Name _______________________________Group 1

19.03.2007

1. The most common form of infection caused by Clostridium botulinum in U.S. is:

a) infant botulism

b) wound infection

c) food poisoning

d) anaerobic cellulitis

2. Clostridium perfringens infections are commonly associated with:

1. contamination of wounds

2. antibiotic treatment

3. immunosuppression

4. consumption of water contaminated with sewage

3. A predisposing factor in pseudomembranous colitis (PMC) is:

1. clindamycin treatment

2. neonatal age

3. high dairy products diet

4. old age ( more than sixty years of age)

4. A 25-years-old medical student presented with a burst appendix. A peritoneal infection developed, despite prompt removal of the organ and extensive flushing of the peritoneal cavity. An isolate from a pus culture was a Gram-negative rod identified as Bacteroides fargilis. Anaerobic infection with B.fragilis is characterized by which one of the following.

1. A black exudates in the wound

2. A foul- smelling discharge

3. A heme-pigmented colony formation

4. Severe neurologic symptoms

5. A patient was hospitalized after an automobile accident. The wounds became infected and the patient was treated with tobramycin, carbenicillin and clindamycin. Five days after antibiotic therapy was initiated, the patient developed severe diarrhea and pseudomembranous enterocolitis. Antibiotic-associated diarrhea and the more serious pseudomembranous enterocolitis can be caused by which of the following organisms.

1. B.fragilis

2. Clostridium difficile

3. Clostridium perfringens

4. S.aureus

6. Which of the following pairs of organisms can be routinely responsible for food poisoning

1. Clostridium botulinum and Bacillus anthracis

2. C. difficile and C.botulinum

3. C.perfrinens and Bacillus cereus

4. Clostridium tetani and B. anthracis

7. Which of the following is the therapy of choise for pseudomembranous enterocolitis

1. Ampicillin

2. Ceftriaxone

3. Erythromycin

4. Vancomycin

8. Antibiotic therapy is a critical step in the management of patients infected with each of the following microorganisms except for one. What is the exception?

a) B.anthracis

b) C.botulinum

c) C.difficile

d) C.tetani

9. The bowel contains many microorganisms, but which of the following is the most prevalent bacterium?

1. B.fragilis

2. E.coli

3. Lactobacillus

4. S.epidermidis

10. Specific antitoxin is an important part of treatment in:

a) gas gangrene

b) tetanus

c) enteritis necroticans

d) pseudomembranous colitis

Name_______________________________Group 2

19.03.2007

1. All of the following are important to the epidemiology or pathogenesis of anthrax except:

1. production of endospores

2. a reservoir of healthy human carriers

3. production of a highly lethal exotoxin

4. possession of an antiphagocytic capsule

2. A 60 year-old man has an abscess for which his physician prescribes a 7- day course of clindamycin. Before completion of the course, the patient returns to the office with cramps, diarrhea and fever of 39ႰC. The results of sigmoidoscopy demonstrate yellowish-white patchy areas on the wall of the colon. Which of the following is true of the causative agent?

1. Gram stain from the pseudomembranes would yield numerous red rods

2. the pseudomembranes are classically caused by staphylococcal organisms

3. the causative agent of the pseudomembranes produces toxins that act as monoglucosyl-transferases that are specific for mammalian Rho protein

4. the causative agent of the pseudomembranes is rarely found among the gut flora of the general population

3. Surgical instruments are boiled for 10 minutes in saline solution containing Escherichia coli, Salmonella typhi, Staphyloccocus aureus and Bacillus cereus. Which one of the following organisms is most likely to survive this procedure?

1. E. coli

2. B. cereus

3. S. typhi

4. S. aureus

4. A 25-years-old medical student presented with a burst appendix. A peritoneal infection developed, despite prompt removal of the organ and extensive flushing of the peritoneal cavity. An isolate from a pus culture was a Gram-negative rod identified as Bacteroides fargilis. Anaerobic infection with B.fragilis is characterized by which one of the following.

