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WorksheetsSIMPIC 2022 Kapita Selecta
Total questions: 71
Worksheet time: 36mins
Name
Class
Date
1.
Name selective media for C.jejuni cultivation!
a)
Campy-Blood Agar
b)
Skirrow Media
c)
MIU broth
d)
XLD agar
2.
The following is/are characteristic(s) of endotoxin (can be >1)
a)
Can not be converted into toxoid
b)
Produced by both Gram-positive and Gram-negative bacteria
c)
Specific receptors not found on cells
d)
Usually do not produce fever in the host
e)
Relatively unstable against heat
3.
Which of the following statements about lipopolysaccharide is<br />correct?
a)
It interacts with macrophages and monocytes yielding<br />release of cytokines.<br />
b)
The toxic component is the O side chain.<br />
c)
It forms holes in red blood cell membranes yielding hemolysis.<br />
d)
It causes hypothermia.<br />
e)
It causes paralysis.
4.
Which of the following best describes the mechanism of action<br />of diphtheria toxin?
a)
Forms pores in red blood cells causing hemolysis<br />
b)
Degrades lecithin in eukaryotic cell membranes<br />
c)
Causes release of tumor necrosis factor<br />
d)
Inhibits elongation factor 2<br />
e)
Causes increased adenylate cyclase activity
5.
Which of the following statements is correct?
a)
Lipopolysaccharide is part of the cell wall of E. coli.<br />
b)
Cholera toxin is attached to the flagella of V. cholerae.
c)
The lecithinase of C. perfringens causes diarrhea.
d)
Toxic shock syndrome toxin-1 is produced by hemolytic<br />stains of S. epidermidis.
6.
Which one of the following is an important virulence factor of<br />Bacillus anthracis?
a)
Protective antigen
b)
Lipopolysaccharide
c)
Pili
d)
A toxin that inhibits peptide chain elongation factor EF-2
e)
Lecithinase
7.
Tetanus toxin (tetanospasmin) diffuses to terminals of inhibitory<br />cells in the spinal cord and brainstem and blocks which of<br />the following?
a)
Release of acetylcholine
b)
Cleavage of SNARE proteins
c)
Release of inhibitory glycine and γ-aminobutyric acid
d)
Release of protective antigen
e)
Activation of acetylcholine esterase
8.
Which of the following statements about tetanus and tetanus<br />toxoid is correct?
a)
Tetanus toxin kills neurons.
b)
Tetanus toxoid immunization has a 10% failure rate
c)
The mortality rate of generalized tetanus is less than 1%.
d)
Double vision is commonly the first sign of tetanus.
e)
Tetanus toxin acts on inhibitor interneuron synapses.
9.
Which of the following food items is most frequently associated<br />with infant botulism?
a)
Corn syrup
b)
Canned infant formula
c)
Liquid multivitamins
d)
Honey
e)
Jarred baby food
10.
The following media can be used for cultivation of C.diphtheriae (can be >1)
a)
Modified Tinsdale's medium
b)
BCYE Agar
c)
cystine-tellurite blood agar
d)
XLD agar
11.
Which of the following Listeria serotype causes most of foodborne outbreak?
a)
1/2a
b)
1/2b
c)
3a
d)
4a
e)
4b
12.
Movement of Listeria monocytogenes inside of host cells is<br />caused by
a)
Inducing host cell actin polymerization
b)
The formation of pili (fimbriae) on the listeriae surface
c)
Pseudopod formation
d)
The motion of listeriae flagella
e)
Tumbling motility
13.
Which of the following statements regarding Rhodococcus equi<br />is correct?
a)
It is transmitted person to person.
b)
It causes tuberculosis in cattle.
c)
It is a rare cause of pulmonary infection in humans.
d)
It produces a black pigment on sheep blood agar.
14.
