1999 Final Exam

1. How did Mary Mallon die?
a) of typhoid fever
b) of consumption (pulmonary tuberculosis)
c) of complications following a stroke
d) of AIDS
e) of syphilis

2. As far as the Tuskegee Study was concerned, during the 1950’s, secrecy
a) was being maintained by a tacit agreement between local physicians, the US Public Health Service, and the national press
b) was not an issue and the study was published openly in the scientific journals
c) was justified by the War Powers Act, even though that act had expired at the end of the War in 1946
d) was enforced by the CIA and other federal police agencies
e) was necessary to protect the reputation of the Tuskegee Institute

3. Currently, the annual number of deaths from Tuberculosis in the world is
a) about 30 thousand
b) about 300 thousand
c) about 3 million
d) about 30 million
e) about 300 million

4. If a nurse is jabbed with a needle that had been used on an HIV-infected person, the probability that he or she will become HIV positive from that event is
a) about 1 in 450,000
b) about 1 in 5,960
c) between 0.1% and 1%
d) between 35% and 65%
e) between 95% and 100%

5. Bubonic Plague differs from Pneumonic Plague in that
a) Pneumonic Plague (the “Plague of Justinian”) died out in Europe in about the year 760 and was replaced by a more virulent form of Bubonic Plague (the “black death”) in 1347.
b) Bubonic Plague has high mortality but Pneumonic is relatively harmless
c) Bubonic Plague is caused by a bacterium but Pneumonic Plague is caused by a virus
d) Bubonic Plague is transmitted by rats but Pneumonic Plague is transmitted by fleas
e) Bubonic Plague is transmitted by the bite of a flea but Pneumonic Plague is transmitted by aerosols

6. The widespread use of penicillin after 1946 was followed by
a) a 10-year decline in the frequency of new syphilis cases followed by a 5 -year rise
b) a 10-year increase in the frequency of new syphilis cases followed by a 5-year decline
c) a continuous (but slow) decline in the frequency of new syphilis cases that has continued until today
d) a continuous (but slow) increase in the frequency of new syphilis cases that has continued until today
e) the appearance of penicillin resistant variants of the organism that causes syphilis

7. What was Typhoid Mary’s ethnicity
a) English
b) Irish
c) Jewish
d) African-American
e) American born

8. The co-receptor for HIV infection of macrophages (the CCR5 or CKR5 protein) was discovered because
a. some people infected who lacked the CD4 receptor were still able to become infected with HIV
b. some people infected with HIV went directly from the primary infection to end-stage disease (full-blown AIDS) with virtually no asymptomatic stage
c. some people failed to become infected with HIV despite very many high-risk exposures
d. people who lack this protein almost always die in infancy of opportunistic infections normally associated with AIDS
e. people who lack CCR5 or CKR5 protein are the most likely to develop Kaposi’s Sarcoma as a result of their HIV infection

9. The effect of the first few waves of the Black Death (1347 to 1500) on European population was
a) an overall reduction in population of about 10%
b) an overall reduction in population of about 50%
c) an overall reduction in population of about 90-95%
d) a reduction of about 70% in the South of Europe but only about 5-8% in the North
e) a reduction of about 70% in the North of Europe (especially England) but only about 5-8% in the South.

10. Treponema pallidum is the causative agent of
a) Typhoid fever
b) Cholera
c) Influenza
d) Syphilis
e) Tuberculosis

11. Which of the following is a scientist associated with the AIDS crisis?
a) Harvey Milk
b) Robert Gallo
c) Cleve Jones
d) Gaetan Dugas
e) Larry Kramer

12. How many people are thought to have died as a result of Typhoid Mary’s activities?
a) 3
b) 16
c) 47
d) 121
e) over 1,000

13. The man who first identified the Tuberculosis bacillus was
a) Robert Koch
b) Louis Pasteur
c) George Soper
d) John Snow
e) Alexander Yersin

14. Typhoid fever is caused by
a) a virus
b) a bacterium
c) a parasitic worm
d) the bite of fleas
e) blood-blood contact

15. An HIV infected adult is non-infectious (incapable of transmitting the virus by sexual intercourse)
a) during the primary stage of infection, but before seroconversion
b) during the latent period (asymptomatic stage)
c) during early end-stage (when expressing the AIDS Related Complex or ARC)
d) during full blown AIDS (end-stage HIV disease)
e) never. Such a person is always able to transmit the disease

