Chapter 022

Chapter 022 Infectious Diseases Affecting the Gastrointestinal Tract Key
Multiple Choice Questions

1.
Defenses of the GI tract against pathogens include

A. Mucus, acid and
saliva
B. Secretory IgA and
lysozyme
C. Peristalsi
s
D. GALT
E. All of the choices are
true
Learning Objective: 22.02 List the natural defenses present in the gastrointestinal tract.
2.
The mucinous glycoprotein covering teeth that streptococci attach to is called the
A. Enam
el
B. Pellicl
e
C. Gingiv
a
D. Lactoferr
in
E. Oral
membrane
Learning Objective: 22.02 List the natural defenses present in the gastrointestinal tract
3.
Which organ of the GI tract has a large commensal population of microorganisms?

A. Live
r
B. Salivary
glands
C. Pancrea
s
D. Large
intestine
E. Small
intestine
Learning Objective: 22.03 List the types of normal biota presently known to occupy the gastrointestinal tract.
4.
The most common infectious disease in humans is

A. The common
cold
B. Dental
caries
C. Pharyngit
is
D. Diarrhe
a
E. Gastriti
s
Learning Objective: 22.05 List the possible causative agents
Learning Objective: diagnostic techniques and prevention/treatment for each of the kinds of oral diseases.
Learning Objective: modes of transmission
Learning Objective: virulence factors
5.
The main causes of dental caries seem to be

A. Streptococcus
pyogens
B. Streptococcus
mutans
C. Streptococcus
sobrinus
D. Both A and B are
correct
E. Both B and C are
correct
6.
Oral flora bacteria on the tooth surface

A. Develop a
biofilm
B. Use fimbriae and slime layers to
adhere
C. Include streptococci that metabolize sucrose, produce sticky glucans and
form plaque
D. Lactobacilli and streptococci ferment carbohydrates and produce acids that
cause caries
correct
7.
Gingivitis
A. Is primarily caused by oral flora
anaerobes
B. Involves the formation of calculus and
plaque
C. Involves a crevice in the gum along the
tooth
D. May involve archaeal
species
correct
8.
All of the following are true of acute necrotizing ulcerative gingivitis (ANUG)
except
A. Involves Treponema vincentii, Prevotella intermedia and
Fusobacterium
B. Associated with severe pain, bleeding, pseudomembrane and
necrosis
C. Due to poor oral hygiene, altered host defenses or prior
gum disease
D. Very
communicable
E. Common in
AIDS

9.
The causative organism for mumps is

A. Paramyxovir
us
B. Morbillivir
us
C. Streptococcus
pyogenes
D. Corynebacteri
um
E. Vibri
o
Learning Objective: diagnostic techniques and prevention/treatment for mumps
Learning Objective: gastritis and gastric ulcers.
10.
The virulence factor for mumps is

A. Inflammati
on
B. Acid
production
C. Endotoxi
n
D. Enterotox
in
E. Spike-induced
syncytium
11.
Orchitis and epididymitis is seen in young adult males as a complication of

A. Crou
p
B. Mump
s
C. Influenz
a
D. Measles
(rubeola)
E. Rubell
a
12.
Helicobacter pylori causes

A. Gastriti
s
B. Duodenal
ulcers
C. Stomach
ulcers
D. Increased risk for stomach
cancer
correct
13.
Which is not a characteristic of Helicobacter pylori?

