OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology | 2022 LATEST UPDATE

OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology Chapter 16: Disease and Epidemiology * = Correct answer Multiple Choice 1. Which term refers to the study of the geographic distribution of disease and its transmission? A. epidemiology* B. etiology C. morbidology D. pathology Difficulty: Easy ASM Standard: 23 2. Which term refers to the study of the cause of disease? A. epidemiology B. etiology* C. morbidology D. pathology Difficulty: Easy ASM Standard: 23 3. Tetanus, which is caused by Clostridium tetani, is an example of which type of disease? A. endemic B. epidemic C. pandemic D. sporadic* Difficulty: Easy ASM Standard: 23 4. Malarial disease in Brazil is an example of which type of disease? A. endemic* B. epidemic C. pandemic D. sporadic Difficulty: Easy ASM Standard: 23 5. Examine the map below. The color distribution on the map is best described as which type of disease? Page 1 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology A. endemic B. epidemic C. pandemic* D. sporadic Difficulty: Moderate ASM Standard: 23 6. Robert Koch was the first to conclusively determine the causative agent of which disease? A. anthrax* B. gonorrhea C. syphilis D. tuberculosis Difficulty: Easy ASM Standard: 23 7. Which of the following most specifically describes a notifiable disease? A. any disease caused by a prion B. any disease of public health importance* C. any disease that is highly infectious D. any disease with a high ID50 Difficulty: Easy ASM Standard: 23 8. Which of the following is not a notifiable disease? Page 2 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology A. giardiasis B. gonorrhea C. MRSA* D. Zika Difficulty: Moderate ASM Standard: 23 9. John Snow developed a detailed map (the “ghost map”) to investigate the etiology of which disease? A. anthrax B. botulism C. cholera* D. listeriosis Difficulty: Easy ASM Standard: 23 10. Which of the following is not an example of evidence used by John Snow to determine that cholera was being transmitted by water in London in the 1800s? A. a high frequency of cholera cases located near a water pump on Broad Street B. beer workers not contracting cholera because they drank beer rather than water C. microscopic examination of water* D. waste and sewage being dumped into the Thames River Difficulty: Hard ASM Standard: 23 11. Which researcher required that surgeons should use a 5% carbolic acid solution to clean surgical tools as a way to prevent the spread of disease? A. Alexander Fleming B. Robert Koch C. Joseph Lister* D. John Snow Difficulty: Easy ASM Standard: 14, 23 12. Which type of studies gathers data from past cases to study present-day cases? A. descriptive B. experimental C. perspective D. retrospective* Difficulty: Easy ASM Standard: 23 Page 3 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology 13. You are hired as an epidemiologist for the following study. You wish to determine if potato salad, served at a local farmer’s market a month ago, caused an outbreak of a food-borne illness. You specifically interview individuals who had eaten potato salad and developed the illness, as well as individuals who ate the potato salad and did not develop illness. Based on this description, which type of study was conducted? A. case-control* B. cohort method C. cross-sectional D. experimental Difficulty: Moderate ASM Standard: 23 14. You wish to determine if a new drug can cure individuals with colds caused by rhinoviruses. You invite 50 individuals to participate in the study. Using a double-blind approach, 25 individuals get a sugar pill and 25 get the test drug. Based on this description, which type of study was conducted? A. case-control B. cohort method C. cross-sectional D. experimental* Difficulty: Moderate ASM Standard: 23 15. Florence Nightingale’s 1958 book included graphs showing that many casualties she observed were due to which of the following? A. helminths contracted on the battlefield B. preventable infectious diseases* C. prions D. wounds sustained in combat action Difficulty: Easy ASM Standard: 23 16. How long does rhinovirus survive outside physiological fluids? A. Less than a day* B. Up to 48 hours C. Up to 72 hours D. Up to 1 week Difficulty: Easy ASM Standard: 23 17. Mary Mallon, aka Typhoid Mary, was which type of carrier? Page 4 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology A. asymptomatic* B. passive C. transient D. zoonotic Difficulty: Easy ASM Standard: 23 18. Who traced the typhoid outbreak of 1900–1915 to Mary Mallon? A. Edward Jenner B. Robert Koch C. John Snow D. George Soper* Difficulty: Moderate ASM Standard: 23 19. Listeria monocytogenes, the causative agent of listeriosis, can pass through the bloodplacenta barrier to infect a fetus. This type of transmission to the fetus is known as which of the following? A. droplet B. horizontal direct contact C. indirect contact D. vertical direct contact* Difficulty: Moderate ASM Standard: 23 20. Sexually transmitted diseases between sexually active partners