BYS 214 Exam 5 HW questions

Hepatitis

viruses designated by A-E

Cycle B

worms mature in intestine; egg released in feces; larvae enter through skin

The flushing action of urine is a defense mechanism that prevents microbial invasion of the urinary system.

True

Noscomial pneumonia

typically caused by a mixture of causative agents transmitted by aspiration and prevented by proper positioning

the _____ respiratory tract is made up of the mouth, the nose, the nasal cavity and sinuses, the throat and the epiglottis and larynx

upper

Tuberculosis is a disease of poverty since susceptibility is increased in the face of inadequate nutrition and poor access to medical care.

True

Place the steps in the correct order to review the stages in soft-tissue infection, gingivitis, and periodontitis.

1. tooth, gingiva, and bone show no inflammation 2. inflammation, calculus are well developed 3. tissue destruct and bone loss occur

An RN in a clinic for the homeless sees many patients infected with hepatitis B. She performs testing as ordered for symptomatic patients, along with providing education about the disease. Which of the following patients would be most at risk for acquiring hepatitis B virus?

36-year-old female using multiple IV drugs

The oral cavity harbors several hundred microbial species and while the _____ has few microbes, the ________ is inhabited by Bacteroides, Clostridium, and many other species.

upper GI, Lower GI

Select all of the statements that apply to the disease diphtheria to test your understanding of upper respiratory diseases caused by microorganisms.

A characteristic pseudomembrane forms on the tonsils and in the pharynx Toxin can enter bloodstream and cause myocarditis and neuritis Disease can be prevented by use of a toxoid containing vaccine

A hospital is experiencing an outbreak of rotavirus. An RN on a pediatric unit takes precautions to protect her patients from acquiring the disease. The mother of an infected 18-month-old patient expresses concern that she may acquire rotavirus infection. Which of the following responses is most appropriate by the RN?

Adults may acquire rotavirus infection, but symptoms are generally mild.

Select all of the correct statements concerning the female genital tract to test your understanding of the normal biota present in the genitourinary tract

After puberty, estrogen production leads to glycogen release in the vagina lowering the pH. After puberty, Lactobacilli dominate discouraging growth of other microbes.

Mycoplasma pneumoniae

adhesins

Helminthic Infections with Intestinal/Migratory Symptoms

Ascaris Lumbricoides & Necator americanus

Acute Otitis Media

Can be caused by bacteria or viral infection; routine use of broad- spectrum antibiotics which has lead to resistant

Select all of the statements that apply to healthcare-associated or nosocomial pneumonia to test your understanding of the differences between healthcare-associated and community-acquired pneumonia

Can be caused by coliform bacteria Can be caused by coliform bacteria Bacteria enter lower respiratory tract due to abnormal breathing Bacteria enter lower respiratory tract due to mechanical ventilation

A vaccine is now recommended for girls & boys in order to reduce their risk of infection with this STI and/or subsequent development of _________ cancer.

Cervical

Select all of the statements that apply to Chlamydia infection to test your understanding of genitourinary tract diseases characterized by discharge.

Causative agent is an obligate intracellular parasite. It is caused by Chlamydia trachomatis. Neonate eye infections are more prevalent than those associated with gonorrhea.

RSV

Caused by virus that produces syncytia in the respiratory tract, passive antibody prep used in high risk

Tranmission of gonorrhea occurs through

Child birth and sexual contact

Select all of the correct answers concerning the disease schistosomiasis caused by Schistosoma sp.

Chronic infection results in liver disease, splenomegaly, and hepatomegaly. Schistosomes are trematodes often referred to as blood flukes. Fluke cloaks itself with host proteins to evade the immune response.

Select all of the statements that are factors affecting a person's susceptibility to TB to test your understanding of the epidemiology of tuberculosis infection

Compromised immune system Crowded living conditions poor access to medical care inadequate nutrition

Choose the statement that best describes the normal biota of the upper respiratory tract.

Contains a variety of microbes including some that can cause serious disease

Campylobacter jejuni

most frequent cause of diarrhea resulting in watery stool, fever, vomiting, headaches and severe abdomen pain

Trichuris trichiura

Cycle A, Whipworm, humans are the sole host

Enterobius vermicularis

Cycle A, pinworm, diagnosis by adhesive tape method

Diphyllobothrium latum

Cycle C, Fish tapeworm, transmitted by sushi

Taenia solium

Cycle C, pork tapeworm, acquired by ingestion of uncooked pork

In addition, the GI tract encounters millions of new microorganisms every day, requiring this system to possess a variety of _________ against infection.

