Deck 10: Infectious Diseases and Sepsis

Question 1

Which of the following measures is most important in protecting EMS providers from infectious disease?

A) Thorough disinfection of the ambulance after every call
B) Tuberculosis vaccination
C) Hand washing after all patient contact
D) Glove use for all patient contact

Answer 1

Hand washing after all patient contact

Question 2

Health care workers can best avoid hepatitis B infection by:

A) using standard precautions for all patients.
B) using an alcohol-based hand sanitizer after each patient contact.
C) completing the hepatitis B vaccine series.
D) receiving gamma globulin in the event of an exposure.

Answer 2

completing the hepatitis B vaccine series.

Question 3

HIV attacks and destroys the:

A) B lymphocytes.
B) T lymphocytes.
C) pluripotent stem cells.
D) macrophages.

Answer 3

T lymphocytes.

Question 4

Your patient is a 40-year-old male. As a child he would have been least likely to have suffered from:

A) RSV.
B) pertussis.
C) measles.
D) mumps.

Question 5

A paramedic within your service was treating an IV drug addict when the patient spit at her, hitting her in the eye. At the hospital, when asked for blood, the patient refused to consent for testing. In this case, which of the following is TRUE?

A) The patient can be placed under detention and be required to give a blood sample.
B) A judge will issue a court order requiring the patient to allow his blood to be tested.
C) By law the patient is required to submit blood for testing.
D) It is within the patient's right to refuse blood testing.

Question 6

Which of the following is NOT a known transmission route for hepatitis B?

A) Blood transfusion
B) Dialysis
C) Tattooing
D) Insect bites

Question 7

Which of the following agencies is the primary agency responsible for establishing guidelines and standards to regulate health care worker safety as it relates to communicable disease transmission?

A) NFPA
B) CDC
C) FEMA
D) OSHA

Question 8

Which of the following is best described as a change from the absence of antibodies to detectable levels of antibodies in the blood after exposure to an infectious disease?

A) Clinical horizon
B) Virulence
C) Chemotaxis
D) Seroconversion

Question 9

For which of the following diseases is there no vaccine?

A) Measles
B) Croup
C) Mumps
D) Rubella

Question 10

All the following are common signs or symptoms of lice infestation EXCEPT:

A) red macules or papules on the affected areas.
B) white, oval-shaped nits on the hair shafts.
C) itching.
D) open lesions in the affected areas.

Question 11

Which of the following agencies monitors national disease data and provides disease information to health care providers?

A) DHHS
B) CDC
C) OSHA
D) NIOSH

Question 12

Which of the following organisms causes mononucleosis?

A) Epstein-Barr virus
B) Pediculus humanus capitis
C) Treponema
D) Herpes zoster

Question 13

Your patient was bitten on the hand by a wild raccoon he tried to capture. Which of the following is the first step in management for this patient?

A) Irrigate the wound with sterile saline, dry the area around the wound, and apply a thin layer of antibiotic ointment.
B) Clean the area with a povidone-iodine swab.
C) Clean the area with an isopropyl alcohol pad.
D) Wash the wound with soap and running water.

Question 14

Which of the following statements about prions is TRUE?

A) They are neither prokaryotes nor eukaryotes.
B) Eastern equine encephalitis is the most common prion disease.
C) Prions are easily destroyed by heat sterilization.
D) Prions are single-celled animals capable of causing disease.

Question 15

Which of the following cells play a functional role in the inflammatory response?

A) Neutrophils
B) T lymphocytes
C) Stem cells
D) B lymphocytes

Question 16

While working in the emergency department, you accidentally stick yourself with the stylette of an IV needle you just used to start an IV. What should you do immediately?

A) Wash the area thoroughly with soap and running water.
B) Stop the bleeding with a sterile gauze pad.
C) Wipe the area with a povidone-iodine swab.
D) Wipe the area with an alcohol prep.

