BI 234 - ELEMENTARY MICROBIOLOGY SAMPLE EXAM 2, SUMMER 2020

CORRECT ANSWERS ON LAST PAGE

MATCHING: For questions 1-5, choose the definition that b est matches the term. (2 points each)
1. Communicable disease. D. 2. Infection C 3. Incidence. E
4. Pathogenesis A 5. Epidemic. B
Definitions for questions 1-5:
a) Manner, or process, by which a disease develops
b) A significant increase in cases of a disease above the expected level
c) Invasion or colonization of the body by pathogenic microorganisms
d) A disease that spreads from one host to another, either directly or indirectly. -
e) None of these (Correct definition not given)

MULTIPLE CHOICE. Choose the answer that b est completes the statement or answers the question.
(2 points each)

6. During the course of an infectious disease, the time between the effective exposure to the pathogen
and the appearance of the very first signs or symptoms is called the: pg 397
a) Period of illness b) Incubation period c) Period of convalescence d) Prodromal period
e) None of the above

7. During 2019, almost 3 million cases of Dengue Fever, including 1,372 deaths, were reported in the
western hemisphere. Dengue is a severe disease transmitted by Aedes aegypti mosquitoes. This is an
example of: a) Vehicle transmission b) Aerosol transmission c) Direct contact transmission
d) Vector transmission e) Droplet transmission

8. Which of the following pathogens is the MOST virulent?

a) Microbe A, LD50 = 100 cells b) Microbe B, LD50 = 1,000 cells c) Microbe C, LD50 = 10,000 cells
d) Microbe D, LD50 = 100,000 cells e) Cannot be determined from information given

9. All of the following are mechanisms or structures used by pathogens to penetrate host defenses
EXCEPT: a) Capsules b) Complement proteins c) Enzymes d) Penetration of the cytoskeleton
e) None of the above (all are examples of how pathogens penetrate host defenses)

10. The most common preferred portal(s) of entry for human pathogens is (are):
a) Intact skin b) Mucous membranes of the respiratory and gastrointestinal tracts
c) Mucous membranes of the genitourinary tract d) Parenteral route e) None of the above

11. Which of the following leukocytes are the most important for phagocytosis of microbes?
a) Neutrophilic granulocytes & lymphocytes b) Basophilic granulocytes & neutrophilic granulocytes
c) Monocytes (macrophages) & neutrophilic granulocytes d) Lymphocytes & monocytes (macrophages)
e) Natural Killer (NK) cells & eosinophilic granulocytes

12. All of the following are examples of NONSPECIFIC host defenses against pathogens EXCEPT:
a) B lymphocytes b) Cleansing flow of body fluids c) Inflammation d) Neutrophilic granulocytes
e) None of the above (All are examples of nonspecific host defenses)
13. Following the initial tissue injury and release of chemicals from damaged body cells, the first stage in
inflammation is: a) Phagocyte migration and phagocytosis b) Tissue repair c) Diapedesis
d) Fever e) Vasodilation and increased capillary permeability

14. Which of the following is NOT true of bacterial exotoxins?

a) Some exotoxins are superantigens. True
b) Some exotoxins have two components, A (active) and B (binding). True
c) Toxic effect may be against organs distant from the site of infection. True
d) Exotoxins are only released as the bacteria that produced them start to die False
e) None of the above (All are true of bacterial exotoxins). True
15. In the antibody molecule diagram at right, at
which location(s) does antigen bind? (Ignore the
A B
circle)
a) A only b) B only c) C only d) C and D e) A and B C

16. Which of the following statements is NOT true?

a) An abscess is an infection and collection of pus in a
walled- off area
b) When connective tissue (e.g., in the dermis) is damaged,
repair leads to scar tissue formation
c) During inflammation, all of the phagocytic leukocytes
remain inside capillaries to prevent pathogens from
entering the bloodstream
d) The typical signs and symptoms of inflammation are D
redness, pain, heat, and swelling
e) None of the above (all statements are true)

