populations. The students who got ill were all female. E) None of the choices explain the outcome of the picnic.

86.4)

The situation described in this case study is an example of a(n)

A) propagated epidemic, because one student became ill, followed by others over several days. B) common-source epidemic, because several students became ill in the same time frame. C) propagated epidemic, because several students became ill in the same time frame. D) epidemic, because one student became ill and then spread the causative organism to many others. E) cohort study, because there was a group of students all affected by the same pathogen.

86.5) There were 27 students at the picnic, of which 18 developed illness. The attack rate was thus nearly 67%. What does this mean?

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A) The attack rate describesthe numberof susceptible people who become ill in a population after exposure to an infectious agent, in this case 67%.  B) The attack rateis the number of new cases in a specific time period in a given population, in this case 27.  C) This describesthe number of people in a defined population who die during a given period, in this case nearly 18%.  D) The attack rate is the total number of cases at any time or for a specific period in a given population, in this case 27.   E) It describes the situation in which a particular disease arises from several genera of a person’s own normal microbiota, in this case 18.

87) You are a newly qualified RN and have just been employed at your first job at a state hospital. Before you start your work with patients, you are required to complete a refresher course on nosocomial infections. You are asked to watch a short video and are then asked a series of questions, whichare given below. You are somewhat nervous but need not be because you understand the risks of these infections and you know how they can be avoided. You answer the questions are directed.

87.1)

Nosocomial(or healthcare-associated) infections are infections that

A) people acquire while receiving treatment in a healthcare setting such as a hospital, therapy center, urgent care facility, or long-term care residence.  B) are caused by organisms that nevercause disease in healthy people, but only in sick or immunocompromised people, such as those in the hospital.  C) that are novel or have recently increased in incidence, such as Ebola disease and Zika virus disease.   D) result as populations increase, and people move into areas where they are more likely to come into contact with reservoirs of disease.  E) follow the natural evolution of microbes that allows them to gain new characteristics such asthe ability to produce a protective capsule.

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87.2) The organisms that cause healthcare-associated infections can originate from a number of different sources, including other patients, the healthcare environment, healthcare workers, visitors, and the patient’s own microbiota. Select the INCORRECT statement. A) P. aeruginosais resistant to many disinfectants and antimicrobial medications, and requires few nutrients, which enables it to multiply in environments containing little other than water. B) A healthcare worker who is an asymptomatic carrier of a pathogen such as Staphylococcus aureus may inadvertentlyinfect patients; sometimes personnel do not realize that they pose a risk to patients until they are implicated in an outbreak. C) Nearly any invasive procedure can transmit organisms of a patient’s normal microbiota to otherwise sterile body sites—for example, skin microbiota such as Staphylococcus epidermidis maygain access to the bloodstream. D) Transmission of HAI-causing infectious agents may be direct through contact with others, including healthcare personnel. However, indirect transmission almost never occurs in hospitals because they are a sterile environment. E) Healthcare personnel should routinely wash or disinfect their hands after touching one patient before going to the next. They should also wear gloves when they have contact with patient's blood, mucous membranes, broken skin, or body fluids.

87.3) Which of the following would be indirect transmission of a pathogen in a healthcare facility? A) Medical devices such as urinary catheters. B) Inadequately sterilized instruments used in invasive procedures. C) Inadequately sterilized instruments used in invasive procedures AND healthcare personnel who wash their hands properly. D) Medical devices such as urinary catheters AND inadequately sterilized instruments used in invasive procedures. E) Healthcare personnel who wash their hands adequately ANDintravenous (IV) catheters colonized with normal skin microbiota.

87.4)

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Which of the following does NOT correctly describe a Standard Precaution?

A) Personal protective equipment (PPE) includes gloves, a gown, and sometimes mask, goggles, or a face shield. B) Respiratory hygiene includes instructing symptomatic healthcare personnel to stay home from work for at least two weeks. C) A patient who is at increased risk of acquiring infection or developing an adverse outcome following infection should be placed in a single-patient room.  D) Personnel should adhere to federal and state requirements for protection from exposure to bloodborne pathogens.  E) Medical personnel who are likely to have had contact with spores (such as those of Clostridioides difficile)should wash their hands with soap and water.

87.5) Which of the following is a possible origin of theorganisms that cause healthcareassociated infections?  A) The patient's normal microbiota B) Other patients C) Medical personnel D) Healthcare environment E) All of the answer choices are correct.

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88) In late 2019, doctors in Wuhan, China reported several cases of severe pneumonias of unknown cause, characterized by high fevers, chills, body aches, and shortness of breath. Although some patients recovered within several days, an alarming number deteriorated rapidly and died, despite interventions such as using mechanical ventilators to help them breathe. The cause of the illness was soon identified as a novel coronavirus subsequently named severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). The disease was named coronavirus disease 2019, or COVID-19. Within weeks, COVID-19 spread globally, and scientists worldwide raced to learn more about the causative agent. The figure shows data taken from New York City between March and June 2020. The total number of diagnosed cases in this time was 166,560; the number of hospitalizations was 39,888 and the number of deaths was 12,525.

Data source:https://www1.nyc.gov/site/doh/covid/covid-19-data.page

88.1) COVID-19 began in Wuhan, China. From there, the causative agent (SARS-CoV2) spread rapidly around the globe. When a situation such as this occurs, it is referred to as a(n) A) outbreak. B) pandemic. C) epidemic. D) endemic. E) communicable.

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88.2) The virus that causes COVID-19 is easily spread in crowded, confined spaces through respiratory droplets. A disease that is transmitted from one host to another like this is referred to as A) noncommunicable. B) zoonotic. C) zoonotic or communicable. D) contagious. E) contagious or communicable.

88.3) Why does the number of cases increase over several incubation periods in a propagated epidemic? A) Individuals pass the infection to others who pass it to others. B) Multiple people develop the infection simultaneously. C) All of the cases result from exposure to a single source of the infectious agent. <!-Markup Copied from Habitat--> D) There are no treatments for people in a propagated epidemic. E) Propogated epidemics occur over winter months, when people are indoors.

88.4)

The peak in number of cases occurred

A) in the second week of April. B) in the first week of April. C) at the beginning of March. D) by the beginning of June. E) sometime in March.

88.5) If the population of NYC is 8.4 million, what proportion of it contracted the disease in the time period shown?

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A) 2% B) 0.02% C) 0.005% D) 20% E) 200%

88.6) What was the case-fatality rate during the time period shown? (hint: CFR is the proportion of people diagnosed with a disease who die from that disease) A) 0.075% B) 13.3% C) 7.5% D) 31.4% E) 23.9%

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Answer Key Test name: Chap 19_10e 1) FALSE 2) TRUE 3) FALSE 4) TRUE 5) TRUE 6) FALSE 7) FALSE 8) TRUE 9) FALSE 10) TRUE 11) TRUE 12) D 13) B 14) E 15) B 16) A 17) A 18) D 19) C 20) A 21) B 22) D 23) C 24) B 25) B 26) E Version 1

27) C 28) A 29) B 30) C 31) B 32) E 33) B 34) A 35) A 36) C 37) C 38) D 39) B 40) A 41) D 42) C 43) A 44) C 45) D 46) A 47) D 48) E 49) B 50) C 51) C 52) B 53) D 54) E 55) E 56) B Version 1

57) A 58) D 59) E 60) E 61) B 62) A 63) B 64) B 65) C 66) B 67) B 68) B 69) A 70) A 71) E 72) D 73) E 74) B 75) D 76) E 77) A 78) A 79) A 80) A 81) B 82) C 83) E 84) D 85) D 86) Section Break Version 1

86.1) A 86.2) D 86.3) C 86.4) B 86.5) A 87) Section Break 87.1) A 87.2) D 87.3) D 87.4) B 87.5) E 88) Section Break 88.1) B 88.2) E 88.3) A 88.4) A 88.5) A 88.6) C

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CHAPTER 20 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The key characteristic of a useful antimicrobial is selective toxicity. ⊚ ⊚

true false

Antimicrobials that have a high therapeutic index are less toxic to the patient. ⊚ ⊚

true false

Broad-spectrum antibiotics have minimal effect on the normal microbiota. ⊚ true ⊚ false

Certain antimicrobials may be life-threatening. ⊚ ⊚

Drugs that target peptidoglycan do not affect eukaryotes. ⊚ ⊚

true false

Beta-lactam drugs are only effective against growing bacteria. ⊚ ⊚

true false

The MBC may be determined by an extension of the MIC. ⊚ ⊚

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true false

Antimicrobial resistance can be due to spontaneous mutation or gene acquisition. ⊚ ⊚

Viruses are very effectively treated with antibiotics. ⊚ ⊚

10)

true false

Antifungal drugs usually target the cell membrane. ⊚ ⊚

true false

11) Carbapenems are easily inactivated by the extended-spectrum β-lactamases (ESBLs) produced by certain Gram-negative bacteria so cannot be used to treat these infections. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 12) One of the earliest researchers to explore the use of chemicals to kill microbial pathogens was A) Koch. B) Ehrlich. C) Hooke. D) Fleming. E) Salvarsan.

13)

The arsenic compound that proved highly effective in treating syphilis was called

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A) penicillin. B) sulfa. C) erythromycin. D) Salvarsan. E) erlichsan.

14)

The first example of an antimicrobial drug synthesized in the laboratory was A) penicillin. B) sulfa. C) erythromycin. D) Salvarsan. E) Erlichsan.

15) Prontosil effectively acted on streptococci when the drug was split by enzymes to produce A) penicillin. B) sulfanilamide. C) erythromycin. D) Salvarsan. E) Salvarsan AND penicillin.

16)

The use of Salvarsan and Prontosil to treat microbial infections were early examples of A) antibiotics. B) toxins. C) chemotherapy. D) inhibitors. E) vaccination.

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17)

Penicillin was discovered by A) Fleming. B) Koch. C) Hooke. D) Ehrlich. E) Pasteur.

18)

The most effective form of penicillin is A) penicillin A. B) penicillin B. C) penicillin E. D) penicillin G. E) penicillium.

19)

One of the earliest antimicrobials isolated from a bacterium was A) penicillin. B) ampicillin. C) streptomycin. D) Salvarsan. E) tetracycline.

20)

Which of the following groups of microorganisms produces antibiotics? A) Penicillium AND Bacillus B) StreptomycesAND Bacillus C) Bacillus, Penicillium, AND Streptomyces D) Penicillium AND Streptomyces E) Clostridium AND Streptomyces

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21)

An antibiotic made by microorganisms and modified by chemists is called A) anti-metabolic. B) catabolic. C) semi-synthetic. D) synthetic. E) semi-catabolic.

22)

The antimicrobials produced by some molds and bacteria are generally called A) insecticides. B) biocides. C) antiseptics. D) antibiotics. E) pesticides.

23)

The toxicity of a given drug is expressed as the A) selective toxicity. B) therapeutic index. C) biocide index. D) biostatic index. E) bacteriostaticwindow.

24)

A high therapeutic index is A) more toxic to the patient. B) less toxic to the patient. C) has no effect on the patient. D) has no effect on the pathogen. E) more toxic to the patient AND has little effect on the pathogen.

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25)

Drugs that are bacteriostatic A) kill all bacteria. B) promote bacterial growth. C) inactivate bacterial spores. D) inhibit the growth of bacteria. E) kill infected host cells.

26)

Antimicrobials that kill microorganisms have the suffix A) -cidal. B) -static. C) -anti. D) -genic. E) -acto.

27)

Antimicrobials that inhibit the growth of microorganisms have the suffix A) -cidal. B) -static. C) -anti. D) -genic. E) -acto.

28) Antibiotics that affect various strains of Gram-positive bacteria and various strains of Gram-negative bacteria are called

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A) isolate usable. B) stress-induced. C) broad-spectrum. D) narrow-spectrum. E) intermediate.

29)

The rate of elimination of an antimicrobial is expressed as its A) metabolicdestructive rate. B) half-life. C) effective time. D) dosage rate. E) therapeutic index.

30)

Antibiotics that are most likely to disrupt the normal microbiota are termed A) broad-spectrum. B) narrow-spectrum. C) targeted spectrum. D) semi-synthetic. E) therapeutic.

31)

Drugs that are more effective when taken together are A) energetic. B) antagonistic. C) synergistic. D) subtractive. E) symbiotic.

32) are

If drugs are less effective when taken together than when each is taken separately, they

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A) energetic. B) antagonistic. C) additive. D) synergistic. E) commensal.

33)

Antimicrobials may cause all of the following EXCEPT A) allergic reactions. B) toxic effects. C) suppression of normal microbiota. D) dysbiosis. E) resistance in people.

34)

Which of the following bacteria have an innate resistance to penicillin? A) S. aureus B) Mycoplasma C) S. epidermidis D) M. luteus E) All of the answer choices are correct.

35)

Which of the following drugs does NOT target peptidoglycan? A) Penicillin B) Cephalosporin C) Vancomycin D) Bacitracin E) Doxycycline

36)

All members of the penicillin family have

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A) beta-lactam rings. B) alpha-lactam rings. C) phenolic rings. D) sulfanilic rings. E) sulfanilic hexons.

37)

Penicillin-binding proteins A) primarily function in the cell to bind to beta-lactam drugs. B) are enzymes. C) are involved in cell wall synthesis. D) inhibit non-growing bacteria. E) are enzymes AND are involved in cell wall synthesis.

38)

Beta-lactamases A) bind to penicillin-binding proteins. B) break the beta-lactam ring. C) bind to peptides. D) prevent the linking of glycan chains in peptidoglycan. E) bind to carbohydrates.

39) The major class(es) of antibiotics that inhibit protein synthesis include all of the following EXCEPT A) bacitracins. B) aminoglycosides. C) tetracyclines. D) macrolides. E) streptogramins.

40)

Inhibitors of protein synthesis typically act on

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A) peptidoglycan precursors. B) penicillin-bindingproteins. C) ribosomes. D) porin proteins. E) transfer RNA.

41)

Which is true of aminoglycosides?

A) They are bacteriostatic AND they reversibly bind to the 30S ribosomal subunit. B) They irreversibly bind to the 30S ribosomal subunit AND they block DNA replication. C) They block peptidoglycan synthesis AND they bind to the 80S ribosomal subunit. D) They are bactericidal AND they block DNA replication. E) They irreversibly bind to the 30S ribosomal subunit AND they are bactericidal.

42)

Fluoroquinolones typically target A) ribosomes. B) DNA gyrase. C) penicillin-binding proteins. D) peptidoglycan. E) cytoplasmic membranes.

43)

Sulfonamide and trimethoprim are both A) examples of metabolic inhibitors. B) folate inhibitors. C) protein synthesis inhibitors. D) inhibitors of cell wall synthesis. E) examples of metabolic inhibitors AND folate inhibitors.

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44)

Folic acid is ultimately used in the synthesis of A) topoisomerases. B) proteins. C) DNA gyrases. D) sulfonamides. E) coenzymes.

45)

Sulfonamides are similar in structure to A) DNA gyrases. B) PABA. C) LPS. D) ribosomes. E) peptidoglycan.

46)

Sulfonamides work as A) competitive inhibitors. B) noncompetitive inhibitors. C) ribosome-binding molecules. D) feedback inhibitors. E) coenzymes.

47)

Trimethoprim and sulfonamides have a(n) A) antagonistic effect. B) synergistic effect. C) energetic effect. D) subtractive effect. E) counteractive effect.

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48)

Mycolic acids are targeted by isoniazid in the treatment of A) S. aureus. B) S. epidermidis. C) M. luteus. D) M. tuberculosis. E) E. coli.

49)

The lowest concentration of a drug that prevents growth of a microorganism is the A) infectious effective dose. B) minimum inhibitory concentration. C) lethal dose. D) most effective concentration. E) minimal death dose.

50) The minimum bactericidal concentration is the lowest concentration of a specific antimicrobial drug that kills _______ of a specific type of bacteria. A) 10% B) 50% C) 99.9% D) 100% E) 25%

51)

The diffusion bioassay

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A) determines the concentration of antimicrobial necessary to kill a bacteria. B) determines the concentration of antimicrobial necessary to inhibit growth of a bacteria. C) is similar in principle to the Kirby-Bauer test. D) determines the concentration of antimicrobial in a fluid. E) is similar in principle to the Kirby-Bauer AND determines the concentration of antimicrobial in a fluid.

52) Which test provides qualitative results regarding antibiotic susceptibility and is reported as susceptible, intermediate, or resistant? A) Minimum inhibitory concentration B) Minimumbactericidal concentration C) Minimally-lethal dose D) Antibiotic stimulating zone test E) Kirby-Bauer test

53)

The zone size obtained in the Kirby-Bauer test is influenced by the drug's A) molecular weight AND concentration. B) stability. C) concentration AND stability. D) molecular weight AND stability. E) molecular weight, stability, AND concentration.

54)

A commercial modification of the disk diffusion test is called the A) E test. B) D test. C) C test. D) B test. E) A test.

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55)

Bacteria may become antibiotic resistant due to A) drug-inactivating enzymes. B) alteration in the target molecule. C) decreased uptake of the drug. D) increased elimination of the drug. E) All of the choices are correct.

56)

Spontaneous development of resistance to a particular antimicrobial is difficult if the drug A) targets a single type of molecule AND binds to a single site on that target molecule . B) targets several different molecules AND affects the cytoplasmic membrane. C) affects only one molecule. D) affects the cytoplasmic membrane. E) binds to several sites on the target molecule AND targets several different molecules.

57)

The most common method of transfer of antimicrobial resistance is through the use of A) viruses. B) R plasmids. C) introns. D) exons. E) F plasmids.

58) For which of these organisms is there a large increase in antibiotic resistance resulting from a lack of patient compliance with the 6 -12 month course of daily antibiotics?

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A) Mycobacterium. B) Streptococcus. C) Staphylococcus. D) Pseudomonas. E) Mycoplasma.

59)

Antiviral drugs may target all of the following EXCEPT A) viral uncoating. B) viral ribosomes. C) nucleic acid synthesis. D) viral assembly. E) viral entry.

60)

The target of most antifungal drugs is A) the ribosome AND the cytoplasmic membrane. B) the nucleus AND mitochondria. C) cholesterol. D) ergosterol. E) cholesterol AND ergosterol.

61)

In what clinical situation is it most appropriate to use a broad-spectrum antimicrobial?

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A) In an example of a viral pediatric otitis media (middle ear) infection. We can't properly test for the specific drug that would best eliminate the infection due to its location, so we use a broad-spectrum drug instead. B) In a case of viral meningitis. The infection spreads so quickly that we must treat it with an antibacterial drug as quickly as possible. We don't have time to determine which drug will work best, because the patient will die in the meantime. C) In a case of bacterial meningitis. The infection spreads so quickly that we must treat it with an antibacterial drug as quickly as possible. We don't have time to determine which drug will work best, because the patient will die in the meantime. D) In a case of Staphylococcus aureus skin infection. Since this microbe can be resistant to several types of drugs, we want to use one that has the broadest spectrum possible to treat this microbe-specific infection. E) There are no appropriate situations for using broad-spectrum antibiotics, because they almost always lead to resistance. It is much better to use a narrow-spectrum medication.

62) Why would antimicrobials that have toxic side effects be used at all? (select the BEST reason) A) We want the largest possible number of choices of drugs in case a microbe shows resistance. With more possible weapons (even toxic ones), we have greater ability to eliminate infections. B) Every person is different. What is toxic to one person may not be toxic to another person. To eliminate a useful drug because it's toxic to 1% of people treated is a waste. C) Depending on thelocation of the infection, we may have no choice but to utilize a drug that hassome toxic side effects to the patient. D) They shouldn't be used. We have enough of a selection of drugs that we can always select a drug with no toxicity. Drugs with toxicity are simply leftovers from a time when we didn't have as many drug options. E) These are all reasons to use antimicrobials that have a low therapeutic index.

63) Why would co-administration of a bacteriostatic drug interfere with the effects of penicillin?

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A) Since most bacteriostatic drugs are produced from bacteria but penicillin is produced from mold, the two drugs are incompatible with each other. B) A bacteriostatic drug interferes with the ability of a bacterial cell to take in compounds from the outside environment. Penicillin must be taken in by the cell in order to have its effect, so this would directly inhibit it. C) The bacteriostaticdrugs would bind directly to the penicillin, preventing both its uptake by thecell and its ability to perform its duty within the bacterial cell. D) Penicillin interferes with cell wall production so it only works when the cells are actively replicating and MAKING new peptidoglycan. A bacteriostatic drug works by shutting down replication, holding the cells "static." This would interfere with the mode of action required by the penicillin. E) Nothing interferes with the effects of penicillin. It is the most effective medication that we have, so is never used with the addition of a second drug when treating a person.

64) Why would it be important for the Kirby-Bauer disc diffusion test to use a standard concentration (number of cells in the sample) of each of the bacterial strains being tested? A) If you were to use one strain that was stationary phase (high concentration, replicating very slowly or not at all), and another strain that was just beginning log phase (low concentration but replicating quickly), you could seedifferent results in thetest, affecting your interpretation. B) Growth on theMueller-Hinton agar plates utilized is very sensitive to the phase of thegrowth curve the bacteria are in when they are placed on the plate. Ifthey are not in the log phase when they are placed on the plate, they will notgrow and the test will be worthless. C) Antibiotic resistance is usually only manifested by bacteria that have achieved a very high concentration. It's important to use bacteria specifically at this particular point for disc diffusion testing. D) Antibiotics only work within a narrow range of cell concentrations. If you use a concentration that is too low or too high, you will get inaccurate measurements of the zone of inhibition. E) Bacteria only develop resistance when there are more than 10 12 cells/ mL. If resistance is to be detected, the test must use at least this concentration of cells. If fewer cells are used, no zone of inhibition will develop.

65) Explain how using a combination of two antimicrobial drugs helps prevent the development of spontaneously resistant mutants. Version 1

A) All drugs work synergistically with each other. Their combined effects are far greater than either could achieve individually. Two drugs together helps to eliminate microbes, even if they have developed spontaneous mutations that would make them resistant to the drugs. B) It is highly unlikely that the microbe might spontaneously develop two specific mutations to resist the effects of a pair of drugs. As such, even if one drug is resisted by the microbe, the second drug will eliminate the mutated microbe, thus preventing the development of spontaneously resistant mutants overall. C) All drugs work antagonistically with each other. Their combined effects are far greater than either could achieve individually. Two drugs together helps to eliminate microbes, even if they have developed spontaneous mutations that would make them resistant to the drugs. D) Drugs can also select for mutations that will enhance the activity of another drug. Therefore, each of the paired drugs will help to select for spontaneous mutations that enhance the activity of the other drug in the pair. E) Bacteria can only ever develop resistance to a single antibiotic. If more than one drug is used, the organisms will definitely become resistant to one of them but it will not become resistant to both of them. The second antibiotic will kill the organism.

66)

Why are nucleoside analogs active only against replicating viruses?

A) These drugs can only be taken up by cells that are infected by viruses. They are shut out from non-infected cells. This makes them effective only against cells where viruses are replicating. B) Each of these drugs is specifically activated by enzymes produced by the viruses. The viruses will only produce these enzymes when they are replicating, so the drugs can only become activated when these processes are occurring. C) Nucleoside analogs work by directly inhibiting the activity of nucleic acid polymerases. If the virus isn't actively replicating, there's no DNA/RNA polymerase active for the drug to inhibit, so the drug cannot work. D) Nucleoside analogs work by being incorporated into growing strands of DNA/RNA. This indirectly shuts down further extension of these chains. However, new strands of viral DNA/RNA are only being created when the virus is replicating. Thus, these drugs can only work when the virus is actively replicating as well. E) Nucleoside analogs work by being incorporated into growing strands of amino acids during enzyme synthesis. This indirectly shuts down further extension of these chains. However, new viral proteins are only being created when the virus is replicating, so these medications only work if that is the case.

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67)

Which is the correct definition of selective toxicity?

A) A medication causing greater harm to a pathogen than to the host. B) A medication causing greater harm to a host than to a pathogen. C) The lowest dose of a medication toxic to the pathogen.  D) The range between the therapeutic dose and the toxic dose of a medication. <!-Markup Copied from Habitat--> E) A medication that only targets Gram-negative bacteria.

68)

What allows for selective toxicity in a medication?

A) Themedication acts against an essential component or biochemical process of microorganisms that does not exist in human cells.  B) The medication is converted into a non-toxic form by the liver in people, but remains highly toxic in bacteria which cannot process the drug. C) Themedication acts against an essential component or biochemical process of human cells that does not exist in microorganisms. D) Onlysome medications cross from the blood into the cerebrospinal fluid of humans.  E) Some medications have a very extended half-life AND onlysome medications cross from the blood into the cerebrospinal fluid of humans.

69) Please select the FALSE statement regarding tissue distribution, metabolism, and excretion of medications.

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A) Patients who have liver dysfunction often metabolize medications more slowly, so their doses must be adjusted to avoid toxic levels.  B) The half-life of a medication is the time it takes for the serum concentration of that chemical to decrease by 100%.  C) Medications that are unstable at low pH are typically given by intravenous or intramuscular injection.  D) A medication with ahalf-life of over 24 hours is taken only once a day or less. <!-Markup Copied from Habitat--> E) A medication that has a very short half-life usually needs to be taken several times a day.

70)

Please select the TRUE statement regarding bacterial resistance to antimicrobials.

A) Gram-positive bacteria are intrinsically resistant to certain medications because the lipid bilayer of their outer membrane prevents the molecules from entering.  B) Intrinsic resistance generally occurs through spontaneous mutation or horizontal gene transfer.  C) The genes for antimicrobial resistance are often carried on fertility plasmids (F plasmids). D) Mycoplasma species lack a cell wall, so they are resistant to penicillin that interferes with peptidoglycan synthesis. This is an example of intrinsic resistance. E) Acquired resistanceis very limited because microorganisms cannot evolve, so are incapable of developing mechanisms to avoid the effects of medications.

71)

Which of the following would you prescribe to treat a person with M. pneumoniae? A) A β-lactam antibiotic such as penicillin B) A glycopeptide antibiotic such as vancomycin C) Bacitracin D) A macrolide such as erythromycin E) Bacitracin OR penicillin

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72)

Which statement about penicillins is INCORRECT?

A) Penicillins + β-lactamase inhibitor is a combination of agents that protects the penicillin against enzymatic digestion. B) Broad-spectrum penicillinsare active against penicillin-sensitive Gram-positive bacteria and also many Gram-negative bacteria.  C) Some S. aureus strains have the ability to make altered penicillin binding proteins to which most β-lactam antibiotics do not bind as well. D) The penicillins produced naturally by the mold P. chrysogenum are broadspectrum, effective against all Gram-positive and many Gram-negative bacteria. E) Bacteria that produce penicillinase are resistant to the natural penicillins.

73) Why must vancomycinbe administered intravenously except when used to treat intestinal infections?  A) Vancomycin is poorly absorbed from the intestinal tract. B) Vancomycin is toxic but less so if injected intravenously. C) Injected vancomycin is easier to target to the site of infection. D) Vancomycinis effective against only Gram-positive bacteria.  E) Vancomycin has a high therapeutic index.

74)

What is the minimum inhibitory concentration (MIC)?

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A) It is the lowest concentration of a specific antimicrobial medication needed to prevent the visible growth of a given bacterial strain in vitro.

75) What are two advantages of automated tests used to determine antimicrobial susceptibility?  A) They are easier to perform. B) They produce results more quickly than conventional tests. C) They produce results more quickly than conventional tests AND they are easier to perform. D) They take longer to perform BUT they give fewer false results. E) They are cheaper than conventional tests AND they give more accurate results.

76)

Please select the statement regarding antimicrobial testing that is FALSE.

A) Commercial tests for determining antimicrobial sensitivity are less labor-intensive and often more rapid than conventional tests. B) Disc diffusion tests can determine whether an organism is susceptible, intermediate, or resistant to a variety of different antimicrobials.  C) The MIC and the MBC are quantitative measures of a bacterial strain’s susceptibility to an antimicrobial medication. D) In the Kirby-Bauer test,the clear area in which there is no visible growth of bacteria is called a zone of inhibition.  E) In the Kirby-Bauer disc diffusion test, aclear zone around the antibiotic disc following incubationindicates that the antibiotic is bactericidal.

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77)

Please select the FALSE statement regarding antibiotic resistance.

A) Modifications in the penicillin-binding proteins (PBPs) prevent β-lactam antibiotics from binding to them. B) Some antibiotic-inactivating enzymes have an extended spectrum and confer resistance to a wide variety of antibiotics.  C) Changes in the porin proteins can prevent certain antimicrobials from entering a cell’s periplasm or cytoplasm. D) The bacterial enzyme chloramphenicol acetyltransferase confers resistance to the penicillins. E) Bacteria that produce efflux pumps sometimes become resistant to several different antimicrobials simultaneously.

78)

Which statement about antiviral medications is INCORRECT?

A) Viral replication generally uses host cell machinery; because of this, there are many targets for selectively toxic antiviral medications.  B) Sofosbuvir is a nucleotide analog that interferes with HCV’s replicase and is extremely effectivewhen used in combination with at least one other anti-HCV medication. C) Nucleoside analogs and nucleotide analogs that interfere with the activity of reverse transcriptase are used in HIV treatment, along with at least one antiviral other medication. <!-Markup Copied from Habitat--> D) Neuraminidase inhibitors inhibit neuraminidase, an enzyme encoded by influenza viruses that is important for the release of viral particles from infected host respiratory epithelial cells.   E) Available antivirals are virus-specific and target viral entry, viral uncoating, nucleic acid synthesis, integrase, and the assembly and release of viral particles.

79)

Which of the following is TRUE about sulfonamide discovery?

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A) Sulfonamides are made be certain fungi. B) The discovery of sulfonamides was by in vitro bacterial testing. C) Sulfonamide is a breakdown product of the dye prontosil.  D) Sulfonamides were known to be effective in all animals except humans. E) The person who discovered sulfonamides was Paul Erlich.

80)

Select the mismatched statement regarding the discovery of antibiotics. A) Alexander Fleming - discovered penicillin when working on Staphylococcus

aureus. B) Alexander Fleming - successfully purified large amounts of penicillin from the mold Penicillium. C) Sulfonamides - discovered accidentally after enzymatic breakdown of the dye prontosil. D) Streptomycin - isolated from the bacterium Streptomyces griseus by Selman Waksman. E) Penicillin G (benzyl penicillin) - penicillin most suitable for treating infections. <!-Markup Copied from Habitat-->

81) All of the following about first-line medications used to treat tuberculosis are true EXCEPT A) they are the most effective against Mycobacterium tuberculosis. B) all four are given in combination for the first 8 weeks. C) combinations of more than two are highly toxic. D) they targetprocesses unique to Mycobacterium tuberculosis. E) they include ethambutol, isoniazid, pyrazinamide and rifampicin.

82)

Which is NOT true about second-line antibiotics used in treating tuberculosis?

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A) They are more toxic than first-line drugs. B) They are used for strains resistant to first-line drugs. C) They are often less effective than first-line medications. D) They are more effective and less toxic than first-line drugs. E) They interfere with processes unique to Mycobacterium tuberculosis.

83) Please select the INCORRECTLY matched pair regarding acquired antimicrobial resistance. A) Medication inactivating enzymes - enzymes such as penicillinase that chemically modify a medication, interfering with its function. B) Alteration of target molecule - structural changes in target molecule such as penicillin binding proteins, preventing drug binding. C) Decreased uptake of drug - changes in porin proteins prevent drugs from entering a cell. D) Elimination of medication - increased production of efflux pumps that eject medication from the cell. E) Reduced drug activity - increases in cross-linking of lipids within peptidoglycan, preventing entry of drug into the cell.

84) Asagroup,bacteriause which three methods to avoid the effects of β-lactam antibiotics? i. Changing porin proteins ii. Spontaneous mutation iii. Producingβ-lactamase iv. Altering penicillin-binding proteins v. Vertical gene transfer A) i; iii; iv B) i; ii; iii; iv C) ii; iii; v D) i; ii E) i; ii; iii; iv; v

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85) Misuse of the medications can eventually lead to resistant strains. Which statement is INCORRECT? A) Combination therapy is effective because the chance thata cell will simultaneously developmutational resistance to multiple antimicrobial medications is extremely low. <!-Markup Copied from Habitat--> B) If an antimicrobial medication has several different targets or can bind to multiple sites on a single target, resistance due to spontaneous mutation is less likely.  C) If antibiotic doses are skipped, the medication level may drop to sub-inhibitory levels, allowing the least sensitive cells to multiply and possibly become resistant. D) If antibiotic treatment is stopped too soon, the least sensitive cells may survive, increasing the chance they might mutate and become resistant.  E) If two or more antibiotics are given simultaneously, bacteria become super-resistant and infections they cause are then incurable.

86)

All of the following are mechanisms of action of antiprotozoal medications EXCEPT A) interfering with mitochondrial electron transport. B) interfering with parasite's ability to detoxify heme. C) interfering with function of 80S ribosomes. D) interfering with neuromuscular activity. E) interfering with ATP synthesis.

SECTION BREAK. Answer all the part questions. 87) Gonorrheais a sexually transmitted infection (STI) caused by the diplococcus Neisseria gonorrhoeae, commonly called gonococcus (GC). This organism developed resistance to penicillin and tetracycline in the 1980s, after which fluoroquinolones were the recommended drugs for treating GC. Subsequent resistance to the fluoroquinolones has led to the current recommended treatment of injected ceftriaxone in combination with oral azithromycin. Although this approach continues to be effective, recentdata from the CDC indicates that resistance to azithromycin is emerging.

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87.1) Initially, GC was treated with penicillin, which targets ______,and tetracycline which targets ______ . A) protein synthesis; peptidoglycan synthesis B) peptidoglycan synthesis; protein synthesis C) protein synthesis; capsule formation D) capsule formation; ergesterol formation E) cell membrane integrity; folic acid synthesis

87.2)

Penicillin is a(n)

A) β-lactam antibioti c and has a low therapeutic index, meaning that it is of high toxicity to the host. B) carbapenam and is thus resistant to extended spectrum β-lactamases. C) glycopeptide antibiotic and is thus used as an antibiotic of last resort. D) β-lactam antibioti c and has a high therapeutic index, meaning that it is of low toxicity to the host. E) aminoglycoside and may sometimes cause kidney damage.

87.3) Fluoroquinolones act by inhibiting DNA gyrase, an enzyme involved in DNA replication. Resistance to this antibiotic is most commonly by A) a change in the DNA gyrase target, an example of acquired resistance. B) enzymatic modification of the ribosomal target, an example of innate resistance. <!-Markup Copied from Habitat--> C) a change in the DNA gyrase target, an example of innate resistance. D) due to a mutation in the gene that encodes RNA polymerase, an example of adaptive resistance.  E) increased efflux of the drug from the target cell, an example of innate resistance.

87.4) Azithromycin is a bacteriostatic antibiotic that interferes with protein synthesis. Ceftriaxone is a β-lactam antibiotic and is primarily bactericidal. This means that

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A) azithromycin kills bacterial cells while ceftriaxone inhibits the growth of bacterial cells. B) bacteria are sensitive to azithromycin but are resistant to ceftriaxone. C) azithromycin inhibits the growth of bacterial cells while ceftriaxone kills bacterial cells. D) bacteria are resistant to azithromycin but are susceptible to ceftriaxone. E) azithromycin can only be used against Gram-positive bacteria.

87.5) The situation in which the effect of two antimicrobials given together is more effective than the effect of either medication given individually is referred to as A) synergism. B) antagonism. C) nihilism. D) symbiosis. E) dysbiosis.

87.6) Which of the following targets would you expect to be the most selective with respect to toxicity?  A) Peptidoglycan synthesis B) 70S ribosome C) DNA synthesis D) Glycolysis E) Cytoplasmic membrane function

88) An elderly patient comes to see you complaining of a very painful rash. When he lifts his shirt, you see that he has a rash of smallblisters (vesicles) on one side of his back. You think he likely has shingles, caused by varicella-zoster virus (VZV), a double-stranded DNA virus that belongs to the Herpesviridae family.You explain this to your patient, who asks you to please give him an antibiotic for his infection. You tell him an antibiotic will not help him,andgive him information on virus infections and their treatment.

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88.1) Antibiotics are effective in treating viral infections provided that they are given early in the course of illness. ⊚ ⊚

true false

88.2) Viruses are completely unaffected by antibiotics because  A) they rely almost completely on the host cell’s metabolic machinery for their replication, making it difficult to find a target for selective toxicity. B) they have no cell wall, ribosomes, or any other structure targeted by antibiotics. C) they rely almost completely on the host cell’s metabolic machinery for their replication, making it difficult to find a target for selective toxicity AND most viruses are innately resistant to broad- and narrow-spectrum antibiotics. D) They have no cell wall, ribosomes, or any other structure targeted by antibiotics ANDthey rely almost completely on the host cell’s metabolic machinery for their replication, making it difficult to find a target for selective toxicity. E) most viruses are innately resistant to broad- and narrow-spectrum antibiotics.

88.3) Several diseases caused by herpesviruses are treated with a medication called acyclovir. This medication is a nucleoside analog, meaning A) it contains a nucleotide analog and a phosphate. B) it contains a nucleotide analog, a phosphate, and a sugar. C) it contains a nucleotide analog and a sugar. D) it is composed of NAG, NAM, and tetrapeptides. E) it is composed of NAG, NAM, and a sugar.

88.4) A nucleoside analog can be phosphorylated in vivo by a virally encoded or normal cellular enzyme to form a nucleotide analog—a chemical structurally similar to the building blocks of DNA and RNA . Nucleotide analogs interfere with

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A) viral protein synthesis. B) viral nucleic acid synthesis. C) viral peptidoglycan synthesis. D) viral replicases. E) All of the choices are correct.

88.5) Acyclovir is selective and low in toxicity, causing little harm to uninfected cells, because A) only a virally encoded enzyme can convert the medication into its active form (from nucleoside analog to nucleotide analog).   B) only a virally encoded enzyme can convert the medication into its active form (from nucleotide analog to nucleoside analog). C) viral DNA is structurally very different from cellular DNA. D) host cells have the ability to repair the damage caused by nucleotide analogs. E) host cells have an enzyme that prevents the conversion of the medication into its active form.

88.6) Acyclovir interferes with viral DNA replication. Other mechanisms of antiviral medications include all of the following EXCEPT A) preventing fusion and inhibiting viral entry into a host cell. B) interfering with viral uncoating and release of viral nucleic acid in a host cell. C) preventing the assembly viral proteins to form capsids. D) inhibition of viral particle release from host cells. E) destroying viral ribosomes and preventing protein synthesis.

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89) A 36-year-old woman came to the emergency department complaining of severe shortness of breath, cough, and chest pain. She said she had been feeling ill for 3 months and had lost 20 pounds as a result. When questioned about her travel history, she said she had immigrated to the United States from India when she was 10 and had since taken several trips back there to visit family members. A chest X ray was done, and lesions in one of her lungs were consistent with pulmonary tuberculosis, a lung infection caused by Mycobacterium tuberculosis. The patient’s cough was not productive (meaning it was dry), so physicians sampled material from her lower respiratory tract using bronchoalveolar lavage (BAL); this involves delivering sterile saline into the lungs via a long thin tube and then collecting the fluid. The BAL fluid was then sent to the clinical laboratory for examination. There, a technicianinoculated the fluid onto media that support the growth of M. tuberculosis. He also did a nucleic acid amplification test (NAAT) designed to detect M. tuberculosis DNA; the testresult was positive. The patient was prescribed the standard four-drug treatment for tuberculosis disease. After 3 weeks, she reported feeling slightly better, but was still coughing. A month later, the culture results were positive for M. tuberculosis. Antimicrobial susceptibility testing was done, and the infecting strain was found to be resistant to isoniazid (INH) andrifampin (RIF). Two other medications were then substituted, and the local public health office was contacted to provide directly observed therapy (DOT) for the remainder of her treatment.

89.1)

Why was the bronchoalveolar lavage used to obtain a sample from the patient?

A) TB is a lower respiratory tract infection and a sample had to be obtained from that site; the patient had a non-productive cough. B) Tuberculosis is an upper respiratory tract infection but the causative bacteria reside in the lungs; the patient had a dry cough. C) Tuberculosis is an upper respiratory tract infection but the causative viruses reside in the lungs. D) Tuberculosis is an upper respiratory tract infection but the mucociliary escalator prevents physicians from obtaining a sample from that site. E) The bacteria causing tuberculosis are encapsulated and adhere to alveoli; the BAL technique is needed to dislodge them for sampling.

89.2)

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Why did it take a month for the culture results to be obtained in this case?

A) M. tuberculosis is an obligate anaerobe and grows slowly in vitro. B) The technician in the case used the incorrect culture medium. C) M. tuberculosis is an acid-fast organism with a slow generation time. D) M. tuberculosis colonies have to grow to a diameter of 5 cm for identification. E) M. tuberculosis is an intracellular parasite and requires live cells to grow.

89.3) What is the significance that the M tuberculosis strain was resistant to isoniazid and rifampin? A) The patient would have to take the antibiotics for several years to be effectively treated. B) The patient had multidrug-resistant (MDR-TB) and extensively-drug resistant TB (XDR-TB). C) They are first-line drugs used to treat TB; the patient would have to be given more toxic second-line drugs. D) They are second-line drugs used to treat TB; without them, the patient cannot be treated effectively. E) They are the only bactericidal drugs effective against all Mycobacterium tuberculosis strains.

89.4)

Which of the following is not a first-line drug used to treat tuberculosis?

A) Isoniazid (INH)  B) Rifampin (RIF)  C) Penicillin (PEN) D) Pyrazinamide (PZA)  E) Ethambutol (EMB)

89.5)

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Each of the following can lead to bacterial drug resistance EXCEPT

A) a drug being blocked from entering the cell. B) a drug being inactivated by the cell. C) a drug being pumped out of the cell. D) the drug target being altered. E) the drug mutating within the cell.

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Answer Key Test name: Chap 20_10e 1) TRUE 2) TRUE 3) FALSE 4) TRUE 5) TRUE 6) TRUE 7) TRUE 8) TRUE 9) FALSE 10) TRUE 11) FALSE 12) B 13) D 14) D 15) B 16) C 17) A 18) D 19) C 20) C 21) C 22) D 23) B 24) B 25) D 26) A Version 1

27) B 28) C 29) B 30) A 31) C 32) B 33) E 34) B 35) E 36) A 37) E 38) B 39) A 40) C 41) E 42) B 43) E 44) E 45) B 46) A 47) B 48) D 49) B 50) C 51) E 52) E 53) E 54) A 55) E 56) E Version 1

57) B 58) A 59) B 60) D 61) C 62) A 63) D 64) A 65) B 66) D 67) A 68) A 69) B 70) D 71) D 72) D 73) A 74) A 75) C 76) E 77) D 78) A 79) C 80) B 81) C 82) D 83) E 84) A 85) E 86) D Version 1

87) Section Break 87.1) B 87.2) D 87.3) A 87.4) C 87.5) A 87.6) A 88) Section Break 88.1) FALSE 88.2) D 88.3) C 88.4) B 88.5) A 88.6) E 89) Section Break 89.1) A 89.2) C 89.3) C 89.4) C 89.5) E

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CHAPTER 21 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Streptococci are grouped by their cell wall carbohydrates. ⊚ ⊚

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

true false

Rhinoviruses are effectively treated with antibiotics. ⊚ ⊚

true false

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

true false

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

true false

Klebsiella specieseasily acquire and are a source of R pneumococcal pneumonia. ⊚ true ⊚ false

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

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true false

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

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

10)

true false

Histoplasmosis may mimic tuberculosis. ⊚ ⊚

true false

11) Corynebacterium diphtheriae is an invasive, toxin-producing, pleomorphic sporeforming bacterium that aggressively enters tissues and the bloodstream. ⊚ ⊚

12)

true false

Adenoviruses may cause eye infections as well as upper respiratory tract infections. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 13) The process used for identifying the different carbohydrates of streptococci is called

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A) Lancefield grouping. B) CHO typing. C) peptidoglycan typing. D) fermentation testing. E) NAAT typing.

14) Rebecca Lancefield showed that almost all the strains of beta-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. E) had the same cell wall carbohydrate "beta."

15) was

The scientist who developed a system of identifying the variety of strains of streptococci

A) Hans Zimmer. B) Donald Sutherland. C) O. T. Avery. D) Rebecca Lancefield. E) Louis Pasteur.

16) 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) Adenoids D) Epiglottis E) Parotid glands

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17)

The conjuctiva A) have few resident bacteria. B) are often covered with bacteria. C) are populated with S. aureus. D) are populated with S. pyogenes. E) are protected by IgE.

18)

The eyes are protected from infection by A) the washing action of the tears and eyelids AND the use of contact lenses. B) the washing action of the tears and eyelids AND the chemical action of lysozyme. C) the chemical action of lysozymeANDthe use of contact lenses. D) the use of contact lenses AND the dryness of the eye surface. E) the dryness of the eye surface AND the chemical action of lysozyme.

19)

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. E) Staphylococcus aureus—beta-hemolytic, group A.

20)

Which of the following statements about the respiratory system is correct? A) The respiratory system humidifies inhaled air. B) The respiratory system warms and dries inhaled air. C) The respiratory system cools and dries inhaled air. D) The respiratory system cools and humidifies inhaled air. E) The respiratory system warms and humidifies inhaled air.

Version 1

21)

Rapid diagnostic tests for streptococcal infections may use A) blood agar AND the Kirby-Bauer test. B) antibodies AND blood agar. C) DNA probes. D) the Kirby-Bauer test AND DNA probes. E) antibodies AND DNA probes.

22)

Virulence factors used by S. pyogenes include all of the following EXCEPT A) protein F. B) M protein. C) a capsule. D) lipopolysaccharide E) protein G.

23) The disease characterized by the appearance of a toxin-mediated rash that causes the tongue to look like the surface of a ripe strawberry is A) scarlet fever. B) measles. C) chickenpox. D) strep throat. E) pharyngitis.

24)

A bacteriophage is necessary for toxin production in A) E. coli. B) Staphylococcus aureus. C) Corynebacteriumdiphtheriae. D) Streptococcus pneumoniae. E) All of the answer choices are correct.