Which of the following statements regarding the role of protein<br />A in the pathogenesis of infections caused by S. aureus is<br />correct
a)
It is responsible for the rash in toxic shock syndrome.
b)
It converts hydrogen peroxide into water and oxygen.
c)
It is a potent enterotoxin.
d)
It is directly responsible for lysis of neutrophils.
e)
It is a bacterial surface protein that binds to the Fc portion<br />of IgG1.
15.
All of the following statements regarding PVL are correct except
a)
It is a two-component toxin.
b)
It is commonly produced by community-associated MRSA<br />strains.
c)
It is an important virulence factor.
d)
It is identical to one of the staphylococcal enterotoxins.
e)
It forms pores in the membranes of white blood cells.
16.
Which of the following statements best describes the function<br />of the agr in S. aureus?
a)
It regulates production of β-hemolysins.
b)
It is influenced by environmental oxygen.
c)
It controls the preferential expression of surface adhesins.
d)
It is important in the control of autolysis.
17.
All of the following are important infection control strategies in<br />containing spread of MRSA in hospitals except
a)
Aggressive hand hygiene
b)
Routine surveillance for nasal colonization among highrisk<br />individuals
c)
Contact isolation for patients who are colonized or infected<br />with MRSA
d)
Routine antimicrobial prophylaxis for all patients hospitalized<br />for more than 48 hours
e)
Aseptic management of skin lesions
18.
A 65-year-old man develops an abscess on the back of his neck.<br />Culture yields S. aureus. The isolate is tested and found to be<br />positive for the mecA gene, which means that
a)
The isolate is susceptible to vancomycin.
b)
The isolate is resistant to vancomycin.
c)
The isolate is susceptible to nafcillin.
d)
The isolate is resistant to nafcillin.
e)
The isolate is susceptible to clindamycin.
19.
The exfoliative toxins, TSST-1, and the enterotoxins are all<br />superantigens. The genes for these toxins are
a)
Present in all strains of S. aureus
b)
Widely distributed on the staphylococcal chromosome
c)
On both the staphylococcal chromosome (TSST-1 and<br />exfoliative toxins) and on plasmids (enterotoxins)
d)
On the staphylococcal chromosome in a pathogenicity<br />island
e)
On plasmids
20.
The following is/are the different feature of S.aureus and S.saprophyticus (can be >1)
a)
The S.aureus exhibits positive result on coagulase test, while S.saprophyticus will exhibit negative result on coagulase test
b)
S.saprophyticus shows resistant against novobiocin test
c)
S.aureus will give pink colour colonies on MSA, while S.saprophyticus will produce yellow colonies on MSA
d)
S.saprophyticus will give negative result on catalase test, while S.aureus will give positive result on catalase test
21.
Important methods for classifying and speciating streptococci<br />is/are (can be >1)
a)
Agglutination using antisera against the cell wall groupspecific<br />substance
b)
Biochemical testing
c)
Hemolytic properties (α-, β-, nonhemolytic)
d)
Capsular swelling (quellung) reaction
22.
Enterococci can be distinguished from nonenterococcal<br />group D streptococci on the basis of which of the following<br />characteristics?
a)
γ-Hemolysis
b)
Esculin hydrolysis
c)
Growth in 6.5% NaCl
d)
Growth in the presence of bile
e)
Gram-stain morphology
23.
All of the following statements regarding the hyaluronic acid<br />capsule of S. pyogenes are correct except
a)
It is responsible for the mucoid appearance of the colonies<br />in vitro.
b)
It is antiphagocytic.
c)
It binds to CD44 on human epithelial cells.
d)
It is an important virulence factor.
e)
A vaccine against the capsule is currently available.
24.
Which of the following statements regarding the S. bovis group<br />is correct?
a)
They possess Lancefield group D antigen.
b)
Some strains are vancomycin resistant.
c)
Infections caused by these organisms are benign.
d)
All subspecies are PYR positive.
e)
All subspecies are β-hemolytic.
25.
