ELEMENTARY MICROBIOLOGY SAMPLE EXAM 3 WINTER 2020

For each question, select the letter of the best answer (2 pts each).
CORRECT ANSWERS ON LAST PAGE
1. Which of the following might cause any of the other four?
a) Toxemia b) Carbuncle c) Scalded skin syndrome
d) Staphylococcus aureus infection e) Toxic Shock Syndrome

2. Which of the following diseases could NOT be correctly described as follows? Viral infection of the
upper respiratory tract leading to viremia, then skin rash (exanthem).
a) Smallpox (Variola) b) Mumps c) Measles (Rubeola) d) Chickenpox (Varicella)
e) None of the above (All could be described in this manner)

3. Shingles (zoster) is a reactivation of a primary infection by which of the following?

a) Epstein-Barr Virus b) Variola virus c) Herpes Simplex Virus type 1 (HSV-1)
d) Herpes Simplex Virus type 2 (HSV-2) e) None of the above

4. Which disease is described by the following? Streptococcus pyogenes infection of the skin, invading
below skin into connective tissue and muscle; rapid progression and death of deep tissue.
a) Necrotizing fasciitis b) Impetigo c) Erysipelas d) Folliculitis e) None of the above

5. All of the following are true of fungal infections of the skin (dermatomycoses) EXCEPT:
a) Some are called “Tineas” or ringworm
b) Caused by Microsporum, Epidermophyton, and Trichophyton
c) Most of them penetrate through the epidermis into the dermis
d) Often caused by fungi that are widespread in the environment
e) None of the above (All are true of fungal infections)

6. A patient has a papular rash between her fingers. Microscopic examination of skin scrapings
reveals tiny 8-legged mites. The patient probably has:
a) Ringworm b) Scabies c) Impetigo d) Body lice (Pediculus) e) None of these

7. The following are stages in the development of cystic (inflammatory) acne. Place them in order and
indicate which one would happen third.
3rd Place
a) Neutrophils attracted, secrete enzymes damaging follicle wall b) Scar tissue forms 5th Place
1st Place c) Sebum channels become blocked d) Pustules form and damage the dermis
4th Place
2nd Placee) Propionibacterium acnes grows on sebum, forms free fatty acids that cause inflammation

8. Which of the following statements is NOT true about bacterial meningitis?

a) Causes severe, life-threatening inflammation inside an enclosed space (the skull)
b) Bacteria are usually carried to the meninges through the blood
c) Bacteria can grow rapidly in the cerebrospinal fluid because of a lack of leukocytes, complement,
and antibodies
d) Usually caused by normal microbiota of the nervous system
e) None of the above (All of the above are true of bacterial meningitis)

9. Which of the following is mismatched?

a) Streptococcus pyogenes – erysipelas b) Staphylococcus aureus – rheumatic heart disease
c) Candida – yeast causing thrush and vaginitis d) Pseudomonas aeruginosa – hot tub folliculitis
e) None of the above (All are matched correctly)

10. The signs and symptoms of botulism are caused by:

a) Inflammation of the brain (encephalitis) caused by Clostridium botulinum infection
b) Clostridium botulinum infecting and destroying peripheral nerve cells
c) Clostridium botulinum exotoxin blocking nerve impulse transmission to muscles
d) Clostridium botulinum exotoxin activating the relaxation pathway in the brain
e) None of the above
 11. Which of the following is NOT true of Streptococcus pneumoniae, Neisseria meningitidis, and
Haemophilus influenzae?
a) When causing meningitis, they can often be seen microscopically in the cerebrospinal fluid
b) All three can be found as normal microbiota of the throat (pharynx)
c) All can have capsules that protect them against phagocytosis
d) Together, they account for about 70% of bacterial meningitis cases
e) None of the above (All are true)

12. Which of the following is NOT true about rabies?

a) Humans are the main natural reservoir for rabies
b) It is possible to prevent rabies by immunizing a person within 10 days after a bite
c) It is caused by a virus that travels up the peripheral nerves to the brain
d) It is a type of viral encephalitis
e) None of the above (All are true about rabies)