16. The disease “Yaws” is caused by a close relative of the organism that causes
a) Syphilis
b) Gonorrhea
c) Tuberculosis
d) Leprosy
e) Smallpox

17. The first evidence of human Tuberculosis comes from a time
a) before the Christianization of Europe
b) the period between 1345 and 1357
c) the period between 1492 and 1500
d) in the late 1800’s

18. Use of a latex condom during intercourse
a) increases the probability of HIV transmission
b) has no effect on the probability of transmitting HIV
c) reduces the probability of HIV transmission by about 10%
d) reduces the probability of HIV transmission by about 90%
e) eliminates the possibility of HIV transmission

19. The causative agent of typhoid fever is a member of the genus
a) Salmonella
b) Vibrio
c) Treponema
d) Mycobacterium
e) Helicobacter

20. Which of these would be the LEAST effective in treating syphilis?
a) Quinine
b) Mercury
c) Arsenicals like Salvarsan
d) Penicillin

21. Complement Fixation is the key element in the
a) ELISA test
b) Wassermann Test
c) Western Blot Test
d) Antibiotic resistance test
e) PCR test for Viral Load

22. The most recent Cholera pandemic
a) ended in 1830
b) ended in 1854
c) ended in 1892
d) ended in 1943 (with the introduction of penicillin)
e) is still going on

23. Typhoid Mary was actively spreading disease during the years
a) during the American Civil War
b) just before World War I
c) during the height of the Depression
d) just after World War II

24. The phrase “And the Band Played On” is taken from
a. an old song
b. a movie starring Judy Garland
c. a poem by the “beat” poet Alan Ginsburg
d. a US government report
e. the title of a popular television show from the 1970’s

25. One of the great newspaper tycoons at the time of Typhoid Mary was
a) Edward R. Murrow
b) Alfred Nobel
c) Walter Winchell
d) Joseph Pulitzer
e) Rupert Murdock

26. “Dr. Erlich’s Magic Bullet,” the first successful specific treatment for an infectious disease was used to control or cure
a) Typhoid fever
b) Tuberculosis
c) Bubonic plague
d) Syphilis
e) Cholera

27. The genes of Influenza viruses reside on or in
a) eight pieces of RNA
b) eight pieces of DNA
c) one single piece of DNA
d) a nucleus with highly condensed chromatin
e) two proteins located on the outer surface of the virus

28. The most lethal pandemic of Influenza ever occurred
a) in 1861-67
b) in 1870-73
c) in 1905-06
d) in 1918-19
e) in 1945-46

29. The second stage of syphilis is sometimes referred to as
a) latent syphilis
b) juvenile (or pediatric) syphilis
c) cerebro-spinal syphilis
d) congenital syphilis
e) gonorrhea

30. Who was the civil engineer who tracked Typhoid Mary down?
a) S. Josephine Baker
b) Hermann Biggs
c) Charles Henry Warren
d) George Soper
e) John Briehof

31. Triple drug therapy for HIV disease uses three kinds of drugs to attack two targets. These two targets are
a) reverse transcriptase and protease
b) protease and nucleoside synthesis
c) nucleoside synthesis and integrase
d) integrase and reverse transcriptase
e) gp120 maturation and CKR-5 activity

32. The first human HIV infections by HIV most likely occurred in
a) Africans living in Africa
b) Europeans working part of the time in Africa
c) North American homosexual men
d) Southeast Asian female prostitutes
e) Haitian men

33. The total number of HIV-infected persons in the world at present is
a) about 1 million
b) about 5 million
c) about 50 million
d) about 500 million
e) about 5 billion

34. The terms “AIDS” and “HIV Disease” are often (and incorrectly) used interchangeably. Which of these is a correct use of the terms?
a) AIDS is a collection of diseases that occur during the late stages of HIV disease.
b) AIDS is an older name for HIV disease.
c) AIDS is almost always fatal (more than 95%); HIV disease refers to persons who are infected but will not progress to AIDS.
d) HIV disease is the term for the end-stage of AIDS where death is imminent
e) AIDS usually refers to homosexually contracted HIV infection and HIV disease usually refers to heterosexually contracted HIV infection

35. The vast majority of persons infected with HIV currently live in
a) North America
b) Latin America
c) Western Europe
d) South and Southeast Asia
e) Sub-Saharan Africa

(Questions 36-44 were different on the two forms of the exam. These questions are given at the end of the list (after #115) and are separated by section.)

