Chapter 10: Infection

MULTIPLE CHOICE
1. What is a significant cause of morbidity and mortality worldwide?
a. Starvation
c. Cardiovascular disease
b. Traumatic injury
d. Infectious disease
ANS: D

Despite the wide-scale implementation of progressive public health and immunization

policies, infectious disease remains a significant cause of morbidity and mortality. The other
options are not significant causes.
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REF: Page 299

2. What is the first stage in the infectious process?

a. Invasion
c. Spread
b. Colonization
d. Multiplication
ANS: B

From the perspective of the microorganisms that cause disease, the infectious process
undergoes four separate stages of progression: (1) colonization, (2) invasion, (3)
multiplication, and (4) spread.
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REF: Pages 300-301

3. Which type of microorganism reproduces on the skin?

a. Viruses
c. Protozoa and Rickettsiae
b. Bacteria and fungi
d. Mycoplasma
ANS: B

Only bacteria and fungi have the capacity to reproduce on the skin.
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REF: Page 303 | Table 10-3

4. Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which

microorganisms?
a. Bacteria
b. Fungi

c. Viruses
d. Yeasts

ANS: A

Invasion is the direct confrontation with an individuals primary defense mechanisms against
only bacteria, which include the complement system, antibodies, and phagocytes, such as
neutrophils and macrophages.
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REF: Page 306

5. Once they have penetrated the first line of defense, which microorganisms do natural killer

(NK) cells actively attack?

a. Bacteria
b. Fungi

c. Viruses
d. Mycoplasma

ANS: C

NK cells are the principal defenders against only tumor cells or virally infected cells.
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REF: Page 320

6. Which statement concerning exotoxins is true?

a. Exotoxins are contained in cell walls of gram-negative bacteria.
b. Exotoxins are released during the lysis of bacteria.
c. Exotoxins are able to initiate the complement and coagulation cascades.
d. Exotoxins are released during bacterial growth.
ANS: D

Exotoxins are proteins released during bacterial growth. The other options are not true of
exotoxins.
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REF: Page 306

7. Which statement is true concerning a fungal infection?

a. Fungal infections occur only on skin, hair, and nails.
b. Phagocytes and T lymphocytes control fungal infections.
c. Fungal infections release endotoxins.
d. Vaccines prevent fungal infections.
ANS: B

The host defense against fungal infection includes the fungistatic properties of neutrophils and
macrophages. T lymphocytes are crucial in limiting the extent of infection and producing
cytokines to further activate macrophages. The other options are not true of fungal infections.
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REF: Page 312

8. Cytokines are thought to cause fevers by stimulating the synthesis of which chemical

mediator?
a. Leukotriene
b. Histamine

c. Prostaglandin
d. Bradykinin

ANS: C

Cytokines seem to raise the thermoregulatory set point through stimulation of prostaglandin
synthesis and turnover in thermoregulatory (brain) and nonthermoregulatory (peripheral)
tissues. The other options do not accurately identify the appropriate chemical mediator.
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REF: Pages 301-302

9. Considering the hypothalamus, a fever is produced by:

a. Endogenous pyrogens acting directly on the hypothalamus.
b. Exogenous pyrogens acting directly on the hypothalamus.
c. Immune complexes acting indirectly on the hypothalamus.
d. Cytokines acting indirectly on the hypothalamus.
ANS: A

Little evidence suggests that exogenous pyrogens directly cause fever. Such pyrogens
indirectly affect the hypothalamus through endogenous pyrogens released by cells of the host.
Neither immune complexes nor cytokines are involved in the process.

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REF: Page 302

10. Which statement about vaccines is true?

a. Most bacterial vaccines contain attenuated organisms.
b. Most viral vaccines are made by using dead organisms.
c. Vaccines require booster injections to maintain life-long protection.
d. Vaccines provide effective protection against most infections.
ANS: C

In general, vaccine-induced protection does not persist as long as infection-induced immunity,

thus booster injections may be necessary to maintain protection throughout life. The other
options are not true of vaccines.
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REF: Page 332

11. Vaccines against viruses are created from:

a. Killed organisms or extracts of antigens
b. Live organisms weakened to produce antigens
c. Purified toxins that have been chemically detoxified
d. Recombinant pathogenic protein
ANS: B

Most vaccines against viral infections (e.g., measles, mumps, rubella, varicella [chickenpox],
rotavirus) contain live viruses that are weakened (attenuated) to continue expressing the
appropriate antigens but are unable to establish more than a limited and easily controlled
infection. The other options are not used in virus-focused vaccines.
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REF: Page 332

12. Which statement is a characteristic of HIV?

a. HIV only infects T-helper (Th) cells.
b. HIV is a retrovirus.
c. HIV carries genetic information in its DNA.
d. HIV has five identified strains.
ANS: B

HIV is a member of the retrovirus family, which carries genetic information in the form of
two copies of RNA (see Figure 10-12). The other statements are not true of HIV.
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REF: Page 324

13. What is the role of reverse transcriptase in HIV infection?

a. Reverse transcriptase converts single-stranded DNA into double-stranded DNA.
b. It is needed to produce integrase.
c. It transports the RNA into the cell nucleus.
d. It converts RNA into double-stranded DNA.
ANS: D

One particular family of viruses, retroviruses (e.g., HIV) carries an enzyme, reverse
transcriptase, which creates a double-stranded DNA version of the virus.