13. Which of the following is NOT true about poliomyelitis?

a) The Sabin live attenuated oral polio vaccine prevents both paralytic polio and natural community
transmission of wild polioviruses
b) Initial poliovirus replication occurs in the throat and small intestine
c) Poliovirus is sometimes spread to the central nervous system by viremia
d) Paralysis due to motor neuron damage in the upper spinal cord occurs in a large majority of
persons who are infected with poliovirus
e) None of the above (All are true about poliomyelitis)

14. Which of the following is NOT true about tetanus?

a) Caused by an anaerobic bacterium growing in a self-sealing puncture wound
b) Preventable by immunization against tetanus exotoxin
c) Tetanus toxin blocks the muscle relaxation pathway in the brain
d) Clostridium tetani bacteria invade and infect the central nervous system
e) None of the above (All are true about tetanus)

15. These are steps in the development of gas gangrene. Place them in order and indicate which one
would come third.
4th Place a) Clostridium perfringens kills and invades surrounding tissues
2nd Place b) Clostridium perfringens spores from the environment (e.g., soil) germinate in wound
5th Place c) Clostridium perfringens ferments carbohydrates, producing CO2 and H2
1st Place d) Blood supply to tissue is interrupted by a wound, causing anaerobic conditions and cell death
3rd Place e) Clostridium perfringens grows and multiplies on dead cell nutrients

16. Which disease best fits this description? Slowly developing infection of the endocardium at a site of
preexisting damage, usually on a heart valve; typically caused by mouth and throat microbiota.
a) Lymphangitis b) Subacute bacterial endocarditis c) Rheumatic heart disease
d) Pericarditis e) None of the above fit the description

17. The usual source of infectious microbes causing otitis media (middle ear infection) is:
a) Distant focal infections spread through the blood b) Airborne bacteria from the environment
c) Normal microbiota of the middle ear d) Bacteria entering through the external ear canal
e) Normal microbiota of the pharynx (throat)

18. Which of the following is mismatched?

a) Plasmodium – protozoan that causes malaria
b) Epstein-Barr Virus – causes infectious mononucleosis
c) African trypanosomiasis (sleeping sickness) – viral disease transmitted by mosquitoes
d) Hepatitis B – Viral infection transmissible through body fluids
e) None of the above (All are matched correctly)
 19. Which of the following is TRUE about rheumatic fever (rheumatic heart disease)?
a) Damage to heart valves caused by immune response against Streptococcus pyogenes M protein
b) It is a complication of Staphylococcus aureus infection of the upper respiratory tract
c) It is an infection of the heart by bacteria carried from distant sites of focal infection
d) It is a result of bacterial colonization of the endothelial lining of the heart and joints
e) None of the above are true about rheumatic fever

20. The following are the initial steps in primary tuberculosis infection. Place them in order and indicate
which one would occur third.
5th Place a) After weeks, macrophages die, releasing Mycobacterium tuberculosis and forming caseous
center in tubercle
2nd Place b) Mycobacterium tuberculosis multiplies inside macrophages, causing chemotactic response
3rd Place c) Macrophages and other cells migrate to area, surround infected cells, forming tubercle

4th Place d) Surrounding macrophages can’t kill Mycobacterium tuberculosis but release enzymes and
cytokines that cause lung-damaging inflammation
1st Place e) Mycobacterium tuberculosis reaching the alveoli is ingested by macrophages

21. Which of the following is mismatched?

a) Rickettsia prowazekii – Louseborne bacterial (rickettsial) pathogen that causes epidemic typhus
b) Mycoplasma pneumoniae – lower respiratory infection called “walking pneumonia”
c) Pneumocystis – fungus causing life-threatening lung infection in AIDS patients
d) Bordetella pertussis – copious mucus accumulation, prolonged coughing; “whoop” on inhalation
e) None of the above are mismatched

