Exam Review Questions- Chapter 18- Nervous System Infections

How do arboviruses cause nervous system infections? A) The virus invades and destroys the blood vessel cells that form the blood-brain barrier. B) The virus is small enough to pass through the blood-brain barrier. C) The virus gains entry into the CNS by hijacking neurons of the PNS. D) The virus produces toxins that damage neuron connections. E) The virus is capable of crossing the blood-brain barrier by binding to transport proteins in the capillaries meant to be used for various nutrients.

A) The virus invades and destroys the blood vessel cells that form the blood-brain barrier.

What is it called when there is only inflammation of the brain? A) encephalitis B) meningitis C) encephalomyelitis D) meningoencephalitis E) endocarditis

A) encephalitis

Which of the following paths does Cryptococcus neoformans take to get to the CNS? A) lungs → macrophages → lymphatic system → blood → CNS B) stomach → intestines → blood → CNS C) skin → blood → CNS D) nose → CNS E) muscles → blood → CNS

A) lungs → macrophages → lymphatic system → blood → CNS

Which of the following comprises the peripheral nervous system? A) nerves B) brain C) spinal cord D) skin E) meninges

A) nerves

Group B Streptococcus is most likely to cause bacterial meningitis in which of the following age groups? A) newborns B) infants and children C) adolescents and young adults D) older adults E) It infects all age groups equally.

A) newborns

Primary amoebic meningoencephalitis is caused by A) Trypanosoma brucei. B) Naegleria fowleri. C) Toxoplasma gondii. D) Cryptococcus neoformans. E) Listeria meningitis.

B) Naegleria fowleri.

The ________ sense internal and external stimuli, and send out responses in the form of chemical messengers called ________. A) muscles; chemokines B) neurons; neurotransmitters C) meninges; axons D) cerebrospinal fluids; myelins E) dendrites; arachnoids

B) neurons; neurotransmitters

What is the best way to protect the population against Haemophilus influenza type b infections? A) Since the chances of complications are rare, no treatment is required. B) use of the Hib vaccine in young children C) antibiotic treatment after onset of symptoms D) antitoxin treatment when exposure has occurred E) IV fluids are commonly prescribed due to loss of fluids.

B) use of the Hib vaccine in young children

Botulinum toxin causes all of the following except A) difficulty breathing. B) constipation. C) petechial rash. D) flaccid paralysis. E) difficulty speaking.

C) petechial rash

Which of the following is the layer of the meninges that has direct contact with the brain? A) dura mater B) arachnoid mater C) pia mater D) dinan mater E) geezin mater

C) pia mater

Which of the following could result in a tetanus infection? A) You order a steak when out with friends for dinner, and although it wasn't completely cooked, you ate it anyways because you didn't want to make a scene or delay anyone else from eating. B) The nurse accidently forgets to wipe your arm with an alcohol pad before giving you your flu shot. C) A fingernail of a coworker accidently scratches you. D) A two-inch piece of wood causes a deep puncture in your arm when replacing a board on your deck. E) While squeezing through to get into your car, you get a surface abrasion from a rough and rusted panel on the car next to you.

D) A two-inch piece of wood causes a deep puncture in your arm when replacing a board on your deck.

Why is leprosy confined to the PNS? A) The immune system is able to hold its ground and protect the CNS. B) Cells of the CNS lack the necessary receptor for M. leprae to gain access. C) M. leprae are aerobic and therefore prefer having the access oxygen that living just under the tattered epidermis can provide. D) Cooler body temperatures of 30-35°C are necessary for M. leprae's growth. E) It's not, but because it grows slowly and takes decades to reach the CNS, many believe that is where it is confined.

D) Cooler body temperatures of 30-35°C are necessary for M. leprae's growth.

Patients who suspect exposure to rabies are A) injected with antirabies antibodies. B) injected with the inactivated vaccine. C) injected with the attenuated vaccine. D) injected with both antirabies antibodies and the inactivated vaccine. E) injected with both antirabies antibodies and the attenuated vaccine.

D) injected with both antirabies antibodies and the inactivated vaccine.

