BIO 251 REVIEWER EXAM 2020 – Nevada State College | BIO251 REVIEWER EXAM CHAPTER 13

BIO 251 REVIEWER EXAM 2020 – Nevada State College REVIEWER CHAPTER 13 1. Infection occurs when A) contaminants are present on the skin B) a person swallows microbes in/on food C) a person inhales microbes in the air D) pathogens enter and multiply in body tissues E) all of the choices are correct 2. All infectious diseases A) are contagious B) only occur in humans C) are caused by microorganisms or their products D) are caused by vectors E) involve viruses as the pathogen 3. Which is not terminology used for resident flora A) pathogenic flora B) normal flora C) indigenous flora D) normal microflora E) all of the choices are correct 4. Endogenous infectious agents arise from microbes that are A) in food B) the patient's own normal flora C) on fomites D) in the air E) transmitted form one person to another 5. The human body typically begins to be colonized by its normal flora: A) before birth, in utero B) during, and immediately after birth C) when a child first goes to school D) when an infant gets its first infectious disease E) during puberty 6. Resident flora are found in/on the A) skin B) mouth C) nasal passages D) large intestine E) all of the choices are correct 7. All of the following genera are considered resident flora of skin sites except A) Escherichia B) Staphylococcus C) Corynebacterium D) Micrococcus E) Mycobacterium 8. Resident flora of the intestines include: A) Streptococcus B) Bacteroides C) Staphylococcus D) Haemophilus E) all of the choices are correct 9. Which genus is resident flora of the mouth, large intestine, and, from puberty to menopause, the vagina? A) Lactobacillus B) Streptococcus C) Haemophilus D) Escherichia E) Mycobacterium 10. Which genus is the most common resident flora of mouth surfaces? A) Lactobacillus B) Streptococcus C) Haemophilus D) Escherichia E) Mycobacterium 11. The body site with resident flora that produces beneficial body products, including vitamin K and several other vitamins is the A) skin B) mouth C) large intestine D) vagina E) nasal passages 12. Virulence factors include all the following except A) capsules B) ribosomes C) exoenzymes D) endotoxin E) exotoxin 13. STORCH is an acronym that represents the most common A) genera of resident flora B) sexually transmitted diseases C) portals of entry D) vectors E) infections of the fetus and neonate 14. Microbial hyaluronidase, coagulase, and streptokinase are examples of A) adhesive factors B) exotoxins C) hemolysins D) antiphagocytic factors E) exoenzymes 15. Exotoxins are A) proteins B) only released after a cell is damaged or lysed C) antiphagocytic factors D) secretions that always target nervous tissue E) lipopolysaccharides 16. Enterotoxins are A) virulence factors B) toxins that target the intestines C) proteins D) exotoxins E) all of the choices are correct 17. Which is mismatched? A) fimbriae - adherence to substrate B) capsules - antiphagocytic factor C) coagulase - dissolve fibrin clots D) leukocidins - damage white blood cells E) hemolysins - damage red blood cells 18. The stage of an infectious disease when specific signs and symptoms are seen and the pathogen is at peak activity is A) prodromal stage B) convalescent stage C) incubation period D) period of invasion E) all of the choices are correct 19. The time from when pathogen first enters the body and begins to multiply, until symptoms first appear is the A) prodromal stage B) convalescent stage C) incubation period D) period of invasion E) all of the choices are correct 20. The initial, brief period of early, general symptoms such as fatigue and muscle aches, is the A) prodromal stage B) convalescent stage C) incubation period D) period of invasion E) all of the choices are correct 21. Which is mismatched? A) secondary infection - infection spreads to several tissue sites B) mixed infection - several agents established at infection site C) acute infection - rapid onset of severe, short-lived symptoms D) local infection - pathogen remains at or near entry site E) toxemia - pathogen's toxins carried by the blood to target tissues 22. The subjective evidence of disease sensed by the patient is termed A) syndrome B) symptom C) sign D) pathology E) inflammation 23. The objective, measurable evidence of disease evaluated by an observer is termed A) syndrome B) symptom C) sign