Chapter 14 Principles of Disease and Epidemiology My Nursing Test Banks

Microbiology: An Introduction, 12e (Tortora)

Chapter 14   Principles of Disease and Epidemiology

14.1   Multiple-Choice Questions

1) A commensal bacterium

A) does not receive any benefit from its host.

B) is beneficial to its host.

C) may also be an opportunistic pathogen.

D) isnt capable of causing disease in its host.

E) always causes disease in its host.

Answer:  C

Section:  14.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.3

Global Outcome:  2

2) Which of the following statements is TRUE?

A) Both members are harmed in a symbiotic relationship.

B) Members of a symbiotic relationship cannot live without each other.

C) A parasite is not in symbiosis with its host.

D) Symbiosis always refers to different organisms living together and benefiting from each other.

E) At least one member must benefit in a symbiotic relationship.

Answer:  E

Section:  14.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.3

Global Outcome:  2

3) A nosocomial infection is

A) always present, but is inapparent at the time of hospitalization.

B) acquired during the course of hospitalization.

C) always caused by medical personnel.

D) only a result of surgery.

E) always caused by pathogenic bacteria.

Answer:  B

Section:  14.7

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  14.15

4) The major significance of Robert Kochs work is that

A) microorganisms are present in a diseased animal.

B) diseases can be transmitted from one animal to another.

C) microorganisms can be cultured.

D) microorganisms cause disease.

E) microorganisms are the result of disease.

Answer:  D

Section:  14.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  7.4

Learning Outcome:  14.5

Global Outcome:  5

5) Which of the following is NOT a verified exception in the use of Kochs postulates?

A) Some diseases have poorly defined etiologies.

B) Some pathogens can cause several disease conditions.

C) Some human diseases have no other known animal host.

D) Some diseases are not caused by microbes.

E) Some diseases are noncommunicable.

Answer:  E

Section:  14.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  7.4

Learning Outcome:  14.5

Global Outcome:  5

6) Which of the following diseases is NOT spread by droplet infection?

A) botulism

B) tuberculosis

C) measles

D) the common cold

E) diphtheria

Answer:  A

Section:  14.6

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.14

7) Biological transmission differs from mechanical transmission in that biological transmission

A) occurs when a pathogen is carried on the feet of an insect.

B) involves fomites.

C) involves reproduction of a pathogen in an arthropod vector prior to transmission.

D) requires direct contact.

E) works only with noncommunicable diseases.

Answer:  C

Section:  14.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.14

8) Which of the following definitions is INCORRECT?

A) endemic: a disease that is constantly present in a population

B) epidemic: a disease that is endemic across the world

C) pandemic: a disease that affects a large number of people in the world in a short time

D) sporadic: a disease that affects a population occasionally

E) incidence: number of new cases of a disease

Answer:  B

Section:  14.4

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.7

9) Focal infections initially start out as

A) sepsis.

B) bacteremia.

C) local infections.

D) septicemia.

E) systemic infections.

Answer:  C

Section:  14.4

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  14.8

10) The rise in herd immunity amongst a population can be directly attributed to

A) increased use of antibiotics.

B) improved handwashing.

C) vaccinations.

D) antibiotic-resistant microorganisms.

E) None of the answers is correct.

Answer:  C

Section:  14.4

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  6.3

Learning Outcome:  14.9

Global Outcome:  5

11) Koch observed Bacillus anthracis multiplying in the blood of cattle. What is this condition called?

A) bacteremia

B) focal infection

C) local infection

D) septicemia

E) systemic infection

Answer:  D

Section:  14.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.5

Global Outcome:  2

12) Which one of the following does NOT contribute to the incidence of nosocomial infections?

A) antibiotic resistance

B) lapse in aseptic techniques

C) gram-negative cell walls

D) lack of handwashing

E) lack of insect control

Answer:  C

Section:  14.7

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.17

Global Outcome:  7

13) Transient microbiota differ from normal microbiota in that transient microbiota

A) cause diseases.

B) are found in a certain location on the host.

C) are always acquired by direct contact.

D) are present for a relatively short time.

E) never cause disease.

Answer:  D

Section:  14.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  14.2

14) Which of the following statements about nosocomial infections is FALSE?

A) They occur in compromised patients.

B) They may be caused by opportunists.

C) They may be caused by drug-resistant bacteria.

D) They may be caused by normal microbiota.

E) The patient was infected before hospitalization.