17. The following are the events in the phagocytosis of a microbe by a leukocyte. Put them in order and
indicate which one would happen fourth.
a) Fusion of the phagosome and lysosome to form a phagolysosome
b) Formation of a residual body and discharge of waste material
c) Chemotaxis and adherence of the microbe to the phagocytic leukocyte
d) Ingestion of the microbe into a phagosome (phagocytic vesicle)
e) Digestion of the microbe by enzyme

Mechanism of phagocytosis
1) Chemotaxis: is the 9chemical attraction of
phagocytes to microorganisms. And adherence is
the attachment of the phagocyte’s plasma
membrane to the surface of the microorganism.
Summary:
1) Chemotaxis and adherence of the microbe
to the phagocytic leukocyte.
2) Ingestion of the microbe into a phagosome
(phagocytic vesicle).

2) Ingestion occurs. The plasma membrane of the 3) Fusion of the phagosome and lysosome to
phagocyte extends projections called pseudopods form a phagolysosome.
that engulf the microorganism. the microorganism
with a sac called a phagosome, or phagocytic 4) Digestion of the microbe by enzymes.
vesicle.
5) Formation of a residual body and discharge
of waste material.
3) The phagosome and lysosome membranes fuse
to form a single, larger structure called a
phagolysosome.

4) Digestion of the microbe by enzymes.

5) After enzymes have digested the contents of the

phagolysosome brought into the cell by ingestion,
the phagolysosome contains indigestible material
and is called a residual body. This residual body
then moves toward the cell boundary and discharges
its wastes outside the cell.
18. For the epidemiologic data shown below, the graph shows all of the following EXCEPT:
a) A comparison of 2017 salmonellosis cases to the previous five years’ median number of cases. True
b) The incidence rate of salmonellosis per unit population in Oregon for 2017. False
c) The number of cases of salmonellosis reported in Oregon by month for 2017. True
d) Seasonal differences in the number of salmonellosis cases reported. True
e) None of the above (All are true about the graph)

19. A child receives measles vaccine and develops

immunity against future exposures to measles virus
as a result. This is an example of:
a) Naturally acquired passive immunity
b) Naturally acquired active immunity
c) Artificially acquired passive immunity
d) Artificially acquired active immunity
e) None of the above

20. All of the following can occur as a direct result

of antigen-antibody binding EXCEPT:
a) Neutralization of viruses and toxins. True
b) Opsonization of bacterial cells. True
c) Destruction of virus-infected body cells by cytotoxic T lymphocytes. False
d) Activation of complement. True
e) None of the above (All are a direct result of Ag-Ab binding). True

21. All of the following are true of antibodies EXCEPT:

a) They are produced in response to antigens. True
b) Each individual antibody molecule is specific for more than one type of antigen. False , 1 antibody for 1
antigen.
c) They are made of proteins. True
d) They are produced by plasma cells. True
e) They are also called immunoglobulins. True
22. All of the following are true of the lymphatic system, EXCEPT:
a) Lymph nodes are located at lymphatic vessel junctions. True
b) It carries interstitial fluid back to the circulatory system. True
c) Lymphatic capillaries lie in close physical proximity to arterial and venous capillaries. True
d) It brings microbial antigens into contact with immunologically active cells in lymph nodes. True
e) None of the above (all are true of the lymphatic system). True

23. All of the following are true of interferons EXCEPT:

a) They are an example of cell-mediated immunity that is specific for each type of virus. False
b) They are produced by animal cells. True
c) They are chemical messengers (cytokines) that stimulate adjacent cells to block virus replication. True
d) They are released by virus-infected cells. True , los interferones son liberados por celulas infectadas
por virus.
e) None of the above (all statements are true of interferon). True

Interferons:

Because viruses hijack host cells to carry out viral multiplication, it is difficult for the immune system to inhibit viral
infections without affecting body cells too. An infected host cell counters viral infections is with a family of cytokines
called interferons (IFNs).

Interferons: These are a class of proteins produced by certain animal cells, such as lymphocytes and macrophages.

There are three main types of human interferons: alpha interferon (IFN-α), beta interferon (IFN-β), and gamma
inter- feron (IFN-γ).

a) They are an example of cell-mediated immunity that is specific for each type of virus.
Son un ejemplo de inmunidad celular que es específica para cada tipo de virus.