45. Bubonic Plague is caused by a bacterium of the genus
a) Vibrio
b) Yersinia
c) Salmonella
d) Mycobacterium
e) Treponema

46. In underdeveloped regions of the world, antibiotics are not available and hence not used in the treatment of Cholera. The result of this absence of antibiotics is
a) a mortality greater than 40% and sometimes approaching 90%
b) a doubling in the time needed for recovery from 2-3 days to 4-6 days
c) a stronger and longer-lasting immune response against the Cholera bacillus
d) an increased prevalence of Tuberculosis following the weakness brought on by Cholera
e) minimal because antibiotics are ineffective against the Cholera bacillus

47. In most cases of death resulting from common Influenza, death is actually caused by
a) penetration of the viruses into the internal organs
b) unrestricted growth of the virus in the bloodstream
c) secondary bacterial infections that occur after the flu has weakened the person
d) the appearance of drug-resistant forms of the virus

48. The main cause of death for Cholera patients is
a) growth of bacteria in the bloodstream and tissues
b) accumulation of bacteria in the lymph nodes
c) suffocation from fluid in the lungs
d) dehydration
e) high fever

49. After World War I, the films, books, and pamphlets that described the effective prophylactic measures that could be taken to prevent contracting syphilis during sexual intercourse
a) were welcomed and circulated widely until a new moral attitude arose during World War II
b) were not available in society at large and were used only in the high schools as teaching aids
c) were made obsolete by the widespread use of the new broadcast medium, radio, to spread the message
d) were banned as too obscene for public view.

50. The causative agent of tuberculosis is a member of the genus
a) Salmonella
b) Vibrio
c) Treponema
d) Mycobacterium
e) Helicobacter

51. At the end of the nineteenth century, many Europeans believed that disease was caused by a poisonous vapor rising from rotting material and initiating disease in people. Such vapors were also known as
a) miasmas
b) the four humours
c) earth, wind, fire, and water
d) evil spirits
e) bacteria

52. During the great Influenza pandemic,
a) nearly 400 million died
b) about 20-40 million died
c) about 2-4 million dies
d) about a million died

53. Which of these practices is most likely to lead to transmission of HIV
a) fisting
b) rimming
c) receptive vaginal intercourse
d) insertive vaginal intercourse
e) inhalation of amyl nitrate and other soluble nitrates

54. The “Social Hygiene” movement of the 1920′ and 1930’s was concerned with
a) preserving the “racial purity” of white middle-class America
b) sanitation and the provision of clean water to cities
c) elimination of sexually transmitted diseases
d) cleaning and disinfection of public facilities such as toilets and drinking fountains
e) legislation to allow isolation and quarantine (by force, if necessary) of persons carrying infectious diseases

55. During the World War I, the US army proposed a set of treatments involving painting the genitalia with bichloride of mercury and the injection of a gel of protargol into the urethra as a prophylaxis against
a) Cholera
b) Influenza
c) Syphilis
d) Plague

56. Which of the following is most like “Typhoid Mary?”
a) Gaetan Dugas
b) Harvey Milk
c) Larry Kramer
d) Luc Montagnier
e) Cleve Jones

57 In the US, the number of new cases of Tuberculosis per year
a) was rising slowly but steadily until the mid 1980’s and then leveled off
b) was rising slowly but steadily until the mid 1980’s and then began falling dramatically
c) was falling slowly but steadily until the mid 1980’s and then began to rise
d) has fallen slowly but steadily since the introduction of modern antibiotics

58. Who was president of the USA during the great influenza pandemic?
a) James Buchanan
b) Theodore Roosevelt
c) Woodrow Wilson
d) Calvin Coolidge
e) Franklin Roosevelt

59. The probability of death for those who contracted typhoid fever in pre-antibiotic America was about
a) 1%
b) 10%
c) 50%
d) 90%
e) 99.9%