D) pathology E) inflammation 24. Local edema, swollen lymph nodes, fever, soreness, and abscesses are indications of A) toxemia B) inflammation C) sequelae D) a syndrome E) latency 25. The study of the frequency and distribution of a disease in a defined population is A) pathology B) clinical microbiology C) medicine D) immunology E) epidemiology 26. The principal government agency responsible for tracking infectious diseases in the United States is A) Centers for Disease Control and Prevention B) World Health Organization C) National Institutes of Health D) United States Department of Agriculture E) Infection Control Committee 27. The number of new cases of a disease in a population over a specific period of time compared with the healthy population is the A) mortality rate B) morbidity rate C) incidence rate D) prevalence rate E) epidemic rate 28. A disease that has a steady frequency over time in a population is A) epidemic B) endemic C) pandemic D) sporadic E) chronic 29. The primary, natural habitat of a pathogen where it continues to exist is called the A) fomite B) carrier C) vector D) reservoir E) source 30. Someone who inconspicuously harbors a pathogen and spreads it to others is a A) fomite B) carrier C) vector D) reservoir E) source 31. An animal, such as an arthropod, that transmits a pathogen from one host to another is a A) fomite B) carrier C) vector D) reservoir E) source 32. An inanimate object that harbors and transmits a pathogen is a A) fomite B) carrier C) vector D) reservoir E) source 33. The intermediary object or individual from which the infectious agent is actually acquired is termed the: A) fomite B) carrier C) vector D) reservoir E) source 34. Reservoirs include A) humans B) animals C) soil D) water E) all of the choices are correct 35. A laboratory technologist splashed a blood specimen onto his face, eyes, nose, and mouth. This specimen was from an HIV positive patient. If this blood exposure leads to HIV infection in the technologist, the transmission route is A) direct B) fomite C) vehicle D) droplet nuclei E) aerosols 36. The dried residues of fine droplets from mucus or saliva that harbor and transmit pathogen are A) fomites B) aerosols C) mechanical vectors D) droplet nuclei E) biological vectors 37. Animals that participate in the life cycles of pathogens and transmit pathogens from host to host are A) fomites B) aerosols C) mechanical vectors D) droplet nuclei E) biological vectors 38. Nosocomial infections involve all the following except A) are only transmitted by medical personnel B) often involve the patient's urinary tract and surgical incisions C) the patient's resident flora can be the infectious agent D) Escherichia coli and staphylococci are common infectious agents E) medical and surgical asepsis help lower their occurrence 39. When would Koch's Postulates be utilized A) determination of the cause of a patient's illness in a hospital microbiology lab B) development of a new antibiotic in a pharmaceutical lab C) determination of the cause of a new disease in a microbiology research lab D) formulation of a vaccine against a new pathogen in a genetic engineering lab E) whenever the scientific method is used to investigate a microbiological problem 40. Most of the skin's resident flora are found in the uppermost, superficial layers of the epidermis. TRUE 41. Under certain circumstances, a person's resident flora can be opportunistic pathogens. TRUE 42. The virulence factors of a pathogen are established by how strong or weak a patient's body defenses are at the time of infection. TRUE 43. The Centers for Disease Control and Prevention assigns the most virulent microbes known to cause human disease to biosafety level 4. TRUE 44. A fetus can get an infection when a pathogen in the mother's blood is capable of crossing the placenta to the fetal circulation and tissues. TRUE 45. When an infected person is in the incubation period, that person cannot transmit the pathogen to others. FALSE 46. Septicemia means that a pathogen is present and multiplying in the blood. TRUE 47. Fomites, food, and air serve as indirect transmission routes of pathogens. TRUE 48. Leukopenia is the _____ in the level of white blood cells in a patient. REUDCTION 49. A _____ is an infection indigenous to animals that can, on occasion, be transmitted to humans. VECTOR 50. _____ carriers are shedding and transmitting