Chapter 10: Infection MULTIPLE MULTIPLE CHOICE
1. What is a significant cause of morbidity and mortality worldwide? a. Starvation c. Cardiovascular disease b. Traumatic injury d. Infectious disease AS! "
"es#ite the wide$scale im#lementation of #rogressive #ublic health and immuni%ation #olicies& infectious disease remains a significant significant cause of morbidity and mortality. The other o#tions are not significant causes. 'TS! 1
()*! 'age +,,
+. What is the first stage in the infectious #rocess? a. Invasion c. S#read b. Coloni%ation d. -ulti#lication AS!
*rom the #ers#ective of the microorganisms that cause disease& the infectious #rocess undergoes four se#arate stages of #rogression! /10 coloni%ation& /+0 invasion& /0 multi#lication& and /20 s#read. 'TS! 1
()*! 'ages 33$31
. Which ty#e of microorganism re#roduces on the s4in? a. 5iruses c. 'roto%oa and Rickettsiae and Rickettsiae b. acteria and fungi d. Mycoplasma AS!
6nly bacteria and fungi have the ca#acity to re#roduce on the s4in. 'TS! 1
()*! 'age 3 7 Table 13$
2. 'hagocytosis involves neutro#hils actively attac4ing& engulfing& and destroying which
microorganisms? a. acteria b. *ungi
c. 5iruses d. 8easts
AS! A
Invasion is the direct confrontation with an individual9s #rimary defense mechanisms aga inst only bacteria& which include the com#lement system& antibodies& and #hagocytes& such as neutro#hils and macro#hages. 'TS! 1
()*! 'age 3:
# enetrated the first line of defense& which microorganisms do natural 4iller ;. 6nce they have #enetrated /<0 cells actively attac4? a. acteria b. *ungi
c. 5iruses d. -yco#lasma
AS! C
< cells are the #rinci#al defenders against only tumor cells or virally infected cells. 'TS! 1
()*! 'age +3
:. Which statement concerning e=oto=ins is true? true? a. )=oto=ins are contained in cell walls of gram$negative bacteria. b. )=oto=ins are released during the lysis of bacteria. c. )=oto=ins are able to initiate the com#lement and coagulation cascades. d. )=oto=ins are released during bacterial growth. AS! "
)=oto=ins are #roteins released during bacterial growth. The other o#tions are n ot true of e=oto=ins. 'TS! 1
()*! 'age 3:
>. Which statement is true concerning true concerning a fungal infection? a. *ungal infections occur only on s4in& hair& and nails. b. 'hagocytes and T lym#hocytes control fungal infections. c. *ungal infections release endoto=ins. d. 5accines 5accines #revent fungal infections. AS!
The host defense against fungal infection includes the fungistatic #ro#erties of neutro#hils and macro#hages. T lym#hocytes are crucial in limiting the e=tent of infection and #roducing cyto4ines to further activate macro#hages. The other o#tions are not true of fungal infections. 'TS! 1
()*! 'age 1+
. Cyto4ines are thought to cause fevers by stimulating the synthesis of which chemical
mediator? a. @eu4otriene b. istamine
c. 'rostaglandin d. rady4inin
AS! C
Cyto4ines seem to raise the thermoregulatory set #oint through stimulation of #rostaglandin synthesis and turnover in thermoregulatory /brain0 and nonthermoregulatory /#eri#heral0 tissues. The other o#tions do not accurately identify the a##ro#riate chemical mediator. 'TS! 1
()*! 'ages 31$3+
,. Considering the hy#othalamus& a fever is #roduced by! a. )ndogenous #yrogens acting directly on the hy#othalamus. b. )=ogenous #yrogens acting directly on the hy#othalamus. c. Immune com#le=es acting indirectly on the hy#othalamus. d. Cyto4ines acting indirectly on the hy#othalamus. AS! A
@ittle evidence suggests that e=ogenous #yrogens directly cause fever. Such #yrogens indirectly affect the hy#othalamus through endogenous # yrogens released by cells of the host. either immune com#le=es nor cyto4ines are involved in the #rocess.