60. Bubonic Plague will be almost impossible to eradicate because it is endemic in
a) the population of the Indian subcontinent
b) a variety of wild rodent populations, including several in the US
c) a variety of mammals, but especially ducks and pigs
d) domestic animals (cattle) and mosquitoes
e) sub-Saharan Africa

61. The project that became the Tuskegee Study began as a demonstration project of treatment of syphilis and changed into
a) a study of untreated syphilis in Negro males
b) an attempt to devise population control methods for rural blacks
c) a project for the treatment of all venereal diseases in rural blacks
d) a test for several experimental treatments using uninformed black men as test subjects
e) a test of several experimental drugs using state but not federal prisoners in rural Alabama

62. Which of these would the last to detect an HIV infection
a) A physical examination by a doctor with training and experience in recognizing the clinical manifestations of AIDS
b) A blood test using an ELISA assay
c) A blood test using a Western Blot assay
d) An antibody test using the p24 antigen
e) a PCR analysis for viral load

63. The first American cases of the disease now known as AIDS were identified in
a) the early 1990’s
b) the early 1980’s
c) the early 1970’s
d) the early 1960’s
e) the early 1950’s

64. Smallpox is caused by
a) a Spirochete
b) a Mite (microscopic spiderlike insect)
c) a Worm
d) a Virus
e) the bite of an infected flea

65. The main route for transmission of Influenza is
a) water that we drink
b) fecal-oral contamination
c) the bites of fleas and some lice
d) droplet in the air
e) sexual contact

66. The surgical alternative offered to Typhoid Mary was removal of her
a) large intestine and lower bowel
b) small intestine
c) spleen
d) gall bladder
e) liver

67. The first person who most convincingly showed that the infectious agent of Cholera was carried by the water supply was
a) John Snow
b) Louis Pasteur
c) Alexander Yersin
d) Robert Koch
e) Johannes Petenkofer

68. HIV-2 differs from HIV-1 in a number of properties. Among these is the fact that
a) HIV-2 is less common in the US than HIV-1
b) HIV-2 appears to have originated in pigs whereas HIV-1 appears to have originated in birds
c) Persons infected with HIV-2 progress to AIDS more quickly than persons infected by HIV-1
d) HIV-2 infections can be cured but HIV-1 infections cannot

69. Typhoid Mary was imprisoned on North Brother Island in the state of
a) Alabama
b) New York
c) Michigan
d) Massachusetts
e) California

70. The national magazine “Ladies Home Journal” broke the “conspiracy of silence” regarding
a) the method by which cholera is spread
b) the method by which syphilis is spread
c) the existence of a carrier of typhoid fever
d) the presence of drug-resistant tuberculosis in New York City
e) the connection of AIDS with homosexuality

71. The term “Columbian Exchange” generally refers to
a) the high correlation between increasing cocaine usage and HIV infection
b) the transport of slaves from the Old World to the New World and the transport of gold from the New World to the Old World
c) US support for Panama’s independence from Colombia in exchange for the right to build the Panama Canal
d) The transport of plants, animals and diseases native to the Old World to the New World and of those native to the New World to the Old World
e) The hostages left by Columbus with the natives on Santo Domingo when he took several of the native nobility back to Europe on his third voyage

72. The germ that causes typhoid fever can enter (and remain) in a carrier state because
a) some people are genetically unable to make the antibody that recognizes it
b) it lodges in tissues that are not supplied with blood or lymph
c) it hides inside cells in special vesicles
d) it is a “slow virus”
e) it can cross the blood-brain barrier

73. Who was Grethe Rask?
a) A Danish physician who worked in Africa and became one of the first Europeans to die of AIDS
b) A co-worker of Robert Gallo and the one who actually developed the procedure for growing retroviruses in culture
c) A public health worker for the city of San Francisco
d) A technician at the CDC who noticed an excessive number of unexplained orders for pentamidine (used to treat pneumocystis pneumonia)
e) The woman who became mayor of San Francisco when George Moscone was assassinated

74. The Bacille Calmette-Guerin (Bacillus of Calmette and Guerin or BCG) is
a) the causative agent of most cases of Tuberculosis
b) the bacterium injected into the skin when doing a tuberculin skin test
c) a widely used anti-Tuberculosis vaccine
d) the most virulent strain of the Tuberculosis agent ever identified