A. Gram
negative
B. Produces enteroxin that causes
diarrhea
C. Curved
rods
D. Lives in the
stomach
E. Produces urease that buffers stomach
acidity

14.
Which of the following is mismatched?

A. H antigen
flagellar
B. K antigen capsule
C. O antigen - cell wall,
somatic
D. All of the choices are
correct
E. None of the choices are
correct
Learning Objective: and also for acute diarrhea with vomiting.
Learning Objective: diagnostic techniques and prevention/treatment for acute and chronic diarrhea
15.
Salmonella are
A. Methane
producers
B. Motil
e
C. Gram positive
rods
D. Lactose
fermenters
correct
16.
Typhoid fever has the following characteristics except

A. Spread by ingestion of food contaminated with
animal feces
B. Transmitted by ingesting fecal contaminated food
and water
C. Chronic carriers have pathogen in their
gallbladder
D. Infect the small intestine with fever, diarrhea and
abdominal pain
E. Becomes a septicemia, spreads to lymph nodes and spleen and causes liver
abscesses
17.
Salmonelloses are
A. Not caused by Salmonella
typhi
B. Associated with undercooked poultry and eggs and reptile and
rodent feces
C. Gastroenteritis with vomiting and
diarrhea
D. Treated with fluid and electrolyte
replacement
correct
18.
Salmonella typhi
A. Multiplies within phagocytes and lymph
nodes
B. Does not cause
typhus
C. Can be treated with
antimicrobials
D. Causes invasive infection of the small
intestine
correct

19.
Which is incorrect about shigellosis?

A. Outbreaks have occurred in day care
centers
B. Watery diarrhea with bloody, mucoid stools and
abdominal cramps
C. Frequently involve
septicemia
D. Human carriers cause fecal
transmission
E. Also called
dysentery
20.
Shigella species have the following characteristics except

A. Not motile, gram-negative
rods
B. Reservoir is human
carriers
C. They produce urease and hydrogen
sulfide
D. Infect the large
intestine
E. Produce enterotoxin called shiga
toxin
21.
E. coli O157:H7 characteristics include all the following except it

A. Only causes occupational illness in people who work with
animals
B. Is transmitted by ingestion of contaminated, undercooked food, especially
hamburger
C. Causes a bloody
diarrhea
D. Has a reservoir of cattle
intestines
E. Some cases go on to hemolytic uremic syndrome (HUS) with possible
kidney failure
22.
Which of the following is not a virulence factor of E. coli O157:H7?

A. Secretes shiga exotoxin from a
bacteriophage
B. Secretes shiga exotoxin from the E. coli
chromosome
C. Protein called intimin for host
attachment
D. Type III secretion
system
E. Provides the receptor for intimin to attach to
the host
23.
Which of the following is not true of Enterotoxigenic E. coli (ETEC)?

A. Causes traveler's
diarrhea
B. Has an A-B, heat labile
exotoxin
C. Has heat-stable
exotoxins
D. A high fever is
present
E. Mainly effects the small
intestine

24.
Which of the following is not true of Enterovasive E. coli (EIEC)?

A. Produces shiga
toxin
B. Invades gut
mucosa
C. Blood and pus in the
stool
D. No heat-labile or heat-stable
exotoxins
E. High fever is
present
25.
Escherichia coli infections

A. Are often transmitted by fecal contaminated water
and food
B. Include EIEC that destroys gut
mucosa
C. Involve enterotoxin in traveler's
diarrhea
D. That are self-limiting with the only treatment being
rehydration
correct
26.
All of the following are characteristics of Campylobacter jejuni except

A. Transmitted through ingestion of contaminated chicken, meat, milk
and water
B. Causes fever and a watery to bloody
diarrhea
C. Infects the
stomach
D. Produces an enterotoxin that stimulates
diarrhea
E. Gram negative curved rods with darting
motility
27.
The most common bacterial cause of diarrhea in the United States is

A. E.
coli
B. Salmonell
a
C. Shigell
a
D. Campylobact
er
E. Yersini
a
28.
Campylobacter infection has all of the following characteristics except

A. Can last over two
weeks
B. Burrow into the mucosa of the ileum and
multiply
C. Can lead to Guillain-Barre
syndrome
D. Can cause acute temporary
paralysis
E. Is caused by a shiga
toxin

29.
Which is true of Yersinia enterocolitica and Yersinia pseudotuberculosis?

A. Y. pseudotuberculosis causes
tuberculosis
B. Intense pain caused by inflammation of the ileum and mesenteric
lymph nodes
C. Causes Guillain-Barre
syndrome
D. Are grampositive
E. Passed only through direct
contact
30.
Production of enterotoxin is a characteristic of

