Deck 22: Microbial Diseases of the Nervous System

Question 1

Which of the following is treated with antibiotics?

A) streptococcal pneumonia
B) botulism
C) polio
D) tetanus
E) All of these diseases can be successfully treated with antibiotics.

Answer 1

A

Question 2

The prodromal symptom(s) of bacterial meningitis is/are

A) mild cold symptoms.
B) fever and headache.
C) stiff neck and back pains.
D) convulsions.
E) fever, headache, and stiff neck.

Answer 2

A

Question 3

Bacterial encephalitis and meningitis are difficult to treat because

A) antibiotics damage nervous tissue.
B) the infections move along peripheral nerves.
C) no medications exist for treatment of these infections.
D) it is very difficult to determine the causative microbe.
E) many antibiotics cannot penetrate the blood-brain barrier.

Answer 3

E

Question 4

Which of the following statements about rabies is FALSE?

A) Hydrophobia is associated with the disease.
B) Diagnosis is based on immunofluorescent techniques.
C) Most infections in the U.S. are the result of bites from infected dogs.
D) Average incubation period is 30 to 50 days after initial infection.
E) It is caused by Lyssavirus.

Question 5

The most effective control of mosquito- borne disease is

A) treatment of uninfected humans.
B) elimination of the mosquito population.
C) treatment of infected humans.
D) avoidance of endemic areas.
E) treatment of infected wild animals.

Question 6

Microscopic examination of cerebrospinal fluid reveals gram- positive rods. What is the organism?

A) Streptococcus
B) Listeria
C) Naegleria
D) Haemophilus
E) Neisseria

Question 7

Initial treatment for tetanus in an unimmunized person with a puncture wound is

A) tetanus immune globulin.
B) tetanus toxoid.
C) debridement.
D) none; no action is necessary.
E) penicillin.

Question 8

Arboviruses cause and are transmitted by .

A) encephalitis; mosquitoes
B) meningitis; exposure to certain trees
C) encephalitis; exposure to certain trees
D) meningitis; mosquitoes
E) both meningitis and encephalitis; mosquitoes

Question 9

All of the following are associated with botulism outbreaks EXCEPT

A) type B toxin is most virulent.
B) Alaskan natives have the highest rate of botulism.
C) type E toxin is associated with seafood.
D) endospores of C. botulinum have been recovered from honey.
E) antibodies are not an effective method of treatment.

Question 10

All of the following organisms are transmitted via the respiratory route EXCEPT

A) Listeria monocytogenes.
B) Haemophilus influenzae.
C) Cryptococcus neoformans.
D) Neisseria meningitidis.
E) None of the answers is correct; all of these organisms are transmitted by the respiratory route.

Question 11

All of the following are true of M. leprae EXCEPT

A) it survives ingestion by macrophages.
B) it invades cells of the PNS.
C) it has a very short generation time of approximately twelve hours.
D) it grows best at temperatures below 37° C.
E) it can be cultured in armadillos.

Question 12

The symptoms of tetanus are due to

A) systemic infection.
B) sustained relaxation of muscles.
C) endospore formation.
D) tetanospasmin.
E) inflammation.

Question 13

Each of the following is caused by prions EXCEPT

A) sheep scrapie.
B) bovine spongiform encephalopathy.
C) kuru.
D) rabies.
E) Creutzfeldt- Jakob disease.

Question 14

Which of the following statements about Neisseria meningitis is FALSE?

A) It is a gram- positive anaerobe.
B) Its most distinguishing feature is a unique rash.
C) It is typically transmitted by droplet aerosols or direct contact with secretions.
D) It is encapsulated.
E) A healthy carrier state can exist.

Question 15

A pathologist detects Negri bodies while examining a brain section taken at autopsy. What was the cause of death?

A) meningococcal meningitis
B) Hansen's disease
C) poliomyelitis
D) rabies
E) eastern equine encephalitis

Question 16

On June 30, a 47- year- old man was hospitalized with dizziness, blurred vision, slurred speech, difficulty swallowing, and nausea. Examination revealed facial paralysis. The patient had partially healed superficial knee wounds incurred while laying cement. He reported eating home- canned green beans and stew containing roast beef and potatoes 24 hours before onset of symptoms. The patient should be treated with

A) antibiotics.
B) surgery.
C) antitoxin.
D) supportive care, including respiratory assistance.
E) vaccination.

Question 17

Which one of the following causes the most severe illness in humans, with a mortality rate of 30 percent?

