Respiratory System Infections Chapter 22 1e Test Bank Docx

Chapter 22: Respiratory System Infections

= Correct answer

Multiple Choice

1. Which passageway connects the nasopharynx to the middle ear?

A. eustachian tube

B. nasal cavity

C. oropharynx

D. sinus cavity

Difficulty: Easy

ASM Standard: N/A

1. Which described the palatine tonsils?

A. connective and muscular tissue within the nasopharynx
B. connective and muscular tissue within the oropharynx
C. lymphoid tissue within the nasopharynx

D. lymphoid tissue within the oropharynx

Difficulty: Easy

ASM Standard: N/A

1. Within the respiratory tract, where are oxygen and carbon dioxide exchanged?

A. alveoli

B. bronchi

C. bronchioles

D. trachea

Difficulty: Easy

ASM Standard: N/A

1. Rhinitis is an inflammation of which component of the respiratory system?

A. nasal passages

B. oropharynx

C. sinuses

D. tonsils

Difficulty: Easy

ASM Standard: N/A

1. Symptoms of the common cold do not include which one of the following?

A. coughing
B. headache

C. high fever

D. runny nose

Difficulty: Easy

ASM Standard: 23

1. Antigenic shift caused a severe influenza pandemic, the “Spanish flu,” during which years?

A. 1908–1909

B. 1918–1919

C. 1955–1956

D. 2006–2007

Difficulty: Easy

ASM Standard: 23

1. Which is the most effective way to reduce the risk of influenza transmission?

A. amantadine

B. annual vaccination

C. oseltamivir

D. tetracycline

Difficulty: Easy

ASM Standard: 14, 23

1. FluMist is which of the following?

A. inactivated flu treatment

B. inactivated flu vaccine

C. live attenuated flu treatment

D. live attenuated flu vaccine

Difficulty: Easy

ASM Standard: N/A

1. Which of the following groups of viruses is not known to be a frequent cause of the common cold?

A. adenoviruses

B. coronaviruses

C. parainfluenza viruses

D. rhinoviruses

Difficulty: Easy

ASM Standard: 23

1. The mucociliary escalator effect helps to do which of the following?

A. localize microbes in specific parts of the respiratory tract, enhancing the immune response against them and reducing the risk that they will be exhaled

B. move air through the respiratory tract

C. move pathogens deeper into the respiratory tract, where macrophages can engulf them

D. remove pathogens from the respiratory tract, eliminating microbes from the lower respiratory tract, and inhibiting pathogen attachment

Difficulty: Moderate

ASM Standard: N/A

1. Which of the following is not part of the immune defense of the upper respiratory system?

A. alveolar macrophages

B. defensins

C. lysozyme

D. secreted IgA antibodies in mucus

Difficulty: Moderate

ASM Standard: 14

1. When the alveoli become fluid filled in pneumonia, the affected areas are called which of the following?

A. a pneumonitis

B. a pneumothorax

C. consolidations

D. inflammations

Difficulty: Moderate

ASM Standard: 23

1. Which microbe causes streptococcal pharyngitis (strep throat)?

A. S. aureus

B. S. epidermidis

C. S. pyogenes

D. S. typhimurium

Difficulty: Easy

ASM Standard: 23

1. Streptokinase is a protein that is responsible for which of the following?

A. dissolving blood clots

B. forming blood clots

C. forming erythrogenic toxin

D. inhibiting the spread of streptococcal bacteria

Difficulty: Moderate

ASM Standard: 23

1. Which of the following is an example of one of the sequelae of strep throat?

A. acute glomerulonephritis

B. high fever

C. red tonsils

D. scarlet fever

Difficulty: Moderate

ASM Standard: 23

1. Based on the carbohydrate antigens in its cell wall, Streptococcus pyogenes is classified within which Lancefield group?

A. A (the group A strep)

B. B (the group B strep)

C. C (the group C strep)

D. D (the group D strep)

Difficulty: Moderate

ASM Standard: 7, 8, 23

1. Otitis media with effusion is distinguished from other forms of otitis media by the presence of which of the following?

