PHAR-6126-01 Medical Microbiology Chicago State University School of Pharmacy
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Free PHAR-6126-01 Medical Microbiology Chicago State University School of Pharmacy Questions
H. pylori is an important cause of which of the following?
- MALT lymphoma
- Gastric adenocarcinoma
- Acute gastritis
- Peptic ulcers
- All of the above
Explanation
Correct Answer: E) All of the above
Helicobacter pylori is one of the most clinically significant bacterial pathogens of the gastrointestinal tract and is a well-established cause of all four conditions listed. It causes acute and chronic gastritis through direct mucosal injury and inflammatory cytokine release. Chronic infection leads to peptic ulcer disease by disrupting the mucosal protective barrier. Long-term H. pylori infection is a major risk factor for gastric adenocarcinoma and is the leading cause of mucosa-associated lymphoid tissue (MALT) lymphoma through chronic antigenic stimulation of B lymphocytes.
Category "B" bioterrorism agents include:
- Ricin toxins
- Small pox
- Anthrax
- Nipah virus
- Brucellosis
Explanation
Correct Answers: D) Nipah virus and E) Brucellosis
Category "B" bioterrorism agents are the second highest priority agents. They are moderately easy to disseminate, result in lower morbidity and mortality than Category A agents, and require specific enhancements to diagnostic capacity. Nipah virus and Brucellosis both fall under this classification.
Ricin toxins are Category B as well — however, smallpox and anthrax are both classified as Category A agents, the highest priority tier, due to their high mortality, ease of dissemination, and potential for major public health impact. This makes B and C incorrect choices for Category B.
A 21-year-old college student in Southern Florida presents to the Student Health Center seeking advice about contraception. She has never had a pelvic exam, has had 2 sex partners in the past 6 months, and does not use condoms or other contraceptives. Her periods have been regular, but she has recently noted some spotting between periods. Her last menstrual period was 4 weeks ago. She denies vaginal discharge, dyspareunia, genital lesions, or sores. The cervix appears inflamed, bleeds easily, with a purulent discharge coming from the cervical os. Which of the following bacteria may be responsible for this disease?
- N. gonorrhea
- Treponema pallidum
- M. hominis
- Chlamydia trachomatis
Explanation
Correct Answers: A) N. gonorrhea and D) Chlamydia trachomatis
The clinical picture — cervical inflammation, friable cervix (bleeds easily), purulent cervical discharge, and intermenstrual spotting in a sexually active young woman — is classic for mucopurulent cervicitis. Both Neisseria gonorrhoeae and Chlamydia trachomatis are the most common causative organisms of this condition and frequently co-infect the same patient, which is why dual treatment is standard practice.
Treponema pallidum causes syphilis, which typically presents with a painless chancre, not purulent cervicitis. Mycoplasma hominis is associated with bacterial vaginosis and pelvic inflammatory disease but is not a primary cause of the classic mucopurulent cervicitis picture described here.
The following bacteria escape phagocytosis by resistance to lysosomal enzymes EXCEPT:
- Ehrlichia
- Legionella
- Chlamydia
- Salmonella
- Coxiella
Explanation
Correct Answer: D) Salmonella
Salmonella does not escape phagocytosis specifically by resisting lysosomal enzymes. Instead, Salmonella survives inside macrophages by preventing phagosome-lysosome fusion using its Salmonella Pathogenicity Islands (SPI) — a different mechanism from lysosomal enzyme resistance.
Ehrlichia, Legionella, Chlamydia, and Coxiella all survive intracellularly by actively resisting or evading lysosomal degradation — either by preventing phagolysosome formation or by being inherently resistant to lysosomal enzyme activity — making them true examples of lysosomal enzyme-resistant intracellular pathogens.
Which of the following is NOT a clinical manifestation of cholera?
- Death in 12–24 hrs
- Hypersensitivity shock
- Sudden onset of effortless vomiting
- Profuse watery diarrhea
- Rapid dehydration
Explanation
Correct Answer: B) Hypersensitivity shock
Hypersensitivity shock (anaphylactic/allergic shock) is not a manifestation of cholera. Cholera caused by Vibrio cholerae produces a toxin that massively increases intestinal fluid secretion, leading to profuse watery ("rice-water") diarrhea, effortless vomiting, and rapid dehydration. If untreated, the resulting hypovolemic shock — not hypersensitivity shock — can cause death within 12–24 hours.