A) western equine encephalitis
B) West Nile encephalitis
C) eastern equine encephalitis
D) California encephalitis
E) St. Louis encephalitis

Question 18

All of the following are true regarding African trypanosomiasis EXCEPT

A) it is transmitted by the tsetse fly.
B) it is also known as "sleeping sickness."
C) all subspecies of Trypanosoma brucei have multiple hosts.
D) death ultimately occurs without proper treatment.
E) Trypanosoma brucei gambiense is the more common cause of disease.

Question 19

All of the following are acquired by ingestion EXCEPT

A) listeriosis.
B) botulism.
C) Creutzfeldt- Jakob disease.
D) cryptococcosis.
E) poliomyelitis.

Question 20

Which of the following is a free- living amoeba that can cause encephalitis?

A) Acanthamoeba
B) Entamoeba
C) Naegleria
D) Naegleria and Acanthamoeba
E) Entamoeba and Naegleria

Question 21

Patients with leprosy usually die from complications such as

A) brain damage.
B) pneumonia.
C) cardiac arrest.
D) tuberculosis.
E) loss of nerve function.

Question 22

Vaccination is available for all the following EXCEPT

A) tetanus.
B) rabies.
C) botulism.
D) Neisseria meningitis.
E) Haemophilus meningitis.

Question 23

A one- year- old boy was listless, irritable, and sleepy. Capsulated Gram- negative rods were cultured from his cerebrospinal fluid. His symptoms were caused by

A) Clostridium tetani.
B) Neisseria meningitidis.
C) a prion.
D) rabies.
E) Haemophilus influenzae.

Question 24

Which of the following statements about leprosy is FALSE?

A) Patients with leprosy must be isolated.
B) The etiologic agent is acid- fast.
C) Diagnosis is based on skin biopsy.
D) It is transmitted by direct contact.
E) It is rarely fatal.

Question 25

All of the following microorganisms can directly cause meningitis EXCEPT

A) virus.
B) bacteria.
C) fungi.
D) mosquitoes.
E) protozoa.

Question 26

All of the following organisms are correctly matched to the recommended treatment EXCEPT

A) Mycobacterium leprae - dapsone.
B) poliovirus - amphotericin B.
C) Cryptococcus neoformans - amphotericin B.
D) Haemophilus influenzae - cephalosporins.
E) Neisseria meningitidis - cephalosporins.

Question 27

All of the following organisms cause meningitis EXCEPT

A) Neisseria meningitidis.
B) Haemophilus influenzae.
C) Cryptococcus neoformans.
D) Mycobacterium leprae.
E) Streptococcus pneumoniae.

Question 28

Which of the following pairs is mismatched?

A) Cryptococcus neoformans - acid- fast rod
B) Naegleria fowleri - causes amoebic encephalitis
C) Haemophilus influenzae - virulence due to capsule
D) Mycobacterium leprae - cultured in armadillos
E) Neisseria meningitidis -produces deadly endotoxins

Question 29

On October 5, a pet store sold a kitten that subsequently died. On October 22, rabies was diagnosed in the kitten. Between September 19 and October 23, the pet store had sold 34 kittens. Approximately 1000 people responded to health care providers following local media alerts. These people were given

A) human diploid cell vaccine.
B) antibiotics.
C) antiviral medications.
D) immune globulin injections.
E) postexposure prophylaxis.

Question 30

All of the following are true of poliomyelitis EXCEPT

A) initial sites of viral replication are the throat and small intestine.
B) the oral polio vaccine contains attenuated strains of the virus.
C) the majority of cases are asymptomatic.
D) infection is due to ingestion of contaminated water.
E) most cases result in muscle paralysis.

Question 31

A physician diagnoses a patient with lepromatous Hansen's disease. All of the following pertain to the patient EXCEPT

A) the disease has progressed from the tuberculoid stage.
B) disfiguring nodules form all over the body.
C) a skin biopsy will be taken to aid diagnosis.
D) treatment will include injections of penicillin.
E) infection probably occurred as a result of prolonged contact with another infected individual.

Question 32

All of the following diseases are caused by arbovirus EXCEPT

A) primary amebic meningoencephalitis (PAM).
B) St. Louis encephalitis.
C) eastern equine encephalitis.
D) West Nile encephalitis.
E) None of the answers is correct; all of these diseases are caused by arbovirus.

Question 33

Which of the following vaccines can cause the disease it is designed to prevent?

A) Haemophilus influenzae capsule vaccine
B) inactivated polio vaccine
C) tetanus toxoid vaccine
D) oral polio vaccine
E) meningococcal capsule vaccine

Question 34

All of the following are true of chronic fatigue syndrome EXCEPT

A) it is also known as myalgic encephalomyelitis.
B) it may be triggered by a viral infection.
C) it is a psychological disorder.
D) it may have a genetic component.
E) it often begins with flu- like symptoms that do not go away.

