Chapter 27 Genitourinary Tract Infections Verified Test Bank

Nester’s Microbiology, 9e (Anderson)

Chapter 27 Genitourinary Tract Infections

1) 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.

2) 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 are considered STIs.

3) 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.

4) The normal microbiota of the lower urethra may show

A) Lactobacillus.

B) Staphylococcus.

C) Corynebacterium.

D) Bacteroides.

E) All of the choices are correct.

5) The normal microbiota of the genital tract of women is

A) affected by estrogen levels.

B) dependent on the activity of Lactobacillus.

C) unchanging.

D) typically composed of Escherichia coli.

E) affected by estrogen levels AND dependent on the activity of Lactobacillus.

6) The most common urinary tract infection is

A) vulvovaginal candidiasis.

B) toxic shock syndrome.

C) bacterial cystitis.

D) bacterial vaginosis.

E) leptospirosis.

7) Bacterial cystitis

A) may occur through the use of a catheter.

B) is typically caused by Pseudomonas aeruginosa.

C) is an uncommon nosocomial disease.

D) is common in men under 50.

E) All of the choices are correct.

8) A disease in which the urinary system is infected from the bloodstream is 

A) cystitis.

B) leptospirosis.

C) pyelonephritis.

D) candidiasis.

E) sepsis.

9) 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 these.

10) 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.

11) 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.

12) Among the major causes of vulvovaginal candidiasis is/are

A) sexual promiscuity AND intense antibacterial treatment.

B) intense antibacterial treatment AND disruption of normal microbiota.

C) disruption of normal microbiota AND advanced age.

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.

13) 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.

14) 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.

15) 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.

16) Gonococci infect 

A) cows.

B) iguanas.

C) sheep.

D) humans.

E) cows AND sheep.

17) Gonococci selectively attach to certain epithelial cells by

A) pili.

B) flagella.

C) cilia.

D) actin bridges.

E) flagella AND cilia.

18) Typically, pathogenic Neisseria gonorrhoeae

A) secretes transferrin.

B) destroys IgA.

C) destroys IgM.

D) is very immunogenic.

E) secretes exotoxin A.

19) 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.

20) A frequent complication of untreated gonorrhea in women is

A) pelvic inflammatory disease.

B) syphilis.

C) dysuria.

D) vaginal discharge.

E) orchitis.

21) 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 these.

22) 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.

23) The disease that results from Chlamydia trachomatis ascending into the fallopian tubes is

A) conjunctivitis.

B) neonatorum ophthalmia.

C) pelvic inflammatory disease.

D) trachoma.

E) ectopic disease.

24) The infectious form of Chlamydia trachomatis is a(n)

A) reticulate body.

B) elementary body.

C) primary element.

D) core body.

E) infectious spore.

25) The causative agent of syphilis is

A) papilloma virus.

B) Neisseria gonorrheae.

C) Chlamydia trachomatis.

D) Treponema pallidum.

E) Mycoplasma genitalium.

26) Treponema pallidum is similar in shape to

A) Escherichia coli.

B) Staphylococcus aureus.

C) Leptospira interrogans.

D) herpes virus.

E) Mycoplasma genitalium.

27) Which of the following manifests itself in three clinical stages?

A) Gonorrhea

B) Syphilis

C) Trachoma

D) M. genitalium infection

E) Chancroid

28) 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.

29) 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.

30) In which disease is a gumma formed?

A) Primary syphilis

B) Secondary gonorrhea

C) Cutaneous diphtheria

D) M. genitalium infection

E) Tertiary syphilis

31) 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.

32) The reservoir of Treponema pallidum is the

A) guinea pig.

B) fox.

C) bat.

D) birds.

E) human.

33) Treponema pallidum, the causative agent of 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.

34) The sexually transmitted disease characterized by painful genital ulcers is

A) chancroid.

B) syphilis.

C) gonorrhea.

D) trachoma.

E) M. genitalium infection.

35) Which of the following diseases may manifest themselves with painful genital ulcers?

A) chancroid AND rubeola

B) chancroid AND herpes

C) herpes AND leptospirosis

D) leptospirosis AND chancroid

E) rubeola AND herpes

36) 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.

37) 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.

38) Which of the following viruses maintains a latent state in nerve cells?

A) Herpes simplex virus.

B) Hepatitis A virus.

C) Varicella zoster virus.

D) Rotavirus.

E) Herpes simplex virus AND varicella zoster virus.

39) Genital herpes, like other ulcerating genital diseases,

A) promotes the spread of AIDS.

B) inhibits the spread of AIDS.

C) inhibits the growth of other viral disease.

D) is easily cured with antibiotics.

E) can be prevented by vaccination.

40) The drug(s) used to treat genital herpes is/are

A) penicillin AND acyclovir.

B) erythromycin AND famciclovir.

C) acyclovir AND erythromycin.

D) famciclovir AND penicillin.

E) acyclovir AND famciclovir.

41) Among the most common of the sexually transmitted viral diseases agents is

A) human papillomavirus.

B) herpes simplex virus.

C) human immunodeficiency virus.

D) leptospirosis virus.

E) varicella zoster virus.

42) 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.

43) Which of the following is associated with cervical cancer?

A) Gonorrhea

B) Genital warts

C) Syphilis

D) Chancroid

E) Genital herpes

44) 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 cancer-associated and wart-causing types.