Which of the following genera requires pyridoxal for growth?
a)
Aerococcus
b)
Granulicatella
c)
Enterococcus
d)
Leuconostoc
e)
Pediococcus
26.
A 37-year-old woman with a history of urinary tract infections<br />comes to the emergency department with burning on urination<br />along with frequency and urgency. She says her urine smells like<br />ammonia. The cause of her urinary tract infection is likely to be
a)
E. aerogenes
b)
Proteus mirabilis
c)
Citrobacter freundii
d)
E. coli
e)
S. marcescens
27.
An 18-year-old student has abdominal cramps and diarrhea.<br />A selective agar plate is inoculated and grows suspicious Gramnegative<br />rods. Triple sugar iron agar is used to identify the<br />isolates as salmonellae or shigellae. A result suggesting one of<br />these two pathogens would be
a)
Production of urease
b)
Motility in the medium
c)
Inability to ferment lactose and sucrose
d)
Fermentation of glucose
e)
Production of gas in the medium
28.
Which of the following statements regarding O antigens is correct?
a)
All Enterobacteriaceae possess identical O antigens.
b)
They are found in the polysaccharide capsules of enteric<br />bacteria.
c)
They are covalently linked to a polysaccharide core.
d)
They do not stimulate an immune response in the host.
e)
They are not important in the pathogenesis of infection<br />caused by enteric bacteria.
29.
Which of the following test methods is the least sensitive procedure<br />for diagnosis of colitis caused by Shiga toxin-producing<br />E. coli?
a)
Culture on sorbitol MacConkey agar
b)
Toxin testing using an enzyme immunoassay
c)
Cell culture cytotoxin assay using Vero cells
d)
Polymerase chain reaction for detection of the genes that<br />encode Shiga toxin
30.
Heat-labile toxin of ETEC acts by which of the following<br />mechanisms?
a)
Attachment and effacement
b)
Activation of adenylyl cyclase
c)
Aggregative adherence
d)
Ribosomal dysfunction
31.
A young woman presents with recurrent urinary tract infections<br />caused by the same Proteus mirabilis strain. What is the<br />major concern?
a)
She does not take her medication.
b)
She is pregnant because pregnant patients are more susceptible<br />to UTIs.
c)
She has a bladder or kidney stone.
d)
Her partner is infected.
e)
She has occult diabetes and should have a glucose tolerance<br />test.
32.
A sputum culture of a patient with cystic fibrosis grows<br />P. aeruginosa that forms very mucoid colonies. The implication<br />of this observation is which one of the following?
a)
The P. aeruginosa is highly susceptible to the aminoglycoside<br />antimicrobial tobramycin.
b)
The P. aeruginosa is infected with a pyocin (a bacteriocin).
c)
The colonies are mucoid because they have polysaccharide<br />capsule of hyaluronic acid.
d)
The exotoxin A gene has been disabled and the P. aeruginosa<br />is no longer able to block host cell protein synthesis.
e)
The P. aeruginosa has formed a biofilm in the patient’s<br />airway.
33.
An environmental Gram-negative bacillus that is resistant to<br />cephalosporins, aminoglycosides, and quinolones has become<br />a very important nosocomial pathogen largely because it is<br />selected by use of those antibiotics. This Gram-negative bacillus<br />can take 2–3 days to grow and must be differentiated from<br />B. cepacia. It is
a)
P. aeruginosa
b)
A. baumannii
c)
Alcaligenes xylosoxidans
d)
Klebsiella pneumoniae
e)
S. maltophilia
34.
Acinetobacter species:
a)
are only found in a hospital environment
b)
May appear as Gram-positive rods
c)
Can mimic the morphology of Haemophilus species in<br />Gram-stains of endocervical secretions
d)
Can be a significant cause of ventilator-associated pneumonia<br />in intensive care unit patients
e)
Are susceptible to most antibiotics
35.