Version 1

25)

Diphtheria toxin works on A) lysosomes. B) mitochondria. C) chloroplasts. D) elongation factor 2. E) messenger RNA.

26)

Which is used in the vaccination for C. diphtheriae? A) Protein A B) M protein C) Lipopolysaccharide D) Intact bacteria E) Exotoxin

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

28)

Otitis media and sinusitis are usually preceded by a(n) A) middle ear infection. B) pseudomonas infection. C) oropharyngeal infection. D) nasopharyngeal infection. E) gastrointestinal infection.

Version 1

29)

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) upward through the Eustachian tube. D) through the tympanic membrane. E) via the meninges.

30)

Most colds are probably caused by A) rhinovirus. B) S. aureus. C) Pseudomonas sp. D) E. coli. E) varicella.

31)

Rhinoviruses need to be grown A) in living cells AND at 39°C. B) in synthetic media AND at 39°C. C) on blood agar AND at 33°C. D) in live animals or plants. E) in living cells AND at 33°C.

32)

The rhinovirus contains A) single-stranded RNA and is an enveloped virus. B) double-stranded RNA and is an enveloped virus. C) single-stranded RNA and is a non-enveloped virus. D) double-stranded RNA and is a non-enveloped virus. E) single-stranded RNA and is a retrovirus.

Version 1

33)

The reservoir of the common cold is the A) family pet. B) human. C) infected fomite. D) fruit. E) rhinovirus.

34)

A vaccine for the common cold is not possible because A) the surface antigens of rhinovirus mutate frequently. B) there are more than 100 types of rhinovirus. C) the causative agent of colds is unknown. D) the rhinovirus cannot be grown in sufficient quantities. E) rhinoviruses are resistant.

35)

Colds are effectively treated with A) antibiotics. B) aspirin and acetaminophen. C) proteases. D) nucleotide analogs. E) None of the choices is correct.

36) Effective preventive methods for avoiding the common cold include all of the following EXCEPT A) hand washing. B) avoiding crowds. C) not touching one's face. D) avoiding close contact with people with colds. E) prophylactic antibiotics.

Version 1

37)

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

38)

Adenoviral pharyngitis is effectively treated with A) antibiotics. B) lysozyme. C) proteases. D) nucleotide analogs. E) None of the choices is correct.

39)

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 E) Influenza and tuberculosis

40) by

About 60% of the bacterial pneumonias that require hospitalization of adults are caused

Version 1

A) S. pyogenes. B) S. pneumoniae. C) S. aureus. D) K. pneumoniae. E) M. pneumoniae.

41)

The characteristic virulence factor of S. pneumoniae is A) a capsule. B) flagella. C) pili. D) cilia. E) A-B toxin.

42)

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. E) All of the answer choices are correct.

43)

The pneumococcal vaccine is directed against the A) flagella. B) pili. C) cilia. D) capsule. E) A-B toxin.

44)

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

Version 1

A) Pili B) Flagella C) Capsules D) Cilia E) Toxins

45) The causative agent of the pneumonia that results in 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. E) M. pneumoniae.

46)

The virulence of Klebsiella is due partly to the A) motility of the organism AND exotoxin produced. B) structure and organization of flagella. C) structure of their pili AND exotoxin produced. D) antiphagocytic properties of their capsules. E) exotoxin produced AND antiphagocytic properties of their capsules.

47)

The resistance of Klebsiella to antibiotics may be A) chromosomal mediated AND lysosomal mediated. B) plasmid mediated ANDlysosomal mediated. C) chromosomal mediated AND plasmid mediated. D) lysosomal mediated AND capsule mediated. E) capsule mediated AND plasmid mediated.

48)

Mycoplasmal and Klebsiella pneumonias

Version 1

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.

49)

The spread of mycoplasma is through A) inhalation of infected droplets. B) the fecal-oral route. C) an insect vector. D) a fomite such as a towel. E) opportunistic normal microbiota.

50)

Which is/are true of the causative agents of coccidioidomycosis and histoplasmosis? A) They are both photosynthetic soil fungi. B) They are both dimorphic parasitic fungi. C) They both cause life-threatening illnesses. D) They both cause diseases that may be treated with antibiotics. E) They are both dimorphic soil fungi.

51)

Which antibiotics may be completely ineffective in treating a mycoplasmal infection? A) Penicillin AND tetracycline B) Penicillin AND cephalosporin C) Tetracycline AND cephalosporin D) Cephalosporin AND erythromycin E) Erythromycin AND tetracycline

52)

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

Version 1

A) productive. B) contagious. C) infective. D) paroxysmal. E) catastrophic.

53)

The causative agent of whooping cough is A) parvovirus. B) M. pneumoniae. C) B. pertussis. D) S. aureus. E) W. pertussis.

54)

Which is FALSEabout pertussis toxin? A) It uses part B to attach to receptors on the host cell. B) It uses part A to inactivate G protein. C) It affects the level of cAMP in a cell. D) It affects the level of mucus secretion. E) It uses part Ato attach to receptors on the host cell.

55) by

Although unusually resistant to many control factors, the tubercle bacillus is easily killed

A) strong acids. B) disinfectants. C) pasteurization. D) strong alkalis. E) All of the answer choices are correct.

56)

The resistance of the tubercle bacillus to various factors is probably due to its

Version 1

A) cell wall. B) capsule. C) larger ribosomes. D) ability to adhere tightly.

57)

The virulence of the tubercle bacillus is due to its A) toxin. B) lysogenicconversion. C) resistance to antibiotics. D) survival within macrophages. E) lysogenicconversion AND resistance to antibiotics.

58)

The destructive nature of tuberculosis can be characterized as a(n) A) endotoxin pyrogenic response. B) delayed-type cell-mediated hypersensitivity reaction. C) immune complex reaction. D) inflammatory response. E) inflammatory pyogenic response.

59)

Influenza is caused by A) orthomyxovirus. B) H. influenzae. C) cytomegalovirus. D) adenovirus. E) coronavirus.

60)

Projecting from the outer envelope of the influenza virus are two glycoproteins called

Version 1

A) leukocidin and hemolysin. B) hyaluronidase and coagulase. C) hemagglutinin and neuraminidase. D) lysozyme and coagulase. E) coagulase and gp160.

61)

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.

62)

Which is true of hantavirus? A) It is a zoonosis involving mice. B) It has threesegments of single-stranded RNA. C) The primary effect is to flood the lungs with fluid. D) Shock and death occur in 30% of the cases. E) All of the choices are correct.

63)

Two relatively widespread North American lung mycoses are A) candidiasis and coccidioidomycosis. B) candidiasis and aspergillosis. C) aspergillosis and Reyes syndrome. D) coccidioidomycosis and histoplasmosis. E) None of the choices is correct.

Version 1

64) What is the most likely reason why smokers are more at risk for respiratory system infections? A) Cigarette smoke iscarcinogenic (cancer-causing), leading to a much higher incidence of lungcancer. B) They aren't; this is just a rumor used to get people to stop smoking. C) Smokers takeinmicrobes from their hands into their lungs as they handle cigarettesand inhale the smoke. D) Tobacco contains viruses that are inhaled when a person smokes; these cause respiratory infections. E) Chemicals incigarette smoke can impair the mucociliary escalator, preventing naturalcleansing of the respiratory tract.

65)

How are pleurisy and pneumonia are different?

A) Pleurisy is inflammation of the lungs (not necessarily due to a microbe), while pneumonia is microbial infection of the linings that surround the lungs. B) Pneumonia is active microbial infection of the lungs, while pleurisy is inflammation of the linings that surround the lungs (not necessarily due to a microbe). C) Pleurisy is caused by viruses (single-stranded or double-stranded RNA), while pneumonia is caused by bacteria (Gram-positive only). D) Pneumonia is caused by viruses (single-stranded or double-stranded DNA), while pleurisy is caused by bacteria (Gram-negative or Gram-positive). E) Pneumonia is always a fatal infection and cannot be easily treated while pleurisy is not—treatment of this condition is by antiviral medications.

66) Why would it be reasonable to treat strep throat but not diphtheria with antibacterial antibiotics?

Version 1

A) The signs and symptoms of diphtheria are mostly caused by the exotoxin produced by the causative agent. An antibiotic won't affect the exotoxin. B) The signs and symptoms of strep throat are mostly from the exotoxin produced by the causative agent. An antibiotic effectively eliminates these exotoxins. C) The causative agent of diphtheria is a virus, not a bacterium. The drug would have no effect against this infectious agent. D) There are no antibiotics that have proven effective against the bacterium that causes diphtheria. E) The causative agent of diphtheria is pleomorphic and does not have a cell wall. There are thus no antibiotics that would be effective against this organism.

67)

The best way to speed up recovery from a common cold is

A) to dose the patient withibuprofen to keep the fever down. Reducing fever speeds up recovery. B) to take decongestants as a means of alleviating the symptoms of the cold. C) to take 1,000 mg of vitamin C every day during the illness. Vitamin C destroys cold viruses. D) let theimmune system do its job. Several of the treatments listed may actually increase the recovery time. E) take an antibiotic such as penicillin that will rid the body of the cold virus.

68) If you are a 20-year-old healthy young adult and you have to CHOOSE a type of pneumonia to become infected with (and you will NOT get treatment for it), which would be the "best," and why?

Version 1

A) Pneumococcal pneumonia; the causative agent doesn't destroy lung tissue and it is possible to recover completely from this disease. B) Mycoplasmal pneumonia; this type of pneumoniacauses the the mildest signs and symptoms and can be effectively treated when treated early. C) Viral pneumonia; there are many antiviral medications that can be given for this type of pneumonia and are effective, with very few side effects. D) Klebsiella pneumonia; this is the mildest form of pneumonia, can easily be treated with antibiotics, and has the shortest recovery time. E) Fungal pneumonia; these types of pneumonia are very mild, remain latent, and are easily treated with antifungal medications in the majority of patients.

69)

Why are pneumococcal pneumonia infections so dangerous in nursing homes?

A) There is a vaccine for protecting children against pneumococcal pneumonia but no vaccine available for protection of older adults. B) There is no longer an antibiotic effective against the infection, and older adults are unable to fight the infection without medication. C) This type ofpneumonia causes permanent lung damage, and old people often have impaired lungfunction in the first place. D) The immune system of older people is usually impaired, leaving them predisposed to more serious and potentially life-threatening pneumonia. E) This question is misleading. Pneumococcal infections are not dangerous.

70) Are people infected with M. tuberculosis always highly infectious to everyone around them?

Version 1

A) Yes. The infected person is constantly shedding bacteria to the environment around them in high numbers, facilitating transmission. B) No. While in the early stages of the illness, the infected person does not have the cough required to spread the organism in respiratory droplets very easily. C) Yes. As the mode of transmission of M. tuberculosis is direct contact, anyone or anything the infected person touches can be infected. D) No. TB has a very high infectious dose. In the early stages of the disease, the patients aren't producing enough bacteria in their respiratory secretions to be infectious. E) Yes. Mycobacterium tuberculosis is shed in all body secretions as well as in respiratory droplets, so is very easily spread.

71)

Which is more likely to happen—antigenic DRIFT, or antigenic SHIFT—and why?

A) Antigenic DRIFT, since infection with only a single virus strain is required, and the random mutations happen as the virus replicates in the infected person's cells. B) Antigenic SHIFT, since infection with only a single virus strain is required, and the random mutations happen as the virus replicates in the infected person's cells. C) Antigenic DRIFT, since infection with only a single virus strain is required and random mutations occur more readily in this situation than if two virus strains are present. D) Antigenic SHIFT, since multiple viruses in a cell at once means more RNA polymerase to copy the RNA, and therefore more possibilities for mistakes to be made (leading to mutations). E) Antigenic drift and antigenic shift occur at the same frequency. Genetic change is just as likely to occur if one viral strain or more than one strain is/are present.

72)

Which is more dangerous to human beings: antigenic DRIFT or antigenic SHIFT?

Version 1

A) Antigenic DRIFT, since this produces the quickest and largest degree of changes in the virus structure and we may not have immunity against it. B) Antigenic SHIFT, since this produces the quickest and largest degree of changes in the virus structure and we may not have immunity against it. C) Antigenic DRIFT; the small changes make the virus look like something we already have an immune response in place for, but we actually don't, letting the virus hide from the immune responses for a longer period of time. D) Antigenic SHIFT; the process completely changes the virus, allowing it to jump from one species to another(such as from birds into humans). As such, we have no responses in place for the new virus. E) These are equally dangerous. In both cases, major genetic and phenotypic changes occur in the virus, which means that people have absolutely no immune responses in place for dealing with the infection.

73)

Is antigenic shift alone likely to lead to influenza pandemics?

A) Yes. ONLY antigenic shift can lead to the large-scale mixing of gene elements required to produce a pandemic flu strain. B) Perhaps, but it would most likely be a mixture of antigenic shift AND drift that would result in a pandemic strain. C) No. ONLY antigenic DRIFT can lead to the large-scale mixing of gene elements required to produce a pandemic flu strain. D) No. Antigenic SHIFT is responsible for changes in the hemagglutinin protein, while antigenic DRIFT is responsible for changes in the neuraminidase protein. You need both to lead to a pandemic strain. E) No. Antigenic SHIFT is responsible for changes in the neuraminidase protein, while antigenic DRIFT is responsible for changes in the hemagglutinin protein. You need both to lead to a pandemic strain.

74)

Which of the following indicates bacterial conjunctivitis rather than viral conjunctivitis?

Version 1

A) Increased tear production B) Redness of conjunctiva C) Swelling and pus D) Sensitivity to light E) All of the answer choices are correct.

75)

Which of the following statements about otitis media is FALSE?

A) The causative organisms may form a biofilm, leading to chronic infections. B) It isusually preceded by infections of the nasal cavity and upper pharynx. <!-Markup Copied from Habitat--> C) It maysometimes spread to the membranes covering the brain, causing meningitis.  D) Using decongestants and antihistamines to treat otitis media is generally very effective.  E) Otitis media during the “flu” season can be decreased by giving the flu vaccine to infants in day-care facilities.

76)

Why do some otitis media cases not respond to antibiotic treatment? A) About 30% of cases are caused by respiratory viruses—antibiotics do not help these

cases. B) Most cases are caused by bacteria that are resistant to commonly prescribed antibiotics. C) Otitis media is caused by viruses that constantly undergo antigenic shift and/or antigenic drift. D) The bacterial causative organisms mutate frequently, changing their antibiotic target sites. E) Unless the exact causative organism is identified, it is impossible to prescribe the correct antibiotic.

77)

Which of the following is/are not associated with strep throat?

Version 1

A) Sore throat and fever. B) Patches of pus in the throat. C) Enlarged lymph nodes in the neck. D) Abdominal pain and headache. E) Cough and nasal discharge.

78) How can Streptococcus pyogenesinitially be differentiated from other species that form part of the throat normal microbiotia?

Streptococcus

A) By Gram staining—it is a Gram-positive organism. B) By culturing the bacteria on nutrient agar and checking for hemolysis. C) By morphology—the bacteria are spherical and grow in long chains. D) By detection of the "A" carbohydrate in its cell wall using antibodies. E) By specific disease signs and symptoms, including sore throat and fever.

79)

Which of the following is a virulence factor of Streptococcus pyogenes? A) M protein B) Capsule C) Endotoxin AND pili D) M protein AND pili E) M protein AND capsule

80)

Which of the following interferes with phagocytosis of S. pyogenes? A) Hyaluronic acid capsule B) M protein C) C5a peptidase D) Protein G E) All of the answer choices are correct.

Version 1

81)

Which step(s) of phagocytosis are avoided by Streptococcus pyogenes? A) Recruitment of phagocytes AND phagolysosome formation B) Phototaxis AND recognition and attachment C) Recruitment of phagocytes AND recognition and attachment D) Phagolysosome formation E) Phagolysosome formation AND lysis

82)

Which statement about S. pyogenes and strep throat pathogenesis is FALSE?

A) S. pyogenes strains that produce streptococcal pyrogenic exotoxins are lysogens. B) Streptococcal pyrogenic exotoxins are A-B toxins that bind to host cells using the B portion. C) Streptolysins O and S produced by S. pyogenesdestroy blood cells by making holes in their cell membranes. D) Spread of S. pyogenes is aided by streptokinase, an enzyme that breaks down blot clots. E) The hyaluronic acid capsule of S. pyogenes helps it avoid the innate immune defenses.

83)

Why are there currently no vaccines against Streptococcus pyogenes?

Version 1

A) There are many antigenic types in the M protein of this organism. A vaccine against one type might not protect against another.  B) There isgreat variation in the polysaccharide capsule of this organism. A vaccine against one type might not protect against another. C) Antibodies to streptococcal M protein may also recognize and bind to myosin in the heart, causing autoimmunity and leading to rheumatic fever. <!--Markup Copied from Habitat-> D) There isgreat variation in the M protein of this organism. A vaccine against one M type might not protect against another AND antibodies to streptococcal M protein may also recognize and bind to myosin in the heart, causing autoimmunity and leading to rheumatic fever. E) There isgreat variation in the polysaccharide capsule of this organism. A vaccine against one type might not protect against another AND antibodies to streptococcal M protein may also recognize and bind to myosin in the heart, causing autoimmunity and leading to rheumatic fever.

84)

Which of the following is specifically associated with diphtheria? A) Pseudomembrane in throat B) General malaise C) Fever and sore throat D) Microhemorrhages E) Widespread rash

85)

Select the best description of the causative agent of diphtheria. A) Pleomorphic, Gram-negative lysogen. B) Gram-positive, spore-forming rod. C) Gram-positive, encapsulated, spore-former. D) Pleomorphic, Gram-positive lysogen. E) Pleomorphic, Gram-positive, flagellated lysogen.

86) Which is the causative agent of the upper respiratory tract infection characterized by the formation of a pseudomembrane on the tonsils or in the throat?

Version 1

A) Corynebacterium diphtheriae B) Streptococcus pneumoniae C) Mycobacterium tuberculosis D) Mycoplasma pneumoniae E) Bordetella pertussis

87)

Why are some tissues damaged by diphtheria toxin while others are unaffected by it?

A) Diphtheria toxin is a superantigen. Only T H cells are affected by this type of toxin, so tissues lacking T H cells are unaffected. B) The causative agent is inhaled into the lungs, so only lung tissue is affected by the toxin released by the organism. C) Diphtheria toxin is an A-B toxin. Cells that do not have a receptor for the toxin are unaffected by it. D) The causative agent is ingested, so only gastrointestinal tissue is affected by the toxin released by the organism. E) Diphtheria is a localized infection. Only tissues in the immediate area of the bacteria are affected by the toxin.

88) The signs and symptoms of adenovirus respiratory tract infections may be confused with those of A) pneumonia AND tuberculosis. B) tuberculosis AND diphtheria. C) pertussis AND pneumonia. D) strep throat AND pneumonia. E) strep throat AND pertussis.

89)

How do adenoviruses avoid the adaptive immune system?

Version 1

A) They cloak themselves with a hyaluronic acid capsule. B) They interfere with antigen presentation on MHC class I molecules. C) They synthesize C5a peptidase. D) They block interferon and antiviral protein production. E) They interfere with antigen presentation on MHC class II molecules.

90) Which statement regarding common colds and adenoviral respiratory tract infections is TRUE? A) Fever is a sign of adenoviral respiratory tract infections, but is not a sign for the common cold. B) The incubation period for adenoviral respiratory tract infections is 1–2 days, while that for common colds is 5–10 days. C) Cold viruses arenon-enveloped, double-stranded DNA viruses while adenoviruses arenon-enveloped single-stranded RNA viruses.  D) Cold viruses may cause infections other than respiratory infections while adenoviruses only cause upper respiratory tract infections. E) Adenoviral respiratory tract infections may also be caused by bacteria while the common cold is always caused by a virus of some kind.

91)

Which of the following statements regarding resistance in Klebsiella species is FALSE?

A) β-lactamase confers resistance to β-lactam antibiotics such as penicillin. B) Extended-spectrum β-lactamase (ESBL) confers resistance to many of the cephalosporins. C) Carbapenemase confers resistance to carbapenems as well as other β-lactam drugs. D) There are few effective treatments available forcarbapenem-resistant K. pneumoniae infections. E) Strains of Klebsiella that produce β-lactamase are resistant to penicillin but will respond to all cephalosporins.

92) Which of the following does NOT explain why a patient with Klebsiella pneumonia is more likely to die than one with pneumococcal pneumonia? Version 1

A) Treatment options for Klebsiella pneumonia are limited because the causative agent is resistant to many antibiotics. Pneumococcal pneumonia can be treated with antibiotics such as penicillin. B) The causative agent of Klebsiella pneumonia is Gram-negative and may cause septic shock. Streptococcus pneumoniae is a Gram-positive bacterium so does not have endotoxin. C) The most severe types of Pneumococcal pneumonia can be prevented with the PPSV23 vaccine. There is no vaccine that protects against Klebsiella pneumonia. D) Klebsiella pneumoniae causes lung abscesses which may result in the death of the patient. Pneumococcal pneumonia does not result in permanent lung damage. E) All of the choices explain why Klebsiella pneumonia is more frequently fatal than pneumococcal pneumonia.

93)

Why is Legionella pneumophila detected using immunofluorescence? A) It is a virus. B) It stains poorly with conventional dyes. C) It is Gram-non-reactive. D) It is an acid-fast bacterium. E) It lacks a peptidoglycan cell wall.

94)

How does Legionella pneumophila survive adverse conditions? A) It forms endospores when in dry or hot environments. B) It produces cysts. C) It is acid-fast and resists dehydration. D) It survives in protozoa that can withstand adverse conditions. E) It is an intracellular parasite in fish.

95) Why did it take so long to understand that L. pneumophila is the cause of a respiratory tract infection?

Version 1

A) It stains poorly and is difficult to detect. B) It has fastidious growth requirements and is difficult to culture. C) It is extremely rare in nature and is seldom present in a population. D) It has fastidious growth requirements and is difficult to culture AND it stains poorly and is difficult to detect. E) It is extremely small and can only be detected using electron microscopy AND it is extremely rare in nature and is seldom present in a population.

96)

Why is legionellosis not treated withβ-lactam medications?

A) The causative organism producesβ-lactamases, so is resistant to many of these medications. B) The medicationmust be able to accumulate within alveolar macrophages to be effective, which β-lactam antibiotics do poorly. C) The causative organism producesβ-lactamases, so is resistant to many of these medications AND the causative organism is acid-fast, so has mycolic acids and waxes in the cell wall thatβ-lactams cannot penetrate. D) The causative organism is acid-fast, so has mycolic acids and waxes in the cell wall thatβ-lactams cannot penetrate AND the causative organism produces endospores so is highly resistant to these medications. E) The medicationmust be able to accumulate within alveolar macrophages to be effective, which β-lactam antibiotics do poorly AND the causative organism producesβlactamases, so is resistant to many of these medications.

97)

Which of the following about Bacillus anthracis is TRUE? A) It contains lipopolysaccharide. B) It is flagellated. C) It is rod-shaped. D) It stains pink in the Gram stain. E) It causes hemolysis on blood agar.

Version 1

98) Which of the following proteins produced by B. anthracis function together to kill phagocytes? A) Local factor, protective antigen, AND edema factor. B) Lethal factor, protective antigen, AND edema factor. C) Local factor, protective antibody, AND edema factor. D) Lethal factor, protective antigen, AND endotoxin. E) Lethal factor, protective antibody, AND endotoxin.

99)

In which disease are monoclonal antibodies against PA protein used as treatment? A) Inhalation anthrax B) Legionellosis C) Pertussis D) Pneumococcal pneumonia E) Influenza

100)

Which of the following most accurately describes the pathogenesis of inhalation anthrax?

A) EF binds to host cell membranes, forming a pore that allows PA or LF to enter the cells, where they disrupt critical cell functions. This triggersa series of events that cause death of the cell resulting in pulmonary edema. B) PA binds to host cell membranes, forming a pore that allows EF or LF to enter the cells, where they disrupt critical cell functions. This triggersa series of events that cause death of the cell resulting in pulmonary edema.  C) LF binds to host cell membranes, forming a pore that allows EF or PA to enter the cells, where they disrupt critical cell functions. This triggersa series of events that cause death of the cell resulting in pulmonary edema. D) PA and EF bind to host cell membranes, forming a pore that allows LF to enter the cells, where they disrupt critical cell functions. This triggersa series of events that cause death of the cell resulting in pulmonary edema. E) EF and LF bind to host cell membranes, forming a pore that allows PA to enter the cells, where it disrupts critical cell functions. This triggersa series of events that cause death of the cell resulting in pulmonary edema.

Version 1

101) Inhaled air passes through the following structures in which order? i. Lung ii. Trachea iii. Pharynx iv. Bronchi v. Larynx A) iii; v; ii; iv; i B) i; ii; iii; iv; v C) i; ii; v; iii; iv D) iii; iv; v; ii; i E) v; i; iv; iii; ii

102) Your patient is a heavy smoker. He comes to see you, complaining that he has this third respiratory infection in six months. What do you tell him? A) Smoking impairs the movement of the cilia in his mucociliary escalator, reducing the movement of mucus and increasing his likelihood of infection. B) Smoking impairs the movement of his epiglottis, causing dangerous swelling and increasing his likelihood of infection. C) Smoking impairs the movement of the microvilli in his mucociliary escalator, reducing the movement of mucus and increasing his likelihood of infection. D) Smoking prevents the cilia of the mucociliary escalator from destroying any trapped microbes, facilitating their entry into the lungs. E) Smoking causes swelling of the tonsils and adenoids, impairing their function and increasing his likelihood of infection.

103)

Why can antigenic shifts cause pandemics?

Version 1

A) Antigenic shifts can lead to extreme changes in the HA and/or NA spikes, leading to pandemics because those viruses can enter different types of body cells. B) Antigenic shifts can lead to the generation of novel flu viruses by genetic reassortment, leading to pandemics because no one is immune to the new virus. C) With antigenic shift, repeated mutations cause a gradual change in the HA and/or NA spikes, so that antibodies against the virus become much less effective.  D) Antigenic shifts can lead to the generation of novel flu viruses by genetic reassortment, leading to pandemics because those viruses can enter different body cells. E) Antigenic shifts actually cause minor changes in flu viruses and do not cause pandemics; antigenic drifts lead to global pandemics.

104)

What are antigenic shift and antigenic drift?

A) Antigenic shift is a deliberate repositioning of viral spikes on the capsid while antigenic drift is a random respositioning of the spikes on the capsid. B) Antigenic drift is a dramatic change in viral HA and NA antigens over time while antigenic shift is a minor change in those same antigens. C) Antigenic drift results in minor changes in a virus, and is responsible for seasonal epidemics; antigenic shift results in major changes and can cause outbreaks. D) Antigenic shift is caused by mutations in genes coding for viral spikes; antigenic drift is caused by genetic reassortment in the virus genome. E) Antigenic drift results in major changes in a virus, and is responsible for seasonal influenza; antigenic shift results in minor changes and can cause pandemic influenza.

105)

All of the following are true regarding COVD-19, SARS and MERS except

A) signs and symptoms include fever, muscle aches, cough and eventual respiratory distress or pneumonia.  B) the causative agents are all zoonotic in origin. C) the causative viruses are spread by respiratory droplets during close person-to-person contact.  D) certain underlying conditions predispose people to severe disease. E) these diseases can be effectively prevented by vaccination.

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106)

Please select the INCORRECT statement regarding COVID-19, SARS and MERS. A) All three diseases are zoonoses, caused by viruses that appear to have originated in

bats. B) The causative viruses are enveloped, single-stranded RNA viruses with characteristic spikes that resemble a crown.  C) Handwashing, disinfection and social distancing are effective in preventing spread of these diseases. D) COVID-19 may be spread by asymptomatic people whileSARS and MERS are generally transmitted only by people with severe symptoms. <!--Markup Copied from Habitat-> E) The intermediate host for SARS-CoV and SARS-CoV-2 is likely camels while that for MERS-CoV is civet cats.

107) A patient comes to the emergency department complaining of fever, fatigue, muscle aches and severe shortness of breath. Within hours he is seriously ill and he dies within a few days. In questioning his family, you discover that he had recently cleared a mouse colony out of his shed. Based on this information and his symptoms, you suspect he died from A) COVID-19 B) Hantavirus pulmonary syndrome C) Respiratory syncytial virus infection  D) Severe acute respiratory syndrome  E) Middle East respiratory syndrome

108) All of the statements about Pneumoncystis pneumonia and its causative agent are true EXCEPT

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A) It is a common opportunistic infection in AIDS patients who are not receiving preventive care. B) Mature P. jiroveciicysts are likely involved in transmission of the disease. C) Activated alveolar macrophages are critical for clearance of P. jirovecii from the lungs. D) Prevention involvesprophylactic antibioticss for certain immunosuppressed or immunodeficient patients.  E) PCP is caused by an anaerobic, endospore-forming Gram-positive bacterium.

109)

Which of the following is NOT caused by coronaviruses? A) COVID-19 B) Severe acute respiratory syndrome C) Middle East respiratory syndrome D) Common colds E) Respiratory syncytial virus infection

110)

Why is Legionella pneumophila detected using immunofluorescence? A) It stains poorly with conventional dyes. B) It is Gram-non-reactive. C) It is an acid-fast bacterium. D) It lacks a peptidoglycan cell wall. E) It is a virus.

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SECTION BREAK. Answer all the part questions. 111) You are an RN working in the emergency department (ED) at a major hospital in New York City. During one shift, you see two patients who are exhibiting coughing with bloodcontaining sputum, and shortness of breath. Both patients report that they have experiencedheadaches, muscle aches, high fever, confusion, and shaking chills in the days preceding their ED visit. One of the patientsalso has some digestive tract symptoms including diarrhea, abdominal pain, and vomiting. You discover that the patients live in the same apartment building, although they do not know each other. You suspect that they have a type of pneumonia, and given the circumstances, think it may be legionellosis. You read up on this disease to refresh your memory about it.

111.1)

Which of the following is the causative agent of legionellosis?

A) Legionella pneumophila, a fastidious Gram-negative rod. B) Legionella pneumophila, an aerobic, Gram-positive rod. C) Mycoplasma legionella, a pleomorphic, poorly staining coccus. D) Acanthamoeba legionella, an acid-fast, anaerobic spirillum. E) Acanthamoeba species,a freshwater protozoan.

111.2) L. pneumophila was unrecognized as the causative agent of legionellosis for a long time. Why is this? A) L. pneumophila both stains poorly with common methods, and is difficult to culture in the laboratory. B) The organism is fastidious and is difficult to culture in the laboratory. C) L. pneumophila stains poorly with common methods, so is difficult to detect. D) L. pneumophila has no surface antigens and thus cannot be stained with fluorescence. E) There is no way to grow L. pneumophila in vitro; this organism can only be cultivated in cell cultures or viruses.

111.3) L. pneumophila is a facultative intracellular parasite. How does it manipulate the immune system so as to enter host cells?

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A) The bacterial cells bind complement component C3b (an opsonin), enhancing phagocytosis.  B) The bacteria have macrophage invasion potentiator (Mip) that promotes their uptake by alveolar macrophages.  C) The bacteria cause necrosis of alveolar cells, leading to an inflammatory response. D) The bacteria survive in alveolar macrophages by preventing phagosome-lysosome fusionAND the bacteria cause necrosis of alveolar cells, leading to an inflammatory response. E) The bacterial cells bind complement component C3b (an opsonin), enhancing phagocytosis AND the bacteria have a surface protein (Mip) that promotes their uptake by alveolar macrophages.

111.4)

Which of the following is/are a reservoir(s) for L. pneumophila?

A) Insects such as mosquitoes. B) Freshwater streams AND cooling towers. C) Animals AND animal urine. D) Marine environments AND insect vectors. E) Humans only.

111.5)

Select the FALSE statement regarding legionellosis and its causative agent.

A) The causative organism survives well in the water systems of buildings, particularly in hot water systems, where chlorine levels are generally low.  B) People become infected with L. pneumophila when they inhale aerosol droplets contaminated with the organism. It is not acquired from other infected individuals. C) L. pneumophila produces a β-lactamase, which makes it resistant to many penicillins and some cephalosporins, sois typically treated with a macrolide or a fluoroquinolone. D) Legionella pneumophila is an obligate intracellular parasite that survives in ameba in the environment and in kupffer cellsin infected people. E) L. pneumophila prevents phagosome-lysosome fusion in phagocytes, thus avoiding destruction; the bacteria manipulate conditions to multiply within these cells.

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111.6)

What is the likely source of the L. pneumophila in this case?

A) The cooling water tower providing feeding airconditioners in the patient's offices. B) The showers or faucets at the local gym where both patients regularly worked out. C) The produce section at the grocery store where vegetables are sprayed with water for freshness. D) The water tank in the patient's building that provides hot water to apartments. E) Further investigation by an agency such as the CDC would be needed to determine this.

112) Your son comes home from school complaining that he is ill. He tells you he thinks he has the flu—he hasa sore throat, runny nose, and a cough, and his eyes are very red. Everyone in your family received a influenza vaccine about a month ago, and as the CDC reports that this year's vaccine is approximately 70% effective, you think it is unlikely that your son does in fact have this disease. In addition, your son does not seem to have muscle aches or a headache, which generally occur with flu. Nonetheless, he does look ill and when you take his temperature, you find that he has a fever of 38.9oC. You take him to see his doctor, because you suspect that while your son likely doesnot have influenza, healso does not havea common cold.

112.1) The doctor knows that your son is unlikely to have a common cold, based on which sign/symptom? A) Sore throat B) Fever C) Cough D) Runny nose E) Fatigue

112.2) The doctor checks your son's throat and notes that he has hasgray-white pus on the pharynx and tonsils. He also has enlarged lymph nodes in his neck. This suggests to the doctor that your son has the bacterial infection ______, which he attempts to confirm by ______.

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A) strep throat;doing arapid antigen detection test (RADT) and throat culture. B) pneumococcal pneumonia;doing arapid antigen detection test (RADT) and throat culture. C) mycoplasmal pneumonia; performing a mantoux skin test and doing a throat culture. D) legionellosis; performing a mantoux skin test and a chest x ray. E) tuberculosis; doing a throat culture and rapid TB skin test.

112.3) TheRADT and throat culture are both negative for Streptococcus pyogenes, the causative agent of strep throat. The doctor tells you that your son likely has an adenoviral respiratory tract infection.Adenoviruses are resistant to destruction by detergents and alcohol solutions. This indicates that these viruses A) are double-stranded RNA viruses. B) are non-enveloped viruses. C) are enveloped viruses. D) are endospore-formers. E) are also resistant to multiple antibiotics.

112.4) You ask the doctor whether there is a vacccine that your children can be given to prevent further adenoviral infections. He tells you A) that there is no need for a vaccine because your son can be treated with antibiotics AND that adenovirus infections can be avoided by handwashing. B) there is a vaccine against two adenovirus serotypes but this is only given to military recruits AND that adenovirus infections can mostly be avoided by handwashing. C) there is a vaccine against two adenovirus serotypes but this is only given to healthcare personnel BUT that adenovirus infections are easily treated with antibiotics. D) it is not possible to generate vaccines against any double-stranded DNA viruses AND that adenovirus infections can be avoided by handwashing. E) it is not possible to synthesize vaccines for preventing diseases caused by RNA viruses BUT that adenovirus infections can be prevented with prophylactic antibiotics.

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113) Your patient is a college student who is complaining of a severe sore throat. She tells you that she had been previouslydiagnosed with strep throat just 2 years ago, but had not felt particularly ill at that time and had recovered without problem. You give the student a rapid strep test (RST), swabbing the back of her throat and usinga kit to immediately determine whether Streptococcus pyogenes, the causative agent of strep throat, is present. The test is negative. You tell the student that you will send the throat swab away for culture and will have a definitive answer for her soon. Meanwhile, you sendher home with a prescription for an antibiotic, but tell her not to fill it until she hearsback from you. A day later, you have the culture results: the sample had been plated on blood agar and colonies showing clear zones ofβ -hemolysis have grown. These are conclusively identified asS. pyogenes. You callthe student and tell her that she does indeed have strep throat and to begin taking the antibiotic immediately.

113.1) If the student had strep throat within the last 2 years, how can she get it again? Why isn't she immune? A) Her adaptive immune system was weakened the first time she had the disease and she cannot fight it the second time. B) The causative organism exhibitis variation in the M protein antigen, which means that a person can get strep throat more than once.  <!-Markup Copied from Habitat--> C) Her innate immune system was weakened the first time she had the disease and she cannot fight it the second time. D) The causative organism has a polysaccharide capsule; the immune system cannot generate a response to capsule material. E) Strep throat can be caused by several different pathogens; this illness may be caused by a different organism from the first time.

113.2) The rapid strep test was negative but the culture test was positive. How can you explain this result?

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A) Rapid strep tests never work; you just gave it to the student to make her feel better. B) The rapid strep test is not as sensitive as bacterial culture, and the result is a false negative. C) The student doesn't actually have strep throat; β-hemolysis shows the culture result is a false positive. D) The strep test won't work because she took an antibiotic the last time she had strep throat. E) There is no rational explanation for this observation.

113.3)

Which would be the most appropriate antibiotic for the student?

A) Penicillin - S. pyogenes is still sensitive to this antibiotic. B) Vancomycin - S. pyogenes is resistant to all penicillins. C) Tetracycline - S. pyogenes does not have a peptidoglycan cell wall. D) Amphotericin B - S. pyogenes is a fungal pathogen. E) Penicillin AND tetracycline - S. pyogenes exhibits mutidrug resistance.

113.4) You tell the student not to take the antibiotic until you have the culture results. Why is this? A) If the culture result is also negative, the student likely does not have step throat and you do not want her to take an antibiotic unnecessarily. B) The culture result will determine whether the student is allergic to penicillin; if she is, she cannot take this antibiotic. C) Penicillin is very toxic; you want the student to take it for as few days as possible so she does not react badly to the drug. D) You want the infection to develop to a stage that all the bacteria have likely stopped multiplying so that the medication has maximum effectiveness. E) If the student does not actually have strep throat but takes penicillin, she will become resistant to that antibiotic.

113.5) Once the strep infection has been confirmed, you tell the student to start taking the antibiotic immediately. Why is this?

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A) Although strep throat itself is not a very serious disease, it can lead to poststreptococcal sequelae or other complications; treating with antibiotics may lessen the chance of these complications.  B) Although strep throat itself is not a very serious disease, it can take several months to resolve; treating with antibiotics may lessen the time for the student to recover. C) The longer the student has the disease, the more likely it is that the causative organism will become resistant to all antibiotics used for treatment. D) Strep throat is a very serious disease, and typically leads to post-streptococcal sequelae or other complications; treating with antibiotics may reduce the likelihood of these complications. E) Strep throat is a very serious disease; untreated, it always develops into pneumonia with a very high fatality rate; treating with antibiotics will reduce the chance of this happening.

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Answer Key Test name: Chap 21_10e 1) TRUE 2) TRUE 3) TRUE 4) FALSE 5) TRUE 6) TRUE 7) TRUE 8) TRUE 9) FALSE 10) TRUE 11) FALSE 12) TRUE 13) A 14) B 15) D 16) C 17) A 18) B 19) B 20) E 21) E 22) D 23) A 24) C 25) D 26) E Version 1

27) B 28) D 29) C 30) A 31) E 32) C 33) B 34) B 35) E 36) E 37) A 38) E 39) C 40) B 41) A 42) B 43) D 44) C 45) B 46) D 47) C 48) E 49) A 50) E 51) B 52) D 53) C 54) E 55) C 56) A Version 1

57) D 58) B 59) A 60) C 61) A 62) E 63) D 64) E 65) B 66) A 67) D 68) B 69) D 70) B 71) A 72) B 73) B 74) C 75) D 76) A 77) E 78) D 79) E 80) A 81) C 82) B 83) D 84) A 85) D 86) A Version 1

87) C 88) D 89) B 90) A 91) E 92) C 93) B 94) D 95) D 96) E 97) C 98) B 99) A 100) B 101) A 102) A 103) B 104) C 105) E 106) E 107) B 108) E 109) E 110) A 111) Section Break 111.1) A 111.2) A 111.3) E 111.4) B 111.5) D Version 1

111.6) E 112) Section Break 112.1) B 112.2) A 112.3) B 112.4) B 113) Section Break 113.1) B 113.2) B 113.3) A 113.4) A 113.5) A

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CHAPTER 22 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Coagulase-positive S. aureus is often involved in disease. ⊚ ⊚

true false

Varicella is a member of the herpes family of viruses and produces a latent infection. ⊚ true ⊚ false

Humans are the only reservoir for varicella-zoster virus. ⊚ ⊚

Complications of measles may include pneumonia and encephalitis. ⊚ ⊚

true false

Chickenpox and measles are both acquired by the respiratory route. ⊚ ⊚

true false

The MMR vaccine is used to protect against measles, mange, and rubella. ⊚ true ⊚ false

Diseases caused by fungi are called mycoses. ⊚ ⊚

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true false

The skin-invading molds are collectively called dermatophytes. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 9) The Rickettsial disease that killed Howard Ricketts and Stanislaus Prowazek was A) louse-borne typhus. B) tick-borne typhus. C) yellow fever. D) bubonic plague. E) unidentified.

10)

Which of the following is an important function of the skin? A) Hold muscle to bone B) Manufacture blood cells C) Produce antibodies D) Control body temperature E) All of the answer choices are correct.

11)

Which of the following is considered a function of the skin? A) Regulation of body temperature B) Prevention of fluid loss C) Synthesis of vitamin D D) Production ofcytokines E) All of the choices are correct.

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12)

The surface layer of the skin is the A) cutaneous. B) keratin. C) epidermis. D) dermis. E) hypodermis.

13)

The oily secretion that lubricates the hair follicles of the skin is A) sebum. B) eczema. C) suder. D) acnus. E) mucus.

14)

The secretions of the sweat and sebaceous glands provide ______ to the microbiota. A) water B) amino acids OR water C) lipids AND amino acids D) water AND lipids E) sebum OR amino acids

15)

The antimicrobial aspect(s) of the skin is/are A) dryness. B) saltiness. C) acidity. D) toxicity. E) All of the choices are correct.

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16)

Which of the following organisms is not normally found on the skin? A) Staphylococci B) Diphtheroids C) E. coli D) Malassezia species E) Staphylococci AND diphtheroids

17)

Which of the following is NOT true about diphtheroids? A) Theyare part of the normal microbiota of the skin. B) They are responsible for body odor. C) Theyinclude Cutibacteriumacnes. D) Theyinclude Malassezia species. E) These are all true.

18)

Which of the following normal skin microbiota is a small yeast? A) Staphylococci B) Malassezia species C) Diphtheroids D) Candida species E) Cutibacterium species

19)

In many people, the growth of C. acnes within hair follicles leads to A) eczema. B) carbuncles. C) boils. D) acne. E) All of the choices are correct.

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20)

The principal species of Staphylococcus found on the skin is A) aureus. B) acnes. C) epidermidis. D) pyogenes. E) saprophyticus.

21) The bacteria that appear to maintain balance between the members of the normal microbiota and play a vital role in limiting colonization by pathogens are A) staphylococci. B) diphtheroids. C) Candida spp. D) Malassezia spp. E) streptococci.

22) Which of the following may be added to normal media to make it more selective for staphylococci? A) 7.5% salt B) 0.5% HCl C) 1.0% glucose D) 5.0% mannose E) 1.0% glucose AND 0.5% HCl

23) The member of the normal microbiota sometimes considered responsible for tinea versicolor is

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A) Staphylococcus species. B) diphtheroids. C) Candidaspecies. D) Malasseziaspecies. E) Streptococcus species.

24)

Which is considered the most serious staphylococcal skin infection? A) Tinea versicolor B) Carbuncles C) Folliculitis D) Furuncles E) Acne

25)

A protein associated with a more virulent form of Staphylococcus is A) leukocidin. B) coagulase. C) mannose. D) streptokinase. E) catalase.

26)

The protein produced by S. aureus that interferes with phagocytosis is A) M protein. B) collagen. C) protein A. D) capsular protein. E) flagellin.

27)

The preferred habitat of S. aureus is the

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A) nasal chamber. B) throat. C) urethra. D) bladder. E) meninges.

28)

Which of the following is a fairly reliable method of characterizing strains of S. aureus? A) Complement fixation B) Protein fingerprint C) Genome typing D) LPS pattern E) All of the choices are correct.

29)

Which of the following may aid Staphylococcus in resisting phagocytosis? A) Leukocidin B) Hemolysin C) Granulation enzyme D) Coagulase E) Lipase

30) Which of the following virulence factors used by Staphylococcus puts holes in host cells? A) Protein A B) Alpha toxin C) Leukocidin D) Clumping factor E) Membrane attack complex

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31)

S. aureus clumping factor A) causes fibrinogen to clump together. B) causes bacteria to clump together in plasma. C) reacts with prothrombin. D) produces staphylothrombin. E) causes phagocytes to clump bacteria.

32)

The S. aureus product that causes scalded skin syndrome is A) exfoliation toxin. B) lipases. C) leukocidins. D) protein M. E) peeling toxin.

33)

Which is true of MRSA strains? A) They are all resistant to vancomycin. B) They carry the R plasmid AND they are all resistant to vancomycin. C) They may be susceptible to linezolid. D) The carry the R plasmid AND they may be susceptible to linezolid. E) The carry the F plasmid AND they may be susceptible to linezolid.

34)

A frequent complication of scalded skin syndrome is A) a bacterial secondary infection. B) secondary viral infections. C) dehydration. D) dehydration and a secondary bacterial infection. E) toxemia.

35)

In addition to S. aureus, impetigo may also involve

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A) M. luteus. B) S. pyogenes. C) S. epidermidis. D) Pseudomonas species. E) Cutibacterium species.