pathogen while they are recovering from an infectious disease. CONVALESCENT 51. A _____ is the presence of small numbers of bacteria in the blood. BACTEREMIA 52. _____ are toxins that are the lipopolysaccharide of the outer membrane of gram negative cell walls. ENDOTOXINS 53. _____ are various bacterial enzymes that dissolve fibrin clots. BACTERIAL KINASES 54. The total number of deaths in a population due to a disease is the _____ rate. MORTALITY 55. _____ are a set of criteria used to identify and link a specific microorganism as the etiologic agent of a new infectious disease. KOCH’S POSTULATE 56. The bone marrow is where A. immune responses to antigen occur. B. blood stem cells give rise to immature lymphocytes. C. antigen is filtered from the blood. D. antigen is filtered from tissue fluid. E. T lymphocytes complete maturation. 57. The progeny cells of a B-cell clone are called A. antibodies. B. sensitized T cells. C. activated macrophages. D. plasma cells. E. Bursa cells. 58. Helper T cells A. secrete antibodies. B. function in allergic reactions. C. directly destroy target cells. D. suppress immune reactions. E. activate B cells and other T cells 59. Plasma cells A. secrete antibodies. B. function in allergic reactions. C. directly destroy target cells. D. suppress immune reactions. E. activate B cells and other T cells 60. Cell surface markers involved in immune reactions A. are the result of genetic expression. B. function in recognition of self molecules. C. receive and transmit chemical messages among other cells of the system. D. aid in cellular development. E. all of the choices are correct. 61. The major histocompatability complex is A. a group of blood vessels that protects the nervous system. B. a set of genes that code for MHC cell receptors. C. also known as the complement system. D. located in the thymus gland. E. all of the choices are correct. 62. Class II MHC genes code for A. certain secreted complement components. B. self receptors recognized by natural killer cells. C. all HLA antigens. D. receptors located primarily on macrophages, dendritic cells, and B cells. E. all of the choices are correct. 63. Class I MHC genes code for A. certain secreted complement components. B. markers that display unique characteristics of self. C. all HLA antigens. D. receptors located primarily on macrophages and B cells. E. all of the choices are correct. 64. Lymphocytes: A. possess MHC antigens for recognizing self. B. have membrane receptors that recognize foreign antigens. C. gain tolerance to self by destruction of lymphocytes that could react against self. D. develop into clones of B and T cells with extreme variations of specificity. E. all of the choices are correct. 65. The monomer subunit of immunoglobulin molecules has all the following, except A. two identical heavy polypeptide chains. B. two identical light polypeptide chains. C. disulfide bonds between polypeptide chains. D. four antigen binding sites. E. a variable and constant region on each polypeptide chain. 66. The region of each antibody molecule where amino acid composition is very different from one clone of B lymphocytes to another is the A. variable region. B. joining region. C. constant region. D. light region. E. hinge region. 67. Lymphocyte maturation involves A. hormonal signals that initiate development. B. B cells maturing in bone marrow sites. C. T cells maturing in the thymus. D. release of mature lymphocytes to begin migration to various lymphoid organs. E. all of the choices are correct. 68. Properties of effective antigens include all the following, except A. foreign to the immune system. B. molecular complexity. C. large molecules with a minimum molecular weight of 1,000. D. large polymers made up of repeating subunits. E. cells or large, complex molecules. 69. The molecular fragment on an antigen molecule that a lymphocyte recognizes and responds to is called a/an A. epitope. B. hapten. C. antigen binding site. D. variable region. E. None of the choices are correct. 70. Small foreign molecules that are too small by themselves to elicit an immune response are termed A. antigenic determinant. B. hapten. C. antigen binding site. D. variable region. E. None of the choices are correct. 