Deck 18: Infectious Diseases Affecting the Skin and Eyes

Question 1

Which material in skin provides protection from abrasions, water damage, and microorganism entry?

A) Keratin
B) Lysozyme
C) Sweat
D) Sebum
E) Salt

Answer 1

Keratin

Question 2

Which of the following is a febrile disease characterized by a rash and is caused by a virus that can cross the placenta to cause serious fetal damage?

A) Measles
B) Smallpox
C) Rubella
D) Shingles
E) Impetigo

Answer 2

Rubella

Question 3

Measles is described as a ______ skin lesion.

A) macule
B) maculopapular
C) vesicular
D) pustular
E) bulla

Answer 3

maculopapular

Question 4

Which microorganism species is most well-adapted to life on the skin?

A) Malassezia
B) Streptococcus pyogenes
C) Corynebacterium diphtheriae
D) Candida albicans
E) Staphylococcus epidermidis

Question 5

Impetigo is caused by ______.

A) C. perfringens
B) C. diphtheriae
C) S. aureus
D) S. pyogenes
E) Both S. aureus and S. pyogenes are correct.

Question 6

Microbes are not likely to be found in which of the following locations on human skin?

A) The stratum corneum
B) Sensory nerve ?ber in the dermis
C) Sebaceous gland
D) Hair follicle

Question 7

The smallpox vaccine uses the ______ virus.

A) herpes simplex
B) vaccinia
C) smallpox
D) human herpesvirus 6
E) variola

Question 8

Which of the following statements about measles is incorrect?

A) It is transmitted by direct contact with the rash.
B) Dry cough, sore throat, fever, and conjunctivitis are symptoms.
C) Humans are the only reservoir for the pathogen.
D) Secondary bacterial otitis media and sinusitis can occur.
E) It may involve a fatal complication called subacute sclerosing panencephalitis (SSPE).

Question 9

The integument includes all of the following except ______.

A) sweat glands
B) skin
C) nails
D) surface capillaries
E) hair

Question 10

Which of the following statements is correct regarding rubella?

A) It is not preventable by a vaccine.
B) It manifests as high fever, severe sore throat, severe cough, and myalgia.
C) It is associated with congenital transmission causing miscarriage, deafness, and cardiac and mental defects in the infant.
D) It is caused by the measles virus (Morbillivirus).

Question 11

Impetigo involves itching papules that break and form a very contagious yellow crust.

Question 12

The enzyme that clots plasma is ______.

A) hyaluronidase
B) catalase
C) kinase
D) staphylokinase
E) coagulase

Question 13

Protective features of the skin include all of the following except ______.

A) resident biota
B) high pH
C) high salt content
D) a keratinized surface
E) lysozyme

Question 14

In the skin, blood vessels are found in the ______.

A) dermis
B) stratum basale
C) subcutaneous layer
D) stratum corneum
E) dermis and subcutaneous layers

Question 15

Necrotizing fasciitis is _______.

A) possibly caused by antibodies to Group A streptococci that cross-react with body tissues
B) associated with strains of Streptococcus pyogenes producing destructive enzymes and toxins
C) not treatable with antimicrobial drugs
D) also called impetigo
E) typically a sequelae of streptococcal pharyngitis

Question 16

Which of the following statements about blisters is correct?

A) Blisters originate in the dermis.
B) Blisters result from a separation of epidermis from dermis.
C) Blisters originate in the subcutaneous layer.
D) Blisters are con?ned to the epidermis.

Question 17

Which of the following skin defenses and its mechanism is mismatched?

A) Lysozyme; hydrolyzes peptidoglycan in bacterial cell walls
B) Sebum; lipid hydrolysis leads to toxic by-products that inhibit microbial growth
C) Keratinized surface; protein that provides waterproo?ng
D) Antimicrobial peptides; disrupt positively charged bacterial membranes

Question 18

Which of the following is the most common form of transmission for impetigo?

A) Mechanical vectors
B) Direct contact
C) Body ?uids
D) Blood
E) Fomites

Question 19

The organisms that cause ringworm, or tinea, use keratin protein as their growth substrate. This is why these infections ________.

A) cause a discoloration of the skin by damaging skin pigment protein
B) have a high mortality rate
C) are restricted to super?cial skin layers
D) produce a rash all over the body during an infection

Question 20

The environment of human skin requires an adaptation for microbes that can tolerate moderately ______ conditions.

A) anaerobic
B) psychrophilic
C) alkaline
D) halophilic
E) thermophilic

Question 21

Which of the following statements is incorrect about the MMR vaccine?

A) It is given in early childhood.
B) It protects against three different viral diseases.
C) It contains attenuated viruses.
D) It contains toxoids.