The mechanism of action of exotoxin A of P. aeruginosa is
a)
To activate acetylcholine esterase
b)
To block elongation factor 2
c)
To form pores in white blood cells and increase cation<br />permeability
d)
To increase intracellular cyclic adenosine monophosphate
e)
To split lecithin into phosphorylcholine and diacylglycerol
36.
Patients deficient in these cells are particularly at high risk for<br />developing serious systemic infections with P. aeruginosa:
a)
Eosinophils
b)
Neutrophils
c)
Macrophages
d)
Natural killer cells
e)
CD4+ T cells
37.
The following is/are true about Vibrio sp
a)
All Vibrio growth well on TCBS agar
b)
V.cholerae will produce green colony, while V.parahaemolyticus will produce yellow colony on TCBS
c)
All Vibrio grow at a very high pH (8,5-9,5)
d)
Vibrio do not require high salt concentration in cultivation media
38.
Bacteremia associated with a gastrointestinal infection is most<br />likely to occur with which of the following?
a)
S. typhi
b)
V. cholerae
c)
Shigella boydii
d)
V. parahaemolyticus
e)
C. jejuni
39.
The V. cholerae factor responsible for diarrhea is a toxin that
a)
Blocks EF-2
b)
Yields increased intracellular levels of cAMP
c)
Cleaves SNARE
d)
Blocks EF-1-dependent binding of amino-acyl-tRNA to<br />ribosomes
e)
Cleaves VAMP
40.
Long-term carriage and shedding is most likely to occur after<br />gastrointestinal infection with which of the following species?
a)
E. coli O157:H7
b)
Shigella dysenteriae
c)
V. cholerae
d)
C. jejuni
e)
Salmonella typhi
41.
The following characteristic(s) is/are true regarding Haemophilus influenzae (can be >1)
a)
Some subtype can produce exotoxin
b)
Nonencapsulated organism maybe part of normal upper respiratory tract flora
c)
Will show satellite phenomena along side the S.aureus colony in blood agar
d)
The polyribose phosphate capsule of type b H. influenzae is the major virulence factor.
42.
Which of the following subspecies of F. tularensis is the most<br />virulent for humans?
a)
tularensis
b)
holarctica
c)
mediasiatica
d)
novicida
43.
The following is/are true regarding Yersinia sp colony (can be >1)
a)
Produce nonlactose-fermenting colony on MacConkey agar
b)
Catalase negative
c)
Indole positive
d)
Oxidase negative
44.
An 8-year-old boy was bitten by a stray cat. Two days later, the<br />wound was red and swollen and drained purulent fluid. P. multocida<br />was cultured from the wound. The drug of choice to treat<br />this infection is
a)
Amikacin
b)
Erythromycin
c)
Gentamicin
d)
Penicillin G
e)
Clindamycin
45.
Intimate contacts of patients with suspected plague pneumonia<br />should receive which of the following agents as<br />chemoprophylaxis?
a)
Gentamicin
b)
Cefazolin
c)
Rifampin
d)
Penicillin
e)
Doxycycline
46.
All of the following statements regarding the pFra/pMT plasmid of Y. pestis are true except
a)
It encodes the capsular protein (fraction FI) that confers antiphagocytic properties.
b)
It contains genes that yield plasminogen-activating protease that has temperature-dependent coagulase activity.
c)
It contains genes that encode phospholipase D, which is required for organism survival in the flea midgut.
d)
It is unique to Y. pestis.
e)
It encodes factors that are important for survival in both the flea and the human.
47.
Which of the following cell components produced by N. gonorrhoeae<br />is responsible for attachment to host cells?
a)
Lipooligosaccharide
b)
Pili (fimbriae)
c)
IgA1 protease
d)
Outer membrane porin protein
e)
Iron-binding protein
48.
One major advantage of the conjugate meningococcal vaccines<br />compared with the polysaccharide vaccine is
a)
Stimulation of mucosal secretory IgA
b)
Fewer side effects
c)
A T cell-dependent response to vaccine is induced
d)
Inclusion of serogroup B
49.
