Infectious Diseases Affecting The + Test Bank Docx Ch.20

Microbiology Fundamentals: A Clinical Approach, 3e (Cowan)

Chapter 20 Infectious Diseases Affecting the Gastrointestinal Tract

1) Defenses of the GI tract against pathogens include ________.

A) mucus, acid, and saliva

B) secretory IgA and lysozyme

C) peristalsis

D) GALT

E) All of the choices are correct.

2) The mucinous glycoprotein covering teeth that streptococci attach to is called the ________.

A) enamel

B) pellicle

C) gingiva

D) lactoferrin

E) oral membrane

3) Which organ of the GI tract has a large commensal population of microorganisms?

A) Liver

B) Salivary glands

C) Pancreas

D) Large intestine

E) Small intestine

4) The most common infectious disease in humans is ________.

A) the common cold

B) dental caries

C) pharyngitis

D) diarrhea

E) gastritis

5) The predominant causative organism of dental caries seem to be ________.

A) Streptococcus pyogenes

B) Streptococcus mutans

C) Streptococcus pneumoniae

D) Staphylococcus epidermidis

E) Staphylococcus aureus

6) Oral biota on the tooth surface ________.

A) develop a biofilm

B) use fimbriae and slime layers to adhere

C) include Streptococci that metabolize sucrose, produce sticky glucans, and form plaque

D) include Lactobacilli and Streptococci, which ferment carbohydrates and produce acids that cause caries

E) All of the choices are correct.

7) The causative organism for mumps is ________.

A) Paramyxovirus

B) Morbillivirus

C) Streptococcus pyogenes

D) Corynebacterium

E) Vibrio

8) The virulence factor for mumps is ________.

A) inflammation

B) acid production

C) endotoxin

D) enterotoxin

E) spike-induced syncytium

9) Orchitis and epididymitis are seen in young adult males as a complication of ________.

A) croup

B) mumps

C) influenza

D) measles (rubeola)

E) rubella

10) Helicobacter pylori causes ________.

A) gastritis

B) duodenal ulcers

C) stomach ulcers

D) increased risk for stomach cancer

E) All of the choices are correct.

11) Which is not a characteristic of Helicobacter pylori?

A) Gram negative

B) Produces enteroxin that causes diarrhea

C) Curved rods

D) Lives in the stomach

E) Produces urease that buffers stomach acidity

12) Which of the following is mismatched?

A) H antigen - flagellar

B) K antigen - capsule

C) O antigen - cell wall

D) All of the choices are correct.

E) None of the choices are correct.

13) Salmonella are ________.

A) methane producers

B) motile

C) gram-positive rods

D) lactose fermenters

E) All of the choices are correct.

14) Salmonelloses are ________.

A) not caused by Salmonella typhi

B) associated with undercooked poultry and eggs, and reptile and rodent feces

C) types of gastroenteritis with vomiting and diarrhea

D) treated with fluid and electrolyte replacement

E) All of the choices are correct.

15) Which is incorrect about shigellosis?

A) Outbreaks have occurred in day care centers

B) Watery diarrhea with bloody, mucoid stools and abdominal cramps

C) It frequently involves septicemia

D) Human carriers cause fecal transmission

E) It is also called dysentery

16) Shigella species have the following characteristics except ________.

A) they are nonmotile, gram-negative rods

B) the reservoir is human carriers

C) produce urease and hydrogen sulfide

D) they infect the large intestine

E) they produce enterotoxin called shiga toxin

17) E. coli O157:H7 characteristics include all the following except it ________.

A) only causes occupational illness in people who work with animals

B) is transmitted by ingestion of contaminated, undercooked food, especially hamburger

C) causes a bloody diarrhea

D) has a reservoir of cattle intestines

E) in some cases goes on to hemolytic uremic syndrome (HUS) with possible kidney failure

18) Which of the following statements describes the main virulence factor of E. coli O157:H7?

A) A pathogen-encoded exotoxin

B) A bacteriophage-encoded exotoxin

C) An endotoxin used for host attachment

D) A coagulase for host clotting

E) A hemolysin for red blood cell destruction

19) Escherichia coli infections ________.

