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DEN 7102 Micro & Immuno Concepts > Exam 2 Juice > Flashcards

Exam 2 Juice Flashcards

1
Q

Of the following, which would be most resistant to sterilization?
A. Bacterial spores
B. Cryptosporidia
C. Mycobacteria
D. Enveloped viruses
E. Gram negative bacteria

A

A. Bacterial spores

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2
Q

What cells are responsible for delayed-type hypersensitivity?

A

Th1 cells, macrophages

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3
Q

Predominant effect of histamine released by basophils and mast cells in immediate hypersensitivity

A

Bronchoconstriction

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4
Q

Which lymphocytes are typically found in a tuberculous granuloma

A

Th1 (macrophages)

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5
Q

Which of the following antibacterial agents is an inhibitor of nucleic acid synthesis, is bactericidal, and has good activity against oral facultative and obligate anaerobes?
A. Metronidazole
B. Vancomycin
C. Sulfonamides and trimethaprim
D. Chloramphenicol

A

A. Metronidazole

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6
Q

Lumpy jaw is a dentoalveolar infection most often associated with which of the following teeth?
A. 1
B. 4
C. 19
D. 25

A

C. 19

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7
Q

Other than its toxin, the major virulence factor of Bacillus anthracis is the:
A. capsule
B. endotoxin
C. teichoic acid
D. fimbrial adhesion factors

A

A. capsule

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8
Q

Which class of beta-lactamases is the MOST COMMON and generally contains mainly penicillinases?

A

Class A

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9
Q

Congenital vaccinia is a potential complication of immunization during pregnancy for prevention of:
A. Smallpox
B. chicken pox
C. pertussis
D. tetanus
E. pneumococcus

A

A. smallpox

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10
Q

Which antimicrobial interacts with 30S bacterial ribosome?
A. Tetracycline
B. Erythromycin
C. Chloramphenicol
D. Clindamycin
E. Fusidic acid

A

A. Tetracycline

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11
Q

Which of the following NAM pentapeptide terminal residues confers intrinsic resistance to Vancomycin?
A. D-ala-D-ala
B. D-ala-D-serine
C. D-serine-D-serine
D. D-lysine-D-serine

A

B. D-ala-D-serine

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12
Q

Opisthotonos is a characteristic manifestation of the effects of which toxin?
A. Alpha toxin
B. Shigatoxin
C. Tetanospasmin
D. Botulinum toxin A
E. Endotoxin

A

C. Tetanospasmin

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13
Q

Mycobacterium tuberculosis is capable of surviving in:

A

Macrophages

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14
Q

Mechanism of action of vancomycin

A

Inhibition of cell wall synthesis

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15
Q

Certain strains of E. coli produce shigatoxin when lysogenized. This means that the toxin protein is coded for by a:

A

Bacteriophage

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16
Q

Drug of choice for cervicofacial actinomycosis

A

Penicillin

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17
Q

Which genus other than Clostridium includes medically important Gram positive, spore forming rods

A

Bacillus

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18
Q

Which of the following antibacterials would never be used systemically?
A. Vancomycin
B. Bacitracin
C. Cycloserine
D. Gentamycin
E. Chloramphenicol

A

B. Bacitracin (it is a topical only!)

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19
Q

A child presents with rash, fever, strawberry tongue. Toxin responsible is:
A. Pyrogenic exotoxin
B. Streptolysin S
C. Exfoliatin
D. Enterotoxin A

A

Pyrogenic exotoxin

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20
Q

Which class of immunoglobulin can be transferred transplacentally, leading to hemolytic disease of the newborn?

A

IgG

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21
Q

Which of the following organisms is associated with “sulfur granules”
A. Actinomyces israelii
B. Aspergillus fumigatus
C. Candida albicans
D. Rhizopus arrhizus
E. histoplasma capsulatum

A

A. Actinomyces israelii

other one is A. viscosus

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22
Q

An eschar is a cutaneous form of which disease?
A. nocardiasis
B. tetanus
C. anthrax
D. actinomycosis
E. Aspergillus

A

C. anthrax

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23
Q

Which of the following may contribute to evasion of the immune system by a tumor?
A. lack of MHC expression by the tumor cells
B. mononuclear infiltrate of the tumor
C. Expression of oncofetal antigens by the tumor cells
D. Expression of viral antigens by the tumor cells

A

A. lack of MHC expression by the tumor cells

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24
Q

In the spleen, T cells are found primarily in the:

A

Periarterial lymphatic sheath (PALS)

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25
Q

Which of the following anti-microbials is an RNA synthesis inhibitor?
A. rifampin
B. Chloramphenicol
C. Vancomycin
D. metronidazole

A

A. rifampin

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26
Q

A mutation in bacterial DNA gyrase is likely to result in resistance to which of the following antimicrobials?
A. amphotericin B
B. ciprofloxacin
C. penicillin
D. streptomycin
E. ceftriaxone

