Exam 2 Vector Borne Diseases
When do IgG antibodies appear in toxoplasmosis A. 1 to 2 weeks B. 2 to 3 weeks C. 3 to 4 weeks
1 to 2 weeks after initial infection
how long may it take for babesiosis symptoms to appear A. 2-3 weeks B. 3-5 weeks C. 1-8 weeks
1-8 weeks
Vector borne diseases account for more than (blank) of infectious diseases A. 20% B. 17% C. 32%
17%
in human granulocytic ehrlichiosis, the diagnosis is confirmed by seroconversion or by a single serolgic titer of (blank) in patients with supporting history and clinical symptoms A. 1:45 B. 1:80 C. 1:100
1: 80
a titer higher than (blank) is considered diagnostic in acute babesiosis infection A. 1: 56 B. 1: 256 C. 1: 80
1:256
When do IgM and IgG antibodies start appearing in lyme disease? A. one week after symptoms B. 2 to 4 weeks after symptoms C. one month after symptoms
2 to 4 weeks after symptoms appear
antibodies are found within the first (blank) after infection with toxoplasmosis A. one week B. two weeks C. three weeks
2 weeks
antibodies to T. gondii are demonstrable within (blank) after infection A 1 week B. 2 weeks C. 3 weeks
2 weeks
what is the incubation period for babesiosis A. 7-21 days B. 2-14 days C. 2-3 days
2-14 days after bite of infected tick
when do RMSF symptoms usually begin A. 3-5 days B. 2-14 days C. 4-21 days
2-14 days after bite of infected tick
When does IgG appear in west nile A. 1-2 weeks after infection B. 2-3 weeks after infection C. 3-4 weeks after infection
3 to 4 weeks after infection
when do the initial bodies form in human erlichiosis A. 1 to 3 days after elementary bodies enter cell B. 3 to 5 days after elementary bodies enter the cell C. Two weeks after elementary bodies enter the cell
3 to 5 days after elementary bodies entrance into cell
when do symptoms appear in Chikungunya A. 3 to 7 days B. 4 to 9 days C. 1-5 days
3-7 days after being bitten
the median length of time for stage 1 of lyme disease is A. 1 week B. 3 weeks C. 4 weeks
4 weeks
On average, the incidence of infection after an I. scapularis tick bite in an endemic area is A. 5% B.10% C. 15%
5%
ECM occurs in about how many lyme disease patients? A. 10% to 20% B. 60% to 80% C. 5% to 15%
60% to 80%
when are antibody titers usually detectable in RMSF A. 7 to 10 days B. 3 to 7 days C. 4 to 16 days
7 to 10 days after illness onset
When do the morular or mulberry form in human erlichiosis A. 7 to 12 days after initial bodies form B. 3-5 days after initial bodies form C. 5-28 days after initial bodies form
7 to 12 days after the initial bodies form
When does IgM appear in West Nile A. 2 to 4 days after onset of symptoms B. 7 to 8 days after onset of symptoms C. 2 to 3 weeks after onset of symptoms
7 to 8 days after onset of symptoms
Antibodies are not detectable for RMSF in the first week in (blank %) of patients A. 20% B. 85 % C. 30%
85%
lyme disease is found on all continents except A. Australia B. Africa C. Antarctica
Antarctica
lyme disease is caused by which microbe? A. Bacteria B. Virus C. Fungus
Borrelia burgdorferi spirochete bacteria
Congenital toxoplasmosis can cause A. death B. CNS malformation C. herpes
CNS malformation
what can congenital toxoplasmosis result in A. CNS malformation B. Prenatal mortality C. Deformation D. A and B E. All of the above
CNS malformation or prenatal mortality
what indicates an acute infection of toxoplasmosis A. Demonstration of tachyzoites B. Demonstration of bradyzoites
Demonstration of tachyzoites in tissue sections or smears of body fluid (e.g., CSF, amniotic fluid, bronchoalveolar lavage fluid)
What is PCR for lyme disease looking for and where are the samples from? A. Detects spirochete in synovial fluid around joints B. Detects burgdorferi in ECM C. Detects spirochetes in ECM
Detects spirochetes in the synovial fluid around the joints and various other body fluids
what causes human ehrlichiosis A. R. Rickettsia B. E. Chaffeensis C. B. Burgdorferi
Ehrlichia chaffeensis carried by ticks
