Microbiology: An Introduction, 13e (Tortora et al.)
Chapter 21 Microbial Diseases of the Skin and Eyes
21.1 Multiple-Choice Questions
1) All of the following are normal microbiota of the skin EXCEPT
A) Streptococcus.
B) Micrococcus.
C) Staphylococcus.
D) Propionibacterium.
E) Corynebacterium.
2) An eight-year-old girl has scabs and pus-filled vesicles on her face and throat. Three weeks
earlier she had visited her grandmother, who had shingles. What infection does the eight-year-
old have?
A) chickenpox
B) measles
C) fever blisters
D) scabies
E) rubella
3) Which of the following is NOT true of acne?
A) It can be treated by eliminating fatty foods from the diet.
B) It is often due to the action of Propionibacterium.
C) Drugs that inhibit sebum formation are useful in treating inflammatory acne.
D) Mild cases are treated with topical agents.
E) Antibiotics may be prescribed for moderate cases.
4) Warts are caused by
A) papillomavirus.
B) poxvirus.
C) herpesvirus.
D) parvovirus.
E) Staphylococcus aureus.
5) All of the following are characteristic of Pseudomonas aeruginosa EXCEPT
A) gram-positive cell wall.
B) resistance to many types of disinfectants and antibiotics.
C) growth in moist environments.
D) production of pyocyanin.
E) rod-shaped.
6) Koplik spots are a diagnostic indicator of
A) chickenpox.
B) smallpox.
C) fifth disease.
D) rubella.
E) measles.
7) All of the following are transmitted via the respiratory route EXCEPT
A) smallpox.
B) chickenpox.
C) rubella.
D) tinea.
E) measles.
8) All of the following are protective factors of the skin and its secretions EXCEPT
A) keratin.
B) tightly packed cells.
C) lysozyme production.
D) pyocyanin production.
E) salt.
9) Thrush and vaginitis are caused by
A) herpesvirus.
B) Chlamydia trachomatis.
C) Candida albicans.
D) Staphylococcus aureus.
E) Streptococcus pyogenes.
10) The greatest single cause of blindness in the world is
A) neonatal gonorrheal ophthalmia.
B) keratoconjunctivitis.
C) trachoma.
D) inclusion conjunctivitis.
E) pinkeye.
11) All of the following are characteristic of the Group A beta-hemolytic streptococci EXCEPT
A) methicillin resistance.
B) M proteins.
C) the ability to damage cell membranes.
D) the ability to dissolve blood clots.
E) hyaluronidase production.
12) Which of the following cause(s) ringworm?
A) Microsporum
B) Epidermophyton
C) Mycobacterium
D) Microsporum and Epidermophyton
E) Microsporum, Epidermophyton, and Mycobacterium
13) Newborns’ eyes are treated with an antibiotic
A) when Neisseria gonorrhoeae is isolated from the eyes.
B) when the mother is blind.
C) when the mother has genital herpes.
D) when the mother has gonorrhea.
E) as a routine precaution.
14) A possible complication of chickenpox is
A) encephalitis.
B) fever blisters.
C) subacute sclerosing panencephalitis.
D) congenital rubella syndrome.
E) macular rash.
15) Which of the following is a subcutaneous mycosis?
A) tinea capitis
B) sporotrichosis
C) erysipelas
D) athlete’s foot
E) Buruli ulcer
16) Which region of the skin supports the largest bacterial population?
A) armpits
B) scalp
C) forearms
D) feet
E) All of these support similarly sized bacterial populations.
17) Staphylococcus aureus is responsible for all of the following EXCEPT
A) pimples.
B) sties.
C) boils.
D) carbuncles.
E) acne.
18) Exfoliative toxin is responsible for
A) otitis externa.
B) impetigo.
C) fever blisters.
D) scalded skin syndrome.
E) thrush.
19) All of the following are causative agents of conjunctivitis EXCEPT
A) Chlamydia trachomatis.
B) herpes simplex.
C) adenovirus.
D) Neisseria gonorrhoeae.
E) Haemophilus influenzae.
20) In which of the following respects is measles similar to German measles (rubella)?
A) They have a similar type of rash.
B) They are caused by the same virus.
C) Encephalitis is a possible complication.
D) Congenital complications may occur.
E) They can be controlled by vaccination.
21) Why is vaccination for rubella recommended?
A) It has a high mortality rate in school-age children.
B) Death from secondary infections is common.
