WEIVER LANIF • 242 SOIB
★ ★
Chamberlain University
C College of Nursing & Health Professions
J O U R N E Y T O E X T R A O R D I N A R Y CO M PA S S I O N AT E C A R E
EST. 1889
BIOS 242 — Fundamentals of Microbiology
CO M P R E H E N S I V E D I S E A S E R E V I E W · S K I N , C N S , R E S P I R ATO R Y, G I , SYST E M I C I N F E C T I O N S
INSTITUTION Chamberlain University COURSE CODE BIOS 242
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
RESOURCE TYPE Comprehensive Final Review / Practice Examination TOTAL QUESTIONS 25 Questions
COURSE TITLE Fundamentals of Microbiology FORMAT Multiple Choice — Select the Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ This comprehensive review covers skin infections, CNS diseases, respiratory infections, GI diseases, and systemic conditions.
▸ All content reflects BIOS 242 learning objectives for disease causation, presentation, and treatment.
▸ Correct answers and detailed rationales appear below each question for exam preparation purposes.
▸ Pay careful attention to causative agents, virulence factors, and distinguishing clinical features.
SECTION I — SKIN, CNS, RESPIRATORY, GI & SYSTEMIC INFECTIONS Questions 1 – 25
1. Necrotizing fasciitis is a rapidly progressive flesh-eating infection. Which of the following correctly identifies its causative agents and treatment?
A. Caused by a virus; treated with antivirals only
B. Caused by S. pyogenes, S. aureus, or C. perfringens; affects skin and soft tissue with systemic involvement (sepsis, shock, multi-organ failure); treated with broad-
spectrum antibiotics
C. Caused by fungi; treated with topical antifungals
D. Caused by prions; no treatment available
CORRECT ANSWER B — Caused by S. pyogenes, S. aureus, or C. perfringens; affects skin and soft tissue; treated with broad-spectrum antibiotics
RATIONALE Necrotizing fasciitis is a bacterial infection caused by Streptococcus pyogenes, Staphylococcus aureus, or Clostridium perfringens. It affects skin and soft tissue,
rapidly destroying tissue (hence "flesh-eating"). Skin findings include fluid-filled blisters and severe pain disproportionate to appearance. Systemic involvement:
sepsis, shock, multi-organ failure. It is fatal in many cases despite treatment with broad-spectrum antibiotics and surgical debridement. This is distinct from viral
skin infections like chickenpox (VZV — itchy fluid-filled bumps) or smallpox (variola virus — deep, firm pustules).
2. Chickenpox and shingles are both caused by the Varicella-Zoster Virus (VZV). How do they differ in pathogenesis and presentation?
A. Chickenpox — reactivation of latent virus causing nerve pain; Shingles — primary infection with widespread rash
B. Chickenpox — primary infection causing widespread itchy rash with fluid-filled bumps; Shingles — reactivation of latent VZV causing painful localized rash in a
dermatomal distribution
C. Both are identical diseases with no differences
D. Chickenpox is bacterial; shingles is viral
CORRECT ANSWER B — Chickenpox: primary VZV infection, widespread itchy rash with fluid-filled bumps; Shingles: reactivation of latent VZV, painful dermatomal rash
RATIONALE Varicella-Zoster Virus (VZV/HHV-3) causes two distinct presentations: (1) Chickenpox — primary infection, typically in childhood, causing a widespread itchy
vesicular rash, mild fever, and fatigue. The virus then becomes latent in dorsal root ganglia. (2) Shingles (herpes zoster) — reactivation of latent VZV, typically in
older adults or immunocompromised, causing a painful, unilateral, dermatomal vesicular rash. Chickenpox is treated with antivirals and prevented by varicella
vaccine. Shingles is treated with antivirals; zoster vaccine is available. Smallpox (variola virus) progresses through macular → papular → vesicular → pustular
stages.
3. Measles (rubeola) is a viral infection with distinct clinical features. Which finding is pathognomonic (diagnostic) for measles?
A. Bull's eye rash at the site of a tick bite
B. Koplik spots — tiny white dots surrounded by a red ring on the oral mucosa
C. Painful vesicular rash in a dermatomal distribution
D. Deep, firm pustules beginning on the face and spreading downward
CORRECT ANSWER B — Koplik spots — tiny white dots surrounded by a red ring on the oral mucosa
RATIONALE Koplik spots are the pathognomonic enanthem of measles (rubeola) — tiny white dots surrounded by a ring of red appearing on the buccal mucosa before the
rash. Measles is a systemic viral infection: it begins in the respiratory tract, causes high fever, cough, conjunctivitis (pink eye), and then a flat rash spreading from
head downward. Prevention: MMR (measles, mumps, rubella) vaccine. Rubella (German measles) causes a milder rash with lymph node enlargement but can
cause severe fetal damage if contracted during pregnancy. Option A describes Lyme disease. Option C describes shingles. Option D describes smallpox.