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REF: Page 324

14. After sexual transmission of HIV, a person can be infected yet seronegative for how many

months?
a. 1 to 2
b. 6 to 14

c. 18 to 20
d. 24 to 36

ANS: B

Antibody appears rather rapidly after infection through blood products, usually within 4 to 7
weeks. After sexual transmission, however, the individual can be infected yet seronegative for
6 to 14 months or, in at least one case, for years.
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REF: Page 326

15. Which cells are primary targets for HIV?

a. CD4+ Th cells only
b. CD4+ Th cells, macrophages, and natural killer cells
c. CD8-positive cytotoxic T (Tc) cells and plasma cells
d. CD8-positive Tc cells only
ANS: B

The primary cellular targets for HIV include CD4+ Th cells, macrophages, and NK cells. The
other options are not the primary target cells of HIV.
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REF: Page 325

16. What area in the body may act as a reservoir in which HIV can be relatively protected from

antiviral drugs?
a. Central nervous system
b. Bone marrow

c. Thymus gland
d. Lungs

ANS: A

HIV may persist in regions where the antiviral drugs are not as effective, such as the central
nervous system (CNS). The other options are not as protected from antiviral drugs.
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REF: Page 327

17. AIDS produces a striking decrease in the number of which cells?

a. Macrophages
c. CD4+ Th cells
+
b. CD8 T cells
d. Memory T cells
ANS: C

The major immunologic finding in AIDS is the striking decrease in the number of CD4+ Th
cells (see Figure 10-15). This finding is not true of the other options.
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REF: Page 325

18. HIV antibodies appear within how many weeks after infection through blood products?
a. 1 to 2
c. 10 to 12
b. 4 to 7
d. 20 to 24
ANS: B

Antibody appears rather rapidly after infection through blood products, usually within 4 to 7
weeks.
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REF: Page 326

19. What is the final stage of the infectious process?

a. Colonization
c. Multiplication
b. Invasion
d. Spread
ANS: D

From the perspective of the microorganisms that cause disease, the infectious process
undergoes four separate stages of progression: (1) colonization, (2) invasion, (3)
multiplication, and (4) spread.
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REF: Page 300

20. Toxigenicity is defined as the:

a. Ability of the pathogen to invade and multiply in the host
b. Pathogens ability to produce disease by the production of a soluble toxin
c. Ability of an agent to produce disease
d. Potency of a pathogen measured in terms of the number of microorganisms

required to kill the host

ANS: B

Toxigenicity is the ability of a pathogen to produce soluble toxins or endotoxins, which are
factors that greatly influence the pathogens degree of virulence. The other options do not
accurately define toxigenicity.
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REF: Page 302

21. The ability of the pathogen to invade and multiply in the host is referred to as:
a. Infectivity
c. Pathogenicity
b. Toxigenicity
d. Virulence
ANS: A

Infectivity is the ability of the pathogen to invade and multiply in the host. The other options
do not accurately denote the pathogens ability to invade and multiply in the host.
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REF: Page 302

22. Some bacterial surface proteins bind with the crystalline fragment (Fc) portion of an antibody

to:
a.
b.
c.
d.

Hide in cells to avoid triggering an immune response

Form self-protecting toxins
Make staining possible for microscopic observation
Produce a protective self protein

ANS: D

Some bacterial surface proteins (protein A of Staphylococcus aureus, protein G of

Streptococcus pyogenes) bind the Fc portion of the individuals antibody, thus forming a
protective coat of self protein. The other options do not accurately define the role of
bacterial surface proteins as they bind with the Fc portion on an antibody.

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REF: Page 308

23. Which organism is a common sexually transmitted bacterial infection?

a. Staphylococcus aureus
c. Helicobacter pylori
b. Clostridium perfringens
d. Treponema pallidum
ANS: D

Treponema pallidum (spirochete, syphilis) is a sexually transmitted disease. Staphylococcus

aureus is commonly ingested, causing food poisoning; Clostridium perfringens (gas gangrene)
is a skin or wound infection; and Helicobacter pylori (gastritis, peptic ulcers) is found in the
gastrointestinal tract.
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REF: Pages 304-305 | Table 10-4

24. Which disease is an example of a rickettsial infection?

a. Cholera
c. Sleeping sickness
b. Candida
d. Rocky Mountain spotted fever
ANS: D

Rocky Mountain spotted fever is a result of a rickettsiae. Cholera is a bacterial infection,

candida is a fungal infection, and sleeping sickness is a protozoal infection.
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REF: Page 302

MULTIPLE RESPONSE
25. Which secretion transmits HIV? (Select all that apply.)
a. Semen
b. Urine
c. Saliva
d. Breast milk
e. Sweat
ANS: A, D

HIV is a blood-borne pathogen present in body fluids (e.g., blood, vaginal fluid, semen, breast
milk).
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REF: Page 322

26. Which infection is fungal? (Select all that apply.)

a. Ringworm
b. Candida
c. Cholera
d. Athletes foot
e. Aspergillus
ANS: A, B, D, E

Infection with a fungus is called mycosis and includes dermatophytes (e.g., tineas, which
refers to several skin mycoses including ringworm, athletes foot, and others) or yeasts (e.g.,
Candida, Aspergillus, Cryptococcus). Cholera is a bacterial infection.