Lyme disease is carried by what ticks? A. Ixodid tick B. Dermacentor occidentalis C. Rhipicephalus sanguineus
Hard bodied ticks of the Ixodes family
what detects IgM antibodies in toxoplasmosis A. IFA B. ELISA C. Immunoblot D. A and B E. All of the above
IFA and ELISA
what is the gold standard serologic test for RMSF A. IFA B. EIA C. western blot
IFA with R. rickettsii antigen performed on two paired serum samples to demonstrate four fold rise in titer
Most patients with an active lyme disease infection have what antibodies present? A. IgG B. IgM C. IgE
IgG
What is the first antibody to appear after about a month in seropositive individuals with Lyme disease A. IgM B. IgG C. IgE
IgM
Which antibodies are less specific and more likely to cause a RMSF false-positive result A. IgM B. IgG C. IgE
IgM
How do they test for chikungunya A. ELISA B. FISH C. Western blot
IgM and IgG antibody test with an ELISA
(blank) antibodies appear earlier and decline more rapidly than (blank) antibodies A. IgM B. IgG C. igD
IgM; IgG
What is the TORCH test
ImmunoDOT TORCH test uses an enzyme immunoassay (EIA) dot technique for the detection of antibodies to Toxoplasma gondii, rubella virus, cytomegalovirus, and herpes simplex virus in serum
What testing should be done for RMSF if patient has a rash A. PCR B. IHC C. ELISA D. A and B E. All of the above
PCR or immunohistochemical (IHC) test can be done on skin biopsy from rash site
what is the molecular method for zika detection A. ELISA B. RT-PCR C. Western blot
RT-PCR assay which detects zika virus RNA
why are antigenic proteins developed through recombinant DNA techniques better for testing? A. more sensitivity B. more accuracy C. less invasive
They provide more accuracy
How is zika serologically detected A. ELISA B. RT-PCR C. Western blot
Zika IgM antibody capture ELISA is the qualitative method used
What does presence of chikungunya IgG suggest A. Current infection B. Past infection C. Current or past infection
a current or past infection
what is west nile A. Japanese encephalitis B. Flavivirus C. Transmitted by ticks D. A and B E. All of the above
a member of the japanese encephalitis virus group of flaviviruses
What does presence of IgM chikungunya suggest? A. a new active infection B. a chronic infection C. immunity
a new active infection
What causes Babesiosis A. B. Burgdorferi B. R. Rickettsia C. Babesia microbe
a tickborne disease caused by the microbe babesia
The presence of IgM antibodies to T. gondii in an adult is indicative of an A. Past infection B. Active infection
active infection
definitive diagnosis of ehrlichiosis requires A. Acute specimen titer B. Convalescent specimen titier C. Acute and convalescent titer
acute and convalescent serum antibody titers
how long does it take for t. gondii culture A. 36 hours B. 4 days C. 2 days
after 4 days, parasites in culture are revealed by immunofluoresence with an anti-P30 monoclonal antibody
When do serodiagnostic tests become sensitive during lyme disease? A. 3 days B. After first several weeks C. 2 months
after the first several weeks of infection
common vectors of lyme disease include A. Ticks B. Mosquitos C. Flys
all ixodid tick species
what tick species carry rickettsia rickettsii A. American dog tick B. Rocky Mountain wood tick C. Brown dog tick D. A and B E. All of the above
american dog tick, rocky mountain wood tick, brown dog tick
ehrlichiosis is a general term for human granulocytic ehrlichiosis, now called A. Human granulocytic erlichiosis B. Anaplasmosis C. Lyme disease
anaplasmosis
A patient who has a specific lyme disease associated manifestation can be treated with A. Antibiotic B. IV fluids C. Hospitalization
antibiotic
what does the western blot detect in Lyme disease A. Antigens to several B. Burgdorferi proteins B. Antibodies to several B. Burgdorferi proteins
antibodies to several B. burgdorferi proteins
