1、第 1 页（共 4 页）南方医科大学授予学士学位工作细则规定：“考试作弊者不授予学士学位” 。南方医科大学 2010-2011 学年第一学期公共卫生与热带医学学院医学微生物学试卷（A）适用班级: 医学英语 2008 级1、在试卷上写上姓名和学号。2、请按题目要求，选择题答案涂在答题卡上，问答题和翻译题直接在试卷上相应位置作答。3、采用考卷考试，只允许带 1 本英汉字典、1 本教材和 1 本配套教材，其他书籍一概不准带进考场。4、考试时请严格遵守考场纪律，独立完成。考试过程中原则上不允许擅自离开考场。年级： 2008 级 专业： 医学英语本科 学号： 姓名： 课程学时数：60 考试日期：2011
2、 年 1 月 21 日，考试时长：120 分钟，组卷人：龙北国题序 一 二 三 四 总分题型 A1 型题 B1 型题 A2A3/A4 型题 病例简答题题量 15 10 10 10满分 30 20 20 30 100一、A1 型题 （单句型最佳选择题。每一道考题下面均有五个备选答案。请从中从中选择一个最合适的答案，并在答题卡上相应位置涂黑，以示正确回答。合计 15 题，每题 2 分，满分 30 分） 1. Which one of the following agents lacks nucleic acid ?下列哪一个选项缺乏核酸?A. Bacteria（细菌）B. Viruses（病毒）C
3、. Prions（朊病毒）D. Protozoa（原生动物）E. Fungi（真菌）2. Which lack cell walls and do not synthesize（合成） the precursors （前体）of peptidoglycan （肽聚糖）?下列哪个缺乏细胞壁肽聚糖的合成前体？A. Spirochetes（螺旋原虫）B. Chlamydiae（衣原体）C. L forms（L 型菌）D. Protozoa（原生动物）E. Mycoplasmas（支原体）3. Which of the following components is present（存在）in gra
4、m-negative（革兰阴性） bacteria but not in gram-positive（革兰阳性） bacteria ?（下列哪种成分是革兰阴性菌存在革兰氏阳性细菌不存在的呢？）A. Peptidoglycan（肽聚糖）B. Lipid A（脂质 A）C. Capsule（胶囊）警示第 2 页（共 4 页）D. Flagella（鞭毛）E. Lipoteichoic acid（磷壁酸）4. Each of the following statements concerning bacterial spores（芽孢） is correct EXCEPT（下列关于细菌芽孢的说法错误
5、的是）A. They are formed only by gram-positive bacteria（他们只由革兰氏阳性细菌形成）B. They can be killed when being heated to 121.3 for 1520 minutes（它们在121.3）C. They contain much less water than bacterial vegetative cellsD. Their survival ability is based on their enhanced metablic activity（他们的生存能力是基于增强代谢活动）E. They
6、 are formed under adverse environmental conditions such as the absence of a carbon source（他们是在不利的环境条件下形成的,如缺乏碳源）5. Most microorganisms（微生物） pathogenic（病原体） for humans grow best in the laboratory when cultures are incubated at（大多数对人致病的病原微生物在实验室的最适宜孵化温度是）A. 15-20B. 20-30C. 30-37D. 38-50E. 50-556. A 23
7、-year-old woman has ten E. coli （大肠埃希菌）inoculated into her bladder while having sex. These E. coli have a generation time of 20 minutes. After a lag phase （迟缓期） of 20 minutes, the E coli enter the logarithmic phase of growth. After 3 hours of lag and logarithmic growth, the total number of E. coli i
8、s（一个 23 岁的女人在做爱时有十个大肠杆菌(大肠埃希菌)跑到了她的膀胱里。这些大肠杆菌繁殖一代需要 20 分钟。经过(迟缓期) 的20 分钟,大肠杆菌进入对数期的增长。经过 3 小时的迟缓期和对数增长期,大肠杆菌的总数是）A. 90B. 1280C. 2560D. 5120E. 1 000 0007. Each of the following statements concerning the killing of bacteria is correct EXCEPT（关于灭菌，下列说法错误的是）A. The pasteurization（巴氏灭菌法） of milk kills pat
9、hogens but allows many organisms and spores to survive（牛奶的巴氏灭菌杀死病原体但允许许多有机体生存和孢子）B. Seventy five percent ethanol kills less effectively than absolute (100%) ethanol（百分之七十五的乙醇杀菌效果不如(100%) 乙醇）C. An autoclave uses steam under 15lb/sq of pressure to reach the killing temperature of 121.3D. Some cationic
10、 surfactants can kills by increasing the membrane permeability of bacteria（一些阳离子表面活性剂可以通过增加膜的通透性来杀死细菌）E. Ultraviolet light kills by causing the formation of thymine dimers in bacterial DNA（紫外线杀死引起细菌的原理是影响细菌 DNA 的胸腺嘧啶二聚体的形成）8. Each of the following statements concerning members of the normal flora（正常
