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PAGE471CASE:A45-year-oldmanpresentedwitha3-weekhistoryoffever,malaise(不舒服),andcough.Theillnessbeganwithlow-gradefever,headache,sorethroat,andnon-productivecough.Hehadsymptomatictreatmentwithover-the-counter(在藥品柜臺買的)medicinesanddidnottakeanyantibiotics.Hisconditionworsened,withexpectorationofnon-bloodstainedsputum(痰液),shortnessofbreath,andsorenessofchest.Therewasnohistoryofexposuretobirdsoranynewenvironment.

Chestauscultation(聽診)detectedscatteredralesandexpiratory(呼氣的)wheezes(喘息).ChestX-rayshowedbilateral(雙側(cè)的)diffuseinfiltratesandconsolidation(固化)ofrightlowerlobe(肺葉).Gram-stainofsputumshowedpresenceofleukocytes(白細胞)andnormalflora.Routinecultureforbacterialpathogensgrewonlynormalflora.Themicrobiologylaboratorywasnotequippedforisolationoffastidious(營養(yǎng)要求較高,不易生長的)organisms,whichrequiredspecialmedia,andforperformingspecificserological(血清學)testsforsuchpathogens.Consideringthepresumptiveclinicaldiagnosisofatypicalpneumonia,asupportivenon-specificserologicaltestwasdonetodetectcross-reactingantibodiestohumanerythrocytes(紅細胞).Testresultshowedsignificanttiteroftheantibodies(1/128).

Ofthefollowing,whichoneismostlikelytobethecausativeagentintheabovepatient?AChlamydiapneumoniaeBLegionellapneumoniae(肺炎軍團菌)CMycoplasmapneumoniaeDChlamydiapsittaci答案:C474A27-year-oldmalestartstocomplainofburningpainwithurination(小便).Thereisalsosomeurethral(尿道的)discharge.Heseeshisfamilyphysicianbecauseofhiscomplaints.Severallaboratorytestsaredone,includingagramstainandcultureonasampleofthedischarge.Theresultsarenegativeandgonorrhea(淋病)isruledout.Heisdiagnosedwithnongonococcal(非淋病)urethritis(尿道炎).Whichofthefollowingisamycoplasma(支原體)thatcouldcausethispatient'snongonococcalurethritis?AChlamydiapsittaciBChlamydiatrachomatisCUreaplasmaurealyticumDTrichomonasvaginalis答案:C475WhichofthefollowingistrueaboutMycoplasma(支原體)?AMycoplasmaarethesmallestfree-livingsmicroorganismsknowntoexistBMycoplasmaistheonlymemberofthefamilyMycoplasmataceaeCMycoplasmapneumoniaeistheonlyspeciesofMycoplasmaknowntocausediseaseinhumansDThelargesizeoftheMycoplasmagenomemostlikelyresultsfromthenumberofgenesnecessarytocodeforthecomplexcellwallpossessedbyallMycoplasmaspecies答案:A478WhichofthefollowingistrueaboutUreaplasma(脲原體)infectionAUreaplasmaurealyticum(溶脲脲原體)isacauseofsomegenitourinarytractinfectionsBUreaplasmahaveacellwallsimilartoothergram-positivebacteriaCParadoxically,thelikelihoodofcolonizationbyUreaplasmaisinverselyrelatedtothenumberofsexualpartnersreportedbyanindividualDUnlikeUreaplasmaurealyticum,U.pneumoniaeisprimarilyassociatedwithrespiratorytractinfections答案:A480AnoutbreakofEpidemiclouse(虱子)bornetyphus(斑疹傷寒)isfavoredbycrowdedlivingconditionswithpoorhygiene(衛(wèi)生)andisespeciallycommoninpartsofcentralandnortheasternAfrica.Whichofthefollowingcausativeorganisms(病原微生物)isspreadbyalouseandcausesepidemiclousebornetyphus?ACoxiellaburnetii(貝納特氏立克次體)BRickettsiarickettsiiCRickettsiatsutsugamushiDRickettsiaprowazekii答案:D485TheWeil-Felixtestisusedfordetectionofwhichofthefollowingtypeofantibodies?AAntirickettsialBAntichlamydialCAntiarenavirus(抗沙粒病毒)DAntiretrovirus答案:A490A45-year-oldwomanbecomesveryill.Shedevelopsahighfever,severeheadache,cough,andmuscleaches.Sheisquiteupsetaboutmissingwork,assheownsherownpetstore(specializinginexoticbirds),andhasnoemployeestocoverforherinherabsence.Shetriestoworkforadaydespiteherillness,butisunableto.Thenextday,sheseesherfamilydoctor.Onphysicalexamination,sheisfoundtobefebrile.Herdoctorsuspectsaninfectionbasedonheroccupationalhistoryandherphysicalexamination.Whatistheclassificationoftheinfectiousagent?AChlamydiaBRickettsiaCMycobacteriaDSpirochete答案:A495Themodeoftransmission(傳播)ofQfeverisABiteofarthropod(節(jié)肢動物)BInhalationofaerosolsCContactwithbodyfluidsDLouse(虱子)bite答案:B501Treponemapallidumssppallidum(蒼白密螺旋體):ACanbevisualizedbygramstainunderlightmicroscopeBCanbegrowninvitroonartificialmediaCIsstrictaerobeDIsassociatedwithcongenitalsyphilis答案:D505A25-year-oldmanlivinginDelawarecomestotheprimarycaredoctorwitharashonhisleftlegthatappeared1weekagoasasmallredareaandisgettingbigger.Healsoexperiencesofmusclepain,jointstiffness,andfatigue(疲勞),butheattributes(歸因于)thistobeinganavidhunterandhehasbeenexercisingmorethanusualduetohuntingseason.Atphysicalexam,hehasaflatcircularlesiononhislegthatispaleinthecenterandredattheperiphery.Therestoftheexamisnormal.