36)

In S. pyogenes, which of the following interferes with phagocytosis? A) M protein B) Protein A C) Collagen D) Pilin E) Peptidoglycan

37) In which of the following does a rash start on the palms and soles and progress toward the trunk? A) Epidemic typhus B) Typhoid C) Measles D) Impetigo E) Rocky Mountain spotted fever

38) The mainvector(s) of Rocky Mountain spotted fever in the western United States is/are ______. A) ticks  B) bats AND humans C) humans D) mosquitoes AND ticks E) fleas AND mites

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39)

Rocky Mountain spotted fever is an example of a(n) A) animalosis. B) tickonosis. C) plantonosis. D) zoonosis. E) aviosis.

40)

After being bitten by an infected tick, transfer of the rickettsial organism occurs A) within 4–10 hours. B) within 20 minutes. C) within 5 minutes. D) immediately. E) after 7 days.

41)

Which of the following is an obligate intracellular parasite? A) Micrococcusluteus B) Streptococcuspyogenes C) Rickettsia rickettsii D) Pseudomonasaeruginosa E) Staphylococcus epidermidis

42) Many childhood diseases caused by viral infections of the upper respiratory tract can usually be diagnosed by A) inspection of the rash. B) the type of cough. C) the type of fever. D) the incubation period. E) the gender of the patient.

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43)

A common viral rash of childhood with the popular name chickenpox is also known as A) bariola. B) rubella. C) rubeola. D) varicella-zoster. E) salmonella.

44)

The varicella-zoster virus is a member of which virus family? A) Paramyxoviridae B) Herpesviridae C) Togaviridae D) Papillomaviridae E) Retroviridae

45)

Reactivation of chickenpox is called A) shingles. B) herpes zoster. C) pneumonia. D) exanthems. E) shingles AND herpes zoster.

46) The childhood disease that damages the body defenses and is frequently complicated by secondary infections involving mostly Gram-positive cocci is A) German measles. B) measles. C) mumps. D) chickenpox. E) shingles.

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47)

The rubeola virus contains A) single-stranded DNA. B) double-stranded DNA. C) single-stranded RNA. D) double-stranded RNA. E) single-stranded RNA OR double-stranded RNA.

48)

Rubella, rubeola, and varicella-zoster are all only acquired via A) the gastrointestinal route. B) the respiratory route. C) wounds. D) blood transfusions. E) arthropods.

49)

An important diagnostic sign of measles is A) Koplik's spots. B) giant cells. C) fever. D) swollen lymph nodes. E) red, weepy eyes.

50)

The MMR vaccine is used to protect against A) mononucleosis, mange, rubeola. B) measles, mumps, rubella. C) measles, mange, rubeola. D) mononucleosis, mumps, rubella. E) mumps, rubella, varicella.

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51)

The most serious consequence of rubella is A) encephalitis. B) birth defects. C) meningitis. D) deafness. E) subacute sclerosing panencephalitis.

52)

Rubella is a member of which virus family? A) Paramyxoviridae B) Herpesviridae C) Togaviridae D) Papovaviridae E) Retroviridae

53)

Warts are caused by A) papillomaviruses. B) parvovirus. C) adenoviruses. D) herpes virus. E) coronavirus.

54)

Whichgenus does not includeskin-invading molds? A) Epidermophyton. B) Microsporum. C) Trichophyton. D) Ixodes. E) These are all skin molds.

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55) Who would have larger numbers of bacteria living on the surface of their skin—a person living in the tropics or in the desert, and why? A) The tropics would provide more shade, so the surface of the skin wouldn't be exposed to high levels of ultraviolet radiation. This would protect the bacteria on the skin, and they would have higher numbers due to this shading effect. B) The very low humidity of the desert would lead to rapid evaporation of sweat and sebum from an individual's skin. Bacteria need these secretions for a nutrient source. Without them, bacteria would be found in much lower numbers on the skin of a person in the desert than the skin of the person in the tropics. C) The constant secretion of high amounts of sweat would produce a highly salty environment on the skin of a person in the tropics. This would provide a local environment that would be too hostile for microbes to survive, so the number of microbes on the skin of the person in the tropics would be lower than that of the person in the desert. D) The constant secretion of large amounts of sweat would wash bacteria off of the skin of the person in the tropics. As such, the person in the desert should have much more bacteria on their skin than the person in the tropics would. E) The very high humidity of the desert would lead to slow evaporation of sweat and sebum from a person's skin. Bacteria thrive on these secretions, using them for a nutrient source. Thus bacteria would be found in much higher numbers on the skin of a person in the desert than the skin of the person in the tropics.

56) The existence of extensive scalded skin syndrome does not indicate that Staphylococcus is growing in all the affected areas. Why not? A) This condition iscaused by an exotoxin produced by certain strains of this microbe, and NOTdirectly by the microbe itself. B) This condition iscaused by an endotoxin produced by certain strains of this microbe, and NOTdirectly by the microbe itself. C) This conditionisn't caused by Staphylococcus at all. D) This microbe grows in the blood; endotoxins it releases are transported to the skin, where it causes the observed effect. E) Scalded skin occurs when a person eats exfoliatin-contaminated food, not by an infection.

57)

Why is the immunization for rubella important for both boys and girls?

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A) As this is a sexually-transmitted disease, vaccinating girls AND boys early in their lives prevents the spread of the disease in adulthood. B) We want to achieve herd immunity, and there's no reason why only girls would be infected by this virus. By vaccinating the entire population, we achieve a higher degree of herd immunity than is possible by vaccinating only girls. C) Only boys get this disease, and one of the common complications of it is sterility, so they should be vaccinated against this virus. D) While this disease is quite very symptomatic in girls, it is completely asymptomatic in boys. Boys can be carriers and transmit it easily to girlswithout realizing it. This can lead to large-scale and dangerous outbreaks in the female population. E) Although boys get this disease, it doesn't cause any health problems for them, so they do not need vaccination. If girls get the disease, it almost always leads to encephalitis, so they should be protected by vaccination.

58)

What is the epidemiological significance of shingles?

A) It shows that, asa latent viral infection, there is always a possible reservoir available toreinfect new susceptible individuals. B) It shows that wemust always be vigilant against this deadly and highly infectious secondaryinfection in elderly and immunocompromised individuals. C) It shows that, asa chronic viral infection, individuals infected are always infectious to othersaround them, even when they do not show outward symptoms. D) It shows that our fight for long-term eradication of varicella zoster virus will be a long one, depending on immunizing all newly born individuals until all the people who had ever had contracted the illness have died. E) It shows that, as a latent viral infection, there is always a possible reservoir available to reinfect new susceptible individuals AND it shows that our fight for long-term eradication of varicella zoster virus will be a long one, depending on immunizing all newly born individuals until all the people who had ever contracted the illness have died.

59) A public health official was asked to speak about immunizations during a civic group lunch. One parent asked if rubella was still a problem. In answering the question, the official cautioned women planning to have another child to have their present children immunized against rubella. Why did the official make this statement to the group?

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A) Rubella is spread very easily by respiratory secretions and is largely asymptomatic. However, it can cause birth defects/stillbirth in pregnant women. Women with other children would want to prevent these childrenfrom acquiring the virus before attempting toconceive a new child in order to protect the fetus. B) Rubella is passedvery easily between children, so the official was trying to protect the childthat would soon be born from this infection that might be brought in by itssiblings after it was born. C) The official isgetting kickbacks and bribes from the companies making the vaccines, and he'strying to pad his pockets by getting as many people immunized as possible,regardless of whether they need it or not. D) Rubella infections often lead to very serious and potentially fatal complications. While a woman is pregnant, she may not be able to take care of a sick child as easily. The vaccine will prevent the child already in the family from falling ill and potentially dying due to these possible complications. E) All of the answer choices are correct.

60)

Which S. aureus virulence factor is not correctly matched with its function? A) Capsule—avoiding phagocytosis. B) Hyaluronidase—facilitates spread in tissues. C) Protein A—interferes with opsonization. D) α-Toxin—makes holes in host cell membranes. E) Leukocidin—kills erythrocytes.

61)

How does protein A help Staphylococcus aureus evade phagocytes?

A) It binds the Fc portion of antibodies, interfering with opsonizaton and phagocytosis. B) It binds the Fab portion of antibodies, interfering with opsonizaton and phagocytosis. C) It coats the bacterial cell, destroying LPS and preventing recognition by phagocytes. D) It makes holes in the cytoplasmic membrane of phagocytes, killing them. E) It degrades complement protein C5a, preventing phagocyte recruitment and attachment.

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62)

How does coagulase help Staphylococcus aureus evade phagocytes?

A) It coats the surface of the bacterial cells with collagen, a tissue binding protein. B) It coats the surface of bacterial cells with fibrin, a protein found in blood. C) It causes formation of small clots in capillaries, slowing progress of phagocytes to the infected area. D) It causes formation of small clots in capillaries, slowing progress of phagocytes to the infected area AND it coats the surface of bacterial cells with fibrin, a protein found in blood. E) It causes formation of small clots in capillaries, slowing progress of phagocytes to the infected area AND it coats the surface of the bacterial cells with collagen, a tissue binding protein.

63)

Which statement regarding Staphyloccocus aureus is FALSE?

A) MRSA strains that can be traced to hospitals and clinics are referred to as HAMRSA (hospital-acquired MRSA).  B) CA-MRSA strains have a group of genes that codes for a leukocyte-destroying leukocidin.  C) Evidence proves that CA-MRSA strains are morevirulentthan HA-MRSA because they produce leukocidin.

64)

Why is staphylococcal scalded skin syndrome sometimes fatal?

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A) The first line of defense is compromised, putting the patient at risk secondary bacterial infection. B) The first line of defense is compromised, putting the patient at risk of both dehydration and secondary bacterial infection. C) The causative organism is Gram-negative and may cause endotoxic shock. D) Exfoliatin can bind to cardiac cells, causing disruption of the heart rhythm and heart failure. E) The first line of defense is compromised, putting the patient at risk of severe dehydration.

65)

Please select the TRUE statement regarding impetigo.

A) Signs and symptoms of impetigo result from inflammation in the keratinized outer epidermal layer.  B) The causative organism of impetigo is Cutibacterium acnes. C) Patients with impetigo experience fever, pain, and malaise. D) Impetigo is an example of a pyoderma—a superficial skin disease characterized by pus production. E) Treatment of impetigo requires administering at least two different antibiotics.

66) Which of the signs and symptoms of Rocky Mountain spotted fever is not typical of other diseases that manifest in a similar way? A) Fever B) Muscle pain C) Headache D) Joint pain E) Rash

67)

Which of the following statements regarding S. aureus and S. pyogenes is FALSE?

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A) S. aureus appears as clusters of spherical cells while S. pyogenes appears as chains of spherical cells. B) S. aureus stains purple with the Gram stain while S. pyogenes stains pink with this procedure. C) S. aureus is catalase positive and coagulase positive while S. pyogenes is catalase negative and coagulase negative. D) The Fc receptor of S. aureus is protein A while the Fc receptor of S. pyogenes is protein G. E) S. aureus is a facultative anaerobe while S. pyogenes is an obligate fermenter.

68)

Why is Rickettsia rickettsii difficult to grow in culture? A) It is a double-stranded DNA virus. B) It is an obligate intracellular parasite. C) It is resistant to multiple antibiotics. D) It is an obligate anaerobe. E) It is Gram-negative.

69)

Which of the following is not involved in the pathogenesis of RMSF?

A) The pathogen releases an A-B toxin that attaches to receptors on T H cell cytoplasmic membranes, leading to destruction of those cells. B) Endotoxin released into the bloodstream from the rickettsial cell walls results in systemic inflammation.  C) Disseminated intravascular coagulation that leads to organ damage may occur following release of endotoxin into the bloodstream. D) Host cells rupture following damage caused by bacterial cells propelling themselves from one cell to another. E) Vasculitisleads to clotting and small areas of necrosis, causing a hemorrhagic skin rash and damaging tissue in the brain, heart, kidneys, and other organs.

70)

The vector for RMSF is a(n)

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A) mosquito. B) flea. C) tick. D) fly. E) deer.

71)

Rickettsia rickettsii is an obligate intracellular pathogen. This means that A) it is a virus. B) it needs oxygen for growth. C) it cannot grow in the presence of oxygen. D) it is non-motile. E) it can only grow within host cells.

72)

The portal of entry of Bacillus anthracis is the A) respiratory tract. B) epidermis. C) gastrointestinal tract. D) epidermis OR gastrointestinal tract. E) respiratory tract,epidermis, OR gastrointestinal tract.

73)

What is eschar (a sign of cutaneous anthrax)? A) A small, red, fluid-filled vesicle B) An ulcer surrounded by swelling C) A large black scar D) Dead tissue resembling a flat scab  E) Swelling with trapped gas

74)

Which description of vegetative Bacillus anthracis is correct?

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A) It is an endospore-forming, Gram-positive, motile, rod-shaped bacterium. <!-Markup Copied from Habitat--> B) It is an endospore-forming, Gram-negative, non-motile, rod-shaped bacterium. C) It is a Gram-positive, non-motile, spherical, encapsulated bacterium. D) It is a Gram-positive, non-motile, encapsulated, spore-forming, rod-shaped bacterium. E) It is an acid-fast, non-motile, spherical, nonspore-forming, encapsulated bacterium.

75) Why does the rash of shingles occur in only a limited region, as opposed to the widespread rash of chickenpox? A) In chickenpox, the replicating virus originates from multiple infected nerve cells, while in shingles it is limited to the bloodstream. B) In shingles, the replicating virus originates from a single infected nerve cell, while in chickenpox it is spread throughout the bloodstream.  C) In chickenpox, the virus spreads through the bloodstream to all parts of the body, while in shingles, the virus remains in the chest area after inhalation. D) The chickenpox virus is a double-stranded DNA virus that is able to infect any nucleated cells, while the shingles virus is a single-stranded RNA virus that only infects epidermal cells. E) This question is misleading because the rash of both chickenpox and shingles is widespread throughout the body.

76)

The portal(s) of entry for varicella-zoster virus is/are A) the skin. B) the respiratory tract. C) the genitourinary tract. D) the genitourinary tract AND the gastrointestinal tract. E) the skin AND the respiratory tract.

77) If an individual in the infectious stage of chickenpox comes into contact with a person who had chickenpox as a child, that second person

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A) will be unaffected by the contact. B) will develop a second case of chickenpox. C) will develop shingles. D) will develop a second case of chickenpox OR will develop shingles. E) will remain healthy if they receive zoster immune globulin.

78) Why is it important to give the MMRV vaccine tohealthy, non-immune contacts of people with immunodeficiencies?  A) The MMRV vaccine is a toxoid vaccine, so immunodeficient people cannot receive it. They are protected by herd immunity. B) The MMRV vaccine is an attenuated vaccine, so immunodeficient people cannot receive it. They are protected by antibodies from their close contacts. C) The MMRV vaccine is an attenuated vaccine, so immunodeficient people cannot receive it. They are protected by herd immunity. D) The MMRV vaccine is an inactivated vaccine, so immunodeficient people cannot receive it. They are protected by antibodies from their close contacts. E) The MMRV vaccine is an inactivated vaccine, so immunodeficient people cannot receive it. They are protected by herd trending.

79) If an immunodeficient person is exposed to VZV and belongs to a non-immune population, how can that person be protected from developing chickenpox? A) They can be passively immunized with zoster hyperimmune globulin. B) They can be actively immunized with the MMRV vaccine. C) They can be passively immunized with the MMRV vaccine. D) They can not be protected at all—they will get the disease. E) They can be given prophylactic antibiotics.

80)

Why are secondary infections a common complication of measles?

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A) The causative agent damages the keratinized epidermal layer. B) The causative agent severely suppresses the immune system. C) Phagocytes are killed by the causative agent of measles. D) The causative agent damages the respiratory mucous membranes. E) The causative agent prevents B cells from producing protective antigens.

81) Why is it important to continue vaccinating children in the United States against measles, even though it is now a rare disease in the Western Hemisphere?  A) A rare complication of measles is subacute sclerosing panencephalitis (SSPE) that is characterized by progressive brain degeneration, and generally results in death within 2 years.  B) Measles that occurs during pregnancy increases the risk of miscarriage, premature labor, and low-birth-weight babies. C) Occasionally,the measles virus causes viral pneumonia, with rapid breathing, shortness of breath, and dusky skin color from lack of adequate O 2 in the blood. D) Encephalitis is a rare but serious complication of measles that sometimes results in permanent brain damage, with mental disability, deafness, and epilepsy.  E) All of the complications are reasons that the measles vaccine should be continued in the United States.

82)

Why would a non-immune pregnant woman not be given the MMRV vaccine?

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A) The adjuvant of the MMRV vaccine is highly toxic and damaging to a developing fetus. B) Babies of women vaccinated during pregnancy frequently develop the complication of pneumonia. C) The MMRV vaccine is attenuated, and a pregnant woman is at great risk of developing a reaction to it. D) This is an attenuated vaccine, so there is a slight risk that her fetus might develop congenital rubella syndrome. E) The MMRV vaccine always affects stem fetal cells, causing severe and lifethreatening birth defects.

83)

Does rubella always lead to congenital rubella syndrome? A) Yes. Rubella virus can infect and damage every cell type in a developing fetus at any

time. B) No. The risk of developing CRS decreases as the pregnancy progresses and the fetus develops. C) No. Some fetuses have a well developed adaptive immune response that prevents them from developing CRS. D) No. All fetuses have a well developed innate immune response that prevents them from producing damaging antibodies. E) Yes. No matter when a woman is infected during her pregnancy, the rubella virus will cross the placenta and destroy the fetus.

84)

All of the following disease examples are correctly matched with a lesion type EXCEPT A) macules - acne B) petechiae - Rocky mountain spotted fever C) vesicles - chickenpox D) bullae - impetigo E) papules - warts

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85) Your patient is in his late teens. He has large, painful, pus-filled lesions on his back. You can see scars where some of these have previously burst and healed. You diagnose him with _______, caused by _______ and prescribe _______, which reduces sebum production. A) acne vulgaris; Cutebacterium acnes; isotretinoin B) acne vulgaris; Cutebacterium acnes; topical agents containing salicylic acid C) impetigo; Cutebacterium acnes; topical agents containing salicylic acid D) scalded skin syndrome; Staphylococcus aureus; vancomycin E) cutaneous anthrax; Staphylococcus aureus; penicillin

86)

Which of the following best describes the pathogenesis of acne?

A) Bacterial lipases break down sebum, producing fatty acids and glycerol that fuel bacterial growth; microbial products cause tissue-damaging inflammation and pus formation. <!-Markup Copied from Habitat--> B) Exfoliatin is carried by the bloodstream to the epidermis, where it causes the outer layer to blister and peel; loss of body fluid and secondary infections contribute to mortality. <!-Markup Copied from Habitat-->  C) Organisms multiply at site of a tick bite, invade the bloodstream, and then infect endothelial cells; blood vessel involvement and systemic inflammatory response damage tissues.  D) Vegetative cells produce antiphagocytic capsuleandthree proteins; these assemble to become toxins that inhibit immune function and cause cell death, resulting in tissue damage. <!-Markup Copied from Habitat--> E) Causative agent enters respiratory tract, replicates in lymph nodes, spreads via bloodstream to the skin and forms lesions; infected cells fuse, swell, and then lyse.

87) A patient has enlarged lymph in her neck nodes but no fever. Lesions on her face are filled with fluid; some have broken and are covered with yellowish crusts. A sample from one of the lesions reveals spherical, Gram-positive bacteria. The patient has

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A) bullous impetigo. B) chickenpox. C) Rocky mountain spotted fever. D) non-bullous impetigo. E) roseola.

88)

Impetigo A) is also called bacterial comodones. B) may be bullous or non-bullous. C) is treated with vancomycin. D) is characterized by peeling skin. E) is a tick-borne disease.

89) All of the following must be cultivated in cell cultures instead of cell-free media EXCEPT  A) Rickettsia rickettsii. B) Candida albicans. C) Varicella zoster virus. D) Rubeola virus. E) Rubeola virus.

90)

Which superficial cutaneous mycosis is incorrectly matched? A) Tineatinea capitis - scalp  B) Tinea barbae - beard C) Tinea axillaris - abdomen D) Tinea cruris - groin E) Tinea pedis - feet

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91)

What is adermatophytid or "id" reaction?

A) A fine rash that develops distant from a dermatophyte-infected area as a result of an allergic reaction to fungal products..  B) The scientific and medical classification of a pathogenic dermatophyte involved in ringworm and athlete's foot. C) A macropapular rash that develops when pathogenic fungi produce an enzyme called keratinase that degrades the skin.  D) A type of dermatitis that infants may develop if left in wet diapers for prolonged periods. E) Theitching, bad odor, and scaly facial rash that develop in people who are exposed to Malassezia furfur .

92)

All of the statements about tinea versicolor are true EXCEPT

A) most patients developa severe rash with pus-filled pimples; internal organs may also be impacted.  B) it is caused by the generally harmless and commonly found Malassezia furfuron the skin . C) it is characterized by increased pigment in light-skinned people, or decreased pigment in dark-skinned people.  D) the causative organism is dimorphic, growing in both yeast and hyphal form. E) diagnosis can be made by scraping discolored skin patches and doing a microscopic examination.

93) You patient is complaining of scaly, light-colored patches on his skin. They are especially noticeable on his back. You take a skin scraping from one of the patches and examine it under the microscope. You note both yeast forms and also hyphae. You suspect that the patient has _______, caused by _______.

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A) tinea versicolor; Malassezia furfur B) tinea versicolor; Candida albicans C) tinea pedis; Malassezia furfur D) dermatophytid; Epidermophyton species E) ringworm; Microsporum gypseum

94)

Identify the skin disease shown in figure.

Medical-on-Line/ Mediscan/Alamy Stock Photo A) Tinea versicolor B) Varicella zoster C) Scalded skin syndrome D) Non-bullous impetigo E) Nodular acne

95) Which of the following are treatments for warts? i. Surgical removal ii. Freezing iii. Narrow-spectrum antibiotics iv. Amphotericin B v. Cauterization vi. Broad-spectrum antibiotics A) i; ii; v B) iii; iv; v C) ii; iv; vi D) i; ii; iii; iv; v E) iii; iv; vi

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96)

All of the following are true about warts EXCEPT A) they are caused by papilloma viruses; more than 100 of these infect humans. B) they are tumors called papillomas and are generally benign. C) the causative agent is an enveloped, double-stranded DNA virus. D) they can be effecively treated by killing the abnormal cells. E) they are called plantar warts if they grow on the underside of the foot.

97)

Which is the best description of a wart? A) Benign, virus-induced tumor. B) Bacterial skin infection. C) Deep tissue fungal infection. D) Malignant, virus-induced tumor. E) Toxin-induced exfoliation.

SECTION BREAK. Answer all the part questions. 98) A young mother brings her three-month old baby into the doctor's office where you work as an RN. The baby is miserable and the mother reports that he has developed afever, which is why she has brought him to the doctor. She tells you that the child is particularly upset when she changes his diaper and that he seems to have diaper rash, which she attributes to the fact that her son's diaper isn't always changed promptly enough at the day-care facility he goes to daily. In fact, she has recently switched him to another facility. You remove the child's diaper and immediately see that he has a very red rash on his buttocks and genital area. There is also red, scaly skin in the area where his diaper touches his thighs. You suspect that this may be more than just a typical case of diaper rash.

98.1) You send a skin scraping to the hospital lab for analysis. The report comes back indicating the presence of unicellular organisms that stained with calcofluor white stain, which binds to chitin. This organism is thus a ______, which is a ______ organism.

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A) virus; parasitic B) bacterium; prokaryotic C) protozoan; eukaryotic D) fungus; eukaryotic E) protozoan; multicellular

98.2) Diaper rash (dermititis) can be caused by a number of factors. A common microbial cause is the fungus ______. A) Malassezia furfur B) Candida albicans C) Microsporum gypseum D) Cutibacterium acnes E) Streptococcus pyogenes

98.3) In the laboratory, rubella virus, VZV, rubeola virus and Rickettsia rickettsii must be cultivated in host cells. Candida albicans does not need to be cultured in cells— why? A) Candida albicans is not an obligate intracellular parasite. B) This fungus is an aquatic organism that requires fresh water for culture. C) Candida species are yeasts and require a medium such as bread for culture. D) Candida albicans is an obligate intracellular parasite. E) Yeasts are autotrophs and are thus able to grow independent of other organisms.

98.4)

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The mother asks you whether her child needs penicillin. You tell her

A) yes—diaper rash is a serious infection, and should be treated promptly with this antibiotic. B) yes—penicillin interrupts protein synthesis, so will kill any type of cell, including a fungus. C) no—penicillin targets peptidoglycan synthesis, but C. albicans is a fungus, so has a chitin cell wall. D) no—penicillin is no longer an effective antibiotic for treating any type of infection. A different antibiotic is needed. E) no—killing C. albicans with an antibiotic increases the risk of endotoxic shock.

98.5) Your patient comments that she has noticed the same signs and symptoms on her grandmother who has Alzheimer's diasese and who uses adult diapers. She asks you whether it is possible that her grandmother also has a Candida infection. You tell her A) No. Candida is part of the skin normal microbiota of infants only. This organism is never present on the skin of older adults. B) Yes. Candida is present among the skin normal microbiota and may cause infection in anyone who wears a diaper, regardless of age. C) No. Older adults have an exceptionally strong immune system and so are unlikely to develop a fungal skin infection. D) Yes. The older an individual gets, the more Candida cells accumulate on their skin, so it is only a matter of time before the person develops a skin infection. E) No. Older adults have extremely oily skin. Sebum (skin oil) has natural antifungal properties, so the chances of an adult developing a fungal infection are very small.

99) You are studying for your NCLEX exams with a group of friends. Each of you presents a case study to the other students in your group. Your friend Sue gives the following information in her case study: the patient is a child, who presents with a high fever (41oC) and a rash.The parents report that three days prior to the onset of the rash, the child had a runny nose, diarrhea, and conjunctivitis, all of which they thought indicated influenza. The childhas not received any of the common recommended vaccines because until recently, he had been receiving chemotherapy for acute lymphoblastic leukemia that was diagnosed at 9 months.

99.1)

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The signs and symptoms of the patient suggest that he has

A) rubella. B) rubeola. C) varicella. D) shingles. E) candidiasis.

99.2) The rubeola virus damages the respiratory mucous membranes of an infected person, putting them at risk of  A) secondary bacterial infections such as pneumonia and otitis media. B) primary bacterial infections such as pneumonia and otitis media. C) type I hypersensitivities such as asthma and anaphylaxis. D) autoimmune disease such as leukocyte adhesion deficiency. E) All of the answer choices are correct.

99.3) In rare cases,the rubeola virus leads to rapid breathing, shortness of breath, and dusky skin color; these are signs and symptoms of  A) viral meningitis. B) otitis media. C) strep throat. D) viral pneumonia. E) subacute sclerosing panencephalitis.

99.4)

Confirmation of the rubeola diagnosis can by made by

A) measuring the intensity of the rash. B) presence of rubella antibodies in the blood. C) detecting Koplik spots on the oral mucosa. D) detecting rubeola viruses using a Gram stain. E) treating the patient with antibiotics.

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99.5) Rubeola can be effectively prevented with the MMR vaccine. The child in this case has not received any vaccines, because he has been receiving chemotherapy. Why wasn't he given the MMR vaccine? A) It is an attenuated vaccine and there is a small risk that the virus used in it may revert to virulence, causing serious illness in the immunocompromised patient. B) It is an inactivated vaccine and there is a small risk that the virus used in it may revert to virulence, causing serious illness in the immunocompromised patient. C) The MMR vaccine is known to cause complications such as autism, and this child already has enough problems with leukemia. D) It is a toxoid vaccine—these vaccines contain deactivated microbial toxins; since the child is severely immunocompromised, the toxin used in the vaccine will damage all of his cells. E) The patient is a child, so will not be able to tolerate any egg proteins that may be present in the MMR vaccine, which is produced in eggs.

100) Your sister has had her first baby, a little boy called Sipho. At six months, the baby is thriving— he is feeding well and gaining weight, sleeps through the night and has started to crawl. Your sister calls one day and tells you she is worried about Sipho. He is irritable, won't eat, and has a fever; his skin is also very red. You immediately suspect staphylococcal scalded skin syndrome (SSSS) and tell your sister to take Sipho to the hospital as soon as possible. There, the little boy is indeed diagnosed with SSSS.

100.1) All of the following are signs and symptoms of staphylococcal scalded skin syndrome EXCEPT A) fluid-filled blisters. B) Koplik spots. C) fever. D) irritability and malaise. E) painful nose, mouth and genitalia.

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100.2) As the disease progresses, Sipho's skin blisters and the outer layer peels. Your sister asks how a bacterium can cause this; she thought that skin bacteria were all good bacteria. You explain thatmost skin bacteria are indeed harmless; however,SSSS is caused by certain A) toxin-producing strains of the bacterium Staphylococcus aureus. B) toxin-producing strains of the bacterium Staphylococcus epidermidis. C) toxin-producing strains of the fungus Candida albicans. D) strains of the virus varicella zoster. E) toxin-producing strains of the bacterium Streptococcus pyogenes.

100.3) Sipho is put into the pediatric intensive care unit (PICU) and monitored carefully. The pediatrician tells you and your sister Sipho is at risk of A) dehydration and secondary bacterial skin infections. B) fungal pneumonia and meningitis. C) viral pneumonia and glomerulonephritis. D) dessication and secondary bacterial skin infections. E) skin loss and permanent scarring.

100.4)

He has these risks because

A) his first line of defense is compromised. B) his complement system is compromised. C) he is an infant so has no adaptive immunity at all. D) he is an infant so has no innate immunity at all. E) SSSS results in the complete loss of both dermis and epidermis.

100.5) Sipho is treated and recovers fully. Which of the following would most likely be included in his treatment?

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A) Debridement, antibiotics and rehydration. B) Debridement, antibiotics and skin grafts. C) Amputation, antiviral medications and skin grafts. D) Amputation, antibiotics and skin grafts. E) Amputation, mechanical ventilation and skin grafts.

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Answer Key Test name: Chap 22_10e 1) TRUE 2) TRUE 3) TRUE 4) TRUE 5) TRUE 6) FALSE 7) TRUE 8) TRUE 9) A 10) D 11) E 12) C 13) A 14) D 15) E 16) C 17) D 18) B 19) D 20) C 21) A 22) A 23) D 24) B 25) B 26) C Version 1

27) A 28) C 29) D 30) B 31) B 32) A 33) D 34) D 35) B 36) A 37) E 38) A 39) D 40) A 41) C 42) A 43) D 44) B 45) E 46) B 47) C 48) B 49) A 50) B 51) B 52) C 53) A 54) D 55) B 56) A Version 1

57) B 58) E 59) A 60) E 61) A 62) D 63) C 64) B 65) D 66) E 67) B 68) B 69) A 70) C 71) E 72) E 73) D 74) D 75) B 76) E 77) A 78) C 79) A 80) D 81) E 82) D 83) B 84) A 85) A 86) A Version 1

87) D 88) B 89) B 90) C 91) A 92) A 93) A 94) A 95) A 96) C 97) A 98) Section Break 98.1) D 98.2) B 98.3) A 98.4) C 98.5) B 99) Section Break 99.1) B 99.2) A 99.3) D 99.4) C 99.5) A 100) Section Break 100.1) B 100.2) A 100.3) A 100.4) A 100.5) A

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CHAPTER 23 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) An abscess is a collection of pus. ⊚ ⊚

true false

2) Clumping factor, coagulase, and protein A serve to coat Staphylococcus with host proteins. ⊚ true ⊚ false

Staphylococci are the leading cause of wound infections. ⊚ ⊚

true false

All staphylococci are coagulase positive. ⊚ true ⊚ false

5) Both Staphylococcus aureus and Streptococcus pyogenes have fibronectin-binding proteins. ⊚ ⊚

true false

6) Individuals who have recovered from tetanus are not immune to the disease and must be immunized. ⊚ ⊚

true false

"Flesh-eating" Streptococcus pyogenes is considered a newly emerging disease.

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⊚ ⊚

Tetanus antitoxin can cross the placenta. ⊚ ⊚

true false

Streptobacillus moniliformis is unusual in that it spontaneously forms L-forms. ⊚ ⊚

10)

true false

Bites by little children typically cause few problems. ⊚ ⊚

true false

11) Clostridium tetani is a highly invasive pathogen that causes tetanus, characterized by spastic paralysis. ⊚ ⊚

true false

CHECK ALL THE APPLY. Choose all options that best completes the statement or answers the question. 12) How is it possible for S. epidermidis to form a biofilm on devices such as indwelling catheters or artificial joints? A) It can bind to fibrinogen and fibronectin that coat these devices. B) It is encapsulated and can form a slime layer on such devices. C) It can bind to slime that coats these devices. D) It can bind to collagen and peptidoglycan that coat these devices. E) It produces pili that allow it to attach to these devices. F) It can produce a slime layer after initial attachment, critical to biofilm formation.

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MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 13) The normal habitat of Clostridium tetani is A) humans. B) animals. C) plants. D) soil and dust. E) dairy products.

14)

The researcher who did much of the early work on Clostridium tetani was A) von Behring. B) Koch. C) Kitasato. D) Pasteur. E) Clouseau.

15)

Wound healing can be slowed by the presence of A) normal microbiota. B) foreign matter. C) antiseptic ointments. D) sweat. E) sweat AND normal microbiota.

16)

Which of the following does not usually result from a wound infection?

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A) Delayed healing. B) Aerobic conditions. C) Abscess formation. D) Bacterial spread. E) These all result from delayed wound healing.

17)

A wound created by the drag of a knife across skin can be classified as a(n) A) incision. B) puncture. C) laceration. D) contusion. E) abrasion.

18)

The nodular, red, translucent surface material of a healing wound is called A) soluble skin. B) irritated scab. C) granulation tissue. D) abscess. E) collagen.

19)

A localized collection of pus in a wound is termed a(n) A) leukocyte. B) dead tissue. C) granulation mound. D) abscess. E) scab.

20)

Factor(s) not found in abscesses is/are

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A) blood vessels. B) pus. C) dead leukocytes. D) tissue remnants. E) live leukocytes.

21) Which of the following is NOT true? Microorganisms in abscesses often are not killed by antimicrobial agents because A) the microorganisms stop dividing. B) of the high level of oxygenation. C) of the chemical nature of the pus. D) of the lack of blood vessels. E) of innate resistance in the microbes.

22) are

An important feature of many wounds that may lead to more serious problems is that they

A) well aerated. B) relatively anaerobic. C) nutrient rich. D) sterile. E) nutrient rich AND sterile.

23)

The most frequent genus causing wound infections in healthy people is A) Pseudomonas. B) Staphylococcus. C) Pasteurella. D) Rochalimea. E) Escherichia.

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24)

Which of the following are involved in coating Staphylococcus with host proteins? A) clumping factor, leukocidin, AND coagulase B) coagulase AND protein A C) leukocidin AND protein A D) leukocidin AND coagulase E) clumping factor, coagulase, AND protein A

25) Formation of biofilms attached to fibronectin and fibrinogen coating plastic devices like catheters and heart valves is a virulence mechanism of A) Staphylococcus. B) Streptococcus. C) Clostridium. D) Pseudomonas. E) Escherichia.

26)

Which of the following has been associated with flesh-eating disease? A) H. lechter B) P. aeruginosa C) S. aureus D) S. pyogenes E) H. pylori

27)

S. pyogenes associated with invasive disease characteristically have A) leukocidinsANDstreptococcal pyrogenic exotoxin A. B) coagulaseANDstreptococcal pyrogenic exotoxinB. C) coagulase AND streptococcal pyrogenic exotoxin A. D) leukocidins AND streptococcal pyrogenic exotoxin B. E) streptococcal pyrogenic exotoxin A AND streptococcal pyrogenic exotoxin B.

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28) Which of the following produces a greenish pigment that may appear in infected wounds? A) P. aeruginosa B) E. coli C) S. aureus D) S. pyogenes E) E. aerogenes

29) Which of the following virulence factors has been associated with Pseudomonas aeruginosa? A) Endotoxin A B) Exoenzyme S C) Pyogenic exotoxin D) Endoenzyme T E) Exoenzyme P

30) The Gram-negative opportunistic rod that can grow in a wide variety of environments, including disinfectants and soaps, is A) E. coli. B) S. aureus. C) P. aeruginosa. D) S. pyogenes. E) P. vulgaris.

31) A striking feature of Clostridium tetani that differentiates it from other pathogenic species of Clostridium is its ability to

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A) produce a greenish pigment. B) grow in strictly anaerobic conditions. C) grow in strictly aerobic conditions. D) produce endospores. E) form terminally located, spherical spores.

32)

The popular name for tetanus is A) hydrophobia. B) lockjaw. C) whooping cough. D) consumption. E) spasticity.

33)

The exotoxin produced by C. tetani is A) tetanoxin. B) exotetanus. C) endospasmin. D) paraloxin. E) tetanospasmin.

34) The disease that involves the muscles and often manifests itself first with spasms of the jaw muscles is A) tetanus. B) myonecrosis. C) streptobacillarosis.  D) necrotizing fasciitis. E) sporotrichosis.

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35)

Tetanus prevents the release of neurotransmitters from A) muscle cells. B) excitatory neurons. C) tetano cells. D) inhibitory neurons. E) muscle cells AND tetano cells.

36)

Tetanus vaccine contains A) inactivated bacteria. B) inactivated spores. C) live bacteria. D) inactivated tetanospasmin. E) inactivated lipopolysaccharide.

37)

Tetanus antitoxin is A) inactivated toxin. B) antibody against the toxin. C) antibody against the bacteria. D) inactivated bacteria. E) antibody against neurotransmitter.

38)

The toxin implicated in C. perfringens toxicity is A) tetanospasmin. B) exoenzyme S. C) alphatoxin. D) endoenzyme T. E) beta toxin.

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39)

Gas gangrene is so named due to the formation of A) carbon dioxide AND oxygen. B) oxygen AND carbon monoxide. C) hydrogen AND oxygen. D) carbon monoxide AND hydrogen. E) carbon dioxide AND hydrogen.

40)

Effective treatment of gas gangrene primarily involves A) use of an antitoxin. B) use of myonecrosis immune globulins. C) surgical removal of dead and infected tissues. D) vaccination with inactivated toxin. E) use of synergistic antibiotics.

41)

The disease most feared to develop after an animal bite is A) tetanus. B) rabies. C) gas gangrene. D) streptobacillary rat bite fever. E) necrotizing fasciitis.

42) The most common infectious agent acquired from the bite wounds of a number of kinds of animals is

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A) Escherichia coli. B) Pasteurella multocida. C) Bartonella henselae. D) Pseudomonas aeruginosa. E) Staphylococcus aureus.

43)

The infectious agent(s) that may arise in a wound from a human bite is/are A) Escherichia coli. B) Bacteroides species. C) Bartonella henselae. D) Staphylococcus aureus. E) Bacteroides species AND Staphylococcus aureus.

44) The most common cause of chronic lymph node enlargement at a localized body site in young children is A) cat scratch fever. B) rat bite fever. C) dead bat fever. D) mouse itch fever. E) dog scuff fever.

45)

Cat scratch fever is caused by A) Bartonellahenselae. B) Pasteurella multocida. C) Teddis nugentaea. D) Staphylococcus aureus. E) Pseudomonis aeruginosa.

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46)

Rat bite fever, characterized by fever, rash, and muscle aches, is caused by A) Streptobacillus moniliformis. B) Afipia felis. C) Bartonella henselae. D) Pasteurella multocida. E) Pseudomonas aeruginosa.

47)

Streptobacillus moniliformis is unusual in that it A) forms spores. B) forms L-forms. C) is anaerobic. D) has a cell wall. E) is unicellular.

48)

Which of the following has not been associated with human bites? A) Syphilis B) Tuberculosis C) Hepatitis B D) Tetanus E) These have all been associated with human bites.

49)

The fungal disease that may be associated with gardening is A) candidiasis. B) actinomycosis. C) tinea capitis. D) sporotrichosis. E) histoplasmosis.

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50)

Sporotrichosis may result when the infectious agent is introduced into the body by A) lotions. B) scissors. C) thorns. D) animal bites. E) insect bites.

51)

Which is true about protein A, produced by S. aureus? A) It binds to the Fc region of antibody AND it enhances binding ofphagocytes. B) It binds to the Fc region of antibody AND it hides bacteria from phagocytes. C) It hides bacteria from phagocytes AND it digests antibodies. D) It enhances binding of phagocytes AND it digests antigens. E) It binds to the Fab region of antibody AND it hides bacteria from phagocytes.

52)

Which is true of leukocidins? A) They kill neutrophils. B) They are superantigens. C) They make holes in host cell membranes. D) They bind to Fc regions of antibodies. E) They destroy erythrocytes.

53)

Both Staphylococcus aureus and Streptococcus pyogenes A) are rod-shaped. B) have fibronectin-binding proteins. C) cause necrotizing fasciitis. D) have exotoxin A. E) are coagulase positive.

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54)

Early work with Clostridium tetani and Corynebacterium diphtheriae demonstrated A) the importance of thoroughly cooking food. B) the potential threat from spore-forming bacteria. C) the usefulness of anti-viral medications. D) that disease can be caused by bacterial toxins. E) that all bacteria form spores.

55) What is NOT a reason why an abscessed wound might not respond to antibiotic treatment? A) The bacteria within the abscess have stopped replicating, and many antibiotics require actively replicating cells in order to be effective. B) The blood vessels that would bring the drug to the area have been destroyed or haveclots, preventing the drug from getting to the microbes. C) The chemical composition of the pus in the abscess often inactivates antibiotics, making them ineffective. D) These are all reasons that it might be difficult to treat an abscess. E) The bacteria in an abscess always acquire multi-drug antibiotic resistance, so any drugs that are used will have no effect.

56)

Why is it not surprising that Staphylococci are the leading cause of wound infections?

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A) This genus is readily present as a part of the normal microbiota on most people's skin, so it could easily enter wounds. B) Members of thisgenus are all particularly virulent and highly capable of causing numerousinfections. C) Staphylococci cannot be eradicated from the skin due to multidrug resistance in most members of the genus. Drugs simply don't kill them. D) Staphylococciacquire antibiotic resistance very readily, making them hard to eliminate by pre-surgical antibacterial soaps. As such, they commonly infect surgical wound sites. E) Staphylococci form endospores, so even with appropriate control measures, there is a high risk that spores will enter a wound and cause infection.

57) Would babies need to be immunized against lockjaw (tetanus) if their mother had been immunized against the disease? Why or why not? A) No, because the mother's IgG antibodies would be passed along through the placenta before birth, protecting the baby from the infection. B) Yes, because even though maternal IgG antibodies might be passed along through the placenta, they will not last forever. The baby will need to create its own antibody response to be protected against future tetanus. C) No, because maternal IgG antibodies would be passed along in the breast milk, protecting the baby from infection. D) Yes, because the maternal response to the tetanus vaccine is to produce IgE antibodies, and IgD antibodies are the predominant type in breast milk. Therefore, even if the baby is breast-fed, it won't receive the mother's protective antibodies. E) Yes, because although the mother will make IgG antibodies in response to the vaccine, these antibodies cannot cross the placenta, so the baby is not protected at all.

58) Why might Candida albicans become pathogenic in a person receiving antibacterial medications?

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A) This fungal organism can actually use the destroyed bacterial cells as a nutrient source and begin to multiply out of control. This can cause a pathogenic state. B) This is an opportunistic pathogen not normally found in normal microbiota. As such, when the bacterial normal microbiota is eliminatedby broad-spectrum antibacterial drugs, this opportunist can adhere to and colonize the area left behind. C) This is a usual member of the normal microbiota. However, when the bacterial members of the normal microbiota are killedby a broad-spectrum antibacterial drug, this fungal cell type has little to no competition for resources and it quickly overgrows, causing disease. D) This is a protozoan species and part of the normal microbiota. When the bacterial members of the normal microbiota are wiped out by a broad-spectrum antibacterial drug, this protozoan cell type has little to no competition for resources and can overgrow,causing disease. E) The person's immune system is severely suppressed when they are on antibiotics. This means that the Candida is able to colonize areas normally protected by phagocytes, and can thrive there, causing disease.

59) Rowley Pharmaceutical company produces a drug that promotes new blood vessel growth. Is there any application for this drug in wound treatment? A) It could be very beneficial. One of the biggest problems with wound infections is that they are anaerobic, because the blood supply to the area is usually compromised. Certain pathogenic microbes then thrive in this environment, creating very serious wound infections. B) It would not be beneficial. Part of the reason abscesses lack blood flow is to keep bacteria from spreading to other areas of the body. Increasing blood flow to the area will provide a way for these bacteria to infect other organ systems. C) It could be dangerous. Wounds need to cut off blood supply to prevent the patient from bleeding to death. Increasing blood vessel development in the wound site might cause the patient to bleed out. D) There would be no beneficial effect. The immune response is already in place in the wound site, so increasing blood cell delivery to the area wouldn't increase or decrease the rate of wound healing. E) It would be dangerous. New blood vessels would reduce the anaerobic nature of the wound but it would also always result in massive edema which may lead to permanent loss of function.

60)

How is Staphylococcus aureus distinguished from Staphylococcus epidermidis?

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A) It is Gram-positive. B) It is spherical in shape. C) It is an opportunistic pathogen. D) S. aureus produces coagulase. E) It does not produce coagulase.

61) Why is it not surprising that staphylococci are the most common cause of wound infections? A) Many people carry staphylococci as part of their normal microbiota. B) Staphylococci are resistant to most common disinfectants. C) Unlike other pathogens, the organism evades the immune system very effectively. D) Staphylococci are encapsulated. E) Staphylococci are Gram-negative and contain LPS.

62)

Select the TRUE statement regarding staphylococci and staphylococcal wound infections.

A) Staphylococcus aureus forms biofilms but lacks virulence factors and is not very pathogenic. B) Staphylococcus epidermidis produces several virulence factors, including exotoxins. C) Both HA-MRSA and CA-MRSA are resistant to multiple antibiotics, including sulfa drugs and tetracyclines.  D) Some S. epidermisis strains produce superantigens that activate many helper T cells, causing a cytokine storm. E) S. aureus and S. epidermidis are both coagulase-positive, encapsulated organisms.