A) are often transmitted by fecal-contaminated water and food

B) have been due to undercooked meat

C) involve enterotoxin in traveler's diarrhea

D) can be self-limiting with the only treatment being rehydration

E) All of the choices are correct.

20) All of the following are characteristics of Campylobacter jejuni except it ________.

A) is transmitted through ingestion of contaminated chicken, meat, milk, and water

B) causes fever and a watery stool

C) infects the stomach

D) produces an enterotoxin that stimulates diarrhea

E) has gram-negative curved rods with darting motility

21) The most common bacterial cause of diarrhea in the United States is ________.

A) E. coli

B) Salmonella

C) Shigella

D) Campylobacter

E) Yersinia

22) Campylobacter infection has all of the following characteristics except it ________.

A) can last over 2 weeks

B) can burrow into the mucosa of the ileum and multiply

C) can lead to Guillain-Barre syndrome

D) can cause acute temporary paralysis

E) is caused by a shiga toxin

23) Production of enterotoxin is a characteristic of ________.

A) Clostridium botulinum

B) Clostridium perfringens

C) Clostridium difficile

D) Clostridium tetani

E) All of the choices are correct.

24) All of the following pertain to Clostridium difficile infection except it ________.

A) is due to ingestion of contaminated, improperly stored, cooked meats and gravies

B) is a colitis that is a superinfection

C) often has an endogenous source

D) is associated with disruption of normal flora due to broad-spectrum antimicrobials

E) is the major cause of diarrhea in hospitals

25) Which is not true of Clostridium difficile?

A) A gram-positive, endospore forming rod

B) Part of normal intestinal biota

C) Infection precipitated by broad-spectrum antibiotic therapy

D) Also called pseudomembranous colitis

E) Produces "rice-water" stools

26) The virulence of Vibrio cholerae is due to its ________.

A) capsule

B) neurotoxin

C) invasive enzymes

D) enterotoxin

E) All of the choices are correct.

27) Cholera symptoms include ________.

A) copious watery diarrhea

B) loss of blood volume

C) acidosis, sunken eyes, and thirst

D) hypotension, tachycardia, and shock

E) All of the choices are correct.

28) The most immediate and important treatment needed to prevent death in cholera victims is ________.

A) water and electrolyte replacement

B) antimicrobials

C) antitoxin

D) surgery

E) None of the choices are correct.

29) "Rice-water stools" are associated with disease caused by which organism?

A) Vibrio vulnificus

B) Vibrio parahaemolyticus

C) Vibrio cholerae

D) Campylobacter jejuni

E) Helicobacter pylori

30) Outbreaks of which disease have been associated with fecal-contaminated drinking water?

A) Cryptosporidiosis

B) Cyclosporiasis

C) Trichinosis

D) Toxoplasmosis

E) None of the choices are correct.

31) Signs and symptoms of cryptosporidiosis include ________.

A) headache, sweats, vomiting, severe abdominal cramps, and diarrhea

B) chills, fever, and sweats

C) bloody, mucus-filled stools and fever

D) a red-skin papule that spreads to a large ulcer

E) None of the choices are correct.

32) The primary viral cause of chronic diarrhea, globally, is ________.

A) cryptosporidium

B) rotavirus

C) adenovirus

D) norovirus

E) astrovirus

33) Which of the following is not a normal causative agent of food poisoning?

A) Clostridium perfringes

B) Staphylococcus aureus exotoxin

C) Clostridium difficile

D) Bacillus cereus

E) All of the choices are correct.

34) A common food intoxication is caused by enterotoxin-producing strains of ________.

A) Staphylococcus aureus

B) Staphylococcus epidermidis

C) Staphylococcus saprophyticus

D) Streptococcus pyogenes

E) Streptococcus agalactiae

35) Which is incorrect about Staphylococcus aureus food intoxication?

