Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1)
Which of the following statements about rabies is FALSE?
1)
A)
Hydrophobia is associated with the disease.
B)
Diagnosis is based on immunofluorescent techniques.
C)
Most infections in the U.S. are the result of bites from infected dogs.
D)
Average incubation period is 30 to 50 days after initial infection.
E)
It is caused by Lyssavirus.
2)
On June 30, a 47–year–old man was hospitalized with dizziness, blurred vision, slurred speech,
difficulty swallowing, and nausea. Examination revealed facial paralysis. The patient had partially
healed superficial knee wounds incurred while laying cement. He reported eating home–canned
green beans and stew containing roast beef and potatoes 24 hours before onset of symptoms. The
patient should be treated with
2)
A)
antibiotics.
B)
surgery.
C)
antitoxin.
D)
supportive care, including respiratory assistance.
E)
vaccination.
3)
All of the following are true regarding African trypanosomiasis EXCEPT
3)
A)
it is transmitted by the tsetse fly.
B)
it is also known as “sleeping sickness.”
C)
all subspecies of Trypanosoma brucei have multiple hosts.
D)
death ultimately occurs without proper treatment.
E)
Trypanosoma brucei gambiense is the more common cause of disease.
Explanation:
4)
All of the following organisms are transmitted via the respiratory route EXCEPT
4)
A)
Listeria monocytogenes.
B)
Haemophilus influenzae.
C)
Cryptococcus neoformans.
D)
Neisseria meningitidis.
E)
None of the answers is correct; all of these organisms are transmitted by the respiratory route.
5)
All of the following are acquired by ingestion EXCEPT
5)
A)
listeriosis.
B)
botulism.
C)
Creutzfeldt–Jakob disease.
D)
cryptococcosis.
E)
poliomyelitis.
6)
Microscopic examination of cerebrospinal fluid reveals gram–positive rods. What is the organism?
6)
A)
Streptococcus
B)
Listeria
C)
Naegleria
D)
Haemophilus
E)
Neisseria
7)
Bacterial encephalitis and meningitis are difficult to treat because
7)
A)
antibiotics damage nervous tissue.
B)
the infections move along peripheral nerves.
C)
no medications exist for treatment of these infections.
D)
it is very difficult to determine the causative microbe.
E)
many antibiotics cannot penetrate the blood—brain barrier.
8)
The prodromal symptom(s) of bacterial meningitis is/are
8)
A)
mild cold symptoms.
B)
fever and headache.
C)
stiff neck and back pains.
D)
convulsions.
E)
fever, headache, and stiff neck.
9)
Which of the following is a free–living amoeba that can cause encephalitis?
9)
A)
Acanthamoeba
B)
Entamoeba
C)
Naegleria
D)
Naegleria and Acanthamoeba
E)
Entamoeba and Naegleria
10)
Initial treatment for tetanus in an unimmunized person with a puncture wound is
10)
A)
tetanus immune globulin.
B)
tetanus toxoid.
C)
debridement.
D)
none; no action is necessary.
E)
penicillin.
11)
Arboviruses cause ________ and are transmitted by ________.
11)
A)
encephalitis; mosquitoes
B)
meningitis; exposure to certain trees
C)
encephalitis; exposure to certain trees
D)
meningitis; mosquitoes
E)
both meningitis and encephalitis; mosquitoes
12)
All of the following are associated with botulism outbreaks EXCEPT
12)
A)
type B toxin is most virulent.
B)
Alaskan natives have the highest rate of botulism.
C)
type E toxin is associated with seafood.
D)
endospores of C. botulinum have been recovered from honey.
E)
antibodies are not an effective method of treatment.
13)
Which of the following is treated with antibiotics?
13)
A)
streptococcal pneumonia
B)
botulism
C)
polio
D)
tetanus
E)
All of these diseases can be successfully treated with antibiotics.
14)
Which one of the following causes the most severe illness in humans, with a mortality rate of 30
percent?
14)
A)
western equine encephalitis
B)
West Nile encephalitis
C)
eastern equine encephalitis
D)
California encephalitis
E)
St. Louis encephalitis
15)
The most effective control of mosquito–borne disease is
15)
A)
treatment of uninfected humans.
B)
elimination of the mosquito population.
C)
treatment of infected humans.
D)
avoidance of endemic areas.
E)
treatment of infected wild animals.
16)
All of the following are true of M. leprae EXCEPT
16)
A)
it survives ingestion by macrophages.
B)
it invades cells of the PNS.
C)
it has a very short generation time of approximately twelve hours.
D)
it grows best at temperatures below 37° C.
E)
it can be cultured in armadillos.
17)
A pathologist detects Negri bodies while examining a brain section taken at autopsy. What was the
cause of death?
17)
A)
meningococcal meningitis
B)
Hansen’s disease
C)
poliomyelitis
D)
rabies
E)
eastern equine encephalitis
18)
The symptoms of tetanus are due to
18)
A)
systemic infection.
