Microbiology with Diseases by Body System, 5e (Bauman)
Chapter 19 Microbial Diseases of the Skin and Wounds
19.1 Multiple Choice Questions
1) The skin is an effective barrier against invading microbes because
A) the outer layers of cells are dead.
B) the surface is covered in salt.
C) it is well supplied with blood vessels to flush microbes from the surface.
D) no microbes are able to survive on the surface.
E) the outer layers are dead and covered in salt.
2) Normal skin microbiota are able to grow on the skin because they can thrive in the presence of
A) sebum.
B) salt.
C) keratin.
D) sebum and salt.
E) sebum, salt, and keratin.
3) An infection of a hair follicle at the base of an eyelid is called a
A) pimple.
B) sty.
C) furuncle.
D) carbuncle.
E) macule.
4) The ________ are Gram-positive pleomorphic bacteria commonly found on the skin.
A) Clostridia
B) diphtheroids
C) Staphylococci
D) Streptococci
E) Pseudomonads
5) Virulent strains of Staphylococcus aureus can resist penicillin because they produce
A) a slime layer.
B) coagulase.
C) beta-lactamase.
D) staphylokinase.
E) lipase.
6) Which of the following is a complication that may result from a Streptococcus pyogenes skin
infection?
A) a carbuncle
B) a sty
C) shingles
D) scalded skin syndrome
E) erysipelas
7) Impetigo can be caused by
A) Staphylococcus aureus.
B) Staphylococcus epidermidis.
C) Streptococcus pyogenes.
D) both Staphylococcus aureus and Streptococcus pyogenes.
E) both Staphylococcus epidermidis and Streptococcus pyogenes.
8) The signs and symptoms of staphylococcal scalded skin syndrome are caused by
A) coagulase.
B) lipase.
C) beta-lactamase.
D) exfoliative toxins.
E) staphylokinase.
9) A(n) ________ is a large mass of inflammation and accumulated pus under the surface of an
area of thick skin.
A) carbuncle
B) furuncle
C) erysipelas
D) mycetoma
E) pox
10) Necrotizing fasciitis is caused by
A) Staphylococcus aureus.
B) Streptococcus pyogenes.
C) Pseudomonas aeruginosa.
D) Rickettsia rickettsii.
E) both Streptococcus pyogenes and Staphylococcus aureus.
11) A specific wavelength of UVA can be used to treat
A) swimmer’s ear.
B) RMSF.
C) acne.
D) cat scratch disease.
E) bacteremia.
12) Localized swelling of a scratch accompanied by fever, malaise, and swollen lymph nodes
may result from infection with
A) Rickettsia rickettsii.
B) Pseudomonas aeruginosa.
C) Propionibacterium acnes.
D) Bartonella henselae.
E) Microsporum canis.
13) Anthrax derives its name from which of the following aspects of the disease?
A) the appearance of eschars on the skin
B) the shape of its endospores
C) the microscopic appearance of its cells
D) the shape of B. anthracis colonies on agar
E) the necessity of burning animals killed by the disease
14) The resistance of Pseudomonas to a wide variety of antimicrobial drugs is due, in part, to its
A) production of exoenzymes.
B) production of pyocyanin.
C) ability to utilize a wide range of carbon and nitrogen sources.
D) ability to grow in almost any moist environment.
E) ability to pump drugs out of the cell.
15) A petechial rash starting on the hands and feet and spreading to the torso is characteristic of
A) RMSF.
B) anthrax.
C) smallpox.
D) necrotizing fasciitis.
E) herpes gladiatorum.
16) Rickettsias require ________, readily available inside cells, for energy production.
A) amino acids
B) glucose
C) lipids
D) complex carbohydrates
E) vitamins
17) What is the pathogenic process underlying Rocky Mountain spotted fever?
A) cellular damage via potent exotoxins
B) damage to blood vessels
C) stimulation of a strong immune response
D) interference with host cell metabolism
E) formation of biofilms in host tissues
18) Infection known as ________ frequently begins as an injury that rapidly becomes red,
swollen, hot to the touch, and intensely painful.
A) staphylococcal scalded skin syndrome
B) anthrax
C) Rocky Mountain spotted fever
D) necrotizing fasciitis
E) gas gangrene
19) Smallpox was the first human disease to be
A) analyzed and studied on the genetic level.
B) treated with antiviral drugs.
C) globally eradicated.
D) identified as a viral disease.