A) Food gets contaminated by a human carrier

B) Common associated foods include custards, ham, cream pastries, and processed meats

C) After contamination, food must be left unrefrigerated for a few hours

D) Ingestion of the pathogen allows it to multiply and damage the GI tract lining

E) Symptoms come on quickly and include nausea, vomiting, and diarrhea

36) Outbreaks of which protozoan disease have been associated with fecal-contaminated imported raspberries and also fresh greens and drinking water?

A) Cryptosporidiosis

B) Cyclosporiasis

C) Trichinosis

D) Toxoplasmosis

E) None of the choices are correct.

37) Entamoeba histolytica is acquired by ________.

A) ingestion of cysts of the pathogen

B) contaminated food

C) contaminated water

D) All of the choices are correct.

38) All of the following can be transmitted by drinking contaminated water except ________.

A) cryptosporidiosis

B) cyclosporiasis

C) malaria

D) campylobacter

E) giardiasis

39) Giardiasis involves ________.

A) a protozoan that does not form cysts

B) infection by a bacteria

C) symptoms of abdominal pain, flatulence, and diarrhea

D) fimbriae for adherence

E) All of the choices are correct.

40) Inflammation of the liver with necrosis of the hepatocytes and swelling due to a mononuclear response is a disease called ________.

A) hepatitis

B) jaundice

C) liver cancer

D) mononucleosis

E) None of the choices are correct.

41) Hepatitis B virus ________.

A) is principally transmitted by blood

B) transmission risks include shared needles, anal intercourse, and heterosexual intercourse

C) is transmitted to the newborn from chronic carrier mothers

D) has many chronic carriers

E) All of the choices are correct.

42) Hepatitis B infection ________.

A) has an incubation of 2 to 7 weeks

B) can be transmitted by the fecal-oral route

C) increases risk for hepatocellular cancer

D) is responsible for most cases of posttransfusion hepatitis

E) All of the choices are correct.

43) Which is incorrect about hepatitis A infection?

A) Transmitted by the oral-fecal route

B) Flulike symptoms with discomfort near the liver and darkened urine

C) Predisposes a person for liver cancer

D) Immunoglobulin therapy helps decrease the severity

E) HAVRAX is an inactivated vaccine for prevention

44) Which is mismatched?

A) Hepatitis A virus – nonenveloped, single-stranded RNA enterovirus

B) Hepatitis B virus – enveloped DNA virus

C) Hepatitis C virus – RNA virus

D) Hepatitis D virus – defective RNA virus that coinfects with HAV

E) Hepatitis E virus – self-limiting RNA virus

45) The most common cause of liver cancer in the United States is ________.

A) HAV

B) HBV

C) HCV

D) HDV

E) HEV

46) Parasitic helminths have the following characteristics except ________.

A) are multicellular animals

B) have a definitive host where the adult form lives

C) do not exhibit drug resistance

D) include roundworms

E) include tapeworms

47) Ascaris lumbricoides ________.

A) is an intestinal roundworm

B) spreads to humans by ingestion of Ascaris eggs in food

C) larvae penetrate into lymphatics and capillaries around intestines

D) larvae migrate to the pharynx, get swallowed, and return to intestines to mature

E) All of the choices are correct.

48) Enterobius vermicularis is ________.

A) a whipworm

B) common only to the tropics and subtropics

C) an intestinal worm that easily contaminates fingers and fomites

D) often fatal in heavy infestations

E) All of the choices are correct.

49) All of the following pertain to tapeworms except ________.

A) scolex is the head

B) strobila is made up of proglottids

C) proglottids are reproductive segments

D) cysticerci are young infective larvae ingested in undercooked meat

E) eosinophilia does not occur

50) General symptoms of helminth infection include all of the following except ________.

A) eggs, larvae, or adult worms found in feces

B) increased sensitivity to helminth antigens

C) intense abdominal pain

D) increased eosinophil count

E) vague nausea

51) Trichinosis includes all the following except ________.

A) encysted larvae get ingested

B) associated with undercooked pork or bear meat

C) migrate from intestines to blood and various body tissues

D) coiled larvae encyst in skeletal muscle

E) All of the choices are correct.

52) Liver flukes live in all of the following areas except the ________.

A) small intestine

B) liver

C) gallbladder

D) bile duct

E) All of the choices are correct.