Question 17

After receiving the hepatitis B vaccine, the blood of a paramedic reveals no circulating antibodies for the disease. Which of the following phases would the paramedic most likely be in regarding the immunization?

A) Latent
B) Window
C) Incubation
D) Seroconversion

Question 18

Which of the following techniques destroys some, but not all, microorganisms?

A) Cleaning
B) Disinfection
C) Decontamination
D) Sterilization

Question 19

Which of the following statements about herpes simplex type 2 (HSV-2) is FALSE?

A) There is a low risk of disease transmission via casual contact.
B) HSV-2 is responsible for 70 to 90 percent of all genital herpes cases.
C) In addition to painful lesions to the infected area, fever and enlarged lymph nodes can be present during the initial presentation of the infection.
D) Treatment with acyclovir can eradicate the virus.

Question 20

Which of the following statements about mumps is TRUE?

A) Mumps are of no concern to the adult patient.
B) There is no vaccine for the mumps virus.
C) Mumps are characterized by enlargement of the salivary glands.
D) Mumps are not highly communicable.

Question 21

The alternate pathway that reacts quickly to foreign bodies and uses antibodies and inflammation to combat pathogens is the ________ system.

A) complement
B) lymphatic
C) humoral
D) cell-mediated

Question 22

Which of the following statements about influenza and the influenza virus is FALSE?

A) High-risk individuals include the elderly.
B) An influenza vaccine confers immunity against only a few strains of the virus each year.
C) Influenza is the leading cause of respiratory disease worldwide.
D) The disease is characterized by nausea, vomiting, and diarrhea.

Question 23

Which of the following types of agents acts specifically by inhibiting bacterial growth or reproduction?

A) Bacteriostatic
B) Antiseptic
C) Pathological
D) Aseptic

Question 24

Clostridium botulinum has its effect primarily by:

A) altering cellular structure to create syncytia.
B) releasing a toxin that results in muscular paralysis.
C) creating gas through the fermentation of carbohydrates in muscle tissue.
D) causing septicemia.

Question 25

Which of the following statements about measles and the measles virus is FALSE?

A) Immunization is ineffective until age 15.
B) Measles is highly communicable.
C) Measles is transmitted by inhalation of infected droplets.
D) Signs of measles infection include high fever and a maculopapular rash.

Question 26

Which of the following statements about rubella and the rubella virus is FALSE?

A) EMS providers should receive an MMR vaccination.
B) The virus is spread via contact with infected blood and body fluids.
C) Immunization via the MMR vaccination is 98 to 99 percent effective.
D) Infection in the first trimester of pregnancy increases the risk of birth defects.

Question 27

Demographics are:

A) statistics related to the morbidity and mortality of all illnesses and injuries.
B) geographical distributions of illness and injury.
C) statistics related to the incidence of infectious disease.
D) characteristics of human populations.

Question 28

Mononucleosis presents with all the following signs and symptoms EXCEPT:

A) enlarged and tender lymph nodes.
B) fatigue.
C) hepatomegaly.
D) sore throat.

Question 29

The destructive substances released from some bacteria when they die are known as:

A) endotoxins.
B) syncytia.
C) prions.
D) exotoxins.

Question 30

Which of the following is a mobile, single-celled, parasitic organism?

A) Fungus
B) Virus
C) Protozoan
D) Bacterium

Question 31

Your patient is a 23-year-old male prisoner who is alert and oriented, complaining of general malaise. He describes a month-long history of weakness, joint pain, nausea and occasional vomiting, and anorexia. He has no medical history and takes no medications. Physical examination reveals clear lung sounds bilaterally; warm, dry skin; several prison tattoos; a firm liver; and jaundice to his sclera. Which of the following is most likely?

A) Fatty liver
B) Cirrhosis of the liver
C) HIV
D) Hepatitis B

Question 32

Which of the following statements about hepatitis A is TRUE?

A) Hepatitis A is transmitted through direct contact with blood and body fluids.
B) Many patients are asymptomatic with hepatitis A infection.
C) Transmission via needle stick injury is common.
D) The incubation period for hepatitis A is three to five days.