Question 22

Smallpox is a disease in which _______.

A) fever, malaise, and rash occur
B) the virus becomes latent in ganglia of sensory neurons
C) recurrent episodes are called shingles
D) transmission occurs by direct contact with skin crusts
E) All of the choices are correct.

Question 23

Which of the following statement(s) is/are correct regarding ?fth disease?

A) It is caused by Parvovirus B19.
B) It is a childhood febrile disease characterized by a red rash on the cheeks.
C) The causative agent is capable of crossing the placenta.
D) It is characterized by a maculopapular rash that lasts for days to weeks.
E) All of the choices are correct.

Question 24

Which of the following is not true of measles?

A) Its causative agent is a member of the Morbillivirus genus.
B) It is transmitted by respiratory droplets.
C) It causes cell membranes to fuse to form syncytia.
D) It is in the Paramyxovirus family.
E) It is a single-stranded nonenveloped RNA virus.

Question 25

Which of the following is not true of staphylococcal scalded skin syndrome (SSSS)?

A) The skin splits within the epidermis.
B) It is an exotoxin-mediated disease.
C) It predominantly affects newborns and babies.
D) The toxins cause bullous lesions.
E) The skin splits between the dermis and epidermis.

Question 26

Which form of anthrax involves a black eschar on the skin?

A) Cutaneous
B) Muscular
C) Gastrointestinal
D) Inhalational

Question 27

Infections caused by Staphylococcus aureus include all of the following except ______.

A) chickenpox
B) carbuncles
C) scalded skin syndrome
D) impetigo
E) meningitis

Question 28

Leishmaniasis is transmitted through the bite of a/an ______.

A) tsetse ?y
B) reduviid "kissing" bug
C) sand ?y
D) hard-bodied tick
E) Anopheles mosquito

Question 29

Streptococcus pyogenes causes all of the following infections except ______.

A) impetigo
B) necrotizing fasciitis
C) scalded skin syndrome
D) erysipelas
E) scarlet fever

Question 30

Which of the following statement is incorrect about warts?

A) They include deep plantar warts on the soles of the feet.
B) They are frequently cancerous.
C) They are caused by human papillomaviruses (HPV).
D) They are transmitted by direct contact or fomites.
E) Topical salicylic acid can be used for removal.

Question 31

Oral lesions called Koplik's spots are seen in patients with ______.

A) measles
B) rubella
C) croup
D) in?uenza
E) mumps

Question 32

Cutaneous anthrax is _______.

A) seen in epidemic proportions in the United States
B) transmitted by contact
C) found only in humans
D) a high mortality disease

Question 33

The toxin of Staphylococcus aureus that causes blisters and desquamation of skin in staphylococcal scalded skin syndrome is ______.

A) erythrogenic toxin
B) toxic shock syndrome toxin
C) hemolysin
D) exfoliative toxin
E) enterotoxin

Question 34

The main causative agent of gas gangrene is ______.

A) Streptococcus pyogenes
B) Mycobacterium leprae
C) Staphylococcus epidermidis
D) Clostridium perfringens
E) Staphylococcus aureus

Question 35

Measles is also known as ______.

A) rubeola
B) ?fth disease
C) varicella
D) shingles
E) rubella

Question 36

Which of the following statements does not pertain to Streptococcus pyogenes?

A) It secretes streptokinase.
B) It coats itself with host proteins.
C) It causes impetigo.
D) It is often spread from an endogenous source.
E) It causes gas gangrene.

Question 37

Which of the following is not true of cellulitis?

A) It causes pain, tenderness, swelling, and warmth.
B) It is caused by S. aureus or S. pyogenes.
C) It affects the epidermis layer of the skin.
D) Lymphangitis may occur with this infection.
E) Surgery may be required for treatment.

Question 38

If a person who has never been infected with human herpesvirus 3 comes in contact with the ?uid of shingles lesions, they will come down with ______.

A) chickenpox
B) herpes labialis
C) shingles
D) infectious mononucleosis
E) herpes keratitis

Question 39

Human herpesvirus 3 (HHV-3) _______.

A) uses the respiratory epithelium as its portal of entry
B) becomes latent in dorsal root ganglia that serve speci?c dermatomes
C) has humans as its reservoir
D) causes chickenpox and shingles
E) All of the choices are correct.

Question 40

Chickenpox _______.

A) is transmitted by inhalation of respiratory secretions
B) is transmitted by skin lesion contact or airborne spread of lesion material
C) has an incubation period of 10 to 20 days
D) has fever and vesicular rash that occurs in successive crops
E) All of the choices are correct.