E) recreated in an experimental animal.
20) Spreading black necrosis, swelling, pain and froth or bubbles are characteristic of
A) anthrax.
B) gas gangrene.
C) necrotizing fasciitis.
D) chromoblastomycosis.
E) Pseudomonas infection.
21) A herpetic lesion on the finger or hand is known as a
A) fever blister.
B) pox.
C) macule.
D) whitlow.
E) furuncle.
22) Shingles, or herpes zoster, is a reactivation of the virus that causes
A) smallpox.
B) German measles.
C) measles.
D) whitlows.
E) chickenpox.
23) Common skin warts are the result of infection with
A) poxviruses.
B) herpesviruses.
C) papillomaviruses.
D) rubeola virus.
E) parvoviruses.
24) Some strains of Papillomavirus are oncogenic due to their ability to
A) lie dormant in cells for years.
B) integrate into the host cell DNA.
C) escape the phagosome before lysosome fusion.
D) produce deoxyribonucleases.
E) cause extensive damage to blood vessels.
25) A reddening of the skin of the face that intensifies when exposed to the sun is characteristic
of
A) herpes.
B) chickenpox.
C) rubeola.
D) rubella.
E) erythema infectiosum.
26) Which of the following can cause birth defects?
A) chickenpox
B) measles
C) roseola
D) smallpox
E) rubella
27) A rash characterized by macules which swell, fill with fluid and then pus, then rupture and
become crusty lesions, is characteristic of
A) human herpes virus 2 primary infection.
B) poxvirus infection.
C) chickenpox virus reactivation.
D) roseola virus.
E) papillomavirus infection.
28) Which of the following is becoming rarer as a result of childhood vaccinations?
A) subacute sclerosing panencephalitis
B) roseola
C) warts
D) neonatal herpes
E) impetigo
29) “Ringworm” is caused by
A) dermatophytes growing in the upper dead tissue layers of the skin.
B) dermatophytes that have invaded deep layers of the skin.
C) parasitic worms that infect the skin.
D) a hypersensitivity reaction caused by superficial contact with dermatophytes.
E) immunosuppression due to HIV infection.
30) Which of the following is a basidiomycete responsible for superficial infections?
A) Malassezia furfur
B) Microsporum species
C) Pseudallescheria
D) Sarcoptes scabiei
E) Epidermophyton floccosum.
31) A series of nodular lesions on an arm that fill with pus and ulcerate through the skin is
characteristic of infection with the fungus
A) Microsporum.
B) Trichophyton.
C) Epidermophyton.
D) Micrococcus.
E) Sporothrix schenckii.
32) A man is suffering severe foot pain in the area of what looks like a large wart. He reports he
has had the wart for some time, and the pain and swelling have developed slowly. A sample from
the lesion shows that the pus contains large cells that stain a golden brown color. The man is
likely suffering from
A) sporotrichosis.
B) necrotizing fasciitis.
C) chromoblasomycosis.
D) mycetoma.
E) phaeohyphomycosis.
33) A child complains of intensely itchy “pimples” on the hands and wrists. The lesions are small
inflamed streaks, but do not appear to contain pus. The child’s condition may be the result of
infection with
A) Staphylococcus epidermidis.
B) Sporothrix schenkii.
C) Sarcoptes scabiei.
D) Pseudomonas aeruginosa.
E) Clostridium perfringens.
34) Which of the following forms of leishmaniasis is typically fatal?
A) visceral
B) mucocutaneous
C) cutaneous
D) Both cutaneous and mucocutaneous are frequently fatal.
E) Visceral, mucocutaneous, and cutaneous are all potentially fatal.
35) A small puncture wound on a woman’s arm has become swollen, hot to the touch, and
intensely painful. There is tissue necrosis but it is not “gassy,” and under the microscope Gram-
positive cocci in chains are present. Which of the following microbes is likely to be responsible?
A) Streptococcus pyogenes
B) Staphylococcus aureus
C) Pseudomonas aeruginosa
D) Clostridium perfringens
E) Sporothrix schenckii
36) A pigment produced by an opportunistic pathogen that contributes to tissue damage is
A) pyocyanin.
B) streptokinase.
C) M protein.
D) lipase.
E) hyaluronidase.
37) Which of the following is an enzyme which results in Staphylococcus aureus being more
invasive than Staphylococcus epidermidis?