A

B

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27
Q

Which of the following is a common initial manifestation of botulism in an adult?
A. diplopia
B. watery diarrhea
C. spasm of the muscles of mastication
D. myonecrosis
E. epiglottis

A

Diplopia

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28
Q

Approximately 10% of patients who demonstrate allergy to penicillins are also allergic to a similar class of compounds known as:

A

Cephalosporins

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29
Q

A third year dental student is found to have a positive PPD skin test. Six months ago the test was negative. Chest x-ray reveals no abnormality. The student should be trated with 6-12 month course of

A

Isoniazid

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30
Q

The profound clinical effect of superantigens is due to their ability to activate huge numbers of:

A

T lymphocytes

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31
Q

Antibiotic-associated colitis is caused by an exotoxin elaborated by:

A

C. difficile

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32
Q

C. perfringens food poisoning is most often associated with:

A

Poultry

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33
Q

Which antibiotic can cause staining of developing teeth?

A

tetracycline

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34
Q

Which of the following antimicrobials inhibits folic acid synthesis?
A. Macrolides
B. Cephalosporins
C. Tetracyclines
D. Aminoglycosides
E. Sulfonamides

A

E. sulfonamides

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35
Q

What is the mechanism of action of the botulinum neurotoxin?

A

Prevents the release of acetylcholine from the alpha motor neuron

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36
Q

Current standard for water quality using in routine dental treatments is below ____ of heterotrophic water bacteria

A

500

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37
Q

Erythromycin, a macrolide, acts by inhibiting bacterial:

A

Protein synthesis

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38
Q

Which of the following lymphokines secreted by Th2 cells is required for class switching resulting in IgE synthesis?

A

IL-4

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39
Q

Among the carbapenem-resistant enterobacteriaceae, which most commonly causes disease?

A

Klebsiella pneumoniae

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40
Q

Which of the following Gram-negative organisms can cause disease characterized by gangrene and septic shock, and has a high fatality rate?
A. Yersinia enterocolitica
B. Vibrio vulnificus
C. Campylobacter jejuni
D. Enterotoxigenic E. coli

A

B

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41
Q

Erysipelas is a skin infection caused by:

A

S. pyogenes

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42
Q

Which of the following T lymphocyte product acts by forming pores in target cell membranes?
A. perforin
B. granzyme
C. complement
D. collagenase
E. interferon-beta

A

Perforin

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43
Q

All children older than one month with definite or probable bacterial meningitis should be initially treated with:

A

Vancomycin plus cephalosporin

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44
Q

The single greatest source of salmonellosis in the US is

A

Chickens

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45
Q

Recognition of antigen by CD8 t cells requires the presentation of antigen in association with

A

MHC I

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46
Q

The most reliable means of diagnosing typhoid fever is:

A

Bone marrow culture

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47
Q

Positive selection of T cells in the thymus involves selection of only those cells which:
A. are self-tolerant
B. react to self peptides
C. do not react to self peptides
D. recognize MHC

A

D. recognize MHC

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48
Q

The most common cause of bacillary dysentery is:
A. campylobacter jejuni
B. E. coli
C. Vibrio cholerae
D. Shigella sonnei
E. Salmonella enteritidis

A

Shigella sonnei

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49
Q

Streptococcal toxin shock syndrome is due to which bacterial product?
A. endotoxin
B. pyrogenic exotoxin
C. hyaluronidase
D. serine protease
E. streptokinase

A

B. pyrogenic exotoxin

50
Q

Which serotype of Haemphilus influenzae causes the most serious disease?

A

b

51
Q

Which organisms can be distinguised from similar organisms by the fact that they can produce H2S from thiosulfate?

A

Salmonella typhi

52
Q

The family of enzymes responsible for TCR gene rearrangements would be:

A

VDJ recombinase

53
Q

Which is the most common cause of bacterial meningitis in a newborn?

A

Streptococcus agalactiae

54
Q

Subjects who lack MHC class II would be most likely to result in a deficiency of:

A

CD4+ T cells

55
Q

In the designation of E. coli O157:H7, the H refers to antigens of the:

A

Flagella

56
Q

Effective immunity to S. pneumoniae is conferred by antibodies directed against:

A

Capsular polysaccharide

57
Q

An organism that forms smooth, pale yellow colonies on blood agar, is catalase positive and coagulase positive is most likely to be:

A

S. aureus

58
Q

In the US, the most common cause overall of bacterial meningitis is:

A

S. pneumoniae

59
Q

Which cytokine is produced by monocytes stimulated by endotoxin and is responsible for the fever production in septic shock?
A. GM-CSF
B. IFN-gamma
C. IL-12
D. TNF-alpha