Question 35

Which of the following vaccine characteristics is (are) mismatched?
$\begin{array}{c}\begin{array}{lll} \text {Salk Vaccine}\\ \hline \text {1. Consists of a formalin- inactivated virus }\\ \text {2. Administered orally}\\ \text {3. Requires booster doses}\end{array}\begin{array}{lll} \text {Sabin Vaccine}\\ \hline\text {4. Consists of a live, attenuated polio virus }\\ \text {5. Administered orally}\\ \text {6. Frovides community immunity}\end{array}\end{array}$

A) 4, 5, and 6
B) 2 only
C) 1 and 3 only
D) 1, 2, and 3
E) None of the answers are correct; all these characteristics are correctly matched.

Question 36

The most common route of central nervous system invasion by pathogens is through

A) the gastrointestinal system.
B) the circulatory system.
C) the skin.
D) direct penetration into nerves.
E) the parenteral route.

Question 37

A 30- year- old woman was hospitalized after she experienced convulsions. On examination, she was alert and oriented and complained of a fever, headache, and stiff neck. Any of the following organisms could be responsible for her symptoms EXCEPT

A) Clostridium botulinum.
B) Haemophilus influenza.
C) Streptococcus pneumoniae.
D) Listeria monocytogenes.
E) Any of these organisms could be the causative agent.

Question 38

Naegleria fowleri meningoencephalitis is commonly acquired by

A) mosquito bites.
B) exposure to body fluids of a contaminated individual.
C) ingestion of water contaminated with fecal material.
D) exposure to bird droppings.
E) swimming in warm ponds or streams.

Question 39

Initial treatment for tetanus in a fully immunized person with a puncture wound is

A) debridement.
B) tetanus toxoid.
C) DTaP.
D) tetanus immune globulin.
E) penicillin.

Question 40

Diagnosis of rabies is confirmed by

A) direct fluorescent- antibody test.
B) Gram stain.
C) passive agglutination.
D) patient's death.
E) patient's symptoms.

Question 41

Which of the following pairs is mismatched?

A) rabies virus - destroys cells of the CNS
B) leprosy - deformation of nose and hands can occur
C) poliomyelitis - multiplication of virus occurs in throat and small intestine
D) botulism - stimulates transmission of nerve impulse
E) tetanus - releases potent neurotoxin

Question 42

The most common host of the virus causing eastern equine encephalitis is horses.

Question 43

An eight- year- old girl in rural Wisconsin has chills, headache, and fever and reports having been bitten by mosquitoes. How would you confirm your diagnosis?

A) brain biopsy for Negri bodies
B) examination of local mosquitoes
C) Gram stain of cerebrospinal fluid
D) complement fixation test for IgG antibodies
E) ELISA test for IgM antibodies

Question 44

A 30- year- old woman was hospitalized after she experienced convulsions. On examination, she was alert and oriented and complained of a fever, headache, and stiff neck. Which of the following is most likely to provide rapid identification of the cause of her symptoms?

A) check serum antibodies
B) Gram stain of cerebrospinal fluid
C) Gram stain of throat culture
D) biopsy of brain tissue
E) None of these would provide rapid identification.

Question 45

The number of leprosy cases in the United States is gradually increasing.

Question 46

If a normal protein typically found on the surface of nervous tissue cells comes into contact with an abnormally folded protein, it can lead to prion- related disease.

Question 47

Which of the following pairs is mismatched?

A) meningococcal meningitis - respiratory route
B) listeriosis - ingestion
C) leprosy - direct contact
D) poliomyelitis - respiratory route
E) rabies - direct contact

Question 48

Cryptococcus neoformans is a gram- negative cocci with a thick capsule.

Question 49

Poliomyelitis is caused by a virus and typically leads to paralysis in those affected.

Question 50

Lifelong immunity is conferred once an individual has had botulism and recovered.

Question 51

Autopsy of a stillborn fetus reveals the cause of death to be meningitis. The likely pathogen is
Haemophilus influenza.

Question 52

Encephalitis is more common in the summer months because

A) pathogens are present in swimming pools and lakes.
B) people encounter more bats during warm summer evenings.
C) ticks are encountered while hiking in the woods.
D) ameba populations increase in swimming pools.
E) mosquito populations increase.

Question 53

CSF contains high levels of complement and circulating antibodies to prevent infection of the brain and spinal cord.

Question 54

Viral meningitis is much more common than bacterial meningitis and tends to cause a milder form of disease.

Question 55

Botulism and tetanus are caused by bacterial endospores commonly found in the soil.