Microbiology: An Introduction, 13e (Tortora et al.)
Chapter 26 Microbial Diseases of the Urinary and Reproductive Systems
26.1 Multiple-Choice Questions
1) Normal microbiota of the adult vagina consists primarily of
A) Lactobacillus.
B) Streptococcus.
C) Mycobacterium.
D) Neisseria.
E) Candida.
2) Cystitis is most often caused by
A) Escherichia coli.
B) Leptospira interrogans.
C) Candida albicans.
D) Neisseria gonorrhoeae.
E) Pseudomonas aeruginosa.
3) Pyelonephritis may result from
A) urethritis.
B) cystitis.
C) ureteritis.
D) systemic infections.
E) All of the answers are correct.
4) All of the following result from N. gonorrhoeae infection. Which one leads to the others?
A) Antibody production is stopped.
B) CD4+ T lymphocytes do not activate.
C) There is an increased risk of other STIs.
D) Opa protein attaches to CD4+ T lymphocytes.
E) CD4+ T lymphocytes do not proliferate.
5) Pyelonephritis usually is caused by
A) Pseudomonas aeruginosa.
B) Proteus spp.
C) Escherichia coli.
D) Enterobacter aerogenes.
E) Streptococcus pyogenes.
6) The most common reservoir for leptospirosis within the United States is
A) humans.
B) water.
C) domestic dogs.
D) domestic cats.
E) rats.
7) Which one of the following is NOT primarily a sexually transmitted infection (STI)?
A) lymphogranuloma venereum
B) genital herpes
C) gonorrhea
D) chancroid
E) bacterial vaginosis
8) Which one of the following is treated with penicillin?
A) genital herpes
B) genital warts
C) candidiasis
D) syphilis
E) trichomoniasis
9) Which one of the following pairs is mismatched?
A) trichomoniasis – fungus
B) gonorrhea – gram-negative cocci
C) chancroid – gram-negative rod
D) Gardnerella – clue cells
E) syphilis – gram-negative spirochete
10) One form of NGU is lymphogranuloma venereum caused by
A) Leptospira interrogans.
B) Chlamydia trachomatis.
C) Neisseria gonorrhoeae.
D) Treponema pallidum.
E) Candida albicans.
11) All of the following can cause congenital infection or infections of the newborn EXCEPT
A) syphilis.
B) gonorrhea.
C) nongonococcal urethritis.
D) genital herpes.
E) pyelonephritis.
12) Which one of the following recurs at the initial site of infection?
A) gonorrhea
B) syphilis
C) genital herpes
D) chancroid
E) LGV
13) Which one of the following is diagnosed by detection of antibodies against the causative
agent?
A) nongonococcal urethritis
B) gonorrhea
C) syphilis
D) lymphogranuloma venereum
E) candidiasis
14) Nongonococcal urethritis can be caused by all of the following EXCEPT
A) Mycoplasma homini.
B) Candida albicans.
C) Trichomonas vaginalis.
D) streptococci.
E) Neisseria gonorrhoeae.
15) Which of the following is caused by an opportunistic pathogen?
A) trichomoniasis
B) genital herpes
C) candidiasis
D) gonorrhea
E) chancroid
16) The pH of the adult vagina is acidic due to the conversion of ________ to ________ by
bacteria.
A) glucose; ethanol
B) protein; acetic acid
C) glycogen; lactic acid
D) mucosal cells; lactic acid
E) urine; lactic acid
17) A “clean” urine sample collected directly from the urinary bladder of a healthy individual
A) should be largely devoid of common skin microbiota.
B) contains fewer than 100 pathogens/ml.
C) contains fewer than 10,000 pathogens/ml.
D) contains more than 100,000 pathogens/ml.
E) has leukocyte esterase.
18) Most nosocomial infections of the urinary tract are caused by
A) Escherichia coli.
B) Enterococcus.
C) Proteus.
D) Klebsiella.
E) Pseudomonas.
19) Which of the following is NOT an antimicrobial feature of the urinary system?
A) physiological valves found in the ureter
B) pH of the urine
C) flushing action of urine
D) the use of the urethra for movement of seminal fluid in women
E) None of the answers is correct; all of these are antimicrobial features of the urinary system.
20) Which of the following is NOT a predisposing factor to cystitis in females?