antigen detection systems in lyme disease testing screen for (blank) rather than for (blank) associated with the infection A. Antigenic products B. Antibody
antigenic products; antibody
what does the first step assay for detection of lyme disease use A. Antigenic proteins developed by recombinant DNA techniques B. Antibody proteins developed by recombinant DNA techniques C. Latex agglutination of cells
antigenic proteins developed by recombinant DNA techniques
in stage three of lyme disease, in addition to late neurologic complications, another clinical manifestation A. ECM B. Arthritis C. Neurologic manifestations
arthritis
What is stage 3 of lyme disease? A. Arthritis B. Chronic neurologic disease C. None of the above D. All of the above
arthritis and chronic neurologic disease many years after onset if left untreated
what causes babesiosis in the eastern United States A. Babesia horda B. Babesia negrii C. Babesia microti
babesia microti
lyme disease is a (blank) type of infection A. Bacterial B. Viral C. Fungal
bacterial
Why is the TORCH test not good alone for babies A. Still detects mothers maternal antibody in children under 1 year old B. Not sensitive for developing antibodies
because it can still detect the mothers maternal antibody in infants under 1 year old
How does RMSF present? A. Sudden onset of fever B. Rash 2-5 days after fever C. Chills D. A and B E. All of the above
begins with sudden onset of fever and headache with rash usually occurring 2-5 days after fever
what does the tissue cyst of toxoplasmosis contain A. Oocytes B. Bradyzoites C. Paramecium
bradyzoites
How is Zika spread A. Mosquito B. Mother to child C. Sexually D. A and C E. All of the above
by the bite of an infected Aedes mosquito, mother to child, or sexually
why my PCR be useful in fetal T. gondii detection A. Can test amniotic fluid without use of more invasive procedures B. Is more sensitive than other tests C. Is more specific than other tests
can test amniotic fluid with use of more invasive procedures
what tests are not recommended by CDC for lyme disease A. Capture assays for antigens in urine B. Culture or immunofluorescence staining C. Measures of antibodies around joint fluid D. IgM or IgG tests without previous ELISA E. All of the above
capture assays for antigens in urine, culture or immunofluorescence staining, measures of antibodies around joint fluid, IgM or IgG tests without previous ELISA
The definitive host of t. gondii is the A. Dog B. Rabbit C. Cat
cat
what detects IgM and IgG antibodies in toxoplasmosis A. IFA B. chemiluminscent assay C. EIA
chemiluminescent assay
what is the standard test for toxoplasmosis in immunocompetant individuals? A. ELISA B. Chemiluminescent assay C. Immunoblot
chemiluminescent assay
cardiac involvement in lyme disease may include A. Cardiac arrest B. Conduction abnormalities C. Cardiac atresion
conduction abnormalities
what are the signs and symptoms in immunocompromised hosts with toxoplasmosis A. asymptomatic B. confusion, seizure, poor coordination, headaches, blurred vision C. diarrhea, fever, hemolytic anemia
confusion, seizure, poor coordination, headaches, blurred vision
ocular involvement in lyme disease includes A. Cranial nerve palsies B. Pnophthalmitis with loss of vision C. Choroiditis with retinal detachment D. A and B E. All of the above
cranial nerve palsies, panophthalmitis with loss of vision, choroiditis with retinal detachment
common signs and symptoms as manifestation after infection in stage 1 of lyme disease is A. Cutaneous erythema chronicum Morgan's B. Arthritis C. Neurologic problems
cutaneous erythema chronicum migrans
how is testing for probable or suspected dengue done A. IgM anti-DENV in serum B. IgG anti-DENV in serum C. ELISA
detection of IgM anti-DENV in serum
how is confirmatory testing for dengue fever done A. Reverse transcriptase PCR B. ELISA C. EIA
detection of dengue virus using reverse transcriptase PCR
What is PCR used for in toxoplasmosis detection A. Detects T. Gondii DNA B. Detects antibodies to T. gondii C. Detects antigens to T. Gondii