A. Clostridium
botulinum
B. Clostridium
perfringens
C. Clostridium
difficile
D. Clostridium
tetani
correct
31.
All of the following pertain to Clostridium difficile infection except it is

A. Due to ingestion of contaminated, improperly stored, cooked meats
and gravies
B. A colitis that is a
superinfection
C. Often has en endogenous
source
D. Associated with disruption of normal flora due to broad spectrum
antimicrobials
E. The major cause of diarrhea in
hospitals
32.
Which is not true of Clostridium difficile?

A. A gram-positive, endospore
forming rod
B. Part of normal intestinal
biota
C. Infection precipitated by broad-spectrum antibiotic
therapy
D. Also called pseudomembranous
colitis
E. Produces "rice-water"
stools
33.
The virulence of Vibrio cholerae is due to its

A. Capsul
e
B. Neurotox
in
C. Invasive
enzymes
D. Enterotox
in
correct

34.
Cholera symptoms are

A. Copious watery
diarrhea
B. Loss of blood
volume
C. Acidosis, sunken eyes,
thirst
D. Hypotension, tachycardia,
shock
correct
35.
The most immediate and important treatment needed to prevent death in Cholera
victims is
A. Water and electrolyte
replacement
B. Antimicrobi
als
C. Antitoxi
n
D. Surger
y
correct
36.
"Rice water stools" are associated with disease caused by which organism?
A. Vibrio
vulnificus
B. Vibrio
parahaemolyticus
C. Vibrio
cholerae
D. Campylobacter
jejuni
E. Helicobacter
pylori
37.
Outbreaks of which apicomplexan disease have been associated with fecalcontaminated drinking water?
A. Cryptosporidio
sis
B. Cyclosporias
is
C. Trichinosi
s
D. Toxoplasmosi
s
correct
38.
Symptoms of cryptosporidiosis include

A. Headache, sweats, vomiting, severe abdominal cramps and
diarrhea
B. Chills, fever,
sweats
C. Bloody, mucus-filled stools and
fever
D. A red skin papule that spreads to a large
ulcer
correct
39.
The primary viral cause of chronic diarrhea, globally is

A. Cryptosporidi
um
B. Rotaviru
s
C. Adenovir
us
D. Noroviru
s
E. Astrovir
us
40.
Which of the following is not a normal causative agent of acute diarrhea with
vomiting (food poisoning)?
A. Clostridium
perfringes
B. Staphylococcus aureus
exotoxin
C. Clostridium
difficile
D. Bacillus
cereus
correct
41.
A common food intoxication is caused by enterotoxin-producing strains of

A. Staphylococcus
aureus
B. Staphylococcus
epidermidis
C. Staphylococcus
saprophyticus
D. Streptococcus
pyogenes
E. Streptococcus
agalactiae
42.
Which is incorrect about Staphylococcus aureus food intoxication?

A. Food gets contaminated by a human
carrier
B. Common associated foods include custards, ham, cream pastries,
processed meats
C. After contamination, food must be left unrefrigerated for a
few hours
D. Ingestion of the pathogen allows it to multiply and damage the GI
tract lining
E. Symptoms come on quickly and include nausea, vomiting,
diarrhea
43.
Outbreaks of which apicomplexan disease have been associated with fecalcontaminated imported raspberries and also fresh greens and drinking water?
A. Cryptosporidio
sis
B. Cyclosporias
is
C. Trichinosi
s
D. Toxoplasmosi
s
correct
44.
Entamoeba histolytica is acquired by

A. Ingestion of cysts of the
pathogen
B. Contaminated
food
C. Contaminated
water
D. Anal-oral sexual
contact
correct
45.
All of the following can be transmitted by drinking contaminated water except

