MCQs on Upper and lower respiratory tract microorganisms and infections - common cold, influenza, Pneumonia and other respiratory infections

Multiple Choice Questions in Upper and lower respiratory tract 
microorganisms and infections -  common cold, pneumonia, tuberculosis and other respiratory tract infections

                          Figure: Respiratory tract (Source- Bailey and Scott's Diagnostic Microbiology)

1) During the flu season, a 69-year-old woman with a 25-year history of hypertension and 3 years of arthritis presented at the hospital. She had been experiencing symptoms resembling a common cold, including a mild cough, chest discomfort, fever, and body aches, all persisting for the past 4 days. A sputum sample is collected for laboratory analysis, and a chest X-ray revealed suspicions of lobar pneumonia. 
Laboratory culture of the specimen yielded colonies of round diplococci organized in chains, indicating a potential infection.
Which of the following bacteria could be the possible pathogen?
a) Neisseria gonorrhoeae
b) Haemophilus influenzae
c) Streptococcus pneumoniae   
d) Bordetella pertussis

2) A prematurely born male infant with low birth weight was delivered at a hospital in Punjab, India. He encountered difficulties with breastfeeding, particularly in the area of sucking. As a result of these challenges, the baby was promptly admitted to the Neonatal Intensive Care Unit (NICU). After spending a week in the NICU, the infant began to experience respiratory distress and presented symptoms reminiscent of the flu. 
A blood specimen was collected for laboratory analysis, revealing the presence of gram-negative bacilli when examined under a microscope. A standard culture procedure was conducted, and non-hemolytic colonies emerged on the culture plate after a few days of incubation.
Name the pathogen that is a causative agent of hospital acquired pneumonia occuring in children under 5 years of age
a) Klebsiella pneumoniae  
b) Legionella pneumophila    
c) Neisseria meningitidis
d) Salmonella enterica

3) Name the common human respiratory gram negative bacterial pathogen that has been found to live in the natural water sources and soil?
a) Streptococcus pneumoniae
b) Mycoplasma pneumoniae
c) Moraxella catarrhalis
d) Legionella pneumophila         

4) All of the following statements regarding Mycoplasma pneumonia are true, Except?
a) It is a cellwall deficient bacteria
b) A causative agent of "atypical pneumonia" in humans
c) A pleomorphic and the smallest free-living microorganism
d) It can grow in regular nutrient agar media 

5) Which Gram-negative, aerobic diplococcus bacterium is a prominent respiratory pathogen in humans, typically infecting the nasopharynx, and is a leading cause of "otitis media" in children?
a) Bordetella pertussis
b) Moraxella catarrhalis    
c) Pseudomonas aeruginosa     
d) Yersinia pestis

6) "Whooping cough" infection of respiratory tract in children is caused by which of the following gram negative pathogen?
a) Bordetella pertussis  
b) Mycoplasma pneumoniae      
c) Mycobacterium tuberculosis
d) Salmonella typhi

7) A 10-month-old baby is presented to the hospital with breathing difficulties, high-grade fever, runny nose, and a dry cough. A physical examination and chest X-ray is performed, nasal swab samples and blood samples are collected for the culture and identification of the pathogen.
There is no growth of respiratory bacterial pathogen on the culture media from the swab specimen and the blood specimen, thus viral infection is suspected.
Name the most common respiratory viral pathogen that is a major cause of bronchitis, bronchiolitis, and chronic obstructive pulmonary disease (COPD) in infants and young children?
a) Dengue virus
b) Hepatitis A virus (HAV)
c) Herpes simplex virus
d) Respiratory syncytial virus (RSV)    

8) Which microorganism can cause both upper respiratory infections and conjunctivitis (pink eye)?
a) Adenovirus
b) Influenza virus
c) Mycoplasma pneumoniae
d) Rhinovirus

9) A 4-year-old child initially displayed symptoms of a typical cold, but after 2 days, the cough took on a distinctive barking sound resembling an animal. On the third day, the child is brought to the hospital due to a continued fever and increasingly audible breathing noises. During the physical examination, swelling is observed below the chin. 
What could be the potential causative agent for these symptoms?
a) Haemophilus influenzae
b) Rhinovirus
c) Parainfluenza virus       
d) Mycobacterium tuberculosis

