mmsc438 GI and Resp quizzes

One of the most common causative agents of lower respiratory tract infection among previously healthy patients 2 months to 5 years of age is:

RSV (respiratory syncytial virus)

Of the various types of specimens collected to diagnose respiratory infections, which one is acceptable for the detection of anaerobic agents?

transtracheal aspirates

Also called acute necrotizing ulcerative gingivitis or trench mouth, which condition is a mixed bacterial spirochetal infection of the gingival edge?

vincent angina 

Evaluation of the quality of the sputum specimen sent to the laboratory for bacterial culture is best performed by:

microscopically examining the Gram-stained smear for squamous epithelial cells and Leukocytes

Infection of the buccal (cheek) mucosa, tongue, or oropharynx by Candida spp. is:

trush

The presence and growth of microorganisms in the respiratory tract without causing tissue invasion or clinical symptoms is: 

colonization

Which of the following is the appropriate specimen type to submit for a Whooping cough sample? 

nasopharynx swab 

A 19-year-old college student presents to the student health clinic with a one-week history of persistent dry cough, low-grade fever, malaise, and sore throat. He denies sputum production or chest pain. On examination, scattered crackles are heard over both lung fields, but the patient appears only mildly ill.

A chest X-ray shows diffuse patchy infiltrates greater than expected for his clinical appearance.

The induced sputum gram stain showed numerous PMNs and no organisms seen. Which of the following would you suspect?

mycoplasma pneumonia (walking pneumonia)

what is the recommended treatment for walking pneumonia

erythromycin

A 22-year-old woman with cystic fibrosis presents to the hospital with increased cough, fever, and worsening shortness of breath over the past week. She reports thick, purulent sputum and fatigue.  She was admitted and sputum cultures were collected.

Gram stain of the sputum revealed numerous PMNs and numerous Gram negative rods. Which pathogen would you suspect?

Burkholeria cepacia 

What media should be added to the culture plating set up to select for B. cepacia? 

OFPBL

Which of the following is true of bronchitis?

Infection and inflammation of the bronchi without involvement of the lung parenchyma (pneumonia)

Which is the preferred sample to isolate the cause of  empyema?

pleural fluid

pseudomonas less than the normal respiratory microbiota

pathogen-need to ID and perform sensitivites

streptococcus pneumoniae less than normal microbiota

non pathogen (colonizer)

staphylococcus aureus predominating over the normal microbiota

pathogen-need to ID and perform sensitivities

legionella less than normal microbiota

pathogen-need to ID and perform sensitivities

Which is the appropriate sample to diagnosis the pathogen of otitis media?

fluid collection (tympanocentesis) or none (can be treated empirically unless complications with treatment)

moraxella catarrahalis gram stain

GNDC

Strep pneumoniae gram stain

GPC in pairs

Haemophilus influenzae gram stain

GN coccobacilli

mycobacterium tuberculosis gram stain

acid fast positive

Which of the following would be most considered a cause of healthcare associated pneumonia?

S. aureus

Why is the travel history of the patient important when evaluating a person with acute diarrhea?

travel to different countries puts one at risk for various infections

how is diarrhea disease usually contracted 

foodborne 

What is the most common cause of travelers’ diarrhea?

ETEC

What type of diarrheal illness has a rapid onset of symptoms after food ingestion (usually less than 12 hours)?

Diarrhea caused by enterotoxins

All of the following organisms can cause enterotoxin-mediated diarrhea except:

Salmonella typhi

Clostridium perfringes

vibrio cholerae

S. aureus 

salmonella typhi

What is the most commonly identified intestinal parasite in the United States?

Giardia lamblia

All of the following organisms are commonly implicated in a foodborne outbreak except:

vibrio cholerae

A microbiologist is reading a Gram stain and observes gram-negative, curved rods with a seagull-wing appearance. What organism could this be?

Campylobacter or Vibrio 

What organism grows best at 42° C and in a reduced oxygen atmosphere (5% to 10%)?

Campylobacter jejuni 

A man and his family drive to the coast and have an oyster dinner. A couple of days later, the man arrives at the emergency department with a fever, bullous skin lesions, and diarrhea. He is extremely ill and the physician questions whether he is septic. Blood and stool specimens are collected. The microbiologist notices curved gram-negative rods on the stool Gram stain. 

vibrio vulnificus 

what media would be needed to isolate Vibrio vulnificus

TCBS

What diarrheal pathogen can produce a disease that may lead to hemolytic-uremic syndrome (hemolytic anemia, low platelet count, and kidney failure)?

EHEC

What virus causes an acute self-limited diarrheal illness that is highly contagious through contaminated food, water, fomites, or person-to-person contact and is associated with vomiting and low-grade fever?

norovirus 

Which of the following is a common predisposing factor that increases susceptibility to gastrointestinal tract infections?

alteration of normal intestinal microbiota due to antibiotic use 

Which of the following correctly lists the relative bacterial population (from least to greatest) in the components of the gastrointestinal tract?

esophagus < stomach < duodenum < small intestine < large intestine

Cycloserine Cefoxitin Fructose Agar (CCFA)

C diff

MacConkey with sorbitol

E coli 0157:H7

Xylose Lysine Deoxycholate (XLD) agar

salmonella and shigella

Cefsulodin-Irgasan-Novobiocin (CIN) agar

Yersinia enterocolitica

The urea-breath test used in diagnosing gastric ulcers is based on detecting which of the following?

Conversion of urea to ammonia and carbon dioxide by Helicobacter pylori urease

Which of the following best describes the pathogenesis of oral cavity and dental infections such as dental caries and periodontal disease?

Formation of dental plaque biofilms by normal oral flora producing acids that demineralize enamel

A 30-year-old woman presents to the emergency department with sudden onset of nausea, vomiting, abdominal cramping, and watery diarrhea that began 3 hours after attending a family picnic. She reports eating potato salad and cream-filled pastries that had been sitting out in the sun for several hours.

her vital signs are stable, and she is afebrile

what could be the cause?

S. aureus 

Which of the following best explains the pathogenesis of a patient with S. aureus food poisoning?

Production of a preformed, heat-stable enterotoxin that acts as a superantigen stimulating the vagus nerve and intestinal peristalsis

What is the best course of treatment for a patient with foodborne S. aurues?

IV hydration and supportive care