Deck 20: Infections of the Nervous System

Question 1

The most common route of infection in meningitis is

A)via peripheral nerves.
B)via the bloodstream.
C)via the paranasal sinuses.
D)from the ears.
E)through the skin.

Answer 1

B

Question 2

Murray Valley encephalitis is usually acquired by

A)a mosquito bite.
B)close skin contact with an infected person.
C)ingestion of toxin in food.
D)a deep puncture wound.
E)exposure to respiratory secretions from an infected person.

Answer 2

A

Question 3

Meningitis caused by Haemophilus influenzae

A)cannot be treated with antibiotics.
B)is less common due to vaccination.
C)is common in head-injured patients.
D)usually follows splenectomy.
E)is transmitted by mosquitoes.

Answer 3

B

Question 4

Meningococcal septicaemia is

A)resistant to most antibiotics.
B)characterised by a haemorrhagic skin rash.
C)not as serious as meningococcal meningitis.
D)due to the actions of a potent exotoxin.
E)all of the above.

Question 5

The blood-brain barrier

A)prevents the passage of all substances.
B)prevents the passage of lipid soluble substances.
C)is the innermost meningeal membrane.
D)is comprised of tightly joined endothelial cells in capillaries.
E)is responsible for the production of cerebrospinal fluid.

Question 6

Which of the following is NOT transmitted by mosquitoes?

A)Murray valley encephalitis.
B)Japanese encephalitis.
C)Herpes encephalitis.
D)West Nile virus infection.
E)Kunjin virus infection.

Question 7

A Gram stain of CSF from a person with suspected meningitis shows large numbers of polymorphs with intracellular Gram-negative diplococci.The causative agent is most likely to be

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

Question 8

Viral meningitis is

A)more severe than bacterial meningitis.
B)often caused by enteroviruses.
C)characterised by a lack of white cells in the CSF.
D)less common than bacterial meningitis.
E)effectively treated with ceftriaxone.

Question 9

Which of the following tests on a CSF specimen would NOT be useful in the diagnosis of meningitis?

A)Culture on agar plates.
B)Microscopic examination for host cell types.
C)Gram stain and microscopy.
D)Electron microscopy.
E)Glucose concentration.

Question 10

Which of the following statements concerning the pneumococcus is FALSE?

A)Pneumococcus can be carried in the throat of healthy people.
B)Pneumococcal meningitis may follow otitis media.
C)Pneumococcal meningitis can occur following skull fracture.
D)Pneumococcus only causes meningitis in young babies.
E)A vaccine is available to protect against pneumococcal infections.

Question 11

Neonatal meningitis

A)is most often caused by Listeria monocytogenes.
B)is usually fatal.
C)may be associated with premature birth.
D)does not result in long-term problems.
E)responds poorly to antibiotic treatment.

Question 12

The term 'aseptic meningitis' usually refers to

A)any non-bacterial meningitis.
B)a meningitis following neurosurgery.
C)a viral meningitis.
D)an infection of the inner parts of the brain.
E)meningitis caused by Neisseria meningitidis.

Question 13

Encephalitis is

A)mainly caused by protozoa.
B)an infection of the brain.
C)always related to a mosquito bite.
D)usually an asymptomatic infection.
E)all of the above.

Question 14

Japanese encephalitis

A)only occurs in Japan.
B)is often successfully treated with aciclovir.
C)virus is found in wading birds and pigs.
D)cannot be prevented by vaccination.
E)has close to a 100% fatality rate.

Question 15

Which of the following is a protozoan which causes infection of the central nervous system,especially in people with AIDS?

A)Toxoplasma gondii.
B)Cryptococcus neoformans.
C)Neisseria meningitidis.
D)Listeria monocytogenes.
E)Haemophilus influenzae.

Question 16

In acute bacterial meningitis

A)the causative organism may initially colonise the nasopharynx.
B)bacterial invasion of the bloodstream often occurs.
C)the inflammatory response is partly responsible for the symptoms.
D)many of the pathogens have an anti-phagocytic capsule.
E)all of the above.

Question 17

Most bacteria that cause meningitis

A)are encapsulated.
B)can multiply inside phagocytes.
C)are resistant to many antibiotics.
D)are strict anaerobes.
E)produce disease symptoms by releasing exotoxins.