B)
sustained relaxation of muscles.
C)
endospore formation.
D)
tetanospasmin.
E)
inflammation.
19)
Each of the following is caused by prions EXCEPT
19)
A)
sheep scrapie.
B)
bovine spongiform encephalopathy.
C)
kuru.
D)
rabies.
E)
Creutzfeldt–Jakob disease.
Explanation:
20)
Which of the following statements about Neisseria meningitis is FALSE?
20)
A)
It is a gram–positive anaerobe.
B)
Its most distinguishing feature is a unique rash.
C)
It is typically transmitted by droplet aerosols or direct contact with secretions.
D)
It is encapsulated.
E)
A healthy carrier state can exist.
21)
All of the following microorganisms can directly cause meningitis EXCEPT
21)
A)
virus.
B)
bacteria.
C)
fungi.
D)
mosquitoes.
E)
protozoa.
22)
A one–year–old boy was listless, irritable, and sleepy. Capsulated Gram–negative rods were
cultured from his cerebrospinal fluid. His symptoms were caused by
22)
A)
Clostridium tetani.
B)
Neisseria meningitidis.
C)
a prion.
D)
rabies.
E)
Haemophilus influenzae.
23)
Initial treatment for tetanus in a fully immunized person with a puncture wound is
23)
A)
debridement.
B)
tetanus toxoid.
C)
DTaP.
D)
tetanus immune globulin.
E)
penicillin.
Explanation:
24)
All of the following organisms are correctly matched to the recommended treatment EXCEPT
24)
A)
Mycobacterium leprae — dapsone.
B)
poliovirus — amphotericin B.
C)
Cryptococcus neoformans — amphotericin B.
D)
Haemophilus influenzae — cephalosporins.
E)
Neisseria meningitidis — cephalosporins.
25)
Which of the following vaccines can cause the disease it is designed to prevent?
25)
A)
Haemophilus influenzae capsule vaccine
B)
inactivated polio vaccine
C)
tetanus toxoid vaccine
D)
oral polio vaccine
E)
meningococcal capsule vaccine
26)
A 30–year–old woman was hospitalized after she experienced convulsions. On examination, she
was alert and oriented and complained of a fever, headache, and stiff neck. Any of the following
organisms could be responsible for her symptoms EXCEPT
26)
A)
Clostridium botulinum.
B)
Haemophilus influenza.
C)
Streptococcus pneumoniae.
D)
Listeria monocytogenes.
E)
Any of these organisms could be the causative agent.
27)
All of the following diseases are caused by arbovirus EXCEPT
27)
A)
primary amebic meningoencephalitis (PAM).
B)
St. Louis encephalitis.
C)
eastern equine encephalitis.
D)
West Nile encephalitis.
E)
None of the answers is correct; all of these diseases are caused by arbovirus.
28)
Vaccination is available for all the following EXCEPT
28)
A)
tetanus.
B)
rabies.
C)
botulism.
D)
Neisseria meningitis.
E)
Haemophilus meningitis.
29)
Naegleria fowleri meningoencephalitis is commonly acquired by
29)
A)
mosquito bites.
B)
exposure to body fluids of a contaminated individual.
C)
ingestion of water contaminated with fecal material.
D)
exposure to bird droppings.
E)
swimming in warm ponds or streams.
30)
All of the following are true of poliomyelitis EXCEPT
30)
A)
initial sites of viral replication are the throat and small intestine.
B)
the oral polio vaccine contains attenuated strains of the virus.
C)
the majority of cases are asymptomatic.
D)
infection is due to ingestion of contaminated water.
E)
most cases result in muscle paralysis.
Explanation:
31)
All of the following are true of chronic fatigue syndrome EXCEPT
31)
A)
it is also known as myalgic encephalomyelitis.
B)
it may be triggered by a viral infection.
C)
it is a psychological disorder.
D)
it may have a genetic component.
E)
it often begins with flu–like symptoms that do not go away.
32)
The most common route of central nervous system invasion by pathogens is through
32)
A)
the gastrointestinal system.
B)
the circulatory system.
C)
the skin.
D)
direct penetration into nerves.
E)
the parenteral route.
33)
Patients with leprosy usually die from complications such as
33)
A)
brain damage.
B)
pneumonia.
C)
cardiac arrest.
D)
tuberculosis.
E)
loss of nerve function.
34)
A physician diagnoses a patient with lepromatous Hansen’s disease. All of the following pertain to
the patient EXCEPT
34)
A)
the disease has progressed from the tuberculoid stage.
B)
disfiguring nodules form all over the body.
C)
a skin biopsy will be taken to aid diagnosis.
D)
treatment will include injections of penicillin.
E)
infection probably occurred as a result of prolonged contact with another infected individual.
Explanation:
35)
Diagnosis of rabies is confirmed by
35)
A)
direct fluorescent–antibody test.
B)
Gram stain.