A

D. TNF-alpha

60
Q

The spinal fluid in bacterial meningitis is characterized by:

A

Increased numbers of neutrophils

61
Q

Target cells present peptide fragments derived from the endogenous pathway using:

A

Class I MHC

62
Q

Strains of E. coli that cause pyelonephritis are characterized by the possession of:
A. Unique P fimbrial antigens
B. Phase variation of flagellar antigens
C. Specific O antigens
D. Production of shigatoxin

A

A. Unique P fimbrial antigens

63
Q

Which of the following cells express both class I and class II MHC?
A. Macrophages
B. Neutrophils
C. Buccal mucosal epithelium
D. erythrocytes
E. resting t lymphocytes

A

A. macrophages

64
Q

In the process of negative selection, an auto-reactive thymocyte is eliminated as a consequence of its interaction with a thymic epithelial cell which:

A

Presents self antigen in association with an MHC molecule

65
Q

The human MHC is located on chromosome:

A

6

66
Q

Growth of which organism is inhibited by optochin?

A

S. pneumoniae

67
Q

In MHC II molecules, antigen peptide fragments are accomodated in a groove between the:

A

alpha 1 and beta 1 domains

68
Q

The organisms that cause plague belong to which genus?

A

Yersinia

69
Q

Patients with cystic fibrosis are particularly susceptible to pulmonary infections caused by which organism?

A

Pseudomonas aeruginosa

70
Q

The bacterium that is strongly associated with gastric ulcers and gastric cancer is characterized by the production of:

A

Urease

71
Q

Currently, the drug of choice for treatment of systemic infections with MRSA is:

A

vancomycin

72
Q

Growth of S. pneumoniae on blood agar is characterized by which type of hemolysis?

A

Alpha

73
Q

Which S. pyogenes antigen is responsible for the induction of protective antibody?
A. hyaluronidase
B. streptolysin
C. Polysaccharise capsular antigen
D. M protein
E. G protein

A

D. M protein

74
Q

Rheumatic fever is a sequela of S. pyogenes infection of the:
A. heart valves
B. bones or joints
C. central nervous system
D. skin
E. Pharynx

A

E. pharynx

Rest are areas where antibodies cross react with these tissues

75
Q

In a patient with intestinal infection, the finding of neutrophils in the feces is indicative of:

A

Invasive bacteria

76
Q

A 25 year old female presents with fever, flank pain, dysuria. Examination of the urine reveals many neutrophils, >200,000 CFU/mL, and many white cell casts. The presence of casts indicates which infection?

A

Pyelonephritis

77
Q

Which interleukin triggers DNA remodeling (and more specifically TCR locus de-methylation)

A

IL-7

78
Q

Currently, Staphylococcal Toxic Shock Syndrome is most commonly associated with:
A. Immune deficiency
B. tampon use
C. wound infection
D. Concurrent STD

A

C. Wound infection

79
Q

The toxin responsible for the pathology of Scalded Skin Syndrome is:

A

Exfoliatin

80
Q

The major function of the CD3 seta (z) chain is:

A

Signal transduction

81
Q

The vast majority of cases of osteomyelitis are caused by:

A

S. aureus

82
Q

Which cytokine is produced primarily by Th1 cells?

A

IL-2

83
Q

Which of the following is a Class II MHC gene product?
A. HLA A2
B. HLA B
C. HLA CR
D. HLA DQ
E. HLA E

A

D

84
Q

Which of the following organisms is most likely to be involved in subacute bacterial endocarditis?
A. Group A Strep
B. S. agalactiae
C. Group B Strep
D. Viridans Strep

A

D. Viridans

85
Q

Which of the following has been implicated in the etiology of dental caries?
A. S. mutans
B. S. agalactiae
C. S. pyogenes
D. S. pneumoniae
E. S. fecalis

A

S. mutans

86
Q

A six year old child presents with symptoms suggestive of rheumatic fever. His mother reports that he complained of a sore throat about three weeks ago, but he was not very ill with it and she did not take him to the pediatrician. Which test would determine if the sore throat has been due to S. pyogenes infection?

A

Anti-streptolysin O (ASO) titer

87
Q

A child presents with lesions on her face and legs that are oozy and covered with a honey colored crust. Culture of the lesions reveals Gram positive cocci that are catalase negative. A zone of hemolysis is noted around the colonies on the blood agar plate. This is reported by the lab to be of which type of hemolysis?
A. alpha
B. beta
C. gamma
D. delta

A

Beta

88
Q

The hemolytic uremic syndrome is caused by a strain of E. coli that produces a toxin similar to that produced by which genus?