63)

Which of the following best describes the causative agent of necrotizing fasciitis?

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A) β-hemolytic, Gram-negative, spore-forming, obligate anaerobe B) β-hemolytic, Gram-positive, chain-forming, aerotolerant anaerobe C) Encapsulated, Gram-negative, chain-forming, facultative aerobe  D) Encapsulated, Gram-negative, spore-forming, facultative aerobe E) Encapsulated, acid-fast, chain-forming, facultative anaerobe

64)

Which of the following help(s) S. pyogenes evade the immune system? A) Hyaluronic acid capsule B) M protein C) G protein D) G protein AND hyaluronic acid capsule E) M protein AND hyaluronic acid capsule

65)

Which statement regarding the pathogenesis of necrotizing fasciitis is INCORRECT?

A) The causative agent produces SPE A, a superantigen that causes helper T cells to release large amounts of cytokines, leading to toxic shock.  B) SPE B is a protease produced by S. pyogenes that causes tissue death and breakdown, leading to fluid accumulation in the area and intense swelling. C) A hyaluronic acid capsule and M protein allow the causative agent to evade the immune responses. D) M protein–fibrinogen complexes causes neutrophils to release inflammatory molecules that increase vascular permeability and lead to a blood pressure drop. E) The causative agent sheds antibodies that attach to fibrinogen and recruit natural killer cells that destroy muscle fascia through ADCC.

66)

Why is debridement and/or amputation often needed to treat necrotizing fascitiis?

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A) These procedures remove the toxins released by the causative organisms. B) These procedures remove infected tissue and thus the source of damaging bacterial toxins. C) S. pyogenes multiplies in dead tissue, using the breakdown products as nutrients. D) These procedures remove infected tissue and thus the source of damaging bacterial toxins AND the procedures remove the source of nutrients for multiplying bacteria. E) These procedures remove the source of nutrients for multiplying bacteria AND these procedures prevent the causative agent from releasing damaging toxins and enzymes.

67) A patient presents with a wound that contains green pus. This suggests to you that the wound is infected with A) S. epidermidis, which produces the water-soluble pigments pyoverdin and pyocyanin. B) S. pyogenes, which produces a water-soluble blue-green capsule. C) P. aeruginosa, which multiplies in photosynthetic biofilms that aregreen. D) P. aeruginosa, which produces the water-soluble pigments pyoverdin and pyocyanin. E) either S. epidermidis or S. aureus, both of which produce pigment soluble coagulase.

68)

Why is it difficult to treat P. aeruginosa wound infections?

A) The organism is resistant to multiple different antibiotics. B) P. aeruginosa forms biofilms, which protect the bacteria. C) The organism is resistant to multiple different antibiotics AND P. aeruginosa forms biofilms, which protect the bacteria. D) The organism is resistant to multiple different antibiotics AND P. aeruginosa forms endospores which are extremely hardy and difficult to destroy. E) P. aeruginosa forms endospores which are extremely hardy and difficult to destroy.

69)

Which virulence factor of P. aeruginosa inhibits host cell protein synthesis?

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A) Exotoxin A B) Exoenzyme S C) Phospholipase C D) Pyoverdin E) Pyocyanin

70)

How may lung damage or pneumonia occur in a person with tetanus? A) Spasms of major chest muscles may be so severe that the lungs are damaged. B) Tetanospasmin is an A-B toxin that binds to lung epithelial cells, killing them. C) C. tetani releases alpha-toxin that causes the alveoli of the lungs to collapse. D) The person may inhale regurgitated (vomited) stomach contents. E) Tetanospasmin causes the release of degradative enzymes in the lungs.

71)

Which statement regarding the treatment of tetanus is FALSE?

A) TIG antibodies bind to circulating toxin molecules, neutralizing their effects and providing passive immunity.  B) TIG neutralizes tetanospasmin that is already attached to nerve tissue, preventing damage to that nerve.   C) An antibacterial medication such as metronidazole is given to kill any actively multiplying bacterial cells.  D) The patient is given muscle relaxants and supportive care, including being placed on a ventilator if needed. E) The person is given tetanus vaccine that results in the production of antitetanospasmin antibodies.

72) Why are signs and symptoms not quickly resolved in a person with tetanus when they are given antibiotics?

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A) Clostridium tetani is an acid-fast organism; it thus has a waxy cell wall that prevents antibiotics from entering the cell. B) Antibiotics will prevent the production of additional tetanospasmin but will not repair nerves already damaged by the toxin. C) The antibiotics are given prophylactically, to prevent secondary infections. Nerves damaged by tetanospasmin need time to repair. D) Clostridium tetani is resistant to most antibiotics; treatment thus involves several weeks of combined antibiotic therapy. E) Clostridium tetani is an acid-fast organism; it thus has a slow generation time, so it takes several weeks for an antibiotic to be effective in killing the cells.

73)

Which characteristic(s) is/are NOT common to C. tetani and C. perfringens? A) They are obligate anaerobes. B) They are spore-formers. C) They are Gram-positive bacteria. D) They produce A-B toxins. E) They are rod-shaped.

74)

Select the TRUE statement regarding clostridial myonecrosis. A) Clostridium perfringens infects healthy tissue and grows easily in well oxygenated

tissues. B) The causative agent producesα-toxin, an A-B toxin that destroys lecithin in host cell membranes, leading to cell lysis. C) Hyperbaric chambers may be used to treat patients with gangrene—high levels of O 2 reduce anaerobic conditions in the tissues. D) Prevention of clostridial myonecrosis can be achieved with the DCTaP vaccine. E) C. perfringens is an endospore-forming organism, and produces large number of spores in wounds or cultures.

75)

Antibiotics are given to a person with gas gangrene to

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A) improve oxygenation in the affected tissues. B) prevent additional toxin production. C) stop bacterial growth AND neutralizeα-toxin. D) stop bacterial growth AND prevent additional toxin production. E) neutralizeα-toxin AND improve oxygenation in the affected tissues.

76)

Choose one FALSE statement about the treatment of clostridial myonecrosis.

A) Placing a person with gangrene in a hyperbaric chamber always eliminates the need for debridement and/or amputation. B) High doses of antibiotics, often a combination of penicillin and clindamycin, are given to help stop bacterial growth and toxin production.  C) Prompt debridement of all dead and infected tissues is essential; in some cases amputation is also necessary.  D) Antibiotic treatment of clostridial myonecrosis is challenging because antibiotics do not diffuse well into necrotic tissue. E) Antibiotic treatment of clostridial myonecrosis stops bacterial growth but has no impact on any toxin already produced by the causative agent.

77) Bite wounds are often serious as they may lead to an infection in which two or more species of pathogens act together to produce an effect greater than the sum of effects if each pathogen were acting alone. This is referred to as a(n) ______ infection. A) mutualistic B) parasitic C) fasciltatory D) complicated E) synergistic

78)

How is it possible for anaerobes to be involved in bite wound infections?

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A) Most bite wounds are on hands or fingers, which have little tissue and few blood vessels, and are thus fairly anaerobic. B) Facultative anaerobes in bite wounds reduce available oxygen in the affected tissue, creating anaerobic conditions. C) Bite wounds result in the release of anaerobinases by keratinocytes; these convert oxygen to nitrogen, generating anaerobic conditions. D) Although anaerobes are introduced into a wound through biting, they do not multiply in the aerobic tissue and do not contribute to a bite wound infection. E) In fact, anaerobes are never involved in bite wound infections; tissues are always well oxygenated, which inhibits any anaerobes from multiplying in them.

79) Why is Staphylococcus epidermidis able to colonize plastic materials used in medical procedures? A) It has fimbriae that allow it to attach to plastic surfaces. B) It can bind to fibronectin, a blood protein that coats plastic implants. C) It produces coagulase that allows it to colonize inert surfaces such as titanium. D) It can produce a glycocalyx that allows it to form biofilms. E) These are all factors that allow S. epidermidis to colonize implants.

80)

Choose the one FALSE statement about Pseudomonas aeruginosa.

A) It is widespread in nature, commonly found in plants. B) Some strains can grow in nutrient-poor environments, including distilled water. <!-Markup Copied from Habitat--> C) It secretes pigments that together produce a green color.  D) Under certain circumstances, it can grow anaerobically.  E) It is a Gram-positive, spore-forming encapsulated rod.

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81) It is possible to cultivate Clostridium tetani from a wound, even if the affected person does not have tetanus. How can this be explained? A) If Clostridium tetani is cultured from a wound, the person MUST have tetanus. However, in some people the signs and symptoms of tetanus are extremely mild, so it can be difficult to detect the disease in them. B) Clostridium tetani may be growing vigorously in the wound. However, the organism only produces tetanospasmin if the person's immune system is compromised, so a healthy person may not develop the disease. C) The wound may contain spores that can be germinated under appropriate conditions in culture. However, they will not germinate in a wound unless it is anaerobic. Since the spores themselves do not produce toxin, their presence does not lead to tetanus. D) Clostridium tetani is part of the normal microbiota of the integumentary, cardiovascular, and lymphatic systems. It makes sense that it would be possible to culture the organism from a wound, even in a healthy person. E) None of the choices adequately explain how C. tetani can be cultured from the wound of a healthy person.

82) Your patient is a child who has enlarged, soft lymph nodes in his left armpit. You examine him and notice a scratch on his arm. He tell you he was playing with his new cat. You suspect he has _______, caused by _______. A) streptobacillosis; Bartonella henselae B) streptobacillosis; Streptobacillus moniliformis C) cat scratch disease; Bartonella henselae D) streptobacillosis; Pasteurella multocida E) bartonellosis; Pasteurella multocida

83)

How does tetanospasmin cause the characteristic spasms associated with tetanus?

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A) It prevents the release of neurotransmitter from inhibitory interneurons, resulting in sustained muscle contraction.  B) It stimulates the release of neurotransmitter from inhibitory interneurons, resulting in decreased muscle contraction. C) It prevents the release of neurotransmitter from stimulatory motor neurons, resulting in sustained muscle contraction. D) It stimulates the release of neurotransmitter from stimulatory motor neurons, resulting in decreased muscle contraction. E) It prevents the release of neurotransmitter from the brain stem, resulting in systemic muscle contraction.

84)

Granulation tissue A) is a good sign in a wound - it indicates that healing has begun. B) is a bad sign in a wound - it indicates that healing is delayed. C) is a bad sign in a wound - it indicates that an infection has begun. D) is a good sign in a wound - it indicates that there will be no scarring. E) is a bad sign in a wound - it indicates that significant scarring will occur.

85)

Granulation tissue is

A) a red, translucent fibrous material that forms during wound healing.  B) a tissue component exposed by a wound, to which microbes can attach. C) collagenous tissue that creates a scar when a wound heals. D) a fibrous tissue that is formed when cells are bound together in a healing wound. <!-Markup Copied from Habitat--> E) a thick yellowish tissue that contains leukocytes, tissue debris, and proteins.

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86) Select the correct sequence on events that occur during wound healing: i. Blood clots form in the wound ii. Granulation tissue fills the wound iii. Phagocytes destroy microbes iv. Scar tissue forms v. Cut blood vessels bleed into the wound A) v; i; iii; ii; iv B) i; ii; iii; iv; v C) iii; ii; v; iv; ii D) v; iv; iii; ii; i E) ii; iv; iii; v; i

87)

Which of the following is NOT exposed by a wound? A) Epidermis B) Collagen C) Fibrin D) Fibrinogen E) Fibronectin

88) Your patient has several small ulcers in a row on her forearm, and enlarged lymph nodes in her armpit on the same side. She works as a landscaper, and tells you that she was planting roses in a community garden several weeks ago. You take a sample from one of the ulcers and send it away for analysis. You suspect that she has _______, caused by _______. If your diagnosis is correct, you will prescribe _______. A) Rose gardener's disease; Candida albicans; antibiotics B) Rose gardener's disease; Candida albicans; antifungal medication C) sporotrichosis; Sporothrix schenckii; antifungal medication D) sporotrichosis; Streptococcus pyogenes; antimicrobial medication E) bartenellosis; Pasteurella multocida; vancomycin

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89) Typically, in cases of sporotrichosis, a chronic ulcer forms at the wound site, followed by a slowly progressing series of ulcerating nodules that develop sequentially toward the center of the body. Why do the ulcers develop in this way? A) The causative fungus is motile and moves under the skin towards abdominal lymph nodes. B) The causative Gram-negative bacterium is motile and moves under the skin towards lymph nodes. C) The causative fungus is carried by the lymph vessels towards lymph nodes. D) The causative bacterium is transported in the lymph vessels towards lymph nodes. E) The causative fungus uses an actin tail to move between epidermal cells towards lymph nodes.

90)

All of the following are true of human bite wound infections EXCEPT

A) they always develop gangrene, leading to amputation of one of more fingers. B) symptoms includepain, massive swelling, and drainage of foul-smelling pus. <!-Markup Copied from Habitat--> C) tissue is destroyed by mouth bacteria acting synergistically.  D) treatment usually involves more than one antimicrobial medication.  E) without treatment, complications including infection of muscles and tendons may occur.

SECTION BREAK. Answer all the part questions. 91) You are looking after your sister's cat Singa. While playing one evening, Singa accidentally bites you instead of the toy mouse you are holding. The bite wound is very small but is in the fleshy part of your hand. You wash the wound, which is not bleeding much, and put a band aid on it. The next day, your whole hand is red, swollen, and painful, and some lymph nodes in your arm are enlarged and tender. You call your sister, who is an RN. She urges you to go to the doctor, telling you that animal bites can sometimes be infected, and that if that is the case, you will need treatment before the infection gets any worse.

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91.1) You go to the urgent care in your neighborhood. There, a physician's assistant (PA) tells you that wounds caused by animal bites (especially cats) can be infected with A) Pasteurella multocida AND Streptobacillus moniliformis . B) Staphylococcus aureus AND Streptobacillus moniliformis . C) Streptococcus epidermidisAND Streptobacillus moniliformis . D) Pasteurella multocida OR Bartonella henselae. E) Bartonella henselaeOR Streptobacillus moniliformis .

91.2) The PA tells you that a disease called cat scratch disease can also be contracted through a cat bite. The organism that causes this disease is ______, and that the disease is characterized by ______. A) Bartonella henselae;peliosis hepatis B) Pasteurella multocida; local lymph node enlargement C) Bartonella henselae; local lymph node enlargement D) Pasteurella multocida; rash and joint pain E) Streptobacillus moniliformis; vomiting, diarrhea and rash

91.3) The PA goes on to explain that cat bite infections and bartonellosis (cat scratch disease) differ in that A) P. multicoda is a Gram-positive organism while B. henselae is a Gram-negative organism. B) P. multicoda is transmitted by cat bites, while B. henselaemay be transmitted by bites or scratches. C) P. multicoda may be transmitted form person-to-person while B. henselae can only be transmitted by cat bites. D) the virulence factors of P. multicoda are as yet unknown while B. henselae has an antiphagocytic capsule. E) cat bite infections can be prevented with prophylactic antibiotics while bartonellosis may be prevented with an attenuated vaccine.

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91.4) You review what the PA has told you about bartonellosis with your sister. She tells you that one statement made by the PA is incorrect. Identify that statement. A) It is a common cause of chronic lymph node enlargement in children.  B) It can cause serious illness in immunocompromised people such as those with AIDS.  C) It can affect the brain or heart valves in a small number of cases.  D) Cat scratches are the only mode of transmission to humans.  E) Bartonellosis does not spread from person to person.

91.5) You are given a prescription for both a penicillin derivative AND aβ-lactamase inhibitor. Why are you given these medications? A) Both P. multicoda and B. henselaeproduceβ-lactamases. They are thus treated withβ-lactamase-inhibiting medications. In addition, skin microbiota such as S. epidermidis respond to penicillins. B) Both P. multicoda and B. henselae respond to penicillin derivatives. In addition, some bite wounds are infected withstrains of β-lactamase-producing Staphylococcus aureus. C) Both P. multicoda and B. henselaeare encapsulated, so respond well to penicillin derivatives. In addition, some bite wounds are infected withstrains of β-lactamaseproducing Staphylococcus epidermidis. D) The causative organisms of cat bite infections and bartonellosis are not well characterized. For this reason, penicillin derivatives and inhibitors of these medications are given synergistically. E) Both P. multicoda and B. henselae respond to penicillin derivatives. In addition, some bite wounds are infected withstrains of β-lactamase-producing Streptobacillusmoniliformis .

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92) Your patienthad abdominal surgery three days ago. She seemed to be doing well after the surgery, but today the skin around the surgicalincision is red and swollen. In addition, your patient has a high fever and is complaining of muscle aches. She also has a rash and has diarrhea. You realize that her wound has become infected, despite your best efforts as a nurse, and you are concerned that she has developedtoxic shock syndrome. You explain the details of this type of infection to the patient's family.

92.1) Wound infections are commonly caused by Staphylococcus species, common inhabitants of the nostrils and the skin. These organisms are A) Gram-positive, pyrogenic, facultative anaerobes. B) Gram-negative, pyogenic, facultative anaerobes. C) Gram-positive, pyogenic, obligate aerobes. D) Acid-fast, pyrogenic, obligate aerobes. E) Gram-positive, pyogenic, facultative anaerobes.

92.2) You are extremely concerned, because the laboratory reports that the organism cultured from your patient's wound is capable of digesting collagen and fibronectin. Why are you worried about this? A) These are structural components of tissue. Their digestion means that not only could the organisms spread easily, but also important structures such as tendons could be destroyed. B) This would indicate that the organism is capable of forming biofilms and it is very difficult to eliminate biofilms once they have developed, because of resistance. C) This would indicate that the bacterium is a lysogen, containing viral DNA conferring new characteristics on the organism. Bacteriophages pose an additional health risk to your patient. D) These are structural components specifically of the heart. Their digestion means that the patient is at risk of heart failure, which will prove fatal. E) This would indicate that the pathogen has the ability to break down activated complement proteins, thereby avoiding the innate immune defenses and allowing it to persist.

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92.3) The fact that your patient has a high fever, a rash and muscle aches suggests the possibility of toxic shock syndrome, which means that the causative agent of her infection is A) an endotoxin-producing S. aureus strain. B) a toxin-producing S. epidermidis strain. C) producing a capsule and forming a biofilm. D) a superantigen-producing S. aureus strain. E) a superantigen-producing S. epidermidisstrain.

92.4) An antibiogram is performed on a sample from your patient's wound. The causative agent is found to be resistant to methicillin and vancomycin. This indicates that A) her infection is untreatable and will likely be fatal within a few days. B) antibiotics such aslinezolid, daptomycin, or tigecycline are needed to treat her. <!-Markup Copied from Habitat--> C) she likely acquired the organism in a community setting rather than in the hospital. D) the causative organism is likely a member of her intestinal normal microbiota. E) the causative organism does not produce the protein coagulase.

92.5) You explain general mechanisms of antibiotic resistance to your patient's family. Which of the following mechanisms is not one used by S. aureus?

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A) Some bacteria produce enzymes that chemically modify a specific medication, interfering with its function. An example is the β-lactamases that inactivate different βlactam antibiotics. B) Some bacteria useefflux pumpsto transport antimicrobials and other damaging compounds out of the cell. Sometimes the pumps are structurally altered, conferring resistanceto several different antimicrobials simultaneously.   C) Some bacteria are able to make minor structural changes in the cellular target of a drug. This can prevent the medication from binding to that target, thereby protecting the organism from its effects.  D) Some bacteria can make changes in porin proteins of the outer membrane andcan therefore prevent certain antimicrobials from entering the cell’s cytoplasm. By stopping entry of an antimicrobial, an organism avoids its effects. E) Resistance in S. aureus may involve any of these mechanisms.

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93) Gas gangrene is most frequently caused by Clostridium perfringens, an encapsulated Gram-positive anaerobicrod that produces two toxins: Alpha-toxin (α-toxin) is an enzyme that hydrolyzes phospholipids in host cell membranes, leading to cell lysis; perfringolysin O (PFO) is a pore-forming toxin that works together (synergistically) with α-toxin. Although C. perfringens is an endospore-forming organism, it usually does not produce spores in wounds or cultures. A 63-year-old woman, healthy except for mild diabetes, had her gallbladder removed. The surgery went well, but within 72 hours the surgical incision became swollen and pale. Within hours, the swelling had spread and the affected areadeveloped a bluish discoloration. The surgeon suspected gasgangrene. Antibiotic treatment was started, and the patient was rushed back to the operating room, where the entire swollen discolored area, including the repaired operative incision, was surgically removed. After that, the wound healed normally, although the patient required a skin graft to close the large wound. High numbers of Clostridium perfringens were grown from the wound culture. Six days later, a 58-year-old woman had surgery in the same operating room for a malignant tumor of the colon. The surgery was performed without difficulty, but 48 hours later she developed rapidly advancing swelling and bluish discoloration of her surgical wound. As with the first case, gangrene was suspected, and the patient was treated with antibiotics and surgical removal of the affected tissue. She also needed a skin graft. Her wound culture also showed C. perfringens. Because none of the surgery department's patients had developedinfections with C. perfringens before this, the hospital epidemiologist was asked to do an investigation. The invstigation revealed that(i) cultures of surfces in the operating room grew large numbers of C. perfringens, (ii) unknownto the medical staff, a worker had recently serviced a fan in the ventilation system of the operating room, and for a time air was allowed to flow into the operating room, rather than out of it, and (iii) aroad outside the hospital was being repaired using heavy machinery, creating clouds of dust.

93.1)

What raised the concern that the two patients in this case had gas gangrene?

A) Their surgical wounds showed advancing swelling and bluish discoloration. B) They each went into an irreversible coma shortly after their surgeries. C) There had been several other cases of gangrene in the same facility. D) Nurses reported a terrible odor emanating from their wounds. E) Both patients complained of very severe pain, as well as anxiety.

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93.2) Both patients in this case received antibiotics after being diagnosed with gangrene. Each also underwent a second surgery. Select the CORRECT statement regarding their treatment. A) Surgery was needed to remove Clostridium endospores from their original surgical sites. B) Gangrene results in tissue death; the necrotic tissue had to be surgically removed. C) Clostridium perfringens is multidrug resistant; the antibiotics were for secondary bacterial infections. D) The antibiotics were given to protect the patients against possible viral infections. E) The antibiotics were given to the patients to treat their underlying conditions.

93.3) Many other patients had surgery in the same operating room. Why did only these two patients develop wound gas gangrene?  A) They both had their surgeries late in the day, when the operating room was nonsterile. B) They both suffered complications during their primary surgical procedures. C) They both had underlying conditions, predisposing them to them to surgical complications. D) They were both operated on by the same surgeon; his/her technique was clearly problematic. E) Both patients were taking antibiotics, which are known to suppress a person's natural immunity.

93.4)

All of the following factors supported the diagnosis of gas gangrene EXCEPT

A) Clostridium perfringens was cultured from both patient's wounds. B) road work that generated dust was occuring outside the hospital. C) the ventilation system under repair had temporarily blown air into the surgery. D) C. perfringens was cultured from surfaces in the operating room. E) the surgeon had multiple previous cases of the disease in his patients.

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93.5) Patients with gas gangrene are given high doses of antibiotics, often a combination of penicillin and clindamycin, to help stop bacterial growth. However, the drugs A) do not diffuse well into dead tissue, and do notinactivate α-toxin or perfringolysin O. B) do not diffuse well into dead tissue, although they can inactivate α-toxin or perfringolysin. C) induce resistance in C. perfringens, meaning that surgery is also required. D) induce production of α-toxin and perfringolysin O, meaning that surgery is also required. E) weaken the patient's immune system, making them vulnerable to secondary infections.

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Answer Key Test name: Chap 23_10e 1) TRUE 2) TRUE 3) TRUE 4) FALSE 5) TRUE 6) TRUE 7) FALSE 8) TRUE 9) TRUE 10) TRUE 11) FALSE 12) [A, F] 13) D 14) C 15) B 16) B 17) A 18) C 19) D 20) A 21) B 22) B 23) B 24) E 25) A 26) D Version 1

27) E 28) A 29) B 30) C 31) E 32) B 33) E 34) A 35) D 36) D 37) B 38) C 39) E 40) C 41) B 42) B 43) E 44) A 45) A 46) A 47) B 48) D 49) D 50) C 51) B 52) A 53) B 54) D 55) E 56) A Version 1

57) B 58) C 59) A 60) D 61) A 62) C 63) B 64) A 65) E 66) D 67) D 68) C 69) A 70) D 71) B 72) B 73) D 74) C 75) D 76) A 77) E 78) B 79) B 80) E 81) C 82) C 83) A

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Normal muscle function involves two types of neurons that release different chemical messengers called neurotransmitters: (1) motor neurons releaseneurotransmitters that cause muscles to contract, and (2) inhibitory interneurons releaseneurotransmitters that block the activity of motor neurons, thereby allowing the muscle to relax. Tetanospasmin prevents the release of the neurotransmitter from the inhibitory interneurons, resulting in sustained muscle contraction (a condition called spastic paralysis) and characteristic muscle spasms  84) A 85) A 86) A 87) A 88) C 89) C 90) A 91) Section Break 91.1) D 91.2) C 91.3) B 91.4) D 91.5) B 92) Section Break 92.1) E 92.2) A 92.3) D 92.4) B 92.5) D 93) Section Break 93.1) A Version 1

93.2) B 93.3) C 93.4) E 93.5) A

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CHAPTER 24 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The bacteria primarily responsible for dental caries is Streptococcus mutans. ⊚ ⊚

true false

Sucrose is one of the major contributors to the development of tooth decay. ⊚ ⊚

true false

Helicobacter pylori appears connected to stomach cancer and ulcers. ⊚ true ⊚ false

The saliva of asymptomatic carriers of herpes simplex is not infectious. ⊚ true ⊚ false

The mumps virus initially infects the respiratory tract. ⊚ ⊚

true false

Virulent strains of Shigella typically carry an R plasmid. ⊚ true ⊚ false

The infectious dose for cholera is much larger than that for shigellosis. ⊚ true ⊚ false

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Cyclospora cayetanensis has, so far, not been identified with an animal source. ⊚ ⊚

Cyclosporiosis is transmissable from person to person. ⊚ ⊚

10)

true false

Both Giardia lamblia and Cryptosporidium parvum are resistant to chlorine. ⊚ true ⊚ false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 11) Who determined that the cholera outbreak in 1850s London was due to contaminated water and approached the problem by removing the pump handle at the contaminated site? A) Pasteur B) Snow C) Koch D) Smith E) Semmelweis

12)

The passage from the mouth to the anus is termed the A) gut canal. B) oral cavity. C) grand canal. D) gastrointestinal tract. E) peristalsis.

13)

Collections of bacteria that adhere to the surfaces of the teeth are called

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A) dental caries. B) dental plaque. C) halitosis. D) periodontal disease. E) dental scum.

14)

The most common infectious disease of humans is A) the common cold. B) dental decay. C) hepatitis A. D) halitosis. E) influenza.

15)

The principal microbe involved in dental caries is A) S. mutans. B) S. salivarius. C) S. mitis. D) S. sanguis. E) S. caries.

16)

Part of the ability of S. mutans to result in dental caries depends on its ability to A) invade plaque and dissolve the gums. B) convert sucrose to lactic acid. C) convert proteins to sugars. D) attach to the gums. E) convert lactic acid to sucrose.

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17) This chemical compound, typically added to drinking water, makes enamel more resistant to dissolving in acid. A) Calcium B) Chlorine C) Chloramine D) Fluoride E) Phosphate

18) The chronic inflammatory process involving the gums and tissues around the teeth is called A) dental caries. B) dental plaque. C) periodontal disease. D) root caries. E) periodontal caries.

19)

Helicobacter pylori is able to survive in the stomach by its ability to produce A) lactic acid from sugar. B) ammonia from urease. C) fatty acids from sebum. D) neutralizing proteins from glucans. E) ammonia from urea.

20)

Helicobacter pylori appears to have some connection with A) acid reflux disease. B) ulcers. C) dental caries. D) stomach cancer. E) ulcers AND stomach cancer.

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21) Where in the body does the latent, non-infectious, non-replicating form of the herpes simplex virus persist? A) Motor neurons B) Sensory nerves C) Red blood cells D) Cranial nerves E) Spinal cord

22)

Which of the following has shown some effectiveness in treating a herpes infection? A) AZT B) Protease inhibitors C) Acyclovir D) Cephalosporin E) Broad spectrum antibiotics

23)

The viral disease that characteristically infects the parotid glands is A) measles. B) mumps. C) herpes. D) chickenpox. E) varicella.

24)

Mumps is a good candidate for elimination from the population due to A) the existence of an effective vaccine. B) a human-only reservoir. C) the absence of a latent state. D) a single serotype. E) All of the choices are correct.

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25)

Most bacterial intestinal infections may be traced to all of the following EXCEPT A) Vibrio species. B) C. jejuni. C) Salmonella species. D) Enterobacteriaceae. E) Haemophilus species.

26)

The initial attachment required for establishment of an intestinal infection is by A) flagella. B) pili. C) cilia. D) pseudopodia. E) a capsule.

27)

The toxins involved in intestinal infections typically

A) kill cells by inhibiting DNA synthesis AND modify cell physiology resulting in increased secretion of water and electrolytes. B) modify cell physiology resulting in increased secretion of water and electrolytes. C) modify cell physiology resulting in decreased secretion of water and electrolytes. D) kill cells by inhibiting DNA synthesis AND modify cell physiology resulting in decreased secretion of water and electrolytes. E) kill cells by inhibiting protein synthesis AND modify cell physiology resulting in increased secretion of water and electrolytes.

28)

Cholera is the classic example of a(n)

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A) foodborne illness. B) zoonosis. C) very severe form of diarrhea. D) opportunistic infection. E) vector-borne disease.

29)

The diarrhea of cholera has been described as A) a viscous fluid. B) a rice water stool. C) small in volume. D) somewhat watery. E) dysentery.

30)

The symptoms of cholera are due to the action of A) an endotoxin. B) an exotoxin. C) modified mucus. D) flagella. E) an exotoxin AND an endotoxin.

31)

A common source of cholera infection is A) acid rain. B) unpasteurized milk. C) fecal contaminatedwater. D) boiled water. E) acid rain AND boiled water.

32)

The primary treatment for cholera is

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A) the administration of antibiotics. B) vaccination AND the administration of antibiotics. C) by blood transfusion AND simple rehydration. D) simplerehydration. E) vaccination AND byblood transfusion.

33)

Shiga toxin and cholera toxin both A) have an A-B arrangement. B) work through ADP ribosylation. C) increase cAMP levels. D) prevent protein synthesis. E) are endotoxins.

34)

Shigellamoves from cell to cell using A) cilia. B) actin tails. C) pili. D) flagella. E) flagella AND pili.

35)

Which of the following groups contain diarrhea-causing E. coli? A) Enterotoxigenic B) Enteroinvasive C) Enteropathogenic D) Enterohemorrhagic E) All of the choices are correct

36) Which of the following E. coli serovars give rise to a disease similar to that caused by Shigella sp.? Version 1

A) Enterotoxigenic B) Enteroinvasive C) Enteropathogenic D) Enterohemorrhagic E) All of the choices are correct.

37) Which of the following E. coli serovars produces a toxin somewhat similar to that produced by Shigella dysenteriae? A) Enterotoxigenic B) Enteroinvasive C) Enteropathogenic D) Enterohemorrhagic E) All of the choices are correct.

38)

Vibrio cholerae and most Salmonella strainsare A) killed by acid conditions. B) stimulated by acid conditions. C) killed by low concentrations of salt. D) killed by neutral conditions. E) acidophiles.

39)

Most cases of Salmonella gastroenteritis have a(n) A) water source. B) human source. C) plant source. D) animal source. E) human source AND animal source.

40)

The food products most commonly contaminated with Salmonella strains are

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A) meat and seafood. B) eggs and poultry. C) milk and cheese. D) fruit and vegetables. E) eggs and fruit.

41)

The animal(s) often associated with Salmonella strains is/are A) turtles. B) iguanas. C) baby chickens. D) ducks. E) All of the choices are correct.

42)

In which of these organs does a carrier of typhoid bacilli maintain the bacteria? A) Liver B) Gallbladder C) Peyer's patches D) Colon E) Liver AND Peyer's patches

43)

The most notorious typhoid carrier was A) Typhoid Tilly. B) Typhoid Tom. C) Typhoid Mary. D) Typhoid Mark. E) Typhoid salmonella.

44)

Which of these bacteria require a special medium and microaerophilic conditions?

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A) Campylobacter jejuni B) Escherichia coli C) Pseudomonas aeruginosa D) Staphylococcus aureus E) Salmonella enterica

45)

A mysterious sequel to Campylobacter jejuni infections is A) Reye's syndrome. B) Guillain-Barrésyndrome. C) Tourette's syndrome. D) Pasteur's syndrome. E) Campylobacter syndrome.

46)

The animal(s) frequently associated with Campylobacter jejuni is/are A) turtles. B) iguanas. C) chickens. D) dogs. E) All of the choices are correct.

47)

Viral gastroenteritis in infants and children is most commonly caused by A) herpes. B) hepatitis B. C) rotavirus. D) norovirus. E) influenza virus.

48) Viral gastroenteritis that affects people of all ages and usually lasts less than 3 days is caused by

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A) herpes. B) hepatitis B. C) norovirus. D) rotavirus. E) influenza virus.

49)

The most common chronic blood-borne infection in the U.S. is A) hepatitis D. B) hepatitis C. C) hepatitis B. D) hepatitis A. E) None of the choices are correct.

50)

Hepatitis A spreads via A) the respiratory route. B) blood transfusion. C) body fluids. D) the fecal-oral route. E) the fecal route.

51)

Which of the following is NOT a mechanism of spread ofHBV? A) Blood B) Blood products C) Perspiration D) Semen E) These are all mechanisms of spread for HBV.

52)

Intestinal protozoan infections are typically spread by

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A) the respiratory route. B) bloodtransfusion. C) body fluids. D) the fecal-oral route. E) vectors.

53)

The most commonly identified waterborne illness in the United States is A) giardiasis. B) amoebiasis. C) cryptosporidiosis. D) balantidiasis. E) histoplasmosis.

54)

Giardiasis may be contracted from A) another person. B) clear mountain streams. C) chlorinated city water. D) cold filtered beer. E) another person, clear mountain streams, AND chlorinated city water.

55)

Cryptosporidium parvum may infect A) dogs. B) pigs. C) cattle. D) humans. E) All of the choices are correct.

56)

Most North American outbreaks of Cyclospora cayetanensis have been associated with

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A) imported cattle. B) iguanas. C) imported vegetables. D) chickens. E) foreign mosquitoes.

57)

The oocytes of Cyclospora cayetanensis A) are mature when eliminated in the stool. B) do not contain sporozoites when passed in the feces. C) are smaller than the oocytes of Cryptosporidium parvum. D) give rise to three sporozoites. E) contain sporozoites when passed in the feces.

58)

Entamoeba histolytica A) causes amebiasis. B) may form cysts. C) cysts survive passage through the stomach. D) may produce a cytotoxic enzyme. E) All of the choices are correct.

59)

Amebiasis A) is caused by Cryptosporidium parvum. B) often causes a bloody diarrhea. C) is an infection of the stomach. D) is restricted to temperate climates. E) is caused by Cryptosporidium parvum AND often causes a bloody diarrhea.

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60) Why is it that the tongue and cheek epithelium doesn't provide a sufficient anaerobic environment for plaque anaerobes to grow, but the surface of teeth might? A) The epithelium is supplied with oxygen by capillary beds. This makes it a relatively aerobic environment and hostile to anaerobes. B) The tooth enamel is supplied with oxygen by capillary beds. This makes it a relatively anaerobic environment and hostile to aerobes. C) The surface of the tongue and cheek are constantly scraped by the action of consuming food. Layers of bacterial growth that might help to supply an anaerobic environment are scraped away, exposing lower levels to oxygen-rich air. D) The surface of teeth like molars have many pits and crevices in which bacteria can grow. The bottoms of these pitsare anaerobic. This isn't possible on the very smooth surface of the tongue and cheek epithelium. E) The epithelium is supplied with carbon dioxide by capillary beds. This makes it a relatively anaerobic environment, friendly to obligate anaerobes.

61) Explain how Vibrio cholerae causes cholera without apparent damage to the intestinal epithelium. A) This microbe causes destruction of the cellular structures underneath the intestinal epithelium—this is what induces the watery rice-stool characteristic of the illness. This leaves the overlying intestinal epithelium intact. B) This microbe directly invades the intestinal epithelial cells, but does not kill them. Instead, while multiplying inside them, it causes them to secrete large amounts of chloride ions. This induces water to follow by osmosis, resulting in the watery rice-stool characteristic of the illness. C) This microbe attaches to the surface of intestinal epithelial cells, producing an exotoxin that causes the epithelium to secrete chloride ions. This induces large amounts of water to follow by osmosis, resulting in the watery rice-stool characteristic of the illness. D) The inflammatory reaction to the presence of this microbe causes the watery ricestool characteristic of the illness. Therefore, it's technically the immune response that initiates the disease, although this response is induced by the presence of the microbe on the intestinal epithelium. E) This microbe attaches to the surface of intestinal epithelial cells, producing an endotoxin that causes the epithelium to secrete potassium ions. This induces small amounts of water to follow by osmosis, resulting in the watery rice-stool characteristic of the illness.

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62) Why might it be more difficult to prepare a vaccine against noroviruses than against rotaviruses? A) We haven't been able to culture noroviruses in a lab setting until recently. Without a starting culture, we haven't been able to create a vaccine. Work on a vaccine is progressing now. B) Noroviruses are RNA viruses, where rotaviruses are DNA viruses. RNA viruses mutate far more easily than DNA viruses, so we COULD make a vaccine, but it would be rendered useless fairly quickly as the virus mutates. C) We lack a proper culturing method for large-scale production of target cells for norovirus, whereas we have such a system for the target cells of rotaviruses. Without a system to get large numbers of target cells, we can't produce a vaccine. D) Norovirus is much more infectious than rotavirus. As such, it's much harder to work with safely. This makes production of a vaccine too dangerous and unpredictable. E) This question is misleading. It has been relatively simple to create vaccines against both of these virus types.

63) Would you expect an individual with giardiasis who has diarrhea to be more likely to transmit the disease than an individual with giardiasis who does NOT have diarrhea? Why or why not? A) No. This illness is spread by respiratory droplets, so diarrhea as a symptom shouldn't matter for transmission of the disease. B) No. This illness isspread by sexual contact, so diarrhea as a symptom shouldn't matter fortransmission of the disease. C) Yes. This illnessis spread by the fecal-oral route, so presence of diarrhea as a symptom shoulddramatically increase the possibility of transmission of infection. D) Yes. This illness is spread by insects that feed on contaminated fecal matter, becoming infected themselves. The disease is spread to new individuals when these infected insects bite a susceptible person, transmitting the cysts of the protozoan. E) No. This illness is spread when peopleingest cysts, and a person with severe diarrhea excretes primarilytrophozoites; an asymptomatic person is more likely to excrete cysts and istherefore more infectious.

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64)

Why are older people (over 65) more likely to lose teeth than to develop cavities?

A) Cavities are less common because the pits and fissures on teeth that bacteria can colonize wear down over time. However, older adults are more likely to develop periodontal disease that can lead to the loss of teeth. B) Older adults never eat sugar, because of the risk of type 2 diabetes that increases with age. However, they are likely to develop periodontal disease, that can lead to the loss of teeth. C) As adults age, the enamel layer on their teeth surfaces increases in strength, making it almost impossible for bacteria to cause decay. However, as the enamel thickens, the gums weaken, so teeth can fall out and be lost. D) As adults age, their tooth enamel becomes less porous. This prevents bacteria from colonizing the teeth, preventing the development of decay. However, as people get older, their saliva becomes more acidic, and this causes periodontal disease. E) The mouth normal microbiota changes over time. In children the predominant bacteria are those that cause tooth decay. However, in adults, the predominant bacteria are those that cause gum disease and tooth loss.

65) Please select the definition regarding aspects of the digestive system that is INCORRECT. A) Cariogenic—causing dental caries. B) Dysentery—diarrhea characterized by fecal pus and blood. C) Cirrhosis—liver scarring that interferes with function. D) Gingivitis—inflammation of the teeth and gums. E) Dysbiosis—imbalance of the intestinal normal microbiota.

66)

Please select the FALSE statement regarding tooth decay.

A) Lactic acid in the mouth forms as a result of fermentation of fructose. B) Cariogenic bacteria can ferment polysaccharides stored in granules. C) Tooth decay never occurs if Streptococcus mutans is absent. D) Plaque forms whenoral streptococci adhere to the proteinaceous pellicle on teeth. <!-Markup Copied from Habitat--> E) Cariogenic bacteria such as Streptococcusmutans are acidophiles.

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67)

Why does removal of plaque reduce the chance of forming cavities?

A) Plaque is a biofilm; it contains cariogenic bacteria, the metabolic byproducts of which facilitate tooth decay. B) Plague causes a significant drop in oral pH. The more acidic condition causes tooth decay. C) Plaque is a polysaccharide covering on tooth enamel. It contains tiny acid-soaked sponges that decay teeth. D) Removing plaque involves brushing. A coincidental side benefit of brushing is removal all oral bacteria. E) Removing plaque actually does not impact the development of cavities. Cavity development has a genetic component and cannot be prevented.

68)

Why is it difficult to determine the causative agents of periodontal disease?

A) The agents are fastidious bacteria that cannot be cultured in the laboratory. B) Identification requires 16S rDNA sequencing and not all bacteria have this gene. C) The infections are polymicrobial, so multiple species of interacting bacteria are involved.  D) The causative agents are typically viruses, which are difficult to identify. E) The causative agents are encased in biofilm polysaccharides that cannot be removed.

69)

Which of the following is/are treatment(s) for advanced periodontal disease? A) Removing plaque and tartar. B) Cleaning out gingival crevices AND removing plaque and tartar. C) Removing plaque and tartar AND minor gum surgery. D) Brushing and flossing, filling cavities with amalgam, AND antibiotic therapy. E) Cleaning out gingival crevices, minor gum surgery, AND antibiotic therapy.

70) A patient presents with bad halitosis, red and swollen gingiva, and several loose teeth. You take a sample from the gum line and after performing a stain, note spirochete bacteria as well as some bacilli. This patient likely has Version 1

A) gingivitis. B) dental caries. C) periodontal disease. D) acute necrotizing ulcerative gingivitis. E) dental caries ANDacute necrotizing ulcerative gingivitis.

71)

Which of the following is not a typical sign or symptom of H. pylori gastritis? A) Belching B) Bloating C) Vomiting D) Pain E) Fever

72)

How does H. pylori survive the acidic conditions of the stomach?

A) Producing urease, an enzyme that converts urea to ammonia, thereby creating an alkaline microenvironment.  B) Burrowing within the layerof mucus that coats the stomach lining. C) Producing urease, an enzyme that converts ammonia to urea, thereby creating an alkaline microenvironment. D) Producing urease, an enzyme that converts urea to ammonia, thereby creating an alkaline microenvironment AND burrowing within the stomach mucus layer. E) Producing urease, an enzyme that converts ammonia to urea, thereby creating an alkaline microenvironment AND covering its flagella with protective sheaths.

73)

Once H. pyloriis in a host's stomach, what happens?

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A) The bacteria move away from the neutral mucus-secreting epithelium toward the acidic stomach lumen. B) H. pylori moves from the basic stomach lumen up toward the neutral esophagus. C) The bacteria move away from the acidic stomach lumen toward the neutral mucussecreting epithelial layer. D) The bacteria move away from the acidic stomach lumen toward the neutral small intestine. E) H. pylori moves from the neutral small intestine toward the acidic stomach lumen.

74)

Which of the following is specific to H. pylori strains associated with stomach cancer? A) They are microaerophilic. B) They have sheathed flagella. C) The are acidophilic. D) They produce CagA. E) They produce VacA.

75)

Which statement regarding CagA and VacA of H. pylori is INCORRECT? A) Strains of H. pylori that produce CagA are associated with stomach cancer. B) CagA is delivered into host cells by a secretion system. C) VacA is an A-B toxin that increases urea flow into the stomach. D) VacA interferes with the function of T cells. E) CagA interferes with cell signaling and promotes inflammation.

76)

Why don't medications such as acyclovir cure oral herpes simplex infections? A) Acyclovir is an antiviral medication, but oral herpes is caused by a bacterium. B) Acyclovir is an antibacterial medication, but oral herpes is caused by a virus. C) Herpes simplex virus DNA persists in a latent form that is not removed by acyclovir. D) Herpes simplex virus RNA persists in a latent form that is not removed by acyclovir. E) Herpes simplex virus forms endospores that are resistant to all medications.

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77)

Only one serotype of mumps virus is known. Why is this important? A) It has been possible to create an effective vaccine that protects against this virus. B) When only one serotype of a virus exists, there is a great risk of mutation in that

agent. C) Herd immunity is not possible in a population if there is only one serotype of a virus. D) It is not possible to create a vaccine for an infectious agent if there is only one serotype of the agent. E) B cells and cytotoxic T cells are unable to respond to a virus if there is only a single serotype of that virus.

78)

What type of vaccine protects against mumps virus?

A) Toxoid B) Conjugate C) Attenuated D) Subunit E) Inactivated whole agent

79)

All of the following are possible complications of mumps EXCEPT A) Orchitis and infertility B) Meningitis C) Miscarriage D) Sudden onset deafness E) Severe scarring

80)

Please select the INCORRECT statement regarding mumps and oral herpes.

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A) Herpes simplex virus is an enveloped double-stranded DNA virus while mumps virus is an enveloped single-stranded RNA virus. B) Both herpes simplex virus and mumps virus are extremely resistant to detergents and disinfectants. C) Cells infected with HSV exhibit an intranuclear inclusion body; cells infected with mumps virus do not exhibit this body. D) Herpes simplex virus and mumps virus are both transmitted in the saliva of infected people. E) A person with HSV infection may experience recurrences while a person who has recovered from mumps has lifelong immunity.