Question 33

Which of the following is classified as a helminth?

A) Trichomonas
B) Treponema
C) Spirochete
D) Fluke

Question 34

From which of the following incidents would infection with Clostridium tetani be most likely?

A) Eating improperly prepared, home-canned food
B) Receiving a puncture wound to the foot
C) Drinking contaminated well water
D) Being bitten by an infected animal

Question 35

Your patient is a 20-year-old female college student who lives in a dormitory. She complains of weakness, fever, chills, nausea, a rash on her chest, and neck pain. Physical examination reveals warm, moist skin; pain with flexion of her neck; and a petechial rash on her chest. HR = 92, BP = 108/68, RR = 14, SaO₂ = 99%. Which of the following is most appropriate?

A) Place an N-95 respirator on the patient, transport BLS, notify the hospital before arrival
B) Place a face mask on your patient and yourself, transport BLS, notify the hospital before arrival
C) Administer oxygen by nonrebreather, BLS, and transport
D) Administer O₂ via nonrebreather mask, cardiac monitor, IV of normal saline, and transport

Question 36

Which hepatitis often presents with hepatitis D?

A) A
B) B
C) C
D) D

Question 37

A 44-year-old male staying in a homeless shelter is alert and complaining of shortness of breath. He has a two-week history of cough with hemoptysis, fever, chills, and night sweats. Physical examination reveals skin to be warm and moist and lung sounds decreased in the right upper lobe with rhonchi. HR = 100, BP = 142/100, RR = 20, SaO₂ = 95%. You should assume this patient has a high likelihood of having:

A) hantavirus pulmonary syndrome.
B) tuberculosis.
C) pneumonia.
D) RSV.

Question 38

You are suspicious that a patient is suffering from active tuberculosis. Which of the following would be most appropriate?

A) Neither you nor the patient should wear a HEPA respirator.
B) Both you and the patient should wear a HEPA respirator.
C) You should wear an N95 mask.
D) The patient should wear a HEPA respirator.

Question 39

A memory or specific response is considered a(n) ________ response.

A) cell-mediated
B) inflammatory
C) humoral
D) immune

Question 40

Your patient is a 21-year-old male who is alert and oriented, complaining of a rash that started about 36 hours ago, first appearing on his trunk. The rash has now spread to his face and extremities. You notice multiple small, fluid-filled vesicles on the patient's body. The patient is concerned that he will miss work as a second-grade student teacher. He has no medical history, including childhood diseases. The patient is most likely suffering from:

A) rubella.
B) Epstein-Barr virus.
C) herpes simplex.
D) varicella.

Question 41

Which of the following statements about Haemophilus influenzae type B is TRUE?

A) It is the leading cause of conjunctivitis in adults.
B) It was once the leading cause of meningitis in children aged 6 months to 3 years.
C) Vaccines are ineffective against Haemophilus influenzae type B.
D) It is a Gram-positive rod.

Question 42

Which of the following statements about Streptococcus pneumoniae is TRUE?

A) Vaccines are ineffective against Streptococcus pneumoniae.
B) It is the second most common cause of pneumonia in adults.
C) It is the leading cause of meningitis in children.
D) It is an infrequent cause of otitis media in children.

Question 43

Which of the following findings would be most specific to mumps?

A) Swelling and tenderness of the parotid glands
B) Temperature of 103°F or higher
C) Redness of the face that gives a "slapped cheeks" appearance
D) Fluid-filled vesicles on the trunk

Question 44

To test for Brudzinski's sign you would:

A) have the patient take a deep breath while you palpate under the right costal margin.
B) check for periumbilical ecchymosis.
C) place the patient in a supine position and flex the neck.
D) stroke the bottom of the foot from heel to toe with a pen.

Question 45

When the body produces antibodies against itself, this is known as:

A) immunology.
B) allergy.
C) autoimmunity.
D) immunocompromise.