A. Cryptosporidio
sis
B. Cyclosporias
is
C. Malari
a
D. Campylobact
er
E. Giardiasi
s
46.
Giardiasis involves
A. A protozoan that does not form
cysts
B. Infection of the large
intestine
C. Symptoms of abdominal pain, flatulence and
diarrhea
D. Vector
transmission
correct

47.
Inflammation of the liver with necrosis of the hepatocytes and swelling due to a
mononuclear response is a disease called
A. Hepatit
is
B. Jaundic
e
C. Liver
cancer
D. Mononucleos
is
correct
Learning Objective: 22.09 Differentiate among the main types of hepatitis and discuss each causative agent
Learning Objective: diagnostic techniques
Learning Objective: mode of transmission
Learning Objective: prevention and treatment of each.
48.
Hepatitis B virus
A. Is principally transmitted by
blood
B. Transmission risks include shared needles, anal intercourse and heterosexual
intercourse
C. Is transmitted to the newborn from chronic carrier
mothers
D. Has many chronic
carriers
correct
49.
Hepatitis B infection
A. Has an incubation of 2 to 7
weeks
B. Can be transmitted by the fecal-oral
route
C. Increases risk for hepatocellular
cancer
D. Is responsible for most cases of posttransfusion
hepatitis
correct
50.
Which is incorrect about hepatitis A infection?

A. Transmitted by the oral-fecal
route
B. Has flu-like symptoms with discomfort near the liver and
darkened urine
C. Predisposes a person for liver
cancer
D. Immune globulin therapy helps decrease the
severity
E. HAVRAX is an inactivated vaccine for
prevention
51.
Which is mismatched?
A. Hepatitis A virus nonenveloped, single-stranded RNA
enterovirus
B. Hepatitis B virus enveloped DNA
virus
C. Hepatitis C virus RNA
virus
D. Hepatitis D virus defective RNA virus that coinfects
with HAV
E. Hepatitis E virus self-limiting RNA
virus
52.
The most common cause of liver cancer in the US is

A. HAV
B. HB
V
C. HC
V
D. HD
V
E. HE
V
53.
Parasitic helminthes have the following characteristics except

A. Are multicellular
animals
B. Have a definitive host where the adult
form lives
C. Have larval forms that do not affect
humans
D. Include
roundworms
E. Include
tapeworms
Learning Objective: 22.10 Describe some distinguishing characteristics and commonalities seen in helminthic infections.
54.
Ascaris lumbricoides
A. Is an intestinal
roundworm
B. Spreads to humans by ingestion of Ascaris eggs
in food
C. Larvae penetrate into lymphatics and capillaries around
intestines
D. Larvae migrate to the pharynx, get swallowed and return to
intestines to mature
correct
Learning Objective: and identify which life cycle they follow and one unique fact about each one.
Learning Objective: objective 22.11 List four helminths that cause primarily intestinal symptoms
55.
Enterobius vermicularis is
A. A
whipworm
B. Common only to the tropics and
subtropics
C. An intestinal worm that easily contaminates fingers
and fomites
D. Often fatal in heavy
infestations
correct
56.
All of the following pertain to tapeworms except

A. Scolex is the
head
B. Strobila is made up of
proglottids
C. Proglottids are reproductive
segments
D. Cysticerci are young infective larvae ingested in
undercooked meat
E. Eosinophilia does not
occur
57.
General symptoms of helminth infection includes all of the following except

A. Eggs, larvae or adult worms found in
feces
B. Increased sensitivity to helminth
antigens
C. Intense abdominal
pain
D. Increased eosinophil
count
E. Vague
nausea
58.
Trichinosis includes all the following except

A. Encysted larvae get
ingested
B. Associated with undercooked pork or bear
meat
C. Migrate from intestines to blood and various body
tissues
D. Coiled larvae encyst in skeletal
muscle
correct
Learning Objective: 22.14 Describe the type of disease caused by Trichinella species.
59.
Liver flukes live in all the following areas except

A. Small
intestine
B. Live
r
C. Gallbladd
er
D. Bile
duct
true
60.
Which of the following is not true of schistosomiasis?

