Deck 18: Nervous System Infections

Question 1

What is the best way to protect the population against Haemophilus influenza type b infections?

A) Since the chances of complications are rare, no treatment is required.
B) use of the Hib vaccine in young children
C) antitoxin treatment when exposure has occurred
D) antibiotic treatment after onset of symptoms
E) IV fluids are commonly prescribed due to loss of fluids.

Answer 1

use of the Hib vaccine in young children

Question 2

Patients who suspect exposure to rabies are

A) injected with both antirabies antibodies and the inactivated vaccine.
B) injected with the inactivated vaccine.
C) injected with both antirabies antibodies and the attenuated vaccine.
D) injected with the attenuated vaccine.
E) injected with antirabies antibodies.

Answer 2

injected with both antirabies antibodies and the inactivated vaccine.

Question 3

Which of the following is a function of the meninges?

A) supply oxygen
B) protect the CNS from physical shocks
C) supply nutrients
D) supply nutrients, remove waste, and protect the CNS from physical shocks
E) remove waste

Answer 3

supply nutrients, remove waste, and protect the CNS from physical shocks

Question 4

The term "gut- brain axis" describes the complex, back- and- forth communication that occurs between all of the following except the

A) muscular system.
B) nervous system.
C) digestive system.
D) endocrine system.
E) immune system.

Question 5

Most bacterial meningitis cases in the United States are pneumococcal meningitis, caused by which of the following bacteria?

A) Haemophilus influenzae
B) Neisseria meningitidis
C) Streptococcus pneumoniae
D) Listeria monocytogenes
E) Escherichia coli

Question 6

Which of the following about the pathogenesis of rabies is false?

A) the rabies virus lyses host cells which explains neurological symptoms including pharyngeal spasms, confusion, loss of coordination, delirium, and the characteristic hydrophobia
B) the virus rapidly travels through neurons, replicating and spreading to the CNS
C) after invading brain cells, rabies spreads back out into the PNS where it replicates and is shed from tissues that are well supplied with nerves, including the salivary glands
D) the virus slowly replicates in the muscle cells leading to a long incubation period that lasts from two months to a year
E) a diagnostic sign of rabies is the formation of Negri bodies, small clusters of virus inside the neurons

Question 7

Which of the following versions of the polio vaccine is preferred in the United States?

A) inactivated polio vaccine which is injected into muscle and requires several boosters
B) oral polio vaccine which is made up of an attenuated viral strain
C) antibiotic treatment to clear the infection
D) transgenic DNA vaccine, which is made by inserting DNA for polio capsid proteins into the genome of a nonvirulent virus
E) Currently no vaccine is available, and patient isolation is the preferred method of control.

Question 8

Group B Streptococcus is most likely to cause bacterial meningitis in which of the following age groups?

A) infants and children
B) newborns
C) older adults
D) adolescents and young adults
E) It infects all age groups equally.

Question 9

Which type of molecule can diffuse through the blood- brain barrier?

A) very small molecules and lipophilic molecules
B) lipophilic molecules
C) very small molecules
D) glucose molecules
E) hydrophilic molecules and glucose molecules

Question 10

Which of the following is not an arbovirus?

A) West Nile
B) La Crosse
C) Rabies
D) Lyme disease
E) dengue

Question 11

Which of the following diseases cause flu- like symptoms in most people infected, but can cause muscle weakness or paralysis?

A) toxoplasmosis
B) tetanus
C) polio
D) spongiform encephalopathy
E) rabies

Question 12

The sense internal and external stimuli, and send out responses in the form of chemical messengers called .

A) muscles; chemokines
B) meninges; axons
C) cerebrospinal fluids; myelins
D) neurons; neurotransmitters
E) dendrites; arachnoids

Question 13

How do arboviruses cause nervous system infections?

A) The virus produces toxins that damage neuron connections.
B) The virus invades and destroys the blood vessel cells that form the blood- brain barrier.
C) The virus is small enough to pass through the blood- brain barrier.
D) The virus is capable of crossing the blood- brain barrier by binding to transport proteins in the capillaries meant to be used for various nutrients.
E) The virus gains entry into the CNS by hijacking neurons of the PNS.

Question 14

Why is the immune response to pneumococcal meningitis the most damaging aspect of the disease?