Question 18

Meningitis that can spread in epidemic form is

A)meningococcal meningitis.
B)cryptococcal meningitis.
C)viral meningitis.
D)neonatal meningitis.
E)tuberculous meningitis.

Question 19

Cryptococcal meningitis may be rapidly diagnosed by

A)microscopic examination of a blood film.
B)estimation of protein and glucose concentrations in the CSF.
C)India ink stain of a centrifuged deposit of CSF.
D)culture of a purulent sputum specimen.
E)microscopic examination of a throat swab.

Question 20

Tetanus is usually acquired from

A)contaminated water.
B)close skin contact with an infected person.
C)ingestion of toxin in food.
D)infection of a deep puncture wound.
E)exposure to blood from an infected person.

Question 21

The form of botulism that is due to exposure to preformed botulinum toxin is

A)food-borne botulism.
B)wound botulism.
C)infant botulism.
D)exogenous botulism.
E)all of the above.

Question 22

The causative agent of Creutzfeldt-Jakob disease

A)is a nucleic acid.
B)is destroyed by standard autoclaving procedures.
C)is usually transmitted via urine.
D)causes microscopic vacuoles in the brain of an infected person.
E)all of the above.

Question 23

Which of the following is used to smooth wrinkles in facial muscles?

A)Botulinum neurotoxin A.
B)Botulinum musculospasmin.
C)Staphylococcus aureus neurotoxin.
D)Tetanospasmin toxin.
E)Tetanus neurotoxin.

Question 24

Infant botulism

A)is often associated with the consumption of honey.
B)occurs because the child has an undeveloped specific immune system.
C)is caused by Mycobacterium botulinum.
D)requires urgent treatment with a broad spectrum antibiotic.
E)all of the above.

Question 25

A man presents at the emergency department after puncturing his foot on an old nail.Upon questioning,he is uncertain as to whether he has been immunised against tetanus.This man should be

A)given tetanus toxoid and sent home.
B)kept in for observation for 24 hours to see if symptoms develop.
C)given tetanus immunoglobulin and tetanus toxoid.
D)advised to start a course of vaccination as soon as possible.
E)given a broad spectrum antibiotic.

Question 26

A person immunised with three doses of tetanus toxoid seven years ago suffers a severe gash with a pruning tool while gardening.He should receive

A)tetanus toxoid.
B)tetanus immunoglobulin.
C)penicillin.
D)gammaglobulin.
E)nothing because he is immune.

Question 27

A rabies-like virus transmitted by Australian fruit bats is

A)Menangle virus.
B)Hendra virus.
C)Nipah virus.
D)Lyssavirus.
E)Barmah Forest virus.

Question 28

Which of the following statements is TRUE?

A)Polio is a disease which dates back to ancient Egyptian times.
B)Poliovirus is only found in humans.
C)A vaccine for polio has been available since the 1950s.
D)Poliovirus is transmitted by faecally contaminated food,water or hands.
E)All of the above.

Question 29

A brain abscess can result from

A)head trauma.
B)neurosurgery.
C)middle ear infection.
D)all of the above.
E)none of the above.

Question 30

Which of the following statements about rabies is FALSE?

A)It is an encephalitis caused by a Lyssavirus.
B)It is primarily a disease of warm-blooded animals.
C)The usual incubation period is at least one month.
D)It can be acquired from a variety of animals,including bats and monkeys.
E)None of the above.

Question 31

A transmissible spongiform encephalopathy

A)is exemplified by kuru.
B)only affects humans.
C)is caused by an infectious nucleic acid.
D)is rarely fatal.
E)all of the above.

Question 32

The Sabin vaccine for polio

A)contains the poliovirus toxin.
B)is administered by intramuscular injection.
C)can cause autism on rare occasions.
D)is not currently used in Australia.
E)all of the above.

Question 33

Which of the following is TRUE? Variant Creutzfeldt-Jakob disease

A)is thought to be acquired by consumption of contaminated beef.
B)led to the slaughter of millions of cattle in Britain.
C)is caused by an infectious protein.
D)is always fatal.
E)All of the above.

Question 34

The alternative name for Hansen's disease is

A)tuberculosis.
B)leprosy.
C)botulism.
D)rabies.
E)trachoma.

Question 35

Leprosy

A)is a highly contagious disease.
B)does not occur in Australia.
C)has a long incubation period of two years or more.
D)is usually transmitted via skin-to-skin contact.
E)all of the above.