11、菌群）is correct EXCEPTA. Are usually nonpathogens but can cause disease in immunocompromised patients（通常是不致病的,但可以导致免疫功能低下的患者发病）B. Prevent some pathogens from colonizing mucous membranes（防止一些病原体附着在黏膜上）C. Are present in larger numbers in the colon 第 3 页（共 4 页）than in other parts of the human body（人体结肠存在
12、的正常菌群比其他地方的多）D. Are important in keeping the pH of the urine low（是保存尿液 PH 的重要条件）E. Play an important role in the development of immunologic competence（在免疫中发挥了重要作用）9. Each of the following statements concerning fungi and bacteria is correct EXCEPTA. Yeasts reproduce by budding（出芽）, whereas bacteria r
13、eproduce by binary（二分裂）（酵母出芽，细菌二分裂）B. Some fungi undergo dimorphic changes when they grow in tissue, whereas bacteria do notC. Fungal spores are less heat-resistant than bacterial endospores（比起细菌内孢子，真菌孢子不耐热）D. Bacterial cells possess peptidoglycan, whereas fungal cells do not（细菌细胞具有肽聚糖,而真菌细胞没有）E. Bo
14、th bacterial cells and fungal cells have 70S ribosomes（核糖体）（所有细菌都有 70S 核糖体）10. Which Virus is likely to establish latent infecions ?（哪个病毒可能建立潜伏感染）A. Herpes simple virus（单纯疱疹病毒）B. Dengue virus（登革病毒）C. Influenza virus（流感病毒）D. Rotavirus（轮状病毒）E. Hepatitis B virus（乙肝病毒）11. The ability of a virus to produ
15、ce disease can result from a variety of mechanisms. Which one of the following statements is LEAST likely（下列病毒产生疾病的机制中。最不可能的是）A. Direct cytopathic effect in virus-infected cells（在感染病毒的细胞直接细胞病变效应）B. Malignant transformation of virus-infected cells（病毒感染细胞让其恶性转化）C. Immune response to virus-induced anti
16、gens on the surfaces of the virus-infected cells（免疫反应病毒诱导感染病毒的细胞的表面抗原）D. Production of an exotoxin that causes damage to host cells（生产的外毒素引起宿主细胞损伤）E. Empolying some ways to induce host cells apoptosis（凋亡）12. Interferons（干扰素）are an important part of the host defense against viral infections. What is
17、interferons principal mode of action ?（干扰素的作用方式）A. They have direct antiviral activityB. They coat viral particles and block their attachment to cellsC. They induce synthesis of antiviral proteins that inhibit translation or transcription of viruses（它们诱导抗病毒蛋白质的合成 ,抑制翻译或病毒的转录）D. They protect the viru
18、s-infected cell that produced it from cell deathE. They are synthesized only by virus-infected cells13. Neutralization antibody can bind viruses and deprive them of their infection ability. Which one of the following statements is LEAST likely（中和抗体可以绑定病毒和剥夺他们的感染能力。哪一个最不可能是下列语句）A. Killing viruses dir
19、ectly（直接杀死病毒）B. Changing viral surface conformation（构型）to prevent viral absorptionC. Binding viral epitopes（表位） associated with absorption to keep viruses from entering host cellsD. Forming immune complex which can easily be phagocytosed and cleared by phagocytesE. Combining with surface antigens of
20、 enveloping viruses to lead to complement（补体） activation and 第 4 页（共 4 页）viral lysis14.Which one of the following statements describes an advantage of killed vaccines over attenuated live vaccines ?（下列哪一个语句描述了一种减毒活疫苗的优势?）A. killed vaccines induce a broader range of immune responses than do attenuate