Answer:  E

Section:  14.7

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.15

Global Outcome:  2

15) One effect of washing regularly with antibacterial agents is the removal of normal microbiota. This can result in

A) body odor.

B) fewer diseases.

C) increased susceptibility to disease.

D) normal microbiota returning immediately.

E) no bacterial growth because washing removes their food source.

Answer:  C

Section:  14.1

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.1

Global Outcome:  7

16) Which of the following is NOT a reservoir of infection?

A) a sick person

B) a healthy person

C) a sick animal

D) a hospital

E) None of the answers is correct; all of these can be reservoirs of infection.

Answer:  E

Section:  14.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.12

Global Outcome:  2

17) Which of the following is NOT a communicable disease?

A) malaria

B) AIDS

C) tuberculosis

D) tetanus

E) typhoid fever

Answer:  D

Section:  14.4

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  14.6

18) Which of the following is a fomite?

A) water

B) droplets from a sneeze

C) pus

D) insects

E) a hypodermic needle

Answer:  E

Section:  14.6

Blooms Taxonomy:  Comprehension

Learning Outcome:  14.13

19) Which of the following statements about biological transmission is FALSE?

A) The pathogen reproduces in the vector.

B) The pathogen may enter the host in the vectors feces.

C) Houseflies are an important vector.

D) The pathogen may be injected by the bite of the vector.

E) The pathogen may require the vector as a host.

Answer:  C

Section:  14.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.14

Global Outcome:  2

20) Which of the following definitions is INCORRECT?

A) acute: a short-lasting primary infection

B) inapparent: infection characteristic of a carrier state

C) chronic: a disease that develops slowly and lasts for months

D) primary infection: an initial illness

E) secondary infection: a long-lasting illness

Answer:  E

Section:  14.4

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.8

21) Symptoms of disease differ from signs of disease in that symptoms

A) are changes felt by the patient.

B) are changes observed by the physician.

C) are specific for a particular disease.

D) always occur as part of a syndrome.

E) None of the answers is correct.

Answer:  A

Section:  14.4

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.6

22) The science that deals with when diseases occur and how they are transmitted is called

A) ecology.

B) epidemiology.

C) communicable disease.

D) morbidity and mortality.

E) public health.

Answer:  B

Section:  14.9

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.20

Global Outcome:  5

23) Figure 14.1

Figure 14.1 shows the incidence of influenza during a typical year. Which letter on the graph indicates the endemic level?

A) a

B) b

C) c

D) d

E) The answer cannot be determined based on the information provided.

Answer:  D

Section:  14.4

Blooms Taxonomy:  Analysis

ASMcue Outcome:  7.1b

Learning Outcome:  14.7

Global Outcome:  3

24) Emergence of infectious diseases can be attributed to all of the following EXCEPT

A) antibiotic resistance.

B) climatic changes.

C) new strains of previously known agents.

D) ease of travel.

E) The emergence of infectious diseases can be attributed to all of these.

Answer:  E

Section:  14.8

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.19

Global Outcome:  7

25) Which of the following pairs is mismatched?

A) malaria vector

B) salmonellosis vehicle transmission

C) syphilis direct contact

D) influenza droplet infection

E) None of the pairs is mismatched.

Answer:  E

Section:  14.6

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.14

26) Which of the following can contribute to postoperative infections?

A) using syringes more than once

B) normal microbiota on the operating room staff

C) errors in aseptic technique

D) antibiotic resistance

E) All of the answers are correct.

Answer:  E

Section:  14.7

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.17

27) Figure 14.2

In Figure 14.2, when is the prevalence the highest?

A) July

B) January

C) February

D) March

E) The answer cannot be determined based on the information provided.

Answer:  C

Section:  14.4

Blooms Taxonomy:  Analysis

ASMcue Outcome:  7.1b

Learning Outcome:  14.7

Global Outcome:  3

28) A cold transmitted by a facial tissue is an example of

A) direct contact.

B) droplet transmission.

C) fomite.

D) vector.

E) vehicle transmission.

Answer:  E

Section:  14.6

Blooms Taxonomy:  Comprehension

Learning Outcome:  14.14

29) A researcher has performed a prospective study on a disease. To which specific kind of epidemiological study is this referring?

A) analytical

B) case control

C) descriptive

D) experimental

E) prodromal

Answer:  C

Section:  14.9

Blooms Taxonomy:  Comprehension

Learning Outcome:  14.20

Global Outcome:  1

30) The CDC is located in

A) Atlanta, GA.