What diagnostic tool is used to confirm a diagnosis of meningitis or encephalitis? A) throat swap B) computed tomography (CT scan) C) magnetic resonance imaging (MRI) D) lumbar puncture E) blood count

D) lumbar puncture

Which type of molecule can diffuse through the blood-brain barrier? A) very small molecules B) lipophilic molecules C) glucose molecules D) very small molecules and lipophilic molecules E) hydrophilic molecules and glucose molecules

D) very small molecules and lipophilic molecules

Most bacterial meningitis cases in the United States are pneumococcal meningitis, caused by which of the following bacteria? A) Neisseria meningitidis B) Haemophilus influenzae C) Escherichia coli D) Listeria monocytogenes E) Streptococcus pneumoniae

E) Streptococcus pneumoniae

Which of the following diseases cause flu-like symptoms in most people infected, but can cause muscle weakness or paralysis? A) spongiform encephalopathy B) toxoplasmosis C) tetanus D) rabies E) polio

E) polio

Which of the following is a function of the meninges? A) remove waste B) supply nutrients C) protect the CNS from physical shocks D) supply oxygen E) supply nutrients, remove waste, and protect the CNS from physical shocks

E) supply nutrients, remove waste, and protect the CNS from physical shocks

The normal microbiota of the nervous system might impact the gastrointestinal system. True False

False

Although bacteria are a rarer cause of meningitis than viruses, they cause a more dangerous form of the disease. True False

True

It is difficult for pathogens to enter the cerebrospinal fluid and brain. True False

True

CASE STUDY #9: After eating canned chili, two children experienced cranial nerve paralysis followed by descending paralysis. The children are on mechanical ventilation. Leftover canned chili was tested by mouse bioassay and the mouse died. Bacteria is isolated from the dead mouse and incubated in aerobic and anaerobic conditions. Colonies do not form on plates grown in the aerobic conditions

What is the disease? Botulism What caused the disease? Clostridium botulinum

CASE STUDY #8: An 8-year-old girl in rural Wisconsin has chills, headache, and fever. She enters the hospital and he condition worsens and she slips into a coma. Her mother tells the doctor she has been spending a lot of time outdoors and complained of mosquito bites recently. A CAT scan indicates swelling of the brain. She is given antibiotics but her condition does not improve.

What is the disease? Encephalitis What caused the disease? Possibly West Nile

CASE STUDY #7: A worker in a day-care center in eastern North Dakota became ill with fever, rash, headache, and abdominal pain. The patient had a clinical decline and died on the first day of hospitalization. A Gram stain was performed on the cerebrospinal fluid. Gram-negative diplococci were observed.

What is the disease? Meningitis and/or Encephalitis What caused the disease? Streptococcus pneumoniae

Clostridium botulinum, a bacterium that is found globally in soils, produces botulinum toxin, which causes the disease botulism. So, why don't more people get botulism? The answer is that a) C. botulinum has very specific growth needs. b) people around the world wash their hands frequently. c) humans are not its hosts. d) the vaccine regimen against the bacterium has been highly effective.

a) C. botulinum has very specific growth needs.

Select the true statement about Clostridium botulinum. a) Canned vegetables provide the perfect growth conditions for C. botulinum endospores to germinate, since salt, pH, and oxygen are all low. b) All foodborne botulism cases in the United States are caused by improperly canned vegetables. c) Salt, pH, and oxygen are not the growth factors for C. botulinum endospores. d) Salt, pH, and oxygen must be neutral for C. botulinum endospores to germinate.

a) Canned vegetables provide the perfect growth conditions for C. botulinum endospores to germinate, since salt, pH, and oxygen are all low.

Children should NOT be allowed to eat honey because of the possibility of contracting Infant Botulism. What is the etiological agent of this disease? a) Clostridium botulinum b) Mycobacterium leprae c) Listeria monocytogenes d) Streptococcus pneumoniae e) Neisseria meningtidis

a) Clostridium botulinum

Select the true statement about pneumococcal meningitis. a) It's caused by Streptococcus pneumoniae. b) It's the sexual transmitted infection. c) It produces an endotoxin called pneumolysin. d) Penicillin is not as effective as tetracycline to treat the infection.

a) It's caused by Streptococcus pneumoniae.

