Deck 17: Infectious Diseases Affecting the Nervous System

Question 1

Treatment for Neisseria meningitidis consists of

A)vancomycin.
B)penicillin G orally.
C)penicillin G intravenously.
D)rifampin.
E)tetracycline.

Answer 1

C

Question 2

Prophylactic rifampin is indicated for individuals in close contact with patients infected by

A)Neisseria menigitidis.
B)Listeria monocytogenes.
C)Cryptococcus neoformans.
D)Coccidiodes immitis.
E)Streptococcus agalactiae.

Answer 2

A

Question 3

Meningococcemia is

A)best treated with ceftriaxone or aztreonam.
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.

Answer 3

E

Question 4

All of the following pertain to Neisseria meningitidis except

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

Question 5

Place the following in order from skull to brain: 1)subarachnoid space;2)arachnoid mater;3)dura mater;4)pia mater.

A)subarachnoid space,arachnoid mater,dura mater,pia mater
B)dura mater,arachnoid mater,subarachnoid space,pia mater
C)dura mater,arachnoid mater,pia mater,subarachnoid space
D)arachnoid mater,subarachnoid space,dura mater,pia mater
E)pia mater,arachnoid mater,subarachnoid space,dura mater

Question 6

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

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

Question 7

Neisseria meningitidis is transmitted by

A)casual contact.
B)close contact.
C)intimate contact.
D)indirect contact.
E)fomites.

Question 8

Which of the following is not true of Streptococcus pneumoniae?

A)most frequent cause of community-acquired meningitis
B)has a polysaccharide capsule that resists phagocytosis
C)produces alpha-hemolysin and hydrogen peroxide
D)small gram-positive flattened coccus
E)responds well to penicillin

Question 9

Cryptococcus neoformans is a

A)virus.
B)bacteria.
C)prion.
D)fungus.
E)helminth.

Question 10

The concept of "immunologically privileged" explains why the CNS

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

Question 11

Each of the following is true for Listeria monocytogenes except

A)resistant to cold.
B)fastidious.
C)resistant to heat.
D)resistant to salt.
E)can result in septicemia.

Question 12

What brain defense restricts substances from entering the brain by the vascular system?

A)meninges
B)blood-brain barrier
C)macrophages
D)microglia
E)cranium

Question 13

Which of the following is a sign of meningitis?

A)headache
B)stiff neck
C)white blood cells in cerebrospinal fluid
D)fever
E)All of the choices are correct.

Question 14

Which type of neuroglia has phagocytic capabilities in the CNS?

A)astrocytes
B)Schwann cells
C)macrophages
D)microglial cells
E)neurons

Question 15

The virulence of Haemophilus influenzae serotype b is associated with its

A)fimbriae.
B)neurotoxin.
C)enterotoxin.
D)capsule.
E)None of the choices is correct.

Question 16

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

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

Question 17

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 18

The normal biota of the CNS consists of

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

Question 19

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

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

Question 20

Meningococci initially colonize the

A)lacrimal ducts.
B)oral mucosa.
C)nasopharynx.
D)eustachian tube.
E)All of the choices are correct.

Question 21

Encephalitis caused by arboviruses involves

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 22

Neonatal meningitis is most commonly transmitted by

A)breast feeding.
B)hospital personnel.
C)transplacental infection.
D)exposure in birth canal.
E)exposure from other infants.

Question 23

Treatment of an animal bite for possible rabies includes

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

Question 24

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 Gerstmann-Straussler-Scheinker syndrome.
E)All of the choices are correct.

Question 25

Which organism is the definitive host for Toxoplasma gondii?
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A)cat
B)dog
C)mouse
D)mosquito
E)raccoon

Question 26

Which of the following has the highest mortality rate?

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

Question 27

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

A)measles.
B)cytomegalovirus.
C)arbovirus.
D)enterovirus.
E)arenavirus.

Question 28

Which is incorrect about rabies?

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

Question 29

The best defense against arborviruses is

A)prophylactic rifampin.
B)vector control.
C)vaccination.
D)prompt treatment with acyclovir.
E)All of the choices are correct.

Question 30

Each of the following is true for Toxoplasma gondii except

A)is a flagellated parasite.
B)is often fatal for AIDS patients.
C)can cause stillbirth.
D)has a narrow host range.
E)All of the choices are true.

Question 31

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

A)JC virus
B)West Nile virus
C)herpes simplex virus
D)Toxoplasma gondii
E)California encephalitis

Question 32

Polio virus initially multiplies in the

A)liver.
B)CNS.
C)oropharynx and intestine.
D)nasal mucosa.
E)None of the choices is correct.

Question 33

All of the following pertain to poliomyelitis except

A)summer outbreaks in the United States have been increasing recently.
B)transmitted primarily by fecal-contaminated water.
C)can be asymptomatic or mild with headache,sore throat,fever,and nausea.
D)if virus enters the central nervous system motor,neurons can be infected and destroyed.
E)caused by enterovirus.

Question 34

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 35

Encephalitis is most commonly caused by a

A)bacteria.
B)protozoan.
C)virus.
D)helminth.
E)All of the choices are correct.

Question 36

Which of the following is not true of meningoencephalitis?

A)causative organisms are Naegleria fowleri and Acanthamoeba
B)infections of both the brain and meninges
C)causative organisms are viruses
D)modes of transmission are direct contact and swimming in warm fresh water
E)treatment for primary amoebic meningoencephalitis is mostly ineffective

Question 37

Toxoplasmosis prevention includes

A)vaccination of humans.
B)vaccination of cats.
C)hygienic precautions.
D)vector control.
E)All of the choices are correct.