75. “Kaposi’s Sarcoma” is one of the common clinical manifestations of AIDS, especially among gay men. What is Kaposi’s Sarcoma?
a) a fungal infection of the mouth and throat
b) a cancer that shows itself as purple patches on the skin
c) a profound weight loss coupled with “night sweats”
d) a dementia that resembles Alzheimer’s disease

76. People who drank water from the Broad Street Pump in August and September 1854
a) were the only ones who got Cholera in those months
b) were 10-20 times less likely to get Cholera than those who drank water from the Water Company pipes
c) were even less likely to get Cholera than other residents of Altona and more than 20 times less likely than those who drank from the New Street pump in Hamburg
d) were found to be immune to Cholera

77. We know surprisingly little about the germ that causes typhoid fever because
a) it is hard to grow it in pure culture
b) typhoid fever is not a very prevalent disease any more, hence funding for study is low
c) it can grow only inside of cells (in vesicles)
d) it does not cause typhoid fever in any animal other than humans
e) the disease it causes is over so quickly

78. The recommended medical treatment for the gastroenteritis caused by common Salmonella is
a) antibiotic therapy
b) quarantine until the feces is free of Salmonella for at least three consecutive months
c) removal of the gall bladder or liver
d) laxatives
e) no treatment at all

79. Tertiary syphilis is often characterized by
a) a mild rash over large parts of the body, especially the torso and face
b) a progressive decay of major organ systems like the liver, the bones, and the brain
c) severe fever and “night sweats”
d) a single, excruciatingly painful ulcer
e) raging diarrhea leading to dehydration and death

80. Which of these “bodily fluids” is probably the safest in terms of transmission of HIV
a) vaginal secretions
b) breast milk
c) blood
d) semen
e) saliva

81. Among all the HIV -infected persons in the United States, the most common route of infection has been homosexual sex. What is second?
a) injection drug use
b) blood transfusion
c) transplacental transfer
d) clotting factor for hemophiliacs

82. Stomach ulcers are caused most often by
a) Salmonella typhi
b) Salmonella enterica
c) Helicobacter pylori
d) stress and spicy foods
e) environmental carcinogens

83. The Tuskegee Study was invalid from the start on scientific grounds because
a) it involved only African Americans
b) it involved only men
c) it did not take socio-economic factors into account
d) it did not set up a control group
e) the participants has already received some treatment

84. The disease most likely to be caused by a bacterium in the genus Vibrio is
a) Cholera
b) Tuberculosis
c) Bubonic Plague
d) Typhoid Fever
e) Syphilis

85. Influenza viruses can change slowly over time from a form that is easily recognized by our immune system to one that is less well recognized, and eventually into a form that is very poorly recognized by our immune system. This sort of slow change us usually called
a) antigenic drift
b) antigenic shift
c) antigenic variation
d) pandemic
e) mutation that resists error correction

86. The symptoms of the first stage of HIV disease, occurring immediately after infection, most resemble the symptoms of
a) cancer, especially sarcoma
b) pneumonia
c) dementia
d) flu or mononucleosis
e) tuberculosis

87. Which of the following is NOT typical of typhoid fever
a) skin rash on the abdomen and torso
b) fever persisting up to several weeks
c) decreased number of white blood cells
d) persistent cough as the lungs fill with fluid
e) enlarged spleen and distended abdomen

88. The initial infections that led to the Cholera outbreak in Hamburg in 1892 probably arrived
a) by ship from New York City
b) by river barge from Hanseatic traders
c) by train from the Ukraine
d) by naval warships returning from the Crimea
e) in unwashed vegetables from the neighboring town of Altona

89. Another term for “rimming” would be
a) brachioproctal manipulation
b) oral-anal sex
c) use of glory holes
d) use of poppers
e) use of bathhouses

90. Bubonic Plague is so named after buboes. What are buboes?
a) black-appearing swellings of lymph nodes
b) disfiguring pustules that form on the body, especially the face and trunk, and leave scars for life on the survivors of the infection
c) the chants of Italian gravediggers “Bubbonni mortandi” or “Bring out your dead”
d) a nickname for quack (fake) physicians

91. In 1925, health department officials thought female carriers of typhoid fever were more dangerous than male carriers because
a) 100% of the known carriers were female
b) women did most of the cooking in families and as servants
c) women had just gained the right to vote
d) women were biologically more susceptible to infections
e) social norms generally required a higher degree of cleanliness for men than for women

