Deck 19: Infectious Diseases Affecting the Nervous System

Question 1

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.

Answer 1

E

Question 2

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

Answer 2

D

Question 3

Place the following in order from skull to brain: subarachnoid space,arachnoid mater,dura mater,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

Answer 3

B

Question 4

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 5

Meningococci initially colonize the

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

Question 6

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 7

The concept of "immunologically privileged" explains why the CNS has

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

Question 8

Cryptococcus neoformans is a

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

Question 9

Which type of neuroglia has phagocytic capabilities in the CNS?

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

Question 10

Treatment for Neisseria meningitidis consists of

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

Question 11

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 12

Neisseria meningitidis is transmitted by

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

Question 13

Which of the following is caused by Haemophilus influenzae?

A)bacterial meningitis
B)influenza (flu)
C)pharyngitis
D)bronchitis
E)epiglottitis

Question 14

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 15

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 16

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 17

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

A)Haemophilus influenzae.
B)Listeria monocytogenes.
C)Cryptococcus neoformans.
D)Coccidiodes immitis.
E)Streptococcus agalactiae.

Question 18

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.

Question 19

All of the following are 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 20

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 21

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 22

Which of the following is not a prion disease?

A)scrapie
B)Creutzfeldt-Jacob disease
C)bovine spongiform encephalopathy
D)subacute sclerosing panencephalitis

Question 23

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 24

Which of the following is not true of meningoencephalitis?

A)causative organisms are Naegleria fowleri and Acanthamoeba
B)involves infection 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 (PAM)is mostly ineffective

Question 25

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

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

Question 26

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

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

Question 27

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 28

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 29

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 30

Toxoplasmosis prevention includes

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

Question 31

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 documents as methods of prion transmission.

Question 32

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

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

Question 33

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 34

Encephalitis is most commonly caused by a

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

Question 35

The organism found in powdered baby formula which can cause meningitis is

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

Question 36

Which of the following diseases exhibits the highest mortality rate?

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

Question 37

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

A)JC virus
B)arbovirus
C)herpes simplex virus
D)Toxoplasma gondii
E)varicella-zoster virus

Question 38

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 39

The best defense against arborviruses is

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

Question 40

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

A)cat
B)dog
C)mouse
D)mosquito
E)raccoon

Question 41

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.

Question 42

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

Question 43

African sleeping sickness is caused by

A)Trypanosoma cruzi.
B)Trypanosoma brucei.
C)Leishmania braziliensis
D)Isospora belli.
E)Plasmodium falciparum.

Question 44

All of the following pertain to poliomyelitis except

A)summer outbreaks in the U.S.have been recently increasing.
B)it is transmitted primarily by fecal contaminated water.
C)it 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)it is caused by poliovirus (genus Enterovirus).

Question 45

Viral meningitis normally requires aggressive antiviral treatment.

Question 46

Which is incorrect about rabies?

A)Rabies 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)The average incubation period in human is 1 week.
E)Symptoms include anxiety,agitation,muscle spasms,convulsions,and paralysis.

Question 47

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 with inactive vaccine.
E)All of the choices are correct.

Question 48

Cryptococcal meningitis is highly communicable among humans.

Question 49

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

A)occurs when endospore-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 50

Polio virus initially multiplies in the

A)intestine.
B)CNS.
C)lymphoid tissue.
D)basal ganglia.

Question 51

The vector involved in African sleeping sickness is the

A)reduviid "kissing" bug.
B)Tsetse fly.
C)Anopheles mosquito.
D)Phlebotomine (sand)fly.
E)hard-bodied tick.

Question 52

The foodborne disease that involves neurotoxin is

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

Question 53

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.

Question 54

Prions can be destroyed by autoclaving.

Question 55

Subacute sclerosing panencephalitis is caused by a prion.

Question 56

In paralytic polio,what structures are damaged?

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

Question 57

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 not for tetanus.
D)muscles cannot relax in tetanus,while muscles cannot contract in botulism.
E)All of the choices are correct.

Question 58

Which is the exotoxin of botulism?

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

Question 59

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

Question 60

The preferred preventative measure for polio in the United States is

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 61

Children with hypogammaglobulinemia are at risk for developing polio if given the oral polio vaccine.

Question 62

Botulism is often referred to as lockjaw.

Question 63

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

Question 64

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

Question 65

Your friend is bitten on the leg by an aggressive dog.Since the dog ran and was not caught,and since the dog bit many other people without reason,it is suspected that it had rabies.The city health department recommends the rabies vaccination for her,even though she has already been exposed to the infectious agent.Which statement best describes why the vaccine can be given post-exposure?

A)This particular strain of the rabies virus is probably nonpathogenic,so the vaccine is given to simply boost the immune system's own protective functions.
B)Since there is really nothing else to do,they suggest the vaccine as a last possibility.
C)The virus exhibits a long incubation period,in many cases providing the vaccine adequate time to have a protective effect in the patient.
D)There were few virus particles in the bite,so her immune system has enough time to kick into high gear.

Question 66

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

Question 67

Botox injections contain botulinum toxin.

Question 68

Toxoplasma gondii infects the brain,as do many pathogens.However,a difference between this pathogen and others is that it:

A)produces behavioral changes in the host.
B)causes brain cancer.
C)causes destruction of brian tissue.
D)always kills the host.

Question 69

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

Question 70

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

Question 71

When you were much younger you received the OPV polio vaccine and its boosters.Now you are going on a mission trip to Bangladesh and the vaccine is recommended by the Centers for Disease Control.When you go to the city health office to get the vaccine,they given you the IPV vaccine.When you ask why you are receiving the IPV rather than the OPV,the personnel there tell you:

A)the IPV is preferred by patients because it can be taken orally.
B)the IPV has fewer active viruses in it than the OPV,so they say it is safer.
C)the health facility is just out of the OPV vaccine,but if they had it that one would be the one they would prefer to use.
D)there is no possibility of actually developing polio from this vaccine.

Question 72

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

Question 73

Your young friend has meningococcemia.Having had microbiology,you understand the severe consequences of this disease and worry that she might:

A)have a progression of the disease leading to respiratory collapse.
B)have to have a limb amputated.
C)transfer the infectious agent to her fetus,since she is pregnant.
D)go into a chronic disease state,where the symptoms come and go for years.

Question 74

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

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

Question 75

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

Question 76

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 at home with flea medication.
B)Do not eat food served from kiosks and food trucks in foreign countries.
C)Always drink bottled water when vacationing outside of the U.S.
D)Do not go outside at dusk nor at dawn,and cover the skin if this is unavoidable.