Deck 22: Microbial Diseases of the Nervous System

Question 1

Encephalitis is more common in the summer months because

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

Answer 1

D

Question 2

Which of the following pairs is mismatched?

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

Answer 2

D

Question 3

All of the following are associated with botulism outbreaks EXCEPT

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

Answer 3

D

Question 4

Which of the following statements about Neisseria meningitis is FALSE?

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

Question 5

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

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

Question 6

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

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

Question 7

Bacterial encephalitis and meningitis are difficult to treat because

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

Question 8

Which of the following statements about rabies is FALSE?

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

Question 9

All of the following are true regarding African trypanosomiasis EXCEPT

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

Question 10

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

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

Question 11

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

Question 12

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

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

Question 13

All of the following diseases are caused by arbovirus EXCEPT

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

Question 14

Which of the following statements about leprosy is FALSE?

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

Question 15

The most effective control of mosquito-borne disease is

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

Question 16

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

A)tetanus toxoid (inactivated tetanus toxin)booster.
B)tetanus immune globulin.
C)penicillin.
D)supportive rehydration therapy.
E)debridement.

Question 17

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

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

Question 18

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

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

Question 19

All of the following organisms cause meningitis EXCEPT

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

Question 20

The symptoms of tetanus are due to

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

Question 21

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

Question 22

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

A)disfiguring nodules form all over the body.
B)the disease has progressed from the tuberculoid stage.
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 23

All of the following are acquired by ingestion EXCEPT

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

Question 24

Patients with leprosy usually die from complications such as

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

Question 25

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

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

Question 26

Naegleria fowleri meningoencephalitis is commonly acquired by

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

Question 27

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

Question 28

Vaccination is available for all the following EXCEPT

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

Question 29

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

Question 30

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

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

Question 31

All of the following are true of chronic fatigue syndrome EXCEPT

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

Question 32

Which of the following vaccine characteristics is (are)mismatched with their respective vaccine type? Salk Vaccine Sabin Vaccine 1.Consists of a formalin-inactivated virus 4.Consists of a live,attenuated polio virus
2)Administered orally 5.Administered orally
3)Requires booster doses 6.Provides community immunity

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

Question 33

Each of the following is caused by prions EXCEPT

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

Question 34

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

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

Question 35

Diagnosis of rabies is confirmed by

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

Question 36

Which of the following is treated with antibiotics?

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

Question 37

Arboviruses cause ________ and are transmitted by ________.

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

Question 38

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

Question 39

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

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

Question 40

Which of the following pairs is mismatched?

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

Question 41

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

Question 42

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

Question 43

All of the following are true of M.leprae EXCEPT

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

Question 44

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

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

Question 45

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

Question 46

Which disease listed below,results in symptoms of a drooping eyelid or mouth on one side of the face,and is caused when a facial muscle nerve becomes inflamed?

A)St.Louis encephalitis
B)Eastern equine encephalitis
C)Bell's palsy
D)chronic fatigue syndrome
E)bovine spongiform encephalopathy

Question 47

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

Question 48

All of the following are true of poliomyelitis EXCEPT

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

Question 49

CSF contains high levels of complement and circulating antibodies,as well as a patrolling group of specialized T lymphocytes,to prevent infection of the brain and spinal cord.

Question 50

Which one of the following statements about West Nile virus is FALSE?

A)The disease is maintained in a horse-human-horse cycle.
B)The disease is maintained in a bird-mosquito-bird cycle.
C)Most human cases are subclinical or mild.
D)The disease caused by the virus can sometimes cause a fatal encephalitis.
E)The virus was introduced to the United States in 1999 in the New York City area.

Question 51

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 52

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

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

Which one of the following diseases causes symptoms in fewer than 1% of infected individuals,but has a mortality rate in symptomatic patients of about 20%?

A)Eastern equine encephalitis
B)Western equine encephalitis
C)St.Louis encephalitis
D)California encephalitis
E)West Nile virus encephalitis

Question 55

Which of the following pairs is mismatched?

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

Question 56

The number of leprosy cases in the United States is around 100 reported cases each year.

Question 57

All of the following microorganisms can directly cause meningitis EXCEPT

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

Question 58

Which one of the following statements on Zika virus is FALSE?

A)It is a member of the Flaviviridae.
B)It is transmitted primarily through the bite of infected Aedes spp.Mosquitoes.
C)It causes temporary and self-resolving facial muscle paralysis.
D)It greatly increases the risks of a fetus developing microcephaly if the mother contracts the virus while pregnant.
E)The virus was first discovered in 1947 in the Zika forest in Uganda.

Question 59

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

Question 60

Which one of the following diseases may cause a polio-like paralysis in older adults?

A)West Nile virus infection
B)cryptococcosis
C)Bell's palsy
D)chronic fatigue syndrome

Question 61

There is an antitoxin for botulism.Why,then,is the outcome of botulism often fatal?

Question 62

Explain the transmission and etiology of meningococcal meningitis.

Question 63

Describe the challenges produced by prion diseases in herds of animals used for human food supplies.

Question 64

What is chronic fatigue syndrome,and how is it diagnosed? What are some of the challenges facing clinicians trying to help CFS patients?

Question 65

Discuss the advantages and disadvantages of the Salk and Sabin vaccines.