A

Shigella

89
Q

Immunogenicity, or the ability of a vaccine to stimulate an effective, specific, adaptive immune response, is inversely correlated with:

A

Attenuation

90
Q

Which of the following is/are examples of natural passive immunity?
A. Placental IgG transfer
B. IgA in breast milk
C. Lactoferrin in breast milk
D. all of the above

A

D

91
Q

In an immunocompetent adult, the most common manifestation of S. pneumoniae infection is:

A

Lobar pneumonia

92
Q

Streptococcal species found as normal oral flora usually produce which sort of hemolysis in culture?

A

Alpha

93
Q

A 31 year old bank teller presents with bloody diarrhea, abdominal cramps, and a fever. Microscopic examination of the stool shows the presence of many neutrophils and erythrocytes. The most likely causative organism is:
A. H. pylori
B. Salmonella Enteritidis
C. Campylobacter jejuni
D. Shigella sonnei
E. Vibrio cholerae

A

D

94
Q

Streptococcal pyrogenic exotoxins (Spe) function as:

A

Superantigens

95
Q

The CDC recommends that water used for routine dental treatment should:
A. Contain less than 500 CFU/mL
B. be dionized
C. Be distilled
D. exceed the regulatory standards for drinking water

A

A

96
Q

S. pneumoniae can best be distinguished from S. pyogenes by which test?

A

Optochin test

97
Q

The currently approved HPV vaccine for both boys and girls (Gardasil) is a quadrivalent vaccine against HPV types:

A

6, 11, 16, 18

98
Q

The currently recommended poliomyelitis vaccine consists of:

A

Killed virus

99
Q

Which would be the most likely non-suppurative sequela of streptococcal impetigo?
A. rheumatic fever
B. Endocarditis
C. Glomerulonephritis
D. Erythema nodosum

A

Glomerulonephritis

100
Q

The hyaluronic acid capsule of S. pyogenes is a virulence factor because it inhibits:

A

Phagocytosis

101
Q

Three days ago, a patient received her third immunization with tetanus toxoid. What class of antibodies specific for tetanus toxoid would one expect to find in her serum?

A

Low IgM; High IgG

102
Q

Which bacterium is thought to be associated with gastric carcinoma?

A

H. pylori

103
Q

Which part of the IgG molecule can bind to a specific membrane receptor on a phagocytic cell?

A

Fc fragment

104
Q

Which of the following cells express both class I and class II MHC

A

B lymphocytes

also macrophages. depends what answer is available

105
Q

The spinal fluid in bacterial meningitis is characterized by

A

Increased protein levels
also high neutrophils
low glucose
wbc 0-60,000

106
Q

The antigenic component upon which Lancefield grouping of Streptococci is based is a:

A

Cell wall polysaccharide

107
Q

T independent antigens include:
A. tetanus toxoid
B. human albumin
C. Streptococcal M protein
D. Pneumococcal polysaccharide

A

D. Pneumococcal polysaccharide

108
Q

In general, live virus vaccines should not be administered to individuals who are:
A. immune deficient
B. pregnant
C. being treated with cytotoxic drugs
D. Receiving radiation therapy
E. all of the above

A

E

109
Q

The cardiac inflammation that occurs in rheumatic fever is probably due to:

A

Antibody cross reactivity between streptococcal and cardiac tissue antigens

110
Q

Which organism if gram negative, motile, and ferments lactose?
A. Shigella sonnei
B. Salmonella paratyphi
C. Vibrio vulnificus
D. E. coli
E. C. jejuni

A

D

111
Q

The drug of choice for prevention of recurrent rheumatic fever is

A

Penicillin

112
Q

Which of the following streptococcal products is responsible for beta hemolysis of blood agar?
A. Erythrogenic toxin
B. streptokinase
C. Streptolysin B
D. Hyaluronidase

A

C

113
Q

The administration of Hep B immune globulin results in which type of immunity?

A

Artificial passive

114
Q

The main advantage of passive immunization over active immunization is:

A

it provides immediate protection

115
Q

Enterotoxins are bacterial products that induce vomiting and diarrhea when ingested in microgram amounts. Which organism below produces them?
A. E faecalis
B. S pyogenes
C. S. aureus
D. S. epidermidis

A

C

116
Q

A patient develops explosive, watery, high volume diarrhea 24 hours after eating seafood imported from South America. No blood is visible in the stool. Which bacterium is most likely involved?

A

Vibrio cholerae

117
Q

The major virulence factor of Group A, beta hemolytic Streptococcus is

A

M protein

118
Q

A confirmatory test for the ID of E. coli is

A

Indole test

119
Q

In humoral immunity, memory cells are formed as a result of differentiation of

A

Antigen activated B cells

120
Q

In healthy carriers of S. Typhi, the organism is found in which site

A

Gallbladder

121
Q

MMR vaccine consists of:

A

Live attenuated organisms

122
Q

The drug of choice for Staphylococcal infections is

A

Methicillin

DEN 7102 Micro & Immuno Concepts (26 decks)

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