Deck 30: Agents of Bioterror and Forensic Microbiology

Question 1

Which of these are designated as sentinel hospitals in the Laboratory Response Network (LRN)?

A)Centers for Disease Control and Prevention (CDC)
B)Reference laboratories
C)State public health laboratories
D)Community hospitals with microbiology laboratories

Answer 1

D
As defined by the LRN, community hospitals with microbiology capabilities are designated as sentinel (formerly level A) LRN laboratories.Sentinel laboratories must have a biosafety level 2 (BSL-2) facility and the laboratory protocols published on the CDC and American Society for Microbiology (ASM) Web sites to rule out the presence of biological agents.

Question 2

What classification system was developed in 1999 by academic infectious disease experts, government officials, military intelligence experts, and law enforcement officials?

A)Biosafety levels
B)High, moderate, and low categories
C)A, B, C categories
D)Normal, increased, and high categories

Answer 2

C
In 1999, academic infectious disease experts, national public health experts, Department of Health and Human Services agency representatives, civilian and military intelligence experts, and law enforcement officials met to comment on the threat potential of infectious agents to civilian populations.As a result, agents were placed into one of three categories-A, B, or C-for initial public health preparedness efforts.

Question 3

What type of anthrax is most deadly and most likely to be seen in a bioterrorism attack?

A)Gastrointestinal
B)Inhalation
C)Cutaneous
D)Spinal

Answer 3

B
Inhalation anthrax occurs when a patient inhales Bacillus anthracis; it usually takes at least 8000 spores to initiate this form of the disease.Inhalation anthrax is the form of anthrax most likely to be seen in a bioterrorism event.Data from the accidental spore release in Sverdlosk, Russia, in 1976 suggested a mortality rate of almost 100%.However, the mortality rate of patients with inhalation anthrax in the United States in 2001 was only 45% (5 out of 11).

Question 4

What is the specimen of choice for cutaneous anthrax?

A)Blood
B)Spinal fluid
C)Vesicular fluid from lesions
D)Sputum

Question 5

Yersinia pestis causes all the following except _____ plague.

A)bubonic
B)septicemic
C)pneumonic
D)meningococcal

Question 6

All the following organizations established the Laboratory Response Network except:

A)United States Army Medical Research Institute for Infectious Diseases (USAMRIID).
B)Centers for Disease Control and Prevention (CDC).
C)Central Intelligence Agency (CIA).
D)Federal Bureau of Investigation (FBI).

Question 7

Organisms that have the following characteristics-aerobic growth, nonhemolytic colonies 2 to 5 mm in diameter, catalase positive, nonmotile, large gram-positive bacilli recovered from lesions, blood, cerebrospinal fluid (CSF) or lymph nodes-can be presumptively identified as:

A)Brucella mallei.
B)Bacillus anthracis.
C)Yersinia pestis.
D)Burkholderia cepacia.

Question 8

What federal regulation establishes the rules of possession, use, and transfer of select agents and toxins?

A)Public Health Security and Bioterrorism Preparedness and Response Act of 2002
B)42 CFR 73
C)Animal Health and Inspection Act
D)Infectious Agent Act

Question 9

Who will be most likely to suspect a covert bioterrorism attack?

A)Firefighters and the police
B)Microbiologists and physicians
C)The public health department
D)Centers for Disease Control and Prevention (CDC) and Homeland Security

Question 10

One of the first recorded terror attacks occurred in 1984 in a restaurant in The Dalles, Oregon.What organism was used in this attack?

A)Salmonella
B)Escherichia coli
C)Clostridium
D)Staphylococcus

Question 11

What is the role of the sentinel laboratory?

A)To rule out or refer suspicious isolates
B)To identify suspicious isolates
C)To act as a reference laboratory for physician office laboratories
D)None of the above

Question 12

What category of bioterrorism agents would have the greatest impact?

A)Category A
B)Category B
C)Category C
D)Category D

Question 13

How can biological weapons enter the host?

A)Through the respiratory tract
B)Through the gastrointestinal (GI) tract
C)Through the mucous membranes
D)All of the above

Question 14

What is bioterrorism?

A)The use of bacteria, viruses, fungi, or toxins to injure people, animals, or crops to cause civil unrest
B)The use of synthetic biological substances to kill innocent people
C)The use of biological substances to kill, maim, or injure as many people as possible
D)The use of biohazardous substances to cause chaos

Question 15

What document prohibits the use of biological agents during war?