81)

Which of the following gastrointestinal pathogens produce(s) A-B toxins? A) Vibrio cholerae B) Some strains of Shigella dysenteriae C) Helicobacter pylori AND some strains of Shigella dysenteriae D) Helicobacter pylori AND Vibrio cholerae E) Vibrio choleraeAND some strains of Shigella dysenteriae

82)

Which of the following media would you use to cultivate Vibrio cholerae? A) Selective—containing NaCl and with basic pH. B) Differential—containing NaCl and with basic pH. C) Selective—containing HCl and with acidic pH. D) Differential—containing HCl and with acidic pH. E) V. cholerae cannot be cultured in the laboratory.

83)

What are A/E lesions, produced by some strains of E. coli?

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A) Inflammatory patches caused by the attachment of the bacteria to the intestinal lining by small suction appendages. B) Intestinal abscesses that form after the bacteria have entered M cells, destroying them and causingbloody diarrhea. C) Intestinal damage characterized by pedestals that form under bacterial cells as a result of induced actin rearrangement in the intestinal cell. D) Cytoplasmic extensions induced in intestinal epithelial cells by the injection of superantigens via type III secretion systems. E) Appendages used by E. coli strains to avoid phagocytosis and enter M cells of the intestinal epithelium.

84)

Which of the following hepatitis viruses are transmitted by the fecal-oral route? A) HAV and HBV B) HAV and HCV C) HAV, HBV, and HCV D) HAV and HEV E) All hepatitis viruses

85)

Which of the following type of hepatitis is/are associated with liver cancer or cirrhosis? A) Hepatitis A B) Hepatitis B C) Hepatitis C D) Hepatitis B AND hepatitis C E) Hepatitis A AND hepatitis B

86)

Which of the following antigens are useful markers for hepatitis B infection?

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A) HBsAg  B) HBcAg  C) HBcAg AND HBsAg  D) HBeAg  E) HBcAg, HBsAg, AND HBeAg

87) What does circulating HBeAg indicate about people with chronic HBV infection? <!-Markup Copied from Habitat--> A) High levels of this antigen are associated with increased risk of liver cancer. B) High levels of this antigen are associated with decreased risk of liver cancer. C) Low levels of this antigen are associated with increased risk of liver cancer. D) Antibodies against this antigen confer immunity to HBV. E) IgM against this antigen indicate active viral replication.

88) Which statement about rotavirus gastroenteritis is false?  A) Rotaviruses are transmitted by the fecal-oral route.  B) Deaths related to the disease are usually caused by dehydration. C) Most cases of the disease occur in infants and children. D) Rotaviruses mainly infect the epithelial cells in the upper part of the small intestine.  E) There are no vaccines available for preventing rotavirus gastroenteritis.

89) Please identify the INCORRECT statement regarding bacterial diseases of the lower gastrointestinal system.

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A) Cholera toxin—A-B toxin that causes intestinal cells to secrete HCl. B) Of the four pathogenic strains of Shigella,S. dysenteriae is the most virulent. C) Shiga toxin-producing E. coli may cause hemolytic uremic syndrome in an infected person. D) There are more than 2,400 serotypes of Shigella, based on differences in their O, H, and K antigens. E) Pseudomembranous colitis may develop in a person with Clostridium difficile infection.

90)

Which is NOT part of the lower digestive tract? A) Stomach B) Pancreas C) Gallbladder D) Small intestine E) Liver

91) All of the following digestive tract components are correctly matched with their function EXCEPT A) Liver - stores bile B) Small intestine - nutrient digestion and absorption C) Large intestine - waste preparation D) Esophagus - food transport to stomach E) Stomach - mechanical digestion

92)

All of the following regarding normal microbiota of the digestive tract are true EXCEPT

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A) It is essential for the normal development of mucosal immunity.  B) It synthesizes a number of vitamins, including vitamin B12 and vitamin K. <!-Markup Copied from Habitat--> C) It degrades a variety of foods components, including dietary fiber.  D) It helps prevent pathogens from colonizing the large intestine.  E) It is composed almost entirely of aerobic species.

93)

Please select the INCORRECT statement regarding the small intestine.

A) It contains a brush border that is composed of ciliated cells; these absorb nutrients and sweep wastes into the large intestine. B) Crypts are small glands that continuously secrete large amounts of enzymecontaining fluids and mucus into the intestinal lumen.  C) Enzymes produced by intestinal cells may be secreted into the intestinal lumen, or remain attached to the cell membranes.  D) Certain cells in the intestinal crypts give rise to new intestinal epithelial cells. <!-Markup Copied from Habitat--> E) The surface area of the small intestine is vastly increased by the brush border cells.

94) All of the following are correct matches between accessory organs and their functions EXCEPT A) Liver - produces bile for fatty acid digestion B) Gallbladder - stores bile produced by liver C) Small intestine - digestion and absorption of nutrients D) Teeth - mechanical breakdown of food E) Parotid glands - production of saliva

95)

Select the INCORRECT pair regarding norovirus and rotavirus infections.

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A) Rotavirus infections - prevented by attenuated vaccines. B) Norovirus infections - symptoms last 21 days or more. C) Rotavirus infections - caused by double-stranded RNA virus. D) Norovirus infections - result in short-term immunity. E) Rotavirus and norovirus infections - acquired by fecal-oral route.

96)

All of the following apply to norovirus and norovirus infections EXCEPT A) the virus has a triple-layered capsid. B) illness lasts for 1 - 3 days. C) there is no preventative vaccine. D) the virus has a single-stranded RNA genome. E) virus transission is via fecal-oral route.

97)

Which is FALSE about norovirus infections?

A) Vomit contains infectious particles. B) The disease is contagious because the infectious dose of norovirus is low. C) Immunity to norovirus lasts for several years. D) Transmission of noroviruses is primarily by the fecal-oral route.  E) Norovirus epidemics are common on cruise ships and in college dormitories. <!-Markup Copied from Habitat-->

SECTION BREAK. Answer all the part questions. 98) You are a nurse on a post-surgical ward. One of your patients is an elderly woman who has just had her gallbladder removed. When you go into her room to check on her, you find that she has significant diarrhea, as well as fever and abdominal pain. You suspect that she has Clostridioidesdifficile infection (CDI), and send a sample of her feces down to the hospital lab for analysis. The test result indicates that your patient does indeed have CDI. You make your patient comfortable and answer her questions about her illness.

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98.1) You tell your patient that her CDI is caused by a bacterium belonging to the genus Clostridium. Which of the following is true of all Clostridia? A) They are Gram-positive, rod-shaped, endospore-forming obligate anaerobes. <!-Markup Copied from Habitat--> B) They are encapsulated, flagellated, toxin-producing aerobes. C) They areGram-negative, rod-shaped, endospore-forming obligate aerobes. <!-Markup Copied from Habitat--> D) They are flagellated and always cause significant inflammation. E) Clostridial infections only occur if a state of dysbiosis exists in the host.

98.2) Your patient wonders how she contracted CDI. Which of the following would be a good explanation for her? A) She is elderly; elderly people frequently develop gastrointestinal complaints such as CDI. It is to be expected in an aging person. B) She has been on antibiotic therapy because of her surgery. The antibiotics disrupted her normal intestinal microbiota, allowing any C. difficile present to flourish. C) C. difficile is usually a community-acquired organism. She most likely came to the hospital already infected with it but it takes several days for signs and symptoms of CDI to appear. D) Most surgical equipment is contaminated with C. difficile endospores, which are ubiquitous. Most likely your patient acquired CDI directly from her surgery. E) Nobody knows how people contract CDI. The causative bacterium is a common environmental organism and it is not known how it becomes pathogenic.

98.3) Clostridioides difficile produces toxins that are involved in the pathogenesis of CDI.Which toxins are associated with ALL strains ofthis organism? A) Toxin A and toxin B B) CagA and vacA C) CagA and toxin A D) Binary toxin and VacA E) Toxin A, toxin B, and binary toxin

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98.4) Your patient asks what treatment she will be given for the CDI. You explain that initially, she will be taken off all antibiotics. This may cure her by A) strengthening her innate and adaptive immune responses against the C. difficile. B) destroying any endospores that the C. difficile may have produced. C) destroying any endospores that the C. difficile may have produced ANDstrengthening her innate and adaptive immune responses against the Clostridium difficile. D) allowing her own gut normal microbiota to recover and to outcompete the C. difficile. E) increasing antibiotic sensitivity in the C. difficile, thereby weakening the pathogen so that the person's own immune system gets effectively rid of it.

98.5) You tell your patient that in some cases, CDI becomes chronic. One approach for treating this condition is a fecal microbiota transplant. How might this help a person with recurrent CDI? A) Genetically modified microbiota is added to the disrupted system of the CDI patient. This creates a balanced population that can compete with the C. difficile. B) Healthy, normal microbiota is added to the disrupted system of the CDI patient, creating a balanced population that outcompetes the C. difficile. C) Healthy, normal microbiota is added to the disrupted system of the CDI patient. These new bacteria secrete exotoxins that kill the pathogenic C. difficile. D) Healthy, normal microbiota is added to the disrupted system of the CDI patient. This stimulates the immune system of the person, eventually causing elimination of the C. difficile. E) Normal microbiota from a person treated with prophylactic antibiotics is added to the disrupted system of the CDI patient. The antibiotic diffuses from the added microbiota, killing the C. difficile.

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99) Your brother is an enthusiastichiker. He returns from a walking vacationand tells you that although he had a good time, he ran into a bit of trouble on one of the days he was away because he had got lost in the woods for several hours. Although he took enough food for the day, he ran out of water. Luckily, he came across a small stream and was able to fill uphis water bottle and to finish his hike without any further problems. Your brother mentions as an aside that he must have eaten something bad while he was away, because he has had pretty bad diarrhea since he got back. He tells you he doesn't feel too bad, but that he has been having what he describes as "explosive diarrhea". He also complains of abdominal pain. You urge him to go to the doctor because you suspect that he may have something more than just food-related diarrhea.

99.1) You suspect that your brother has giardiasis, caused by Giardia lamblia. Which of the following is NOT true about this disease? A) The cysts of G. lamblia areare resistant to stomach acid and are infectious. B) A person with giardiasis diarrhea is likely to eliminate G. lamblia cysts rather than trophozoites. C) The causative organism has energy-metabolizing organelles called mitosomes. D) Giardiasis is a zoonotic disease. E) Chlorinated water may still contain G. lamblia because the cysts are resistant to this chemical.

99.2) The signs and symptoms of giardiasis vary among people. Which of the following is your brother unlikely to experience with his infection? A) Bloody, frothy urine B) Jaundice and malabsorption C) Indigestion and gas D) Nausea and vomiting E) These all may be experienced with giardiasis.

99.3)

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Giardiasis involves

A) treatment with mitochondria-targeting medications. B) aerosol droplet transmission. C) a Gram-negative causative agent. D) a protozoan that uses fimbriae for attachment. E) production of resistant, infectious cysts.

99.4) There are several stages in the life cycle of G. lamblia. Which is the correct sequence? 1. Trophozoites multiply in the intestine. 2. Mature cysts or trophozoites are released in feces. 3. Cysts pass through the stomach to the lower small intestine. 4. Dehydration in the large intestine stimulates formation of cysts. 5. Cysts enter the mouth by ingestion of contaminated food or water. 6. Trophozoites are released from the cysts. A) 1, 2, 3, 4, 5, 6 B) 2, 3, 1, 5, 4, 6 C) 5, 2, 3, 1, 6, 4 D) 5, 3, 6, 1, 4, 2 E) 2, 5, 6, 1, 3, 4

99.5) You brother asks whether he will be given penicillin for his infection. What do you tell him? A) Yes— G. lamblia has a peptidoglycan cell wall. B) Yes— G. lamblia has 70S ribosomes. C) No— G. lamblia is a virus. D) No— G. lamblia is a protozoan. E) No— G. lamblia has a protective LPS layer.

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100) An 18-day old infant who was born healthy became lethargic and stopped feeding. She was rushed to the hospital when she became unresponsive and her parents could not wake her up. At the hospital, she was diganosed with meningitis (inflammation of the membranes covering the brain and spinal cord). The causative agent of the child's illness was determined to be herpes simplex virus type 1 (HSV-1). Both parents were tested for the virus but were negative. The doctors involved in the case concluded that the baby had likely contracted the virus at about a week old after being been touched or kissed by an infected friend or family member who may have been asymptomatic or who had a cold sore.Despite the efforts of doctors, the baby died.

100.1)

Herpes simplex virus is

A) an enveloped, double-stranded DNA virus. B) a nonenveloped, double-stranded DNA virus. C) an enveloped, single-stranded RNA virus. D) an enveloped, double-stranded RNA virus. E) a nonenveloped, single-stranded RNA virus.

100.2) HSV-1 is a virus that is commonly acquired in childhood. An immune response typically develops and quickly limits the infection. Why then, did the baby in this case get so ill? A) The child was only 18-days old; at that young age, her adaptive immunity had not yet developed, so she was unable to fight the infection. B) The child was only 18-days old; at that young age, her innate immunity had not yet developed, so she was unable to fight the infection. C) HSV-1 is a very virulent pathogen; if the infant had acquired HSV-2, she would have been able to mount a successful immune response. D) The child was only 18-days old; she was too young to have received her HSV vaccine that would have protected her from the virus. E) Because the child was just an infant, it was easy for the virus to get from her mouth to her brain; the head of an infant is very small.

100.3) Typical signs and symptoms of HSV-1 infection include fever, enlarged lymph nodes and eventually small blisters in the throat, around the mouth or on the lips. Why were the parents of the infant tested for HSV-1?

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A) Although the parents were not reported to have symptoms, HSV-1 infections are often asymptomatic; the parents may have infected the baby. B) Although the parents were not reported to have symptoms, theywould also be at risk of developing meningitis if they were positive for HSV. C) Although the parents were not reported to have symptoms, they likely required aggressive treatment if positive for HSV infection. D) The parents needed to be vaccinated against HSV, even if they tested negative for the virus. E) The parents were at risk of developing neonatal herpes simplex because their infant had developed HSV-1 associated disease.

100.4) How would an asymptomatic friend or family member have been able to transmit HSVto this child? A) The virus is transmitted by the fecal-oral route; the person touched the baby with contaminated hands and the child then touched her own mouth. B) Asymptomatic people can still release virions through sweat; they touched the infant and passed on the virus to her that way. C) Asymptomatic people can exhale virions; if the person put his/her face close to the baby, she could have inhaled the HSV-1. D) HSV-1 can be transmitted via the saliva of asymptomatic people; if the person kissed the baby, they could have passed on the virus. E) All of the choices are possible ways in which an asymptomatic person could have passed on the virus to the infant in this case.

100.5) ⊚ ⊚

HSV-1 infections are typically cured with antiviral medications. true false

100.6) ⊚ ⊚

Infants with neonatal herpes simplex always die. true false

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Answer Key Test name: Chap 24_10e 1) TRUE 2) TRUE 3) TRUE 4) FALSE 5) TRUE 6) TRUE 7) TRUE 8) TRUE 9) FALSE 10) TRUE 11) B 12) D 13) B 14) B 15) A 16) B 17) D 18) C 19) E 20) E 21) B 22) C 23) B 24) E 25) E 26) B Version 1

27) E 28) C 29) B 30) B 31) C 32) D 33) A 34) B 35) E 36) B 37) D 38) A 39) D 40) B 41) E 42) B 43) C 44) A 45) B 46) C 47) C 48) C 49) B 50) D 51) C 52) D 53) A 54) E 55) E 56) C Version 1

57) B 58) E 59) B 60) A 61) C 62) A 63) E 64) A 65) D 66) C 67) A 68) C 69) E 70) D 71) E 72) D 73) C 74) D 75) C 76) C 77) A 78) C 79) E 80) B 81) A 82) A 83) C 84) D 85) D 86) E Version 1

87) A 88) E 89) D 90) A 91) A 92) E 93) A 94) C 95) B 96) A 97) C 98) Section Break 98.1) A 98.2) B 98.3) A 98.4) D 98.5) B 99) Section Break 99.1) B 99.2) A 99.3) E 99.4) D 99.5) D 100) Section Break 100.1) A 100.2) A 100.3) A 100.4) D 100.5) FALSE 100.6) FALSE Version 1

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CHAPTER 25 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Muscles aid the flow of venous blood. ⊚ ⊚

true false

Sepsis is only caused by Gram-negative bacteria. ⊚ ⊚

true false

Both Francisella tularensis and Brucella melitensis are able to survive phagocytosis. ⊚ true ⊚ false

Gram-positive organisms are more likelythan other infectious agents to cause fatal sepsis. ⊚ ⊚

The media used to successfully grow Francisella tularensis must contain cysteine. ⊚ ⊚

true false

The genes for the capsule and YOPs of Yersinia pestisare carried on a plasmid. ⊚ ⊚

true false

Yellow fever is caused by a protozoan infection. ⊚ ⊚

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true false

Both malaria and yellow fever are transmitted by mosquitoes. ⊚ ⊚

Plasmodium falciparum causes the most serious form of malaria. ⊚ ⊚

10)

true false

In a malarial infection, only sporozoites can infect the human liver. ⊚ ⊚

11)

true false

Borrelia burgdorferi is a microaerophilic spirochete. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 12) The scientist responsible for the development of the first anti-plague vaccine in 1866 was A) Alexandre Yersin. B) Robert Koch. C) Louis Pasteur. D) Josef Marburg. E) Barbara McClintock.

13)

The plague bacillus is known as

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A) Plasmodium vivax. B) Pneumocystis carinii. C) Streptococcus pyogenes. D) Yersinia pestis. E) Bacillus anthracis.

14)

The circulation of an agent in the bloodstream is given a name ending in A) -ase. B) -ing. C) -emia. D) -ation. E) -cyte.

15)

The sac which surrounds the heart is called the A) endocardium. B) pericardium. C) atrium. D) myocardium. E) endothelium.

16)

The heart chamber that passes blood to the lungs is the A) left ventricle. B) right ventricle. C) right atrium. D) left atrium. E) right ventricle AND left atrium.

17)

Which organism may be implicated in atherosclerosis?

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A) Escherichia coli B) Pseudomonas aeruginosa C) Staphylococcus aureus D) Chlamydophila pneumoniae E) Mycoplasma pneumoniae

18)

The fluid which bathes and nourishes the tissue cells is the A) cytoplasm. B) interstitial fluid. C) lymph. D) blood. E) hyperstitial fluid.

19)

The small bean-shaped bodies into which the lymphatic vessels drain are the A) lymph nodes. B) adrenals. C) subclavian veins. D) valves. E) lymph beans.

20)

A visible red streak in an infected hand or foot is referred to as A) septicemia. B) bacteremia. C) lymphangitis. D) edema. E) plasmitis.

21)

Blood and lymph may carry

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A) antibodies. B) complement. C) lysozyme. D) interferon. E) All of the choices are correct.

22)

The spleen, in part, functions to cleanse the A) blood. B) lymph. C) interstitial fluid. D) cytoplasm. E) fluid.

23)

The condition that develops on a previously damaged heart valve is called A) an aneurysm. B) acute bacterial endocarditis. C) infective endocarditis. D) myocarditis. E) effective endocarditis.

24)

The most common agent(s) causing infective endocarditis is/are A) Streptococcus pyogenes. B) Pseudomonas aeruginosa. C) normal skin or mouth microbiota. D) Escherichia coli. E) normal gut microbiota.

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25) High levels of antibodies in patients with infectious endocarditis cause inflammation because A) they may form immune complexes thatget trapped in skin and eyes. B) the surface antigens change rapidly and become unrecognizable. C) the antibodies initiate type I, type II, or type III hypersensitivities. D) the antibodies degrade quickly and debris gets trapped in these organs. E) they may form clots that lead to life-threatening emboli.

26)

The inflammatory effect of immune complexes lodged in the kidney is called A) renal nephritis. B) glomerulonephritis. C) edema. D) urethritis. E) endophritis.

27) Which of the following is NOT a route by which bacteria that cause infective endocarditis may gain access to the bloodstream? A) Trauma B) Dental procedures C) Brushing teeth D) Ingestion E) Kidney infection

28)

Acute bacterial endocarditis differs from infective endocarditis in the A) suddenness and severity of onset. B) population affected. C) resultant damage. D) development of exotoxin shock. E) causative organisms.

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29)

Which of the following is more likely to cause fatal sepsis? A) Gram-positive bacteria B) Gram-negative bacteria C) Negatively stained bacteria D) Acid-fast bacteria E) Mycoplasmas

30)

The material released from bacteria that may lead to shock and death in sepsis is A) exotoxin. B) protein A. C) endotoxin. D) interferon. E) M protein.

31) Although sepsis affects many organs, the organ(s) most seriously and irreversibly affected is/are the A) heart. B) lungs. C) kidneys. D) spleen. E) pancreas.

32)

Enlargement of lymph nodes or spleen is often associated with

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A) tularemia AND plague. B) brucellosis AND tularemia. C) plague. D) gastritis AND plague. E) tularemia, brucellosis, AND plague.

33) In order to culture the organism responsible for tularemia, the growth medium must contain A) cysteine. B) glucose. C) charcoal. D) NAD. E) ATP.

34)

The common name for tularemia is A) Bang's disease. B) rabbit fever. C) Hansen's disease. D) Chagas' disease. E) dog tick fever.

35) The development of lymph node enlargement in the region of a skin ulcer after a tick or insect bite or handling of a wild animal suggests A) brucellosis. B) endocarditis. C) sepsis. D) tularemia. E) Lyme disease.

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36)

Which of the following is/are able to survive phagocytosis? A) Brucella species AND Staphylococcus aureus. B) Staphylococcus aureus AND Francisella tularensis C) Brucella species AND Francisella tularensis D) Francisella tularensis AND Staphylococcus epidermidis E) All of the choices are correct.

37)

Brucellosis may also be known as A) Bang's disease OR rabbit fever. B) Bang's disease OR undulant fever. C) undulant fever OR Hansen's disease. D) Hansen's disease OR rabbit fever. E) rabbit fever OR undulant fever.

38)

Traditionally, the animal(s) associated with hosting Brucella is/are A) cattle. B) dogs. C) goats. D) pigs. E) All of the choices are correct.

39)

The "Black Death" may also be known as A) tularemia. B) plague. C) brucellosis. D) endocarditis. E) necrosis.

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40) The disease responsible for the death of approximately 25% of the population of Europe from 1346 to 1350 was A) typhus. B) pneumonia. C) influenza. D) plague. E) endocarditis.

41)

Symptoms of plague appear in A) one to two years. B) two to three months. C) one to six days. D) three to six hours. E) three to six months.

42)

The causative agent of plague is A) Yersinia pestis. B) Vibrio cholerae. C) Staphylococcus aureus. D) Brucella abortus. E) Infected fleas.

43)

The major virulence factors of Yersinia pestis(capsule and Yops) are carried on A) the chromosome. B) a plasmid. C) three separateplasmids. D) the nuclear membrane. E) the chromosome AND plasmids.

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44)

The virulence factor of Yersinia pestis that is a protease that destroys C3b and C5a is A) Yops. B) pla. C) F1. D) protein A. E) V antigen.

45)

YOPs, proteins produced by Yersinia pestis, A) interfere withphagocytosis. B) activate plasminogen activator. C) destroy C3b and C5a. D) promote apoptosis. E) control a type III secretion system.

46)

The plague is typically transmitted via the bite of infected A) ticks. B) fleas. C) lice. D) mites. E) mosquitoes.

47) Enlargement of lymph nodes or spleen is often associated with all of the following EXCEPT

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A) tularemia. B) brucellosis. C) plague. D) infectious mononucleosis. E) vibriosis.

48)

The cause of infectious mononucleosis is A) varicella-zoster virus. B) Staphylococcus aureus. C) Epstein-Barr virus. D) Francisella tularensis. E) Yersinia pestis.

49)

Epstein-Barr virus may become latent in A) red blood cells. B) B cells. C) T cells. D) nerve cells. E) macrophages.

50)

The production of heterophile antibody is associated with A) tularemia. B) brucellosis. C) plague. D) infectious mononucleosis. E) sepsis.

51)

Which of the following may be contracted from saliva?

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A) Infectious mononucleosis B) Dengue fever C) Plague D) Yellow fever E) Chikungunya

52)

Yellow fever is transmitted by A) ticks. B) fleas. C) Aedes mosquitoes. D) Anopheles mosquitoes. E) lice.

53) The disease caused by an enveloped single-stranded RNA arbovirus of the flavivirus family is A) brucellosis. B) yellow fever. C) malaria. D) herpes. E) chikungunya.

54)

Which of the following is caused by a protozoan? A) Malaria B) Yellow fever C) Tularemia D) Infectious mononucleosis E) Dengue fever

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55)

Which of the following are transmitted by mosquitoes? A) plague AND yellow fever. B) yellow fever AND tularemia. C) yellow fever AND malaria. D) malaria AND tularemia. E) tularemia AND plague.

56)

Which species of Plasmodium causes the most serious form of malaria? A) Falciparum B) Ovale C) Malariae D) Vivax E) Knowlesi

57)

The spleen enlarges in A) infectious mononucleosis AND Lyme disease. B) malaria AND Lyme disease. C) brucellosis AND sepsis. D) infectious mononucleosis AND malaria. E) plague AND sepsis.

58)

What is the difference between "bacteremia" and "sepsis"?

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A) Bacteremia is an infection with bacteria. Sepsis is an infection with Septic protozoans. B) Sepsis is the presence of bacteria in the blood. Bacteremia is caused by bacteria multiplying in the blood, and is the result of an inflammatory response to these organisms. C) Bacteremia is the presence of bacteria in the blood. Sepsis is caused by bacteria multiplying in the blood, and is the result of an inflammatory response to these organisms. D) Bacteremia is a serious infection that is almost always fatal. Sepsis is less serious and can usually be treated with broad-spectrum antibiotics. E) There is no difference; both terms indicate the presence of living bacterial cells in the bloodstream.

59)

How would crowded conditions in cities favor spread of bubonic plague?

A) Plague is transmitted by rats; more people means more waste, and more waste means more rats. This would favor the spread of plague. B) Plague is transmitted by infected fleas; these fleas may be found on rodents (such as rats). More people in an area means a greater chance of interactions with animals carrying infected fleas, increasing the spread of plague. C) Plague is transmitted by mosquitoes; more people close together gives an infected mosquito more chances to bite humans and transmit the causative agent, spreading plague. D) Plague is transmitted by direct contact (e.g. skin to skin). More people in an area provides more chances for infected individuals to directly contact and infect other individuals, spreading plague. E) Bubonic plague is transmitted by aerosol droplets. People in cities are always dependent on public transport, which is typically overcrowded, so are at risk of acquiring plague bacteria.

60) Why does it take more than a week before a mosquito that has just become infected with yellow fever virus can transmit the disease?

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A) The virus must replicate in the gut of the mosquito before it can reach high enough numbers for transmission to another human. B) Mosquitoes onlyfeed once a week, which limits their ability to transmit the diseaserapidly. C) Mosquitoes that acquire yellow fever virus become ill for a week thereafter. They have to recover before they can feed again and transmit the virus to the next host. D) The virus multiplies in the gut of the mosquito, but then needs to migrate to the mouth of the insect in order to infect a new human being after a new bite. This migration takes time. E) The mosquito actually transmits the virus almost immediately. It takes a week for the virus to multiply in the gut of the host before it causes any ill effects in that host.

61)

The unique characteristic of Lyme disease is A) erythema migrans. B) fever. C) carbuncle. D) furuncle. E) rash on palms.

62)

The stage of Lyme disease that is characterized by arthritis is the A) primary. B) third. C) second. D) fourth. E) intermediate.

63)

The most important vector of Lyme disease in the eastern United States is

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A) Dermacentor virabilis. B) Dermacentor andersoni. C) Staphylococcus aureus. D) Ixodes scapularis. E) Borrelia burgdorferi.

64)

Which of the following pertains to Borrelia burgdorferi? A) Coccus B) Bacillus C) Spirochete D) Filament E) Capsid

65)

The preferred host of Ixodes scapularis is the A) wood rat. B) white-footed mouse. C) moose. D) human. E) ground squirrel.

66) the

The growth stage of the vector that is mainly responsible for transmitting Lyme disease is

A) nymph stage. B) egg. C) moulter. D) adult. E) mouse.

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67) When Lyme disease was first being investigated, the observation thatfrequently onlyone person in a household was infected was a clue leading to the discovery that the disease was transmitted by arthropod bites. Why was this so? A) If the infection is spread by the bite of an arthropod, it wouldn't spread easily by respiratory secretions, direct contact, or sexual contact between individuals within the family. B) Mosquitoes (an example of arthropods) are never inside a house. They are strictly outdoor insects, so they couldn't spread the infection inside the household. C) Mosquitoes (an example of arthropods) only bite once in their lifetime. As such, they can only transmit the illness once before they die. Even if an infectedmosquito was inside a house, it could only infect one human. D) Arthropods lose their mechanical ability to bite a human after a single bite, much like certain bees lose their stinger after a single sting. This prevents them from transmitting the infection to more than one individual in a household. E) These are all valid reasons that support the theory that Lyme disease must be transmitted by arthropod bites.

68)

Which statement about the cardiovascular and lymphatic systems is NOT true?

A) The cardiovascular and lymphatic systems are typically sterile. B) Veins carry blood away from the heart while arteries carry blood towards the heart. C) Lymphatic vessel inflammation is called lymphangitis, and presentsas a red streak from an infection site toward the nearest lymph node. D) Blood is exposed to immune cells as it passes through the spleen.  E) Phagocytes in spleen red pulp remove aging or damaged RBCs, bacteria, and other antigens from the blood.

69) In infective endocarditis, septic emboli may break off. What is/are the possible outcome(s) of emboli in the circulation?

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A) They mayblock blood vessels, leading to death of the tissue supplied by the vessel.  B) They can cause a vessel to weaken and balloon out, forming an aneurysm. <!-Markup Copied from Habitat--> C) They lead to the formation of immune complexes that lodge in the skin, the eyes, and other body structures. D) They can cause a vessel to weaken and balloon out, forming an aneurysm AND they mayblock blood vessels, leading to death of the tissue supplied by the vessel. E) They may block blood vessels, leading to death of the tissue supplied by the vessel AND they can cause a vessel to weaken and balloon out, forming an aneurysm, AND they lead to the formation of immune complexes that lodge in the skin, the eyes, and other body structures.

70)

What leads to organ failure in sepsis?

A) Uncontrolled inflammation that leads to neutrophils releasing damaging toxins and lysosomal enzymes. B) Helper T cells and dendritic cells undergo apoptosis, causing immunosuppression that results in organ rejection. C) Formation of small clots in capillaries, impairing blood flow to organs and causing hypoxia and cell death. D) Accumulation of endotoxins released from Gram-negative bacteria in the organs, causing tissue damage and cell death. E) Organisms from an infected site generate biofilms that break apart, leading to emboli and organ destruction.

71)

Which of the following contribute(s) to lung damage in people with sepsis?

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A) Increased capillary leakage of plasma AND damaging lysosomal enzymes released from leukocytes. B) Damaging lysosomal enzymes released from leukocytes AND organ damage from clots in capillaries. C) Depletion of clotting proteins AND decreased muscle tone of heart and arteries. D) Depletion of clotting proteins AND damaging lysosomal enzymes released from leukocytes. E) Decreased muscle tone of heart and arteries AND increased capillary leakage of plasma.

72)

Select one FALSE statement about sepsis.

A) Lung damage is an important cause of death in people with sepsis. B) Sepsis can be caused by Gram-positive or Gram-negative bacteria. C) Common causes of fatal sepsis include members of the normal microbiota of the large intestine.  D) Sepsis is sometimes a healthcare-associated illness  but is more commonly a community-acquired infection.  E) Use of medical equipment where biofilms readily develop increases the risk of sepsis.

73)

Select the statement about plague that is TRUE. A) When Yersinia pestisinfects the lungs, septicemic plague always develops. B) Bubonic plague is transmitted by the bite of infected mosquitoes that have also bitten

rats. C) The causative agent of plague isa facultatively anaerobic, Gram-positive rod. <!-Markup Copied from Habitat--> D) DIC causes the dusky color of skin and mucous membranes characteristic of bubonic plague.  E) Bubonic plague is almost always fatal.

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74) Which of the following virulence factors of Yersinia pestis aid(s) in attachment to host cells? A) Yersinia outerproteins (Yops) B) Endotoxin C) PsaA D) Pla E) V antigen

75)

Which of the following is/are the modes of transmission for T. francisella? A) By inhalation B) Through minor cuts or abrasions C) Via ingestion of contaminated meat D) By tick bites E) All of the answer choices are correct.

76)

How does F. tularensis avoid the immune system?

A) By having altered surface components AND by destroying lymphocytes. <!-Markup Copied from Habitat--> B) By escaping from the macrophage phagolysosome AND by producing streptokinases. C) By synthesizing a large polysaccharide capsule AND by degrading complement component C3b. D) By synthesizing a large polysaccharide capsule AND by escaping the macrophage phagolysosome. E) By having altered surface components AND by escaping the macrophage phagolysosome.

77)

Which of the following is NOT a possible sign/symptom or complication of brucellosis?

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A) Depression B) Endocarditis C) Meningitis D) Erythema migrans E) Osteomyelitis

78)

Which of the following is NOT a zoonosis? A) Brucellosis B) Infectious mononucleosis C) Lyme disease D) Tularemia E) Plague

79)

Which statement about infectious mononucleosis is FALSE?

A) Initial signs and symptoms of EBV infection resemble those of pharyngitis. B) In a non-productive EBV infection, the virus establishes a latent infection and is maintained as either a plasmid or a provirus.  C) EBV-infected B cellsproduce a heterophile antibody that plays no role in the pathology of mononucleosis, but can be used for diagnosis.  D) Infectious mononucleosis results in lymph node and spleen enlargement, and is occasionally fatal because the spleen may rupture. E) Antiviral medications such as acyclovir and famciclovir inhibit both productive and non-productive EBV infections.

80) What is the significance of immune complex formation in infective endocarditis? <!-Markup Copied from Habitat-->

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A) They can be deposited in tissues and organs, causing damage. B) They lead to the formation of biofilms that are difficult to eliminate. C) They cause disseminated intravascular coagulation. D) They result in the enzymatic destruction of neutrophils and macrophages. E) They lead to the development of autoimmunity.

81) Which of the following possibly explains the development of severe dengue? <!-Markup Copied from Habitat--> A) Previously formed antibodies to one serotype of dengue virus bind to the second serotype and rather than neutralizing it, facilitate its entry into cells that express Fc receptors. This leads toincreased numbers of infected cells and a high viral load.  B) Previously formed antibodies to one serotype of dengue virus suppress the immune response to infection with other serotypes; this allows the second infection to become much more severe than the first infection. C) Infection with one serotype of dengue virusresults in the formation of clots in small blood vessels throughout the body; viruses from a second infection enter these clots and multiply uninhibited within them, resulting in serious disease.  D) Antibodies generated in response to one serotype of dengue virus cross-react with a second serotype of the virus. This leads to the formation of immune complexes that lodge in the brains of infected people, causing serious illness. E) Dengue viruses are DNA viruses that can integrate into the chromosome of the host cell. If a cell is already infected with one serotype of the virus, infection with a second serotype will lead to the death of that cell.

82) Why might the Yersinia pestis from a patient with pneumonic plague be more dangerous than the same organism from fleas? A) The organism mutates in a person with pneumonic plague, so is more dangerous. B) The organism involved in pneumonic plague is resistant to multiple antibiotics. C) The organism acquired this way is already fully virulent, so is especially dangerous. D) Y. pestis in the lungs has a polysaccharide capsule while that in fleas does not. E) These are all true.

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83) Which is NOT a reason that it would be more difficult to eradicate Lyme dis-ease than rubeola or rubella? A) Lyme disease is transmitted by Ixodes tick vectors—it would be impossible to eliminate these ticks from earth. B) The causative agent of Lyme disease is harbored in intermediate hosts (mice and deer)—elimination of these would be impossible. C) Rubeola and rubella only infect humans—if all humans were immune (through vaccination for example), the diseases would be eliminated. D) Lyme disease cannot be treated successfully with antimicrobials, while rubella and rubeola can be successfully treated—it is thus easier to eliminate them. E) These are all valid reasons to explain why eradicating Lyme disease would be more difficult than eliminating rubella and rubeola.

84) You are working for Nursing Beyond Borders and have recently returned to the U. S. from your posting in Africa. You wake up with flu-like signs and symptoms, includingfever, headache, and pain in the joints and muscles. You also are experiencing cycles of chills, fevers, and sweats. You have a lot of itchy bites on your arms and legs. You suspect that you have _______, a _______ disease transmitted by _______.  <!-Markup Copied from Habitat--> A) malaria; protozoan; mosquitoes B) yellow fever; protozoan; mosquitoes C) malaria; bacterial; ticks D) Dengue; protozoan; flies E) Ebola disease; viral; the fecal-oral route

85)

Select the INCORRECT statement regarding infectious mononucleosis.

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A) It may be fatal if an affected person's spleen ruptures. B) It is caused by Epstein-Barr virus, a double-stranded DNA virus. C) Asymptomatic people continue to shed EBV in saliva for up to 18 months. D) Transmission is by blood and blood products. E) People with the disease are sometimes misdiagnosed with leukemia.

86) What is the importance of heterophile antibodies in infectious mononucleosis? <!-Markup Copied from Habitat--> A) They are important in infectious mononucleosis diagnosis. B) They bind to and neutralize Epstein-Barr virus. C) They activate complement proteins, initiating inflammation. D) They cause B cell differentiation into plasma cells. E) They activate cytotoxic T cells, initiating virus destruction.

87) Please select the correct sequence for infectious mononucleosis pathogenesis. 1. Virions are carried to lymph nodes. 2. Latently infected B cells produce heterophile antibodies. 3. Viruses bind to and infect B lymphocytes. 4. Virions escape lymph nodes and enter bloodstream. 5. EBV binds to and infects throat epithelium. 6. EBV replicates, causing pharyngitis. A) 5; 6; 1; 4; 3; 2 B) 3; 1; 4; 2; 6 ;5 C) 4; 5; 6; 3; 2; 1 D) 1; 3; 5; 2; 4; 6 E) 5; 6; 4; 3; 1; 2

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88) You examine a blood smear taken from your patient. You observe atypical lymphocytes, as seen this figure. You diagnose

Chamberlain, Medical Microbiology: The Big Picture A) Yellow fever. B) severe Dengue. C) infectious mononucleosis. D) Zika virus disease. E) Ebola disease.

89) All of the following are true of Ebola disease (EBOD) and Marburg disease (MARD) EXCEPT A) they frequently have a high case-fatality rate. B) they may cause death through multi-organ failure and shock. C) they are caused byfilamentous, enveloped, single-stranded RNA viruses. <!-Markup Copied from Habitat--> D) they can be cured with investigational monoclonal antibody treatments.  E) transmission is human-to-human occurs direct contact with body fluids.

90)

All of the following are TRUE of dengue and severe dengue EXCEPT

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A) they are caused by four differentsingle-stranded RNA dengue viruses.  B) severe dengue may led to disseminated intravascular coagulation and shock. C) they are widely prevented by vaccination recommended for all children. D) they are treated with pain medications, rehydration and sometimes blood transfusions. E) they are often characterized byfever, headache, rash, and severe joint pain. <!-Markup Copied from Habitat-->

91) Why should people with dengue or severe dengueavoid aspirin and nonsteroidal antiinflammatory drugs such as ibuprofen?  A) These medications can worsen bleeding associated with dengue AND aspirin has been linked to Reye’s syndrome in children who have viral infections. B) These medications can worsen bleeding associated with dengue. C) Aspirin has been linked to Reye’s syndrome in children who have viral infections. D) These medications cause clotting and coagulation AND aspirin has been linked to Reye’s syndrome in children who have viral infections. E) These medications cause disseminated intravascular coagulation and multi-organ failure in children.

92) Why does WHO only recommend the dengue vaccine for people who have laboratoryconfirmed cases of the disease? A) The vaccine may increase the risk of severe dengue in children who already have the disease. B) The vaccine may increase the chance of severe dengue in those who are not infected with DENV. C) The vaccine is not very useful because it only protects against DENV1. D) The vaccine is not very useful because it only protects against DENV1 and DENV2. E) The vaccine causes severe dengue in children who have already acquired several dengue viruses.

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93)

Why must a vaccine against dengue fever be effective against all strains of the virus?

A) Severe denguecan occur in patients that have a second dengue infection; the vaccine must be effective against all DENV strains so that the recipient is not vulnerable to acquiring a different strain and thus a second infection. B) Severe denguealways occurs in patients that have multiple dengue infections; the vaccine must be effective against at least two DENV strains so that the recipient is not vulnerable to acquiring a different strain and thus a secondary infection. C) If the vaccine is only against a single strain, the person would have to get four different shots every time they are exposed to DENV; most people are unlikely/ unwilling to endure this discomfort and financial cost. D) Being vaccinated against a single DENV strain increases a person's probability of acquiring the other strains of the virus, making them more vulnerable to the less severe form of the disease. E) The question in misleading; vaccination against one DENV strain is sufficient to protect a person from ever developing dengue or severe dengue.

94)

All of the following are methods for preventing dengue EXCEPT A) using insecticide-impregnated bed nets. B) destruction of mosquito breeding areas. C) biological control of mosquito larvae. D) taking prophylactic antibiotics. E) wearing protective, insect-proof clothing.

95) All of the following are true of severe dengue EXCEPT

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A) it is thought to result fromantibody-dependent enhancement.  B) it is characterized bychanges in vascular permeability.  C) it may result in respiratory distress and dehydration.  D) it is only caused by certain DENV strains. E) it may result inmassive gastrointestinal and vaginal bleeding.

96)

How can chikungunya be differentiated from dengue?

A) Chikungunya is caused by a protozoan; dengue is caused by a virus. B) Chikungunya may cause chronic joint pain; dengue joint pain resolves. C) Chikungunya can be cured with antiviral medication; dengue has no specific treatment. D) Chikungunya is sexually transmitted; dengue is vector-borne.   E) Chikungunya is prevented with a vaccine; there is no dengue vaccine.

97)

Which of the following is/are possible complications of Zika virus disease? A) Guillain-Barré syndrome B) Congenital Zika syndrome  C) Guillain-Barré syndrome AND congenital Zika syndrome D) Congenital Zika syndrome AND infertility E) Infertility ANDGuillain-Barré syndrome

98)

All of the following are true of Zika virus disease EXCEPT

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A) it may cause microcephaly and neurological abnormalities in fetuses/infants. B) it is caused by an enveloped, single-stranded RNA arbovirus.  C) Zika virus can bind to receptors on cells of the skin, joints, nerves, and eyes. <!-Markup Copied from Habitat--> D) it is characterized by fever, rash, joint pain, and red eyes.  E) it can be prevented by a recombinant attenuated vaccine.

SECTION BREAK. Answer all the part questions. 99) You go hiking in the woods with some of your classmates. A few days after the hike, your friend Alice calls to tell you she is not feeling well and that she is going to skip soccer practice that evening. She says she has a weird rash on her leg and wonders if she was bitten by a spider while your were hiking. She sends you a photo of the rash. Youare in your final semester of nursing school and have recently studied disease of the cardiovascular system. You think that the rash that Alice has is a sign of Lyme disease, and offer to go with her to the urgent care to get medical help. While you are waiting to see a clinician, youanswer Alice's questionsabout Lyme disease.

99.1) What is unusual about Borrelia bergdorferi, the causative agent of Lyme disease? A) Borrelia bergdorferi is a pathogenic spirochete. B) The bacterium is a Gram-negative, microaerophilic pathogen. C) The organism contains plasmids that have genes normally found on the chromosome. D) B. bergdorferi causesflu-like signs and symptoms when it first infects a host. E) The cells have a thin peptidoglycan cell wall with an outer membrane containing LPS.

99.2)

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What causes the characteristic erythema migrans of Lyme disease?

A) After a person acquires the causative bacteria by eating contaminated meat, the bacteria migrate to the skin in a corkscrew-like motion, killing host cells as they move and causing the bull's-eye rash. B) After being introduced into the skin by the bite of an infected tick, the Gram-negative bacteria migrate outward in a circular manner; the LPS in their outer layer causes an inflammatory reaction. C) After being introduced into the skin by the bite of an infected mosquito, the Grampositive bacteria migrate outward in a corkscrew-like manner; the NAGs and NAMs in their cell wall causes an inflammatory reaction. D) Borrelia bergdorferi cells propel themselves from host cell to host cell using actin tails, in a manner similar to Shigella cells. As they move, the bacteria destroy the host cells, causing the characteristic rash. E) Borrelia bergdorferi is an encapsulated organism. The capsule of these cells is composed of hyaluronic acid that causes a widespread inflammatory response in the skin of the host that manifests as a rash.

99.3) Lyme disease is a zoonosis with humans being an accidental host. What does this mean?  A) Borrelia burgdorferi is transmitted to animals from humans AND the bacterium cannot complete its life cycle in humans. B) Borrelia burgdorferi is found predominantly in zoo animals ANDthe bacterium cannot complete its life cycle in humans. C) Borrelia burgdorferi is transmitted to humans from animals AND humans are NOT the normal host for the tick vector. D) Borrelia burgdorferi is found predominantly in zoo animals ANDthe tick vector cannot complete its life cycle in humans. E) Borrelia burgdorferi is found predominantly in zoo animals ANDhumans are not the normal host for the tick vector.

99.4) Why is it more difficult to treat a late persistent Lyme infection than an early disseminated Lyme infection?

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A) The bacteria have developed resistance to multiple antibiotics by the late stage of the disease, so it is difficult to effectively treat a person. B) A person with Lyme disease develops resistance to multiple antibiotics throughout the course of the disease, so treating them in the late stage of the disease becomes challenging. C) Borrelia bergdorferi produces extremely resistant endospores in the late stage of the disease. Once these have been formed, it is very difficult to treat the disease. D) The bacteria are no longer dividing in the late stage of Lyme disease, and as antibiotics only work against actively dividing bacteria, they are less effective at this stage. E) Borrelia bergdorferi forms dense biofilms under the skin of infected people in the late stage of the disease. Bacteria within biofilms are protected from the effects of antibiotics and are difficult to kill.

