Deck 22: Microbial Diseases of the Nervous System

Question 1

Meningitis that begins as an infection of the lungs is caused by

A) Neisseria meningitidis.
B) Haemophilus influenzae.
C) Cryptococcus neoformans.
D) Flavobacterium meningosepticum.
E) Streptococcus pneumoniae.

Answer 1

C

Question 2

Which of the following organisms is not capable of causing meningitis?

A) Cryptococcus neoformans
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Neisseria meningitidis
E) None of the above

Answer 2

E

Question 3

Which of the following is true about the normal microbiota of the nervous system?

A) Normal microbiota are present in the central nervous system only.
B) There are no normal microbiota.
C) Only transient microbiota are present.
D) Normal microbiota are present in the peripheral nervous system only.
E) None of the above.

Answer 3

B

Question 4

A 1- year- old female was hospitalized with fever, lethargy, and rash. Gram- negative,
Oxidase- positive cocci were cultured from her cerebrospinal fluid. All of the following are true about the microbe responsible for her symptoms except it may

A) Be treated with antibiotics.
B) Be normal in the throat.
C) Be normal in the cerebrospinal fluid.
D) Cause epidemics.
E) None of the above.

Question 5

A 30- year- old female 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) Biopsy of brain tissue
B) Gram stain of throat culture
C) Gram stain of cerebrospinal fluid
D) Check serum antibodies
E) None of the above; it can't be diagnosed

Question 6

Encephalitis and meningitis are difficult to treat because

A) Antibiotics damage tissues.
B) They are not caused by bacteria.
C) The infections move along peripheral nerves.
D) Antibiotics cannot penetrate the blood- brain barrier.
E) All of the above.

Question 7

Which of the following pairs is mismatched?

A) Meningococcal meningitis - respiratory route
B) Rabies - direct contact
C) Poliomyelitis - respiratory route
D) Leprosy - direct contact
E) None of the above

Question 8

All of the following are caused by prions except

A) Creutzfeldt- Jakob disease.
B) Transmissible mink encephalopathy.
C) Rabies.
D) Kuru.
E) Sheep scrapie.

Question 9

Patients with leprosy usually die from

A) Influenza.
B) Brain damage.
C) Loss of nerve function.
D) Tuberculosis.
E) Leprosy.

Question 10

A 30- year- old female was hospitalized after she experienced convulsions. On examination, she was alert and oriented and complained of a fever, headache, and stiff neck. Her symptoms could be due to all of the following except

A) Streptococcus pneumoniae.
B) Clostridium botulinum.
C) Listeria monocytogenes.
D) Naegleria fowleri.
E) None of the above.

Question 11

The symptoms of tetanus are due to

A) Deep puncture wounds.
B) Clostridial neurotoxin.
C) Lack of oxygen.
D) Hemolysins.
E) All of the above.

Question 12

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) Vaccination.

Question 13

Treatment for tetanus in an unimmunized person is

A) Penicillin.
B) DTP.
C) Tetanus immune globulin.
D) Tetanus toxoid.
E) None of the above.

Question 14

All of the following are true about the lepromin test except

A) It detects the presence of anti- M. leprae antibodies.
B) It consists of human tissue extract.
C) It consists of M. leprae.
D) It is negative in the lepromatous form.
E) None of the above.

Question 15

Purplish spots on the skin are characteristic of an infection by

A) H. influenzae.
B) N. meningitidis.
C) S. pneumoniae.
D) M. leprae.
E) C. neoformans.

Question 16

Microscopic examination of cerebrospinal fluid reveals amoebae. What is the organism?

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

Question 17

The most effective control of a vectorborne disease is

A) Treatment of infected humans.
B) Elimination of the vector.
C) Treatment of infected wild animals.
D) Avoidance of endemic areas.
E) None of the above.

Question 18

The treatment for tetanus is

A) Antibodies.
B) Penicillin.
C) Toxoid.
D) Cleansing the wound.
E) There is no treatment.

Question 19

A vaccine is available for all of the following except

A) Tetanus.
B) Neisseria meningitis.
C) Haemophilus meningitis.
D) Botulism.
E) Rabies.

Question 20

Which of the following statements is not true?

A) Spontaneous recovery occurs in tuberculoid and borderline leprosy.
B) Leprosy is highly contagious.
C) Loss of nerve sensation occurs in tuberculoid leprosy.
D) The lepromin test is positive during tuberculoid leprosy.
E) Disfiguring nodules and deformation occur in lepromatous leprosy.

Question 21

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

A) Stiff neck and back pains.
B) Convulsions.
C) Like a mild cold.
D) Fever and headache.
E) Paralysis.

Question 22

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. Cultures taken from the knee wounds should be incubated

A) Aerobically.
B) Anaerobically.
C) In animal cell culture.
D) In 5- 10% CO₂.
E) Any of the above will work.

Question 23

Treatment for tetanus in an immunized person is

A) Penicillin.
B) DTP.
C) Tetanus toxoid.
D) Tetanus immune globulin.
E) None of the above.

