病原微生物学资料：病原测试一

.1.Anexperimentisdevisedtostudytheinvitroeffectsofcytokinesandotherchemokinesonmacrophages.Recombinantinterferonsalpha,beta,andgamma,interleukin-1,interleukin-2,interleukin-4,interleukin-6,granulocytemacrophagecolonystimulatingfactorandtumorgrowthfactorbetawereaddedindividuallytomacrophages.Whichofthefollowingcytokinesorchemokinesactivatemacrophagesbyamechanismthatinvolvesincreasedionexchange?(2.0分)A.Interferon-alpha,interferon-beta,andinterferon-gammaB.Interleukin-1C.GranulocytemacrophagecolonystimulatingfactorD.Tumorgrowthfactor-betaE.Interferon-betaF.interferon-gamma2.ThetoxinofCorynebacteriumdiphtheriae（白喉棒状杆菌）isresponsibleforthevaccine-preventablechildhoodillnessdiphtheria（白喉）.Toxinproductioninthisorganismismediatedbychromosomalgenesthatoriginatedfromabacteriophage.WhenincorporatedintotheDNAofahostcell,bacteriophageDNAiscalledaprophage（原噬菌体）.Organismsthatcontaintheprophageproducethetoxinandcausediphtheria,whilethosethatdonotcontaintheprophageareprobablynonpathogenic.ThismechanismofDNAtransferfromonecelltoanotherbywayofabacteriophageiscalled(2.0分)A.Transduction（转导）B.Transformation（转化）C.Conjugation（接合）D.Transfection（转染）E.Recombination（重组）3.CASE:A13-year-oldgirlwasadmittedtoahealthcarefacilitywitha5-hourhistoryofdiarrhea(腹泻)andvomiting（呕吐）.Onpatientinterview,thephysiciansuspectedittobeaninfectionbycontaminatedfood.Thephysicianrecommendeddiagnosticteststobedoneforthepatient.MicroscopicexaminationofthestoolonGramstainingrevealedGramnegativebacilli.Themicrobiologistdiscoveredshort,slender（瘦长的）rodsduringmicroscopicexaminationandsuspectedtheorganismtobeEscherichiacoli.WhichamongthefollowingmediahelpsindifferentiatingE.colifromothergeneraofentericbacteria?(2.0分)A.Sheepbloodagar(SBA)B.Eosinmethyleneblue(EMB)agarC.ChocolateagarplateD.Liquidmedia4.Themedicalimportanceofspores（芽胞）liesinthefactthat:(2.0分)A.Theyhavekeratin(角蛋白)-likecoatsB.TheycontainbacterialDNAC.Theyareextremelyresistanttoheatandchemicals.D.Theyareformedinadverseconditions.5.AGramstainhasbeenperformedonabacterialisolatetakenfromasheepbloodagarplate.Uponobservation,thecellsappeartoberedtopinkrods.TheorganismispresumptivelyidentifiedasCitrobacterkoseri(克氏柠檬酸杆菌).Themostlikelyreasonfortheredcolorofthecellsinthestainisthatthe(2.0分)A.Peptidoglycan（肽聚糖）layerofthecellwallisrelativelythinB.PeptidoglycanlayerofthecellwallisrelativelythickC.OrganismsinthisgenushavealipopolysaccharideoutermembraneD.OrganismsinthisgenushaveonlyacytoplasmicmembraneE.Capsule（荚膜）tendstocapturethesafraninfromtheGramstainreagent6.Asexuallyactive18-year-oldmanattendsagenitourinarymedicineclinic（泌尿生殖医药门诊）withacomplaintofpainfulurethraldischarge（尿道排出物）.Afterappropriatestudies,adiagnosisofgonorrhea（淋病）ismade.Whichofthefollowingwouldmostlikelybefoundonasmearofhisdischarge?