Deck 22: Diseases of the Nervous System

Question 1

What are the primary responsibilities of the Nervous System?

A) controls and regulates other organs
B) center for all internal communication
C) center for all mental activity
D) all of these are correct

Answer 1

D

Question 2

Unlike other types of tissues, neurons

A) are able to regenerate themselves rapidly
B) are able to regenerate themselves only after hormonal stimulation
C) are unable to regenerate themselves if damaged
D) require exogenous factors to regenerate themselves

Answer 2

C

Question 3

Neurological defenses against both physical damage and microbial infection include all of the following
EXCEPT:

A) encasement of central nervous system with bones
B) a surrounding CNS with five layers of membranes
C) presence of cerebrospinal fluid between the arachnoid mater and the pia mater
D) protection by circulating white blood cells

Answer 3

B

Question 4

Which of the following is a characteristic of the blood-brain barrier?

A) it is a single-walled physical barrier
B) gap junctions bind the endothelial cells in the capillary walls together
C) there are neurally controlled pores in the capillary walls
D) there are layers of cells including astrocytes that serve as a secondary barrier

Question 5

Cerebrospinal fluid (CSF) is produced by which of the following?

A) a special layer of tissue called the choroid plexus
B) the double-walled blood-brain barrier
C) the endothelial cells that line the capillaries
D) the astrocytes that participate in the blood-brain barrier

Question 6

Pathogens that are able to move through the skin or mucous membranes and attain entry into the PNS often have similar strategies such as:

A) production of toxins that bind to neurons and prevent neurotransmission
B) production of toxins that are pathogenic at concentrations that cannot be detected by the immune system
C) loss of neural function due to chronic inflammation
D) all are correct

Question 7

Pathogens able to cross the blood brain barrier because inflammation causes capillary walls to become more permeable.

Question 8

Pneumococcal meningitis is the most common type of meningitis in children in countries where the Hib vaccine is not available.

Question 9

Which of the following statements about transmission of bacterial meningitis pathogens are true?

A) transmission is via respiratory droplets
B) healthy carriers may be asymptomatic because their strain lacks a polysaccharide capsule
C) outbreaks can occur in day care centers, camps, and schools
D) all bacterial pathogens are gram-positive and will be susceptible to the same antibiotics

Question 10

Clinical features of acute meningitis include which of the following?

A) fever
B) severe headache
C) stiff neck
D) all of the above

Question 11

Treatment for bacterial meningitis involves which of the following?

A) often not treated because disease is self-limiting
B) usually includes Beta-lactam antibiotics
C) prophylactic treatment with antibiotics for family members
D) all of the above

Question 12

Neonatal Meningitis is characterized by which of the following?

A) horizontal transmission from mother to baby usually during childbirth
B) risk factors include high birth weight and an extended labor.
C) E. coli and Streptococcus agalactiae, are often implicated pathogens
D) all are correct

Question 13

Early onset neonatal meningitis occurs 7 days after birth in premature infants to otherwise healthy mothers

Question 14

Tetanus is treated by a 2-step protocol that includes which of the following?:

A) administering antibiotic to kill bacterium and administering antibiotic to kill the endospores
B) administering antibiotic to kill the endospores and administering HTI (human tetanus immunoglobulin) to inactivate tetanus toxin
C) administering HTI (human tetanus immunoglobulin) to inactivate tetanus toxin and administering antibiotic to kill the endospores and bacteria
D) administering HTI (human tetanus immunoglobulin) to inactivate tetanus toxin and administering antibiotic to kill the bacteria

Question 15

Tetanus neurotoxin causes which of the following?

A) flaccid paralysis
B) transient paralysis
C) spastic paralysis
D) lateral paralysis

Question 16

Tetanus is caused by a gram-negative endospore-forming bacterium

Question 17

Botulism toxin can be used to treat which of the following conditions?

A) spasticity caused by MS, cerebral palsy or CNS injury
B) halitosis
C) hirsutism
D) blepharospasm

Question 18

Botulism neurotoxin causes which of the following?

A) flaccid paralysis
B) transient paralysis
C) spastic paralysis
D) lateral paralysis

Question 19

How does botulism toxin impact muscle function?

A) it ultimately prevents release of acetylcholine
B) it blocks signal transmission from inhibitory neurons
C) it blocks signals from muscles to nerves
D) it degrades the membrane docking protein

Question 20

identify the correct characteristic of leprosy (Hansen's Disease).

A) leprosy is an acute disease
B) it is not transmissible
C) it may present with transient nerve damage
D) treatment includes long-term multidrug therapy

Question 21

Viral pathogens of the nervous system are always latent and persist in the CNS

Question 22

What is the major difference between bacterial and viral meningitis?

A) unlike bacterial meningitis, viral meningitis usually resolves without complications in several weeks
B) unlike bacterial meningitis, viral meningitis is referred to as "aseptic" because of lack of cellular presence in CSF
C) unlike bacterial meningitis, viral meningitis is usually treated symptomatically with medication for pain and fever as well as fluids for rehydration.
D) all are correct

Question 23

Which statement best characterizes meningitis caused by enteroviruses?