A. Caused by blood
flukes
B. Larvae called cercariae can invade
intact skin
C. Snail is the intermediate
host
D. Worms can invade the
brain
E. Can "cloak" itself with proteins in the
blood
Learning Objective: 22.15 Diagram the life cycle of Schistosoma mansoni and Schistosoma japonicum
Learning Objective: discuss how it differs from the life cycle of the Schistosoma involved in urinary disease and describe the
importance of all three organisms in world health.

61.
Which of the following infections involves intermediate development in snails and

freshwater fish?
A. Opisthorchis
sinensis
B. Clonorchis
sinensis
C. Fasciola
hepatica
D. Both A &
B
Learning Objective: 22.13 List the modes of transmission
Learning Objective: Clonorchis sinensis
Learning Objective: and Fasciola hepatica.
Learning Objective: diagnostic techniques and prevention/treatment for each of the helminth infections resulting in liver and
intestinal symptoms. These are infections caused by Opisthorchis sinensis
62.
Which of the following helminths is paired with a correct characteristic(s) of its

pathogenesis?
A. Ascaris lumbricoides- life and transmission
cycle B
B. Necator americanus- life and transmission
cycle A
C. Ancylostoma duodenale- life and transmission
cycle A
D. Strongyloides stercoralis- life and transmission
cycle B
Learning Objective: 22.12 List four helminths that cause intestinal symptoms that may be accompanied by migratory symptoms
True / False Questions

63.
In the absence of dietary carbohydrates, bacteria do not cause tooth decay.

TRUE
64.
Mumps causes permanent sterility in young male adults.

FALSE
65.
E. coli O157:H7 secretes shiga exotoxin.

TRUE
66.
Antibiotics are used to treat E. coli O157:H7 caused diarrhea.

FALSE
67.
Enteropathogenic E. coli (EPEC) cause gut effacement with shiga toxin.

FALSE
68.
The best treatment for acute diarrhea is oral replacement of electrolytes and
water.
TRUE
69.
Only feces from humans that contaminate food and water can be involved in
transmission of amebiasis.
FALSE
70.
Boiling will not kill Giardia lamblia cysts in contaminated water.

FALSE
71.
Carriers of hepatitis B virus are not common.

FALSE
72.
There are vaccines for immunity to the hepatitis B virus.

TRUE
73.
The only body fluid that can transmit hepatitis B virus is blood.
TRUE
74.
Most antihelminth medications act only against the worms, not the human host.
FALSE
75.
There are no infectious agents that can invade intact skin.

FALSE
Learning Objective: 22.01 Draw or describe the anatomical features of the gastrointestinal tract.
76.
Research does not indicate a link between the numbers and types of bacteria
causing periodontitis and thicker carotid arteries in an individual.
FALSE
Learning Objective: 22.06 Discuss current theories about the connection between oral bacteria and cardiovascular disease.
77.
Despite acidic conditions, some microorganisms have been found residing within
the human stomach.
TRUE
Learning Objective: 22.04 Describe how our view has changed of normal biota present in the stomach.
Chapter 022 Infectious Diseases Affecting the Gastrointestinal Tract

Summary
Category
# of Qu
estions
Learning Objective: 22.01 Draw or describe the anatomical features of the gastrointestinal tract.
Learning Objective: 22.02 List the natural defenses present in the gastrointestinal tract
Learning Objective: 22.02 List the natural defenses present in the gastrointestinal tract.
Learning Objective: 22.03 List the types of normal biota presently known to occupy the gastrointestinal tract.
Learning Objective: 22.04 Describe how our view has changed of normal biota present in the stomach.
Learning Objective: 22.06 Discuss current theories about the connection between oral bacteria and cardiovasc
ular disease.
39
Learning Objective: 22.10 Describe some distinguishing characteristics and commonalities seen in helminthic
infections.
Learning Objective: 22.12 List four helminths that cause intestinal symptoms that may be accompanied by mi
gratory symptoms
Learning Objective: 22.13 List the modes of transmission
Learning Objective: 22.14 Describe the type of disease caused by Trichinella species.
Learning Objective: 22.15 Diagram the life cycle of Schistosoma mansoni and Schistosoma japonicum
1
39
Learning Objective: and Fasciola hepatica.
Learning Objective: Clonorchis sinensis