(2.0分)A.Gram-positiverodsB.Gram-negativerodsC.Gram-positivecocciD.Gram-negativecocciE.Acid-fastbacilli（抗酸细菌）7.BiologicactionsofProteinIassociatedwithgonococciinclude(2.0分)A.AntiphagocyticactionsB.FormationofsurfaceporesC.AttachmenttohumancellslikeepitheliumofvaginaD.Hydrolysisofβ-lactamringinpenicillinE.Ironbinding8.TheantibioticrecommendedbyCentersforDiseaseControl(CDC)fortreatmentofgonorrheais(2.0分)A.PenicillinB.Ceftriaxone（头孢曲松）C.Erythromycin（红霉素）D.Tetracycline（四环素）E.Aminoglycosides（氨基糖甙类）9.6hoursaftereatingrawfishandotherseafoodataJapaneserestaurant,acoupledevelopednauseaandvomiting,waterydiarrhea,abdominalcramps,andfever.Whatorganismislikelyinvolvedinthepatients’condition?(2.0分)A.Salmonellaenteritidis（肠炎沙门氏菌）B.Bacilluscereus（蜡样芽胞杆菌）C.Clostridiumperfringens（产气芽胞梭菌）D.StaphylococcusaureusE.Vibrioparahaemolyticus（副溶血弧菌）10.Whichofthefollowinggram-negativerodsarefoundinseawaterandarethecommoncauseoftoxigenicwater-lossdiarrhea?Thesebacteriaarehighlymotilewithasinglepolarflagella.(2.0分)A.Vibriocholerae（霍乱弧菌）B.Proteusmirabilis（奇异变形杆菌）C.Shigellaflexneri（弗氏志贺菌）D.Escherichiacoli11.A45-year-oldwomancomesintoyourofficewitha2-dayhistoryofabdominalcrampsandbloodydiarrhea.ShehasjustreturnedfromhervacationinIndia,wheresheatemanyofthelocalfoods.Herbloodpressureis120/80mmHg,pulserateis84/minute,andtemperatureis37.8°C.StoolexaminationrevealsmanypolymorphonuclearleukocytesandaerobicGramnegativenon-motileorganisms.Fromthestoolculture,aGram-negativerodwasisolatedthatformscolorlesscoloniesoneosin-methyleneblue(EMB)agar.Whatorganismisthemostlikelycause?(2.0分)A.ShigelladysenteriaeB.EscherichiacoliC.VibriocholeraeD.VibrioparahaemolyticusE.Yersiniaenterolitica（黑死病致病菌耶尔森菌）12.ThemajorpropertythatdistinguishesE.colifromthetwootherintestinalpathogensShigellaandSalmonellaisthatitferments(2.0分)A.LactoseB.MaltoseC.FructoseD.GlucoseE.Acetate13.WhichofthefollowinggroupofEscherichiacoliisthecommoncauseofdiarrheaininfantsandisimplicatedinoutbreaksofdiarrheainnurseries?(2.0分)A.EnterotoxigenicB.EnteroinvasiveC.EnteropathogenicD.EnterohemorrhagicE.Enteroaggregative14.A30-year-oldmancomesintoyourofficebecauseofdiarrhea（腹泻）thatbeganontheairplanewhilehewasreturningfromavacationintheMiddleEast.Hehadmultipleepisodesofwatery,non-bloodydiarrheaandlittlevomiting.BP130/85mmHg,P76,T36,8°C.Youmakeastainforfecalleukocytes,whichrevealsnoPMNs.Testforoccultbloodisnegative.Cultureofthestoolrevealspigmented（有颜色的）coloniesoneosin-methyleneblue(EMB)agar.Whichoneofthefollowingorganismsisthemostlikelycause?(2.0分)A.Escherichiacoli(enterotoxigenicstrains)B.Escherichiacoli(enteropathogenicstrains)C.EscherichiacoliO157:H7D.S.typhimuriumE.S.dysenteriae15.Anelderlywomanwasadmittedtothehospitalforasepticwoundtreatmentonherlowerabdomenwhichdevelopedafteracolonoperation.Herwoundwas1.5-cmopen,andoozing（渗出）ayellowexudate（分泌液）.Whichisthebestwayofsterilizing（消毒）thesheetofthebed（床单）contaminatedwiththesepticwound'ssecretion?