ATI RN
Microbiology An Introduction Tortora Test Bank Questions
Question 1 of 5
A child entering the school for the first time was given Mantoux test in order to determine if there was a need for revaccination. The reaction was negative. What is the meaning of this test result?
Correct Answer: B
Rationale: The correct answer is B: Availability of cell-mediated immunity to tuberculosis. A negative Mantoux test indicates the presence of an immune response to the TB bacteria, as the test measures the body's delayed hypersensitivity reaction to TB antigens. This means the child has been exposed to TB in the past or has been vaccinated, resulting in the development of cell-mediated immunity against TB. Incorrect choices: A: No cell-mediated immunity to tuberculosis - This is incorrect as a negative Mantoux test actually indicates the presence of cell-mediated immunity. C: No antibodies to the tuberculosis bacteria - Mantoux test measures cell-mediated immunity, not antibody response. D: No anti-toxic immunity to tuberculosis - Mantoux test does not assess anti-toxic immunity, it specifically measures cell-mediated immunity.
Question 2 of 5
A patient has got pain in the axillary area, rise of temperature developed 10 hours ago. On examination: shaky gait is evident, the tongue is coated with white deposit. The pulse is frequent. The painful lymphatic nodes are revealed in the axillary area. The skin over the lymph nodes is erythematous and glistering. What is the most probable diagnosis?
Correct Answer: B
Rationale: The correct answer is B: Acute purulent lymphadenitis. The symptoms described indicate an acute bacterial infection of the lymph nodes. The presence of painful lymph nodes, erythema, and shiny appearance of the skin overlying the nodes suggest an inflammatory process. The rise in temperature and frequent pulse indicate an active infection. The white-coated tongue may be a sign of systemic involvement. The shaky gait may indicate systemic toxicity. Bubonic plague (A) presents with buboes, not just painful lymph nodes. Lymphogranulomatosis (C) is a type of lymphoma and would not present with these acute bacterial infection symptoms. Anthrax (D) typically presents with a black eschar and is less likely in this context.
Question 3 of 5
A 43-year-old cattle farm worker is brought to the surgeon with fever, malaise, and inflamed lesions on his hands and arms. He reports that about 2 weeks before his presentation at the hospital he noticed small, painless, pruritic papules that quickly enlarged and developed a central vesicle. The vesicles developed into erosion and left painless necrotic ulcers with black, depressed eschar. Gram's staining of the ulcer reveals gram-positive spore-forming bacilli. Which of the following diseases is the most likely cause of these findings?
Correct Answer: A
Rationale: The correct answer is A: Anthrax. The clinical presentation of painless necrotic ulcers with black eschar, along with the gram-positive spore-forming bacilli seen on Gram's staining, is classic for cutaneous anthrax. Anthrax is caused by Bacillus anthracis, which produces spores and can lead to skin lesions in individuals working with animals or animal products. Choice B, Chickenpox, typically presents with vesicular rash all over the body. Choice C, Syphilis, is caused by Treponema pallidum and does not present with the characteristic eschar seen in the patient. Choice D, Tularemia, caused by Francisella tularensis, presents with ulceroglandular lesions but lacks the black eschar characteristic of anthrax.
Question 4 of 5
A 45-year-old patient complains of fever up to 40oC, general weakness, headache and spasmodic contraction of muscles in the region of a shin wound. The patient got injured five days ago when tilling soil and didn't seek medical attention. What kind of wound infection can be suspected?
Correct Answer: A
Rationale: Step 1: The patient's symptoms align with tetanus infection, such as muscle spasms and fever. Step 2: Tetanus is caused by Clostridium tetani bacteria found in soil. Step 3: The wound from tilling soil provides an entry point for the bacteria. Step 4: Delayed seeking medical attention increases the risk of tetanus development. Step 5: Tetanus toxin affects the nervous system, leading to muscle stiffness and spasms. Summary: Choice A is correct due to symptom alignment, bacterial source, wound type, delayed treatment, and specific neurological effects. Choices B, C, and D lack these specific connections to the given scenario.
Question 5 of 5
In the morning a patient had nausea, abdominal discomfort, single vomiting, dry mouth. In the evening, the patient presented with the increasing general weakness, double vision, difficult swallowing of solid food. Objectively: ptosis, mydriasis, anisocoria, absence of gag and pharyngeal reflex, dry mucous membranes. The previous evening the patient had dinner with canned food and alcohol. What is the presumptive diagnosis?
Correct Answer: A
Rationale: The correct answer is A: Botulism. The symptoms described, such as ptosis, mydriasis, anisocoria, dry mouth, and absent gag reflex, are classic signs of botulism. Botulism is caused by the bacterium Clostridium botulinum, commonly found in improperly preserved canned foods. The progression from gastrointestinal symptoms to neurological symptoms, like double vision and difficulty swallowing, is characteristic of botulism due to the toxin's effect on neuromuscular transmission. Poliomyelitis primarily affects the motor neurons and presents with different symptoms. Food toxicoinfection typically involves gastrointestinal symptoms and does not manifest with the neurological findings seen in this case. Acute ischemic stroke presents with sudden onset neurological deficits due to impaired blood flow to the brain, which is not consistent with the gradual progression of symptoms in this scenario.