1. A black exudates in the wound

2. A foul- smelling discharge

3. A heme-pigmented colony formation

4. Severe neurologic symptoms

5. A patient was hospitalized after an automobile accident. The wounds became infected and the patient was treated with tobramycin, carbenicillin and clindamycin. Five days after antibiotic therapy was initiated, the patient developed severe diarrhea and pseudomembranous enterocolitis. Antibiotic-associated diarrhea and the more serious pseudomembranous enterocolitis can be caused by which of the following organisms.

1. B.fragilis

2. Clostridium difficile

3. Clostridium perfringens

4. S.aureus

6. Which of the following pairs of organisms can be routinely responsible for food poisoning

1. Clostridium botulinum and Bacillus anthracis

2. C. difficile and C.botulinum

3. C.perfrinens and Bacillus cereus

4. Clostridium tetani and B. anthracis

7. Which of the following is the therapy of choise for pseudomembranous enterocolitis

1. Ampicillin

2. Ceftriaxone

3. Erythromycin

4. Vancomycin

8. Antibiotic therapy is a critical step in the management of patients infected with each of the following microorganisms except for one. What is the exception?

a) B.anthracis

b) C.botulinum

c) C.difficile

d) C.tetani

9. The bowel contains many microorganisms, but which of the following is the most prevalent bacterium?

1. B.fragilis

2. E.coli

3. Lactobacillus

4. S.epidermidis

10. Specific antitoxin is an important part of treatment in:

a) gas gangrene

b) tetanus

c) enteritis necroticans

d) pseudomembranous colitis

Name_______________________________Group 3

19.03.2007

1. Your patient is a 70-year-old man who underwent bowel surgery for colon cancer 3 day ago. He now has a fever and abdominal pain. You are concerned that he may have peritonitis. Which one of the following organisms is most likely to be the cause?

1. Bacteroides fragilis

2. Bordatella pertussis

3. Clostridium botulinum

4. Clostridium tetani

2. Each of the following statements concerning Bacteroides fragilis is correct except:

1. B.fragilis is a Gram-negative rod that is a part of the normal flora of the colon

2. B. fragilis forms endospores, which allow it to survive in the soil

3. The capsule of B. fragilis is an important virulence factor

4. B. fragilis infections are characterized by foul-smelling pus

3. Five days ago, a 65-year-old woman with a lower urinary tract infection began taking ampicillin.

She now has a fever and severe diarrhea. What is the most likely causative agent?

1. Clostridium difficile

2. Bacteroides fragilis

3. Proteus mirabilis

4. Bacillus anthracis

4. A 25-years-old medical student presented with a burst appendix. A peritoneal infection developed, despite prompt removal of the organ and extensive flushing of the peritoneal cavity. An isolate from a pus culture was a Gram-negative rod identified as Bacteroides fargilis. Anaerobic infection with B.fragilis is characterized by which one of the following.

1. A black exudates in the wound

2. A foul- smelling discharge

3. A heme-pigmented colony formation

4. Severe neurologic symptoms

5. A patient was hospitalized after an automobile accident. The wounds became infected and the patient was treated with tobramycin, carbenicillin and clindamycin. Five days after antibiotic therapy was initiated, the patient developed severe diarrhea and pseudomembranous enterocolitis. Antibiotic-associated diarrhea and the more serious pseudomembranous enterocolitis can be caused by which of the following organisms.

1. B.fragilis

2. Clostridium difficile

3. Clostridium perfringens

4. S.aureus

6. Which of the following pairs of organisms can be routinely responsible for food poisoning

1. Clostridium botulinum and Bacillus anthracis

2. C. difficile and C.botulinum

3. C.perfrinens and Bacillus cereus

4. Clostridium tetani and B. anthracis

7. Which of the following is the therapy of choise for pseudomembranous enterocolitis

1. Ampicillin

2. Ceftriaxone

3. Erythromycin

4. Vancomycin

8. Antibiotic therapy is a critical step in the management of patients infected with each of the following microorganisms except for one. What is the exception?

a) B.anthracis

b) C.botulinum

c) C.difficile

d) C.tetani

9. The bowel contains many microorganisms, but which of the following is the most prevalent bacterium?

1. B.fragilis

2. E.coli

3. Lactobacillus

4. S.epidermidis

10. Specific antitoxin is an important part of treatment in:

a) gas gangrene

b) tetanus

c) enteritis necroticans

d) pseudomembranous colitis

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