B) Washington, DC.

C) New York City, NY.

D) Los Angeles, CA.

E) Chicago, IL.

Answer:  A

Section:  14.9

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.21

31) A disease in which the causative agent remains inactive for a time before producing symptoms is referred to as

A) subacute.

B) subclinical.

C) latent.

D) zoonotic.

E) acute.

Answer:  C

Section:  14.4

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  14.8

32) A needlestick is an example of

A) direct contact.

B) droplet transmission.

C) indirect contact transmission by fomite.

D) direct biological transmission by vector.

E) vehicle transmission.

Answer:  C

Section:  14.6

Blooms Taxonomy:  Comprehension

Learning Outcome:  14.14

Global Outcome:  2

33) Which of the following is NOT a predisposing factor of disease?

A) lifestyle

B) genetic background

C) climate

D) occupation

E) All of these are predisposing factors of disease.

Answer:  E

Section:  14.5

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.10

Global Outcome:  7

34) In which of the following diseases can gender be considered a viable predisposing factor?

A) urinary tract infections

B) pneumonia

C) salmonellosis

D) tetanus

E) anthrax

Answer:  A

Section:  14.5

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.10

Global Outcome:  7

35) In which of the following patterns of disease does the patient experience no signs or symptoms?

A) prodromal

B) decline

C) convalescence

D) incubation

E) both incubation and convalescence

Answer:  E

Section:  14.5

Blooms Taxonomy:  Comprehension

Learning Outcome:  14.11

Global Outcome:  2

Situation 14.1

During a six-month period, 239 cases of pneumonia occurred in a town of 300 people. A clinical case was defined as fever 39C lasting >2 days with three or more symptoms (i.e., chills, sweats, severe headache, cough, aching muscles/joints, fatigue, or feeling ill). A laboratory-confirmed case was defined as a positive result for antibodies against Coxiella burnetii. Before the outbreak, 2000 sheep were kept northwest of the town. Of the 20 sheep tested from the flock, 15 were positive for C. burnetii antibodies. Wind blew from the northwest, and rainfall was 0.5 cm compared with 7 to 10 cm during each of the previous three years.

36) Situation 14.1 is an example of

A) human reservoirs.

B) a zoonosis.

C) a nonliving reservoir.

D) a vector.

E) a focal infection.

Answer:  B

Section:  14.6

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  14.14

Global Outcome:  2

37) The etiologic agent of the disease in Situation 14.1 is

A) sheep.

B) soil.

C) Coxiella burnetii.

D) pneumonia.

E) wind.

Answer:  C

Section:  14.1

Blooms Taxonomy:  Analysis

Learning Outcome:  14.1

Global Outcome:  2

38) The method of transmission of the disease in Situation 14.1 was

A) direct contact.

B) droplet.

C) indirect contact.

D) vector-borne.

E) vehicle.

Answer:  E

Section:  14.6

Blooms Taxonomy:  Analysis

Learning Outcome:  14.14

Global Outcome:  2

39) Which of the following is NOT an example of microbial antagonism?

A) acid production by bacteria

B) bacteriocin production

C) bacteria occupying host receptors

D) bacteria causing disease

E) bacteria producing vitamin K

Answer:  D

Section:  14.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.2

Global Outcome:  2

40) The yeast Candida albicans does not normally cause disease because of

A) symbiotic bacteria.

B) antagonistic bacteria.

C) parasitic bacteria.

D) commensal bacteria.

E) other fungi.

Answer:  B

Section:  14.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  14.2

41) If a prodromal period exists for a certain disease, it should occur prior to

A) incubation.

B) illness.

C) decline.

D) convalescence.

Answer:  B

Section:  14.5

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.11

42) Which one of the following is NOT a zoonosis?

A) cat-scratch disease

B) Hantavirus pulmonary syndrome

C) rabies

D) tapeworm

E) All of these are zoonoses.

Answer:  E

Section:  14.6

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  14.14

Global Outcome:  2

43) Pseudomonas bacteria colonized the bile duct of a patient following his liver transplant surgery. This is an example of a

A) communicable disease.

B) latent infection.

C) nosocomial infection.

D) sporadic disease.

E) None of the answers is correct.

Answer:  C

Section:  14.7

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.15

Global Outcome:  2

44) Figure 14.3

The graph in Figure 14.3 shows the incidence of polio in the United States. The period between 1945 and 1955 indicates a(n)

A) endemic level.

