Practice Q's

Question 1

A complication of typhoid fever that is most directly related to the carrier state is:

Answer 1

Colonization of the gall bladder

Question 2

During the immune stage of leptospirosis, the best source for isolating the infecting spirochete is:

Answer 2

Urine

Question 3

A 40-year-old man recovering from abdominal surgery who had been catheterized (Foley) for 4 days, now shows an elevated urine pH and suprapubic tenderness. There are struvite crystals on a removed urinary catheter. After 6 days of treatment with a cephalosporin, his condition has not changeD. Based on these results, his infection is most likely due to:

Answer 3

Bacteroides fragilis???

Question 4

Which of the following is not a manifestation of inhalation anthrax?

Answer 4

A. Initial symptoms consistent with a flu-like syndrome
B. Thoracic edema
C. Hemorrhagic meningitis
D. Pneumonia
E. Mediastinal widening observed on x-ray

Question 5

Your patient works for the animal control department of Flagstaff and has complaints of a sudden onset of fever and persistent headachE. Upon physical examination, you observe the structure in Figure 1, that when aspirated produces the organisms found in the inset. Based on these findings your most likely

Answer 5

Bubonic plague

Question 6

In June your patient returns from a two-week camping and kayaking trip along the coast of Rhode IslanD. He suffers from headaches and arthralgia in his knees. He also presents with several rashes on his ankle and lower back (Figure 2). Based on this evidence you initiate treatment for:

Answer 6

Borrelia hermsii

Question 7

During a summer in Wisconsin, which of the following stages of the tick life cycle is responsible for the majority of Lyme disease infections?

Answer 7

Pupa

Question 8

The recurrent signs and symptoms of relapsing fever are due to:

Answer 8

The random interval of antigenic changes in the outer membrane protein of the pathogen8. Which of the following virulence factors is the primary antigenic component of the oral vaccine for Salmonella typhi that is used to immunize individuals traveling to endemic regions?

Question 9

8. Which of the following virulence factors is the primary antigenic component of the oral vaccine for Salmonella typhi that is used to immunize individuals traveling to endemic regions?

Answer 9

Vi Antigen

Question 10

How is Borrelia recurrentis transmitted?

Answer 10

Indirect inoculation of a bite from viscera of a crushed vector

Question 11

Regarding the infectivity of Borrelia burgdorferi, which of the following is the most important virulence factor?

Answer 11

Outer Surface Proteins

Question 12

The temperature-regulated virulence factor responsible for the direct transmission of Yersina pestis from a flea vector to its host is/are:

Answer 12

Coagulase

Question 13

Your patient, who works for the water department, suffers from headaches, fever and nuchal rigidity. You learn that about a week earlier, he fell into a water reservoir while repairing sewer lines near a slaughterhouse. You begin treatment for his current signs. Although no bacteria can be cultured from a CSF sample, the laboratory does report a positive MAT from the patient’s serum. Based on these laboratory results, you adjust your treatment protocol for:

Answer 13

Leptospirosis

Question 14

The bacteria and vector responsible for the cause and transmission of epidemic relapsing fever is:

Answer 14

Borrelia recurrentis; Pediculus sp.

Question 15

You have diagnosed and begun antibiotic treatment for a 12-year-old patient with leptospirosis. Within 6 hours of beginning oral medication, your patient is brought by ambulance to an ED, diagnosed and treated for Jarisch-Herxheimer response. The response is directly due to:

Answer 15

Rapid killing of the bacteria and release of toxic products

Question 16

A person with suffering from subacute endocarditis suffers a massive emboli and heart failure what organism(s) would be associated?

Answer 16

HACEK

Question 17

Oslers nodes, roth spots are due to what process?

Answer 17

circulating immune complex

Question 18

What do tuleremia, bartonella, and brucellosis have in common.

Answer 18

intracellular pathogen

Question 19

Which of the following diseases is transmitted by a chigger bite and may have eschar formation?

Answer 19

scrub typus (NOT ON OUR CURRENT TEST 2014)

Question 20

How is b recurrentis spread?

Answer 20

crushing louse on skin and innoculates

Question 21

A person has symptoms of meningitis but no organisms can be isolated from csf, he also present with a positave MAT test what is the infecting organism?

Answer 21

leptospirosis

Question 22

Where would you get a postive test result if a person was infected with the immune phase of leptospirosis?

Answer 22

urine

Question 23

1&2 are linked
1. A boy living in Tennesse suddenly develops a fever, headache, chills and myalgias. A maculopapular rash initially noted on his wrists and ankles spreads centripetally. What’s the organism responsible?

2. After you have drawn blood from the patient above, what should you do next to manage this patient?

Answer 23

1. Rickettsia rickettsia

2. Immediately start the patient on doxycycline

Question 24

How is Babesia microti transmitted?

Answer 24

Deer tick bite

Question 25

What will you most likely see in an IVDU with infective endocarditis?

Answer 25

Staph lung lesions with infiltrations

Question 26

The increase of Filarial round worm endemic is due to:

Answer 26

A. Technology of travel
B. Increased sexual contact
C. Poor sanitation????
D. Vector Density
E. Crowded living quarters

Question 27

A Co-infection of HBV and HDV will usually lead to

Answer 27

Immunity and recovery

Question 28

A patient comes in with SIRS, an infection, and hypotension that is corrected by administering fluids. What state is the patient in?

Answer 28

Severe Sepsis (due to hypotension, but its correctable)

Question 29

Drinking un-pasteurized milk from Goats could increase your risk of getting which of the following?

Answer 29

Brucellosis

Question 30

The stripped field mouse is associated with which virus

Answer 30

Hantaan virus

Question 31

What species of malaria has a predilection for invading young RBCs?

Answer 31

P. vivax

Question 32

Which stage of Plasmodium vivax is linked to relapse?

Answer 32

Hypnozoite

Question 33

The infective stage of malaria is the

Answer 33

Sporozoite

Question 34

Blackwater fever is a serious complication of:

Answer 34

Falviparum malaria

Question 35

Paroxysms for vivax malaria occur every:

Answer 35

48 hr

Question 36

A patient who emigrated from India complain of fever, shaking chills, sweats, and nausea. Physical examination reveals hepatosplenomegaly, and intracellular double ring stages are evident on blood smear. Schuffner’s dots are not present, however. Identify the causative agent

Answer 36

Plasmodium falciparum

Question 37

Identify the infective stage and vector for human cutaneous leishmaniasis:

Answer 37

Promastigote, sand fly

Question 38

Which microbial disease best fits the following description: Romana’s sign, cardiac disease with chronic disease, and vector posterior station development?

Answer 38

Chagas disease

Question 39

While completing an international rotation in an urban clinic in Peru, a medical attends to a young child who is ill with fever and malaise. Incident to the illness is regional lymphadenitis and a bloodborne microbe (figure to the right). Which of the following disease is the most reasonable

Answer 39

Early Chagas disease

Question 40

A wildlife photographer travels to a big game park in East Africa and returns home with intermittent fever and painless chancre-like sore on his neck. A giemsa-stained blood smear is positive for a flagellated microbe (figure to right). Which of the following mechanism gives this microbe the ability to evade humoral defense responses?

Answer 40

Glycoprotein switching

Question 41

A US Army Special Forces unit is considering establishing a training center in a tropical forested region of Central America. A reconnoiter team of Army physicians and public health officers note that a substantial number of children and young adults are afflicted with chronic sores like the ones show in the photograph below. Which of the following measures is the most relevant in preventing this disease from becoming a in the US soldiers?

Answer 41

Protecting themselves from the bites of sand flies