Upper Respiratory tract infections include all but the following:

A. Bordetella pertussis (Whooping cough)

B. Corynebacterium diphtheriae (diphtheria)

C. Group A streptococci

D. Mycobacterium tuberculosis (tuberculosis)

D. Mycobacterium tuberculosis (tuberculosis)

Tuberculosis is a lower respiratory tract infection.

• Limited to the nasopharynx

• Lower respiratory tract infections involve the airways and parenchyma of the lung.

Which of the following is NOT a lower respiratory tract infection?

A. Bronchitis

B. Streptococcus pneumoniae (pneumonia)

C. The common cold

D. S. aureus following viral infectin 

C. The common cold

The common cold affects the upper respiratory tract.

Which is not a characteristic of Group A streptococcal pharyngitis or "strep throat"?

A. Gram negative cocci in short chains

B. Facultative but perfers to grow anaerobically

C. Catalase positive, bacitracin susceptible

D. A and B

E. A and C

E. A and C

Group A streptococcal pharyngitis is gram positive cocci in short chains, and catalase negative, bacitracin susceptible.

Strep throat is:

A.  Prevalent teenagers aged between 15 and 25 years old

B.  Requires close contact

C.  Has the M protein, which allows phagocytosis

D.  None of the above

B. Requires close contact

Strep is spread person-person most likely via droplets

The M protein:

A. Is the key virulence factor for Strep throat

B. Acts as an adhesion

C. Is anti-phagocytic

D. All of the above

Group A Streptococcal pharyngitis or "strep throat" has all of the following except:

A. Q protein

B.  Hyaluronic acid capsule

C. Pyrogenic exotoxins

D. Streptokinase

The group A Streptococcal pharngitis' hyaluronic capsule has all the following characteristics except:

A.  Is anti-phagocytic

B.  May give the organism mucoid appearance

C.  Is degraded by hyaluronidase

D.  Can act as a superantigen

D. Can act as a superantigen

Pyrogenic exotoxins (another virulence factor for strep throat) can act as a superantigen 

Group A streptococcal pharyngitis can avoid phagocytosis by two means. They are:

A. Their characteristic as a gram postive cooci in short chains

B. Streptokinase and DNase

C. Hyaluronic acid capsule and M protein

D. Q protein and mucoid appearance

C. Hyaluronic acid capsule and M protein

Hyaluronic acid capsule and the M protein are anti-phagocytic.

Which statement is false about Pyrogenic exotoxins?

A. Three are 3 types: A, B, C

B. Can act as a superantigen

C. Spec A (Type A) has been associated with streptococcal toxic shock syndrome

D.  All of the above is correct

D. All the above is correct

True or False

Group A streptococcal pharyngitis DNase degrades RNA.

False

DNase degrades DNA

True or False

Group A Streptococcal pharyngitis uses streptokinase. Streptokinase can dissolve fibrin clots.

Which of the following is not a mechanism used by Group A streptococcal pharyngitis to spread organisms through tissue?

A.  C5a peptidase

B.  Streptolysin S and O

C.  Polysaccharide capsule

D.  Proteinase

C. Polysaccharide capsule

A patient exhibits a skin rash which spares the palms and the soles. The patient has:

A. GAS (Group A Streptococcal) pharyngitis

B. Scarlet fever

C. A lower respiratory infection

D. A and B

E. B and C

D. A and B 

Chicken pox has been shown to be an important predisposing factor for which one of the following types of GAS pharyngitis:

A. Scarlet Fever

B. Impetigo

C. Pyoderma

D. Necrotizing fasciitis

Patients with streptococcal toxic shock syndrome:

A. Have hypertension

B. Have invasive streptococcal disease

C. Do not have experience skin rashes

D. All of the above

Patients that have edema, hypertension, and smoky or rust colored urine, usually have:

A. Rheumatic fever

B. Scarlett fever

C. Acute glomerulonephritis

D. Meningitis

C. Acute glomerulonephritis

Occurs 2-3 weeks following either pharyngitis or  pyoderma (skin infections)

When the streptococcal pathogen is found in sterile sites such as blood, pleural, or cerebrospinal fluid:

A. The patient has necrotizing fasciitis.

B. The patient has kidney, lungs, or liver failure.

C. The patient has strepococcal toxic shock syndrome.

D. All of the above

Suppurative GAS infections are outbreaks of invasive infections. Which of the following is NOT an suppurative GAS infection?