A) the proximity of the anus to the urethra
B) the length of the urethra
C) sexual intercourse
D) poor personal hygiene
E) None of the answers is correct; all of these are predisposing factors.
21) The most common reportable disease in the United States is
A) cystitis.
B) lymphogranuloma venereum.
C) gonorrhea.
D) syphilis.
E) candidiasis.
22) Which of the following is NOT a complication of gonorrhea?
A) arthritis
B) pelvic inflammatory disease
C) endocarditis
D) meningitis
E) None of the answers are correct; all of these are potential complications of gonorrhea.
23) Which of the following is the most difficult to treat with chemotherapeutic agents?
A) genital herpes
B) gonorrhea
C) syphilis
D) trichomoniasis
E) leptospirosis
24) Vaginal itching and cheesy discharge are symptoms of
A) Gardnerella vaginosis.
B) genital herpes.
C) candidiasis.
D) trichomoniasis.
E) lymphogranuloma venereum.
25) Recurring vesicles on the surface of human skin are symptoms of
A) Gardnerella vaginosis.
B) genital herpes.
C) candidiasis.
D) trichomoniasis.
E) lymphogranuloma venereum.
26) Leukocytes at the infected site are a symptom of
A) Gardnerella vaginosis.
B) genital herpes.
C) candidiasis.
D) trichomoniasis.
E) lymphogranuloma venereum.
27) Which one of the following is caused by Chlamydia?
A) Gardnerella vaginosis
B) genital herpes
C) candidiasis
D) trichomoniasis
E) lymphogranuloma venereum
28) A positive LE test and greater than 100 CFU/ml of a single species in urine indicates
A) cystitis.
B) gonorrhea.
C) urethritis.
D) pyelonephritis.
E) genital herpes.
29) Which of the following diseases causes a skin rash, hair loss, malaise, and fever?
A) gonorrhea
B) syphilis
C) NGU
D) trichomoniasis
E) genital herpes
30) Staphylococcus saprophyticus causes
A) cystitis.
B) pyelonephritis.
C) vaginitis.
D) gonorrhea.
E) syphilis.
31) Which one of the following statements about genital warts is FALSE?
A) It is transmitted by direct contact.
B) It is caused by papillomaviruses.
C) Lesions are always precancerous.
D) It can be treated by removing them.
E) It can lead to cervical cancer in women.
32) The most common NGU in the United States is treated with
A) penicillin.
B) cephalosporins.
C) acyclovir.
D) AZT.
E) doxycycline.
33) Which one of the following statements about pelvic inflammatory disease is FALSE?
A) It can cause sterility and chronic pain.
B) It can be caused by N. gonorrhoeae.
C) It can be transmitted sexually.
D) It can be caused by C. trachomatis.
E) It can be caused by T. pallidum.
34) Which one of the following genera of microorganisms causes gonorrhea?
A) Chlamydia
B) Mycoplasma
C) Neisseria
D) Ureaplasma
E) None of the answers is correct; all of these cause gonorrhea.
35) Infants born to asymptomatic mothers with recurrent genital herpes are less likely to acquire
herpesvirus at birth than infants born to newly infected mothers because
A) maternal antibodies offer protection.
B) the disease cannot be transmitted to newborns.
C) the disease is not communicable.
D) prophylactic antibiotics are administered to the newborn.
E) the virus is not growing.
36) Which of the following is greater?
A) the number of reported cases of gonorrhea last year
B) the number of reported cases of AIDS last year
C) The number of reported cases of gonorrhea and AIDS are likely equal.
37) A patient presents with fever and extensive lesions of the labia minora. Her VDRL test was
negative. What is the most likely treatment?
A) metronidazole
B) cephalosporins
C) acyclovir
D) miconazole
E) No treatment is available.
38) A patient is experiencing profuse greenish-yellow, foul-smelling discharge from her vagina.
She is complaining of itching and irritation. What is the most likely treatment?
A) metronidazole
B) cephalosporins
C) acyclovir
D) miconazole
E) No treatment is available.
39) A 25-year-old man presented with fever, malaise, and a rash on his chest, arms, and feet.
Which one of the following causative agents is most likely to cause these symptoms?
A) Nesseria
B) HPV
C) HSV-2
D) Candida
E) Treponema
40) A 25-year-old man presented with fever, malaise, and a rash on his chest, arms, and feet.
