Deck 19: Infectious Diseases Affecting the Nervous System

Question 1

Which of the following is/are a sign or symptom of meningitis?

A) Headache
B) Stiff neck
C) White blood cells in cerebrospinal fluid
D) Fever
E) All of the choices are correct.

Answer 1

E

Question 2

Pneumovax is a vaccine for prevention of disease caused by strains of Neisseria meningitidis.

Answer 2

False

Question 3

Treatment for Neisseria meningitidis consists of ______.

A) intravenous penicillin G
B) vancomycin
C) rifampin
D) oral penicillin G
E) tetracycline

Answer 3

A

Question 4

The concept of "immune privilege" explains why the central nervous system has

A) more MHC markers than other tissues.
B) a greater immune response than the rest of the body.
C) a completely different set of immune responses.
D) a reduced immune response compared to the rest of the body.

Question 5

Which brain defense restricts substances from entering the brain via the vascular system?

A) Meninges
B) Blood-brain barrier
C) Macrophages
D) Microglia
E) Cranium

Question 6

Which of the following does not apply to Neisseria meningitidis?

A) It can be easily transmitted in day care facilities, dorms, and military barracks.
B) Its reservoir is the nasopharynx of human carriers.
C) Its virulence factors include a capsule, pili, endotoxin, and IgA protease.
D) It causes a serious meningitis.
E) It is a common cause of bacterial pneumonia.

Question 7

Which organism is a common cause of meningitis in AIDS patients and can be found in bird droppings?

A) Listeria monocytogenes
B) Neisseria meningitidis
C) Cryptococcus neoformans
D) Streptococcus agalactiae
E) Haemophilus influenzae

Question 8

Meningococcemia is

A)best treated with penicillin G.
B)associated with vascular collapse,hemorrhage,and petechiae.
C)started from a nasopharyngeal infection.
D)caused by a gram-negative diplococcus.
E)All of the choices are correct.

Question 9

Which of the following is not true of Streptococcus pneumoniae?

A) It is a small, gram-negative coccus.
B) It is the most frequent cause of community-acquired meningitis.
C) It has a polysaccharide capsule that resists phagocytosis.
D) It produces an alpha-hemolysin and hydrogen peroxide.

Question 10

Which type of cell has phagocytic capabilities in the central nervous system?

A) Macrophages
B) Neurons
C) Astrocytes
D) Schwann cells
E) Microglial cells

Question 11

Neisseria meningitidis is transmitted by ______.

A) an insect vector
B) sexual contact
C) fomites
D) close contact

Question 12

Meningococci initially colonize the ______.

A) Eustachian tube
B) oral mucosa
C) nasopharynx
D) lacrimal ducts

Question 13

Which of the following statements is incorrect regarding Listeria monocytogenes?

A) It is fastidious.
B) It does not produce a capsule.
C) It is resistant to salt.
D) It is resistant to cold.
E) It is resistant to heat.

Question 14

Cerebrospinal fluid is found in the ______.

A) pia mater
B) dura mater
C) subarachnoid space
D) arachnoid mater
E) All of the choices are correct.

Question 15

Although many viruses can cause meningitis,the most common viral cause is ______.

A) cytomegalovirus
B) enterovirus
C) arenavirus
D) herpes simplex
E) arbovirus

Question 16

The organism responsible for the majority of neonatal meningitis is ______.

A) Listeria monocytogenes
B) Streptococcus agalactiae
C) Neisseria meningitidis
D) Haemophilus influenzae
E) Escherichia coli K1

Question 17

The gut-brain axis refers to

A) changes in brain chemistry and behavior caused by the gut microbiota.
B) neurons in the spinal cord that connect the gut and the brain.
C) the location of dormant viruses that infect both the gut and the brain.
D) pores in the blood-brain barrier that permit the passage of glucose and other nutrients.

Question 18

The presence of Neisseria in a sample of cerebrospinal fluid indicates that

A) the patient is healthy; Neisseria is part of the normal biota.
B) the patient has an infection with Neisseria.
C) there is a deficiency in the patient's blood-brain barrier.
D) the patient has previously had an infection with Neisseria.

Question 19

Place the following components of the nervous system anatomy in order from skull to brain.

A) Pia mater, arachnoid mater, subarachnoid space, dura mater
B) Subarachnoid space, arachnoid mater, dura mater, pia mater
C) Dura mater, arachnoid mater, subarachnoid space, pia mater
D) Arachnoid mater, subarachnoid space, dura mater, pia mater
E) Dura mater, arachnoid mater, pia mater, subarachnoid space

Question 20

The normal biota of the central nervous system includes ______.

A) Neisseria meningitidis
B) Herpes simplex I
C) Herpes simplex II
D) Streptococcus agalactiae
E) The CNS has no normal biota.