A. a high fever

B. an inflamed tympanic membrane

C. fluid within the middle ear

D. pharyngeal abscesses

Difficulty: Moderate

ASM Standard: 23

1. Against which lower respiratory infection does vaccination with PCV13 protect?

A. diphtheria

B. mycoplasma pneumonia

C. pneumococcal pneumonia

D. tuberculosis

Difficulty: Moderate

ASM Standard: 14, 23

1. Common cold viruses can often be differentiated from influenza by which of the following?

A. absence of a high fever

B. absence of aches and pains

C. absence of lower respiratory symptoms

D. occurrence of headaches

Difficulty: Moderate

ASM Standard: 23

1. Which of the following groups of viruses is not known to be a frequent cause of the common cold?

A. adenoviruses

B. coronaviruses

C. parainfluenza viruses

D. rhinoviruses

Difficulty: Easy

ASM Standard: 23

1. Which of the following is not a fungus?

A. Blastomyces dermatitidis

B. Mucor spp.

C. Mycoplasma pneumoniae

D. Rhizopus arrhizus

Difficulty: Moderate

ASM Standard: 23

1. Which virus is teratogenic, meaning that pregnant women must be especially cautious in avoiding this virus?

A. measles

B. mumps

C. rubella

D. varicella

Difficulty: Moderate

ASM Standard: 23

1. Measles causes primarily which of the following?

A. a skin rash and associated symptoms

B. muscle paralysis and weakness

C. swelling of the parotid glands, giving a swollen appearance

D. teratogenic effects

Difficulty: Moderate

ASM Standard: 23

1. Which is an important sign used to diagnose measles?

A. a butterfly rash

B. a scratchy, inflamed throat

C. Koplik’s spots

D. pus-filled lesions in the pharynx

Difficulty: Moderate

ASM Standard: 23

1. Which of the following describes how rubella is transmitted?

A. primarily through aerosols produced by infected individuals

B. primarily through contact with fomites touched by infected individuals

C. only through contaminated body fluids, such as blood

D. only through direct contact with infected individuals

Difficulty: Moderate

ASM Standard: 23

1. German measles is another name for which disease?

A. mumps

B. rubella

C. rubeola

D. shingles

Difficulty: Moderate

ASM Standard: 23

1. Which virus becomes dormant in dorsal ganglia after infection?

A. the common cold virus

B. the influenza virus

C. the rubella virus

D. the varicella-zoster virus

Difficulty: Moderate

ASM Standard: 23

1. Influenza transmission between adults is most effectively prevented by which of the following?

A. a complete influenza vaccination series in childhood

B. annual vaccination of adults

C. use of prophylactic antiviral medications

D. use of prophylactic supportive treatment

Difficulty: Moderate

ASM Standard: 14, 23

1. Why is Cryptococcus neoformans especially capable of avoiding destruction by the immune system?

A. Their cells have a protective capsule.

B. Their cells have an unusual cell membrane structure that resists attack.

C. Their cells thrive within alveolar macrophages.

D. They produce chemicals that neutralize antibodies.

Difficulty: Moderate

ASM Standard: 7, 8, 23

1. Which of the following is true about the risk of measles transmission?

A. As health-care providers see fewer cases of measles, they are more likely to misdiagnose infected individuals, increasing the risk of transmission.

B. Lower vaccination rates decrease herd immunity and make transmission to susceptible individuals less likely.

C. Measles is not highly contagious, so transmission requires extended contact with an infected individual.

D. Travel patterns have not increased the risk of measles transmission around the world over the last century.

Difficulty: Difficult

ASM Standard: 23

1. Which is not a benefit of using acyclovir treatment for shingles?

A. It is used to reduce the duration of the symptoms of shingles.

B. It is used to reduce the risk of developing shingles after a chicken pox infection.
C. It is used to reduce the risk of postherpetic neuralgia, a painful condition that can develop after shingles.

D. It is used to reduce the severity of shingles symptoms.

Difficulty: Difficult

ASM Standard: 14, 23

1. Which of the following is true about histoplasmosis?

A. Histoplasmosis is transmitted directly from one infected person to another person.

B. Histoplasmosis normally produces severe symptoms.

C. Histoplasmosis results in the development of Ghon complexes.

D. Histoplasmosis spores reproduce within alveolar macrophages.

Difficulty: Difficult

ASM Standard: 23

1. Which of the following patients would require the most aggressive treatment for coccidiomycosis?

A. an individual known to have been exposed to spores but who had not yet developed symptoms

B. an individual who had previously had coccidiomycosis

C. an individual who had previously received a liver transplant and who had a disseminated infection

D. a teenager with symptoms but no evidence of disseminated infection

Difficulty: Difficult

ASM Standard: 14, 23

1. Which of the following microbes requires the greatest precautions when cultured in the laboratory?

A. Blastomyces dermatitidis

B. Coccidiodes immitis

C. Histoplasma capsulatum

D. Rhizopus arrhizus

Difficulty: Difficult

ASM Standard: 23, 36

1. An individual with HIV develops a fungal infection and has shortness of breath, fever, and cough. Which microbe is the most likely causative agent?

A. Aspergillus fumigatus

B. Blastomyces dermatitidis

C. Coccidiodes immitis

D. Pneumocystis jirovecii

Difficulty: Difficult

ASM Standard: 23

1. Which medication would be the best choice for treating a patient unfortunate enough to have both aspergillosis and histoplasmosis?

