ATI RN
microbiology basic and clinical principles test bank Questions
Question 1 of 9
The most important mechanism of tetracycline resistance is
Correct Answer: C
Rationale: The correct answer is C: Increased active efflux from the bacterial cell. This is the most important mechanism of tetracycline resistance because it involves the bacteria actively pumping out the antibiotic, reducing its intracellular concentration. This prevents tetracycline from effectively targeting bacterial ribosomes. Choice A is incorrect as tetracycline resistance typically involves active efflux rather than reduced influx. Choice B is incorrect because tetracycline resistance mechanisms do not primarily involve altered cell membrane components affecting passive influx. Choice D is also incorrect as tetracycline resistance mechanisms do not typically involve direct enzymatic inactivation of the antibiotic.
Question 2 of 9
A 30-year-old patient complains about having abdominal pain and diarrhea for five days; body temperature rise up to 37, 5oC along with chills. The day before a patient had been in a forest and drunk from an open water reservoir. Laboratory analyses enabled to make the following diagnosis: amebic dysentery. What is the drug of choice for its treatment?
Correct Answer: A
Rationale: The correct answer is A: Metronidazole. Rationale: 1. Metronidazole is the drug of choice for amebic dysentery due to its effectiveness against the causative agent, Entamoeba histolytica. 2. Metronidazole has good tissue penetration and is able to reach the site of infection in the gut. 3. It is a bactericidal drug that acts by disrupting the DNA structure of the parasite. 4. Metronidazole is well-absorbed orally and has minimal side effects. Summary of other choices: B: Furazolidonum - Not the drug of choice for amebic dysentery. It is primarily used for treating bacterial diarrhea. C: Levomycetin - Not effective against Entamoeba histolytica and not recommended for amebic dysentery. D: Phthalazol - Not commonly used for amebic dysentery treatment. Metronidazole is preferred due
Question 3 of 9
A patient with fever, headache, and neck stiffness had a cerebrospinal fluid sample showing Gram-negative diplococci. What is the most likely causative agent?
Correct Answer: A
Rationale: The correct answer is A: Neisseria meningitidis. This is because Neisseria meningitidis is a Gram-negative diplococcus known to cause bacterial meningitis, presenting with fever, headache, and neck stiffness. It is a common cause of meningitis in young adults and teenagers. Streptococcus pneumoniae (B) is a Gram-positive bacteria and a common cause of bacterial pneumonia, not meningitis. Haemophilus influenzae (C) is a Gram-negative coccobacillus that can cause meningitis, but it is less common in adults. Klebsiella pneumoniae (D) is a Gram-negative bacillus known to cause pneumonia and urinary tract infections, not meningitis.
Question 4 of 9
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 5 of 9
Rheumatic fever is an inflammatory disease and rare complication of:
Correct Answer: A
Rationale: Rheumatic fever is caused by untreated strep throat. Step 1: Strep throat is caused by Streptococcus bacteria. Step 2: If strep throat is not treated with antibiotics, it may lead to rheumatic fever due to the body's immune response attacking its own tissues. Summary: Gangrene, brucellosis, and tularemia are not associated with rheumatic fever.
Question 6 of 9
Which of the following bacteria is responsible for causing the disease known as pneumonia?
Correct Answer: D
Rationale: Rationale: 1. Streptococcus pneumoniae is a common cause of bacterial pneumonia. 2. Mycobacterium tuberculosis can cause a type of pneumonia called tuberculosis. 3. Escherichia coli is not typically associated with pneumonia. 4. "All of the above" includes both Streptococcus pneumoniae and Mycobacterium tuberculosis, which are known to cause pneumonia. Therefore, D is the correct answer.
Question 7 of 9
A lymph node punctate of a patient with suspected protozoa disease was examined. Examination of the stained specimen (Romanovsky's stain) revealed some crescent bodies with pointed end, blue cytoplasm and red nucleus. What protozoan were revealed in the smears?
Correct Answer: B
Rationale: The correct answer is B: Malarial plasmodiums. The description of crescent bodies with a pointed end, blue cytoplasm, and red nucleus corresponds to the characteristics of Plasmodium species seen in Romanovsky's stain. Plasmodium species are known to cause malaria and have distinct features like the ones described. Incorrect choices: A: Toxoplasmas - Toxoplasma gondii typically appear as tachyzoites or bradyzoites under staining, not crescent bodies. C: Dermotropic leishmania - Leishmania species appear as amastigotes in tissue smears, not crescent bodies. D: Viscerotropic leishmania - Similar to choice C, Leishmania species do not typically present as crescent bodies in stained specimens.
Question 8 of 9
A sputum smear from a patient with pneumonia revealed Gram-positive cocci in pairs with pointed ends and capsules. What is the likely microorganism?
Correct Answer: A
Rationale: The correct answer is A: Streptococcus pneumoniae. The description of Gram-positive cocci in pairs with pointed ends and capsules matches the morphology of S. pneumoniae. This bacterium is known to cause pneumonia, especially in individuals with underlying conditions like COPD. Staphylococcus aureus (B) typically appears in clusters, not pairs. Klebsiella pneumoniae (C) is a Gram-negative rod, not a cocci. Neisseria meningitidis (D) is a Gram-negative diplococcus, not a cocci. Hence, based on the morphology and clinical context, Streptococcus pneumoniae is the likely microorganism causing pneumonia in this patient.
Question 9 of 9
A patient with a sore throat and fever had a throat culture revealing Gram-positive cocci in chains. The bacteria were beta-hemolytic. What is the most likely causative agent?
Correct Answer: A
Rationale: The correct answer is A: Streptococcus pyogenes. 1. Gram-positive cocci in chains suggest streptococci. 2. Beta-hemolytic activity indicates Streptococcus pyogenes. 3. Streptococcus pyogenes is commonly associated with sore throat (pharyngitis) and fever. 4. Streptococcus pneumoniae (choice B) is alpha-hemolytic and mainly causes pneumonia. 5. Enterococcus faecalis (choice C) is not typically associated with sore throat. 6. Staphylococcus aureus (choice D) is not commonly beta-hemolytic and is not a typical cause of pharyngitis.