_________ is considered a classical zoonosis. a) Rabies b) Poliomyelitis c) Meningitis d) Ebola

a) Rabies

Select all true statements about transmissible spongiform encephalopathy. a) The disease is caused by infectious proteins called prions. b) Several treatments are currently available to treat the disease. c) The disease only affects the central nervous system of humans and mammals. d) The disease can only be confirmed by autopsy.

a) The disease is caused by infectious proteins called prions. c) The disease only affects the central nervous system of humans and mammals. d) The disease can only be confirmed by autopsy.

African sleeping sickness is caused by a) Trypanosoma brucei. b) Toxoplasma gondii. c) Naegleria fowleri. d) Cryptococcus gattii.

a) Trypanosoma brucei.

If the result of a lumbar puncture from a patient reveals purulent (pus-containing) meningitis, it's usually associated with a a) bacterial infection. b) viral infection. c) fungal infection. d) parasitic infection.

a) bacterial infection.

The prevention of all fungal diseases is almost impossible because a) fungal spores are found in the dirt, air, and water all around us. b) there are too many construction or industrial work sites. c) fungal infections are relatively rare. d) only a few fungi are primary pathogens.

a) fungal spores are found in the dirt, air, and water all around us.

Botulinum toxin effect is the action of a) stimulatory neurotransmitters. b) inhibitory neurotransmitters. c) tetanospasmin toxins. d) spastic inducers.

a) stimulatory neurotransmitters.

Microscopic examination of cerebrospinal fluid from a person who washes windows on a building in a large city reveals ovoid, eukaryotic cells. What is the etiological agent? a)Cryptococcus b)Haemophilus c)Listeria d)Naegleria e)Neisseria

a)Cryptococcus

Which of the following accounts for Mycobacterium leprae initially infecting hands and feet and not the body? a)It grows best at 30°C b)It grows best in the central nervous system c)It grows best in liver cells d)It grows best in the cerebral spinal fluid e)All of the above

a)It grows best at 30°C

In September 2008, a previously healthy 25-year-old man was admitted with a 24-hour history of fever, vomiting, and neck rigidity. CSF analysis was performed. Test results were negative for bacteria, and wet mount slide preparation of CSF showed motile amebic trophozoites. Despite therapy with intravenous amphotericin B, oral fluconazole, and rifampin, his condition deteriorated, and he died 14 days after admission. Which of the following was most likely the cause of his death? a)Naegleria fowleri b)Clostridium botulium c)Streptococcus pyogenes d)Francisella tularensis e)Poor nutrition

a)Naegleria fowleri

Trypanosoma brucei is transmitted by a)Tsetse flies b)Body lice c)Houseflies d)Head lice

a)Tsetse flies

Which of the following does not have an animal reservoir or vector? a)Cryptococcosis b) Amebic meningoencephalitis c) Rabies d) African trypanosomiasis

b) Amebic meningoencephaliti

After receiving a corneal transplant, a woman developed dementia and loss of motor function; she then became comatose and died. Cultures were negative. Serological tests were negative. Autopsy revealed spongiform degeneration of her brain. She most likely had a) rabies. b) Creutzfeldt-Jakob disease. c) botulism. d) tetanus. e) Leprosy.

b) Creutzfeldt-Jakob disease.

______ primarily infects immunocompromised hosts; it is the leading cause of death for people who have HIV/AIDS. a) Cryptococcus gattii b) Cryptococcus neoformans c) Trypanosoma brucei d) Naegleria fowleri

b) Cryptococcus neoformans

The inflammation of the brain is called a) Meningitis b) Encephalitis c) Neuritis d) Hydrocephalus

b) Encephalitis

Tetanus neurotoxin blocks neurotransmitter release at the neuromuscular junction, causing flaccid paralysis. a) True b) False

b) False

Select the true statement about the Sabin or oral polio vaccine (OPV). a) It is injected into muscle and requires several boosters. b) Immunocompromised individuals can develop illness from the attenuated virus in the OPV. c) This vaccine gives lifelong immunity in the blood. d) Its expensive production cost makes the OPV unavailable in underdeveloped nations.

b) Immunocompromised individuals can develop illness from the attenuated virus in the OPV.