'TS! 1
()*! 'age 3+
13. Which statement about vaccines is true? true? a. -ost bacterial vaccines contain attenuated organisms. b. -ost viral vaccines are made by using dead organisms. c. 5accines 5accines reBuire booster injections to maintain life$long #rotection. d. 5accines 5accines #rovide effective #rotection against most infections. AS! C
In general& vaccine$induced #rotection does do es not #ersist as long as infection$induced immunity& thus booster injections may be necessary to maintain #rotection throughout life. The other o#tions are not true of vaccines. 'TS! 1
()*! 'age +
11. 5accines 5accines against viruses are created from! a.
-ost vaccines against viral infections /e.g.& measles& mum#s& rubella& varicella chic4en#o=D& rotavirus0 contain live viruses that are wea4ened /attenuated0 to continue e=#ressing the a##ro#riate antigens but are unable to establish more than a limited and easily controlled infection. The other o#tions are not used in virus$focused vaccines. 'TS! 1
()*! 'age +
1+. Which statement is a characteristic of I5? a. I5 only infects T$hel#er T$hel#er /Th0 cells. b. I5 is a retrovirus. c. I5 carries genetic information in its "A. d. I5 has five identified strains. AS!
I5 is a member of the retrovirus family , which , which carries genetic information in the form of two co#ies of (A /see *igure 13$1+0. The other statements are not true of I5. 'TS! 1
()*! 'age +2
1. What is the role of reverse transcri#tase in I5 infection? a. (everse transcri#tase converts single$stranded "A into double$stranded "A. b. It is needed to #roduce integrase. c. It trans#orts the (A into the cell nucleus. n ucleus. d. It converts (A into double$stranded "A. AS! "
6ne #articular family of viruses& retroviruses /e.g.& I50 carries an en%yme& reverse transcriptase, which creates a double$stranded "A version of the virus.
'TS! 1
()*! 'age +2
12. After se=ual transmission of I5& a #erson can be infected yet seronegative for how man y
months? a. 1 to + b. : to 12
c. 1 to +3 d. +2 to :
AS!
Antibody a##ears rather ra#idly after infection through blood #roducts& usually within 2 to > wee4s. After se=ual transmission& however& the individual can be infected yet seronegative for : to 12 months or& in at least one case& for years. 'TS! 1
()*! 'age +:
1;. Which cells are #rimary targets for I5? a. C"2E Th cells only b. C"2E Th cells& macro#hages& and natural 4iller cells c. C"$#ositive cytoto=ic T /Tc0 cells and #lasma cells d. C"$#ositive Tc cells only AS!
The #rimary cellular targets for I5 include C"2E Th cells& macro#hages& and < cells. The other o#tions are not the #rimary target cells of I5. I5. 'TS! 1
()*! 'age +;
1:. What area in the body may act as a reservoir in which I5 can be relatively #rotected from
antiviral drugs? a. Central nervous system b. one marrow
c. Thymus gland d. @ungs
AS! A
I5 may #ersist in regions where the antiviral drugs are not as effective& such as the central nervous system /CS0. The other o#tions are not as #rotected from antiviral drugs. 'TS! 1
()*! 'age +>
1>. AI"S #roduces a stri4ing decrease in the number of which cells? a. -acro#hages c. C"2E Th cells b. C"E T cells d. -emory T cells AS! C
The major immunologic finding in AI"S is the stri4ing decrease in the number of C"2E Th cells /see *igure 13$1;0. This finding is not true of the other o#tions. 'TS! 1
()*! 'age +;
1. I5 antibodies a##ear within how many wee4s after infection through blood #roducts? a. 1 to + c. 13 to 1+ b. 2 to > d. +3 to +2 AS!
Antibody a##ears rather ra#idly after infection through blood #roducts& usually within 2 to > wee4s. 'TS! 1
()*! 'age +:
1,. What is the final stage of the infectious #rocess? a. Coloni%ation c. -ulti#lication b. Invasion d. S#read AS! "
*rom the #ers#ective of the microorganisms that cause disease& the infectious #rocess undergoes four se#arate stages of #rogression! /10 coloni%ation& /+0 invasion& /0 multi#lication& and /20 s#read. 'TS! 1
()*! 'age 33
+3. To=igenicity To=igenicity is defined as the! a. Ability of the #athogen to invade and multi#ly in the host b. 'athogen9s ability to #roduce disease by the #roduction of a soluble to=in c. Ability of an agent to #roduce disease d. 'otency of a #athogen measured in terms of the number of microorganisms
reBuired to 4ill the host AS!
