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MCQ’s Chapter 36 (Lab)

Some of Common Questions and Answers for Laboratory Technicians and Technologists.

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MCQs Chapter 36

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Questions 1751 to 1800

  1. Your patient has a brain abscess that was detected 1 month after a dental extraction. Which one of the following organisms is MOST likely to be involved?
    1. Mycobacterium smegmatis
    2. Lactobacillus acidophilus
    3. Anaerobic streptococci
    4. Mycoplasma pneumoniae
  2. Each of the following statements concerning Pneumocystis carinii is correct EXCEPT:
    1. P. carinii infections primarily involve the respiratory tract.
    2. P. carinii symptomatic infections can be prevented by administering penicillin orally.
    3. P. carinii can be diagnosed by seeing cysts in tissue.
    4. P. carinii infections are symptomatic primarily in immunocompromised patients.
  3. A 50-year-old homeless alcoholic has a fever and is coughing up 1 cup of green, foul-smelling sputum per day. You suspect that he may have a lung abscess. Which one of the following pairs of organisms is MOST likely to be the cause?
    1. Listeria monocytogenes and Legionella pneumophila
    2. Fusobacterium nucleatum and Peptostreptococcus intermedius
    3. Clostridium perfringens and Chlamydia psittaci
    4. Nocardia asteroides and Mycoplasma pneumoniae
  4. A 22-year-old woman presents with “the worst sore throat I’ve ever had.” She also complains of fatigue and anorexia. She is not immunocompromised and has not been hospitalized recently. On examination, she is febrile to 38°C, the pharynx is inflamed, and there are a few tender cervical nodes bilaterally. There are no white lesions on the tongue or pharynx. A throat culture grows alpha-hemolytic colonies on blood agar that are optochin-resistant. Of the following, which one is the MOST likely cause?
    1. Streptococcus pneumoniae
    2. Epstein–Barr virus
    3. Streptococcus pyogenes
    4. Parvovirus B19
    5. Streptococcus mutans
  5. A 45-year-old man presents to the emergency department with shortness of breath and a productive cough. His sputum was gelatinous and bloody. Gram stain of the sputum revealed numerous PMNs and gram-negative rods. Which of the following descriptions is most likely to fit the patient?
    1. IV drug user
    2. Hiker
    3. Homeless
    4. Veterinarian
    5. Alcoholic
  6. Which one of the following organisms is MOST likely to be the cause of pneumonia in an immunocompetent young adult?
    1. Mycoplasma pneumoniae
    2. Nocardia asteroides
    3. Serratia marcescens
    4. Legionella pneumophila
  7. The MOST important way the host counteracts the function of the pneumococcal polysaccharide capsule is via:
    1. Activated macrophages
    2. Anticapsular antibody
    3. Polysaccharide-degrading enzymes
    4. T lymphocytes sensitized to polysaccharide antigens
  8. A 70-year-old man presents to the emergency department with a fever of 103.5°F, a dry cough, tachypnea, and chest pain. History reveals he has been smoking since he was a teen. He mentions that several people at the assisted living community where he resides have had similar symptoms. A sputum sample isolated organisms that grew on buffered charcoal yeast extract agar and stained weakly gram-negative. Which of the following properties is consistent with the above organism?
    1. Optochin sensitive
    2. Requires iron and cysteine for growth
    3. Capsule
    4. No cell wall
    5. Serpentine growth in vitro
  9. Which one of the following statements concerning Legionella pneumophila is CORRECT?
    1. It is part of the normal flora of the colon.
    2. It does not have a cell wall.
    3. It causes atypical pneumonia, especially in those with reduced cell-mediated immunity.
    4. It cannot be grown on laboratory media.
  10. A 12-year-old boy presents to his pediatrician with fever, malaise, and a sore throat. Physical examination reveals a fever of 103°F, cervical lymphadenopathy, and pharyngeal erythema. A swab is taken from some of the tonsillar exudate and cultured on blood agar. Culture reveals beta hemolytic, gram-positive cocci, and a rapid antigen test is positive. What is the major component that protects the causal agent from osmotic damage?
    1. Peptidoglycan
    2. Polysaccharide
    3. Phospholipids
    4. Teichoic acid
    5. Lipopolysaccharide
  11. A 45-year-old homeless man presents to the emergency department with fever and night sweats, coughing up blood. Acid-fast bacilli are identified in his sputum. Which of the following virulence factors allows the causal agent to inhibit phagosome-lysosome fusion to survive intracellularly?