, 4. Ocular trachoma is a leading cause of preventable blindness worldwide. It is caused by:
A. Neisseria gonorrhoeae — a sexually transmitted bacterium
B. Chlamydia trachomatis — causing chronic conjunctivitis leading to scarring, trichiasis, and blindness
C. Herpes simplex virus — causing corneal ulceration
D. Staphylococcus aureus — causing purulent conjunctivitis
CORRECT ANSWER B — Chlamydia trachomatis — chronic infection causing conjunctival scarring → trichiasis → blindness
RATIONALE Ocular trachoma is caused by Chlamydia trachomatis serovars A–C. It is a chronic follicular conjunctivitis that, after repeated infections, causes conjunctival
scarring → trichiasis (eyelashes turn inward) → corneal abrasion → opacity → blindness. Findings: eye discharge, irritation. Treatment: antibiotics (azithromycin).
It is the leading infectious cause of blindness globally, primarily in developing countries. This contrasts with meningitis (inflammation of meninges causing
headache, stiff neck, photophobia, fever, increased WBC in CSF) and Creutzfeldt-Jakob disease (prion disease causing rapid neurodegeneration, dementia, and
death).
5. Meningitis can be caused by bacteria, viruses, or fungi. Which of the following correctly identifies bacterial causes and treatment?
A. Caused only by viruses; treated with supportive care only
B. Bacterial causes: S. pneumoniae, L. monocytogenes, H. influenzae, N. meningitidis; treated with IV antibiotics; vaccines available (meningococcal, pneumococcal, Hib)
C. All meningitis is fungal and treated with antifungals
D. Meningitis only affects the skin and requires topical treatment
CORRECT ANSWER B — Bacterial causes: S. pneumoniae, L. monocytogenes, H. influenzae, N. meningitidis; IV antibiotics; vaccines available
RATIONALE Meningitis is inflammation of the meninges (brain and spinal cord coverings) that increases intracranial pressure. Bacterial causes include Streptococcus
pneumoniae, Listeria monocytogenes, Haemophilus influenzae, and Neisseria meningitidis. Viral meningitis is commonly caused by enteroviruses. Findings: light
sensitivity (photophobia), headache, painful/stiff neck, fever, and increased WBC in CSF. Treatment: IV antibiotics (bacterial) and antivirals (viral). Complications:
brain damage, hearing loss, death. Prevention: meningococcal, pneumococcal, and Hib vaccines. Multiple bacterial species can cause meningitis.
6. Creutzfeldt-Jakob disease (CJD) is caused by prions. What are its key characteristics?
A. Bacterial infection treated with broad-spectrum antibiotics
B. Infectious protein particles (prions) causing spongiform brain degeneration → rapidly progressive dementia, memory loss, poor coordination, personality changes; no
cure — supportive care only
C. Viral infection prevented by vaccination
D. Fungal infection treated with antifungals
CORRECT ANSWER B — Prions (infectious proteins) cause spongiform brain degeneration → rapidly progressive dementia; no cure — supportive care only
RATIONALE Creutzfeldt-Jakob disease (CJD) is caused by prions — misfolded infectious proteins that contain no nucleic acid (no DNA/RNA). They cause transmissible
spongiform encephalopathies characterized by sponge-like holes in brain tissue. Findings: rapidly progressive dementia, memory loss, poor coordination,
personality changes. There is NO cure — only supportive care. Outcome: severe dementia and death. Transmission: contaminated medical instruments, infected
meat (variant CJD from bovine spongiform encephalopathy). Prions are highly resistant to standard sterilization methods.