71. Superantigens are A. body tissues that the immune system mistakes as foreign. B. cell markers found in some member of a species but not in other members. C. bacterial toxins that activate T cells at a 100 times greater rate than other antigens. D. those that evoke allergic reactions. E. None of the choices are correct. 72. Antigen presenting cells A. include dendritic cells. B. include macrophages. C. engulf and modify antigen to be more immunogenic. D. hold and present processed antigen on their cell membrane surface. E. All of the choices are correct. 73. T cell response to T-cell-dependent antigens requires A. typically a protein antigen. B. binding of T cell to a Class II MHC receptor on an antigen-presenting cell. C. binding of T cell to a site on the antigen. D. interleukin-1 activating the T helper cell. E. All of the choices are correct. 74. Which is incorrect about the Fc region of an immunoglobulin? A. It determines the antibody's distribution in the body. B. It forms the antigen binding sites. C. It contains an effector molecule that can bind to cells such as macrophages and mast cells. D. It contains an effector molecule that can fix complement. E. It determines the class to which the immunoglobulin belongs. 75. Which process involves antibodies covering surface receptors on a virus or toxin molecule thereby disrupting their activity? A. Neutralization B. Opsonization C. Complement fixation D. Agglutination E. Anamnestic response 76. Which process involves antibodies cross-linking cells or particles into large aggregates? A. Neutralization B. Opsonization C. Complement fixation D. Agglutination E. Anamnestic response 77. Which process involves antibodies coating microorganisms in order to facilitate phagocytosis? A. Neutralization B. Opsonization C. Complement fixation D. Agglutination E. Anamnestic response 78. Which process involves a more rapid synthesis and greatly increased titer of antibody when the immune system is subsequently exposed to the same antigen? A. Neutralization B. Opsonization C. Complement fixation D. Agglutination E. Anamnestic response 79. The immunoglobulin class that has a dimer form found in mucus, saliva, colostrum, and other body secretions is A. IgA. B. IgD. C. IgE. D. IgG. E. IgM. 80. The immunoglobulin class that is the only one capable of crossing the placenta is A. IgA. B. IgD. C. IgE. D. IgG. E. IgM. 81. The immunoglobulin class that has an Fc region that binds to receptors on basophils and mast cells is A. IgA. B. IgD. C. IgE. D. IgG E. IgM. 82. All of the following are characteristics of IgM, except A. it has 10 antigen binding sites. B. it contains a central J chain. C. it is the first class synthesized by a plasma cell. D. it can fix complement. E. it is a dimer. 83. Which immunoglobulin class/es can fix complement? A. IgM only B. IgG only C. IgD only D. IgM and IgG E. IgE and IgA 84. The immunoglobulin/s found on the surface of B cells is/are A. IgM only. B. IgG only. C. IgD only. D. IgM and IgG. E. IgE and IgA. 85. When antiserum is subjected to electrophoresis, the gamma globulin band contains mostly A. IgM. B. IgA. C. IgD. D. IgE. E. IgG. 86. The most significant cells in graft rejection are A. helper T cells. B. suppressor T cells. C. cytotoxic T cells. D. B cells. E. natural killer (NK) cells. 87. Which are the first to attack cancer cells and virus-infected cells? A. helper T cells B. suppressor T cells C. cytotoxic T cells D. delayed hypersensitivity T cells E. natural killer (NK) cells 88. Monoclonal antibodies A. originate from a single B cell clone. B. have a single specificity for antigen. C. are secreted by hybridomas. D. are used in immunology lab tests and cancer therapy. E. All of the choices are correct. 89. Cytotoxic T cells A. stimulate B cell proliferation. B. lack specificity for a target cell. C. secrete granzymes and perforins that damage target cells. D. secrete interleukin-2 to stimulate B and T cells. E. All of the choices are correct. 90. An example of artificial passive immunity would be A. chickenpox infection is followed by lifelong immunity. B. chickenpox vaccine triggers extended immunity to chickenpox. C. giving a person immune serum globulins to chickenpox virus after exposure to the disease. D. a fetus acquiring maternal IgG to the chickenpox virus across the placenta. E. None of the choices are correct. 