are most commonly transmitted by which method? A. fomites B. horizontal direct contact* C. vehicles D. vertical direct contact Difficulty: Easy ASM Standard: 23 21. Which of the following is not a fomite? A. catheter B. nurse* C. scalpel D. syringe Difficulty: Easy ASM Standard: 23 Page 5 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology 22. Tuberculosis is typically transmitted via which of the following? A. air* B. food C. sexual activity D. water Difficulty: Easy ASM Standard: 23 23. A fruit fly lands on cow feces and then flies over to a bowl of watermelon being served at a farm picnic. The fruit fly in this example is which of the following? A. biological vector B. fomite C. mechanical vector* D. vehicle Difficulty: Easy ASM Standard: 23 24. Infected fleas that have the bacterium Yersinia pestis growing inside them are able to transmit plague. In this case, the infected fleas are best described as which of the following? A. biological vectors* B. fomites C. mechanical vectors D. vehicles Difficulty: Moderate ASM Standard: 23 25. Which agency monitors notifiable diseases in the United States? A. Centers for Disease Control and Prevention* B. Environmental Protection Agency C. Food and Drug Administration D. Homeland Security Difficulty: Easy ASM Standard: 23 26. SARS first occurred in ________, before becoming a(n) ________ disease. Choose the correct pair from the following. A. China, endemic B. China, pandemic* C. Ireland, endemic D. Ireland, pandemic Page 6 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology Difficulty: Moderate ASM Standard: 23 27. Which is the transmission mechanism for West Nile Virus? A. body-fluid contact B. droplets C. fomite D. vector* Difficulty: Easy ASM Standard: 23 28. The tsetse fly transmits which disease? A. African sleeping sickness* B. leishmaniasis C. malaria D. typhus Difficulty: Moderate ASM Standard: 23 29. Which of the following is true about modern emerging diseases? A. Malaria is an example of an emerging disease. B. They are diseases that increase in frequency after a period of decline. C. They are diseases that the WHO has classified as being poorly understood. D. They occur in both developing and developed countries.* Difficulty: Moderate ASM Standard: 3, 23 30. Which of the following statements about quarantine is false? A. Patients may be released from quarantine if preventive treatment can be administered. B. Public health authorities can quarantine patients for any diseases.* C. Quarantine facilities can be equipped with special air-handling methods such as HEPA filters. D. Quarantine times depend on the incubation period of the disease. Difficulty: Hard ASM Standard: 14, 23 True/False 31. The prevalence of HIV is generally higher than its incidence. Answer: True Difficulty: Moderate Page 7 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology ASM Standard: 23 32. Etiology is the study of the transmission of diseases. Answer: False Difficulty: Easy ASM Standard: 23 33. All etiologic agents are pathogens. Answer: False Difficulty: Hard ASM Standard: 23 34. Nosocomial infections can be acquired in hospital settings. Answer: True Difficulty: Easy ASM Standard: 23 35. In the 1800s, nosocomial diseases were prevalent. Answer: True Difficulty: Moderate ASM Standard: 23 36. In experimental epidemiological studies, study subjects are manipulated in some manner. Answer: True Difficulty: Easy ASM Standard: 28 37. Humans can be reservoirs for pathogens. Answer: True Difficulty: Moderate ASM Standard: 23 38. An individual with human papillomavirus (HPV) who has genital warts can transmit HPV to their partner via kissing on the lips. Answer: False Difficulty: Easy ASM Standard: 23 39. The WHO only monitors the prevalence of infectious diseases around the world. Page 8 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology Answer: False Difficulty: Easy ASM Standard: 31 40. Lyme disease is more prevalent in the northern hemisphere. Answer: True Difficulty: Easy ASM Standard: 23 Matching 41. Match the outbreak to its proper description. A. endemic i. A disease occurs relatively rarely, without a geographic focus. B. epidemic ii. A disease produces more cases than expected within a short time in a localized area. C. pandemic iii. A disease occurs at a relatively constant and often low level within a population. D. sporadic iv. A disease increases in frequency worldwide. Answers: A. iii., B. ii., C. iv., D. i. Difficulty: Easy ASM Standard: 23 42. Match the disease to the most appropriate description, choosing the best option for each disease to use each term once. A. AIDS i. endemic B. Creutzfeldt-Jakob disease ii. pandemic C. influenza during most winters iii. sporadic D. malaria in Brazil iv. epidemic Answers: A. ii., B. iii., C. iv., D. i. Difficulty: Moderate ASM Standard: 23 43. Match the type of spread to the best description. A. common-source spread i. transmitted from a single source to all individuals infected B. continuous-source spread ii. transmitted from a common source that operates for longer than the incubation