Defenses

Shigella dysenteriae

Diarrhea containing blood and mucus from the GI tract

Vibrio cholerae

Diarrhea described as rice water stools

Wart Diseases

HPV

Cycle D

Eggs released by humans; larvae enter through ingestion or direct penetration

Helminthic Infections w/ Intestinal Distress

Enterobius vermicularis & Trichuris trichuria

"The influenza virus is able to decrease the effectiveness of the host immune response by a mechanism called antigenic drift, which involves the swapping of gene strands with other influenza viruses."

False

Dental diseases, in particular periodontal disease, provide excellent models of diseases mediated by single organisms.

False

Read this case study below and complete the question that follows. A 32-year-old recent immigrant from Mexico applied for work at the hospital where I was completing my first practicum as a radiology technician. All new employees of the hospital were required to have a Mantoux test to rule out tuberculosis (TB). My patient's Mantoux skin test was positive, and was sent to me for a chest X ray for further verification of his disease status. He was concerned about his positive skin test but stated that he couldn't possibly have tuberculosis because he didn't feel sick. When the X ray was completed, I noticed something strange. I called my preceptor, who was supervising my practicum, to help me interpret the X ray. Although I was able to identify many abnormalities on chest films, what I was seeing was something that I had never seen before in a patient so young. The X ray showed numerous areas of scarring in the patient's left lower lobe, which seemed unusual to me given my patient's age. My preceptor viewed the X ray and commented that we would have to phone the patient's physician immediately. Unable to identify what I was seeing, I asked my preceptor what she thought was wrong with the patient. She replied, "Your patient recently immigrated from Mexico, has had a positive Mantoux test, and has evidence of scarring on his chest X ray. The patient has tuberculosis." The patient was then admitted to the hospital and placed on respiratory isolation precautions. A sputum sample was obtained, and Ziehl-Neelsen staining confirmed the diagnosis of tuberculosis based upon the presence of AFB (acid-fast bacilli). The patient was started immediately on isoniazid, since cultures showed that there was no resistance to the drug. The patient was told that he needed to continue taking isoniazid for at least 9 months. Compliance with the prescribed therapy was stressed to the patient as being of utmost importance, and he was made to understand that not taking the drug as prescribed for the duration of therapy could lead to drug resistance, putting himself and others at risk. Public health was notified when the patient was discharged from the hospital and made arrangements to follow up with the patient to ensure that he was complying with treatment. True or False: The patient in the case study would be treated by directly observed therapy

False Although directly observed therapy was not warranted in this case because the patient's strain was not identified as MDR-TB (multidrug-resistant) nor XDR-TB (extensively drug-resistant), public health officials were to follow up with the patient to ensure that he was compliant for the entire duration of his treatment to avoid the development of resistance.

HPV, or human papillomavirus, is a causative agent of wart diseases of the _______ tract.

Genital

Chronic Diarrhea

Giardia & Entarmoeba

Genital Discharge Diseases

Gonorrhea & chlamydia

Select all of the correct statements pertaining to the protective characteristics of urine to test your understanding of the natural defenses of the genitourinary tract.

Has acidic pH Contains lactoferrin, an iron-binding protein Contains lysozyme which breaks down peptidoglycan Contains secretory IgA

Gastritis/Gastric Ulcer

Helicobacter pylori

Nector americanus

Hookworms that infect by penetrating the skin

Read the clinical scenario and then answer the question that follows. A RN at a high school is teaching a health education course about sexually transmitted infections. She provides the students with information about gonorrhea. Which of the following statements by a student demonstrates understanding of gonorrhea transmission?

If I have no symptoms, I can still pass the infection to others

Microbial defenses present in the upper tract consist of nasal hairs, the ciliary escalator, mucus, coughing/sneezing, and secretory ______ in the mucus.

IgA

Secretory ________ can be found on the surfaces of nearly all areas of the GI tract, and GALT is found throughout this system as well.

