1.
Clostridium perfringens is notable for causing gas gangrene. Which other condition is this bacterium associated with?
Correct Answer
D. D) A self limiting, acute, diarrheal illness associated with Type A bacteria
Explanation
Clostridium perfringens is associated with a self-limiting, acute, diarrheal illness caused by Type A bacteria. This bacterium is known to produce toxins that can cause gastrointestinal symptoms such as abdominal pain, cramping, and diarrhea. The illness typically resolves on its own without treatment within a few days. Gas gangrene, on the other hand, is a separate condition caused by Clostridium perfringens infection in deep wounds or tissue injuries.
2.
A 52-year-old medical missionary has recently returned to the US from a tour in an emerging nation. She presents to her family physician with a complaint of a productive cough and some dyspnea. She says that this has been going on for some time, but she wanted to wait for medical care in the states. She has not history of smoking and rarely drinks alcohol. Physical exam reveals some lung consolidation on auscultation and a low grade fever. A chest x-ray reveals multifocal 1-3 cm nodules, a few being cavitated. Acid fast stains or the sputum reveal acid-fast organisms; however the results of cultures are yet to be determined. Which of the following is the Most Likely cause of the lung lesions?
Correct Answer
B. Granulomatous inflammation
Explanation
The presence of multifocal nodules, some of which are cavitated, along with acid-fast organisms in the sputum, suggests a chronic infectious process. Granulomatous inflammation is a characteristic feature of certain chronic infections, such as tuberculosis. This type of inflammation is characterized by the formation of granulomas, which are aggregates of immune cells that wall off the infectious agent. Therefore, granulomatous inflammation is the most likely cause of the lung lesions in this case.
3.
A pathologist receives a surgical specimen taken from a 12-year-old boy. The submitted history is not helpful. The specimen is processed for histopathology and the pathologist submits the following report. The specimen was one cm in diameter and nodular. The cut surface revealed a central region of white creamy material surrounded by a rim of firm tissue. Microscopically, the central region consisted of neutrophils, some of which were apoptotic. The neutrophils were surrounded by a capsule of proliferating granulation tissue. What is your diagnosis?
Correct Answer
A. Abscess
Explanation
The given report describes a surgical specimen with a central region of white creamy material surrounded by a rim of firm tissue. Microscopically, the central region consists of neutrophils, some of which are apoptotic, surrounded by a capsule of proliferating granulation tissue. This is consistent with the characteristics of an abscess, which is a localized collection of pus caused by an infection. The presence of neutrophils, apoptotic cells, and granulation tissue supports the diagnosis of an abscess.
4.
A 49-year-old woman has a high fever and a productive cough for 3 days. Her sputum is copious and yellow. Crackles are audible bilaterally at both lung bases and chest x-rays reveal patchy pulmonary infiltrates. Which of the following would most likely be found in greatest number in her sputum specimens?
Correct Answer
B. NeutropHils
Explanation
Neutrophils would most likely be found in the greatest number in her sputum specimens. Neutrophils are a type of white blood cell that are involved in the body's immune response to infection. They are typically the first cells to arrive at the site of infection and help to fight off bacteria and other pathogens. In this case, the woman's symptoms of high fever, productive cough, and lung infiltrates suggest a respiratory infection, which would trigger an increased number of neutrophils in the sputum as they migrate to the lungs to combat the infection.
5.
A patient is scheduled to have a chronic abscess incised and drained. What would you expect microscopic examination of the contents of the abscess to most likely show?
Correct Answer
C. A chronic inflammatory infiltrate of neutropHils, lympHocytes, macropHages & plasma cells
Explanation
Microscopic examination of the contents of a chronic abscess would most likely show a chronic inflammatory infiltrate of neutrophils, lymphocytes, macrophages, and plasma cells. This is because chronic abscesses are characterized by a prolonged inflammatory response, which involves the accumulation of various immune cells. Neutrophils are the first responders to an infection and are present in both acute and chronic inflammation. Lymphocytes, macrophages, and plasma cells are also involved in the chronic inflammatory response.