7. Rabies is a viral infection that causes encephalitis. What are its two clinical forms and treatment?
A. Only one form — mild fever that resolves spontaneously
B. Furious rabies (agitation, disorientation, seizures, hydrophobia) and Paralytic rabies (paralysis, disorientation); treated with post-exposure prophylaxis (vaccine +
immunoglobulin) before symptoms appear
C. Both forms are treated with antibiotics after symptoms develop
D. Rabies only affects animals and cannot infect humans
CORRECT ANSWER B — Furious rabies (agitation, seizures, hydrophobia) and Paralytic rabies (paralysis); post-exposure prophylaxis before symptoms
RATIONALE Rabies virus travels via peripheral nerves to the brain, causing fatal encephalitis. Two clinical forms: (1) Furious rabies — agitation, disorientation, seizures,
twitching, hydrophobia (fear of water); (2) Paralytic rabies — paralysis, disorientation. Both progress to coma and death from cardiac or respiratory arrest.
Treatment: post-exposure prophylaxis (rabies vaccine + rabies immune globulin) must be given BEFORE symptoms appear — once symptoms develop, the disease
is nearly always fatal. This illustrates why immediate treatment after animal bites is critical. Rabies affects the CNS (brain and spinal cord).
8. Tetanus and wound botulism are both caused by Clostridium species but produce opposite effects. Which statement correctly distinguishes them?
A. Tetanus — flaccid paralysis from blocked acetylcholine; Botulism — spastic paralysis from blocked inhibitory signals
B. Tetanus (C. tetani) — toxin blocks inhibitory signals → spastic paralysis (lockjaw/trismus, muscle rigidity, respiratory failure); Botulism (C. botulinum) — toxin blocks
acetylcholine release → flaccid paralysis (descending paralysis, respiratory failure)
C. Both produce identical types of muscle paralysis
D. Tetanus is viral; botulism is fungal
CORRECT ANSWER B — Tetanus: spastic paralysis (lockjaw, rigidity, "TIGHT"); Botulism: flaccid paralysis (descending, acetylcholine blockade)
RATIONALE Tetanus (Clostridium tetani): toxin blocks inhibitory neurotransmitter release → spastic paralysis. Mnemonic: tetanus = "TIGHT" — lockjaw (trismus), muscle
rigidity, opisthotonos (arched back), respiratory failure. Wound botulism (Clostridium botulinum): toxin blocks acetylcholine release at neuromuscular junctions
→ flaccid paralysis (descending, muscles cannot contract). Treatment: tetanus — tetanus immune globulin, wound care, DTaP/Tdap booster; botulism — wound
debridement, antibiotics, botulinum antitoxin. Both are Clostridium species causing opposite clinical presentations.
★ ★
Chamberlain University
C College of Nursing & Health Professions
J O U R N E Y T O E X T R A O R D I N A R Y CO M PA S S I O N AT E C A R E
EST. 1889
BIOS 242 — Fundamentals of Microbiology
CO M P R E H E N S I V E D I S E A S E R E V I E W · S K I N , C N S , R E S P I R ATO R Y, G I , SYST E M I C I N F E C T I O N S
INSTITUTION Chamberlain University COURSE CODE BIOS 242
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
RESOURCE TYPE Comprehensive Final Review / Practice Examination TOTAL QUESTIONS 25 Questions
COURSE TITLE Fundamentals of Microbiology FORMAT Multiple Choice — Select the Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ This comprehensive review covers skin infections, CNS diseases, respiratory infections, GI diseases, and systemic conditions.
▸ All content reflects BIOS 242 learning objectives for disease causation, presentation, and treatment.
▸ Correct answers and detailed rationales appear below each question for exam preparation purposes.
▸ Pay careful attention to causative agents, virulence factors, and distinguishing clinical features.
SECTION I — SKIN, CNS, RESPIRATORY, GI & SYSTEMIC INFECTIONS Questions 1 – 25
1. Necrotizing fasciitis is a rapidly progressive flesh-eating infection. Which of the following correctly identifies its causative agents and treatment?
A. Caused by a virus; treated with antivirals only
B. Caused by S. pyogenes, S. aureus, or C. perfringens; affects skin and soft tissue with systemic involvement (sepsis, shock, multi-organ failure); treated with broad-
spectrum antibiotics
C. Caused by fungi; treated with topical antifungals
D. Caused by prions; no treatment available
CORRECT ANSWER B — Caused by S. pyogenes, S. aureus, or C. perfringens; affects skin and soft tissue; treated with broad-spectrum antibiotics
RATIONALE Necrotizing fasciitis is a bacterial infection caused by Streptococcus pyogenes, Staphylococcus aureus, or Clostridium perfringens. It affects skin and soft tissue,
rapidly destroying tissue (hence "flesh-eating"). Skin findings include fluid-filled blisters and severe pain disproportionate to appearance. Systemic involvement:
sepsis, shock, multi-organ failure. It is fatal in many cases despite treatment with broad-spectrum antibiotics and surgical debridement. This is distinct from viral
skin infections like chickenpox (VZV — itchy fluid-filled bumps) or smallpox (variola virus — deep, firm pustules).