91. An example of natural passive immunity would be A. chickenpox infection is followed by lifelong immunity. B. chickenpox vaccine triggers extended immunity to chickenpox. C. giving a person immune serum globulins to chickenpox virus after exposure to the disease. D. a fetus acquiring maternal IgG to the chickenpox virus across the placenta. E. None of the choices are correct. 92. An example of artificial active immunity would be A. chickenpox infection is followed by lifelong immunity. B. chickenpox vaccine triggers extended immunity to chickenpox. C. giving a person immune serum globulins to chickenpox virus after exposure to the disease. D. a fetus acquiring maternal IgG to the chickenpox virus across the placenta. E. None of the choices are correct. 93. Which type of cell is severely depressed in AIDS patients? A. Cytotoxic T cells B. Helper T cells C. B cells D. Plasma cells E. Suppressor T cells 94. In the primary response to an antigen, the first class of antibody to be secreted is A. IgD. B. IgE. C. IgG. D. IgM. E. IgA. 95. In the secondary response to an antigen, the predominant antibody is A. IgD. B. IgE. C. IgG. D. IgM. E. IgA 96. All of the following characterize the secondary response to an antigen except A. a higher titer of antibody is produced than the primary response. B. a longer persistence of antibody than with the primary response. C. a quicker rate of antibody synthesis than the primary response. D. it is mostly IgM antibodies that are produced. E. it is also known as the anamnestic response. 97. Which antibody confers the most important specific local immunity to enteric, respiratory, and genitourinary pathogens? A. IgD B. IgE C. IgG D. IgM E. IgA 98. The process of clonal deletion is designed to A. destroy clones of lymphocytes able to react to self molecules. B. slow down the primary immune response to an antigen. C. slow down the secondary immune response to an antigen. D. limit the number of lymphocyte clones an individual has in order to make the system more efficient. E. slow down the immune system in the elderly. 99. Herceptin is an example of a monoclonal antibody-based drug for A. asthma. B. Chron's disease. C. breast cancer. D. respiratory syncytial virus. E. All of the choices are correct. 100. Immune sera is produced in horses for all the following except A. diphtheria. B. botulism. C. snake bites. D. chickenpox. E. spider bites. 101. Sam works in construction and stepped on a sharp nail. He can't remember the last time he had a tetanus shot. What type of immunity is the most important for him to receive? A. Natural active immunity B. Artificial passive immunity C. Natural passive immunity D. Artificial active immunity E. None of the choices will help him. 102. Cody is 4 months old and is given a DTaP injection by his pediatrician as part of the routine immunization schedule. What type of immunity will develop as a result of this? A. Natural active immunity B. Artificial passive immunity C. Natural passive immunity D. Artificial active immunity E. None of the choices will protect him. 103. Edward Jenner's work involved A. inoculation of dried pus from smallpox pustules into a person to stimulate immunity. B. development of passive immunotherapy. C. development of an immunization to protect people against cowpox. D. immunization using a related, less pathogenic organism to give protection against a more pathogenic one. E. All of the choices are correct. 104. Immunotherapy is the A. use of antitoxins. B. use of immune serum globulin. C. conferring of passive immunity. D. administering of preformed antibodies. E. All of the choices are correct. 105. High titers of specific antibodies are components of A. specific immune globulin (SIG). B. gamma globulin. C. immune serum globulin (ISG). D. attenuated vaccines. E. toxoids. 106. Killed or inactivated vaccines are prepared by A. removal of virulence genes from the microbe. B. treatment with formalin, heat, or radiation. C. passage of the pathogen through unnatural hosts or tissue culture. D. long-term subculturing of the microbe. E. All of the choices are correct. 107. Live, attenuated vaccines A. include the Sabin polio vaccine. B. include the measles, mumps, rubella vaccine (MMR). C. contain viable microbes that can multiply in the person. D. require smaller doses and fewer boosters compared to inactivated vaccines. E. All of the choices are correct. 108. Acellular vaccines and subunit vaccines A. contain modified bacterial exotoxin molecules. B. are always genetically engineered. C. contain select antigenic components of a pathogen rather than whole cells or viruses. D. confer passive immunity. E. All of the choices are correct. 