OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections | LATEST UPDATE

T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 1 of 15 Chapter 23: Urogenital System Infections * = Correct answer Multiple Choice 1. What is a glomerulus? A. a capillary bed that contacts a nephron* B. a connecting duct in the urinary system C. a part of the urinary bladder D. the part of the nephron that drains into the ureter Difficulty: Easy ASM Standard: N/A 2. Urine leaves the urinary bladder through which structure? A. collecting duct B. meatus C. ureter D. urethra* Difficulty: Easy ASM Standard: N/A 3. What tube(s) in the male reproductive system transfer(s) sperm to the vas deferens? A. the epididymis* B. the prostate C. the seminal tubules D. the seminal vesicles Difficulty: Easy ASM Standard: N/A 4. Which of the following refers to inflammation of the bladder? A. cystitis* B. glomerulonephritis C. orchitis D. pyelonephritis Difficulty: Easy ASM Standard: N/A 5. Which of the following is typically true of the kidneys? A. They are colonized by Candida spp. B. They are colonized by lactobacilli. C. They are colonized by staphylococci. D. They are colonized by no normal microbiota.* TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 2 of 15 Difficulty: Easy ASM Standard: 23, 24 6. Which refers to dysuria? A. bladder pain B. painful urination* C. production of urine that contains blood D. production of urine that contains pus Difficulty: Easy ASM Standard: N/A 7. In the United States, which sexually transmitted infection is especially common in individuals between the ages of 15 and 24 years? A. chlamydia B. gonorrhea* C. HIV/AIDs D. syphilis Difficulty: Easy ASM Standard: 23 8. Which condition occurs when the normal vaginal microbiota is unbalanced but there is no inflammation? A. bacterial vaginitis B. bacterial vaginosis* C. chancroid D. pelvic inflammatory disease Difficulty: Easy ASM Standard: 22 23, 24 9. Which of the following STIs is caused by a protozoan? A. chlamydia B. genital warts C. herpes D. trichomoniasis* Difficulty: Easy ASM Standard: 23 10. Which of the following is not a function of the urinary system? A. excreting wastes B. filtering blood C. producing urea* TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 3 of 15 D. regulating the balance of salt and water in the body Difficulty: Moderate ASM Standard: 23, 24 11. In most women, which is the most common acid-producing bacterial genus in the vagina? A. Lactobacillus* B. Megasphaera C. Pseudomonas D. Staphylococcus Difficulty: Moderate ASM Standard: 23, 24 12. Which of the following does not contribute to nonspecific immune defense against vaginal infections? A. The normal microbiota decreases estrogen levels that enhance microbial growth.* B. The normal microbiota outcompetes other microbes for binding sites and nutrients. C. The normal microbiota produces an acidic environment that inhibits microbial growth. D. The normal microbiota produces hydrogen peroxide and bacteriocins. Difficulty: Moderate ASM Standard: 22 23, 24 13. What are the two most common causative agents of pelvic inflammatory disease? A. Escherichia coli and Proteus vulgaris B. Group B Streptococcus and Neisseria gonorrhoeae C. Lactobacillus spp. and Escherichia coli D. Neisseria gonorrhoeae and Chlamydia trachomatis* Difficulty: Moderate ASM Standard: 23 14. If a urinary dipstick shows the presence of nitrite, which bacteria would most likely be present because of their ability to convert nitrate to nitrite? A. Escherichia coli or Klebsiella pneumoniae* B. Klebsiella pneumoniae or Staphylococcus saprophyticus C. Neisseria gonorrhoeae or Streptococcus agalactiae D. Streptococcus pyogenes or Chlamydia trachomatis Difficulty: Moderate ASM Standard: N/A 15. Half of all cases of leptospirosis in the United States are found in which state? A. Alaska B. Florida TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 4 of 15 C. Hawaii* D. Texas Difficulty: Moderate ASM Standard: N/A 16. Which of the following is not a major cause of nongonococcal urethritis? A. Chlamydia trachomatis B. Mycoplasma genitalium C. Treponema pallidum* D. Ureaplasma urealyticum Difficulty: Moderate ASM Standard: 23 17. The most common treatment for nongonococcal urethritis involves which of the following? A. azithromycin and penicillins B. azithromycin and tetracyclines, unless resistance is present* C. cephalosporins and tetracyclines, unless resistance is