21、d live vaccines（死疫苗能引起比减毒活疫苗更广泛的免疫反应）B. killed vaccines more closely mimic natural infections than do attenuated live vaccines（死疫苗比减毒活疫苗更类似于自然感染）C. killed vaccines pose no risk that vaccine might be transmitted to susceptible contacts（死疫苗没有接触传播的风险）D. killed vaccines are efficacious against respirato
22、ry infections because they induce good mucosal immunity（死疫苗对呼吸道感染有免疫作用,因为它们可以诱导产生粘膜免疫）15. Each of the following statements concerning human immunodeficiency virus is correct EXCEPTA. The virus particle carries an RNA-directed DNA polymerase encoded by the viral genome（病毒粒子携带一个 RNA 指导由病毒基因组编码的 DNA 聚合
23、酶）B. The virus consists of two identical of single- stranded RNA (diploid)（病毒是由两个相同的单链 RNA 构成的二倍体）C. The virion is enveloped and enters cells via an interaction with receptor CD4 molecule and coreceptor (CCR5 or CXCR4) on the host cellsD. During infection, the virus synthesizes a DNA copy of its RNA
24、, and this DNA becomes covalently integarated into host cell DNA(在感染过程中,病毒 RNA 逆转录形成DNA，然后该 DNA 与宿主细胞 DNA进行整合）E. Purified RNA extracted from the virus particle is infectious（病毒纯化的 RNA具有感染力）二、B1 型题 （配伍题。以下提供了若干组考题，每组题共用五个备选答案，备选答案后有两个以上的问题，每个问题要从备选答案中选择一个正确答案，并在答题卡上相应位置涂黑，以示正确回答。每个备选答案可选一次以上，也可以一次也不选
25、择。合计 10 题，每题 2 分，满分 20 分） 16-17A. Cholera enterotoxin （霍乱肠毒素）B. Tetanospasmin （破伤风痉挛毒素）C. Botulinum toxin（肉毒毒素）D. Diphtheria toxin（白喉毒素）E. Shiga toxin（志贺毒素）16. This NADase toxin inactivates elongation factor 2 (EF-2) by attaching ADPR to it, so it can inhibits protein synthesis.17. This toxin causes
26、 flaccid paralysis by preventing the release of acetylcholine（乙酰胆碱） at the neuromuscular junction, but it does not affect the central nervous system.C18-19A. Vancomycin（万古霉素，糖肽类）B. Rifampin（利福平，利福霉素类）C. Ceftriaxone （头孢曲松，头孢菌素类)D. Ciprofloxacin（环丙沙星，喹诺酮类）E. Erythromycin（红霉素，大环内酯类）18. Which antibiotic
27、 acts by inhibiting bacterial DNA-dependent RNA polymerase ?D19. Which antibiotic binds to the 50S ribosomal subunit and inhibits protein synthesis ?E第 5 页（共 4 页）20-21A. AcyclovirB. ZidovudineC. LamivudineD. OseltamivirE. Interferon20. Nonimmune individuals exposed to influenza A virus can be protec
28、ted from developing disease by administering21. Which one of the above is a recommended therapy for herpes simplex virus genital infection?22-23A. Synthetic peptide vaccineB. Killed vaccineC. Attenuated live vaccineD. Subunit vaccine produced using recombinant DNAE. Toxoid vaccine22. Which type of h
29、epatitis B vaccine is currently in use in China ?23. Which type of vaccine is tetanus prevent by immunization with ?24-25A. Hepatitis B virusB. EB virusC. Herpes simple virusesD. human papilloma virus（人乳头瘤病毒）E. human T cell lymphotropic virus 24. Which is the causative agent of nasopharyngeal carcin
30、oma （鼻咽癌） ?B25. A 38-year-old woman with many lifetime sexual partners is diagnosed with cervical cancer. This cancer is common worldwide and has a sexually transmitted viral etiology. The causative agent of human cervical cancer （宫颈癌）is D三、A2、A3、A4 型题（以下提供若干个案例，每个案例下设若干道考题。请根据案例所提供的信息，在五个备选答案中选择一个最