A. Streptococcal toxic shock syndrome

B. Necrotizing fasciitis

C. Acute glomerulonephritis

D. All of the above

Nonsupporative GAS sequelae are:

A. Rheumatic fever and acute glomerulonephritis

B. Streptococcal toxic shock syndrome

C. Necrotizing fasciitis

D. All of the above are nonsuppurative GAS sequelae

The treatment of GAS pharyngitis is generally accomplished by:

A. Treatment with penicillin or macrolide antimicrobials

B. Aminoglycoside antimicrobials or Cephalosporin

C. Vancomycin or tetracyclines

D. TMP/ SMX

A. Treatment with penicillin and or macrolide antimicrobials

Pneuminia due to Streptococcus pneumoniae is:

A. Gram positive diplococci

B. Facultative

C. The leading cause of bacterial pneumonia

D. All of the above

Pneumonia is:

A. Least common in elderly, infants/ young children

B. Is aspirated from the lower airways

C. The second most common cause of bacterial meningitis

D. A and B

E. B and C

C. The second most common cause of bacterial meningitis.

It is most common in the elderly, infants/ young children and is aspirated from the upper airways

True or False

People with sickle cell are at increased risk for systemic pneumonia infections.

Patients with active TB have which symptoms?

A.  Fevers/ night sweats

B. Increased cough/ increased sputum

C. Significant weight loss

D. All of the above

Which of the following is a true statement?

A. There is no vaccine for TB

B. Patients, especially children, suspected of having influenza should be given aspirin for treatment of fever.

C. Penicillin resistant pneumococci are being less common in the world.

D. None of these statements are true.

D. None of these statements are true.

• There is a vaccine for TB called (BCG) Bacillus Calmette-Guerin
• Patients, especially children, suspected of having influenza should not be given aspirin for treatment of fever because Reyes syndrome can emerge.
• Penicillin resistant pneumococci are being more common in the U.S.

Mycobacterium tuberculosis is:

A. Fast growing, generation time is 20-30 minutes

B. A strict aerobic bacilli

C. Spread by aerosolized droplets

D. A and B

E. B and C

F. None of the above

E. B and C

Mycobacterium tuberculosis grows very slowly; The generation time is 1 day.

True or False

People who are most susceptible to mycobacterium tuberculosis in the United States are:

A. HIV positive individuals

B. Homeless

C. Incarcerated

D. Immigrants

True or False

Mycobacterium tuberculosis is particularly problematic in sub-Saharan Africa because of high combination rates of HIV and drug resistant TB.

TRUE

True or False

Mycobacterium tuberculosis can remain suspended in the air for extended periods of time, but is not infectious.

False

M. tuberculosis can remain suspended and infectious for extended periods of time (up to at least 1 hour)

The formation of granulomatous inflammation is caused:

A. When CD4 cells activate macrophages to kill tubercule bacilli

B. When the infected person coughs.

C. When the infected person drinks kool-aid.

D. When the infected person quits smoking.

Tubercule bacilli may remain latent for decades but can reactivate. Reactivation is characterized by:

A. Erosion of the large airways

B. Hemoptysis- erosion into blood vessels

C. Expansion of the area of necrosis

D. All of the above

A patient who has the flu, most likely has:

A. Aching muscles

B. Dry hacking cough

C. A headache

D. All of the above

Which pathogens are spread by droplets from the exhalations of infected people:

A. Influenza virus

B. Streptococcus pneumoniae

C. GAS streptococcal pharyngitis

D. Mycobacterium tuberculosis

E. All of these

F. None of these

All of the following are facultative EXCEPT:

A. GAS pharyngitis

B. Streptococcus pneumoniae

C. Mycobacterium tuberculosis

D. All the above are facultative

C. Mycobaterium tuberculosis

Mycobacterium tuberculosis is a strict aerobic bacilli

and although GAS pharyngitis is facultative, it prefers to grow anaerobically