Question 41

In a recent surgery, when the cut area was sutured, bacteria entered the open tissue. As a result, you now have an infection of deep tissue exhibiting redness, swelling, pain, fever, and a rash. With your knowledge of microbiology, you predict that you have a developed an infection caused by ______.

A) E. coli
B) human herpesvirus 3
C) Staphylococcus
D) Neisseria

Question 42

To perform the coagulase test on a strain of bacteria that is believed to be S. aureus, the ?rst step is to inoculate a tube of ______ with the strain of interest.

A) blood plasma
B) mannitol salt medium
C) blood
D) nutrient broth

Question 43

Mottled, discolored skin pigmentation is observed in patients with tinea versicolor.

Question 44

Chickenpox is caused by an orthopoxvirus.

Question 45

Transmission of tineas include _______.

A) human to human
B) animal to human
C) soil to human
D) All of the choices are correct.

Question 46

Which of the following is mismatched?

A) Tinea cruis - ringworm of the groin
B) Tinea capitis - ringworm of the beard
C) Tinea corporis - ringworm of the body
D) Tinea pedis - ringworm of the foot
E) Tinea unguium - ringworm of the nails

Question 47

Molluscum contagiosum is transmitted by direct contact with skin lesions, fomites, and sexual
activity.

Question 48

Debridement of diseased tissue is important in the care of patients with gas gangrene.

Question 49

Which of the following statements concerning rubella immunization is correct?

A) Administration of the rubella vaccine at 12 to 15 months of age is good protection against congenital rubella.
B) A pregnant woman who contracts rubella should be immunized to protect her unborn child.
C) A child born with congenital rubella may be immunized to prevent recurrence of the disease.
D) The rubella vaccine given in childhood can protect both the child and any children that she may bear in the future.

Question 50

All warts caused by human papillomaviruses are linked to cancers.

Question 51

Impetigo can be caused by either Staphylococcus aureus or Streptococcus pyogenes. Culture- based identi?cation of the causative organism can be complicated by _______.

A) their common optimal growth temperature, 37°C
B) the fastidious nature of both organisms
C) the ability of S. aureus to kill S. pyogenes
D) the common surface antigens of these two organisms

Question 52

Your sister cut herself with a knife, and within a few days, she had a severe pus-producing infection of the hand. A day later, skin begins to come off, exposing muscle and other tissue below the skin.
Predict what caused the severity of this infection.

A) The infectious agent produces exotoxins.
B) This is not an infectious disease; it is an autoimmune disease.
C) The infectious agent is a fungus.
D) The infectious agent is likely a virus.

Question 53

Which of the following statements regarding vaccines as disease preventatives is incorrect?

A) Zostavax is recommended for older adults to prevent shingles.
B) The Carter Center has promoted the development of a vaccine against river blindness.
C) Immunization is currently not possible against Clostridium perfringens.
D) There is currently no smallpox vaccine available to the general public.

Question 54

Diseases that manifest as skin rashes are transmitted through direct contact with affected individuals or with fomites.

Question 55

Staphylococcus can be differentiated from Streptococcus by the ______.

A) coagulase test
B) Gram stain
C) catalase test
D) fermentation of mannitol
E) cellular morphology

Question 56

Considering the diseases and conditions described in this chapter, those transmitted by respiratory droplets are caused by ______.

A) viruses
B) bacteria
C) fungi
D) All of these choices are correct.

Question 57

Which of the following is the causative agent of tinea versicolor?

A) Microsporum
B) Epidermophyton
C) Trichophyton
D) Malassezia

Question 58

Which of the following statements regarding viremia is incorrect?

A) Droplet transmission of viruses like the measles virus results in viremia.
B) Shingles is a manifestation of persistent viremia after a course of chicken pox.
C) HHV-3 is disseminated to the skin by viremia.
D) The variola virus multiplies in white blood cells, and cell lysis results in viremia.

Question 59

Which of the following is not a causative agent of cutaneous mycoses?

A) Trichophyton
B) Microsporum
C) Malassezia
D) Epidermophyton

Question 60

Despite the fact that skin-to-skin contact is important in establishing bonding between babies and their caregivers, that same contact can also expose them to pathogens. You have been asked to teach a short class for child care workers to help them identify highly contagious diseases that can cause outbreaks in their environment. Which two of these conditions are most common and most
Infectious in babies?

A) Ringworm and hand, foot, and mouth disease
B) Conjunctivitis and rubella
C) Impetigo and ringworm
D) Impetigo and conjunctivitis
E) Impetigo and cellulitis

Question 61

The two tissues of the eye with exposed surfaces susceptible to contamination are the ______ and the ______.

