Chp. 24: Microbial Diseases of the Respiratory System

A 22-year-old American woman working in southern Ukraine is hospitalized with a sore throat. Physical examination of the throat reveals a tonsillar and posterior pharyngeal membrane. What is the etiology?

Corynebacterium diphtheriae

Which of the following statements is NOT true of diphtheria?

It is readily treated with antibiotics.

Defenses against microbial infection in the lower respiratory system include all of the following EXCEPT _________.

microbial antagonism

A(n) _________ disease is one where recovery will usually occur without medical intervention.

self-limiting

A 54-year-old woman has diphtheria caused by a toxigenic strain of Corynebacterium ulcerans. Which of the following is the most likely explanation for the production of toxin by C. ulcerans?

It carries the same bacteriophage as C. diphtheria.

One of the most serious infections of the upper respiratory system is __________.

Epiglottitis

Which of the following best describes why antibiotic administration is inappropriate for most of the common upper respiratory tract infections?

Most are caused by viruses.

Which of these answers describes normal microbiota of the respiratory system?

Microbial antagonism maintains a balance among the normal microbiota.

Streptococcal sore throat is best diagnosed by _______.

enzyme immunoassay

A 7-year-old female has a 1-week history of fever, sore throat, and headache. Which pathogen would most likely grow from her throat culture?

Streptococcus pyogenes

The DTaP immunization is for _______.

Diphtheria, tetanus, pertussis

The ______ have at least 113 antigenic types and are the most common agent of colds.

Rhinoviruses

A patient has a high fever and displays strawberry-like appearance of her tongue. Which of the following is she likely suffering from?

scarlet fever

Which of the following bacteria is most commonly found to cause otitis media?

S. pneumoniae

Which if the following is NOT part of the upper respiratory system?

Pleura

One of the most important reasons to diagnose and treat strep throat is that _______.

untreated strep throat may contribute to the development of rheumatic fever

Which of the following organisms typically cause the common cold?

Rhinoviruses

An effective vaccine does NOT exist for the common cold, because __________.

there are likely over 200 agents that cause the common cold

If you mix a patient's serum, toxin, and mammalian cells and the cells survive, you know the patient has antibodies against __________.

C. diphtheriae toxin

Large-scale changes in influenza envelope proteins, such as those found in the H5N1 strain, are due to re-assortment between different strains. This is called antigenic ______.

shift

Which of the following is the best technique to prevent nosocomial transmission of legionellosis?

use sterile water in respiratory therapy equipment

Which of the following statements is NOT true of tuberculosis?

Infection has been greatly reduced because of mass immunization.

Which of the following diseases does NOT belong with the others?

tuberculosis

A 45-year-old male demolition worker is hospitalized with an acute respiratory illness. Yeast cells are seen in microscopic examination of a lung biopsy, and a mold is cultured. What is the etiology?

Histoplasma capsulatum

Which of the following descriptions does NOT pertain to mycoplasmal pneumonia?

usually a life-threatening illness in adolescence

A positive tuberculin skin test can indicate all of the following information about the patient EXCEPT what?

(B) The patient was near someone with tuberculosis

A 35-year-old male is hospitalized for cough, fever, and shortness of breath. He is HIV-positive. Bronchial washings reveal cysts. What is the etiology?

Pneumocystis

A 30 year old homeless male is examined for a persistent cough with sputum production. He is HIV-positive and has a low CD4+ count. Acid-fast rods grow from sputum. The recommended treatment is with _____

isoniazid and rifampin

A physician receives a lab report indicating that acid-fast bacilli were found in sputum from a patient with a lower respiratory tract infection. The physician suspects __________.

tuberculosis

An 81-year-old female has a mass in her lower-left lung. Her tuberculin skin test is negative. Microscopic examination of her lung biopsy reveals large, ovoid cells. The patient has ________.

Histoplasmosis

All of the following cause lower respiratory tract infections EXCEPT _______.

Rhinovirus

A 90-year-old patient is diagnosed with pneumonia. Microscopic examination shows a bacterial agent that lacks cell walls. What is the etiology cause of the patient's pneumonia?

Mycoplasma pneumonia

Mycoplasma pneumoniae, a frequent cause of pneumonia in children and young adults, is called ________ pneumonia.

walking

An outbreak of pneumonia occurs in a wing of a hospital housing kidney-transplant patients. The source of infection is traced to the water supply of the air conditioner. This case describes transmission of which of the following?

Legionella pneumophila

The ____________ stage of pertussis is characterized by intense mucus production and violent coughing.

paroxysmal

A patient has a rapid onset of fever, chills, labored breathing, and sore throat. He recently returned from Mexico, where he drank local water and stayed in an air-conditioned room. Several weeks ago, he purchased a parrot. After a physical exam, his physician prescribes tetracycline. What is the cause of the patient's illness?

Chlamydia psittaci

The frequency of influenza epidemics is associated with the __________.

frequency of mutations in viral genes for envelope spikes

Some respiratory diseases are best diagnosed by a gram-stained smear and/or culture, while others are best diagnosed by specific antigen testing or by detecting IgM antibodies. Which of the following respiratory diseases is best diagnosed by doing a specific IgM titer?

Mycoplasma pneumoniae

Which of these diseases has symptoms that could be due to endotoxin?

Haemophilus pneumonia

________ causes respiratory disease mostly in infants under the age of two.

Respiratory syncytial virus (RSV)

Pertussis is characterized by __________.

a whooping type cough

All of the following statements about influenza are true EXCEPT:

The etiologic agent is Haemophilus influenzae.

Which one of the following is a zoonosis?

Psittacosis

The walled-off lesions in lung tissue formed by Mycobacterium tuberculosis are called _________.

tubercles

The following sequence occurs during the initiation of tuberculosis. What is the first step?

Mycobacteria reproduce in macrophages.

Which of the following is a common sample collected to diagnose pertussis?

a throat swab inserted through the nose

_________ grows in water in air-conditioning units.

Legionella pneumophila

Which of the following diseases spreads rapidly and may cause extensive abscess formation and tissue destruction?

Blastomycosis