time for a pathogen C. intermittent-source spread iii. occurs through direct or indirect person-to-person contact D. point-source spread iv. transmitted from a common source that operates for less than the incubation time of a pathogen E. propagated spread v. transmitted from a common source that operates sporadically Page 9 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology Answers: A. i., B. ii., C. v., D. iv., E. iii. Difficulty: Moderate ASM Standard: 23 44. Match the pathogen to the disease it causes. A. Borrelia burgdorferi i. African sleeping sickness B. Plasmodium falciparum ii. Lyme disease C. Rickettsia rickettsii iii. malaria D. Trypanosoma brucei iv. plague E. Yersinia pestis v. Rocky Mountain spotted fever Answers: A. ii., B. iii., C. v., D. i., E. iv. Difficulty: Moderate ASM Standard: 23 Fill in the Blank 45. Of 100,000 individuals exposed to a particular bacterial pathogen, 500 develop disease. Of the 500 individuals who develop the disease, 100 die. The morbidity rate is ________ cases per 100,000 people. Answer: 500 Difficulty: Moderate ASM Standard: 23 46. Of 100,000 individuals exposed to a particular bacterial pathogen, 500 develop disease. Of the 500 individuals who develop the disease, 100 die. The mortality rate is ________ per 100,000 people. Answer: 100 Difficulty: Moderate ASM Standard: 23 47. John Snow’s work on cholera showed that a water pump on Broad Street served as a ________ for the spread of infectious disease. Answer: common source Difficulty: Moderate ASM Standard: 23 48. Joseph Lister required surgeons to use ________ when washing hands and cleaning surgical tools as a means of reducing nosocomial infections. Answer: phenol (carbolic acid) Difficulty: Easy ASM Standard: 14, 23 Page 10 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology 49. ________ epidemiological studies are ones in which data are gathered from study participants through measurements. Answer: Observational Difficulty: Easy ASM Standard: 28, 31 50. A health-care provider who does not have signs or symptoms of disease and is not infected but transmits a pathogen from one patient to another is said to be a(n) ________ carrier. Answer: passive Difficulty: Easy ASM Standard: 23 51. During a parasitic pathogen’s lifecycle, it reaches sexual maturity in the ________ host. Answer: definitive Difficulty: Moderate ASM Standard: 14, 23 52. Transmission of pathogens via water, food, and/or air is known as ________ transmission. Answer: vehicle Difficulty: Easy ASM Standard: 20, 23 53. A ________ is used to isolate infected individuals to prevent further transmission of a particular pathogen. Answer: quarantine Difficulty: Easy ASM Standard: 14, 23 54. An infectious disease that caused a pandemic in western Africa in 2014–2015 is ________. Answer: Ebola hemorrhagic fever (or Ebola) Difficulty: Easy ASM Standard: 23 Short Answer 55. What does the field of epidemiology cover? Sample Answer: Epidemiology is the study of infectious disease distribution, timing, and transmission. Page 11 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology Difficulty: Easy ASM Standard: 23 56. Morbidity is dependent upon what two aspects of a disease? Sample Answer: prevalence and incidence Difficulty: Hard ASM Standard: 23 57. What is the difference between morbidity and mortality? Sample Answer: Morbidity refers to the state of being diseased, whereas mortality refers to death. Difficulty: Easy ASM Standard: 23 58. What information is reported in the CDC’s MMWR? Sample Answer: MMWR refers to the Morbidity and Mortality Weekly Report. This report contains the latest information on notifiable diseases. Information it presents can include the number of cases reported for the week, the median number of cases over a 52 weeks, and the cumulative number of cases over the year. Difficulty: Moderate ASM Standard: 31 59. What does it mean to say that a disease is spread from a point source? Sample Answer: When a disease spreads from a point source, there is a single source for all individuals infected. The source operates for a shorter time than the incubation period of the pathogen. Difficulty: Easy ASM Standard: 23 60. What is the difference between intermittent common-source spread and propagated spread of disease? Sample Answer: In intermittent common-source spread, there is a single source for all individuals infected. Infections can occur sporadically. In propagated spread, there is no single source. Transmission can occur either by direct or indirect contact between individuals. Difficulty: Moderate ASM Standard: 23 61. What is the difference between descriptive and analytical epidemiological studies? Page 12 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology Sample Answer: Descriptive studies gather information about a disease outbreak through interviews and examination of medical records. Analytical studies involve studying a carefully selected group of individuals. Difficulty: Moderate ASM Standard: 28, 31, 38 62. What is a cross-sectional observational study? Sample Answer: A cross-sectional