A. amphotericin B

B. fluconazole

C. itraconazole

D. trimethoprim-sulfamethoxazole

Difficulty: Difficult

ASM Standard: 14, 23

1. Which of the following diseases is a zoonosis?

A. histoplasmosis

B. Q fever

C. rubella

D. tuberculosis

Difficulty: Difficult

ASM Standard: 23

1. What would be the most effective method of reducing the risk of Legionnaire’s disease transmission?

A. avoiding contact with any infected individuals

B. avoiding the inhalation of soil and dust with possible spores

C. cleaning and maintaining air conditioning systems well

D. using careful food preparation techniques

Difficulty: Difficult

ASM Standard: 14, 23

1. Which of the following is true for individuals with an egg allergy?

A. They can receive a bivalent influenza vaccination.

B. They can receive a trivalent influenza vaccination.

C. They can receive a vaccination against influenza A strains only.

D. They cannot receive an influenza vaccination.

Difficulty: Difficult

ASM Standard: 14, 23

1. The influenza vaccine is designed to contain which of the following:

A. one influenza A strain and one influenza B strain, based on a review of the most dominant influenza strains in October

B. two influenza A strains and one to two influenza B strains, based on a review of the most dominant influenza strains in February and September

C. two influenza A strains and two influenza B strains, based on a review of the most dominant influenza strains in February

D. two influenza A strains and four influenza B strains, based on a review of the most dominant influenza strains in March and October

Difficulty: Difficult

ASM Standard: 14, 23

True/False

1. Microbes are abundant in the lower respiratory tract.

Difficulty: Easy

ASM Standard: 20, 23

1. In the elderly, pneumonia is a significant cause of mortality.

Difficulty: Easy

ASM Standard: 23

1. Although it is a potential pathogen, Staphylococcus aureus is commonly carried in the nostrils of asymptomatic individuals.

Difficulty: Moderate

ASM Standard: 20, 23

1. The second leading cause of pediatrician visits by young children (under age 5 years) in the United States is acute otitis media.

Difficulty: Moderate

ASM Standard: 23

1. The common cold is actually caused by more than 200 different viruses.

Difficulty: Moderate

ASM Standard: 23

1. Respiratory syncytial virus can be life-threatening in infants.

Difficulty: Moderate

ASM Standard: 23

1. Rickettsial infections are safe to culture in the laboratory, so these approaches are preferred to molecular techniques for diagnosis.

Difficulty: Difficult

ASM Standard: 23, 34, 36

1. Acute otitis media is less common in individuals who have been vaccinated against influenza, because it can be caused by the same microbes.

Difficulty: Difficult

ASM Standard: 23

Matching

1. Match each illness with the most appropriate definition.

Answers: A. v., B. iv., C. i., D. ii., E. iii.

Difficulty: Easy

ASM Standard: 23

1. Match each illness with its common causative agent.

Answers: A. iv., B. i., C. v., D. ii., E. iii.

Difficulty: Easy

ASM Standard: 23

1. Match each type of illness with the appropriate vaccine for its prevention.

Answers: A. iv, B. ii, C. iii, D. v, E. i

Difficulty: Moderate

ASM Standard: 14

1. Match each illness with the most appropriate treatment.

Answers: A. i, B. iv, C. ii, D. iii

Difficulty: Moderate

ASM Standard: 14, 23

1. Match each bacterial disease with its distinguishing characteristics.

Answers: A. i, B. iii, C. iv, D. ii, E. v

Difficulty: Moderate

ASM Standard: 23

1. Match each fungal disease with its distinguishing characteristics.

Answers: A. i, B. iv, C. ii, D. v, E. iii

Difficulty: Moderate

ASM Standard: 23

1. Match each type of pneumonia with its distinguishing characteristics.

Answers: A. i, B. ii, C. iv, D. iii

Difficulty: Difficult

ASM Standard: 23

Fill in the Blank

1. MALT stands for ________.

Difficulty: Easy

ASM Standard: N/A

1. In DTaP, the “P” stands for ________.

Difficulty: Easy

ASM Standard: 14

1. The round lesions that form in the alveoli of patients with tuberculosis are called ________.

Difficulty: Easy

ASM Standard: 23

1. The microbe that causes whooping cough is ________.

Difficulty: Easy

ASM Standard: 23

1. Most bacterial pneumonia is caused by Haemophilus influenzae, Mycoplasma pneumoniae, and ________ pneumoniae.

Difficulty: Moderate

ASM Standard: 23

1. Walking pneumonia is formally called ________ pneumonia.

Difficulty: Moderate

ASM Standard: 23

1. ________ is a rare respiratory infection caused by a strain of Chlamydia that is sometimes transmitted to humans from domestic birds.