45) 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.

46) HIV attacks a variety of cell types but the most critical are

A) red blood cells.

B) nerve cells.

C) platelets.

D) T helper cells.

E) T cytotoxic cells.

47) HIV typically attaches to

A) CD4 protein.

B) CD8 protein.

C) protein A.

D) complement component C3b.

E) complement component C5a.

48) 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.

49) 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.

50) HIV may be present in

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.

51) Trichomoniasis is caused by a

A) fungus.

B) protozoan.

C) virus.

D) bacteria.

E) yeast.

52) 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.

53) Women are more likely than men to get urinary tract infections due to their anatomy.

54) Urine contains antimicrobial substances.

55) Toxic shock syndrome toxins are superantigens.

56) Most strains of gonococcus do not survive long outside the body.

57) There is no long-lasting immunity to gonorrhea and a person may contract gonorrhea repeatedly.

58) The patient is non-infectious in the third stage of syphilis.

59) Genital herpes may be cured with the use of acyclovir or famciclovir.

60) Protease inhibitors are useful in curing AIDS.

61) Trichomonas vaginalis lacks mitochondria.

62) Herpes simplex enhances the spread of HIV.

63) Typically, Candida albicans causes no symptoms.

64) What changes might occur in the vagina if lactobacilli were eliminated?

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.

65) 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.

66) Why should scarring of a fallopian tube raise the risks of an ectopic pregnancy?

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.

67) Former president Ronald Reagan once commented at a press conference that the best way to combat the spread of 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.

68) Which of the following genitourinary tract infections is a zoonosis?

A) Leptospirosis

B) Cystitis

C) Syphilis

D) M. genitalium infection

E) Genital herpes

69) 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

70) Why do patients with leptospirosis sometimes undergo unnecessary surgery?

A) The person may develop abscesses throughout the body that need surgical draining.

B) Blood vessels are damaged, causing clotting and impaired blood flow in tissues that are resolved by surgery.

C) Multiplication of the causative organism in the kidneys leads to the need for kidney surgery.

D) Infected people may experience pain that can be mistaken for a symptom of appendicitis or gallbladder infection.

E) The immune system causes tissue damage while destroying the causative organism; this is repaired by surgery.

71) 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 include liver 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.

72) Which of the following may lead to infertility?

A) Cystitis

B) Pelvic inflammatory disease

C) Vaginosis

D) Pyelonephritis

E) All of these

73) Why is 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 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.

74) Which statement about bacterial vaginosis is FALSE?

A) Women voluntarily 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.

E) The causative agent of the disease is Gardnerella vaginalis that interacts antagonistically with members of the genera Mobiluncus, Prevotella, and Peptostreptococcus.

75) 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.

76) 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.

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.

77) In early attempts to identify and isolate the cause of syphilis, various bacteria in the discharge from chancres in experimental 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.

78) 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 organism is highly motile and requires actin from host cells to make tails for movement.

C) The organism lacks mitochondria and obtains all of its essential macromolecules 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 essential macromolecules from the host AND the organism is an obligate intracellular parasite.

79) 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.

80) 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.

Please read the scenario and answer the questions.

Mycoplasma genitalium is an emerging cause of genital tract infections in men and women worldwide. The organism was discovered and identified only 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.

81) 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.

82) Select the statement that applies to Mycoplasmas.

A) These bacteria have mycolic acids in their cell wall.

B) These bacteria are intrinsically resistant to β-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.

83) People who contract M. genitalium infections are also at risk of acquiring other STIs.

84) 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 through direct mucosal contact.

D) This organism is classified as a psychrotroph or psychrophile.

E) M. genitalium acquires many nutrients from the host cell.

85) Suspected M. genitalium infections are treated with antibiotics such as macrolides. Why are these infections "suspected" and why are they treated with macrolide antibiotics?

A) The signs and symptoms of M. genitalium infections are unique and diagnosis can thus be based on them AND 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 AND mycoplasmas 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 them AND 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 STIs AND 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 diagnosis AND mycoplasmas are intrinsically resistant to peptidoglycan synthesis inhibitors so are treated with antibiotics that target other cellular activities such as protein synthesis.

Please read the scenario and answer the questions.

You go for your regular Pap test and 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 HPV strains 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.

86) 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.

87) 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 that induce cytokine production.

E) None of these. Warts can be removed but HPV may remain and cause recurrences.

88) Which of the following STI signs and symptoms do NOT apply to HPV infection?

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.

89) 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.

90) My sister told me that there is a vaccine called Gardasil 9 (9vHPV) that protects against HPV and is recommended for women under the age of 26 (like me). Should I still consider getting it even though I have HPV 16?

A) Yes—even though you have HPV16, the vaccine also protects against HPVs 6, 11, 18, 31, 33, 45, 52, and 58.

B) No—you already have HPV 16 so there is no point in getting the vaccine now. It is too late.

C) No—if you have HPV 16 you also definitely have the other cancer—causing strains of the virus so the vaccine won't help.

D) Yes—the vaccine is used to cure HPV infections so you should get it to eliminate your HPV 16 infection.

E) No—the vaccine involves injecting anti—HPV antibodies and you already have those because of your infection.   

91) Only females should receive the 9vHPV vaccine.