ATI RN
Microbiology An Introduction Tortora Test Bank Questions
Question 1 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 2 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 3 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.
Question 4 of 5
For serological diagnostics of the whooping cough it was made large-scale reaction with parapertussis and pertussis diagnosticums. At the bottom of the test-tubes with diagnosticum of Bordetella parapertussis grain-like sediment formed. What antibodies have this reaction revealed?
Correct Answer: B
Rationale: Rationale: 1. The grain-like sediment indicates a precipitation reaction. 2. Precipitins are antibodies that cause precipitation reactions. 3. In serological diagnostics, precipitation reactions are used to detect specific antibodies. 4. Therefore, the reaction revealed in this scenario is due to the presence of precipitins. Summary: A: Bacteriolysins - These antibodies cause bacterial lysis, not precipitation. C: Antitoxins - These antibodies neutralize toxins, not involved in precipitation reactions. D: Opsonins - These antibodies enhance phagocytosis, not related to precipitation reactions.
Question 5 of 5
A 23-year-old man developed a perforation in his hard palate, a dense formation with clear margins was detected in this area. After a surgery, microscopy of excised formation shows there a large focus of caseous necrosis surrounded with a granulation tissue with endovasculitis and a cellular infiltration consisting of lymphocytes and epithelioid cells with predominance of plasma cells. What is the most likely disease in this case?
Correct Answer: B
Rationale: The correct answer is B: Tuberculosis. The case describes a man with a perforation in the hard palate and features of caseous necrosis with granulation tissue, endovasculitis, and a cellular infiltration mainly of lymphocytes, epithelioid cells, and plasma cells. These findings are classic for tuberculosis infection, commonly seen in extrapulmonary sites like the oral cavity. Syphilis (choice A) typically presents with a painless ulcer and different histopathological features. Leprosy (choice C) presents with granulomas containing foamy macrophages. Scleroma (choice D) is caused by Klebsiella rhinoscleromatis and presents with chronic granulomatous inflammation.