detects T. gondii DNA in body fluids and tissues
what does an ELISA do in lyme disease detection A. Detects antibodies to B. Burgdorferi B. Detects antigens to B. burgdorferi C. Detects flagellar proteins to B. Burgdorferi
detects antibodies to B. burgdorferi
all of the following are specific methods for preventing congenital toxoplasmosis except A. Avoid touching mucous membranes while handling raw meat B. Wash hands thoroughly after handling raw meat C. Eliminate food contamination D. Dispose of fecally contaminated litter into plastic garbage bags
dispose of fecally contaminated litter into plastic garbage bags
lyme disease, the most common tickborne disease is a major health hazard for A. Dogs B. Horses and cattle C. Humans D. A and C E. All of the above
dogs, horses and cattle, humans
when is the best time to collect specimens for PCR or IHC tests in RMSF A. Acute phase B. Convalescent phase C. Acute and convalescent phase
during the acute phase of illness before treatment has begun
What is stage two of lyme disease? A. Targets nervous system B. Targets heart, eyes, and skin C. Causes vision changes and facial paralysis D. A and B E. All of the above
early disseminated lyme: targets nervous system, heart, eyes, skin, vision changes, and facial paralysis
What is stage one of lyme disease? A. Flu like symptoms B. ECM C. Stiff joints D. A andB E. All of the above
early localized lyme disease: flulike symptoms, ECM
west nile virus causes A. Encephalitis B. Meningitis C. Mono
encephalitis
what type of test is used in step one detection of lyme disease A. chemiluminescent test B. Western blot C. EIA or IFA
enzyme immunoassay (EIA) or rarely indirect immunofluorescence assay (IFA)
what is the standard test method for lyme disease A. IFA B. ELISA C. chemiluminescent
enzyme linked immunosorbent assay (ELISA)
The method of choice for detecting IgM antibodies in toxoplasmosis is A. Immunoblot B. Chemiluminescent C. ELISA
enzyme-linked immunosorbent assay (ELISA)
The skin lesion that occurs in lyme disease is called A. Red rash B. ECM C. Hay fever
erythema chronicum migrans (ECM)
what is the gold standard for babesiosis testing A. Thick and thin blood films B. ELISA C. Western blot
examining thick and thin blood films under microscope to observe parasite
one of the most common physical findings in adults with ehrlichiosis is A. blood loss B. fever C. rash
fever
what are the most common symptoms of chikungunya A. fever and joint pain B. rash and chills C. nausea and dementia
fever and joint pain
Babesiosis is characterized by A. Rash, fever, chills B. Fever, fatigue, hemolytic anemia C. Fever, fatigue, rash
fever, fatigue, hemolytic anemia
The first B. burgdorferi antigen to elicit an antibody response is A. Flagellar 41-kDa polypeptide B. Flagellar 43-fGh polypeptide C. Flagellar 65-kDa polypeptide
flagellar 41-kDa polypeptide
what are the three typical routes of transmission for toxoplasmosis A. Foodborne B. Animal to human C. Mother to child D. A and B E. All of the above
foodborne, animal to human, mother to child
Which systems are usually involved in human ehrlichiosis A. Hematologic B. Hepatic C. Central nervous system D. A and C E. All of the above
hematologic, hepatic, and central nervous system
what is the sensitivity/specificity of PCR with lyme disease detection? A. High specificity;high sensitivity B. High specificity; low sensitivity C. Low specificity; high sensitivity D. Low specificity; low sensitivity
high specificity, low sensitivity (70%)
when would exchange transfusion be useful in treating babesiosis? A. Patients with high level of parasites B. Sever diseases C. Massive hemolysis D. A and B E. All of the above
in patients with high level of parasites (>10%), severe disease, or massive hemolysis
what other virus does toxoplasmosis simulate with symptoms A. Flu B. Mono C. Ebola
infectious mononucleosis