92. Both Syphilis and Lyme Disease are caused by
a) Spirochetes
b) Mites (microscopic spiderlike insects)
c) Worms
d) Viruses
e) Excessively promiscuous sexual behavior

93. Which of these would you expect to find on the outside of an HIV virus particle
a) protease
b) integrase
c) reverse transcriptase
d) gp120
e) RNA

94. In most HIV infected adults, the initial stage (“window period”) before appearance of HIV-specific antibodies in the blood usually lasts for
a) days
b) weeks
c) years
d) decades
e) indefinitely (most HIV infected adults never develop antibodies against HIV)

95. Which of the following names would you associate with syphilis?
a) Louis Pasteur
b) George Soper
c) August von Wassermann
d) Edward Jenner
e) Robert Koch

96. In the 1909 court hearing, Typhoid Mary’s lawyer tried to have her released by challenging
a) the unfair treatment of Irish-Americans
b) her imprisonment without a trial
c) the credibility of the health department of New York City
d) the definition of healthy carriers as “sick” under the law
e) the prejudicial representation of her story in the tabloid press

97. The use of mercury rubs is to syphilis as
a) the use of streptomycin is to tuberculosis
b) the use of penicillin is to syphilis
c) the use of vaccination is to smallpox
d) the use of bleeding is to tuberculosis
e) the use of “triple drug” therapy is to AIDS

98. Four of these names refer to the same person, which one does not fit?
a) Mary Ilverson
b) Mrs. Brown
c) Typhoid Mary
d) Mary Mallon
e) Josephine Baker

99. The Tuskegee Study took place in Macon County in the state of
a) Georgia
b) Mississippi
c) Louisiana
d) Tennessee
e) Alabama

100. In 1500, syphilis in Europe
a) was unknown
b) was much less virulent than syphilis in 1900 and was rarely fatal
c) was much more virulent and killed more rapidly than syphilis in 1900
d) was much the same as that described by Hippocrates 2 ,000 years earlier
e) caused the deaths of the kings of England, Spain, and Sweden within three months of each other, leading to a destabilization of the balance of power

101. The term “Herd Immunity” implies that
a) viral diseases can be transmitted from animals to humans, but not from humans to animals
b) if the animal source of a viral or bacterial epidemic can be eliminated, then that epidemic will die out after two or three generations
c) large numbers of individuals need to become infected in order for an epidemic to begin in the first place
d) infectious diseases are rarely transmitted among animals that live in densely packed herds or flocks
e) if the probability that a given contact between two individuals will result in transmission can be reduced enough, an epidemic will not be self-sustaining

102. John Keats, Fryderyk Chopin, and most of the Brontë family died of
a) Bubonic Plague
b) Syphilis
c) Cholera
d) Tuberculosis
e) Influenza

103. The Influenza of the great pandemic was unique because
a) it killed very young children (under 1 year of age)
b) it killed 20-40 year olds
c) it killed very old people (65 and older)
d) it killed more women than men

104. During Mary Mallon’s lifetime, the number of deaths from typhoid fever (per 100,000 population) declined dramatically. This correlated strongly with
a) the provision of filtered water to cities
b) the discovery and widespread use of antibiotics
c) the discovery of the concept of “healthy carriers”
d) the decline in immigration from Europe and especially Ireland
e) the widespread acceptance of tobacco use by the lower classes

105. Treatment of HIV-infected pregnant women with AZT (zidovudine) reduces the probability of transmitting HIV to the child by
a) an insignificant amount
b) from about 25-30 % to about 8%
c) about 75%, but with a substantial (about 15%) risk of causing birth defects.
d) about 10% overall, but greater than 90% for the most damaging mutants of HIV
e) about 75% overall, but an insignificant amount for the most damaging mutants of HIV

106. Nurse Rivers, the liaison between the officials of the Tuskegee study and the men under study was recruited through her previous employer,
a) The Tuskegee Institute
b) The US Public Health Service
c) The Centers for Disease Control
d) The American Social Hygiene Association
e) The NAACP

107. The most common cause of “single birth sterility” in the 1920’s was
a) Syphilis
b) Gonorrhea
c) Tuberculosis
d) Lyme Disease
e) Septic abortions