Question 21

Which of the following is not true of meningoencephalitis?

A) The condition involves infection of both the brain and meninges.
B) The mode of transmission is via respiratory droplets.
C) The treatment for primary amoebic meningoencephalitis (PAM) is mostly ineffective.
D) The causative organisms are Naegleria fowleri and Acanthamoeba.

Question 22

The best defense against arboviruses is ______.

A) prophylactic rifampin
B) prompt treatment with acyclovir
C) vector control
D) vaccination

Question 23

Which of the following is not a causative agent of acute encephalitis?

A) JC virus
B) Toxoplasma gondii
C) Varicella-zoster virus
D) Herpes simplex virus
E) Arbovirus

Question 24

What organism is the main reservoir and host for Toxoplasma gondii?

A) Mouse
B) Mosquito
C) Cat
D) Raccoon
E) Dog

Question 25

Cryptococcal meningitis is highly communicable among humans.

Question 26

The organism found in contaminated powdered infant formula that can cause meningitis is ______.

A) Escherichia coli K1
B) Escherichia coli O157:H7
C) Cronobacter sakazakii
D) Cryptococcus neoformans
E) Streptococcus agalactiae

Question 27

Agricultural workers and field archaeologists are exposed to this organism which,despite entering via the respiratory tract,can cause meningitis.

A) Cryptococcus neoformans
B) Haemophilus influenzae
C) Streptococcus pneumoniae
D) Coccidioides immitis
E) Neisseria meningitidis

Question 28

Which of the following is caused by Haemophilus influenzae?

A) Pharyngitis
B) Tetanus
C) Kuru
D) Influenza (flu)
E) Bacterial meningitis

Question 29

Arthrospores of Coccidioides immitis develop into ______ that will release endospores into the lungs.

A) capsules
B) hyphae
C) capsids
D) spherules
E) buds

Question 30

Each of the following statements is true for Toxoplasma gondii except that

A) infection often fatal for AIDS patients.
B) it has a narrow host range.
C) it can cause stillbirth.
D) it is a flagellated parasite.

Question 31

As a nurse,you have to teach your patients about control and management of their diseases as well as the facts of the disease--risk,treatment,symptoms,etc.How might you instruct a patient who has West Nile virus to avoid the infectious agent in the future?

A) Be sure to treat your dogs and cats with flea medication.
B) Do not go outside at dusk or dawn, and cover the skin if this is unavoidable.
C) Do not eat food served from kiosks and food trucks in foreign countries.
D) Always drink bottled water when outside of the U.S.
E) Get an annual vaccination if you live in an area where the virus is known to circulate.

Question 32

Spongiform encephalopathies are

A) associated with abnormal, transmissible, protein in the brain.
B) chronic, fatal infections of the nervous system.
C) caused by prions.
D) Creutzfeldt-Jacob disease, kuru, and Gertsmann-Straussler-Scheinker syndrome.
E) All of the choices are correct.

Question 33

What is the likelihood that a patient infected by West Nile virus will develop West Nile encephalitis?

A) Less than 1%
B) Between 1% and 10%
C) Between 10% and 15%
D) Greater than 20%
E) Greater than 50%

Question 34

Viral meningitis normally requires aggressive antiviral treatment.

Question 35

Which of the following diseases exhibits the highest mortality rate?

A) La Crosse encephalitis
B) Jamestown Canyon encephalitis
C) Eastern equine encephalitis
D) West Nile encephalitis

Question 36

Toxoplasmosis prevention includes ______.

A) vector control
B) hygienic precautions
C) vaccination of humans
D) vaccination of cats

Question 37

Encephalitis caused by arboviruses involves the development of

A) fever, headache, and rash.
B) coma, convulsions, and paralysis in severe cases.
C) myalgia and orbital pain.
D) muscle aches and joint stiffness.
E) All of the choices are correct.

Question 38

Neonatal meningitis is most commonly transmitted by ______.

A) transplacental infection
B) breastfeeding
C) hospital personnel
D) exposure from other infants
E) exposure in the birth canal

Question 39

Encephalitis is most commonly caused by a ______.

A) bacterium
B) protozoan
C) virus
D) helminth

Question 40

Cryptococcus neoformans is a ______.

A) gram-positive bacterium
B) prion
C) fungus
D) gram-negative bacterium

Question 41

Botulism is often referred to as lockjaw.

Question 42

Production of a neurotoxin that prevents acetylcholine release from motor neurons at neuromuscular junctions is a characteristic of ______.

A) Clostridium botulinum
B) Clostridium tetani
C) Clostridium difficile
D) Clostridium perfringens

Question 43

The food-borne disease that involves neurotoxin is ______.

A) Clostridium perfringens gastroenteritis
B) botulism
C) gastrointestinal anthrax
D) Bacillus cereus intoxication

Question 44

Which is the exotoxin of botulism?

