Host Defense II

Week 2

1. A patient with a venous catheter develops a localized infection around the device. A sample is sent to
the lab and the result is a coagulase negative staphylococci. What is the most likely infectious organism?
A. Staphylococcus aureus
B. Staphylococcus saprophyticus
C. Staphylococcus epidermidis
D. Staphylococcus haemolyticus

2. Pathogenicity islands are usually acquired via…

A. Transduction
B. Transposition
C. Conjugation
D. Transformation

3. What is the primary mechanism of resistance in Methicilin Resistant Staphylococcus Aureus (MRSA)?
A. Increased efflux of the drug
B. Increased expression of B-lactamase
C. Altered Penicillin Binding Protein
D. Acquisition of an outer membrane through plasmid transfer

4. Self-directed uptake of gram negative intracellular pathogens uses…

A. Antigen-antibody interactions
B. Phagocytosis
C. MAC
D. Type III secretion system

5. What is an easy way to distinguish Staphylococci and Streptococci in the absence of clear
morphology?
A. Staphylococci are coagulase positive
B. Staphylococci are catalase positive
C. Streptococci will form spores
D. Streptococci will grow on MacConkey agar

6. What is the distinguishing feature of a confirmatory laboratory test?

A. High sensitivity
B. High specificity
C. Fast results
D. Low cost

7. Which of the following is a characteristic shared by both Pseudomonas/ Pseudomonas like bacteria
and the Enterobacteriaceae family?
A. They both cause UTI’s in catheterized patients
B. They are both oxidase negative
C. They both represent obligate aerobic organisms
D. Some members of both groups can ferment lactose

8. Which of the following are the preferred environment for intracellular microbes?
A. RBCs
B. PMNs
C. Mononuclear phagocytes
D. Lymphocytes
 Host Defense II
Week 2

9. Which of the following is the MOST common cause of Urinary Tract Infections?
A. Proteus mirabilis
B. Citrobacter
C. E. coli
D. Klebsiella
E. Yersenia enterocolitica

10. A group of genes that are controlled by a single promoter and is transcribed into a single RNA is
called a…
A. Monocistron
B. Polycistron
C. Operon
D. Regulon

11. Why is disease prevalence important to consider in the pre-analytical stage of a laboratory test?
A. Low disease prevalence will increase positive predictive value
B. Low disease prevalence will decrease positive predictive value
C. Disease prevalence determines the cost of laboratory tests
D. Disease prevalence determines the accuracy of laboratory tests

12. A 15 y.o. girl who is a member of her high school swim team presents with edema and purulent
discharge from the external ear. She is most likely infected with a bacteria that…
A. Can be grown on charcoal yeast extract
B. Produces alginate
C. Can be prevented with a DPT vaccination
D. Is often spread from patient to patient

13. What organism is responsible for causing Scarlet Fever?

A. Streptococcus pyogenes
B. Streptococcus pneumoniae
C. Streptococcus agalactiae
D. Viridans Streptococci

14. Patient presents to the ER at 3am with fever, convulsion and signs of bacteremia. His history includes
the fact that he was backpacking in the Himalayas 3 weeks ago. He ran out of water during the trip and
had to drink from a fresh water spring. During physical exam you notice rose colored spots on his trunk
which don’t blanch. Which statement is incorrect regarding his disease?
A. This bacteria invaded the distal ileum of his intestines
B. This bacteria is currently harboring in his gallbladder, which will need to be removed
C. He needs to be administered a broad spectrum cephalosporin immediately
D. This bacteria uses a type III secretion system to invade his epithelial cells

15. A patient presents with rapid onset of fever with shaking chill, sharp pleuritic chest pain, and
productive cough with blood-tinged sputum. A chest x-ray reveals lobar opacification. A sputum gram
stain demonstrates neutrophils with gram positive diplococci. What is the most likely infectious organism?
A. Streptococcus pyogenes
B. Streptococcus pneumoniae
C. Streptococcus agalactiae
D. Viridans Streptococci

16. A patient who presents with whooping cough is likely infected with a bacteria that…
A. Is invasive
B. Produces a toxin that inhibits ribosome function
C. Produces a toxin that stimulates B and T cell production
D. Belongs to a genus that is also likely to cause meliodosis
 Host Defense II
Week 2

17. What is the classification and morphology of Helicobacter pylori?

A. Gram negative rod
B. Gram positive rod
C. Gram negative cocci
D. Gram positive cocci
E. Gram positive spirochete
F. Gram negative spirochete

