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Infection travels to the middle ear by way of the ______.


A) auditory canal
B) sinuses
C) nasal cavity
D) eustachian (auditory) tubes
E) subarachnoid space

F) A) and C)
G) B) and C)

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The causative organism of whooping cough is ______.


A) Bordetella pertussis
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Streptococcus pyogenes
E) Cornyebacterium diphtheriae

F) A) and B)
G) A) and C)

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Which of the following pertains to diphtheria?


A) Results in meningitis
B) Symptoms include vomiting and diarrhea
C) Can be transmitted from mother's birth canal to neonate
D) Prevented by the DTaP immunization

E) All of the above
F) A) and B)

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The tubercles formed in primary tuberculosis are caused by an influx of ______.


A) neutrophils
B) basophils
C) mononuclear cells
D) polymorphonuclear leukocytes
E) antibodies

F) D) and E)
G) B) and C)

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Otitis media is commonly treated with broad spectrum antibiotics, although there is a lot of push- back or pressure against doing this. Why are these drugs given for this condition?


A) No other kinds of drugs and antibiotics can kill the bacteria causing otitis media other than the broad-spectrum class of drugs.
B) The narrow-spectrum drugs are very toxic as opposed to the rather benign broad- spectrum ones.
C) Otitis media is often caused by a variety of bacteria growing together in a biofilm, and the bacteria often exhibit different susceptibilities to drugs.
D) Fungi are the most common cause of otitis media, and the fungi do not respond well to the narrow-spectrum drugs.

E) B) and C)
F) A) and B)

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Cold viruses are transmitted by _______.


A) droplet contact
B) indirect contact
C) direct contact
D) All of the choices are correct.

E) B) and C)
F) A) and D)

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Which of the following does not describe S. pyogenes?


A) Group A streptococcus
B) Gram-positive
C) Forms endospores
D) Sensitive to bacitracin
E) Beta-hemolytic

F) D) and E)
G) B) and D)

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Which of the following is not part of the upper respiratory tract?


A) Mouth
B) Nasal cavity
C) Trachea
D) Pharynx
E) Larynx

F) A) and B)
G) C) and E)

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Influenza viruses A and B contain eight RNA strands and influenza virus C has seven strands. During antigenic drift, genes coding for glycoproteins recognized by the host immune system are mutated, Whereas during antigenic shift, whole RNA strands can be swapped with those of another influenza Virus, greatly increasing the virulence and transmissibility of the virus and minimizing the ability of The host's defenses to recognize it. Which of the following statements is true?


A) Genetic drift creates a need for an annual flu vaccine to keep up with the seasonal genetic changes, and if genetic shift occurs, an additional vaccine will have to be administered
Since the shift creates a different strain of virus.
B) Genetic drift creates a need for an annual flu vaccine to keep up with the seasonal genetic changes, and if a genetic shift occurs, the same vaccine will be effective against both
Strains.
C) If a novel strain resulting from antigenic shift appears, it is not necessary to get vaccinated because these strains are typically less pathogenic than seasonal strains.
D) The worst influenza pandemics throughout history have occurred as a result of genetic drift rather than genetic shift.

E) A) and B)
F) All of the above

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Which is incorrect about histoplasmosis?


A) The pathogen grows inside macrophages.
B) It is transmitted by inhalation of spores.
C) It causes respiratory infections that range from mild to severe.
D) Chronic cases have symptoms similar to tuberculosis.
E) It never spreads to sites outside the respiratory tract.

F) B) and E)
G) C) and D)

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Symptoms of influenza include _______.


A) nasal discharge, mild fever, and absence of cough
B) fever, diarrhea, and vomiting
C) fever, myalgia, sore throat, cough, and nasal discharge
D) fever, sore throat, rash, and cough
E) fever and pneumonia

F) A) and C)
G) A) and D)

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Formation of a pseudomembrane in the back of the throat is seen in cases of _______.


A) diphtheria
B) pharyngitis
C) tuberculosis
D) pertussis
E) SARS

F) None of the above
G) All of the above

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Influenza vaccines include all of the following except _______.


A) inactivated, intramuscular vaccine
B) usually incorporates three or four different strains
C) attenuated, nasal drops vaccine
D) provides lifelong immunity
E) has an overall effectiveness of 70% - 90%

F) C) and D)
G) A) and C)

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People at greatest risk for pneumococcal infections include all the following except _______.


A) the elderly
B) those with underlying lung disease and viral infections
C) patients without a spleen
D) adolescents and young adults
E) young infants

F) A) and E)
G) B) and D)

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Drug-resistant strains of Streptococcus pneumoniae are now treated with ______.


A) penicillin V
B) eryrthromycin
C) tetracyline
D) vancomycin
E) Ketek

F) None of the above
G) C) and D)

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Hantavirus is transmitted by which of the following ways?


A) Aerosolized droplets from human to human
B) Directly from the saliva of a deer mouse after being bitten
C) From a mosquito that ?rst bites a deer mouse, and then bites a human
D) Aerosolized particles of deer mouse feces, urine, or saliva
E) Via the oral-fecal route when deer mouse feces contaminate drinking water

F) B) and C)
G) None of the above

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Organisms other than bacteria make up the microbiota; non-bacterial microbes that occupy the respiratory tract include ________.


A) Pseudomonas
B) Candida
C) Prevotella
D) Acinetobacter
E) Staphylococcus

F) None of the above
G) A) and D)

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Both Streptococcus pyogenes and Corynebacterium diphtheriae are highly pathogenic, and the disease symptomology can be very severe. Why is this?


A) Infants and children are the high-risk groups, and their mortality rate is higher than for other ages.
B) Both bacteria produce potent exotoxins.
C) They induce autoimmune states in the patients.
D) There are no antibiotics useful for diseases caused by these bacteria.

E) None of the above
F) B) and D)

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Diphtheria is considered to be an upper respiratory tract infection. However, it can have a very high mortality rate if not caught early and treated. Predict why this is so.


A) It makes a toxin that can be carried in blood and produce organ damage, particularly the heart.
B) It successfully hides from the immune system of the patient.
C) The patient cannot eat or drink and so basically starves to death.
D) The bacterium moves from the throat to the brain, causing strokes to occur.

E) B) and D)
F) C) and D)

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A factor in the development of multidrug-resistant strains of Mycobacterium tuberculosis is that _______.


A) multiple antibiotics must be taken in the daily regimen
B) the daily multidrug regimen lasts up to nine months
C) many TB patients live in less-than ideal circumstances
D) All of these choices contribute to the development of resistant strains of Mycobacterium tuberculosis.

E) All of the above
F) C) and D)

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