what does babesia do? A. Infects T cells B. Causes autoimmune disorder C. Infects red blood cells
infects red blood cells
What do the IgM antibodies form against in lyme disease? A. Flagellar peptide B. Additional cell wall antigens C. Bacterial toxins D. A and B E. All of the above
initially against the flagellar peptide, but later react to additional cell wall antigens
what is associated with transfusion transmitted toxoplasmosis A. leukocyte concentrates B. increased bilirubin C. increased macrophages
leukocyte concentrates
What two factors affect chance of disease after bitten A likelihood that local ixodid tick carries disease B. Likelihood of infection after bite by infected tick C both are correct
likelihood that local ixodid tick carries disease and likelihood of infection after bite by infected tick
what is the most commonly reported vector-borne illness in the US A. Dengue Fever B. Lyme disease C. Babeiosis
lyme disease
what does the cell culture for T.gondii use A. B cells B. macrophages C. leukocytes D. monocytes
monocytes
What cellular response occurs during spirochete dissemination A. Mononuclear cell, antigen-specific B. Humoral response C. Cell-mediated D. A and B E. All of the above
mononuclear cell, antigen-specific response followed by humoral response
What is the viral vector for dengue A. Mosquitoes B. Ticks C. Pigeons
mosquitos
Where is lyme disease distribution concentrated most heavily? A. Northeast US B. Upper midwest US C. Southwest D. A and B E. All of the above
northeast and upper midwest US
What is the test for anaplasmosis A. Observation of intraleukocytic morulae B. Use wright-giemsa stained peripheral blood C. Both A and B
observation of intraleukocytic morulae in wright-giemsa stained peripheral blood or buffy coat smears
in which patients is babesiosis most common A. Older individuals B. Splenectomized patients C. Immunocompromised patients D. A and C E. All of the above
older individuals, splenectomized patients, or immunocompromised patients
Toxoxplasmosis is a (blank) infection A. Bacterial B. Viral C. Fungal
parasitic
toxoplasmosis is a serious health threat to A. Children B. Elderly C. Patients with AIDS
patients with AIDS
Who can toxoplasmosis harm A. Immunocompromised B. Children C. Older people
people with suppressed immune systems
babesia organism can be found in A. Urine B. Peripheral blood C. Saliva
peripheral blood
The most useful test for distinguishing between true-positives and false-positive serologic test results in lyme disease is A. ELISA B. PCR C. Immunoblot
polymerase chain reaction
What does the CDC define lyme disease as? A. Presence of ECM B. At least one objective late manifesting sign of musculoskeletal, neurologic, or cardiovascular disease C. Positive antibody test to B. Burgdorferi D. A and C E. All of the above
presence of ECM and at least one objective, late manifesting sign of musculoskeletal, neurologic, or cardiovascular disease and a positive antibody test to B. burgdorferi
what is the appeal of the PCR method for lyme disease diagnosis A. more sensitivity B. Rapid turn around time C. less invasive
rapid turn around time
what two things are lyme disease diagnosis usually based off of? A. Recognition of characteristic clinical findings B. History of exposure in endemic area C. Amount of ticks in the area
recognition of the characteristic clinical findings and history of exposure in endemic area
ehrlichia belong to the same family as the organism that causes A. Lyme disease B. Babeiosis C. Rocky Mountain spotted fever
rocky mountain spotted fever
diagnosis of toxoplasmosis is typically made by A. Immunologic testing B. Molecular testing C. Serologic testing
serologic testing
The predominant symptoms of lyme meningitis are A. Severe headache B. High fever C. Mild neck stiffness D. A and C E. All of the above
severe headache and mild neck stiffness
