Exam IV                       Name ______________ 

Directions: Multiple choice. Circle the correct
answer. Total of 42 points. 

1. All of the following statements regarding
    Treponema pallidum are true EXCEPT ? 
    a. shape - spirochete 
    b. Gram reaction - gram-nonreactive 
    c. culture - Thayer Martin Selective agar 
    d. transmission - sexually 
    e. transmission - open lesion on hands 

2. All of the following are reportable sexually
    transmitted diseases EXCEPT ? 
    a. Gonorrhea. 
    b. AIDS. 
    c. Trichomoniasis. 
    d. Syphilis.
    e. All of the above. 

3. Most cases of complicated cystitis are caused
    a. E. coli. 
    b. Enterococcus. 
    c. Proteus. 
    d. Klebsiella.
    e. Pseudomonas.

4. Which of the following is not a complication of
    a. Sterility 
    b. Pelvic inflammatory disease 
    c. Arthritis 
    d. Meningitis
    e. None of these

5. Which of the following pairs are mismatched
    for syphilis ? 
    a. incubation period - three weeks 
    b. chancre - indolent 
    c. antibodies produced, no outward signs -
        primary phase 
    d. flu like syndrome - secondary phase 
    e. None of these 

6. Which of the following statements regarding
    neonatal syphilis is incorrect ? 
    a. Transmitted through placenta during 5th
    b. Early lesions resemble chancres. 
    c. 25% of the cases die in utero. 
    d. Late lesions resemble gummas. 
    e. None of these 

7. Which of the following statements regarding
    the Rapid Plasma Reagin test for syphilis is
    TRUE ? 
    a. Uses the Reiter strain of T. pallidum. 
    b. Uses the Nichol strain of T. pallidum. 
    c. Almost no biologically false positives. 
    d. Reacts with Wasserman antibodies of
    e. None of the above. 

Exam IV, Page 2 

8. All of the following are symptoms of gonorrhea
    in males EXCEPT ? 
    a. dysuria 
    b. purulent discharge 
    c. urethral stricture 
    d. chronic prostatitis
    e. salpingitis

9. A major cause of septic arthritis in adults is ? 
    a. Neisseria gonorrhoeae 
    b. Treponema pallidum 
    c. Chlamydia trachomatis 
    d. Herpes simplex
    e. None of these.

10. Most cases of posttransfusion hepatitis are
     caused by 
     a. Hepatitis A virus. 
     b. Hepatitis B virus. 
     c. Hepatitis C virus. 
     d. All of these. 
     e. None of these; modern screening
         techniques have eliminated
         posttransfusion hepatitis. 

11. All of the following statements about
      salmonellosis are true except
      a. It is a food infection disease.
      b. It requires a small infective dose.
      c. main symptoms involve GI disturbance
          and septicemia
      d. results in about two million food
          poisonings annually
      e. It is often associated with poultry

12. Which of the following does not produce a
      gastrointestinal disease that includes
      production of an exotoxin?
      a. Escherichia coli
      b. Vibrio cholerae
      c. Shigella dysenteriae
      d. Salmonella typhimurium
      e. all of the above produce exotoxins

13. Treatment of gonorrhea includes all of the
      following EXCEPT ?
      a. ampicillin - for penicillin sensitive strains.
      b. ceftriaxone - effective against incubating
      c. spectinomycin - prevents
            post-gonococcal urethritis.

      d. ceftriaxone - pharyngeal gonorrhea.
      e. All of these are correct treatments. 

14. Chemoprophylaxis for meningitis caused by
      Neisseria includes ?
      a. Penicillin G.
      b. chloramphenicol.
      c. streptomycin.
      d. rifampin.
      e. both a and b are correct.

Exam IV, Page 3 

15. Which of the following is diagnosed by the
      presence of flagellates in the patient's
      a. Balantidiasis
      b. Giardiasis
      c. Trichinosis
      d. Trypanosoma
      e. Plasmodium

16. Which of the following causes an acute
      infection in humans, which is transmitted by
      a. Giardia lamblia
      b. Balantidium coli
      c. Trypanosoma
      d. Toxoplasma gondii
      e. Entamoeba histolytica

17. Which of the following pairs regarding
      Helminth infestations is incorrect?
      a. Platyhelminths - roundworm.
      b. Nematodes - roundworm.
      c. Tapeworm - flatworm.
      d. Pinworm - roundworm.
      e. Fluke - flatworm.

