Chapter 21: Cardiovascular and Lymphatic Infections

A 20-yr woman recently traveled to the tropics for a 5-day research trip. While there she went on a jungle safari to document the social interactions among monkeys. Upon returning she began experiencing fever, nausea, chills, and headaches. Shortly after the outset of these symptoms she began to show signs of jaundice. What is the disease? a) Yellow fever b) Dengue fever c) Gastroenteritis d) Sepsis e) Acute lymphoma

A

Cardiovascular and lymphatic system infections are often referred to as A. systemic infections. B. focal infections. C. local infections. D. lymphatic infections.

A

Dengue fever is transmitted by A. arthropod-borne viruses. B. blood and bodily fluids of infected people. C. infected saliva. D. sexual contact.

A

Mosquitoes infected with Plasmodium pass on which of the following to the host? A) sporozoites B) merozoites C) gametocytes D) trophozoites E) schizonts

A

The _________________ is responsible for malaria's characteristic recurrent episodic attacks. A. parasite's asexual merozoite stage B. parasite's sexual merozoite stage C. parasite's asexual sporozoite stage D. parasite's sexual sporozoite stage

A

The mosquito is a ______________ in the transmission cycle of malaria. A. biological vector B. mechanical vector C. direct vector D. indirect vector

A

The presence of bacteria in the blood is called A. bacteremia. B. bacterial sepsis. C. septic bacteremia. D. systemic infection.

A

When is the human T lymphotropic virus typically detected in a patient? A) Patient develops cancer or donates blood. B) Initial symptoms of infection are a clear indicator. C) The sores that develop in stage 2 give it away. D) It can only be detected postmortem. E) Typically screened for when memory loss symptoms present

A

Which of the following describes how blood travels through the heart? A) right atrium, right ventricle, lungs, left atrium, left ventricle, rest of the body B) left atrium, left ventricle, lungs, right atrium, right ventricle, rest of the body C) right atrium, left atrium, lungs, right ventricle, left ventricle, rest of the body D) left atrium, right atrium, lungs, left ventricle, right ventricle, rest of the body E) left atrium, left ventricle, right atrium, right ventricle, lungs, rest of the body

A

Which of the following infections presents with three stages: a cold stage hallmarked by shivering and a sensation of cold, a hot stage with fever, and a sweating stage? A) malaria B) invasive candidiasis C) ehrlichiosis D) Rocky Mountain spotted fever E) Lyme disease

A

Which of the following is associated with hemorrhagic fevers? a) Filovirus b) Coronavirus c) Rhinovirus d) Norovirus e) Rhabdovirus

A

Which of the following numbers represents arterioles? A) 1 B) 2 C) 3 D) 4 E) 5

A

Which of the following would limit your possible exposure to the Lassa virus? A) keeping a rodent-free home B) not eating bushmeat C) not eating anything that hasn't been well cooked D) using insect repellant E) avoiding sexual intercourse

A

__________ infects the lungs and is the only form of plague that is transmitted from person to person. A. Pneumonic plague B. Bubonic plague C. Septicemic plague D. Black Death plague

A

__________ is a member of our own normal microbiota. A. Candida albicans B. Candida aureus C. Borrelia burgdorferi D. Ixodes scapularis

A

_____________ are the most common agents causing bacterial endocarditis. A. Streptococci species and Staphylococcus aureus B. Yersinia pestis and Bacillus subtilis C. Bacillus subtilis and Staphylococcus aureus D. Streptococci species and Bacillus subtilis

A

_____________ is a common systemic protozoan infection. A. Malaria B. Burkitt's lymphoma C. Invasive candidiasis D. Anaplasmosis

A

Complicated malaria includes episodic attacks but may be accompanied by ________. Choose all that apply. A. anemia B. hypotension C. hypertension D. acidosis

A, B, D

1. Which of the following is considered the world's most common bacterial zoonosis that is often transmitted via contaminated milk and is associated with an undulating fever? a) Rhabdoviridae b) Brucellosis c) Anthrax d) Botulism e) Rocky Mountain Spotted Fever

B

A man and women honeymooned in Brazil and both came down with mild symptoms of a Zika infection upon returning home. How long should the couple wait to start a family based on this information? A) If they are in love they shouldn't wait. B) 6 months C) 1 year D) 8 weeks E) 3 months

B

A(n) _________ can indicate whether a patient may have dengue fever that has progressed to a hemorrhagic form. A. intravenous test B. tourniquet test C. white blood cell differential test D. blood pressure test

B

Erythema migrans often develops as a result of what infection? A) Rickettsia rickettsii B) Borrelia burgdorferi C) Francisella tularensis D) Staphylococcus aureus E) Yersinia pestis

B

Individuals who are more susceptible to fungal disease, such as AIDS patients, may be placed on antifungal medication as A. a septic measure. B. a preventive measure. C. a clinical feature. D. an antiviral therapy.