what is the best way to obtain evidence for a current toxoplasmosis infection A. Significant change in two appropriately timed and paired specimens tested in the same lab at the same time B. Looking at synovial fluid PCR C. Blood smears
significant change in two appropriately timed and paired specimens tested in the same lab at the same time
The B. burgdorferi antigens stimulate IL-1 in the body...what does it do? A. Stimulates synovial cells and fibroblasts B. Secretes collagenase and prostaglandin E2 C. Causes erosion of joint cartilage and bone D. All of the above E. A and C
stimulates synovial cells and fibroblasts to secrete collagenase and prostaglandin E2 that can cause erosion of joint cartilage and bone
unlike some procedures, the polymerase chain reaction can be used to detect lyme disease causing organisms in A. Synovial fluid B. Blood C. Urine
synovial fluid
what might cause false positive lyme disease tests? A. syphilis B. other vector borne diseases C. zika
syphilis or other borrelia or treponeme organisms
how is laboratory diagnosis of west nile done A. CSF B. FISH C. ELISA
testing of serum or CSF to detect virus specific IgM and neutralizing antibodies
What causes rocky mountain spotted fever A. B. Burgdorferi B. Varicella-Zoster C. Rickettsia rickettsii
the bacterium rickettsia rickettsii
when should the paired serum samples be taken for a RMSF IFA A. First week;2 to 4 weeks later B. First day; one week later C. First two weeks; 3 to 6 weeks later
the first within the first week of symptoms, the second 2 to 4 weeks later
The sensitivities of IFA and ELISA are usually low for how long during a lyme disease infection A. First 3 weeks of infection B. first 5 weeks of infection C. first week of infection
the initial 3 weeks of infection
How is Chikungunya transmitted A. Ticks B. Flys C. Mosquitos
through mosquito bites
how is west nile transmitted A. Mosquitos B. Ticks C. Flys
through mosquitos
True or False: erythema chronicum migrans harbors b. burgdorferi in the advancing edge
true
true or false: pregnancy in lyme disease has been associated with transplacental infection
true
How does IFA work for detection of toxoplasmosis
uses killed substrate and patient serum is assayed against it
lyme disease prevention methods include A. Wearing light colored clothes B. Tucking pants into socks C. Applying insect repellant to skin and clothes D. All of the above
wearing light-colored clothes, tucking pants into socks, applying insect repellant to skin and clothes
in stage 3 of lyme disease, the length of time after initial infection is A. days to weeks B. weeks to years C. years
weeks to years
what is used in the second step detection of Lyme disease A. ELISA B. Western blot C. FISH
western blot or other immunoblot procedure
when may false positive IFA results occur in toxoplasmosis A. When antinuclear antibodies are present B. When antinuclear antigens are present
when antinuclear antibodies are present
when may false negatives occur in toxoplasmosis IFA A. Low titers of IgG B. Low titers of IgM C. High titers of IgM D. High titers of IgG
when patient has low titers of IgG
When might PCR be helpful in diagnosing lyme disease? A. In immunocompromised patients B. When patient is still seronegative C. As a confirmatory tool
when patient is still seronegative
when is testing for lyme disease important? A. when the characteristic bullseye rash is missing B. its always important C. in new infants
when the characteristic bullseye rash is missing
What is the host for early tick stages with lyme disease? A. White tailed deer B. White footed mouse C. Rabbit
white footed mouse
What is the host for adult lyme disease ticks? A. White tailed deer B. White footed mouse C. Rabbit
white tailed deer
the primary reservoir in nature for B. burgdorferi is the A. White footed mouse B. White tailed deer C. Rabbit
white tailed deer
the first native american case of what would later be called lyme disease occured in A. Indiana B. Wisconsin C. Illinois
wisconsin