18. The most common cause of traveler's
      diarrhea is probably
      a. Shigella spp.
      b. Salmonella typhi.
      c. Giardia lamblia.
      d. Escherichia coli.
      e. Entamoeba coli. 

19. Which of the following can be transferred
      from an infected mother to her fetus
      across the placenta?
      a. Mumps
      b. Cytomegalovirus inclusion disease
      c. Infectious hepatitis
      d. Typhoid fever
      e. Enteroinvasive E. coli

20. Treatment of superficial candidiasis includes?
      a. chloroquine
      b. metronidazole
      c. tetracycline
      d. griseofulvin (oral)
      e. miconazole (topical), nystatin (oral) 

21. Which of the following causes an infection of
      the liver?
      a. Salmonella
      b. Shigella
      c. Hepatitis A virus
      d. Vibrio
      e. Balantidium

22. "Rice water stools" are characteristic of
     a. Salmonellosis.
      b. Cholera.
      c. Bacillary dysentery.
      d. Amoebic dysentery.
      e. Tapeworm infestation. 

Exam IV, Page 4 

23. Most gastrointestinal infections are treated
      a. Antitoxin.
      b. Penicillin.
      c. Fluid and electrolytes.
      d. Quinacrine.
      e. None of these.

24. Which of the following is treated with
      a. Staphylococcal food poisoning
      b. Vibrio cholerae
      c. Infectious hepatitis
      d. Travelers diarrhea
      e. Shigellosis 

25. All of the following are gram-negative rods
      that cause gastroenteritis except
      a. Pseudomonas.
      b. Escherichia.
      c. Salmonella.
      d. Shigella.
      e. Vibrio.

26. Systemic mycoses include all of the following
      a. Ringworm.
      b. Blastomyces.
      c. Coccidioidomycosis.
      d. Histoplasmosis.
      e. Cryptococcosis.

27. Treatment of Pseudomonas aeruginosa
      Urinary Tract Infections includes?
      a. Tetracycline
      b. Gentamicin
      c. Carbenicillin
      d. Gentamicin with carbenicillin
      e. Erythromycin

28. A primary symptom of this disease is a
      spasmodic coughing accompanied by a rapid
      intake of air. Complications include a
      collapsed lung and convulsions. This disease
      a. Pertussis. 
      b. Legionnaire's disease. 
      c. Pseudomonas pyoderma. 
      d. Contagious meningitis.
      e. Hepatitis E virus.

29. Which of the following is not a characteristic
      of P. aeruginosa? 
      a. Gram-positive rods 
      b. Aerobic 
      c. Green pigment 
      d. Resistant to antibiotics
      e. None of these 

30. Which of these is not caused by herpes
      a. Chickenpox 
      b. Shingles 
      c. fever blisters 
      d. Hepatitis C 
      e. None of these 

Exam IV, Page 5 

31. Thrush and vaginitis are caused by 
      a. Herpes virus. 
      b. Chlamydia trachomatis. 
      c. Candida albicans. 
      d. Staphylococcus aureus. 
      e. Streptococcus pyogenes. 

32. The greatest single cause of ophthalmia
      neonatorum in the world is 
      a. Neisseria gonorrhoeae. 
      b. Pseudomonas aeruginosa. 
      c. Chlamydia trachomatis. 
      d. Haemophilus influenzae. 
      e. Haemophilus aegyptius. 

33. All of the following are true regarding
      Legionnaire's disease EXCEPT? 
      a. Transmission is by droplet. 
      b. An atypical pneumonia. 
      c. A gram negative rod. 
      d. Air conditioning units implicated in
      e. Prevention is by DPT vaccine. 

34. The most common etiology for shigellosis in
      the northern USA is? 
      a. Shigella enteriditis. 
      b. Shigella flexneri. 
      c. Shigella sonnei. 
      d. Shigella dysenteriae. 
      e. Shigella coli

35. Transmission of shigellosis is primarily by? 
      a. poultry such as chickens. 
      b. pet turtles. 
      c. cats spreading it to humans. 
      d. mice spreading it to humans. 
      e. humans to humans.