Difficulty: Moderate

ASM Standard: 23

1. A type of pneumonia that is a particular problem for individuals with cystic fibrosis is ________ pneumonia.

Difficulty: Moderate

ASM Standard: 23

1. Ghon complexes are associated with the disease called ________.

Difficulty: Moderate

ASM Standard: 23

1. Serious pneumonia in patients with cystic fibrosis is often caused by ________.

Difficulty: Moderate

ASM Standard: 23

1. Bordetella pertussis specimens must be cultured rapidly because viability decreases after ________ hours.

Difficulty: Difficult

ASM Standard: 23, 34

1. In DTaP, the “a” stands for ________.

Difficulty: Difficult

ASM Standard: 14

Short Answer

1. Why are patients with cystic fibrosis at particular risk of respiratory infections?

Sample

Difficulty: Difficult

ASM Standard: 23

1. Compare the diversity and amount of microbiota of the upper and lower respiratory tracts.

Sample

Difficulty: Easy

ASM Standard: 23

1. Describe the pathway traveled by an inhaled microbe that reaches an alveolus.

Sample

Difficulty: Easy

ASM Standard: N/A

1. What is the mucociliary escalator effect?

Sample

Difficulty: Easy

ASM Standard: 23

1. What are some examples of virulence factors used by opportunistic pathogens from the normal respiratory tract microbiota?

Sample

Difficulty: Easy

ASM Standard: 23

1. Why are β-lactam antibiotics ineffective against M. pneumoniae?

Sample

Difficulty: Moderate

ASM Standard: 23

1. What would be a good reason for using Sabouraud’s agar for a culture?

Sample

Difficulty: Moderate

ASM Standard: 23, 33

1. What could cause someone to develop reactivation tuberculosis?

Sample

Difficulty: Moderate

ASM Standard: 23

1. How does pertussis cause a buildup of mucus in the lungs?

Sample

Difficulty: Moderate

ASM Standard: 23

1. Why is understanding amoeba important in understanding Legionnaire’s disease?

Sample

Difficulty: Moderate

ASM Standard: 14, 23

1. Why might a health-care professional choose itraconazole rather than amphotericin B or ketoconazole to treat disseminated histoplasmosis?

Sample

Difficulty: Moderate

ASM Standard: 14, 23

1. People frequently encounter the fungi that can cause histoplasmosis, coccidiomycosis, and other fungal illnesses. Why do most people who encounter these fungi either not develop symptoms or develop only mild symptoms?

Sample

Difficulty: Moderate

ASM Standard: 14, 23

1. Why is antigenic shift associated with influenza pandemics?

Sample

Difficulty: Moderate

ASM Standard: 23

1. What are the causative agents most commonly responsible for viral pneumonia?

Sample

Difficulty: Moderate

ASM Standard: 23

1. Why are normally benign species such as S. aureus and K. pneumoniae problematic in a hospital setting?

Sample

Difficulty: Difficult

ASM Standard: 23

1. How is pertussis diagnosed within 2 weeks of infection? How does the method of diagnosis change if diagnosis is needed 2 to 4 weeks into the infection, compared with after a month?

Sample

Difficulty: Difficult

ASM Standard: 23, 34, 36

1. Once pathogens start to establish a respiratory infection, how do they make it easier for microbes (either of the same or other species) to establish and spread?

Sample

Difficulty: Difficult

ASM Standard: 14, 23

Brief Essay

Essay Question Rubric

Assume rating/grading scale for the question ranges from 0 to 3 points.

1. There was a devastating influenza pandemic in 1918–1919. What factors leading up to this pandemic contributed to its severity?

Difficulty: Moderate

ASM Standard: 23, 31

1. For many respiratory illnesses discussed in the chapter, antibiotic resistance is an increasing concern. Give some specific examples from the chapter and discuss how this problem can be addressed.

Difficulty: Moderate

ASM Standard: 14, 23, 31

1. Consider the pros and cons of maintaining samples of dangerous diseases such as smallpox after they have been eradicated from humans. What are the arguments for and against maintaining these samples? What do you personally think is the best course of action? Justify your answer with evidence from this chapter.

Difficulty: Difficult

ASM Standard: 23, 31

1. Concerns about vaccination have led to drops in vaccination rates despite a lack of evidence to back up these concerns. Discuss the implications of falling vaccination rates for respiratory illnesses and your thoughts on how this problem may be addressed.

Difficulty: Difficult

ASM Standard: 14, 23, 31

1. Why is the influenza vaccine each year based on a review of dominant influenza strains in February and October, not just at the start of influenza season? What is the length of time between the peak of influenza season and the decision about strains to include and why?

Difficulty: Difficult

ASM Standard: 14, 23, 31

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