9
39
Learning Objective: diagnostic techniques and prevention/treatment for each of the helminth infections resulti
ng in liver and intestinal symptoms. These are infections caused by Opisthorchis sinensis
Learning Objective: discuss how it differs from the life cycle of the Schistosoma involved in urinary disease an
d describe the importance of all three organisms in world health.
51
6
9
52

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Chapter 022 Infectious Diseases Affecting the Gastrointestinal Tract Key

Multiple Choice Questions

Defenses of the GI tract against pathogens include

Which organ of the GI tract has a large commensal population of microorganisms?

The most common infectious disease in humans is

The main causes of dental caries seem to be

Oral flora bacteria on the tooth surface

Learning Objective: modes of transmission

The causative organism for mumps is

The virulence factor for mumps is

Orchitis and epididymitis is seen in young adult males as a complication of

Helicobacter pylori causes

Which is not a characteristic of Helicobacter pylori?

Learning Objective: diagnostic techniques and prevention/treatment for mumps

Which of the following is mismatched?

Typhoid fever has the following characteristics except

Learning Objective: and also for acute diarrhea with vomiting.

Which is incorrect about shigellosis?

Shigella species have the following characteristics except

E. coli O157:H7 characteristics include all the following except it

Which of the following is not a virulence factor of E. coli O157:H7?

Which of the following is not true of Enterotoxigenic E. coli (ETEC)?

Learning Objective: and also for acute diarrhea with vomiting.

Which of the following is not true of Enterovasive E. coli (EIEC)?

Escherichia coli infections

All of the following are characteristics of Campylobacter jejuni except

The most common bacterial cause of diarrhea in the United States is

Campylobacter infection has all of the following characteristics except

Learning Objective: and also for acute diarrhea with vomiting.

Which is true of Yersinia enterocolitica and Yersinia pseudotuberculosis?

Production of enterotoxin is a characteristic of

All of the following pertain to Clostridium difficile infection except it is

Which is not true of Clostridium difficile?

The virulence of Vibrio cholerae is due to its

Learning Objective: and also for acute diarrhea with vomiting.

Cholera symptoms are

Symptoms of cryptosporidiosis include

The primary viral cause of chronic diarrhea, globally is

A common food intoxication is caused by enterotoxin-producing strains of

Which is incorrect about Staphylococcus aureus food intoxication?

Entamoeba histolytica is acquired by

All of the following can be transmitted by drinking contaminated water except

Learning Objective: and also for acute diarrhea with vomiting.

Which is incorrect about hepatitis A infection?

Learning Objective: prevention and treatment of each.

The most common cause of liver cancer in the US is

Parasitic helminthes have the following characteristics except

All of the following pertain to tapeworms except

General symptoms of helminth infection includes all of the following except

Trichinosis includes all the following except

Liver flukes live in all the following areas except

Which of the following is not true of schistosomiasis?

importance of all three organisms in world health.

Which of the following infections involves intermediate development in snails and

Which of the following helminths is paired with a correct characteristic(s) of its

True / False Questions

In the absence of dietary carbohydrates, bacteria do not cause tooth decay.

Mumps causes permanent sterility in young male adults.

E. coli O157:H7 secretes shiga exotoxin.

Antibiotics are used to treat E. coli O157:H7 caused diarrhea.

Enteropathogenic E. coli (EPEC) cause gut effacement with shiga toxin.

Boiling will not kill Giardia lamblia cysts in contaminated water.

Carriers of hepatitis B virus are not common.

There are vaccines for immunity to the hepatitis B virus.