6.
A severely neutropenic transplant has died from pulmonary hemorrhage due to hyphae invading the pulmonary blood vessels resulting in infarct and major hemorrhage. Which of these fungi could do this?
Correct Answer
B. Aspergillus
Explanation
Aspergillus is a type of fungus that can invade the pulmonary blood vessels, leading to infarct and major hemorrhage. This can result in pulmonary hemorrhage, which is the cause of death in this case. The other fungi listed, such as Blastomyces, Sporothrix, Histoplasma, and Coccidioides, may cause other types of respiratory infections but are not typically associated with invading blood vessels in the lungs.
7.
Which description below best describes colorless fungal fiaments?
Correct Answer
D. Hyaline hypHae
Explanation
Hyaline hyphae are colorless fungal filaments. "Colorless" refers to the absence of pigmentation, while "hyaline" describes their transparent and glass-like appearance. This term is commonly used to describe the typical appearance of fungal hyphae under a microscope. It is important to note that the other options provided in the question do not accurately describe colorless fungal filaments.
8.
A 45-year old man from Missouri was referred to the hospital with a 3-week history of fever, cough, shortness of breath and fatigue. The patient has been diagnosed with AIDS S years previously. A routine direct examination of a blood smear is shown below.
Which of the following is the growth form of the most probable causative pathogen?
Correct Answer
B. A thermally dimorpHic fungus, mould form at 25°C (77°F) and yeast form at 37°C (99°F)
Explanation
The correct answer is "A thermally dimorphic fungus, mould form at 25°C (77°F) and yeast form at 37°C (99°F)". This is because the question mentions that the patient has been diagnosed with AIDS, which makes him immunocompromised. Immunocompromised individuals are more susceptible to fungal infections, and thermally dimorphic fungi are known to cause infections in these patients. The growth form of the most probable causative pathogen is important to determine because it can help guide treatment strategies. In this case, the pathogen is a thermally dimorphic fungus, meaning it can exist as a mould form at lower temperatures (25°C) and as a yeast form at higher temperatures (37°C).
9.
Clostridium difficile is an important cause of nosocomiai diarrhea and disease in C. difficile colitis is mediated by toxins produced by the organism. Which type of laboratory test would be the most rapid and efficient way of confirmng infection with this organism?
Correct Answer
D. Detection of the toxin produced by the organism
Explanation
Detection of the toxin produced by the organism would be the most rapid and efficient way of confirming infection with Clostridium difficile. This is because C. difficile colitis is mediated by toxins produced by the organism, so detecting the presence of these toxins directly indicates the presence of the infection. Cultivating the microbe on semi-solid media or in cell lines may take longer and may not always yield accurate results. Gram staining of the specimen may provide some information, but it does not directly confirm the presence of the toxin or the infection. Detection of the patient's immune response against the organism may also take longer and may not be as specific as directly detecting the toxin.
10.
Fungi are a main cause of human infection.
Correct Answer
B. False
Explanation
Relatively few cause human disease
Healthy humans have innate resistance
11.
Infections from fungi occur mostly due to:
Correct Answer
D. All of the above
Explanation
Infections from fungi can occur due to various reasons. Disruption of natural barriers, such as a compromised skin barrier or damage to the mucous membranes, can provide an entry point for fungal infections. Immunosuppression weakens the body's immune system, making it more susceptible to fungal infections. Occupational contact with fungi, such as in certain industries like agriculture or construction, can also increase the risk of fungal infections. Therefore, all of the mentioned factors - disruption of natural barriers, immunosuppression, and occupational contact - can contribute to the occurrence of fungal infections.
12.
Fungi that infect outside layers of skin or hair only are classified as?