A useful test to differentiate M. catarrhalis from saprophytic<br />neisseriae in respiratory samples is
a)
Butyrate esterase
b)
Gram-stain
c)
Growth on 5% sheep blood agar
d)
PYR
e)
Oxidase
50.
Infections caused by Bacteroides species can be treated with all of<br />the following antibiotics except
a)
Ampicillin–sulbactam
b)
Clindamycin
c)
Metronidazole
d)
Penicillin
e)
Cefoxitin
51.
All of the following statements regarding anaerobes are true except
a)
They possess the enzyme cytochrome oxidase.
b)
Many species are part of the normal human microbiota.
c)
They are often found along with aerobes in complicated infections.
d)
Special techniques are required to ensure their recovery from clinical specimens.
e)
Some species are more tolerant of exposure to oxygen than others.
52.
If the patient’s M. tuberculosis isolate (Question 1) proves to be<br />resistant to isoniazid, the likely mechanism for resistance is
a)
β-Lactamase
b)
Mutations in the catalase-peroxidase gene
c)
Alterations in the β subunit of RNA polymerase
d)
Mutations in the DNA gyrase gene
e)
Mutations in the genes encoding the S12 protein and<br />16S rRNA
53.
A newly characterized rapidly growing Mycobacterium that has emerged as an important cause of central venous catheter associated<br />infections is
a)
M. phlei
b)
M. mucogenicum
c)
M. xenopi
d)
M. smegmatis
e)
M. terrae
54.
Which of the following statements regarding interferon-γ release assays (IGRAs) is correct?
a)
They are useful for evaluating immunocompromised patients for active tuberculosis.
b)
They detect antigens present in all Mycobacterium species.
c)
They are not available yet for testing in the United States.
d)
They are performed using molecular probes that detect organism DNA.
e)
They are used as alternatives to the tuberculin skin test to evaluate for latent tuberculosis.
55.
A 10-year-old child has a primary pulmonary M. tuberculosis<br />infection. Which of the following features of tuberculosis is most correct?
a)
In primary tuberculosis, an active exudative lesion develops and rapidly spreads to lymphatics and regional lymph<br />nodes.
b)
The exudative lesion of primary tuberculosis often heals slowly.
c)
If tuberculosis develops years later, it is a result of another exposure to M. tuberculosis.
d)
In primary tuberculosis, all of the infecting M. tuberculosis organisms are killed by the patient’s immune response.
e)
In primary tuberculosis, the immune system is primed, but the PPD skin test result remains negative until there is a<br />second exposure to M. tuberculosis.
56.
Nontreponemal serological tests:
a)
Are useful in definitively identifying a T. pallidum infection.
b)
Measure antibodies against T. pallidum.
c)
Can be used to monitor antibiotic treatment of primary or secondary syphilis.
d)
Measure antibodies against lipids released from damaged cells.
e)
Are useful in diagnosing a disseminated gonococcal infection.
57.
Which of the following organisms principally infects the liver and kidneys?
a)
L. interrogans
b)
<br />Staphylococcus aureus
c)
Escherichia coli
d)
Enterococcus faecalis
e)
T. pallidum
58.
Which type of test is most readily used to obtain laboratory<br />confirmation of M. pneumoniae infection?
a)
Culture in broth containing serum, glucose, and a penicillin (to inhibit other flora)
b)
PCR
c)
Electron microscopy
d)
EIA tests on acute and convalescent phase sera
59.
U. urealyticum is so named because
a)
It thrives in the upper urinary tract.
b)
It requires urea as a growth substrate.
c)
It is a frequent cause of symptomatic urinary bladder infections in young women.
d)
It causes chronic urinary tract infections in premature babies born to mothers with ureaplasmas as part of the<br />genital flora.
60.