A) Factor V
B) Hemolysin
C) Botulinum
D) Tetanospasmin
E) Peroxidase

Question 45

Which of the following pertains to both tetanus and foodborne botulism?

A) Treatment involves antitoxin therapy.
B) An exotoxin blocks acetylcholine release.
C) Nausea and diarrhea are symptoms.
D) They occur when endospore-contaminated soil enters deep wounds.
E) They are caused by enterotoxins of the pathogen.

Question 46

Prions can be destroyed by autoclaving.

Question 47

Prions can be transmitted by all of the following except

A) ingesting brain material.
B) ingesting meat from infected animals.
C) surgical instruments.
D) cornea transplants.
E) All of the choices have been documented as methods of prion transmission.

Question 48

Some cases of CJD may be caused by a mutation of the PrP gene.

Question 49

Poliovirus initially multiplies in the ______.

A) lymphoid tissue
B) central nervous system
C) nasopharynx
D) intestine
E) basal ganglia

Question 50

In paralytic polio,which structures are damaged?

A) Brain stem
B) Diaphragm
C) Sensory nerves
D) Anterior horn cells
E) Peripheral nerves

Question 51

Production of a neurotoxin that binds to target sites on spinal cord neurons responsible for inhibiting skeletal muscle contraction is a characteristic of ______.

A) Clostridium tetani
B) Clostridium botulinum
C) Clostridium difficile
D) Clostridium perfringens

Question 52

Subacute sclerosing panencephalitis is caused by a prion.

Question 53

Although prion infectious agents are more closely related to viruses than any other kind of infectious agents,there are still some major differences between the two.Which statement describes a major difference?

A) Viruses can be transmitted by animal to human or human to human, but prions are always human to human transmission.
B) Prions are not destroyed by heat, but viruses can be inactivated by heat.
C) Viruses do not contain protein, whereas prions do.
D) Viral infections can always be treated and cured, whereas prion diseases cannot.

Question 54

Which of the following statements regarding poliomyelitis is incorrect?

A) The virus is transmitted by contaminated water.
B) Summer outbreaks in the U.S. have been increasing in frequency.
C) It is caused by poliovirus (genus Enterovirus).
D) If the virus enters the central nervous system, motor neurons can be infected and destroyed.
E) It can be asymptomatic or mild with headache, sore throat, fever, and nausea.

Question 55

Which of the following statements about rabies is incorrect?

A) Transmission can involve bites, scratches, and inhalation.
B) Rabies is a zoonotic disease.
C) Symptoms include anxiety, agitation, muscle spasms, convulsions, and paralysis.
D) The average incubation period in human is 1 week.
E) Wild populations of bats, skunks, raccoons, cats, and canines are primary reservoirs.

Question 56

Subacute encephalitis may be caused by ______.

A) Toxoplasma gondii
B) prions
C) herpes simplex virus
D) persistent measles virus
E) All of the choices are correct.

Question 57

African sleeping sickness is caused by ______.

A) Plasmodium falciparum
B) Trypanosoma brucei
C) Leishmania braziliensis
D) Toxoplasma gondii
E) Lyssavirus

Question 58

Patients with Creutzfeldt-Jacob disease live ______ post diagnosis.

A) less than 1 year
B) 1 to 5 years
C) 5 to 10 years
D) 10 to 20 years
E) greater than 25 years

Question 59

Tetanus differs from botulism in that

A) tetanus results in flaccid paralysis, while botulism paralysis is rigid.
B) tetanus results from an exotoxin, botulism from an endotoxin.
C) there is a vaccine for botulism but not for tetanus.
D) muscles cannot relax in tetanus, while muscles cannot contract in botulism.
E) All of the choices are correct.

Question 60

Which of the following is not a prion disease?

A) Creutzfeldt-Jacob disease
B) Scrapie
C) Bovine spongiform encephalopathy
D) Subacute sclerosing panencephalitis

Question 61

A group is planning a cross-country hike on the Pacific Crest Trail,from the Mexican border,through California,Oregon,and Washington,to the Canadian border.Which of the following should not be a concern for the group while on this trip?

A) Rabies
B) Valley Fever
C) Powassan Virus
D) West Nile Encephalitis

Question 62

In both botulism and tetanus,respiratory muscles cannot facilitate breathing and,if untreated,respiratory collapse leads to death.

Question 63

Toxoplasma gondii infects the brain,as do many other pathogens.However,Toxoplasma differs from other pathogens in that it

A) causes tumor formation in the brain.
B) causes destruction of brain tissue.
C) always kills the host.
D) manifests in behavioral changes in the host.

Question 64

Infectious diseases of the nervous system include those that affect the meninges only (meningitis),those that affect both the meninges and the brain (meningoencephalitis),and those that affect the brain only (encephalitis).From the list below,identify the disease and its classification that is mismatched.