22. Which of the following is TRUE about influenza?

a) Influenza viruses cause gastroenteritis; also known as “stomach flu”
b) Influenza can sometimes lead to lower respiratory tract infections, including pneumonia
c) Influenza A viruses are genetically stable and do not often change types or subtypes
d) Immunization against one subtype of Influenza A virus protects against all subtypes
e) None of the above are true about influenza

23. Which of the following is NOT true of bacterial pneumonia?

a) Results in consolidation of at least one lobe of the lung (filled with fluid, pus and debris)
b) Often caused by Streptococcus pneumoniae or Haemophilus influenzae
c) Sometimes occurs as a secondary infection following a primary viral infection
d) Usually caused by normal microbiota of the lower respiratory tract
e) None of the above (All are true of bacterial pneumonia)

24. Which of the following is a disease of the cardiovascular or lymphatic system caused by a eukaryotic
microorganism?
a) Typhus b) Lymphangitis c) Giardiasis d) Infectious mononucleosis e) Malaria

25. Which of the following is NOT true about diphtheria?

a) There is no effective vaccine against diphtheria
b) Highly virulent exotoxin can damage internal organs such as heart and kidneys
c) Caused by a species of Corynebacterium
d) Produces tough, grayish pseudomembrane in the throat
e) None of the above (All are true about diphtheria)

26. The following are the steps in periodontal disease. Place them in order and indicate which one
would occur fourth.
2nd Place a) Plaque irritates gums, initiating gingivitis
3rd Place b) Gingivitis progresses to damage bone and cementum around root
5th Place c) Porphyromonas invades tissues
1st Place d) Plaque accumulates on tooth at or below gum line
4th Place e) Periodontal pockets form, separating tooth from gingivae
 27. The following are the steps in tooth decay (dental caries). Place them in order and indicate which
one would occur third.
3rd Place a) Streptococcus mutans converts sugars to plaque (dextran) and acid
5th Place b) Bacteria invade interior of tooth
1st Place c) Pellicle forms on tooth
4th Place d) Acid destroys tooth enamel
2nd Place e) Streptococcus mutans attaches to pellicle

28. Which of the following is mismatched?

a) Foodborne intoxication – bacteria grow in food and produce toxins, which are ingested
b) Diarrhea – watery stools (feces)
c) Gastroenteritis – inflammation of the mucous membranes of the stomach and intestine
d) Dysentery – presence of blood or mucus in stools; indicates tissue damage by pathogen
e) None of the above are mismatched

29. Which of the following is NOT true about cholera?

a) Shock and death can result from huge water volume loss through diarrhea
b) Transmitted mainly by fecally contaminated water
c) Caused by a virulent strain of Salmonella
d) Etiologic agent produces an exotoxin that causes secretion of salts across mucous membranes
e) Etiologic agent grows in the small intestine

30. Which microbial agent best fits the following description? RNA virus, transmitted by fecal-oral route,
causes mild infection but may cause acute liver disease, sometimes with jaundice. No carrier state.
a) Hepatitis B virus b) Epstein-Barr Virus c) Herpes simplex virus d) Hepatitis A virus
e) None of the above fit this description

31. Which of the following is mismatched?

a) Mumps virus – parotid (salivary) gland infection
b) Giardia lamblia - amoebic dysentery
c) Cryptosporidium – Oocysts in contaminated water can be a source of human infection
d) Norovirus (Norwalk virus) – major epidemics of acute viral gastroenteritis
e) None of the above are mismatched

32. Which microbial agent best fits the following description? Human infection acquired by handling
reptiles (iguanas, turtles) and handling or eating birds (poultry, eggs). Usually self-limiting infection
of intestinal mucosa, with pain, cramps and diarrhea.
a) Norovirus b) Escherichia coli O157:H7 c) Salmonella typhi
d) Shigella e) None of the above fit this description

33. Which of the following is NOT true about infectious mononucleosis (“mono”)?
a) In the blood, monocytes are the site of long-term viral replication and persistence
b) Cytotoxic T-lymphocytes attack virus-infected B-lymphocytes
c) Often transmitted from person to person through saliva
d) Caused by Epstein-Barr Virus, a type of herpesvirus
e) None of the above (All are true of infectious mononucleosis)