36. The etiologic agent of chickenpox. 
      a. human herpes virus 1 
      b. human herpes virus 2 
      c. human herpes virus 3 
      d. human herpes virus 4
      e. human herpes virus 5

37. Probably the most common cause of infantile
      diarrhea is?
      a. Enteropathogenic E. coli
      b. Enterotoxigenic E. coli
      c. Enteroinvasive E. coli
      d. Shigella dysenteriae
      e. Proteus mirabilis 

38. This organism ranks second to E. coli as a
      cause of uncomplicated cystitis.
      a. Shigella
      b. Salmonella
      c. Proteus
      d. Vibrio
      e. Pseudomonas 

Exam IV, Page 6 

39. The etiologic agent of fever blisters.
      a. human herpes virus 1
      b. human herpes virus 2
      c. human herpes virus 3
      d. human herpes virus 4
      e. human herpes virus 5

40. This organism is a common cause of
      nosocomial pneumonia.
      a. Streptococcus pneumoniae
      b. Mycoplasma pneumoniae
      c. Haemophilus influenzae
      d. Klebsiella pneumoniae
      e. Proteus mirabilis

41. This antibiotic is used for UTI caused by
      Proteus mirabilis.
      a. Ampicillin.
      b. Cefotaxime.
      c. Penicillin.
      d. Streptomycin.
      e. Cefotaxime with Penicillin.

42.The major cause of meningitis in children
     under two years of age is?
     a. Streptococcus pneumoniae
     b. Staphylococcus aureus
     c. Streptococcus pyogenes
     d. Haemophilus influenzae
     e. Yersinia pestis 

Exam IV, Page 7 

Part B Directions: Essay. Answer the questions in the space provided. Total of 58 points. 

1. Discuss the possible outcomes for the late
     latent phase of syphilis ? (6 pts) 
25%-completely cured. No symptoms, no Abs.
25%-remain in late latent phase for life. Slow destruction of tissues.
50%-enter tertiary phase. Gummas. Rapid destruction of tissues.

2. What is the recommended treatment for
     syphilis ? (2 pts) 
benzathine Pen G

3. Explain the difference between healthy and
     convalescent carriers. (4 pts) 
healthy-no symptoms but shedding organism.
convalescent-no longer has disease but still shedding organaism.

4. What two factors are associated with
     Pseudomonas Urinary Tract Infections?
     (2 pts) 
nosocomial and instrumentation

5. What is the better choice in prevention of
     ophthalmia neonatorum, silver nitrate or
     erythromycin? Explain giving a specific
     example. (4 pts) 
erythromycin, since silver nitrate not effective against Chlamydia trachomatis

6.What treatment is recommended for
    Shigellosis? (2 pts)
fluid and electrolytes

7. Define "uncomplicated" cystitis. (2 pts) 
no predisposing factors such as obstruction, antibiotics, instrumentation

8. Compare treatments for meningitis and acute
     bacterial epiglottitis caused by Haemophilus
     influenzae and explain the differences.
     (5 pts) 
meningitis-ampicillin and chloramphenicol
epiglotitis-ampicillin and trachea tube to avoid chloramphenicol

9. What is the drug of choice for shingles?
     (2 pts) 

10. Give at least two reasons why genital herpes
      is a serious infection. (4 pts)
cervical cancer

11. Two functions of the capsid of a virus are? (4
recognition of host cells

12. List the major opportunistic bacterial, fungal,
      protozoan, and viral diseases used to define
      AIDS. (4 pts)
Mycobacterium avium complex
Pneumocystis carinii pneumonia
Herpes simplex and herpes zoster

Exam IV, Page 8 

13. Bacteriophages have what basic shape? (2
T or binal shape

14. For hepatitis A and hepatitis B, compare the
      following factors: synonym, transmission, is
      it associated with hepatoma? (6 pts)

15. True or False? One common characteristic of
       Herpes viruses is that once the infection is
       over, you are usually completely cured. (2

16. What are retroviruses, and how are they
       different from other viruses? (2 pts) 
single-stranded RNA viruses. They have oncogenic abilities

17. This Rickettsial disease is louse-borne and is
       associated with poor personal hygiene. (2
epidemic typhus

18. Differentiate between HIV infection, HIV
      disease, and AIDS.(3 pts)
HIV infection-mononucleosis-like symptoms
HIV disease-incubation period 2 to 15 years, with fever, swollen lymph glands, fatigue, diarrhea, weight loss, opportunistic infections.
AIDS-severe immunodeficiency, life-threatening opportunistic infections, persistent fever, unusual cancers, chronically swollen lymph nodes, weight loss, diarrhea.