Question 46

While on a call you receive a laceration to your thigh from a jagged piece of metal. Which of the following is the correct recommendation for tetanus prophylaxis?

A) You must receive a tetanus booster annually to be protected from tetanus.
B) You should receive a tetanus booster if you have not had one in the past ten years.
C) If you are over the age of 60, you should receive tetanus immune globulin but not a tetanus booster.
D) If you received the entire series of tetanus immunizations as a child, you do not need a tetanus booster.

Question 47

The lymphatic system is comprised of all of the following EXCEPT:

A) spleen.
B) lymph nodes.
C) thymus.
D) liver.

Question 48

Mushrooms and yeasts are examples of:

A) parasites.
B) fungi.
C) helminthes.
D) protozoa.

Question 49

Poisonous proteins shed by bacteria growth are called:

A) exotoxins.
B) endotoxins.
C) spores.
D) fungi.

Question 50

Your patient is a 27-year-old male complaining of difficulty breathing. He states that he has just returned from a month-long backpacking trip across Arizona. He describes a two-week history of fatigue, fever, nausea, vomiting, diarrhea, and abdominal pain. He started experiencing difficulty breathing yesterday. He has no significant medical history and takes no medications. Physical examination reveals hot, moist skin; bilateral lower-lobe rales on auscultation of the lungs; and the abdomen is soft and nontender. Which of the following is most likely?

A) Legionnaire's disease
B) Hantavirus infection
C) Anthrax
D) Scorpion bite

Question 51

Cell-mediated immunity generates:

A) T lymphocytes.
B) B lymphocytes.
C) inflammation.
D) histamine.

Question 52

Which of the following statements about Neisseria meningitidis is TRUE?

A) The vaccine is recommended for health care workers.
B) It is the bacteria that most often causes serious cases of meningitis.
C) It is responsible for 90 percent of patients with a viral meningitis.
D) Signs and symptoms of infection can take weeks to develop.

Question 53

All the following pathogens typically cause meningitis in children EXCEPT:

A) Haemophilus influenza type B
B) Streptococcus pneumoniae
C) Neisseria meningitidis
D) Paramyxovirus

Question 54

The body will produce antibodies in response to:

A) pathogens.
B) antigens.
C) T cells.
D) phagocytes.

Question 55

Hepatitis E is often associated with:

A) HIV infection.
B) tuberculosis infection.
C) contaminated drinking water.
D) HBV infection.

Question 56

Which of the following is NOT a government organization involved with infectious diseases?

A) CDC
B) OSHA
C) EPA
D) FEMA

Question 57

A life-threatening medical condition that is caused by systemic inflammatory response syndrome (SIRS) is:

A) hypoglycemia.
B) thrombocytopenia.
C) septicemia.
D) pernicious anemia.

Question 58

Contaminated sharps need to be placed in:

A) properly labeled puncture-resistant containers.
B) biohazard containers in the dirty-utility room.
C) the decontamination room.
D) They can be thrown in the trash if they are "self containing."

Question 59

Your patient is a 19-year-old female college student complaining of a low-grade fever, extremely sore throat, tenderness of the cervical lymph nodes, and extreme fatigue. Examination reveals warm, moist, flushed skin. Heart rate = 88, respirations = 12, and blood pressure = 118/78. There is tenderness to palpation of the left upper quadrant of the abdomen. Which of the following is most likely?

A) Bacterial meningitis
B) Hantavirus pulmonary syndrome
C) Mononucleosis
D) Fifth disease

Question 60

Which of the following is NOT a common form of pathogen transmission?

A) Cough
B) Sneeze
C) Sexual contact
D) Organisms shed into the environment

Question 61

You respond to an ill patient. Upon arrival, you find out that the patient has just traveled from an area with active Ebola virus disease (EVD). You should initially:

A) examine the patient like any other.
B) examine the patient over the phone.
C) wait for a hazmat tech who is also a paramedic.
D) assess the patient from at least three feet away.