Whatistheagentcausingthisinfection?ABordetellapertussis(百日咳博德特氏菌)BBorreliaBurgdorferi(伯氏疏螺旋體)CBrucella(布氏桿菌)DRickettsiarickettsii(立氏立克次體)答案:B51216gameshowcontestants(參賽者)volunteertobestranded(滯留)for39daysonaremoteislandinBorneo(婆羅洲,一半屬馬來西亞,一半屬印尼),inthemiddleoftheSouthChinaSea,forachancetowinonemilliondollars.Duringthethirdweekofthegame,oneofthecontestantsdevelopsfever,chills,andmuscleaches.Sheisunabletocompeteinanychallengesbecausesheistooill,hermusclesache,andpainsmarkedlylimitherphysicalcapacity.Herconditionworsensandshehasvomitinganddiarrheaaswell.Sheisexaminedbythetelevisionnetwork’sdoctor.Henoticesthatherliverisenlarged.Shehasconjunctivalsuffusion.Whatistheclassificationoftheagentwhichislikelycausingherdisease?ARickettsiaBSpirocheteCChlamydiaDMycobacteria答案:B766AnHIVpositiveyoungwomangivesbirthtoababygirl.Baby'sPCRHIVnucleicacidisfoundpositiveafterbirth.Apgarscoreafterthebirthis9andthefirstgeneralexaminationofthebabyiscompletelynormalexceptthepositiveHIVnucleicacids.Whichofthefollowingvaccinationswillbecontraindicatedforthisbabyinherimmunizationschedule?(MMR=measles(麻疹),mumps(腮腺炎),rubella(風疹);HBV=HepatitisB;HiB=HaemophilusinfluenzaB;DTP=Diphtheria,tetanus;pertussis)AMMRBHBVCSalkpolio(脊髓灰質(zhì)炎)vaccineDDTP答案:A814A42-year-oldIVdruguserexperiencesvaguecomplaintsconsistingoffatigue(疲勞),achesandpains,andnausea.Shehasdevelopedadistasteforhercigarettes.Shehashadafewdayswheresheappearsjaundiced,butthisspontaneouslyresolved.Shegoestothefreeclinic,andtheyrunpreliminary(初步的)bloodtests.ThestaffatthefreeclinictellsthepatientshedoesnothavehepatitisB;however,theyarewrong.Inreality,sheisinthewindowperiod.Clearanceofwhichofthefollowingmarkersmarksthestartofthewindowperiod?AHBsAGBAnti-HBcCHBcAGDHBeAg答案:A816A42-year-oldIVdruguserexperiencesvaguecomplaintsconsistingoffatigue,achesandpains,andnausea.Shehasdevelopeddistasteforhercigarettes.Shehashadafewdayswheresheappearsjaundiced,butthisspontaneouslyresolved.Shegoestothefreeclinicandtheyrunpreliminarybloodtests.ThestaffatthefreeclinictellsthepatientshedoesnothavehepatitisB;however,theyarewrong.Inreality,sheisinthewindowperiod.WhichofthefollowingwouldbetheonlyevidenceofhepatitisBinfectionduringthewindowperiod?AAnti-HBcBHBsAgCHBeAgDAnti-HBs答案:A818WhichofthefollowingvirusesconsistsofcircularDNAthatispartiallydoublestrandedandpartiallysinglestranded?AHepatitisBvirusBVaricella-zostervirusCEpstein-BarrvirusDRespiratorysyncytialvirus(呼吸道合胞體病毒)答案:A823WhichofthefollowingisaDeltaviruswhichisinfectiveonlyinthepresenceofthehepatitisBvirus?AHepatitisAvirusBHepatitisEvirusCHepatitisCvirusDHepatitisDvirus答案:D842IfinalaboratorysettinganappropriatehostcellwasinfectedwithacompositevirusmadeupofVaricella-ZostercapsidandenvelopeandHSV-1DNA,theprogeny(子代)ofthatviruswouldhavewhatfeature?AhavethehostrangeofHSV-1virus.BuseRNAdependentRNApolymeraseforreplicationinthesubsequenttargetcell.ChavearecombinantgenomeconsistingofhalfVZVandhalfHSV-1genomes.Dnotbeinfectiousfornewhoststhathaveantibodiesagainstchickenpox(水痘).