Correct Answer
A. Superficial
Explanation
Fungi that infect only the outside layers of the skin or hair are classified as superficial. Superficial fungal infections typically affect the topmost layers of the skin, such as the epidermis, and do not penetrate deeper tissues. They are often characterized by symptoms like itching, redness, and scaling of the skin. Cutaneous fungal infections, on the other hand, involve the deeper layers of the skin, while subcutaneous infections affect the tissues beneath the skin. Systemic infections refer to fungal infections that spread throughout the body, and opportunistic infections occur in individuals with weakened immune systems.
13.
Fungi that invade skin, hair, nails are classified as?
Correct Answer
B. Cutaneous
Explanation
Cutaneous refers to conditions or infections that affect the skin. Fungi that invade the skin, hair, and nails are classified as cutaneous because they specifically target and infect these areas. This classification helps in understanding the nature and location of the infection, allowing for appropriate diagnosis and treatment.
14.
Fungi that are localized and enter by trauma are classified as?
Correct Answer
C. Subcutaneous
Explanation
Subcutaneous fungi are classified as fungi that are localized and enter the body through trauma. They infect the tissues just below the skin, causing infections such as abscesses or cellulitis. These infections are typically caused by fungi that are found in the environment, such as Sporothrix schenckii. Subcutaneous infections are different from superficial infections, which only affect the surface of the skin, and systemic infections, which spread throughout the body.
15.
Fungi that are more virulent and cause disease in healthy hosts are classified as?
Correct Answer
D. Systemic
Explanation
Fungi that are more virulent and cause disease in healthy hosts are classified as systemic. Systemic fungi are able to infect and spread throughout the body, affecting multiple organs and systems. They are typically more severe and difficult to treat compared to other types of fungal infections.
16.
Fungi that infect only infect compromised hosts are clasified as?
Correct Answer
E. Opportunistic
Explanation
Fungi that infect only compromised hosts are classified as opportunistic. Opportunistic infections occur when a person's immune system is weakened or compromised, allowing the fungi to take advantage of the opportunity to infect. These infections typically do not occur in healthy individuals with normal immune function. Therefore, the correct answer is opportunistic.
17.
Which part of the fungal cell should a drug target so as to cause the least amount of damage to the human host?
Correct Answer
B. Ergosterol in cell membrane
Explanation
ergosterol can be targeted to alter permeability
drugs must not inhibit cholesterol as well
18.
Which antifungal drug binds to ergosterol in the fungal membrane and forms pores in the membrane?
Correct Answer
A. AmpHotericin
Explanation
Amphotericin is an antifungal drug that binds to ergosterol, which is a key component of the fungal membrane. By binding to ergosterol, amphotericin forms pores in the fungal membrane, leading to leakage of cellular contents and ultimately killing the fungus. This mechanism of action makes amphotericin effective against a broad range of fungal infections.
19.
A person can only get a certain amount of Amphotercin in his/her lifetime.
Correct Answer
A. True
Explanation
Amphotericin is a medication used to treat serious fungal infections. It is a potent and potentially toxic drug that can cause various side effects. Due to its toxicity, it is generally administered with caution and limited to a certain amount in a person's lifetime to minimize the risk of adverse effects. Therefore, the statement that a person can only get a certain amount of Amphotericin in his/her lifetime is true.
20.
Which drug do fungi take it up using a permease that our cells do not make. It gets incorporated into the fungal RNA in place of uracil.
Correct Answer
B. 5-fluorocytosine
Explanation
5-fluorocytosine is the correct answer because it is a drug that fungi can take up using a permease that our cells do not make. Once inside the fungal cells, it gets incorporated into the fungal RNA in place of uracil. This incorporation disrupts the normal functioning of the fungal RNA, leading to inhibition of protein synthesis and ultimately fungal cell death.
21.
The fungal cells can develop a resistance to *this drug* if given by itself, so it is usually given in combination with Amphotericin B
Correct Answer
A. 5-fluorocytosine
Explanation
Fungal cells can develop resistance to 5-fluorocytosine if given alone. Therefore, it is typically administered in combination with Amphotericin B to enhance its effectiveness and prevent the development of resistance.
22.
This drug is good for fungal meningitis since it can enter the CNS.
Correct Answer
B. 5-fluorocytosine
23.