2. Chickenpox and shingles are both caused by the Varicella-Zoster Virus (VZV). How do they differ in pathogenesis and presentation?
A. Chickenpox — reactivation of latent virus causing nerve pain; Shingles — primary infection with widespread rash
B. Chickenpox — primary infection causing widespread itchy rash with fluid-filled bumps; Shingles — reactivation of latent VZV causing painful localized rash in a
dermatomal distribution
C. Both are identical diseases with no differences
D. Chickenpox is bacterial; shingles is viral
CORRECT ANSWER B — Chickenpox: primary VZV infection, widespread itchy rash with fluid-filled bumps; Shingles: reactivation of latent VZV, painful dermatomal rash
RATIONALE Varicella-Zoster Virus (VZV/HHV-3) causes two distinct presentations: (1) Chickenpox — primary infection, typically in childhood, causing a widespread itchy
vesicular rash, mild fever, and fatigue. The virus then becomes latent in dorsal root ganglia. (2) Shingles (herpes zoster) — reactivation of latent VZV, typically in
older adults or immunocompromised, causing a painful, unilateral, dermatomal vesicular rash. Chickenpox is treated with antivirals and prevented by varicella
vaccine. Shingles is treated with antivirals; zoster vaccine is available. Smallpox (variola virus) progresses through macular → papular → vesicular → pustular
stages.
3. Measles (rubeola) is a viral infection with distinct clinical features. Which finding is pathognomonic (diagnostic) for measles?
A. Bull's eye rash at the site of a tick bite
B. Koplik spots — tiny white dots surrounded by a red ring on the oral mucosa
C. Painful vesicular rash in a dermatomal distribution
D. Deep, firm pustules beginning on the face and spreading downward
CORRECT ANSWER B — Koplik spots — tiny white dots surrounded by a red ring on the oral mucosa
RATIONALE Koplik spots are the pathognomonic enanthem of measles (rubeola) — tiny white dots surrounded by a ring of red appearing on the buccal mucosa before the
rash. Measles is a systemic viral infection: it begins in the respiratory tract, causes high fever, cough, conjunctivitis (pink eye), and then a flat rash spreading from
head downward. Prevention: MMR (measles, mumps, rubella) vaccine. Rubella (German measles) causes a milder rash with lymph node enlargement but can
cause severe fetal damage if contracted during pregnancy. Option A describes Lyme disease. Option C describes shingles. Option D describes smallpox.
, 4. Ocular trachoma is a leading cause of preventable blindness worldwide. It is caused by:
A. Neisseria gonorrhoeae — a sexually transmitted bacterium
B. Chlamydia trachomatis — causing chronic conjunctivitis leading to scarring, trichiasis, and blindness
C. Herpes simplex virus — causing corneal ulceration
D. Staphylococcus aureus — causing purulent conjunctivitis
CORRECT ANSWER B — Chlamydia trachomatis — chronic infection causing conjunctival scarring → trichiasis → blindness
RATIONALE Ocular trachoma is caused by Chlamydia trachomatis serovars A–C. It is a chronic follicular conjunctivitis that, after repeated infections, causes conjunctival
scarring → trichiasis (eyelashes turn inward) → corneal abrasion → opacity → blindness. Findings: eye discharge, irritation. Treatment: antibiotics (azithromycin).
It is the leading infectious cause of blindness globally, primarily in developing countries. This contrasts with meningitis (inflammation of meninges causing
headache, stiff neck, photophobia, fever, increased WBC in CSF) and Creutzfeldt-Jakob disease (prion disease causing rapid neurodegeneration, dementia, and
death).
5. Meningitis can be caused by bacteria, viruses, or fungi. Which of the following correctly identifies bacterial causes and treatment?