Initiation of infection by M. pneumoniae begins with
a)
Elaboration of a polysaccharide capsule that inhibits<br />phagocytosis
b)
Secretion of a potent exotoxin
c)
Endocytosis by ciliated respiratory epithelial cells
d)
Adherence to respiratory epithelial cells mediated by P1 adhesin
e)
Phagocytic uptake by alveolar macrophages
61.
Infection with M. genitalium:
a)
is not restricted to the genitourinary tract.
b)
results in inflammation causing urethritis in males and cervicitis in females.
c)
is best treated with a first-generation cephalosporin.
d)
is associated only with nongonococcal urethritis in males.
e)
is asymptomatic unless a co-infection with Clamydia trachomatis is present.
62.
The vector for Rickettsia prowazekii is
a)
Louse
b)
Flea
c)
Mite
d)
Tick
63.
The vector for Anaplasma phagocytophilum is
a)
Louse
b)
Flea
c)
Mite
d)
Tick
64.
The following statement(s) is/are true regarding C.burnetti
a)
Culture of C.burnetti can be done in biosafety level 1 laboratory
b)
It exists in two antigenic forms called phase I and phase II
c)
In chronic infection, doxycycline is the drug of choice without any additional antibiotics
d)
Endocarditis is the most common form of chronic infection, and is associated with antibodies to phase I antigen
65.
Morulae (intracellular inclusions in leukocytes) are characteristic of which of the following diseases?
a)
Malaria caused by Plasmodium falciparum infection but not Plasmodium malariae infection
b)
Dengue
c)
Babesia infection
d)
Ehrlichiae infection
e)
Loa loa
66.
Which of the following statements about epidemic typhus (R. prowazekii disease) is most correct?
a)
The disease occurs primarily in sub-Saharan Africa.
b)
It is transmitted by ticks.
c)
Mice are the reservoir.
d)
Historically, the disease occurs in times of prosperity.
e)
Recrudescence can occur many years after the initial infection.
67.
The following characteristic(s) can differentiate C.trachomatis to C.pneumoniae and C.psittaci (can be >1)
a)
Natural host for C.trachomatis is human, while natural host for C.psittaci is birds
b)
C.trachomatis is not susceptible to sulfonamides, while C.pneumoniae is susceptible to sulfonamides
c)
C.trachomatis may contain plasmid but C.pneumoniae does not contain plasmid
d)
C.trachomatis may be transmitted person to person, while C.psittaci is transmitted via bird excreta
e)
C.psittaci contain glycogen in inclusion body, while C.trachomatis does not contain glycogen in inclusion
68.
Which of the following statements about chlamydial antigens is correct?
a)
Chlamydiae have shared group or genus-specific antigens.
b)
There is no cross-reaction between C. trachomatis and C. pneumoniae antigens.
c)
All five serovars of C. pneumoniae cross-react with C. psittaci.
d)
One serovar of C. trachomatis causes eye infections, and the second serovar causes genital infections.
e)
Chamydiae frequently vary the epitopes of their antigens to avoid immune clearance.
69.
Perinatal C. trachomatis infections frequently manifest as:
a)
urogenital disease.
b)
necrotic pneumonia.
c)
inclusion conjunctivitis.
d)
a pustular rash.
e)
endophthalmitis.
70.
Which of following statements about trachoma is most accurate?
a)
It follows an acute eye infection with C. trachomatis.
b)
Millions of people in the United States have trachoma.
c)
There is nochlamydial vaccine to prevent trachoma.
d)
Progression of trachoma is accelerated by intermittent treatment with azithromycin.
e)
Trachoma involves direct damage to corneal epithelium.
71.
Which one of the following statements about C. pneumoniae is<br />most correct?
a)
Transmission from person to person is by the airborne<br />route.
b)
It makes glycogen-rich inclusions that stain with iodine.
c)
There are multiple serovars, including three that cause a systemic illness.
d)
They are resistant to macrolides.
e)
The reservoir is house cats.
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