To=igenicity To=igenicity is the ability of a #athogen to #roduce soluble to=ins or endoto=ins& which are factors that greatly influence the #athogen9s degree of virulence. The other o#tions do n ot accurately define to=igenicity. 'TS! 1
()*! 'age 3+
+1. The ability of the #athogen to invade and multi#ly in the host is referred to as! a. Infectivity c. 'athogenicity b. To=igenicity d. 5irulence AS! A
Infectivity is the ability of the #athogen to invade and multi#ly in the host. The other o#tions do not accurately denote the #athogen9s ability to invade and multi#ly in the host. 'TS! 1
()*! 'age 3+
++. Some bacterial surface #roteins bind with the crystalline fragment /*c0 #ortion of an antibody
to! a. b. c. d.
ide in cells to avoid triggering an immune res#onse *orm self$#rotecting to=ins -a4e staining #ossible for microsco#ic observation 'roduce a #rotective FselfG #rotein
AS! "
Some bacterial surface #roteins /#rotein A of Staphylococcus aureus& aureus& #rotein H of Streptococcus pyogenes0 pyogenes0 bind the *c #ortion of the individual9s antibody& antibody& thus forming a #rotective coat of FselfG #rotein. The other o#tions do not accurately define the role of bacterial surface #roteins as they bind with the *c #ortion on an antibody.
'TS! 1
()*! 'age 3
+. Which organism is a common se=ually transmitted bacterial infection? a. Staphylococcus aureus c. Helicobacter pylori b. Clostridium perfringens d. Treponema Treponema pallidum AS! "
Treponema Treponema pallidum /s#irochete& sy#hilis0 is a se=ually transmitted disease. Staphylococcus disease. Staphylococcus aureus is commonly ingested& causing food #oisoning Clostridium #oisoning Clostridium perfringens /gas gangrene0 is a s4in or wound infection and Helicobacter and Helicobacter pylori /gastritis& #e#tic ulcers0 is found in the gastrointestinal tract. 'TS! 1
()*! 'ages 32$3; 7 Table 13$2
+2. Which disease is an e=am#le of a ric4ettsial infection? a. Cholera c. Slee#ing sic4ness b. Candida d. (oc4y -ountain s#otted fever AS! "
(oc4y -ountain s#otted fever is a result of a ric4ettsiae. Cholera is a bacterial infection& candida is a fungal infection& and slee#ing sic4ness is a #roto%oal infection. 'TS! 1
()*! 'age 3+
MULTIPLE RESPONSE
+;. Which secretion transmits I5? (Select all that apply. a. Semen b. Jrine c. Saliva d. reast mil4 e. Sweat AS! A& "
I5 is a blood$borne #athogen #resent in bod y fluids /e.g.& blood& vaginal fluid& semen& b reast mil40. 'TS! 1
()*! 'age ++
app ly. +:. Which infection is fungal? (Select all that apply. a. (ingworm b. Candida c. Cholera d. Athlete9s foot e. !spergillus !spergillus AS! AS! A& & & "& "& )
Infection with a fungus is called mycosis and mycosis and includes dermato#hytes /e.g.& tineas& which refers to several s4in mycoses including ringworm& athlete9s foot& and others0 or yeasts /e.g.& Candida& Candida& !spergillus& !spergillus& Cryptococcus0. Cryptococcus0. Cholera is a bacterial infection.