    1. Sulfatides
    2. Calcium dipicolinate
    3. Peptidoglycan
    4. Tuberculin
    5. Cord factor
  12. Each of the following statements concerning Mycobacterium tuberculosis is correct EXCEPT:
    1. Some strains of M. tuberculosis isolated from patients exhibit multiple drug resistance (i.e., they are resistant to both isoniazid and rifampin).
    2. The antigen in the tuberculin skin test is a protein extracted from the organism.
    3. M. tuberculosis contains a small amount of lipid in its cell wall and therefore stains poorly with the Gram stain.
    4. M. tuberculosis grows slowly, often requiring 3 to 6 weeks before colonies appear.
  13. A 14-year-old girl develops a sore throat, fever, and earache of approximately 1 week duration. Upon examination by her physician, an erythematous rash is noted covering most of her body and her tongue appears bright red. Which of the following is the description of the causal agent?
    1. Gram-positive coccus, alpha hemolytic, catalase negative
    2. Gram-positive coccus, gamma hemolytic, catalase negative
    3. Gram-positive coccus, beta hemolytic, catalase positive
    4. Gram-positive coccus, alpha hemolytic, catalase positive
    5. Gram-positive coccus, beta hemolytic, catalase negative
  14. Each of the following statements concerning infection with Chlamydia psittaci is correct EXCEPT:
    1. The organism appears purple in Gram-stained smears of sputum.
    2. The infection is more commonly acquired from a nonhuman source than from another human.
    3. C. psittaci can be isolated by growth in cell culture and will not grow in blood agar.
    4. The infection is more readily diagnosed by serologic tests than by isolation of the organism.
  15. A 22-year-old woman complains of a persistent nonproductive cough and a fever of 101°F that came on slowly over the last 4 days. Physical examination reveals some rales in the left lung base. A patchy infiltrate is seen on chest X-ray. She works as a secretary in a law office and has not traveled recently. She is not immunocompromised and has not been hospitalized recently. A sample of her serum agglutinates red blood cells at 4°C but not at 37°C. Which one of the following BEST describes the organism that is the MOST likely cause of her disease?
    1. A filamentous gram-positive rod that is weakly acid-fast
    2. A spirochete that has never been grown on blood agar
    3. An acid-fast rod that forms colonies within 7 days
    4. A gram-negative diplococcus with a large capsule
    5. A very small bacterium that has no cell wall
  16. Which one of the following is NOT an important characteristic of Streptococcus pyogenes?
    1. Beta-hemolysin
    2. Polysaccharide group-specific substance
    3. Protein A
    4. M protein
  17. Which genetic material is found in pathogenic Corynebacterium diphtheriae but not in nonpathogenic normal flora diphtheroids?
    1. A diphthamide on eEF-2
    2. An episome
    3. An integrated temperate phage
    4. Highly repetitive bacterial DNA
    5. An F factor
  18. A 55-year-old woman had her rheumatic heart valve replaced with a prosthetic valve. Six blood cultures became positive after 3 days of incubation. An optochin- resistant, catalase-negative gram-positive coccus that was alpha-hemolytic was isolated. What was the most likely causal agent?
    1. Pseudomonas aeruginosa
    2. Streptococcus pneumoniae
    3. Serratia marcescens
    4. Streptococcus viridans
    5. Staphylococcus aureus
  19. Your patient has subacute bacterial endocarditis caused by a member of the viridans group of streptococci. Which one of the following sites is MOST likely to be the source of the organism?
    1. Colon
    2. Skin
    3. Urethra
    4. Oropharynx
  20. A 70-year-old woman is brought to the emergency department by her spouse with complaints of shortness of breath and fever. Physical examination revealed a fever of 103°F, hypotension, and a diastolic murmur. History revealed a cardiac valve replacement 5 years earlier. Three consecutive blood cultures taken during febrile periods revealed gram-positive cocci that were catalase-positive and coagulase-negative. Which of the following organisms is the most likely cause?