study compares individuals affected by a disease or condition at a single point in time with those unaffected at the same point in time. Difficulty: Easy ASM Standard: 28 63. What is a double-blind study? Sample Answer: A study in which neither the participants nor the researchers know what treatment (if any) was given. Difficulty: Easy ASM Standard: 28 64. During which periods of disease progression can an active carrier transmit disease? Sample Answer: An active carrier can transmit disease during any or all stages of disease progression (i.e., incubation, prodromal, illness, decline, convalescence). Difficulty: Moderate ASM Standard: 23 65. While aboard a cruise ship, 10 passengers report having muscle pains, chills, and fever. They all drank from a water fountain located at the stern on the second floor of the ship. You immediately suspect they have Legionnaires disease. This disease is most commonly caused by Legionella pneumophila, which is normally found living within amoebae. From this scenario, identify the reservoir and source of L. pneumophila. Sample Answer: The reservoir is the amoebae and the source is the water fountain. (Students may say that water or cooling towers are the reservoir, based upon information found elsewhere, because reservoirs may be living or environmental). Difficulty: Easy ASM Standard: 23 66. Give an example of a way that a disease can be acquired through horizontal direct-contact transmission. Sample Answer: Answers may vary. Horizontal direct contact means direct contact between individuals other than mother to child (which is vertical direct contact). Examples of ways that diseases can be transmitted through horizontal direct-contact transmission include kissing, licking, and biting. Page 13 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology Difficulty: Moderate ASM Standard: 23 67. What is the difference between mechanical and biological vectors? Sample Answer: A live animal (other than a human) that transmits an infectious agent from one host to another is called a vector. Biological vectors actively participate in a pathogen’s life cycle. Mechanical vectors merely transport the infectious agent without being infected. Difficulty: Easy ASM Standard: 14, 23 68. How is the overuse of antibiotics contributing to the reemergence of some infectious diseases? Sample Answer: The overuse of antibiotics leads to the development of antibiotic-resistant bacteria. Diseases that can normally be treated with antibiotics are now becoming difficult to treat. Difficulty: Moderate ASM Standard: 3, 23 69. What is the definition of a nosocomial disease? Sample Answer: A nosocomial disease is a disease acquired in a hospital or other clinical setting. This disease must be different from the disease that originally required the patient to enter the clinical setting. Difficulty: Easy ASM Standard: NA Brief Essay Essay Question Rubric RATING Failing Below Average Competent Advanced Criteria for evaluati on Answer does not provide an argument. Answer contains inaccuracies. Writing is poor and contains numerous grammatical mistakes and misspellings. Answer fails to provide examples to support an argument. Writing is poor and grammatical errors are common. Answer is somewhat incoherent. Answer provides an argument with one or two examples that support it. Writing is acceptable for the college level but may contain one or two grammatical Answer clearly provides an argument with two or more excellent examples that support it; student makes the argument clearly and eloquently. Answer is well organized and Page 14 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology mistakes or misspellings. free of grammatical errors and misspellings. POINT VALUE 0 1 2 3 Assume rating/grading scale for the question ranges from 0 to 3 points 70. John Snow is considered the “father of epidemiology.” (a) Why is he considered to be the father of epidemiology instead of Robert Koch? (b) What etiological agent did John Snow determine? (c) How does this agent cause disease? (d) What was the reservoir and source of the agent? Sample Answer: Student answers may vary but should include components of the following. (a) Although Koch was the first to develop a method of identifying a pathogen as the causative agent of a disease (i.e., anthrax), the field of epidemiology also covers the geographic distribution and the mechanisms of transmission of disease. These were aspects that Koch did not determine when he developed his postulates. (b) John Snow investigated an outbreak of cholera in London in 1854. (c) Cholera is an enterotoxin produced by the gram-negative bacterium Vibrio cholerae. The toxin binds to intestinal epithelial cells, causing the production of cAMP. cAMP activates a chloride ion channel in the cell, resulting in the release of ions and an increase in the osmotic pressure of the intestinal lumen. Water will flow out of the cells, resulting in watery diarrhea. (d) Snow determined that the source of the cholera came from contaminated water from the Thames River. A high