present D. fluoroquinolones and trimethoprim/sulfamethoxazole Difficulty: Moderate ASM Standard: 14, 23 18. Vaginolysin, a toxin that damages red blood cells and vaginal epithelial cells, is produced by which pathogen? A. Bacteroides sp. B. Fusobacterium sp. C. Gardnerella vaginalis* D. Lactobacillus sp. Difficulty: Moderate ASM Standard: 23 19. Which of the following describes clue cells? A. epithelial cells with attached bacterial cells; associated with bacterial vaginosis* B. epithelial cells with damaged cell membranes; associated with nongonococcal urethritis C. lysed epithelial cells; associated with nongonococcal urethritis D. lysed epithelial cells found within the urinary tract during urinary tract infections Difficulty: Moderate ASM Standard: 23 20. Which symptom is not commonly associated with chronic gonorrhea in women? A. amenorrhea (lack of menstruation)* B. increased menstrual flow TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 5 of 15 C. pelvic pain D. vaginal discharge Difficulty: Moderate ASM Standard: N/A 21. Due to antibiotic resistance, which of the following is the preferred first treatment for gonorrhea? A. cephalosporins* B. fluoroquinolones C. penicillins D. tetracyclines Difficulty: Moderate ASM Standard: 7, 14 22. Which of the following is not associated with chlamydial infections? A. cystitis* B. increased risk of cervical cancer C. orchitis D. salpingitis Difficulty: Moderate ASM Standard: N/A 23. For which infection is routine screening recommended for women younger than age 25 years, beginning prenatal care, or considered to be at high risk? A. bacterial vaginosis B. chancroid C. chlamydia* D. syphilis Difficulty: Moderate ASM Standard: 23 24. Haemophilus ducreyi causes which condition? A. chancroid* B. chlamydia C. syphilis D. urethritis Difficulty: Easy ASM Standard: 23 25. Systemic herpes infections are best detected using which method? A. cultures TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 6 of 15 B. examination for cytopathic effects C. immunostaining D. PCR techniques* Difficulty: Moderate ASM Standard: N/A 26. What are condylomata acuminata? A. abundant lesions caused by HSV-2 B. fleshy pink growths caused by HPV infection* C. rounded, sometimes purulent, lesions caused by Treponema pallidum D. viruses that cause warts to develop Difficulty: Difficult ASM Standard: 23 27. What test is commonly used to combine HPV and Pap testing, in addition to methods that may be used separately to detect HPV? A. ELISA B. LBC* C. NAAT D. PCR Difficulty: Difficult ASM Standard: N/A 28. Trichomonas vaginalis is found as which of the following? A. a cyst only B. a trophozoite only* C. a trophozoite or as a cyst D. an intracellular parasite only Difficulty: Difficult ASM Standard: 23 29. Trichomonas vaginalis consumes other microbes. What effect does this have? A. By consuming other pathogens, it reduces the overall microbial load. B. By consuming other pathogens, it reduces the risk of coinfection. C. By consuming the normal microbiota, it causes an imbalance that increases the risk of infection.* D. By consuming the normal microbiota, it exhausts its food source and dies. Difficulty: Difficult ASM Standard: 23, 24 TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 7 of 15 30. NAAT testing is preferred over evaluation of wet mounts for the diagnosis of trichomoniasis because NAAT is which of the following? A. less expensive than using wet mounts B. less likely to cause adverse effects to the patient than are wet mounts C. more convenient than using wet mounts D. more sensitive than using wet mounts* Difficulty: Difficult ASM Standard: 34 31. How can primary and secondary syphilis be distinguished? A. The presence of a hard chancre lesion indicates primary syphilis, whereas lesions of the skin and mucous membranes are found in secondary syphilis.* B. The presence of a localized, soft chancre lesion indicates primary syphilis, whereas secondary syphilis is associated with damage to the nervous system. C. The presence of localized, soft lesions indicates primary syphilis, whereas systemic disease with lesions throughout the body is associated with secondary syphilis. D. The presence of more severe, more painful symptoms indicates primary syphilis, whereas secondary syphilis is less noticeable until tertiary syphilis develops. Difficulty: Difficult ASM Standard: 23 32. Tinidazole is a recommended treatment for which disease? A. human papillomavirus B. syphilis C. trichomoniasis* D. vaginosis Difficulty: Difficult ASM Standard: 14 33. HPV is extremely common and can be associated with genital warts, vaginal cancer, vulvar cancer, penile cancer, and anal cancer. How can it be so common with many infected people not realizing they have been infected? A. Infections are often asymptomatic although they generally persist throughout life. B. Infections are often asymptomatic and clear without treatment.