109. Toxoids A. contain modified bacterial exotoxin molecules. B. are always genetically engineered. C. contain select antigenic components of a pathogen rather than whole cells or viruses. D. confer passive immunity. E. All of the choices are correct 110. Vaccinia virus is often used in the technique to make A. Adjuvant. B. Booster. C. Antibodies to toxin. D. Gamma globulin. E. "Trojan horse" recombinant vaccine. 111. Which of the following is a special binding substance that enhances immugenicity and prolongs antigen retention at the injection site? A. Adjuvant B. Booster C. Antibodies to toxin D. Gamma globulin E. "Trojan horse" recombinant vaccine 112. Variolation involved using A. dried, ground smallpox scabs. B. a recombinant carrier with genetic material of the smallpox virus. C. preparations of human cowpox lesions. D. antibodies to the smallpox virus. E. None of the choices are correct. 113. Antitoxins A. contain antibodies to neutralize specific toxin. B. use Vaccinia virus with genetic material of bacterial toxins. C. contain purified, chemically denatured bacterial exotoxin. D. include capsule material against the pneumococcus and meningococcus. E. contain attenuated organisms. 114. The DTaP immunization A. contains diphtheria toxoid. B. is administered in childhood. C. contains tetanus toxoid. D. contains a pertussis vaccine with acellular capsule material. E. All of the choices are correct. 115. Which of the immunizations would carry the greatest risk for immunocompromised patients? A. Killed, inactivated vaccines B. Attenuated vaccines C. Toxoids D. Immune serums E. Subunit vaccines 116. Which of the following conditions have been conclusively proven to be linked to childhood vaccinations? A. Autism B. Diabetes C. Asthma D. All of the choices are correct. E. None of the choices are correct. 117. Reliable vaccines exist for all of the following diseases except A. Malaria. B. Botulism. C. Cholera. D. Yellow fever. E. Rabies. 118. All of the following are advantages of attenuated vaccines over inactivated vaccines except A. they require smaller doses. B. they require fewer boosters. C. they confer longer lasting protection. D. they can be transmitted to other people. E. they produce infection but not disease. 119. All of the following are advantages of attenuated vaccines over inactivated vaccines except A. they confer longer lasting protection. B. they produce infection but not disease. C. they can mutate back to a virulent strain. D. they require fewer boosters. E. they require smaller doses. 120. All of the following are characteristics of an effective vaccine except A. it should have a relatively long shelf life. B. it should stimulate only the antibody (B-cell) response. C. it should protect against wild forms of the pathogen. D. it should not require numerous boosters. E. it should be easy to administer. 121. Which cells' direct involvement are required for cell-mediated immunity? A. T-cells B. B-cells C. Bacterial cells D. Viral components E. Neutrophils 122. Which sequence of events is correct for a specific immune response? A. Lymphocyte development, presentation of antigens, antibody production, challenge of B cells. B. Lymphocyte development, challenge of B cells, antibody production, presentation of antigens. C. Lymphocyte development, presentation of antigens, B cell challenge, antibody production. D. Antibody production, lymphocyte production, B cell challenge, presentation of antigens. E. Presentation of antigens, B cell challenge, antibody production, lymphocyte development. 123. Which kind of T cell synthesizes perforins and granzymes to destroy bacteria, viral infected cells, and cancer cells? A. TC B. TH C. CD4 D. MHC 124. Antibody molecules circulate in lymph, blood, and tissue fluids. TRUE 125. Human B lymphocytes mature in an intestinal region called the bursa. FALSE 126. Alloantigens are the basis for an individual's blood group and MHC profile. TRUE 127. Activation of B cells occurs when antigen bonds to B cell surface immunoglobulin receptors. TRUE 128. After secreting antibodies during an immune response, plasma cells then differentiate into memory cells. FALSE 129. A disadvantage of using an attenuated live microbe in a vaccine is that it can conceivably mutate back to a virulent strain. TRUE 130. Autoantigens are types of self-antigens that initiate an autoimmune response that can cause damage to host tissue. TRUE 131. The differences in the classes of immunoglobulins are due primarily to variations in the Fc fragment. TRUE 132. The albumin fraction of serum separated by electrophoresis will contain most of the antibodies. FALSE 133. Antibody molecules can act as enzyme to directly destroy an antigen. FALSE 134. Gamma globulin can be given as immunotherapy to confer artificial passive immunity. TRUE 135. Each genetically distinct group of lymphocytes that possesses the same specificity is called a __ Clone ___. 