53) Which of the following is not true of schistosomiasis?

A) It is caused by blood flukes

B) Larvae called cercariae can invade intact skin

C) It may cause liver swelling or malfunction

D) Worms can invade the brain

E) It can "cloak" itself with proteins in the blood

54) Which of the following helminths is paired with correct characteristics of its pathogenesis?

A) Ascaris lumbricoides - life and transmission cycle B

B) Necator americanus - life and transmission cycle A

C) Trichuris trichuria - life and transmission cycle B

D) Strongyloides stercoralis - life and transmission cycle B

E) Taenia solium - life and transmission cycle A

55) In the absence of dietary carbohydrates, bacteria do not cause tooth decay.

56) Mumps causes permanent sterility in young male adults.

57) E. coli O157:H7 secretes shiga exotoxin.

58) Diarrhea caused by E. coli O157:H7 is treated with antibiotics.

59) The best treatment for acute diarrhea is oral replacement of electrolytes and water.

60) Only feces from humans that contaminate food and water can be involved in transmission of amoebiasis.

61) Boiling will not kill Giardia lamblia cysts in contaminated water.

62) Carriers of hepatitis B virus are not common.

63) There are vaccines for immunity to the hepatitis B virus.

64) The only body fluid that can transmit hepatitis B virus is blood.

65) Most antihelminth medications act only against the worms, not the human host.

66) There are no infectious agents that can invade intact skin.

67) Research does not indicate a link between the numbers and types of bacteria causing periodontitis and thicker carotid arteries in an individual.

68) Despite acidic conditions, some microorganisms have been found residing within the human stomach.

69) All of the following are components of the digestive tract except the ________.

A) kidneys

B) large intestine

C) mouth

D) esophagus

E) rectum

70) Which of the following is not considered an accessory organ to the gastrointestinal tract?

A) Stomach

B) Liver

C) Salivary glands

D) Pancreas

E) Gallbladder

71) The gallbladder, while not strictly a component of the GI tract, is considered an accessory organ since it aids digestion by secreting necessary fluid and enzymes into the system.

72) Certain molecules contribute to the first line of defense in the gastrointestinal tract, including ________.

A) lysozyme and lactoferrin

B) complement and interleukin-1

C) interferon and complement

D) histamine and leukotriene

73) Natural defenses of the GI tract include mechanical factors, such as peristalsis, and chemical factors, such as secretory IgA on the surface of the intestines.

74) Which of the following statements is incorrect regarding the microbiome of the gastrointestinal tract?

A) The gut microbiome, while playing an important role in gastrointestinal function, does not influence other systems in the body.

B) Many organisms of the microbiome are commensals but others are mutualistic; they synthesize important molecules, such as vitamins, that humans cannot make themselves.

C) The GI microbiome plays a role in "teaching" the immune system how to recognize and react to foreign cells.

D) The gut microbiome plays a protective role by preventing the growth of pathogens through microbial antagonism.

75) Which of the following is incorrect regarding the microbiome of the stomach?

A) The high acid content of the stomach prevents any microbes from colonizing the organ.

B) Researchers for the Human Microbiome Project revealed the molecular signatures of over 100 microbial species in the stomach.

C) Microbes including Staphylococcus, Clostridium and Bacillus are known to be part of the stomach microbiome.

D) Helicobacter pylori, the organism known to cause stomach ulcers and cancer, is a known member of our stomach microbiome.

76) Helicobacter pylori is an acidophile that causes stomach ulcers and cancer; because it is a pathogen it is not part of our stomach microbiome.

77) Evaluate the following statements and choose the one that best explains why infection with Taenia solium is one of the five neglected parasitic infections in the United States.

A) Thousands of Latinos are thought to be infected with T. solium but is is underreported because American physicians are unaware of the signs and symptoms.

B) There is no treatment for T. solium so the infected individuals are neglected.

C) There are so few cases of T. solium in the United States, so those individuals that are infected are ignored.

D) Because infection with T. solium is not a deadly disease, physicians rarely treat those that are infected.