B

The cardiovascular system includes the ______ and ________ A. heart; lungs. B. heart; blood vessels. C. blood vessels; lungs. D. blood vessels; lymphatic nodes.

B

What is currently the most crucial way of reducing incidence of dengue, yellow fever, chikungunya, and Zika? A) educate the public about safe sex and condom use B) control mosquito levels C) avoid areas with high prevalence of these diseases D) providing better quality health care E) increasing the availability of current vaccines

B

What is lymph? A) thick carbohydrate matrix that supports cells in various tissues of the body B) protein-rich blood plasma that has left capillaries C) the layer of lipids that collects under the skin for protection and insulation D) the portion of blood that contains red blood cells E) the portion of blood that contains white blood cells and platelets

B

When traveling to regions where malaria is common, what is the recommendation? A) If you get malaria buy some antimalarial drugs while traveling. B) Preventive antimalarial drugs should be taken daily while traveling in endemic areas. C) Spray your clothes with insecticide each morning you are traveling in endemic areas. D) Buy a bed net while traveling. E) Get vaccinated for malaria before traveling.

B

Which of the following is not a sign of sepsis? A) body temperature above 101°F (38.3°C) or below 96.8°F (36°C) B) dilated pupils C) increased respiratory rate (more than 20 breaths per minute) D) rapid heart rate (more than 90 beats per minute) E) increased white blood cell count

B

Which of the following is one of the most common agents to cause endocarditis? A) Yersinia pestis B) Staphylococcus aureus C) Rickettsia rickettsii D) Borrelia burgdorferi E) Francisella tularensis

B

Why are early symptoms of a Francisella tularensis infection often difficult to diagnose? A) Symptoms are often mild and go unnoticed. B) Early symptoms can vary based on how the bacteria are transmitted. C) Patient symptoms are the only indication that leads to a diagnosis. D) The bacteria do not grow in culture. E) Symptoms progress so slowly it can be months before the patient seeks medical care.

B

Zach recently started dating a new girl; a week later he became ill. He had a headache, low-grade fever, and sore throat. His symptoms did not improve over the next 2 weeks so he decided to go to the doctor. Upon examination, he had swollen lymph nodes. A throat swab culture was negative for bacteria; however an abdominal ultrasound revealed an enlarged spleen. What is the disease? a) Burkitt's lymphoma b) Infectious mononucleosis c) Cytomegalovirus d) Typhus e) Relapsing fever

B

___________ is the agent that causes invasive candidiasis. A. Candida auris B. Candida albicans C. Candida demitis D. Candida demis

B

_______________ is the most common form of plague and it infects the lymphatic system. A. Pneumonic plague B. Bubonic plague C. Septicemic plague D. Black Death plague

B

A man found living in a rat-infested building develops a high fever and swollen lymph nodes, called buboes, in the armpit and groin. A gram-negative bacillus is isolated from the patient, and the rats are found to be infested with Xenopsylla cheopis. What is the disease? a) Relapsing fever b) Rat-scratch disease c) Bubonic plague d) Cat-scratch disease e) Lyme disease

C

Areas with a high population and low vaccination rates are susceptible to which type of transmission for yellow fever? A) jungle B) intermediate C) urban D) jungle, intermediate, and urban E) jungle and intermediate

C

Inflammation of the outermost heart layer is called A. myocarditis. B. endocarditis. C. pericarditis. D. paracardial.

C

Margaret is a thirty-two year old woman living in Florida. In the fifth week of her pregnancy she had a miscarriage. In trying to determine why Margaret had the miscarriage, her doctor learns that Margaret and her husband recently purchased a kitten from Petco. Not knowing any better, Margaret had been in charge of cleaning out the litter box. In conducting a blood test, the doctor discovers that Margaret is infected with cysts from a protist parasite. What is the most likely cause of Margaret's condition? a) Plasmodium spp. b) Schistosomia spp. c) Toxoplasma gondii d) Cytomegalovirus e) Rubella virus

C

There are five ___________ species that cause malaria. A. Anopheles B. Yersinia C. Plasmodium D. Francisella

C

What is the innermost layer of the heart? A) myocardium B) pericardium C) endocardium D) epicardium E) cardium

C

Which form of a Yersinia pestis infection can result in acral gangrene caused by intravascular coagulation? A) pneumonic plague B) bubonic plague C) septicemic plague D) hepatic plague E) cardiatic plague