(2.0分)A.Usinganionicagentsolvents（阴离子溶剂）B.Usingnonionicagentsolvents（非离子型表面活性剂的溶剂）C.Dryheatsterilization（干热灭菌）D.Autoclavesterilization（湿热灭菌）E.Radiation（辐射）16.A36-year-oldAmericanIndianisadmittedtotheisolationunitatyourhospitalfortreatmentofpulmonarytuberculosis,whichwasdetectedataroutinecheckupthedaybefore.Heworksataconstructionsite（建筑工地）downtown（市中心）andhasnotbeenincontactwithanyfarmanimals.Besidestreatment,youneedtoinformhimofthemostcommonwayoftransmittingthedisease.Whichcontaminationisusuallyresponsible?(2.0分)A.BloodcontactB.HandsC.Eatingutensils（餐具）D.MilkproductsE.Dropletnuclei（飞沫核）17.A5-year-oldboyistakentoaphysicianafterhisinsectbitegetsinfected.Thedoctortakesaspecimenfromthelesionforcultureandacatalase（触酶）-positive,Gram-positivebacteriagrowinginclustersisisolated.Whatelseisafeatureofthisorganism?(2.0分)A.CanmakesporesB.Producesgamma-hemolysisonbloodagarC.CanonlygrowanaerobicallyD.ProducesapotentendotoxinE.Canfermentmannitol（甘露糖）andgrowonhighsalt18.Staphylococcalbacteriacauseawidevarietyofhumandisorders,fromfoodpoisoningtorashes（发疹）.Somestrainsofstaphylococcicausetoxicshocksyndrome(TSS),amultisystemdisease.ThecauseofTSSisatoxincalledtoxicshocksyndrometoxin1(TSST-1),originallyrecognizedasoneofthepyrogenic（化脓性）staphylococcalenterotoxins.Itisoneofagroupoftoxinsknownaswhat?(2.0分)A.Superantigens（超抗原）B.Immunotoxins（免疫毒素）C.Immunophilins（亲免素）D.Toxoids（类毒素）E.RTXtoxins（在细胞膜上打孔的外毒素）19.AmanbringshisuncletoyourofficeandtellsyouthattheunclelivesintheCaribbean（加勒比海）butisintheUnitedStatesonvacation.Hecomplainsofaverysorethroatandhasproblemsswallowing.Thelymphglands（淋巴腺体）inhisneckareveryswollen（肿大）.Yoususpectthathehasdiphtheria,whichisconfirmedbyathroatculture.Onedomainofthetoxinisinvolvedintheinhibitionofproteinsynthesis.Aseconddomainisinvolvedin(2.0分)A.toxinbindingtothecellreceptorB.inhibitingDNAreplicationC.cleavageofthe28SribosomalRNAD.bindingandsequesteringelongationfactorsE.transportingtoxinintothenucleus20.A39-year-oldwomancomesintoyourofficebecauseshehashadseverediarrheaforthepast2days,accompaniedbyfeverandashakingchill.Sheusesantacids（抗酸药）.Otherwisesheishealthy.Astainforfecal（粪便）leukocytes（白细胞）revealsmanyPMNs（中性粒细胞）.Testforoccultblood（便隐血）waspositive.Fromthestoolcultureagram-negativerodwasisolatedthatdoesnotfermentlactose（乳糖）.Triplesugariron（TSI）agarshowsanalkalineslant,acidbutt,withbothgasandH2S.Theurease（尿素酶）testwasnegative.Whichoneofthefollowingorganismsisthemostlikelycause?(2.0分)A.Salmonellatyphimurium（鼠伤寒沙门氏菌）B.EscherichiacoliC.Campylobacterjejuni（空肠弯曲菌）D.Vibrioparahaemolyticus（副溶血弧菌）E.Vibriocholerae21.Aninvitroexperimentisdesignedtoexaminethesequentialstepsinvolvedinviralinfectionandreplication.Givenhealthyviablecellsandvirus,whichofthefollowingaccuratelydescribesthecorrectsequenceofstepsinviralinfectionandreplication?