CBIC - CIC exam Questions bank 2024
UPDATED Study Guide QUESTIONS
AND CORRECT ANSWERS
- An exotoxin is a protein that can be released from a bacterial cell
and can cause disease symptoms. Which of the following diseases has
symptoms that are caused primarily by an exotoxin?
a)Typhoid fever
b) Tetanus
c) Tuberculosis
d) Tularemia - CORRECT ANSWERS b) Tetanus
Tetanus is a disease caused by the bacterium Clostridium tetani,
which is found in soil and in the intestines of some animals. The C.
tetani bacteria usually enter the body through a wound. C. tetani
produces an exotoxin called tetanospasmin that acts as a neurotoxin,
binding to sites in the central nervous system and blocking the release
of neurotransmitters, which results in contraction of muscles and
spasms. An effective vaccine is available to prevent tetanus.
References: Centers for Disease Control and Prevention.
Epidemiology and Prevention of Vaccine-Preventable Diseases.
Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C.
Public Health Foundation, 2015
A 38-year-old woman being treated for breast cancer has a WBC
count of 2.3. This is an improvement over the counts seen during the
past 2 weeks. Her physician has been aggressive in treating every
potential infection she has had. She is currently on an antibiotic for a
bloodstream infection from Staphylococcus epidermidis. She now has
a fever of 100.4°F. What action should be taken?
,a) None b/c she may have neutropenic fever and no real infection
b) More blood cultures b/c she may be developing fungal septicemia
c) Abx stopped b/c she may have "drug fever"
d) Her IV sites should be inspected frequently - CORRECT
ANSWERS b) More blood cultures b/c she may be developing
fungal septicemia.
Sepsis (staphylococci and fungi ) is a leading cause of mortality in
neutropenic cancer patients. Early initiation of effective causative
therapy as well as intensive adjunctive therapy is mandatory to
improve outcome. Blood cultures as part of the usual microbiological
work-up remain the gold standard for the diagnosis of bacteremia.
Reference: APIC Text Online, Chapter 23 - The immunocompromised
host, Chapter 44 - Infection prevention in oncology and other
immunocompromised patients
A 10-year-old boy is admitted to the hospital with a 3-day history of
fever, abdominal pain, diarrhea, and vomiting. He and his family have
just returned from a week-long camping expedition in the mountains
that included trips to the seashore. A stool culture is reported with
many lactose-negative colonies. Which of the following is the most
probable causing organism?
a) Rotavirus
b) Yersinia enterocolitica
c) Providencia alcalifaciens
d) Shigella - CORRECT ANSWERS b) Yersinia enterocolitica.
,Yersiniosis is an infectious disease caused by a bacterium of the genus
Yersinia. In the United States, most human illness is caused by one
species, Y. enterocolitica. Infection with Y. enterocolitica can cause a
variety of symptoms depending on the age of the person infected.
Infection with Y. enterocolitica occurs most often in young children.
Common symptoms in children are fever, abdominal pain, and
diarrhea, which is often bloody. Symptoms typically develop 4 to 7
days after exposure and may last 1 to 3 weeks or longer. In older
children and adults, right-sided abdominal pain and fever may be the
predominant symptoms, and may be confused with appendicitis. In a
small proportion of cases, complications such as skin rash, joint pains,
or spread of bacteria to the bloodstream can occur.
Reference: APIC Text Online, Chapter 79- B: Diarrheal Diseases:
Bacterial
The IP is reviewing the chart of a patient with a sputum culture
positive for pathogens. Which of the following findings indicates that
the specimen had been properly collected from a patient with possible
bacterial pneumonia?
a) Variety of both gram-positive and Gram-Negative bacteria
b) Numerous neutrophils and few if any epithelial cells
c) Many epithelial cells and few neutrophils
d) Presence of blood - CORRECT ANSWERS b) Numerous
neutrophils and few if any epithelial cells.
Useful sputum culture results rely heavily on good sample collection.
If examination of a Gram stain of the sample reveals that it contains a
significant number of normal cells that line the mouth (squamous
epithelial cells), then the sample is not generally considered adequate
for culture and a re-collection of the sample may be required. If the
, sample contains a majority of neutrophils that indicate a body's
response to an infection, then it is considered to be an adequate
sample for culturing.
Reference: APIC Text Online, Chapter 24 - Microbiology basics
A 14-year-old boy from rural Maryland was seen in the emergency
room with fever, fatigue, chills, headache and a large annular lesion
on his left thigh which the patient described as burning and itching.
What is the most probable vector of this child's illness?
a) Mosquito
b) Tick
c) Louse
d) Flea - CORRECT ANSWERS b) Tick.
Lyme disease is caused by the bacterium Borrelia burgdorferi and is
transmitted to humans through the bite of infected blacklegged ticks.
Typical symptoms include fever, headache, fatigue, and a
characteristic skin rash called erythema migrans. If left untreated,
infection can spread to joints, the heart, and the nervous system. Lyme
disease is diagnosed based on symptoms, physical findings (e.g.,
rash), and the possibility of exposure to infected ticks; laboratory
testing is helpful if used correctly and performed with validated
methods. Most cases of Lyme disease can be treated successfully with
a few weeks of antibiotics. Steps to prevent Lyme disease include
using insect repellent, removing ticks promptly, applying pesticides,
and reducing tick habitat. The ticks that transmit Lyme disease can
occasionally transmit other tick-borne diseases as well.
