chapter 16

The integument is strictly composed of the skin. It does not include the various accessory structures that may be present on or beneath the skin layers.

True false question.

True

False

A statement indicating that the integument refers only to the skin itself, excluding hair, nails, and glands.

Which of the following areas have a dense microbial population?

Multiple choice question.

back

groin

abdomen

skin

groin

MRSA indicates which of the following?

Multiple choice question.

methicillin-resistant skin antibiotics

methicillin-resistant skin acne

methicillin-susceptible S. aureus

methicillin-resistant S. aureus

MRSA stands for methicillin-resistant Staphylococcus aureus, a type of bacteria that is resistant to several antibiotics, making infections difficult to treat. It commonly causes skin infections but can also lead to more severe infections.

Which of the following describe the typical growth patterns/bacterial type of S. aureus?

Multiple select question.

grows in long chains

Grows in grape-like clusters

Gram-positive

Gram-negative

bacillus

coccus

spirochete

S. aureus typically grows in grape-like clusters, is Gram-positive, and is classified as a coccus.

Which of the following statements concerning Staphylococcus aureus is true?

Multiple choice question.

Someone carrying MRSA will exhibit dramatic symptoms of infection.

Methicillin-resistant strains are not found on healthy people.

It is found in the normal microbiota of many people.

Staphylococcus aureus is found in the normal microbiota of many healthy individuals, often without causing any symptoms. However, methicillin-resistant strains (MRSA) can be carried by individuals without showing dramatic symptoms.

Identify the components of the integument.

Multiple select question.

sweat glands

salivary glands

oil glands

nails

hair

skin

The integumentary system includes sweat glands, oil glands, nails, hair, and skin, which function to protect the body, regulate temperature, and provide sensory information.

Which of the following areas of the skin have low microbial populations?

Multiple choice question.

dry, flat areas

areas covered by hair

moist areas

skin folds

Low microbial populations are typically found in dry, flat areas of the skin.

Strains of MRSA are usually resistant to which of the following?

Multiple choice question.

methicillin only

antimicrobial peptides

multiple antibiotics

all known antibiotics

Strains of MRSA are usually resistant to multiple antibiotics, making treatment challenging.

Under which conditions would S. aureus survive?

Multiple select question.

Heating to 55°C for 60 minutes

Heating to 35°C for 60 minutes

Heating to 65°C for 60 minutes

S. aureus can survive in temperatures up to 60°C for short periods, but typically cannot survive prolonged exposure to higher temperatures.

Which of the following describe S. aureus?

Multiple select question.

destructiveness due to superantigens

motile

grows in chains that look like a string of pearls

nonmotile

S. aureus is a nonmotile bacterium known for its destructiveness due to superantigens, and it typically grows in clusters resembling grape-like structures, not chains.

Which of the following describe a MRSA lesion?

Multiple select question.

flat

bloody

red

macular

featuring pus

raised

MRSA lesions can be red, raised, and often feature pus. They may also appear macular, depending on the stage of infection, but typically do not present as flat.

Approximately what percent of people have S. aureus as part of their normal skin microbiota?

Multiple choice question.

30

60

50

10

About 30% of people have S. aureus as part of their normal skin microbiota, with varying prevalence among different populations.

A rapid screening test that will distinguish Staphylococcus aureus from other staphylococci is the blank test.

coagulase

The integument is strictly composed of the skin. It does not include the various accessory structures that may be present on or beneath the skin layers.

True false question.

True

False

False. The integument includes not only the skin but also the accessory structures such as hair, nails, and glands.

The microbial medium blank blank agar is often used to isolate Staphylococcus species because of its high salt content that mimics the environment of the skin.

Mannitol salt

Which two conditions must be tolerated by the normal microbiota populating the majority of the skin on the human body?

Multiple select question.

Carbohydrate-rich

Salty

Dry

Moisture

Warm temperature

The normal microbiota on human skin must tolerate salty and dry conditions.

PCR is an acronym for

Polymerase Chain Reaction, a technique used to amplify small segments of DNA.

Under which two salt concentrations would S. aureus survive?

Multiple select question.

Salt at 50%

Salt at 5%

Salt at 0.5%

Salt at 15%

Salt at 5% and Salt at .5%

Which of the following enzymes are expressed by some strains of Staphylococcus aureus?

Multiple select question.

Streptokinase

Staphylokinase

Coagulase

Lipase

RNase

Mucinase

DNase

Hyaluronidase

Some strains of Staphylococcus aureus express enzymes such as coagulase, staphylokinase, lipase, DNase, and hyaluronidase.

blank is an enzyme that breaks down the hydrogen peroxide produced in oxidative metabolism.