(2.0分)A.uncoating,attachment,biosynthesis,penetrationB.attachment,uncoating,penetration,biosynthesisC.attachment,penetration,uncoating,biosynthesisD.uncoating,attachment,penetration,biosynthesisE.uncoating,penetration,attachment,biosynthesis22.Althoughtheusualwayinwhichaparticleentersacellisbyphagocytosissothattheparticleisenclosedinaphagocyticvacuole,thereareothermethodsofentry.Ifvirusesentercellsbyphagocytosis,theyaredestroyedbyhydrolyticenzymes.Howdomostnonenvelopedandenvelopedvirusesentercells?(2.0分)A.EndocytosisB.OpsonizationC.NeutralizationD.PhagocytosisE.Pinocytosis23.Whichofthefollowingarestructurallymostcloselyrelatedtotheinfluenzavirus?(2.0分)A.RetroviridaeB.TogaviridaeC.ParamyxovirusesD.CoronaviridaeE.Rhabdoviridae24.Whichofthefollowingarestructurallymostcloselyrelatedtotheinfluenzavirus?(2.0分)A.RetroviridaeB.TogaviridaeC.ParamyxovirusesD.CoronaviridaeE.Rhabdoviridae25.Theseenveloped,pleomorphic（多形性）,andss-RNAvirusescauserespiratoryinfectionsbydropletnucleiorcontacttransmission.Thesebelongtotheorthomyxovirusgroupandarecalledwhat?(2.0分)A.LentivirusesB.InfluenzavirusC.ParainfluenzavirusD.Respiratorysyncytialvirus26.Amantadine（金钢胺）,usedfortheprophylaxisofinfluenza,functionsbywhichofthefollowingmechanisms(2.0分)A.InhibitionofviraltranscriptionB.InhibitionofviraltranslationC.NeutralizationofextracellularviralparticlesD.InhibitionofthereleaseofviralparticlesE.Inhibitionofpenetrationofthecellmembraneofthetargetcell27.Corynebacteriaare(2.0分)A.Small,pleomorphicgram-negativebacilliB.MotileC.Non-sporeformersD.Devoidofmycolicacid（无分枝菌酸）E.Strictanaerobes28.Corynebacteria（棒状菌）are(2.0分)A.MotileB.CatalasepositiveC.SporeformersD.DonotfermentcarbohydratesE.Strictanaerobes29.DPTvaccinecontains(2.0分)A.ToxoidfordiphtheriaandtetanusandheatkilledorganismsforwhoopingcoughB.ToxoidfortetanusandheatkilledorganismsfordiphtheriaandwhoopingcoughC.ToxoidforwhoopingcoughandtetanusandheatkilledorganismsfordiphtheriaD.Toxoidfordiphtheria,tetanusandwhoopingcoughE.Heatkilledorganismsfordiphtheria,tetanusandwhoopingcough30.Diphtheriatoxinactsby(2.0分)A.InhibitingproteinsynthesisB.BlockingmRNAbindingC.Producingedema（水肿）D.Increasingtranslation31.Whichofthefollowinganaerobeisassociatedwithproductionofdoublezoneofhemolysis?(2.0分)A.ClostridiumperfringensB.ClostridiumdifficileC.ClostridiumsepticumD.ClostridiumtetaniE.Clostridiumsordellii32.A10-year-oldboyisbroughttotheemergencyroombyhismother.Hehasa4-dayhistoryofmalaise,sorethroat,anorexia,andlow-gradefever.OnPE,pharyngealinflammationandagreypseudomembranecoveringthetonsilsarevisualized,whichbleedsontryingtoremoveit.Cultureshowsblackcoloniesandsmearshowsclub-shapedgrampositiverods.Howdoesthetoxinproducedbythisbacteriaact?(2.0分)A.ItdecreasesglycineandgammaaminobutyricacidbyproteincleavageB.ItincreasescAMPbyADPribosylationofGi-alfaproteinC.ItincreasescAMPbyADPribosylationoftheGs-alfaproteinD.ItinhibitstheproteinsynthesisbyaddingADP-ribosetotheelongationfactor2E.ItstimulatesadenylatecyclasebyADPribosylationofGTPbindingprotein33.Thetetanospasmin（破伤风痉挛毒素）(2.0分)A.isapotentendotoxinB.isaheatstableproteinC.causescontinuousexcitationofmotorneuronsD.AandCE.BandC34.Speciesofspore-formingbacteriabelongingtotheClostridiumgenusincludeseveralpathogensofmedicalimportance.Whichofthefollowingisthemostlife-threateningcharacteristicofsuchbacteria?