C)
passive agglutination.
D)
patient’s death.
E)
patient’s symptoms.
36)
Which of the following pairs is mismatched?
36)
A)
Cryptococcus neoformans — acid–fast rod
B)
Naegleria fowleri — causes amoebic encephalitis
C)
Haemophilus influenzae — virulence due to capsule
D)
Mycobacterium leprae — cultured in armadillos
E)
Neisseria meningitidis —produces deadly endotoxins
37)
On October 5, a pet store sold a kitten that subsequently died. On October 22, rabies was diagnosed
in the kitten. Between September 19 and October 23, the pet store had sold 34 kittens.
Approximately 1000 people responded to health care providers following local media alerts. These
people were given
37)
A)
human diploid cell vaccine.
B)
antibiotics.
C)
antiviral medications.
D)
immune globulin injections.
E)
postexposure prophylaxis.
38)
Which of the following vaccine characteristics is (are) mismatched?
Salk Vaccine Sabin Vaccine
1. Consists of a formalin–inactivated virus 4. Consists of a live, attenuated polio virus
2. Administered orally 5. Administered orally
3. Requires booster doses 6. Provides community immunity
38)
A)
4, 5, and 6
B)
2 only
C)
1 and 3 only
D)
1, 2, and 3
E)
None of the answers are correct; all these characteristics are correctly matched.
39)
All of the following organisms cause meningitis EXCEPT
39)
A)
Neisseria meningitidis.
B)
Haemophilus influenzae.
C)
Cryptococcus neoformans.
D)
Mycobacterium leprae.
E)
Streptococcus pneumoniae.
40)
Which of the following statements about leprosy is FALSE?
40)
A)
Patients with leprosy must be isolated.
B)
The etiologic agent is acid–fast.
C)
Diagnosis is based on skin biopsy.
D)
It is transmitted by direct contact.
E)
It is rarely fatal.
41)
Which of the following pairs is mismatched?
41)
A)
meningococcal meningitis respiratory route
B)
listeriosis ingestion
C)
leprosy direct contact
D)
poliomyelitis respiratory route
E)
rabies direct contact
42)
Encephalitis is more common in the summer months because
42)
A)
pathogens are present in swimming pools and lakes.
B)
people encounter more bats during warm summer evenings.
C)
ticks are encountered while hiking in the woods.
D)
ameba populations increase in swimming pools.
E)
mosquito populations increase.
43)
Which of the following pairs is mismatched?
43)
A)
rabies virus destroys cells of the CNS
B)
leprosy — deformation of nose and hands can occur
C)
poliomyelitis multiplication of virus occurs in throat and small intestine
D)
botulism stimulates transmission of nerve impulse
E)
tetanus releases potent neurotoxin
44)
A 30–year–old woman was hospitalized after she experienced convulsions. On examination, she
was alert and oriented and complained of a fever, headache, and stiff neck. Which of the following
is most likely to provide rapid identification of the cause of her symptoms?
44)
A)
check serum antibodies
B)
Gram stain of cerebrospinal fluid
C)
Gram stain of throat culture
D)
biopsy of brain tissue
E)
None of these would provide rapid identification.
45)
An eight–year–old girl in rural Wisconsin has chills, headache, and fever and reports having been
bitten by mosquitoes. How would you confirm your diagnosis?
45)
A)
brain biopsy for Negri bodies
B)
examination of local mosquitoes
C)
Gram stain of cerebrospinal fluid
D)
complement fixation test for IgG antibodies
E)
ELISA test for IgM antibodies
TRUE/FALSE. Write ‘T’ if the statement is true and ‘F’ if the statement is false.
46)
Cryptococcus neoformans is a gram–negative cocci with a thick capsule.
46)
47)
Poliomyelitis is caused by a virus and typically leads to paralysis in those affected.
47)
48)
Botulism and tetanus are caused by bacterial endospores commonly found in the soil.
48)
49)
Viral meningitis is much more common than bacterial meningitis and tends to cause a milder form
of disease.
49)
50)
Lifelong immunity is conferred once an individual has had botulism and recovered.
50)
51)
The number of leprosy cases in the United States is gradually increasing.
51)
52)
CSF contains high levels of complement and circulating antibodies to prevent infection of the brain
and spinal cord.
52)
53)
Autopsy of a stillborn fetus reveals the cause of death to be meningitis. The likely pathogen is
Haemophilus influenza.
53)
54)
The most common host of the virus causing eastern equine encephalitis is horses.
54)
55)
If a normal protein typically found on the surface of nervous tissue cells comes into contact with an
abnormally folded protein, it can lead to prion–related disease.
55)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
56)
There is an antitoxin for botulism. Why, then, is the outcome of botulism often fatal?
57)
Explain the transmission and etiology of meningococcal meningitis.
58)
Discuss the advantages and disadvantages of the Salk and Sabin vaccines.
Answer Key
Testname: C22
Answer Key
Testname: C22