99.5)

Which statement is NOT true of Lyme disease?

A) Untreated Lyme disease can lead to serious complications, including arthritis and cardiovascular and neurological problems. B) The main reservoirs for Borrelia bergdorferi are infected mosquitoes, white-footed mice, deer, and deer ticks. C) Several different antibiotics can be used to treat patients in the early stages of Lyme disease, including doxycycline, amoxicillin,andcefuroxime.  D) Chronic Lyme disease signs and symptoms such as arthritisoccur due to persisting bacteria and the host's immune response to them. E) Signs and symptoms of Lyme disease occur in three phases, although individual patients may be asymptomatic in one or more of these stages.

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100) Two people are brought to the Emergency Department where you work. The first patient reportsfever, abdominal pain, vomiting, and diarrhea. The second patient appears extremely ill. Her family tells you that she also had gastrointestinal signs and symptoms a few days ago. Shehas nowdeveloped severe skin blistering, has a very high fever andis only semi-conscious. When you question the first patient and the family of the second patient, you discover that they know each other and that they have all recently returned from a beach vacation in a major city onthe U.S. Gulf Coast. The group tells you that the enjoyed a rawoyster dinner on the last day of their summer vacation. They think that both patients are probably just allergic to seafood, but given the severity of the signs and symptoms of your patients, you suspect that they may have Vibrio vulnificus infection. Lab tests confirm your suspicion. You give the families information on this disease.

100.1) Which of the statements regarding Vibrio vulnificus infection and its causative agent is FALSE? A) Vibrio vulnificusis a Gram-negative, motile, curved, rod-shaped bacterium that is related to V. choleraebut lacks a capsule. B) V. vulnificusreleases degradative enzymes as well as toxins in a coordinated manner, controlled by a quorum-sensing mechanism. C) V. vulnificusproduces endotoxin, which causes an uncontrolled inflammatory response that leads to endotoxic shock. D) In most people, V. vulnificuscauses fever, vomiting, diarrhea, and abdominal pain, but immunocompromised people are at risk of developing sepsis. E) V. vulnificus produces a cytotoxin called RTX thatkills epithelial cells by forming pores in their membranes.

100.2) Patients with V. vulnificus infection are givena combination of synergistic antibiotics. This means that

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A) each antibiotic works independently, but does not inhibit the action of the other antibiotic(s) in the combination. B) the action of one antibiotic diminishes the effect of the other(s) in the combination. C) the antibiotics work together to produce a stronger effect than eitherantibiotic on its own. D) one antibiotic in the combination is always broad-spectrum while the other(s) is/are always narrow spectrum. E) the antibiotics given in combination are always broad-spectrum medications.

100.3) You find out that the seriously ill patient has an underlying condition. Which of the following likely predisposed her to the more severe infection? A) Cirrhosis B) Asthma C) Glomerulonephritis D) Osteoporosis E) Cystitis

100.4) People with chronic liver disease frequently have elevated levels of iron in their blood. Iron is needed by V. vulnificus for growth. How does it acquire iron from the host? A) V. vulnificusproduces siderophores that allow it to scavenge iron. B) V. vulnificusproduces a hemolysin that lyses blood cells to release iron-containing hemoglobin. C) V. vulnificusproduces a hemolysin that lyses blood cells to release iron-containing hemoglobin AND itproduces siderophores that allow it to scavenge iron. D) V. vulnificusproduces a hemolysin that lyses white blood cells to release ironcontaining hemoglobin ANDitproduces transferrins that allow it to scavenge iron. E) V. vulnificusproduces a hemolysin that lyses white blood cells to release ironcontaining hemoglobin ANDitproduces lactoferrins that allow it to scavenge iron.

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101) A19-year old female presented at her college healthcare facility complaining of sore throat (6 days), hoarseness, fatigue, muscle pain and a fever of 39.9oC. She had not been on vacation and did not report any insect bites. Physical examination indicated enlarged tonsils covered with pus, swollen lymph nodes in the neck, and splenomegaly. Blood tests indicated that her hematocrit was 44% (red blood cell count;normal range 38-48%), her leukocyte count was 9,000 cells/mm3 (reference range 4,500 - 11,000cells/m3) and a hepatic panel showed her liver function was normal (indicated by ALT, AST, GGT, total bilirubin (TB), blood urea nitrogen (BUN) and creatinine (Cr) levels). A rapid strep test was negative, confirmed by a negative throat culturefor β -hemolytic streptococci; achest x-ray confirmed that her lungs were clear of fluid. A blood smear showed atypical B lymphocytes (figure).

Chamberlain, Medical Microbiology: The Big Picture

101.1)

Select the CORRECT statement regarding the student's signs and symptoms.

A) Fever indicates that she had a bacterial infection. B) She had an elevated red blood cell count. C) Her white blood cell count was depressed. D) She had an enlarged spleen. E) Her liver enzyme aspartate transaminase was elevated.

101.2)

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The medical tests given to the patient indicated that she had

A) hepatitis C. B) bacterial pneumonia. C) viral pneumonia. D) streptococcal pharyngitis. E) infectious mononucleosis.

101.3)

The causative agent in this case is

A) Epstein-Barr virus, a double-stranded DNA virus. B) Epstein-Barr virus, a single-stranded DNA virus. C) ebola virus, a single-stranded RNA virus. D) yellow fever virus, a single-stranded RNA virus. E) Dengue virus 1, a single-stranded RNA virus.

101.4)

How was the student likely infected with EBV?

A) Inhalation of virus-containing aerosol drops. B) Consumption of contaminated food. C) Consumption of undercooked food. D) Exposure to contaminated saliva. E) Sharing clothing with a roommate.

101.5)

What is the most problematic sign/ symptom of the student, and why?

A) Fever; can lead to immunosuppression. B) Splenomegaly; may lead to spleen rupture. C) Sore throat; prevents eating and drinking. D) Tonsils with exudate; pus contains bacteria. E) atypical lymphocytes; results in leukemia.

101.6) Version 1

Which of the following treatments would NOT be given to this patient?

A) Splenectomy if the spleen ruptures. B) Analgesics (pain relievers). C) Broad-spectrum antibiotics. D) Antiviral medication such as acyclovir.  E) Anti-inflammatory medication.

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Answer Key Test name: Chap 25_10e 1) TRUE 2) FALSE 3) TRUE 4) FALSE 5) TRUE 6) TRUE 7) FALSE 8) TRUE 9) TRUE 10) TRUE 11) TRUE 12) A 13) D 14) C 15) B 16) B 17) D 18) B 19) A 20) C 21) E 22) A 23) C 24) C 25) A 26) B Version 1

27) D 28) A 29) B 30) C 31) B 32) E 33) A 34) B 35) D 36) C 37) B 38) E 39) B 40) D 41) C 42) A 43) C 44) B 45) A 46) B 47) E 48) C 49) B 50) D 51) A 52) C 53) B 54) A 55) C 56) A Version 1

57) D 58) C 59) B 60) A 61) A 62) B 63) D 64) C 65) B 66) A 67) A 68) B 69) E 70) C 71) A 72) D 73) D 74) C 75) E 76) E 77) D 78) B 79) E 80) A 81) A 82) C 83) D 84) A 85) D 86) A Version 1

87) A 88) C 89) D 90) C 91) A 92) B 93) A 94) D 95) D 96) B 97) C 98) E 99) Section Break 99.1) C 99.2) B 99.3) C 99.4) D 99.5) B 100) Section Break 100.1) A 100.2) C 100.3) A 100.4) C 101) Section Break 101.1) D 101.2) E 101.3) A 101.4) D 101.5) B 101.6) C Version 1

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CHAPTER 26 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Inflammation of the membranes covering the central nervous system (CNS) is called meningitis. ⊚ true ⊚ false

2) The initial symptoms of bacterial meningitis are the same regardless of the causative agent. ⊚ true ⊚ false

Mycobacterium leprae is only grown in living cells. ⊚ ⊚

Death from botulism is usually due to respiratory paralysis. ⊚ ⊚

true false

Viral meningitis is much more common than bacterial meningitis. ⊚ ⊚

true false

6) All cases of paralytic polio acquired in the U.S. between 1980 and 1999 were caused by Salk's polio vaccine. ⊚ true ⊚ false

Meningoencephalitis and African sleeping sickness are both caused by protozoans.

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⊚ ⊚

true false

Prions are small single-stranded pieces of RNA. ⊚ ⊚

true false

9) The PPSV23 vaccine may protect against pneumococcal pneumonia, pneumococcal meningitis, and otitis media. ⊚ ⊚

true false

10) Streptococcus pneumoniae and Haemophilus influenzae are frequently part of the normal microbiota of the nasal passages and throat. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 11) The central nervous system is made up of the A) brain and spinal cord. B) spinal cord and spinal nerves. C) sympathetic and parasympathetic system. D) brain and endocrine organs. E) spinal nerves and meninges.

12)

The nerves that carry information to the central nervous system (CNS) are termed

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A) motor nerves. B) endocrine nerves. C) cerebrospinal nerves. D) central nerves. E) sensory nerves.

13)

The cavities inside the brain are termed A) sinuses. B) ventricles. C) cavities. D) sulci. E) gyri.

14)

The membranes that cover the surface of the brain and spinal cord are known as the A) neurolemma. B) dura mater. C) meninges. D) collagen. E) sarcolemma.

15) To determine the causative agent of a central nervous system (CNS) infection, a sample is taken from the A) cerebrospinal fluid. B) arterial blood. C) venous blood. D) urine. E) ventricles.

16)

The nervous system typically

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A) is sterile. B) has a small number of normal microbiota. C) contains Gram-positive bacteria. D) contains a small number of viruses. E) has transient microbiota.

17)

An infection of the membranes covering the brain is called A) encephalitis. B) meningitis. C) arachnitis. D) ventriculitis. E) duramitis.

18)

The central nervous system (CNS) may become infected through the A) bloodstream. B) nerves. C) extensions from bone. D) ventricles. E) bloodstream, nerves, AND extensions from bone.

19)

The primary source of central nervous system (CNS) infections is through the A) bloodstream. B) genitourinary system. C) skin. D) nerves. E) gastrointestinal tract.

20)

The leading cause of bacterial meningitis in adults is

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A) Escherichia coli. B) Haemophilus influenzae. C) Streptococcus pneumoniae. D) Neisseria meningitidis. E) Mycoplasma pneumoniae.

21)

Identification of the various strains of N. meningitidis is through A) Gram staining. B) serogrouping. C) fluorescent antibodies. D) titering. E) signs and symptoms.

22)

Meningococcal meningitis is typically acquired through the A) respiratory tract. B) genitourinary tract. C) gastrointestinal tract. D) skin. E) any of these.

23)

The meningococcus attaches to the mucous membrane via ______. A) flagella B) pili C) cilia D) a capsule E) axial filaments

24)

Epidemics of meningitis appear to involve

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A) Streptococcus pneumoniae. B) Haemophilus influenzae. C) Neisseria meningitidis. D) Streptococcus pyogenes. E) Staphylococcus aureus.

25)

All of the following are true of listeriosis EXCEPT A) it is a foodborne disease. B) it may result in meningitis. C) it is usually asymptomatic in healthy people. D) it is caused by a psychrotroph. E) it is treated with acyclovir.

26)

Leprosy is A) an infectious disease caused by a virus. B) a disease of the blood. C) also known as Hansen's disease. D) always fatal. E) acquired by droplet transmission.

27)

Mycobacterium leprae has a generation time of A) 12 days. B) 6 hours. C) 1 day. D) 20 minutes. E) 12–13 hours.

28)

The only known human pathogen that preferentially attacks the peripheral nerves is

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A) N. meningitidis. B) poliovirus. C) M. leprae. D) E. coli. E) H. leprae.

29) The limited type of leprosy in which cell-mediated immunity suppresses proliferation of the bacilli is called A) lepromatous. B) limited. C) immune. D) tuberculoid. E) Hansen's.

30)

The incubation period of leprosy is A) 1 week. B) 3 weeks. C) 3 months. D) 3 or more years. E) over 10 years.

31)

M. leprae may infect A) skunks. B) iguanas. C) armadillos. D) raccoons. E) birds.

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32)

The transmission of M. leprae is by A) direct human-to-human contact AND the fecal-oral route. B) the fecal-oral route AND contact with contaminated blood products. C) contact with contaminated blood products. D) contact with infected nasal secretions AND the fecal-oral route. E) direct human-to-human contact AND contact with infected nasal secretions.

33)

Which is true about C. botulinum? A) It is aerobic. B) It grows well below pH 4.5. C) It produces an enterotoxin. D) It is Gram-negative. E) Itforms endospores.

34)

Which is true of the Clostridium botulinum toxin? A) It is heat-resistant. B) It is a neurotoxin. C) It stimulates nerve to muscle signal transmission. D) It causes spastic paralysis. E) All the choices are correct.

35)

Intestinal botulism, especially in infants, has been linked to ingestion of A) seafood. B) honey. C) milk. D) applesauce. E) syrup.

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36)

Food contaminated with Clostridium botulinum often A) appears normal. B) looks odd. C) smells bad. D) tastes bad. E) is frothy.

37)

Viral central nervous system infections may result in A) meningitis. B) encephalitis. C) poliomyelitis. D) rabies. E) All of the choices are correct.

38)

Humans acquire the arbovirus that causes epidemic encephalitis by A) the fecal-oral route. B) human to human contact. C) the bite of an infected mosquito. D) contaminated food. E) unprotected sex with an infected person.

39)

Which animal is used as an early warning system for viral encephalitis? A) Armadillos B) Chickens C) Mice D) Foxes E) Hawks

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40)

The poliomyelitis virus appears to selectively destroy A) sensory nerve cells. B) mixed nerve cells. C) autonomic nerve cells. D) motor nerve cells. E) muscle cells.

41)

The polioviruses usually enter the body through A) the oral route. B) contaminated blood. C) cuts in the skin. D) the respiratory route. E) insect bites.

42)

Which is true of the poliomyelitis virus? A) non-enveloped AND single-stranded DNA B) non-enveloped AND single-stranded RNA C) enveloped AND single-stranded DNA D) enveloped AND double-stranded RNA E) enveloped ANDsingle-stranded RNA

43)

The poliomyelitis virus is in the picornavirus family in the subgroup A) adenoviruses. B) enteroviruses. C) arboviruses. D) dermotrophs. E) retroviruses.

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44)

The early symptoms of rabies generally begin A) 1 day after viral entry. B) 1–2 months after viral entry. C) 6 months after viral entry. D) 1 year after viral entry. E) immediately after viral entry.

45)

The symptom at the site of an animal bite that suggests rabies as a possible diagnosis is A) failing to heal. B) blue-green pus. C) tingling or twitching. D) inflammation with high fever. E) blisters.

46)

Painful spasms of the throat triggered by swallowing or the sight of water is called A) hydrophobia. B) hydrophagia. C) tetany. D) paralysis. E) aquaphobia.

47)

The principal mode of transmission of rabies virus is through A) blood. B) fomites. C) saliva. D) pus. E) insect bites.

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48)

In rabies, the virus multiplies in one kind of cell then binds to receptors in the A) neuromuscular region. B) spinal cord. C) respiratory area. D) brain. E) cerebrospinal fluid.

49)

The incubation period of rabies is partially determined by

A) age of the patient ANDlength of journey from the bite site to the brain. B) season of the year that the disease is acquired AND length of journey from the bite site to the brain. C) length of journey from the bite site to the brain AND the amount of virus introduced into the wound. D) the amount of virus introduced into the wound AND season of the year that the disease is acquired. E) season of the year that the disease is acquired AND the age of the patient.

50) Characteristic inclusion bodies formed in cells of organisms infected with rabies are called A) Negri bodies. B) metachromatic bodies. C) polyphasic bodies. D) Koplik's spots. E) rhabdobodies.

51)

Stained smears of the surface of the eye might be useful in diagnosing

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A) influenza. B) rabies. C) herpes. D) polio. E) encephalitis.

52)

Central nervous system (CNS) diseases caused by fungus may occur in A) cancer patients. B) diabetics. C) AIDS patients. D) immunosuppressed people. E) All of the choices are correct.

53) Cryptococcal meningoencephalitis caused by Cryptococcus gattii differs from the general pattern of fungal central nervous system (CNS) disease by occurring in A) otherwise healthy people. B) children. C) AIDS patients. D) immunosuppressed people. E) animals only.

54)

Naegleria fowleri may cause A) meningitis. B) primary amebic meningoencephalitis. C) African sleeping sickness. D) AIDS. E) primary amebic microencephalitis.

55)

African sleeping sickness is transmitted by

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A) ticks. B) black flies. C) Aedes mosquitoes. D) tsetse flies. E) tsetse mosquitoes.

56)

The more severe form of African sleeping sickness is called the A) Gambian form. B) Rhodesian form. C) Guyanan form. D) Brazilian form. E) Zambian form.

57)

Corneal implants have been implicated in a few cases of A) botulism. B) trypanosomiasis. C) scrapie. D) encephalitis. E) Creutzfeldt-Jakob disease.

58)

Which is true about prions?

A) They are made of DNA and protein AND they are a normal brain protein that has folded differently. B) They cause a degenerative brain condition AND they are a normal brain protein that has folded differently. C) They cause a degenerative brain condition AND they are naked pieces of DNA. D) They cause a degenerative brain condition AND they are naked pieces of RNA. E) They cause fatal neurodegenerative disease AND they are naked pieces of RNA or DNA.

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59) Why can an infection in the brain's ventricles usually be detected in spinal fluid obtained from the lower back (lumbar region)? A) Cerebrospinal fluid(CSF) originates in the ventricles, but percolates over and around the brainand spinal cord. B) There is a highdegree of vascularity that exists, allowing easy transfer of bacteria in thecerebrospinal fluid (CSF) and the blood. C) There is a set of lymph nodes specifically in place to drain the cerebrospinal fluid (CSF) from the ventricles. They are found in the lumbar region of the spinal column. D) When ventricles are infected, the brain reacts by pumping the causative pathogens into the CFS so that they can be removed by the immune system. E) This is an incorrect statement. Since the central nervous system (CNS) is a protected site due to the blood-brain barrier, there can never BE an infection in the ventricles.

60)

Why are infants at risk of developing botulism after they ingest honey, but adults are not?

A) Bees cultivate C. botulinum bacteria within their hives as a food source. This gets mixed in with the honey they make, and is ingested by infants they are given food containing honey. Adults seldom eat honey, so are not exposed to this organism. B) The infant digestive tract is immature and is extremely susceptible to the effects of botulism toxin which found in the honey in relatively high levels. The adult digestive tract is immune to the effects of botulinum toxin because of M cells and Peyer's patches. C) The spores of C. botulinum produce a strong endotoxin. This endotoxin has little effect on adults because their immune system is fully developed. Infants, however, do not have a fully developed immune system and therefore far more susceptible to the toxin than adults. D) Honey can containC. botulinumendospores. Thesemay germinate in the intestines of infants that have eatenit, leading to colonization and pathogenesis as the bacteria begin forming botulism toxin. Adults' normal intestinal microbiota will out-compete the new microbes. E) Honey can contain C. botulinumendospores. Thesemay germinate in the intestines of adults that have eatenit. The bacteria are then sampled by M cells within the adult intestinal tract, leading to resistance to botulism. Infants do not have any M cells in their tract.

61) Why would the Sabin oral polio vaccine need to be eliminated after eradication of the poliovirus?

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A) Since it is a live, attenuated viral vaccine, there's always the chance it could revert back into a pathogenic state by mutation. This would introduce new strains still capable of causing the illness into human populations, preventing elimination. B) The Sabin vaccine is cheaper than the Salk (killed virus) vaccine, but it isn't as effective at producing a protective response. We'll need to shift to the more effective Salk vaccine worldwide eventually to complete the eradication process. C) The Salk vaccine is far cheaper than the Sabin vaccine. To effectively eradicate polio, we'll need to shift all of our resources into the cheapest and easiest to deliver vaccine possible. That is the Salk vaccine. D) The Sabin vaccine can only be administered to human beings. We need to vaccinate bird populations as well to effectively control the spread of polio. Birds are a natural reservoir for the virus. E) There will be no need to eliminate the polio vaccine after poliovirus eradication. Both the Sabin and the Salk vaccines will still be essential.

62) What underlying infection should a physician immediately suspect when confronted with a patient with confirmed cryptococcal meningoencephalitis caused by Cryptococcus neoformans, and why? A) Influenza infection. Influenza virus and C. neoformans are frequently transmitted together in respiratory droplets. B) HIV infection/disease. People with healthy immune systems generally fend off this fungal infection before it becomes clinically symptomatic. C) Varicella-zoster virus (chickenpox). During the incubation period for chickenpox, C. neoformans has an increased ability to colonize the respiratory tract. D) Syphilis. This sexually-transmitted illness depletes CD4+ helper T cells that are necessary to directly attack the fungal infection of C. neoformans. E) Primary amebic meningoencephalitis. The causative agent of PAM also causescryptococcal meningoencephalitis.

63) You're a famous eye surgeon, specializing in corneal transplants. Given your choice, would you rather use a cornea from a 20-year old person, or one from a 60-year old person (assuming there are no optical defects due to age) for transplantation, and why?

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A) The 60-year old cornea. If the person has gone 60 years with no optical defects, this is a very good organ for transplantation. The 20-year old cornea may have defects that simply haven't become apparent yet. B) The 20-year old cornea. Younger is always better when dealing with tissue transplants. You want to give the transplant the longest possible time for survival in the recipient. C) The 20-year old cornea. While extremely rare, it may bepossible to transmit prions through corneal transplants. It's less likely that a youngercornea would have become contaminated by prions than the older cornea. D) The 20-year old cornea. There are a variety of agents that can hide in corneal tissues and that might cause disease. It's far more likely that the older cornea would be harboring one or more of these pathogens than the younger cornea. E) The 20-year old cornea. The recipient of the cornea is much less likely to reject the younger tissue, which will have fewer antigens on it. The older cornea is more likely to be rejected by the recipient.

64) Why is it important to learn about rabies, considering that only a few cases occur in the United States each year? A) The U.S. isn't the entire world. Rabies might be more common in other areas, and it's important to understand due to the fact that this disease is nearly always fatal. B) The only reason why rabies isn't common in the U.S. is due to our lack of interaction with animal carriers. We could very easily have an outbreak of rabies if we don't know the warning signs to watch for that we've learned about by studying the virus and disease. C) Rabies can never be completely eliminated—it has too many different animal reservoirs/carriers. As such, we need to remain constantly aware of how to protect human populations, both by preventing and treating the illness. We can only do that by learning about it. D) All of the answer choices are correct. E) None of the choices is correct.

65) A pathologist claims it's much easier to determine the causative agent of meningitis than that of an infection of the skin or intestines. Is this true? Why or why not?

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A) It's not true. An infection is an infection, and it's always difficult to track down the exact causative agent. The organ system involved in the illness has nothing to do with identification of the causative agent. B) It's true. The CNS is generally microbe free, whereas the skin and intestines have a diverse normal microbiota. Separating out a pathogenic causative agent from the normal microbiota in these areas would be much harder to do than in the CNS. C) It's not true. The ventricles of the brain can provide a direct route for microbes to enter the CNS from the bloodstream. Therefore, it would be just as likely to find a pathogenic microbe in the CNS as it would be in the skin or intestines. D) It's true. There are only 1 or 2 microbes that can cause meningitis, yet there are hundreds (if not thousands) that can cause skin/intestinal infections. This makes it much easier to determine the causative agent for a case of meningitis. E) It's not true. It is almost impossible to obtain a sample of cerebrospinal fluid, which is required to diagnose meningitis. It is far simpler to obtain a sample from the skin or intestines, so it is easier to diagnose diseases of these systems.

66) Which statement regarding the anatomy and physiology of the nervous system is FALSE? A) The bloodstream is the primary source of CNS infections, but these infections are rare because it is difficult for microbes to move from the bloodstream into the brain. B) There is no normal microbiota in the central nervous system, while the peripheral nervous system contains a few common bacterial genera. C) Information in the form of electrical impulses enters the neuron via the dendrites, and exits that neuron via the axon, from where they enter another cell. D) Neurons communicate via chemicals called neurotransmitters; these are released by one cell and bind to receptors on the membrane of the next cell. E) The central nervous system is protected by bone and membranes called meninges, while nerves in the peripheral nervous system do not have these protective coverings.

67)

For what is a lumbar puncture used?

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A) To release pressure in the meninges caused by viral infection. B) To obtain a sample of the cerebrospinal fluid for examination. C) To obtain small pieces of meninges for biopsy. D) To prevent movement of pathogens from CSF to the meninges. E) To examine the spinal cord for inflammation.

68) Identify the meninges from closest to the brain to furthest away: 1. dura mater 2. pia mater 3. arachnoid mater A) 1, 2, 3 B) 3, 2, 1 C) 2, 3, 1 D) 3, 1, 2, 3 E) 1, 3, 3, 1

69) Which statement is would NOT apply to CSF taken from a person you suspect has bacterial meningitis? A) The CSF would be cloudy and opaque rather than pale yellow and clear. B) The CSF would have high protein levels compared with blood. C) The CSF would contain neutrophils. D) The CSF would have low glucose levels compared with blood. E) The CSF would be bloody and opaque rather than pale yellow and cloudy.

70)

Which of these descriptions does NOT apply to the pathogenesis of meningitis?

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A) Vasodilation from inflammation results in accumulation of fluid, causing brain swelling and nerve damage. B) Vasodilation disrupts the blood-brain barrier and allows neutrophils and proteins to enter the CSF. C) Inflammation results in the formation of small blood clots that block capillaries and interrupt blood supply, leading to cell death. D) Fever causes the blood pressure to increase significantly, forcing lymph fluid into the meninges and causing brain swelling. E) Inflammation impedes normal outflow of CSF, causing it to accumulate and press the brain against the skull.

71)

Which statement regarding meningitis is FALSE?

A) If bacterial meningitis is suspected, a person is given broad-spectrum antibiotics immediately, without waiting for identification of the causative organism. B) Bacterial causative agents of meningitis are transmitted through respiratory droplets, while viral agents of the disease may also be transmitted via the fecal-oral route. C) The cerebrospinal fluid of people with either viral meningitis or bacterial meningitis is cloudy and opaque rather than being clear and pale yellow in color. D) Meningitis is a relatively rare disease, because it is very difficult for the causative agents to cross the blood-brain barrier. E) Vaccines protect against the most important types of bacterial meningitis but prevention of viral meningitis depends on increased handwashing and avoiding crowded areas.

72) Which of the following mostly causes typically pneumonia but may also cause meningitis? A) Mycoplasma pneumoniae B) Klebsiella pneumoniae C) Mycoplasma meningitidis D) Neisseria meningitidis E) Streptococcus pneumoniae

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73) Why is PPSV23 not an effective vaccine for protecting children against pneumococcal meningitis? A) Children never get pneumococcal meningitis. They get typically get meningococcalmeningitis, which is less severe. B) The vaccine contains capsular polysaccharides, and children do not mount a strong immune response against T-independent antigens. C) PPSV23 is an attenuated vaccine and children cannot be given this type of vaccine because they are high risk of contracting the disease rather than being protected from it. D) Pneumococcus causes pneumonia in children, not meningitis. Children could receive this vaccine but it is unnecessary because pneumonia is less severe than meningitis. E) The vaccine contains capsular polysaccharides, and children do not mount a strong immune response against T-dependent antigens.

74) What sign would differentiate meningococcal meningitis from pneumococcal meningitis?  A) Petechiae are seen in meningococcal meningitis but not in pneumococcal meningitis. B) Petechiae are seen in pneumococcal meningitis but not in meningococcal meningitis. C) Headache and neck stiffness are experienced with meningococcal meningitis but not with pneumococcal meningitis. D) Headache and neck stiffness are experienced with pneumococcal meningitis but not with meningococcal meningitis. E) It is impossible to differentiate between pneumococcal meningitis and meningococcal meningitis.

75)

Which statement about viral meningitis is TRUE?

A) There are effective vaccines to protect against viral meningitis. B) Paralysis is a common sign of viral meningitis. C) The causative agents do not survive well in the environment.  D) Transmission of the causative agent is by the fecal-oral route. E) Recovery is seldom complete—permanent disabilities usually occur.

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76)

Which of the following is NOT a characteristic of meningococcus? A) It is a diplococcus. B) It is an encapsulated bacterium. C) It can vary its surface antigens. D) It uses pili for attachment to mucosal epithelium. E) Antigenic variation prevents the development of a vaccine.

77)

Please select the TRUE statement regarding Haemophilus influenzae. A) It is a virus. B) All strains are encapsulated. C) It frequently causes meningitis in adults. D) Polysaccharide antigen from type b is used in vaccination. E) It is a highly motile spirochete.

78) Why do Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae seldom cause meningitis in newborns? A) Infants seldom come into contact with these pathogens. B) These pathogens are unable to colonize infants. C) Infants are protected by maternal IgM against these pathogens. D) Infants are protected by maternal IgG against these pathogens. E) Infants are vaccinated against these pathogens.

79)

The most common cause of meningitis in newborn infants is Streptococcus agalactiae, a

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A) Gram-positive group A staphylococcus. B) Gram-negative group B staphylococcus. C) fungus that often colonizes a woman's vagina. D) group A streptococcus that often colonizes a woman's vagina. E) group B streptococus that often colonizes a woman's vagina.

80)

Why can't botulism be transmitted from person to person?

A) The disease is caused by eating spores that germinate into vegetative cells that produce toxin. B) The disease is a toxin-mediated disease; it is caused by ingestion of food contaminated with botulinum toxin produced under anaerobic conditions by Clostridium tetani. C) The disease is caused by eating spores that germinate into vegetative cells that produce toxin AND people with botulism die before they can transmit the disease to others. D) The disease is caused by ingestion of food contaminated with botulinum toxin AND the disease is caused by eating spores that germinate into vegetative cells that produce toxin. E) Botulism is a toxin-mediated blood-borne disease ANDpeople with botulism die before they can transmit the disease to others.

81)

How does Cryptococcus gattii enter the body? A) Through peripheral nerves. B) Inhalation of fungal spores. C) Ingestion of fungal spores. D) Direct contact with an infected person. E) All of the answer choices are correct.

82)

Why is it possible to prevent rabies with vaccine given after expo-sure to the virus?

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A) The virus replicates extremely slowly. It is possible to prevent the disease by vaccinating while the viral load is very low. B) It takes some time for the virus to invade the peripheral neurons and travel to the CNS. Vaccination before this occurs will prevent the disease. C) It takes some time for the virus to invade the CNS and travel to the peripheral nerves. Vaccination before this occurs will prevent the disease. D) Rabies vaccine contains anti-rabies antibodies. These bind to the rabies and virus and destroy it before it is able to cause any neuronal damage. E) People receive a rabies vaccine in their childhood. Giving a vaccine after exposure to the virus quickly boosts their memory cell populations, protecting them.

83) Why must amphotericin B be given intravenously and the dose carefully regulated when treating cryptococcal meningoencephalitis?   A) To minimize the toxic effects of the medication. B) To prevent development of resistance in the causative organism. C) To prevent autoimmunity in the patient. D) To avoid development of drug resistance in the patient. E) To minimize the risk of endotoxic shock.

84)

Which statement regarding polio vaccines is FALSE?

A) OPV is an oral, attenuated vaccine. It provides better mucosal immunity than IPV and it can transmit immunity from person to person. B) OPV does not require an injection and is cheaper, but it requires refrigeration and may occasionally cause the disease. C) The rare cases of polio that still occurred in the U.S. after poliovirus was eliminated were caused by vaccine-derived poliovirus (VDPV).  D) IPV is unreliable at eliciting production of mucosal antibodies as demonstrated when polio occurred in a country that previously relied only on IPV vaccination. E) The small risk of developing poliomyelitis due to vaccine-derived poliovirus led the United States to change to the routine use of OPV only.

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85)

How do neonates acquire group B streptococcus? A) From the mother’s genital tract shortly before or during birth. B) By inhalation of contaminated aerosol droplets after birth. C) By ingestion of contaminated colostrum shortly after birth. D) Through minor skin wounds such as scratches. E) Via placental transfer of the pathogen from the mother.

86) Select the correct path a nerve impulse takes from a neuron to a muscle cell: 1. Muscle cell 2. Cell body 3. Axon 4. Dendrites A) 4; 2; 3; 1 B) 4; 3; 2; 1 C) 1; 3; 4; 2 D) 2; 1; 3; 4; 3 E) 4; 3; 2; 3; 1

87)

Which part of a neuron receives a chemical message from an adjacent cell? A) Soma B) Axon C) Dendrites D) Synapse E) Neurotransmitter

88)

The long projection of a neuron along which a nerve impulse passes is the

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A) synapse. B) axial filament. C) axon. D) dendrite. E) myelin sheath.

89)

All of the following are associated with infant botulism EXCEPT A) difficulty suckling. B) stiff neck. C) weak limbs. D) drooling. E) drooping eyelids.

90)

What is the vector for African sleeping sickness? A) Fly B) Tick C) Mosquito D) Flea E) Trypanosome

91)

All of the statements regarding African sleeping sickness are true EXCEPT

A) the causative agent is a protozoan called Trypanosoma brucei. B) the disease can occur in two forms: acute and chronic. C) signs and symptoms includefatigue, headaches, muscle and joint pains, fever, and enlarged lymph nodes.  D) the disease is transmitted by the bite of an infected tsetse mosquito. E) it can be prevented byprotective clothing, insecticides, and clearing vegetation where vectors breed.

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92) Select the INCORRECT statement regarding the pathogenesis of African sleeping sickness. A) Initial signs and symptoms occur when the parasite multiplies in the bloodstream. B) Fever and antibody production initially control replication of the parasite. C) T. brucei constantly changes a surface glycoprotein, avoiding the immune system by antigenic variation. D) With T. b. rhodesiense infections, progression of the disease is slow and death often occurs from secondary infections. E) Sleep cycle disturbances typically develop when the causative agent enters the central nervous system.

93)

Neonatal meningitis is most commonly caused by A) Streptococcus pneumoniae. B) Haemophilus influenzae. C) Listeria monocytogenes. D) Streptococcusagalactiae. E) Neisseria meningitidis.

94) Why are most newborn babies unlikely to contract pneumococcal, meningococcal, or Haemophilus influenzae meningitis? A) They are protected from these pathogens by maternal IgG antibodies. B) They are protected from these pathogens by maternal IgM antibodies. C) They produce antibodies to these pathogens while in the uterus. D) They are vaccinated against these pathogens immediately after birth. E) They are highly unlikely to be exposed to these pathogens as infants.

95)

What might indicate to a doctor that a newborn infant has meningitis?

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A) Fever and chills B) Irritability C) Vomiting D) Bulging soft spots E) Headache

96)

All of the following are true of prions EXCEPT

A) they area protease-resistant misfolded version of a normal protein.  B) they cause incurable, ultimately fatal encephalopathies. C) theyincrease in quantity by converting normal protein to more prions.  D) they can be transmitted human-to-human by contaminated surgical instruments. <!-Markup Copied from Habitat--> E) they can be destroyed by appropriate antibiotic therapies.

97) Which is TRUE of transmissible spongiform encephalopathies (TSEs) diseases in humans? A) They are caused by prions and are ultimately fatal. B) They may be transmitted in air-borne droplets. C) They are relatively common but seldom harmful. D) They can be prevented by cooking meat thoroughly. E) The causative agent is a double-stranded DNA molecule.

98)

How do prions cause disease?

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A) Normal protein (PrP C) is taken into the neuronal cells, where it causes death of the cell. B) Misfolded protein (PrP SC) is taken up by phagocytes that then release enzmyes, causing tissue damage. C) Misfolded protein (PrP SC) accumulates, then aggregates in insoluble masses in the brain, causing tissue damage. D) Misfolded protein (PrP SC) accumulates in the meninges, causing damaging pressure in the brain tissue. E) Normal proteins (PrP C) accumulate in neuronal nuclei, forming insoluble masses in the brain that damage it.

99)

How do prions increase in number in the brain?

A) They divide asexually by binary fission. B) Normal protein(PrP c) divides by mitosis while misfolded protein (PrP sc) divides by binary fission. C) Misfolded protein (PrP sc) acts as a template that promotes misfolding of the normal cellular protein (PrP c). D) Nomal protein (PrP c) acts as a template that promotes misfolding of the abnormal cellular protein (PrP sc). E) Normal protein (PrP c) highjacks the cellular machinery of the neuron and makes copies of itself by replication.

SECTION BREAK. Answer all the part questions. 100) Presenters on the morning news channel that you watch alert consumers to a food recall. A particular brand of ice cream has tested positive for Listeria monocytogenes, an organism that causes asymptomatic orrelatively milddisease in otherwise healthy individuals, but can be problematic in pregnant women. Your sister is expecting her first child, so you call her immediately and tell her about the recall. You fill her in on what you know about this organism and the disease it causes, having just learned about it yourself in your pre-nursing microbiology class. Your sister has questions that you are able to answer.

100.1) Which of these statements concerning the causative agent of listeriosis is TRUE?

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A) It can cause meningitis during the first month of life.  B) It is usually transmitted by the respiratory route.  E) Most strains of L. monocytogenes are resistant to penicillin.

100.2) If a person infected with L. monocytogenes develops meningitis, which of the following signs and symptoms would they experience? A) Fever and muscle aches B) Headache, stiff neck, and vomiting C) Nausea and diarrhea D) Widespread tissue abscesses  E) All of the choices are correct.

100.3) Why is listeriosis so important in pregnant women even though it usually causes them few symptoms?  A) Listeriosis suppresses the woman's immune system; she fails to make IgG that would protect her fetus. B) Listeriosis causes significant signs and symptoms in pregnant women and may prove fatal because they cannot take medication while pregnant. C) Bacteremia commonly occurs, resulting in infection of the fetus; miscarriage, stillbirth, or infection of the newborn can result. D) Infants born with listeriosis are sensitized against the foods in which the causative agent is found, such as soft cheeses. They can never eat these foods. E) Listeriosis in a pregnant woman usually leads to untreatable meningitis. Neither she nor her fetus is able to survive the infection.

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100.4) The U.S. Food and Drug Administration has approved an additive that is sprayed onto a variety of meats during the production process. The additive contains viruses and has increased the safety of these foods by 80–99%. How does this additive work? A) The additive contains bacteriophages specific for L. monocytogenes. The viruses are lytic phages—they infect and kill the bacterial host. B) The additive contains bacteriophages specific for L. monocytogenes. The viruses are temperate (lysogenic) phages that infect and kill the bacterial host. C) The additive contains viruses that produce antibiotics which destroy L. monocytogenes cells. Several strains are used to prevent resistance. D) The additive contains phages that infect the person that consumes them on food. They integrate into the host cell's chromosomes, protecting the cells from L. monocytogenes. E) The viruses in the additive cause an immune response in pregnant women, who make IgA in response to them. The IgA protects the fetus against L. monocytogenes.

100.5)

How would L. monocytogenes meningitis be diagnosed and treated?

A) Antibiogram results; antibiotics B) Gram staining; acyclovir C) Brain biopsy; acyclovir D) Signs and symptoms; phage therapy E) Lumbar puncture; antibiotics

101) You are reviewing for your nursing school entry exam with your study group. Each person in the group agrees to cover one disease. You select toxoplasmosis for your presentation.Toxoplasmosis can be a serious problem for those who are immunosuppressed, as well as for fetuses. Even in healthy people, the immune system may not clear the organism, resulting in a latent infection that can reactivate when immunitydeclines.

101.1)

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Please select the FALSE statement regarding toxoplasmosis.

A) People contract toxoplasmosis by ingesting oocytes discharged in the feces of acutely infected cats or inadequately cooked meat containing tissue cysts.  B) Toxoplasmosis is usually asymptomatic among healthy people, although some people develop sore throat, fever, and enlarged lymph nodes and spleen.  C) Toxoplasmosis occurs in two main forms—tuberculoid and lepromatous—depending on the immune status of the individual. D) Infection of the fetus with the causative organism, especially during the first trimester, results in miscarriage, stillbirth, or birth defects.  E) Toxoplasmosis may cause encephalitis, brain masses, and other nervous system problems in immunodeficient people.

101.2) Please identify the correct sequence of events in the pathogenesis of toxoplasmosis. 1.Each cyst contains large numbers of bradyzoites,a smaller form of T. gondiiwhich persists in a latent infection. 2.As host immunity develops, a tough, fibrous capsule forms around infected host cells, forming a tissue cyst. 3. Within the small intestinal cells, sporozoites develop rapidly into tachyzoites which spread systemically. 4.T. gondii enters the hostwhen either mature oocysts containing two sporocysts are eaten. 5. Sporozoites emergefrom each of the sporocysts, and invade the cells of the small intestine.

A) 4, 5, 3, 2, 1 B) 1, 2, 4, 3, 5 C) 4, 1, 3, 2, 5 D) 2, 4, 5, 1, 3 E) 4, 5, 1, 2, 3

101.3)

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Why is toxoplasmosis is not treated in otherwise healthy people?

A) Healthy people do not get toxoplasmosis. B) There are no medications available for treatment. C) T. gondii is extremely resistant to medications. D) The disease is brought under control by their immune system. E) The available medications are very toxic to most people.

101.4)

Prevention of toxoplasmosis involves

A) vaccination of domestic animals. B) avoiding inadequately cooked meat. C) prophylactic antibiotics for cat owners. D) filtering and chlorinating water. E) vaccination of people and their pets.

101.5) Immunosuppressed patients who test positive for antibody to T. gondiialways have an active infection. ⊚ ⊚

true false

102) A 31-month-old girl was admitted to the hospital because of fever, headache, drowsiness, and vomiting. She had been well until 12 hours before admission, when she developed a runny nose, fever, and loss of appetite. The child'sbirth and development were normal, buther routine immunizations had been neglected.On examination, her temperature was 40°C (104°F), her neck was stiff, and she did not respond to verbal commands. There was no history of head trauma. The child’s white blood cell count was elevated and showed a marked increase in the percentage of neutrophils. Her blood sugar was in the normal range.A spinal tap revealed cloudy CSF containing 18,000 white blood cells per microliter (normally, there are few or none), a markedly elevated protein level, and a markedly low glucose level. Gram stain of the fluid showed tiny, Gram-negative coccobacilli.

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102.1) What was the diagnosis, and what was the causative agent?  A) Meningitis, caused by Neisseria meningitidis. B) Encephalitis,caused by Neisseria meningitidis. C) Polio, caused by poliovirus. D) Listeriosis, caused by Listeria monocytogenes. E) Meningitis, caused by Haemophilus meningitidis serotype b.

102.2)

Which of the signs and symptoms exhibited by the patient suggested meningitis?

A) Temperature of 40°C (104°F). B) Failure to respond to verbal commands. C) Fever and stiff neck. D) Fever and headache. E) Elevated white blood cell count.

102.3)

Why was it important that there was no history of head trauma?

A) Certain types of trauma, such as skull fractures that allow contact between the CSF and the sinuses and middle ear,can predispose a patient to meningitis.  B) The fever, stiff neck, and elevated neutrophil numbers exhibited by the child were consistent with a significant head trauma; this possibility had to be ruled out. C) Certain types of trauma (including skull fractures that allow contact between the CSF and the sinuses and middle ear) cause meningitis. D) Certain types of trauma (such as skull fractures that allow contact between the CSF and the sinuses) allow damaging neutrophils into the CSF. E) Head trauma causes inflammation and brain swelling; this ultimately causes untreatable meningitis in the patient.

102.4) Please select the INCORRECT statement pertaining to the disease described in this case.

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A) Haemophilus influenzae is spread by respiratory droplets. B) Haemophilus influenzae meningitis is caused by a DNA virus. C) Haemophilus influenzae meningitis can be prevented by vaccination. D) The virulence factor of the causative agent is a capsule. E) This disease may lead to permanent brain damage, even with treatment.

102.5)

How could the child have been protected from the disease described in this case?

A) She should have received the Hib vaccine at the appropriate age. B) She should have received the polio vaccine at the appropriate age. C) She should have received the pneumococcal vaccine at the appropriate age. D) She should have received the meningococcal vaccine at the appropriate age. E) She should have been dressed in mosquito-repellant clothing when going outdoors.

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Answer Key Test name: Chap 26_10e 1) TRUE 2) TRUE 3) TRUE 4) TRUE 5) TRUE 6) FALSE 7) TRUE 8) FALSE 9) TRUE 10) TRUE 11) A 12) E 13) B 14) C 15) A 16) A 17) B 18) E 19) A 20) C 21) B 22) A 23) B 24) C 25) E 26) C Version 1

27) A 28) C 29) D 30) D 31) C 32) E 33) E 34) B 35) B 36) A 37) E 38) C 39) B 40) D 41) A 42) B 43) B 44) B 45) C 46) A 47) C 48) A 49) C 50) A 51) B 52) E 53) A 54) B 55) D 56) B Version 1

57) E 58) B 59) A 60) D 61) A 62) B 63) C 64) D 65) B 66) B 67) B 68) C 69) E 70) D 71) C 72) E 73) B 74) A 75) D 76) E 77) D 78) D 79) E 80) D 81) B 82) B 83) A 84) E 85) A 86) A Version 1

87) C 88) C 89) B 90) A 91) D 92) D 93) D 94) A 95) D 96) E 97) A 98) C 99) C 100) Section Break 100.1) A 100.2) B 100.3) C 100.4) A 100.5) E 101) Section Break 101.1) C 101.2) A 101.3) D 101.4) B 101.5) FALSE 102) Section Break 102.1) E 102.2) C 102.3) A 102.4) B Version 1

102.5) A

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CHAPTER 27 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Women are more likely than men to get urinary tract infections due to their anatomy. ⊚ true ⊚ false

Urine contains antimicrobial substances. ⊚ ⊚

Toxic shock syndrome toxins are superantigens. ⊚ ⊚

true false

Most strains of gonococcus do not survive long outside the body. ⊚ ⊚

true false

5) There is no long-lasting immunity to gonorrhea and a person may contract gonorrhea repeatedly. ⊚ ⊚

The patient is non-infectious in the third stage of syphilis. ⊚ ⊚

true false

Genital herpes may be cured with the use of acyclovir or famciclovir.

