Deck 22: Microbial Diseases of the Nervous System

Question 1

The symptoms of tetanus are due to

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

Answer 1

E

Question 2

All of the following are true regarding African trypanosomiasis EXCEPT

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

Answer 2

A

Question 3

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

Answer 3

C

Question 4

Which of the following pairs is mismatched?

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

Question 5

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

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

Question 6

Which of the following statements about leprosy is FALSE?

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

Question 7

All of the following are associated with botulism outbreaks EXCEPT

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

Question 8

Encephalitis is more common in the summer months because

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

Question 9

Bacterial encephalitis and meningitis are difficult to treat because

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

Question 10

All of the following organisms cause meningitis EXCEPT

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

Question 11

Which of the following statements about rabies is FALSE?

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

Question 12

The prodromal (i.e. pre-acute disease stage) symptoms of bacterial meningitis is/are

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

Question 13

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

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

Question 14

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

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

Question 15

Which of the following statements about Neisseria meningitis is FALSE?

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

Question 16

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

A) rabies
B) eastern equine encephalitis
C) poliomyelitis
D) Hansenʹs disease
E) meningococcal meningitis

Question 17

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

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

Question 18

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

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

Question 19

All of the following diseases are caused by arbovirus EXCEPT

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

Question 20

The most effective control of mosquito-borne disease is

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

Question 21

Naegleria fowleri meningoencephalitis is commonly acquired by

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

Question 22

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

Question 23

Diagnosis of rabies is confirmed by

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

Question 24

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

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

Question 25

All of the following are true of chronic fatigue syndrome EXCEPT

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

Question 26

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

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

Question 27

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

Question 28

Each of the following is caused by prions EXCEPT

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

Question 29

All of the following are acquired by ingestion EXCEPT

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

Question 30

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

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

Question 31

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

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

Question 32

Vaccination is available for all the following EXCEPT

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

Question 33

Which of the following pairs is mismatched?

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

Question 34

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 of arboviral encephalitis?

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

Question 35

On June 30, a 47-year-old man was hospitalized with dizziness, blurred vision, slurred speech, difficulty swallowing, and nausea. Examination revealed facial paralysis. 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) vaccination.
B) surgery.
C) toxin.
D) supportive care, including respiratory assistance.
E) antibiotics.

Question 36

Arboviruses cause and are transmitted by .

A) both meningitis and encephalitis; mosquitoes
B) meningitis; bee stings
C) meningitis; mosquitoes
D) encephalitis; mosquitoes
E) encephalitis; dog bites

Question 37

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

Question 38

Patients with leprosy usually die from complications such as

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

Question 39

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

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

Question 40

Which of the following is treated with antibiotics?

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

Question 41

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

Question 42

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

Question 43

All of the following are true of poliomyelitis EXCEPT

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

Question 44

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 45

All of the following are true of M. leprae EXCEPT

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

Question 46

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

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

Question 47

All of the following microorganisms can directly cause meningitis EXCEPT

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

Question 48

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

Question 49

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

Question 50

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

Question 51

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

Question 52

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

Question 53

Autopsy of a stillborn fetus reveals the cause of death to be meningitis. Cultures show the presence of a gram-positive rod. The likely pathogen is Haemophilus influenza.

Question 54

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