136. Certain body sites contain sequestered molecules, called _autoantigens____ that escaped assessment during development of immune tolerance and are mistaken as foreign. Autoantigens 137. Antigens that elicit allergic reactions are called __ Allergens ___. 138. _ IgG ____ is the most abundant class of antibodies in serum. 139. A hybridoma results from the fusion of a myeloma cell with a normal __plasma___ cell. 140. Each __fab___ fragment of an antibody molecule contains the variable regions of a heavy and light chain that folds into a groove for one antigenic determinant. 141. During presentation of APC-bound antigen, macrophages secrete the cytokine, _interleukin-1_, that activates T helper cells. 1. Which is NOT a characteristic of spirochetes? A) all pathogenic B) gram negative C) helical shape D) always motile E) endoflagella enclosed in periplasmic space 2. Treponema, Borrelia, and Leptospira are all: A) obligate parasites requiring host cells B) curved rods C) transmitted by arthropod vectors D) spirochetes E) bacteria without cell walls 3. Treponena pallidum subspecies pallidum: A) has humnas as the reservoir B) can cross the placenta C) has a hooked tip to attach to epithelium D) is transmitted by direct sexual contact E) all of the choices are correct 4. The chancre of syphilis: A) occurs due to small hemorrhaging of capillaries B) is very painful C) occurs during the tertiary stage D) develops into a lesion with firm margins and an ulcerated central crater E) all of the choices are correct 5. The pathogen Syphilis enters the blood during the A) Primary stage of syphilis B) Secondary stage of syphilis C) Tertiary stage of syphilis D) latent stage of syphilis E) none of the choices are correct 6. During which stage of syphilis does fever, lymphadenopathy and a red to brown rash occur? A) primary B) secondary C) tertiary D) latent E) all of the choices are correct 7. Permanent cardiovascular and neurological damage is seen in which stage of syphilis? A) primary B) secondary C) tertiary D) latent E) all of the choices are correct 8. The Argyll Robertson pupil that is fixed and small and does not react to light but does accommodate for focusing is associated with: A) Lyme disease B) leptospirosis C) chlamydiosis D) Rocky Mountain spotted fever E) tertiary syphilis 9. Infected animals shed Leptospira inter organs in their: A) feces B) blood C) urine D) respiratory secretions E) saliva 10. The causative agent of Lyme disease is: A) Ixodes scapularis B) Borrelia hermsii C) Borrelia burgdorferi D) Ixodes pacificus E) Leptospira interrogans 11. Erythema migrans a bull's-eye rash at the portal of entry is associated with: A) syphilis B) Rocky Mountain spotted fever C) relapsing fever D) Lyme disease E) leptospirosis 12. The white-foot mouse, deer, and deer ticks are important to maintaining the enzootic transmission cycle associated with: A) Lyme disease B) leptospirosis C) chlamydiosis D) Rocky Mountain spotted fever E) tertiary syphilis 13. Lyme disease involves: A) early symptoms of fever, headache, stiff neck B) crippling polyarthritis and cardiovascular and neurological problems C) people having contact with wooded or forested areas D) treatment with antimicrobics E) all of the choices are correct 14. The virulence of Vibrio cholerae is due to its: A) capsule B) neurotoxin C) invasive enzymes D) enterotoxin E) all of the choices are correct 15. Cholera symptoms are: A) copious watery diarrhea B) loss of blood volume C) acidosis, sunken, eyes, thirst D) hypotension, tachycardia, shock E) all of the choices are correct 16. The most immediate and important treatment needed to prevent death in Cholera victims is: A) water and electrolyte replacement B) antimicrobics C) antitoxin