ATI RN
Microbiology Basic and Clinical Principles Test Bank Questions
Question 1 of 5
A 45 year old male died from disseminated tuberculosis. On autopsy the symptoms of tuberculosis were confirmed by both microscopical and histological analyses. What kind of hypersensitivity reaction underlies the process of granuloma development?
Correct Answer: A
Rationale: The correct answer is A: Delayed hypersensitivity reaction. In granuloma development in tuberculosis, macrophages present antigen to T cells, leading to a delayed hypersensitivity reaction. This triggers the recruitment of more macrophages and formation of granulomas. Antibody-dependent cytotoxicity (B) and complement-dependent cytotoxicity (C) involve antibodies and complement proteins in immediate hypersensitivity reactions, which are not the primary mechanisms in tuberculosis. Anaphylactic reaction (D) is an acute systemic allergic reaction mediated by IgE antibodies, not relevant to granuloma formation in tuberculosis.
Question 2 of 5
A 45-year-old patient, a sailor, was hospitalized on the 2nd day of the disease. A week ago he returned from India. Complains of body temperature of 41oC, severe headache, dyspnea, cough with frothy rusty sputum. Objectively: the patient is pale, mucous membranes are cyanotic, breathing rate - 24/min, tachycardia is present. In lungs: diminished breath sounds, moist rales over both lungs, crepitation. What is the most likely diagnosis?
Correct Answer: A
Rationale: The most likely diagnosis is A: Pneumonic plague. The patient's symptoms align with the presentation of pneumonic plague, caused by the bacterium Yersinia pestis. Symptoms include high fever, severe headache, dyspnea, cough with bloody sputum, and cyanosis. The characteristic bubonic plague lymphadenopathy may be absent in the pneumonic form. The patient's recent travel history to India also raises suspicion, as plague is endemic in some regions. The other choices can be ruled out based on the patient's symptoms and presentation. Miliary tuberculosis typically presents with diffuse miliary nodules on imaging. Influenza typically presents with more generalized symptoms and does not usually cause rusty sputum. Ornithosis is caused by Chlamydophila psittaci and usually presents with pneumonia-like symptoms after exposure to infected birds.
Question 3 of 5
The bacteriological laboratory needs to prepare for analysis of materials that are suspected to be contaminated with spores of anthrax causative agent. What diagnostic preparation allows for quick detection of these spores?
Correct Answer: D
Rationale: The correct answer is D: Monoclonal antibodies to anthrax causative agent. Monoclonal antibodies are highly specific for detecting anthrax spores, providing quick and accurate results. They bind only to the anthrax causative agent, allowing for precise identification. Choice A (Anti-anthrax fluorescent serum) is incorrect because it is not as specific and sensitive as monoclonal antibodies. Choice B (Standard anthrax antigen) is incorrect as it is used to stimulate antibody production in the body, not for direct detection of spores. Choice C (Anti-anthrax immunoglobulin) is incorrect as it is a general term for antibodies and may not be specific to anthrax spores. In summary, monoclonal antibodies are the most suitable option for quick and accurate detection of anthrax spores due to their high specificity and sensitivity.
Question 4 of 5
A 38-year-old male complains of tonic tension of the masticatory muscles, so that he cannot open his mouth. 12 days before, he was bitten by an unknown dog. Objectively: there is pronounced tension and twitching of the masticatory muscles. What is the most likely diagnosis?
Correct Answer: A
Rationale: The correct answer is A: Tetanus. The symptoms of tonic tension of the masticatory muscles following a dog bite are indicative of tetanus, caused by the bacterium Clostridium tetani. The incubation period of tetanus is usually 3-21 days, consistent with the patient's history of being bitten 12 days ago. Tetanus toxin causes muscle stiffness and spasms, leading to the inability to open the mouth. Rabies (B) presents with hydrophobia and neurological symptoms. Hysteria (C) is a psychological condition. Trigeminal neuralgia (D) is characterized by severe facial pain, not muscle stiffness.
Question 5 of 5
A 12-year-old boy presents with nausea, frequent repeated vomiting that first occurred after eating canned vegetables. Objectively: the patient has dry mucous membranes, muscular hypotonia, anisocoria, mydriasis, dysphagia and dysarthria. What is the most likely diagnosis?
Correct Answer: A
Rationale: The most likely diagnosis is A: Botulism. The symptoms, such as nausea, vomiting after eating canned vegetables, dry mucous membranes, muscular hypotonia, anisocoria, mydriasis, dysphagia, and dysarthria, are classic signs of botulism poisoning. Botulism is caused by the neurotoxin produced by Clostridium botulinum bacteria found in improperly canned or preserved food. The neurotoxin affects the nervous system, leading to symptoms like those described. Shigellosis (B), Salmonellosis (C), and Cholera (D) typically present with different symptoms such as diarrhea, fever, and abdominal pain, which are not seen in this patient.