A. Caused only by viruses; treated with supportive care only
B. Bacterial causes: S. pneumoniae, L. monocytogenes, H. influenzae, N. meningitidis; treated with IV antibiotics; vaccines available (meningococcal, pneumococcal, Hib)
C. All meningitis is fungal and treated with antifungals
D. Meningitis only affects the skin and requires topical treatment
CORRECT ANSWER B — Bacterial causes: S. pneumoniae, L. monocytogenes, H. influenzae, N. meningitidis; IV antibiotics; vaccines available
RATIONALE Meningitis is inflammation of the meninges (brain and spinal cord coverings) that increases intracranial pressure. Bacterial causes include Streptococcus
pneumoniae, Listeria monocytogenes, Haemophilus influenzae, and Neisseria meningitidis. Viral meningitis is commonly caused by enteroviruses. Findings: light
sensitivity (photophobia), headache, painful/stiff neck, fever, and increased WBC in CSF. Treatment: IV antibiotics (bacterial) and antivirals (viral). Complications:
brain damage, hearing loss, death. Prevention: meningococcal, pneumococcal, and Hib vaccines. Multiple bacterial species can cause meningitis.
6. Creutzfeldt-Jakob disease (CJD) is caused by prions. What are its key characteristics?
A. Bacterial infection treated with broad-spectrum antibiotics
B. Infectious protein particles (prions) causing spongiform brain degeneration → rapidly progressive dementia, memory loss, poor coordination, personality changes; no
cure — supportive care only
C. Viral infection prevented by vaccination
D. Fungal infection treated with antifungals
CORRECT ANSWER B — Prions (infectious proteins) cause spongiform brain degeneration → rapidly progressive dementia; no cure — supportive care only
RATIONALE Creutzfeldt-Jakob disease (CJD) is caused by prions — misfolded infectious proteins that contain no nucleic acid (no DNA/RNA). They cause transmissible
spongiform encephalopathies characterized by sponge-like holes in brain tissue. Findings: rapidly progressive dementia, memory loss, poor coordination,
personality changes. There is NO cure — only supportive care. Outcome: severe dementia and death. Transmission: contaminated medical instruments, infected
meat (variant CJD from bovine spongiform encephalopathy). Prions are highly resistant to standard sterilization methods.
7. Rabies is a viral infection that causes encephalitis. What are its two clinical forms and treatment?
A. Only one form — mild fever that resolves spontaneously
B. Furious rabies (agitation, disorientation, seizures, hydrophobia) and Paralytic rabies (paralysis, disorientation); treated with post-exposure prophylaxis (vaccine +
immunoglobulin) before symptoms appear
C. Both forms are treated with antibiotics after symptoms develop
D. Rabies only affects animals and cannot infect humans
CORRECT ANSWER B — Furious rabies (agitation, seizures, hydrophobia) and Paralytic rabies (paralysis); post-exposure prophylaxis before symptoms
RATIONALE Rabies virus travels via peripheral nerves to the brain, causing fatal encephalitis. Two clinical forms: (1) Furious rabies — agitation, disorientation, seizures,
twitching, hydrophobia (fear of water); (2) Paralytic rabies — paralysis, disorientation. Both progress to coma and death from cardiac or respiratory arrest.
Treatment: post-exposure prophylaxis (rabies vaccine + rabies immune globulin) must be given BEFORE symptoms appear — once symptoms develop, the disease
is nearly always fatal. This illustrates why immediate treatment after animal bites is critical. Rabies affects the CNS (brain and spinal cord).
8. Tetanus and wound botulism are both caused by Clostridium species but produce opposite effects. Which statement correctly distinguishes them?
A. Tetanus — flaccid paralysis from blocked acetylcholine; Botulism — spastic paralysis from blocked inhibitory signals
B. Tetanus (C. tetani) — toxin blocks inhibitory signals → spastic paralysis (lockjaw/trismus, muscle rigidity, respiratory failure); Botulism (C. botulinum) — toxin blocks
acetylcholine release → flaccid paralysis (descending paralysis, respiratory failure)
C. Both produce identical types of muscle paralysis
D. Tetanus is viral; botulism is fungal
CORRECT ANSWER B — Tetanus: spastic paralysis (lockjaw, rigidity, "TIGHT"); Botulism: flaccid paralysis (descending, acetylcholine blockade)
RATIONALE Tetanus (Clostridium tetani): toxin blocks inhibitory neurotransmitter release → spastic paralysis. Mnemonic: tetanus = "TIGHT" — lockjaw (trismus), muscle
rigidity, opisthotonos (arched back), respiratory failure. Wound botulism (Clostridium botulinum): toxin blocks acetylcholine release at neuromuscular junctions
→ flaccid paralysis (descending, muscles cannot contract). Treatment: tetanus — tetanus immune globulin, wound care, DTaP/Tdap booster; botulism — wound
debridement, antibiotics, botulinum antitoxin. Both are Clostridium species causing opposite clinical presentations.