A) Released antibodies bind to the basal membrane of tissues which results in the damage of these tissues and the neighboring cells.
B) An exotoxin stimulates severe inflammation and provokes host tissue damage as immune cells release oxygen radicals and enzyme- destroying proteins in response to the toxin.
C) A particularly potent endotoxin stimulates a rapid fever that typically holds at 104°C for 3- 4 days unless other actions are taken.
D) Neurons infected with the bacteria are identified and destroyed by the immune system resulting in paralysis or in some cases death.
E) Blood clots are formed in the circulatory system in an effort to isolate the bacteria; however, these clots are often the cause of heart attack or stroke in patients that don't seek medical treatment.

Question 15

What is it called when there is only inflammation of the brain?

A) encephalitis
B) meningitis
C) meningoencephalitis
D) endocarditis
E) encephalomyelitis

Question 16

What diagnostic tool is used to confirm a diagnosis of meningitis or encephalitis?

A) computed tomography (CT scan)
B) magnetic resonance imaging (MRI)
C) blood count
D) lumbar puncture
E) throat swap

Question 17

What is so particular about the onset and course of meningococcal meningitis?

A) The incubation time for this type of bacteria is always 30 days.
B) Rash begins on patient extremities and spreads to the torso as patient itches.
C) Resulting diarrhea is particularly bloody if not treated within the first 24 hours.
D) If not treated, death can occur within hours of fever onset.
E) Bacteria are only spread through contact with sweat.

Question 18

Neisseria meningitidis, which causes meningococcal meningitis, is capable of triggering sporadic disease outbreaks by which of the following methods?

A) efficient spreading in the host by breaking down blood clots
B) capsular switching
C) hides from the immune system inside neurons
D) infecting compromised hosts
E) mutations due to utilization of reverse transcriptase

Question 19

Which of the following comprises the peripheral nervous system?

A) brain
B) skin
C) meninges
D) nerves
E) spinal cord

Question 20

Which of the following is the layer of the meninges that has direct contact with the brain?

A) pia mater
B) arachnoid mater
C) dinan mater
D) dura mater
E) geezin mater

Question 21

Encephalitis is most often caused by a virus.

Question 22

Which of the following is true about spongiform encephalopathies?

A) Spongiform encephalopathies occur in a wide variety of mammals, but the infectious prions are species specific and do not cause disease in other species.
B) Spontaneous cases of Creuztfeldt- Jakob disease may be caused by mutations during cell division in neuronal stem cells.
C) The disease is tied to a normal cellular prion protein (PrPC) that is found mostly on the surface of neurons.
D) When the normal prion protein encounters an abnormally shaped version of itself, PrPSC, the normal prion's shape is changed and it becomes an infectious PrPSC.
E) Abnormal prions clump together and kill the affected neurons, which accounts for the spongelike appearance of brain tissue found in TSE autopsies.

Question 23

Which of the following is false about the tropical disease African sleeping sickness?

A) If the disease goes untreated, it is fatal.
B) It induces an immune system reaction so strong that host neutrophils can harm host neurons.
C) It is carried by a blood- sucking mosquito from host to host.
D) It is caused by the flagellated protozoan Trypanosoma brucei.
E) Those infected cannot sleep at night and cannot stay awake during the day.

Question 24

Which of the following is false about toxoplasmosis?

A) It is caused by a protozoan called Toxoplasma gondii.
B) Risk factors include eating raw or undercooked meat such as wild game, pork, and shellfish.
C) Cats act as the definitive host, shedding the protozoans in their feces.
D) Tachyzoites can invade tissues like the heart, muscles, eyes, and brain.
E) Meningitis results in a majority of patients since there are currently no treatment options.

Question 25

A lumbar puncture allows for CSF analysis to differentiate between viral and bacterial meningitis.

Question 26

Congenital toxoplasmosis can cause all of the following except

A) convulsions.
B) neurological disabilities.
C) miscarriage or stillbirth.
D) deafness.
E) anemia.

Question 27

The tetanospasmin toxin blocks normal inhibition while botulinum toxin blocks normal stimulation.

Question 28

Which of the following about Naegleria fowleri is true?

A) Although debilitating, most patients live long lives.
B) Infection occurs when contaminated water is ingested.
C) Only the flagellated form of the protozoan is infectious.
D) This bacteria typically feeds off of nutrients in the soil.
E) The organism prefers warm stagnant waters.

Question 29

Which of the following is not how botulism is contracted?