Which antifungal drug Blocks squalene epoxidase enzyme to prevent squalene conversion to ergosterol.
Correct Answer
C. Terbinafine
Explanation
Terbinafine is the correct answer because it is an antifungal drug that blocks the squalene epoxidase enzyme. This enzyme is responsible for converting squalene to ergosterol, which is an essential component of the fungal cell membrane. By inhibiting this enzyme, terbinafine prevents the synthesis of ergosterol, leading to disruption of the fungal cell membrane and ultimately killing the fungus.
24.
Which antifungal drug inhibits cytochromes (cytochrome P450)? This prevents ergosterol formation, which disrupts membrane function and growth
Correct Answer
D. The azoles
Explanation
The correct answer is the azoles. Azoles are a class of antifungal drugs that inhibit cytochromes, specifically cytochrome P450 enzymes. This inhibition prevents the formation of ergosterol, which is an essential component of fungal cell membranes. Without ergosterol, the membrane function is disrupted, leading to impaired growth and survival of the fungus.
25.
Which antifungal drug can have the following side effects?males – may develop breastsfemales – irregular menstrual cyclesliver toxicity
Correct Answer
D. The azoles
Explanation
The azoles are a class of antifungal drugs that can have the listed side effects. They can cause hormonal imbalances in both males and females, leading to breast development in males and irregular menstrual cycles in females. Additionally, the azoles can cause liver toxicity as a potential side effect.
26.
Thiazoles have the same SE but are less toxic than imidazoles
Correct Answer
A. True
Explanation
Thiazoles and imidazoles are both types of organic compounds that contain a five-membered ring structure. They have similar side effects (SE) but thiazoles are considered to be less toxic compared to imidazoles. This means that thiazoles are less likely to cause harmful effects or adverse reactions in comparison to imidazoles. Therefore, the statement that thiazoles have the same side effects but are less toxic than imidazoles is true.
27.
Which antifungal drug Inhibits β-(1,3)-D-glucan synthesis, which usually makes the cross-bridges in the fungal cell wall. Therefore cell wall formation is inhibited
Correct Answer
E. Capsofungin
Explanation
Caspofungin is the correct answer because it inhibits β-(1,3)-D-glucan synthesis, which is responsible for forming the cross-bridges in the fungal cell wall. By inhibiting this process, caspofungin prevents the formation of the cell wall, leading to the inhibition of fungal growth and replication.
28.
Fluconazole is used to treat meningitis, because it can attain good CNS levels
Correct Answer
A. True
Explanation
Fluconazole is used to treat meningitis because it can reach high levels in the central nervous system (CNS). Meningitis is an infection that affects the protective membranes surrounding the brain and spinal cord, and it requires a medication that can effectively penetrate the CNS. Fluconazole is an antifungal medication that is able to cross the blood-brain barrier and reach therapeutic concentrations in the CNS, making it an effective treatment option for meningitis caused by certain fungal infections.
29.
Echinocandins is a class of antifungals that act as a fungicidal for Candida and also work against Aspergillus
Correct Answer
A. True
Explanation
Echinocandins are a class of antifungal drugs that are effective against Candida and Aspergillus fungi. They work by inhibiting the synthesis of a component in the fungal cell wall, leading to cell death. Therefore, it is true that echinocandins act as a fungicidal (killing the fungus) for Candida and also work against Aspergillus.
30.
Nystatin is a polyene similar to Amphotericin B.
Correct Answer
A. True
Explanation
Nystatin is indeed a polyene antifungal medication that is similar to Amphotericin B. Both drugs belong to the same class of antifungals and work by binding to the cell membrane of fungi, causing damage and ultimately leading to their death. Therefore, the statement "Nystatin is a polyene similar to Amphotericin B" is true.
31.