答案:A843An18-year-oldfemaleprostitutepresentstotheemergencyroomwithfever,shakingchills,andbodyacheswhichsheattributestotheflu.Herbodytemperaturewas38.9°C;pulsewas75/minute;andbloodpressurewasnormal.Thepatienthadahistoryofsexuallytransmitteddisease(STD).1yearpreviouslyshehadadocumentedcaseofaNeisseriagonorrheathatwastreatedand2clinicexaminationsprovedeliminationoftheinfection.Thepatientmentionedapainfulgenital(生殖器)region.Examinationrevealedlesionsthatwerevesicularandulcerative(潰瘍性的)inappearancearoundthelabiaminora(小陰唇)andmajora(陰唇).SpecimenswereobtainedforHIVtesting,Neisseriagonorrheaculture,viralculture,andchlamydiaculture.TheHIVtestwasnegative.Tzanckprep(Tzanck涂片)wasorderedandwasreportedaspositive.Basedontheclinicalfindings,history,andTzanckprepfinding,whatisthelikelyorganismcausingdiseaseinthispatient?AHerpessimplextype1BHerpessimplextype2CEpstein-BarrvirusDVaricella-zoster答案:B851HerpesviruscanbedetectedbytheTzancksmear(Tzanck涂片)oftheskinlesion,whichstainsforthepresenceofAMultinucleatedgiantcellsBInclusionbodiesCDeadcellsDHerpesDNA答案:A853Whichofthefollowingviralinclusionscorrespondwiththecytomegalovirus(巨細胞病毒)?AOwl(鷹)'seye-intranuclearbasophilicinclusionbodyincellsoftissuesorurinesediment.BNegribodies(intracytoplasmic)inbraintissue.CCowdryTypeAintranuclearinclusionbodyinsinglecellsorinlargesyncytia.DGuarnieribodiesinthecytoplasmofinfectedcells.答案:A854Whichoneofthefollowingvirusescausesgingivostomatitis(齦口炎)?AHerpessimplexvirus-1BHerpessimplexvirus-2CVaricellazostervirusDEpsteinBarrvirus答案:A857Whichofthefollowingviralpathogensisassociatedwithgenitaldiseases?ARespiratorysyncytialvirus,influenzavirus,parainfluenzavirusBDenguefevervirusandLassafevervirusCHumanpapillomavirusesandherpessimplexvirustype2DCoxsackievirustypeBandechoviruses答案:C860Herpessimplexvirus(簡單皰疹病毒)containsASinglestrandedDNAwithnakedicosahedralnucleocapsidBLineardoublestrandedDNAwithnakedicosahedralnucleocapsidCDoublestrandedlinearDNAwithenvelopedicosahedralnucleocapsidDDoublestrandedRNAwithnakedicosahedralnucleocapsid答案:C863A23-year-old,sexuallyactivegraduatestudentdevelopspainfulsoresonhispenis.Heignoresthemforawhileandtheygoaway.Severalmonthslater,shortlybeforehisfinalexams,theyrecur(再次發(fā)生).Thistime,hegoestothestudenthealthservicesoffice.Onphysicalexaminationhehasafeverandtenderenlargedinguinal(腹股溝的)lymphnodes.Therearenumerousvesicular(有小泡的)sores(傷處)onaredtissue.Whatisthemostlikelydiagnosis?APrimarysyphilis(原發(fā)性梅毒)BChancroid(軟下疳)CHerpesgenitalis(生殖器皰疹)EGonorrhea(淋病)答案:C864Whichstatementistrueconcerningthesetwosexually-transmittedviruses:herpessimplexvirusandhepatitisBvirus?AThesevirusesallhaveagenomecontainingdouble-strandedDNA.BOftheseviruses,onlyherpessimplexvirushasagenomecontainingRNA.COftheseviruses,onlyhepatitisBvirushasagenomecontainingRNA.DThesevirusesallhaveagenomecontainingRNA.