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REF: Page 311

27. Which statement is true regarding the development of HIV symptoms? (Select all that apply.)
a. Symptoms generally appear in the clinical latency stage.
b. Symptoms are generally observable within 5 years of the initial infection.
c. T cells levels, particularly those of memory T cells, progressively decrease.
d. Untreated infected individuals may remain asymptomatic for up to10 years.
e. Secondary lymphoid organs experience damage and resulting malfunction.
ANS: C, D, E

Individuals during the early stages of HIV (early stage disease or clinical latency) are usually
asymptomatic. The early stage may last as long as 10 years in untreated people, during which
the viral load increases and the numbers of CD4+ cells progressively decrease. As a result of
these processes, the level of T cells decreases (particularly memory T cells, which seem more
susceptible to HIV infection); thymic production of new T cells is decreased; and the
secondary lymphoid organs (particularly the lymph nodes) are damaged.
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REF: Pages 326-327

28. Which statements are true regarding endotoxins? (Select all that apply.)
a. Endotoxins are lipopolysaccharides.
b. Endotoxins are located in the walls of bacteria.
c. Endotoxins are created during the process of lysis.
d. Endotoxins are found in gram-negative microorganisms.
e. Endotoxins are released during the destruction of its host.
ANS: A, B, D, E

Endotoxins are lipopolysaccharides (LPSs) contained in the cell walls of gram-negative

bacteria and released during lysis (or destruction) of the bacteria.
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REF: Page 306

29. Which statements are true regarding viruses? (Select all that apply.)
a. Viruses are very complex microorganisms.
b. Viruses are referred to as eukaryotes.
c. Viruses are capable of producing messenger RNA (mRNA).
d. Viruses penetrate plasma membranes via endocytosis.
e. Viruses are capable of uncoating cytoplasmic nucleocapsid.
ANS: C, D, E

Viruses are extremely simple microorganisms and do not possess any of the metabolic
organelles found in prokaryotes (e.g., bacteria) or eukaryotes (e.g., human cells). Once bound,
the virus can penetrate the plasma membrane by receptor-mediated endocytosis. Within the
cytoplasm, the virus uncoats the protective nucleocapsid and releases viral genetic
information. Most RNA viruses directly produce mRNA, which is translated into viral
proteins, and genomic RNA, which is eventually packaged into new viruses.
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REF: Pages 317-319

30. Which of the following play a role in the control of fungal infections? (Select all that apply.)
a. Cytokines

b.
c.
d.
e.

Macrophages
Natural killer cells
Neutrophils
T lymphocytes

ANS: A, B, D, E

The host defense against fungal infection includes the fungistatic properties of neutrophils and
macrophages. T lymphocytes are crucial in limiting the extent of infection and producing
cytokines to further activate macrophages. Natural killer cells are a component of innate
immune system.
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REF: Page 312

31. Complications of AIDS include: (Select all that apply.)

a. Kaposi sarcoma
b. Helicobacter pylori
c. Cytomegalovirus retinitis
d. Herpes simplex infection
e. Legionella pneumophila
ANS: A, C, D

Kaposi sarcoma, cytomegalovirus retinitis, and herpes simplex infection are clinical
complications characteristically observed in patients with AIDS. Neither Helicobacter pylori
nor Legionella pneumophila are considered classic AIDS opportunistic diseases.
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REF: Page 328 | Figure 10-16

MATCHING

Match each term with its definition.

______ A. Toxigenicity
______ B. Infectivity
______ C. Pathogenicity
______ D. Virulence
32. Ability of the pathogen to invade and multiply in the host
33. Capacity of a pathogen to cause severe disease
34. An important factor in determining a pathogens ability to produce disease by the production

of a soluble toxin
35. Ability of an agent to produce disease
32. ANS: B
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REF: Page 302
MSC: Infectivity is the ability of the pathogen to invade and multiply in the host.
33. ANS: D
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REF: Page 302
MSC: Virulence is the capacity of a pathogen to cause severe disease.
34. ANS: A
PTS: 1
REF: Page 302
MSC: Toxigenicity is the ability to produce soluble toxins or endotoxins, factors that greatly influence
the pathogen's degree of virulence.
35. ANS: C
PTS: 1
REF: Page 302
MSC: Pathogenicity is the ability of an agent to produce disease.