34. Which of the following is NOT true about urinary bladder infections (cystitis)?
a) Usually caused by normal microbiota of the lower digestive system (fecal bacteria)
b) Usually an infection starting in the kidneys and descending through the ureters
c) May become chronic in patients who cannot completely empty their bladder
d) Urinary bladder catheterization is a major predisposing factor
e) None of the above (All are true about urinary bladder infections)
35. Based on the figure below and information presented in class, which of the following is a TRUE
statement about HIV and Acquired Immunodeficiency Syndrome (AIDS)?
a) After about the first year of infection, the amount of HIV/RNA in blood plasma remains fairly
constant at a low level until the onset of AIDS
b) The CD4 T cell population remains steady through the first 8 years of infection
c) HIV-infected people are not infectious for other people until they have developed AIDS
d) Following initial infection, antibodies against HIV are made and they prevent AIDS
e) All the above are true statements

36. Which of the following is NOT true about genital herpes?

a) Virus often causes latent infection in nerves
(HSV-2)
b) Fetuses and infants can become infected via placental transfer of virus, or during delivery
c) Usually caused by herpes simplex virus type 2
d) Following the initial infection, recurrences of lesions are rare
e) None of the above (all are true of genital herpes)

37. Which of the following is NOT true about syphilis?

a) Darkfield microscopy can be used to identify the causative microbe in lesion fluid
b) Can be diagnosed serologically using an indirect fluorescent antibody test
c) Tertiary stage is characterized by hard-based painless lesion called a chancre
d) Caused by a “spirochete” bacterium, Treponema pallidum
e) None of the above (All are true of syphilis)

38. All of the following are true of gonorrhea in women EXCEPT:

a) Complications can be severe, including pelvic inflammatory disease
b) Can be transmitted to the eyes of infants during birth
c) Primary site of infection is often the cervix
d) Most infections cause signs and symptoms
e) None of the above (All are true of gonorrhea in women)
39. Which of the following pathogens can be transmitted both sexually and congenitally (to the fetus or
newborn)?
a) Herpes simplex virus type 2 (HSV-2) b) Human Immunodeficiency Virus (HIV)
c) Neisseria gonorrhoeae d) Treponema pallidum
e) All of the above can be transmitted both sexually and congenitally

40. Which of the following is NOT a true statement about human papillomaviruses (HPV)?
a) All of the 100+ types of HPV cause genitourinary infection that is sexually transmissible
b) Two types of HPV cause at least 70% of all cervical cancer cases
c) About 10% of women who are initially infected with sexually transmissible HPV become
persistently infected for at least 2 years
d) Infection by cervical cancer-causing types of HPV can be prevented by immunization
e) None of the above (all are true statements about HPV)

41. Which of the following is NOT true about sexually transmissible Chlamydia infection?
a) The primary site of infection in males is usually the urethra
b) Almost all infections of females cause signs and symptoms: a profuse cervical discharge
composed of mucus and pus
c) Untreated cervical infections can ascend, causing pelvic inflammatory disease, infertility or
ectopic pregnancy
d) The form (life cycle stage) of Chlamydia transmitted from cell-to-cell or person-to-person is the
elementary body
e) None of the above (all are true about sexually transmissible Chlamydia infection)

42. All of the following are true of Pneumocystis pneumonia EXCEPT:

a) Caused by Pneumocystis jiroveci, a fungus
b) Forms thick-walled cysts in the lungs containing intracystic bodies
c) A leading cause of severe disease and death in AIDS patients
d) Pneumocystis can be commonly found in the lungs of healthy people
e) None of the above (all are true of Pneumocystis pneumonia)