Question 62

You respond to a 2-year-old child who has a seal-like cough and stridor. You suspect:

A) laryngotracheobronchitis.
B) influenza.
C) pneumonia.
D) pharyngitis.

Question 63

You respond to a patient who has been having trouble with his indwelling urinary catheter. Vital signs are: pulse, 110; respiration rate, 22; ETCO₂, 28; temperature, 101.2°F. You suspect:

A) sepsis.
B) urinary tract infection (UTI).
C) renal failure.
D) rhabdomyolysis.

Question 64

One area in which paramedics have a chance to assume leadership is:

A) public education and infectious disease prevention.
B) FEMA studies.
C) CDC studies.
D) hospital advisory boards.

Question 65

Hepatitis B is stable on surfaces with dried visible blood for:

A) 3 days.
B) 3 hours.
C) 8 hours.
D) 8 days.

Question 66

You are treating a patient you suspect may be suffering from septic shock. You should consider fluid and pressor therapy to maintain a mean arterial pressure (MAP) of:

A) above 90 mmHg.
B) above 60 mmHg.
C) below 120 mmHg.
D) below 60 mmHg.

Question 67

You are called to evaluate an ill child. The mother states that the child was fine a few hours ago but now is exhibiting, dysphonia, drooling, dysphagia, and distress. You suspect:

A) croup.
B) epiglottitis.
C) bronchitis.
D) influenza A.

Question 68

Hepatitis A is can exist on unwashed hands for:

A) 5 days.
B) 4 days.
C) 6 hours.
D) 4 hours.

Question 69

HIV uses the host cell to copy itself by:

A) carrying its genetic material in its RNA.
B) replicating its genetic material in its DNA.
C) infiltrating the mitochondria.
D) glucogenolysis.

Question 70

As hepatitis progresses, the patient may become:

A) edematous.
B) jaundiced.
C) more infectious.
D) less Infectious.

Question 71

One of the most effective ways to prevent disease transmission is:

A) use of gloves.
B) sterilizing all equipment.
C) washing your hands.
D) using an alcohol-based sanitizer.

Question 72

You are caring for a patient you suspect of having an active TB infection. Your personal protective equipment (PPE) should include:

A) Tyvek suit.
B) hazmat level B protection.
C) powered air-purifying respirator (PAPR) mask.
D) N-95 mask.

Question 73

In response to fever, the patient's metabolic needs will:

A) increase.
B) decrease.
C) remain the same.
D) become anaerobic.

Question 74

The most common complication in adults contracting the varicella virus is:

A) chickenpox.
B) pneumonia.
C) respiratory syncytial virus (RSV).
D) paranoia.

Question 75

You and your partner have just been notified by the infection control officer that you have been exposed to an active meningitis case. You would expect to receive prophylactic:

A) Cipro.
B) Zithromax.
C) penicillin.
D) nothing, just self-monitor.

Question 76

According to the 2009 extension of the Ryan White Care Act, an employee who has been exposed to an infectious disease has the right to:

A) demand that the patient be tested for infectious disease.
B) ask about the source patient's infection status.
C) have the receiving ED draw a sample of the patient's blood for testing.
D) nothing; HIPAA is in effect.

Question 77

You respond to an ill patient. Upon your arrival, the patient's caregivers state that the patient has been complaining of lethargy, vomiting, and nuchal rigidity. You suspect:

A) pertussis.
B) meningitis.
C) varicella.
D) pneumonia.

Question 78

Whooping cough is also known as:

A) meningococcus.
B) pertussis.
C) varicella.
D) pneumonia.

Question 79

You are caring for a patient who is complaining of chills, fever, night sweats, sudden weight loss, and hemoptysis. You suspect:

A) AIDS.
B) hepatitis B virus.
C) tuberculosis.
D) Ebola virus disease (EVD).

Question 80

While examining a patient, you note that he exhibits a positive Brudzinski's sign. You suspect:

A) meningitis.
B) pertussis.
C) varicella.
D) tuberculosis.