'TS! 1
()*! 'age 11
+>. Which statement is true regarding true regarding the develo#ment of I5 sym#toms? (Select all that apply. a. Sym#toms generally a##ear in the clinical latency stage. b. Sym#toms are generally observable within ; years of the initial infection. c. T cells levels& #articularly those of memory T cells& #rogressively decrease. d. Jntreated infected individuals may remain asym#tomatic for u# to13 years. e. Secondary lym#hoid organs e=#erience damage and resulting malfunction. AS! C& "& "& )
Individuals during the early stages of I5 (early stage disease or clinical latency are usually asym#tomatic. The early stage may last as long as 13 years in untreated #eo#le& during which the viral load increases and the numbers of C"2E cells #rogressively decrease. As a result of these #rocesses& the level of T cells decreases /#articularly memory T cells& which seem more susce#tible to I5 infection0 thymic #roduction of new T cells is decreased and the secondary lym#hoid organs /#articularly the lym#h nodes0 are damaged. 'TS! 1
()*! 'ages +:$+>
+. Which statements are true regarding true regarding endoto=ins? (Select all that apply. a. )ndoto=ins are li#o#olysaccharides. b. )ndoto=ins are located in the walls of bacteria. c. )ndoto=ins are created during the #rocess of lysis. d. )ndoto=ins are found in gram$negative microorganisms. e. )ndoto=ins are released during the destruction of its host. AS! AS! A& & & "& "& )
)ndoto=ins are li#o#olysaccharides /@'Ss0 contained in the cell walls of gram$negative bacteria and released during lysis /or destruction0 of the bacteria. 'TS! 1
()*! 'age 3:
+,. Which statements are true regarding true regarding viruses? (Select all that apply. ap ply. a. 5iruses 5iruses are very ver y com#le= microorganisms. b. 5iruses 5iruses are referred to as eukaryotes. eukaryotes. c. 5iruses 5iruses are ca#able of #roducing messenger (A /m(A0. d. 5iruses 5iruses #enetrate #lasma membranes via endocytosis. e. 5iruses 5iruses are ca#able of uncoating cyto#lasmic nucleoca#sid. nu cleoca#sid. AS! C& "& "& )
5iruses 5iruses are e=tremely sim#le microorganisms and do not #ossess an y of the metabolic organelles found in #ro4aryotes /e.g.& bacteria0 or eu4aryotes /e.g.& human cells0. 6nce bound& the virus can #enetrate the #lasma membrane by rece#tor$mediated endocytosis. Within the cyto#lasm& the virus uncoats the #rotective nucleoca#sid and releases viral genetic information. -ost (A viruses directly #roduce m(A& which is translated into viral #roteins& and genomic (A& which is eventually #ac4aged into new viruses. 'TS! 1
()*! 'ages 1>$1,
3. Which of the following #lay a role in the control of fungal infections? (Select all that apply. app ly. a. Cyto4ines
b. c. d. e.
-acro#hages atural 4iller cells eutro#hils T lym#hocytes
AS! AS! A& & & "& "& )
The host defense against fungal infection includes the fungistatic #ro#erties of neutro#hils and macro#hages. T lym#hocytes are crucial in limiting the e=tent of infection and #roducing cyto4ines to further activate macro#hages. "atural macro#hages. "atural killer cells are cells are a com#onent of innate immune system. 'TS! 1
()*! 'age 1+
1. Com#lications of AI"S include! (Select all that apply. app ly. a.
()*! 'age + 7 *igure 13$1:
MATCHING
Match each term &ith its definition. KKKKKK A. To=igenicity To=igenicity KKKKKK . Infectivity KKKKKK C. 'athogenicity KKKKKK ". 5irulence 5irulence +. Ability of the #athogen to invade and multi#ly in the host . Ca#acity of a #athogen to cause severe disease 2. An im#ortant factor in determining a #athogen9s ability to #roduce disease by the #roduc tion
of a soluble to=in ;. Ability of an agent to #roduce disease +. AS! 'TS! 1 ()*! 'age 3+ -SC! Infectivity is the ability of of the #athogen to invade and multi#ly in the the host. . AS! " 'TS! 1 ()*! 'age 3+ -SC! 5irulence 5irulence is the the ca#acity of a #athogen #athogen to cause severe disease. 2. AS! A 'TS! 1 ()*! 'age 3+ -SC! To=igenicity To=igenicity is the ability to #roduce soluble soluble to=ins or endoto=ins& endoto=ins& factors that greatly influence the #athogenLs degree of virulence. ;. AS! C 'TS! 1 ()*! 'age 3+ -SC! 'athogenicity is the ability of of an agent to #roduce disease.