(2.0分)A.LackofprophylacticvaccinesB.FeverproductionC.ProductionofexotoxinsD.InvasivepotentialE.Formationofendospores35.Gramnegativediplococcialongwithlargenumberofpolymorphonuclearneutrophilswereseeninthecerebrospinalfluidofa21yroldmalehavingsymptomsofpurulentmeningitis.Thecoloniesonchocolateagarwerecatalasepositiveandoxidasepositive.Theisolateproducedacidfromglucoseandmaltose（麦芽糖）butnotfromsucrose（蔗糖）andlactose.Thecausativeorganismis(2.0分)A.Streptococcuspneumoniae（肺炎链球菌）B.Streptococcusagalactiae（无乳链球菌）C.NeisseriameningitidisD.NeisseriagonorrhoeaeE.Escherichiacoli36.Rfactorsmediate(2.0分)A.DrugresistanceB.CellmediatedimmunityC.ToxicpropertiesofpathogenicbacteriaD.Allergicreactions37.Amotherbringsher2-year-olddaughterintoyourofficeandreportsthatthechilddoesnotwanttoeatandappearstohaveafever.Uponexamination,youconfirmthatthechildhasaninflamedthroatanddecidetotreatherwith7daysofpenicillin.After4days,themothercallsyourofficetoreportthatthechildhasnotsignificantlyimproved.Youknowthatthisproblemissomehowrelatedtobacterialplasmids.Thetransferofaplasmidfromonebacteriatoanotherisanexampleofwhat?(2.0分)A.mechanismofspreadingbacterialresistancetoantibioticsB.situationwhichcanneverbeharmfultothepatientC.mechanismofconveyingsensitivitytoallantibioticstothebacteriaD.meansofrestoringsensitivitytotheantibioticE.mechanismofpreventingantibioticresistance38.Streptococcuspneumoniaevaccinecontainswhichofthefollowing?(2.0分)A.Thecapsularpolysaccharideofthe23mostprevalenttypesB.AtoxoidC.KilledStreptococcuspneumoniaeD.AnantigenpurifiedfromtheorganismE.AttenuatedstrainsofStreptococcuspneumoniae39.WhichoneofthefollowingenzymesproducedbyStreptococcicausesdepolymerizationofDNAinexudatesornecrotictissue(2.0分)A.StreptodornaseB.StreptokinaseC.HyaluronidaseD.StreptolysinOE.StreptolysinS40.Virulencefactorsresponsibleforantiphagocyticandanticomplementarypropertyofbacteriainclude(2.0分)A.LipoteichoicAcidB.MproteinC.FproteinD.StreptokinaseE.Dnase41.α-hemolyticStreptococci(2.0分)A.ProduceclearzoneofhemolysisB.LysetheRBCcompletelyC.ProducenozoneofhemolysisD.ProducegreendiscolorationonbloodagarE.Producebluepigmentonbloodagar42.TheLancefieldclassification（兰斯菲耳德氏分类法）forStreptococciisbasedon(2.0分)A.ClinicalpropertiesB.HemolyticpropertiesC.SerologicpropertiesD.MorphologicpropertiesE.Biochemicalproperties43.CASE:Apreviouslyhealthy24-year-oldwomanpresentedwithhighfeverofsuddenonset,severemyalgia（肌肉疼痛）,headache,vomiting,diarrhea,anddiffusescarlatini-formrashresemblingsunburns.Shewasonthefourthdayofhermensesandwasusingtampons（卫生棉塞）.Herbloodpressurewasnotedas70/40mmmercury.Aspartoflaboratoryinvestigations,blood,urine,andvaginalculturesweredone.Accordingtothemicrobiologyreport,heavygrowthofstaphylococcusaureuswasobtainedfromvaginalculture.Preliminaryreportofherbloodcultureshowednogrowthafter24hrsincubation.Microscopyofurinesedimentshowed15leucocytesperhighpowerfield.Urineculturedidnotyieldanysignificantgrowth.Whichofthefollowingstaphylococcaltoxinsplaysamajorroleincausingthispatient'sillness?