A) African sleeping sickness; encephalitis
B) La Crosse Virus infection; encephalitis
C) Naegleria fowleri infection; meningoencephalitis
D) polio; meningitis
E) Valley Fever; meningitis

Question 65

As a child,you received the OPV vaccine and its boosters.Now you are going on a mission trip to Pakistan,and the vaccine is recommended by the Centers for Disease Control and Prevention.When you go to the health office for the vaccine,they give you the IPV vaccine.When you ask why you are receiving the IPV rather than the OPV,the personnel explain that

A) there is no possibility of actually developing polio from this vaccine.
B) IPV is used as a booster only, and OPV is used exclusively for children's first immunization.
C) the IPV has fewer active viruses in it than the OPV, so it is safer.
D) the IPV is preferred by patients because it can be taken orally.

Question 66

The oral and inactivated polio vaccines are made from plant cell cultures.

Question 67

The preferred preventative measure for polio in the United States is the

A) inactive vaccine developed by Jonas Salk.
B) oral, active vaccine developed by Jonas Salk.
C) inactive vaccine developed by Albert Sabin.
D) oral, active vaccine developed by Albert Sabin.
E) No preventative measures are used because polio has been eradicated in the United States.

Question 68

Botox injections contain botulinum toxin.

Question 69

Your friend was bitten by an aggressive dog with a history of biting without cause,and it is suspected to have rabies.The city health department recommends the rabies vaccination,even though she has already been exposed to the infectious agent.Which statement best describes why the vaccine can be given post-exposure?

A) There were few virus particles in the bite, so her immune system has enough time to respond.
B) Since there is no treatment available, they suggest the vaccine as a last resort.
C) The virus exhibits a long incubation period, and therefore, in many cases, this provides the vaccine adequate time to have a protective effect in the patient.
D) This particular strain of the rabies virus is probably nonpathogenic, so the vaccine is given to boost the immune system's protective functions.

Question 70

No cases of attenuated polio virus reverting to a neurovirulent strain have been documented.

Question 71

What do all of these diseases -- amoebic encephalitis,rabies,Creutzfeld-Jacob disease -- have in common?

A) They are all caused by protozoans.
B) They are all transmitted through animal bites.
C) There is a genetic component to all of these diseases, in addition to the infectious agent.
D) Mortaility rates are all extremely high.

Question 72

The vector involved in African sleeping sickness is the ______.

A) tsetse fly
B) reduviid "kissing" bug
C) sand fly
D) hard-bodied tick
E) Anopheles mosquito

Question 73

The expected outcome of an oxidase test performed to identify Neisseria menigitidis is

A) the amplification of the oxi gene as detected on an agarose gel.
B) cells colored black when stained and viewed under the microscope.
C) the appearance of bubbles when cells are mixed with hydrogen peroxide.
D) a zone of clearing surrounding colonies on chocolate agar.
E) a color change of a colony from tan to black when oxidase reagent is added.

Question 74

Cultivation of Coccidioides species to confirm a diagnosis of Valley Fever is accomplished by plating the samples on ______ agar.

A) birdseed
B) Sabourad's
C) chocolate
D) blood

Question 75

In rabies,spasms of muscles for swallowing lead to a fear of water.

Question 76

Meningitis can be caused by a number of microbes,and the causative organism is often identified by microscopic observation of the cerebrospinal fluid.Identify the mismatch in the following list of organisms and the description of the microscopic observation.

A) Streptococcus pneumoniae; gram-positive flattened coccus
B) Cryptococcus neoformans; fungal cells with a thick capsule
C) Listeria monocytogenes; gram-negative coccobacillus with flagella
D) Enterovirus; no bacteria appear to be present in CSF
E) Neisseria meningitidis; gram-negative diplococcus

Question 77

A group of men make an annual week-long hunting trip for deer season in West Virginia.This year,they had to chase a family of squirrels out of the cabin,and during the week,they killed several deer and processed the meat,eating venison steaks most nights.All of the men had a few mosquito bites,and two cases of beer were consumed.The following week,they all developed symptoms of fever,headache,confusion,and seizures.Which of the following organisms can be ruled out as the cause of this encephalitis?

A) Jamestown Canyon Virus
B) JC Virus
C) Powassan Virus
D) Eastern Equine Encephalitis Virus

Question 78

Treatment of an animal bite for possible rabies includes

A) debridement.
B) washing the bite with soap or detergent.
C) infusing the wound with human rabies immune globulin (HRIG).
D) postexposure vaccination.
E) All of the choices are correct.

Question 79

Tetanus can be prevented with the DTaP childhood immunization and boosters with the tetanus toxoid.

Question 80

Up to 50% of persons who survived polio as children will suffer from post-polio syndrome later in life.