Reference: APIC Text Online, Chapter 85 - Lyme Disease
UPDATED Study Guide QUESTIONS
AND CORRECT ANSWERS
- An exotoxin is a protein that can be released from a bacterial cell
and can cause disease symptoms. Which of the following diseases has
symptoms that are caused primarily by an exotoxin?
a)Typhoid fever
b) Tetanus
c) Tuberculosis
d) Tularemia - CORRECT ANSWERS b) Tetanus
Tetanus is a disease caused by the bacterium Clostridium tetani,
which is found in soil and in the intestines of some animals. The C.
tetani bacteria usually enter the body through a wound. C. tetani
produces an exotoxin called tetanospasmin that acts as a neurotoxin,
binding to sites in the central nervous system and blocking the release
of neurotransmitters, which results in contraction of muscles and
spasms. An effective vaccine is available to prevent tetanus.
References: Centers for Disease Control and Prevention.
Epidemiology and Prevention of Vaccine-Preventable Diseases.
Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C.
Public Health Foundation, 2015
A 38-year-old woman being treated for breast cancer has a WBC
count of 2.3. This is an improvement over the counts seen during the
past 2 weeks. Her physician has been aggressive in treating every
potential infection she has had. She is currently on an antibiotic for a
bloodstream infection from Staphylococcus epidermidis. She now has
a fever of 100.4°F. What action should be taken?
,a) None b/c she may have neutropenic fever and no real infection
b) More blood cultures b/c she may be developing fungal septicemia
c) Abx stopped b/c she may have "drug fever"
d) Her IV sites should be inspected frequently - CORRECT
ANSWERS b) More blood cultures b/c she may be developing
fungal septicemia.
Sepsis (staphylococci and fungi ) is a leading cause of mortality in
neutropenic cancer patients. Early initiation of effective causative
therapy as well as intensive adjunctive therapy is mandatory to
improve outcome. Blood cultures as part of the usual microbiological
work-up remain the gold standard for the diagnosis of bacteremia.
Reference: APIC Text Online, Chapter 23 - The immunocompromised
host, Chapter 44 - Infection prevention in oncology and other
immunocompromised patients
A 10-year-old boy is admitted to the hospital with a 3-day history of
fever, abdominal pain, diarrhea, and vomiting. He and his family have
just returned from a week-long camping expedition in the mountains
that included trips to the seashore. A stool culture is reported with
many lactose-negative colonies. Which of the following is the most
probable causing organism?
a) Rotavirus
b) Yersinia enterocolitica
c) Providencia alcalifaciens
d) Shigella - CORRECT ANSWERS b) Yersinia enterocolitica.
,Yersiniosis is an infectious disease caused by a bacterium of the genus
Yersinia. In the United States, most human illness is caused by one
species, Y. enterocolitica. Infection with Y. enterocolitica can cause a
variety of symptoms depending on the age of the person infected.
Infection with Y. enterocolitica occurs most often in young children.
Common symptoms in children are fever, abdominal pain, and
diarrhea, which is often bloody. Symptoms typically develop 4 to 7
days after exposure and may last 1 to 3 weeks or longer. In older
children and adults, right-sided abdominal pain and fever may be the
predominant symptoms, and may be confused with appendicitis. In a
small proportion of cases, complications such as skin rash, joint pains,
or spread of bacteria to the bloodstream can occur.
Reference: APIC Text Online, Chapter 79- B: Diarrheal Diseases:
Bacterial
The IP is reviewing the chart of a patient with a sputum culture
positive for pathogens. Which of the following findings indicates that
the specimen had been properly collected from a patient with possible
bacterial pneumonia?
a) Variety of both gram-positive and Gram-Negative bacteria
b) Numerous neutrophils and few if any epithelial cells
c) Many epithelial cells and few neutrophils
d) Presence of blood - CORRECT ANSWERS b) Numerous
neutrophils and few if any epithelial cells.
Useful sputum culture results rely heavily on good sample collection.
If examination of a Gram stain of the sample reveals that it contains a
significant number of normal cells that line the mouth (squamous
epithelial cells), then the sample is not generally considered adequate
for culture and a re-collection of the sample may be required. If the
, sample contains a majority of neutrophils that indicate a body's
response to an infection, then it is considered to be an adequate
sample for culturing.
Reference: APIC Text Online, Chapter 24 - Microbiology basics
A 14-year-old boy from rural Maryland was seen in the emergency
room with fever, fatigue, chills, headache and a large annular lesion
on his left thigh which the patient described as burning and itching.
What is the most probable vector of this child's illness?
a) Mosquito
b) Tick
c) Louse
d) Flea - CORRECT ANSWERS b) Tick.
Lyme disease is caused by the bacterium Borrelia burgdorferi and is
transmitted to humans through the bite of infected blacklegged ticks.
Typical symptoms include fever, headache, fatigue, and a
characteristic skin rash called erythema migrans. If left untreated,
infection can spread to joints, the heart, and the nervous system. Lyme
disease is diagnosed based on symptoms, physical findings (e.g.,
rash), and the possibility of exposure to infected ticks; laboratory
testing is helpful if used correctly and performed with validated
methods. Most cases of Lyme disease can be treated successfully with
a few weeks of antibiotics. Steps to prevent Lyme disease include
using insect repellent, removing ticks promptly, applying pesticides,
and reducing tick habitat. The ticks that transmit Lyme disease can
occasionally transmit other tick-borne diseases as well.
Reference: APIC Text Online, Chapter 85 - Lyme Disease