A) cornea; lens
B) cornea; iris
C) conjunctiva; iris
D) conjunctiva; cornea
E) conjunctiva; lens

Question 62

Eyes are relatively vulnerable to infection because _______.

A) they are not covered by keratinized epithelium
B) immune privilege restricts access to the cells conferring innate immunity
C) there is a restricted response by B and T cells
D) All of these choices are correct.

Question 63

The eye generally has diverse normal biota present, similar to the skin microbiome.

Question 64

Current recommendations in the United States for treatment of MRSA are to use _______.

A) more than one antibiotic
B) erythromycin and a second antibiotic
C) any antibiotic other than methicillin
D) no antibiotics to curb the development of resistance
E) no antibiotics to allow the immune system to function

Question 65

Among the natural defenses present in tears is the protein lactoferrin. As you can infer from its name, it is also present in milk and other body secretions, and its function involves binding iron ions.
The presence of lactoferrin in tears is protective against bacterial infection because _______.

A) all pathogens must acquire iron from their environment and lactoferrin ensures that the iron concentration is low
B) in the presence of lysozyme, as found in tears, the proteins form a protective barrier on the lens
C) pathogens with magnetosomes will be segregated from the eye tissue and swept away by the tears
D) free iron serves as an immune signal to recruit T cells to the eye

Question 66

River blindness is _______.

A) endemic in Australia, New Zealand, and South Paci?c islands
B) preventable by a vaccine administered to travelers
C) a disease caused by helminths invading the eyes
D) transmitted by mosquito vector

Question 67

Which of the following statements is true of viral conjunctivitis?

A) It has a mucopurulent discharge.
B) It must be treated with both topical and oral antibiotics.
C) It is caused by Chlamydia trachomatis or Neisseria gonorrhoeae.
D) It is caused by adenoviruses.

Question 68

Herpes keratitis is an infection of the eye.

Question 69

Which of the following provides the eye with its best defense against microorganisms?

A) Eyelashes
B) Tears
C) Eyelids
D) Lymphocytes
E) Conjunctiva

Question 70

Which of the following is not true of bacterial conjunctivitis?

A) Treatment is with a broad-spectrum topical antibiotic.
B) It can be transmitted through both direct and indirect contact.
C) Infection produces a clear discharge from the eye.
D) It can be caused by S. pyogenes or S. pneumoniae.

Question 71

A higher rate of eye infections can be expected from a person who _______.

A) has a vitamin de?ciency
B) is very young
C) wears glasses
D) cannot produce tears

Question 72

Which of the following statements is incorrect regarding the effects of rubella and rubeola in different populations?

A) Congenital rubella is least serious if it is contracted during the ?nal trimester of pregnancy.
B) A six-year-old child infected with rubeola will experience fever, cough, and a rash, and barring complications, should recover in a few weeks.
C) Infection during pregnancy with either of these viruses can cause serious injury to the fetus.
D) A 30-year-old man infected with rubella will experience severe symptoms and require constant medical attention for several weeks.

Question 73

Current recommendations for the treatment of MRSA infections in the United States will change based on _______.

A) patterns of antibiotic resistance
B) the availability of different antibiotics
C) congressional approval
D) the cost of different antibiotics

Question 74

The most serious teratogenic effects of intrauterine rubella infection occur if it is acquired during the third trimester.

Question 75

The causative agent of trachoma is ______.

A) adenovirus
B) herpes simplex virus type 1 (HSV-1)
C) C. trachomatis
D) N. gonorrhoeae
E) S. aureus

Question 76

Keratitis is usually caused by ______.

A) Streptococcus pyogenes
B) Neisseria gonorrhoeae
C) Staphylococcus aureus
D) herpes simplex virus type 1 (HSV-1)

Question 77

Which of the following statements regarding eye infections is correct?

A) In?ammation occurs in most eye infections and serves to initiate repair of the damaged tissue.
B) Immune privilege restricts virtually all microbes from the tissues of the eye.
C) Eye infections may be opportunistic infections by the normal microbiota of the eye.
D) Lysozyme in tears targets the gram-negative microbes that contact the eye.

Question 78

Occassionally, Staphylococcus epidermidis may be isolated from the eye.

Question 79

Which eye disease is characterized by a pannus forming over the cornea?

A) Keratitis
B) Trachoma
C) Stye
D) Simple conjunctivitis
E) River blindness

Question 80

Which of the following ocular tissues and infections is mismatched?

A) Conjunctivitis - milky discharge and infection of eyelid lining
B) River blindness - micro?lariae visible in the vitreous chamber
C) Trachoma - infection of epithelial cells
D) Keratitis - infection of deep eye tissue