A) lipase
B) M protein
C) hyaluronidase
D) pyrogens
E) neuraminidase
38) Under some circumstances, ________ is beneficial, but under other conditions the bacteria
become overabundant leading to inflammation of hair follicles.
A) Propionibacterium acnes
B) Pseudomonas aeruginosa
C) Streptococcus pyogenes
D) Microsporum
E) Bacillus anthracis
39) The rash described as “teardrops on rose petals” is characteristic of
A) anthrax.
B) chickenpox.
C) herpes.
D) smallpox.
E) warts.
40) A child has a rash on the face, arms, upper legs, and torso. It is splotchy and intensifies after
being in the sun. The child does not complain of fever or itchiness. The signs and symptoms are
consistent with
A) chickenpox.
B) roseola.
C) fifth disease.
D) cat scratch disease.
E) scabies.
41) A sample from an abscess is stained and examined under the microscope. A Gram stain
appears uniformly pink, but a GMS (Gomori methenamine silver) stain reveals brownish
filaments in the sample. These findings suggest
A) necrotizing fasciitis.
B) sporotrichosis.
C) leishmaniasis.
D) phaeohyphomycosis.
E) dermatophytosis.
42) The ________ is a layer of tough fibers and fat cells that anchors the skin to the deeper
tissues.
A) epidermis
B) dermis
C) hypodermis
D) fascia
E) follicles
19.2 True/False Questions
1) Clostridium perfringens may cause necrotizing fasciitis.
2) M protein is an antiphagocytic factor produced by Streptococcus pyogenes.
3) Humans are the only hosts of Rickettsia rickettsii.
4) Because they are common soil saprobes, dermatophytes are fungi that are not contagious in
humans.
5) Chromoblastomycosis is rarely a severe disease and can be treated easily with appropriate
drugs.
6) Mucocutaneous leishmaniasis, also known as kala-azar, is fatal in 100% of untreated cases.
7) Smallpox vaccination was originally discontinued in the 1970s in the U.S. because of adverse
effects of the vaccine.
8) Herpesvirus infections can be controlled with chemotherapeutic agents.
9) Roseola is a rare but very dangerous childhood viral infection.
10) Pityriasis’ characteristic appearance is the result of a fungal infection causing changes in the
production of melanin.
1) The production of (exotoxin/coagulase/hyaluronidase) enzyme breaks down connections
between cells, allowing Streptococcus pyogenes to invade tissue and cause necrotizing fasciitis.
2) Immunization with (chickenpox/cowpox/HPV) provides protection against smallpox.
3) Chickenpox and (herpes/shingles/warts) are caused by the same virus.
4) Ringworm is the result of skin infection with (Madurella/Microsporum/Mycobacterium).
5) An arachnid parasite causes the skin disease known as (leishmaniasis/ringworm/scabies).
6) “Three-day measles” is caused by the (roseola/rubella/rubeola) virus.
7) Fungus infection of the nail is known as tinea (capitus/pedis/unguium).
8) Contact with soil may result in infection with (anthropophilic/geophilic/zoophilic)
dermatophytosis.
9) Infection with (Sporothrix/Staphylococcus/Streptococcus) may result in disease known as
scalded skin syndrome.
10) A (furuncle/pimple/sty) is a type of folliculitis characterized by a large, painful, pus-filled
nodule.
11) The syndrome known as cat scratch disease results when
(Bartonella/Pseudomonas/Rickettsia) is introduced into a wound.
12) The presence of Koplik’s spots is sufficient for a diagnosis of (chickenpox/measles/rubella).
13) Localization of lesions within a band of skin on one side of the body is a characteristic of the
disease (measles/shingles/sporotrichosis).
14) Warts on the sole of the foot are known as (seed/flat/plantar) warts.
15) Pseudomonas aeruginosa is the most common microbe associated with infections of
(burn/immunocompromised/elderly) patients.
19.4 Essay Questions
1) Explain the relationship between chickenpox and shingles, paying special attention to the
pathogenic processes and transmission of each of these diseases.
2) Describe the natural defenses of the skin that prevent many infections of this area.
3) Both necrotizing fasciitis and gas gangrene are diseases characterized by rapid, spreading
tissue necrosis. Compare and contrast the infectious agents, the pathology and treatment.
4) Explain why Pseudomonas aeruginosa is described as a “medical puzzle.”
5) Explain why smallpox vaccination is still being considered and debated, even though
smallpox has been eradicated.