IgA

Gastritis

Infection (not necessarily disease with the causative agent found in up to 35% of US adults

Select all of the statements that apply to gonorrhea to test your understanding of genitourinary tract diseases characterized by discharge.

It is caused by Neisseria gonorrhoeae, a gram-negative diplococcus. It can result in eye and respiratory infections of neonates during birthing process. Infection can render both males and females sterile.

Read the introduction below and proceed to complete the question that follows. A 49-year-old triathlete presents to your research hospital in Illinois with one complaint: "Something is wrong." As a triathlete, his body is used to a rigorous daily training regimen; however, lately he has been unable to keep pace with his exercise routine. He is tired, he feels weak, and he notices tingling in his extremities. A check of his vitals does not show any abnormal signs, but at the last minute you notice a bit of jaundice developing in his sclera. Blood and sputum samples were obtained from the patient for analysis. The specimens were subsequently cultured onto various media. Staining and microscopic analysis of the cultures were performed as well ruling out viruses and revealing spirochete bacteria. Based upon all of the information obtained through specimen testing, along with the patient's symptoms, which of the following is the most likely pathogen?

Leptospira interrogans

While working as an ultrasound technician, I performed an abdominal ultrasound on a teenaged girl who had been admitted to the hospital with nausea and vomiting. In an effort to distract my nervous patient, and also to elicit more information, I asked the patient to tell me about the symptoms that had led to her hospitalization. The patient related to me that she had recently traveled with her church youth group to Costa Rica in order to take part in an international fellowship conference. The patient had returned home to the United States 3 weeks ago. Although she intially felt well, within a week of returning home she began to experience mild fever, fatigue, and loss of appetite. She stated she "wanted to sleep all the time." She felt nauseated and would sometimes vomit when she ate. Her parents were not overly alarmed and initially thought that the symptoms would pass until the patient's skin and sclera began to turn yellow. At that point, her parents brought her to the emergency room, and she was subsequently admitted for treatment of dehydration and further testing. The patient described at the beginning of the chapter was found to have an abnormality of the liver on ultrasound, referred to as a "starry sky" appearance caused by pathogenic changes of the organ. The ultrasound findings, coupled with elevated liver enzymes, the patient's symptoms (particularly jaundice), and serology results led to a diagnosis of hepatitis A. The patient likely contracted the disease while traveling in South America and consuming contaminated food or water. There is no specific treatment for hepatitis A. Most patients recover fully in 3 to 6 months. Symptomatic treatment may involve hydration, antiemetics for nausea and vomiting, and rest. Avoidance of fatty foods and alcohol is important to avoid further irritation of the liver. Which of the following symptoms made the physician include hepatitis viruses in the differential diagnosis?

Jaundice

Select all of the correct statements that apply to vaginitis to test your understanding of vaginal diseases caused by microorganisms.

Most commonly caused by Candida albicans Candida infections are opportunistic

A healthy 6-month-old infant was visiting her grandparents. Upon returning home, she developed a slight dry cough and runny nose. Her mother thought it was a common cold and chose not to seek medical attention for the baby. By the end of the week, however, she and her husband knew this was not just a cold. Their daughter began to cough with such force that her face turned red and she began to expectorate thick phlegm. At times, she even vomited. With each day, she became increasingly fatigued as well. Her mother finally brought her to the emergency room when her face turned blue during a bout of violent coughing. A nasopharyngeal swab was taken from the patient and the specimen was tested for the presence of viral pathogens and was subsequently cultured onto various media. Staining of cultures was performed as well. The pathogen was determined to be a bacterium. Based upon this diagnosis, what disease is the patient suffering from?

Pertussis

___________ is an inflammation of the prostate gland, typically due to endogenous transfer of GI microbes, and can be observed in either an acute or chronic form, which often is caused by an antibiotic-resistant biofilm.

Prostatitis

___________ is inflammation of a male reproductive gland accompanied by pain in the pelvic area and lower back, difficulty urinating, and painful ejaculation.

Prostatitis

Read the clinical scenario and then answer the question that follows. A patient reports frequent urges to urinate and burning pain with urination. The physician suspects the patient has a urinary tract infection. The RN provides the patient with education regarding the diagnosis and treatment plan. The patient develops a high fever and flank pain. What complication may this indicate?