Catalase is an enzyme that breaks down the hydrogen peroxide produced in oxidative metabolism.

Which of the following media is often used to isolate Staphylococcus species?

Multiple select question.

urea agar

blood agar

EMB agar

Mueller-Hinton agar

mannitol salt agar

• blood agar

• mannitol salt agar

Which test is used to diagnose MRSA?

Multiple choice question.

catalase test

Gram stain

PCR

ELISA

The PCR test is used to diagnose MRSA by amplifying specific genetic material from the bacteria.

Which of the following practices are most likely to spread MRSA?

Multiple select question.

Sharing silverware

Blowing out birthday candles on a cake

Not sanitizing gym equipment

Sharing a razor

Sexual intercourse without a condom

Practices such as sharing razors, not sanitizing gym equipment

Which of the following are characteristics of S. aureus?

Multiple select question.

It resists many disinfectants and antibiotics.

It's difficult to grow in culture.

It can withstand high salt concentrations.

It is extremely hardy, remaining viable for months in the air.

It tolerates a very narrow temperature range around body temperature.

It is rarely pathogenic.

• It resists many disinfectants and antibiotics.

• It can withstand high salt concentrations.

• It is extremely hardy, remaining viable for months in the air.

Which of the following describe a MRSA lesion?

Multiple select question.

red

featuring pus

macular

bloody

raised

flat

A MRSA lesion is typically characterized by being red, featuring pus, and often raised.

The current recommendation for an antibiotic to treat a MRSA infection is to prescribe which of the following antibiotics?

Multiple choice question.

methicillin

penicillin

bacitracin

vancomycin

Vancomycin is the current recommended antibiotic for treating MRSA infections.

A diagnostic test for which of the following enzymes differentiates staphylococci from streptococci?

Multiple choice question.

nuclease

lipase

polymerase

coagulase

catalase

catalase

The microbial medium blank blank agar is often used to isolate Staphylococcus species because of its high salt content that mimics the environment of the skin.

Mannitol salt agar

A skin eruption that is characterized by flat to slightly raised colored bumps is classified as a(n) rash.

maculopapular

The best prevention strategy against MRSA infection is to do which of the following?

Multiple choice question.

Practice careful hygiene.

Avoid public showers in gyms.

Keep your hands away from your face.

Get the MRSA vaccine.

Practice careful hygiene.

Treatment of MRSA infection may include which of the following?

Multiple select question.

bed rest for 2-5 days

treatment with more than one antibiotic

prescription for methicillin

incision of the lesion to drain pus

physical therapy to enhance mobility

Treatment options include antibiotics, drainage of abscesses, and supportive care.

blank is an enzyme that breaks down the hydrogen peroxide produced in oxidative metabolism.

Catalase

The maculopapular rash shown in this image is associated with the measles, and is caused by which type of microorganism?

Multiple choice question.

fungus

amoeba

bacterium

virus

A virus is the type of microorganism that causes the maculopapular rash associated with measles.

A skin eruption that results in flat to slightly raised colored bumps is termed _____.

Multiple choice question.

vesicular

pustular

epidermal

maculopapular

maculopapular

Despite availability of a vaccine, measles still causes many deaths worldwide. This is due to which of the following?

Multiple select question.

ineffectiveness of the vaccine

waterborne transmission

animal reservoirs

subacute sclerosing panencephalitis (SSPE)

low levels of herd immunity

• subacute sclerosing panencephalitis (SSPE)

• low levels of herd immunity

Which of the following represent the initial signs and symptoms of measles?

Multiple select question.

Febrile seizures

Sore throat

Headache

Vomiting/diarrhea

Fever

"Slapped-face" rash

Conjunctivitis

Dry cough

Blisters in throat

• Sore throat

• Headache

• Fever

• Conjunctivitis

• Dry cough

The red maculopapular rash of measles appears on which area of the body first?

Multiple choice question.

legs

head

arms

trunk

soles of the feet

face and neck

What causes SSPE to occur in some cases of measles?

Multiple choice question.

Co-infection with bacteria

Pregnancy

Leukemia or thymic deficiencies in host

Defective virus that cannot form a capsid

Defective virus that cannot form a capsid

A condition known as blank is characterized by viruses traveling within the bloodstream.

viremia, leading to widespread infection in the body.

Despite the availability of an effective vaccine, hundreds of thousands of children still die yearly worldwide due to measles infections.

True false question.

True

False

This statement highlights the ongoing global health challenge of measles, despite vaccination efforts. It underscores the importance of immunization programs to prevent outbreaks and protect vulnerable populations.

Which of the following are not initial signs or symptoms of measles?