24. In this figure, the rapid rise in Ab titer after second exposure to the same Ag is possible because of: Pg 486
a) Eosinophilic granulocytes
b) Plasma cells that live many years
c) Presence of memory B cells specific for the Ag 2nd Ag
d) Cytotoxic T cells specific for the Ag exposure
1st Ag
e) All of the above
exposure
25. The first class of immunoglobulin produced in
response to initial contact with an Ag is:
a) IgA b) IgM c) IgG d) IgD e) IgE

26. The following events cause an antibody response

to a T-dependent antigen (Ag). Put them in order
and indicate which one would occur fourth.
a) Helper T cell (TH) activates an appropriate B cell
b) Helper T cell (TH) specific for the Ag binds to MHC-Ag complex
c) Ag-presenting cell displays Ag fragments next to self (MHC) molecule on its surface
d) Ag-presenting cell phagocytizes Ag-carrying microbe
e) B cell differentiates into a plasma cell; secretes antibodies specific for the Ag

Correct order.
c) Ag-presenting cell phagocytizes Ag-carrying microbe. 1step
d) Ag-presenting cell displays Ag fragments next to self (MHC) molecule on its surface. 2step
e) Helper T cell (TH) specific for the Ag binds to MHC-Ag complex. 3rd step
b) Helper T cell (TH) activates an appropriate B cell. 4th step
a) B cell differentiates into a plasma cell; secretes antibodies specific for the Ag. 5th step

27. The following events result in the destruction of a virus-infected body cell. Place them in the correct
order and indicate which one would happen third.
a) Cytotoxic T Cell (TC) binds to infected cell
b) Infected cell displays virus-directed antigens on its surface
c) Perforin damages infected cell membrane
d) Infected cell lyses
e) Cytotoxic T Cell (TC) releases perforin

Correct order:
Correct order.
b) Virus-infected cell displays virus-directed antigens on its surface. 1st
a) Cytotoxic T Cell (TC) binds to virus-infected cell. 2nd step
e) Cytotoxic T Cell (TC) releases perforin. 3rd step
d) Perforin damages cell membrane of virus-infected cell. 4th step
c) Virus-infected cell lyses. 5th step
28. Which of the following is mismatched?
a) Toxoid - inactivated toxin that induces immunity against a microbial toxin. True
b) Attenuated whole-agent vaccine - uses living but weakened microbes. True
c) Inactivated whole-agent vaccine - uses killed microbes. True
d) Subunit vaccine - uses antigenic fragments of a microbe to stimulate immunity. True
e) None of the above (All are matched correctly)

29. You mix a few drops of a patient’s blood with ABO and Rh typing serums (antibodies against A, B, & Rh
erythrocyte antigens), with these results: Anti-A agglutination; Anti-B agglutination; Anti-Rh no
agglutination. What is the patient’s ABO blood group and Rh type?
ABO
a) B positive b) A negative c) AB negative d) O negative e) AB positive

Anti-A agglutination. = A
Anti-B agglutination. = B
Anti-Rh no agglutination= negative
 30. In the direct immunofluorescence test shown below, positive fluorescence means:
a) Group A Streptococcus has been identified from the patient’s throat sample
b) Some pathogen, but not necessarily Streptococcus, is present in the patient’s throat
c) The fluorescent dye-labeled antibodies have killed the Streptococcus
d) The patient has made antibodies against Group A Streptococcus
e) Cannot be determined from information given

Ab

Ag
31. The indirect agglutination test shown at right is being performed to test
a patient’s sample for:
a) The presence of IgM antibody of any specificity. b) Antibodies specific for latex
c) The presence of a specific antigen d) The presence of antibody specific for an antigen
e) None of the above

32. Which of the following is NOT correctly matched?

a) Hapten – an “incomplete Ag” that requires a larger carrier molecule to stimulate immunologic responses
b) Cytokines – molecules that carry chemical messages between cells
c) Natural Killer Cells – lymphocytes that become specific for a given Ag after first being exposed to that Ag
d) Apoptosis – programmed cell death
e) None of the above (all are matched correctly)

33. Which of the following is NOT true about the production of monoclonal antibodies?
a) Spleen cells hybridize with myeloma cells (cancerous B cells) in culture. True
b) Monoclonal antibodies can be used in diagnostic lab tests True
c) Hybrid cells proliferate into hybridomas that grow continuously in culture to produce antibodies. True
d) Spleen cells are harvested from mice that were immunized with an antigen True
e) Each hybridoma clone produces antibodies against several different antigens. False

Monoclonal antibodies are used therapeutically to treat such inflammatory disorders.