Cutaneous Mycoses are also called Called tineas or ringworms
Correct Answer
A. True
Explanation
Cutaneous mycoses, also known as tineas or ringworms, are fungal infections that affect the skin, hair, and nails. These infections are caused by various types of fungi that invade and grow in the superficial layers of the skin. The term "ringworm" is used because the infection often causes a circular rash with a raised, red border that resembles a ring. Therefore, the statement that cutaneous mycoses are also called tineas or ringworms is true.
32.
Which of the following shows up as typical “ringworm” lesions
Correct Answer
A. Tinea corporis
Explanation
Tinea corporis is a fungal infection that affects the skin, commonly known as ringworm. It typically appears as circular or ring-shaped lesions on the body, hence the name "ringworm." The infection causes redness, itching, and scaling of the skin in the affected area. Tinea capitis refers to ringworm of the scalp, tinea cruris refers to ringworm in the groin area, and tinea unguium refers to ringworm of the nails. However, only tinea corporis is specifically associated with the characteristic ring-shaped lesions.
33.
Which of the following is mostly seen in children before puberty?
Correct Answer
D. Tinea capitis
Explanation
Tinea capitis is mostly seen in children before puberty. This is a fungal infection that affects the scalp and hair follicles, causing symptoms such as itching, redness, and hair loss. It is more common in children due to their underdeveloped immune systems and close contact with others in school or daycare settings. Tinea corporis, tinea unguium, and tinea cruris are fungal infections that primarily affect the body, nails, and groin respectively, and are not specifically associated with children before puberty.
34.
Which of the following is NOT true regarding treatment of tinea capitis?
Correct Answer
A. Only topical treatment is needed
Explanation
oral + topical needed
35.
Tinea pedis is the most prevalent dermatophytosis in U.S.
Correct Answer
A. True
Explanation
uncommon in children
primarily in adults who wear shoes
chronic infection of toe webs, soles
fluid-filled lesions dry to itch, crack, peel
36.
Which of the following is a subcutaneous Mycosis known as “rose-handler’s” disease
Correct Answer
C. Sporotrichosis
Explanation
Sporotrichosis is a subcutaneous mycosis commonly known as "rose-handler's" disease. It is caused by the fungus Sporothrix schenckii and is often associated with handling thorny plants or gardening. The infection typically starts at the site of a minor cut or injury, and can spread along the lymphatic vessels, causing nodular lesions that may ulcerate. It is not transmitted from person to person, but rather through contact with contaminated soil or plants. Treatment usually involves antifungal medications.
37.
Which of the following is the cause of sporotrichosis?
Correct Answer
B. Sporothrix schenckii
Explanation
subcutaneous mycosis - under the skin
generally introduced by trauma
found in soil, decaying vegetation
most common in agricultural workers, gardeners
38.
Treat Sporotrichosis caused by Sporothrix schenckii with newer azole, e.g. itraconazole
Correct Answer
A. True
Explanation
Sporotrichosis is a fungal infection caused by the organism Sporothrix schenckii. It is commonly treated with antifungal medications, and one of the newer options is an azole drug called itraconazole. Azoles are a class of antifungals that work by inhibiting the growth of the fungus. Itraconazole has been found to be effective in treating sporotrichosis, making the statement true.
39.
What is the primary focus of infection for Systemic Mycoses
Correct Answer
A. Lung
Explanation
most cases asymptomatic to mild
resolve spontaneously and confer resistance
40.
Which systemic mycosis is usually found in the oil of southwest U.S., Mexico, South America and is referred to as San Joaquin Valley Fever?
Correct Answer
B. Coccidioidomycosis
Explanation
people inhale spores when dust is stirred up
41.
Which of the following is not true regarding Histoplasma capsulatum
Correct Answer
B. It is capsulated
Explanation
it does NOT have a capsule!
42.
Which of the following is not dimorphic and is the only medically important encapsulated yeast?
Correct Answer
B. Cryptococcus neoformans
Explanation
Cryptococcus neoformans is the only medically important encapsulated yeast among the given options. This means that it has a protective polysaccharide capsule surrounding its cell wall, which helps it evade the host's immune system. Dimorphism refers to the ability of a microorganism to exist in two different forms, typically a mold form and a yeast form. Both Histoplasma capsulatum and Coccidioides immitis are dimorphic fungi, meaning they can exist as molds in the environment and as yeast forms in the host. Therefore, the correct answer is Cryptococcus neoformans, which is not dimorphic but still medically significant due to its encapsulation.