78) Cysticercosis is common in Latin America. The increasing population of Latinos in the United States has brought with it an increase in T. solium infection, so American physicians can now rapidly diagnose and treat all cases.

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

A nurse is caring for an 18-month-old girl in the pediatric intensive care unit. She was admitted following three days of bloody diarrhea and fever. Her parents report she had fewer wet diapers than normal. She was admitted with hyperkalemia, as well as increased blood urea nitrogen (BUN) and creatinine levels, indicating acute renal failure. After further lab work, the toddler is diagnosed with hemolytic uremic syndrome (HUS), possibly caused by drinking unpasteurized milk.

79) What organism is the leading cause of HUS in the United States?

A) Shigella dysenteriae

B) Enteroinvasive Escherichia coli

C) Shiga-toxin-producing Escherichia coli

D) Clostridium difficile

80) The child's parents are noticeably distressed. They ask the nurse what could have been done to prevent their child from contracting this illness. Which of the following responses by the nurse is most appropriate?

A) While there are some individuals who advocate for health benefits of consuming unpasteurized milk, the risks of acquiring organisms such as pathogenic E. coli, Salmonella, Listeria, and Campylobacter, among others, outweighs any benefit.

B) You should consider having your daughter vaccinated with the E. coli vaccine.

C) Next time your daughter exhibits these symptoms, bring her in to the emergency department sooner to prevent this severe illness.

D) Since nobody knows the true cause of HUS, there's nothing you could have done to prevent this from happening.

E) You should seek out a safer supplier of unpasteurized milk.

81) Which of the following clinical manifestations are diagnostic of HUS?  

A) Hemolytic anemia

B) Thrombocytopenia

C) Acute kidney failure

D) All of the choices are correct.

82) The child's parents ask the nurse to explain why their child has not received antibiotics. Which of the following statements are true about the use of antibiotic therapy in HUS?

A) Antibiotics are of no help and may increase the pathology

B) There are no antibiotics that can effectively treat E. coli

C) Antibiotic therapy may stunt the immune system response

D) Antibiotics are reserved for the most virulent cases of HUS, specifically patients receiving dialysis

83) Why does a patient with HUS present with bloody diarrhea?

A) The blood is actually from the kidneys, which are in failure

B) The diarrhea is red in color because the body is shedding shiga toxin

C) Shiga toxin damages the gut lining, causing it to bleed

D) E. coli attaches to small bowel outpouchings and because of underlying thrombocytopenia, causes bleeding

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

An inner city medical clinic provides medical screening and basic care for low-income individuals and families. A nurse completes an intake assessment for a 37-year-old homeless male. He denies current intravenous drug use and presents for hepatitis, HIV, and STD screening. He is found to be positive for hepatitis B.

84) The patient asks how he could have contracted this infection. Which of the following are possible modes of hepatitis B transmission? 

A) Needle stick

B) Sexual contact

C) Sharing a toothbrush

D) All of the choices are correct.

85) The patient asks what treatment is available for hepatitis infections. What is the best response by the nurse?

A) Curing hepatitis is challenging and expensive. What kind of support structure do you have in place to help you through this?

B) There are many treatment modalities available. You should talk to our doctors right away about starting treatment.

C) Right now, the only treatable hepatitis is hepatitis C, but new modes of treatment are being developed and studied every day.

D) Hepatitis can be well controlled with lifestyle change. If we can figure out how you contracted the disease, we can figure out how to cure it.

86) Which test(s) is (are) used to detect hepatitis B?  

A) Radioimmunoassay

B) ELISA

C) Antibody test

D) All of the choices are correct.

87) After drawing the patient's blood for hepatitis B testing, the healthcare worker set the needle on a counter instead of disposing of it in a sharps container. Several hours later, another healthcare worker accidentally stuck herself with the needle. How concerned should she be that she could contract hepatitis B?  

A) She should not be concerned at all. The virus dies once the blood dries.

B) She should not be concerned at all. The virus is not transmitted via blood.

C) She should be very concerned. The virus can survive several days in dried blood.

D) She should be very concerned. The virus multiplies indefinitely on hard surfaces.