    1. Enterococcus faecalis
    2. Kingella kingae
    3. Staphylococcus aureus
    4. Staphylococcus epidermidis
    5. Staphylococcus saprophyticus
  21. Each of the following statements concerning kala-azar is correct EXCEPT:
    1. Kala-azar is transmitted by the bite of sandflies.
    2. Kala-azar is caused by Leishmania donovani.
    3. Kala-azar can be diagnosed by finding amastigotes in bone marrow.
    4. Kala-azar occurs primarily in rural Latin America.
  22. Regarding Lyme disease, which one of the following is MOST accurate?
    1. Mice are the main reservoir of the causative organism.
    2. The Lyme disease vaccine contains toxoid as the immunogen.
    3. Fleas are the principal mode of transmission of the causative organism.
    4. The causative organism is a small gram-positive rod.
    5. The diagnosis in the clinical laboratory is typically made by culturing the organism on chocolate agar.
  23. Which one of the following protozoa primarily infects macrophages?
    1. Trypanosoma cruzi
    2. Leishmania donovani
    3. Trichomonas vaginalis
    4. Plasmodium vivax
  24. A 35-year-old captain in the army reserves has been plagued by a painful, erosive lesion near his ear lobe since his return from Operation Desert Storm several years ago. He denies exposure to the toxic by-products of burning oil fields. Punch biopsy of the leading edge of the erosion reveals macrophages distended with oval amastigotes. How was this infection acquired?
    1. Bite of reduviid bug
    2. Bite of tsetse fly
    3. Contact with contaminated drinking water
    4. Bite of Anopheles mosquito
    5. Bite of sandfly
    6. Fecal contamination of food
  25. Listed below are five bacteria paired with a mode of transmission. Which one of the pairings is MOST accurate?
    1. Coxiella burnetii—bat guano
    2. Borrelia burgdorferi—mosquito bite
    3. Yersinia pestis—flea bite
    4. Rickettsia rickettsii—contaminated food
    5. Haemophilus influenzae—penetrating wound contaminated with soil
  26. Each of the following statements concerning Toxoplasma gondii is correct EXCEPT:
    1. T. gondii can be transmitted by cat feces.
    2. T. gondii can be transmitted across the placenta to the fetus.
    3. T. gondii can cause encephalitis in immunocompromised patients.
    4. T. gondii can be diagnosed by finding trophozoites in the stool.
  27. Each of the following statements concerning spirochetes is correct EXCEPT:
    1. Species of Borrelia cause a tick-borne disease called relapsing fever.
    2. Species of Treponema are part of the normal flora of the mouth.
    3. The species of Leptospira that cause leptospirosis grow primarily in humans and are usually transmitted by human-to-human contact.
    4. Species of Treponema cause syphilis and yaws.
  28. An outbreak of sepsis caused by Staphylococcus aureus has occurred in the newborn nursery. You are called upon to investigate. According to your knowledge of the normal flora, what is the MOST likely source of the organism?
    1. Throat
    2. Nose
    3. Vagina
    4. Colon
  29. Which one of the following zoonotic illnesses has NO arthropod vector?
    1. Lyme disease
    2. Brucellosis
    3. Plague
    4. Epidemic typhus
  30. A 81-year-old woman who is receiving chemotherapy for leukemia develops a fever to 40°C and has two episodes of teeth-chattering chills, and her blood pressure drops to 80/20 mmHg. Of the following factors, which one is MOST likely to be the cause of her fever, chills, and hypotension?
    1. Coagulase
    2. Lipid A
    3. Mycolic acid
    4. Polysaccharide capsule
  31. A 68-year-old woman on chemotherapy for leukemia has developed sepsis due to an infection with Escherichia coli . The following day the patient develops septic shock and dies. The structure on the bacterium most likely responsible for causing septic shock in this patient is
    1. capsule
    2. teichoic acid
    3. pili
    4. spore
    5. lipopolysaccharide
  32. Each of the following statements concerning Trypanosoma cruzi is correct EXCEPT:
    1. T. cruzi can be diagnosed by seeing amastigotes in a bone marrow aspirate.
    2. T. cruzi typically affects heart muscle, leading to cardiac failure.
    3. T. cruzi is transmitted by the reduviid bug.
    4. T. cruzi occurs primarily in tropical Africa.
  33. A 28-year-old woman with a previous history of rheumatic fever now has a fever for the past 2 weeks. Physical examination reveals a new heart murmur. You suspect endocarditis and do a blood culture, which grows a viridans group streptococcus later identified as Streptococcus sanguis. Of the following body sites, which one is the MOST likely source of this organism?
    1. Colon
    2. Skin
    3. Stomach
    4. Vagina
    5. Mouth
  34. A 24-year-old primiparous woman in her eighth month of gestation develops a positive IgM titer to Toxoplasma gondii for the first time. She should be advised by her physician that
    1. this child and all future fetuses are likely to be infected
    2. future infections can be avoided by proper vaccination and worming of cats
    3. retinochoroiditis can be prevented by drug treatment of an infant with a positive IgM response
    4. major organ damage can be reversed by prompt treatment of the newborn
    5. a newborn with a positive anti-Toxoplasma IgG response should be treated with anti-parasitics
  35. A 33-year-old man presents to the emergency department with a fever of 102.5°F, facial palsy, headache, and malaise. A circular maculopapular rash was identified on the patients left shoulder; the patient was unaware of the rash. The patient likely acquired the above infection via which of the following routes?