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⊚ ⊚

Protease inhibitors are useful in curing AIDS. ⊚ ⊚

true false

Herpes simplex enhances the spread of HIV. ⊚ ⊚

11)

true false

Trichomonas vaginalis lacks mitochondria. ⊚ ⊚

10)

true false

Typically,Candida albicans causes no symptoms. ⊚ true ⊚ false

12) Repeated episodes of pyelonephritis lead to scarring and shrinkage of the kidneys and can cause kidney failure.  ⊚ ⊚

13)

true false

Genital warts always require treatment for removal. ⊚ ⊚

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true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 14) Treponema pallidum A) is the organism that causes syphilis. B) is a spirochete. C) can be more easily viewed with dark-field illumination. D) has become less virulent over time. E) All of the answer choices are correct.

15)

Urinary tract infections A) are relatively rare. B) are the most common nosocomial infections. C) include puerperal fever. D) are considered STIs. E) are the most common nosocomial infections AND areconsidered STIs.

16)

The urinary tract above the bladder usually contains A) Escherichia coli. B) Staphylococcus aureus. C) Proteus vulgaris. D) no bacteria. E) Escherichia coli AND Staphylococcus aureus.

17)

The normal microbiota of the lower urethra may show A) Lactobacillus. B) Staphylococcus. C) Corynebacterium. D) Bacteroides. E) All of the choices are correct.

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18)

The normal microbiota of the genital tract of women is A) affected by estrogen levels. B) dependent on the activity of Lactobacillus. C) unchanging throughout their lifetime. D) typically composed of Escherichia coli. E) affected by estrogen levels AND dependent on the activity of Lactobacillus.

19)

The most common urinary tract infection is A) vulvovaginal candidiasis. B) toxic shocksyndrome. C) bacterialcystitis. D) bacterialvaginosis. E) leptospirosis.

20)

Bacterial cystitis A) may occur through the use of a catheter. B) is typically caused by Pseudomonas aeruginosa. C) is anuncommon nosocomial disease. D) is common in men under 50. E) All of the choices are correct.

21)

A disease in which the urinary system is infected from the bloodstream is A) cystitis. B) leptospirosis. C) pyelonephritis. D) candidiasis. E) sepsis.

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22)

Leptospirosis is contracted A) by eating infected animals. B) by eating contaminated vegetables. C) from exposure to contaminated animal urine. D) via the respiratory route. E) All of the choices are correct.

23)

Pregnant women with bacterial vaginosis are at risk of A) having a premature baby. B) placental insufficiency. C) being unable to nurse. D) being unable to deliver vaginally. E) viral meningitis.

24) The genital tract infection characterized by an unpleasant odor and an increase in clue cells is A) trichomoniasis. B) candidiasis. C) amoebiasis. D) bacterial vaginosis. E) cystitis.

25)

Among the major causes of vulvovaginal candidiasis is/are

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A) sexual promiscuity AND intense antibacterial treatment. B) intense antibacterial treatment AND disruption of normal microbiota. C) disruption of normal microbiota AND advancedage. D) the use of oral contraceptives, advanced age, AND disruption of normal microbiota. E) intense antibacterial treatment, disruption of normal microbiota, AND the use of oral contraceptives.

26)

Staphylococcus aureus is the causative agent of A) bacterial vaginosis. B) puerperal fever. C) toxic shock syndrome. D) gas gangrene. E) bacterial vaginosis AND puerperal fever.

27)

Toxic shock syndrome A) is due to exotoxins produced by Streptococcus pyogenes. B) is due to exotoxins produced by Staphylococcus aureus. C) may spread from person to person. D) has a very low rate of recurrence, approximately 1%. E) is always the result of using super-absorbent tampons.

28)

The incubation period of gonorrhea is approximately A) 2–5 days. B) 1–2 weeks. C) 14–21 days. D) several months. E) 24 hours.

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29)

Gonococci infect A) cows. B) iguanas. C) sheep. D) humans. E) cows AND sheep.

30)

Gonococci selectively attach to certain epithelial cells by A) pili. B) flagella. C) cilia. D) actin bridges. E) flagella AND cilia.

31)

Typically, pathogenic Neisseria gonorrhoeae A) secretes transferrin. B) destroys IgA. C) destroys IgM. D) is very immunogenic. E) secretes exotoxin A.

32)

Untreated gonorrhea in males may lead to all of the following EXCEPT A) sterility. B) urinary tract infections. C) prostatic abscesses. D) orchitis. E) pelvic inflammatory disease.

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33)

A frequent complication of untreated gonorrhea in women is A) pelvic inflammatory disease. B) syphilis. C) dysuria. D) vaginal discharge. E) orchitis.

34) The treatment of neonates with an erythromycin ointment placed directly into the eyes is to prevent A) viral conjunctivitis. B) ophthalmia neonatorum. C) cataracts. D) ocular herpes. E) All of the choices are correct.

35) Which of the following causes signs and symptoms that mimic the infection caused by Neisseria gonorrhea? A) Chlamydia trachomatis B) Mycoplasma pneumonia C) Treponema pallidum D) Escherichia coli E) Staphylococcal toxic shock syndrome.

36) is

The disease that results from Chlamydia trachomatisascending into the fallopian tubes

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A) conjunctivitis. B) neonatorum ophthalmia. C) pelvic inflammatory disease. D) trachoma. E) ectopic disease.

37)

The infectious form of Chlamydia trachomatis is a(n) A) reticulate body. B) elementary body. C) primary element. D) core body. E) infectious spore.

38)

The causative agent of syphilis is A) Treponema syphillum. B) Neisseria gonorrheae. C) Chlamydia trachomatis. D) Treponema pallidum. E) Mycoplasma genitalium.

39)

Treponema pallidum is similar in shape to A) Escherichia coli. B) Staphylococcus aureus. C) Leptospira interrogans. D) herpes virus. E) Mycoplasma genitalium.

40)

Which of the following manifests itself in three clinical stages?

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A) Gonorrhea B) Syphilis C) Trachoma D) M. genitalium infection E) Chancroid

41)

The hard chancre in primary syphilis is caused by A) an intense inflammatory response. B) an antibody response. C) rejection of the invaded tissue. D) sepsis due to spread of the organism. E) a type III hypersensitivity.

42)

During which stage of syphilis is the patient non-infectious? A) First B) Second C) Third D) Early latent E) A person with syphilis is always infectious.

43)

In which disease is a gumma formed? A) Primary syphilis B) Secondary gonorrhea C) Cutaneous diphtheria D) M. genitalium infection E) Tertiary syphilis

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44) During which stage of pregnancy can Treponema pallidum cross the placenta and possibly infect the fetus? A) First trimester B) Second trimester C) Third trimester D) Never E) At any stage

45)

The reservoir of Treponema pallidum is the A) guinea pig. B) fox. C) bat. D) birds. E) human.

46)

Treponema pallidum, the causative agentof syphilis, can be transmitted by A) sexual or oral contact. B) contact with contaminated objects. C) clothing. D) the fecal-oral route. E) aerosol droplets.

47)

The sexually transmitted disease characterized by painful genital ulcers is A) chancroid. B) syphilis. C) gonorrhea. D) trachoma. E) M. genitalium infection.

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48)

Which of the following diseases may manifest themselves with painful genital ulcers? A) chancroidAND rubeola B) chancroid AND herpes C) herpes AND leptospirosis D) leptospirosis AND chancroid E) rubeola AND herpes

49)

Which of the following is a small, fastidious Gram-negative rod? A) Escherichia coli B) Treponema pallidum C) Neisseria gonorrheae D) Haemophilus ducreyi E) Mycoplasma genitalium

50)

The usual cause of genital herpes is A) herpes simplex virus type 1. B) herpes simplex virus type 2. C) herpes simplex virus type 3. D) genital simplex virus type 1. E) genital simplex virus type 2.

51)

Which of the following viruses maintains a latent state in nerve cells? A) Herpes simplex virus AND hepatitis A virus. B) Hepatitis A virus AND varicella-zostervirus. C) Varicella-zoster virus AND rotavirus. D) Rotavirus AND hepatitis A virus. E) Herpes simplex virus AND varicella-zoster virus.

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52)

Genital herpes, like other ulcerating genital diseases, A) promotes the spread of HIV. B) inhibits the spread of HIV. C) inhibits the growth of other viral disease. D) is easily cured with antibiotics. E) can be prevented by vaccination.

53)

The drug(s) used to treat genital herpes is/are A) penicillin AND acyclovir. B) erythromycin AND famciclovir. C) acyclovir AND erythromycin. D) famciclovirAND penicillin. E) acyclovir AND famciclovir.

54)

Among the most common of the sexually transmitted viral diseases agents is A) humanpapillomavirus. B) herpes simplex virus. C) human immunodeficiency virus. D) leptospirosis virus. E) varicella-zoster virus.

55)

Human papillomavirus is A) a small, enveloped double-stranded DNA virus. B) a small, non-enveloped double-stranded DNA virus. C) a large, enveloped double-stranded RNA virus. D) a small, non-enveloped single-stranded DNA virus. E) a small, non-enveloped double-stranded RNA virus.

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56)

Which of the following is associated with cervical cancer? A) Gonorrhea B) Genital warts C) Syphilis D) Chancroid E) Genital herpes

57)

HPV

A) infections always lead to cancer AND always integrates into the host's chromosome. B) infections always lead to cancer AND may be categorized into cancer-associated and wart-causing types. C) infections always lead to cancer AND may or may not integrate into the host's chromosome. D) cannot infect newborns at birth AND may be categorized into cancer-associated and wart-causing types. E) can integrate into the host's chromosome AND may be categorized into cancerassociated and wart-causing types.

58)

The human immunodeficiency virus is a(n) A) non-enveloped double-stranded DNA virus. B) enveloped double-stranded DNA virus. C) enveloped single-stranded RNA virus. D) non-enveloped single-stranded DNA virus. E) non-enveloped double-stranded RNA virus.

59)

HIV infects a variety of cell types but the most critical are

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A) red blood cells. B) nerve cells. C) platelets. D) T helper cells. E) T cytotoxic cells.

60)

HIV typically attaches to A) CD4 protein AND a coreceptor. B) CD8 protein. C) protein A AND CD8 protein. D) complement component C3b AND a coreceptor. E) complement component C5a AND CD4 protein.

61)

HIV adversely affects A) red blood cells AND macrophages. B) nerve cells AND T helper cells. C) macrophages AND nerve cells. D) T helper cells AND red blood cells. E) macrophages AND T helper cells.

62)

Treatment of HIV attempts to do all of the following EXCEPT A) block attachment to host cells. B) block reverse transcriptase activity. C) block viral polymerase. D) block viral integrase. E) block viral protease activity.

63)

HIV may be present in

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A) blood, semen, AND tears. B) semen, vaginal secretions, AND tears. C) tears, sweat, AND colostrum. D) vaginal secretions, colostrum, AND sweat. E) blood, semen, AND vaginal secretions.

64)

Trichomoniasis is caused by a A) fungus. B) protozoan. C) virus. D) bacteria. E) yeast.

65)

Trichomonas vaginalis is an unusual eukaryote in that it A) has chloroplasts. B) lacks mitochondria. C) has flagella. D) lacks a nuclear membrane. E) has 80S ribosomes.

66)

What changes might occur in the vagina if lactobacilli were eliminated?

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A) The acidic pH might change to a more neutral (and pathogen-fostering) level. B) Lactobacilli often produce the hydrogen peroxide. Without it, anaerobic pathogens might cause disease. C) There would be no change in the health of the woman. Other members of the normal microbiota would replace the lactobacilli, resulting in no overall change. D) The acidic pH might change to a more neutral (and pathogen-fostering) level AND lactobacilli often produce hydrogen peroxide. Without it, anaerobic pathogens might cause disease. E) There would be no change in the health of the woman. Other members of the normal microbiota would replace the lactobacilli, resulting in no overall change OR the acidic pH might change to a more neutral (and pathogen-fostering) level.

67) Why might a person with an STI need to be checked for other STIs, even though he/she has no symptoms of any others? A) Several STI-causing pathogens are known to coexist with each other, being carried into the genital tract together. B) A diagnosis of an STI implies that the person had unprotected sex. Several STIs are largely asymptomatic, so it is wise to test for a variety of typical STIs when the patient admits to or shows signs of engaging in such risky behavior. C) They don't need to be tested. All STIs are highly obviously symptomatic, so there is no need to test for other diseases than the one currently manifesting itself in the patient. D) It's a public health issue. It's best to know who is positive for what in the population of sexually-active individuals. This lets healthcare professionals act to best safeguard the population as a whole from the range of STIs. E) They don't need to be tested. When a person becomes infected with one STI, they automatically become immune to any others, so will not acquire any further infections.

68)

Why would scarring of a fallopian tube raise the risks of an ectopic pregnancy?

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A) Scarring may slow the progression of the ovum (egg) from the fallopian tubes into the uterus. If it is fertilized by a sperm cell while it is stopped in the fallopian tube, it may implant there, resulting in an ectopic pregnancy. B) Scarring can completely block the ovum (egg) from being able to exit the fallopian tube to enter the uterus. It may implant in the wall of the fallopian tube (since it can't enter the uterus) and result in an ectopic pregnancy. C) Scarring may allow the sperm cells to enter the fallopian tubes and bind to the scar tissue. The inflammatory response generated when this occurs is termed an ectopic pregnancy. D) Scarring of the fallopian tubes results from undiagnosed bacterial infections. These bacteria can also make the lining of the uterus inhospitable to implantation of a fertilized egg. If the fertilized egg can't implant , it may travel back into the fallopian tube and implant there instead, resulting in an ectopic pregnancy. E) Scarring and inflammation make the ovum (egg) more susceptible to bacterial invasion. If the ovum becomes infected, in can no longer progress down the fallopian tube, and instead it implants where ever it is when the infection occurs, causing ectopic pregnancy.

69) Former president Ronald Reagan once commented at a press conference that the best way to combat the spread of HIV/AIDS in the US was to prohibit everyone from having sexual contact for 5 years. What would be the success of such a program if it were possible to carry out? A) It would "cure" the population of HIV/AIDS. Everyone that had it would become noninfectious through medication, and no new cases would occur, since sexual contact is the only mode of transmission for this virus. B) It would be a failure. This "program" wouldn't eliminate IV drug use or transmission of HIV from mother to child. Sexual transmission isn't the ONLY mode of transmission for this virus. C) It would be a failure. Many HIV positive individuals survive for longer than 5 years, even without treatment. Once sexual contact resumed, sexual transmission would also resume. D) It would be a failure. This "program" wouldn't eliminate IV drug use or transmission of HIV from mother to child. Sexual transmission isn't the ONLY mode of transmission for this virus, AND many HIV positive individuals survive for longer than 5 years, even without treatment. Once sexual contact resumed, sexual transmission would also resume. E) It would be a success. If no one had sex for five years, the virus would have nowhere to go and would die out. HIV only exists in a person for approximately this amount of time.

70)

Which of the following genitourinary tract infections is a zoonosis?

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A) Leptospirosis B) Cystitis C) Syphilis D) M. genitalium infection E) Genital herpes

71)

Which is a characteristic of the septicemic phase of leptospirosis? A) Flu-like symptoms B) Sudden headache and fever C) Red eyes and photophobia D) Jaundice E) Vomiting, rash, and confusion

72)

Which of the statements does not apply to leptospirosis?

A) The causative organism is a slender aerobic Gram-negative spirochete with hooked end.  B) Complications of leptospirosis in some people includeliver and kidney failure, hemorrhage in many organs, and meningitis.  C) Leptospira interrogans is primarily transmitted by aerosol droplets or by direct contact between a person and an infected animal. D) Small doses of a tetracycline antibiotic can prevent the disease in high-risk individuals, such as veterinarians.  E) Most infections cause mild signs and symptoms and are self limiting, so do not require treatment.

73)

Which of the following may lead to infertility?

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A) Cystitis B) Pelvic inflammatory disease C) Vaginosis D) Pyelonephritis E) All of the choices are correct.

74) Puerperal fever not regarded as a sexually transmitted infection.What spreads the disease? A) A physician that doesn't observe proper sterile technique may introduce bacteria from the environment into the genitourinary tract of a woman during delivery of a child, inducing puerperal fever several days later. B) The trauma of the delivery of the placenta through the vaginal tract after the fetus introduces bacteria directly into the bloodstream, resulting in puerperal fever. C) A woman's own normal fecal microbiota can occasionally cause puerperal fever if it contaminates the genitourinary tract following delivery. This can especially occur after an episiotomy procedure (cutting between the vaginal opening and the rectum). D) A physician that doesn't observe proper sterile technique may introduce bacteria from the environment into the genitourinary tract of a woman during delivery of a child, inducing puerperal fever several days later AND a woman's own normal fecal microbiota can occasionally cause puerperal fever if it contaminates the genitourinary tract following delivery. This can especially occur after an episiotomy procedure (cutting between the vaginal opening and the rectum). E) The trauma of the delivery of the placenta through the vaginal tract after the fetus introduces bacteria directly into the bloodstream, resulting in puerperal fever AND aphysician that doesn't observe proper sterile technique may introduce bacteria from the environment into the genitourinary tract of a woman during delivery of a child, inducing puerperal fever several days later.

75)

Which statement about bacterial vaginosis is FALSE?

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A) Womenvoluntarily inoculated with cultures of Gardnerella vaginalis,and members of the genera Mobiluncus, Prevotella, and Peptostreptococcus do not always develop BV. B) Low numbers of G. vaginalis,and members of the genera Mobiluncus, Prevotella, and Peptostreptococcus can occur in vaginal secretions of healthy women. C) Women with BV can be diagnosed by the presence of clue cells and a fishy vaginal odor caused by metabolic byproducts of anaerobic bacteria. D) BV in pregnant women should be treated because it may cause premature birth. <!-Markup Copied from Habitat--> E) The causative agent of the disease is Gardnerella vaginalis that interacts antagonistically with members of the genera Mobiluncus, Prevotella, and Peptostreptococcus.

76)

Which one of the following statements about bacterial vaginosis is FALSE?

A) Women with BV always experience inflammation of the vagina. B) In pregnant women, it is associated with premature delivery.  C) It is the most common vaginal disease in women of childbearing age.  D) The vaginal microbiota shows a decrease in lactobacilli and an increase in anaerobic bacteria.  E) Treatment of the male sex partners of patients with BV does not prevent recurrences.

77)

Which of the following does not apply to staphylococcal toxic shock syndrome? A) It may lead to kidney failure. B) The causative organism produces superantigens. <!--Markup Copied from Habitat--

> C) The causative organism usually does not enter the bloodstream.  D) Person-to-person spread frequently occurs.  E) It is can occur in males and females.

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78) In early attempts to identify and isolate the cause of syphilis, vari-ous bacteria in the discharge from chancres in experimen-tal animals were isolated in pure culture. None of the bacteria, however, would cause the disease when used in attempts to infect healthy animals. What is a possible explanation for this observation? A) The bacteria isolated from the animals were in fact the animal's normal microbiota and not pathogenic organisms; these bacteria would not cause disease in inoculated animals. B) The bacteria thought to be isolated from the animals were actually skin bacteria from the people performing the experiments; these human bacteria would not cause disease in experimental animals. C) The bacteria isolated from the animals were in fact the animal's normal microbiota; these bacteria would not cause disease in inoculated animals OR the bacteria thought to be isolated from the animals may have come from the people performing the experiments; these human bacteria would not cause disease in experimental animals. D) The bacterial agent of syphilis causes disease in three stages; the organisms cultured from the first animals would be those that cause primary symptoms and would not be the same as those needed to cause disease in a second set of experimental animals. E) When the causative organism of syphilis is removed from a host and cultured in the laboratory, it loses its capsule, without which it is unable to colonize a new host and will thus not cause disease OR the bacteria isolated from the animals were in fact the animal's normal microbiota; these bacteria would not cause disease in inoculated animals.

79)

Why is it not possible to culture Treponema pallidum in vitro?

A) The organism is an obligate intracellular parasite AND the organism is a psychrophilic anaerobe. B) The organism is an obligate halophile AND the organismis highly motile and requires actin from host cells to make tails for movement. C) The organism lacks mitochondria and obtains all of its essentialmacromolecules from the host AND the organism is Gram-negative.  D) The organism is highly motile and requires actin from host cells to make tails for movement AND the organism is Gram-negative. E) The organism obtains most of its essentialmacromolecules from the host AND the organism is an obligate intracellular parasite.

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80)

Why is tertiary syphilis difficult to treat? A) The bacteria are no longer actively multiplying, and antibiotics work against dividing

cells. B) The bacteria have moved into deep tissues that are not accessible by medications. C) The bacteria have migrated to the brain, which is protected by the blood-brain barrier. D) The bacteria have formed biofilms, which protect them from the effects of antibiotics. E) The bacteria have formed endospores, which are resistant to the effects of antibiotics.

81)

Which of the following applies to gonorrhea?

A) The causative agent is a slow-growing, bottle-shaped, Gram-positive bacterium. B) The causative agent is a human-specific pathogen that survives poorly in the environment.  C) A trivalent vaccine protects people from the most virulent strains of N. gonorrhoeae. D) Recovery from gonorrhea confers lifelong resistance to the causative agent. E) The causative agent uses a capsule to attach to squamous epithelium and ciliated cells.

82)

In a male, when urine leaves the kidney, the first structure it enters is the A) ureter. B) bladder. C) urethra. D) prostate. E) vas deferens.

83)

A Gram stain of a urine sample reveals tiny pink rods. This is most likely

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A) Escherichia coli. B) Treponema pallidum. C) Staphylococcus saprophyticus. D) Candid albicans. E) Neisseria gonorrhoeae.

84) Identify the correct flow of urine: 1. Ureter 2. Bladder 3. Urethra 4. Kidney A) 4; 1; 2; 3 B) 4; 3; 2; 1 C) 3; 1; 4; 2 D) 2; 3; 4; 1 E) 2; 3; 1; 4

85)

Which of the following manifests itself in four clinical stages? A) Gonorrhea B) HPV C) HIV D) Syphilis E) Bacterial vaginitis

86) Which of the following sexually transmitted infections can be prevented through vaccination? A) HIV B) Gonorrhea C) Syphilis D) HPV E) Bacterial vaginitis

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87) Which of the following is NOT a predisposing factor in women for developing bacterial cystitis? A) Enlarged prostate gland B) Birth control devices C) Catheterization D) Sexual intercourse E) Short urethra

88)

Identify the virulence factor found in uropathogenic E. coli. A) Toxins. B) Protein capsule. C) Polysaccharide capsule. D) Pili. E) Degradative enzymes.

89)

All of the following are true about the causative agent of leptospirosis EXCEPT A) it is a Gram-negative spirochete. B) it has hooked ends. C) it moves by endoflagella. D) it is transmitted through urine. E) it is encapsulated.

90)

Which of the following is characteristic of the septicemic phase of leptospirosis?

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A) Photophobia B) Muscle-aches C) Jaundice D) Fever E) Headache

91)

All of the following are true of the pathogenesis of leptospirosis EXCEPT

A) the causative agent enters the body through mucous membranes, eyes, and skin breaks.  B) certain events in the infectious process may lead to excessive cytokine production.  C) a large lesion develops at the site of entry of the causative agent. D) the lipid A of the cell's outer membrane does not provoke a strong inflammatory response. E) the mechanisms involved in later stages of the disease are very well understood. <!-Markup Copied from Habitat-->

92) Your patient complains ofitching of the vulva, inner thighs, and vagina, and a frothy, sometimes smelly, yellowish-green vaginal discharge. You examine her and notice pinpoint hemorrhages on the cervix, commonly called strawberry cervix. You diagnose _______ , caused by _______ (a _______).  A) trichomoniasis; Trichomonas vaginalis; protozoan B) trichomoniasis; Trichomonas vaginalis; bacterium C) syphilis; Trichomonas vaginalis; protozoan D) vulvovaginal candidiasis; Gardenerella species; bacterium E) bacterial vaginosis; Trichomonas vaginalis; protozoan

93)

Which is the only common sexually transmitted infection caused by a protozoan?

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A) Trichomoniasis B) Vulvovaginal candidiasis C) Leptospirosis D) Syphilis E) Chlamydia

SECTION BREAK. Answer all the part questions. 94) Mycoplasma genitalium is an emerging cause of genital tract infections in men and women worldwide. The organism wasdiscovered and identifiedonly in the early 1980s. Rising incidence and increasing resistance to antimicrobial medications are problematic. You are asked by your nursing professor to prepare a short presentation on this emerging disease. The questions that follow are those that you anticipate that being asked by your classmates.

94.1) Mycoplasma genitalium infections frequently go undiagnosed for all of the following reasons EXCEPT A) there are no widely available FDA-approved diagnostic tests for M. genitalium infections. B) infections are often asymptomatic in both males and females. C) if signs and symptoms do occur, they resemble those of gonorrhea or chlamydia. D) NAAT tests that are commonly used for clinical diagnosis often give false positive results. E) All of the answer choices are true.

94.2)

Select the statement that applies to Mycoplasmas.

A) These bacteria have mycolic acids in their cell wall. B) These bacteria are intrinsically resistant toβ-lactam antibiotics . C) These organisms all contain a terminal organelle. D) Mycoplasmas resist the effects of β-lactam drugs by synthesizing a β-lactamase. E) These organisms have a rapid generation time.

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94.3) STIs.

People who contract M. genitalium infections are also at risk of acquiring other

⊚ ⊚

true false

94.4)

Select the FALSE statement regarding Mycoplasma genitalium.

A) M. genitalium is flask- or bottle-shaped, with a terminal projection. B) The organism is fastidious and has a slow generation time. C) M. genitalium transmission is throughdirect mucosal contact. D) This organism is classified as a psychrotroph or psychrophile. E) M. genitalium acquires many nutrients from the host cell.

94.5) Suspected M. genitalium infections are treated with antibiotics such as macrolides. Why are these infections "suspected" and why are they treated with macrolide antibiotics?

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A) The signs and symptoms of M. genitalium infections are unique and diagnosis can thus be based on themAND mycoplasmas are intrinsically resistant to peptidoglycan synthesis inhibitors so are treated with antibiotics that target other cellular activities such as protein synthesis. B) Signs and symptoms of M. genitalium infections resemble those of other STIs, confusing the diagnosis of this disease ANDmycoplasmas are intrinsically resistant to protein synthesis inhibitors so are treated with antibiotics that target other cellular activities such as DNA replication. C) The signs and symptoms of M. genitalium infections are unique and diagnosis can thus be based on themAND mycoplasmas are viruses, so there are very limited choices in the available medications used for treating these infections. D) A person with M. genitalium never has signs and symptoms, so infection is suspected if they have other STIsAND mycoplasmas are intrinsically resistant to peptidoglycan synthesis inhibitors so are treated with antibiotics that target other cellular activities such as protein synthesis. E) There are no approved diagnostic tools for M. genitalium infections, so it is not possible to easily confirm the diagnosisAND mycoplasmas are intrinsically resistant to peptidoglycan synthesis inhibitors so are treated with antibiotics that target other cellular activities such as protein synthesis.

95) You go for your regular Pap testand are informed by your OBGYN that you are positive for HPV16. You are surprised because you have not noticed any signs or symptoms of infection. Your doctor explains that sexually transmitted HPVstrains are among the most common of the STI agents, and that while some HPV strains cause warty growths of the external and internal genitalia, other strains cause non-warty lesions of mucosal surfaces such as the uterine cervix. These strains are of concern because they are a major factor in the development of cervical cancer. You ask your doctor a number of questions regarding HPV and HPV infection.

95.1)

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Is the risk of developing cervical cancer the same for all strains of HPV?

A) Yes. HPV is a double-stranded DNA virus, so any HPV strain will definitely integrate into the host cell chromosome, becoming oncogenic and leading to the development of cancer. B) No. Wart-causing HPV types exists in infected cells as extrachromosomal, closed DNA circles, while the genome of high-risk (cancer-associated) HPV types integrate into the chromosome of the host cell.  C) No. Wart-causing HPV types are double-stranded RNA viruses which are easily eliminated by the immune system while cancer-causing HPV types are double-stranded DNA viruses that can integrate into the host cell chromosome. D) No. It depends on the infected person's immune system rather than the virus. Any HPV type can cause cancer but some people have a stronger immune system than others and are able to fight off the virus before it gets a chance to integrate into the host chromosome. E) No. Wart-causing HPV types are double-stranded DNA viruses which are easily eliminated by the immune system while cancer-causing HPV types are retroviruses that can integrate into the host cell chromosome.

95.2) If I had developed external genital warts, how would I be cured of the HPV infection? A) Freezing of warts with liquid nitrogen.  B) Surgical excision of the warts. C) Acid treatment of the warts using trichloroacetic acid.  D) Removal of the warts using creams thatinduce cytokine production.  E) None of the choices are correct. Warts can be removed but HPV may remain and cause recurrences.

95.3) I've read a lot about signs and symptoms of STIs. Which of the following STI signs and symptoms would I never get with an HPV infection?

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A) Possible rectal or vaginal bleeding, depending on wart location.  B) Flat, raised, or cauliflower-like warts at the vaginal opening AND detectable warts at the anus.  C) Possible rectal or vaginal bleeding, depending on wart location AND warts at the vaginal opening or anus. D) Painless ulcer (chancre) at the site of pathogen entry AND pus containing diplococci. E) These signs and symptoms are all associated with HPV infections.

95.4) I know HPV is sexually transmitted, but my male partner knows he is HPV positive, so always wears a condom whenever we have sex. I am not sure how I contracted this virus. How can this be explained? A) Condoms prevent the transmission of bacterial pathogens but do not protect against viral diseases because viruses are small enough to get through the latex. B) Condoms do not provide complete protection against HPV because the virus can be transmitted by exposure to areas not covered by the condom.  C) Only latex condoms prevent the transmission of HPV because there are medications in the latex that destroy viruses. Other types of condoms lack these medications. D) Condoms are never an effective way of preventing transmission of viruses. People who avoid HPV infections take daily doses of antiviral medications as long as they are sexually active. E) Condoms are never an effective way of preventing transmission of viruses. People who avoid HPV infections take daily doses of prophylactic antibiotics as long as they are sexually active.

95.5) My sister has received the Gardasil 9 (9vHPV) that protects against 9 strains of HPV most commonly associated with genital warts and cancers. Does she still need to get screened for cervical cancer (Pap test)?

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A) Yes—although the vaccine protects againstthe most common strains associated with cervical cancer, it does not protect against ALL cancer-causing strains. B) No—once your sister received the HPV vaccine, she developed immunity against all HPV strains and will thus never develop cervical cancer. C) No—the HPV vaccine causes minor changes in the cervical epithelium which resemble precancerous lesions, so a Pap test will always come up positive. D) Yes—although the vaccine is used to cure active HPV infections, the virus can go latent and reactivate at a later stage, causing cancer that the Pap test will detect. E) No—the Pap test is designed to detect cancer antibodies; your sister will have these antibodies because of receiving the HPV vaccine, so will always test positive for cervical cancer.

95.6)

My younger brother, who is 16,should not bother to get the 9vHPV vaccine.

⊚ ⊚

true false

96) A 32-year-old married woman complained of 1 week of burning pain on urination and frequent release of small amounts of bloody urine. About 8 days earlier, she had completed 3 days of co-trimoxazole (TMP-SMX) treatment for similar symptoms;urine culture results before that treatment showed Escherichia coli, resistant only to amoxicillin. When her symptoms returned, she began drinking 12 ounces of cranberry juice three times daily but felt only slightly better. She did not have other symptoms such as chills, fever, back pain, nausea, or vomiting, and the results from the rest of her physical examination were normal. The patient's medical history showed that she had suffered two or three similar episodes of urinary symptoms every year for a number of years. On one occasion several years before the present illness, she had chills, fever, back pain, nausea, and vomiting with her other urinary symptoms, and she had beenhospitalized.

96.1)

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What is the likely diagnosis for this patient?

A) Bacterial vaginosis B) Glomerulonephritis C) Bacterial cystitis D) Pyelonephritis E) Gonorrhea

96.2) The patient had completed a course of co-trimoxazole taken for the same signs and symptoms only 8 days earlier. Select the most likely reason she had a recurrence so quickly. A) She was resistant to the antibiotic (co-trimoxazole) she had been taking. B) Tests showed that the bacterium causing her illness was resistant to co-trimoxazole. C) Uropathogenic bacteria create intracellular bacterial communities (IBCs) in the bladder, providing a reservoir for future infections. D) She was using a diaphragm for birth control; these are a site of uropathogenic E. coli biofilms, thus increasing the risk of UTI. E) She was drinking cranberry juice, which contains a lot of sugar and encourages E. coli growth; this predisposed her to repeated UTIs.

96.3) What do the signs and symptoms reported in the patient's medical history suggest? A) The patient had likely developed pyelonephritis. B) The patient was probably immunocompromised. C) The patient was probably allergic to the medication she was taking. D) The patient likely had a concurrent infection with a virus. E) The patient's reproductive system was being impacted by the infection.

96.4)

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Why was the patient hospitalized at this time?

A) The patient was suffering from nausea and vomiting; patients with these symptoms are always hospitalized to prevent them becoming dehydrated. B) The patient was suffering from nausea and vomiting; patients with these symptoms are highly contagious, so they are hospitalized as a way to isolate them. C) The signs and symptoms suggest reproductive tract involvement, a serious situation that may require intravenous antibiotic administration. D) The signs and symptoms suggest kidney involvement, a serious situation that may require intravenous antibiotic administration. E) The patient was hospitalized so that her physician could obtain a urine sample from her, an invasive and difficult procedure.

96.5) All of the following are recommendedfuture preventive measures for this patient EXCEPT  A) drinking plenty of fluids to ensure frequent urination. B) avoiding delays in urination. C) urinating immediately after intercourse. D) taking a prophylactic course of amoxicillin. E) taking a low dose of an antibiotic daily or after sexual intercourse.

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Answer Key Test name: Chap 27_10e 1) TRUE 2) TRUE 3) TRUE 4) TRUE 5) TRUE 6) TRUE 7) FALSE 8) FALSE 9) TRUE 10) TRUE 11) TRUE 12) TRUE 13) FALSE 14) E 15) B 16) D 17) E 18) E 19) C 20) A 21) B 22) C 23) A 24) D 25) E 26) C Version 1

27) B 28) A 29) D 30) A 31) B 32) E 33) A 34) B 35) A 36) C 37) B 38) D 39) C 40) B 41) A 42) C 43) E 44) E 45) E 46) A 47) A 48) B 49) D 50) B 51) E 52) A 53) E 54) A 55) B 56) B Version 1

57) E 58) C 59) D 60) A 61) E 62) C 63) E 64) B 65) B 66) D 67) B 68) A 69) D 70) A 71) C 72) C 73) B 74) D 75) E 76) A 77) D 78) C 79) E 80) A 81) B 82) A 83) A 84) A 85) D 86) D Version 1

87) A 88) D 89) E 90) A 91) C 92) A 93) A 94) Section Break 94.1) D 94.2) B 94.3) TRUE 94.4) D 94.5) E 95) Section Break 95.1) B 95.2) E 95.3) D 95.4) B 95.5) A 95.6) FALSE 96) Section Break 96.1) C 96.2) C 96.3) A 96.4) D 96.5) D

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CHAPTER 28 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Bacteria are the most numerous soil inhabitants, but the biomass of fungi is greater. ⊚ ⊚

A mycorrhiza is a symbiotic association between roots and fungi. ⊚ ⊚

true false

Fungi are able to handle acidic environments much better than bacteria. ⊚ ⊚

true false

Protozoa, algae, and fungus are typically found near the surface of soil. ⊚ ⊚

true false

Streptomyces produces geosmins which give soil a characteristic musty odor. ⊚ ⊚

true false

Oligotrophic waters are usually hypoxic. ⊚ ⊚

true false

7) The organisms found near warm vents on the bottom of the ocean are typically chemoautotrophic.

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⊚ ⊚

Many orchids require fungi for seeds to germinate. ⊚ ⊚

true false

No eukaryotic organisms have been shown to fix nitrogen without the aid of prokaryotes. ⊚ ⊚

10)

true false

Sulfur occurs in all living matter primarily as a component of carbohydrates. ⊚ true ⊚ false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 11) An early contributor to the understanding of nitrogen fixation was A) Hooke. B) Pasteur. C) Winogradsky. D) Beijerinck. E) Lister.

12) The term used to describe the interrelationship between the living and non-living environments in an area is called a(n)

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A) group. B) community. C) ecosystem. D) ecological niche. E) habitat.

13)

The role that an organism plays in its environment is called its A) activity. B) niche. C) position. D) ecosystem. E) habit.

14)

The region of the earth inhabited by living organisms is called the A) biosphere. B) niche. C) ecosystem. D) community. E) environment.

15)

The environment immediately surrounding an individual cell is called its A) macroenvironment. B) microenvironment. C) microniche. D) colony. E) macrohabitat.

16)

Which group is composed of autotrophs?

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A) Primary consumers B) Secondary consumers C) Decomposers D) Rotters E) Primary producers

17)

Biofilms are likely to be found in environments A) that are nutrient rich. B) that are relatively warm. C) with rapidly flowing water. D) with low nutrients. E) that are anaerobic.

18)

A microbial mat A) is a form of biofilm. B) is poorly organized. C) contains only obligate anaerobes. D) is constructed to prevent interactions between the various layers of microorganisms. E) is a form of biofilm that contains only anaerobes,AND is poorly organized.

19) The practice of cells turning on the production of some enzymes and turning off others in response to a changing environment is called A) compromise. B) adaptation. C) metabolism. D) nutritional metabolism. E) quorum sensing.

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20)

The problem of not being able to cultivate most microorganisms has led to the use of A) FISH. B) microscopy with fluorescent dyes. C) 16SrRNA analysis. D) FISH and 16S rRNA analysis. E) All of choices are methods used to help identify microorganisms in the environment.

21)

Nutrient poor waters are described as being A) hypoxic. B) oligotrophic. C) autotrophic. D) eutrophic. E) anoxic.

22)

Eutrophic waters A) are nutrient rich AND contain 3.5% salt. B) may become hypoxic AND lack phosphate, nitrate, and iron. C) lack phosphate, nitrate, and iron AND contain 3.5% salt. D) contain 3.5% salt AND are alkaline. E) are nutrient rich AND may become hypoxic.

23)

It is estimated that the mass of bacteria and fungi in the top six inches of an acre of soil is A) 2 tons. B) 100 lbs. C) 10 tons. D) 500 lbs. E) 2 kilograms.

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24)

The bacteria cultured from a soil sample typically represents A) all the bacteria present in that sample. B) a very small number of bacteria present in that soil. C) all the metabolically active bacteria. D) all the metabolically inactive bacteria. E) most of the types of bacteria in that soil.

25)

Bacteria survive adverse conditions by forming A) zygotes. B) capsules. C) endospores. D) a glycocalyx. E) capsules AND endospores.

26)

The organic matter in soil is referred to as A) mineral soil. B) humus. C) inorganic substance. D) bedrock. E) mulch.

27)

Geosmins are

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A) a strain of Bacillus. B) nitrogen-fixing bacteria. C) metabolites that give soil its odor. D) produced by Rhizobium. E) metabolites that give soil its odor AND produced by Rhizobium. F) metabolites that give soil its odor AND produced by Bacillus.

28)

Streptomyces A) may produce antibiotics. B) may produce antivirals. C) are typically found in the air. D) are frequently transmitted by vectors. E) use metabolites called geosmins.

29)

Which of the following soil organisms play a major role in decomposing plant matter? A) Bacteria AND fungi B) Bacteria AND viruses C) Fungi AND protozoa D) Protozoa AND viruses E) Viruses AND fungi

30)

The major effect of excess water in the soil is to A) increase the levelof oxygen. B) lower the amountof oxygen. C) reduce the pH. D) increase the amount of nitrogen. E) reduce the amount of carbon.

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31) The zone of soil that surrounds the roots and contains a variety of organic exudates is called the A) mycorrhizae. B) rootsphere. C) rhizosphere. D) geosmin. E) biosphere.

32) The organisms that obtain energy by oxidation of hydrogen sulfide and use carbon dioxide as a carbon source are called A) heterotrophs. B) chemolithoautotrophs. C) chemoheterotrophs. D) autotrophs. E) chemoliths.

33) Which of the following may be used by prokaryotes, under anaerobic conditions, as terminal electron acceptors? A) Nitrate B) Nitrite C) Sulfate D) Carbon dioxide E) All of the choices are correct.

34)

The carbon cycle revolves around

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A) nitrogen. B) carbon dioxide. C) water. D) phosphorus. E) carbon monoxide

35)

The organisms that convert carbon dioxide into organic matter are the A) secondary consumers. B) primary consumers. C) producers. D) decomposers. E) secondary decomposers.

36)

Turning inorganic carbon into organic carbon is called A) mineralization. B) eutrophication. C) respiration. D) carbon fixation. E) carbonation.

37)

During aerobic decomposition of organic matter the primary gas produced is A) oxygen. B) hydrogen sulfide. C) nitrogen. D) carbon dioxide. E) ethylene dioxide.

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38) During anaerobic decomposition of organic matter with carbon dioxide as the terminal electron acceptor, the primary gas(es) produced is/are A) oxygen. B) hydrogen sulfide. C) methane. D) hydrogen. E) methane AND hydrogen.

39)

Next to carbon and oxygen, the element organisms most require is A) sulfur. B) phosphorus. C) iron. D) potassium. E) nitrogen.

40)

Atmospheric nitrogen is A) used directly by plants. B) used directly by animals. C) turned into ammonia by microorganisms. D) directly used to make carbohydrates. E) converted into urea by bacteria.

41)

Nitrogen is

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A) an important constituent of carbohydrates AND primarily fixed by fungi. B) turned into ammonia by microorganisms AND ultimately used in making amino acids and nucleotides. C) primarily fixed by fungi AND ultimately used in making amino acids and nucleotides. D) ultimately used in making amino acids and nucleotides AND an important constituent of carbohydrates. E) turned into ammonia by microorganisms AND ultimately used in making bacterial capsules.

42)

The nitrogen in our atmosphere is only usable to us after it is converted to A) ammonia. B) amino acids. C) fertilizer. D) nitrous oxide. E) oxygen.

43)

Azotobacter

A) are the chief suppliers of fixed nitrogen in grasslands. B) form symbiotic associations with algae. C) have a very low respiratory rate. D) are methanogens. E) are the chief suppliers of fixed nitrogen in grasslands AND form symbiotic associations with algae.

44)

Nitrifiers

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A) are obligate anaerobes. B) are chemolithotrophs. C) convert nitrate to nitrite. D) are reducers. E) are thermophiles.

45)

Sulfur occurs in all living matter primarily as a component of A) fatty acids. B) nucleotides. C) amino acids. D) carbohydrates. E) DNA and RNA.

46)

The sulfur cycle is similar to the cycle of A) carbon. B) oxygen. C) phosphorus. D) water. E) nitrogen.

47)

Phosphorus is a component of all of the following EXCEPT A) RNA and DNA. B) phospholipids. C) nucleotides. D) carbohydrates. E) ATP.

48) of

In many aquatic habitats, the growth of algae and cyanobacteria is limited by the amount

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A) nitrogen. B) phosphorus. C) calcium. D) sulfur. E) nitrites.

49) The conical sea floor vents that spout sulfide-rich, super-heated water at temperatures up to 300ºC are called A) hydrothermal vents. B) yellow smokers. C) warm vents. D) hot vents. E) hyperthermophiles.

50)

The organisms isolated from hydrothermal vents are typically A) phototrophs. B) chemolithoautotrophs. C) rhizobia. D) bacteroids. E) phototrophs, rhizobia, AND bacteroids.

51)

Which of the following refers to a symbiotic association between plant roots and fungi? A) Lichens B) Geosmins C) Extremophiles D) Ant gardens E) Mycorrhizae

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52)

Mycorrhizae are a symbiotic association of A) bacteria and algae. B) plant roots and fungi. C) bacteria and virus. D) fungi and virus. E) plants roots and bacteria.

53)

Truffles A) are endomycorrhizas. B) are a mushroom. C) are a lichen. D) form a sheath around a root of an appropriate tree. E) are endomycorrhizas AND form a sheath around a root of an appropriate tree.

54)

The rumen is A) found in horses and rabbits. B) an anaerobic fermentation vessel found in herbivores. C) found in carnivores. D) an offshoot of the colon. E) an anaerobic fermentation vessel found in most carnivores.

55)

Which of the following involve symbiotic relationships? A) Rhizobia AND ruminants B) Mycorrhizae AND ruminants C) Ruminants AND myxobacteria D) Myxobacteria, ruminants, AND rhizobia E) Rhizobia, mycorrhizae, AND ruminants

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56)

Explain how nutrient-rich runoff can cause waters to become hypoxic.

A) Algae and cyanobacteria flourish on the nutrients in the runoff. Heterotrophic microbes then flourish on the organic molecules produced by these organisms, using oxygen in the process and leading to a hypoxic state in the area. Larger animals cannot survive in the hypoxic area. B) Algae and cyanobacteria flourish on the nutrients in the runoff, using oxygen in the process. This consumption of oxygen leads to a hypoxic state in the area. Larger animals cannot survive in the hypoxic area. C) The nutrients in the runoff often include chemicals that spontaneously oxidize in the presence of oxygen. They tend to deplete the amount of oxygen present in an area simply by being present themselves. This consumption of oxygen leads to a hypoxic state in the area. Larger animals cannot survive in the hypoxic area. D) The nutrients in the runoff often include toxic chemicals that kill anaerobes such as cyanobacteria. Aerobes flourish, depleting the amount of oxygen present. This consumption of oxygen leads to a hypoxic state in the area. Larger animals cannot survive in the hypoxic area. E) It doesn't. This claim is a scare tactic used by environmental extremists to prevent farmers and individuals from fertilizing their crops and lawns. There is no induction of a hypoxic state in bodies of water where runoff occurs.