B) epidemic level.

C) sporadic infection.

D) communicable disease.

E) pandemic.

Answer:  B

Section:  14.4

Blooms Taxonomy:  Analysis

ASMcue Outcome:  7.1b

Learning Outcome:  14.7

Global Outcome:  3

45) Which of the following statements is FALSE?

A) Antimicrobial therapy for hemodialysis-associated infections increases antibiotic resistance.

B) S. aureus is differentiated from other mannitol+ cocci by the coagulase test.

C) The M in MRSA stands for mannitol.

D) The USA100 strain accounts for most hospital-acquired MRSA.

E) The USA300 strain accounts for most community-acquired MRSA.

Answer:  C

Section:  14.8

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.19

14.2   True/False Questions

1) For a particular disease at a specific time period, morbidity rates should always be equal or greater than mortality rates.

Answer:  TRUE

Section:  14.9

Blooms Taxonomy:  Comprehension

Learning Outcome:  14.22

Global Outcome:  2

2) Testing the effectiveness of a new drug for anthrax would be best performed as an experimental study.

Answer:  TRUE

Section:  14.9

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  14.20

Global Outcome:  1

3) MMWR is a publication by the CDC that reports on only emerging diseases.

Answer:  FALSE

Section:  14.9

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.21

Global Outcome:  5

4) A researcher only needs to select a cohort group when implementing an analytical epidemiological study.

Answer:  FALSE

Section:  14.8

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  7.1

Learning Outcome:  14.20

Global Outcome:  1

5) Diseases that are referred to as emerging infectious diseases have only been discovered in the past fifty years.

Answer:  FALSE

Section:  14.8

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.19

Global Outcome:  7

6) Compromised hosts are always suffering from suppressed immune systems.

Answer:  FALSE

Section:  14.7

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.16

7) A host is not considered diseased until an infection changes ones state of health.

Answer:  TRUE

Section:  14.5

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  14.11

8) Reservoirs of infections are always animate objects.

Answer:  FALSE

Section:  14.6

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.12

9) Urinary tract infections are the most common forms of nosocomial infections.

Answer:  FALSE

Section:  14.7

Blooms Taxonomy:  Knowledge

Learning Outcome:  14.15

10) Both normal and transient flora can become opportunistic pathogens.

Answer:  TRUE

Section:  14.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  14.2

14.3   Essay Questions

Situation 14.2

A 37-week-old infant was delivered by cesarean section and discharged from a Connecticut hospital when he was ten days old. Two days later he was lethargic and had a fever. When he was readmitted to the hospital, he had multiple brain abscesses caused by Citrobacter diversus. After a prolonged illness, the baby died. A second infant with a normal pregnancy and delivery died of C. diversus meningitis after a short illness. Nine infants in the hospital nursery had umbilical cord colonization by C. diversus. Environmental cultures were negative for hospital equipment.

1) Refer to Situation 14.2 What is the normal habitat of this gram-negative, facultatively anaerobic, non-endospore-forming, lactose-positive rod? Provide a plan for identifying the source of infection and preventing further infection.

Section:  14.7

Blooms Taxonomy:  Evaluation

ASMcue Outcome:  7.1a

Learning Outcome:  14.17

Global Outcome:  8

2) Figure 14.4

Salmonella Heidelberg gastroenteritis occurred on three cruises aboard the T.S.S. Festivale. Figure 14.4 shows on-board clinic visits for diarrheal illness between February 10 and March 3. Explain the incidence pattern shown on the graph. What are probable modes of transmission? What changes would you recommend before the ship books more cruises after March 3?

Section:  14.9

Blooms Taxonomy:  Evaluation

ASMcue Outcome:  7.1b

Learning Outcome:  14.20

Global Outcome:  3

3) Dengue fever, a zoonotic disease, is endemic in northern Mexico, but not in the U.S. Provide two plausible explanations for this dichotomy, and explain.

Section:  14.8

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  7.3a

Learning Outcome:  14.19

Global Outcome:  8

4) When studying the epidemiology of a particular disease, why are retrospective studies commonly undertaken before prospective studies?

Section:  14.9

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  7.3a

Learning Outcome:  14.20

Global Outcome:  1

5) Would you expect all EIDs to be on the notifiable infectious disease list? Explain.

Section:  14.8

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  7.3a

Learning Outcome:  14.19

Global Outcome:  8

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