1.

A 27-year-old woman is admitted to the hospital because of fever, with increasing anorexia,
headache, weakness, and altered mental status of 2 days’ duration. She works for an air- line as a
cabin attendant, ying between the Indian subconti- nent and other places in Southeast Asia and
the West Coast of the United States. Ten days before admission, she had a diar- rheal illness that
lasted for about 36 hours. She has been con- stipated for the past 3 days. Her temperature is
39°C, heart rate is 68 beats/min, blood pressure is 120/80 mm Hg, and respira- tions are 18
breaths/min. She knows who she is and where she is but does not know the date. She is picking
at the bedclothes. Rose spots are seen on her trunk. The remainder of the physical examination is
normal. Blood cultures are done, and an intra- venous line is placed. The most likely cause of her
illness is

(A) EnterotoxigenicE.coli(ETEC)

(B) S. sonnei

(C) S. enterica subspecies enterica serotype Typhimurium (Salmonella Typhimurium)

(D) S. enterica subspecies enterica serotype Typhi (Salmonella Typhi)

(E) Enteroinvasive E. coli (EIEC)

2.Which type of the cell can phagocytose and kill Y. pestis?

A. Neutrophil

B. Dendritic cells

C. Macrophages

D. Epithelial cell

3.The ability of Y. pestis to spread in blood stream is attributed to which virulence factor?

A. Type III secretion system

B. Apoptosis of macrophage

C. Type II secretion system

D. Plasmin activator

E. LPS

4.Which type of specimen is best used for anti- Y. pestis antibody detection?

A. Sputum

B. Serum

C. CSF

D. Lymph node aspirate

5.The disease caused by Y. pestis is a serious disease, because:

A. There is no vaccine

B. There is no antibiotic therapy

C. The pathogen is highly antibiotic resistant

D. There is no speci c diagnostic test

E. It is a highly communicable disease

6.Which one of the following statements concerning the organisms that cause brucellosis is
CORRECT?

A. Brucella are transmitted primarily by tick bite.

B. Brucella infect reticuloendothelial cells in the liver, spleen, and bone marrow.

C. The principal reservoirs of Brucella are small rodents

D. Brucella are obligate intracellular parasites that are usually identi ed by growth in human cell
culture.

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B

7.Minister returns from mission trip to Central America and he develops fever, myalgia, abdominal
pain, watery diarrhea, hepatosplenomegaly and rose spots on umbilical area. What organism is
most likely?

A. Salmonella typhi

B. Brucella melitensis

C. Vibrio cholera

D. Salmonella enteritis