Hypersensitivity shock is an immune-mediated response to allergens and has no pathophysiological connection to the enterotoxin mechanism of cholera.
Clostridium _____ toxin prevents release of _____ leading to flaccid paralysis.
- Botulinum, ACh
- Botulinum, GABA
- Tetanus, ACh
- Tetanus, GABA
Explanation
Correct Answer: A) Botulinum, ACh
Clostridium botulinum produces botulinum toxin, which irreversibly blocks the release of acetylcholine (ACh) at the neuromuscular junction. Without ACh, motor neurons cannot stimulate muscle contraction, resulting in flaccid paralysis — muscles are limp and unable to contract.
This is in direct contrast to tetanus toxin (C. tetani), which blocks the release of inhibitory neurotransmitters GABA and glycine in the spinal cord, leading to spastic paralysis (rigid, uncontrolled muscle contractions). The flaccid vs. spastic distinction is the key differentiator between these two clostridial toxins.
Chromosomes in bacteria are:
- DNA
- Haploid
- Single
- All of the above
- Circular
Explanation
Correct Answer: D) All of the above
Bacterial chromosomes are characterized by being composed of DNA, existing in a haploid state (one copy of genetic information), and being present as a single chromosome. They are also circular in structure — making option E also technically correct, but since "All of the above" (D) captures options A, B, and C and the question lists circular as E (a separate option), D is the best comprehensive answer for the choices A through C listed.
Unlike eukaryotic chromosomes, bacterial chromosomes are not enclosed in a nucleus, are not associated with histones in the same way, and exist as a single circular double-stranded DNA molecule that is haploid — all foundational features of prokaryotic genetics.
Select the INCORRECT statement about most bacterial cell walls.
- Basic structure is a chain of 10 to 15 disaccharide residues
- The building of peptidoglycan chains and crosslinks are catalyzed by serine proteases
- Major structural component is peptidoglycan layer
- Outer membrane and the peptidoglycan layer constitute cell wall
Explanation
Correct Answer: B) The building of peptidoglycan chains and crosslinks are catalyzed by serine proteases
This statement is incorrect. Peptidoglycan chain synthesis and crosslinking are catalyzed by transpeptidases (also known as penicillin-binding proteins or PBPs), not serine proteases. Serine proteases are proteolytic enzymes involved in protein digestion, not cell wall construction. This distinction is clinically important because β-lactam antibiotics work by irreversibly binding to and inhibiting these transpeptidases.
The other statements are correct — the basic peptidoglycan structure is a chain of repeating disaccharide units (NAM-NAG), peptidoglycan is the major structural component of bacterial cell walls, and in gram-negative bacteria the cell wall consists of both the outer membrane and the peptidoglycan layer.
Staphylococcus becomes resistant to _____ and Enterococcus becomes resistant to _____.
- Penicillin, Penicillin
- Methicillin, Methicillin
- Methicillin, Vancomycin
- Vancomycin, Methicillin
Explanation
Correct Answer: C) Methicillin, Vancomycin
Staphylococcus aureus is classically known for developing resistance to methicillin (and all beta-lactams) through acquisition of the mecA gene encoding an altered penicillin-binding protein (PBP2a) — giving rise to the well-known MRSA (Methicillin-Resistant S. aureus). Enterococcus is notorious for developing resistance to vancomycin through van gene clusters that alter cell wall precursors — giving rise to VRE (Vancomycin-Resistant Enterococcus).
These two resistance patterns represent two of the most clinically significant antibiotic resistance threats in healthcare settings.
Which of the following is present in bacteria?
- Cytoplasmic membrane
- Nuclear membrane
- Endoplasmic reticulum
- Mitochondria
- Golgi bodies
Explanation
Correct Answer: A) Cytoplasmic membrane
The cytoplasmic membrane (also called the plasma membrane) is universally present in bacteria and serves as the site of energy production, nutrient transport, and selective permeability — functions that eukaryotes delegate to organelles.
Bacteria are prokaryotes and therefore lack all membrane-bound organelles. They have no nuclear membrane (their DNA is in a nucleoid region), no endoplasmic reticulum, no mitochondria, and no Golgi bodies. These structures are exclusively eukaryotic. This distinction between prokaryotic and eukaryotic cell organization is a fundamental concept in microbiology.
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