Multiple select question.

headache

dry cough

vomiting/diarrhea

conjunctivitis

fever

blisters in throat

"slapped-face" rash

febrile seizures

sore throat

• vomiting/diarrhea

• blisters in throat

• "slapped-face" rash

• febrile seizuresThe initial signs or symptoms of measles typically do not include vomiting/diarrhea or blisters in throat.

Which of the following describes the rash in measles?

Multiple choice question.

Bull's eye rash about 10-12 inches in diameter

Long-lasting red rash that starts on the head and spreads to the whole body

"Slapped-face" rash that spreads to trunk and extremities

Mild red rash lasting a few days

Long-lasting red rash that starts on the head and spreads to the whole body

What is the typical age for the first dose of the MMR vaccine?

Multiple choice question.

3-6 months

18-24 months

5 years old

12-15 months

The typical age for the first dose of the MMR vaccine is between 12-15 months, as it provides early protection against measles, mumps, and rubella.

In SSPE which areas of the body are degenerated?

Multiple select question.

lungs

pancreas

brain stem

cerebral cortex

white matter

• brain stem

• cerebral cortex

• white matter

The measles virus contacts and infects skin cells by which method?

Multiple choice question.

traveling through the bloodstream

entering through breaks in the skin

using hair follicles as a portal of entry

The measles virus contacts and infects skin cells primarily by traveling through the bloodstream, allowing it to spread rapidly throughout the body.

Which is the sign/symptom that often differentiates postnatal rubella from adult rubella?

Multiple choice question.

Ocular lesions

Deafness

Lymphadenopathy

Mild rash

Mild rash

Despite availability of a vaccine, measles still causes many deaths worldwide. This is due to which of the following?

Multiple select question.

ineffectiveness of the vaccine

animal reservoirs

subacute sclerosing panencephalitis (SSPE)

waterborne transmission

low levels of herd immunity

Measles continues to cause deaths globally despite vaccination due to low levels of herd immunity, subacute sclerosing panencephalitis (SSPE), and other factors.

Any agent that causes abnormal development to the developing fetus is referred to as a(n) blank agent.

teratogenic

Which of the following represent the initial signs and symptoms of measles?

Multiple select question.

Vomiting/diarrhea

Dry cough

Conjunctivitis

"Slapped-face" rash

Fever

Headache

Blisters in throat

Febrile seizures

Sore throat

Initial signs include fever, dry cough, conjunctivitis, and sore throat, headache

How many doses of the MMR vaccine are recommended for children?

Multiple choice question.

3

2

4

1

The recommended dosage of the MMR vaccine for children is 2 doses.

Which of the following is the most important virulence factor that contributes to the pathogenicity of S. aureus in impetigo?

Multiple choice question.

exfoliative toxin

catalase

collagenase

coagulase

Exfoliative toxin is a key virulence factor produced by Staphylococcus aureus that contributes to the skin lesions associated with impetigo.

The most important virulence factors relevant to S. aureus impetigo are exotoxins called toxins blank A and B.

Exfoliative toxin A and B

Which of the following is the most serious complication of measles?

Multiple choice question.

upper respiratory tract infections

subacute sclerosing panencephalitis

secondary bacterial infection

pneumonia

Subacute sclerosing panencephalitis is a rare but serious complication of measles that can occur years after the initial infection, leading to severe neurological deterioration.

Postnatal rubella is differentiated from other forms of rubella disease by which of the following?

Multiple choice question.

mild rash lasting a few days

deafness

"slapped-face" rash

lymphadenopathy

mild rash lasting a few days

Which agent is strongly teratogenic?

Multiple choice question.

herpesvirus 6 or 7

parvovirus B19

rubella virus

measles virus

Rubella virus is known to cause severe birth defects when a pregnant woman is infected, making it a strongly teratogenic agent.

blank is the appearance of visible red lines that develop when microbes and inflammatory products are carried away from an infected area by the lymphatic system.

Lymphangitis

Carriers of S. aureus harbor the bacteria in which areas of the body?

Multiple select question.

nasopharynx

perineum

mouth

stomach

axilla

ureter

• nasopharynx

• perineum

• axilla

What causes SSPE to occur in some cases of measles?

Multiple choice question.

Pregnancy

Co-infection with bacteria

Defective virus that cannot form a capsid

Leukemia or thymic deficiencies in host

SSPE, or Subacute Sclerosing PDefective virus that cannot form a capsid

Symptoms such as pain, tenderness, swelling, fever, and lymphangitis are characteristic of blank

cellulitis

Which of the following represent the initial signs and symptoms of measles?

Multiple select question.

