Deck 19: Infectious Diseases Affecting the Nervous System

Question 1

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) pores in the blood-brain barrier that permit the passage of glucose and other nutrients
D) the location of dormant viruses that infect both the gut and the brain

Answer 1

changes in brain chemistry and behavior caused by the gut microbiota

Question 2

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

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

Answer 2

a reduced immune response compared to the rest of the body

Question 3

Which of the following is not true of Streptococcus pneumoniae?

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

Answer 3

It is a small, gram-negative coccus.

Question 4

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

Question 5

Neisseria meningitidis is transmitted by ______.

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

Question 6

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

Question 7

Which of the following statements is incorrect regarding Listeria monocytogenes?

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

Question 8

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

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

Question 9

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

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

Question 10

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

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

Question 11

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

A) Listeria monocytogenes
B) Streptococcus agalactiae
C) Cryptococcus neoformans
D) Haemophilus in?uenzae
E) Neisseria meningitidis

Question 12

Meningococci initially colonize the ______.

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

Question 13

The presence of Neisseria in a sample of cerebrospinal ?uid indicates that _______.

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

Question 14

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 15

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) It is a common cause of bacterial pneumonia.
C) It causes a serious meningitis.
D) Its reservoir is the nasopharynx of human carriers.
E) Its virulence factors include a capsule, pili, endotoxin, and IgA protease.

Question 16

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

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

Question 17

Cerebrospinal ?uid 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

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

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

Question 19

Treatment for Neisseria meningitidis consists of ______.

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

Question 20

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 21

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 22

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

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

Question 23

Encephalitis is most commonly caused by a ______.

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

Question 24

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

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

Question 25

The best defense against arboviruses is ______.

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

Question 26

Cryptococcal meningitis is highly communicable among humans.

Question 27

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 28

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

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

Question 29

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 hasWest Nile virus to avoid the infectious agent in the future?

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

Question 30

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

A) Coccidioides immitis
B) Cryptococcus neoformans
C) Streptococcus pneumoniae
D) Neisseria meningitidis
E) Haemophilus in?uenzae

Question 31

Viral meningitis normally requires aggressive antiviral treatment.

Question 32

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 33

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

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

Question 34

Toxoplasmosis prevention includes ______.

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

Question 35

Neonatal meningitis is most commonly transmitted by ______.

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

Question 36

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

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

Question 37

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 38

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 39

Cryptococcus neoformans is a ______.

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

Question 40

Which of the following is caused by Haemophilus in?uenzae?

A) Tetanus
B) In?uenza (?u)
C) Kuru
D) Bacterial meningitis
E) Pharyngitis

Question 41

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

Question 42

Prions can be destroyed by autoclaving.

Question 43

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

A) Clostridium tetani
B) Clostridium perfringens
C) Clostridium botulinum
D) Clostridium di?cile

Question 44

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 45

Tetanus differs from botulism in that _______.

A) tetanus results in ?accid 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 46

The food-borne disease that involves neurotoxin is ______.

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

Question 47

African sleeping sickness is caused by ______.

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

Question 48

Which is the exotoxin of botulism?

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

Question 49

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 50

In paralytic polio, which structures are damaged?

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

Question 51

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 52

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 di?cile
D) Clostridium tetani

Question 53

Which of the following statements about rabies is incorrect?

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

Question 54

Which of the following is not a prion disease?

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

Question 55

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

Question 56

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

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

Question 57

Which of the following statements regarding poliomyelitis is incorrect?

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

Question 58

Poliovirus initially multiplies in the ______.

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

Question 59

Subacute sclerosing panencephalitis is caused by a prion.

Question 60

Botulism is often referred to as lockjaw.

Question 61

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

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

Question 62

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

Question 63

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

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

Question 64

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

Question 65

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 66

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

Question 67

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

Question 68

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

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

Question 69

The vector involved in African sleeping sickness is the ______.

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

Question 70

A group is planning a cross-country hike on the Paci?c 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 71

Botox injections contain botulinum toxin.

Question 72

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 73

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) always kills the host
C) manifests in behavioral changes in the host
D) causes destruction of brain tissue

Question 74

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

Question 75

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

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

Question 76

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) 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.
B) This particular strain of the rabies virus is probably nonpathogenic, so the vaccine is given to boost the immune system's protective functions.
C) Since there is no treatment available, they suggest the vaccine as a last resort.
D) There were few virus particles in the bite, so her immune system has enough time to respond.

Question 77

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

Question 78

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

Question 79

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

Question 80

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 classi?cation that is
Mismatched.

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