As soon as it was determined that antibodies were produced by B cells, it was understood that these were a
potential source of a single type of antibody. If such a B cell producing a single type of antibody could be
isolated and cultivated, it would be able to produce the desired antibody in nearly unlimited quantities and
without contamination by other antibodies.

34. Which of the following is NOT true about Rh hemolytic disease (erythroblastosis fetalis)?
a) Occurs in Rh positive women carrying Rh negative fetuses. False
b) It is a result of antibodies binding to the Rh antigen on erythrocytes (red blood cells). True
c) It is an example of Type II (Cytotoxic) hypersensitivity. True
d) Can be prevented in subsequent pregnancies by administering anti-Rh antibody (RhoGam) to the
mother during pregnancy or soon after childbirth. True
e) None of the above (All are true about Rh hemolytic disease)
35. All of the following are true of antigen-presenting cells (APCs) EXCEPT:
a) They interact directly with lymphocytes. True
b) They include macrophages and dendritic cells. True
c) APCs by themselves can remember prior exposure to specific microbial antigens and respond
specifically to them. False
d) APCs process antigens from phagocytized microbes and present them to
lymphocytes. True
e) They play a key role in eliciting (triggering) specific immune responses True
36. An indirect enzyme-linked immunosorbent assay (ELISA) test on a patient’s
sample is shown at right. Development of a strong color reaction would
indicate:
a) The patient’s antibody is specific for the enzyme’s substrate
b) A high concentration of an enzyme in the patient’s sample
c) A high concentration of a specific antigen in the patient’s sample
d) A high concentration of a specific antibody in the patient’s sample. True
e) None of the above

37. Which of the following is mismatched?

a) Incidence – number of existing cases of a disease in a population at a given point in time False
b) Systemic (generalized) infection – microbes or their products (e.g., toxins)
spread throughout the body. True
c) Viremia – presence of virus in the blood. True
d) Endemic – disease is constantly present in the population True
e) None of the above are mismatched True

38. All of the following are true of health care-associated infections EXCEPT:
a) Many are caused by opportunistic pathogens in compromised patients. True
b) Some are caused by medical procedures such as surgery, catheterization, & intubation True
c) They are not uncommon, occurring in 5-15% of hospitalized patients True
d) They are sometimes caused by microbes from the health care environment
(including staff). True
e) None of the above (all are true of nosocomial infections). False

39. The diagram below shows the sites of action for the antibiotics Sulfamethoxazole and
Trimethoprim. Which of the following statements is NOT true?
a) They have a high differential toxicity because humans don’t have a pathway to synthesize folic acid True
b) There is synergy between the two antibiotics (less needed in combination than the sum of the
two individually). True
c) These antibiotics prevent the synthesis of precursors for bacterial proteins, DNA and RNA. True
d) Both antibiotics are competitive inhibitors of enzymes that make substances needed by bacterial cells. True
e) None of the above (All are true statements)
40. The polymerase chain reaction (PCR) is a valuable tool for diagnosing microbial infections. Which of the
following is NOT true about PCR?
a) It utilizes DNA polymerase enzymes that were originally derived from thermophilic bacteria
b) It allows direct identification of specific DNA sequences of microbes in clinical samples or cultures
c) It is theoretically sensitive enough to detect just one copy of a target DNA sequence in a sample
d) It utilizes specific DNA primer sequences plus nucleotides and DNA polymerase to initiate each cycle
of amplification
e) None of the above (All are true statements about PCR)