Question 24

Which of the following is not transmitted by ingestion?

A) Listeriosis
B) Creutzfeldt- Jakob disease
C) Botulism
D) Poliomyelitis
E) Meningococcal meningitis

Question 25

Which of the following pairs is mismatched?

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

Question 26

A diagnosis of rabies is confirmed by

A) Gram stain.
B) Patient's symptoms.
C) Passive agglutination.
D) Direct fluorescent- antibody test.
E) Patient's death.

Question 27

The most common cause of meningitis in children is

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

Question 28

Situation 22.1
On July 5, an 11-year-old girl complained of pain in the knuckles of her left hand. During July 6-7, she had increasing pain that extended up to the left shoulder. A throat culture was obtained and amoxicillin was prescribed.
On July 9, she had difficulty walking and hallucinations. The throat culture was positive for Streptococcus pyogenes.
She was treated with ceftriaxone. On July 11, she was hospitalized with a temperature of 40.7°C and she could not drink. She developed respiratory distress and tachycardia; she died from cardiac arrest. Fluorescent antibody testing of brain tissue revealed inclusions in the brain stem

-The disease described in Situation 22.1 is

A) Meningitis.
B) Botulism.
C) Rabies.
D) Tetanus.
E) Streptococcal sore throat.

Question 29

Which of the following is not acquired by ingestion?

A) Cryptococcosis
B) Botulism
C) Poliomyelitis
D) Listeriosis
E) None of the above

Question 30

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

A) Oral polio vaccine
B) Haemophilus influenzae capsule vaccine
C) Inactivated polio vaccine
D) Tetanus toxoid vaccine

Question 31

Which of the following organisms is not correctly matched to the recommended treatment?

A) Mycobacterium leprae - dapsone
B) Poliovirus - Salk vaccine
C) Haemophilus influenzae - cephalosporins
D) Neisseria meningitidis - cephalosporins
E) Cryptococcus neoformans - amphotericin B

Question 32

All of the following are requirements for an outbreak of botulism except

A) An incubation period.
B) An anaerobic environment.
C) Killing bacteria that compete with Clostridium.
D) A nutrient medium with a pH below 4.5.
E) None of the above.

Question 33

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) Serological tests for rabies.
B) Antibiotics.
C) Rabies vaccination.
D) Antirabies immunoglobulin.
E) Treatment if they tested positive.

Question 34

All of the following are true about rabies except

A) Diagnosis is based on immunofluorescent techniques.
B) It is caused by Rhabdovirus.
C) Hydrophobia is an early symptom.
D) It is not fatal in bats.
E) The reservoir is mainly rodents.

Question 35

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

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

Question 36

All of the following are true about H. influenzae, except

A) It is used in a whole bacterial vaccine.
B) It requires a blood supplement in media.
C) It usually infects children.
D) A healthy carrier state can exist.
E) It is encapsulated.

Question 37

Which of the following is treated with antibiotics?

A) Polio
B) Tetanus
C) Streptococcal pneumonia
D) Botulism
E) All of the above

Question 38

All of the following are true about leprosy except

A) It is rarely fatal.
B) It is transmitted by direct contact.
C) Patients with leprosy must be isolated.
D) Diagnosis may be based on the lepromin test.
E) None of the above.

Question 39

Which of the following pairs is not correctly matched?

A) Botulism - stimulates transmission of nerve impulse
B) Tetanus - blocks relaxation nerve impulse
C) Poliomyelitis - kills CNS cells
D) Rabies virus - grows in brain cells
E) None of the above

Question 40

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

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

Question 41

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

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

Question 42

Which of the following is not transmitted by the respiratory route?

A) N. meningitidis
B) H. influenzae
C) C. neoformans
D) L. monocytogenes
E) None of the above

Question 43

A 1- year- old female was hospitalized with fever, lethargy, and rash. Gram- negative,
Oxidase- positive cocci were cultured from her cerebrospinal fluid. Her symptoms were caused by

A) Mycobacterium leprae.
B) Neisseria meningitidis.
C) Clostridium tetani.
D) Rabies.
E) A prion.

Question 44

Situation 22.1
On July 5, an 11-year-old girl complained of pain in the knuckles of her left hand. During July 6-7, she had increasing pain that extended up to the left shoulder. A throat culture was obtained and amoxicillin was prescribed.
On July 9, she had difficulty walking and hallucinations. The throat culture was positive for Streptococcus pyogenes.
She was treated with ceftriaxone. On July 11, she was hospitalized with a temperature of 40.7°C and she could not drink. She developed respiratory distress and tachycardia; she died from cardiac arrest. Fluorescent antibody testing of brain tissue revealed inclusions in the brain stem.

-In Situation 22.1, the antibiotics did not cure her disease because the pathogen was

A) Resistant to antibiotics.
B) A virus.
C) Already growing in her brain.
D) Protected by the blood- brain barrier.
E) Part of her normal microbiota.