31、佳答案。并在答题卡上将相应题号的相应字母涂黑，以示正确答案。合计 10 题，每题 2 分，满分 20 分）26. A 26-year-old woman visits her physician because of an unusual vaginal discharge. On examination the physician observes a thin, homogeneous, white-gray discharge that adheres to the vaginal wall. The pH of the discharge is 5.5 (normal: 4.3). O
32、n Gram stain, many epithelial cells covered with gram-variable rods are seen. bacterial vaginosis（阴道炎） is diagnosed. Which one of the following normal genital flora is present in greatly decreased numbers in bacterial vaginosis?A. S. epidermidis（表皮葡萄球菌）B. C. albicans（ 白假丝酵母菌）C. E. coli（大肠埃希菌）D. L. a
33、cidophilus（嗜酸乳杆菌）E. G. vaginalis（阴道加德纳菌）27. A pregnant woman may give birth to an infant with a severe congenital abnormality, such as blindness, neurosensory deafness, microcephaly, or heart disease, if the woman is infected during the first trimester of pregnancy withA. Measles virus（麻疹病毒）B. Mumpu
34、s virus（腮腺炎病毒）C. Rubella virus（风疹病毒）D. Hepatitis B virus（乙型肝炎病毒）E. Coxsackie virus（柯萨奇病毒）28-3028. A 40-year-old man has HIV/AIDS characterized by a low CD4 count and a high viral load.Highly active antiretroviral therapy (HAART) will be initiated. One of the drugs under consideration is a nucleoside
35、 analog that inbibits viral reverse transcriptase and is active against both HIV and HBV. That drug is DA. Acyclvir（无环鸟苷）B. Amantadine（金刚烷胺）C. Saquinavir（沙奎那韦）D. Lamivudine（拉米夫定）第 6 页（共 4 页）E. Zidovudine（齐多夫定）29. Regarding the HIV/AIDS patient in Question 28, a peptidomimetic agent that blocks virus
36、-mediated cleavage of viral structural protein precursors is chosen as a second drug. That drug isA. AcyclvirB. AmantadineC. SaquinavirD. LamivudineE. Zidovudine30. The presumptive diagnosis of HIV infection is made byA. ELISAB. Western blotC. RT-PCRD. Isolation and culture of virusesE. PCR31-32A 24
37、-year-old woman in New York is admitted to the hospital because of jaundice（黄疸）. On workup she is found to have hepatitis C virus infection. 31. The major risk factor for HCV infection in the United States isA. Tattoos（纹身）B. Injecting drug useC. Blood transfusionD. Sexual activityE. Working in healt
38、h care occupations32. Which one of the following drugs is a recommended therapy ?A. AcyclovirB. ZidovudineC. LamivudineD. Oseltamivir（奥塞米韦，达菲）E. Interferon33-35A 15-year-old girl develops severy diarrhea. The stool looks like “rice water.” It is voluminous- more than 1L in the last 90 minutes. She h
39、as no fever and seems otherwise normal except th the effects of loss of fluid and electrolytes. Her fecal effluent is examined by darkfield microscopy and found to contain comma-shaped organisms. 33. The most likely cause of her illness isA. Clostridium difficile（艰难梭菌）enterotoxinB. Vibrio cholerae （
40、霍乱弧菌）enterotoxinC. Shigella dysenteriae （痢疾志贺菌）Shiga toxinD. Enterohemorrhagic E. coli（肠出血型大肠埃希菌）Shiga toxinE. Staphylococcus aureus（金黄色葡萄球菌）enterotoxin34. The microbial responsible for the patientss diarrhea is a toxin thatA. Blocks EF-2 and inhibits protein synthesisB. Yields increased intracellul