57) How can the biomass of fungi in soil be greater than that of bacteria, considering that bacteria are more numerous?

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A) Fungi are always multicellular organisms, while bacteria are unicellular. As such, biomass of fungi would always be larger than that of bacteria, since they possess more cells in each individual organism. B) This is a matter of size. Fungi, whether unicellular or multicellular, are eukaryotic and are generally larger than bacteria (which are prokaryotic). This means that, even with a lower overall number, they will have more total biomass. C) It depends on where they grow. Fungi generally grow in the most moist areas near the top of soil, giving them an advantage over bacteria. They may not be as numerous, but this advantage in location and nutrients is what makes them larger than the bacteria (and therefore having more biomass). D) Fungi are capable of incorporating the dead materials around them into themselves as nutrient sources. This capacity allows them to greatly increase their biomass per each organism, well beyond what a simple bacterial cell could hold. This capability is what allows them to achieve higher biomass than bacteria. E) Bacteria may be more numerous, but in soil they exist mostly in a dehydrated state. Because they lack moisture, they weigh less than fungi, which may occur in lower numbers but are heavier because they are well hydrated in all soil environments.

58) Gardeners sometimes plant clover between productive growing seasons. Why would this practice be beneficial? A) Several types of nitrogen-fixing bacteria form a symbiotic relationship with the roots of clover. This would increase the amount of nitrogen in the soil available for subsequent seasons of other plants' growth. B) Clover is consumed by a number of animals. This would encourage the animals to feed/graze on the areas, leaving behind nitrogen-rich manure (feces) that would act as a natural fertilizer for subsequent seasons of other plants' growth. C) Clover is a unique plant that is capable of atmospheric nitrogen-fixation (pulling nitrogen directly out of the air and turning it into ammonia or amino acids). This directly provides nitrogen compounds for the soil for subsequent seasons of other plants' growth. D) The beneficial effect is more for water retention and elimination of soil erosion in between growing seasons than for any nutrient value. It has nothing to do with nitrogen compounds in the soil. E) Several types of oxygen-fixing bacteria form a symbiotic relationship with the roots of clover. This would increase the amount of oxygen in the soil available for subsequent seasons of other plants' growth.

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59) Which statement describes the relationship between ammonia oxidizers and nitrite oxidizers?  A) Ammonium oxidizers use ammonium as an energy source, oxidizing it to nitrite. The nitrite produced then serves as the energy source for nitrite oxidizers. B) Ammonium oxidizers use ammonium as an energy source, oxidizing it to nitrate. The nitrate produced then serves as the energy source for nitrite oxidizers. C) Ammonium oxidizers use urea as an energy source, oxidizing it to nitrite. The nitrite produced then serves as the carbon source for nitrite oxidizers. D) Ammonium oxidizers use ammonium as an energy source, reducing it to nitrate. The nitrate produced then serves as the energy source for nitrite oxidizers. E) None of the choices explain the relationship—ammonia and nitrite are produced by different nutrient cycles which also involve sulfur reduction.

60) How do bacteriocins benefit bacteria in their natural habitat?  A) They protect the bacteria from the effects of antibiotics in the environment. B) They provide a source of nutrients during adverse environmental conditions. C) They allow bacteria to compete against other bacteria that may attempt to use the same or similar resources. D) They are protective structures that allow bacteria to survive adverse environmental conditions. E) They induce resistance in the bacteria, helping them survive when medications are introduced into their habitat.

61) Which of the following statements regarding microbial identification is false? <!-Markup Copied from Habitat-->

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A) FISH can be used to distinguish subsets of prokaryotes that contain a specific nucleotide sequence.  B) Studying the genome of one organism can give insights into the characteristics of another organism.  C) 16S rRNA sequences can be used to determine taxonomic similarity among prokaryotes.  D) Metagenomics involves comparison of gene sequences in DNA from environmental samples to known gene sequences in databases.  E) Culture techniques are an accurate way of determining which members in a microbial community are most common.

62) What gene sequences are used to identify the prokaryote organisms present in an environmental sample?  A) 18S rRNA genes B) 16S rRNA genes C) 70S rRNA genes D) 80S rRNA genes E) All of the choices are correct.

63) What is the likely fate of a fish living in a eutrophic stream?  A) Fish will first thrive as they have more oxygen from the increase in photosynthetic organisms; eutrophic streams are low in nutrients however, so they will quickly die. B) Eutrophic streams have high levels of carbon dioxide. Fish will be able to use this for aerobic respiration, so will thrive in this environment. C) Eutrophic streams are always anoxic. This means that only anaerobic fish will be able to survive in a eutrophic environment. D) Fish will first thrive as they have more food from the increase in photosynthetic organisms; as they deplete the dissolved oxygen, however, they will die. E) Eutrophic streams have low levels of nutrients in them. Only fish that feed off other fish will be able to survive in these streams.

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64) Please select the correct sequence of steps involved in the creation of a dead zone in a water body. 1.Heterotrophic microbes metabolize the organic compounds synthesized by primary producers. 2. Water becomes hypoxic and toxic algal blooms may occur;animals in the area either flee or die. 3.Water accumulates nutrients as it runs through agricultural, industrial, and urbanized regions. 4. Dissolved O2is consumed by metabolic activity of heterotrophs. 5.Excess nitrate and phosphate in nutrient-rich water causes algae and cyanobacteria to flourish. A) 3; 5; 1; 4; 2 B) 3; 1; 4; 2; 5 C) 1; 3; 4; 2; 5  D) 5; 3; 4; 2; 1 E) 3; 5; 2; 1; 4

65)

Which of the following is not a matching pair?  A) Soil—minimal biodiversity B) Bacillus—endospores C) Streptomyces—geosmin production D) Fungi—lignin degradation E) Rhizosphere—soil that adheres to plant root

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Answer Key Test name: Chap 28_10e 1) TRUE 2) TRUE 3) TRUE 4) TRUE 5) TRUE 6) FALSE 7) TRUE 8) TRUE 9) TRUE 10) FALSE 11) D 12) C 13) B 14) A 15) B 16) E 17) D 18) A 19) B 20) E 21) B 22) E 23) A 24) B 25) C 26) B Version 1

27) C 28) A 29) A 30) B 31) C 32) B 33) E 34) B 35) C 36) D 37) D 38) C 39) E 40) C 41) B 42) B 43) A 44) B 45) C 46) E 47) D 48) B 49) A 50) B 51) E 52) B 53) D 54) B 55) E 56) A Version 1

57) B 58) A 59) B 60) C 61) E 62) B 63) D 64) A 65) A

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CHAPTER 29 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The term "potable water" refers to water that is not necessarily pure, but is safe to drink. ⊚ ⊚

true false

Zero coliforms per 100 ml of water is considered safe for treated potable water. ⊚ ⊚

true false

3) High BOD values reflect small amounts of degradable organic matter in a sample of wastewater or other material. ⊚ ⊚

The conversion of organic to inorganic matter is called co-metabolism. ⊚ ⊚

true false

As much as 95% of BOD can be removed during secondary treatment. ⊚ ⊚

true false

The activated sludge method can be stopped by the presence of toxic industrial wastes. ⊚ ⊚

true false

Trickling filters may be used in place of activated sludge in secondary sewage treatment.

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⊚ ⊚

true false

8) The compost pile temperature at which pathogens, but not thermophiles, are killed is about 20–30ºC. ⊚ ⊚

true false

9) If a compost pile is turned frequently and other conditions are adequate for aerobic digestion, the composting can be completed in 6 weeks. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 10) An effective means used early in the 19th century to clear water of the majority of bacteria was the use of A) chlorine. B) iodine. C) alcohol. D) sand filters. E) antibiotics.

11)

Vibrio cholerae is most often associated with A) breathing air. B) eating food. C) drinking water. D) touching animals. E) having unprotected sex.

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12)

The term "potable water" refers to water that is A) safe to swim in but not to drink. B) only good for irrigation of crops. C) contaminated with chemicals. D) safe to drink. E) in carrying containers.

13)

A high BOD value means

A) a large amount of oxygen has been used AND a small amount of degradable organic matter is present. B) a small amount of oxygen has been used ANDa large amount of degradable organic matter is present. C) a large amount of degradable organic matter is present AND a small number of viruses are present. D) a small number of viruses are present AND a large amount of oxygen has been used. E) a large amount of oxygen has been used AND a large amount of degradable organic matter is present.

14)

Effective treatment of wastewater/sewage is reflected in a(n) A) lower BOD. B) higher BOD. C) unchanging BOD. D) increase in sulfur. E) decrease in biomass.

15) In sewage treatment, the removal of large objects and particulate matter is achieved during

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A) primary treatment. B) secondary treatment. C) tertiary treatment. D) quaternary treatment. E) the night.

16) In sewage treatment, the removal of phosphates and nitrogen compounds is achieved during A) primary treatment. B) secondary treatment. C) advanced treatment. D) quaternary treatment. E) All of the choices are correct.

17)

Advanced treatment of sewage A) is done to promotenutrient enrichment. B) is done to prevent possible overproduction of algae and other organisms. C) involves the removal of phosphates and sulfur compounds. D) is done to promote growth of photosynthetic organisms. E) All of the choices are correct.

18)

The activated sludge process A) is used during secondary treatment of sewage. B) is meant to convert inorganic to organic matter. C) is meant to increase the BOD. D) removes large objects from the sewage. E) is meant to convert inorganic to organic matter AND is meant to increase the BOD.

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19)

The anaerobic organisms used in sewage treatment may produce the useful product(s) A) oxygen. B) nitrogen. C) carbon monoxide. D) methane. E) nitrogen AND carbon monoxide.

20)

The oxygen consuming property of a wastewater sample is designated by the term A) lagooning. B) stabilization. C) biological nitrogen demand. D) biochemical oxygen demand. E) lagooning AND stabilization.

21)

The approximate BOD value for raw sewage is A) 2000–7000 milligrams per milliliter. B) 500–800 grams per milliliter. C) 0–50 kilograms per milliliter. D) 300–400 milligrams per liter. E) 300–400 grams per liter.

22)

In which phase of sewage treatment are trickling filters sometimes used? A) Primary treatment. B) Secondary treatment. C) Tertiary treatment. D) Quaternary treatment. E) All of the choices are correct.

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23)

Which of the following plays some role in sewage treatment? A) Activated sludge B) Trickling filter C) Septic tank D) Lagooning E) All of the choices are correct.

24)

The problem(s) with using sludge as a fertilizer is/are the

A) presence of heavy metals and similar pollutants AND inhibitory effect it has on plant growth. B) presence of heavy metals and similar pollutants AND presence of pathogenic organisms and viruses. C) presence of pathogenic organisms and viruses ANDinhibitory effect it has on plant growth. D) inhibitory effect it has on plant growth AND stimulatory effect it has on methane production. E) stimulatory effect it has on methane production AND presence of pathogenic organisms and viruses.

25)

Sludge A) is a byproduct of sewage treatment. B) may be a source of pollution. C) takes up space in a landfill. D) All of the choices are correct. E) None of the choices is correct.

26)

Wastewater treatment decreases the amount of

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A) biodegradable carbon. B) ammonia and nitrate. C) phosphate. D) pathogens. E) All of the choices are correct.

27)

Water treatment processes for drinking water A) are similar to wastewater treatment. B) have no biological treatment phase. C) are only necessary when using recycled water. D) include disinfection but not filtration. E) include filtration but not disinfection.

28)

Which of the following is used to cause flocculation? A) Charcoal B) Methane C) Natrium potassium phosphate (nalum) D) Chlorine E) Aluminum potassium phosphate (alum)

29) The accepted method of testing water supplies for the possible presence of pathogens is to determine the presence of A) Streptococci. B) coliforms. C) Staphylococci. D) Streptomyces. E) vibrios.

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30)

Coliforms are A) lactose-fermenting. B) Gram-positive. C) coccus-shaped. D) spore-forming. E) All of the choices are correct.

31) Other microorganisms/infectious agents besides coliforms that have been used as indicators of fecal contamination may be all of the following EXCEPT A) Clostridia. B) Enterococci. C) bacteriophages. D) Bacteroides. E) Clostridia, Enterococci AND bacteriophages.

32)

Which of the following statements about landfills is FALSE?

A) Degradation of wastes is rapid and inexpensive. B) The excavated site has a plastic liner to prevent wastes from leaching into groundwater. C) Recycling greatly reduces the amount of wastes sent to landfills. D) Dangerous levels of methane gas can accumulate. E) All of the answer choices are true.

33)

Which of the following cannot be used in composting? A) Grass clippings B) Nutrient-poor potting soil C) Meats and fats D) Vegetable peelings E) Leaves

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34) If a compost pile is turned frequently and other conditions are adequate for aerobic digestion, the composting can be completed in A) six months. B) six weeks. C) 1 month. D) 1 day. E) three years.

35) The compost pile temperature at which pathogens, but not thermophiles, are killed is about A) 20–30ºC. B) 55–66ºC. C) 62–75ºC. D) 90–100ºC. E) 97ºF.

36)

Bioremediation

A) is the use of biological agents to degrade/detoxify pollutants AND may involve biostimulation or bioaugmentation. B) is the use of biological agents to degrade/detoxify pollutants AND has as its goal the elimination of pathogens. C) may involve biostimulation or bioaugmentation ANDhas as its goal the elimination of pathogens. D) produces xenobiotics ANDis the use of biological agents to degrade/detoxify pollutants. E) has as its goal the elimination of pathogens AND produces xenobiotics.

37)

Pollutant degradation may be enhanced by

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A) providing dry conditions. B) providing adequate nutrients. C) maintaining an acidic pH. D) lowering the temperature. E) All of the choices are correct.

38)

Bioaugmentation

A) adds specific microorganisms to a contaminated site. B) aims at enhancing the growth of the resident population of microbes. C) usually utilizes genetically engineered bacteria. D) is typically done offsite. E) depends on competition between resident and added microbes.

39) Which would be more likely to cause illness: a water sample that tested positive for coliforms or one that tested positive for E. coli O157:H7? A) Both would be equally capable of causing illness because all coliforms cause illness. B) The coliform-positive sample would be more likely to cause illness. Coliforms are inherently more pathogenic than the weak O157:H7 lab strain of E. coli. C) The E. coli O157:H7 sample would be more likely to cause illness. This strain of bacterium is highly pathogenic and capable of causing kidney damage. D) Neither; there is usually a small amount of coliforms (including E. coli O157:H7) in all water. E) The coliform-positive sample would be more likely to cause illness. Coliforms indicate the presence of fecal contamination, which always leads to illness.

40)

Why would soil and water be added to a compost pile?

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A) The organisms inthe soil, along with the moisture from the water, would facilitate the naturaldecomposition of the material in the compost pile. B) Without adding soil and water, no decomposition of the material can take place. The material would simply sit there. C) Water is the medium that photosynthetic organisms use to break down the organic materials in the compost pile. D) Soil spreads out the material in the pile. If the material is too close together, natural aeration cannot occur and decomposition stops. E) Water provides the energy that soil organisms need to break down the material in the compost pile.

41) Why is oil not degraded when in a natural habitat underground, yet is susceptible to bioremediation in an oil spill? A) The high pressure the oil is subjected to underground prevents bacteria from growing and consuming it. B) The bacteria can't be giventhe right amounts or types of nutrients to foster an increase in their number deep underground. Nearer the surface, human intervention can increase the factors that will raise the microbe quantity. C) The bacteria that degrade the oil require a higher than normal salt content, much like what is found in seawater. Underground, they lack this salt level. D) Oil IS degraded underground, but it happens at a much slower rate because a portion of the cycle is photosynthetic in nature. This process is dramatically increased nearer to the water's surface. E) There is no oxygen underground, so bacteria are unable to metabolize oil, an aerobic process. When the oil leaks into a water supply, the bacteria present in that oxygen-rich habitat begin to break it own.

42)

Why does secondary treatment of wastewater require O

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A) Secondary treatment relies on anaerobic microbes to oxidize organic material. B) Secondary treatment relies on anaerobic microbes to reduce organic material. C) Secondary treatment relies on aerobic microbes to oxidize organic material. D) Photosynthetic bacteria are involved in secondary treatment and they require O 2. E) Flocs require oxygen to facilitate biofilm formation.

43) What is the advantage of removing phosphates and nitrates from wastewater? <!-Markup Copied from Habitat--> A) Nitrates and phosphates can support the growth of algae and cyanobacteria, and these photosynthetic organisms will then produce organic compounds, thereby increasing the BOD of the water. B) Nitrates and phosphates can support the growth of fish, which then produce increased amount of wastes, thereby increasing the BOD of the water. C) Nitrates and phosphates inhibit the growth of bacteria that normally purify the water; without them, the BOD of the water rapidly increases. D) Nitrates are usually removed by denitrifying bacteria that use nitrate during anaerobic respiration to form N 2,a gas that is toxic and detrimental to other organisms. Removing nitrates protects these organsisms. E) Phosphates are an integral part of prokaryote cytoplasmic membranes. If there are too many phosphates in the water, microbial growth is stimulated, leading to the risk of contamination.

44) Considering that Cryptosporidium oocysts are resistant to chlorine, which step in water treatment protects us from this pathogen? A) Settling B) Coagulation C) Sedimentation D) Filtration E) Disinfection and storage

45)

What are indicator organisms?

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A) Microbes that are contaminants in laboratory media. B) Microbes whose presence in an environment suggests fecal contamination. C) Microbes whose presence in an environment suggests the presence of animal urine. D) Microbes that alert a physician to the presence of a gastrointestinal illness. E) All of the choices are correct.

46) All of the following are methods used to detect total coliforms in a water sample EXCEPT  A) the ONPG/MUG test.  B) the presence/absence test.  C) the most probable number (MPN) method.  D) membrane filtration. E) the Gram-stain test.

47) A site used for disposal of non-hazardous solid wastes in a manner that minimizes damage to human health and the environment is a(n) A) composter. B) water treatment facility. C) sanitary landfill. D) septic tank. E) activated sludger.

48) What is the purpose of coagulation in drinking water treatment?

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A) Antibodies are used bind bacteria into large masses that can be removed by filtration. B) Pollutants such as lead are combined into clumps using toxic chemicals, for easy removal. C) Suspended material is combined using toxic chemicals for easy removal from water. D) To bind together pollutants, bacteria, and other organisms for removal by chemicals. E) When suspended material clumps, it sinks and can be easily removed.

49)

Which of the following is a disadvantage of landfills?

A) Only a limited number of sites are available for making landfills near urban and suburban areas.  B) Methane gas that is produced in landfills as the organic waste material anaerobically decomposes must be removed.  C) Pollutants such as heavy metals and pesticides frequently leak from landfill sites, reaching underground aquifers and contaminating drinking water.  D) Methane gas that is produced in landfills as the organic waste material anaerobically decomposes must be removed AND only a limited number of sites are available for making landfills near urban and suburban areas. E) Pollutants such as heavy metals and pesticides frequently leak from landfill sites, reaching underground aquifers and contaminating drinking water, ANDonly a limited number of sites are available for making landfills near urban and suburban areas.

50)

What is the purpose of grinding yard waste before putting it into composting piles?

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A) Bacteria are microscopic organisms and can only break down very small pieces of matter, which grinding produces. B) Grinding the material breaks down some of the components that microbes cannot digest, such as cellulose. C) Grinding the matter introduces large amounts of oxygen into the material, which is essential for microbial degradation of matter. D) Grinding yard waste is a method for introducing degradative microbes into the mix, needed for composting. E) Grinding the material increases the surface area available for microbial action, so that the material can be degraded more efficiently.

51) Please select the statement that applies to pollutants in the environment and bioremediation. A) Synthetic compounds are more likely to be biodegradable if their chemical composition is different from that of naturally occurring substances.  B) Xenobiotics usually persist in the environment because microorganisms are unlikely to have suitable enzymes to break them down.  C) The biodegradability of a compound can only be changed by significant molecular changes in that compound.  D) Most herbicides and insecticides only are toxic to their target, and do not damage other organisms such as fish, birds, and other animals.  E) Bioremediation generally relies on the addition of specific organisms to the polluted environment.

52)

Please select the statement that does NOT apply to strategies of bioremediation.

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A) Providing optimal bacterial growth conditions is likely to promote pollutant degradation.  B) Biostimulation enhances pollutant degradation by enhancing growth of resident microbes in a contaminated site through providing additional nutrients.  C) Bioaugmentation involves adding microorganisms to contaminated material, complementing the resident population.  D) Low temperature, arid conditions and acidic pH will speed up the rate of pollutant degradation. E) Co-metabolism occurs when an enzyme produced by a microbe to degrade an added substrate in an environment degrades a pollutant as well.

53)

What is the difference between biostimulation and bioaugmentation?

A) Bioaugmentation enhances the growth of local microbes in a contaminated site by providing additional nutrients while biostimulation relies on activities of microorganisms added to the contaminated material, complementing the resident population. B) Biostimulation generally occurs in situ and is less disruptive while bioaugmentation is performed off siteusing a bioreactor, a large tank designed to accelerate microbial processes. C) Biostimulation enhances the growth of local microbes in a contaminated site by providing additional nutrients while bioaugmentation relies on activities of microorganisms added to the contaminated material, complementing the resident population. D) Biostimulation is a method of degrading environmental pollutants while bioaugmentation is a method of supplementing microbial populations in landfills and composters. E) Biostimulation is a bioremedaiotn process designed to remove pollutants from an environment. Bioaugmentation is a method used in laboratories to promote the growth of fastidious microbes.

54)

In treating an oil spill, why might biostimulation be preferred over bioaugmentation?

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A) Adding new microbes (bioaugmentation) poses some risk—when new microbes are added to an environment, the consequences of those additions on resident populations are unknown. Adding nutrients (biostimulation) is safer because once those nutrients are used up, the microbial populations are likely to return to their original levels. B) Biostimulation involves adding novel microbes to boost the populations of resident microbes. These novel microbes are generally genetically engineered to enhance their abilities to metabolize pollutants such as oil, so are very effective. Bioaugmentation merely involves adding nutrients, so all microbes are favored, even those not performing a useful function. C) Bioaugmentation involves adding novel microbes to boost the populations of resident microbes. These novel microbes are highly genetically engineered to enhance their abilities to metabolize pollutants such as oil, so are very effective. Biostimulation merely involves adding nutrients, so all microbes are favored, even those not performing a useful function. D) In fact, biostimulation is not generally favored as an approach. Biostimulation often leads to the generation of antibiotic—resistant microbes, which become a problem for other organisms in the environment. Bioaugmentation is the favored approach because adding nutrients to the area simply enhances the activities of the bacteria already present. E) Biostimulation and bioaugmentation are always used simultaneously. This is done because neither one of these approaches works well individually. Adding bacteria to an environment will never be successful unless nutrients are also added to that environment.

55)

Why do water–testing procedures look for coliforms rather than pathogens?

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A) Pathogens are seldom found in water. Testing for coliforms is a way of determining whether there is any human normal microbiota contamination in that water, which should then be treated with chlorine. B) Pathogens are extremely fastidious in their nutrient requirements and require special growth conditions. Coliforms are easier to culture in a laboratory setting, so it makes sense to test for these rather than for actual pathogens. C) It is always somewhat dangerous to culture pathogens in a laboratory setting– people in the lab are at risk of contracting serious disease. It is much safer to test for coliforms which simply indicate that humans have been swimming in the water. D) It is not possible to test for all of the potential pathogens in water, so indicator organisms such as coliforms are used. These microbes are found in feces, so finding them suggests fecal contamination, and indicates a greater likelihood that intestinal pathogens are also present.  E) Pathogens and coliforms are the same thing. Testing for one is also testing for the other.

56)

Select the pair that is INCORRECTLY matched. A) Potable water—lacks pathogenic microbes and harmful chemicals B) High BOD—low organic content C) Primary treatment—removal of material that settles D) High BOD—high organic content E) Total coliforms—lactose-fermenting members of the family E nterobacteriaceae

57)

Which statement is FALSE?

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A) Artificial wetlands provide a habitat for wildlife.  C) Chlorine, ozone and UV light can be used to disinfect water.  D) Trickling filter systems are used for secondary water treatment.  E) Removal of nitrates by microorganisms requires aerobic conditions.

58) Synthetic compounds are most likely to be biodegradable if they  A) are chemically different from naturally occurring substances.  B) have three chlorine atoms per molecule.  C) are chemically similar to naturally occurring substances.  D) are present in very large amounts.  E) None of the choices are true.

59)

Which definition is INCORRECT?

A) Biochemical oxygen demand (BOD)—the amount of O 2 required for the microbial decomposition of organic matter in a sample. B) Indicator organisms—microbes whose presence in an environment suggests fecal contamination. C) Primary treatment—a wastewater treatment process that uses microbes to convert suspended solids to inorganic compounds and removable cell mass. D) Constructed wetland—method of wastewater treatment in which water is channeled into ponds where aerobic and anaerobic degradation occurs. E) Anaerobic digestion—process that uses anaerobic microbes to degrade the sludge obtained during wastewater treatment.

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60)

Which statement does NOT apply to water treatment?

A) The primary treatment of wastewater is a physical process designed to remove materials that settle out . B) Advanced treatment of wastewateris often designed to remove ammonia, nitrates, and phosphates.  C) Biosolids that result from anaerobic digestion of sludge can be used to improve soils and promote plant growth.  D) Secondary treatments are designed to convert suspended solids into inorganic compounds and microbial biomass. E) An important goal of wastewater treatment is the increase of the BOD that stimulates microbial growth.

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Answer Key Test name: Chap 29_10e 1) TRUE 2) TRUE 3) FALSE 4) FALSE 5) TRUE 6) TRUE 7) TRUE 8) FALSE 9) TRUE 10) D 11) C 12) D 13) E 14) A 15) A 16) C 17) B 18) A 19) D 20) D 21) D 22) B 23) E 24) B 25) D 26) E Version 1

27) B 28) E 29) B 30) A 31) D 32) A 33) C 34) B 35) B 36) A 37) B 38) A 39) C 40) A 41) B 42) C 43) A 44) D 45) B 46) E 47) C 48) E 49) D 50) E 51) B 52) D 53) C 54) A 55) D 56) B Version 1

57) E 58) C 59) C 60) E

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CHAPTER 30 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The water activity in foods with high levels of salt or sugar is high. ⊚ ⊚

Lactobacillus acidophilus can potentially colonize the intestinal tract. ⊚ ⊚

true false

Aflatoxin is a potent carcinogen produced by certain bacteria. ⊚ ⊚

true false

Yeast alone cannot convert grain to alcohol. ⊚ ⊚

true false

Foodborne intoxication requires the ingestion of living organisms. ⊚ ⊚

true false

The toxin produced by Staphylococcus aureus is heat-stable. ⊚ true ⊚ false

The bacteria associated with hemolytic uremic syndrome is Escherichia coli O157:H7. ⊚ ⊚

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true false

Egg white is rich in the antimicrobial lysosome. ⊚ ⊚

true false

9) High concentrations of nucleic acids in the diet may lead to high levels of uric acid in the blood. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 10) Most large cities have required the pasteurization of milk and milk products since ______. A) 1800 B) 1850 C) 1900 D) 1920 E) 1985

11)

Human disease(s) from milk may include A) brucellosis AND anthrax. B) anthrax AND amoebiasis. C) amoebiasis AND tuberculosis. D) tuberculosis AND anthrax. E) brucellosis AND tuberculosis.

12)

The connection between unpasteurized milk and brucellosis in humans was made by

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A) Evans. B) Pasteur. C) Koch. D) Fleming. E) Ehrlich.

13) Foods that have been altered due to the carefully controlled growth of microorganisms are called A) cooked. B) controlled. C) preserved. D) fermented. E) spoiled.

14) Foods that have been unacceptably changed due to uncontrolled bacterial growth are called A) refrigerated. B) spoiled. C) preserved. D) fermented. E) oxidized.

15) Growth of pathogens in a food generally does not result in perceptible changes in the quality of the food but the ingestion of this food can result in A) spoilage. B) foodborne illness. C) aging. D) toxin infection. E) respiratory illness.

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16) The conditions normally present in food such as moisture, acidity, and nutrients are referred to as A) intrinsic factors. B) extrinsic factors. C) endogenous factors. D) exogenous factors. E) intrinsic factors AND endogenous factors.

17)

The growth of microorganisms in a food product is influenced by A) theavailability of moisture. B) acidity. C) theavailability of nutrients. D) temperature. E) All of the choices are correct.

18)

The amount of moisture available in foods is designated by the term A) fluid availability. B) water activity. C) dampness quotient. D) aqueous usability. E) hydro factor.

19)

Pure water has a water activity value of ______.

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A) 1.00 B) 0.80 C) 0.70 D) 0.90 E) 100

20)

Which of the following foods has the greatest amount of available water? A) Cake B) Jam C) Syrup D) Bread E) Steak

21)

For growth, most bacteria require water activity levels above ______. A) 1.00 B) 0.80 C) 0.70 D) 0.90 E) 100

22) Which of the following organisms can grow at a lower water activity than most spoilage bacteria? A) Pseudomonas species B) Staphylococcus aureus C) Most yeasts D) Streptococcus pyogenes E) E. coli

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23) On which of the following foods can Staphylococcus aureus multiply with little competition? A) Bread B) Jam C) Salty ham D) Milk E) Bread and jam

24)

The water activity in foods that have high levels of salt or sugar is A) low. B) high. C) dense. D) osmotic. E) All of the answer choices are correct.

25)

Which of the following are most likely to be found growing on salted or dried foods? A) Fungi B) Bacteria C) Viruses D) Protozoa E) Fungi AND bacteria

26)

Which of the following organisms may grow at pH 3.5? A) Clostridium AND fungi B) Streptococcus AND lactic acid bacteria C) fungi AND Streptococcus D) fungi AND lactic acid bacteria E) lactic acid bacteria AND Clostridium

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27)

Which of the following organisms may grow at pH 2.2? A) Clostridium B) Streptococcus C) fungi D) lactic acid bacteria E) fungi AND lactic acid bacteria

28)

Clostridium botulinum typically does not produce its toxin under conditions that are A) anaerobic. B) acid. C) alkaline. D) neutral. E) anaerobic AND acid.

29)

Lactic acid bacteria

A) consume lactic acid, allowing them to grow on foods such as yogurt. B) produce lactic acid, allowing them to produce foods such as yogurt. C) are important spoilage organisms AND consume lactic acid, allowing them to grow on foods such as yogurt. D) can grow on lemons, are important spoilage organisms, AND consume lactic acid, allowing them to grow on foods such as yogurt. E) produce lactic acid, allowing them to produce foods such as yogurt AND are important spoilage organisms.

30)

Which of the following does NOT produce lactic acid?

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A) Lactobacillus B) Leuconostoc C) Streptococcus D) Lactococcus E) Escherichia

31)

Foods such as acidic fruits are often spoiled by A) fungi. B) protozoans. C) viruses. D) bacteria. E) bacteria AND viruses.

32)

Most bacteria are inhibited by a pH of ______. A) 7.2 B) 7.0 C) 6.0 D) 4.5 E) 6.5

33)

Naturally occurring antimicrobial chemicals may include all of the following EXCEPT A) benzoic acid. B) lysozyme. C) allicin. D) peroxidase. E) lysosome.

34)

Egg white is rich in the antimicrobial

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A) lysosome. B) allicillin. C) lysozyme. D) benzoic acid. E) hydrogen peroxide.

35)

Which of the following is most likely to grow at refrigerator temperatures? A) Mesophiles B) Psychrotrophs C) Thermophiles D) Acidophiles E) Hyperthermophiles

36)

Limiting the activity of microbes in food can be accomplished by A) pasteurization. B) cold storage. C) lowering the pH. D) growth inhibiting substances. E) All of the choices are correct.

37) Slow cooking for a long time and then storage at room temperature would tend to favor the growth of A) endospore-formersAND thermophiles. B) endospore-formers AND mesophiles. C) anaerobes AND endospore-formers. D) mesophilesAND thermophiles. E) thermophilesAND anaerobes.

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38)

In a cow's udder, milk A) is sterile. B) contains Lactococcus. C) contains Lactobacillus. D) is acidic. E) contains Streptococcus.

39)

Sugar is used in the making of fermented sausages to A) help preserve the sausage. B) provide raw material for the fermentation process. C) sweeten the taste of spicy sausage. D) counteract the action of the salt in the sausage. E) remove water from the surface of the meat.

40) Lactic acid bacteria are used to ferment and produce foods/beverages from which of the following? A) Dairy B) Vegetables C) Meat D) Grains E) All of the choices can be fermented by lactic acid bacteria to make foods or beverages.

41)

The tart taste of yogurt, pickles, and sharp cheeses is due to the presence of

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A) lactic acid. B) acetic acid. C) sorbic acid. D) benzoic acid. E) hydrochloric acid.

42)

The resulting solids and juices of grapes used to make wine are termed its A) mash. B) must. C) germinater. D) malt. E) skin.

43)

The most prevalent cause of wine spoilage is the presence of A) sulfur dioxide. B) carbon dioxide. C) acetic acid bacteria. D) ethanol. E) lactic acid bacteria.

44)

The malolactic fermentation of wine is performed by A) Lactobacillus species. B) Saccharomycesspecies. C) Leuconostocspecies. D) Aspergillus species . E) acetic acid bacteria.

45)

The final characteristics of beer such as color, flavor, and foam primarily depend on the

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A) roasted malt. B) adjuncts. C) wort. D) whey. E) alcohol.

46)

Soy sauce is made by fermentation of soybeans and wheat by A) Aspergillusspecies. B) lactic acid bacteria. C) Saccharomycesspecies. D) lactic acid bacteria AND Saccharomycesspecies. E) lactic acid bacteria, Aspergillus species, AND Saccharomycesspecies.

47)

Most human pathogens grow best at temperatures near ______. A) 20ºC B) 25ºC C) 45ºC D) 37ºF E) 37ºC

48)

Staphylococcus aureus toxin is A) heat-stable AND an endotoxin. B) heat-stable AND an exotoxin. C) an exotoxin AND heat-sensitive. D) an endotoxin AND heat-sensitive. E) None of the answer choices is correct.

49)

As an added safety precaution, low-acid, home canned foods should be

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A) boiled at least 10 minutes before consumption. B) frozen for 1 hour before consumption. C) dried prior to eating. D) eaten with spoons. E) irradiated for 60 minutes before consumption.

50)

Clostridium botulinum toxin is A) heat-stable. B) an exotoxin. C) an endotoxin. D) an exotoxin AND heat-stable. E) an exotoxin AND heat-sensitive.

51)

The toxin causing botulism is classified as a(n) A) enterotoxin. B) endotoxin. C) neurotoxin. D) toxoid. E) superantigen.

52)

Which strain of Escherichia coli may be involved in foodborne infection? A) HB101 B) O157:H7 C) M309 D) AB220 E) O7:H157

53)

Which of the following is often associated with poultry products?

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A) Salmonella AND Pseudomonas B) Campylobacter AND Lactobacilllus C) Pseudomonas AND Campylobacter D) Lactobacillus AND Salmonella E) Salmonella AND Campylobacter

54)

The bacteria associated with hemolytic uremic syndrome is A) Salmonella cholerasuis. B) Campylobacter jejuni. C) Pseudomonas aeruginosa. D) Escherichia coli O157:H7. E) Lactobacillus.

55)

Irradiation of foods

A) involves the use of gamma radiation. B) is used on all foodstuffs. C) changes the taste of foods. D) is not regulated by the government. E) involves the use of gamma radiation, changes the taste of foods, AND is not regulated by the government.

56) Why would the use of a known, reliable starter culture improve the safety of fermented meat products?

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A) It doesn't. All fermented meat products are basically unsafe since we can't determine what fermentation products are left behind in the food. Some of them may be toxic. B) By using pure starter cultures, we KNOW what we're adding in, and how much. We can control the microbial fermentation precisely to best prepare the food product. C) We need to be very careful which microbes are introduced into a food product. Some microbes can interact with microbes already present in the food, producing toxins and toxic byproducts that might harm human beings. D) It doesn't. Every fermenting microbe ferments the same way, producing the sameproducts. Whatever we start with, the outcome is the same. E) None of the choices explain why we would use known starter cultures.

57) Why might a large number of competing microorganisms in a food sample result in lack of sensitivity of culture methods for detecting pathogens? A) Many microbes secrete compounds that can be toxic for their competitors. If you need a pathogenic microbe to grow in a culture in order to detect it, these toxic compounds might inhibit the growth of the pathogen and impede the test. B) You can't obtain a pure culture from a food sample that has a large number of microbes present. It would be impossible to detect only one from within the sample. C) Culture methods often rely on biochemical changes taking place in medium for identification. With multiple microbes present, you may not be sure that the biochemical change observed is from the presence of a pathogen or from some other non-dangerous bacterium that also induces the biochemical change. D) The sheer number of microbes present might shut down the growth/replication of a pathogenic microbe in a food sample due to a "starving out" effect. If it can't grow/replicate, it won't be detectable by a culturing method test. E) Many microbes secrete compounds that can be toxic for their competitors. If you need a pathogenic microbe to grow in a culture in order to detect it, these toxic compounds might inhibit the growth of the pathogen and impede the test AND culture methods often rely on biochemical changes taking place in medium for identification. With multiple microbes present, you may not be sure that the biochemical change observed is from the presence of a pathogen or from some other non-dangerous bacterium that also induces the biochemical change.

58)

Please select the definition that is INCORRECT.

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A) Foodborne intoxication—an illness that results from consuming a food product contaminated with microbes that colonize the host and cause disease. B) Water activity (a w)—the relative amount of water available for microbial growth; pure water has an a w of 1.0. C) Intrinsic factors—in food microbiology, the natural characteristics of a food that influence the rate of microbial growth. D) Food preservation—increasing the shelf life of foods by preventing the growth and activities of microorganisms. E) Fermented foods—foods intentionally altered during production by encouraging the activity of bacteria, yeasts, or molds.

59) You are cleaning out your pantry and find that your bread has spoiled. Which organism caused the spoilage, and why? A) Bread is spoiled by bacteria because it does not have enough water available for mold growth. B) Bread is spoiled by mold because it does not have enough water available for bacterial growth. C) Bread is spoiled by mold because there is too much water present for bacterial growth. D) Bread is spoiled by both bacteria and mold simultaneously—these organisms always act synergistically in spoilage. E) Pseudomonas aeruginosa—this bacterium is the primary cause of spoilage in grain products.

60)

What is the difference between fermented food and spoiled food?

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A) Fermented foods are made using certain genera of bacteria only. Spoilage of food involves bacteria, molds, AND yeasts. B) Fermented foods are changed by microbes but are edible. Spoiled foods are also changed by microbes but are full of microbial toxins that always lead to illness. C) Fermented foods may change in appearance but they taste the same as non-fermented foods. Spoiled foods look the same as unspoiled foods but they taste different. D) Fermented foods are intentionally altered during production by carefully controlling the activity of bacteria, yeasts, or molds. Spoiled foods have microbe-induced changes that are undesirable. E) Fermented foods result from undesirable changes made by microbes. Spoiled foods result from desirable changes made by the same types of microbes.

61)

Why do bacteria generally predominate on fresh meats?

A) Fresh meat provides amoist, acidic, salty, nutrient-rich environment. B) Most bacteria obtain iron from red blood cells—these are abundant in meat. C) Fresh meat provides amoist, pH-neutral, nutrient-rich environment.  D) Fresh meat provides a somewhat dry, pH-neutral, saline environment that bacteria prefer. E) The preservatives found on fresh meat stimulate the growth of bacteria.

62) Which of the following is not an intrinsic factor affecting growth of microorganisms on food? A) Water availability B) Benzoic acid C) Lysozyme D) Temperature E) Fruit rinds

63)

Why is ham is a common vehicle for S. aureus food poisoning?

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A) S. aureus is part of the normal microbiota of cows, so is a frequent cause of S. aureus food poisoning. B) Staphylococci are adapted to salty conditions and thrive with little competition on cured meats such as ham. C) Staphylococci are able to act synergistically with the normal microbiota of pigs, creating toxins that result in food poisoning. D) Ham is a particularly moist meat, so encourages the growth of the staphylococci, which can only survive on foods with a high a w. E) Ham is an untreated raw meat. As such, it is prone to contamination by the staphylococci that thrive on meat, resulting in food poisoning.

64)

What is the purpose of the mashing step in beer making?

A) During mashing, the enzymes of malted barley degrade fermentable sugars, converting them to starches. B) Mashing increases the surface area available for microbes to adhere to during the fermentation process. C) Mashing is required to remove residual solids, leaving wort that can be fermented by bacteria. D) During mashing, the enzymes of malted barley degrade starches, converting them to fermentable sugars. E) All of the answer choices are correct.

65)

Which statement regarding canning and pasteurization is TRUE?

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A) Pasteurization uses a process that destroys all microorganisms that can grow under normal storage conditions; the resulting product is commercially sterile. Canning significantly decreases the number of spoilage microbes and eliminates pathogens; however, viable organisms still remain. B) Canning and pasteurization both significantly decrease the number of spoilage microbes and eliminates pathogens; however, viable organisms still remain. C) Canning and pasteurization both use a process that destroys all microorganisms that can grow under normal storage conditions; the resulting products are commercially sterile. D) Canning and pasteurization are essentially the same process—one is used on fresh food while the other is used on preserved food; both result in sterilization of the product. E) Canning uses a process that destroys all microorganisms that can grow under normal storage conditions; the resulting product is commercially sterile. Pasteurization significantly decreases the number of spoilage microbes and eliminates pathogens; however, viable organisms still remain.

66)

Why might the presence of Apsergillus flavus in grain products be a problem? A) All species of Aspergillus produce aflatoxin, a potent carcinogen. B) Some species of Aspergillus produce aflatoxin, a potent carcinogen. C) Some species of Aspergillus produce aflatoxin, which kills plants and causes crop

loss. D) Some species of Aspergillus cause systemic infections in animals that consume them. E) Presence of Aspergillus indicates a highly contaminated environment.

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SECTION BREAK. Answer all the part questions. 67) A 37-year-old man is admitted to the hospital where you arean RN, exhibitingdizziness, dry mouth, blurred vision, and slurred speech. He also reportsabdominal symptoms, including pain, nausea, vomiting, and diarrhea.The patient'sfamily tells you that he was recently at a church potluck, where heate bread,homemade tomato-beefstew and home-canned green beans.Based on the patient's signs and symptoms, the physician with whom you are workingsuspects botulism, and the patient is immediately given botulinum antitoxin. He develops breathing difficulty and is placed on a mechanical ventilator. A stool sample from the patient is cultured in the laboratory, and confirms the presence ofClostridium botulinum. In addition, the patient's stool, theleftover stew and green beans aretested for botulinum toxin—toxin is present inthe green beans and in the stool sample, but not in the stew. These results confirmthe diagnosis of foodborne botulism. The patient remains in the hospital for several weeks, before being discharged.

67.1)

Please select the statement that does NOT apply to botulism.

A) The causative agent is Clostridium botulinum. B) Clostridium endospores can germinate in food with an acidic pH. C) Vegetative Clostridium cells release botulinum toxin, a potent neurotoxin. D) The causative agent is an obligate anaerobe. E) Boiling home-canned foods for 10 minutes will destroy any botulinum toxin present.

67.2)

Why is botulism primarily a problem in canned foods rather than fresh ones?

A) Canned food is never sterilized, so bacteria such as C. botulinum thrive in cans. B) Fresh food contains normal microbiota that prevents the growth of pathogens such as C. botulinum. C) The canning process dramatically reduces the pH of food, and C. botulinum is an acidophile. D) The causative agent is an obligate anaerobe—the canning process removes O 2. E) All of the answer choices are correct.

67.3)

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How did the antitoxin help the patient?

A) The antitoxin is a mixture of antigens that bind to and thereby neutralize the different serotypes of botulinum toxin.  B) The antitoxin binds to and destroys Clostridium botulinum cells, preventing them from releasing botulinum toxin. C) The antitoxin is a mixture of antibodies that bind to and thereby neutralize the different serotypes of botulinum toxin.  D) The antitoxin contains antibodies to botulinum toxin type A, which is the type that causes illness. E) The antitoxin stimulates phagocytes to neutralize botulinum toxin type A.

67.4) Why would the home-canned green beans rather than the tomato-beef stew be a possible source of C. botulinum? A) Beans are low-acid. Any C. botulinum endospores that survived the home-canning process could germinate in the cans, giving rise to vegetative cells that produce botulinum toxin. B) Canning creates an anaerobic environment. Any spores surviving the canning process could germinate, giving rise to vegetative cells that produce botulinum toxin. C) The acidic pH of the tomato-beef stew would likely inhibit that growth of vegetative Clostridium botulinum cells. Low-acidity beans would not inhibit the growth of these cells. D) The tomato-beef stew was not canned. The presence of oxygen in this food would prevent the growth of Clostridium botulinum, which is a obligate anaerobe. E) All of the answer choices are correct.

67.5) Clostridium botulinum grows optimally at 26-30 How should it be classified?

C, pH>4.6 and 1% oxygen.

A) Obligate anaerobe, neutrophile, mesophile B) Obligate anaerobe, neutrophile, psychrophile C) Obligate aerobe, neutrophile, mesophile D) Microaerophile, alkaliphile, mesophile E) Microaerophile, alkaliphile, thermophile

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Answer Key Test name: Chap 30_10e 1) FALSE 2) TRUE 3) TRUE 4) FALSE 5) FALSE 6) TRUE 7) TRUE 8) FALSE 9) TRUE 10) C 11) E 12) A 13) D 14) B 15) B 16) A 17) E 18) B 19) A 20) E 21) D 22) B 23) C 24) A 25) A 26) D Version 1

27) C 28) B 29) E 30) E 31) A 32) D 33) E 34) C 35) B 36) E 37) B 38) A 39) B 40) E 41) A 42) B 43) C 44) C 45) A 46) A 47) E 48) B 49) A 50) E 51) C 52) B 53) E 54) D 55) A 56) B Version 1

57) E 58) A 59) B 60) D 61) C 62) D 63) B 64) D 65) E 66) B 67) Section Break 67.1) B 67.2) D 67.3) C 67.4) E 67.5) A

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