Question 38

The organism responsible for the majority of neonatal meningitis is

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

Question 39

Which of the following is not a prion disease?

A)scrapie
B)Creutzfeldt-Jacob disease
C)bovine spongiform encephalopathy
D)subacute sclerosing panencephalitis
E)All of the choices are prion diseases.

Question 40

Patients with Creutzfeldt-Jacob disease live

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

Question 41

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

Question 42

Cryptococcal meningitis is highly communicable among humans.

Question 43

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 botulinum.
B)Clostridium perfringens.
C)Clostridium difficile.
D)Clostridium tetani.
E)All of the choices are correct.

Question 44

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

Question 45

Which is the exotoxin of botulism?

A)hemolysin
B)tetanospasm
C)peroxidases
D)factor V
E)botulinum

Question 46

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

Question 47

Viral meningitis normally requires aggressive antiviral treatment.

Question 48

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

Question 49

The foodborne disease that involves neurotoxin is

A)gastrointestinal anthrax.
B)bacillus cereus intoxication.
C)botulism.
D)clostridium perfringens gastroenteritis.
E)All of the choices are correct.

Question 50

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

A)Clostridium botulinum.
B)Clostridium perfringens.
C)Clostridium difficile.
D)Clostridium tetani.
E)All of the choices are correct.

Question 51

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

Question 52

Prions can be destroyed by autoclaving.

Question 53

Subacute sclerosing panencephalitis is caused by a prion.

Question 54

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

Question 55

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

A)occurs when spore-contaminated soil enters deep wounds
B)caused by enterotoxins of the pathogen
C)exotoxin blocks acetylcholine release
D)nausea and diarrhea are symptoms
E)treatment involves antitoxin therapy

Question 56

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

Question 57

The preferred preventative measure for polio in the United States is

A)inactivated poliovirus vaccine (IPV)developed by Jonas Salk.
B)oral poliovirus vaccine (OPV)developed by Jonas Salk.
C)inactivated poliovirus vaccine (IPV)developed by Albert Sabin.
D)oral poliovirus vaccine (OPV)developed by Albert Sabin.

Question 58

In paralytic polio,what structures are damaged?

A)peripheral nerves
B)diaphragm
C)anterior horn cells
D)sensory nerves
E)brain stem

Question 59

Botulism is often referred to as lockjaw.

Question 60

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

Question 61

Nancy wants to know with which antibiotics you will be treating her mother.What is the best antibiotic for this illness?

A)vanomycin
B)cefotaxime
C)cefepime
D)No antibiotic therapy is indicated.

Question 62

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

Question 63

What other questions would be most important to ask to elicit a thorough history?

A)family history,mosquito exposure,allergies,medications
B)medications,food preferences,religious preference
C)birth history,childhood development,level of education
D)mosquito exposure,use of DEET,level of water filtration

Question 64

What is the transmission of the polio virus?

A)fecal-oral
B)arthropod
C)bat vector
D)unsanitary food

Question 65

You are saddened to learn from serology testing that Raj,in fact,has polio.What is the best treatment modality?

A)antibiotics and fever control
B)acyclovir and morphine
C)immunization and sanitation
D)pain control and mechanical ventilation

Question 66

A lumbar puncture is performed,which confirms a diagnosis of meningitis.Antibiotics are started right away.Amanda's cerebral spinal fluid is placed on a microscope slide and Gram-stained.On stain,you see gram-positive cocci in pairs.What is the most likely offending organism?

A)Streptococcus pneumoniae
B)Neisseria meningitides
C)Haemophilus influenzae
D)Listeria monocytogenes

Question 67

Which of the following tests will be most helpful in confirming Amanda's diagnosis?

A)CT scan
B)chest X ray
C)complete blood count
D)lumbar puncture

Question 68

You are wondering what the specific causative agent is,so you do a search on PubMed from the hospital's medical library.What is the causative agent for polio?

A)Enterovirus picornaviridae
B)Streptococcus pneumoniae
C)Naegleria fowleri
D)Poliovirus intoxicum

Question 69

Nancy is very concerned about her mother,and wants to know if her mother will live.What is the best response?

A)"I promise you,we won't rest until your mother is walking out of this hospital."
B)"We'll do our best."
C)"I'm sorry,but your mother will probably die.Would you like to see a chaplain?"
D)"Unfortunately,we see about a 70% mortality rate nationwide.You've done everything you can do,we'll do everything we can do."

Question 70

Which of the following diseases are you most concerned about,considering the history Raj gave you?

A)meningitis
B)tetanus
C)polio
D)typhoid

Question 71

What is the most likely diagnosis for Amanda?

A)prolonged sinus infection
B)meningitis
C)tumor of the cervical spine
D)necrotizing encephalitis

Question 72

What would have been the best way for Amanda to prevent getting this strand of meningitis?

A)not live in a college dormitory
B)take antibiotics with every cold
C)be vaccinated with Pneumovax
D)drink plenty of fluids

Question 73

Multiple tests are performed,and it is discovered that Leah has Eastern equine encephalitis.What is the best initial treatment regimen?

A)acyclovir,hydration,antiepileptic drugs,LP
B)LP,CT,MRI
C)acyclovir,medical coma,heart catheterization
D)hydration,antiepileptic drugs,rapid cooling,neurosurgery consult

Question 74

Which antibiotic(s)is/are best suited to treat this particular infection?

A)vancomycin and ceftriaxone
B)amoxicillin
C)TMP-SMZ
D)penicillin V