Conjunctivitis

Headache

Fever

Blisters in throat

"Slapped-face" rash

Febrile seizures

Vomiting/diarrhea

Sore throat

Dry cough

• Conjunctivitis

• Headache

• Fever

• Sore throat

• Dry cough

Smallpox and chickenpox are caused by which type of microbes?

Multiple choice question.

viruses

fungi

protozoa

bacteria

helminths

Smallpox and chickenpox are caused by viruses, specifically the variola virus for smallpox and the varicella-zoster virus for chickenpox.

Asymptomatic carriers of SSSS can harbor Staphylococcus aureus in the nasopharynx, axilla, perineum, and even in which area?

Multiple choice question.

vagina

fingernails

anus

umbilicus

vagina

Which of the following is the most serious complication of measles?

Multiple choice question.

secondary bacterial infection

subacute sclerosing panencephalitis

upper respiratory tract infections

pneumonia

Subacute sclerosing panencephalitis is a rare neurological complication that can occur years after a measles infection, leading to severe brain damage and death.

All of the following are typical signs and symptoms of chickenpox except which two?

Multiple select question.

centrifugal lesions

superficial lesions

deep lesions

centripetal lesions

itchy vesicles

fever

Centrifugal and deep lesions

Which is the sign/symptom that often differentiates postnatal rubella from adult rubella?

Multiple choice question.

Deafness

Mild rash

Lymphadenopathy

Ocular lesions

mild rash

blank is the appearance of visible red lines that develop when microbes and inflammatory products are carried away from an infected area by the lymphatic system.

Lymphangitis

blank (female/male) sand flies can transmit leishmaniasis.

Female

Which diseases present as generalized rashes with fluid-filled lesions?

Multiple select question.

Athletes foot

Smallpox

Gas gangrene

Cutaneous anthrax

Warts

Chickenpox

Chickenpox, Smallpox

Tinea blank is a dermatophyte infection of the body.

capitis

Carriers of S. aureus harbor the bacteria in which areas of the body?

Multiple select question.

nasopharynx

axilla

mouth

ureter

perineum

stomach

Carriers of S. aureus typically harbor the bacteria in areas such as the nasopharynx and skin, particularly in regions like the axilla and perineum.

• axilla

• perineumarly in regions like the axilla and perineum.

What is the incubation period for chickenpox?

Multiple choice question.

24-48 hours

10-20 days

2-3 days

4-8 days

The incubation period for chickenpox is generally 10-20 days, during which the virus replicates before symptoms appear.

Microbes found on the surface of the eye are typically also found on/in blank.

skin

Which of the following is a large pustular lesion disease transmitted by sand flies?

Multiple choice question.

leishmaniasis

molluscum contagiosum

cutaneous anthrax

smallpox

Leishmaniasis is a disease caused by protozoan parasites transmitted through sand fly bites, resulting in large pustular lesions.

An infection of the thin membrane-like covering of the eyeball is called .

conjunctivitis.

The blank is a thin membrane that covers the eye and lines the eyelids.

Conjunctiva

An eye infection that affects the deeper tissues of the eye and often is a result of trauma to the eye is known as ________.

Multiple choice question.

chalazion

keratitis

trachoma

conjunctivitis

keratitis

Which of the following has been found to be a dominant genus in the healthy eye microbiome?

Multiple choice question.

Streptococcus

Corynebacterium

Staphylococcus

Saccharomyces

Corynebacterium

Which of the following events are unlikely to lead to conjunctivitis?

Multiple select question.

Traumatic event to the eye

Proliferation of the normal microbiota of the eye

Use of contact lenses

Destruction of the normal eye microbiota by antibiotic therapy

Presence of pathogenic microorganisms with affinity for eye

Allergic reactions or irritants. Conjunctivitis is less likely if there is no underlying infection or irritant present.

Carriers of S. aureus harbor the bacteria in which areas of the body?

Multiple select question.

axilla

perineum

stomach

ureter

mouth

nasopharynx

is a serious eye infection of the deeper tissues of the eye that can be caused by any organism and often follows trauma to the eye.

Keratitis

Microbes found on the surface of the eye are typically also found on/in

skin

Which of the following events can lead to conjunctivitis?

Multiple select question.

Proliferation of the normal microbiota of the eye

Traumatic event to the eye

Presence of pathogenic microorganisms with affinity for eye

Use of contact lenses

Destruction of the normal eye microbiota by antibiotic therapy

• Traumatic event to the eye

• Presence of pathogenic microorganisms with affinity for eye

• Use of contact lenses

• Tinea is a dermatophyte infection of the scalp.

Tinea, commonly known as ringworm, is a fungal infection affecting the scalp (tinea capitis), causing scaly patches and hair loss.

An infection of the thin membrane-like covering of the eyeball is called .

conjunctivitis