* C. Infections generally cause mild symptoms although they generally persist throughout life. D. Infections generally produce variable symptoms and are difficult to diagnose, even when suspected. Difficulty: Difficult ASM Standard: N/A True/False TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 8 of 15 34. In treating urethritis, it is important to consider that N. gonorrhoeae and C. trachomatis are often both present and must both be treated. Answer: True Difficulty: Easy ASM Standard: 14, 23 35. Mycoplasma hominis, M. genitalium, and Ureaplasma urealyticum are rarely present in the microbiota of individuals without symptoms of urethritis. Answer: False Difficulty: Easy ASM Standard: N/A 36. Lack of a cell wall means penicillins are ineffective against Mycoplasma genitalium. Answer: True Difficulty: Moderate ASM Standard: 7, 14 37. Chlamydia often does not cause symptoms. Answer: True Difficulty: Moderate ASM Standard: N/A 38. Herpes can be passed from mother to fetus, causing neonatal herpes. Answer: True Difficulty: Moderate ASM Standard: 23 39. Lesions must be present in the birth canal for a mother to transmit herpes to a neonate. Answer: False Difficulty: Moderate ASM Standard: 14, 23 40. All HPV strains are associated with both genital warts and cervical cancer. Answer: False Difficulty: Moderate ASM Standard: 23 41. HPV vaccination protects against all strains of HPV that can cause cervical cancer. Answer: False TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 9 of 15 Difficulty: Difficult ASM Standard: 14, 23 42. There is no way to conclusively determine whether an individual has candidiasis because Candida is found in the normal microbiota. Answer: False Difficulty: Moderate ASM Standard: 23, 24 Matching 43. Match each type of inflammation with the affected structure. A. cystitis i. inflammation of the urethra B. orchiditis ii. inflammation of the bladder C. pyelonephritis iii. inflammation of the fallopian tubes D. salpingitis iv. inflammation of the testicle E. urethritis v. inflammation of the kidney Answers: A. ii., B. iv., C. v., D. iii., E. i. Difficulty: Easy ASM Standard: 23 44. Match each pathogen with the best description (bacterial, fungal, protozoal, or viral). A. Candida albicans i. bacterial B. Chlamydia trachomatis ii. fungal C. HSV-2 iii. protozoal D. Trichomonas vaginalis iv. viral Answers: A. ii., B. i., C. iv., D. iii. Difficulty: Moderate ASM Standard: 23 45. Match each disease with the common causative agent. A. bacterial vaginosis i. Haemophilus ducreyi B. cervical cancer ii. Gardnerella vaginalis C. chancroid iii. HPV D. syphilis iv. Treponema pallidum E. yeast infection v. Candida albicans Answers: A. ii., B. iii., C. i., D. iv., E. v. Difficulty: Moderate ASM Standard: 23 46. Match each disease with the best treatment. A. bacterial vaginosis i. azithromycin, ceftriaxone, erythromycin, ciprofloxacin TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 10 of 15 B. chancroid ii. azithromycin and ceftriaxone but not erythromycin or ciprofloxacin C. chlamydia iii. penicillin G, tetracycline, doxycycline D. gonorrhea iv. clindamycin, metronidazole, tinidazole E. syphilis v. azithromycin, doxycycline, erythromycin, ofloxacin, levofloxacin Answers: A. iv., B. i., C. v., D. ii., E. iii. Difficulty: Difficult ASM Standard: 7, 14, 23 47. Match each disease with the best diagnostic approach. A. bacterial vaginosis i. testing from a sample obtained during a Pap smear with LBC B. herpes ii. vaginal smear with DNA probe, sialidase assay, and Gram staining; use of Amsel’s diagnostic criteria C. human papillomavirus iii. wet mounts, NAATs, Affirm VPII Microbial Identification Test, and OSOM Rapid Test D. trichomoniasis iv. culture from lesions, immunostaining of cultures, PCR, or ELISA; PCR is especially valuable for systemic infections Answers: A. ii., B. iv., C. i., D. iii. Difficulty: Difficult ASM Standard: 23 Fill in the Blank 48. Another word for vesicles is ________. Answer: blisters Difficulty: Easy ASM Standard: N/A 49. Bacterial vaginosis is associated with a(n) ________ in vaginal pH. Answer: increase Difficulty: Easy ASM Standard: 22, 23 50. The two main categories of bacterial urethritis are ________ and ________. Answer: gonococcal, nongonococcal Difficulty: Moderate ASM Standard: N/A 51. A gonorrhea infection may enter the bloodstream. This results in ________, which is a bacterial infection of the blood. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 11 of 15 Answer: bacteremia Difficulty: Moderate ASM Standard: 23 52. The pathogen that is the major protozoan cause of urinary tract infections is ________. Answer: Trichomonas vaginalis Difficulty: Easy ASM Standard: 23 53. Exposure to contaminated water can lead to a bacterial kidney infection called ________. Answer: leptospirosis Difficulty: Moderate ASM Standard: 23 54. Nervous system damage can occur in ________ syphilis. Answer: tertiary Difficulty: Moderate ASM Standard: 23 55. Soft chancres are a symptom of ________, an infection of the reproductive tract. Answer: chancroid Difficulty: Moderate ASM Standard: 23 56. Candida is a dimorphic fungus, so the formation of ________ and pseudohyphae from germ tubes after cultivation can be used for diagnosis. Answer: chlamydospores Difficulty: Difficult ASM Standard: 23 57. ________ may be chronic or acute and can develop after S. pyogenes infection. Answer: Glomerulonephritis Difficulty: Moderate ASM Standard: 23 Short Answer 58. Why are the urinary and reproductive systems generally more prone to infections than are other body systems? TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 12 of 15 Sample Answer: The urinary and reproductive tracts are open to the external environment, increasing the risk of infection. Difficulty: Easy ASM Standard: 23, 24 59. Describe the pathway urine takes from the kidney until it leaves the body. Sample Answer: Urine is produced in the nephrons of the kidneys and drains from the kidney through the ureter. It travels through the ureter to the urinary bladder, then through the urethra to leave the body. Difficulty: Easy ASM Standard: N/A 60. What is the difference between vaginitis and vaginosis? Sample Answer: Vaginitis is a general term used to refer to any vaginal inflammation, whereas vaginosis refers to an imbalance in the normal vaginal microbiota without inflammation. Difficulty: Moderate ASM Standard: 23 61. What is intermenstrual bleeding? Sample Answer: Intermenstrual bleeding is bleeding that occurs between normal periods of menstruation; this suggests a possible infection. Difficulty: Easy ASM Standard: 23, 24 62. Why is it better to diagnose bacterial vaginosis using examination of vaginal secretions instead of bacterial culture? Sample Answer: Because the most common causative agent, Gardnerella vaginalis, is commonly found in healthy women, its presence in culture is not diagnostic of bacterial vaginosis. Difficulty: Moderate ASM Standard: 23, 24 63. How does disruption of the normal microbiota lead to bacterial vaginosis? Sample Answer: When the normal lactobacilli are disrupted through factors such as hormonal changes, the pH of the vagina increases, along with the risk of bacterial vaginosis. Difficulty: Moderate ASM Standard: 22, 23 64. What types of systemic effects can STIs have? TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 13 of 15 Sample Answer: In addition to affecting the urogenital system, STIs can cause a wide range of systemic effects. For example, tertiary syphilis affects the nervous system, gonorrhea can cause bacteremia, and HPV can lead to the development of cancer. Difficulty: Moderate ASM Standard: 23 65. What are some symptoms of cystitis? Sample Answer: Cystitis is associated with dysuria, bladder pain, hematuria, and pyuria. Difficulty: Moderate ASM Standard: N/A 66. It is often important to obtain a “clean catch” of urine to test for infection. How is a clean catch obtained? Sample Answer: The penis of male patients and both the urethral opening and labia of female patients are washed before sample collection and the first part of the urine flow is discarded. Difficulty: Moderate ASM Standard: 23, 24 67. What complications can develop in elderly patients who develop cystitis? Sample Answer: Elderly patients often develop potentially serious complications, including kidney infections and sepsis. Difficulty: Moderate