108. In the State of Michigan
a) the names of persons with AIDS are reported to the county health department but not the state health department
b) the names of persons who test positive for HIV (if known) are reported to the county health department but not the state health department
c) sex between consenting homosexual adults is legal
d) injection drug users can exchange used needles for sterile ones at state clinics and most hospitals
e) convicted prostitutes, even those suspected of spreading HIV infection, can refuse to be tested for HIV

109. In the present day, standard antibiotic therapy
a) is effective against the active form of typhoid fever, but not the carrier state
b) is effective against the carrier state of typhoid fever, but not the active form
c) is effective against both the active form and the carrier state of typhoid fever
d) is effective against neither the active form nor the carrier state of typhoid fever
e) is almost always effective against the active form of typhoid fever, but only very rarely against the carrier state

110. “Complement” is a normal component of human blood. When complement is activated, its role is
a) as a normal part of cell membranes
b) to bind to antigens
c) to distinguish between “self” and “foreign” for the immune system
d) to punch holes in cell membranes
e) to raise body temperature (cause fever)

111. The euphemism for syphilis used by the officials in the Tuskegee Study when dealing with the men was
a) The Trembles
b) Bad Blood
c) The Wasting
d) Parlor Fever
e) Shuffling Fever

112. The health department wanted samples to test from “Typhoid Mary” for the presence of the typhoid fever germ. Which of these did they NOT request
a) feces
b) urine
c) blood
d) sputum

113. When you go for an HIV test and an Western Blot assay is performed, the test is looking for the presence of
a) HIV viral particles in your blood
b) HIV-derived nucleic acid (RNA) in your blood
c) HIV antigens in your blood
d) HIV-specific DNA inserted into the chromosomes of your T cells in the lymph nodes
e) HIV-specific antibodies in your blood

114. Prophylaxis is a general term for a treatment or set of treatments that will
a) prevent an infectious disease from becoming a sexually transmitted disease
b) prevent a disease or condition
c) cure a disease or condition
d) inadvertently cause the death of a patient

115. Which of these occurred during the years that Mary Mallon was cooking and spreading typhoid fever
a) The Irish potato famine sent another million or more immigrants to the US
b) The English army brutally suppressed the “Easter rebellion” in Ireland, sending another million immigrants to the US
c) Walter Reed “conquered” yellow fever in Cuba and William Gorgas was doing the same in Panama
d) Penicillin was discovered and was slowly gaining acceptance as an effective therapy for the treatment of bacterial diseases
e) John Snow proved that cholera was transmitted by drinking water, thus proving that at least one bacterial disease has a fecal-oral route of transmission

Here are the answers to questions 36-44 from Form 2 (Chad’s sections)

36. Which of the following BEST describes an antibody?
a) a cell that can be infected by HIV
b) a complex molecule that recognizes a specific antigen
c) a chemical produced by fungi or bacteria that kills bacteria
d) a cell that engulfs and digests foreign substances in the blood
e) a “wonder drug” that kills both bacteria and viruses by blocking their ability to replicate their DNA

37. Which of the following BEST describes a macrophage?
a) a complex of proteins and RNA, not a cell
b) a cell that cannot be infected by viruses of any kind
c) a cell that engulfs and digests foreign substances in the blood
d) a cell that produces “memory” in the human immune system
e) a complex of proteins that pokes holes in bacteria or infected cells

38. A drug resistant bacterium may prevent an antibiotic from killing it by
a) exporting the antibiotic from the bacterium
b) surrounding and sequestering the antibiotic with antibodies
c) digesting the antibiotic with lysozyme
d) hiding in human lymphocytes
e) preventing the antibiotic from replicating its DNA (or RNA)

39. In the movie “When Wonder Drugs Don’t Work,” the spread of drug resistant Staphylococcus aureus (MSRA) in the hospital was tracked by
a) a case-control study
b) isolating hospital employees
c) ELISA tests on blood samples
d) monitoring performance of janitors cleaning rooms
e) testing skin and nasal swabs from patients and staff

40. Which of the following is LEAST likely to encourage bacterial resistance to antibiotic drugs?
a) feeding antibiotics to livestock
b) taking antibiotics for viral infections
c) continuing to take a prescribed antibiotic for the full dose, even if symptoms have completely disappeared after only half the prescription is taken
d) using broad-spectrum rather than narrowly focused antibiotics for most infections