C) There is a high incidence of congenital infections and birth defects.
D) Health care workers have a high incidence of infection.
E) It is no longer recommended; rubella has been eradicated.
22) Which of the following statements about congenital rubella syndrome is FALSE?
A) It is contracted during the first trimester of pregnancy.
B) It may be fatal to the unborn child.
C) It may result in deafness, blindness, and mental retardation.
D) It does not occur with subclinical infections.
E) It can be prevented by vaccinating women prior to pregnancy.
23) Which of the following are incorrectly matched?
A) varicella-zoster – chickenpox
B) parvovirus – fifth disease
C) HHV-6 – roseola
D) herpes zoster – shingles
E) poxvirus – fever blisters
24) Which of the following is NOT caused by HSV-1?
A) cold sores
B) canker sores
C) herpes gladiatorum
D) herpes whitlow
E) herpes encephalitis
25) Which of the following statements about Reye syndrome is FALSE?
A) It is associated with aspirin use.
B) It is a complication that may occur in chickenpox infection.
C) It mostly affects older adults.
D) Symptoms may include vomiting, drowsiness, or behavior changes.
E) Prolonged neurological problems may occur.
26) The eradication of smallpox was possible because
A) it was a relatively mild disease.
B) insect vectors were eliminated.
C) there are no animal reservoirs of the virus.
D) it can be prevented with the same vaccine used to prevent chickenpox.
E) it occurs only in the tropics.
27) Which of the following is used to treat herpetic keratitis?
A) penicillin
B) sulfonamide
C) trifluridine
D) fungicide
E) acyclovir
28) Which of the following is used to treat shingles?
A) penicillin
B) sulfonamide
C) trifluridine
D) fungicide
E) acyclovir
29) Which of the following is used to treat sporotrichosis?
A) penicillin
B) sulfonamide
C) trifluridine
D) oral potassium iodide
E) acyclovir
30) Which of the following is used to treat candidiasis of the skin or mucous membranes?
A) penicillin
B) sulfonamide
C) trifluridine
D) miconazole
E) acyclovir
31) Scabies is a skin disease caused by a
A) slow virus.
B) protozoan.
C) mite.
D) bacterium.
E) prion.
32) Scabies is transmitted by
A) fomites.
B) food.
C) water.
D) soil.
E) respiratory secretions.
33) A patient has pus-filled vesicles and scabs on her face, throat, and lower back. She most
likely has
A) measles.
B) mumps.
C) chickenpox.
D) rubella.
E) smallpox.
34) Furuncles, toxic shock syndrome, and scalded skin syndrome all are caused by
A) Streptococcus pyogenes.
B) Staphylococcus aureus.
C) Pseudomonas aeruginosa.
D) Candida albicans.
E) Propionibacterium acnes.
35) Buruli ulcer is caused by
A) gram-positive bacteria.
B) acid-fast bacteria.
C) a fungus.
D) a virus.
E) a mite.
36) The patient has a papular rash. Microscopic examination of skin scrapings reveals small
eight-legged animals. The etiology is
A) Candida.
B) Microsporum.
C) Pseudomonas aeruginosa.
D) Staphylococcus aureus.
E) Sarcoptes.
37) The patient has vesicles and scabs over her forehead. Microscopic examination of skin
scrapings shows gram-positive cocci in clusters. The etiology is
A) Candida.
B) Microsporum.
C) Pseudomonas aeruginosa.
D) Staphylococcus aureus.
E) Sarcoptes.
38) The patient has scaling skin on his fingers. Conidiospores are seen in microscopic
examination of skin scrapings. The etiology is
A) Candida.
B) Microsporum.
C) Pseudomonas aeruginosa.
D) Staphylococcus aureus.
E) Mycobacterium ulcerans.
39) A 45-year-old man has pus-filled vesicles distributed over his back in the upper right
quadrant, over his right shoulder, and upper right quadrant of his chest. His symptoms are most
likely due to
A) Candida albicans.
B) herpes simplex virus.
C) Staphylococcus aureus.
D) Streptococcus pyogenes.
E) varicella-zoster virus.
40) A 35-year-old woman has a red, raised rash on the inside of her thighs. Gram-stained skin
scrapings show large budding cells with pseudohyphae. The infection is caused by
A) Candida albicans.
B) herpes simplex virus.
C) Staphylococcus aureus.
D) Streptococcus pyogenes.