    1. Respiratory route
    2. Sexual contact
    3. Consumption of contaminated food
    4. Arthropod vector
    5. Direct contact with fomite
  36. Black water fever is a special manifestation of malaria caused by;
    1. P. vivax
    2. P. falciparum
    3. P. ovale
    4. P. malariae
  37. Which one of the following statements concerning the organisms that cause brucellosis is CORRECT?
    1. Brucellae are transmitted primarily by tick bite.
    2. The principal reservoirs of Brucellae are small rodents.
    3. Brucellae are obligate intracellular parasites that are usually identified by growth in human cell culture.
    4. Brucellae infect reticuloendothelial cells in the liver, spleen, and bone marrow.
  38. Which one of the following illnesses is NOT a zoonosis?
    1. Q fever
    2. Rocky Mountain spotted fever
    3. Tularemia
    4. Typhoid fever
  39. Mosquitoes is/are the vector in the following disorder(s)
    1. Onchocerciasis
    2. Bancroftian filariasis
    3. African trypanosomiasis
    4. Visceral leishmaniasis
  40. Sixteen residents in a retirement home have fever, malaise, and anorexia. These residents have taken their meals prepared by the same kitchen. Blood cultures from of these residents grow Salmonella enterica subsp. typhi. The primary reservoir of this organism is
    1. dogs and cats
    2. turkeys
    3. people
    4. water
    5. hen’s egg
  41. Each of the following statements concerning Rocky Mountain spotted fever is correct EXCEPT:
    1. The disease is caused by a Rickettsia.
    2. Headache, fever, and rash are characteristic features of the disease.
    3. The causative organism forms beta-hemolytic colonies on blood agar.
    4. The disease occurs primarily east of the Mississippi.
  42. Each of the following statements concerning epidemic typhus is correct EXCEPT:
    1. The disease is caused by a Rickettsia.
    2. The Weil-Felix test can aid in diagnosis of the disease.
    3. The causative organism is transmitted from rodents to humans by a tick.
    4. The disease is characterized by a rash.
  43. What organism is most likely responsible for bacterial endocarditis in men following urological instrumentation.
    1. Ureaplasma urealyticum
    2. Enterococcus faecalis
    3. Streptococcus pyogenes
    4. Pseudomonas aeruginosa
    5. Viridans streptococci
  44. A 12-year-old boy from North Carolina presents to the emergency department with rash, fever, and severe headache that began 3 days ago. The rash began on his arms and legs and then spread to the trunk. The pediatrician notes conjunctival redness, and lab tests reveal proteinuria. Which of the following events likely led to the child’s illness?
    1. Cutting himself while butchering rabbits
    2. Hiking in the woods
    3. Kissing
    4. Not washing his hands
    5. Eating undercooked meat
  45. After sporozoite gain entrance to human body it undergoes developmental cycle first in liver than in RBC, only after which fever is seen. This incubation period varies between plasmodium species, and ………….. species has longest incubation period.
    1. P. malariae
    2. P. ovale
    3. P. falciparum
    4. P. vivax
  46. Which of the following statement(s) regarding Plasmodium falciparum are true?
    1. is the only cause of cerebral malaria
    2. is associated with recurrent relapses after initial treatment because of liver hypnozoites
    3. is the only malarial parasite causing greater than 20% parasitaemia
    4. causes benign tertian malaria
  47. Each of the following parasites is transmitted by mosquitoes EXCEPT:
    1. Leishmania donovani
    2. Plasmodium vivax
    3. Wuchereria bancrofti
    4. Plasmodium falciparum
  48. A 35-year-old man comes to the emergency department complaining of high fever, chills, severe headache, and confusion. He has recently returned from Africa. A peripheral blood smear reveals multiple ring structures and crescent-shaped gametes. Which of the following organisms is the most likely cause?
    1. Leishmania species
    2. Plasmodium vivax
    3. Plasmodium ovale
    4. Plasmodium falciparum
    5. Plasmodium malariae
  49. Ticks are vectors for the transmission of each of the following diseases EXCEPT:
    1. Tularemia
    2. Lyme disease
    3. Epidemic typhus
    4. Rocky Mountain spotted fever

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