D) surgery E) none of the choices are correct 17. In patients with diabetes or liver disease ingestion of raw oysters contaminated with this organism can lead to death: A) Vibrio vulnificus B) Vibrio parahaemolyticus C) Vibrio cholerae D) Campylobacter jejuni E) Helicobacter pylori 18. "Rice water stools" are associated with disease caused by this organism: A) Vibrio vulnificus B) Vibrio parahaemolyticus C) Vibrio cholerae D) Campylobacter jejuni E) Helicobacter pylori 19. Helicobacter pylori CAUSES: A) gastritis B) duodenal ulcers C) stomach ulcers D) increased risk for stomach cancer E) all of the choices are correct 20. Which is NOT a characteristic of Helicobacter pylori: A) gram negative B) produces enteroxin that causes diarrhea C) curved rods D) lives in the stomach E) produces urease that buffers stomach acidity 21. All of the follwoing are characteristics of Campylobacter jejuni EXCEPT: A) transmitted through ingestion of contaminated chicken, meat, milk, and water B) causes fever and a watery to bloody diarrhea C) infects the stomach D) produces an enterotoxin that stimulates diarrhea E) gram negative curved rods with darting motility 22. Characteristics of rickettsias include: A) obligate parasites requiring host cells for growth B) arthropods serve as life cycle hosts and vectors C) gram negative coccobacilli D) infect the endothelial lining of blood vessels E) all of the choices are correct 23. Which is mismatched: A) epidemic typhus- louse feces, rash & low urine output B) murine typhus- flea feces, inoculated through the skin or inhalation C) rickettsial pox- mite bite, lesion can become necrotic with black, crusty scab D) Rocky Mountain spotted fever- thick bite, include fever headache and rash E) human ehrlichiosis- flea bite, vomiting 24. Which is mismatched: A) Bartonella henselae- cat scratch disease B) Coxiella burnetii- Q fever C) Bartonella quintana- trench fever D) Rickettsia typhi- endemic (murine) typhus E) all of the choices are correct 25. Chlamydia trachomatis causes: A) nongonococcal urethritis (NGU) in males B) cervicitis in females C) congenital and adult inclusion conjunctivitis D) ocular trachoma E) all of the choices are correct 26. Lymphogranuloma venereum is caused by: A) specific strains of Chlamydia trachomatis B) Ureaplasma urealyticum C) Mycoplasma hominis D) Chlamydia psittaci E) Chlamydia pneumoniae 27. Which is INCORRECT about Mycoplasma pneumoniae: A) has birds as a reservoir B) common cause of primary atypical pneumonia C) initially causes fever, malaise, sore throat, headache D) after 2 or 3 weeks develops into an unproductive cough and earache E) is a bacterial cell without a cell wall 28. Oral flora bacteria on the tooth surface: A) develop a biofilm B) use fimbriae and slime layers to adhere C) include streptococci that metabolize sucrose, produce sticky glucans, and form plaque D) lactobacilli ferment carbohydrates and produce acids that cause caries E) all of the choices are correct 29. Gingivitis is: A) primarily caused by oral flora anaerobes B) erosion of tooth enamel causing a lesion C) caused by Streptococcus mutans D) also called ANUG E) none of the choices are correct 30. The spirochete of relapsing fever changes cell surface antigens many times in order to avoid destruction by the immune response. A) True B) False 31. Louse-borne relapsing fever is more common where there are crowded, stressful living conditions. A) True B) False 32. Lyme disease is only seen in people living in Lyme, Connecticut. A) True B) False 33. In severe cases of Rocky Mountain spotted fever, the enlarged lesions of the rash can become necrotic and predispose the patient to gangrene of toes and fingertips. A) True B) False 34. Chlamydia trachomatis is commonly transmitted by direct sexual activity. A) True B) False 35. Chlamydia can cross the placenta and cause intrauterine infection. A) True B) False 36. Chlamydiosis can lead to endometritis, salpingitis and pelvic inflammatory disease. A) True B) False 37. Syphilitic tumors called gummas develop in the liver, skin, bone, and cartilage during the tertiary stage of syphilis. A) True B) False 38. The two bacterial genera of non-obligate parasites are Chlamydia and Rickettsia. A) True B) False 39. Bacteria that lose their cell walls due to penicillin or lysozyme and result in persistent wall-deficient bacteria are called L forms. A) True B) False