41. Which of the following opportunistic infections is NOT associated with AIDS patients in “And the Band Played On?”
a) toxoplasmosis
b) cholera
c) Pneumocystis carinii
d) Kaposi’s sarcoma
e) cytomegalovirus

42. Which of the following was NOT considered as a possible cause of GRID by the CDC in the early 1980’s?
a) nitrate inhalants (poppers)
b) known infectious diseases that had mutated
c) genetic linkage to a trait for homosexuality
d) two or more know infectious diseases acting in concert in a new way
e) new sexually transmitted infectious disease

43. Which of the following is NOT true of BOTH HIV/AIDS and Syphilis?
a) latent yet infectious period (carriers)
b) caused by a viral infection
c) associated with socially marginalized groups in the US
d) transmissible by sex and blood contact
e) transmission reduced using condoms during intercourse

44. Which of the following is curable with antibiotics?
a) HIV
b) syphilis
c) influenza
d) smallpox
e) measles

Here are the answers to questions 36-44 from Form 1 (Jay’s sections)

36. The proteins in the “GAG family” (group specific antigen family), p18, p24, and p17,
a) are made as very small pieces from the “small genes” and joined to together to make larger proteins
b) are made as three separate proteins from the small genes
c) are made as part of a larger “polyprotein” and cut into smaller pieces
d) are encoded in the gag, pol, and env genes respectively

37. Which of these is true of triple drug therapy
a) It can cure HIV disease, but leaves the person susceptible to future infections by the same strain of HIV
b) It can cure HIV disease, and the cured person is immune to that strain of HIV, but susceptible to other strains
c) It can cure about 70% of the people of HIV disease with about half of the remaining people non-responsive to the treatment and the other half unable to take the drugs because of side effects
d) It can alleviate the symptoms of HIV disease, but leaves the person infected with HIV
e) It neither cures nor alleviates symptoms of HIV disease

38. There are two organisms that cause malaria in man. Their names are
a) Plasmodium africanus and Plasmodium falciparum
b) Plasmodium vivax and Plasmodium falciparum
c) Plasmodium vivax and Plasmodium africanus
d) Plasmodium falciparum and Plasmodium anopheles
e) Plasmodium vivax and Plasmodium anopheles

39. Which of the following statements is FALSE?
a) Bacterial resistance is transferred among bacteria via small pieces of DNA
b) The malarial parasite requires a single RBC during it’s life cycle in the human host
c) Faster, more frequent transportation of people around the globe has been at least partially responsible for the transmission of AIDS
d) In the movie shown in discussion, one big problem with MSRA transmission was the fact that many staff members did not wash their hands properly after dealing with each patient

40. Which of the following is FALSE about malaria
a) Malaria is characterized by a weakness/fatigue and a constant high fever
b) Most malaria control strategies have focused on mosquito control
c) Forty percent of the human population lives in areas where malaria is endemic
d) Only female mosquitoes are involved in malaria transmission
e) Both carbon dioxide and bad feet can attract malaria-transmitting mosquitoes

41. An antigen is BEST defined as
a) a substance that tells helper T-cells to kill infected body cells
b) a substance that causes the innate immune system to function
c) a substance consumed and eliminated by macrophages
d) a substance that causes an immune response
e) a substance that tells B-cells to activate macrophages

42. T cells are an important component of our blood because they
a) carry oxygen to the tissues
b) activate macrophages to be more aggressive
c) lead to regeneration of bone and bone marrow
d) can resist infection by HIV
e) can cross the blood-brain barrier with ease

43. Which is true about malaria?
a) Malaria is caused by a virus that infects liver cells and red blood cells
b) Malaria is caused by a protozoan that requires two hosts in its life cycle
c) Malaria is caused by a bacterium that is transmitted by mosquitoes
d) When a malaria-infected mosquito bites a human, adult malarial parasites move from the mosquitoes salivary glands to the human’s red blood cells

44. Vaccination is designed to
a) prevent infection by a bacterium or virus
b) cure an infection by a bacterium or virus
c) alleviate the symptoms of a bacterial or viral infection
d) render a bacterial or viral infection non-infectious