E) varicella-zoster virus.
41) Which of the following is incorrectly matched?
A) Haemophilus influenzae – pinkeye
B) Chlamydia trachomatis – trachoma
C) Neisseria gonorrhea – opthalmia neonatorum
D) Acanthamoeba – keratitis
E) Pseudomonas – inclusion conjunctivitis
42) Assume that your lab partner swabs the side of his face and uses the swab to inoculate a
nutrient agar plate. The next day, he performs a Gram stain on the colonies. They are gram-
positive cocci. You advise him that he should next look for
A) an acid-fast reaction.
B) a coagulase reaction.
C) conidiospores.
D) pseudohyphae.
E) pseudopods.
43) Which of the following pairs is mismatched?
A) chickenpox – poxvirus
B) conjunctivitis – Chlamydia trachomatis
C) keratitis – Acanthamoeba
D) otitis externa – Pseudomonas
E) Buruli ulcer – Mycobacterium
44) A 17-year-old boy has pus-filled cysts on his face and upper back. Microscopic examination
reveals gram-positive rods. This infection is caused by
A) Acanthamoeba.
B) herpes simplex virus.
C) Propionibacterium acnes.
D) Staphylococcus aureus.
E) Streptococcus pyogenes.
45) Which of the following is likely to spread MRSA among athletes?
A) physical contact
B) whirlpool baths
C) taping gels
D) shared equipment
E) All of the answers are correct.
46) Inflammation of the thin clear membrane lining the eyelid and eye is properly termed
A) keratititis.
B) trachoma.
C) ophthalmia neonatorum.
D) conjunctivitis.
E) whitlow.
47) You are examining a scraping of an infected cornea under the brightfield microscope and see
eukaryotic cells. This is probably a case of
A) Ophthalmia neonatorum.
B) Trachoma.
C) Trichiasis.
D) Acanthomoeba keratitis.
E) Herpetic keratitis.
48) Which disease commonly leads to blindness in parts of the world but can be largely
controlled through sanitary practices and health education?
A) Yaws
B) Buruli ulcer
C) Trachoma
D) Acanthomoeba keratitis
E) Herpetic keratitis
49) Which infectious agent causes conjunctivitis and may be contracted from non-chlorinated
swimming pools?
A) Haemophilus influenzae
B) Chlamydia trachomatis
C) Treponema pallidum
D) Simplexvirus
E) Neisseria gonorrhoeae
50) A newborn infant develops a whitish overgrowth on the tongue and inner lips. This newborn
is suffering from an infection with
A) Acanthomoeba.
B) Pediculus humanus.
C) Trichophyton.
D) Sporothrix schenkii.
E) Candida albicans
21.2 True/False Questions
1) Pathogens of the skin often enter via hair follicles and ducts of the sweat glands.
2) The majority of the staphylococci isolated from human skin are coagulase-positive.
3) The abbreviation “GAS” refers to pathogenic strains of Staphylococcus.
4) Haemophilus influenzae is the most common bacterial cause of pinkeye.
5) Candidiasis often occurs following antibiotic therapy for bacterial infections.
6) Only infestation with the body louse Pediculus humanus corporis, and not the head louse,
spreads diseases.
7) Blue-green pus is characteristic of Pseudomonas wound infections.
8) The normal flora of the skin is predominantly gram-negative rods.
9) Acanthamoeba infections are usually transmitted via insects.
10) The varicella-zoster virus is the causative agent of chickenpox and shingles.
21.3 Essay Questions
1) Compare and contrast the virulence factors associated with Staphylococcus and Streptococcus.
Which of these agents is the most difficult to treat? Explain your answer.
2) Currently, the only remaining stocks of smallpox are located in the United States and in
Russia. Several dates for the destruction of these stocks have been set, but then postponed.
Discuss the pros and cons of destroying these remaining smallpox stocks. Do you feel they
should be destroyed? Explain your answer.
3) List the disease symptoms and virulence factors associated with Pseudomonas infections.
Why can Pseudomonas be difficult to control in a hospital environment?
4) Describe the protective characteristics of the skin and mucus membranes and the ways
pathogens may circumvent these to cause infections.
5) A patient reports to the eye clinic associated with the regional health center with a painful
inflamed left cornea. The patient reports that he typically wears contacts. What types of
infectious agent might be causing the problem? What further information would you seek?
Describe how you would confirm you suspicion and choose a drug to treat this individual.