C

Which of the following diseases is NOT associated with presence of a bacterial infection? a) Acute endocarditis b) Gangrene c) Rheumatic fever d) Plague e) Tularemia

C

Which of the following is MISMATCHED? a) Epidemic Typhus; Rickettsia prowazekii b) Lyme Disease; Borrelia burgdorferi c) Malaria; Trypanosoma spp. d) Relapsing Fever; Borrelia spp. e) Rocky Mountain Spotted Fever; Rickettsia rickettsia

C

Which stage marks the progression of HIV to AIDS? A) stage I B) stage II C) stage III D) stage IV E) stage V

C

Why is the second stage of a dengue infection of concern? A) A high fever can lead to dehydration. B) Vomiting can lead to dehydration. C) Hemorrhagic features may develop and lead to shock, organ failure, and eventually death. D) Body aches and extreme abdominal pain can indicate an intestinal perforation. E) Nausea can be a symptom of the virus getting past the blood brain barrier, infecting the brain, and quickly killing the patient.

C

_________ is a condition in which Candida yeast invades the bloodstream. A. Candidemidis B. Candidemitis C. Candidemia D. Candidemis

C

____________ develops if Yersinia pestis, the bacterium that causes plague, enters the bloodstream. A. Pneumonic plague B. Bubonic plague C. Septicemic plague D. Black Death plague

C

A slaughterhouse worker develops fever and chills, with the fever reaching a high of 40°C each evening. He complains of muscle and joint pain. Oxidase-positive, gram-negative coccobacilli are isolated from a lesion on his arm. What is your diagnosis? a) Rocky Mountain spotted fever b) Malaria c) Relapsing fever d) Brucellosis e) Whooping cough

D

According to the CDC, at least _________ of the U.S. population experiences an EBV infection at some point, but most cases are mild or asymptomatic. A. 30% B. 50% C. 70% D. 90%

D

An 8-year-old girl in rural North Carolina is hospitalized with a fever, severe headache, and macular rash on her palms and feet. Over the next day the rash spreads up her arms and legs toward her trunk. A tick was removed from her hairline one week earlier. An ELISA test is positive for anti-rickettsial antibodies. The girl has ________. a) Lyme disease b) Mononucleosis c) Polio d) Rocky Mountain spotted fever e) Typhus fever

D

Burkitt's lymphoma is a possible complication of which disease? A) Lassa virus B) Marburg virus C) Ebola virus D) Epstein-Barr virus E) human immunodeficiency virus

D

Common bacterial phyla in blood microbiome do not include the A. proteobacteria. B. actinobacteria. C. firmicutes. D. cyanobacteria.

D

Ebola, Marburg, and Lassa viruses are classified as biosafety level ______ agents. A. 1 B. 2 C. 3 D. 4

D

The Ebola virus is a single-stranded RNA virus that targets _______________; thus, the adaptive immune response is essentially stopped from fighting the infection. A. white blood cells B. red blood cells C. phagocytic cells D. antigen-presenting cells

D

The nickname "the kissing disease" refers to an infection caused by which pathogen? A) Ebola virus B) Marburg virus C) Lassa virus D) Epstein-Barr virus E) human immunodeficiency virus

D

Unsanitary and crowded conditions increase the incidence of all of the following diseases EXCEPT a) Plague. b) Epidemic typhus. c) Rotavirus. d) Rocky Mountain spotted fever. e) Pertussis.

D

What happens if lymph is not collected? A) anemia B) liver toxicity C) hemorrhaging D) edema E) blood clots form

D

Which of the following events does not put you at risk for contracting a Francisella tularensis infection? A) a tick bite while out camping B) taking away a wounded rabbit your cat brought back for you C) cleaning a deer that you just shot D) adopting a dog from an animal shelter E) removing an injured squirrel from the road in front of your house

D

Which of the following pairs does NOT apply to Chagas' disease? a) Causative agent: Trypanosoma cruzi b) Vector: kissing bug c) Reservoir: rodents d) Distribution: United States only

D

Which of the following statements about sepsis is false? a) Symptoms include fever and decreased blood pressure. b) Lymphangitis may occur. c) Symptoms can be due to bacterial endotoxin. d) It is always caused by gram-positive bacteria. e) It may be aggravated by antibiotics.

D

Which of the following would not be the origin of the bacteremia leading to endocarditis? A) infected gums B) skin abscesses C) urinary tract infections D) pneumonia E) venous catheters

D

CASE STUDY #13: A 20-yr woman was admitted to the hospital with a high fever, rash, and severe joint pain. Her blood work was negative for bacterial infection. Her husband mentioned they had just returned from their honeymoon in Mexico. What is the disease? What caused the disease?