_______ occurs when bacteria are passed to a newborn from the mother during delivery. a) Meningococcal meningitis b) Neonatal meningitis c) Pneumococcal meningitis d) Parenteral meningitis

b) Neonatal meningitis

The toxin, __________ , becomes active in the spinal cord and blocks the release of inhibitory neurotransmitters, preventing muscle relaxation. a) botulinum toxin b) tetanospasmin c) botox d) endotoxin

b) tetanospasmin

You would expect more cases of primary amoebic meningoencephalitis, caused by the amoeba Naegleria fowleri, to occur in warm climates than cold climates because a) the amoeba feeds solely on bacteria in its aquatic environment. b) the amoeba is a thermophilic protist. c) its hosts usually swim in warm and stagnant water. d) the vaccine against the amoeba is not effective in cold climates.

b) the amoeba is a thermophilic protist.

If the result of a lumbar puncture from a patient reveals aseptic (without cultivable organisms) meningitis, it's usually associated with a a) bacterial infection. b) viral infection. c) fungal infection. d) parasitic infection.

b) viral infection.

A 65-year man is working in his shed one weekend and he accidentally steps on a rusty nail. One week later he experiences trouble eating and muscle spasms. Gram-positive, anaerobic bacteria were isolated from the nail puncture wound. The patient was treated with a toxoid and he began to recover. What was causing his symptoms? a)Clostridium botulinum b)Clostridium tetani c)Listeria monocytogenes d)Pseudomonas aeruginosa e)Staphylococcus aureus

b)Clostridium tetani

The toxin, __________ , becomes active in the spinal cord and blocks the release of inhibitory neurotransmitters, preventing muscle relaxation. a)botulinum toxin b)tetanospasmin c)botox d)endotoxin

b)tetanospasmin

Which of the following is NOT transmitted by the respiratory route? a) Neisseria meningitidis b) Haemophilus influenzae c) Listeria monocytogenes d) Streptococcus pneumoniae

c) Listeria monocytogenes

Select the false statement about Neisseria meningitidis, which causes meningococcal meningitis. a) Neisseria meningitidis is a Gram-negative aerobe. b) Neisseria meningitidis has a capsule. c) Neisseria meningitidis produces exotoxin. d) Neisseria meningitidis is transmitted during contact between carriers and susceptible hosts.

c) Neisseria meningitidis produces exotoxin.

____________ is an inability to relax muscles, and it causes intense muscle spasms, drooling, sweating, and irritability. a) Flaccid paralysis b) Myalgial paralysis c) Spastic paralysis d) Extremity paralysis

c) Spastic paralysis

Which of the following statements about rabies is false? a) It is caused by Rhabdovirus. b) Hydrophobia is an early symptom. c) The reservoir is mainly insects. d) The virus initially replicates at the site of the bite. e) It is can be fatal.

c) The reservoir is mainly insects.

Select the false statement about enteroviruses. a) They are named for their fecal-oral transmission route. b) They are the most common causes of viral meningitis. c) They routinely cause enteric (gastrointestinal) disease. d) They are able to pass through the blood-brain barrier of the nervous system.

c) They routinely cause enteric (gastrointestinal) disease

_________ cause the most common nervous system infections. a) Bacteria b) Fungi c) Viruses d) Parasites

c) Viruses

Which of the following can be diagnosed on the basis of symptoms and the presence of gram-negative rods in the cerebrospinal fluid? a)Neisseria meningitis b)Streptococcus pneumonia c)Haemophilus meningitis d)Listeria meningitis e)Arboviral encephalitis

c)Haemophilus meningitis

Microscopic examination of cerebrospinal fluid reveals gram-positive rods. a)Cryptococcus b)Haemophilus c)Listeria d)Naegleria e)Neisseria

c)Listeria

Which of the following can cause meningitis and is associated with pigeon and chicken droppings? a) Mycobacterium leprae b) Listeria monocytogenes c) Trypanosoma brucei d) Cryptococcus neoformans e) Naegleria fowleri