A) adults eating canned vegetables such as beets, carrots, or spinach
B) IV drug users who use needles contaminated with C. botulinum endospores
C) Elderly farmers encounter C. botulinum endospores through wind and dust.
D) Infants encounter C. botulinum endospores through wind and dust.
E) Infants encounter C. botulinum endospores by eating honey.

Question 30

How is Listeria monocytogenes capable of spreading in the body?

A) After being phagocytized, the bacteria initiates apoptosis in the cell and spreads to other cells in the vesicles that are released from the dying cell.
B) The bacteria initiate apoptosis in the cell and spread to other cells in the vesicles that are released from the dying cell, and actin in the cytoskeleton propels the bacteria into an adjacent cell.
C) It evades the immune system by adhering to cells, being phagocytized, and then breaking out of the phagosome into the cytoplasm.
D) The bacteria initiate apoptosis in the cell and spread to other cells in the vesicles that are released from the dying cell.
E) Actin in the cytoskeleton propels the bacteria into an adjacent cell.

Question 31

Which of the following could result in a tetanus infection?

A) The nurse accidently forgets to wipe your arm with an alcohol pad before giving you your flu shot.
B) You order a steak when out with friends for dinner, and although it wasn't completely cooked, you ate it anyways because you didn't want to make a scene or delay anyone else from eating.
C) A two- inch piece of wood causes a deep puncture in your arm when replacing a board on your deck.
D) A fingernail of a coworker accidently scratches you.
E) While squeezing through to get into your car, you get a surface abrasion from a rough and rusted panel on the car next to you.

Question 32

Which of the follow is false concerning the tetanospasmin toxin?

A) taken up by peripheral motor neurons and transported to the spinal cord
B) causes irreversible damage to neurons
C) blocks the release of inhibitory neurotransmitters, preventing muscle relaxation
D) causes intense muscle spasms, drooling, sweating, and irritability
E) leads to flaccid paralysis

Question 33

The West Nile virus damages neurons by lysing them as they exit after replication or by triggering apoptosis.

Question 34

Rabies is the only virus that infects the PNS.

Question 35

Which of the following paths does Cryptococcus neoformans take to get to the CNS?

A) lungs - macrophages - lymphatic system - blood - CNS
B) nose - CNS
C) stomach - intestines - blood - CNS
D) muscles - blood - CNS
E) skin - blood - CNS

Question 36

Primary amoebic meningoencephalitis is caused by

A) Toxoplasma gondii.
B) Cryptococcus neoformans.
C) Naegleria fowleri.
D) Trypanosoma brucei.
E) Listeria meningitis.

Question 37

Why is leprosy confined to the PNS?

A) Cooler body temperatures of 30- 35°C are necessary for M. leprae's growth.
B) The immune system is able to hold its ground and protect the CNS.
C) Cells of the CNS lack the necessary receptor for M. leprae to gain access.
D) M. leprae are aerobic and therefore prefer having the access oxygen that living just under the tattered epidermis can provide.
E) It's not, but because it grows slowly and takes decades to reach the CNS, many believe that is where it is confined.

Question 38

Botulinum toxin causes all of the following except

A) petechial rash.
B) difficulty breathing.
C) flaccid paralysis.
D) constipation.
E) difficulty speaking.

Question 39

Which of the following is false about the lepromatous form of leprosy?

A) The lepromatous form can spread to others.
B) The lepromatous form is more common than the milder tuberculoid form.
C) The lepromatous form causes irreversible tissue damage in the form of macules, papules, and nodules in many places on the body.
D) Without treatment, lepromatous leprosy is often fatal.
E) The lepromatous form is more serious than the tuberculoid form.

Question 40

Which of the following is not a risk factor for contracting Listeria monocytogenes?

A) neonates
B) elderly patients
C) pregnant women
D) bedridden
E) immunocompromised individuals

Question 41

Protists reproduce through sexual as well as asexual means, depending on their life stage.

Question 42

When infected with Toxoplasma gondii, a protist, symptoms are always present within two weeks.

Question 43

C. gattii is usually contracted from urban environments, C. neoformans is associated with natural settings.

Question 44

A new drug for depression was developed by taking a disaccharide, sucrose, and combining several different hydrophilic functional groups onto the molecule. After hearing about its structure, you are positive that this molecule has zero direct effect on the brain. Why?

Question 45

Why has polio been eradicated in the U.S. but is still present in developing nations, including Afghanistan and Pakistan?

Question 46

Explain why children under 1 year old should not be fed honey, yet honey is okay to eat for older healthy individuals.