A)Geneva Protocol
B)Treaty of Versailles
C)Antiproliferation Pact
D)Law of Armed Conflict

Question 16

A microbiologist is looking at a sheep blood agar (SBA) plate from a patient who might have been exposed to a biological agent.The colonies that are growing on the plate are nonhemolytic, large, have a ground-glass appearance, and look like a Medusa's head.On Gram stain, the colonies are large gram-positive rods that seem to have central spores.What is the most probable organism?

A)Bacillus anthracis
B)Brucella mallei
C)Burkholderia cepacia
D)Yersinia pestis

Question 17

What is the specimen of choice for gastrointestinal and inhalation anthrax?

A)Sputum
B)Vesicular fluid from lesions
C)Spinal fluid
D)Blood

Question 18

What organism caused the disease known as the Black Death?

A)Brucella mallei
B)Bacillus anthracis
C)Yersinia pestis
D)Burkholderia cepacia

Question 19

What type of plague is the most common and results from the bite of a flea?

A)Bubonic plague
B)Septicemic plague
C)Pneumonic plague
D)Osmotic plague

Question 20

A microbiologist is looking at a set of plates from a seriously ill patient.The sheep blood agar (SBA) plate shows small, nonhemolytic colonies that have a fried egg appearance.On MacConkey, these organisms grow as a small, nonlactose fermenter.On Gram stain, this organism is a bipolar staining, plump gram-negative rod.What is the most probable organism?

A)Brucella mallei
B)Bacillus anthracis
C)Yersinia pestis
D)Burkholderia cepacia

Question 21

What organism causes Q fever?

A)Coxiella burnetii
B)Brucella abortus
C)Yersinia pestis
D)Burkholderia cepacia

Question 22

What is characteristic of smallpox?

A)The pustules penetrate deeply into the tissue
B)Infections also occur on the palms and the soles of the feet
C)The synchronous progression of the lesions
D)All of the above

Question 23

Viral hemorrhagic fevers include all the following except:

A)Ebola.
B)Crimean-Congo.
C)Lassa fever.
D)black fever.

Question 24

A microbiologist is looking at the blood culture plates taken from a woman who had ingested fresh, unpasteurized milk.The growth on the blood agar and chocolate agar showed small, circular, smooth, convex, nonpigmented, and nonhemolytic colonies.Gram stain revealed tiny gram-negative rods.The organism was catalase, oxidase, nitrate reduction, and urease positive, but showed a lack of motility.What is the most probable organism?

A)Francisella tularensis
B)Brucella abortus
C)Yersinia pestis
D)Burkholderia cepacia

Question 25

What is ricin?

A)A potent biological toxin that disrupts native DNA strands
B)A potent biological toxin that stops cell wall synthesis
C)A potential biological toxin that inhibits protein synthesis
D)All of the above

Question 26

What organism causes glanders?

A)Francisella tularensis
B)Brucella abortus
C)Yersinia pestis
D)Burkholderia mallei

Question 27

How is smallpox diagnosed?

A)Through a Centers for Disease Control and Prevention (CDC) algorithm
B)By clinical signs
C)Through cell culture
D)All of the above

Question 28

A microbiologist observes culture plates that have larger nonpigmented gray colonies at 24 hours that are indole-negative, nonmotile, catalase-positive, and resistant to polymyxin B disks.The Gram stain shows this is a gram-negative coccobacilli.What is the most probable organism?

A)Francisella tularensis
B)Brucella mallei
C)Yersinia pestis
D)Burkholderia cepacia

Question 29

What disease is associated with rabbits?

A)Francisella tularensis
B)Bacillus anthracis
C)Yersinia pestis
D)Burkholderia cepacia

Question 30

Botulism toxin is a(n) _____ primarily produced by Clostridium botulinum.

A)neurotoxin
B)mucosal toxin
C)enterotoxin
D)endotoxin

Question 31

When should a microbiologist consider Francisella tularensis?

A)Tiny, gram-negative coccobacilli that do not grow well on chocolate or MacConkey's and are biochemically inert
B)Tiny, gram-negative coccus that grows well on blood agar
C)Tiny, pleomorphic, poor-staining, gram-negative coccobacilli that do not grow well, if at all on blood agar
D)None of the above

Question 32

What is the most common presentation for tularemia?

A)Pneumonic tularemia
B)Ulceroglandular tularemia
C)Bubonic tularemia
D)Septicemic tularemia

Question 33

All of the following are synonyms for brucellosis except _____ fever.

A)Malta
B)undulant
C)Gibraltar
D)relapsing