d) Cryptococcus neoformans

___________ is the inflammation of both the brain and the three layers of specialized tissue that encase the central nervous system. a) Encephalitis b) Meningitis c) Cerebrositis d) Meningoencephalitis

d) Meningoencephalitis

__________ , an injection of both antirabies antibodies and the inactivated vaccine for rabies, is often given to those exposed to the virus. a) Human antibody injection b) The Salk vaccine c) Specific host species vaccine d) Rabies postexposure prophylaxis

d) Rabies postexposure prophylaxis

The transmission of toxoplasmosis is unlikely from a) food from undercooked meat containing Toxoplasma gondii cysts. b) cat feces exposed to the source of infection. c) eating raw or undercooked shellfish containing Toxoplasma gondii cysts. d) inhaling polluted air.

d) inhaling polluted air.

One way to clinically distinguish between bacterial and viral meningitis is to measure: a) the pressure released on lumbar puncture, which is low or no pressure. b) the cerebrospinal fluid composition, which has a higher level of protein and normal glucose. c) white blood cell counts, which are usually less than 300/mm3. d) the cerebrospinal fluid composition has a higher level of protein and lower glucose.

d) the cerebrospinal fluid composition has a higher level of protein and lower glucose.

One way to determine the cause of bacterial meningitis is to measure a) the pressure released on lumbar puncture, which is low or no pressure. b) the cerebrospinal fluid composition, which has a higher level of protein and normal glucose. c) white blood cell counts, which are usually less than 300/mm3. d) the cerebrospinal fluid composition, which has a higher level of protein and lower glucose.

d) the cerebrospinal fluid composition, which has a higher level of protein and lower glucose.

Which of the following organisms is not a cause of meningitis? a) Neisseria meningitidis b) Haemophilus influenzae c)Cryptococcus neoformans d)Clostridium tetani Listeria monocytogenes

d)Clostridium tetani

A discovery channel journalist traveled to Papua New Guinea to film a documentary on a small tribe. His filming took 1 year to complete and while there he immersed himself in the tribal culture and took part in hunting and cooking as well as wedding and funeral rituals. Upon his return he began to feel uncoordinated and experienced a loss of appetite. A CAT scan revealed spongiform encephalopathy. What disease is the journalist suffering from? a)Botulism b)Tetanus c)West Nile d)Kuru e)Rabies

d)Kuru

Which of the following defenses of the nervous system prevents certain molecules from passing into brain and spinal cord tissue? a)bony casing of the skull b)microglia c)cerebrospinal fluid d)blood-brain barrier e)brain macrophages

d)blood-brain barrier

Which of the following is NOT normally associated with meningitis? a) Haemophilus influenza b) Neisseria meningtidis c) Streptococcus pneumoniae d) Listeria monocytogenes e) Clostridium botulinum

e) Clostridium botulinum

Which of the following is associated with amebic meningoencephalitis? a) Mycobacterium leprae b) Listeria monocytogenes c) Trypanosoma brucei d) Cryptococcus neoformans e) Naegleria fowleri

e) Naegleria fowleri

10. Sleeping sickness is caused by: a)Yersenia pestis b)Naegleria fowleri c)Toxoplasma gondii d)Cryptococcus neoformans e)Trypanosoma spp.

e)Trypanosoma spp.

An 8-year-old girl in rural Wisconsin has chills, headache, and fever. She enters the hospital and her condition worsens and she slips into a coma. Her mother tells the doctor she has been spending a lot of time outdoors and complained of mosquito bites recently. A CAT scan indicates swelling of the brain. She is given antibiotics but her condition does not improve. Which of the following could be a possible cause of her condition? a)Coronavirus b)Haemophilus influenza c)Mycobacterium leprae d)Rotavirus e)West Nile

e)West Nile

Which of the following is MISMATCHED? a)Polio; fecal-oral transmission b)Rhabdoviridae; transmitted by animal bite c)Cryptococcus neoformans; associated with chicken and pigeon droppings d)Sleeping sickness; transmitted by Tsetse fly e)Western equine encephalitis; transmitted by ticks

e)Western equine encephalitis; transmitted by ticks