43. All of the following are true statements EXCEPT:

a) Infectious diseases represent a battle between the host’s nonspecific and specific immune defenses
and the microbe’s ability to penetrate and avoid those defenses
b) Infectious diseases of humans can be caused by microbes originating from outside the body; i.e.,
transmitted from other people, animals, or environmental sources, or from microbes living inside or
upon the human body
c) Systemic microbial diseases always involve invasion and destruction of tissues at the site of an
infection, followed by microbial spread into surrounding tissues and/or distant body sites
d) Some diseases are caused by exotoxins that are produced by bacteria in localized infections and
travel through the blood to cause systemic (generalized) effects
e) The etiologic agents of human microbial diseases include members of various different groups of
microbes, for example bacteria, fungi, protozoa, and viruses

44. Which of the following is NOT true about mad cow disease in cattle and Creutzfeldt-Jakob Disease in
humans?
a) Represent a slow, progressive, degenerative, fatal disease of the brain
b) Caused by prions, which are infectious proteins without DNA or RNA
c) Brain pathology looks sponge-like (“spongiform”)
d) Caused by a persistent viral infection over several years
e) None of the above (All are true)

45. All of the following diseases are caused by a bacterial exotoxin EXCEPT:
a) Botulism b) Tetanus c) Staphylococcus aureus food poisoning
d) Diphtheria e) Neisseria meningitidis (meningococcus) septic shock
46. Which of the following is NOT true about Lyme Disease?
a) Humans are the main reservoir for Lyme Disease
b) Transmitted by ticks of the genus Ixodes
c) Site of initial infection develops into a “bullseye rash”
d) Caused by the spirochete bacterium Borrelia burgdorferi
e) None of the above (all are true about Lyme Disease)

47. Some bacteria produce the enzyme penicillinase, which breaks the beta-lactam ring in the penicillin
molecule and converts it into penicilloic acid, which is harmless to bacteria. This is an example of which of
the following mechanisms of antibiotic resistance?
a) Alteration of the drug’s target site(s) within the microbe
b) Destruction or inactivation of the antibiotic by the microbe
c) Rapid ejection (pumping) of the drug out of the microbial cell
d) Preventing penetration to the target site within the microbe
e) None of these
48. The figure below shows the number of bacteria/ml in a series of patient’s samples collected and cultured
over time, and the resistance of these bacteria to a given antibiotic. This shows all of the following
EXCEPT:
a) After about 5 days of treatment, the bacteria in the patient’s samples were resistant to 50 mg/ml of the
antibiotic
b) During antibiotic therapy, resistant bacteria emerged as the predominant type in the patient
c) At the beginning of antibiotic therapy, most of the bacteria were already resistant to 50 mg/ml of the
antibiotic
d) After an initial decline, the number of bacteria eventually rises again as antibiotic-resistant bacteria
emerge and multiply
e) None of the above (All of these statements are true)

49. The following describes which helminthic parasite? Eggs shed in feces, embryonate in warm, moist soil
or on vegetation, develop into larvae which penetrate bare human skin; larvae travel to lungs via blood
or lymph, up trachea into throat, are swallowed, attach to wall of small intestine, feed on blood and
tissue, shed eggs into feces.
a) Enterobius vermicularis b) Necator or Ancylostoma (Hookworm) c) Ascaris lumbricoides
d) Schistosoma e) Diphyllobothrium
50. The following describes which helminthic parasite? Humans ingest undercooked beef or pork
containing larval forms in muscle. Cysticerci develop into adults that attach to intestinal wall by hooks
and suckers on scolex. Worm grows by producing new segments (proglottids) that produce eggs.
a) Taenia (tapeworm) b) Ancylostoma c) Enterobius d) Ascaris e) Schistosoma

CORRECT ANSWERS

1d 26e (dabec)
2b 27a (ceadb)
3e 28e
4a 29c
5c 30d
6b 31b
7a (ceadb) 32e
8d 33a
9b 34b
10c 35a
11e 36d
12a 37c
13d 38d
14d 39e
15e (dbeac) 40a
16b 41b
17e 42e
18c 43c
19a 44d
20c (ebcda) 45e
21e 46a
22b 47b
23d 48c
24e 49b
25a 50a