10) A 27-year-old otherwise healthy female presents to her primary care physician with complaints of a sore throat, difficulty swallowing, and a mild fever for the past two days. She reports a gradual onset of symptoms and mentions that her throat feels scratchy and painful, especially when she swallows. She mentions that she has had a runny nose, sneezing, and occasional coughing. She has not experienced any significant fatigue, body aches, or shortness of breath. She denies any recent changes in her diet, medication use, or allergies. She has not had any significant weight loss.
Upon physical examination, the physician observes the patient appears well-nourished and hydrated.
Her temperature is 100.4°F. Her throat examination reveals erythema and swelling of the tonsils, with exudate visible on the right tonsil. The posterior pharynx appears red and inflamed. No other remarkable findings on physical examination.
Based on the clinical presentation and physical examination, the patient is diagnosed with acute pharyngitis, likely of viral origin.
Which of the following virus is likely the causative agent of pharyngitis infection in young adults?
a) Herpes simplex virus
b) Influenza types A and B
c) Measles virus
d) Polio virus

11) Which of the following viral pathogen is the most common cause of "bronchiolitis" in infants?
a) Coxsackievirus      
b) Herpes simplex virus
c) Respiratory Syncytial virus
d) Rhinovirus

12) All of the following pathogens can cause bacterial pneumonia in humans, Except
a) SARS-CoV-2
b) Streptococcus pneumoniae   
c) Mycoplasma pneumoniae
d) Pneumocystis jirovecii        
e) Respiratory syncytial virus

13) Which of the following fungal pathogen is prevalent in different states of America and can cause flu-like symptoms, also known as "valley fever"?
a) Mycoplasma pneumoniae
b) Coccidioides immitis     
c) Histoplasma capsulatum
d) Bordetella pertussis

14) Which type of influenza virus primarily infects humans and is categorized into subtypes based on H and N proteins?
a. Avian Influenza
b. Influenza A
c. Influenza B
d. Influenza C

15) Among the following Gram-negative bacteria, which of the following has been identified as the primary causative agent of hospital-acquired pneumonia in patients within healthcare facilities?
a) Escherichia coli
b) Bordetella pertussis
c) Pseudomonas aeruginosa
d) Yersinia pestis

16) In April 2021, a significant number of individuals succumbed to the emergence of coronavirus variants and the second wave of COVID-19. Many COVID patients experienced opportunistic fungal respiratory infections. 
What is the most likely pathogen associated with these fungal infections?
a) Aspergillus spp
b) Cladosporium cladosprioides
c) Nocardia asteroides
d) Paracoccidioides brasiliensis

17) Which influenza virus is known for causing the 1918 pandemic, also known as the Spanish flu?
a. H1N1
b. H2N2
c. H3N2
d. H7N9

18) All of the following methods are the common preventive measures taken to reduce the transmission of respiratory infections during the flu season, Except?
a) Avoiding close contact with the infected persons
b) Providing flu vaccine to only the people who have respiratory illnesses
c) Covering the face and nose while sneezing and coughing
d) Maintaining clean hygiene habits, washing hands regularly
e) Using the disinfectants and sanitizers regularly

19) What type of infection is primarily caused by Haemophilus influenzae in the upper respiratory tract?
a. Bronchitis
b. Influenza
c. Sinusitis
d. Strep throat

20) Rhinitis (common cold) is most commonly associated with which type of infectious agents?
a) Bacteria
b) Fungi
c) Parasites
d) Viruses

21) What is the primary route of transmission of bacterial meningitis?
a) Respiratory droplets
b) Skin contact
c) Sexual contact
d) Water and Foodborne

22) According to the CDC the most contagious respiratory viral pathogen in 2021 was found to be one of the following viruses?
Name the possible virus
a) Sars Cov
b) Adenovirus
c) Covid-19 Delta variant
d) Haemophilus influenza type b

23) Select all the correct answers, respiratory diseases that can be transmitted from animals to humans
a) Candidiasis
b) Brucellosis
c) Tularemia
d) Anthrax

24) Pneumonias can be categorized into community-acquired and hospital-associated types. What is one key difference between these categories?
a) The causative pathogens are always different.
b) The patient age groups affected are distinct.
c) The clinical symptoms are unique to each category.
d) The epidemiology and causes differ between the two.