Dengue fever Arbovirus

After excess lymph drains from our tissues, it is shuttled to the lymph nodes and ________, where waste filtering and pathogen detection take place. A) body tissues lacking sufficient lymph B) kidneys C) spleen D) pancreas E) MALT tissue

E

An antiretroviral regimen usually consists of two reverse transcriptase inhibitors and a(n) A) protease inhibitor. B) integrase inhibitor. C) reverse transcriptase inhibitor. D) protease inhibitor or integrase inhibitor. E) protease inhibitor, integrase inhibitor, or reverse transcriptase inhibitor.

E

Complicated malaria is more common in which of the following patient populations? A) young patients B) elderly patients C) young adult patients D) immunocompromised patients E) young or elderly patients, as well as those who are pregnant or immunocompromised

E

How can a chikungunya infection be differentiated from a dengue infection? A) Differentiation is based on symptoms due to the two presenting quite differently. B) microscopic analysis of the blood C) stool analysis D) liver biopsy E) blood tests that identify viral antigens, viral RNA, or patient antibodies to the virus

E

How does blood enter the heart? A) through the pulmonary arteries B) from the aorta C) as paracardial fluid D) by means of the capillaries surrounding the heart E) via the vena cava

E

Which of the following is CORRECT? a) Possible treatment of gram negative sepsis is anticoagulant. b) Anthrax is caused by the gram-positive, aerobic rod Bacillus anthracis. c) Cytomegalovirus infections may be transmitted across the placenta in pregnant women. d) Ebola causes disseminated intravascular coagulation which can lead to tissue necrosis. e) All of the above are correct.

E

Which of the following is NOT a characteristic of Bacillus anthracis? a) Aerobic b) Gram-positive c) Forms endospores d) Found in soil e) Produces endotoxins

E

Which of the following is not a risk factor for developing sepsis? A) chronic health issues such as cancer, diabetes, AIDS, and cardiovascular disease B) recent surgery or invasive procedures C) nervous system infection D) blunt force trauma E) a wound

E

Which of the following ways can candidiasis be contracted? A) surgery or central venous catheters B) central venous catheters or kidney dialysis C) kidney dialysis or intravenous lines D) intravenous lines or surgery E) surgery, central venous catheters, kidney dialysis, or intravenous lines

E

Who is primarily at risk for a candidiasis infection? A) patients with cancer B) elderly patients C) patients with long hospital stays D) patients confined to a bed E) immunocompromised individuals who have underlying conditions such as cancer, diabetes mellitus, AIDS, or who are taking medication that suppresses the immune system

E

Recent microbiome studies indicate that normal blood is sterile. True False

FALSE

Some strains of Candida albicans are now resistant to first- and second-line drugs. True False

FALSE

CASE STUDY #24: Robert decides to take a hike. Three days after his hike he develops chills, fever, severe headache, and muscle pain. The following day he wakes up and notices a rash over his body including the palms of his hands. What is the disease? How did he get the disease? What caused the disease?

Rocky Mountain Spotted Fever Tick Rickettsia rickettsii

CASE STUDY #10: A 27-year-old woman had a fever and cough for 5 days. She was hospitalized when her blood pressure dropped. Despite aggressive treatment with fluids and massive doses of antibiotics, she died 5 hours after hospitalization. Catalase-negative, gram-positive cocci were isolated from her blood. What is the disease? What caused the disease?

Septic shock Possibly enterococci or streptococci

Plasmodium's life cycle is dependent upon a mosquito and human host. True False

TRUE

CASE STUDY #1: Your Special Pathogens team just received a call from a physician in Angola. She reported that at least one hundred people have become ill and are dying from a mysterious infection. Their symptoms include fever, vomiting, cough, diarrhea, and in some cases bleeding. The infection is highly contagious but she is unsure of exactly how it is transmitted. Your team flies out the next morning for Angola. Five days have passed since you landed in Angola. The situation is devastating. Hundreds of people are sick and many have died. In the villages temporary hospitals have been made out of tents. But even the caregivers (families and friends) are frightened to get too close to the patients to give them food and water. You have seen many patients and they all have the same symptoms: fever, diarrhea, vomiting and bleeding. The disease seems to spread most rapidly in families living close together. You decide to send a blood sample from one of the victims for analysis at Americo Boa Vista Hospital in the capital city of Luanda. The scientist working in the Luanda hospital isolates the viral RNA from the blood sample. What is the disease? What caused the disease?

Viral hemorrhagic fever Marburg or Ebola