Pyelonephritis

Most clinicians divide the _______ into two parts: the upper & lower tracts

Respiratory system

Acute Diarrhea

Salmonella & Shigella

Gastric Ulcers

Sharp, Burning pain from the abdomen caused by the development of the lesions in the mucosa of the stomach

Food Poisoning

Staphylococcus aureus & Bacillus cereus

Genital Ulcer Diseases

Syphilis & Herpes

Read the clinical scenario and then answer the question that follows. A 32-year-old woman presents to a women's health clinic for an annual exam. She reports to the RN that she has had multiple sexual partners in the past year. The patient denies pain with urination, changes in vaginal discharge character, or vaginal itching. She consents to testing for STDs due to her risk factors. The patient tests positive for Chlamydia infection. The patient asks the RN how she could have acquired the infection without noticeable symptoms. What is the most appropriate reply by the RN?

The vast majority of people infected with Chlamydia do not have symptoms.

Read the case file and complete the question that follows. A young female patient presented with a high fever (39.4 degrees Celsius [103 degrees Fahrenheit]) and was complaining of severe lower abdominal pain. Upon questioning, the patient also admitted to painful urination. As she was led into an examining room, it was noticed that she walked taking very small steps. She did not lift her feet off the floor and seemed reluctant or unable to straighten up fully. Her odd gait raised a red flag. After performing a quick abdominal examination and obtaining vital signs, the physician on call was found and told about the patient's symptoms, along with how the patient moved with an odd shuffling gait. The young patient was given a pelvic exam and was found to have a purulent and foul-smelling vaginal discharge, in addition to fever and lower abdominal pain. Cultures of the vaginal discharge and the cervix were obtained. Blood work and an ultrasound were also ordered. The blood work revealed an elevated white blood cell count and erythrocyte sedimentation rate (ESR), while the ultrasound revealed an abscess near the left ovary. The patient was admitted with a diagnosis of pelvic inflammatory disease (PID) for IV antibiotics and possible surgical drainage of the abscess. Cultures eventually yielded the specific causative agent, Neisseria gonorrhoeae. The "PID shuffle" is a term used to decribe the typical gait of a patient with PID, in which the feet are advanced in a shuffling manner to avoid jarring the pelvic organs, which results in severe pain. Which of the following drugs is commonly used for the treatment of gonorrhea today?

There is no common treatment due to the development of resistance

Select all of the correct statements about dental caries (tooth decay).

Tooth decay is the most common infectious disease of humans. Decay is due to metabolic action of the bacteria

____________ however, occurs in the female genital tract and is an inflammation of the vagina caused most commonly by Candida albicans.

Vaginitis

__________, an inflammation of the vagina most commonly caused by Candida, is characterized by some degree of vaginal itching; ________, however, does not appear to induce vaginal inflammation and is most likely due to a reduction in Lactobacillus species.

Vaginitis; vaginosis

Conversely, mixed bacterial infections of the vaginal tract typically include Gardnerella sp. and can lead to the development of ________, a condition characterized by vaginal discharge but generally lacking inflammation.

Vaginosis

Mumps

Virus

Cycle A

Worm Develops in the intestine, egg released in feces and ingested by new host

Cycle C

adult matures in intestine; egg is ingested by grazing animals; larvae encyst in tissue; humans consume cysts

pertussis

also known as whooping cough, causative bacteria produces an endotoxin and spread by droplets

A 3-year-old boy presents to the emergency department. His parents report 3 days of fever, lethargy, and poor feeding intake. They report diarrhea and visible blood in his stool for the past day. During assessment by the RN, the patient is irritable and shows signs of moderate dehydration. The patient is admitted to the hospital and worked up for gastrointestinal illness. The presence of blood in the stool and fever are most indicative of shiga-toxin-producing E. coli. The RN could expect all of the following to be ordered as treatment for this patient, except:

antibiotics

Although previously thought to be sterile, the _______ is now known to harbor many different species

stomach

Escherichia coli O157: H7

bloody diarrhea with development of hemolytic uremic syndrome in 10% of patients

Streptococcus pneumoniae

capsule

Diptheria

caused by a bacteria that produces an endotoxin; prevented by a vaccine

community-acquired pneumonia

caused by a variety of bacteria; viral & fungal agents ranging in severity

Influenza

caused by one of three types of viruses, seasonal vaccines are used to prevent. pandemic strains are possible