(2.0分)A.StaphylococcalalphatoxinB.PantonValentineleucocidinC.ExfoliativetoxinD.EnterotoxinBE.TSST144.CASE:A38-year-oldmanwasadmittedtoahealthcarefacilitywithnausea,vomiting,diarrhea,andabdominalcrampingforthepast2hours.HisBPwas100/60mmHg.Oninterviewingthepatient,herevealedthathehadconsumedmeatthathadbeenleftuncoveredforanight.Thephysiciansuspecteditasacaseoffoodpoisoning.Duringlaboratoryexaminationitwasfoundthatthemeatwascontaminatedwithcircular,clusteredorganisms,whichonGramstainingwerefoundtobeGrampositive.Fairlylarge,yellowcoloredcolonieswereformedwhentheorganismwasgrownonmannitolagarmediainatemperaturerangeof15to45°C.Theorganismshowedpositiveresultsforcoagulaseenzymeactivityandshowedresistancetopenicillinandmethicillinantibiotics.Whatorganismwasthecausativeagentofthefoodpoisoning?(2.0分)A.ClostridiumperfringensB.EnterococcusfecalisC.EscherichiacoliD.StaphylococcusaureusE.Salmonellaspecies45.A32-year-oldwomanisbroughttotheemergencyroomwithsuddenonsetoffever,headache,sorethroat,profusewaterydiarrhea,vomiting,andlethargy,whichstartedinthemorning.Onphysicalexamination,sheisslightlyconfused,hertemperatureis39°C(103°F),herbloodpressureis100/50mmHgandshehasdiffusesunburnlikeaerythematousrash.Whentheemergencydoctoristryingtofindoutifsheispregnant,shementionsthatherperiodstarted2daysago.Whichofthefollowingisthemostlikelydiagnosis?(2.0分)A.Scarletfever（猩红热）B.RockyMountainspottedfeverC.MeningococcemiaD.ToxicshocksyndromeE.Foodpoisoning46.A7-montholdchildpresentstotheemergencyroomexhibitingtoxicepidermalnecrolysisandlarge,flaccidbullaethatareformingandrupturingundertheepidermis,causingdesquamationinthediaperarea.Thisspectrumofdiseasedescribesaconditionusuallycausedby:(2.0分)A.ToxinproducingStaphylococcusaureus.B.InvasiveEscherichiacoli.C.ProphageinfectedCorynebacteriumdiphtheriae.D.Flesh-eatingStreptococcuspyogenes.E.DermalinfectionwithClostridiumperfringens.47.Mycobacteriumtuberculosis(2.0分)A.IsacidfastduetoverylowlipidcontentofcellwallB.IsanobligateanaerobeC.Hascordfactorandsulfatideproduct,whichcontributestovirulenceD.CannotsurviveinsidenormalmacrophageE.Producesendotoxins48.Althoughprimarytuberculosisisofthegreatestconcerntomostphysicians,somepatientswhohavebeenpreviouslyinfectedwithMycobacteriumtuberculosismayexperiencesecondaryorreactivationdisease.Themostlikelyexplanationforthereactivationofthisdiseaseinpatientsis(2.0分)A.Thereisalocalactivationofthehumoralimmuneresponseandaconcomitantactivationofthecomplementsystemthatinit