答案:A868Thislarge-envelopedds-DNAvirusisassociatedwith70%oftheinitialgenital(生殖器)infectionsbythisvirusgroup.Clinically,theseinfectionspresentwithsmallerythematous(紅斑)papules(丘疹)whichprogresstoopenulcerations(潰瘍).Infectionscanbecomelatent(潛伏的)andrecurrent(反復發(fā)作的).Whichvirusisthis?AHSV-1BHSV-2CHIV-1DHIV-2答案:B880Apatienthasallthegastrointestinal(胃腸道)symptomsofinfectionwithHepatitisAvirus(HAV),yetallthetestsforHAV-IgGandHAV-IgMarenegative.Laboratorydiagnosisrevealsa(+)RNAvirus.Whatisthemostprobablecauseofthisinfection?AHepatitisEBHepatitisCCRotavirusDYellowfever答案:A882Whichofthefollowingviralpathogensisassociatedwithgastroenteritis?ARespiratorysyncytialvirus,influenzavirus,parainfluenzavirusBDenguefevervirusandLassafevervirusCHumanpapillomavirusesandherpessimplexvirustype2DRotavirusandNorwalkvirus答案:D883Whichofthefollowingviralinclusionscorrespondwiththerabiesvirus(狂犬病毒)?AOwl(鷹)'seye-intranuclearbasophilicinclusionbodyincellsoftissuesorurinesedimentBNegribodies(intracytoplasmic)inbraintissueCCowdryTypeAintranuclearinclusionbodyinsinglecellsorinlargesyncytiaDGuarnieribodiesinthecytoplasmofinfectedcells答案:B884CASE:Agroupofteensgoonanexplorationtrip.Againsttheadviceofherfriends,a15-year-oldgirlgoesoffbyherselfandentersacave.Sheseesabatthatisunabletoflyand,inanattempttoseeifitishurt,approachesit.Unfortunately,shegetsbittenbythebat.Becauseshehadbeenforewarnedaboutenteringthecave,sheistooembarrassedtotellanybodyaboutthebite.Besideswhich,thebitemarksaresmall,sosheisnotconcerned.Afewweeksafterthetrip,shebecomesveryill.Shedevelopsfever,headache,andfatigue(疲勞).Thisisfollowedbyhallucinations(幻覺),seizures(痙攣),andepisodes(好幾輪的)ofagitation(激惹惱怒不安).Inaddition,whensheswallows,shehasdramaticmusclespasms(強直).Sheprogressestoacomaandthendies.Whatisthegeneticnatureoftheinfectiveagent?ASinglestrandedDNABSinglestrandedRNACDoublestrandedDNADDoublestrandedRNA答案:B885Prions(阮粒)areassociatedwithslowneurodegenerative(神經(jīng)退行性的)diseaseinhumansandanimals.Selectthemostcorrectstatementaboutprions.APrionsarefilterable(可過濾去除的)infectiousagentsBCanelicitimmuneresponseCConsistsofRNADConsistsofproteasesensitiveprotein答案:A887Whichofthefollowingviralpathogensisassociatedwithhemorrhagic(出血性)fever?ARespiratorysyncytialvirus,influenzavirus,andparainfluenzavirusBDenguefevervirusandLassafevervirusCRotavirusandNorwalkvirusDCoxsackievirustypeBandechoviruses答案:B889WhichofthefollowingclinicalconditionsisassociatedwiththeDenguefevervirus?AHepatocellularcarcinomaBCervicalcancerCGingivostomatitis(齦口炎)DBonebreakfever答案:D894A45-year-oldHIVpositivemancomesinforaroutinephysical.Hesayshefeelswellandhasnocomplaints.Hisphysicalexamrevealsswollenlymphnodesintheneckandaxilla(腋窩).TherestofhisexamisWNL.Whatimmunityismostlikeytobedeficientwiththesesymptomsandatthisstageduringhisdiseaseprocess?AHumoralBCell-mediatedCComplementsystemDPhagocyticdysfunction答案:B895Humanimmunodeficiencyvirus,orHIV,isanenvelopedhumanretrovirus(逆轉(zhuǎn)錄病毒)ofthelentivirusfamily.ThereisalsoasignificantnumberofHIV-infectedindividualswhoneverbecomesick,neverexperienceadeclineintheirCD4counts,andneverdevelophighplasma(血漿)loadsofviralRNA.Thereasonsthattheyneverbecomesickincludehostfactorssuchasthepresenceofmutations(突變)provideresistancetoHIV,likemutationswhere?ACXCR4BCCR5CMac-1DSDF-1答案:B898AvirologistinamicrobiologydepartmentofamedicalschoolstudiestheabilityofDNAandRNAvirusestotransformcellsinanimalsandcellcultures.WhichDNAvirusinthefollowinglistdoesnotshowtransformingabilityineitheranimalsorcellcultures?ARetroviruses(逆轉(zhuǎn)錄病毒)BHepatitisBvirus(乙肝病毒)CParvovirus(細小病毒)DEpstein-Barrvirus(EB病毒)答案:C899Anindividualisinfectedwiththehumanimmunodeficiencyvirus(HIV).Assumingthatonecouldfollowthecourseofinfectioninnumeroustissues,whichofthefollowingstatementsabouttheinteractionofthehumanimmunodeficiencyvirus(HIV)withmacrophages(巨噬細胞)iscorrect?AHIVneverinfectsmacrophagesofthebrainandspinalcord.BTheinfectionofmacrophagesisunrestrictedandcontinuouslyactive.CPulmonarymacrophagesmaybeinvolved.DLangerhanscells(郎格罕細胞)arenotinvolved.答案:C900AmouseisexposedtoanaerosolofinfluenzaX31,amurinestainofinfluenza.Bloodsamplesarecollectedatvarioustimepointsfollowingtheexposuretothevirus.Thesamplesarecentrifuged(離心)topellet(沉淀)theredbloodcells.TheplasmaisanalyzedforantibodylevelsusinganELISA.Whichofthefollowingantibodyresponsesfirstemergesuponinfectionwithinfluenza?AIgGBIgMCIgADIgE答案:B901WhichofthefollowingisavirusassociatedwiththedevelopmentofKaposi'ssarcoma(卡波濟肉瘤)?AHerpessimplexvirusBParainfluenza1CCoxsackievirusA16DHumanimmunodeficiencyvirus答案:D916Humanimmunodeficiencyvirusshowstropism(定向性感染性)forAThrombocyte(血小板,凝血細胞)BBlymphocyte(B淋巴細胞)CCD4+TlymphocytesDHepatocytes(肝細胞)答案:C918Whichofthefollowingisamajorcauseofseriousdiarrhea(腹瀉)inyoungchildren?AHerpessimplexvirus(皰疹單純病毒)BLassafevervirus(拉沙熱病毒)CParainfluenza1(副流感的巨細胞)DHumanrotavirus(人輪狀病毒)答案:D919Rotaviruses(輪狀病毒)areASinglestrandedDNAwithnakedicosahedralnucleocapsid(二十面體的核心顆粒)BLineardoublestrandedDNAwithnakedicosahedralnucleocapsidCDoublestrandedcircularDNAwithnakedicosahedralnucleocapsidDDoublestrandedRNAwithnakedicosahedralnucleocapsid答案:D921CASE:Agroupofteensgoonanexplorationtrip.Againsttheadviceofherfriends,a15-year-oldgirlgoesoffbyherselfandentersacave.Sheseesabatthatisunabletoflyand,inanattempttoseeifitishurt,approachesit.Unfortunately,shegetsbittenbythebat.Becauseshehadbeenforewarned(警告不要)aboutenteringthecave,sheistooembarrassedtotellanybodyaboutthebite.Besideswhich,thebitemarksaresmall,sosheisnotconcerned.Afewweeksafterthetrip,shebecomesveryill.Shedevelopsfever,headache,andfatigue.Thisisfollowedbyhallucinations(幻覺),seizures,andepisodesofagitation.Inaddition,whensheswallows,shehasdramaticmusclespasms.Sheprogressestoacomaandthendies.Whatwouldbefoundonautopsy(尸檢)inherbrain?AD?hlebodies(杜勒小體)BRussellbodies(拉塞爾小體)CFoamcells(泡沫細胞)DNegribodies(內(nèi)基氏小體)答案:D932Apatientcomplainsofhertonguehaving"athickwhitecoating,andotherwiseredandirritated."Shehadbeentryingto"scrapethewhitestuffoff"andalthoughsuccessfulattakingoffthecoatinginsomeareasofhertongue,shereportsthattheseareashavebecomerawandmoreerythematous(紅斑).Whatisthemostlikelydiagnosis?AHairyleukoplakia(毛狀黏膜白斑)BAtrophicglossitis(萎縮性舌炎)CHairytongue

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