18. Hemophores are…

A. Fastidious bacteria that can only grow in blood
B. Bacteria that grow at body temperature
C. Heme compounds produced by bacteria
D. A type of differential media that distinguish alpha-, beta- and gamma- hemolytic bacteria

19. Which of the following is currently considered the drug of choice in treating shigellosis, an infection
caused by enteric gram-negative bacteria?
A. Fluoroquinones
B. TMP-SMX
C. Carbapenems
D. None – resistant to antibiotics

20. Which drug will be least effective in treating Stenotrophomonas?

A. Cefipime
B. Cephalexin
C. Imipenam
D. Trimethoprim – sulfamethoxazole

21. A 72-year old woman presents with pneumonia, confusion, and diarrhea. She was hospitalized 4
months ago for complications related to COPD. She recently returned to the US after a trip to visit her
daughter in South America. What should your next step be?
A. Obtain a sputum sample and run a Gram stain
B. Obtain a urine sample and run an antigen assay
C. Start her on carbapenems
D. Start her on penicillin

22. What category of antibiotic is nafcillin?

A. Second generation cephalosporin
B. Broad-spectrum beta lactam
C. Penicillinase-susceptible beta lactam
D. Penicillinase-resistant beta lactam

23. 4 year old Timmy is brought into the pediatrician by his mother because he has been having bloody
diarrhea for 1 week. When performing a stool culture you notice the bacteria is producing only one type of
toxin. Timmy’s mother denies that has had any fever, vomiting or chills. After brilliant discovering the
bacteria that has caused Timmy problems, you tell his mother that, “Timmy is infected by _____?______
and should recover soon.”
A. Enterotoxigenic E. coli (ETEC)
B. Enteroinvasive E. coli (EIEC)
C. Enterohemorrhagic E. coli (EHEC)
D. Enteropathogenic E. coli (EPEC)
E. Enteropathogenic E. coli (EAggEC)
 Host Defense II
Week 2

24. What commensal gram positive bacteria are not very virulent but when implicated in infection are
extraordinarily resistant to antibiotics?
A. Corynebacterium sp.
B. Listeria sp.
C. Bacillus sp.
D. Enterococcus sp.

25. A patient with a respiratory infection due to Burkholderia cepacia is most likely to…
A. Have had recent contact with a horse
B. Have a genetic defect in NADPH production
C. Be a smoker
D. Have a persistent cough

26. A patient presents with symptoms suggesting acute renal failure, thrombocytopenia, and
hypertension. An EIA assay of the stool detected presence of Shiga-toxin. What is the most probable
diagnosis?
A. Gastroenteritis
B. Salmonellosis
C. Hemolytic-Uremic Syndrome
D. Reactive arthritis
E. Trinary tract infection

27. Which of the following is considered an endotoxin?

A. LPS
B. Pore forming toxins
C. Streptokinase
D. Hemolysis
E. All of the above

28. Gram negative bacteria have all of the following EXCEPT…

A. Peptidoglycan
B. Penta-glycine crosslinks
C. Periplasm
D. Outer membrane

29. Which of the following is a colonization factor of Gram positive bacteria?

A. Fimbriae and pili
B. Invasin
C. Lipotechoic acid
D. P-selectin

30. In which of the following situations would you be most inclined to be concerned about Pseudomonas
or a related bacteria?
A. A 21 y/o female who presents to her ob/gyn complaining of dysuria, urinary frequency and urinary
urgency.
B. A 33 y/o male with intraabdominal abscesses who now has bacteremia.
C. A 45 y/o male prisoner who presents with headache, stiff neck, and fever.
D. A 57 y/o female with diabetes who is being prepared for open-heart surgery.

31. Which of the following bacteria uses a actin-based method to evade the innate immune system and
also for motility?
A. Enteropathogenic Escherichia coli (EPEC)
B. Salmonella typhimurium
C. Yersinia pestis
D. Campylobacter jejuni
E. Shigella boydii
 Host Defense II
Week 2

32. A 6 year old patient who presents with dysphagia, drooling, and distress, sore throat, hoarse
voice,and tripod posture is most likely infected with a bacteria that…
A. Is strictly an opportunistic pathogen
B. Does not have a capsule
C. Also commonly causes otitis externa
D. Is fastidious
 Host Defense II
Week 2

Answers:

1. C
2. A
3. C
4. D
5. B
6. B
7. A
8. C
9. C
10. C
11. B
12. B
13. A
14. B
15. B
16. C
17. A
18. C
19. A
20. C
21. B
22. D
23. E
24. D
25. B
26. C
27. A
28. B
29. C
30. D
31. E
32. D