41. Which of the following is mismatched?

a. Protista (Microeukaryotes) - A catchall for eukaryotic organisms that do not fit other kingdoms
(protozoa, algae, “slime molds”)
b. Fungi - Chemoheterotrophic; unicellular or multicellular; cell walls of chitin; develop from spores or
hyphal fragments
c. Animalia (animals) - Multicellular; no cell walls; chemoheterotrophic
d. Plantae (plants) - Multicellular; cellulose cell walls; usually photoautotrophic
e. None of the above (All are matched correctly)

42. Which of the following is NOT true of prions?

a. Normal cellular prions are converted to disease-associated forms during prion infections. True
b. They cause fatal diseases of the brain in humans and other animals True
c. They are a type of negative (antisense) single-stranded RNA virus with a unique mode of replication. False
d. They are infectious protein without any DNA or RNA. True
e. None of the above (All are true of prions)

43. You perform a Minimum Inhibitory Concentration (MIC) assay on a bacterium that you have isolated
from a patient, with the results shown below (white material = bacterial growth):

Kanamycin

Tetracycline

Concentration
ug/mL 400 300 Concentration
Antibiotic 200 100
(ug/mL) 50
All of the following are correct statements about these results EXCEPT:
a) These results do not show us the MIC for Tetracycline. True
b) A lower concentration of Kanamycin than Tetracycline will inhibit growth of this bacterium. True
c) The bacterium was susceptible to Tetracycline at all concentrations tested. False
d) The MIC for Kanamycin was 200 ug/mL. True
e) None of the above (All statements are true)

44. Which of the following is NOT an example of non-specific (innate) resistance mechanisms
interacting directly with specific acquired immunity mechanisms?
a) Inflammation causing vasodilation and chemotaxis, resulting in diapedesis of phagocytic leukocytes
b) Antibodies binding to bacterial surface antigens, coating (opsonizing) the bacteria and enhancing
their phagocytosis by leukocytes
c) Complement being activated by antigen-antibody binding
d) Macrophages and dendritic cells presenting antigens to lymphocytes
e) Antibody-dependent cell-mediated cytotoxicity
45. When a patient exhibits a four-fold or greater rise in antibody titer against a specific microbial antigen
between acute-phase and convalescent-phase serum samples, this is considered to be a
“seroconversion”. Which of the following would be a correct interpretation of a seroconversion?
a) These results show that the microbe itself has been detected in the patient’s sample(s)
b) These findings cannot be interpreted because antibodies aren’t specific enough for antigens
c) There is no evidence of current active infection because that would require that the antibody titer
is decreasing rather than increasing
d) The results show evidence of current or recent infection by the specific microbe because there has been
an active immunologic response to its antigen
e) None of the above are a correct interpretation of a seroconversion

46. If a bacterium undergoes a genetic mutation that leads to a change in the amino acid sequence of a
ribosomal protein, which prevents the action of a protein synthesis-inhibiting antibiotic (thereby making
the bacterium resistant to the antibiotic) this is an example of which resistance mechanism?
a) Alteration of the drug’s target site(s) within the microbe
b) Rapid ejection (pumping) of the drug out of the microbial cell
c) Preventing penetration to the target site within the microbe
d) Destruction or inactivation of the antibiotic by the microbe
e) None of these (not an example of any of these mechanisms)

47. You culture a gram-negative rod from the urine of a patient with a bladder infection. The bacterium has
these characteristics: Can ferment lactose, cannot use citric acid as a sole carbon source. Using the key
above, what would be your identification of the bacterium?
a. Salmonella b. Enterobacter. c. Escherichia d. Citrobacter e. Shigella
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 figure illustrates all of the
following EXCEPT:
a) At the beginning of therapy, most of the bacteria were susceptible to the antibiotic. True
b) During antibiotic therapy, resistant strains of bacteria emerged in the patient. True
c) The bacterial population eventually increases again as antibiotic-resistant bacteria
replace susceptible bacteria. True
d) After about 5 days of treatment, virtually all of the bacteria in the patient’s samples have reverted to
being susceptible to the antibiotic. False
e) None of the above (All of these statements are illustrated by the figure). True

CORRECT ANSWERS
(Real exam will have 50 questions)

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