Hep C

est to infect 4 million US adults; Caused in chronic infection & liver damage, represents the most common

Salmonella typhi

typhoid fever characterized by progressive, invasive infection that leads to septicemia

Select all of the sequelae associated with group B Streptococcus infections in infants to test your understanding of GI tract infections caused by microorganisms.

hearing loss impaired vision developmental disabilities

A telephone advice RN receives a call from a parent regarding her 6-year-old child. The mother reports that the child developed a sore throat, fever, and lethargy that morning. The child also reports pain upon swallowing. The RN advises the mother to assess the child's oral cavity whereupon white packets are observed. Based upon the mother's response to the appearance of the oral cavity, the RN advises the mother to seek medical attention for her child. In educating the mother about potential complications for untreated streptococcal throat infections, she indicates that all of the following are potential complications except:

hemolytic uremic syndrome

Hantavirus

induction of inflammation response

Ascaris lumbricoides

intestinal roundworm that can cause abdnormal obstruction

Found in more distinct locations, though, are ___________ (found in saliva), ______________ (present in the upper GI), and _____________ (present in the lower GI).

lactoferrin, low pH fluids, bile

the larynx then leads into the _____ respiratory tract, which begins with the _______ a structure that feeds into the bronchi and bronchioles in the lungs, and finally ending in the sacklike _____

lower, trachea, alveoli

The gastrointestinal (GI) tract is a long tube, extending from the _____ to the _____ , which carries a large variety of normal biota.

mouth, anus

In contrast, the lower respiratory tract has few, if any, ______ and its defense mechanisms are reduced to the action of sticky ______ phagocytic _______ in the alveoli, and secretory IgA.

normal biota, mucus, macrophages

Sinusitis

often caused by mixed bacterial infections which are then treated with broad-spectrum antibiotics

Many types of HPV exist, including some that are ________ or capable of causing cancer.

oncogenic

A 5-month-old patient is admitted to the hospital with a 4-day history of low-grade fever, runny nose, cough, lethargy, and poor feeding intake. Upon admission, the patient requires supplemental oxygen to maintain adequate oxygen saturation. Respiratory cultures are sent to the laboratory for analysis, and the patient is started on antibiotics as the medical team awaits the results of the lab studies. The parents of the child are at the bedside and anxious. All of the following are potential differential diagnoses that the RN may anticipate for this patient except:

otitis media

Hep A or E

outbreaks linked to unhygienic food handling or lax standards of sanitation; fecal-oral or vehicle transmission most common

Hep B

parenteral transmission through blood, direct contact through sexual activity

Mumps (microbiological aspects)

prevented through administered of a vaccine

Select all of the correct statements concerning the normal biota of the gastrointestinal tract.

provides a protective function helps educate the immune system contains billions of microorganisms

Schistosomiasis

schistosoma mansoi

The influenza virus is able to evade the immune response by two mechanisms: antigenic _______, which is the swapping out of one of the gene strands with a gene strand from a different influenza virus, and antigenic ________, in which the antigens gradually change their amino acid composition.

shift; drift

This variety of defenses is needed because this area is exposed to the external environment, and it therefore also harbors a large number of commensal microorganisms, such as Pseudomonas, Fusobacterium, _________ , and many others.

streptococci

Dental Caries

streptococcus mutans

A 76-year-old female with a history of emphysema, high blood pressure, and type 2 diabetes presents to the emergency department. Upon initial assessment by the RN, she is noted to have increased work of breathing with a rapid, shallow breathing and low oxygen saturation on room air. She is also noted to have a productive cough, expectorating moderate amounts of thick yellow sputum. Her temperature is 103°F. The patient likely has pneumonia and respiratory specimens are sent to the lab to confirm this initial diagnosis. In educating the patient about the diagnosis, which organism does the RN state is the primary cause of community-acquired pneumonia?

streptococcus pneumonia

Pharyngitis

streptococcus pyogenes, causes a severe form of this disease, viral forms are typically less severe

Histoplasma capsulatum

survival in phagocytes

cysticercosis

taenia solium

Rhinitis

the common cold, caused by 200+ viruses, transmitted by droplet or indirect contact