43.
Histoplasmosis is the hallmark infection of AIDS patients
Correct Answer
B. False
Explanation
Cryptococcosis is the hallmark infection of AIDS patients
44.
Cryptococcosis may mimic brain tumor, abscess, or MS
Correct Answer
A. True
Explanation
Cryptococcosis, a fungal infection caused by Cryptococcus neoformans, can present with symptoms that mimic those of brain tumors, abscesses, or multiple sclerosis (MS). This is because the infection can lead to the formation of lesions in the brain, which can cause similar symptoms such as headaches, confusion, and neurological deficits. Therefore, it is important to consider cryptococcosis as a potential differential diagnosis when evaluating patients with these symptoms, especially in individuals with compromised immune systems.
45.
Which of the following is true regarding Cryptococcosis Treatment
Correct Answer
E. All of the above are true
Explanation
The statement "all of the above are true" means that all the options mentioned in the question are correct regarding Cryptococcosis Treatment. This implies that treatment for pulmonary infection is not usually needed, but it is mandatory for meningitis. The treatment typically involves the use of Amphotericin B intravenously, sometimes in combination with 5-fluorocytosine. Additionally, it is mentioned that the treatment can sometimes be switched to oral azole.
46.
A diaper rash is also known as a candidiasis infection.
Correct Answer
A. True
Explanation
A diaper rash is indeed commonly caused by a candidiasis infection. Candidiasis is a type of fungal infection that can occur in moist areas of the body, such as the diaper area in infants. It is characterized by redness, irritation, and discomfort in the affected area. Therefore, the statement "A diaper rash is also known as a candidiasis infection" is true.
47.
With dimorphic pathogens the Yeast forms are found in tissue and in culture at ______ degrees celsius.
Correct Answer
B. 37
Explanation
Dimorphic pathogens are microorganisms that can exist in two different forms, typically a yeast form and a mold form. In the case of this question, the yeast forms of dimorphic pathogens are found in tissue and in culture at 37 degrees Celsius. This is the optimal temperature for these pathogens to grow and thrive in their yeast form. The higher temperature of 37 degrees Celsius allows for the yeast forms to replicate and cause infection in the host.
48.
When a dimorphic pathogen is isoleated, we try and convert it to the "_______" temperature.
Correct Answer
C. Opposite
Explanation
When a dimorphic pathogen is isolated, we try and convert it to the opposite temperature. This means that if the pathogen is typically found or grows well at a higher temperature, we would try to culture it at a lower temperature, and vice versa. This is done to study the pathogen's behavior and characteristics under different temperature conditions, which can provide valuable insights into its biology and potential strategies for controlling or treating infections caused by the pathogen.
49.
Evidence suggests that each Dimorphic Fungi is a saprophyte in soil. But are they part of the normal flora in man?
Correct Answer
B. No
Explanation
The evidence suggests that each Dimorphic Fungi is a saprophyte in soil, meaning they obtain nutrients from decaying organic matter in soil. However, the question asks if they are part of the normal flora in man. Normal flora refers to the microorganisms that naturally inhabit the human body. Since Dimorphic Fungi are typically found in soil and not as part of the normal flora in humans, the answer is "No".
50.
Primary infection in most cases of dimorphic fungi is _________.
Correct Answer
C. Pulmonary infection
Explanation
Dimorphic fungi are a group of fungi that can exist in two different forms depending on the environmental conditions. In most cases, the primary infection caused by dimorphic fungi occurs in the lungs, leading to a pulmonary infection. This is because the spores or conidia of these fungi are usually inhaled, and the lungs provide a suitable environment for their growth and colonization. Once established in the lungs, the fungi can cause respiratory symptoms and potentially spread to other organs in the body.