prevalence of cases was found near a water pump. Contaminated water is the reservoir for V. cholerae and its toxin. Difficulty: Hard ASM Standard: 23 71. You wish to determine whether a probiotic pill protects individuals against food-borne illnesses. Explain how you would develop a hypothetical, observational prospective cohort study to see if this is true. (You can assume that you already have clearance from your institution for this study involving human subjects.) Sample Answer: Student answers may vary but should include components of the following. The study the student is describing must be: - Observational: The epidemiologist cannot manipulate the subjects. Therefore, the study cannot be one in which the probiotic pill is given to any individual by the researcher. - Prospective: The epidemiologist must track individuals while they are taking the pill. Past use of the pill cannot be used in the study. - Cohort study: Subjects selected for the study must share a particular characteristic. Sample Study: Page 15 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology You wish to see if the pill is protective against food-borne illnesses in individuals between the ages of 30 and 40 years. You identify 50 people who self-report that they are currently taking the probiotic pill according to the manufacturer’s directions. The other 50 individuals report they do not take the pill. You conduct surveys once per month asking these individuals to report what they ate over the past month, how often they took the probiotic pill (regardless of their original treatment group), and whether they experienced symptoms of food-borne illness (using a checklist). Difficulty: Moderate ASM Standard: 28 72. Please note this question has two parts, A and B. You are working for the CDC when a report comes in that individuals on a camping trip have acquired Lyme disease. You are told all the patients have fever, chills, headaches, and muscle aches. They all have a rash (see below). The graph below shows the number of cases of Lyme disease occurring over 20 years. (credit “photo”: modification of work by Centers for Disease Control and Prevention) A. Based on the information provided, briefly describe Lyme Disease. Your essay should discuss the following: 1. What is the causative agent of Lyme disease? 2. How is Lyme disease transmitted (i.e., is it person-to person, contact, vehicle, or vector transmission)? 3. Identify the sign(s) the patients are presenting for Lyme disease. 4. Identify the symptom(s) the patients are presenting for Lyme disease. 5. Is Lyme disease an emerging or re-emerging disease? Be sure to explain why or why not, based on the data presented in the graph. When you arrive at the hospital where the campers are being cared for, you wish to set up an epidemiological study to determine where the outbreak of Lyme disease is occurring. The campers have been going around to different campsites for the past 2 weeks and they are unsure when they first began to feel unwell. B. Discuss how you would set up an observational epidemiological study to determine where the campers may have acquired Lyme disease. Be sure to explain what type of observational study you would choose (i.e., retrospective or prospective) and why. What information would you want to collect to answer your question? Page 16 of 17 OpenStax Microbiology Test Bank Chapter 16: Disease and Epidemiology Sample answer: Student answers may vary but should include components of the following. Part A: 1. Lyme disease is caused by the bacterium Borrelia burgdorferi. 2. It is transmitted from mammal reservoirs to humans by tick vectors. 3. Signs can be identified by a health-care provider. In this case, they are fever and rash. 4. Symptoms can only be identified by the patient themselves. Symptoms listed in this scenario are chills, headaches, and muscle aches. 5. The graph suggests that Lyme disease is an emerging disease. The definition of an emerging disease is a disease that is either new to the human population or has shown an increase in prevalence in the previous 20 years. The data show the number of cases increasing in the past 20 years. Part B: Before beginning the study, you would need a list of the locations the campers have visited. You could then develop a retrospective study in which you identify individuals who have visited the different campsites these patients have visited. You can then collect data on their medical history to see if they developed Lyme disease. If they did, then you could trace it back to which campsite has the infected ticks. Alternatively, a prospective study could be designed. You could follow campers visiting each of the campsites and monitor if they acquire Lyme disease during the course of the study. You would need to take a medical history of each camper before they visit the campsite. In both cases, you would want to look for the same signs and symptoms that the original campers had. Difficulty: Moderate ASM Standard: 28 This file is copyright 2017, Rice University. All rights reserved. Page 17 of 17