41、ar levels of cAMPC. Yields increased intracellular levels of cGMPD. Inbibits the release of acetylcholine at the synapseE. Stimulates neural receptors35. The most important thing that can be done to treat the patients isA. To give her ciprofloxacin（环丙沙星）B. To give her a toxoid vaccineC. To give her
42、the appropriate antitoxinD. To treat her with fluid and electrolyte replacementE. To give her probiotic（益生菌）四、病例分析题（以下提供若干个案例，每个案例下设若干道考题。请根据案例所提供的信息，用中文回答，直接做在试卷上，回答要求简明扼要。合计 10 题，每题 3 分，满分 30 分）36-40第 7 页（共 4 页）Chief Compiaint A 30-year-old woman with nausea and vomiting for 3 days. History The pa
43、tient was well until 1 week ago, when she noted some stiffness and swelling in the fingers of both hands; this lasted a few days. Four days ago, malaise（不适）, fatigue （疲乏）, and anorexia（食欲缺乏）began, followed the next day by nausea and vomiting, which have continued to the present. No hematemesis（吐血）or
44、 diarrhea has occurred. Upper abdominal aching began yesterday. The smell of food induces nausea. She noticed that her urine was darker than usual today.She is a waitress who smokes 2 packs of cigarettes and drinks a 6-pack of beer per day. She has had 5 sex partners in the last 3 months. No recent
45、travel, transfusions, or intravenous drug abuse. No one else she knows has similar symptoms.Laboratory The results of the serologic tests were as follows: IgM HAV antibody, negative; HBV surface antigen, positive; HBV e antigen, positive; IgM HBV core antibody, positive; HBV surface antibody, negati
46、ve.Questions（请用中文回答）36. In view of these results, what disease does the patient have?答：37. What is your explanation for the arthralgias （关节痛）described an the beginning of the history ?答：38. What specific antiviral therapy, if any, is available for hepatitis B ?答：38. How did she acquire this disease
47、?答：40. What would you advise this patient regarding protecting her newborn child if she becomes pregnant ?答：41-45Chief Compiaint A 30-year-old male with a cough of sevsral weeks duration.History The patient noted the gradual onset of tiredness and loss of appetite about 1 month ago. A week or so lat
48、er, he felt feverish and the cough began. At first the cough was nonproductive, but for the past week he has brought up several tablespoons per day of greenish sputum that is steaked with blood. He has lost 10 lb during the past month. He is a nonsmoker.Physical Exam T38, BP 124/70, P 80, R 16. The
49、patient does not appear acutely ill.Laboratory Chest x-ray: Infiltrate in posterior segment of right upper lobe with suggestion of a cavity. Gram stain of the sputum revealed mixed flora with no predominant organism. The acid-fast stain showed numerous 第 8 页（共 4 页）long, slender, pink rods. A sputum specimen was sent for culture.Questions（请用中文回答）41. In view of these results, what is the most likely diagnosis ?答：42. What is the treatment of choice for this disease ?答：43. Approximately how long after the start of treatment is the patient considered to be infectious