25) What is a common etiologic agent responsible for lower respiratory disease in children under 5 years of age?
a) Legionella pneumophila
b) Mycoplasma pneumoniae
c) Staphylococcus aureus
d) Streptococcus pneumoniae

26) What is one of the most common etiologic agents responsible for lung infections in cystic fibrosis (CF) patients?
a. Escherichia coli
b. Mycoplasma pneumoniae
c. Pseudomonas aeruginosa
d. Streptococcus pneumoniae

27) Which of the following intracellular bacteria is most commonly associated with common and severe lung respiratory tract infection in HIV positive individuals?
a) Burkholderia cepacia complex
b) Brucella canis
c) Clostridium difficile
d) Mycobacterium tuberculosis

28) Which bacterium produces a disease characterized by the action of an extracellular toxin that can lead to myocarditis, peripheral neuritis, and local respiratory distress?
a) Corynebacterium diphtheriae
b) Haemophilus influenzae
c) Mycobacterium tuberculosis
d) Streptococcus pneumoniae

29) Which of the following bacteria is the common cause of chronic lower repiratory tract infections?
a) Clostridium difficile
b) Mycobacterium tuberculosis
c) Moraxella catarhalis
d) Staphylococcus epidermidis

1- c)Streptococcus pneumoniae. A gram positive bacteria, common pathogen of respiratory tract infection. Older adults and individuals with compromised immune system (HIV), can be at increased risk of severe pneumococcal infections.
2- a)Klebsiella pneumoniae. A gram negative bacteria that is a part of the normal flora in the human digestive system. Common cause of  respiratory infections in healthcare facilities especially in individuals with weakened immune systems and children. 
3- d)Legionella pneumophila. Legionellae are ubiquitous and widely distributed in the environment, found primarily in aquatic habitats and thrive at warmer temperatures. A gram negative pathogen associated with Legionnaires’ disease (severe pneumonia).

4- d)It can grow in regular nutrient agar media. . Mycoplasma spp are slow grower, thus highly selective media is used to prevent overgrowth of faster-growing organisms that may be present in a clinical sample. A media with beef or soybean protein with serum, yeast extract are the growth factors for the bacteria.

5- b)Moraxella catarrhalis  
6- a)Bordetella pertussis   
7- d)Respiratory syncytial virus (RSV)
8- a) Adenovirus
9- c)Parainfluenza virus
10- b) Influenza types A and B. It is a common cause of upper respiratory tract infection, pharyngitis (sore throat) and tonsilitis.
11- c)Respiratory Syncytial virus (RSV). Bronchiolitis is a RSV infection, it is an acute viral lower respiratory tract infection that primarily occurs in children under 2 years of age.

12- a)SARS-CoV-2   d)Pneumocystis jirovecii and, e)Respiratory syncytial virus
13- b)Coccidioides immitis 
14- b) Influenza A
15- c)Pseudomonas aeruginosa
16)-a) Aspergillus spp
17)-a) H1N1
18- b)Providing flu vaccine to only the people who have respiratory illnesses
19- c) Sinusitis
20- d) Viruses
21- a) Respiratory droplets. Bacterial meningitis is typically transmitted through respiratory droplets when an infected person coughs or sneezes. Close contact with an infected individual is a common mode of transmission.
22- c)Covid-19 Delta variant
23-b), c), and d)
24-d) The epidemiology and causes differ between the two.
25- d) Streptococcus pneumoniae
26- c) Pseudomonas aeruginosa
27- d) Mycobacterium tuberculosis. Tuberculosis (TB) caused by M. tuberculosis  is more common and tends to be more severe in HIV-positive individuals due to their compromised immune systems.

28- a) Corynebacterium diphtheriae. It colonizes the upper respiratory epithelium and produces a toxin that is disseminated systemically, mainly to central nervous system and heart muscles. Systemic disease is characterized by myocarditis, peripheral neuritis, and local disease that can lead to respiratory distress.

29. b) Mycobacterium tuberculosis


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