A) diagnosis is based upon lack of bacterial and fungal pathogens
B) transmission is usually respiratory route but viruses can also be spread by fomites.
C) the demographic group most at risk for infections are young adults during the winter
D) most non-polio enterovirus infections are asymptomatic

Question 24

Encephalitis involves inflammation and swelling of the brain, meninges, and spinal cord.

Question 25

What feature does encephalitis NOT share with meningitis?

A) fever
B) headache
C) altered mental status
D) seizures and speech disturbances

Question 26

Encephalitis is a rare complication of infection with which virus?

A) enterovirus
B) West Nile Virus
C) HPV
D) HSV

Question 27

Characteristics of arboviral encephalitis diseases include which of the following?

A) these diseases are mosquito-borne or tick-borne
B) causative viruses are enveloped with a polyhedral capsid surrounding a double stranded-DNA molecule
C) the incubation period is approximately two weeks
D) these diseases are always fatal

Question 28

Identify the clinical features of encephalitis?

A) fever
B) localized rash
C) tissue swelling
D) increased white blood cell proliferation

Question 29

West Nile viral disease incidence is monitored by surveillance of deer and tick populations.

Question 30

Which wild poliovirus (es)has (have) been eradicated?

A) WPV1
B) WPV2
C) WPV3
D) none of the above

Question 31

Which poliovirus vaccine preparation may give rise to infectious cVDPV strains?

A) IPV
B) cVDPV
C) OPV
D) all of the above

Question 32

Identify the clinical features of polio virus infection.

A) most infections are asymptomatic
B) initial viral replication occurs in the intestines
C) paralysis occurs in 0.1% of cases because of damage to motor neurons in the CNS
D) all of the above

Question 33

Rabies may be prevented by vaccination after infection

Question 34

Which of the following characteristics describes the rabies virus

A) it has an icosahedral capsid
B) the capsid is non-enveloped
C) it has positive-sense single-stranded RNA
D) its genome encodes three proteins

Question 35

Clinical features of rabies include which of the following?

A) presence of hydrophobia
B) partial, descending paralysis
C) presence of fever, headache, malaise plus beginning of neurological symptoms
D) inevitable death once CNS symptoms are observed

Question 36

Treatment for rabies infection may include which of the following?

A) antiviral medications
B) administration of rabies immunoglobulin
C) post exposure vaccination 20 days after an animal bite
D) all of the above

Question 37

Which viral disease of the nervous system may result in microcephaly in children of infected mothers?

A) HSV encephalitis
B) PML
C) Measles
D) Zika virus disease

Question 38

Fungal meningitis is characterized by which of the following?

A) it is usually diagnosed in immuno-competent patients
B) the opportunistic, implicated fungal pathogens are spread person to person
C) the number of cases have increased as a result of the HIV/AIDS pandemic
D) outbreaks are common

Question 39

Which description best characterizes cryptococcal meningitis?

A) It is caused by an encapsulated yeast found in soil containing bat guano
B) it is an active disease only in those with severe immune- deficiencies
C) it is diagnosed by Gram staining of CSF samples
D) all of the above

Question 40

Unlike Cryptococcal meningitis, Toxoplasmosis usually resolves quickly when it causes:

A) fungal encephalitis in immune-competent patients who have healthy immune systems
B) fungal meningitis in immune-competent patients who have healthy immune systems
C) protozoan encephalitis in immune-competent patients
D) protozoan meningitis in immune-competent patients

Question 41

Which of the following describes the pathogen Toxoplasma gondii ?

A) it is a spore-forming sporozoan
B) it is often carried by rats that leave droppings in soil
C) oocysts are shed in feline feces and mature into sporocysts
D) antibiotics effectively eliminate the pathogen

Question 42

Humans may become infected with Toxoplasma gondii by which route?

A) consumption of contaminated vegetables
B) picking up dog feces
C) consuming undercooked meat containing sporocysts
D) transmission vertically from pregnant mother to fetus across the placenta

Question 43

Identify the correct description of prions

A) they are subviral infectious agents containing only RNA
B) they cause nontransmissible neurodegenerative diseases in humans and some other mammals
C) prion diseases are known as TSEs
D) they are composed of protein and nucleic acids like viruses

Question 44

The human prion disease, Kuru, was eradicated using which strategy?

A) vaccinating populations against the prion
B) eliminating the cultural practice of cannibalism
C) eliminating mosquito vectors in the region
D) providing antiviral medications to impacted communities

Question 45

Pathogenesis of human prion disease includes which of the following?

A) during disease a conformational change in protein structure from 3% Beta-sheets to 43% Beta sheets occurs
B) prions are degraded by host cell proteases
C) neurons in the CNS become abnormally dense
D) PrP^c prion protein induces conformational change in PrP^sc proteins spreading the damage

Question 46

Variant Creutzfeldt-Jakob disease (vCJD) occurs in which group?

A) cattle
B) sheep
C) deer
D) humans

Question 47

Treatment for prion diseases includes a variety of antiviral drugs.

Question 48

Which of the following pathologies are apparent in patients who died from prion disease

A) deposition of amyloid protein
B) neurons filled with vacuoles
C) proliferation of astrocytes
D) all of the above

Question 49

Prions are easily destroyed by weak acids or by autoclaving for 15 minutes at 121° C