Microbiology: An Introduction, 13e (Tortora et al.)
Chapter 24 Microbial Diseases of the Respiratory System
24.1 Multiple-Choice Questions
1) The lower respiratory tract is protected by all of the following EXCEPT
A) competition with the normal flora of the lungs.
B) IgA antibodies.
C) mucous secretions.
D) the ciliary escalator.
E) alveolar macrophages.
2) Which one of the following pairings is mismatched?
A) pharyngitis – sore throat
B) laryngitis – voice loss
C) epiglottitis – sore throat
D) sinusitis – headache and nasal mucous
E) otitis media – earache
3) Members of the group A streptococci (GAS) cause all of the following EXCEPT
A) strep throat.
B) scarlet fever.
C) rheumatic fever.
D) pharyngitis.
E) epiglottitis.
4) Which one of the following statements about mycoplasmal pneumonia is TRUE?
A) The causative agent is a virus.
B) The symptoms resemble pneumococcal pneumonia.
C) The causative agent cannot be cultured.
D) Treatment is tetracyclines.
E) Annual vaccination can prevent infection.
5) Which one of the following is NOT a typical symptom of influenza?
A) fever
B) chills
C) headache
D) diarrhea
E) muscle aches
6) Which one of the following pairings is mismatched?
A) Corynebacterium – gram-positive rod
B) Mycobacterium – acid-fast rod
C) Mycoplasma – gram-positive pleomorphic rod
D) Bordetella – gram-negative pleomorphic rod
E) Haemophilus – gram-negative rod
7) Which one of the following microorganisms causes symptoms most like tuberculosis?
A) Histoplasma
B) Coccidioides
C) Legionella
D) Mycoplasma
E) Influenza virus
8) All of the following can lead to a positive tuberculin skin test EXCEPT
A) vaccination.
B) current tuberculosis infection.
C) previous tuberculosis infection.
D) immunity to tuberculosis.
E) being near someone with tuberculosis.
9) Which one of the following diseases is NOT correctly matched to its vaccine?
A) tuberculosis – toxoid
B) whooping cough – heat-killed bacteria
C) diphtheria – toxoid
D) influenza – viruses grown in embryonated eggs
E) pneumococcal pneumonia – capsular polysaccharides
10) Which one of the following diseases has a cutaneous form, especially in individuals over 30
years of age?
A) coccidioidomycosis
B) diphtheria
C) legionellosis
D) scarlet fever
E) psittacosis
11) Which one of the following requires treatment with both antibiotics and antitoxins?
A) diphtheria
B) tuberculosis
C) whooping cough
D) scarlet fever
E) psittacosis
12) Which one of the following is mismatched?
A) epiglottitis – Haemophilus
B) Q fever – Rickettsia
C) psittacosis – Chlamydia
D) whooping cough – Bordetella
E) melioidosis – Burkholderia
13) Which one of the following does NOT cause otitis media?
A) Streptococcus pneumoniae
B) Haemophilus influenzae
C) Streptococcus pyogenes
D) Moraxella catarrhalis
E) Coxiella burnetii
14) Which one of the following causes opportunistic infections in AIDS patients?
A) Pneumocystis
B) Aspergillus
C) Rhizopus
D) Mucor
E) All of the answers are correct.
15) Which one of the following diseases is NOT correctly matched to its reservoir?
A) tuberculosis – cattle
B) histoplasmosis – soil
C) psittacosis – parakeets
D) coccidioidomycosis – air
E) pneumocystis – humans
16) All of the following are true of the common cold EXCEPT
A) it is caused by rhinoviruses and coronaviruses.
B) it is transmitted via aerosols and contact.
C) early treatment will drastically reduce the disease symptoms.
D) complications include laryngitis and otitis media.
E) the duration of symptoms is approximately one week.
17) Which one of the following causes a disease characterized by the catarrhal, paroxysmal, and
convalescent stages?
A) Bordetella pertussis
B) Corynebacterium diphtheriae
C) Mycobacterium tuberculosis
D) Streptococcus pyogenes
E) respiratory syncytial virus
18) Which one of the following is an irregular, gram-positive rod?
A) Bordetella pertussis
B) Corynebacterium diphtheriae
C) Burkholderia pseudomallei
D) Streptococcus pyogenes
E) Pneumocystis jirovecii
19) Infection by which one of the following results in the formation of Ghon complexes?
A) Bordetella pertussis
B) Corynebacterium diphtheriae
C) Mycobacterium tuberculosis
D) Streptococcus pyogenes
E) Blastomyces dermatidis
20) Which one of the following produces the most potent exotoxin?
A) Bordetella pertussis
B) Corynebacterium diphtheriae
C) Mycobacterium tuberculosis
D) Streptococcus pyogenes
E) Streptococcus pneumoniae
21) The most effective means of preventing influenza is
A) annual vaccination.
B) isolation of carriers.
C) vector control.
D) pasteurization of milk.
E) administration of amantadine.
22) Which one of the following is an opportunistic pathogen?
A) Pneumocystis
B) Legionella
C) Histoplasma
D) Mycoplasma
E) rhinovirus
23) Which one of the following etiologic agents results in the formation of abscesses?
A) Staphylococcus
B) Mycoplasma
C) Streptococcus
D) Blastomyces
E) Coccidioides
24) The primary victims of the influenza pandemic of 1918-1919 were
A) members of the military.
B) infants and the elderly.
C) residents of Spain; therefore, it was known as the “Spanish Flu.”
D) young adults.
E) residents of the U.S.
25) All of the following are used as first-line drugs for treating tuberculosis EXCEPT
A) ethambutol.
B) isoniazid.
C) fluoroquinolones.
D) rifampin.
E) pyrazinamide.
26) Infection by which one of the following is often confused with viral pneumonia?
A) Blastomyces
B) Coccidioides
C) Mycoplasma
D) Streptococcus
E) Mycobacterium
27) Which one of the following causes a disease characterized by a red rash?
A) Blastomyces
B) Coccidioides
C) Mycoplasma
D) Streptococcus
E) RSV
28) Inhalation of arthroconidia is responsible for infection by which one of the following
organisms?
A) Blastomyces
B) Coccidioides
C) Mycoplasma
D) Streptococcus
E) Chlamydophila
29) Soil is a reservoir for the pathogen for all of the following diseases EXCEPT
A) Q fever.
B) melioidosis.
C) blastomycosis.
D) histoplasmosis.
E) coccidioidomycosis.
30) A patient has pneumonia. Gram-negative rods are cultured on nutrient agar from a sputum
sample. The etiology is
A) Burkholderia pseudomallei.
B) Chlamydophila psittaci.
C) Haemophilus influenzae.
D) Legionella pneumophila.
E) Staphylococcus aureus.
31) The patient is suffocating because of an inflamed epiglottis. What is the etiology of the
symptoms?
A) Corynebacterium
B) Haemophilus
C) Bordetella
D) Mycobacterium
E) RSV
32) The patient has a sore throat. What is the etiology of the symptoms?
A) Corynebacterium
B) Rhinovirus
C) Bordetella
D) Streptococcus
E) The answer cannot be determined based on the information provided.
33) The patient is suffocating because of the accumulation of dead tissue and fibrin in her throat.
What is the etiology of the symptoms?
A) Corynebacterium
B) Haemophilus
C) Bordetella
D) Mycobacterium
E) The answer cannot be determined based on the information provided.
34) Which one of the following pairings is mismatched?
A) Burkholderia – melioidosis
B) Coxiella – Q fever
C) Mycoplasma – walking pneumonia
D) Chlamydophila – psittacosis
E) Mycobacterium – whooping cough
35) All of the following are classified as fungi EXCEPT
A) Blastomyces.
B) Coccidioides.
C) Histoplasma.
D) Mycobacterium.
E) Pneumocystis.
36) Microscopic examination of a lung biopsy shows thick-walled cysts. What is the etiology of
the symptoms?
A) Blastomyces
B) Coccidioides
C) Histoplasma
D) Mycobacterium
E) Pneumocystis
37) Microscopic examination of a lung biopsy shows spherules. What is the etiology of the
symptoms?
A) Blastomyces
B) Coccidioides
C) Histoplasma
D) Mycobacterium
E) Pneumocystis
38) Which one of the following statements regarding tuberculosis is FALSE?
A) Nearly 1/3 of the world’s population is infected with tuberculosis.
B) Nearly 1/3 of the world’s population shows symptoms of tuberculosis.
C) It is responsible for nearly 2 million deaths per year.
D) At least 1/3 of those who are TB-positive are also HIV-positive.
E) Treatment requires at least six months of antibiotic therapy.
39) A patient has a paroxysmal cough and mucus accumulation. What is the etiology of the
symptoms?
A) Bordetella
B) Corynebacterium
C) Burkholderia
D) Mycobacterium
E) Mycoplasma
40) A patient who presents with red throat and tonsils can be diagnosed as having
A) streptococcal pharyngitis.
B) scarlet fever.
C) diphtheria.
D) the common cold.
E) The answer cannot be determined based on the information provided.
41) A patient has fever, difficulty breathing, chest pains, fluid in the alveoli, and a positive
tuberculin skin test. Gram-positive cocci are isolated from the sputum. The patient most likely
has
A) tuberculosis.
B) influenza.
C) pneumococcal pneumonia.
D) mycoplasmal pneumonia.
E) the common cold.
42) Which one of the following is responsible for epidemics of respiratory disease in infants?
A) rhinovirus
B) adenovirus
C) respiratory syncytial virus
D) influenza
E) Mycoplasma
43) Which one of the following is NOT an intracellular parasite?
A) Chlamydophila
B) Coccidioides
C) Coxiella
D) Influenza virus
E) RSV
44) Which one of the following produces small “fried-egg” colonies on medium containing horse
serum and yeast extract?
A) Chlamydophila
B) Legionella
C) Mycobacterium
D) Mycoplasma
E) Streptococcus
45) Legionella is transmitted by
A) airborne transmission.
B) foodborne transmission.
C) person-to-person contact.
D) fomites.
E) vectors.
46) Melioidosis is a relatively new disease. Its means of transmission is primarily via
A) sexual contact.
B) contaminated water.
C) inhalation.
D) blood-borne transmission.
E) surgical wound contamination.
47) The causative agent of melioidosis is
A) Burkholderia pseudomallei.
B) Pseudomonas aeruginosa.
C) RSV.
D) influenza virus.
E) Mycoplasma.
48) The best diagnostic method for detection of chlamydial pneumonia is
A) direct brightfield light microscopic examination.
B) PCR detection.
C) biochemical testing of cultured microbes.
D) serological testing of the patient’s blood.
E) fluorescent microscopy.
49) In Q fever cases, involvement of which organ/system is responsible for the rare fatalities
observed?
A) gastrointestinal tract
B) central nervous system
C) heart tissue
D) kidneys/urinary tract
E) pancreas/endocrine system
50) In cases of psittacosis, mortality is approximately ________ in the absence of antibiotic
therapy via tetracyclines.
A) 1-3%
B) 80-90%
C) 0% (this infection is not lethal)
D) 15-20%
E) 5-10%
24.2 True/False Questions
1) It is common for a normal, healthy individual to carry potentially pathogenic organisms in
their upper respiratory tract.
2) Most cases of sinusitis and otitis media do not require treatment with antibiotics. They will
usually resolve on their own due to natural immune responses.
3) The symptoms of diphtheria are due to an exotoxin that blocks proteins synthesis in host cells.
4) The most common causative agent of bacterial pneumonia is Streptococcus pneumoniae.
5) A positive tuberculosis skin test indicates that the patient has active tuberculosis.
6) Vaccination with the influenza vaccine confers lifelong immunity to influenza virus.
7) Coccidioides immitis causes Valley fever, a fungal pulmonary disease that is endemic to the
Mississippi Valley.
8) Mycoplasma pneumoniae causes atypical pneumonia, also known as “walking pneumonia.”
9) Risks for Q fever include contact with infected cattle and drinking unpasteurized milk.
10) Infections with Legionella pneumophila are usually transmitted via aerosols from
contaminated air conditioning systems, showers, and humidifiers.
24.3 Essay Questions
1) Compare and contrast antigenic shift and antigenic drift in influenza virus. How do antigenic
shifts and drifts contribute to the need for annual vaccinations to prevent influenza?
2) Pneumonia is diagnosed by the presence of fluid (dark shadows in an X-ray image) in the
alveoli. Given that pneumonia usually is caused by a microorganism, what causes the fluid
accumulation? Name a bacterium, a virus, a fungus, a protozoan, and a helminth that can cause
pneumonia.
3) Using diphtheria and whooping cough as examples, discuss why it is necessary to continue to
vaccinate against diseases that are relatively rare in the U.S. today.
4) Tuberculosis and influenza are both worldwide problem infections. Compare and contrast
prevention and treatment options for both diseases. Make and support an argument for
prevention or treatment as the best option for either one of the two infections.
5) Characterize the disease melioidosis, then draft a control plan to prevent the spread of the
infection if it should reach the United States.