Which of the following will be most useful for a rapid diagnosis?
A) bacterial culture
B) microscopic examination of blood
C) serological test for antibodies
D) serological test for antigen
E) viral culture
41) A 25-year-old man presented with fever, malaise, and a rash on his chest, arms, and feet.
Diagnosis was based on serological testing. The patient then reported that he had an ulcer on his
penis two months earlier. What stage of disease is the patient in?
A) NGU
B) primary
C) secondary
D) tertiary
42) A 25-year-old male presented with fever, malaise, and a rash on his chest, arms, and feet.
Diagnosis was based on serological testing. The patient then reported that he had an ulcer on his
penis two months earlier. This disease can be treated with
A) acyclovir.
B) metronidazole.
C) miconazole.
D) penicillin.
E) surgery.
43) A pelvic examination of a 23-year-old woman showed vesicles and ulcerated lesions on her
labia. Cultures were negative for Neisseria and Chlamydia; the VDRL test was negative. Which
treatment is appropriate?
A) acyclovir
B) metronidazole
C) miconazole
D) penicillin
E) surgery
44) A pelvic examination of a 23-year-old woman showed vesicles and ulcerated lesions on her
labia. Cultures were negative for Neisseria and Chlamydia; the VDRL test was negative. Which
of the following is probable?
A) candidiasis
B) genital herpes
C) gonorrhea
D) NGU
E) syphilis
45) Which of the following is treated with cephalosporins because the organism is resistant to
penicillin and fluoroquinolones?
A) Mycoplasma hominis
B) Haemophilus ducreyi
C) Neisseria gonorrhoeae
D) Treponema pallidum
E) Gardnerella vaginalis
46) Which one of the following is a STI that may be confused with syphilis due to its ulcer
formation on the genitalia?
A) gonorrhea
B) candidiasis
C) chancroid (soft chancre)
D) leptospirosis
E) nongonococcal urethritis
47) The causative agent of chancroid is
A) Treponema pallidum.
B) Haemophilus ducreyi.
C) Neisseria gonorrhoeae.
D) HSV-2.
E) HPV.
48) There are many types of HPV, and the available vaccines don’t (can’t) cover all of them.
However, the vaccine is still recommended for helping to control the disease caused by the virus.
Why?
A) The vaccine covers strains frequently associated with development of cancerous states.
B) The vaccine gives cross-protection against bacterial STIs.
C) The protection initiated against some strains of the virus gives cross-protection to a lesser
extent against all HPV strains.
D) The vaccine specifically and only provides protection against HPV types that produce genital
warts.
49) Which one of the following is an effective means of treatment for genital warts?
A) surgery
B) cryotherapy
C) podofilox and imiquimod gels
D) acyclovir
E) nine-valent vaccination
50) In the United States, approximately how many people over the age of 30 are infected with
HSV-2?
A) 1-3%
B) approximately 25%
C) 90%
D) approximately 75%
E) 5-10%
26.2 True/False Questions
1) Anatomically, women have more portals of entry in the reproductive system compared to
men.
2) Women and men typically have the same normal microbiota in their reproductive systems.
3) A microbe that enters the vagina would likely cause cystitis if left untreated.
4) Candida is a normal flora fungal microorganism found in the majority (greater than 50%) of
women.
5) The male urethra is typically sterile.
6) Genital candidiasis is a disease that only affects women.
7) Trichomoniasis is the only known STI caused by a protozoan.
8) Microscopic tests using fluorescently-labeled monoclonal antibodies are commonly used for
detection of primary syphilis.
9) Only HSV-2 can cause genital herpes.
10) Most UTI infections in the population are a result of catheterization in a hospital setting.
26.3 Essay Questions
1) Why are the unreported cases of STIs an important public health concern?
2) Nearly 70 percent of the patients seen in STI clinics are men. Offer a reason men are more
likely to seek treatment than women. Why is it important that women seek treatment for STIs?
3) Would you expect reported cases of urethritis to be higher than pyelonephritis? Explain.
4) Would you expect the incidence of leptospirosis to be higher in urban or rural communities?
Explain.
5) Differentiate neonatal herpes from genital herpes. What are risks to the fetus if the mother is
HSV-2 positive prior to conception, and how can those risks be reduced? What about if the
mother becomes HSV-2 positive during the pregnancy?