ASM Standard: N/A 68. What culture medium is used to culture a urine specimen? Sample Answer: MacConkey agar and blood agar are generally used to culture urine specimens. Difficulty: Moderate ASM Standard: 23 69. Why is it important to do blood cultures when evaluating patients with pyelonephritis? Sample Answer: The pathogens may spread through the blood, requiring immediate treatment. Difficulty: Moderate ASM Standard: 14, 23 70. How can Streptococcus pyogenes infection potentially cause glomerulonephritis? Sample Answer: When S. pyogenes antigens are in the blood, immune complexes form between these and antibodies. These immune complexes become lodged in the glomeruli and the resulting immune response causes damage to the kidneys. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 14 of 15 Difficulty: Difficult ASM Standard: 23 71. How is leptospirosis generally diagnosed? Sample Answer: The fastest methods for diagnosis involve using PCR, ELISA, indirect immunofluorescence, and slide agglutination. Difficulty: Moderate ASM Standard: 23 72. What virulence factors does C. trachomatis have? Sample Answer: C. trachomatis has a range of virulence factors. These include stress response proteins, polymorphic outer-membrane autotransporter proteins, and type III secretion effectors. Difficulty: Moderate ASM Standard: 23 Brief Essay Essay Question Rubric RATING Failing Below Average Competent Advanced Criteria for evaluation 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 mistakes or misspellings. 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 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. 73. Explain how bacterial vaginosis can be diagnosed, including Amsel’s diagnostic criteria. Answer: Student answers will vary but should include the following. Culturing is not effective because the causative agents are common in the normal microbiota. Instead, vaginal secretions should be examined using a DNA probe, a sialidase assay, or microscopic examination. Clue cells are an important potential diagnostic feature. Amsel’s diagnostic criteria include at least three of the four following criteria: white to yellow discharge, a fishy odor (especially if 10% KOH is added), a pH higher than 4.5, and the presence of clue cells. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 23: Urogenital System Infections Page 15 of 15 Difficulty: Moderate ASM Standard: 23 74. Why is N. gonorrhoeae urethritis sometimes difficult to treat? Answer: Student answers will vary but should include the following. There are two major considerations. The first is that antibiotic resistance has been a problem with this species, leading to a shift to cephalosporins for treatment. The second is that N. gonorrhoeae often occurs along with C. trachomatis and treatment must effectively address both. The current recommendation is to use ceftriaxone and azithromycin. Difficulty: Moderate ASM Standard: 14, 23, 31 75. Explain how the virulence factors of Ureaplasma urealyticum increase its ability to cause disease. Answer: Student answers will vary but should include the following. Ureaplasma urealyticum produces phospholipases that damage target cell plasma membranes, immunoglobulin α proteases that protect against host antibodies, and other substances. Immunoglobulin α also produces hydrogen peroxide that can damage target cell membranes. Other possible virulence factors include multiple banded antigen and urease. Difficulty: Moderate ASM Standard: 23 76. Discuss how antibiotic resistance affects treatment recommendations and what can be done to deal with resistance. Answer: Student answers will vary but should include the following. Students should provide examples of how antibiotic recommendations have changed for some pathogens because of resistance. Additionally, students should mention the general concepts of the following recommendations for antibiotic use: completing courses of antibiotics and using multiple antibiotic agents when needed. One potential example would be the common co-occurrence of N. gonorrhoeae and C. trachomatis, meaning that both should be treated simultaneously. Another example is the increasing U. urealyticum resistance to tetracyclines, meaning that fluoroquinolones are increasingly used instead. Difficulty: Difficult ASM Standard: 14, 23, 31 This file is copyright 2017, Rice University. All rights reserved. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER